公共卫生研究摘要 (2025-08-18)
共收录 54 篇研究文章
1. Dexamethasone conjugation to an Avidin-Nucleic-Acid-NanoASsembly eliminates the steroid plasma absorption, enhancing selective lung tropism in a murine model of pulmonary fibrosis.
期刊: Drug delivery 发表日期: 2025-Dec 链接: PubMed
摘要
Despite their anti-inflammatory activity, corticosteroids are limited in clinic due to poor selectivity and their side effects. The ability to cross biological barriers makes them powerful yet unspecific, leading to toxicity and a low therapeutic index that limits their chronic use in autoimmune, inflammatory, and infectious diseases. It is needed another approachfor innovative targeted delivery strategies. This study aimed at investigating if the dexamethasone conjugation to Avidin-Nucleic-Acid-NanoASsembly (ANANAS) could allow its selective lung release in the bleomycin-induced pulmonary fibrosis model. Since recent evidence showed a selective ANANAS accumulation in macrophage lysosomes in a liver fibrosis model, an acid-sensitive hydrazone linker was used to facilitate dexamethasone release into pulmonary macrophages, key players in lung fibrosis. Systemic ANANAS-Dex administration in healthy mice showed no dexamethasone release in plasma or peripheral organs, with delivery exclusively targeting the liver, independent of the health status. While this confirmed the nanocarrier safety, it underscored the influence of the administration route, rather than the disease state, on ANANAS-Dex tropism. The study on intranasal administration highlighted that: 1) free Dex circulates in the bloodstream, while ANANAS keeps the drug confined in the lungs; 2) ANANAS-Dex results in sustained drug release in the lungs, enhancing the lungs/plasma-peripheral organs ratio; 3) fibrotic mice exhibited prolonged kinetics and macrophage targeting. Based on the biodistribution and pharmacokinetics studies, it is possible to achieve controlled and safe steroid release in lung disorders, reducing systemic toxicity and potentially enhancing clinical compliance.
2. Addressing Burnout and Supporting Mental Health in Laboratory Medicine.
期刊: Clinics in laboratory medicine 发表日期: 2025-Sep 链接: PubMed
摘要
Burnout is an occupational phenomenon that has been shown to affect the mental health of laboratory staff. This has major impacts on the daily functions of the laboratory which in turn affects the functions of the health care system at large. Interventions to mitigate the effects of burnout should prioritize systemic changes. Individual interventions although helpful, generally do not address the root causes of burnout. From an organizational standpoint, addressing burnout is crucial, as burnout is associated with increased costs, decreased employee engagement, and decreased patient satisfaction.
3. Reimagining Macro Social Work to Advance Environmental Justice and Health Equity in the Climate Crisis.
期刊: Social work in public health 发表日期: 2025-Aug-17 链接: PubMed
摘要
The climate crisis, which is currently recognized as a “threat multiplier” by the United Nations, exacerbates health disparities, deepens structural inequities, and often disproportionately affects marginalized communities globally. While social work values maintain a commitment to social justice, dignity and worth of the person and integrity, macro-level interventions remain constrained by national and neoliberal paradigms. These limitthe profession’s capacity to address global and transnational challenges such as disaster capitalism, food insecurity, and the financialization and dispossession of essential resources. As the climate crisis deepens, macro social work should reconfigure its theoretical commitments and practical applications to center environmental justice and health equity. This paper discusses the limitations of macro social work in addressing climate-induced social and public health crises and proposes a reimagining of macro practice through intersectional and interdisciplinary lenses to interrogate the structural roots of these crises.
4. Conservative Protestantism and Penis Size: More Evidence Against the Theory of Evangelicalism and Phallocentric Masculine Insecurity.
期刊: Journal of religion and health 发表日期: 2025-Aug-17 链接: PubMed
摘要
We use national probability data from the 2023 Masculinity, Sexual Health, and Politics survey to test whether conservative Protestant men in the USA are (a) more dissatisfied with the appearance/size of their penises and (b) more likely to have attempted penis enlargement. Across all three outcomes, we failed to observe any theoretically meaningful differences. Although conservative Protestant men consistently report greater dissatisfaction with the appearance and size of their penises than men who affiliated with other religions (a mixed group including Jewish, Buddhist, and Muslim men, among others), there were no religious affiliation differences in penis enlargement behavior. Our analyses cast further doubt on the theory of evangelicalism and phallocentric masculine insecurity at the individual level.
5. Ankle-brachial index trajectory before death in patients receiving maintenance hemodialysis.
期刊: Clinical and experimental nephrology 发表日期: 2025-Aug-17 链接: PubMed
摘要
The trajectory of the ankle-brachial index (ABI) over time in relation to death has not been fully described in patients undergoing hemodialysis. We modeled ABI trajectory pattern before death in patients undergoing maintenance hemodialysis. Patients undergoing hemodialysis in a dialysis facility were retrospectively enrolled and categorized into two groups, deceased and surviving groups, based on their status at the end of the observation period. Linear mixed-effect model and a backward timescale from the year of death or study end date were used to compare ABI trajectory between the deceased and surviving groups during the observation period. A total of 442 patients (median age, 65 years; 60.2%, men) were included. During the observation period (median, 5.3 years; maximum, 8.5 years), 130 deaths were observed. Differences in ABI between the deceased and survivors were detected in the early stages (difference at 7 years before death, 0.08; p = 0.01), with the differences between these groups becoming more pronounced at 1 year before death (difference at 1 year before death, 0.11; p < 0.001). Differences in ABI trajectory between the deceased and survivors were detected from the early stages to just before death.
6. Federal health workforce policy in Australia and its implications: a descriptive policy document review.
期刊: The Medical journal of Australia 发表日期: 2025-Aug-17 链接: PubMed
摘要
To identify which federal health workforce policies are current in Australia, and describe their mode, scope, and focus. Descriptive policy document review; categorisation according to the Howlett-Ramesh policy instrument framework. Health workforce policy documents available on the Australian Department of Health and Aged Care website, 1 June - 31 October 2024. Primary policy focus (specific health profession, population group or location); scope of policy (alignment with one or more strategic domains: supply, distribution, or performance), service sectors affected by policy, substantive mention of specific health professions; policy instrument types. We included 121 policy documents in our analysis. By policy group, the number of documents was greatest for the rural health workforce (35), aged care (22), and Aboriginal and Torres Strait Islander health workforce (19); the numbers were lowest for pharmacy (three) and allied health (one), and none had public health or emergency care as their focus. Mixed policy instruments (multiple interest group programs, sub-programs, incentives, grants) were more numerous (98 documents) than government-led instruments (23 documents). Health workforce supply was a focus of 72 documents, performance of 57 documents, and distribution of 42 documents. Document nomenclature was inconsistent; 44 documents had policy labels that did not correspond to their content or purpose. We identified substantial fragmentation in Australian federal health workforce policy. The absence of a unified federal health workforce strategy exacerbates policy fragmentation, undermining coordinated workforce planning and equity. Adopting a consistent policy nomenclature and reducing imbalances in strategic focus are critical for effective health workforce reform. Our findings provide a baseline for analyses of policy processes and governance in Australian health workforce policymaking.
7. Coexistence of hepatitis B e antigen and antibody during antiviral treatment predicts better clinical outcomes in children.
期刊: Journal of pediatric gastroenterology and nutrition 发表日期: 2025-Aug-17 链接: PubMed
摘要
The coexistence of hepatitis B e antigen (HBeAg) and hepatitis B e antibody (HBeAb) during antiviral therapy is considered atypical in patients with chronic hepatitis B (CHB), and its clinical implications remain inadequately understood, particularly in pediatric patients. This study aimed to investigate the clinical characteristics of this coexistence pattern and its impact on the outcomes of combined antiviral therapy in children with CHB. A total of 254 treatment-naïve children diagnosed with HBeAg-positive CHB were retrospectively enrolled. All patients received combination therapy with entecavir and interferon-alpha/pegylated-interferon-alpha. Participants were categorized into a coexistence group and a control group based on whether HBeAg and HBeAb coexisted during treatment period. Clinical characteristics and treatment outcomes were compared, and Cox regression analysis was used to evaluate factors influencing the coexistence pattern and its association with antiviral responses. The incidence of HBeAg and HBeAb coexistence during antiviral therapy was 35.43% (90/254). This pattern was associated with the higher HBV DNA levels (hazard ratio [HR] = 1.25, p = 0.009) at baseline. Notably, children in the coexistence group demonstrated a greater likelihood of achieving HBsAg loss (HR = 2.58, p < 0.001), HBeAg loss (HR = 2.23, p < 0.001) and HBV-DNA undetectability (HR = 1.42, p = 0.034). The HBeAg/HBeAb coexistence pattern is relatively common during antiviral therapy in children and is associated with significantly improved treatment outcomes. These findings highlight the importance of monitoring HBeAg/HBeAb dynamics and continuing treatment during this critical phase.
8. Advancing the Prevention of Severe Mental Illness: Insights and Future Directions from a Public Health Perspective.
期刊: Schizophrenia bulletin 发表日期: 2025-Aug-17 链接: PubMed
摘要
9. Reevaluating Clozapine-Induced QT Prolongation.
期刊: Schizophrenia bulletin 发表日期: 2025-Aug-17 链接: PubMed
摘要
Clozapine is the most effective medicine for treatment-resistant schizophrenia, but is limited by adverse events, including potential QT prolongation which can lead to life-threatening arrhythmias. Studies linking clozapine and corrected QT (QTc) prolongation may overestimate this risk due to high rates of clozapine-associated tachycardia. We investigated whether trough clozapine plasma levels are independently associated with QT prolongation after accounting for heart rate. We conducted a retrospective, cross-sectional analysis of inpatients treated with clozapine at a tertiary hospital between 2017 and 2023. Trough clozapine plasma levels, and 12-lead electrocardiograms were extracted from electronic medical records. QT intervals were manually measured and corrected using Bazett’s, Fredericia, Hodges’ formulae, and the QT nomogram. Multivariable regression and causal mediation were used to test the association between clozapine plasma level, heart rate, and QTc. Among 313 patients, Bazett’s correction classified 27.5% as having prolonged QTc, whereas only one patient (0.3%) exceeded the at-risk threshold using Fredericia, Hodges, or the QT nomogram. Clozapine plasma level correlated with Bazett’s-corrected QT (QTcB) (P = .02), but not after adjustment for heart rate (P = .75). Mediation analysis showed that heart rate significantly mediated the relationship between clozapine plasma level and QTcB intervals (P < .001). Apparent clozapine-induced QTc prolongation is largely an artifact of tachycardia and over-correction by Bazett’s formula. The Fredericia and Hodges formulae, and the QT nomogram provide a more reliable assessment of torsadogenic risk and prevent unnecessary discontinuation or dose reductions of clozapine.
10. Qualified Multilingual Assessment Policy for US Medical Students: A National Delphi Consensus Study.
期刊: Teaching and learning in medicine 发表日期: 2025-Aug-17 链接: PubMed
摘要
While US health systems are implementing language proficiency assessments to verify skills needed to ensure meaningful language access for patients, there is no consensus on best practices for multilingual medical students who want to demonstrate language proficiency for direct patient care. Many medical students who report non-English language skills face challenges navigating when and how to appropriately use those skills in clinical interactions. We used a modified Delphi process to seek consensus from an expert panel through the National Association of Medical Spanish (NAMS) for a Qualified Multilingual Assessment (QMA) policy for medical students. The survey included five topics related to QMA logistics and five topics related to QMA implementation guidance for clinical affiliates: QMA purpose, language access standards, responsibilities of supervising physicians, guarding against implicit bias, and monitoring learning opportunities. We set 80% as the threshold for consensus and revised topics that yielded <80% consensus. We circulated the revised topics in a second survey to establish consensus. Following two rounds of surveys among expert stakeholders, we reached consensus across all topics, yielding a first-of-its-kind QMA policy that administrators may adapt for clinical learning environments and institutions with health professional trainees. This policy includes key QMA policy recommendations for medical students: selecting a QMA, QMA logistics, and QMA implementation guidance for clinical affiliates.
11. Weight Loss in Veterans with Schizophrenia and Multimorbidity Prescribed Semaglutide: Results From a National Retrospective Cohort Study.
期刊: Schizophrenia bulletin 发表日期: 2025-Aug-17 链接: PubMed
摘要
People with schizophrenia are at heightened risk for physical multimorbidity and premature death. Semaglutide improves cardiometabolic outcomes, yet research is limited among individuals with schizophrenia. This study explored weight loss in Veterans with schizophrenia and physical multimorbidity (ie, heart failure and diabetes) prescribed semaglutide and compared weight changes to those in Veterans without schizophrenia. We hypothesized that those with schizophrenia would experience less weight loss compared to those without schizophrenia. This retrospective cohort study examined national data from the Department of Veterans Affairs. The cohort included Veterans who filled a semaglutide prescription between 2018 and 2023 and had diagnoses of heart failure and diabetes. Body weight was examined one year prior to and one year following the first semaglutide prescription. Linear regression with inverse probability of treatment weighting (IPTW) was used to examine the relationship between schizophrenia status and one-year change in weight, accounting for hospital, demographic, clinical, and healthcare utilization factors. The sample comprised n = 36 482 Veterans with physical multimorbidity (n = 559 with schizophrenia). The schizophrenia sample lost 3.1% of their baseline weight (raw weight loss = 8.7 pounds) and the sample without schizophrenia lost 4.7% of baseline weight (raw weight loss = 12.1 pounds). IPTW-adjusted regression analyses demonstrated significantly lower percent weight loss for those with schizophrenia compared to those without schizophrenia (Estimate = -0.85, 95% confidence intervals (CIs): -1.63, -0.07). Semaglutide appears to confer weight loss in Veterans with schizophrenia and multimorbidity, albeit at slightly lower amounts than those without schizophrenia.
12. The Challenge of Long COVID: Is the Pandemic Really Over?
期刊: Public health reports (Washington, D.C. : 1974) 发表日期: 2025-Aug-17 链接: PubMed
摘要
Sequelae of SARS-CoV-2 infection began appearing among patients who had COVID-19 within months of the first wave of the COVID-19 pandemic in 2020. This phenomenon, termed post-COVID-19 condition and also known as long COVID, has been a source of controversy among physicians, as presentation of long COVID has been a somewhat mysterious constellation of signs and symptoms that seem mostly impervious to efficacious treatment. Although a considerable amount has been learned about the pathophysiology and other biomedical features of long COVID, the epidemiologic parameters of long COVID, including incidence and prevalence, are uncertain in the United States and globally. The best estimates are that millions of people have long COVID. Despite the declining incidence of COVID-19, the low case fatality of long COVID suggests that its prevalence is poised to continue to grow. This increasing prevalence of long COVID presents a challenge for the public health sector. Here, we examine the public health implications of long COVID. We offer policy recommendations, including ending congratulatory talk that the pandemic is over, encouraging more focused attention from the United States and global nongovernmental organizations, and establishing a multinational research initiative to better understand and respond to long COVID and other postviral and postinfectious chronic conditions. Although COVID-19 may not be as widespread and disruptive as in the early months of the pandemic, it would be a mistake to presume that, because the acute crisis is behind us, the pandemic is past. Long COVID is an ongoing public health threat and merits our concern.
13. Telehealth Use in Medicaid: Implications for Quality Care for Individuals With ADHD and Tourette Syndrome.
期刊: Public health reports (Washington, D.C. : 1974) 发表日期: 2025-Aug-17 链接: PubMed
摘要
The expansion of telehealth during the COVID-19 pandemic transformed behavioral health care delivery, including for individuals with attention-deficit/hyperactivity disorder (ADHD) and Tourette syndrome (TS), conditions that require ongoing treatment and monitoring. We explored the implications of telehealth on the quality of care for Medicaid beneficiaries with ADHD and TS, highlighting the benefits, challenges, and policy considerations. Telehealth has increased access to behavioral health services, including for ADHD and TS, by reducing geographic and financial barriers to care. The expanded use of telehealth has allowed patients to more easily interact with health care providers, and it particularly benefits those with limited access to specialized care. However, challenges remain, such as concerns about stimulant misuse in online ADHD treatments and the limited privacy offered in home telehealth settings. Furthermore, disparities in broadband access may exacerbate existing inequalities in care. Despite telehealth’s potential to increase access to specialized care, the quality of telehealth provided is not guaranteed. Current quality measures for Medicaid telehealth services, especially for ADHD and TS, are insufficient. While some Medicaid programs have integrated telehealth into quality reporting, a need exists for more tailored measures that assess the unique needs of people with ADHD and TS. We recommend the development of quality measures for ADHD and TS, performance improvement projects for these conditions, better alignment of Medicaid managed care oversight, and research into the long-term outcomes of telehealth for care of people with ADHD and TS. Such efforts would support continued Medicaid telehealth expansion while ensuring high-quality care.
14. Impact of home-based preoperative physical activity on postoperative complications in patients undergoing oncologic surgery: a systematic review and meta-analysis.
期刊: Discover oncology 发表日期: 2025-Aug-17 链接: PubMed
摘要
This systematic review and meta-analysis aimed to determine whether home-based preoperative physical activity (PA) influenced the incidence of postoperative complications (PCs) in patients who underwent oncologic surgery. A comprehensive literature search was conducted using five electronic databases. Full articles with observational designs that compared by preoperative PA or PCs were included. The primary outcome was some type of PC, and a meta-analysis was performed to determine the impact of preoperative low PA on the incidence of PCs. Sub-analysis was performed to identify subgroups based on the severity of the PCs and the cancer site. Eight studies were included in the analysis. Low preoperative PA was associated with all PCs (odds ratio [OR] = 2.42, 95% confidence interval [CI] = 1.44 to 4.07) but not with severe PCs (OR = 1.93, 95% CI = 0.51 to 7.37). In a subgroup of patients with gastrointestinal cancers, low preoperative PA was associated with all PCs (OR = 3.44, 95% CI = 1.63 to 7.26) and severe PCs (OR = 2.93, 95% CI = 1.30 to 6.58). This systematic review and meta-analysis revealed that patients with low preoperative PA undergoing oncologic surgery, particularly those with gastrointestinal cancers, are more likely to develop PCs. A definitive conclusion could not be reached, however, due to the limited number of studies exclusively examining this relationship in cancer patients.
15. Epilepsy and systemic autoimmune diseases: A bidirectional two-sample Mendelian randomization study.
期刊: Epilepsia open 发表日期: 2025-Aug-17 链接: PubMed
摘要
Epidemiological data indicates that individuals with epilepsy exhibit an elevated susceptibility to autoimmune disorders, and conversely, those with systemic autoimmune diseases (SAD) demonstrate a heightened predisposition to epilepsy. Although an increasing number of publications support this association, the causal direction remains undetermined. This investigation offers evidence supporting a causal relationship between these conditions through a bidirectional two-sample Mendelian randomization (MR) analysis. Bidirectional two-sample MR analyses were performed to investigate the causal relationships and directionality between various epilepsy subtypes and eight SAD. The analysis utilized genome-wide association study (GWAS) summary data for the following conditions: type 1 diabetes, systemic lupus erythematosus (SLE), inflammatory bowel disease (IBD), rheumatoid arthritis, coeliac disease, multiple sclerosis (MS), ulcerative colitis, and Crohn’s disease. In this study, causal analyses were performed for different epilepsy subtypes and SAD disorders. In the Inverse-Variance Weighted (IVW) model, the MR study indicated that focal epilepsy increased the risk of IBD [odds ratio (OR): 1.15, confidence interval (CI): 1.02-1.30, p: 0.027] and MS [OR: 1.25, CI: 1.07-1.47, p: 0.004]. Childhood absence epilepsy increased the risk of MS [OR: 0.25, CI: 0.07-0.90, p: 0.034]. Reverse analyses showed that SLE increased the risk of myoclonic epilepsy in adolescents [OR: 1.01, CI: 1.00-1.01, p: 0.042], and IBD [OR: 0.99, CI: 0.99-1.00, p: 0.013], and celiac disease [OR: 0.99, CI: 0.99-1.00, p: 0.021] reduced the risk of generalized epilepsy. The results demonstrated homogeneity, and the MR-Egger directions were concordant. This study shows that epilepsy is a causal risk factor for both IBD and MS, providing new insights into the prevention of SAD in people with epilepsy. This paper employs a bidirectional two-sample MR analysis to investigate the genetic correlation between epilepsy and autoimmune diseases, revealing potential associations between the onset of epilepsy and MS as well as IBD. Further exploration in this area requires support from clinical data.
16. The pathogenicity and multi-organ proteomic profiles of Mpox virus infection in SIVmac239-infected rhesus macaques.
期刊: Nature communications 发表日期: 2025-Aug-17 链接: PubMed
摘要
Mpox poses a heightened risk of severe disease and mortality among individuals with HIV, yet the molecular mechanisms and immunopathology underlying multi-organ damage caused by the mpox virus (MPXV), particularly in the context of HIV co-infection, remain poorly understood. Here, we observe increased MPXV replication, more extensive skin lesions, and impaired humoral and cellular immune responses in SIV-MPXV co-infected rhesus macaques compared to those infected with MPXV alone. Multi-organ proteomic and phosphoproteomic analyses reveals upregulation of proteins involved in immune and inflammatory pathways in skin lesions and across multiple organs, especially in immune-related tissues. Abnormal activation of DNA replication and cell cycle signaling pathways, which may contribute to enhanced viral replication, is evident in both MPXV and SIV-MPXV co-infected groups. CDK4/6 may present a potential therapeutic target to suppress MPXV replication. These comprehensive proteomic datasets offer valuable insights into the pathogenesis of MPXV in the context of SIV co-infection and support ongoing efforts to mitigate the impact of mpox.
17. Synthesis, anti-biofilm and molecular docking of amino-substituted chalcones targeting Staphylococcus aureus sortase A.
期刊: Future medicinal chemistry 发表日期: 2025-Aug-17 链接: PubMed
摘要
Antibiotic resistance is an urgent global health challenge that requires the development of new antibacterial agents. In this study, 14 aminochalcones bearing electron-withdrawing groups were synthesized and evaluated for antibacterial activity. Chalcone C5, with an ortho-chlorine on ring B, demonstrated the most potent effect, notably against methicillin-susceptible and methicillin-resistant Staphylococcus aureus (MICs of 1.9 and 3.9 µg/mL, respectively), comparable to vancomycin. C5 showed synergistic interaction with vancomycin, reducing its MIC tenfold. Time-kill assays confirmed C5’s bactericidal action within 8 h, with no bacterial regrowth up to 12 h. C5 also significantly inhibited bacterial adhesion to keratinocytes (HaCaT) and reduced biofilm formation and survival at both MIC and 10× MIC, showing effects comparable to vancomycin. In silico, ADMET predictions indicated favorable pharmacokinetic and safety profiles, including high intestinal absorption and lack of hERG inhibition or cytotoxicity. Molecular docking against S. aureus sortase A (SrtA) suggests strong interactions with key residues (Arg197, Glu105, Asn114), supporting the anti-adhesion activity. Furthermore, in vivo toxicity assessment using Galleria mellonella larvae showed minimal toxicity at 100× MIC. These findings support chalcone C5 as a promising lead compound for the development of new antibacterial agents, particularly for combating S. aureus infections and biofilm-associated pathologies.
18. Climate induced heat stress and its psychological effects among South Indian workers.
期刊: Archives of environmental & occupational health 发表日期: 2025-Aug-17 链接: PubMed
摘要
Rising temperatures and extreme weather pose a significant public health threat. Workers in low- and middle-income countries are particularly vulnerable to heat stress, which can lead to psychological repercussions, including climate anxiety. This study investigated the psychological impacts of heat stress and coping strategies among workers in relation to climate anxiety. A cross-sectional survey of 800 indoor and outdoor workers was conducted in 2024. Environmental heat stress was measured using a wet bulb globe temperature (WBGT) monitor, defining heat stress as exceeding task-specific threshold limits. Heat strain indicators (HSIs) such as core body temperature (CBT) and urine specific gravity (USG) were assessed alongside perceived heat stress and psychological impacts using a validated HOTHAPS questionnaire. The WBGT exceeded recommended limits for 62% of workers (30.3 ± 5.0 °C). Among heat-exposed workers, 80% reported heat-related health symptoms, with a significant rise in HSIs, including CBT (AOR = 1.9; 95% CI: 1.4-2.7). Psychological symptoms were prevalent in 94% of exposed workers, with heightened risks of climate anxiety (AOR = 2.8), stress (AOR = 2.7), and mental fatigue (AOR = 3.7). Women and summer months showed greater vulnerability. Heat stress significantly affects psychological well-being among South Indian workers. Protective workplace policies are crucial to mitigating climate-induced psychological impacts.
19. Effectiveness of Mindfulness-Based Intervention on Physical and Psychological Well-Being of Young Adults.
期刊: Health education & behavior : the official publication of the Society for Public Health Education 发表日期: 2025-Aug-17 链接: PubMed
摘要
Mindfulness-based Interventions have expanded beyond the health care field over the past 30 years into numerous social and occupational contexts, although their underlying mechanisms are not so clear. The aim of this controlled trial was to examine the effects of a Mindfulness-Based Stress Reduction (MBSR) intervention on physical and psychological health in young adults. Eight sessions of MBSR intervention were applied in the experimental group (n = 38), while no interventions were used in the control group (n = 40). To evaluate the effects of MBSR intervention, participants completed the Psychological General Well-Being Index, the Ford Insomnia Response to Stress Test and the Postural Awareness Scale, the Mindfulness Attention and Awareness Questionnaire, the Five Facets Mindfulness Questionnaire before the intervention (T0), after the intervention (T1) and after 3 months from the end of the intervention (T2). The authors developed an ad hoc questionnaire to monitor the subjects’ mindfulness practice in the 3 months following the end of the mindfulness program. Independent and paired t-tests to analyze differences between and within groups were carried out, and correlation analyses were performed between the questionnaires’ scores and the degree of self-practice of the MBSR group participants. Results showed significant improvement in sleep quality, psychological distress, physical symptoms, and postural control awareness in the MBSR group compared with the control group. Some effects were maintained at follow-up. In particular, postural awareness significantly correlated with the frequency of self-practice of the MBSR protocol. This suggests the MBSR intervention can positively impact young adults’ stress-related symptoms and psychophysical health.
20. Cadmium exposure and advanced cardiovascular-kidney-metabolic syndrome: An integrated multi-organ perspective based on epidemiology and adverse outcome pathways.
期刊: Ecotoxicology and environmental safety 发表日期: 2025-Aug-16 链接: PubMed
摘要
While metal exposures are linked to cardiovascular and renal diseases, their role in cardiorenal comorbidity remains poorly understood. Using the American Heart Association’s Cardiovascular-Kidney-Metabolic Syndrome (CKM syndrome) framework, we combined population epidemiology and Adverse Outcome Pathway (AOP) analysis to explore how cadmium exposure influences CKM progression and advanced-stage outcomes. Data from 5865 adults aged 30-79 years in the National Health and Nutrition Examination Surveys (NHANES) were analyzed to investigate serum metal exposure patterns and CKM syndrome progression. Logistic regression showed that higher blood cadmium levels were associated with CKM progression (OR = 1.21, 95 % CI = 1.05-1.40), highlighting cadmium as a key risk factor. Subsequent Cox proportional hazards regression analyses demonstrated amplified effects of cadmium exposure on all-cause mortality in advanced-stage CKM patients (HR = 1.30, 95 % CI = 1.09-1.56). To mechanistically characterize Cd-induced CKM syndrome progression and advanced-stage outcomes, we constructed a Chemical-Gene-Phenotype-Disease (CGPD) network through integrative mining of the Comparative Toxicogenomics Database (CTD) and GeneCards databases. This was synergistically combined with AOP-Wiki and PubMed databases to establish an AOP framework. This investigation represents the first study combining population epidemiology with AOP methodology to delineate the multi-organ interaction mechanisms between metal exposure (Cd) and CKM syndrome. This study not only furnishes a novel evidence base for risk assessment of metal exposure, but also establishes a paradigmatic reference for constructing adverse outcome pathway (AOP) frameworks across multiple organ systems, demonstrating significant public health implications.
21. Chemical carcinogenicity of neodymium nitrate in AML12 hepatocytes: Dose-response metabolomics and sensitive biomarker identification.
期刊: Ecotoxicology and environmental safety 发表日期: 2025-Aug-16 链接: PubMed
摘要
This study aims to investigate the chemical carcinogenic toxicity of neodymium nitrate (Nd(NO3)3) in mouse hepatocytes AML12 using dose-response metabolomics. Specifically, our objectives are to: Identify key metabolites that respond to Nd(NO3)3 exposure. Elucidate the mechanisms underlying Nd(NO3)3-induced liver toxicity. Provide a scientific basis for risk assessment of Nd(NO3)3 exposure. AML12 cells were exposed to different concentrations of Nd(NO3)3 (0, 0.2, 0.4, and 0.8 µM) for 24 h. Metabolite changes were analyzed using UPLC-MS, and differential metabolites (DMs) were identified. Key metabolic pathways affected by Nd(NO3)3 include amino acid metabolism, nucleotide metabolism, and energy metabolism. Significant changes in these pathways suggest that Nd(NO3)3 induces metabolic disturbances that may lead to cytotoxicity. We identified potential biomarkers, such as UDP-N-acetylglucosamine, L-glutathione, and glycine, which exhibit dose-dependent responses. These findings provide insights into the mechanisms of Nd(NO3)3-induced chemical carcinogenicity and offer a scientific basis for risk assessment. Future research should further explore the toxicity and mechanisms in in vivo settings. CONCLUSION: Our study reveals that Nd(NO3)3 induces metabolic disturbances in AML12 hepatocytes, leading to potential cytotoxicity. The identified potential biomarkers, such as UDP-N-acetylglucosamine, L-glutathione, and glycine, provide a basis for early detection and risk assessment of Nd(NO3)3 exposure. Further in vivo studies are needed to explore the long-term effects and mechanisms of Nd(NO3)3 toxicity.
22. Bias in the estimated association between all-cause mortality and long-term exposure to a specific chemical component of fine particulate matter: The example of black carbon.
期刊: Ecotoxicology and environmental safety 发表日期: 2025-Aug-16 链接: PubMed
摘要
Long-term exposure to fine particulate matter (PM2.5) has been linked to many adverse health outcomes, which can vary significantly depending on the chemical profile of the PM2.5. However, many meta-analyses of the health effects of a specific component of PM2.5 have ignored the effects of other components, leading to omitted variable bias (OVB). This study developed a new method to address this problem and conducted a simulation using black carbon (BC) as an example. We used data from two published meta-analyses as input for our model, with supplementary information obtained from a reanalysis product of PM2.5 components. Based on the classical OVB formula, we developed a post hoc adjusted model and verified its performance via a simulation study. We obtained pooled estimates of the effect of BC on all-cause mortality, with adjustment for the effect of non-black carbon (NBC) components. Finally, based on the estimated effects of BC and NBC, we investigated global patterns in PM2.5 toxicity (i.e., the per-unit effect of PM2.5) and the degree of OVB associated with ignoring the differential effects of BC and NBC. The post hoc adjusted model included 46 individual estimates of the effects of BC or NBC on all-cause mortality. Results from the model indicate that a 10 μg/m³ increase in BC and NBC was associated with a 49 % (95 % confidence interval [CI]: 26 - 76 %) and 6 % (95 % CI: 3 - 10 %) increase in mortality risk, respectively. Based on global average total PM2.5 mass composition values (6.1 % and 93.9 % for BC and NBC, respectively), we estimated that the relative risk of all-cause mortality increased by 1.09 (95 % CI: 1.06 - 1.12) per 10 μg/m3 increment in long-term PM2.5 exposure. Estimation of the effects of BC on mortality based on observations obtained within one city yielded a median OVB of 147 % (95 % CI: -151 - 700) when using a single-pollutant model. In meta-analyses on the health impacts of PM2.5 components, ignoring the differential effects of BC and NBC causes significant biases in estimating associations with all-cause mortality. Our study presents a novel method to adjust for OVB in meta-analyses, and we find that BC more harmful than NBC components of PM2.5 by using the novel method.
23. Incentivizing Adherence to Gender-Affirming PrEP Programs: A Stated Preference Discrete-Choice Experiment among Transgender and Gender Nonbinary Adults.
期刊: Medical decision making : an international journal of the Society for Medical Decision Making 发表日期: 2025-Aug-16 链接: PubMed
摘要
ObjectivesTransgender (trans) people have disproportionately high HIV risk, yet adherence to preexposure prophylaxis (PrEP) remains low in this population. We aimed to determine which factors matter most in the decision of HIV-negative transgender adults to adhere to long-acting injectable PrEP (LA-PrEP), and the acceptability of providing incentives conditional on LA-PrEP program engagement.MethodsFrom March to April 2023, 385 trans adults in Washington State completed a discrete-choice experiment (DCE) eliciting preferences for a conditional economic incentive program that would provide free LA-PrEP and gender-affirming care during bimonthly visits. We used the best-best preference elicitation method across 2 hypothetical programs with an opt-out option. Program attributes included incentive format and amount, method for determining PrEP adherence, and type of hormone co-prescription. We used a rank-ordered mixed logit model for main results and estimated respondents’ marginal willingness to accept each program attribute. We plotted the probability of choosing an incentivized LA-PrEP program over a range of respondent characteristics.ResultsThe optimal program design would 1) deliver incentives in cash, 2) confirm PrEP adherence via blood testing, 3) provide counseling in person, and 4) provide prescriptions for injectable gender-affirming hormones. From a maximum incentive amount of $1,200/year, respondents were willing to forgo up to $689 to receive incentives in cash (instead of voucher) and up to $547 to receive injectable (instead of oral) hormones. The probability of choosing a hypothetical program over no program waned as adults aged (>40 y) and as income increased (>$75,000/y).ConclusionsConditional economic incentives are likely acceptable and effective for improving LA-PrEP adherence, especially among younger trans adults with fewer financial resources. A randomized trial is needed to confirm the DCE’s validity for predicting actual program uptake.HighlightsGender-related stigma, economic barriers, and medical concerns about hormone interactions can keep transgender (trans) adults from engaging in HIV prevention behaviors.Combining gender-affirming care with conditional economic incentives may help reduce present bias and increase trans persons’ motivation to adhere to long-acting injectable preexposure prophylaxis (LA-PrEP).From a maximum yearly incentive of $1,200, trans discrete-choice experiment respondents were willing to forgo up to $689 to receive a cash (rather than voucher) incentive and up to $547 to receive co-prescriptions for injectable (rather than oral) hormones as part of a hypothetical HIV prevention program.The probability of choosing an LA-PrEP program over no program begins to wane as adults age (>40 y) and as annual income increases (>$75,000/year), such that incentivized LA-PrEP programs may be especially salient for younger trans adults with fewer financial resources.
24. Evaluating neonatal cord serum metabolome in association with adolescent cardiometabolic risk factors.
期刊: Pediatric research 发表日期: 2025-Aug-16 链接: PubMed
摘要
Risk factors for cardiometabolic disease may have fetal origins, but the biological pathways linking gestational conditions to these risk factors are only partially understood. Among 145 Cincinnati-based HOME Study mother-child dyads, we detected 14,384 cord serum metabolic features using liquid chromatography high-resolution mass spectrometry. We measured cardiometabolic risk factors, including visceral fat, serum triglyceride, high-density lipoprotein cholesterol (HDL), leptin, adiponectin, insulin concentration, glucose, and systolic blood pressure (SBP) at age 12 years. Using sparse Partial Least Squares Regression (sPLS-R), we simultaneously modeled the association of metabolic features with all 8 risk factors. We prioritized features with the highest sPLS-R-derived CM risk factor correlations for metabolic pathway enrichment analysis. We identified two groups of cardiometabolic risk factors in adolescents maximally associated with neonatal metabolic features. The first was visceral fat, triglycerides, HDL, insulin, and leptin; the second was glucose and SBP. The 178 metabolic features with the highest sPLS-R-derived feature-outcome correlations were enriched in 31 pathways related to short-chain fatty acid, vitamins C and B3, and amino acid metabolism, as well as glycolysis and gluconeogenesis. We identified 31 pathways that may help elucidate underlying mechanisms between fetal environmental stressors and the development of cardiometabolic risk factors. Using non-targeted metabolomics, we identified neonatal metabolic features linked to two groups of cardiometabolic risk factors in adolescents, suggesting distinct early-life CM risk trajectories and adolescent subphenotypes. One cardiometabolic group was characterized by higher visceral fat, triglycerides, insulin, leptin, as well as lower HDL; the other group was related to elevated glucose and systolic blood pressure. Using a variable selection and data-dimension reduction technique, these two groups were associated with 178 metabolic features and 31 biological pathways related to short-chain fatty acid, vitamins C and B3, and amino acid metabolism, as well as glycolysis and gluconeogenesis.
25. The association between dietary antioxidant index with tumor size, proliferation marker, and the odds of breast cancer in Iranian women.
期刊: Scientific reports 发表日期: 2025-Aug-16 链接: PubMed
摘要
This study investigated the relationship between the dietary antioxidant index (DAI) with pathological markers (tumor size and Ki-67 marker) and the odds of breast cancer in Iranian women. In this matched case-control study, 155 women with breast cancer and 155 cancer-free women (18-70 years old) were recruited from Iran, using a convenience sampling method. Control participants were frequency-matched to cases by 5-year age-group. DAI score was calculated based on dietary data obtained from a 168-item FFQ. Linear regression with adjustment for confounding factors was used to determine the relationship between DAI and pathological markers. Logistic regression, adjusted for confounding factors, was employed to investigate the odds ratio (OR) of breast cancer according to the quantitative and qualitative (quartiles) scores of the DAI, with 95% CI. Logistic regression subgroup according to menopausal status was also performed. A non-significant inverse relationship was observed between DAI score and Ki-67 marker in the crude model and the adjusted models 2 and 3 (p ≥ 0.05). In the crude model, in the second quartile, the odds of breast cancer was significantly reduced compared to the first quartile (OR: 0.50, CI: 0.26-0.96). However, after adjusting for confounding factors in model 2, the odds of breast cancer decreased significantly in the second and third quartiles compared to the first quartile (p < 0.05). Also, by entering the DAI as a quantitative variable in model 3 of logistic regression, a significant decrease in the odds of breast cancer was observed (p = 0.03). In the postmenopausal stage, the odds of breast cancer in the second quartile decreased significantly compared to the first quartile in the crude model. Also, in model 3, after adjusting for confounding factors, the odds ratio of breast cancer in the second and third quartiles was significantly reduced compared to the first quartile (p < 0.05). This study suggests that a higher dietary antioxidant intake, as measured by the DAI, may be associated with a lower risk of breast cancer in Iranian women and this relationship is more significant in the postmenopausal stage. These findings highlight the potential benefits of dietary antioxidants and warrant further investigation into their role in breast cancer prevention strategies.
26. ROSIE: AI generation of multiplex immunofluorescence staining from histopathology images.
期刊: Nature communications 发表日期: 2025-Aug-16 链接: PubMed
摘要
Hematoxylin and eosin (H&E) is a common and inexpensive histopathology assay. Though widely used and information-rich, it cannot directly inform about specific molecular markers, which require additional experiments to assess. To address this gap, we present ROSIE, a deep-learning framework that computationally imputes the expression and localization of dozens of proteins from H&E images. Our model is trained on a dataset of over 1300 paired and aligned H&E and multiplex immunofluorescence (mIF) samples from over a dozen tissues and disease conditions, spanning over 16 million cells. Validation of our in silico mIF staining method on held-out H&E samples demonstrates that the predicted biomarkers are effective in identifying cell phenotypes, particularly distinguishing lymphocytes such as B cells and T cells, which are not readily discernible with H&E staining alone. Additionally, ROSIE facilitates the robust identification of stromal and epithelial microenvironments and immune cell subtypes like tumor-infiltrating lymphocytes (TILs), which are important for understanding tumor-immune interactions and can help inform treatment strategies in cancer research.
27. Evaluating Variation in Lymph Node Sampling During Sentinel Lymph Node Biopsy for Melanoma.
期刊: Annals of surgical oncology 发表日期: 2025-Aug-16 链接: PubMed
摘要
The operative standard for melanoma, implemented by the Commission on Cancer (CoC), addresses margin width and excision depth, but does not collect information on sentinel lymph node biopsy (SLNB). However, SLNB, an implemented technical standard in breast cancer, is also critical in the management of melanoma through its impact on nodal staging. This study aimed to characterize the current facility-level variation in nodal yield and nodal positivity to determine if there is an opportunity for improvement through standardization. Using the National Cancer Database, we identified patients with T1b-T4 melanoma of the trunk and upper extremities who underwent SLNB from 2018 to 2022. Reliability-adjusted estimates for nodal yield and nodal positivity were calculated using Poisson regression and logistic regression with random intercepts for hospitals. We identified 48,653 melanoma patients from 1167 facilities. SLNB median nodal yield was 2.4 (IQR 2.2-2.7), ranging from 1.4 to 7.0. SLNB median nodal positivity was 18.0% (IQR 17.1-19.5%), ranging from 11.6 to 40.5%. A weak correlation between nodal yield and nodal positivity was observed (Spearman correlation coefficient = 0.08, p = 0.009). Facility-level variation in nodal yield was minimal and weakly correlated with nodal positivity. This suggests that SLNB performed for melanoma of the trunk and upper extremities is well standardized across CoC hospitals in the absence of a defined operative standard. Future efforts to improve the quality of melanoma nodal surgery may be best focused on technical elements of other procedures, such as lymphadenectomy or more novel lymph node dissection approaches following neoadjuvant therapy.
28. Genetic testing for oral clefts: reflections based on a single Brazilian public genetics service.
期刊: Orphanet journal of rare diseases 发表日期: 2025-Aug-16 链接: PubMed
摘要
Genomic medicine has allowed for an improvement in the diagnosis and molecular understanding of congenital defects. However, its implementation into routine clinical practice demands enormous challenges worldwide. This study describes the etiological diversity and access to genetic diagnosis of individuals with oral clefts (OC) at a single genetics service. This cross-sectional and descriptive study analyzed primary records of the Brazilian Database on Craniofacial Anomalies from 2006 to 2019, before the National Policy of Comprehensive Care for People with Rare Diseases (NPCCPRD) implementation in this service. Among 103 individuals (51 Female and 52 Male), the proportion of syndromic OC (SOC) and non-syndromic OC (NSOC) was 73.8% and 26.2%, respectively, showing that NSOC seems not to be referred for genetic evaluation. Diagnosis occurred in 64/103 (62.13%) cases; 36/64 (56,25%) had clinical diagnoses, of which 27/36 were NSOC. The tests allowing a conclusive diagnosis were whole exome sequencing (WES) (11/20-55.00%), followed by chromosomal microarray analysis (CMA) (4/52-7.69%), Fluorescent in situ hybridization (FISH) (6/21-28.57%), multiplex ligation-dependent probe amplification (MLPA) (2/32-6.25%), and G-banding karyotype (6/72-8.33%). Age at diagnosis ranged from 0 to 46 years (mean = 9.56 /median = 7). Diagnostic investigations of 39/76 SOC cases are still ongoing, relying on clinical follow-up and genetic tests. Etiological diversity reinforces the need for different laboratory resources and clinical follow-up. These results and reflections about the need to implement Genomic Medicine are of universal interest. They also show the need to improve public health policies for genetic evaluation, diagnostic tests, and genetic counseling for an effective NPCCPRD.
29. Sterile syringe availability in Georgia pharmacies remained rare, despite policy change permitting sales.
期刊: Harm reduction journal 发表日期: 2025-Aug-16 链接: PubMed
摘要
Numerous states, including Georgia in April 2019, have advanced policies designed to increase availability of sterile syringes in pharmacies for people who inject drugs (PWID); however, the extent to which pharmacies are willing to sell syringes to PWID is unclear. We examine sterile syringes sales practices in Georgia pharmacies to PWID following a recent policy change and pharmacists’ cited reasons for these practices. We conducted a telephone survey from October 2020 through May 2021 of one pharmacist (staff or manager) per pharmacy in a sample of Georgia retail pharmacies stratified by urbanicity. The 15-question survey queried respondents about the pharmacy’s current practices regarding nonprescription sterile syringe sales and the respondents’ perceptions of syringe sales and counseling practices to those purchasing syringes. Pharmacy and pharmacist demographics were collected and correlations between these characteristics were estimated using unadjusted logistic regression models. We obtained responses from 119 pharmacies (response rate = 34%). Most surveyed pharmacies (81%) reported that they did not sell syringes to patients without a prescription for nonmedical uses, including intravenous drug use. There were no differences in whether pharmacies were more or less likely to sell syringes by level of urbanicity, local poverty rate, local racial/ethnic composition, or pharmacy type (i.e., chain vs. independently owned). The most common reasons cited for not selling syringes were security concerns, that syringe sales encourage drug use, and corporate policy. Among pharmacists in pharmacies not currently selling syringes, only 54% of were aware of the state law change allowing sales of syringes without a medical reason. Despite an important policy change advancing harm reduction through sterile syringe access, availability of sterile syringes to PWID in Georgia pharmacies was likely still hampered by lack of dispensing by pharmacies. Implementation efforts following important policy changes-including building awareness of the new policy, encouraging support of harm reduction efforts, and continuing education around substance use disorders-are essential for achieving the intended outcomes of the policy.
30. What Do Parents Want? A Qualitative Study on Parental Preferences for Infant Sleep Health Education in Dutch Preventive Youth Health Care.
期刊: Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners 发表日期: 2025-Aug-16 链接: PubMed
摘要
Infant sleep problems are an important and frequent concern for parents and negatively affect infant and parental health. Sleep education via pediatric primary care can aid in promoting healthy infant sleep, but currently seems suboptimal. To promote healthy infant sleep, this study explores parents’ experiences, needs, and wishes regarding infant sleep education in Dutch pediatric primary care (i.e., Youth Health Care). A qualitative needs assessment with semistructured interviews was conducted with nine parents of children aged 0-2 years receiving Dutch Youth Health Care. Data were analyzed independently by two researchers using thematic content analysis. Parents perceived Youth Health Care sleep education can be improved. Improvement suggestions included providing more timely information about infant sleep, proactive screening for infant sleep problems, tailoring guidance to parents’ needs, and offering more support and follow-up. These insights can improve the promotion of healthy infant sleep via Youth Health Care.
31. The Consolidated Framework for Implementation Research (CFIR) User Guide: a five-step guide for conducting implementation research using the framework.
期刊: Implementation science : IS 发表日期: 2025-Aug-16 链接: PubMed
摘要
The Consolidated Framework for Implementation Research (CFIR) is a determinant framework that includes constructs from many implementation theories, models, and frameworks; it is used to predict or explain barriers and facilitators to implementation success. CFIR is among the most widely applied implementation science frameworks, and after 15 years of use in the field, the framework was updated based on user feedback obtained via literature review and survey. Dissemination of the updated CFIR and accompanying outcomes addendum resulted in hundreds of requests from users for further guidance in applying the framework. In addition, observations of potential and actual misuse of CFIR in grant reviews and published manuscripts were the catalyst for the development of this user guide. As a result, the objective of this article is to provide a user guide and essential tools and templates for using CFIR in implementation research. This user guide was generated from the combined wisdom and experience of the CFIR Leadership Team, which includes the lead developers of the original and updated CFIR (LJD, CMR), and has collectively used CFIR in more than 50 projects. The five steps as well as the tools and templates were finalized via consensus discussions. The five steps below guide users through an entire research project using CFIR and include 1) Study Design; 2) Data Collection; 3) Data Analysis; 4) Data Interpretation; and 5) Knowledge Dissemination. In addition, the article provides a Frequently Asked Questions (FAQs) section based on user queries and six tools and templates: 1) CFIR Construct Example Questions; 2) CFIR Construct Coding Guidelines; 3) Inner Setting Memo Template; 4) CFIR Construct Rating Guidelines; 5) CFIR Construct x Inner Setting Matrix Template; and 6) CFIR Implementation Research Worksheet. This user guide details how to use CFIR in implementation research, from the design of the study through dissemination of findings, answers frequently asked questions, and offers essential tools and templates. We hope this guidance will facilitate appropriate and consistent application of the framework as well as generate feedback and critique to advance the field.
32. Unmet healthcare needs, out-of-pocket payments and catastrophic health expenditures among hypertensive adults in Bangladesh.
期刊: BMC health services research 发表日期: 2025-Aug-16 链接: PubMed
摘要
This study aims to examine unmet healthcare needs and the burden of out-of-pocket (OOP) payments in Bangladesh among hypertensive adults using the most recent survey data. A total of 5086 hypertensive patients aged 18 to 80 were recruited from 75 pharmacies in Bangladesh in 2023, 35 being located in urban areas and 40 in rural areas. Unmet healthcare needs was the primary outcome variable, while the incidence of catastrophic health expenditures (CHE) was the secondary outcome variable. A multilevel logistic regression model was performed to identify factors associated with unmet healthcare needs and CHE. A multilevel Tobit regression model was used to identify the determinants of OOP health expenditures. The study indicated that the prevalence of unmet healthcare needs among hypertensive adults was around 26% and incidence of CHE was 46% at 10% threshold of total consumption in Bangladesh. The most common reason for unmet healthcare needs was affordability, long waiting times, lack of availability, and transportation issues etc. Unmet healthcare needs were more prevalent among men, individuals with no education, divorced/separated, non-Muslims and poor population. Regression models suggested that older people, men, those with higher education, Muslim, married people, larger household, overweight and obese people, and rural residents were more likely to burden of OOP expenses. High unmet needs and CHE prevalence in Bangladesh reveal inadequate health risk protection. Prioritizing affordability, addressing disparities, and strengthening financial risk protection can improve access and outcomes for hypertensive adults.
33. The effect of multimodal educational interventions on improving the lifestyle of the elderly: a quasi-experimental study.
期刊: BMC public health 发表日期: 2025-Aug-16 链接: PubMed
摘要
The health of the elderly represents a critical public health concern that can be positively influenced by the adoption of health-promoting lifestyle behaviors. This quasi-experimental study aimed to evaluate the effectiveness of multimodal educational interventions in improving the lifestyle of older adults. This quasi-experimental intervention study was conducted with 118 eligible elderly participants recruited from health service centers in Qom, Iran. Data were collected using a two-part questionnaire comprising demographic information and the Health-Promoting Lifestyle Profile II (HPLP-II). The intervention group participated in eight 30-minute group sessions (organized into six groups), held twice weekly, covering topics such as nutrition, physical activity, stress management, and mental health. The control group did not receive any educational intervention during the study period. Two months following the completion of the educational program, the questionnaire was re-administered to both groups. Data were analyzed using SPSS version 21. Descriptive statistics were employed to summarize participant characteristics and study variables. Inferential analyses included Box’s M test to assess the homogeneity of variance-covariance matrices, as well as univariate and multivariate analyses of covariance (ANCOVA and MANCOVA), with the significance level set at 0.05. The mean scores for lifestyle dimensions-including health responsibility, physical activity, nutrition, stress management, interpersonal relationships, spiritual growth, and self-actualization-did not differ significantly between the intervention and control groups prior to the educational program. However, following the intervention, the mean scores in the intervention group increased significantly across all dimensions (p < 0.0001). The findings indicate that the educational intervention had a positive effect on all six dimensions of lifestyle-related behaviors among the elderly.
34. Phosphorylated pullulan as a local drug delivery matrix for cationic antibacterial chemicals to prevent oral biofilm.
期刊: BMC oral health 发表日期: 2025-Aug-16 链接: PubMed
摘要
Preventing oral infections, such as oral caries and periodontal disease, helps reduce the risks of various systemic diseases. In this study, the polysaccharide pullulan produced by the black yeast Aureobasidium pullulans was modified in combination with the cationic surfactant cetylpyridinium chloride (CPC) to create a local drug delivery system, and its antibacterial potential on oral bacteria was examined in vitro. Pullulan was phosphorylated at the CH2OH residue of α6 in the maltotriose structure and mixed with CPC. Bacterial attachment of cariogenic Streptococcus mutans on hydroxyapatite plates (HAPs) treated with the phosphorylated pullulan (PP) and CPC compound (0.01% PP and 0.001- 0.03% CPC, and vice versa) was assessed by observing bacteria using a field emission scanning electron microscope (FE-SEM) and quantified through 16 S rRNA amplification via real-time polymerase chain reaction (PCR). Additionally, the quartz crystal microbalance (QCM) method was employed to evaluate the sustained release of CPC. PP-CPC compound maintained significant bactericidal activity even at 0.01%, which is one-fifth of the conventional applicable concentration of CPC. Additionally, a residual mixture was detected by the hydroxyapatite sensor of the crystal oscillator microbalance detector, suggesting an unknown molecular interaction that enables the sustained release of CPC after attachment to hydroxyapatite. The combination of PP and CPC may contribute to the low concentration and effective prevention of oral infections, such as dental caries.
35. Achieving inclusive healthcare through integrating education and research with AI and personalized curricula.
期刊: Communications medicine 发表日期: 2025-Aug-16 链接: PubMed
摘要
Precision medicine promises significant health benefits but faces challenges such as complex data management and analytics, interdisciplinary collaboration, and education of researchers, healthcare professionals, and participants. Addressing these needs requires the integration of computational experts, engineers, designers, and healthcare professionals to develop user-friendly systems and shared terminologies. The widespread adoption of large language models (LLMs) such as Generative Pretrained Transformer (GPT) and Claude highlights the importance of making complex data accessible to non-specialists. We evaluated the Stanford Data Ocean (SDO) precision medicine training program’s learning outcomes, AI Tutor performance, and learner satisfaction by assessing self-rated competency on key learning objectives through pre- and post-learning surveys, along with formative and summative assessment completion rates. We also analyzed AI Tutor accuracy and learners’ self-reported satisfaction, and post-program academic and career impacts. Additionally, we demonstrated the capabilities of the AI Data Visualization tool. SDO demonstrates the ability to improve learning outcomes for learners from broad educational and socioeconomic backgrounds with the support of the AI Tutor. The AI Data Visualization tool enables learners to interpret multi-omics and wearable data and replicate research findings. SDO strives to mitigate challenges in precision medicine through a scalable, cloud-based platform that supports data management for various data types, advanced research, and personalized learning. SDO provides AI Tutors and AI-powered data visualization tools to enhance educational and research outcomes and make data analysis accessible to users from broad educational backgrounds. By extending engagement and cutting-edge research capabilities globally, SDO particularly benefits economically disadvantaged and historically marginalized communities, fostering interdisciplinary biomedical research and bridging the gap between education and practical application in the biomedical field. Precision medicine is the use of various types of health data specific to an individual to improve disease prevention, diagnosis, or treatment. We used artificial intelligence to build a precision medicine learning platform for clinicians and researchers in training. Students in 93 countries accessed the platform and found it helpful. It could be particularly helpful for training students in low- and middle-income countries.
36. The relationship between liver stiffness, fat content measured by liver elastography, and coronary artery disease: a study based on the NHANES database.
期刊: Scientific reports 发表日期: 2025-Aug-16 链接: PubMed
摘要
This study aimed to investigate the relationship between liver stiffness measurements (LSM), controlled attenuation parameter (CAP), and coronary heart disease (CHD) using data from the National Health and Nutrition Examination Survey (NHANES). A total of 12,684 American populations who underwent health examinations were included from the NHANES database spanning 2017-2020 (pre-pandemic) and 2021-2023. Logistic regression was employed to analyze the associations between LSM, CAP, and CHD. Restricted cubic spline (RCS) regression was used to evaluate the dose-response relationship between LSM, CAP, and CHD. Stratified analyses were performed according to age, sex, race, education level, income, BMI, blood pressure, hepatitis B surface antibody, and cholesterol to explore potential interactions and identify specific subpopulations at risk. Finally, predictive models were developed using logistic regression, decision trees, XGBoost classifiers, and neural networks to assess the predictive value of LSM and CAP for CHD risk. During the study period, 12,684 participants were included, of whom 539 (4.24%) were diagnosed with CHD. After adjusting for confounders, both LSM and CAP were found to be significantly positively associated with CHD risk in U.S. adults. Subgroup analyses revealed a significant positive association between LSM and CHD incidence in participants stratified by race and blood parameters (interaction P-value < 0.050). Additionally, sex, age, and lipid profiles showed a significant positive correlation between CAP and CHD risk. Predictive models also indicated a positive relationship between LSM, CAP, and CHD risk. Both LSM and CAP were nonlinearly and positively associated with CHD risk, highlighting the importance of maintaining lower levels of liver stiffness and fat as a potential preventive strategy for CHD.
37. β-Nicotinamide mononucleotide alleviates Alcohol-Induced liver injury in a mouse model through activation of NAD+/SIRT1 signaling pathways.
期刊: Hereditas 发表日期: 2025-Aug-16 链接: PubMed
摘要
Alcoholism is a significant contributor to the development of alcoholic liver disease, for which no universally accepted and effective treatment currently exists. A precursor of NAD+, β-Nicotinamide mononucleotide (NMN), has revealed potential therapeutic benefits. However, its effectiveness in preventing ethanol-induced liver damage remains uncertain. The objective of this study was to assess the protective effects of NMN and elucidate its potential mechanisms using a mouse model subjected to chronic and binge ethanol feeding. Eight-week-old C57BL/6J mice were randomly assigned to one of four groups (n = 10 per group): control (CTRL), ethanol (EtOH), ethanol with low-dose NMN (EtOH + NMN(L)), and ethanol with high-dose NMN (EtOH + NMN(H)). Following the completion of the experimental protocol, the mice were euthanized at designated time points, and blood, liver, and ileum tissues were collected for analysis of relevant biomarkers. Compared to the CTRL group, the EtOH group demonstrated increased liver specific gravity and elevated blood ALT levels. Administration of NMN improved histopathological changes in the liver and ileum of the mice. NMN significantly counteracted the ethanol-induced elevation in liver MDA levels and restored the diminished glutathione (GSH) and superoxide dismutase (SOD) activity levels caused by ethanol exposure. Additionally, NMN inhibited the ethanol-induced expression of cytochrome P450 2E1 (CYP2E1). It also reduced the release of pro-inflammatory cytokines, including TNF-α, IL-6, and IL-1β, which were triggered by ethanol exposure, improved energy homeostasis in the ileum, and reversed the downregulation of mRNA and protein expression of key tight junction proteins in the ileum, specifically ZO-1, Claudin-1, and Occludin, thereby restoring their functional integrity. Furthermore, NMN activated the NAD+/ SIRT1 signaling pathway, leading to the upregulation of all target genes. NMN supplementation provides protection against alcoholic liver injury in a mouse model, potentially through the upregulation of the cellular NAD+/ SIRT1 pathway. This upregulation enhances antioxidant and anti-inflammatory activities and improves intestinal permeability.
38. An epigenome-wide association study in the case-control study to explore early development identifies differential DNA methylation near ZFP57 as associated with autistic traits.
期刊: Journal of neurodevelopmental disorders 发表日期: 2025-Aug-16 链接: PubMed
摘要
Quantitative measures of autism spectrum disorder (ASD)-related traits can provide insight into trait presentation across the population. Previous studies have identified epigenomic variation associated with ASD diagnosis, but few have evaluated quantitative traits. We sought to identify DNA methylation patterns in child blood associated with Social Responsiveness Scale score, Second Edition (SRS). We conducted an epigenome-wide association study of SRS in child blood at approximately age 5 in the Study to Explore Early Development, a case-control study of ASD in the United States. We measured DNA methylation using the Illumina 450K array with 857 samples in our analysis after quality control. We performed regression of the M-value to identify single sites or differentially methylated regions (DMRs) associated with SRS scores, adjusting for sources of biological and technical variation. We examined methylation quantitative trait loci and conducted gene-ontology-term pathway analyses for regions of interest. We identified a region about 3.5 kb upstream of ZFP57 on chromosome 6 as differentially methylated (family-wise error rate [fwer] < 0.1) by continuous SRS T-score in the full sample (N = 857; fwer = 0.074) and among ASD cases only (N = 390; fwer = 0.021). ZFP57 encodes a transcription factor involved in imprinting regulation and maintenance, and this DMR has been previously associated with ASD in brain and buccal samples. Blood DNA methylation near ZFP57 was associated (fwer < 0.1) with SRS in the full population sample and appears to be largely driven by trait heterogeneity within the autism case group. Our results indicate DNA methylation associations with ASD quantitative traits are observable in a population and provide insights into specific biologic changes related to autism trait heterogeneity.
39. Jab1 regulates HRR mRNA stability to modulate PARP inhibitor sensitivity in triple-negative breast cancer.
期刊: Molecular cancer 发表日期: 2025-Aug-16 链接: PubMed
摘要
Triple-negative breast cancer (TNBC) is a highly aggressive breast cancer subtype associated with the highest mortality rate among all breast cancer subtypes, primarily due to the absence of actionable therapeutic targets. Although poly (ADP-ribose) polymerase inhibitors (PARPi) have shown promising therapeutic effects in TNBC patients harboring homologous recombination deficiency (HRD), their clinical benefit remains limited, highlighting an urgent need for novel targets that enhance PARPi efficacy. This study investigates the role of Jab1 in regulating the stability of homologous recombination repair (HRR)-related RNAs and evaluates its potential as a therapeutic target to enhance PARPi sensitivity in TNBC. RNA-Seq analysis revealed that shRNA-mediated Jab1 knockdown profoundly affected HRR and DNA replication processes in TNBC cells. Using Nuclear Run-On Assay, RNA Immunoprecipitation, RNA Pull-Down Assay, and RIP-Seq, we identified Jab1 as a potential RNA-binding protein (RBP) that stabilizes HRR-related mRNAs by competing with the exosome complex. Genetic and pharmacological inhibition of Jab1 (using CSN5i-3) were evaluated for their impact on HRR efficiency, ionizing radiation (IR) sensitivity, and PARPi sensitivity. A comprehensive panel of in vitro assays was performed, including clonogenic survival assays, PrestoBlue assays, apoptosis assays, DR-GFP reporter assays, qRT-PCR, Western blot, comet assays, and immunofluorescence. In vivo efficacy was assessed using zebrafish xenografts, nude mouse xenografts, and syngeneic orthotopic mouse models to examine the therapeutic effect of Jab1 inhibition in combination with PARPi. Jab1 was found to be overexpressed in TNBC and correlated with poor clinical outcomes. Functional analyses revealed that Jab1 knockdown impaired HRR, increased DNA damage accumulation, and sensitized TNBC cells to IR and PARPi, irrespective of BRCA mutation status. Mechanistically, Jab1 functioned as an RBP through its MPN domain, stabilizing HRR-related transcripts by competitively antagonizing the RNA exosome complex. Pharmacological inhibition of Jab1 using CSN5i-3 recapitulated these effects and synergized with PARPi to induce synthetic lethality. In multiple preclinical models, this combination significantly suppressed tumor growth and promoted apoptosis. This study uncovers a novel role for Jab1 as an RBP, specifically through interactions between its MPN domain and HRR-related RNAs, regulating RNA stability and maintaining HRR competency. Targeting Jab1 represents a promising strategy to pharmacologically induce HRD and enhance the efficacy of PARPi therapies in TNBC. This combination approach may hold translational value for improving clinical outcomes in patients with TNBC.
40. Peroxidase mimics through DEHP-rich plastic wastes upcycling for colorimetric sensing neonicotinoid insecticides.
期刊: The Science of the total environment 发表日期: 2025-Aug-16 链接: PubMed
摘要
Pesticide residues in agricultural products are closely related to people’s daily dietary health, and the detection for pesticide residues is always a concern. Simple and sustainable methods for real-time monitoring and screening of pesticide residues still faced challenges. The dechlorination and plasticizers decomposition to achieve high-value recycling of waste plastics was urgent demand. Herein, diethylhexyl phthalate (DEHP)-rich polyvinyl chloride (PVC)/iron filings were dechlorinated in subcritical water at low temperatures while DEHP was decomposed, resulting in waste plastics upcycling to simulated enzyme materials for colorimetric detecting pesticides. The recycled materials (CM-FeOOH/Fe3O4-dPVC) were different from the previous treatment for PVC without plasticizers (CM-Fe-dPVC). In subcritical water treatment, decomposition of DEHP led to the formation of FeOOH and magnetic Fe3O4 nanoparticles. Mechanism studies revealed that the flocculation of FeOOH and multi-layer or sheet-like C matrix double increased the specific surface area, resulting in strong catalytic activity of Fe3O4 nanocomposites for 3,3’,5,5’-tetramethylbenzidine (TMB)-H2O2 reaction. Acetamiprid and imidacloprid interacted with CM-FeOOH/Fe3O4-dPVC to change microscopic electron distribution of the materials and increase Fermi level (EF), thereby weakening materials’ mediated electron migration and inhibiting the generation of ·OH free radicals. The colorimetric analysis for neonicotinoid pesticides was constructed by inhibiting simulated enzyme activity of CM-FeOOH/Fe3O4-dPVC, and the detection limit of neonicotinoid pesticide combinations was 8.6 × 10-8 M. The developed paper-based colorimetric sensor was extremely easy to operate and could complete pesticides detection within 30 min at ambient temperatures. LCA (life-cycle assessment) results indicated that this strategy had significantly small environmental impact. This work pioneered environmentally friendly and inexpensive method for detecting pesticides based on the decomposition and transformation of waste plastics, and also provided insights for high-value recycling of organic solid wastes co-processing.
41. Comparative study of neoadjuvant chemoradiotherapy, chemotherapy, and chemoimmunotherapy for locally advanced esophageal squamous cell carcinoma.
期刊: BMC cancer 发表日期: 2025-Aug-16 链接: PubMed
摘要
This study aimed to compare the efficacies of neoadjuvant chemoradiotherapy (NCRT), chemotherapy (NCT), and chemoimmunotherapy (NCIT) in patients with locally advanced esophageal squamous cell carcinoma (LAESCC). The primary objective was to assess the overall survival (OS) among the three treatment groups. A retrospective cohort of 625 patients treated at the Fourth Hospital of Hebei Medical University between 2016 and 2022 was analyzed. Patients received NCRT, NCT, or NCIT followed by radical esophagectomy. To adjust for confounding factors, inverse probability of treatment weighting (IPTW) was employed. Chi-square tests, Fisher’s exact tests, and multivariate Cox survival analyses were used to assess prognostic factors and survival outcomes. Before IPTW, significant differences in baseline characteristics were observed among the three groups. After IPTW adjustment, differences were mitigated, allowing for a balanced comparison. NCIT demonstrated superior 4-year OS rate (91.4%) compared with NCRT (60.4%) and NCT (62.5%). The addition of adjuvant therapy further improved survival outcomes. NCIT may offer superior survival benefits over NCRT and NCT in patients with LAESCC, particularly when combined with adjuvant chemoimmunotherapy (ACIT). These findings underscore the potential of immunotherapy in multimodal treatment of LAESCC and warrant further investigation in prospective clinical trials.
42. Critical investments in bioregenerative life support systems for bioastronautics and sustainable lunar exploration.
期刊: NPJ microgravity 发表日期: 2025-Aug-16 链接: PubMed
摘要
NASA and the CNSA have both released plans for lunar human exploration. This paper reviews those plans through the lens of strategic capability development. It examines the history of NASA’s development of bioregenerative space habitation systems and shows how past research and policy decisions, including funding cuts and program discontinuations, have led to critical gaps in current NASA capabilities. These gaps pose a strategic risk to US leadership in human space exploration that must be addressed urgently to sustain international competitiveness. It concludes with recommendations for program investments crucial for the deployment of mature bioregenerative technologies in the coming decade.
43. Association of workplace support for health with occupational health literacy and illness avoidance: moderated mediation by functioning through a salutogenic lens.
期刊: BMC public health 发表日期: 2025-Aug-16 链接: PubMed
摘要
An increase in the proportion of older employees over the coming decades is an outcome of ageing of the world’s population. Workplace interventions that enable older employees to maintain work productivity and avoid illness are, therefore, increasingly important. An aspect of these interventions is Workplace Support for Health (WSH), which fosters Occupational Health Literacy (OHL) and encourages health behaviours in an organization. Common health behaviours are healthy diet and physical activity, both of which protect physical functioning and well-being. Employees are more likely to avoid illness and maintain physical functioning if they receive enough WSH and improve their OHL. This study aimed to investigate whether there is a moderated mediation by functioning in the relationship between WSH, OHL, and illness avoidance. A cross-sectional design with sensitivity analyses and measures against common methods bias was adopted. The participants were 1015 middle-aged and older adult employees aged 50 to 85 years. The participants were workers of public and private organizations in Accra, Ghana. The main variables (i.e., WSH, OHL, functioning, and illness avoidance) were measured with Likert-type scales adopted in whole from the literature. Data were analysed with Hayes’ Process Model through structural equation modelling. WSH had a positive effect on functioning (β = 0.29; p < 0.001) and illness avoidance (β = 0.25; p < 0.001) in the whole sample. Functioning had a positive effect on illness avoidance (β = 0.45; p < 0.001). A positive indirect effect of WSH (through functioning) on illness avoidance was confirmed. Evidence of a moderated mediation was found, suggesting that the indirect effect of WSH on illness avoidance was stronger at higher OHL. Our sensitivity analysis yielded similar effects in men and women. WSH can enable older employees to improve their physical functioning and avoid illness, especially if it fosters higher OHL. WSH can be an appropriate way to protect employee health in response to ageing of the workforce.
44. Improving mental health and well-being of hospital staff: mixed-methods process evaluation of the SEEGEN trial.
期刊: BMC public health 发表日期: 2025-Aug-16 链接: PubMed
摘要
45. Detectable prostate-specific antigen after radiotherapy for clinically localized prostate cancer.
期刊: Cancer 发表日期: 2025-Aug-15 链接: PubMed
摘要
This study assesses the incidence and timing of undetectable prostate-specific antigen (PSA) after radiotherapy (RT) ± androgen deprivation therapy (ADT) and its association with prostate cancer mortality. This is a population-based study including 5299 men undergoing RT (2006-2020) in the Stockholm County, Sweden with all their PSA tests until death or emigration. The authors calculated incidence and timing of undetectable PSA (PSA ≤0.1 ng/mL) and used competing risk regression to evaluate the association of detectable PSA at 6 and 12 months with prostate cancer mortality (PCSM). Median follow-up for survivors was 81 (32, 130) months. PSA nadir values were reached before 6 and 12 months in 233 (23%) and 470 (36%) patients undergoing RT and 2871 (85%) and 3612 (90%) patients undergoing RT+ADT. No significant association was found between PSA at nadir, 6 and 12 months and PCSM in the radiotherapy group and evidence of association with higher PCSM in RT+ADT group (PSA at nadir: subdistribution hazard ratio [sHR], 2.23 [2.01-2.49]; PSA at 6 months: sHR, 6.91 [5.17-9.23]; and PSA at 12 months: sHR, 37.9 [23.0-62.5]). At 12 years after RT + ADT, PCSM rates were 27%, 15%, 13%, and 5% for patients with PSA at 6 months of ≥0.5, 0.2-0.5, 0.1-0.2, and ≤0.1 ng/mL, respectively; corresponding rates by PSA at 12 months were 34%, 18%, 12%, and 5%. Most patients undergoing RT+ADT reached a PSA ≤0.1 ng/mL within 6 and 12 months. PSA>0.1 ng/mL at these time points indicated a higher risk of PCSM, emphasizing the need for timely restaging and intensified salvage treatments.
46. Association between Hospital Safety-Net Status and Delivery of Rehabilitation to Older Adults with Acute Respiratory Failure.
期刊: Chest 发表日期: 2025-Aug-14 链接: PubMed
摘要
Older adults with socioeconomic disadvantage suffer greater decline in function and cognition following critical illness, an adverse outcome potentially preventable through mobilization. Whether safety-net hospitals (SNHs) that serve the highest proportions of patients with socioeconomic disadvantage are less likely to deliver rehabilitation during hospitalization with stay in the intensive care unit (ICU) is unknown. Are SNHs less likely to provide rehabilitation (physical and/or occupational therapy) services to older adults hospitalized with acute respiratory failure (ARF) who receive invasive mechanical ventilation (IMV) than non-SNHs? A retrospective cohort study of older adults (age≥65 years) hospitalized with ARF, ICU stay≥1 day, and receipt of IMV between 2016-19 using Medicare Provider Analysis and Review files. The primary outcome was delivery of rehabilitation during hospitalization. The exposure was SNH status defined as hospitals in top quartile of Disproportionate Share Hospital index. We constructed hierarchical multivariable logistic regression models with hospitals as random effect, adjusting for patient and hospital characteristics, to evaluate the association between SNH status and rehabilitation delivery. We calculated hospital-level risk-standardized rehabilitation delivery rate and characterized variation using median odds ratio (MOR). We identified 868,735 ICU hospitalizations across 1,859 US hospitals; half were adults between 65-74 years, 48% were female and 77% were of White race. Rehabilitation was delivered in 59.1% of all hospitalizations. In the adjusted model, SNHs had 20% lower odds of delivering rehabilitation compared with non-SNHs [Adjusted Odds Ratio (aOR) (95% CI): 0.80 (0.75-0.86)]. Hospitals varied widely in delivering rehabilitation services with a median risk-standardized rehabilitation rate of 59.4% (IQR 51.7, 67.3) and a MOR of 1.69. SNHs had 20% lower odds of delivering rehabilitation to older adults hospitalized with ARF; differences in rehabilitation delivery could be a potential mechanism for socioeconomic disparities in functional and cognitive decline after critical illness.
47. Comprehensibility in Measurement of Neurobehavioral Function in Disorders of Consciousness: Integrating Data Visualization and Change Indices for the Coma/Near-Coma Scale.
期刊: Archives of physical medicine and rehabilitation 发表日期: 2025-Aug-14 链接: PubMed
摘要
To apply a person-centered measurement principle, comprehensibility, to the reporting of Coma/Near-Coma Scale (CNC-8), a measure of neurobehavioral function (NBF) for patients with disorders of consciousness. We developed Rasch equal-interval measures and change indices on a 0-100 equal-interval scale to support comprehensibility and applied data visualization techniques to enhance transparency for interpreting change in CNC-8 measures over time. Secondary data set using the partial credit Rasch Measurement Model and a case example. Post-acute care rehabilitation. Participants (n=40) with disorders of consciousness (DoC) following a severe brain injury. None. CNC-8. We transformed CNC-8 raw total scores to 0-100 equal-interval measures so that lower values indicated less NBF and higher values indicated more NBF. Indices of responsiveness, including minimal detectable change (MDC) = 15 units and conditional minimal detectable change (cMDC) ranged from 16-62 units. cMDCs provide a more precise method for examining NBF change; however, without an electronic approach to data visualization, a single MDC is easier and quicker to apply in clinical practice. Relationship to PCM principle(s): Person-centered measurement emphasizes the need for assessment results that are comprehensible to all relevant parties, including clinicians and family care partners. Integration of Rasch equal-interval measures, change indices, and modern data visualization techniques can facilitate comprehensibility of interpreting CNC-8 assessment results in real time at the bedside.
48. Celecoxib inhibits skin fibrosis via suppressing adipocyte progenitor-myofibroblast transdifferentiation by attenuating the YAP/TAZ signaling pathway.
期刊: Life sciences 发表日期: 2025-Aug-14 链接: PubMed
摘要
Excessive fibrosis and abnormal scarring, such as hypertrophic scars and keloids, pose significant challenges in wound healing. Myofibroblasts derived from various cell types, including adipocyte progenitors, play a crucial role in driving fibrotic tissue formation. This study aimed to investigate the anti-fibrotic potential of celecoxib, a selective cyclooxygenase-2 inhibitor, and elucidate its underlying mechanisms. We utilized a bleomycin-induced sclerosis mouse model to evaluate the in vivo effects of topically administered celecoxib on skin fibrosis. In vitro experiments were conducted using the 3 T3-L1 adipocyte progenitor cell line to investigate the impact of celecoxib on transforming growth factor-β (TGF-β1)-induced myofibroblast transdifferentiation and the involvement of the Yes-associated protein (YAP)/transcriptional coactivator with PDZ-binding motif (TAZ) signaling pathway. Topical celecoxib treatment significantly attenuated dermal thickening and preserved the intradermal adipose tissue in the bleomycin-induced fibrosis model. In vitro, celecoxib suppressed TGF-β1-induced myofibroblast transdifferentiation in 3 T3-L1 cells, as evidenced by reduced α-smooth muscle actin expression and extracellular matrix production. Mechanistically, celecoxib inhibited the TGF-β1-induced activation of the YAP/TAZ signaling pathway by suppressing YAP and TAZ protein expressions and preventing their nuclear translocation, without affecting the canonical TGF-β/SMAD signaling pathway. Celecoxib exhibited anti-fibrotic effects by targeting the YAP/TAZ signaling pathway, inhibiting adipocyte progenitor-myofibroblast transdifferentiation, and suppressing extracellular matrix production. These results suggest that celecoxib could serve as a promising therapeutic agent for abnormal scarring and fibrosis, offering valuable insights into novel anti-fibrotic strategies for wound healing.
49. Explainable multiplex graph propagational network with multimodal neuroimage integration for dementia subtype diagnosis.
期刊: Neural networks : the official journal of the International Neural Network Society 发表日期: 2025-Aug-07 链接: PubMed
摘要
Dementia encompasses diverse subtypes with distinct characteristics, including cognitive functions, cerebrospinal fluid biomarkers, and neuroimages. Neuroimaging-based diagnosis is advantageous due to low variability and minimal invasiveness, ensuring safe and accurate outcomes. Recently, integrating multimodal neuroimages with machine learning techniques has enhanced diagnostic precision. Especially, graph neural network (GNN) has emerged as promising models by considering connectivity between brain regions. However, current GNN-based methods are limited by focusing solely on local connectivity, failing to adequately capture global interactions crucial to structural pathways and functional brain activities. Additionally, existing methods pose a trade-off between improving diagnostic performance and maintaining explainability, as complex feature transformations across hidden layers obscure model explanations. This limitation is especially critical in clinical settings, where transparent decision-making directly impacts patient outcomes. Motivated by these limitations, we propose a novel method for diagnosing dementia subtypes by integrating multimodal neuroimages, called Explainable Multiplex Graph Propagational Network (EMGPN). Our method employs multiplex graphs derived from multiple neuroimaging modalities, propagating features across brain regions to concurrently represent local and global connectivity. EMGPN subsequently integrates these multimodal features through region-specific, probabilistically derived parameters, thus preserving individual modality characteristics. Crucially, EMGPN maintains explainability through a transparent architecture without hidden layers, allowing clinicians to clearly understand model outcomes. We validated EMGPN using an elderly South Korean cohort across various dementia subtypes. The results indicated that EMGPN achieved an average performance improvement of 8.6 % compared to existing methods, while generating explainable outputs, including region-specific modality contributions and subtype-specific brain region importance maps. These findings underscore EMGPN’s significant potential as a clinically applicable, explainable, and robust tool for neuroimaging-based dementia diagnosis.
50. Developing biobanking processes for Alzheimer's disease and related dementia research in Africa: Experience from the Recruitment and Retention for Alzheimer's Disease Diversity in the Alzheimer's Disease Sequencing Project (READD-ADSP).
期刊: Alzheimer’s & dementia : the journal of the Alzheimer’s Association 发表日期: 2025-Aug 链接: PubMed
摘要
The Recruitment and Retention for Alzheimer’s Disease Diversity in the Alzheimer’s Disease Sequencing Project (READD-ADSP) aims to recruit 5000 African participants (Alzheimer’s disease [AD] and cognitively unimpaired controls) to generate genomic and biomarker data to better characterize AD neurobiology in Africa from countries that constitute the African Dementia Consortium (AfDC). Blood samples from study participants are separated into fractions and transported to the African Coordinating Centre (ACC: Ibadan, Nigeria), where DNA extraction and long-term biospecimen storage are carried out. Plasma and DNA aliquots are shipped to the John P. Hussman Institute for Human Genomics, University of Miami (HIHG-UM, Miami, USA) for genotyping, whole genome sequencing, and biomarker analysis. Innovative solutions were devised to mitigate challenges encountered so far. Our biobanking experience in a low-resource setting demonstrates the feasibility of establishing a successful African biobanking network, as an important infrastructure to support Alzheimer’s disease and related dementias research in Africa. HIGHLIGHTS: Biobanking is gaining grounds in Africa in studies related to neurological disorders. The Recruitment and Retention for Alzheimer’s Disease Diversity in the Alzheimer’s Disease Sequencing Project (READD-ADSP) biobanking network is a new initiative to enhance infrastructure for Alzheimer’s disease and related dementias (ADRD) research in Africa through the African Dementia Consortium. The processes of the stepwise creation and development of the READD-ADSP biobanking network have been guided by global best practices and regulatory standards. Challenges were encountered in the process of establishing the READD-ADSP biobank, and home-grown solutions were developed to mitigate the challenges. The READD-ADSP biobanking experience offers lessons to researchers in low-resource settings on how collaborative efforts between the global north and global south enhance cutting-edge team science to tackle ageing-associated brain disorders in low- and middle-income countries.
51. IPSC-Derived Conditioned Medium Reduces Oxidative Stress and Vascular Remodeling in Rat Models of Pulmonary Arterial Hypertension.
期刊: Journal of cellular physiology 发表日期: 2025-Aug 链接: PubMed
摘要
Pulmonary arterial hypertension (PAH) is a progressive vascular disease characterized by elevated pulmonary vascular resistance, leading to right ventricular (RV) hypertrophy and eventual heart failure. Although current therapies provide symptomatic relief, they offer limited efficacy in reversing the underlying vascular remodeling. In this preclinical study, we investigated the therapeutic potential of induced pluripotent stem cell-derived conditioned medium (iPSC-CM) in a monocrotaline (MCT)-induced rat model of PAH, employing both prophylactic and therapeutic administration strategies. iPSC-CM treatment significantly reduced right ventricular systolic pressure (RVSP) and mitigated RV hypertrophy compared to MCT-only controls. Histological analyses revealed attenuated pulmonary arterial wall thickening and muscularization. At the molecular level, iPSC-CM downregulated the expression of hypoxia-inducible factor 1-alpha (HIF-1α) and platelet-derived growth factor-BB (PDGF-BB) in lung tissues, and modulated oxidative stress by decreasing NADPH oxidase 1 (Nox1) and increasing superoxide dismutase 1 (SOD1) levels. In vitro, iPSC-CM suppressed the proliferation and migration of pulmonary artery smooth muscle cells (PASMCs) under hypoxic and PDGF-BB-stimulated conditions. These findings suggest that iPSC-CM targets key pathogenic pathways involved in vascular remodeling and redox imbalance in PAH. Together, these findings support iPSC-CM as a promising acellular approach for targeting vascular remodeling and oxidative stress in PAH, warranting further investigation toward clinical translation.
52. Efficacy of hyperbaric oxygen salvage therapy for sudden sensorineural hearing loss after ineffective primary treatment in the Slovak Republic.
期刊: Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc 发表日期: 2025 链接: PubMed
摘要
We evaluated the efficacy of hyperbaric oxygen (HBO₂) therapy used to salvage sudden sensorineural hearing loss (SSNHL) at a short distance from ineffective primary treatment. We examined the data on 70 patients who suffered from SSNHL. The treatment was administered from 1 to 3 months after the onset of the hearing loss, i.e., after ineffective primary corticosteroid therapy. The monitored group was divided into three subgroups according to the degree of hearing impairment. Treatment success was assessed by using pre- and post-treatment audiograms. A statistically significant improvement in auditory threshold in all three frequency bands was observed in patients with severe hearing impairment of more than 60 dB, with mean auditory gains of 14.5 dB in low frequencies, 11.2 dB in middle (spoken speech) frequencies, and 13.2 dB in high frequencies. In this subgroup, 54.17 % of patients with severe hearing impairment experienced an improvement in hearing gain by 5 dB or more, 33.33 % by > 10 dB, and 25.00 % by > 20 dB. In patients with moderate and slight hearing impairments, the tendency to improve the hearing gain was not statistically significant. Based on our findings, we conclude that salvage HBO₂ treatment in patients with SSNHL is apparently most efficacious for individuals with severe hearing impairment. This finding is valuable for effective resource management in healthcare and public health.
53. RADAR-ES: A Methodological Framework for Conducting Environmental Scans in Health Services Delivery Research.
期刊: Journal of primary care & community health 发表日期: 2025 链接: PubMed
摘要
To propose a methodological framework for conceptualizing, planning, and implementing an environmental scan (ES) in health services delivery research (HSDR). An ES is a methodological approach employed to examine a range of practices, policies, issues, programs, technologies, trends, and opportunities from a variety of data sources to inform program or policy development. Despite the wide use of ESs in health care to inform decision-making, a lack of methodological guidance exists to support researchers in planning and conducting an ES in HSDR. Adapting McMeekin et al’s process for developing methodological frameworks, we identified literature that described approaches to planning and conducting ESs in addition to exemplar articles that featured ESs in HSDR. We integrated original research findings and synthesized data from all sources to generate an evidence-informed methodological framework. We developed RADAR-ES that consists of 5 phases and is informed by 4 guiding principles: (1) Recognizing the Issue; (2) Assessing Factors for ES; (3) Developing an ES Protocol; (4) Acquiring and Analyzing the Data; and (5) Reporting the Results. RADAR-ES will provide comprehensive guidance for researchers and health services stakeholders who plan and conduct ESs in HSDR.
54. Factors related to the prognosis of hyperbaric oxygen therapy for postoperative paralytic ileus.
期刊: Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc 发表日期: 2025 链接: PubMed
摘要
Postoperative paralytic ileus is one of the most common complications associated with abdominal surgery. Although the Japanese Society of Hyperbaric and Undersea Medicine officially approves paralytic ileus as an indication for hyperbaric oxygen therapy, the factors related to the prognosis of this therapy have not been determined. Accordingly, in this study, we evaluated factors that may be related to the prognosis of this therapy in patients with postoperative paralytic ileus. Patients in gastroenterological surgery, obstetrics and gynecology, and urology who underwent hyperbaric oxygen therapy for postoperative paralytic ileus from April 1, 2017, through March 31, 2022, were retrospectively evaluated. We set the primary outcome as the number of days to oral intake after the start of the therapy. First, we compared the differences in the number of days for various factors possibly related to its prognosis. Next, multivariate analysis using multiple linear regression analysis was performed. We evaluated 110 patients. Younger age, no prevalence of diabetes mellitus, the kind of surgery, no history of previous abdominal surgery, a shorter number of days from the onset to the start of therapy, and higher mean pressure of therapy had at least 1.5 fewer days of nothing by mouth. Multiple linear regression analysis revealed that only the mean pressure of therapy was a factor associated with the prognosis of hyperbaric oxygen therapy. Only the mean pressure of therapy is related to the prognosis of hyperbaric oxygen therapy. Further prospective studies adopting higher pressure therapy will be necessary to evaluate the efficacy of this treatment.