公共卫生研究摘要 (2025-08-17)
共收录 57 篇研究文章
1. Structure-based standardization of prebiotic soluble dietary fibers based on monosaccharide composition, degree of polymerization, and linkage composition.
期刊: Carbohydrate polymers 发表日期: 2025-Nov-01 链接: PubMed
摘要
Dietary fibers are diverse indigestible polysaccharides that can be categorized according to their physicochemical properties, including molecular size, monosaccharide composition, and glycosidic bond profile. Fiber promotes health by maintaining intestinal homeostasis. Prebiotic dietary fibers are utilized by microbes in the lower gastrointestinal tract under anaerobic conditions, producing essential metabolites, such as short-chain fatty acids. Microorganisms differ in their ability to hydrolyze and utilize fibers as energy sources, which depends on the microbe’s enzymes and the available fiber’s physicochemical properties. Thus, different fibers promote specific microbes, in turn modulating metabolite production. As certain taxa provide health benefits and thus are candidates for selective promotion, guidelines for the structure-based standardization of prebiotic fibers are needed to ensure consumer products conform to stated claims and help the prebiotics market transition to more evidence-based prebiotic fiber utilization. We review dietary fiber isolation and purification methods and analyze appropriate structural characteristics for fiber standardization. We propose a stepwise approach to standardization, beginning with monosaccharide composition and eventually adding degree of polymerization and linkage composition, ultimately providing comprehensive structural specifications. We envision a future where standardized, well-characterized dietary fibers are available to consumers and manufacturers, accelerating microbiome and dietary fiber research and improving consumer health.
2. Mechanisms of DNA repair and mutagenesis induced by acetaldehyde, acrolein, aristolochic acids, and vinyl chloride.
期刊: Journal of environmental science and health. Part C, Toxicology and carcinogenesis 发表日期: 2025-Aug-16 链接: PubMed
摘要
Humans are continually exposed to a diverse array of environmental chemicals that can damage DNA and compromise genomic integrity. Among these genotoxic agents, acetaldehyde, acrolein, aristolochic acids, and vinyl chloride are particularly concerning due to their widespread presence in industrial emissions, dietary sources, and lifestyle-related exposures such as smoking and alcohol consumption. These compounds can induce structurally distinct forms of DNA damage including bulky DNA adducts, interstrand crosslinks, and other replication-blocking lesions. While canonical DNA repair pathways serve as the primary defense against such DNA damage, some lesions persist, challenging the capacity of DNA repair systems. If not efficiently repaired, DNA lesions may disrupt replication and transcription. In many cases, translesion synthesis polymerases are recruited to bypass unrepaired lesions, introducing mutations that contribute to agent-specific mutational signatures found in cancer genomes. This review systematically examines how each of these four exogenous chemicals induces DNA damage, the DNA repair pathways responsible for removing their lesions, and the role of translesion synthesis in shaping their mutational signatures. We also highlight how three-dimensional genome organization regulates lesion susceptibility and repair, contributing to variability of mutational landscapes.
3. The Effect of α-Mangostin on the Pharmacokinetic Profile of Tofacitinib in Rats Both In Vitro and In Vivo.
期刊: Biopharmaceutics & drug disposition 发表日期: 2025-Aug-16 链接: PubMed
摘要
This study investigated the effects of α-mangostin (α-MG) on the pharmacokinetics of tofacitinib in vitro and in vivo, aiming to recommend its appropriate application in clinical practice. To investigate the values of IC50 and inhibition of α-MG in vitro, rat liver microsomes were incubated with tofacitinib. In this study, Sprague-Dawley rats were randomly assigned to three groups: a control group, a single-dose group (50 mg/kg of α-MG), and a multiple-dose group (50 mg/(kg/d) of α-MG for 7 days). Tofacitinib (10 mg/kg) was administered 30 min after the intervention of α-MG to each group. The plasma was collected from the caudal vein at different time points and in heparinized tubes. Tofacitinib metabolites in the plasma were determined by UPLC-MS/MS. Further analyses were conducted utilizing Pymol molecular docking simulation to evaluate the effect of α-MG on tofacitinib. Our results showed that MG inhibited the metabolism of tofacitinib in vitro by exhibiting both competitive and noncompetitive inhibition. More importantly, we found that multiple-dose administration of α-MG significantly increased the AUC(0-12h), AUC(0-∞), and Cmax, prolonged the t1/2 and shortened the MRT(0-12h) and MRT(0-∞) of tofacitinib. At the same time, the CLz/F was decreased, which was consistent with the results of in vitro experiments. Furthermore, we observed no significant difference between single-dose and multiple-dose groups. Intriguingly, α-MG and tofacitinib were close at the CYP3A4 spatial location. In summary, our investigation demonstrated that α-MG significantly impacts the metabolism of tofacitinib both in vitro and in vivo, suggesting potential herb-drug interactions (HDIs). The use of tofacitinib with herbs containing MG should be monitored clinically.
4. Bidirectional Associations Between Civic Engagement, Depressive Symptoms, and Suicidality in Youth: A Population-Based Study.
期刊: Journal of adolescence 发表日期: 2025-Aug-16 链接: PubMed
摘要
Civic engagement is common in youth, yet its longitudinal association with mental health remains understudied. This study aims to document bidirectional associations between civic engagement, depressive symptoms, and suicidality at 20 and 23. We included 1451 participants born in 1997/98 from the Québec Longitudinal Study of Child Development in Canada. At 20 and 23, youth self-reported their engagement in five types of civic activities, namely political engagement, volunteering, activism, charitable actions, community involvement, depressive symptoms, and suicidality. Cross-lagged path models adjusted for sex and parental socioeconomic status were used to test associations between civic engagement and mental health outcomes. Concurrently, individuals who engaged in political engagement and activism were more likely to experience increases in depressive symptoms and suicidality at 20, while those who engaged in volunteering tended to report fewer depressive symptoms. At 23, political engagement remained positively associated with depressive symptoms. Longitudinal analyses revealed that individuals who engaged in activism at 20 were more likely to experience increases in depressive symptoms over time (β = 0.17) and those who participated in charitable actions (β = -0.14) and volunteering (β = -0.11) at 20 tended to report fewer depressive symptoms at 23, though these associations were not independent. Mental health at 20 was not associated to later civic engagement. Types of civic engagement were differentially associated with later depressive symptoms, but not suicidality. Further research is needed to clarify the mechanisms underlying these associations, including the potential role of engagement frequencies, motivations, and contextual factors.
5. The Impact of Multimarket Competition on Generic Drugs' Regulated Prices.
期刊: Health economics 发表日期: 2025-Aug-16 链接: PubMed
摘要
Competition between firms selling similar drugs is often fostered by policymakers as a means to curb pharmaceutical spending. While firms may compete within these specific drug markets, they also repeatedly encounter rival firms in different markets. This may shape competitive dynamics within and between markets. Yet, multimarket contacts, particularly relevant for multiproduct firms such as pharmaceutical companies, are often overlooked by pricing regulations. This paper investigates how multimarket contacts influence competition between pharmaceutical firms in off-patent markets. Using detailed product-level information on all retail pharmacy sales of generic statin drugs, we quantify the universe of multimarket contacts between firms in these off-patent markets, in Portugal, between 2015 and 2017. We then assess how multimarket contacts affect price competition. To do so, we explore the strict price regulation in Portuguese generic drug markets. Specifically, the Portuguese Internal Reference Pricing System (RPS) defines a price cap for each generic drug. Rather than examining absolute drug prices, we quantify the degree of price competition as the ratio between a firm’s drug price and its regulatory price cap (price-to-cap ratio). We find that firms with more multimarket interactions set prices closer to price caps, consistent with the mutual forbearance hypothesis. This effect persists after controlling for brand status, lagged market share, and is not explained by common ownership. Our main results are consistent across alternative model specifications. However, due to limited within-firm variation over time, the effect is not significant in system generalized method of moment instrumental variable estimates. These results suggest that price caps may act as coordination anchors, thus lowering price competition between firms. Policymakers should consider targeted price cap adjustments as safeguards to preserve competition in off-patent drug markets.
6. Global research status and trends of compulsive sexual behavior disorder: A comprehensive bibliometric analysis.
期刊: Journal of behavioral addictions 发表日期: 2025-Aug-16 链接: PubMed
摘要
Compulsive sexual behavior disorder (CSBD) is a mental health condition that has attracted significant research attention, especially following its inclusion in the eleventh revision of the International Classification of Diseases (ICD-11) by the World Health Organization. Despite this recognition, the field remains fragmented with ongoing debates about its classification and a lack of comprehensive cross-cultural research. In this study, bibliometrics was used to characterize the development status of CSBD over the past 25 years and to identify key research hotspots and future trends. This study collected data from the Web of Science Core Collection and analyzed the literature related to CSBD from 2000 to 2024. A total 2,261 publications were examined for their characteristics, including annual publication volume, countries/regions, institutions, authors, journals, references, and keywords. Several bibliometric and visualization tools (e.g., VOSviewer, CiteSpace, Scimago Graphica, and Pajek) were used to conduct the analysis of co-authorship, co-citation, co-occurrence and descriptive. The analysis identified a consistent upward trend in research interest in CSBD, particularly after its inclusion in ICD-11. Co-occurrence analysis of 82 author keywords with frequencies of more than 12 resulted in 5 clusters: (1) competing conceptualizations of CSBD; (2) comorbidity of CSBD with other psychiatric disorders; (3) assessment, risk factors, and treatment; (4) gender differences and sexual health; (5) CSB caused by neurological diseases. Moreover, the findings of countries/regions analysis indicate that publications are mainly from Western, educated, industrialized, rich, and democratic (WEIRD) countries/regions, and collaborative networks mainly connect countries from the North America and Europe. Despite its growing recognition, the field still lacks interdisciplinary collaboration and comprehensive studies from non-WEIRD contexts, highlighting a need for broader, cross-cultural research. This study comprehensively maps global research trends in CSBD, identifies critical knowledge gaps, and provides a foundation for future research. By synthesizing the current research status, it aims to guide researchers toward emerging topics and foster a more cohesive understanding of CSBD.
7. Unpaid care, time taken off work and healthcare costs before and after partner bereavement among same-gender and different-gender partners: A national population-based study.
期刊: Palliative medicine 发表日期: 2025-Aug-16 链接: PubMed
摘要
Recent research has demonstrated higher levels of psychological distress for bereaved same-gender partners compared to different-gender partners. Economic outcomes have not yet been examined. To examine whether there are differences between same- and different-gender civil partners or spouses (hereafter ‘partners’) in the amount of unpaid care provided in the 3 months pre-bereavement, and time taken off work and formal healthcare used in the 3 months pre- or post-bereavement. A population-based cross-sectional survey of bereaved partners from England/Wales was conducted including three economic outcomes of interest: unpaid care, time taken off work, and formal healthcare used. We estimated formal healthcare costs using reference costs. We balanced groups on sociodemographic characteristics using propensity score weights and estimated average marginal difference in outcomes between groups using multivariable regressions. There were 542 complete cases for primary analysis (220 same-gender partners, 322 different-gender partners). Same- and different-gender partners provided very high levels of unpaid care pre-bereavement (mean 122 h/week). Of those in paid employment, 85% missed some work pre- and post-bereavement. Same-gender partners had higher formal healthcare costs post-bereavement (+£79, 95% CI: +2 to +156). There were no other significant differences between groups. The economic burdens of bereavement are substantial. Same-gender partners were associated with more formal healthcare use than different-gender partners post-bereavement, possibly connected to higher levels of psychological distress. Future research should consider longer-term impacts of partner bereavement on health outcomes, explore whether care services are experienced as inclusive, and target ethnically diverse and gender diverse communities.
8. Clinical characteristics of simple bone cyst associated within florid cemento-osseous dysplasia: a meta-analysis.
期刊: Medicina oral, patologia oral y cirugia bucal 发表日期: 2025-Aug-16 链接: PubMed
摘要
The objectives of this study were to better understand the association between simple bone cysts (SBC) diagnosed within florid cemento-osseous dysplasia (FCOD) by systematically reviewing the literature with a meta-analysis. This review allows us to study the epidemiology, characteristics, treatments, and follow-up of the association between these two entities. A systematic review was performed on PubMed, Scopus, Cochrane library, Embase and Google Scholar. Articles reporting primary studies, case reports and case series were included. We reviewed all articles between 1976 and November 2024. Recorded data were patient’s characteristics, clinical and radiological features, diagnosis, treatment, and follow-up. The meta-analysis was performed for the prevalence of the localization of SBC associated FCOD and the number of SBC lesions within FCOD. A total of 615 studies were assessed for eligibility by reading titles and abstracts. Finally, 16 articles were included, with 51 patients presenting SBC associated with FCOD. Patients were mostly women (92%) with most of an African origin (81,25% ). The mean age was 41-year-old. The usual treatment for the cyst was surgical exploration with bleeding stimulation to improve healing. After surgical procedure, a majority of the followed-up cases healed completely (52%) or partially (32%). Eight cases reported a recurrence during the mean follow-up period of 6,6 years. SBC and FCOD are two conditions which can be rarely associated. This may be under-diagnosed as SBC can be misdiagnosed as part of the FCOD lesions. This review highlights the similar clinical characteristics to FCOD which makes important to find out more clinical and radiographic diagnosis criteria to better diagnose and provide the adequate treatment to obtain bone healing.
9. Analysis of the Increased Incidence of Aggressive Prostate Cancer After Prior Testicular Cancer.
期刊: The Prostate 发表日期: 2025-Aug-16 链接: PubMed
摘要
Men with a history of testicular cancer are known to have an increased risk of developing prostate cancer. The objective of this study is to determine if testicular cancer survivors are predisposed to a higher incidence of aggressive prostate cancer later in life and greater risks of mortality. The Surveillance, Epidemiology, and End Results database was searched for patients diagnosed with prostate cancer and either no prior cancer diagnosis or a previous diagnosis (≥ 5 years ago) of either testicular cancer or another cancer with a high survival rate (5-year survival > 70%). Cox regression models were used to determine the risk of mortality. Of the 392,238 prostate cancer patients, 423 had a history of testicular cancer, 31,428 had a history of another cancer, and 377,975 had no prior history of cancer. The mean ages of prostate cancer diagnosis were 62.53 +/- 8.23 years, 67.95 +/- 8.46 years, and 67.95 +/- 9.47, respectively (p < 0.001). Testicular cancer was associated with earlier mortality on survival analysis in multivariable analysis controlling for age of prostate cancer diagnosis, race, clinical T stage, PSA level at diagnosis, and Gleason score. A history of testicular cancer may be associated with an increased risk of developing early prostate cancer and increased mortality. Confirmatory studies are warranted.
10. Burn Care: A Review-Part 1: First 48 Hours.
期刊: World journal of surgery 发表日期: 2025-Aug-16 链接: PubMed
摘要
The purpose of part one of this review is to provide basic information about the initial treatment of all burns. The current literature and experience of the author were used to provide guidelines for treating burns in all parts of the world. No artificial intelligence was used to create this manuscript. Although survival has improved, burns often lead to significant scarring and disabilities. While there are new and expensive technologic advances, basic burn care can be performed with relatively few resources. Early treatment can have a significant impact on outcomes. This review describes guidelines for worldwide use and introduces the newest technologies for treating burns. Because it is difficult to include all information in one paper, the review will be divided into two sections, the first section describing epidemiology, pathophysiology and the initial 48 h of treatment. The second part will cover care after 2 days. Any caregiver should be able to manage the first 48 h. The real challenge starts after 48 h when care, at least for large burns, can last years.
11. Ticks and tick-borne bacterial pathogens found on hard ticks (Acari: Ixodidae) on cattle in the Central River region of The Gambia.
期刊: Medical and veterinary entomology 发表日期: 2025-Aug-16 链接: PubMed
摘要
Ticks are significant vectors of pathogens affecting both animals and humans, with the climate and environment of Sub-Saharan Africa providing ideal conditions for their growth. However, there are limited data on ticks and tick-borne pathogens (T&TBPs) in cattle in The Gambia. This study aimed to identify tick species on cattle and conduct molecular screening for T&TBPs. A total of 92 ticks were collected from 306 indigenous cattle. Ticks were first identified morphologically using taxonomic keys and then confirmed molecularly through DNA sequencing. DNA was extracted from the right fourth leg of six representative ticks for species confirmation, while 77 whole adult ticks were used for screening T&TBPs. Screening polymerase chain reaction (PCR) assays targeted Anaplasma marginale msp1β gene, Ehrlichia spp. dsb gene and hemotropic Mycoplasma spp. 16S rRNA gene. Ehrlichia-positive samples underwent additional assays targeting the sodB, 16S rRNA and groEL genes, followed by Sanger sequencing and phylogenetic analyses. A total of 92 (53 M, 37 F and two nymphs) ticks were collected from 30/306 (9.8%; 95% confidence interval [CI]: 5.6%-12.2%) cattle. Adult ticks were identified as Hyalomma marginatum (73/92; 79.3%; 45 M and 28 F), Amblyomma variegatum (8/92; 8.7%; 8 M), Hyalomma rufipes (4/92; 4.3%; 4 F) and Rhipicephalus evertsi (1/92; 1.1%; one F). The 16S rRNA sequences of six (four engorged female and two nymphs) ticks showed 98.6-100% identity with reference sequences from Rhipicephalus geigyi. Twelve out of 77 (15.6%) ticks tested positive for at least one TBP. Eight H. marginatum (six M and two F) (10.4%) were positive for Ehrlichia spp. dsb gene, three H. marginatum (two M and one F) (3.9%) for A. marginale and two (one H. marginatum F and one A. variegatum M) (2.6%) for hemotropic Mycoplasma spp. All Ehrlichia-positive samples showed 100% detection for the 16S rRNA gene and 62.5% for the sodB gene. BLASTn analysis revealed 99.3%-99.7% identity with Ehrlichia sp. from Brazil and 98.2%-99.3% identity with E. minasensis from Panama and Pakistan. Phylogenetic analysis grouped the sequences from this study with Ehrlichia spp. and E. minasensis from ticks in the Czech Republic and Brazil. This study identified various tick species and pathogens in cattle from The Gambia, including the first report of E. minasensis, A. marginale and hemotropic Mycoplasma spp. in the country. These findings highlight the importance of ongoing surveillance and research on tick-borne diseases in the region.
12. Is the incidence of early-onset cancers increasing in the northeast of Italy? A 30-year analysis of the regional cancer registration data by age, 1987-2019.
期刊: International journal of cancer 发表日期: 2025-Aug-16 链接: PubMed
摘要
The analysis of cancer incidence trends in adolescents and young adults reveals a concerning increase. This observational study aims to investigate cancer incidence trends among young adults under 50, compared to older age trends, using the population-based Cancer Registry of the Veneto Region (Northeastern Italy) from 1987 to 2019. Yearly age-standardized cancer incidence rates per 100,000 individuals were obtained from the Veneto Tumour Registry for 24 tumor sites and all cancers combined. Temporal trends from 1987 to 2019 were analyzed for each cancer type, stratified by sex and age group at diagnosis (0-49, 50-64, and 65+ years). Significant changes in incidence trends were assessed by the annual percent change (APC), calculated through joinpoint regression analysis. Since 1987, the incidence rate of cancers among young adults decreased in males, while among females it increased until 2014 and then stabilized. One cancer showed increasing incidence in both sexes (invasive cutaneous melanoma), two in males (testicular, and multiple myeloma), and two more in females (breast, and Hodgkin disease). Four cancer sites showed a decline in both sexes (oral cavity, stomach, lung, and bladder), and four further cancers only in males (esophagus, rectum, larynx, and non-Hodgkin lymphoma). Two cancers showed complex trends (Corpus uteri, and thyroid in women). Eight cancers showed no significant changes in APCs. Cancer incidence data for young adults reveal a heterogeneous landscape. These findings provide valuable insights into the expected evolution of cancer epidemiology in young populations.
13. Phylogenomic analysis of bovine astrovirus expands the known repertoire of mamastrovirus genotypes in northern India.
期刊: Archives of virology 发表日期: 2025-Aug-16 链接: PubMed
摘要
Bovine astrovirus (BoAstV) belongs to the family Astroviridae and the genus Mamastrovirus (MAstV). Phylogenomic analysis based on partial sequences of the RNA-dependent RNA polymerase (RdRp) gene has allowed BoAstV isolates to be classified into the genotypes MAstV-13, 24, 28-30, and 33-35. However, information about the clinical significance and molecular characteristics of BoAstV from India is restricted to a single study from western Maharashtra, India. In this study, using RT-PCR detection of a portion of the RdRp gene, we investigated the presence of BoAstV in 134 rectal swabs samples from diarrheic and non-diarrheic calves less than three months of age from four states of North India (Rajasthan, Uttar Pradesh, Himachal Pradesh, and Haryana). Of these, 31 (23.1%) samples tested positive for BoAstV, with a higher rate of positivity in calves less than one month of age (30%, 21/70) than in calves between 1 and 3 months of age (15.6%, 10/64). Phylogenetic analysis based on partial RdRp gene sequences revealed the circulation of four different genotypes (MAstV 28, MAstV-33, MAstV-35, and MAstV-3) in Haryana. To the best of our knowledge, this is the first report of the presence of bovine astrovirus in cattle and buffalo calves in North India and of genotype MAstV-3 in calves.
14. Diagnostic performance of deep learning for predicting glioma isocitrate dehydrogenase and 1p/19q co-deletion in MRI: a systematic review and meta-analysis.
期刊: European radiology 发表日期: 2025-Aug-16 链接: PubMed
摘要
We aimed to evaluate the diagnostic performance of deep learning (DL)-based radiomics models for the noninvasive prediction of isocitrate dehydrogenase (IDH) mutation and 1p/19q co-deletion status in glioma patients using MRI sequences, and to identify methodological factors influencing accuracy and generalizability. Following PRISMA guidelines, we systematically searched major databases (PubMed, Scopus, Embase, Web of Science, and Google Scholar) up to March 2025, screening studies that utilized DL to predict IDH and 1p/19q co-deletion status from MRI data. We assessed study quality and risk of bias using the Radiomics Quality Score and the QUADAS-2 tool. Our meta-analysis employed a bivariate model to compute pooled sensitivity and specificity, and meta-regression to assess interstudy heterogeneity. Among the 1517 unique publications, 104 were included in the qualitative synthesis, and 72 underwent meta-analysis. Pooled estimates for IDH prediction in test cohorts yielded a sensitivity of 0.80 (95% CI: 0.77-0.83) and specificity of 0.85 (95% CI: 0.81-0.87). For 1p/19q co-deletion, sensitivity was 0.75 (95% CI: 0.65-0.82) and specificity was 0.82 (95% CI: 0.75-0.88). Meta-regression identified the tumor segmentation method and the extent of DL integration into the radiomics pipeline as significant contributors to interstudy variability. Although DL models demonstrate strong potential for noninvasive molecular classification of gliomas, clinical translation requires several critical steps: harmonization of multi-center MRI data using techniques such as histogram matching and DL-based style transfer; adoption of standardized and automated segmentation protocols; extensive multi-center external validation; and prospective clinical validation. Question Can DL based radiomics using routine MRI noninvasively predict IDH mutation and 1p/19q co-deletion status in gliomas, and what factors affect diagnostic accuracy? Findings Meta-analysis showed 80% sensitivity and 85% specificity for predicting IDH mutation, and 75% sensitivity and 82% specificity for 1p/19q co-deletion status. Clinical relevance MRI-based DL models demonstrate clinically useful accuracy for noninvasive glioma molecular classification, but data harmonization, standardized automated segmentation, and rigorous multi-center external validation are essential for clinical adoption.
15. Perceived blood glucose regulation after menopause: a cross-sectional survey in women with type 1 diabetes in the Netherlands.
期刊: Diabetologia 发表日期: 2025-Aug-16 链接: PubMed
摘要
Women with type 1 diabetes experience changes in insulin requirements in pregnancy and throughout the menstrual cycle. It remains to be explored whether women with type 1 diabetes perceive changes in glucose regulation during and after the menopausal transition, another period of marked hormonal change in a woman’s life. We conducted a cross-sectional survey to investigate whether women with type 1 diabetes perceive changes in glucose regulation after their final menstrual period. The online questionnaires were distributed through advertisements in hospitals and through online platforms for people living with type 1 diabetes in the Netherlands. Postmenopausal women (≥1 year of amenorrhoea) with type 1 diabetes, aged 45-65 years, were included. Participants with primary amenorrhoea, premenopausal hysterectomy or a postmenopausal diabetes diagnosis were excluded from the study. The primary outcome was the extent to which participants perceived changes in their glucose regulation following their final menstrual period, assessed using a five-point Likert scale. Menopausal symptom severity was estimated using the Greene climacteric scale (GCS). Questionnaires from a total of 159 women were eligible for inclusion. Participants had a mean age of 54.9 years (SD 3.8), a mean diabetes duration of 30.3 years (SD 12.8), and had their final menstrual period at a mean age of 50.1 years (SD 5.0). Overall, 67.4% of participants reported moderate to severe postmenopausal changes in glucose regulation. Increased blood glucose levels were perceived by 41.9% of participants, 19.6% perceived lower glucose levels and 38.5% perceived no change in blood glucose levels. For fluctuations in glucose levels, 55.0% experienced more fluctuations and 18.1% experienced less fluctuation. More hyperglycaemic events were experienced by 61.6% of participants, while 38.5% experienced more hypoglycaemic events and 28.0% experienced fewer hypoglycaemic events. Reported menopausal symptoms were more severe after the final menstrual period compared with before the final menstrual period (mean GCS score ± SD: 18.8±9.9 vs 11.7±8.3, p<0.001). An increase in postmenopausal symptom severity score was associated with an increase in the odds of perceiving postmenopausal changes in glucose regulation, with an adjusted OR of 1.04 (95% CI 1.01, 1.08; p=0.014). A total of 57.2% of participants had a global Pittsburgh sleep quality index (PSQI) score >5, indicating poor sleep quality. Poor sleep quality was not associated with perceived glycaemic changes after menopause (global PSQI >5) (adjusted OR 1.10; 95% CI 0.58, 2.08; p=0.731). Approximately two-thirds of women with type 1 diabetes perceive changes in their glucose regulation after menopause, including subjective changes in the number of hyperglycaemic and hypoglycaemic events. Changes in perceived glucose regulation were associated with the severity of reported menopausal symptoms. These results highlight the need for awareness among medical professionals treating women with type 1 diabetes, as those going through the menopausal transition may experience changes in glucose metabolism, which can affect their diabetes management. The data that support the findings of this study are available on request from DataVerseNL with the identifier https://doi.org/10.34894/84QJOO .
16. Real-World Ibrexafungerp Use Patterns Among Patients with Commercial Health Insurance, United States, 2021-2023.
期刊: Drugs - real world outcomes 发表日期: 2025-Aug-16 链接: PubMed
摘要
Vulvovaginal candidiasis (VVC) is a common gynecological complaint. Ibrexafungerp (brand name: Brexafemme®) is a new, first-in-class oral antifungal medication approved as a 1-day treatment for VVC and as a monthly treatment to reduce frequency of recurrent VVC. This article describes characteristics of patients who received ibrexafungerp and potential ibrexafungerp-related side effects in order to help inform optimal future use of this medication. We used a large, national commercial health insurance claims database (the MerativeTM MarketScan® Commercial/Medicare Database) to identify female patients with one or more outpatient ibrexafungerp prescription during 1 July 2021 to 31 December 2023. We examined patient demographic characteristics, medical conditions and medications, type of healthcare provider seen, diagnostic testing performed, and potential ibrexafungerp side effects. Among 1368 female patients who received ibrexafungerp, most were also prescribed fluconazole or topical antifungals (84.7%) or had one or more vaginitis/vulvitis-related healthcare visit (76.9%) in the previous year. Few patients (2.9%) experienced a potential ibrexafungerp-related side effect. Our results suggest that ibrexafungerp was generally used as non-first-line treatment for VVC.
17. Randomized phase II comparison of single-agent carboplatin versus combination of carboplatin and everolimus for advanced triple negative breast cancer.
期刊: Breast cancer research and treatment 发表日期: 2025-Aug-16 链接: PubMed
摘要
Triple-negative breast cancers (TNBCs) are associated with a high frequency of PTEN loss, which can lead to activation of the mTOR pathway and tumor proliferation but may be reversible with the mTOR inhibitor everolimus. A prior phase II single-arm trial of carboplatin and everolimus in patients with advanced TNBC demonstrated good tolerability and preliminary efficacy. A phase II randomized trial in patients with advanced TNBC, with 0-3 prior lines of therapy, was conducted. Patients were randomized 2:1 to receive carboplatin and everolimus or carboplatin alone. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), overall response rate (ORR), clinical benefit rate (CBR), and safety. Between 2015 and 2022, 59 patients were randomized to carboplatin/everolimus (n = 38) or carboplatin alone (n = 21). The median age of the population was 62 years and 68% had received at least one prior line of therapy. Median PFS was significantly improved in patients who received carboplatin/everolimus (4.7 months) versus carboplatin alone (4.2 months; HR:0.49; 95% CI: 0.25-0.98; p = 0.0390). OS was 17.6 months with the combination and 14.6 months with carboplatin alone (HR:1.17; 95% CI: 0.59-2.30; p = 0.6593). The most common adverse events (AEs) on the combination included thrombocytopenia, anemia, leukopenia, and neutropenia. The combination of carboplatin and everolimus in this study reduced the risk of progression or death by 52%. The regimen was well tolerated and provides a promising treatment option for patients with advanced TNBC.
18. Considering climate contexts: Examining promotive and punitive school characteristics among diverse high school students.
期刊: Journal of prevention & intervention in the community 发表日期: 2025-Aug-16 链接: PubMed
摘要
Schools are a critical developmental context for adolescents that can, depending on certain characteristics, do a better or worse job at promoting student resilience and well-being. In working to meet student needs and respond to student behaviors, schools can exhibit more punitive characteristics, like exclusionary discipline practices, or more promotive characteristics, including restorative practices and marshaling of mental health resources. While punitive factors have been associated with more negative outcomes, especially for marginalized students, and promotive factors have been associated with more positive outcomes for students, these factors have rarely been considered together. We conducted an online survey of students from high schools in the Midwest. Students rated their experiences of various promotive and punitive characteristics at their schools, as well as their sense of the school climate-perceived safety, fairness, and belonging. Promotive factors uniquely and positively predicted climate outcomes, eclipsing any effect of punitive factors. Further, while main effects indicated differences across racial groups in perceptions of school climate, there were no racial group differences in the impact of promotive factors on these climate perceptions. When exploring different promotive elements, support from teachers and staff, as well as available resources and mental health resources had the largest predictive effects on climate outcomes for students. We discuss implications for how educators and policy makers can leverage such promotive characteristics to create equitable contexts for all students to flourish.
19. Change targets, messaging, and content delivery for a community-engaged social media campaign addressing HIV-related stigma in Peru: a qualitative study.
期刊: AIDS care 发表日期: 2025-Aug-16 链接: PubMed
摘要
Mitigating stigma related to human immunodeficiency virus (HIV) is critical to improving HIV outcomes and achieving global HIV targets. We conducted formative community-engaged research to identify key characteristics of a social media campaign to address HIV-related stigma among youth in Lima, Peru. Focus groups and in-depth interviews with young people living with HIV (men who have sex with men, transgender women, sex workers, persons with perinatally-acquired HIV, cisgender women, and Venezuelan migrants), HIV advocates, and healthcare providers were conducted from November 2022 to July 2023. Audio recordings were transcribed verbatim and analyzed for emergent themes using framework analysis. Two change targets were identified for campaign messaging: (1) changing how HIV and people living with HIV (PLWH) are perceived and (2) changing attitudes and actions towards PLWH. Messages aligning with the first change target included education to raise awareness that HIV does not discriminate; HIV is a chronic, treatable condition; and “undetectable equals untransmittable” (U = U). Messages aligning with the second target included normalizing open conversations about HIV, encouraging support versus pity for PLWH, fostering unity among HIV-affected communities, and promoting inclusion of PLWH. Participants provided recommendations to achieve these messaging objectives, including how, to whom, and by whom messages are delivered.
20. Trends in health behaviour indicators between 1987 and 2023 among adults in the general population in Denmark.
期刊: Scandinavian journal of public health 发表日期: 2025-Aug-16 链接: PubMed
摘要
Health surveys constitute an essential component in comprehensive public health surveillance systems by providing information relevant for health care planning and policy development. This study aimed to describe trends in key indicators of health risk behaviours based on data from nine health survey waves conducted in Denmark between 1987 and 2023. Data were derived from the Danish Health and Morbidity Survey and the Danish National Health Survey conducted in the general population aged ⩾16 years. The number of respondents varied between 4,667 (1994) and 183,646 (2021). Data collection methods included both face-to-face interviews and self-administered (paper-and-pencil or web) questionnaires. Trends in the prevalence of the following health risk behaviours were examined: Daily smoking, a high weekly alcohol intake, unhealthy dietary pattern, leisure-time sedentary behaviour, obesity, and cannabis use in the past 12 months. Furthermore, the five-year change in odds ratio was calculated for each indicator. A decreasing prevalence was observed for daily smoking (from 44% to 12%) and a high weekly alcohol intake (from 25% to 16%), while the prevalence of obesity (from 6% to 19%) and unhealthy dietary pattern (from 13% to 19%) increased. Leisure-time sedentary behaviour showed inconsistent patterns across different time periods, and cannabis use remained relatively stable (~7%). Overall, five-year trends confirmed these patterns. Based on health risk behaviour trends in Denmark during the past decades demonstrated in the present study, policymakers are encouraged to develop national prevention strategies targeting these behaviours to support favourable trends and reverse unfavourable trends.
21. Estimating accuracy and precision in the bioavailability-adjusted exposure point concentration to support human health risk assessment of lead-contaminated soils.
期刊: Journal of toxicology and environmental health. Part A 发表日期: 2025-Aug-16 链接: PubMed
摘要
Under the United States Environmental Protection Agency’s (U.S. EPA) CERCLA program, soils suspected of lead (Pb) contamination are evaluated to assess the impact of soil Pb exposure on blood Pb levels. The decision to remediate relies, in part, on whether the measured soil exposure point concentration (EPC) excee ds an action level. The U.S. EPA established data quality objectives (DQOs) to support data collection used to estimate the EPC and assess confidence in remediation decisions. To support DQO processes at sites where site-specific soil Pb relative bioavailability (RBA) is assessed, a statistical simulation model was developed that estimates false compliance/exceedance decision error probabilities based upon uncertainty in the RBA-adjusted EPC, employing model inputs defining (1) the sampling protocol being evaluated, (2) variability in total and bioavailable soil Pb across the assessed area, and (3) analytical measurement uncertainty. A framework for utilizing the simulation model is presented using a hypothetical site informed by concentration and soil Pb bioavailability distributions from an actual Pb-contaminated site. Pre-sampling, false compliance/exceedance decision error probabilities were predicted for various sampling protocols. A DQO-compliant sampling protocol was then selected, and accuracy and precision in the measured EPC were assessed relative to a specified risk-based action level.
22. When Health Behavior Meets Technology: Artificial Neural Network-Based Prediction of Breast Self-Examination Intentions Among Filipino Female College Students.
期刊: Journal of cancer education : the official journal of the American Association for Cancer Education 发表日期: 2025-Aug-16 链接: PubMed
摘要
Early detection of breast cancer is crucial, particularly in low-resource settings. Emerging technologies like artificial neural networks (ANNs) offer innovative approaches to predict health behavior intentions. Hence, this study used an artificial neural network-multilayer perceptron (ANN-MLP) model to determine the predictors of breast self-examination (BSE) intention among female college students. With ethical approval, an analytical cross-sectional study was conducted among 382 female college students from a private higher education institution. Data on sociodemographic factors, knowledge, practices, perceived barriers, and health beliefs were collected using validated research questionnaires. Pearson’s correlation, chi-square, and ANN-MLP modeling were performed to identify significant predictors of BSE intention and actual breast screening behavior. Knowledge adequacy, frequent BSE practice, perceived susceptibility, and self-efficacy were significant predictors of intention to perform BSE. The ANN-MLP model achieved a testing accuracy of 74.1% and an AUC of 0.698 in predicting BSE intention. For actual breast screening behavior, significant predictors included degree program, knowledge, practice, self-benefit, and self-efficacy. The corresponding ANN-MLP model achieved 88.7% testing accuracy with an AUC of 0.779. The interplay of cognitive and behavioral factors significantly influences BSE intentions. The use of ANN-MLP modeling can effectively determine key predictors of BSE intentions, offering opportunities for robust, data-driven, and targeted health promotion interventions. The findings may inform patient, public, and professional cancer education by identifying cognitive and behavioral predictors of BSE intention, enabling health professionals to design tailored education and training programs that enhance early screening behaviors and advocacy for breast cancer prevention.
23. Space Dentistry Combined With Remote and AI Technologies, a Necessity for Long-Term Stays: Thoughts of US Astronauts' Unexpected Stay.
期刊: Oral diseases 发表日期: 2025-Aug-16 链接: PubMed
摘要
24. Effects of the Flavonoid Diosmin on Post Exercise Muscle Soreness - A Randomized Controlled Trial.
期刊: Journal of dietary supplements 发表日期: 2025-Aug-16 链接: PubMed
摘要
women’s league. A randomized, double‑blind and placebo‑controlled crossover trial was conducted in 15 professional futsal female athletes. They received one daily capsule of DSM or placebo (750 mg) for 3 days as a preventive regimen, and an intense dynamic exercise protocol (concentric/eccentric actions) was applied to the lower limbs. Evaluations on the effects of DSM on athletic performance and DOMS‑related muscle soreness, blood oxidative stress, recovery of strength capacity, and postural balance were performed during a 48 h‑period. Although DSM had no greater effect than placebo on athletic performance, it presented trivial‑to‑moderate effects in other parameters without statistical significance, with the best effects including containing oxidative damage (through reduction in lipid peroxidation) (p = 0.3857, EF = 0.72) and muscle soreness upon climbing stairs (p = 0.7136, EF = 0.50) at the 48th hour, and in preventing the reduction of muscle strength (p = 0.6784, EF = 0.61) and improving unipedal postural balance in contralateral leg (p = 0.7446, EF = 0.69) at the 24th hour. Althought not significant in the ANOVA, the flavonoid DSM seems effective for futsal athletes as a dietary supplement for some variables evaluated. These include preventing muscle soreness, oxidative stress, impairment of muscle strength, and postural balance postexercise, which is desirable to promote better results in sporting terms. Clinical trial registry number: NCT06125002.
25. Clinical progress note: Tetanus.
期刊: Journal of hospital medicine 发表日期: 2025-Aug-16 链接: PubMed
摘要
Tetanus is a pathogen with a significant global burden which has largely been eradicated in the developed world through safe and highly effective vaccination. In this era of increasing vaccine hesitancy, physicians should remain cognizant of this rare, preventable and high-consequence pathogen.
26. Addressing Critical Fungal Pathogens Under a One Health Perspective: Key Insights from the Portuguese Association of Medical Mycology.
期刊: Mycopathologia 发表日期: 2025-Aug-16 链接: PubMed
摘要
Fungal infections have emerged as a significant public health concern, especially with the increasing incidence of severe mycoses caused by pathogens such as Aspergillus fumigatus, Candida auris, Candida albicans, and Cryptococcus neoformans. These fungi, listed as critical priorities by the World Health Organization, pose a heightened risk due to rising antifungal resistance and their severe impact on immunocompromised individuals. This article, coordinated by the Portuguese Association of Medical Mycology, highlights the importance of adopting a One Health perspective to address fungal threats comprehensively. Drawing on interdisciplinary collaboration, the association aims to foster greater awareness, improve diagnostic capabilities, and stimulate research and public health policies in Portugal but also at global level. The paper outlines key strategies for surveillance, prevention, and innovation in fungal diagnostics and therapeutics. Moreover, it emphasizes the urgent need for national coordination and international cooperation in managing fungal infections, advocating for integrative approaches that link human, animal, and environmental health. By presenting a consolidated overview of current challenges and future priorities, this work seeks to enhance preparedness and response mechanisms in the face of escalating fungal threats.
27. Boosting Brain Clean-Up: Can Targeting UPS Genes Offer Neuroprotection?
期刊: Molecular neurobiology 发表日期: 2025-Aug-16 链接: PubMed
摘要
The ubiquitin-proteasome system (UPS) plays a critical role in protein homeostasis within eukaryotic cells. This review article examines the UPS’s role in neuronal morphology and neurodegeneration through systematic analysis of current research. In neurodegenerative disorders (NDDs) such as Alzheimer’s disease (AD), Parkinson’s disease (PD), Huntington’s disease (HD), and amyotrophic lateral sclerosis (ALS), UPS dysfunction contributes significantly to pathogenesis through accumulation of ubiquitinated misfolded proteins, disruption of cellular proteostasis, impaired substrate ubiquitination, and proteasomal deterioration. The UPS maintains normal central nervous system (CNS) function by regulating protein degradation. When this system fails, cellular proteostasis becomes compromised, accelerating neurodegeneration. Recent research has identified potential interventions for UPS activation through genetic modification and synthetic compounds. This review assesses how specific UPS components could serve as pharmacological targets for treating NDDs. By modulating UPS-mediated genes and pathways, novel therapeutic strategies may emerge for conditions including AD, PD, HD), and ALS. Current evidence suggests the UPS represents a promising therapeutic target for addressing the fundamental protein homeostasis disruptions underlying these devastating neurological conditions. Targeting this system could potentially slow disease progression by restoring proper protein degradation mechanisms and preventing toxic protein accumulation characteristic of NDDs.
28. Beyond transfusions and transplants: genomic innovations rewriting the narrative of thalassemia.
期刊: Annals of hematology 发表日期: 2025-Aug-16 链接: PubMed
摘要
Thalassemia is a globally prevalent inherited blood disorder that usually leads to severe complications and even premature death due to impaired hemoglobin synthesis. The conventional treatment approach encompasses a range of interventions, including red blood cell transfusions, iron chelation therapy, splenectomy, and allogeneic hematopoietic stem cell transplantation. However, transfusion-induced iron overload and the limitation of graft matching have emerged as significant clinical impediments. In recent years, with the advent of precision medicine and translational research, the treatment of thalassemia has undergone a paradigm shift toward stem cell gene therapy, gene editing combined with nanodelivery, and pharmacogenomics-guided, personalized treatment regimens. In preclinical and early-phase clinical trials, these approaches have demonstrated efficacy in modulating hemoglobin gene expression and reversing ineffective hematopoiesis. Consequently, this review explores the constraints imposed by conventional therapeutic approaches and the advancements in the field of gene therapy for thalassaemia. It elucidates the mechanisms of gene editing and the potential of stem cell therapies. Furthermore, the discourse encompasses the advancement of primary prevention strategies, including genetic testing and prenatal screening, in the context of reducing morbidity. It is our hope that this review will provide the latest clues and insights in gene therapy for the effective management of thalassemia.
29. Protective role of geraniol in high fat diet-induced NAFLD: balancing lipid homeostasis, antioxidant defence, and inflammatory responses.
期刊: The Journal of pharmacy and pharmacology 发表日期: 2025-Aug-16 链接: PubMed
摘要
This study aimed to evaluate the preventive effects of geraniol on non-alcoholic fatty liver disease (NAFLD) induced by a high fat diet (HFD) in a rat model, focusing on its impact on lipid metabolism, oxidative stress, and inflammation. NAFLD was induced in male Sprague-Dawley rats by feeding them a HFD for 10 weeks. Geraniol was administered orally at doses of 50, 100, and 200 mg/kg. The following parameters were assessed: body weight, hepatic index, lipid profile (total cholesterol, triglycerides, HDL, LDL), serum hepatic enzymes (ALT, AST, ALP), oxidative stress markers (MDA, SOD, CAT, GSH), and inflammatory markers (TNF-α, IL-6, IL-10). Histopathological evaluation of liver tissues was performed to assess structural changes and inflammation. Geraniol treatment, particularly at 100 and 200 mg/kg, significantly reduced body weight gain and hepatic index in HFD-fed rats. It improved lipid profiles by lowering total cholesterol, triglycerides, and LDL while increasing HDL levels. Hepatic enzyme levels were markedly decreased, indicating hepatoprotection. Geraniol also restored antioxidant enzyme activity and reduced markers of oxidative stress. Moreover, it lowered pro-inflammatory cytokines and elevated anti-inflammatory cytokines. Histopathological analysis confirmed reduced hepatic steatosis and inflammation. Geraniol demonstrated potent protective effects against HFD-induced NAFLD in rats by improving lipid metabolism, mitigating oxidative stress, and modulating inflammatory responses. These findings support its potential as a therapeutic agent for the prevention and management of NAFLD.
30. Trends in the incidence of cancers of the male genital system and urinary bladder in Harare, Zimbabwe, 1990-2019.
期刊: Cancer causes & control : CCC 发表日期: 2025-Aug-16 链接: PubMed
摘要
The cancer registry of Harare, Zimbabwe, founded in 1986 allows the study of the evolution of the cancer epidemic in a Black (African) population over a 30-year period, and is used to investigate trends in the incidence of cancers of the male genital system and urinary tract. Age standardised incidence rates (ASRs) in the black (African) population of Harare are calculated for four cancers: prostate, testis and penis in men, and bladder in both sexes. Trends are expressed as the average annual percentage change in incidence. The incidence of prostate cancer is very high (an ASR of 71.4 per 105) and over the period increased at a rate of 5.1% annually, but even faster (6.1%) in the most recent decade. The incidence of penile cancer is high, and has increased significantly (3.8% per year), while there was no change in the incidence of testicular cancer. Bladder cancer has shown significant declines in incidence in both sexes (1.9% annually in males, 3.8% in females). There has been little change in the histological composition of the bladder cancer cases in the last 25 years, with transitional cell carcinomas comprising some 50-60% of cancers. While some of these trends are related to population-level changes in lifestyles, and exposure to environmental factors (such as HPV), the reasons for other changes in incidence are more obscure. Some may be in part due to improvements in diagnostic techniques (endoscopy and imaging), but others-e.g. bladder-merit further investigation.
31. Occurrence and environmental fate/behaviors of tire wear particles and their human and ecological health: an emerging global issue.
期刊: Archives of toxicology 发表日期: 2025-Aug-16 链接: PubMed
摘要
Rapid societal and urban development has driven a surge in tire production, generating tire wear particles (TWPs), a pervasive environmental pollutant. Upon environmental release, TWPs interact with physio-chemical factors, altering their fate and amplifying toxicity. Available evidence indicates that TWPs mainly enter the organism body through inhalation and dermal contact. Toxicokinetic studies reveal that TWPs and additives penetrate biological barriers, accumulating in the liver and metabolizing via P450 enzymes, producing detoxified compounds or more toxic derivatives like N-(1,3-dimethylbutyl)-N’-phenyl-p-phenylenediamine-quinone(6PPD-q). Currently, the adverse ecological and health effects have gained increasingly public concerns. A series of advances have been achieved to address their ecological and human risks across aquatic, terrestrial, and mammal models, even at population level. Their toxicological effects span across respiratory diseases, metabolic disorders, and reproductive toxicology. Considering the challenges arising from the large-scale production and mismanagement of TWPs, this review synthesizes the latest knowledge on their generation, environmental fate, toxicokinetic, and ecological and human health effects. However, critical gaps remain in long-term low-dose effects, cross-generational toxicity, and biomarker validation. This review highlights the urgent need for global regulatory frameworks and interdisciplinary strategies to mitigate the cascading ecological and health impacts originated from TWPs.
32. Dissolved oxygen-driven transformations of inorganic sulfur and heavy metals during mariculture sediment aging.
期刊: Environmental geochemistry and health 发表日期: 2025-Aug-16 链接: PubMed
摘要
Dissolved oxygen (DO) critically regulates biogeochemical processes in mariculture sediments, yet its integrated effects on sulfur-metal interactions during sediment aging remain poorly understood. This study investigated the migration and transformation of reduced inorganic sulfur (RIS) and heavy metals in mariculture sediments under varying DO levels. Lower DO accelerated the dominance of acid-volatile sulfide (AVS) within the reduced inorganic sulfur pool (AVS/RIS = 56.11% under DO-1 vs. 41.18% under DO-3) and shortened the time required for AVS to become the dominant component by 16.67% (compared to DO-3). DO variations minimally affected overall metal mobility (coefficient of variation, CV < 12%), but Cu exhibited exceptional sensitivity. The influence of DO concentration was particularly significant on the oxidizable (F3) and residual (F4) fractions of Cu, and the F4 fraction of Pb. The F4 fraction of both Cu and Pb increased under low DO, likely due to reductive activation and lattice diffusion. The differing impacts of DO on RIS (significant) versus heavy metal speciation (relatively minor) resulted in significant variations in the correlations between sulfur species and heavy metal fractions across DO treatments. Sediment microbial richness and diversity declined with decreasing DO, significantly altering the relative abundance of bacterial phyla and the genus Desulfuromonas. DO primarily regulated sediment carbon, sulfur, and iron cycling, exerting its most pronounced impacts on sulfur transformations. Depleted DO intensifies the environmental hazards of inorganic sulfides through enhanced mobilization. Proactive control strategies are therefore imperative during hypoxic episodes to mitigate sulfide-driven ecological risks. This study provides new insights for managing sediment redox conditions in mariculture systems.
33. "We Have to Evict Certain People Sometimes": A Descriptive Mixed-Methods Study of Service Providers' Perceptions of the Impacts of High-Risk Issues in Supportive Housing and Housing First.
期刊: Community mental health journal 发表日期: 2025-Aug-16 链接: PubMed
摘要
High-risk issues, such as overdose, suicidality, hoarding, violence, property damage, and apartment takeovers, are known challenges in supportive housing and Housing First programs. However, the effects of these incidents on residents, service providers, and programs have been minimally studied. The objective of this mixed-methods study was to understand what service providers perceived as the impacts of various high-risk issues in supportive housing and Housing First programs, with an emphasis on housing tenure. This descriptive study used an exploratory sequential mixed-methods design, with unequal weighting (QUAL→quan). In-depth interviews were held with 32 service providers working in supportive housing and Housing First programs, followed by an online survey of 202 additional service providers across Canada. In the qualitative dataset, high-risk issues were identified as having three types of potentially harmful impacts: [1] “we have to evict certain people sometimes” (residents’ housing stability); [2] “we’re exposed to these traumas as well” (service providers’ mental health); and [3] “we’re losing our stock, basically” (organizational relationships with landlords and access to housing units). Convergence was generally found in the quantitative findings, with high-risk issues affecting other individuals and property being perceived as more likely to cause housing loss. Service providers working in scattered-site programs reported that hoarding, overdose, and apartment takeovers were significantly more likely to cause housing loss than did participants of single-site programs. Overall, study findings underscore how high-risk issues, particularly those affecting others and property, can be potential housing trajectory-altering events and that this is further shaped by housing and support models.
34. Upper Extremity Motor Performance During a Shirt Buttoning Task in Huntington's Disease.
期刊: OTJR : occupation, participation and health 发表日期: 2025-Aug-16 链接: PubMed
摘要
Motor impairment in Huntington’s Disease (HD) includes chorea, bradykinesia, dystonia, and rigidity, causing Upper extremity (UE) impairments in daily activities. Describe motor patterns and analyze execution times for buttoning a shirt in premanifest and manifest-HD versus controls; explore the relationship between clinical assessments and UE motor performance and assess interobserver reliability of the motor pattern coding system. Cross-sectional observational study with 30 manifest-HD, 9 premanifest-HD, and 30 controls from Burgos University Hospital, Spain. Participants buttoned a five-button shirt and time spent and motor patterns were analyzed using Observer-XT-software. Significant differences were found in movement time and motor patterns between groups. Manifest-HD took nearly twice as long as controls to complete the task. Correlations were found with clinical assessments. Degree of interobserver agreement was excellent. Evaluating motor patterns helps in early detection of motor impairment, monitoring disease progression, and developing rehabilitation programs to maintain and improve UE function. How Huntington’s Disease affects upper limb movements and impact on quality of life, motor, cognitive, and psychiatric symptoms when buttoning a shirtThe research aims to explore motor patterns and execution times during buttoning a shirt in people with Huntington’s Disease (HD) at different stages (premanifest-HD and manifest-HD) compared to controls. Premanifest-HD is the stage before noticeable symptoms appear, while manifest-HD is when symptoms become noticeable (involuntary movements, difficulty with coordination, changes in thinking . . .). The disease progresses over time, and symptoms become more severe. The primary research question is: How do motor patterns and execution times differ between individuals with HD (premanifest and manifest) and controls? The hypothesis is that individuals with manifest-HD will exhibit significantly impaired motor patterns and longer execution times compared to controls. The study hopes to uncover early indicators of motor decline and provide insights for developing targeted rehabilitation programs. This research is crucial because motor impairments in HD, such as chorea, bradykinesia, dystonia, and rigidity, significantly impact the quality of life and independence of individuals. HD is a progressive neurodegenerative disorder, and understanding these impairments can lead to better management and treatment strategies. HD affects approximately 5–10 per 100,000 people worldwide. This research impacts not only individuals with HD but also their families, caregivers, and health care systems. The study employed an observational cross-sectional design, ideal for comparing different groups at a single point in time. It provides a snapshot of the differences in motor function between individuals with manifest-HD, premanifest-HD, and healthy controls. Key variables included the time taken to button a five-button shirt and the motor patterns used during the task. Participants included 30 individuals with manifest-HD, 9 with premanifest-HD, and 30 healthy controls. The use of Observer-XT software ensured precise and objective measurement of the variables.
35. Correction to: Notable differences in changes between ventral and dorsolateral spinal longitudinal extradural CSF collection after treatment in patients with spontaneous spinal CSF leaks.
期刊: Neurosurgical review 发表日期: 2025-Aug-16 链接: PubMed
摘要
36. NEST: Not even a safe territory; The uncertainty overshadowing women seeking asylum during their maternity care, in Australia.
期刊: Women and birth : journal of the Australian College of Midwives 发表日期: 2025-Aug-15 链接: PubMed
摘要
Asylum seekers and undocumented migrants are a distinct group with different needs from refugees or migrants. This research focuses on the experiences of women seeking asylum in Australia during pregnancy, labour, and the postnatal period. This study is derived from a larger Ph.D. study that explored the maternity care experiences of women who seek asylum and the midwives and doulas who care for them in Australia. This paper focuses on the maternity care experiences of women seeking asylum, enriched by further insights from midwives and doulas about the women’s access to care. Qualitative research was conducted using a phenomenological approach to explore the maternity care experiences of women seeking asylum and undocumented migrants. Data were collected via in-depth semi-structured interviews with ten women seeking asylum and three undocumented migrants and 17 midwives and nine doulas. The overarching concept of this paper is Living with uncertainty. Four themes explore the adversities faced by women seeking asylum, including, ‘The detrimental effects of detention’, ‘Financial constraints due to payment difficulties’, ‘The absence of family and friends’, and ‘Women’s resilience in overcoming these challenges’. Organisational and systemic changes are needed to address the challenges of identifying women seeking asylum and improve access to maternity care for these disadvantaged women. This study provides some important insights into the challenges faced by women seeking asylum in accessing quality maternity care and highlights the need for potential changes in policy and service provision to provide appropriate support. Social, emotional, financial and practical support are important factors that should be addressed to overcome these challenges. Further research is necessary to design and implement changes to current maternity models.
37. A study of the relationship and drivers between participation in sports program diversity and physical fitness.
期刊: Scientific reports 发表日期: 2025-Aug-15 链接: PubMed
摘要
Leisure-time physical activity has changed over the past few decades. Participation in diverse sports programs by children and adolescents is more conducive to increasing physical activity levels and promoting individual health. The purpose of this study was to explore the correlation between adherence to participation in diversity of sports programs and physical fitness among children and adolescents, in addition to analyzing individual attitudinal, family, and school dimensional factors that influence children’s and adolescents’ participation in diversity of sports programs. This study included cross-sectional data from 3309 child adolescents. Next, physical fitness indicators were also included. The study used Pearson correlation analysis, one-way ANOVA, and linear regression. Pearson correlation and one-way ANOVA were used to explore the correlation between diversity and physical fitness in participating sports and the differences in physical fitness between different sports groups. In addition, the linear regression method was used to analyze the impact of diversity on physical fitness. Finally, ordinal logistic regression was used to analyze the influencing factors of diversity in participating sports programs.Significant correlations were observed between diversity of participation in sports programs and various physical fitness indicators across all age groups, including muscular strength, speed, endurance, and flexibility (p < 0.01). Additionally, physical fitness levels significantly differed among groups with different numbers of sports participation (p < 0.05).Furthermore, misconceptions about physical activity were identified as a negative factor influencing sports program diversity (β = -0.193, p < 0.01), whereas willingness to consistently engage in physical activity was a strong positive predictor (β = 0.494, p < 0.01). Longer screen time negatively affected sports program diversity (β = -0.047, p < 0.05), and difficulty completing school physical education requirements was also a limiting factor (β = -0.112, p < 0.05). In contrast, peer influence served as a positive factor promoting sports program diversity (β = 0.071, p < 0.01).Conclusion: Greater diversity in sports program participation is associated with better physical fitness outcomes and contributes to overall health promotion in children and adolescents. Sustained participation in a variety of sports programs requires broader social support, especially from families and peers, which may enable more youth to remain engaged in diverse physical activities. Participation in diverse sports programs can bring lasting benefits and is recognized as a key element of a healthy lifestyle. Therefore, more targeted strategies are needed to increase participation in both diverse sports programs and general physical activity among youth.
38. Exploring the social representations of breastfeeding among mothers and grandmothers in Uruguay using word association.
期刊: International breastfeeding journal 发表日期: 2025-Aug-15 链接: PubMed
摘要
A comprehensive understanding of women lived experiences is crucial for developing effective strategies to support breastfeeding at both individual and systemic levels. In this context, this study aimed to explore the social representations of breastfeeding among Uruguayan mothers and grandmothers through a structural approach. A total of 154 women, 77 mothers and 77 grandmothers, biologically related, were recruited from eight public health centers in Montevideo, Uruguay, between June and August 2022. Participants completed a free word association task using the stimuli “breastfeeding” and “exclusive breastfeeding.” Interviews were conducted by trained researchers via telephone, and participants were asked to provide 3-5 associations per term. Responses were analyzed using structural analysis with openEvoc software to identify core and peripheral elements of the social representations. “Love” emerged as the central element in the social representations of both breastfeeding and exclusive breastfeeding for mothers and grandmothers, highlighting the emotional and symbolic importance of breastfeeding across generations. Among mothers, representations were emotionally rich and experientially grounded, with frequent references to “baby,” “affection,” “attachment,” and health-related benefits. Mothers also acknowledged challenges such as “pain” and “tiredness.” In contrast, grandmothers’ representations were more heterogeneous and less detailed, especially for exclusive breastfeeding, which lacked a clear structure. Grandmothers frequently used normative or moral terms such as “correct,” “essential,” and “nutrition,” and showed limited familiarity with exclusive breastfeeding as a defined concept. Health-related benefits were present in peripheral areas for both groups, while references to the mother’s well-being were largely absent. The findings highlight intergenerational continuity in the emotional anchoring of breastfeeding but reveal differences in knowledge and cognitive engagement, particularly concerning exclusive breastfeeding. While mothers integrate biomedical and experiential dimensions, grandmothers rely more on traditional values. These results underscore the need for generationally tailored communication strategies that acknowledge emotional and practical experiences and actively involve grandmothers in breastfeeding promotion efforts to strengthen intergenerational support for optimal breastfeeding practices.
39. "Impact of health promotion practices on health-related quality of life (HRQoL) among geriatric population in Karachi, Pakistan".
期刊: BMC public health 发表日期: 2025-Aug-15 链接: PubMed
摘要
Demographic transition has resulted in increased life expectancy among older adults that will lead to the emergence of new illnesses, long-term impairments, and alterations in social attitudes. The need to prioritize actions for this population, with a focus on enhancing the quality of life, fostering autonomy and independence, and promoting active and healthy aging, has made health education for the elderly a topic of global interest due to current demographic and epidemiological changes. The purpose of the study is to assess the impact of health promotion on enhancing health-related quality of life among elderly people in Karachi, Pakistan. Data was collected at a Senior Citizen & Recreation center, located near the participants’ residence in Karachi, Pakistan. A well-structured generic HRQoL instrument (SF-36) short form was used because it has demonstrated strong reliability and validity among the elderly population, making it a suitable tool for assessing quality of life outcomes. One-group pre-test and post-test interventional (Quasi-experimental) research design using a mixed method approach (Qualitative and Quantitative). Inferential statistics are drawn through paired sample t-test to compare the mean of pre-test HRQoL scores with post-test HRQoL scores. The qualitative analysis was made through a thematic categorical method. Revealed significant impact of health-promoting activities on 3 sub-scales of HRQoL. However, on other subscales of HRQoL, health-promoting interventions produced little impact. Health promotion can play a significant role in improving health-related quality of life.
40. Deprescribing drugs with anticholinergic effects in older patients with increased risk of dementia in the multicomponent intervention study AgeWell.de.
期刊: British journal of clinical pharmacology 发表日期: 2025-Aug-15 链接: PubMed
摘要
Drugs with anticholinergic effects are often considered as potentially inappropriate medications, especially for older patients, and deprescribing such drugs may improve cognitive function. The aim was to investigate the effectiveness of counselling on drug risks as part of a multimodal intervention to prevent cognitive decline. The AgeWell.de study, a multi-centre, cluster-randomized controlled study, was conducted in 123 German general practices between June 2018 and January 2022. The study included a multicomponent intervention programme for patients at increased risk of dementia, delivered over a 2-year period. As part of the medication optimisation intervention, patient data and medication records were screened to identify medication risks and provide recommendations to general practitioners. In total, 808 patients with complete data were included in the present analysis (intervention group = 374, control group = 434). At baseline, 132 (16.8%) patients had at least one anticholinergic prescription. After 2 years, approximately one-third of these patients no longer received drugs with anticholinergic effects. There were no significant differences between the intervention and control groups, with 67.6% and 72.1%, respectively, continuing to take drugs with anticholinergic effects (P = 0.57). Patients reported anticholinergic symptoms more frequently when taking any medication (5.0% vs 33.8%), and even more so when taking drugs with anticholinergic effects (56.1%). Deprescribing of all drugs with anticholinergic effects was non-significantly higher in patients who reported at least one anticholinergic symptom compared to patients without any anticholinergic symptoms (58.6% vs 54.1%). The medication optimisation intervention did not entail significant differences in anticholinergic deprescribing between the groups.
41. Leveraging Pharmacy Education through a Train-the-Trainer Model to Enhance Breast Cancer Literacy in Rural Communities.
期刊: Journal of cancer education : the official journal of the American Association for Cancer Education 发表日期: 2025-Aug-15 链接: PubMed
摘要
Rural versus urban communities experience disproportionate challenges in breast cancer outcomes, with higher breast cancer mortality and later stage disease presentation, despite similar diagnosis rates. These disparities are driven by structural barriers, including rural hospital closures, transportation difficulties, and limited access to oncology specialists. This study evaluated a train-the-trainer program designed to equip PharmD students located at a pharmacy school in a rural county in South Carolina with breast cancer education training, leveraging the pharmacists’ position as accessible healthcare professionals in rural communities. Training focused on breast cancer risk factors, prevention, screening, genetics, staging, and treatment options. Effectiveness was measured through pre- and post-workshop confidence surveys and knowledge assessments. Results showed significant improvement in student confidence across educational domains, with average scores increasing from 6.30 to 8.59 (p < 0.0001). Understanding of screening guidelines (mean difference: 4.30; p-value: < .0001) and target therapy options showed the greatest improvement (mean difference: 3.65; p-value: < .0001), while knowledge of BRCA gene inheritance showed the smallest change (mean difference: 0.369; p-value: ns), suggesting some pre-existing awareness but limited understanding of its clinical applications. Overall, this pilot program demonstrates how pharmacy education can address healthcare disparities in rural communities. By preparing pharmacists to deliver accurate breast cancer education and to increase rural patient agency, this model creates a sustainable approach to improving health literacy in medically underserved areas. Future research could further expand this model to include diverse healthcare professionals and incorporate long-term impact assessments in community settings.
42. Ambulance professionals' adaptations in prehospital services: a critical incident study.
期刊: BMC emergency medicine 发表日期: 2025-Aug-15 链接: PubMed
摘要
The working environment for ambulance professionals in prehospital services is complex, dynamic, and associated with a high degree of unpredictability. It is therefore essential that ambulance professionals adapt to provide high-quality and safe care, yet the research literature on how they successfully adapt in their everyday work remains sparse. The aim of this study is to address this knowledge gap by exploring adaptations in the context of prehospital services, through ambulance professionals’ descriptions of successful missions. A qualitative descriptive study was conducted using the Critical Incident Technique methodology for data collection and analysis, the latter through the processes of re-storying and cross-incident analysis. Twenty semi-structured individual interviews were conducted between October 2023 and May 2024 with ambulance professionals, including licensed ambulance medical technicians and paramedics with dual licensing or other additional medical licenses across four ambulance stations in Norway with contrasting geographical locations. A wide range of successful adaptations were described by the ambulance professionals and grouped into seven core themes: (1) Adaptations in mission planning; (2) Practical adaptations; (3) Time-critical adaptations; (4) Personal adaptations; (5) Task-focused adaptations; (6) Adaptations in stakeholder coordination; (7) Adapting to patients and informal caregivers. This study provides insight and new knowledge about successful adaptations in prehospital services and illuminates the variety of adaptations ambulance professionals make in different contexts. Trust is an underlying feature for successful adaptations, while communication is the overall predominant feature, especially vital in stakeholder coordination and decision-making processes impacting team efforts and mission efficiency. Further research should provide insight into cross-occupational and cross-stakeholder collaborative processes.
43. Lead bioaccumulation in human breast cancer tissue is associated with DNA instability and cell death resistance.
期刊: Cell death discovery 发表日期: 2025-Aug-15 链接: PubMed
摘要
Lead (Pb) is increasingly recognized for its potential to alter cellular processes and contribute to cancer development. Although Pb is classified as a probable carcinogen by the IARC, the clinical evidence for its role in breast cancer is inconsistent and limited to epidemiological studies yet. The aim of this study was to investigate the Pb bioaccumulation in human breast cancer tissues by correlating its concentration with specific cancer factors related to carcinogenesis. Biopsy samples from 26 breast cancer patients were collected for molecular investigations (DNA and RNA sequencing), histological analysis, and the assessment of Pb concentration by ICP-MS. Data reported here revealed Pb bioaccumulation in all breast cancer samples, with a significant positive correlation between Pb levels and both Tumoral Mutational Burden and Microsatellite Instability, suggesting an association of Pb with genomic instability in human breast cancer samples. Additionally, Pb was associated with increased expression of cell death-related molecules such as BCL2 and p53. This association allows us to hypothesize a potential involvement of Pb in affecting cell death resistance. Interestingly, Pb concentration showed no correlation to other established prognostic and predictive biomarkers of breast cancer, such as PAM50. Thus, Pb concentration may represent a new independent risk factor for breast cancer development. This study provides new insights into the role of Pb bioaccumulation in breast cancer and suggests that environmental exposure to Pb may contribute to more aggressive tumor behavior through mechanisms involving genomic instability and resistance to apoptosis.
44. Prevalence of human West Nile Virus infections in Iran: A systematic review and meta-analysis.
期刊: Journal of vector borne diseases 发表日期: 2025-Aug-14 链接: PubMed
摘要
The current systematic review and meta-analysis aims to estimate the prevalence of West Nile Virus (WNV) among humans in Iran. A comprehensive search was conducted in national databases, including SID, Magiran, and Barekat knowledge network and international databases, including Web of Science, MEDLINE, Embase, and Scopus, to identify the articles on the prevalence of human WNV in Iran. A random-effects model was used to assess the pooled prevalence. A meta-regression method was applied to determine the factors affecting the heterogeneity among the studied population. An analysis was performed on 11 studies with a total sample size of 3747. The total pooled estimate for the prevalence of human WNV was 14.92% (95% CI: 9.13 to 20.71). The highest pooled prevalence was in Khuzestan (southwest Iran) (58.31%; 95% CI: 21.12 to 90.82), and the lowest were in East Azerbaijan (Central Iran) (0.0%; 95% CI: 0.0 to 7.11) and Mazandaran (north Iran) (0.0%; 95% CI: 0.0 to 1.69), respectively. Based on the results of the univariate meta-regression, province (b: 0.35; p < 0.001) showed a significant direct association with the prevalence of human WNV, but other variables, including detection method, study population, publication year, and sample size, had no association with the prevalence of human WNV. The percentage of positive cases in serum samples shows that the WNV spreads in Iran.
45. Age-stratified analysis of the outcomes of craniotomy versus minimally invasive surgery in patients with spontaneous intracerebral hemorrhage.
期刊: Journal of the Formosan Medical Association = Taiwan yi zhi 发表日期: 2025-Aug-14 链接: PubMed
摘要
Spontaneous intracerebral hemorrhage (ICH) results in severe neurological deficits. Currently, the primary surgical interventions for ICH are traditional craniotomy and minimally invasive surgery (MIS). This study was conducted to compare surgical outcomes between craniotomy and MIS in age-stratified patients. This retrospective study included patients with spontaneous ICH undergoing craniotomy or MIS between January 2013 and December 2018. The diagnosis of ICH was confirmed by head computed tomography. We included patients with ICH in the subcortical, putamen, or thalamic region with volume >15 mL. We excluded patients with secondary ICH due to tumors or vascular lesions, those with coagulopathy and using anticoagulants. The selected patients were stratified by age into younger (<65 years) and older (≥65 years) groups. The study cohort comprised 169 patients. The younger and older groups included 105 (62 %) and 64 (38 %) patients, respectively. Craniotomy and MIS were performed in 55 and 50 patients in the younger and 37 and 27 patients in the older group, respectively. Between-group comparisons revealed significant age-based differences in Glasgow Coma Scale (GCS) scores 1 and 6 months after surgery (p = 0.0067 and p = 0.0001) and Glasgow Outcome Scale (GOS) scores 6 months after surgery (p = 0.0372). In the older group, 6-month GOS scores were significantly lower for patients undergoing craniotomy (p = 0.0332). Hemorrhagic stroke carries high risks of mortality and morbidity. Age is a crucial factor that influences recovery. MIS yields favorable outcomes and should be prioritized for spontaneous ICH, particularly older patients.
46. Accelerated Biological Aging, Genetic Predisposition, and Incident Valvular Heart Disease.
期刊: JACC. Asia 发表日期: 2025-Aug-13 链接: PubMed
摘要
The association between biological aging and valvular heart disease (VHD) has not yet been evaluated. This study aimed to evaluate the associations between 2 biological age indicators, Klemera-Doubal method biological age (KDM-BA) acceleration and PhenoAge acceleration, and the risk of VHD, as well as explore the potential gene-environment interplay. The study included 341,460 UK Biobank participants without VHD at enrollment. Biological age was assessed using KDM-BA and PhenoAge methods. Genetic risk was measured by genome-wide-association study-based polygenic risk scores (PRS). Cox models were used to assess the individual and joint effects of biological age and PRS on incident VHD. Both multiplicative and additive interactions between the 2 factors were also estimated. During a median follow-up of 13.58 years (Q1-Q3: 12.83-14.25 years), 8,146 VHD cases were documented. The results showed a significant association between older biological age and an increased risk of VHD, with a HR of 1.35 (95% CI: 1.32-1.38) for each 1-SD increase in KDM-BA acceleration, and 1.29 (95% CI: 1.26-1.32) for PhenoAge acceleration. Compared with individuals in the first quartile group (Q1) for KDM-BA acceleration, those in Q4 showed the highest risk of VHD, with an 86% higher risk (HR: 1.86; 95% CI: 1.74-1.99). There was an additive interaction between KDM-BA acceleration and PRS for VHD. Similar results were found for the association between PhenoAge acceleration and VHD. Advanced biological aging was significantly associated with an increased risk of VHD and could serve as a potential target for clinical prediction and intervention.
47. Association between serum metal levels and NLRP3 gene polymorphisms with cognitive function in aluminum workers: A combined epidemiological and genetic study.
期刊: Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS) 发表日期: 2025-Aug-12 链接: PubMed
摘要
Metals, genes, and cognitive function are closely related. This study evaluated serum metal levels, NLRP3 gene polymorphisms, and their association with cognitive function in aluminum workers. A cross-sectional survey was conducted with 478 aluminum workers. Serum metal levels were measured using Inductively Coupled Plasma Mass Spectrometry (ICP-MS), and cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale. Generalized Linear Models (GLM), Least absolute shrinkage and selection operator (Lasso) regression, Bayesian Kernel Machine Regression (BKMR), and Weighted Quantile Sum (WQS) were used to analyze the relationship between metal exposure, cognitive function, and the interaction with NLRP3 gene polymorphisms. Zinc (Zn) levels were positively associated with MoCA scores (β= 4.73, 95 % CI: 0.54, 8.92). A metal mixture (Na, Zn, Co, Mo, Ti, Sr, Ba) below the 60th percentile also showed a positive correlation with MoCA scores. The NLRP3 rs3806265C/C and rs4612666C/T and T/T genotypes were negatively associated with MoCA scores (β= -0.91, 95 % CI: -1.64, -0.17; β= -0.61, 95 % CI: -1.19, -0.02; β= -0.86, 95 % CI: -1.62, -0.10). In individuals with the C/T genotype of rs3806265 and rs4612666, Zn was positively associated with MoCA scores (β= 5.99, 95 % CI: 0.60, 11.38; β= 6.46, 95 % CI: 0.80, 12.12). Decreased serum Zn levels may increase cognitive dysfunction risk. Individuals carrying the NLRP3 rs3806265C/C and rs4612666C/T or T/T more susceptible to cognitive decline. Individuals carrying the rs3806265C/T and rs4612666C/T genotypes are more likely to cause cognitive decline in the presence of Zn deficiency.
48. Blood transcriptome changes linked to long-term arsenic exposure through drinking water - a cross-sectional study from the Bolivian Andes.
期刊: Environment international 发表日期: 2025-Aug-12 链接: PubMed
摘要
Chronic exposure to inorganic arsenic (As) in drinking water is a serious health concern but people differ in susceptibility. Naturally occurring As in Bolivian drinking water was recently reported, however, its long-term effects on the blood transcriptome remain unexplored. To bridge this gap, we conducted a transcriptome-wide analysis of whole blood cells from individuals in the Bolivian Andes. Blood and urine samples were collected for transcriptomic analysis, genotyping of AS3MT polymorphisms, and measurements of inorganic As metabolites in urine. Linear regression models were employed for extracting As-associated genes, and cell deconvolution to estimate cell fractions from the transcriptome. Functional annotations of the As-associated genes were performed using Ingenuity Pathway Analysis (IPA) and ClusterProfiler. Protein-protein interaction analysis was conducted to identify networks between As-associated genes. A total of 588 genes were identified from linear regression analysis and associated with downregulation of autophagy-related functions and a reduction in activated NK cells. Stratification by gender showed a significant enrichment of pathways related to carcinogenesis, oxidative stress, glucose metabolism, and epigenetic regulation in females, e.g., PI3K/AKT/MTOR signaling, HIF-1 signaling, insulin receptor signaling, and microRNA biogenesis pathway. Carriers of the AS3MT genotypes associated with a poorer As metabolism showed enrichment in DNA replication and cell proliferation, whereas carriers of the genotype associated with an efficient As metabolism showed suppression of autophagy and DNA damage pathways. Our data indicate the importance of the autophagy pathway in relation to As exposure, and its crosstalk with PI3K/AKT/mTOR and miRNA biogenesis, providing new insights into the biological pathway under As exposure. Overall, this study identified novel genome-wide changes in blood mRNA in response to long-term As exposure in Bolivia, an underrepresented population, laying groundwork for further study.
49. Exposure assessment of PAHs on duplicate diet, indoor dust, and air measurements, and comparison with urinary biomonitoring: a family-based panel (CAFE-P) study.
期刊: Environment international 发表日期: 2025-Aug-11 链接: PubMed
摘要
Polycyclic aromatic hydrocarbons (PAHs) are products of the incomplete combustion of organic materials. Understanding the major sources of PAH exposure and quantifying their contribution in the general population remains limited and fragmented. In the present study, we recruited a panel of families (48 households, 124 participants) and assessed their PAH exposure across three separate seasons through measurement of indoor air, dust, duplicate diets, and urinary biomarkers. Among the general population, oral dietary intake was identified as the primary contributor to PAH exposure, accounting for an average of 97.8 % of the total exposure. Inhalation exposure from indoor air contributed minimally (1.8 % for the median exposure group), but increased to 5.3 % among the high exposure group (upper 10th percentile). Approximately 32 % of the participants exhibited a potential cancer risk, primarily due to inhalation of NaP (45.3 %) and dietary ingestion of BaP (45.5 %) and DahA (8.1 %). Estimated daily intakes (EDIs) derived from urinary biomonitoring were up to two orders of magnitude higher than the total EDI calculated based on exposure scenarios, suggesting that EDIs based on the urinary metabolite levels may be exaggerated and subject to significant uncertainties.
50. Apolipoprotein CIII in statin-treated type 2 diabetic patients: Its implications for plaque progression and instability: The pre-specified analysis from the OPTIMAL randomized controlled trial.
期刊: Atherosclerosis 发表日期: 2025-Aug-07 链接: PubMed
摘要
Apolipoprotein CIII (ApoCIII) has a variety of proatherogenic properties. Given that hyperglycemia induces ApoCIII transcription, this apolipoprotein may promote coronary atherosclerosis in type 2 diabetic patients. We aimed to elucidate whether ApoCIII affects plaque progression and instability in statin-treated type 2 diabetic patients. The OPTIMAL study was a prospective randomized controlled trial that employed serial NIRS/IVUS imaging to evaluate the efficacy of glycemic control on coronary atherosclerosis in 94 statin-treated type 2 diabetic patients (UMIN000036721). Of these, 78 patients with both ApoCIII levels and NIRS/IVUS images at baseline and week 48 were analyzed. Any increase in ApoCIII levels at week 48 was observed in 47.4 % of study participants. On-treatment LDL-C levels did not differ among participants with and without any increase in ApoCIII levels (1.76 ± 0.55 vs. 1.74 ± 0.55 mmol/L, p = 0.91). Serial changes in IVUS-derived atheroma volume were similar between two groups (-0.7 ± 2.2 vs. -2.4 ± 1.6 mm3, p = 0.51). However, greater progression in NIRS-derived maxLCBI4mm was observed in those with any increase in ApoCIII levels (91.2 ± 24.8 vs. -44.2 ± 23.5, p < 0.001). Even after adjusting for clinical characteristics, maxLCBI4mm in participants with any increase in ApoCIII levels still progressed (87.0 ± 24.9 vs. -44.2 ± 23.5, p < 0.001). Moreover, maxLCBI4mm less likely regressed in patients with any increase in ApoCIII levels (16.2 vs. 80.5 %, p < 0.001). Even in those achieving on-treatment LDL-C<1.4 mmol/L, maxLCBI4mm progressed in association with any increase in ApoCIII levels. Circulating ApoCIII promoted the accumulation of lipidic plaque components in statin-treated type 2 diabetic patient, suggesting ApoCIII as a residual risk that requires therapeutic intervention.
51. A phenomenological exploration of registered nurse degree apprentices' lived experiences.
期刊: British journal of nursing (Mark Allen Publishing) 发表日期: 2025-Aug-07 链接: PubMed
摘要
This qualitative study examines the mental health and wellbeing of registered nurse degree apprenticeship (RNDA) students across their 3-year programme. Using interpretative phenomenological analysis on interviews with three RNDA students, the study identifies distinct stressors, coping strategies and support structures affecting mental health. Findings reveal unique pressures from balancing academic and clinical roles, with themes including exhaustion from academic demands, programme design challenges, support network limitations, and role ambiguity. Recommendations for enhanced support systems and policy adjustments are offered to improve RNDA students’ mental health and educational experiences.
52. Urinary biomarker-based seasonal mycotoxin exposure assessment in rural resident populations of North-central Nigeria.
期刊: Environment international 发表日期: 2025-Aug-06 链接: PubMed
摘要
The concentrations of mycotoxins and their metabolites in adult first morning void urine (n = 286) from agricultural populations in two north-central Nigerian states (Nasarawa and Niger) across harvest and storage seasons were assessed using LC-MS/MS. In total, 97 % of the urine contained at least one mycotoxin; with 10 distinct mycotoxins quantified. Ochratoxin A (OTA) was the most frequently occurring (86 %), while aflatoxin M1 (AFM1) and fumonisin B1 (FB1) were quantified in 40 % and 71 % of the urine, at median concentrations of 0.2 and 11 µg/g creatinine, respectively. Other detected mycotoxins/metabolites were dihydrocitrinone (60 %), zearalenone (ZEN) (58 %), citrinin (37 %), nivalenol (14 %), deoxynivalenol (5 %), α-zearalenol (3 %) and β-zearalenol (1.4 %). Median urinary AFM1, citrinins, OTA and ZEN levels were significantly higher (p < 0.05) in Nasarawa than in Niger. Urine from Nasarawa and at the harvest season contained more diverse mycotoxin classes than urine from Niger and at the storage season, respectively. Only three mycotoxin classes (aflatoxins, citrinins and fumonisins) showed significant seasonal variations, with higher urinary levels during harvest than at storage in Nasarawa. In Niger state, citrinins were mostly higher in urine during storage compared to harvest season, whereas urinary FB1 was higher at harvest compared to storage. Margin of exposure calculations indicated a risk of chronic exposure to aflatoxin B1 (AFB1) (detected as AFM1 in urine) and OTA in both states and across seasons, while the estimated average probable daily intake values for CIT, FB1 and ZEN exceeded the EFSA established reference values in both states and across seasons. The results clearly demonstrate chronic exposure to (carcinogenic) mycotoxins and call for intensive efforts towards design and implementation of feasible mitigation actions to reduce mycotoxin exposures and prevent potential health risks in the long-term in the affected region.
53. Dementia friendly communities: A concept analysis.
期刊: Archives of psychiatric nursing 发表日期: 2025-Aug 链接: PubMed
摘要
To conceptualize the concept of dementia friendly communities. Walker and Avant’s method of concept analysis was used to identify the concept, antecedents, attributes and consequences of dementia friendly communities. Four dimensions of dementia friendly communities’ attributes were identified around target population, social life involvement, socio-cultural environment, living space and physical environment. Antecedents of dementia friendly communities were reduced physical and mental health, increased stigma and social isolation of people with dementia and caregivers, required dementia-supportive physical environment and mismatch between supply and demand of care resources. Consequences of dementia friendly communities were increased personal empowerment, reduced financial burden, promotion of dementia inclusion and healthy aging. The result of the analysis provided a clearer definition of dementia friendly communities, which can be further tested and used to develop guide future research and interventions.
54. Sense of coherence as a mediator in the relationship between belonging and suicide tendency in nursing students.
期刊: Archives of psychiatric nursing 发表日期: 2025-Aug 链接: PubMed
摘要
This study was conducted to examine the mediating role of a sense of coherence in the relationship between belonging and suicide tendency in nursing students. Our descriptive and correlational study was conducted with 606 nursing students enrolled in a university, stratified randomly sampled by classes, between December 2022 and February 2023. The data were collected using the Characteristics Form, Sense of Coherence Scale, Belonging Scale, and Suicide Tendency Subscale. In our study, a negative statistically significant relationship was found between the mean scores of the Sense of Coherence and Belonging Scale and the mean scores of the Suicidal Tendency Subscale of nursing students. The mediating role of a sense of coherence in the relationship between belonging and suicide tendency was found to be at a high level. The Sense of Coherence and Belonging Scale explains 38.5 % of students’ suicide tendency scores. As a result of the study, it was determined that suicidal tendencies increased as students’ sense of belonging and sense of coherence scores decreased. In addition, it is seen that the development in the sense of coherence has a high level of mediation in both belonging and suicidal tendencies. These results reveal a need for studies to strengthen students’ sense of coherence in health protection and promotion practices in their educational and professional lives.
55. Educating staff on physical activity promotion in secure psychiatric care: the development of a self-determination theory informed intervention.
期刊: Archives of psychiatric nursing 发表日期: 2025-Aug 链接: PubMed
摘要
Healthcare assistants (HCAs) are well placed to promote physical activity (PA) in secure hospitals, though multiple barriers limit these opportunities. Using a Medical Research Council (MRC) commissioned framework, this study aimed to develop a self-determination theory (SDT) informed e-learning module for HCA’s. The development process included three phases. (1) a preparatory phase involved a scoping review, immersive fieldwork and 15 patient interviews. (2), a development phase involved establishing an intervention development team, selecting appropriate theory (SDT) and collecting pilot data (3) a user testing phase exploring intervention acceptability through a staff survey. The outputs from each phase informed the production of an e-learning educational module. The first section of the module incorporated information on: the importance of PA and consequences of prolonged inactivity in inpatient settings, benefits of PA in secure settings and the role of ward staff in PA promotion. The second section, underpinned by the tenets of SDT, outlined the three basic needs, highlighted the importance of these needs in motivating behaviour change and provided specific practical examples of how HCAs can adopt need supportive behaviours. The final section provided interactive case studies where HCAs identified strategies to meet patients individualised needs regarding PA engagement. Following preliminary testing, 71 % of staff reported changing PA promotion practices after the training. Following MRC guidelines on the development phase of an intervention allowed for exploration of both population and environmental considerations and provided a strategy to develop an intervention that can be integrated into routine care.
56. Hemiarthroplasty versus nonoperative treatment of comminuted proximal humeral fractures: results of the ProCon multicenter randomized clinical trial.
期刊: Injury 发表日期: 2025-Jul-19 链接: PubMed
摘要
The best treatment of comminuted, proximal humeral fractures in the elderly population is an unresolved clinical problem. This study aimed to compare the outcome of hemiarthroplasty (HA) and nonoperative treatment in the elderly population patients with a comminuted proximal humeral fracture. From October 6, 2009 to April 26, 2017, 57 elderly patients with a comminuted proximal humeral fracture were enrolled in the multicenter randomized controlled trial (RCT). Patients were randomized to HA or nonoperative treatment. Outcome measures were the Constant-Murley score (primary outcome), Disabilities of the Arm, Shoulder, and Hand, pain (Visual Analog Score), quality of life (Short Form-36 and EuroQoL-5D-3 L), complications, revision operation, health care consumption, and costs. Patients were followed for two years. Of the 57 patients included, 30 underwent treatment with HA and 27 were treated nonoperatively. Patients had a median age of 77 years, and 89 % was female. According to the Hertel classification, most fractures were type 7 (47 %) or type 12 (42 %). The median Constant-Murley score increased from 23 (95 % CI 17-29) at six weeks to 48 (95 % CI 41-53) at 24 months in the HA group, and from 24 (95 % CI 17-31) to 59 (95 % CI 52-65) in the nonoperative group. Throughout follow-up, scores were similar in both groups. The DASH score consistently decreased over time in both groups. At 24 months, median DASH scores were 24.0 (95 % CI 17.4-30.8) and 23.4 (95 % CI 16.5-30.4) in the HA and nonoperative group, respectively. Pain levels, SF-36, and EQ-5D were similar in both groups throughout follow-up. Eleven patients, of which seven in the HA group, developed one or more complications, of which six patients required surgical interventions. Total costs were higher for HA, although not statistically significant. Based on results of this RCT, primary hemiarthroplasty cannot be considered superior to nonoperative treatment for comminuted proximal humeral fractures in the elderly population. A trend favoring nonoperative treatment is observed in outcomes and in costs.
57. From Policy to Practice: A Qualitative Study on Reforms and Frontline Retention in Healthcare.
期刊: Inquiry : a journal of medical care organization, provision and financing 发表日期: 2025 链接: PubMed
摘要
In Canada, healthcare reforms typically aim to improve the quality of care and access while making healthcare systems more efficient. These reforms have led to a 2-level healthcare system consisting of provincial and regional health authorities (RHAs). RHAs are responsible for providing and administering health services within specific territories. One of the 2 language-based RHAs in New Brunswick (NB) operates in French-speaking rural minority communities. This study explored key factors affecting the retention of nurses and physicians within a RHA operating in a language minority context. This descriptive qualitative study explored how macro-level decisions are experienced on the frontlines. Data were collected through semi-structured interviews with 21 physicians and 37 registered nurses, as well as 2 focus groups involving 20 key informants in managerial roles. Thematic analysis was used to identify key themes. Three main factors emerged: organizational accountability and frustration, local autonomy and contextual responsiveness, and a culture of openness and perceived loss of control. These factors are associated with policy changes that affect operational settings and resource distribution within the RHA and influence the retention of nurses and physicians. Stakeholders in health system reforms, including governments and RHAs, must recognize that policy adjustments can have direct implications on everyday care. Participants expressed a growing disconnect from decision-making hierarchies and a perceived loss of control. Both are seen as barriers to delivering quality care. Ensuring adequate support and resources for implementing system-level changes is key to fostering professional engagement and enhancing job satisfaction.