公共卫生研究摘要 (2025-08-19)
共收录 54 篇研究文章
1. Comparative cross-sectional analysis of asthma outcomes and sinus surgery utilization in Appalachian and non-Appalachian counties of Ohio.
期刊: Journal of osteopathic medicine 发表日期: 2025-Aug-19 链接: PubMed
摘要
Healthcare inequities disproportionately affect underprivileged groups, leading to negative health outcomes. Challenges are compounded in regions like Appalachian Ohio, where rurality and poverty exacerbate issues such as access to care and environmental stressors, significantly impacting conditions like asthma. In severe cases of asthma, sinus surgery is sometimes indicated, because it has been shown to improve asthma-related symptoms. However, the specialists who perform these procedures, such as otolaryngologists, may be less available to certain underprivileged groups. The purpose of this study was to compare the effects of social determinants of health on the prevalence and treatment of asthma in Appalachian vs. non-Appalachian regions of Ohio, and how those factors affect the rate at which sinus surgery is performed in different populations. This cross-sectional study utilized public data gathered in the year 2021 from the Centers for Disease Control and Prevention (CDC) and the Center for Medicare and Medicaid Services (CMS) to compare asthma prevalence, emergency visit and hospitalization rates, sinus surgery frequencies, and social determinants of health in Appalachian vs. non-Appalachian regions. Both the average prevalence rate of asthma (p<0.001) and the number of emergency department visits as a complication of asthma (p<0.01) in Appalachian Ohio counties were significantly higher than non-Appalachian counties. Interestingly, the ratio between sinus surgery prevalence and the number of procedures was not statistically different between Appalachian and non-Appalachian counties. This included balloon sinuplasty (p=0.4), septoplasty (p=0.4), and functional endoscopic sinus surgery (FESS, p=0.4). Additionally, several social determinants of health, specifically the poverty rate (r=0.9, p<0.001), uninsured rate (r=0.4, p<0.001), unemployment rate (r=0.5, p<0.001), and housing burden rate (r=0.6, p<0.001) were shown to have a significant correlation with the rate of asthma prevalence among adults in Ohio. Asthma prevalence and treatment availability differ significantly between Appalachian and non-Appalachian regions of Ohio, highlighting the need to improve access to specialists and address barriers to care in rural populations.
2. Promoting Comprehensive Care for People With Rare Diseases in a Tertiary Care Setting in Brazil: Protocol for a Mixed Methods Implementation Study.
期刊: JMIR research protocols 发表日期: 2025-Aug-18 链接: PubMed
摘要
Rare diseases (RDs) have gained attention in public policy due to their complexity and low prevalence and the challenges they present in health care settings. Comprehensive care for people with RDs requires strengthening of services, programs, and care levels. It is imperative to make digital health tools available to support epidemiological surveillance, facilitate patient follow-up, and enhance the education and awareness of health care professionals (HCPs) regarding these conditions. This study aims to implement enhanced actions aligned with the Brazilian National Policy for Comprehensive Care for People with Rare Diseases to improve the attention and care provided to individuals. This will be achieved by developing a computational tool and establishing guidelines to optimize the regulation of the reference services for RDs, providing updated information to expedite diagnosis and promote collaboration. The methodology includes mapping the regulation processes in the Clinics Hospital of Ribeirão Preto Health Complex. Participants will include HCPs from the hospital complex and associated primary care centers and patients with a confirmed or suspected RD selected through medical records and patient associations. Data collection methods include questionnaires, semistructured interviews, and patient tracking using health information systems. The project will apply the 5W2H (what, who, where, when, why, how, and how much) framework to align tasks, responsibilities, and resources. Integrating digital tools adhering to the findability, accessibility, interoperability, and reusability principles will promote real-time monitoring, improved resource allocation, and enhanced workflow efficiency. Training initiatives will boost awareness and capacity among HCPs, while the computational tool seeks to streamline patient follow-up and tracking. Digital integration and interoperability will reduce referral process inefficiencies and support evidence-based decision-making. Education and awareness campaigns will fill knowledge gaps among HCPs and patients. Ethics approval was granted on December 9, 2024. We conducted technical meetings with the IT team to align procedures for obtaining secondary data. Concurrently, we identified key guidelines and applied a knowledge management maturity questionnaire based on which we began mapping RD-related management processes. A computational ontology is currently under development to ensure semantic interoperability. This framework supported initiatives promoting education and awareness regarding RDs, targeting HCPs and patients. The study emphasizes the potential of digital health solutions to transform RD care by improving coordination, resource allocation, and stakeholder education. When effectively adopted, these solutions can enhance access to specialized care, reduce inefficiencies, and inform public health policies. Future efforts will focus on expanding the tool’s implementation, refining its functionalities, and evaluating its long-term impact on patient outcomes and system efficiency. This initiative highlights the crucial role of integrating digital technologies in managing RDs and underscores the need for ongoing collaboration among health care stakeholders to achieve sustainable improvements in patient care and policy development. PRR1-10.2196/68949.
3. Universal Pharmacare and Contraceptive Dispensations Among Youth.
期刊: JAMA pediatrics 发表日期: 2025-Aug-18 链接: PubMed
摘要
Previous studies have suggested that removing financial barriers to contraception could help reduce unintended pregnancy. To assess whether introduction of universal public funding for prescription contraception in Ontario (OHIP+) for individuals younger than 25 years and the amended program, which limited public funding to those without private insurance (OHIP-), is associated with changes in contraceptive dispensations. Interrupted time-series analyses were used to evaluate whether implementation of either policy was associated with changes in monthly contraceptives dispensed. The setting included a national database on contraceptives dispensed from retail pharmacies between September 2016 and February 2020; data analysis was performed from May 2022 to 2024. Participants included Ontario females aged 15 to 24 years to whom prescriptions were dispensed (intervention) vs controls: (1) Canadian females aged 15 to 24 years, excluding Ontario, and (2) Ontario females aged 25 to 49 years. Implementation of free prescription contraception through OHIP+ (January 2018-March 2019) and OHIP- (April 2019-February 2020). Monthly dispensations of intrauterine devices (IUDs) and oral contraceptive pills (OCPs) per 1000 females overall and by area-level socioeconomic status (SES). After OHIP+, there was an immediate level increase in IUDs dispensed to Ontario females aged 15 to 24 years (intervention) of 0.50 (95% CI, 0.15-0.84) vs 0.03 (95% CI, -0.26 to 0.32) in Canadian females aged 15 to 24 years-a relative increase of 0.48 (95% CI, 0.02-0.91). There was an immediate level increase in OCPs dispensed to Ontario females aged 15 to 24 years of 22.3 (95% CI, 14.8-29.8) vs 7.57 (95% CI, 3.07-12.1) in those aged 25 to 49 years-a relative increase of 14.8 (95% CI, 6.15-23.4). There were no statistically significant changes in monthly dispensation trends after OHIP+ and no statistically significant changes after OHIP-. In areas with lower SES, there was a significant increase in the level for IUDs of 0.64 (95% CI, 0.02-1.26) and for OCPs of 13.2 (95% CI, 1.33-25.0) after OHIP+, and a significant decrease in the level for IUDs of 0.82 (95% CI, -1.55 to -0.09) after OHIP- in Ontario vs Canadian females aged 15 to 24 years. No statistically significant changes in IUD or OCP dispensations were observed in areas with higher SES vs controls. Results reveal that providing comprehensive and confidential access to prescription contraceptives was associated with increased dispensations among Ontario youth.
4. Metformin for Treatment of Knee Osteoarthritis in Patients With Overweight or Obesity-Reply.
期刊: JAMA 发表日期: 2025-Aug-18 链接: PubMed
摘要
5. The Vocabulary of Our Discontent.
期刊: JAMA 发表日期: 2025-Aug-18 链接: PubMed
摘要
This Perspective examines the vocabulary used to describe how US health care is increasingly governed by the rules, values, and practices of other sectors of the market economy.
6. Intravenous Argatroban or Eptifibatide in Patients Undergoing Mechanical Thrombectomy: A Subgroup Analysis of the MOST Randomized Clinical Trial.
期刊: JAMA neurology 发表日期: 2025-Aug-18 链接: PubMed
摘要
The addition of direct thrombin inhibitors or glycoprotein platelet inhibitors to intravenous thrombolysis in patients undergoing endovascular thrombectomy for acute ischemic stroke may improve reperfusion rates and clinical outcomes. To investigate the safety and efficacy of these agents. This was a preplanned cohort analysis from the Multi-Arm Optimization of Stroke Thrombolysis (MOST) randomized clinical trial, which lasted from 2019 to 2023 with a 90-day follow-up. Centrally read outcomes were assessed blinded to treatment. The MOST study was a multicenter, multiarm, adaptive, single-blind, phase 3 trial that included patients with acute ischemic stroke who were selected for thrombectomy per standard of care. Patients were randomized to placebo, argatroban, or eptifibatide within 75 minutes of intravenous thrombolysis. The 90-day utility-weighted modified Rankin Scale (UW-mRS) score (range, 0-10, with higher scores reflecting better outcomes) was used as the primary outcome measure. Reperfusion rates and safety (hemorrhage rates) were also assessed, where good reperfusion was defined as a Thrombolysis in Cerebral Infarction score of 2b/2c/3 on the completion angiogram. A total of 5376 patients were assessed for eligibility. Of these individuals, 4332 did not meet inclusion criteria, 251 eligible patients did not have consent obtained, 279 were excluded for other reasons, and 514 were randomized in the MOST trial. A total of 254 were planned for thrombectomy (110 in the placebo group, 31 in the argatroban group, and 113 in the eptifibatide group). Mean (SD) age was 68 (14.3) years, and 134 (53%) were female. Of these patients, 219 received thrombectomy: 94 in the placebo group, 27 in the argatroban group, and 98 in the eptifibatide group. There was no effect of treatment on outcome (mean UW-mRS score: eptifibatide, 6.47; 95% CI, 5.79-7.15; argatroban, 5.35; 95% CI, 4.13-6.58; placebo, 6.68; 95% CI, 5.98-7.39). Rates of good reperfusion were similar between groups (83 of 92 in the placebo group [83%]; 17 of 27 in the argatroban group [63%], and 82 of 98 in the eptifibatide group [84%]). The proportion of symptomatic intracranial hemorrhage was similar between groups. Results of this secondary analysis of the MOST randomized clinical trial reveal that the addition of argatroban or eptifibatide to intravenous thrombolysis was not associated with better reperfusion rates or clinical outcomes in patients undergoing endovascular thrombectomy. Future investigations of these agents as intravenous adjuncts to thrombectomy should focus on populations who are ineligible for intravenous thrombolysis. ClinicalTrials.gov Identifier: NCT03735979.
7. Balance of Increased Costs for Some Beneficiaries With Protections for Users of Expensive Drugs-Medicare Part D Reforms.
期刊: JAMA internal medicine 发表日期: 2025-Aug-18 链接: PubMed
摘要
8. Brain Abnormalities in Children Exposed Prenatally to the Pesticide Chlorpyrifos.
期刊: JAMA neurology 发表日期: 2025-Aug-18 链接: PubMed
摘要
Chlorpyrifos (CPF) is one of the most widely used insecticides throughout the world. Preclinical and clinical studies have suggested that prenatal CPF exposure is neurotoxic, but its effects on the human brain are unknown. To identify the associations of prenatal CPF exposure with brain structure, function, and metabolism in school-aged children. This prospective, longitudinal pregnancy cohort study was conducted from January 1998 to July 2015, with data analysis from February 2018 to November 2024 in a community in northern Manhattan and South Bronx, New York. Of 727 pregnant women of African American or Dominican descent in the original community cohort, 512 had CPF levels measured at delivery. Offspring 6 years and older were approached for magnetic resonance imaging (MRI) scanning. Prenatal CPF exposure. Anatomical MRI measures of cortical thickness and local white matter volumes, diffusion tensor imaging indices of tissue microstructure, MR spectroscopy indices of neuronal density, arterial spin labeling measures of regional cerebral blood flow, and cognitive performance measures. Prespecified hypotheses before data collection included CPF-related structural abnormalities in frontotemporal cortices, basal ganglia, and white matter pathways interconnecting them, and reduced neuronal density. Participants included 270 youths (123 boys and 147 girls) aged 6.0 to 14.7 years (mean [SD] age, 10.38 [1.12] years) with self-identified Dominican or African American mothers. Progressively higher prenatal CPF exposure levels associated significantly in childhood with progressively thicker frontal, temporal, and posteroinferior cortices; reduced white matter volumes in the same regions; higher fractional anisotropy and lower diffusivity in internal capsule white matter; lower regional blood flow throughout the brain; lower indices of neuronal density in deep white matter tracts; and poorer performance on fine motor (β, -0.30; t261 = -5.0; P < .001) and motor programming (β, -0.27; t261 = -4.36; P < .001) tasks. Prenatal CPF exposure was associated with altered differentiation of neuronal tissue into cortical gray and white matter, increased myelination of the internal capsule, poorer motor performance, and profoundly impaired neuronal metabolism throughout the brain. CPF is known to increase oxidative stress and inflammation and in turn impair mitochondrial functioning, neuronal development, and maturation of the oligodendrocyte precursor cells responsible for axonal myelination. These molecular and cellular effects of CPF likely account at least in part for the observed associations of CPF with poorer long-term brain and motor outcomes.
9. Uncovering the Understanding of the Concept of Patient Similarity in Cancer Research and Treatment: Scoping Review.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-18 链接: PubMed
摘要
Patient similarity is a fundamental concept in precision oncology, offering a pathway to personalized medicine by identifying patterns and shared characteristics among patients. This concept enables stratification into clinically meaningful subgroups, prediction of treatment responses, and the tailoring of therapeutic interventions to individual needs. Despite its transformative potential, the definition, measurement, and clinical application of patient similarity remain inconsistently established, creating challenges in its integration into cancer research and clinical practice. This study aimed to synthesize evidence on the multidimensional concept of patient similarity in cancer research by analyzing its application across different points of possible data types, methodological frameworks, biological contexts, and commonly studied cancer types. This scoping review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) framework and the Joanna Briggs Institute guidelines. A systematic search was conducted across PubMed, MEDLINE, LIVIVO, and Web of Science (covering the period from 1998 to February 2024) and was supplemented by snowball sampling and manual searches. Duplicate records were removed, and study selection was carried out in 3 phases: title and abstract screening, disagreement resolution, and full-text screening. Each step was independently performed by 2 reviewers in Rayyan, with conflicts resolved by a third reviewer. Data extraction was performed using a predefined template to capture methodological approaches, data types, cancer types, and research objectives related to similarity in patients with cancer. This scoping review synthesized evidence from 137 studies, emphasizing the multidimensional concept of patient similarity in cancer research, which integrates diverse data types, methodological frameworks, research objectives, and cancer types. Transcriptomic data (92/137, 67.1%) and clinical data (65/137, 47.4%) were the most frequently used, often combined to enhance the comprehensiveness of similarity analyses. Machine learning (76/137, 55.5%) and network-based approaches (72/137, 52.5%) were prominent methods, reflecting their capacity to handle complex, high-dimensional data and uncover intricate relationships. Cancer subtype identification (70/137, 51.1%) and biomarker discovery (41/137, 29.9%) were the primary research objectives, underscoring the centrality of patient similarity in precision oncology. Breast, lung, and brain cancers were the most frequently studied, benefiting from established research frameworks and abundant datasets. Conversely, rare cancers were underrepresented, highlighting a critical gap in the generalizability of current methodologies. This comprehensive scoping review examines the concept of patient similarity in cancer research and highlights the critical role of a multilayered perspective in capturing its complexity and identification to enhance understanding and application in precision oncology.
10. Italian adaptation of the European guidelines for breast cancer diagnosis, staging, and preoperative planning: a GRADE-ADOLOPMENT approach.
期刊: La Radiologia medica 发表日期: 2025-Aug-18 链接: PubMed
摘要
An Italian guideline panel issued the national recommendations for breast cancer diagnosis, staging, and preoperative planning. The panel employed the ADOLOPMENT process to adopt or adapt the guidelines developed by the European Commission Initiative on Breast Cancer (ECIBC). This process utilises the Grading of Recommendations Assessment, Development and Evaluation evidence-to-decision framework. Hereby, we present 15 prioritised recommendations from the second chapter of the Italian guidelines. All of the recommendations as originally developed by the ECIBC were adopted. For the assessment of women with positive screening result, the diagnostic recommendations suggest using digital breast tomosynthesis instead of additional mammographic projections. Recommendations include using needle core biopsy (NCB) instead of fine-needle aspiration for suspicious lesions, and stereotactic-guided -rather than ultrasound-guided- NCB for suspicious calcifications. For preoperative planning, they recommend clip marking after biopsy and not using additional magnetic resonance imaging (MRI) for confirmed ductal carcinoma in situ. Contrast-enhanced mammography is preferred over MRI for presurgical planning, when needed. Other imaging tests are not recommended for stage I, IIa, and IIb BC without signs of metastasis, while positron emission tomography-computed tomography alone is suggested for stage III BC. Adjuvant hormone therapy is recommended when 1% or more tumour cells show oestrogen or progesterone receptor positivity, which replaces the 10% threshold. Adopting shared and trustworthy guidelines for BC screening across Europe will help standardise the process across settings and advance healthcare quality and equity.
11. Strengthening Parkinson's disease epidemiology: refining diagnosis and survival metrics.
期刊: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology 发表日期: 2025-Aug-18 链接: PubMed
摘要
12. Impact of age on PUAL as an indicator of opioid effect in adult subjects.
期刊: Journal of clinical monitoring and computing 发表日期: 2025-Aug-18 链接: PubMed
摘要
Opioid-induced respiratory depression (OIRD) remains a critical safety concern, particularly in older adults, yet timely, reliable detection methods are limited. Decline of pupillary unrest in ambient light (PUAL) has demonstrated potential as a marker of opioid effect in young adult subjects. We evaluated whether previously observed PUAL thresholds for high-risk opioid exposure in younger adults remain valid in 40-60-year-old subjects. Ten healthy volunteers 40-60 years of age underwent PUAL measurement at baseline and every 2.5 min during a 10-minute remifentanil infusion (0.2-0.3 µg/kg/min) and 25-minute recovery period. High-risk opioid exposure was defined primarily by modeled remifentanil effect-site concentration (CEREMI) threshold during infusion. Findings were then combined with previously collected data from 20 younger subjects (aged 20-39 years) undergoing an identical infusion protocol. PUAL declined consistently during infusion and increased toward baseline during recovery (p < 0.001). During infusion no significant difference in slope over time or CEREMI was observed between age groups, but during recovery a flatter slope was observed in older subjects (p = 0.016). PUAL reliably distinguished between high-versus low-risk opioid exposure during infusion (AUROC = 0.9833 [95% CI: 0.8935, 0.9995]), with interval likelihood ratio (iLR) for high-toxic opioid effect 27.98 (95% CI: 1.79, 438.33) for PUAL < 0.04, 0.75 (95% CI: 0.38, 1.50) for PUAL 0.04-< 0.14, and 0.030 (95% CI: 0.002, 0.477) for PUAL ≥ 0.14. Comparison of discriminatory performance to that of younger subjects showed no significant difference (chi2 = 1.02, p = 0.3129). PUAL thresholds for high-risk opioid exposure are consistent between younger and older adults and do not require age-specific adjustment up to age 60. PUAL offers a reliable, real-time marker of opioid effect with potential to enhance early OIRD detection in adults.
13. Impact of royal jelly consumption on oxidative stress, anti-oxidant markers and physical activities of patients with multiple sclerosis: a randomized double-blind placebo-controlled study.
期刊: Irish journal of medical science 发表日期: 2025-Aug-18 链接: PubMed
摘要
The study investigates the effects of royal jelly (RJ) on patients with relapsing-remitting multiple sclerosis (RRMS), focusing on its potential to reduce oxidative stress, improve antioxidant levels, and enhance quality of life. A total of 61 RRMS patients were randomly assigned to either a RJ group or a placebo group, receiving a daily dose of 500 mg for 45 days. Key outcomes measured included expanded disability status scale (EDSS) scores, levels of malondialdehyde (MDA), and activities of antioxidants such as catalase (CAT) and superoxide dismutase (SOD), along with assessments of fatigue and quality of life. Results indicated that the RJ group experienced a significant reduction in EDSS scores (P < 0.001) and MDA levels (P < 0.0001). The activity of SOD and CAT after consumption of RJ had increased significantly (P < 0.0001, P < 0.001), respectively. Additionally, improvements were noted in some parameters of fatigue and quality of life measures. The findings suggest that RJ may help decrease oxidative stress and improve motor function and anti-oxidant capacity in MS patients, potentially slowing disease progression. This study was registered on the Iranian Registry of Clinical Trials (Registration No. IRCT20220116053732N1) on 2022.05.08.
14. Unhealthy lifestyles accelerated aging and consequential musculoskeletal morbidity.
期刊: Journal of bone and mineral metabolism 发表日期: 2025-Aug-18 链接: PubMed
摘要
Few studies assessed comprehensive effects of composite unhealthy lifestyles on aging and musculoskeletal health. This study aimed to address such issues with the UK Biobank datasets. An unhealthy lifestyle score (UHLS) was constructed based on 9 lifestyle behaviors. Aging indicators were calculated from 18 clinical traits. General linear and Cox proportional hazards regression models were used to analyze associations between UHLS, aging, and musculoskeletal morbidity. Mendelian randomization (MR) analysis was performed for causal relationship exploration. Among 396,037 participants, 54.5% and 3.3% of them were designated to the low (scored 0-2) and high UHLS (scored 6-9) groups, respectively. Increasing UHLS was associated with elevated aging acceleration (AA) based on biological age (0.343 per unit; 95% CI: 0.331, 0.355) and phenotypic age (AA_PA) (0.408 per unit; 95% CI: 0.394, 0.422), and higher morbidity of low grip strength (HR = 1.025; 95% CI: 1.001, 1.050), slow walking pace (HR = 1.134; 95% CI: 1.074, 1.198), osteoporosis (HR = 1.077; 95% CI: 1.063, 1.091), fracture (HR = 1.059; 95% CI: 1.048, 1.069) and osteoarthritis (HR = 1.036; 95% CI: 1.030, 1.042). Unhealthy lifestyles in conjunction with AA jointly increased musculoskeletal morbidity. Besides, AA mediated UHLS effects on slow walking pace, osteoporosis and fracture, with mediating proportion of 4.85%-12.79%. MR analyses revealed causal relationships between UHLS and low grip strength, osteoarthritis, and reduced femoral neck bone mineral density. In addition, AA_PA suggestively mediated the UHLS-osteoarthritis association. Composite unhealthy lifestyles accelerate aging and impair musculoskeletal health. Both mediating and joint effects of AA showed unhealthy lifestyle-associated musculoskeletal morbidity.
15. The impact of vitreous floaters on quality of life: a qualitative study.
期刊: Journal of patient-reported outcomes 发表日期: 2025-Aug-18 链接: PubMed
摘要
Many people perceive moving spots in their vision (vitreous floaters), but not everyone is bothered by them. The impact of floaters is difficult to assess with clinical tests. Previous studies have used questionnaires or a small number of interviews to investigate quality of life, but these studies may not cover all relevant quality-of-life issues. With 44 interviews, we found that vitreous floaters can have a unique and previously unidentified impact on the quality of life of individuals with this eye condition, such as difficulties in daily activities, concerns about work, being bothered by bright light, and wanting their concerns to be taken seriously. Eye care clinicians should recognize these issues when evaluating a person who experiences floaters. To help weigh the quality-of-life impact of floaters and their treatments for each individual, a floater-specific questionnaire is helpful, but only if it is relevant, valid, and developed with patient input. The findings from this study can inform the development of a new floaters-specific questionnaire that covers a more complete range of relevant quality-of-life issues.
16. Conflicts of Interest in Federal Vaccine Advisory Committees.
期刊: JAMA 发表日期: 2025-Aug-18 链接: PubMed
摘要
This study analyzes the prevalence of reported conflicts of interest (COIs) among attendees at 2000-2024 meetings of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) and the US Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee (VRBPAC).
17. Engaging Peer Mentors for Opportunity, Well-Being, and Equity Realization-A Leadership Intervention for Women in Academic Medicine.
期刊: Journal of women’s health (2002) 发表日期: 2025-Aug-18 链接: PubMed
摘要
Background: The underrepresentation of women in senior positions persists in academic medicine. Data-driven strategies are needed to catalyze advancement. Methods: We designed a novel, National Institutes of Health-funded intervention-Engaging Peer Mentors for Opportunity, Well-Being, and Equity Realization (EMPOWER) to be evaluated in a randomized study. This educational innovation was modeled on the Leadership Learning Model Framework developed for the Executive Leadership in Academic Medicine (ELAM)® program and integrated existing research and multidisciplinary content expertise. EMPOWER strives to support the career advancement of women faculty by cultivating fundamental leadership competencies implemented within a peer mentorship framework. Early outcomes surrounding perceptions, feasibility, as well as engagement are described. Results: We share the EMPOWER curriculum implemented among a national cohort of women clinician-scientists within a broader randomized trial design; 94 consenting participants were assigned to the intervention. Many participants (68%; n = 54) found EMPOWER valuable or very valuable for their personal or career development. It was easy or very easy for 79% (n = 63) of participants to access the online educational materials, and 61% (n = 49) attended all or almost all of the peer circle meetings. Conclusions: We describe EMPOWER, a novel, potentially scalable, virtual intervention, to address the unmet needs of women faculty in academic medicine at the pivotal transition to leadership. The EMPOWER intervention was feasible, and we report early lessons learned from its development. Future evaluation will include qualitative analyses and comparison of outcomes between program participants and control subjects.
18. Facing the Next Generation of US Newborn Screening.
期刊: JAMA pediatrics 发表日期: 2025-Aug-18 链接: PubMed
摘要
This Viewpoint discusses the critical role of the Advisory Committee on Heritable Disorders in Newborns and Children and the importance of continued national guidance to the future of US newborn screening.
19. Deriving Health Utility Values Using Mapping Methods Among the Chinese Population: A Systematic Review.
期刊: Applied health economics and health policy 发表日期: 2025-Aug-18 链接: PubMed
摘要
Despite an increasing number of mapping studies being conducted in China, there is an absence of a systematic reviews, which makes it difficult to inform the applications and further assess the methodological consistency, accuracy, and applicability of existing mapping studies. The objective of this review is to consolidate existing evidence, identify methodological gaps, and provide recommendations for improving mapping studies conducted among the Chinese population. A systematic literature search was conducted in 14 databases from inception to May 31, 2025 to identify studies that developed mapping algorithms to estimate health utility values, specifically among Chinese populations. A data template was applied to extract dataset information, source and target measures, mapping types (direct vs indirect), models used, goodness-of-fit indicators, validation methods, and the optimal mapping algorithms selected. Potential challenges for future related studies were further discussed. A total of 33 studies was included. Most studies (87.9%) focused on mapping disease-specific non-preference-based measures (PBMs) to generic PBMs. The studies covered a broad range of disease areas, including oncology (36.4%), musculoskeletal disorders (15.2%), metabolic diseases (15.2%), cardiovascular diseases (9.1%), and neurological conditions (6.1%). All studies used direct mapping, with the ordinary least squares model (n = 37) being used most frequently, followed by Tobit model (n = 32) and Beta model (n = 22). Eleven studies explored indirect mapping, with the Ordered Logit and Ordered Probit models being the most employed techniques. Thirty-two studies conducted internal validation, with the N-fold cross-validation being the most used method-no study conducted external validation. The sample size ranged from 133 to 3320, with a median sample size of 553. Conducted conceptual analysis was performed in 81.8% of the studies to assess the degree of overlap between the source measure and target measure; 72.7% of the studies reported the utility/score distributions, and 15.2% of studies further reported the response distributions. This systematic review provides insights into methodologies employed in mapping studies in China and identifies key areas for improvement. Addressing issues related to sample size, conceptual overlap, model selection, and validation methods will enhance the quality and applicability of mapping algorithms, ultimately supporting more robust cost-utility analyses in the Chinese healthcare system.
20. Educational Targets for Patient-Reported Outcomes and Caregiver-Reported Outcomes in Psycho-oncology Research.
期刊: Journal of cancer education : the official journal of the American Association for Cancer Education 发表日期: 2025-Aug-18 链接: PubMed
摘要
Patient-reported outcomes (PROs) and caregiver-reported outcomes (CROs) are tools for evaluating behavioral medicine interventions and for bringing the patient voice into observational research. This study aimed to identify barriers to using PROs/CROs in behavioral cancer research and to equitably address those barriers. Forty-nine members of a cancer special interest group from a research society completed surveys in early 2023 about needs related to the use of PROs and CROs. Descriptive statistics were used to summarize results. Most participants used PROs (n = 34, 69%) but few frequently used CROs (n = 12, 24%). More than 80% of the sample were familiar with common PRO/CRO properties such as reliability and validity. Participants reported considering a wide variety of population characteristics when using PROs and CROs, including language (n = 31, 70%) and education level (n = 31, 70%). The most common barriers to using PROs/CROs in research were time, funding, and technology with many reflecting potential reasons for inequitable representation of certain groups in research. Webinars were the most preferred educational format (n = 38, 78%) for resources related to PROs/CROs. Many participants encountered barriers to using PROs in research. Creation and dissemination of educational resources to promote equitable use of PROs/CROs across underrepresented groups and overcome common barriers to use of these measurement tools are warranted.
21. Integrated evaluation of Nigrosome 1 sign, neuromelanin-sensitive MR and iron deposition.
期刊: Japanese journal of radiology 发表日期: 2025-Aug-18 链接: PubMed
摘要
To differentiate between Parkinson’s Disease (PD) and healthy controls by using integrated analysis of PD-specific MR findings including deformation of the substantia nigra pars compacta (SNpc), signal loss in neuromelanin (NM) sensitive MRI, and iron deposition in the deep gray matter (DGM) structures. Patients with PD and healthy controls were recruited between August 2022 and December 2023. All subjects underwent 3 T MRI including a magnetization transfer contrast (MTC) and a double flip angle multi-echo protocol as part of Strategically Acquired Gradient Echo (STAGE). The data analysis included detecting the presence of Nigrosome-1 (N1) sign in the SNpc, signal intensity and volume of NM content and iron quantification through quantitative susceptibility mapping (QSM) in DGMs. The 3D regions of interest were manually demarcated on QSM maps. Mean susceptibility values from global analysis (whole structure) as well as regional high iron analysis (age-based threshold) were extracted for each individual structure. Univariate and multivariate analyses were performed using these parameters. Nineteen patients with PD (68.0 ± 8.0 years, 10 males, Hoehn and Yahr scale 1 (n = 1), 2 (n = 13), 3 (n = 4), 4 (n = 1)) and 21 healthy controls (68.3 ± 8.6 years, 12 males) were enrolled. Discriminating PD from controls was successful using each method: N1 sign (P < 0.001), NM volume (P < 0.001), susceptibility values of global analysis (caudate, P < 0.001; putamen, P < 0.001; pulvinar, P = 0.006), regional analysis (putamen, P < 0.001; pulvinar, P = 0.009, thalamus, P = 0.008). Stepwise logistic regression analyses were performed, and the best model was created using N1 sign, NM volume, regional analysis (putamen, red nucleus and thalamus) (area under the curve of 0.99). Integrated analysis of PD specific MR findings including N1 sign, NM volume, and iron content in the DGM structures robustly discriminates between PD and healthy controls.
22. Harm reduction of heated tobacco in outdoor spaces in place of burnt tobacco smoking.
期刊: Analytical methods : advancing methods and applications 发表日期: 2025-Aug-18 链接: PubMed
摘要
The effect of heat-not-burn (HnB) tobacco in smoking practices has been evaluated in outdoor scenarios by using gas sensors. The data obtained confirmed that the use of HnB tobacco has a minimal impact on ambient suspended particles, that is, PM10 and PM2.5 levels, resulting in approximately half the effect of combustion tobacco, in line with harm reduction principles. In addition, using HnB products outdoors did not lead to high levels of VOCs in the surrounding air nor in the breath of people who use them, whether directly or through passive exposure. This contrasts sharply with the increased levels found in the breath of both active and passive users of traditional tobacco cigarettes. On the other hand, liquid chromatography high resolution mass spectrometry (LC-HRMS) analysis of HnB passive volunteers’ exhaled breath extracts showed typical compounds of tobacco manufacturing products.
23. Use of Wearable Sensors to Assess Fall Risk in Neurological Disorders: Systematic Review.
期刊: JMIR mHealth and uHealth 发表日期: 2025-Aug-18 链接: PubMed
摘要
Assessing fall risk, especially in individuals with neurological disorders, is essential to prevent hospitalization, hypomobility, and reduced functional independence. Wearable sensors are increasingly used in neurorehabilitation, as they enable unsupervised fall risk assessment by providing continuous monitoring during daily functional tasks, thereby offering a reflection of the individual’s real-world fall risk. We systematically reviewed the literature on reliable biomechanical gait parameters detected with wearable sensors to assess fall risk in neurological disorders, focusing on patients with Parkinson disease, multiple sclerosis, stroke, or Alzheimer disease. In addition, we examined the latest advancements in wearable sensor technology, including best practices for device placement as well as data processing and analysis. We conducted a comprehensive systematic search for relevant peer-reviewed articles published up to April 18, 2025, using PubMed, Web of Science, Embase, and IEEE Xplore, which are the most used databases in the fields of health and bioengineering. The 19 included studies involved 2630 patients with neurological disorders, including 226 (8.59%) with multiple sclerosis (n=7, 37% studies), 2305 (87.64%) with Parkinson disease (n=8, 53% studies), 51 (1.94%) with stroke (n=3, 16% studies), and 48 (1.83%) with Alzheimer disease or cognitive impairment (n=1, 5% study). This review highlights the role of wearable technologies in assessing fall risk in patients with neurological disorders. Although the included studies showed variation in methods and a focus on technology over clinical context, the lack of standardization reflects ongoing advancements, which may be seen as a strength. PROSPERO CRD42023463944; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023463944.
24. Association Between Refrigerator Openings and Protein Intake After Hospitalization for Heart Failure Decompensation: Protocol for a Prospective Cohort Pilot Study.
期刊: JMIR research protocols 发表日期: 2025-Aug-18 链接: PubMed
摘要
Sarcopenia, characterized by loss of muscle mass, reduced strength, and increasing frailty, is common in older adults and is often the result of underlying diseases such as advanced stages of heart failure (HF). Protein intake is crucial for maintaining muscle mass and strength. However, older adults typically consume less protein compared to younger individuals. It has recently been shown that the time of the first refrigerator opening in the morning, indicated by a door sensor, may be correlated with frailty in older individuals living alone. The aim of this study is to determine whether the time of the first refrigerator opening in the morning can serve as a potential indicator of protein intake in older patients (age ≥70 years) after hospitalization for HF decompensation over a period of 6 months. This is a substudy of a prospective interventional cohort study that aims to identify changes in digital biomarkers derived from an ambient sensor system, which may support the early detection of HF decompensation. In this substudy, the frequency and timing of refrigerator door openings in participants’ homes will be measured. To assess associations between protein intake and refrigerator openings, dietary intake will be evaluated using 24-hour dietary recalls at 3 different timepoints: at 1, 3, and 6 months after hospital discharge. All 24-hour dietary recalls will be conducted by trained dietitians in face-to-face interviews on weekdays. The primary outcome of this study will be the correlation between protein intake and the time (in minutes after midnight) of the first refrigerator door opening at each of the 3 assessment points. The study is currently in the data collection phase. Recruitment began in February 2024. Data analysis will begin after all data have been collected. As of manuscript submission, 12 patients have been recruited. Results are expected to be published by the end of 2025. Considering that protein-rich foods are typically stored in the refrigerator, the relationship between frailty and refrigerator usage may be a relevant indicator for nutritional assessment, particularly regarding protein intake. In addition, sarcopenia and frailty may also be linked to protein distribution across meals. This study will explore whether monitoring refrigerator openings can serve as a simple method for identifying increased risk of frailty and sarcopenia. Early detection through such monitoring could facilitate timely interventions and potentially reduce the risk of these conditions. ClinicalTrials.gov NCT06126848; https://clinicaltrials.gov/study/NCT06126848. DERR1-10.2196/66299.
25. Thiol Reactome Profiling in Plant-Derived Foods and Discovery of an Abundant Insecticidal Natural Product (R)-Dihydromaleimide in Snow Pea (Pisum sativum).
期刊: Journal of agricultural and food chemistry 发表日期: 2025-Aug-18 链接: PubMed
摘要
While thiol-reactive compounds have been extensively utilized by plants as defensive metabolites, prior investigations into these natural products remained limited. We employed a reactivity-directed analysis method utilizing high-resolution mass spectrometry to conduct thiol reactome profiling on extracts from 70 different plant-derived foods, resulting in the tentative prediction of chemical formulas of 71 abundant molecular adduct ions. Then, we selected a prominent adduct ion for structural elucidation, leading to the identification of (R)-dihydromaleimide (DHM) and (R)-dihydromaleimide β-d-glucoside (DHMG) in snow pea (Pisum sativum). DHM demonstrated insecticidal properties against the fall armyworm (FAW) and Protaetia brevitarsis and antifeedant activity against FAW, with oxidative stress as a contributing mechanism. Quantitative analyses indicated considerable concentrations of DHMG and DHM in many parts of pea plants and easy conversion of DHMG to DHM in aqueous extracts. This research provided a feasible strategy for the high-throughput screening and discovery of novel botanical natural products for pest control.
26. Cytomegalovirus prophylaxis with letermovir in pediatric (birth to <18 years of age) hematopoietic cell transplant recipients: pharmacokinetics, efficacy, and safety results of a Phase 2b study.
期刊: Antimicrobial agents and chemotherapy 发表日期: 2025-Aug-18 链接: PubMed
摘要
Letermovir, a cytomegalovirus (CMV) terminase complex inhibitor, was first approved for prophylaxis of CMV infection and disease in adult CMV-seropositive allogeneic hematopoietic cell transplant (HCT) recipients (R+). This study evaluated the pharmacokinetics (PK), efficacy, and safety of letermovir in pediatric R+ allogeneic HCT recipients. In this Phase 2b, single-arm, open-label study, 65 participants were enrolled sequentially in three age groups (AG; AG1, 12 to <18 years; AG2, 2 to <12 years; and AG3, birth to <2 years). PK was evaluated in an initial cohort in each AG using intensive PK data to confirm or modify dosing before enrolling the remaining participants. Adult HCT population PK (PopPK) data were used to establish the exposure reference range. The adult letermovir dose evaluated in AG1 and AG2 participants achieved exposures generally within the adult HCT reference range. In AG3, the initial cohort (letermovir with cyclosporin A) achieved exposures trending lower than the median exposure target; the letermovir dose was increased for the remaining participants. Efficacy and safety in pediatric participants were generally consistent with adult HCT data. A pediatric HCT PopPK model was developed to determine dose recommendations to be included in patient prescribing information. The doses evaluated achieved exposures generally within the adult HCT reference range. At exposures achieved, letermovir was efficacious and safe in preventing clinically significant CMV infection in pediatric allogeneic HCT recipients. The observed concentration data informed a pediatric PopPK model to optimize final letermovir dose recommendations in this population.CLINICAL TRIALSThis study is registered with ClinicalTrials.gov as NCT03940586.
27. Mediators linking gut microbiota and sporadic Creutzfeldt-Jakob disease: a Mendelian randomization study.
期刊: AMB Express 发表日期: 2025-Aug-18 链接: PubMed
摘要
While gut microbiome associations with sporadic Creutzfeldt-Jakob disease (sCJD) are recognized, causal mechanisms and mediation via cerebrospinal fluid (CSF) metabolites remain unestablished. Using bidirectional Mendelian randomization (MR) with mediation analysis and integrating genome-wide association study (GWAS) summary statistics from gut microbiota (composition in the FINRISK 2002 prospective cohort, n = 5,959), CSF metabolites (from the Wisconsin Alzheimer’s Disease Research Center Registry and Wisconsin Registry for Alzheimer’s Prevention, n = 291), and sCJD case-control data (5,208 cases vs. 511,675 controls), we identified five microbial taxa influencing sCJD risk. Protective effects were observed for the family Atopobiaceae [odds ratio (OR) = 0.527, 95% confidence interval (CI) = 0.321-0.864, P = 0.011], the species Enterococcus faecalis (OR = 0.647, 95% CI = 0.427-0.980, P = 0.040), and the genus Lactobacillus (group B) (OR = 0.768, 95% CI = 0.602-0.981, P = 0.035). Conversely, the species Bacteroides eggerthii (OR = 1.228, 95% CI = 1.027-1.468, P = 0.025) and the order Chloroflexales (OR = 3.455, 95% CI = 1.214-9.835, P = 0.020) were pathogenic. Mediation analysis revealed that S-methylcysteine mediates 8.8% of the effect of order Chloroflexales on sCJD risk, establishing it as a significant biological mediator in this pathogenic pathway. These findings provide novel biomarkers for early sCJD risk stratification, identify the family Atopobiaceae, the species Enterococcus faecalis, and the genus Lactobacillus (group B) as probiotic candidates for primary prevention, reveal S-methylcysteine pathway modulation as therapeutic entry points, and establish mechanistic foundations for disrupting gut-CSF transmission in prion diseases.
28. Know your enemy: understanding mosquito biology to advance malaria elimination in Africa.
期刊: Parasitology research 发表日期: 2025-Aug-18 链接: PubMed
摘要
Over a century has passed since the discovery that the female anopheline mosquito is a vector of malaria, prompting extensive efforts to combat the disease. Vector control remains the primary malaria prevention strategy, accounting for a remarkable 65% reduction in malaria cases between 2000 and 2015. A thorough understanding of the fundamental biology of malaria vectors is essential for national malaria control programmes, governments, and local communities to implement sustainable and effective vector control measures. This article explores the key aspects of mosquito biology, such as adult and juvenile life stages, the intrinsic incubation period, and blood-seeking behaviour, within the context of the mosquito life cycle. By emphasizing the importance of this knowledge, we illustrate how it can inform community-level control initiatives and guide national programmes in designing more effective interventions for vector-borne disease management. Furthermore, the article underscores how researchers can harness these biological insights to develop and deploy innovative tools that have the potential to revolutionize malaria control efforts.
29. Microbial transformation: the role of fermentation in advancing nutritional quality and human health.
期刊: Archives of microbiology 发表日期: 2025-Aug-18 链接: PubMed
摘要
Fermentation, one of the oldest food preservation techniques, has recently garnered renewed interest due to its ability to enhance the nutritional and functional characteristics of food. Fermentation’s microbial metabolism preserves food while transforming its bioactive components, synthesizing health-promoting metabolites, including vitamins, bioactive peptides, antioxidants, and short-chain fatty acids. This review article examines how fermentation utilizes microbial populations to enhance food quality and confer health benefits. We begin by examining the fundamental role of microbes in fermentation, emphasizing essential microorganisms such as lactic acid bacteria, yeast, and mold, which are responsible for the biochemical changes that enhance the quality of fermented foods. These microbes not only enhance flavor, texture, and shelf life but also contribute to improved gut health, regulate the immune system, and reduce inflammation by producing probiotics and other bioactive compounds. The review discusses the emerging applications of fermentation in developing functional foods, emphasizing the growing body of evidence that fermented products can help prevent and manage chronic diseases, including gastrointestinal disorders, cardiovascular disease, and metabolic syndrome. Particular emphasis is placed on how microbial fermentation can enhance the bioavailability of key elements, such as B vitamins and minerals, while degrading anti-nutritional substances like phytates and oxalates, making fermented foods extremely beneficial to a wide range of individuals. In conclusion, this review emphasizes the underutilized potential of microbial metabolism in food fermentation as a valuable tool for improving human health. Researchers and the food industry can design nutrient-dense, functional foods that fulfill customers’ desire for healthier alternatives while simultaneously contributing to global food system sustainability.
30. The Role of Plant Oils in Combating Streptococcal Infections: Mechanisms, Efficacy, and Therapeutic Potential.
期刊: Current microbiology 发表日期: 2025-Aug-18 链接: PubMed
摘要
Streptococcal infections, caused by species such as Streptococcus pyogenes, Streptococcus pneumoniae, and Streptococcus mutans, represent a major global health concern, particularly in the face of rising antimicrobial resistance (AMR). Conventional treatments-including vaccines and antibiotics-are increasingly compromised by factors such as genetic variability, biofilm formation, and drug resistance mechanisms. In this context, plant-derived oils emerge as promising alternatives due to their broad-spectrum antimicrobial activity and complex phytochemical profiles that hinder resistance development.This review consolidates current findings on the antimicrobial efficacy of plant oils against streptococcal pathogens, emphasizing their mechanisms of action-disruption of bacterial membranes, inhibition of biofilm formation, and interference with quorum sensing. Essential oils from Thymus vulgaris, Origanum vulgare, Cinnamomum verum, and Eucalyptus spp. exhibit notable activity. The review further highlights the phytochemical composition of these oils, including terpenes, aldehydes, and phenolics, and their synergistic effects, both internally and with conventional antibiotics. Applications in topical formulations, oral hygiene products, and advanced delivery systems such as nanoemulsions are explored, alongside cytotoxicity, allergenicity, and environmental sustainability considerations. Despite their potential, plant oils face challenges such as variability in chemical composition and limited clinical validation. Future directions call for standardization, advanced delivery methods, expanded toxicological studies, and sustainable production practices. Overall, this review explores plant oils as natural, effective, and sustainable alternatives to combat streptococcal infections, particularly in the era of escalating antibiotic resistance.
31. Jiao-Tai-Wan Improves Cognitive Impairment by Regulating Nrf2/ARE/HO-1 Signaling Pathway in APP/PS1 Mice.
期刊: Neurochemical research 发表日期: 2025-Aug-18 链接: PubMed
摘要
Alzheimer’s disease (AD) is a chronic, progressive, and destructive neurodegenerative disorder that severely affects human memory, intelligence, and behavioral abilities. Jiao Tai Wan (JTW) is a classic formula composed of two traditional Chinese medicines, coptis chinensis (CC) and cinnamon (CIN), the ratio of CC and CIN is 10:1. JTW has the effects of promoting cognitive function, and improving learning and memory function. But the specific mechanism has not been systematically studied. We conducted Morris water maze and Y-maze behavioral tests, polymerase chain reaction (PCR), assay kit and ELISA, nissl’s staining, and western blotting to verified the improvement of cognitive function of JTW on APP/PS1 mice. Through behavioral experiments, JTW can improved the learning and spatial exploration abilities of APP/PS1 mice. Nissl’s staining and PCR detection of BDNF, NGF, and SYP showed that JTW can improved neurodegenerative lesions in APP/PS1 mice. By detecting the activities of A β 1-40, A β 1-42, α - secretase, β - secretase, and γ - secretase, as well as cholinergic labeling enzymes of Ach, AchE, and ChAT activities showed that JTW improved cerebral amyloidosis and cholinergic nervous system in APP/PS1 model mice. The detection of inflammatory factors and oxidative stress indicators revealed that JTW can inhibited the activity of inflammatory factors and oxidative stress. Western Blotting was used to detect the Nrf2/ARE/HO-1 pathway, and the result showed that JTW can regulate the Nrf2/ARE/HO-1 pathway to improving cognitive function of APP/PS1 mice. JTW enhanced the activity of Nrf2, regulated the Nrf2/ARE/HO-1 pathway, increased the activity of nerve growth factors, improved the cholinergic nervous system, inhibited inflammatory factors and oxidative stress, and ameliorated cognitive dysfunction in APP/PS1 mice.
32. Barriers and Drivers of Using Alternative Fertilizers in Sustainable Agriculture: Case Study of Poland.
期刊: Environmental management 发表日期: 2025-Aug-18 链接: PubMed
摘要
Fertilizers are crucial for enhancing soil fertility and agricultural productivity, playing a pivotal role in modern farming practices. However, the reliance on mineral fertilizers has raised concerns due to their environmental impacts, including soil degradation, water contamination, and greenhouse gas emissions. Consequently, there is growing interest in sustainable alternatives that leverage organic waste streams to recycle nutrients back into agricultural systems. Alternative fertilizers produced from such as sewage sludge, animal manure and digestate, are increasingly recognized for their potential to support sustainable agriculture. This paper presents the goal of assessing the current state and development potential of alternative fertilizer use in Poland in the context of circular economy (CE). The SWOT (strengths, weaknesses, opportunities, threats) method was used to carry out the analysis. The key findings include identification of strengths such as the environmental benefits of nutrient recycling, reduced waste generation and cost savings for farmers. However, the analysis also indicates weaknesses, such as inconsistent quality, potential contamination risks and social resistance to using waste-derived products. Opportunities were identified, including increasing demand for eco-friendly agricultural practices, technological advancements in waste treatment and supportive policies that promote CE initiatives. Nevertheless, the sector faces threats such as regulatory barriers, competition with synthetic fertilizers and potential health risks from pollutants in organic waste streams. Considering the rising importance of social dimensions in sustainability assessment, a growing number of studies in the fertilizer sector is expected to adopt Social Life Cycle Assessment (S-LCA) to evaluate social impacts and acceptance of alternative fertilizers.
33. Multifunctional 3D-Printed Wound Dressings Containing a Combination of Synergistic Antimicrobials in the Management of MRSA Infected Topical Wounds.
期刊: ACS applied materials & interfaces 发表日期: 2025-Aug-18 链接: PubMed
摘要
Despite increased pre- and postoperative care and aseptic practices in surgical rooms, methicillin-resistant Staphylococcus aureus (MRSA) continues to colonize acute surgical wounds. MRSA is also present in chronic nonhealing wounds, such as diabetic foot and pressure ulcers. In this work, advanced antimicrobial-loaded wound dressings are 3D printed using fused deposition modeling. To achieve a high antimicrobial effect, the topical antiseptic octenidine (OCT) was incorporated into the pellets used in the feeder of the extruder prior to fused modeling. Lysostaphin (LYS), a lytic enzyme that cleaves MRSA peptidoglycan, was incorporated by supramolecular interactions on the surface of the OCT-loaded dressings to exploit the anti-MRSA synergy identified here between OCT and LYS showing a fractional inhibition concentration index (FICI) of 0.156. Minimum inhibitory concentration (MIC) and bactericidal concentration (MBC) values for the OCT were 1 and 25 μg/mL, respectively, whereas the MIC and MBC values for the LYS were 0.1 and 0.2 μg/mL, respectively. The resulting dressings completely eradicate MRSA USA 300 inocula (105 CFU/mL) in 96 h. The bactericidal mechanisms exerted by these dressings were identified through molecular techniques, showing lytic effects on the cell wall peptidoglycans of treated bacteria. Additionally, OCT at 1 μg/mL was able to reduce lipopolysaccharide (100 ng/mL)-induced NO production on murine J774A.1 macrophages by more than 90% demonstrating its simultaneous anti-inflammatory action. This effect was also corroborated by the qRT-PCR analysis of several pro-inflammatory genes including IL-1β, IL-6, TNF-α, and Nos2. The combination of OCT and LYS within the dressings reveals higher in vivo therapeutic effects compared to free compounds or individual antimicrobial-loaded dressings. In vitro and in preclinical models, the use of OCT-LYS dressings effectively reduces MRSA bioburden and inflammation, promoting fast wound healing.
34. What Losing the National Institute for Occupational Safety and Health Means for Respiratory Health.
期刊: American journal of respiratory and critical care medicine 发表日期: 2025-Aug-18 链接: PubMed
摘要
35. Developing a Model of Health and Supportive Care for People with Silicosis in Australia.
期刊: Annals of the American Thoracic Society 发表日期: 2025-Aug-18 链接: PubMed
摘要
Silicosis is an occupational lung disease caused by the inhalation of respirable crystalline silica (RCS) dust. Stone benchtop industry workers exposed to RCS are at high risk of artificial stone silicosis, a totally preventable disease with no cure and limited treatment options. Little is known about the impact and daily challenges associated with living with the disease. This study aimed to develop a model of health and supportive care addressing the needs of people with silicosis based on their lived experiences. Patients with silicosis identified from two Australian tertiary clinics were invited to participate in semi-structured interviews by telephone from May to August 2024. Interviews explored the impact of silicosis on health, wellbeing, and supportive care needs. Interviews were transcribed verbatim and thematic analysis was used to identify key elements of a health and supportive care model. 40 people were interviewed. All were male with an average age of 42.80±9.24 years (range 29-62 years). Major themes included: unclear pathway to diagnosis; uncertainty regarding prognosis; limited information on silicosis especially in other languages; significant financial impact related to loss of occupation, with substantial effects on mental health; and challenges of managing life with silicosis. Components of the person-centred, individualised care model included: lung health, mental health, reliable information, occupational support, fitness programs, lifestyle, peer support, care pathways and coordination. People with silicosis have a range of unmet health care and supportive needs. The proposed model provides a person-centred approach to meet the unique needs of this cohort.
36. Particles Matter: Air Pollution and Disparities in Sarcoidosis.
期刊: American journal of respiratory and critical care medicine 发表日期: 2025-Aug-18 链接: PubMed
摘要
37. Treatment Patterns, Healthcare Utilization, and Related Costs for Prurigo Nodularis in Sweden.
期刊: Acta dermato-venereologica 发表日期: 2025-Aug-18 链接: PubMed
摘要
Prurigo nodularis (PN) is a chronic, itchy, inflammatory skin condition that negatively affects quality of life. A study was undertaken to investigate the healthcare utilization, including treatment patterns and direct costs for specialist care, for PN in Sweden. Linkage cohorts were created from national Swedish patient and prescription registers, and the cost-per-patient database of PN adults in specialist care in Sweden from 2015 to 2020. Around 875 patients were registered annually with a specialist diagnosis of PN in Sweden, with 3,548 specialist visits per year on average. In patients with severe PN with AD, the most common treatment sequence was topical treatment with corticosteroids followed by systemic prednisolone and methotrexate (32.6%). More than one-fifth of individuals with PN, and most with severe PN, had treatment for more than 1 year. For in- and outpatient care, the mean cost per visit was €458.6 and per patient per year around €1,862. The total annual cost of PN patients is estimated to be €1.6 million in Sweden. A high proportion of patients are treated for years with several, often systemic, treatment sequels. Targeted treatments for PN might improve patients’ quality of life and reduce the high related costs for the healthcare system.
38. Causal relationship between gastroesophageal reflux disease and pneumoconiosis: Evidence from a clinical retrospective study and two-sample Mendelian randomization.
期刊: Chinese medical journal 发表日期: 2025-Aug-18 链接: PubMed
摘要
39. Quality of Life in Autistic Children: Discrepancies Between Self- and Caregiver-Proxy Reports and Associations With Individual Characteristics.
期刊: Autism research : official journal of the International Society for Autism Research 发表日期: 2025-Aug-18 链接: PubMed
摘要
Quality of life (QoL) is important for everyone and has been identified as a priority for autistic people. However, studies typically focus on caregiver-proxy-reported QoL and its related individual characteristics, even though self- and caregiver-proxy-reported QoL may differ in autistic children. In 74 autistic children (5.04-10.99 years old, intelligence quotient [IQ] 47-141), we sought to determine the level of agreement between self- and caregiver-proxy-reported QoL and determine if self- and caregiver-proxy-reported QoL are differently related to personal characteristics such as age, IQ, autism features, attention-deficit/hyperactivity disorder (ADHD) features, sleep difficulties, and sensory features. Findings suggested poor inter-rater agreement (ICC = 0.16) between self- and caregiver-proxy-reported QoL. Across both self- and caregiver-proxy reports, sensory features and sleep difficulties related to QoL, but age and IQ did not. We also found an interaction effect of reporter on the relation between QoL and both autism and ADHD features, with these associations driven by caregiver-proxy-reported QoL. These findings emphasize the importance of measuring both self- and caregiver-proxy-reported QoL to provide complementary perspectives. Moreover, these results underscore the importance of understanding a child’s sensory features and sleep difficulties, as these two areas were similarly related to both self- and caregiver-proxy-reported QoL.
40. Long noncoding RNA MIR100HG regulates inflammatory response by interacting with RNA-binding protein Quaking in periodontitis.
期刊: Journal of periodontology 发表日期: 2025-Aug-17 链接: PubMed
摘要
Long noncoding RNAs (lncRNAs) are emerging regulators of periodontal inflammation. This study investigates the role of lncRNA MIR100HG in periodontitis and its interaction with the RNA-binding protein Quaking (QKI). In vitro, human gingival fibroblasts (HGFs) were stimulated with Porphyromonas gingivalis lipopolysaccharide (Pg.LPS, 200 ng/mL, 24 h). In vivo, ligature-induced periodontitis was established in mice. RNA sequencing, RNA immunoprecipitation (RIP), fluorescence in situ hybridization (FISH), and Western blotting were employed to dissect molecular mechanisms. MIR100HG was downregulated in inflamed gingival tissues (RNA-seq). FISH and Subcellular RNA fractionation analysis confirmed MIR100HG was primarily localized in the nucleus of HGFs. Knockdown of MIR100HG attenuated Pg.LPS-stimulated inflammation (interleukin [IL]-1β, IL-6 and tumor necrosis factor alpha [TNF-α]) in HGFs, while overexpression exacerbated cytokine release. The interaction between QKI and MIR100HG was identified by RNA immunoprecipitation assays. QKI silencing reversed anti-inflammatory effects of MIR100HG knockdown, linking this axis to nuclear factor kappa B (NF-κB) activation. In mice, knockdown of MIR100HG significantly mitigated alveolar bone loss and the levels of inflammatory markers. This study identifies MIR100HG as a key lncRNA in periodontitis, showing its downregulation in human and murine models. MIR100HG knockdown alleviates periodontal inflammation via a QKI-mediated feedback loop, underscoring its potential as a therapeutic target for periodontitis management. Long non-coding RNAs (lncRNAs) are emerging as critical regulators in the pathogenesis of periodontitis, yet the functional roles of most differentially expressed lncRNAs remain poorly understood. In this study, we identified MIR100HG as a significantly downregulated lncRNA in periodontitis-affected gingival tissues through RNA transcriptome sequencing. Functional experiments revealed that MIR100HG knockdown attenuates Porphyromonas gingivalis lipopolysaccharide (Pg.LPS) -induced inflammation in human gingival fibroblasts (HGFs), as evidenced by reduced levels of proinflammatory cytokines (interleukin [IL] -1β, IL-6, and tumor necrosis factor [TNF] -α), whereas MIR100HG overexpression exacerbates inflammatory responses. Mechanistically, MIR100HG activates the nuclear factor kappa B (NF-κB) signaling pathway by interacting with the RNA-binding protein Quaking (QKI), a known suppressor of NF-κB. This interaction forms a negative feedback loop that regulates inflammatory responses. Importantly, MIR100HG knockdown alleviated periodontal inflammation and bone loss in periodontitis mouse model, further supporting its pivotal role in disease progression. Our findings demonstrate that MIR100HG modulates periodontal inflammation through a QKI- mediated mechanism, highlighting its potential as a therapeutic target for periodontitis. This study provides novel insights into lncRNA-mediated immune regulation and highlights its potential as a therapeutic target for managing periodontitis.
41. Authors' Reply: Equity-Centered Optimization of Virtual Cancer Survivorship Care.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-12 链接: PubMed
摘要
42. A time-resolved framework for the recruitment of mRNP processing and assembly factors to a site of transcription.
期刊: Nucleic acids research 发表日期: 2025-Aug-11 链接: PubMed
摘要
Processing and packaging of messenger ribonucleoprotein (mRNP) particles involve complex, coordinated interactions between nascent transcripts, RNA-binding proteins (RBPs), and associated factors. Despite the critical role of co-transcriptional mRNP assembly in gene expression, the temporal dynamics of this process are not well understood. Here, a live cell imaging assay is reported in Saccharomyces cerevisiae to detect recruitment of endogenous fluorescently tagged proteins to a transcriptionally active locus. Protein recruitment to an inducible integrated gene array composed of 25 transcriptional units is detected by colocalization with lacO repeats. Using arrays with two different promoters and the same coding sequence (GFA1), arrival times for a variety of mRNP processing and assembly factors were quantified. These analyses revealed Yra1, Cbp80, and Yhs7 as pioneering mRNP assembly factors. Notably, Yra1 recruitment occurs independently of the THO complex, with early localization supported by Cbp80 and the RNA recognition motif of Yra1. Altogether, this work establishes the first comprehensive temporal framework for understanding protein recruitment during co-transcriptional mRNP assembly, providing mechanistic insights into the dependencies of Yra1 recruitment.
43. Pharmacy Barriers to Receiving Buprenorphine Among Patients Undergoing Telemedicine Addiction Treatment.
期刊: JAMA network open 发表日期: 2025-Aug-01 链接: PubMed
摘要
Buprenorphine is a first-line medication for opioid use disorder, yet many individuals face barriers to filling buprenorphine prescriptions. Telemedicine patients may have prescriptions questioned and rejected more frequently due to being perceived as a diversion risk due to their prescriber’s physical distance from the pharmacy. To evaluate pharmacy challenges in filling buprenorphine prescriptions among adults receiving telemedicine treatment for opioid use disorder overall and by rural and nonrural residence. This cross-sectional study analyzed a web-based survey conducted from August to September 2024. Adult patients receiving treatment from a telemedicine practice providing low-barrier treatment for opioid use disorder in 5 US states were included. Participants were identified through electronic health records; inclusion criteria were diagnosis of opioid use disorder, enrollment in telemedicine treatment with a valid zip code, and completion of a new evaluation visit and follow-up appointment. Rural and nonrural residence determined by patient zip codes mapped to Rural-Urban Commuting Area codes. Self-reported frequency of buprenorphine fill problems in the past year, types of fill problems, and days without buprenorphine due to pharmacy-related challenges. A total of 601 patients participated, with 300 (49.9%) residing in nonrural areas, 363 (60.4%) identifying as women, and a mean (SD) age of 41.44 (8.60) years. Nearly one-third of patients (192 [31.9%]) had to go without buprenorphine due to a pharmacy-related barrier in the past 12 months, and more than one-quarter (165 [27.5%]) reported having problems filling their buprenorphine prescription. There was no statistically significant difference in the experience of buprenorphine fill problems between rural and nonrural respondents. The most common problems were that buprenorphine was unavailable and needed ordering (90 of 165 [54.5%]), insurance coverage-related barriers (37 [22.4%]), and pharmacy hesitancy in filling a telemedicine prescription (32 [19.4%]). In this cross-sectional study of patients receiving telemedicine treatment for opioid use disorder, challenges filling buprenorphine prescriptions were prevalent and led to concerning periods when patients were untreated and at an increased risk of returning to nonprescribed opioid use. There is a critical need for interventions to ensure sufficient access to buprenorphine, including implementing buprenorphine stocking requirements and medication delivery services through collaborating pharmacies.
44. Performance of 4 Methods to Assess Health-Related Social Needs.
期刊: JAMA network open 发表日期: 2025-Aug-01 链接: PubMed
摘要
Organizations use health-related social needs (HRSN) information to identify patients in need of referrals, to increase clinician awareness, to improve analytics, and for quality reporting. To contrast the performance of screening questionnaires, natural language processing (NLP) of clinical notes, rule-based computable phenotypes, and machine learning (ML) classification models in measuring HRSNs. This cross-sectional study assessed 4 measurement approaches for 5 HRSNs in parallel. Each approach was treated as a screening test. Data included notes from adult patients treated at primary care clinics in 2 health systems in Indianapolis, Indiana, from January 2022 to June 2023. Data were analyzed from December 2024 to February 2025. Reference standard instruments measured food insecurity, housing instability, financial strain, transportation barriers, and history of legal problems. Participants completed the HRSN screening questions in the electronic health record (EHR). NLP algorithms, gradient-boosted decision tree ML classifiers, and refined versions of human-defined rule-based computable phenotypes were applied to participants’ past 12 months EHR data. Sensitivity, specificity, area under the curve (AUC), and positive predictive values (PPV) described performance of each approach against the reference standard measures. False-negative rates were used to explore fairness. Data from a total of 1252 adult patients (407 [32.51%] aged 30 to 49 years; 821 [65.58%] female) were assessed, including 94 (7.51%) who identified as Hispanic, 602 (48.08%) as non-Hispanic Black or African American, and 442 (35.30%) as non-Hispanic White. The screening questions method had the strongest overall performance for food insecurity (AUC, 0.94; 95% CI, 0.93-0.95), housing instability (AUC, 0.78; 95% CI, 0.75-0.80), transportation barriers (AUC, 0.77; 95% CI, 0.74-0.79), and legal problems (AUC, 0.81; 95% CI, 0.77-0.85). The screening questions had poor performance for financial strain (AUC, 0.62; 95% CI, 0.60-0.65). The PPV for screening tools ranged from 0.77 to 0.92, indicating utility for individual-level decision-making. NLP and rule-based computable phenotypes had poor performance. ML classification resulted in higher sensitivities than the other methods. False-negative rates indicated differential, unfair performance for all measurement approaches by gender, race and ethnicity, and age groups. In this cross-sectional study of HRSN measurement, no approach performed strongly for every HRSN, and every approach had indication of unfair performance. These findings suggest that practitioners, health care and public health organizations, researchers, and policymakers who rely on a single method to collect HRSN data will likely underestimate patients’ true social burden.
45. Over-the-Counter Oral Contraceptive Use and Initiation of Contraception.
期刊: JAMA network open 发表日期: 2025-Aug-01 链接: PubMed
摘要
The US Food and Drug Administration approved the first over-the-counter (OTC) oral contraceptive pill (OCP) in 2023, potentially expanding access to contraception. Understanding whether OTC availability reaches individuals with systemic barriers to care is essential to assessing its public health impact. To evaluate whether the newly available OTC progestin-only OCP is reaching individuals not previously using contraception or who rely on less-effective methods. This cross-sectional study used baseline data from a national, prospective US cohort. Participants were individuals aged 15 to 45 years obtaining OCPs at pharmacies or online between April 2024 and February 2025. Participants were eligible if they obtained an OCP (prescription or OTC) for contraceptive use and were at risk of pregnancy. Obtaining an OTC progestin-only OCP vs a prescription OCP. Primary outcomes were (1) initiation of contraception among individuals previously not using any modern method and (2) transition from a less-effective method (eg, condoms or emergency contraception) to OCP use. Multivariable logistic regression models with robust SEs were used to determine adjusted absolute estimated probabilities and percentage point differences in outcomes. The sample included 986 individuals, predominantly single (692 participants [70.2%]), and the largest proportion was aged 20 to 24 years (338 participants [34.3%]). OTC OCP users accounted for 320 (32.5%) of the participants. Individuals using the OTC option were more likely to be uninsured (101 participants [31.6%] vs 23 participants [3.5%]) and to reside in rural areas (46 participants [14.4%] vs 56 participants [8.4%]) compared with prescription users. Groups did not differ in fertility preferences. OTC use of contraception was associated with a 31.8 percentage point increase (95% CI, 24.1-39.5 percentage points) in moving from nonuse of contraception to the OTC pill, when compared with prescription OCP users. Similarly, OTC access was associated with a 41.0 percentage point increase (95% CI, 33.8-48.1 percentage points) in transitioning from use of a less-effective method of contraception to the OTC pill. In this cross-sectional study of US individuals obtaining oral contraception, the OCP was accessed OTC by many who previously used no method or less-effective contraception. These findings suggest that OTC access may improve equitable access to contraception.
46. Breastfeeding, Adiposity, and Precocious Puberty in Boys and Girls.
期刊: JAMA network open 发表日期: 2025-Aug-01 链接: PubMed
摘要
47. Biannual Mass Azithromycin Distributions for Preschool Children and Malaria Parasitemia: A Secondary Analysis of the MORDOR Cluster Randomized Trial.
期刊: JAMA network open 发表日期: 2025-Aug-01 链接: PubMed
摘要
Mass azithromycin distributions may reduce malaria parasitemia in the short term, but longer-term effectiveness is unclear. To examine whether biannual mass azithromycin distributions are associated with lower rates of malaria parasitemia in preschool children living in Niger. A cluster randomized trial was performed from November 23, 2014, until June 9, 2020, as an ancillary trial to a larger trial studying the effect of mass azithromycin on child mortality. Study communities (ie, government-defined health catchment areas) in Niger were randomized in a 1:1 ratio to biannual (ie, twice-yearly) mass administration of azithromycin or placebo to all children aged 1 to 59 months and followed up for 5 years. Data analyses were performed from June 25, 2023, to April 27, 2025. Twice-yearly administration of a single dose of oral azithromycin, 20 mg/kg, or placebo. The prevalence of parasitemia 4 years after the community started treatment, assessed in a random sample of 40 children per community. Among the 30 communities in Niger included in the study at baseline, the 15 communities randomized to azithromycin consisted of 1695 children (mean [SD] age, 30.8 [2.8] months; 858 [51.8%] male) and the 15 communities randomized to placebo consisted of 3031 children (mean [SD] age, 30.6 [2.6] months; 157 [52.0%] male). The mean prevalence of malaria parasitemia at baseline was 8.9% (95% CI, 5.1%-15.7%) in the azithromycin arm and 6.7% (95% CI, 4.0%-12.6%) in the placebo arm. At annual follow-up visits up until month 48, parasitemia was not statistically significantly lower in the azithromycin arm compared with the placebo arm, assuming a 10% prevalence in the placebo arm (-3.3 percentage points [PP]; 95% CI, -5.8 to -0.2 PP; permutation P = .05). The Niger Ministry of Health instituted seasonal malaria chemoprevention (SMC) after the month 36 study visit. Analysis restricted to the period before SMC found significantly less parasitemia in the azithromycin arm compared with the placebo arm (4.8 PP lower; 95% CI, -7.4 to -1.3 PP; permutation P = .02). In this placebo-controlled cluster randomized trial, malaria among children aged 1 to 59 months was lower in communities treated with biannual mass azithromycin, but the effect was significant only for the first 3 years of the trial, before SMC. ClinicalTrials.gov Identifier: NCT02048007.
48. Successful treatment of refractory tracheal stenosis complicating anti-neutrophil cytoplasm antibody-associated vasculitis with sirolimus.
期刊: Reumatismo 发表日期: 2025-Jul-30 链接: PubMed
摘要
Laryngotracheal granulomatous inflammation is a clinical entity that may complicate either localized or systemic disorders. It can result in life-threatening airway compromise, requiring urgent medical or surgical intervention. We report the case of a patient presenting with recurrent tracheal stenosis secondary to anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis, refractory to conventional treatments. Despite multiple endoscopic dilatations and surgical resection of tracheal rings, disease control remained suboptimal. Introduction of sirolimus led to a sustained improvement of the stenotic lesion, as demonstrated by clinical and instrumental assessment. Sirolimus may be considered a valuable therapeutic option for severe subglottic inflammatory manifestations in ANCA-associated vasculitis.
49. Determinants of Smoking Among University Students in Northern Iraq.
期刊: Journal of research in health sciences 发表日期: 2025-Jun-10 链接: PubMed
摘要
Smoking remains a serious public health issue on a global scale and warrants increased attention. This research aimed to assess the prevalence of smoking and identify key predictors driving the adoption of smoking prevention behaviors among university students in northern Iraq. Study Design: A cross-sectional study. An online study was conducted among 765 students at Raparin University, Sulaymaniyah, Iraq. The required data were collected using a structured questionnaire distributed through Google Forms. The questionnaire, developed from standardized instruments, assessed sociodemographic factors and determinants of smoking behaviors. Finally, the data were analyzed by SPSS-16 using linear and logistic regressions. The average age of the students was 21.04 years [95% confidence interval: 20.89, 21.20], with ages ranging from 17 to 29 years. The age group of 21-23 years old increased the chances of cigarette smoking among students (odds ratio [OR]: 2.068). In addition, male students were more likely to have cigarette smoking (OR: 11.675). Father smoking, brother smoking, and friend smoking increased the chances of cigarette smoking by 1.981, 2.687, and 10.426 times among students, respectively. Our study identified key determinants of smoking preventive behaviors, including peer pressure (B=0.507), self-image (B=0.235), belief (B=0.134), value (B=0.184), attitude (B=0.115), and the influence of friends who smoke (B=-1.110). Our findings emphasize the critical roles of peer pressure and self-image in influencing smoking behaviors among students. To address this issue, targeted educational programs that foster positive self-image and resilience against peer influence are vital for effective smoking prevention strategies.
50. Why have extensive efforts to improve adolescents' physical fitness seen limited success? A mediation analysis of physical activity enjoyment, physical activity and physical fitness.
期刊: Frontiers in psychology 发表日期: 2025 链接: PubMed
摘要
Investigate the association of physical activity enjoyment (PAE), physical activity (PA) and physical fitness (PF) among adolescents using a mediation model. 845 students (420 males, 425 females) were selected via stratified random cluster sampling. Demographic data were gathered through a structured questionnaire. Adolescent PAE was evaluated using the Physical Activity Enjoyment Scale, while PA was quantified with the Physical Activity Rating Scale (PARS-3). PF was assessed on-site in accordance with the guidelines outlined in the National Physical Fitness Standards for Students. To analyze the relationships among these variables, correlation analyses and mediation techniques were employed. The correlation analysis revealed that PAE was positively correlated with PA (r = 0.622, p < 0.001) and PF (r = 0.291, p < 0.001), PA was positively correlated with PF (r = 0.256, p < 0.001). According to the results of the mediation analysis, PAE significantly predicts PA (standardized β coefficient = 0.5274, p < 0.001) and PF (standardized β coefficient = 0.2660, p < 0.001) in a positive direction. PA significantly predicts PF (standardized β coefficient = 0.1878, p < 0.001). Bootstrap-generated confidence intervals (CI) revealed a significant indirect effect for PAE on PF (β = 0.269, 95% CI = 0.147 to 0.389, p < 0.05) and a significant direct effect for PAE on PF (β = 0.721, 95% CI = 0.513 to 0.930, p < 0.001). According to the proportion of effect calculation, the mediation effect was 27.2%. PAE is positively associated with PF, with PA partially mediated the relation between PAE and PF. This suggests that neglecting the development of PAE in adolescents may undermine efforts to improve PF through increases in PA levels.
51. Editorial: Exploring the interaction between health-promoting and health risk behaviors in health, volume II.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
52. Integrative review of artificial intelligence applications in nursing: education, clinical practice, workload management, and professional perceptions.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
Artificial Intelligence (AI) is rapidly transforming the nursing profession, presenting significant opportunities and challenges. Despite its promising potential in enhancing nursing education, clinical practice, and operational efficiency, critical barriers related to ethics, workforce adaptation, and humanistic care persist. This integrative review systematically evaluates the integration of AI in nursing practice, with a specific focus on nursing education, clinical care, workload management, and professional perceptions. Guided by PRISMA 2020 and the SPIDER framework, a thematic synthesis was conducted. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT), and the risk of bias evaluated through ROBINS-I. This review encompassed 25 studies, from which six overarching themes emerged. AI-powered simulations and content-creation platforms enriched nursing curricula by presenting realistic clinical scenarios, which consistently yielded deeper student engagement, enhanced case-management performance, and higher satisfaction scores. Learners also reported an increased cognitive load and heightened stress levels when navigating these more complex, AI-driven activities. AI-enabled alert algorithms and wearable sensors enabled nurses to detect subtle signs of patient deterioration and fever significantly earlier than conventional methods, supporting timelier clinical interventions. Qualitative feedback from critical-care staff underscores that these automated insights must be balanced with professional judgment to avoid overreliance. In neurosurgical, gynecological, and orthopaedic settings, AI-guided imaging tools and personalized follow-up pathways were linked to smoother recovery trajectories, streamlined follow-up processes and richer patient feedback, and exceptionally high patient satisfaction. Nurses noted that these technologies enhanced the precision of assessments without wholly replacing the need for human touch. AI systems that automated routine follow-up tasks and generated predictive workload models freed nurses from repetitive, non-clinical duties and offered data-driven insights to inform staffing decisions. These efficiencies allowed nursing teams to devote more time to direct patient care and were associated with reductions in burnout and improved workplace morale. Across practice settings, nursing students and practicing nurses broadly welcomed AI’s ability to streamline workflows and support decision-making, recognizing its potential to elevate patient care and professional practice. Simultaneously, nurses voiced significant ethical concerns-chiefly around safeguarding patient data privacy, mitigating algorithmic bias, and preserving the compassionate, human-centered essence of nursing in an increasingly automated environment. The Nursing AI Integration Roadmap (NAIIR) was developed, emphasizing transformational education, advanced clinical integration, ethical governance, robust organizational infrastructure, participatory design, and rigorous economic evaluation. This framework offers a structured, ethically informed, and user-centric approach, advocating for AI as complementary to human expertise. Successfully integrating AI into nursing requires comprehensive strategic planning that addresses educational, clinical, ethical, organizational, participatory, and economic dimensions, reinforcing the core humanistic values of nursing. Of the 25 included studies, 21 were judged at moderate risk of bias; despite this limitation, evidence suggests improvements in critical thinking, learner engagement, and clinical satisfaction across diverse educational and practice settings.
53. Longitudinal impact of oral bacteria and endotoxin on lung function.
期刊: European clinical respiratory journal 发表日期: 2025 链接: PubMed
摘要
Chronic respiratory diseases are on the rise globally, and growing evidence shows that lungs whether healthy or diseased harbor bacterial communities that primarily originate from the oral cavity. Despite this, longitudinal studies examining how oral bacteria influence respiratory health trajectories in the general population are lacking. This study aimed to explore the influence of oral bacteria on lung function (LF) outcomes measured 6 years later in a community-based Norwegian population. Analyses included measurements of endotoxin load and lipid A profiling to assess the inflammatory potential of oral bacterial communities. Saliva samples and spirometry data were collected from 75 participants in the RHINESSA study (Bergen, Norway) at baseline (2014-2015). Spirometry was repeated at follow-up (2020-2021). Bacterial community composition and endotoxin lipid A profiling were determined by targeted sequencing of the 16S rRNA gene (V3-V4 region). Associations between baseline salivary microbiota and lung function at follow-up were assessed using multivariate linear regression. The relative abundance of Selenomonas, Mogibacterium, Tannerella, and Prevotella was positively associated with both forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC), while Kingella, and Anaerococcus showed negative associations. Endotoxin load was positively associated with FEV1 and FVC. A negative association was observed between the proinflammatory hexa-acylated lipid A variant and LF outcomes, whereas a positive association was found for the penta-acylated lipid A variant. Salivary bacterial community characteristics were associated with LF outcomes measured 6 years later. Our findings suggest that the oral microbiota may represent a potential target for disease prevention or intervention strategies, warranting further investigation.
54. The Role of Diabetes Distress and Self-Efficacy as Mediators of Barriers to Diabetes Self-Management in Young Adults With Type 1 Diabetes: A Cross-Sectional Study.
期刊: Diabetes spectrum : a publication of the American Diabetes Association 发表日期: 2025 链接: PubMed
摘要
This study examined how structural and contextual barriers, including social needs and gender, influence diabetes self-management (DSM) through psychosocial pathways, particularly diabetes distress (DD) and self-efficacy (SE). Although these barriers are well documented, their interactions with psychosocial factors remain underexplored. We analyzed cross-sectional baseline data from the REAL-T (Resilient, Empowered, Active Living-Telehealth) study (n = 198). Using hierarchical regression, we assessed factors influencing DSM. Structural predictors included unmet social needs and limited insulin access; contextual predictors included gender and ethnicity. Hypothesized mediators were the scores on the Diabetes Distress Scale, the Diabetes Empowerment Scale, and the Audit of Diabetes Dependent Quality of Life. After identifying significant predictors and potential mediators through hierarchical multivariate regression analysis, separate path models were tested for each hypothesized mediator. Unmet social needs, as well as female and nonconforming genders, were found likely to increase DSM challenges. All selected predictors became nonsignificant when accounting for all psychosocial variables. DD mediated all tested relationships, and SE partially mediated the relationship between unmet social needs and DSM. The proposed model suggests the need for targeted interventions addressing psychosocial pathways, particularly DD and SE, to mitigate the downstream effects of structural barriers to DSM. Inclusive gender-specific care models and systemic reforms to reduce social inequities are crucial for improving DSM outcomes and overall well-being.