公共卫生研究摘要 (2025-08-14)
共收录 61 篇研究文章
1. Racial Inequities in Cognitive Decline of Middle-Aged and Older Adults: Findings of the ELSA-Brasil Study.
期刊: Neurology 发表日期: 2025-Sep-09 链接: PubMed
摘要
Racial and ethnic minority groups experience higher burden of cognitive decline but are usually underrepresented in cognition-related research, particularly in cohort studies. We aimed to examine the trajectory of cognitive function over approximately 9 years according to race and ethnicity groups. We analyzed data from the Estudo Longitudinal de Saude do Adulto (ELSA-Brasil) study. Participants (35-74 years) were enrolled between 2008 and 2010 and followed up between 2017 and 2019. We categorized participants based on self-reported information into Black, Brown (mixed race), and White groups. We evaluated global and domain-specific (memory, verbal fluency, and executive function) cognitive function at baseline and follow-up, considering incident cognitive impairment as a global cognitive function score at follow-up lower than -1.5 SD from the baseline mean. We investigated the trajectory of cognitive decline according to race and ethnicity groups through cubic spline linear mixed-effects models with random intercept and slope. Relative risk and the difference in median age at onset of cognitive impairment were examined using Poisson and Laplace regression models, respectively. Participants (N = 10,308; 56% female) had a mean baseline age of 50.7 years. We observed lower global and domain-specific scores at baseline in Black (n = 1,510) and Brown (mixed race) (n = 2,902) than in White (n = 5,896) participants, with inequities increasing with aging. Declines in global cognitive function, memory, and executive function were faster from early to mid-adulthood in Brown (mixed race) than in White adults. The incidence of cognitive impairment in Black and Brown (mixed race) was 3 times that in White participants, when adjusting for study center, age, and sex. Their onset of cognitive impairment occurred 9.6 (95% CI 8.1-11.1) and 9.4 (95% CI 8.0-10.7) years earlier, respectively. In participants with ≤8 years of schooling, the incidence of cognitive impairment was 90% (95% CI 85%-97%) and 82% (95% CI 73%-96%) higher in Black and Brown (mixed race) than in White adults, whereas in those with ≥12 years, differences were 36% (95% CI 4%-57%) and 68% (95% CI 58%-74%), respectively. Our findings revealed early and marked racial inequities in global and domain-specific cognitive function in middle-aged and older Brazilian adults, particularly among those of lower schooling.
2. Applying Digital Technology to a Hollow Palatal Augmentation Prosthesis in an Older Adult Hemiglossectomy Patient: A Case Report.
期刊: Gerodontology 发表日期: 2025-Sep 链接: PubMed
摘要
To report that digital technology for palatal augmentation prosthesis in older adult hemiglossectomy patients can be fabricated with less burden and effectively improves oral function. The palatal augmentation prosthesis is a dental prosthesis featuring a thickened palatal plate, designed for patients with significant tongue movement disorders to achieve proper contact between the tongue and the palate. This prosthesis compensates for the impaired tongue function and serves to improve both dysphagia and speech disorders in patients with post-operative oral cancer, cerebrovascular disease and oral frailty. An 81-year-old patient, who had been treated for tongue cancer since theage of 72 and who underwent hemiglossectomy, required palatal augmentation prosthesisreproduction. The existing palatal augmentation prosthesis was scanned and 3D printed. The copied palatal augmentation prosthesis was then adjusted intraorally, scanned again and used to produce a new milled palatal augmentation prosthesis with cast metal clasps. The palatal augmentation prosthesis was fabricated in four appointments using a digital workflow, successfully restoring the patient’s oral function without any adjustments. An oral hypofunction test was then performed, demonstrating satisfactory recovery. Digital technology enables rapid fabrication of palatal augmentation prostheses with reduced patient burden, facilitating the creation of lightweight hollow prostheses that protect remaining teeth while ensuring satisfactory functional recovery.
3. Our current climate already merits serious research and policy attention.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Aug-19 链接: PubMed
摘要
4. Expanding the Treat-to-Target Toolbox for Obesity and Diabetes Care.
期刊: The New England journal of medicine 发表日期: 2025-Aug-14 链接: PubMed
摘要
5. Economic Evaluations and Equity in the Use of Artificial Intelligence in Imaging Examinations for Medical Diagnosis in People With Dermatological, Neurological, and Pulmonary Diseases: Systematic Review.
期刊: Interactive journal of medical research 发表日期: 2025-Aug-13 链接: PubMed
摘要
Health care systems around the world face numerous challenges. Recent advances in artificial intelligence (AI) have offered promising solutions, particularly in diagnostic imaging. This systematic review focused on evaluating the economic feasibility of AI in real-world diagnostic imaging scenarios, specifically for dermatological, neurological, and pulmonary diseases. The central question was whether the use of AI in these diagnostic assessments improves economic outcomes and promotes equity in health care systems. This systematic review has 2 main components, economic evaluation and equity assessment. We used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) tool to ensure adherence to best practices in systematic reviews. The protocol was registered with PROSPERO (International Prospective Register of Systematic Reviews), and we followed the PRISMA-E (Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Equity Extension) guidelines for equity. Scientific articles reporting on economic evaluations or equity considerations related to the use of AI-based tools in diagnostic imaging in dermatology, neurology, or pulmonology were included in the study. The search was conducted in the PubMed, Embase, Scopus, and Web of Science databases. Methodological quality was assessed using the following checklists, CHEC (Consensus on Health Economic Criteria) for economic evaluations, EPHPP (Effective Public Health Practice Project) for equity evaluation studies, and Welte for transferability. The systematic review identified 9 publications within the scope of the research question, with sample sizes ranging from 122 to over 1.3 million participants. The majority of studies addressed economic evaluation (88.9%), with most studies addressing pulmonary diseases (n=6; 66.6%), followed by neurological diseases (n=2; 22.3%), and only 1 (11.1%) study addressing dermatological diseases. These studies had an average quality access of 87.5% on the CHEC checklist. Only 2 studies were found to be transferable to Brazil and other countries with a similar health context. The economic evaluation revealed that 87.5% of studies highlighted the benefits of using AI in dermatology, neurology, and pulmonology, highlighting significant cost-effectiveness outcomes, with the most advantageous being a negative cost-effectiveness ratio of -US $27,580 per QALY (quality-adjusted life year) for melanoma diagnosis, indicating substantial cost savings in this scenario. The only study assessing equity, based on 129,819 radiographic images, identified AI-assisted underdiagnosis, particularly in certain subgroups defined by gender, ethnicity, and socioeconomic status. This review underscores the importance of transparency in the description of AI tools and the representativeness of population subgroups to mitigate health disparities. As AI is rapidly being integrated into health care, detailed assessments are essential to ensure that benefits reach all patients, regardless of sociodemographic factors.
6. Health Self-Management Behaviors as a Bridge Between Electronic Health Literacy and Health-Related Quality of Life: Cross-Sectional Study From China.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-13 链接: PubMed
摘要
Electronic health literacy (eHL) has been increasingly associated with health-related quality of life (HRQoL). However, the underlying mechanisms, especially in the general population, remain insufficiently explored. This study aimed to investigate the mediating role of health self-management behaviors (HSMB) in the relationship between eHL and HRQoL. A cross-sectional study was conducted in Shanghai, China, from October to December 2022. Participants were recruited via convenience sampling from 7 community health service centers. Data were collected through an online survey platform Wenjuanxing. Validated scales, including the eHL Scale, the adults’ health self-management skill rating scale, and the 12-item short form health survey were used to measure eHL, HSMB, and HRQoL, respectively. The HRQoL was summarized into the physical component summary (PCS) and the mental component summary (MCS). Correlation analysis, multivariate linear regression with stepwise backward selection, and mediation analysis were performed to explore the relationships among eHL, HSMB, PCS, and MCS, with adjustments for sociodemographic and health-related covariates. Among the 2364 participants recruited from urban, periurban, and rural areas, eHL scores varied significantly by demographic characteristics. Positive correlations among eHL, HSMB, PCS, and MCS were observed, with Spearman correlation coefficients ranging from 0.24 to 0.46 (P<.001). Multivariate analysis showed that eHL was significantly positively associated with PCS (R2=0.14, 95% CI 0.09-0.18, P<.001) and MCS (R2=0.23, 95% CI 0.17-0.28, P<.001). Mediation analysis indicated that eHL had a significant direct (PCS: βc=.18, 95% CI 0.13-0.23, P<.001; MCS: βc=.32, 95% CI 0.25-0.38, P<.001) and an indirect effect on HRQoL through HSMB (PCS: βc’=.11, 95% CI 0.09-0.14, P<.001; MCS: βc’=.14, 95% CI 0.10-0.17, P<.001). This study demonstrated a positive association between eHL and HRQoL, with HSMB acting as a partial mediator among the general population in Shanghai. Targeted interventions should be implemented to improve eHL and HSMB.
7. Centenarian Mortality Rate During COVID-19: Protocol for a Systematic Review and Meta-Analysis.
期刊: JMIR research protocols 发表日期: 2025-Aug-13 链接: PubMed
摘要
Marked by high mortality rates on a global scale, with disease mortality being notably focused among older adults, the COVID-19 pandemic has become a significant health crisis. Despite the numerous publications on COVID-19 mortality among older adults, there is still a gap in knowledge when considering centenarians, as there is no systematic review and meta-analysis that summarizes COVID-19 mortality in centenarians globally. This study aims to systematically review and synthesize global evidence on COVID-19 mortality rates among centenarians and the population of older adults worldwide, whether residing in long-term health facilities, hospitals, or their homes. An automated search was conducted on the following databases: PubMed, Scopus, and Web of Science. Observational studies, both cohort and case-control, were selected. Quality assessment of the selected studies was based on the Joanna Briggs Institute critical appraisal tool for observational cohort and case-control studies. Three independent authors conducted the searches, and any possible disagreements were resolved by consensus. A meta-analysis of mortality proportions will be conducted to calculate the raw, logit, and arcsine proportions for all studies included in our meta-analyses. Heterogeneity between studies with a significance of P=.05 will be assessed by calculating the I2 value using the DerSimonian and Laird method for random effects. Odds ratios and 95% CIs for dichotomous data and weighted mean risk differences and 95% CIs for continuous variables will be calculated. Further subgroup analyses will be attempted to explore heterogeneity among over 6.7 million older adults. Leave-one-out sensitivity tests will be conducted to assess the robustness of our results. The meta-analysis will be conducted using R software version 4.4.2 (R Foundation for Statistical Computing). A total of 4 studies were included in our systematic review and meta-analysis. Of the included studies, 3 are retrospective cohort studies and 1 is an observational, retrospective case-control study. As for study group size, 1 cohort study was conducted on a population of less than 1000 participants, 2 studies (1 cohort and 1 case-control) involved more than 10,000 participants, and 1 cohort study included more than 6 million participants. This study has significant potential. Given the consensus that older adults, let alone centenarians, are the most vulnerable demographic to serious outcomes and deaths during pandemics. Addressing these gaps is crucial for the informed development of public policies, enabling countries to minimize the impacts on this population, particularly during health crises such as the COVID-19 pandemic. PROSPERO CRD42025645150; https://www.crd.york.ac.uk/PROSPERO/view/CRD42025645150. DERR1-10.2196/74068.
8. Using Artificial Intelligence ChatGPT to Access Medical Information About Chemical Eye Injuries: Comparative Study.
期刊: JMIR formative research 发表日期: 2025-Aug-13 链接: PubMed
摘要
Chemical ocular injuries are a major public health issue. They cause eye damage from harmful chemicals and can lead to severe vision loss or blindness if not treated promptly and effectively. Although medical knowledge has advanced, accessing reliable and understandable information on these injuries remains a challenge. This is due to unverified web-based content and complex terminology. Artificial intelligence tools like ChatGPT provide a promising solution by simplifying medical information and making it more accessible to the general public. This study aims to assess the use of ChatGPT in providing reliable, accurate, and accessible medical information on chemical ocular injuries. It evaluates the correctness, thematic accuracy, and coherence of ChatGPT’s responses compared with established medical guidelines and explores its potential for patient education. A total of 9 questions were entered into ChatGPT regarding various aspects of chemical ocular injuries. These included the definition, prevalence, etiology, prevention, symptoms, diagnosis, treatment, follow-up, and complications. The responses provided by ChatGPT were compared with the International Classification of Diseases-9 and International Classification of Diseases-10 guidelines for chemical (alkali and acid) injuries of the conjunctiva and cornea. The evaluation focused on criteria such as correctness, thematic accuracy, and coherence to assess the accuracy of ChatGPT’s responses. The inputs were categorized into 3 distinct groups, and statistical analyses, including Flesch-Kincaid readability tests, ANOVA, and trend analysis, were conducted to assess their readability, complexity, and trends. The results showed that ChatGPT provided accurate and coherent responses for most questions about chemical ocular injuries, demonstrating thematic relevance. However, the responses sometimes overlooked critical clinical details or guideline-specific elements, such as emphasizing the urgency of care, using precise classification systems, and addressing detailed diagnostic or management protocols. While the answers were generally valid, they occasionally included less relevant or overly generalized information. This reduced their consistency with established medical guidelines. The average Flesch Reading Ease Score was 33.84 (SD 2.97), indicating a fairly challenging reading level, while the Flesch-Kincaid Grade Level averaged 14.21 (SD 0.97), suitable for readers with college-level proficiency. The passive voice was used in 7.22% (SD 5.60%) of sentences, indicating moderate reliance. Statistical analysis showed no significant differences in the Flesch Reading Ease Score (P=.38), Flesch-Kincaid Grade Level (P=.55), or passive sentence use (P=.60) across categories, as determined by one-way ANOVA. Readability remained relatively constant across the 3 categories, as determined by trend analysis. ChatGPT shows strong potential in providing accurate and relevant information about chemical ocular injuries. However, its language complexity may prevent accessibility for individuals with lower health literacy and sometimes miss critical aspects. Future improvements should focus on enhancing readability, increasing context-specific accuracy, and tailoring responses to a person’s needs and literacy levels.
9. Assessment of Two Online Interventions for Veterans With Chronic Pain: Protocol for a Randomized Controlled Efficacy Trial.
期刊: JMIR research protocols 发表日期: 2025-Aug-13 链接: PubMed
摘要
Chronic pain is a debilitating condition that disproportionately impacts US veterans who manage numerous negative pain-related outcomes. There is an urgent need for accessible, engaging, and innovative treatments that can help veterans with chronic pain better self-manage their pain at home and improve their daily functioning. Technology-delivered acceptance- and mindfulness-based interventions for pain have shown strong efficacy, particularly when they are engaging and tailored to specific client needs. However, more research is needed to assess the impact of such interventions, particularly in terms of pain-related functioning and quality of life. The primary aim of this study is to test the efficacy of Veteran Acceptance and Commitment Therapy for Chronic Pain (VACT-CP), an online self-management pain program, compared to an active online control (Online Pain School) for improving pain-related functioning in a 3-site randomized controlled trial. The secondary aim is to explore psychological flexibility as a potential mediator between pain severity and pain-related functioning. This study will use a mixed methods approach to examine the efficacy of VACT-CP in a 2-arm, multisite, randomized controlled superiority trial including 200 participants with chronic musculoskeletal pain compared to Online Pain School. Participants will be assigned to 1 of these 2 online interventions. Both interventions will include 7 modules delivered over 7 weeks, with each module lasting approximately 15 minutes. Mixed effects models will be used to analyze the primary hypothesis that participants in the VACT-CP group will have greater improvement in pain-related functioning (Brief Pain Inventory-Interference subscale) than those in the active control group (Online Pain School). The main acceptance and commitment therapy process mediator (ie, Multidimensional Psychological Flexibility Inventory), pain-related functioning outcomes (Brief Pain Inventory-Interference subscale), and quality of life (Veterans RAND 36-Item Health Survey) will be measured at baseline, end of treatment, and 3 and 6 months after treatment. In addition, qualitative exit interviews will be conducted with a random set of 30 VACT-CP users (n=10, 33% per site) to obtain intervention usability, feasibility, and acceptability information. The recruitment for this study began in January 2025. It is expected to continue through January 2027. Data collection is expected to be completed by June 2027, and primary data analyses are expected to be completed by early 2028. Online interventions such as VACT-CP and Online Pain School have the potential to expand access to behavioral interventions that improve quality of life and provide nonpharmacological pain treatment options for veterans experiencing chronic pain. However, research on their impact and underlying mechanisms of change is required to support this area of potential at-home programming. ClinicalTrials.gov NCT06058624; https://clinicaltrials.gov/study/NCT06058624. PRR1-10.2196/70601.
10. Ethics and Equity Challenges in Telerehabilitation for Older Adults: Rapid Review.
期刊: JMIR aging 发表日期: 2025-Aug-13 链接: PubMed
摘要
The integration of technology in rehabilitation is transforming health care delivery for older adults, especially through telerehabilitation, which addresses barriers to in-person care. This rapid review explores the ethical and equity concerns associated with telerehabilitation for older adults, focusing on challenges such as internet access, technology adoption, and digital literacy. Conducted according to Cochrane Rapid Review guidelines, this review used the Metaverse Equitable Rehabilitation Therapy framework, focusing on equity and ethics. Studies included telerehabilitation services for adults aged 55 years and older, published between 2010 and 2023. Screening was conducted independently by 2 researchers using Rayyan (Qatar Computing Research Institute, Hamad Bin Khalifa University), with full-text review by additional team members. Searches were performed in Medline and CINAHL. From 323 papers retrieved, 49 studies met the inclusion criteria. The included studies were published between 2013 and 2023. Disparities in socioeconomic status, geographic location, and racial and ethnic backgrounds were found to impact telerehabilitation use. Additionally, ethical concerns around privacy, security, and autonomy were often inadequately addressed. This review emphasizes the need for culturally appropriate, accessible, and inclusive telerehabilitation services that integrate ethical and equity considerations into their design and delivery.
11. Improving early intervention: identifying risk factors for UK military veterans that access military charities-a case-control study and an AI-powered predictive model.
期刊: European journal of public health 发表日期: 2025-Aug-13 链接: PubMed
摘要
Some veterans face unique physical, mental, and social challenges, leading them to seek assistance from military charities. This case-control study uses data from the MONARCH Study and the tri-service food insecurity study, with the aim to identify key risk factors associated with charity usage among UK veterans. Cases (veterans who accessed charities in 2022) were compared to controls (veterans who did not access charities). Logistic regression and a random forest algorithm were used to identify risk factors for charity use. Several risk factors for charity use were identified: younger age, living alone, being a non-officer, and living in rented accommodation. Having dependents was found to be protective but emerged as a risk factor for veterans living alone and protective for veterans living with others. The use of a random forest algorithm confirmed the statistical importance of these variables, offering deeper insights into complex interactions. These results improve our understanding of the risk factors for charity usage by veterans and provide a predictive model that could be implemented in planning service provision in public health. Additionally, it could be used as the basis for the implementation of targeted preventive interventions, allowing for proactive measures to be taken to support veterans before they reach a point of needing charity services in a period of crisis. These predictive models could enable more efficient resource allocation and the development of tailored strategies to address the specific needs of at-risk veteran subgroups.
12. Response to Yang et al.
期刊: Clinical and translational gastroenterology 发表日期: 2025-Aug-13 链接: PubMed
摘要
13. Impact of Probable Deployment Traumatic Brain Injury on Post-9/11 Veteran's Productive Activity Participation After Service: A TVMI Study.
期刊: The Journal of head trauma rehabilitation 发表日期: 2025-Aug-13 链接: PubMed
摘要
To assess the impact of probable deployment traumatic brain injury (TBI) history on post-9/11 US veterans’ participation in productive activities-including employment, caregiving, volunteering, and education-after military service. This secondary cross-sectional analysis of the Veterans Metrics Initiative (TVMI) study examined productive activities among 8946 veterans who transitioned from service in 2016 and completed the TVMI survey. Associations between probable deployment TBI and activity engagement were analyzed using bivariate analysis and multinomial logistic regression. Probable deployment TBI, the independent variable, was defined as a head injury with loss or alteration of consciousness. The dependent variable was engagement in productive activities, categorized as neither paid nor unpaid labor (reference), paid labor only, paid and unpaid labor, and unpaid labor only. Covariates included demographic characteristics, self-reported premilitary TBI, and a positive screen for probable post-traumatic stress disorder (PTSD) identified using the PC-PTSD-5 screening tool. Veterans with probable deployment TBI were significantly less likely to engage in paid labor only (risk ratio [RR] = 0.66, 95% confidence interval [CI]: 0.55-0.79, P < .001) or paid and unpaid labor (RR = 0.79, 95% CI: 0.65-0.96, P = .023) compared to those without TBI. Conversely, they were more likely to engage in unpaid labor only (RR = 1.23, 95% CI: 1.02-1.48, P = .024). These associations remained after adjusting for covariates described above. Productive activity engagement differed between veterans with and without probable deployment TBI. Veterans with probable deployment TBI were less likely to participate in paid labor and more likely to engage in unpaid or no labor. Additional support may be needed to facilitate their transition into the civilian workforce.
14. Benefit of Chemoradiotherapy Versus Chemotherapy After Induction Therapy for Conversion of Unresectable Into Resectable Pancreatic Cancer: The Randomized CONKO-007 Trial.
期刊: Journal of clinical oncology : official journal of the American Society of Clinical Oncology 发表日期: 2025-Aug-13 链接: PubMed
摘要
To determine the benefit, measured as complete removal of a tumor so that no tumor cells are detectable during histopathologic examination of the resection margin (R0 resection rate), of induction chemotherapy plus chemoradiotherapy (CRT) compared with chemotherapy alone for unresectable pancreatic tumors. CONKO-007, an investigator-initiated open-label, multicentric, phase III randomized clinical trial, enrolled 525 patients with unresectable tumors, and 495 patients received induction chemotherapy (402 with fluorouracil, irinotecan, and oxaliplatin [FOLFIRINOX] and 93 with gemcitabine). Patients without progression after 3 months of induction chemotherapy (n = 336) were randomly assigned for continuation of the same chemotherapy (n = 167) or CRT (n = 169; 50.4Gy concurrently with gemcitabine). Resectability was centrally reassessed by a panel of surgeons. Surgery was recommended if possible. After an interim analysis, the primary end point was changed from overall survival (OS) to overall R0 resection rate because of slow recruitment. The median follow-up was 76 months. Important planned secondary end points were R0 resection rate in the surgically treated population and OS. The primary end point (overall R0 resection rate) was not significantly different between treatment arms with 25% (43 of 169) in the CRT arm versus 18% in the chemotherapy arm (30 of 167; P = .113). Secondary end point analysis showed that surgery was performed equally often (P = .91); R0 resection rate in patients who underwent surgery was higher after CRT, 69.4% (43 of 62) compared with chemotherapy alone: 50.0% (30 of 60 patients, P = .04). Other parameters of resection (ratio of R0/R1/R2/no resection) also favored CRT (P = .02). No difference in OS was seen between treatment arms (hazard ratio [HR], 0.937 [95% CI, 0.747 to 1.174]; P = .57; randomly assigned intention-to-treat patients). Surgery was associated with longer OS (P < .001, HR, 0.525 [95% CI, 0.408 to 0.676]). Although not improving overall R0 resection rate or survival, CRT enables a R0 resection in surgically treated patients more often than chemotherapy alone.
15. Artemisinin Partial Resistance Mutations in Zanzibar and Tanzania Suggest Regional Spread and African Origins, 2023.
期刊: The Journal of infectious diseases 发表日期: 2025-Aug-13 链接: PubMed
摘要
Artemisinin partial resistance (ART-R), driven by Plasmodium falciparum K13 mutations, threatens malaria control. Zanzibar is vulnerable to ART-R spread but lacks recent molecular surveillance. We sequenced samples in Zanzibar and mainland Tanzania collected in 2022-2024. K13 mutations (P441L, A675V) were found in 2/1440 Zanzibar participants and 6/3762 (R561H, P441L) in mainland Tanzania. K13 mutations appear to be of African origin and spreading regionally based on whole genome sequencing data. Frequent parasite importation appears to maintain partner drug mutation frequencies similar to the mainland, where artemether-lumefantrine selects for mutations favoring artesunate-amodiaquine sensitivity. Ongoing molecular surveillance remains essential to track these patterns.
16. Risk factors for fluoroquinolone- and macrolide-resistance among swine Campylobacter coli using multi-layered chain graphs.
期刊: PLoS computational biology 发表日期: 2025-Aug-13 链接: PubMed
摘要
Campylobacter spp. resistant to fluoroquinolones and macrolides are serious public health threats. Studies aiming to identify risk factors for drug-resistant Campylobacter have narrowly focused on antimicrobial use at the farm level. Using chain graphs, we quantified risk factors for fluoroquinolones- and macrolide-resistance in Campylobacter coli isolated from two distinctive swine production systems, conventional and antibiotic-free (ABF). The chain graphs were learned using genotypic and antimicrobial susceptibility data from 1082 isolates and host exposures obtained through surveys for 14 cohorts of pigs. The gyrA T86I point mutation alone explained at least 58% of the variance in ciprofloxacin minimum inhibitory concentration (MIC) for ABF and 79% in conventional farms. For macrolides, genotype and host exposures explained similar variance in azithromycin and erythromycin MIC. Among host exposures, heavy metal exposures were identified as risk factors in both conventional and ABF. Chain graph models can generate insights into the complex epidemiology of antimicrobial resistance by characterizing context-specific risk factors and facilitating causal discovery.
17. Infection with Mycobacterium tuberculosis alters the antibody response to HIV-1.
期刊: PLoS pathogens 发表日期: 2025-Aug-13 链接: PubMed
摘要
Co-infection with Mycobacterium tuberculosis (MTB) differentially modulates untreated HIV-1 infection, with asymptomatic MTB reducing HIV-1 viremia and opportunistic infections and active tuberculosis (TB) accelerating AIDS progression. Here, we investigate antibody (Ab) responses to HIV-1 in people with HIV (PWH) without MTB, with asymptomatic MTB, and with later progression to active TB to elucidate MTB-associated effects on HIV-1 immune control. Using the Swiss HIV Cohort Study (SHCS), we conducted a retrospective study that included 2,840 PWH with data on MTB status and HIV-1-specific plasma binding-/neutralizing-responses. We evaluated associations between MTB status and binding-/neutralizing-responses while adjusting for key disease and demographic parameters. Among the included 2,840 PWH, 263 PWH had asymptomatic MTB based on either a positive TST-/IGRA-test at the baseline (time of HIV-1 Ab measurement) or on later progression to active TB. Compared to PWH without MTB infection, PWH with asymptomatic MTB infection showed reduced HIV-1 Ab levels, both for Env binding (e.g., IgG1 BG505 trimer antigen, p = 0.024) and neutralization of a diverse panel of HIV-1 viruses (p = 0.012). Conversely, PWH (n = 32) who later progressed to active TB (>180 days after baseline) demonstrated a significant shift towards IgG3 in their HIV-1 Ab repertoire (p = 0.011), detectable in median 3.8 years (IQR 2.4 - 8.7) before active TB onset. Our data indicate that asymptomatic MTB infection and active TB exert profound heterologous effects on HIV-1 specific Ab development. These findings advance our understanding of host-pathogen dynamics and may have implications for new diagnostic approaches in predicting future active TB.
18. Spatial and clinical epidemiology of spotted fever rickettsioses and ehrlichiosis, North Carolina, 2010-2019.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Aug-13 链接: PubMed
摘要
North Carolina (NC) ranks among the top five states for spotted fever rickettsiosis (SFR) cases and second for ehrlichiosis in the U.S. Identifying geographic clusters of cases is important to elucidate disease risk and inform public health response, including resource allocation. This study examined geographic patterns of tick-borne disease incidence in NC over a 10-year period and modeled predictors of disease severity. We analyzed 6,748 SFR and 1,216 ehrlichiosis cases reported to the NC Electronic Disease Surveillance System between January 2010 and December 2019. Average annual incidence was evaluated in two-year periods using global spatial autocorrelation (Moran’s I) and Local Indicator of Spatial Association. We found that ehrlichiosis clusters were detected in north and central NC as well as the coastal Tidewater region, with consistently high incidence in these areas. SFR clustering occurred in similar areas, with high and increasing incidence statewide. Severe cases of ehrlichiosis followed a similar pattern, while severe SFR clusters were distributed more broadly across the state. Additionally, Black/African-American individuals made up a greater proportion of both severe ehrlichiosis and SFR cases relative to non-severe cases. Regression models showed that known tick exposures were associated with lower odds of severe SFR. For SFR, treatment delays of 1-7 days were linked to severity, but delays >7 days were not. In contrast, delays >7 days for ehrlichiosis were associated with lower odds of severe disease. Associations found here between severity and treatment delay may reflect care-seeking behaviors, testing practices, and background seroprevalence. Geographic differences in disease incidence and severity warrant further investigation and future surveillance. Public health interventions should focus on the north-central and Tidewater regions, focusing on exposure risks awareness for outdoor activities and checking for ticks, which could impact treatment timing and ultimately reduce severity.
19. Rice Bran: A Comprehensive Review of Phytochemicals and Bioactive Components With Therapeutic Potential and Health Benefits.
期刊: Nutrition reviews 发表日期: 2025-Aug-13 链接: PubMed
摘要
Rice bran is a by-product of paddy rice milling that has emerged as a versatile source of nutritional, preventive, and therapeutic compounds. Rich with diverse bioactive elements, rice bran serves as a nontraditional functional food ingredient with health promoting attributes. The nutritional profile of rice bran compared to those of other cereal grains is inclusive of energy-providing carbohydrates, essential vitamins and minerals, and amino and fatty acids, as well as unique phytochemicals. The composition of rice bran consists of an array of phytosterols, prebiotics, tocotrienols, tocopherols, flavonoids, and phenolic compounds that contribute antioxidant, anti-inflammatory, and antimicrobial activities. A unique rice bran compound is γ-oryzanol, which is widely recognized for supporting the immune system, regulating blood lipids, and protecting against some types of cancer. In this review we have summarized the multifaceted potential of rice bran for reducing diarrhea and controlling diabetes and cardiometabolic disease, as well as preventing or controlling progression of cancer. Rice bran-mediated regulation of bowel function through prebiotics and soluble and insoluble fiber acts synergistically in lowering gut inflammation through microbiota and regulating the metabolism of lipids and proteins that are important for health. The capacity of rice bran to enhance nutritional status in connection with the prevention and management of chronic diseases merits greater attention in the food product marketplace. In this comprehensive overview of rice bran as a functional food for human health, we have also included its medical food potential for holistic well-being, health promotion, and disease prevention.
20. Obesity and Its Association With Micronutrient Deficiency Among Mexican Children and Adolescents: A Systematic Review and Meta-analysis.
期刊: Nutrition reviews 发表日期: 2025-Aug-13 链接: PubMed
摘要
Obesity and micronutrient deficiencies in the pediatric population of Mexico pose significant public health challenges. However, the relationship between these two conditions is still being studied. To systematically review evidence on the association between overweight and obesity and micronutrient deficiencies among Mexican children and adolescents. A systematic search was conducted in 13 databases and one search engine. Sixteen studies met the eligibility criteria and were included in this review. A total of 20 043 participants were included across the included studies, and the results were highly varied, as not all micronutrients showed a significant deficit in the presence of obesity. Calcium, phosphorus, magnesium, and vitamin E deficiencies were noted among participants with obesity; however, these did not significantly differ from those of individuals with normal weight. Current evidence suggests that Mexican children who have overweight or obesity are more likely to have zinc, iron, and vitamins D and B6 deficiency. A random-effects meta-analysis of 4 studies showed that children who have overweight or obesity were significantly more likely to have a deficit of vitamin D (odds ratio [OR], 1.84; 95% CI, 1.46-2.32), which was stronger for school-aged children (OR, 1.99; 95% CI, 1.56-2.55). Current evidence suggests that Mexican children and adolescents who have overweight or obesity are more likely to experience vitamin D deficiency, and some evidence suggests that they are also prone to zinc, iron, and vitamin B6 deficiencies. For this reason, health-promotion and -prevention efforts must be comprehensive and address micronutrient deficiencies, common risk factors, and broader social determinants linked to noncommunicable diseases. PROSPERO registration no. CRD42019154132.
21. Biallelic variants in DNAJC7 cause familial amyotrophic lateral sclerosis with the TDP-43 pathology.
期刊: Acta neuropathologica 发表日期: 2025-Aug-13 链接: PubMed
摘要
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder characterized by the progressive degeneration of motor neurons. ALS pathology primarily involves the failure of protein quality control mechanisms, leading to the accumulation of misfolded proteins, particularly TAR DNA-binding protein 43 (TDP-43). TDP-43 aggregation is a central pathological feature of ALS. Maintaining protein homeostasis is critical and facilitated by heat shock proteins (HSPs), particularly the HSP40 family, which includes co-chaperones such as DNAJC7. Here, we report a family with three siblings affected by ALS who carry a homozygous c.518dupC frameshift variant in DNAJC7, a member of the HSP40 family. All three patients exhibited progressive muscle weakness, limb atrophy, bulbar palsy, and respiratory failure. Pathological examination revealed degeneration of both upper and lower motor neurons, with phosphorylated TDP-43-positive neuronal cytoplasmic inclusions in the frontal and temporal cortices. Immunoblot analysis were consistent with a type B pattern of phosphorylated TDP-43 in the precentral gyrus. Immunohistochemistry and RNA sequencing analyses demonstrated a substantial reduction in DNAJC7 expression at both the protein and RNA levels in affected brain regions. In a TDP-43 cell model, DNAJC7 knockdown impaired the disassembly of TDP-43 following arsenite-induced stress, whereas DNAJC7 overexpression suppressed the assembly and promoted the disassembly of arsenite-induced TDP-43 condensates. Furthermore, in a zebrafish ALS model, dnajc7 knockdown resulted in increased TDP-43 aggregation in motor neurons and reduced survival. To the best of our knowledge, this study provides the first evidence linking biallelic loss-of-function variants in DNAJC7 to familial ALS with TDP-43 pathology.
22. An exploratory analysis of the relationship between ultraprocessed food consumption, alcohol intake, body composition, and cardiometabolic markers in individuals with alcohol use disorder.
期刊: Alcohol, clinical & experimental research 发表日期: 2025-Aug-13 链接: PubMed
摘要
Ultraprocessed foods (UPFs) are often high in salt, fat, and sugar and low in fiber and nutrients. Research has suggested that UPFs are associated with all-cause mortality and have recently been proposed to align with properties of addictive substances. While research suggests that people with alcohol use disorder (AUD) have poor dietary habits in general, little is known about whether these people consume more UPFs than those without AUD. In an exploratory analysis, we examined how UPFs, diet quality, and added sugars consumption would be associated with other health outcomes in newly abstinent and currently drinking people with AUD and compared those to healthy individuals. Participants were individuals with AUD who were newly abstinent or currently drinking, and healthy controls. Two weeks of food intake records in an outpatient setting were assessed for UPF, diet quality, and added sugars, and were compared between the three groups. Correlations were assessed across diet and alcohol measures, body composition, resting energy expenditure, and atherosclerotic cardiovascular disease (ASCVD) risk scores within each group. All groups consumed similar poor quality diets with >55% usual foods from UPFs and >8% of energy intake from added sugars. Within groups, only the newly abstinent individuals showed associations between ASCVD risk and alcohol use history along with diet quality and body composition. Despite the lack of statistically significant differences in diet quality measures between groups, nutrition support for healthier food choices in people with AUD, especially during alcohol recovery, should be carefully investigated.
23. Machine Learning-Aided Meta-Analysis Reveals Changes in Penaeus vannamei Gut Bacterial Communities Upon Dietary Supplementation-Induced Immunostimulation.
期刊: Journal of fish diseases 发表日期: 2025-Aug-13 链接: PubMed
摘要
Gut bacterial communities play a key role in shrimp health; thus, their modulation has been a target of dietary supplements which also function in enhancing disease and stress resistance of shrimp. However, this also raised the question of whether immunostimulants yield distinct changes in the gut bacterial composition or whether there are consistent features across all treatments. Here, we performed a machine learning-aided meta-analysis of 16S rRNA gut bacterial community studies of immunostimulants for Penaeus vannamei. Sequence reads from the selected studies were obtained and processed through bioinformatics tools. While beta diversity analysis suggests similarities between the normal, infected and stimulated shrimp, alpha diversity indices showed higher species richness in the gut bacterial communities of shrimp fed with immunostimulants. Specific beneficial taxa were enriched upon immunostimulation, while potentially pathogenic taxa decreased in abundance. Random forest modelling also identified key predictor taxa which may be used to classify gut bacterial communities based on immune status, type of immunostimulant and the specific immunostimulant. Despite some shared patterns in differential abundance-having decreased relative abundances of Photobacterium and other members of Gammaproteobacteria-the influence of immunostimulation on gut bacterial community composition was type- and treatment-specific, as evident in the distinct abundance profiles of the predictor taxa. Functional prediction analysis also showed distinct pathways enriched in immunostimulated shrimp, as influenced by the type of the immunostimulant. This study highlighted the specific impacts of dietary supplementation-induced immunostimulation on gut bacterial communities and identified key features in immunostimulated shrimp which provide a novel perspective on the interplay between gut bacterial community and immunity.
24. ABCC11 Earwax Trait and Genotype Are Suitable Tools for Introductory Labs to Learn Genetics and Molecular Techniques.
期刊: Biochemistry and molecular biology education : a bimonthly publication of the International Union of Biochemistry and Molecular Biology 发表日期: 2025-Aug-13 链接: PubMed
摘要
Professional experiments in genetic research usually start in a class at university. However, interest in genetic research techniques from an early age is essential. We have continuously performed a short genetic experimental course for high school students using a simple molecular experiment and computer-based learning for Mendelian inheritance. We utilized the phenotype-genotype association of ABCC11 polymorphism (rs17822931), in which the A allele at rs17822931 of ABCC11 is the recessive genotype for the dry earwax phenotype. Conversely, the G allele is the dominant genotype for the wet earwax phenotype. The phenotype is primarily determined by a single-nucleotide polymorphism (SNP), rs17822931, with the A or G allele, which has global prevalence with few exceptions. The A or G allele is easily typed using the DdeI restriction enzyme. The students experienced molecular techniques and created computer-equipped pedigree charts using the software “f-tree.” The earwax trait is an excellent tool for genetic education to understand Mendelian inheritance, genotype-phenotype association, PCR cloning, and restriction enzyme digestion, and it is suitable for discussing the historical and geographical migration of the ancient Mongolian people. After the short course, a survey showed that 81% of students were satisfied, including 71% of very satisfied students.
25. Addressing Digital Disparities in Alzheimer Disease by Improving Access to Alzheimer Resources for Spanish-Speaking Latino or Latina Individuals in Los Angeles County: Mixed Methods Study.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-13 链接: PubMed
摘要
The COVID-19 pandemic disrupted traditional health care delivery models, exacerbating disparities between those with and without ready access to digital technology. This digital divide poses a structural barrier to accessing equitable healthy aging resources and dementia care. Latino and Hispanic individuals, who constitute nearly half of Los Angeles County’s population and face a projected tripling of Alzheimer disease and related dementia (ADRD) prevalence by 2040, are particularly impacted. This paper aims to examine the barriers and facilitators affecting access to digital health education and resources for Alzheimer disease (AD) prevention and care management during the COVID-19 pandemic. This study focuses on the digital barriers possibly hindering Spanish-speaking Latino and Hispanic individuals in Los Angeles County from using online services offering critical AD prevention and care resources amid the COVID-19 pandemic. We developed a conceptual model based on users’ digital access or web literacy and language as barriers and facilitators impacting access to digital AD prevention and care resources. Between January 2022 and February 2022, we identified 15 websites of local organizations providing digital AD prevention services and resources in Los Angeles County during the pandemic. We applied our digital divide model to qualitatively evaluate the 15 websites. A post hoc analysis was conducted to reevaluate the 15 websites in 2025, and interrater reliability was evaluated using a Cohen κ analysis. Out of the 15 websites, 5 featured web navigation accessibility tools (4/15 in 2025), 4 provided content available in Spanish (6/15 in 2025), and 2 included resources for family dialogue about AD care and management (3/15 in 2025). One website showed cultural and linguistic responsiveness in its content (2/15 in 2025). Cohen κ analysis revealed substantial agreement for digital acceptability factors including Spanish language (κ=0.71), resources available in Spanish (κ=0.71), and family dialogue resources (κ=0.74). Agreement for web accessibility tools was moderate at (κ=0.53). We uncovered other unforeseen structural barriers to digital access, including email subscription requirements, English language-centered online forms, and the limited availability of Spanish-speaking staff. Our study highlights structural barriers hindering access to digital AD prevention and care resources tailored to the needs and values of Latino and Hispanic communities living in Los Angeles County. The findings emphasize the need to bridge the digital gap by incorporating user-friendly features and culturally and linguistically responsive elements in website design and implementation. This approach will move our field toward equitable access to digital ADRD prevention and care resources by mitigating structural barriers that sustain ADRD disparities in Latino and Hispanic communities.
26. Antibacterial Activity of MC-170, a 2,2-Disubstituted Indole-3-one Derivative, Against Staphylococcus aureus via Phosphatidylglycerol.
期刊: Chemistry & biodiversity 发表日期: 2025-Aug-13 链接: PubMed
摘要
Staphylococcus aureus, a major human pathogen, poses a significant threat in both healthcare settings and the community. Developing novel inhibitors against S. aureus and elucidating their antibacterial mechanisms represents a highly promising strategy for combating S. aureus infections. In this study, we investigated the molecular mechanism underlying the antibacterial activity of MC170, a 2,2-disubstituted indole-3-one derivative exhibiting potent and selective activity against S. aureus, including methicillin-resistant S. aureus (MRSA). MC170 demonstrated strong inhibitory effects, with minimum inhibitory concentrations of 1 µg/mL against S. aureus and 2 µg/mL against MRSA. Growth curve measurements and time-kill curves were employed to analyze the growth patterns of S. aureus exposed to MC170. Transcriptome analysis was performed on S. aureus to further elucidate the mechanism by which MC-170 inhibits the growth of S. aureus. Transcriptome analysis revealed that MC170 significantly disrupted glycolysis/gluconeogenesis and carbon metabolism. These pathways are critical for generating essential precursors required for bacterial membrane phospholipid biosynthesis. Notably, exogenous phosphatidylglycerol (PG) significantly attenuated the antibacterial activity of MC170. These findings collectively suggest that MC170 exerts its antibacterial effects through inhibition of PG metabolism. Elucidating the antibacterial mechanism of MC170 could provide a foundation for developing novel strategies to combat antimicrobial resistance.
27. Health Benefits of Phytosterols in the Management of Several Non-Communicable Disorders.
期刊: Chemistry & biodiversity 发表日期: 2025-Aug-13 链接: PubMed
摘要
Phytosterols, encompassing plant sterols and stanols, are bioactive compounds prevalent in plant-derived foods. These compounds have garnered attention for their extensive pharmacological properties, which include cardioprotective, anticancer, neuroprotective, hepatoprotective, wound healing, antidiabetic, antimicrobial, immunomodulatory, and anti-aging effects, as well as potential applications in managing ocular diseases and hormonal disturbances. Recent studies indicate that phytosterols may significantly reduce lipid profiles, thereby mitigating cardiovascular disease risk. Furthermore, their role in cancer prevention is underscored by evidence suggesting a significant reduction in cancer risk associated with phytosterol-rich diets. This review aims to gather the current literature on the therapeutic potential of phytosterols for human health, highlighting their diverse biological activities. Overall, this comprehensive overview seeks to elucidate the promising role of phytosterols in enhancing health outcomes and their viability as therapeutic agents.
28. Rift Valley fever virus and Coxiella burnetii infections among febrile patients, Eastern Ethiopia.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Aug-13 链接: PubMed
摘要
Rift Valley fever (RVF) virus and Coxiella burnetii infections are significant public health concerns in East Africa, causing recurring outbreaks. However, the prevalence of these pathogens among febrile patients in Ethiopia remains unknown. This study aimed to determine the prevalence and associated factors of these infections among febrile patients. A multisite cross-sectional study was conducted among 415 randomly selected adult febrile patients from health facilities in Shinile and Dire Dawa, Ethiopia, between March 01, 2023, and February 28, 2024. Serum samples were tested for the presence of antibodies against RVF virus and C. burnetii infections using various Enzyme Linked Immunosorbent Assays. Polymerase Chain Reaction (PCR) was used to detect RVF virus RNA and C. burnetii DNA in blood samples. A multivariable logistic regression model was used to identify predictive factors. A p value <0.05 was considered statistically significant. Of the 402 serum samples analyzed, 21 (5.2%) tested positive for immunoglobulin G (IgG) antibodies against RVF virus, and 86 (21.4%) tested positive for C. burnetii Phase I and Phase II antibodies. No RVF virus IgM was detected. Among the C. burnetii antibodies positive sera, 6 (7.0%) were positive for Phase II IgG antibodies. No blood samples tested positive for RVF virus RNA or C. burnetii DNA. Febrile patients aged ≥35 years had significantly higher odds of RVF virus exposure (AOR: 3.1, 95% CI: 1.3-7.8). Females (AOR: 1.7, 95% CI: 1.1-2.9), rural residents (AOR: 2.4, 95% CI: 1.3-4.5), and febrile patients who disposed of dead animals (AOR: 2.6, 95% CI: 1.2-5.6) exhibited significantly higher odds of C. burnetii infection. This study reveals significant but underrecognized exposure to RVF virus (5.2%) and C. burnetii (21.4%) infections among febrile patients. Risk factors for RVF included older age, whereas C. burnetii infection was associated with females, rural residents, and exposure to dead animals. Health authorities are advised to consider these infections in the differential diagnosis of fever, implement active surveillance, and target public health interventions.
29. Acylcarnitine concentrations increase in response to an extended energy deficit, but return to baseline concentrations following a 2-week recovery in male US Army Rangers.
期刊: Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme 发表日期: 2025-Aug-13 链接: PubMed
摘要
Energy deficit often occurs during military training and operations due to prolonged and strenuous physical exertion and limited access to food. During energy deficit, the body predominately relies on fat stores. This results in greater circulating acylcarnitine species as acyl groups are moved into the mitochondria for β-oxidation. Carnitine and acylcarnitine species have not been assessed during prolonged energy deficit and following a recovery period in healthy men undergoing strenuous military training. To determine longitudinal changes in plasma carnitine and aclycarnitines following a prolonged and severe energy deficit and short-term recovery. This secondary analysis examined plasma carnitine and acylcarnitine concentrations before (PRE) and after (POST) 61-d U.S. Army Ranger training and following 2 weeks of recovery (REC). During training, participants (n=22; mean ± SD: 23.2±2.8 y; 81.7±9.3 kg; 16.5±6.8% body fat) consumed ~2200 kcal/d and were in a ~1000 kcal/d energy deficit. Carnitine and acylcarnitine (C2-C22) concentrations were measured by tandem mass spectrometry. At POST, participants had increased concentrations of total short-chain and 10 of 58 acylcarnitine species (C2, C5, C8-DC, C16:1, C16:1-OH, C18:1-OH, C18:1-DC, C18:2-OH, C20:2-OH, C22:3; P≤0.05) compared to PRE. All acylcarnitine species returned to PRE concentrations following REC (P>0.05). Greater bodyweight loss (≥7.7 kg) was associated with higher short chain acylcarnitine (r=-0.68; P=0.0006), medium chain acylcarnitine (r=-0.61; P=0.0035), and long-chain acylcarnitine (ρ=-0.65; P=0.0013) concentrations. Severe energy deficit incurred during strenuous military training increased 10 acylcarnitine species. However, 2 weeks of recovery was sufficient for most acylcarnitine concentrations to return to baseline.
30. Enzyme-Responsive Peptide-Prodrug Integrated Biphasic Microneedle Patch for Enhanced Transdermal Delivery and Hypertension Therapy.
期刊: ACS applied materials & interfaces 发表日期: 2025-Aug-13 链接: PubMed
摘要
Hypertension is a major risk factor for cardiovascular diseases and needs effective blood pressure reduction. Current antihypertensive drugs, such as captopril, face challenges, including the enzymatic degradation and the liver first-pass effect. Here, we developed a dissolving microneedle (MN) loaded with a peptide-based enzyme-responsive prodrug peptide-captopril (PC) to enhance the stability of captopril and enable efficient transdermal delivery. Kinetic studies revealed that PC exhibited a lower Km value (1.1 × 10-5 M) for esterase-mediated hydrolysis compared to free captopril (2.1 × 10-5 M), indicating improved enzymatic stability. Meanwhile, PC was encapsulated stably in microneedle tips to form the PC MN, achieving approximately 90% transdermal drug delivery. In spontaneously hypertensive rat models, PC MN elicited a rapid and potent blood-pressure-lowering effect, outperforming oral captopril administration. This study presents a promising self-administering strategy to enhance hypertension treatment through efficient transdermal drug delivery.
31. DEK Interacts with IRE1α to Modulate Endoplasmic Reticulum Stress in Deoxynivalenol-Induced Intestinal Inflammation.
期刊: Journal of agricultural and food chemistry 发表日期: 2025-Aug-13 链接: PubMed
摘要
Deoxynivalenol (DON), a mycotoxin prevalent in grains and feeds, poses a serious threat to humans and animal health. The intestine is the primary target organ of DON toxicity. However, the molecular mechanisms linking DON exposure to intestinal injury remain poorly understood. Here, we identify DEK, a multifunctional nuclear protein, is a critical target protein of DON-induced intestinal damage through endoplasmic reticulum (ER) stress activation. We demonstrate that DON directly binds to DEK via key residues (Phe56, Lys68, and Leu106) and disrupts its interaction with IRE1α, a central regulator of the ER stress. Structural analyses revealed that Lys68 of DEK is essential for its binding to IRE1α. DON interferes with the interaction between DEK and IRE1α by binding to DEK and reducing its expression. DEK overexpression attenuated ER stress and inflammatory cytokine production (IL-1β, IL-6, TNF-α) in intestinal cells. Conversely, DEK knockdown exacerbates DON-triggered ER stress by activating the IRE1α/PERK/eIF2α pathways, thereby amplifying intestinal inflammation via MAPK signaling. In vivo, DON-treated mice and piglets exhibited intestinal villus atrophy, crypt hyperplasia, and DEK-dependent ER stress activation. Collectively, our findings reveal a novel DEK-IRE1α axis in DON toxicity, underscoring that DEK may serve as a potential therapeutic target for mitigating DON-induced intestinal injury.
32. One Job, One Standard: How the Revised NFPA Standard 1580 Alters Firefighter Fit for Duty Status Across Age.
期刊: Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme 发表日期: 2025-Aug-13 链接: PubMed
摘要
The National Fire Protection Association (NFPA) sets operational standards for fire departments, including criteria for evaluating firefighters’ readiness and fit for duty status. The recently revised NFPA 1580 standard replaces absolute aerobic capacity threshold with the American College of Sports Medicine’s general population, percentile-based classification system. The purpose of this study was to compare classification outcomes between the previous NFPA 1582 and the revised NFPA 1580 to examine whether age, sex, or BMI were associated with differing fit for duty status’ by age classifications. Retrospective data were analyzed from 6,009 career firefighters (366 females). Aerobic capacity was directly assessed via a cycling-based protocol. Participants were classified under the previous NFPA 1582 and the revised NFPA 1580 standards. Ordinal logistic regression models estimated the odds of being categorized into a restricted duty classification (RDC), using age, BMI, and sex as predictors. Odds ratios with 95% confidence intervals were calculated. Under the previous NFPA 1582, increased age, higher BMI, and being female were associated with lower odds of being classified as fit for duty. Under the revised NFPA 1580, older age groups, especially those aged 60-69, were ~38× more likely (OR=37.48) to be classified as fit for duty, despite lower aerobic capacity. RDC likelihood increased among younger, male firefighters. The transition to a percentile-based framework may misalign fit for duty classification with unchanging job demands and compromise occupational safety. Future standards should prioritize task-based validations to ensure occupational readiness reflect the actual physiological demands of firefighting.
33. Anxiety symptoms and associated factors in the scleroderma patient-centered intervention network (SPIN) cohort: a cross-sectional study.
期刊: Rheumatology (Oxford, England) 发表日期: 2025-Aug-13 链接: PubMed
摘要
We (1) compared anxiety symptom levels in a multinational systemic sclerosis (SSc) cohort to a general population normative sample and (2) evaluated sociodemographic, lifestyle, and SSc disease factors associated with symptoms. Scleroderma Patient-centered Intervention Network Cohort participants completed the Patient-Reported Outcomes Measurement Information System (PROMIS) Version 2 4a Anxiety domain upon enrolment. PROMIS domain scores use T-scores (mean = 50, standard deviation = 10) calibrated to a United States normative sample. We compared T-scores to the PROMIS United States normative sample and, in SSc, assessed associations of sociodemographic, lifestyle, and physician-reported disease-related variables with multivariable linear regression. Among 2,463 participants with SSc, mean anxiety symptom T-score (52.6, standard deviation [SD] = 10.0, 95% confidence interval [CI] 52.2-53.0) was ∼1/3 SD higher than the United States general population mean of 50 (SD = 10), though within normal limits. Higher T-scores were associated with younger age (1.07 T-score points per 10 years, 95% CI 0.74, 1.40), female sex (1.81, 95% CI 0.63, 3.00), non-married status (0.99, 95% CI 0.14, 1.84), race or ethnicity other than White (1.79, 95% CI 0.72, 2.85), living in Canada (1.70, 95% CI 0.61-2.79), the United Kingdom (1.53, 95% CI 0.06, 2.99) or France (2.01, 95% CI 0.98, 3.03) (vs the United States), higher body mass index (0.11, 95% CI 0.03, 0.17), less time since non-Raynaud’s symptom onset (0.82 per 10 years, 95% CI 0.40, 1.30), gastrointestinal involvement (2.70, 95% CI 1.52-3.88), moderate small joint contractures (1.24, 95% CI 0.10, 2.38), the absence of interstitial lung disease (0.93, 95% CI -1.79, -0.07) and Sjögren disease (1.67, 95% CI 0.17, 3.17). Interstitial lung disease was not statistically significant when accounting for an interaction with country. Anxiety was also associated with pruritus and pain intensity in a sensitivity analysis that included variables with possible bi-directional pathways with anxiety. Anxiety symptoms were somewhat elevated among individuals with SSc and associated with multiple sociodemographic and disease factors.
34. Correction: Sexual and Gender Diversity in Thailand: Associations with Recalled Childhood Sex-Typed Behavior and Adulthood Occupational Preferences.
期刊: Archives of sexual behavior 发表日期: 2025-Aug-13 链接: PubMed
摘要
35. The relationship between PFAS exposure and dyslipidemia: an updated review, meta-analysis, and evaluation of bias.
期刊: European journal of epidemiology 发表日期: 2025-Aug-13 链接: PubMed
摘要
There is concern that widespread exposure to per- and polyfluoroalkyl substances (PFAS) may induce changes in serum lipids, however, current evidence is insufficient to establish causality in humans. This systematic review evaluated 69 articles examining exposure to perfluorooctanoic acid (PFOA) or perfluorooctane sulfonic acid (PFOS) and alterations in adult serum lipid outcomes. The majority of associations for PFOA or PFOS with serum lipids were either not significant, significantly negative, or were mixed versus significantly positive findings, suggesting non-consensus of any associations. A subset of 37 studies were examined via meta-analysis and reviewed for biases. Using pooled estimates, PFOA and PFOS exposure were significantly positively associated with total cholesterol (TC) and low-density lipoprotein (LDL). PFOA was significantly positively associated with triglycerides (TG), whereas PFOS had a non-significant positive association with high-density lipoprotein (HDL). TC and LDL estimates demonstrated high heterogeneity, peaking within cross-sectional and non-occupational studies that comprised the majority of the meta-analysis. Conversely, pooled estimates from longitudinal investigations trended towards null and were not significant. Potential reasons for heterogeneity were identified in a bias analysis and primarily included inconsistent confounding controls and possible subject recruitment bias from regions with known PFAS contamination. These factors indicate inconsistencies in PFAS-lipid literature that require further prospective investigations.
36. Heat-related emergency medical service operations: the relevance of the heat definition.
期刊: International journal of biometeorology 发表日期: 2025-Aug-13 链接: PubMed
摘要
Heat is associated with an increase in Emergency Medical Service (EMS) operations. However, different heat definitions in research, including outside air temperature (T), Heat Index (HI) and Universal Thermal Climate Index (UTCI), impair the assessment of heat onthe frequency of EMS operations. Therefore, this study aims to compare (1) the relationship between different heat definitions and the frequency of days defined as heat events, (2) the percentage change in the number of EMS operations per heat definition, and (3) the goodness of model fit of each heat definition. We analyzed data from EMS operations and 106 weather stations in Bavaria, Germany (2018-2020), comparing 40 heat definitions with varying thresholds, percentiles (e.g. 90th percentile), and durations (≥ 1 or ≥ 2 days) based on T, HI, and UTCI. Negative binomial regression models were adjusted for confounders. All definitions indicate significant increased EMS operations during heat events, with effect sizes ranging from 8.3% (Tnight≥20.0 °C; confidence interval: 4.2-12.5%) to 18.7% (HImean≥26.7 °C ≥ 2 days; confidence interval: 9.7-28.4%). Definitions with higher thresholds, percentiles, or longer durations have larger effects but worse model fits. Heat definitions based on HI or UTCI are not superior to temperature-based ones, and definitions using mean or maximum values yield similar frequencies, effects, and model fits. All heat definitions show increased EMS operations during heat events, with larger effects for higher thresholds or longer durations. Complex definitions offer no advantage over temperature-based ones, which we recommend for further research. Percentile-based definitions are preferable for better comparability.
37. Sustained effects of a community-based intervention targeting illicit drugs in nightlife: A 20-year cross-sectional follow-up of 'Clubs against Drugs'.
期刊: The International journal on drug policy 发表日期: 2025-Aug-12 链接: PubMed
摘要
Swedish law states that any handling or use of narcotics, including cannabis, is illegal. Nightlife is known to have high concentrations of illicit drug use and related problems. ‘Clubs against Drugs’ was implemented in 2003 and is a community-based, multi-component prevention program targeting illicit drug use and problems in licensed premises. Previous studies of the program have demonstrated improvements in staff interventions over time. The study evaluated the long-term effects of the program on staff intervention frequency rates of dealing with obviously drug intoxicated patrons. Cross-sectional data was collected in 2023 and compared to earlier assessments conducted in 2003, 2004, and 2008. Three teams, each consisting of two actors and three observers, visited licensed premises with doormen and open until 1 am or later in Stockholm city, Sweden on weekends. Professional male actors (pseudo-patrons) were trained by an expert panel to enact three standardized scenes of intoxication by stimulant drugs. In 2023, a total of 137 visits were made. The results reveal an intervention rate of 56.9 % [CI 0.49-0.65] which is considerably higher than the 7.5 % [CI -0.01-0.16] at baseline (p < 0.001). However, the rate was lower than that at the 2008 follow-up (65.5 % [CI 0.53-0.78]), although the difference was not statistically significant (p < 0.28). The effects of the ‘Clubs against Drugs’ program has been sustained for over 20 years indicated by the high level of staff interventions targeting obviously drug-intoxicated patrons, suggesting consistency in the work with different components of the preventive program.
38. A cleavage-gated terminal exposure-driven CRISPR-RCA self-amplifying system for ultra-fast DNA detection.
期刊: Biosensors & bioelectronics 发表日期: 2025-Aug-08 链接: PubMed
摘要
The one-pot detection technology based on nucleic acid isothermal amplification combined with CRISPR has a significant advantage in on-site detection of infectious diseases. It is superior to quantitative polymerase chain reaction (qPCR) due to its lack of temperature variation and significantly faster reaction speed. Nevertheless, Cas proteins compete with amplification enzymes for reaction substrates, which results in the signal amplification effect being less than expected. To overcome this limitation, we have developed a single-tube self-amplifying system driven by cleavage-gated terminal exposure based on CRISPR and rolling circle amplification (AURORA), enabling ultra-fast and sensitive monkeypox virus (MPXV) detection. This method innovatively designs a dual-function probe (DF probe). In the presence of the target, the trans-cleavage activity of Cas12a is activated, only cleaving the single-stranded DNA to expose the 3’ terminal of the DF probe. The cleaved DF probe hybridizes with the circular DNA template and is bound by phi29 DNA polymerase to initiate RCA. Here, we utilize the characteristics of Cas12a and phi29 DNA polymerase acting on substrates in different strand states to avoid substrate competition between the two enzymes in a single-tube reaction. This assay can achieve ultra-fast signal amplification of MPXV DNA within 8 min, with a limit of detection (LOD) of 88 aM (53 copies/μL). Combining the viral nucleic acid thermal lysis method, it is possible to achieve results from sample input to output in 10 min. The AURORA detection strategy was further used to detect MPXV in clinical samples (36 MPXV samples), and the results were completely consistent with qPCR. The AURORA system features ultra-fast and precise detection, providing a more efficient tool for the prevention and control of severe infectious diseases.
39. An assessment of knowledge, attitudes, and practices concerning rabies among communities with a high disease risk in Timor-Leste.
期刊: Preventive veterinary medicine 发表日期: 2025-Aug-07 链接: PubMed
摘要
Timor-Leste reported its first rabies outbreak in March 2024, making it an emerging zoonotic health threat in the country. However, there was a lack of information about community knowledge, attitudes, and practices (KAP) regarding rabies which is crucial for informing disease response plans. This study investigated the KAP regarding rabies among communities in high-risk areas for rabies incursion and spread. Between July to September 2023, 660 heads of households were interviewed using structured questionnaires in municipalities bordering Indonesian West Timor, and Dili municipality. Dog ownership by households was high (65.3 %, 431/660) and almost all households that owned dogs allowed free-roaming of dogs (98.1 %, 423/431). A small proportion of participants (2.3 %; 15/660) imported dogs from Indonesia. Around half of the participants (52.3 %, 345/660) have heard of rabies, and the majority of these participants were knowledgeable about the disease (86.7 %, 299/345). Almost one-third (30.8 %, 203/660) of households reported dog bite events and only two-thirds of households that experienced dog bites in the last 12 months (67.0 %, 132/197) reported seeking professional medical assistance. Multivariable logistic regression showed that participants with higher education and from Dili municipality were more likely to have positive attitudes towards rabies prevention. This study found limited community awareness about rabies, but positive attitudes towards rabies prevention. Healthcare-seeking behaviour was poor following dog bite events. There is a need to enhance rabies risk communication and community engagement to improve dog rabies vaccination uptake, health-seeking behavior after dog bites, and prevention of unauthorized import and in-country movement of dogs.
40. Predicting future tropical theileriosis risk in China using tick distribution and climate models.
期刊: Preventive veterinary medicine 发表日期: 2025-Aug-07 链接: PubMed
摘要
Tropical theileriosis, caused by Theileria annulata, is a tick-borne protozoan disease with high morbidity and mortality rates. While climate change and expanding livestock trade may increase transmission risks, the spatial distribution dynamics of tropical theileriosis in China under future climate scenarios remain poorly understood. This study aimed to predict the future distribution dynamics of tropical theileriosis in China by integrating climate variables and tick vector distribution data. We developed two MaxEnt-based prediction frameworks: one incorporating 19 climatic variables alone, and another combining these with distribution data of four major tick vectors (H. scupense, H. anatolicum, H. detritum, and H. asiaticum). Risk zones were projected across three periods (2021-2041, 2041-2060, and 2061-2080) under three climate scenarios (SSP126, SSP245, and SSP585). Model performance was evaluated using the Area Under Curve (AUC) metric. The results showed that integration of tick vector distribution data improved model prediction accuracy (AUC: 0.874-0.882). Current high-risk zones, predominantly in central and northwestern China, showed strong correlation with H. detritum distribution. Under future climate scenarios, the model projected a contraction of tick vector habitable areas and disease risk zones. The most substantial reduction (14.39 %) was predicted for 2061-2080 under the SSP126 scenario. This study provides a systematic assessment of tropical theileriosis risk dynamics in China under climate change scenarios. The improved prediction accuracy achieved through vector distribution integration emphasizes the importance of combining vector ecology with climate data in disease risk modeling. These findings support the development of targeted prevention strategies that account for both vector distribution patterns and regional climate characteristics. Future disease management planning should prioritize vector surveillance and formulate relevant policies to effectively reduce the risk of disease transmission.
41. Fathers' experiences, views and perspectives of childbirth attendance: a qualitative evidence synthesis.
期刊: Midwifery 发表日期: 2025-Aug-05 链接: PubMed
摘要
Fathers’ involvement in childbirth is common in most countries worldwide, yet an understanding of fathers’ perspectives on childbirth attendance is lacking. To gain global insight and understanding of fathers’ experiences and views of childbirth attendance, a synthesis of the qualitative evidence was performed. To synthesise the qualitative evidence on fathers’ views, perspectives, and experiences of childbirth attendance. MEDLINE, CINAHL, MIDIRS, PsycINFO and Web of Science were searched from inception dates to May 2024 to identify eligible studies. Included studies were quality appraised using the critical appraisal skills programme (CASP) checklist. Extracted data were thematically synthesised. Confidence in the findings was assessed using GRADE-CERQual. Thirty studies were included from which six analytical themes were generated. These were: Choices and challenges in birth attendance; Evolution of paternal role; Interplay of personal and cultural influences; Transformative impact of birth attendance; Transition to fatherhood; and Emotional complexity in childbirth attendance. Key findings revealed that fathers’ experienced emotional duality, simultaneously feeling joy and distress, competence and inadequacy, connection and isolation. While many fathers chose to attend birth, others felt pressured by external variables. Cultural factors influenced experiences, and traditional values were sometimes in conflict with contemporary expectations. Birth attendance strengthened relationships, although fathers also struggled with feelings of exclusion, unpreparedness, or helplessness throughout attendance. Findings from this qualitative evidence synthesis challenge assumptions that fathers universally benefit from birth attendance. The findings will help inform future policy and practice in supporting fathers’ who attend childbirth.
42. Image Imputation with conditional generative adversarial networks captures clinically relevant imaging features on computed tomography.
期刊: PLOS digital health 发表日期: 2025-Aug 链接: PubMed
摘要
Kidney cancer is among the top 10 most common malignancies in adults, and is commonly evaluated with four-phase computed tomography (CT) imaging. However, the presence of missing or corrupted images remains a significant problem in medical imaging that impairs the detection, diagnosis, and treatment planning of kidney cancer. Deep learning approaches through conditional generative adversarial networks (cGANs) have recently shown technical promise in the task of imputing missing imaging data from these four-phase studies. In this study, we explored the clinical utility of these imputed images. We utilized a cGAN trained on 333 patients, with the task of the cGAN being to impute the image of any phase given the other three phases. We tested the clinical utility on the imputed images of the 37 patients in the test set by manually extracting 21 clinically relevant imaging features and comparing them to their ground truth counterpart. All 13 categorical clinical features had greater than 85% agreement rate between true images and their imputed counterparts. This high accuracy is maintained when stratifying across imaging phases. Imputed images also show good agreement with true images in select radiomic features including mean intensity and enhancement. Imputed images possess the features characteristic of benign or malignant diagnosis at an equivalent rate to true images. In conclusion, imputed images from cGANs have large potential for clinical use due to their ability to retain clinically relevant qualitative and quantitative features.
43. The Case for Creating Flourishing Nursing Education Environments.
期刊: The Journal of nursing education 发表日期: 2025-Aug 链接: PubMed
摘要
44. Investigation of Genetic Causality Between Epstein-Barr Virus Infection and Risk of Autoimmune Diseases.
期刊: International journal of rheumatic diseases 发表日期: 2025-Aug 链接: PubMed
摘要
45. Does Zipf's law of abbreviation shape birdsong?
期刊: PLoS computational biology 发表日期: 2025-Aug 链接: PubMed
摘要
In human languages, words that are used more frequently tend to be shorter than words that are used less frequently. This pattern is known as Zipf’s law of abbreviation. It has been attributed to the principle of least effort - communication is more efficient when words that are used more frequently are easier to produce. Zipf’s law of abbreviation appears to hold in all human languages, and recently attention has turned to whether it also holds in animal communication. In birdsong, which has been used as a model for human language learning and development, researchers have focused on whether more frequently used notes or phrases are shorter than those that are used less frequently. Because birdsong can be highly stereotyped, have high interindividual variation, and have phrase repertoires that are small relative to human language lexicons, studying Zipf’s law of abbreviation in birdsong presents challenges that do not arise when studying human languages. In this paper, we describe a new method for assessing evidence for Zipf’s law of abbreviation in birdsong, and we introduce the R package ZLAvian to implement this method. We used ZLAvian to study Zipf’s law of abbreviation in the songs of 11 bird populations archived in the open-access repository Bird-DB. We did not find strong evidence for Zipf’s law of abbreviation in any population when studied alone, but we found evidence for Zipf’s law in a synthetic analysis across all populations. Overall, the negative concordance between phrase length and frequency of use in birdsong was several times weaker than the negative concordance between word length and frequency of use in written human languages. The method and the results we present here offer a new foundation for researchers studying if or how the principle of least effort shapes animal communication.
46. A survey on deep learning for polygenic risk scores.
期刊: Briefings in bioinformatics 发表日期: 2025-Jul-02 链接: PubMed
摘要
Polygenic risk scores (PRS) combine the effects of multiple genetic variants to predict an individual’s genetic predisposition to a disease. PRS typically rely on linear models, which assume that all genetic variants act independently. They often fall short in predictive accuracy and are not able to explain the genetic variability of a trait to the full extent. There is growing interest in applying deep learning neural networks to model PRS given their ability to model non-linear relationships and strong performance in other domains. We conducted a survey of the literature to investigate how neural networks model PRS. We categorize deep learning-based approaches by their underlying architecture, highlighting their modeling assumptions, likely strengths and potential weaknesses of the architectures. Several categories of neural network architectures exhibited promising signs for the improvement of PRS’ predictive power, namely sequence-based architectures, graph neural networks and those that incorporated biological knowledge. Additionally, the use of latent representations in autoencoders has improved predictive performance across diverse ancestries. However, a lack of existing model benchmarks on consistent datasets and phenotypes makes it challenging to understand the extent to which different architectures improve performance. Interpretability of deep learning-based PRS is also challenging with great care required when inferring causation. To address these challenges, we suggest the establishment and adherence to reporting standards and benchmarks to aid the development of deep learning-based PRS to find quantifiable trends in neural network architectures.
47. CROI 2025: Acute and Postacute COVID-19.
期刊: Topics in antiviral medicine 发表日期: 2025-Jun-30 链接: PubMed
摘要
New research on acute and postacute COVID-19 was presented at the 2025 Conference on Retroviruses and Opportunistic Infections (CROI). Results of the SCORPIO-PEP (Stopping COVID-19 Progression With Early Protease Inhibitor Treatment-Postexposure Prophylaxis) study indicated that the protease inhibitor ensitrelvir is effective for postexposure prophylaxis. Results from the second phaseof the Ubuntu study suggested that monovalent or bivalent booster doses of mRNA vaccines are equally protective in people with or without HIV. A phase II study of an inhaled broad-spectrum antiviral small interfering RNA showed faster clearance of virus and more rapid resolution of symptoms with its use. In addition, numerous studies improved our understanding of the long-term consequences of SARS-CoV-2 infection, including immunologic, metabolic, cardiovascular, neurologic, and other clinical sequelae. The application of new and more specific case definitions in research studies of long COVID provided new insights into the epidemiology and pathogenesis of this condition, although data on therapeutics from randomized clinical trials are still lacking.
48. CROI 2025: Metabolic and Other Complications of HIV Infection.
期刊: Topics in antiviral medicine 发表日期: 2025-Jun-30 链接: PubMed
摘要
Aging-related comorbid conditions have major effects on health, quality of life, and survival in people with HIV (PWH). The 2025 Conference on Retroviruses and Opportunistic Infections (CROI) featured numerous studies about comorbid diseases in PWH. Cardiovascular diseases, including atherosclerosis and heart failure were important topics at the CROI, with ancillary analyses from REPRIEVE (the Randomized Trial to Prevent Vascular Events in HIV) and studies from lower- and middle-income countries. Numerous studies examined epigenetic markers of biologic aging in PWH and the effects of treatments, including glucagon-like peptide-1 receptor agonists. In a clinical trial, cytomegalovirus suppression was shown to decrease immune activation and systemic inflammation, as well as improve physical function. Large epidemiologic studies examining the effect of switching to integrase strand transfer inhibitors showed an increased risk of diabetes and hypertension, which was independent of weight gain. This review focuses on the abstracts presented at CROI 2025 in these areas, highlighting those with the most clinical impact.
49. Exploring outdoor workers' knowledge, attitudes, practices, and perceived risks of heatwaves in Nepal.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The rise in global temperatures due to climate change has intensified the frequency and severity of heat waves, disproportionately affecting outdoor workers. This is particularly concerning in low- and middle-income countries like Nepal, where inadequate policies and limited awareness leave outdoor workers highly vulnerable. This study explores the knowledge, attitudes, practices (KAP), and perceived risks of heatwaves among outdoor workers in Nepal. A cross-sectional mixed-method study was conducted across eight districts in five provinces of Nepal, surveying 356 outdoor workers from five occupational groups: street vendors, agricultural workers, rickshaw drivers/pullers, laborers, and service workers. Eleven focus group discussions (FGDs) were conducted to gain deeper insights. Descriptive statistics were used to assess KAP scores, while Kernel-Based Regularized Least Square (KRLS) analysis examined the variations in practice scores among groups. Thematic analysis was applied to FGDs. The quantitative analysis was done in STATA-14, and the qualitative analysis was conducted manually. The average age of participants in the study was 37.2 years (SD = 10.5), and just over half (57%) were male. On average, they had worked outdoors for about 10.7 years (SD = 8.6). Among all participants, 43% had heard of heatwaves, 86.2% were aware of heat-related incidents, and 78.6% had personally experienced them. Awareness about heatwave was positively associated with the practices of heat protection for the overall sample (practice score = 1.46, p < 0.001). Age was found to be negatively associated with the practices of heat protection (practice score = -0.03, p < 0.001). Compared to females, males had lesser practices of heat protection (practice score = -0.97, p < 0.001). Heatwaves pose significant health risks, particularly for vulnerable outdoor workers who often lack knowledge about protective measures. This highlights an urgent need for government-led interventions and awareness programs at both community and policy levels to address and mitigate heat stress.
50. Acceptability, feasibility and fidelity of an expanded role for community health workers for malaria elimination in Myanmar: A mixed-method study.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
As countries transition to malaria elimination many are considering expanding the role of dedicated malaria community health workers (CHWs) to provide both malaria and limited primary health care services. The acceptability, feasibility and fidelity of an expanded role for CHW are vital factors for the successful implementation and sustainability of this health care model and data are needed to inform policy change.To further inform an expanded CHW model for malaria elimination, a mixed-method study nested in a trial which demonstrated effectiveness was undertaken to determine the acceptability, feasibility and fidelity of an expanded role for CHW in Myanmar. Data were collected as part of the trial including qualitative semi-structured in-depth interview with community leaders (n = 6) and health stakeholders (n = 14), focus group discussions (n = 36), supervision (n = 69) and field observation visits (n = 6) with CHWs. A quantitative cross-sectional survey was administered to community members (n = 643). Qualitative and quantitative data were analysed thematically and descriptively, and then triangulated for rigour. The expanded CHW model was acceptable to different levels of health stakeholders, CHWs and community members (97.4%, 626/643) because it addressed the community demand of health services (93.0%, 598/643) and promoted the roles of the CHWs within the framework of health regulations. Its implementation was also feasible due to the enthusiasm and high fidelity (97.1%, 67/69) of the CHWs as well as reliance of community members on expanded CHW services (98.3%, 632/643). However, aspects of training, supervision, supply chain management, referral mechanisms, and recording and reporting of data could have been improved. The expanded role for CHW model was found to be feasible to implement and acceptable to community members and stakeholders. With further investment and optimisation, wider-scale implementation of the model in malaria elimination settings may contribute to the goals of malaria elimination and effective primary health care in malaria elimination settings.
51. Understanding the perspectives of people with dementia and family carers about clinical pharmacists in primary care: A qualitative study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The number of people living with dementia is increasing, placing significant strain on healthcare systems and family carers. Primary care teams, including clinical pharmacists, are crucial in supporting people with dementia. While clinical pharmacists have demonstrated benefits in other areas of healthcare, their role in dementia care is less understood. This study aims to explore the perspectives of people with dementia and family carers on the potential contributions of clinical pharmacists to dementia support within primary care in England. To explore the views and perspectives of people with dementia and family carers of dementia care received from primary care teams, with a specific focus on clinical pharmacists in England. We conducted thirteen semi-structured interviews with family carers and fifteen with people with dementia in 2022-2024. Interviews were analysed using reflexive thematic analysis. Three overarching themes, were developed from the interviews: 1) Recognising the value of clinical pharmacists 2) Building and developing rapport, with personalised care and a holistic approach; and 3) The needs of patients without clinical pharmacy support - left in uncertainty about their care. This study highlights the potential of clinical pharmacists in dementia care, highlighting both positive experiences as well as unmet needs of those who did not have access to the service. Awareness of these services hinder the impact that they might be able to achieve otherwise. Increasing awareness, standardising training, and further research on service delivery models are crucial.
52. Simulating the blood transfusion system in Kenya: Modelling methods and exploratory analyses.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
The process of collecting blood from donors and making it available for transfusion requires a complex series of operations involving multiple actors and different resources at each step. Ensuring hospitals receive adequate and safe blood for transfusion is a common challenge across low- and middle-income countries, but is rarely addressed from a system level. This paper presents the first use of discrete event simulation to study the blood system in Kenya and to explore the effect of variations and perturbations at different steps of the system on meeting blood demand at patient level. A process map of the Kenyan blood system was developed to capture critical steps from blood donation to transfusion using interviews with blood bank, hospital and laboratory personnel at four public hospitals across three counties in Kenya. The blood system was simulated starting with blood collection, a blood bank where blood is tested and stored before it is issued, a major hospital attached to the blood bank, and several smaller hospitals served by the same blood bank. Values for supply-side parameters were based mainly on expert opinion; demand-side parameters were based on data from blood requisitions made in hospital wards, and dispatch of blood from the hospital laboratory. Illustrative examples demonstrate how the model can be used to explore impacts of changes in blood collection (e.g., prioritising different donor types), blood demand (e.g., differing clinical case mix), and blood distribution (e.g., restocking strategies) on meeting demand at patient level. The model can reveal potential process impediments in the blood system and aid in choosing between alternate strategies or policies for improving blood collection, testing, distribution or use. Such a systems approach allows for interventions at different steps in the blood continuum to be tested on blood availability for different patients presenting at diverse hospitals across the country.
53. Associations between neighborhood social capital, oral health risk factors, and tooth decay among Medicaid-enrolled adolescents: A hypothesis-generating preliminary study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Neighborhood-based social capital - defined as resources within neighborhood social networks - is a potential contributor to adolescent oral health, but mechanisms that link the two are not well elucidated. We evaluated the potential mediating role of neighborhood, household, and individual oral health risk factors in the neighborhood social capital-tooth decay relationship. We collected cross-sectional data from 331 Medicaid-enrolled adolescents (ages 12-18 years) and one of their caregivers from 73 census tracts (neighborhoods) in three counties in Oregon, U.S.A in 2015 and 2016. Medicaid is a public insurance program in the U.S. providing no-cost dental insurance to low-income children. We measured four neighborhood social capital constructs: social support, social leverage, informal social control, and neighborhood organization participation. Oral health risk factors included worrying about food money, poor access to vegetables and fruits, inconsistent family and oral health routines, and adolescent stress. The outcome was number of untreated decayed tooth surfaces. Causal mediation analyses with mixed effect models were used to examine associations. Neighborhoods with higher social support had a lower prevalence of worrying about food money (prevalence ratio [PR] 0.74;95% CI: 0.56, 0.96;p = .02) as did neighborhoods with higher informal social control (PR 0.75;95% CI:0.58, 0.97;p = .03). All oral health risk factors were strongly associated with untreated decayed tooth surfaces. No form of neighborhood social capital was significantly associated with tooth decay. Natural indirect effects of neighborhood social support and informal social control operating through worrying about food money were not statistically significant. Future longitudinal studies that include robust measures of neighborhood social capital and adequate sample sizes are needed to enable neighborhood-based interventions that promote adolescent oral health.
54. Construction and validation of an educational booklet on prematurity for pregnant women, postpartum women and family members.
期刊: Revista brasileira de enfermagem 发表日期: 2025 链接: PubMed
摘要
to develop and validate an educational booklet on prematurity for pregnant women, postpartum women, and family members. a methodological study developed in three stages: preparation of the educational booklet itself; content validation by nurse judges in two stages using a Content Validity Index higher than 0.80 and an agreement rate higher than 90%; and evaluation with the target audience using the Suitability Assessment of Materials. the material entitled “My Premature Baby in the Neonatal ICU: a booklet for the family” was developed, addressing topics on care and interventions for premature babies and guidance for families, validated by nurse judges with a Content Validity Index of 0.98 and evaluated with 95.39% of the variables classified as “Very good” by the target audience. the booklet proved to be representative, didactic, and easy to understand, contributing to the education and health promotion of caregivers of premature babies.
55. Catalytic activity evaluation of phyto synthesized SrO and chitosan encapsulated SrO nanomaterials.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Industrial wastewater contaminated with organic dyes poses significant environmental and health risks. Developing effective and eco-friendly removal methods is crucial to mitigate the harmful impact of dye pollution. This study explores the green synthesis and application of strontium oxide (SrO) nanoparticles and chitosan-encapsulated strontium oxide (CS-SrO) nanocomposite as adsorbents for the removal of cationic and anionic dyes from aqueous solutions. Characterization revealed that the SrO nanoparticles exhibited a sharp localized surface plasmon resonance (LSPR) peak at 274 nm, while the CS-SrO nanocomposite depicted a broad LSPR peak between 230-280 nm. XRD analysis confirmed the face-centered cubic structure of the SrO nanoparticles, with an average crystallite size of 32 nm. Detailed dye removal studies revealed that the SrO nanoparticles achieved up to 80% removal of the cationic crystal violet dye, while the CS-SrO nanocomposite demonstrated 81% removal of the anionic methyl orange dye under optimized conditions. Further investigations into adsorption kinetics, isotherms, and thermodynamics provided insights into the mechanisms governing the dye removal processes. This work contributes to the advancement of green nanotechnology for environmental remediation purposes. These findings pave the way for the development of practical applications in water purification and pollution control strategies.
56. Tracking Enterobacteria, microbiomes, and antibiotic resistance genes from waste to soil with repeated compost applications.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The dissemination of antibiotic resistant bacteria (ARB) and genes is one factor responsible for the increasing antibiotic resistance and the environment plays a role in resistance spread. Animal excreta can contribute to the contamination of the environment with ARBs and antibiotics and in some cases, environmental bacteria under antibiotic pressure may acquire antibiotic resistance genes (ARGs) from ARBs by horizontal gene transfer. In Guadeloupe, a French overseas department, organic amendments derived from human and animal waste are widely used in soil fertilization, but their contribution to antibiotic resistance remains unknown. The objective of this study was to evaluate the impact of composting animal and human raw waste and the repeated application of their derived-composts, on the fate of ARGs and antibiotic resistant Enterobacteria, for the first time, in tropical soils of Guadeloupe used for vegetable production. An unculturable approach was used to characterize the bacterial community composition and ARG content from raw waste to composts. A cultivable approach was used to enumerate Enterobacteria, and resistant isolates were further characterized phenotypically and genotypically. Based on this original approach, we demonstrated that the raw poultry droppings exhibited a depletion of Escherichia and Shigella populations during the composting treatment, which was corroborated by the results on the culturable resistant Enterobacteria. Significant differences in the abundance of ARGs were also observed, with some gene levels increasing or decreasing after composting. In addition, other bacterial genera potentially involved in the spread of antimicrobial resistance were identified. Taken together, these results demonstrate that successive applications of raw waste-derived-composts from green waste, sewage sludge, and poultry droppings reshape the Enterobacterial community and influences the abundance of ARGs, with some gene levels increasing or decreasing, in Guadeloupe’s tropical vegetable production soils.
57. OptiSelect and EnShap: Integrating machine learning and game theory for ischemic stroke prediction.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Stroke analysis using game theory and machine learning techniques. The study investigates the use of the Shapley value in predictive ischemic brain stroke analysis. Initially, preference algorithms identify the most important features in various machine learning models, including logistic regression, K-nearest neighbor, decision tree, support vector machine (linear kernel), support vector machine ( RBF kernel), neural networks, etc. For each sample, the top 3, 4, and 5 features are evaluated and selected to evaluate their performance. The Shapley value method was used to rank the models using their best four features based on their predictive capabilities. As a result, better-performing models were found. Afterward, ensemble machine learning methods were used to find the most accurate predictions using the top 5 models ranked by shapely value. The research demonstrates an impressive accuracy of 92.39%, surpassing other proposed models’ performance. This study highlights the utility of combining game theory and machine learning in Ischemic stroke prediction and the potential of ensemble learning methods to increase predictive accuracy in ischemic stroke analysis.
58. SCORE: Serologic evidence of COVID-19 and social and occupational contacts in healthcare workers in long-term care and acute care facilities in Southeastern Ontario (SCORE).
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
We established a longitudinal cohort of healthcare workers (HCWs) in an acute care hospital (ACH) and four long-term care homes (LTCHs) in Ontario, Canada, to follow the incidence of SARS-CoV-2 infection, humoral immune response to infection and/or vaccination, and determinants of infection risk. Here, we 1) describe the cohort regarding the distribution of main exposures, outcomes and serologic assays, 2) describe the unadjusted incidence of SARS-CoV-2 infection risk in the overall population, and 3) summarize the analysis and its pertinence. HCWs were recruited between November 24, 2020, and July 24, 2021. They completed a baseline survey, monthly surveillance for 9-12 months, a post-Omicron-wave survey, and provided blood samples for anti-SARS-CoV-2 antibody measurements. We collected data on host-related (humoral response to vaccines and SARS-CoV-2 infection) and environmental factors (social contact history and occupational, household and community conditions). Descriptive analysis by setting, comparison of distributions, and unadjusted survival analysis were performed. In total, 143 HCWs from the ACH and 57 from LTCHs had complete data, and 72% were followed until September 2022. Nearly 60% of the sample consisted of nurses, nurse assistants and personal support workers. Survival analysis showed that the risk of infection was bimodal, with low risk throughout the study period until the first Omicron wave. ACH HCWs had a higher risk of infection during the Omicron waves than during the preceding waves (Odds Ratio = 7.64; CI95%: 4.24-13.7), while LTCH HCWs at high-risk facilities experienced a similar risk of infection before and during the Omicron waves (OR = 1.76; CI95%: 0.63-4.9). During the Omicron waves, the use of protective equipment by HCWs working with institutional COVID-19 cases increased, but the use of community protective measures diminished. Household infections reported by participating HCWs also increased during the Omicron waves compared to previous waves. Immunoglobulin G (IgG) antibody levels increased over two time periods, (Pre vs Post- Omicron) likely due to the immune response to high levels of both vaccination and SARS-CoV-2 infections. We observed a low incidence of COVID-19 until the onset of the Omicron waves, which highlights the drastic impact of this Variants of Concern (VOC) on transmission and the importance of infectious agent characteristics. Our analysis indicated a ninefold increased risk of infection compared to that in earlier pandemic periods. Further analysis will allow the estimation of 1) the risk factors for SARS-CoV-2 infection at the community, household and healthcare facility levels, 2) the relationship between humoral responses and SARS-CoV-2 infection/vaccination, and 3) the role of social contact in work, household and community settings in the risk of infection.
59. Deep learning reveals that multidimensional social status drives population variation in 11,875 US participant cohort.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
As an increasing realization, many behavioral relationships are interwoven with inherent variations in human populations. Presently, there is no clarity in the biomedical community on which sources of population variation are most dominant. The recent advent of population-scale cohorts like the Adolescent Brain Cognitive DevelopmentSM Study (ABCD Study®) are now offering unprecedented depth and width of phenotype profiling that potentially explains interfamily differences. Here, we leveraged a deep learning framework (conditional variational autoencoder) on the totality of the ABCD Study® phenome (8,902 candidate phenotypes in 11,875 participants) to identify and characterize major sources of population stratification. 80% of the top 5 sources of explanatory stratifications were driven by distinct combinations of 202 available socioeconomic status (SES) measures; each in conjunction with a unique set of non-overlapping social and environmental factors. Several sources of variation across this cohort flagged geographies marked by material poverty interlocked with mental health and behavioral correlates. Deprivation emerged in another top stratification in relation to urbanicity and its ties to immigrant and racial and ethnic minoritized groups. Conversely, two other major sources of population variation were both driven by indicators of privilege: one highlighted measures of access to educational opportunity and income tied to healthy home environments and good behavior, the other profiled individuals of European ancestry leading advantaged lifestyles in desirable neighborhoods in terms of location and air quality. Overall, the disclosed social stratifications underscore the importance of treating SES as a multidimensional construct and recognizing its ties into social determinants of health.
60. Research on the impact of career advancement on the mental health of young workers.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Mental health is an important component of overall health. Currently, the mental health issues among Chinese workers are becoming increasingly severe, especially under the backdrop of increased uncertainty in career advancement, where depression and anxiety issues among young workers are prominent. Based on the panel data from the China Family Panel Studies (CFPS) in 2018 and 2020, this paper constructs an OLS regression model to empirically analyze the impact of career advancement constraints on workers’ mental health and its mechanism of action. The study finds that limited career advancement significantly increases workers’ depression index. Pathways such as extended working hours, deteriorated health conditions, and distorted labor value concepts play a partial mediating role, thereby reducing mental health levels. Heterogeneity analysis shows that compared to female, low-income, and low-educated individuals, male, those with medium to high income, and higher education levels are more likely to experience a decline in mental health due to career advancement constraints. This study provides empirical evidence for understanding the impact of career advancement uncertainty on mental health and offers important insights for improving occupational mental health policies and enhancing worker welfare.
61. Dynamics of fungal bioaerosols in Kuwait City: An 8-year survey.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Fungi are ubiquitous eukaryotic microorganisms that are often implicated in a wide range of diseases. Exposure to fungal bioaerosols is often associated with conditions such as asthma, allergic rhinitis, keratitis, and pneumonitis, among others. This study aims to shed some light on the configuration of airborne culturable fungal genera in the atmosphere of Kuwait City with analysis of seasonal patterns, intra-diurnal variations and correlations with meteorological factors. Outdoor fungal bioaerosols samples were collected twice a day, two times a week, from January 2016 to December 2023 via volumetric active sampling in Al-Sabah Medical District, Kuwait City, Kuwait. The meteorological data were supplied by Kuwait Meteorological Department, Directorate General of Civil Aviation. The rates of fungal bioaerosols remained relatively high during the months of March, April and May, ranging from 269 to 296 CFU/m3. Cladosporium, Aspergillus and Alternaria were the most common fungal genera in the atmosphere, with a prevalence of 49%, 16% and 14%, respectively. Statistically significant differences (p < 0.05) in fungal composition between intra-diurnal periods were demonstrated in most monthly analyses. A strong negative correlation was demonstrated with temperature and haze events. Conversely, positive correlations were observed with relative humidity, wind action, rainfall and dust phenotypes. Fungal dynamics in relation to seasonality and intra-diurnal variations require further elucidation. Collaborative research is needed to advance our understanding of the implications of elevated rates of fungal bioaerosols, the seasonality of specific fungal allergens and what may be suitable means of mitigation. Efforts such as this study will hopefully help facilitate regionally specific air quality management decisions and provide baseline information for health-care providers.