公共卫生研究摘要 (2025-08-20)

共收录 59 篇研究文章

1. From 'What's This?' To 'I Grew It!': Evaluation of a School Nutrition Program in Queensland, Australia.

期刊: Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals 发表日期: 2025-Oct 链接: PubMed

摘要

This study aimed to evaluate the implementation and impact of the ‘Pick of the Crop’ (POTC) program. POTC is a whole-school nutrition program aimed at increasing opportunities for primary school students in Queensland to learn about and eat more vegetables and fruit (VF). A mixed-methods evaluation was undertaken that included analysis of school action plans, Most Signficant Change interviews and surveys with school champions, as well as focus groups with regional coordinators and programme managers. Data sources explored access to VF within the school and the perceived knowledge, skills, attitudes, and behaviour of staff and students regarding VF consumption. Quantitative data were analysed using descriptive statistics, and qualitative data were inductively coded and thematically analysed. Sources of data were triangulated to cross-validate key themes identified from interviews, focus groups, surveys and action plans. A total of 63 schools participated in the POTC evaluation. School staff reported high acceptability of POTC within schools for the first 2 years of its implementation. School staff considered the program feasible with the support of regional coordinators, strong curriculum links, networks with the community, and local leadership. Respondents from schools in their first and second year of implementation reported an increase in student knowledge, skills, and attitudes towards VF consumption. Schools in their second year of implementation reported higher levels of VF consumption among students, with some improvement to school policies, food culture and school networks. POTC demonstrates an acceptable and feasible model that has potential for increasing consumption of VF among primary school students. Further research is required to determine long-term program efficacy with a larger sample size. School-based nutrition programs should consider incorporating the capacity for flexibility within program structures, whereby schools determine context-specific priorities and the specific activities to be implemented. Recruiting dedicated regional coordinators is also important to ensure support is available to meet the individual needs of schools.

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2. Impact of Epilepsy on Productivity and Quality of Life: The Australian Epilepsy Project.

期刊: Neurology 发表日期: 2025-Sep-09 链接: PubMed

摘要

Epilepsy occurs in 4% of Australians over their lifetime. European studies show that over 75% of epilepsy-related health care costs are indirect, with 80% due to absenteeism. In Australia, studies capturing absenteeism in epilepsy are limited and presenteeism data are unavailable. This study investigated employment rates, absenteeism, presenteeism, and quality of life reported by people who experienced seizures in Australia. The Australian Epilepsy Project (AEP) is a prospective cohort study of adults with first unprovoked seizure (FUS), newly diagnosed epilepsy (NDE), or focal drug-resistant epilepsy (DRE), referred mainly from tertiary care clinics. This study is a cross-sectional analysis of AEP baseline data, reporting quality of life (EuroQol 5 Dimensions [EQ-5D-5L] and Quality of Life in Epilepsy Inventory [QOLIE-31]); employment rates; and the prevalence and extent of absenteeism and presenteeism, assessed using the Work Productivity and Activity Impairment questionnaire. Correlations were assessed using either Spearman or Pearson methods. Logistic regression was used for odds. Of 670 participants (median age 35.6 years, interquartile range [IQR] 26.9-47.3 years, 53.4% female participants), 15.9% had FUS, 34.6% had NDE, and 49.4% had DRE. The median (IQR) EQ-5D-5L score for the cohort was 0.93 (0.83-0.96). The mean QOLIE-31 score was lower for people with DRE (49.7 ± 16.8), compared with both NDE (57.9 ± 17.4, p = 0.003) and FUS (59.4 ± 16.2, p = 0.003) groups. The employment rate was 62.3% (95% CI 58.4%-66.1%), with lower rates in the DRE group (53.9% p < 0.001). 30.8% (95% CI 26.1%-35.7%) of workers reported absenteeism, 45% (95% CI 40.0%-50.0%) reported presenteeism, and 23% (95% CI 19.6%-28.5%) reported both. Among those with absenteeism, each year, full-time workers lost a median of 60 (IQR 31.5-189.4) days of work and part-time workers lost 37.8 (IQR 18.9-75.7) days of work. The mean percentage of presenteeism was higher in patients with DRE compared with those with NDE (22.9% vs 15.2%, p = 0.007). People with absenteeism and presenteeism had lower QOLIE-31 scores (mean difference -9.9, 95% CI -6.4 to -13.3, p < 0.001; -9.2, 95% CI -0.016 to -0.076, p < 0.001) than those without. Employment and work productivity are commonly reduced in people who experience seizures, particularly those with DRE. Lower productivity was associated with poorer quality of life. Further studies are needed to understand the nature of this relationship.

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3. Effects of Biological Sex on Access to Care and Outcomes After Acute Spinal Cord Injury: A Series of Propensity Score-Matched Cohort Studies.

期刊: Neurology 发表日期: 2025-Sep-09 链接: PubMed

摘要

While preclinical studies documented potential neuroprotective effects of estrogen/progesterone, the impact of biological sex on outcomes after traumatic spinal cord injury (tSCI) remains incompletely understood. The aim of this study was to compare male and female age-stratified subgroups, which presumably correspond to premenopausal, perimenopausal, and postmenopausal states, concerning access to optimal care and their outcomes after tSCI. A series of propensity score-matched cohort studies was performed, comparing female individuals with male individuals in the younger (age≤ 40 years), middle-aged (41-50 years), and older (>50 years) subgroups regarding baseline data; management strategies; access to optimal care; and hospital, neurologic, and functional outcomes after tSCI. Data were selected from 5,571 individuals with tSCI at C1-L2 who were enrolled in the Rick Hansen Spinal Cord Injury Registry from July 2004 to September 2019. Outcome measures included in-hospital mortality and motor and sensory score changes from admission to an acute care hospital to discharge from a rehabilitation center. In the younger subgroups, female individuals (n = 320, mean age: 26 years) were more often White and had a greater proportion of tSCIs due to falls or transportation-related accidents than male individuals (n = 320, mean age: 26.5 years). Younger female and male subgroups had similar in-hospital mortality rates (0.6% vs 0.6%, p = 1) and motor (4 vs 5, p = 0.8919) and sensory (2 vs 5, p = 0.5) score changes after tSCI. In the middle-aged subgroups, female individuals (n = 133, mean age: 46 years) and male individuals (n = 113, mean age: 46 years) had statistically comparable baseline data, in-hospital mortality rates (2.3% vs 3.0%, p = 1), and motor (12 vs 5, p = 0.8766) and sensory (0 vs 2, p = 0.4918) score changes. In the older subgroups, female individuals (n = 531, mean age: 68 years) showed a higher frequency of fall-related tSCI but they had similar in-hospital mortality rates (7.7% vs 9.8%, p = 0.2324) and motor (9 vs 8, p = 0.7594) and sensory (5 vs 0, p = 0.7204) score changes after tSCI compared with male individuals (n = 531, mean age: 68 years). The results of this study suggest that biological sex does not significantly affect in-hospital mortality and neurologic recovery after tSCI when optimal care is applied, according to data from a Canadian registry. Those findings support the notion that sex equity in management strategies promotes equal outcomes after tSCI.

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4. Climate Adaptation and Nursing.

期刊: The American journal of nursing 发表日期: 2025-Sep-01 链接: PubMed

摘要

Climate change is real, present, and impacting the health of people across the world. Mitigation of further climate change is essential, but nurses must also promote adaptation to this new reality by incorporating climate-sensitive care into their day-to-day practice. This article describes key adaptation actions nurses can take to promote patient, organizational, and population health in the context of climate change. Suggestions for personal and professional disaster preparedness, as well as ways of applying the nursing process to climate adaptation in various arenas of practice are discussed. The outcomes of climate change are currently inequitable and severe. Nurses can transform their concern into action by promoting adaptation measures in all care settings.

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5. Using the Brøset Violence Checklist Beyond Behavioral Health and the ED: A Mixed-Methods Study.

期刊: The American journal of nursing 发表日期: 2025-Sep-01 链接: PubMed

摘要

Violence initiated by hospitalized patients is increasingly common, prominently affecting nurses. Workplace violence has profound effects beyond physical injury and can lead to nurse turnover and even to nurses leaving the profession entirely. The primary aim of this study was to determine the relationship between Brøset Violence Checklist (BVC) scores and the incidence of violent behavior within 12 hours of BVC assessment among patients on adult medical-surgical, telemetry, progressive care, and intermediate and intensive care units. A secondary aim was to identify nurse perceptions of barriers and facilitators related to BVC use. This mixed-methods study used a retrospective, descriptive cohort study design and included psychometric evaluation of BVC use. Focus groups were held to elicit nurses’ perceptions of BVC barriers and facilitators. Psychometric evaluation of BVC use on inpatient adult care units found that the instrument predicted violent behavior within 12 hours at a cutoff score of 1 or higher with a sensitivity of 0.85, a specificity of 0.83, and an area under the curve of 0.89, performing well overall. Five themes emerged from qualitative analysis of the focus group transcripts: feasibility and acceptance, a new awareness allows a proactive approach, the information process, collaboration and coordination, and barriers to implementation. Use of the BVC in inpatient adult care areas presents an opportunity for nurses to plan safer workplace environments.

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6. Reliability and Concurrent Validity of a Low-Cost Handgrip Dynamometer: The Camry.

期刊: The American journal of occupational therapy : official publication of the American Occupational Therapy Association 发表日期: 2025-Sep-01 链接: PubMed

摘要

Handgrip testing is highly valid and reliable, but the high cost of dynamometers limits their use in some settings. A more affordable option, the Camry dynamometer, has recently been used in fitness surveillance; however, its reliability and validity compared with known weights and well-validated models remain unknown. To investigate test-retest reliability, intermodel reliability (new vs. old Camry), and interinstrument reliability (Camry vs. TKK dynamometer) and concurrent validity of the Camry dynamometer by using calibrated known weights. Comparison study with a digital TKK 5401 dynamometer and two Camry EH101 dynamometers (new and old, with more than 3,000 uses). Intrainstrument and interinstrument reliability and concurrent validity were assessed to compare measures of the dynamometers with calibrated weights using the Bland-Altman method. Intrainstrument (retest minus test) reliability was very high (systematic error for test-retest reliability): new Camry, M = 0.01 kg (SD = 0.49); old Camry, M = -0.10 kg (SD = 0.49); TKK, M = 0.14 kg (SD = 0.76). Comparison showed small mean differences between Camry dynamometers and TKK (new Camry vs. TKK, M = 0.84 kg, SD = 0.79; old Camry vs. TKK, M = 0.88 kg, SD = 0.85). The mean systematic error between the new and old Camry dynamometers was 0.03 kg (SD = 0.57). Concurrent validity showed smaller magnitude systematic errors in the Camry than TKK: new Camry, M = -0.21 kg (SD = 0.35); old Camry, -0.18 kg (SD = 0.79); TKK, M = -1.07 kg (SD = 0.75). The Camry dynamometer is highly reliable and valid and is a more affordable alternative for handgrip strength assessment. Plain-Language Summary: Handgrip strength is an important measure of health and is linked to outcomes such as overall mortality and illness. Testing handgrip strength is useful for health and fitness-related professionals, including occupational therapists, to track rehabilitation progress. However, the cost of the dynamometers limits their use in some places or large-scale studies. Recently, a cheaper alternative, the Camry dynamometer, has been used, but its accuracy compared with known weights or other validated devices has not been confirmed. This study tested the reliability and accuracy of two Camry dynamometers (a new and an old device) versus the TKK dynamometer and known weights. Results showed that the Camry dynamometer is highly reliable, valid, and durable and remains accurate even after many uses. The findings could make handgrip strength testing more accessible in health care and fitness evaluations.

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7. Social and Academic Belonging: Developing an Ecological Belonging Program for Occupational Therapy Students.

期刊: The American journal of occupational therapy : official publication of the American Occupational Therapy Association 发表日期: 2025-Sep-01 链接: PubMed

摘要

Occupational therapy students can experience a lack of social and academic belonging during their education, affecting their well-being and confidence. There is a lack of evidence-based programs to increase social and academic belonging. To explore experiences of belonging and adversity among entry-level occupational therapy doctorate (OTD) graduate students and develop an ecological belonging program to address the findings. Qualitative descriptive methodology with a constructivist paradigm. An entry-level OTD program at an urban research university. Forty-one entry-level OTD students were recruited from a 3-yr graduate program. A semistructured interview guide. Students at different stages in the entry-level OTD program participated in focus groups (n = 41). Themes illustrated that students experienced a lack of social and academic belonging at three program time points related to specific struggles they encountered. Themes included making friends, balancing school and personal life, questioning whether they belonged in occupational therapy, whether they would succeed in fieldwork, and how to excel as an entry-level practitioner. A three-session, evidence-based ecological belonging program, Supporting Hardiness and Inclusion for New Endeavors (SHINE), was developed from focus group findings. Occupational therapy students experience a lack of social and academic belonging and often feel alone in their struggles throughout graduate school. Evidence-based programs can be tailored and implemented to address this adversity. Educators can support students at key transition points to normalize adversity and encourage success. Plain-Language Summary: This study explored the experiences of belonging and adversity among entry-level occupational therapy doctorate students. The study aimed to develop a program to normalize challenges and address self-doubt among students. Focus groups revealed that students often question their career path and experience feelings of self-doubt, especially during key transitions. These concerns extended to clinical settings, both as students and as future clinicians. The findings informed the development of an evidence-based, ecological belonging program focused on building confidence, belonging, and strategies to overcome self-doubt, helping students develop resilience for success in education and future practice.

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8. Chronotype Shifts and Cognitive Performance in Stroke Survivors: Exploring the Impact of Occupational Therapy Treatment Timing on Rehabilitation Outcomes.

期刊: The American journal of occupational therapy : official publication of the American Occupational Therapy Association 发表日期: 2025-Sep-01 链接: PubMed

摘要

Stroke survivors commonly report persistent sleep disruptions during rehabilitation and postrecovery. Despite little research that explores the impact of stroke on a patient’s chronotype, no studies have explored the differences in cognitive performance between treatment timing fitted and nonfitted to the patient’s chronotype. To characterize the sleep chronotype in patients in the subacute poststroke period, to explore cognitive task performance differences during fitted and nonfitted hours, and to examine the relationships between sleep quality and cognitive performance. Cohort design. Health care institution. Twenty men and women (M  age = 60.2, SD = 8.6) post-first stroke. The following measures were collected twice, during fitted and nonfitted chronotypic times: demographic surveys, the Munich Chronotype Questionnaire, the Montreal Cognitive Assessment (MoCA), the Rivermead Behavioral Memory Test, Second Edition (RBMT-2), a fatigue questionnaire, and of actigraphy for 4 to 5 days. Stroke survivors exhibited an earlier sleep chronotype postinjury compared with preinjury. Enhanced memory (higher RBMT-2 scores) occurred during fitted hours. No significant differences emerged in executive functions, attention tasks, and MoCA scores between fitted and nonfitted hours. The Wake After Sleep Onset index correlated with the MoCA and RBMT-2 scores during fitted hours (MoCA: r = .53, p = .021; RBMT-2: r = .51, p = .027). Number of awakenings correlated with the MoCA letter task during nonfitted hours (r = .45; p = .044). Occupational therapy practitioners should be aware of the relationship between chronotype and cognitive performance, with a focus on the importance of personalized rehabilitation strategies in stroke care. Plain-Language Summary: The timing of cognitive assessments poststroke can influence their reliability, particularly when considering a patient’s chronotype (sleep cycle). For instance, if a morning person is evaluated later in the day (nonfitted to their chronotype), the results may indicate greater cognitive decline compared with scores they might achieve in the morning. In our study, we assessed cognitive performance twice: once fitted to the patient’s chronotype and once not. Our findings revealed that memory function significantly improved during evaluations conducted at personalized times. This suggests that occupational therapy practitioners who evaluate patients during nonoptimal times may prescribe a more extensive rehabilitation plan than necessary.

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9. Use Challenges and Training Needs of In-Vehicle Technologies for Older Drivers With Vision Impairments.

期刊: The American journal of occupational therapy : official publication of the American Occupational Therapy Association 发表日期: 2025-Sep-01 链接: PubMed

摘要

Older drivers with impaired vision may face challenges using in-vehicle technologies, affecting user experience. To explore use challenges with in-vehicle technologies and training preferences of older drivers with and without central vision loss (CVL). A telephone questionnaire on perceptions of driver-vehicle interface use difficulties, challenges with existing advanced driver assistance systems (ADAS), and preferences for ADAS acquisition and training. Community-dwelling U.S. older adults. A total of 126 volunteers 18 yr and older with valid driver’s licenses who had driven within the last 2 mo were recruited. The CVL group self-reported diagnoses of various forms of CVL. Fifty-eight older drivers with CVL (Mdn age = 71.4 yr, 41% male) and 68 without (Mdn age = 71.8 yr, 37% male) completed the questionnaire. The CVL group reported greater difficulty using in-vehicle technologies compared with the non-CVL group, particularly in recognizing visual information in vehicle interfaces. Greater difficulty correlated with poorer self-reported vision status and with increased self-regulated driving exposure. Primary challenges for the CVL group included issues with small button and font sizes, inadequate color contrast, and display glare. Both groups expressed a desire for guidance and training in effective ADAS use, with the CVL group preferring guidance from health care professionals. Older drivers with CVL face challenges using in-vehicle technologies, especially in accessing visual information. They prefer guidance from health care professionals, suggesting potential for tailored support from occupational therapists specializing in driving rehabilitation. Plain-Language Summary: This study explored the challenges faced by older drivers with central vision loss when using in-vehicle technologies. Older drivers with central vision loss reported significantly more difficulty than drivers without central vision loss, particularly in recognizing and using visual information in vehicle interfaces and with advanced driver assistance systems. Challenges included issues with small buttons and font sizes, poor color contrast, and display glare. Individuals with more severe vision impairment, who drive less and avoid more driving situations, face more challenges with in-vehicle technologies, yet these are the drivers who might benefit most from such technologies. Both groups expressed a desire for guidance in selecting and using driver assistance technologies, with drivers with central vision loss preferring support from health care professionals. The study findings highlight the need for tailored training and support, which could enhance occupational therapy clients’ ability to effectively use modern vehicle technologies to drive safely.

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10. Assessing the harmonization of current total vitamin B12 measurement methods: relevance and implications.

期刊: Clinical chemistry and laboratory medicine 发表日期: 2025-Aug-20 链接: PubMed

摘要

The UK National Institute for Health and Care Excellence has recommended thresholds for total vitamin B12 (B12) assays with interchangeable results for identifying B12 deficiency. We assessed the agreement between B12 methods, to evaluate whether the thresholds may be assumed applicable to all assays. A total of 19 External Quality Assessment (EQA) exercises (1791 determinations) based on human subjects-pool materials and 97 serum samples were retrieved to characterize the agreement between Alinity and Architect (Abbott Diagnostics), Access DXi (Beckman Coulter Diagnostics), Atellica and ADVIA Centaur (Siemens Healthcare Solution) compared to Cobas (Roche Diagnostics), considered as comparator because its calibrator traceability to the World Health Organisation (WHO) International Standard (IS) code 03/178. Ordinary least squares and Bland-Altman were used for this purpose. Abbott and Beckman methods overestimated and underestimated, respectively, B12 concentrations vs. Roche and the other methods. We reported similar systematic or proportional error patterns between EQA and serum samples. Only Beckman was affected by both errors. Due to the wide Limit of Agreement Interval, we cannot confidently conclude on the agreement between Roche and the other methods. However, the inter-method bias was well lower than the desirable goal of 9.4 % for Abbott Architect and also lower for Siemens ADVIA Centaur. The recommended thresholds for serum total B12 should not be assumed applicable to all assays, due to the poor agreement among the currently available methods, a limitation that persists despite the release of the WHO IS 03/178.

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11. Acceptance of AI-Powered Chatbots Among Physiotherapy Students: International Cross-Sectional Study.

期刊: JMIR medical education 发表日期: 2025-Aug-19 链接: PubMed

摘要

Artificial intelligence-powered chatbots (AI-PCs) are increasingly integrated into educational settings, including health care disciplines. Despite their potential to enhance learning, limited research has investigated physiotherapy (PT) students’ acceptance of this technology. This study aims to assess undergraduate PT students’ acceptance of AI-PCs and to identify personal, academic, and technological factors influencing their acceptance. Over a 4-month period, a cross-sectional survey was conducted across 7 PT programs in 5 countries. Eligible participants were national undergraduate PT students. The technology acceptance model (TAM)-based questionnaire was used for capturing perceived usefulness, perceived ease of use, attitude, behavioral intention, and actual behavioral use of AI-PCs. The influence of personal, academic, and technological factors was examined. Descriptive and inferential statistics were conducted. The mean total TAM score was 3.59 (SD 0.82), indicating moderate acceptance. Of the 1066 participants, 375 (35.2%) showed high acceptance, 650 (60.9%) moderate, and 41 (3.9%) low. Prior experience with artificial intelligence (AI) tools emerged as the strongest predictor of acceptance (β=.43; P<.001), followed by university affiliation (ANOVA P<.001). Cumulative grade point average percentage was positively correlated with TAM score (r=0.135; P<.001) but was not a significant predictor in regression (P=.23). Age (P=.54), sex (P=.56), academic level (P=.26), and current use of AI-PCs (P=.10) were not significant predictors. PT students demonstrated moderate acceptance of AI-PCs. Prior technological experience was the strongest predictor, underscoring the importance of early exposure to AI tools. Educational institutions should consider integrating AI technologies to enhance students’ familiarity and foster positive attitudes toward their use.

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12. An extension of the Benefit Risk Assessment of VaccinEs toolkit to evaluate Comirnaty and Spikevax vaccination in the European Union.

期刊: European journal of public health 发表日期: 2025-Aug-19 链接: PubMed

摘要

Amid the global COVID-19 pandemic, vaccines were conditionally authorized for human use to protect against severe infection. The Benefit Risk Assessment of VaccinEs (BRAVE) toolkit, a user-friendly R Shiny application, was developed retrospectively together with the European Medicine Agency (EMA) with the aim of fulfilling the need for flexible tools to assess vaccine benefits and risks during and outside a pandemic situation. This study employed BRAVE to evaluate the impact of COVID-19 mRNA vaccines across 30 European Union (EU)/EEA countries by quantifying the number of prevented clinical events [i.e. confirmed infections, hospitalizations, intensive care unit (ICU) admissions, and deaths], using a probabilistic model informed by real-time incidence data and vaccine effectiveness estimates. The analysis assumes fixed population dynamics and behaviour. Additionally, BRAVE assesses risks associated with mRNA-based vaccines (myocarditis or pericarditis) by comparing observed incidence rates in vaccinated individuals with background incidence rates. mRNA vaccines were estimated to directly prevent 11.150 million [95% confidence interval (CI): 10.876-11.345] confirmed COVID-19 infections, 0.739 million (95% CI: 0.727-0.744) COVID-19 hospitalizations, 0.107 million (95% CI: 0.104-0.109) ICU admissions, and 0.187 million (95% CI: 0.182-0.189) COVID-19-related deaths in the EU/EEA between 13 December 2020 and 31 December 2021. Despite increased vaccination-associated myocarditis or pericarditis observed in younger men, the benefits of vaccination still outweigh these risks. Our study supports the benefit/risk profile of COVID-19 vaccines and emphasizes the utility of employing a flexible toolkit to assess risks and benefits of vaccination. This user-friendly and adaptable toolkit can serve as a blueprint for similar tools, enhancing preparedness for future public health crises.

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13. Advancing public health workforce's professional development: implications for Ukraine.

期刊: European journal of public health 发表日期: 2025-Aug-19 链接: PubMed

摘要

Despite many challenges, Ukraine has prioritized the need to develop and professionalize the public health workforce (PHWf) to respond to its transitioning public health (PH) system. This study explores how various PH stakeholders can develop and advance the PHWf professionalization programme in Ukraine using the WHO-ASPHER Roadmap to Professionalize the PHWf in the European region as the theoretical foundation. A mixed-methods qualitative approach was used to (i) document analysis of Ukrainian policy and regulatory documents related to PHWf and (ii) qualitative survey research involving relevant PH stakeholders. Directed and conventional content analysis was applied to analyse data. The document analysis reviews key areas as LoPHS, PH higher education, and continuous professional development. The analysis helped explain the current state of the PHWf and to understand enabling factors for its professionalization. Results from the qualitative survey research suggest several actions to enhance PHS in Ukraine based on three priority areas: (i) PH laws and regulation; (ii) PH education and training; and (iii) financing for the development and professionalization of PHWf. The PHWf professionalization programme for Ukraine resonates with the WHO-ASPHER Roadmap to Professionalizing the PHWf in the European region. It attempts to close the gap between PH legislation, the current state of the PHWf, and international PH practice ambitions. The study suggests the need for a well-coordinated development process across PHS and PHWf domains.

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14. Adolescents' and Young Adults' Perceptions of a Pop-Up Aimed at Combating the Spread of E-Cigarette Misinformation on Social Media: Cross-Sectional Survey Study.

期刊: JMIR formative research 发表日期: 2025-Aug-19 链接: PubMed

摘要

Social media is an important source of e-cigarette-related information for adolescents and young adults. However, misinformation is being shared across platforms, which may encourage e-cigarette use. This study aims to examine adolescent and young adult perceptions of a novel pop-up on social media that provides links to vaping-related health information from credible sources (eg, CDC). Between December 2023 and March 2024, participants aged 13-24 years (N=5326) completed a web-based cross-sectional survey. Participants were asked to select from 4 positive (eg, useful to share, helpful to check health-related information) and 4 negative or neutral sentiments (eg, usually ignore such notifications, would not trust it) to reflect their perceptions about a mock pop-up that provided a link to e-cigarette-related information on social media. More participants endorsed positive sentiments than negative or neutral sentiments in relation to the pop-up. Specifically, 1078 (20.8%) endorsed two or more positive sentiments, and 690 (13.3%) endorsed two or more negative or neutral sentiments when searching for “vaping” on social media; similarly 913 (17.6%) participants endorsed two or more positive sentiments and 690 (13.3%) endorsed two or more negative or neutral sentiments when viewing e-cigarette-related posts in their feed (all P<.001). Among those who were searching for e-cigarette-related information, participants aged 13-18 years were more likely to endorse at least two positive sentiments compared to those aged 19-24 years (ie, 646, 22.0% vs 423, 19.2%, respectively), those who had never used e-cigarettes compared with those who had ever used them (ie, 674, 23.6% vs 404, 17.3%, respectively), and those who last used e-cigarettes more than 30 days ago compared with those who had used them in the past 30 days (ie, 187, 19.8% vs 217, 15.6%, respectively). Similarly, among participants who viewed e-cigarette-related posts in their feed, those who had never used e-cigarettes were more likely to endorse two or more positive perceptions compared to those who had ever used e-cigarettes (ie, 563, 19.7% vs 350, 15.0%), and those who had last used e-cigarettes more than 30 days ago (ie, 159, 16.9% vs 191, 13.7%) were more likely to endorse two or more positive perceptions compared to those who had used them in the past 30 days (all Ps<.001). Participants who had never used e-cigarettes were also less likely to trust pop-ups, compared to those who had ever used them, whether while searching for e-cigarette-related information on social media or while seeing e-cigarette-related posts in their feed (approximately, 19%vs 24%). There were no significant differences in the endorsement of negative or neutral sentiments. However, participants aged 13-18 years were more likely to ignore such notifications while viewing e-cigarette-related posts in their social media feed compared to those aged 19-24 years (ie, 850, 28.9% vs 563 25%); further, participants who had never used e-cigarettes were less trusting of e-cigarette-related information while searching for vaping or in their feed. Positive perception of a social media pop-up indicates its potential to prevent e-cigarette-related misinformation. Further development of a pop-up requires strategies to better engage and inform adolescents and young adults, specifically younger individuals, as they may be more likely to disregard pop-ups, and older individuals and those who used e-cigarettes in the past 30 days, as they are potentially more dismissive of such information.

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15. The Impact of Young and/or Exercised Blood Plasma Transfusions in Individuals With Neurodegenerative Conditions: Protocol for a Scoping Review.

期刊: JMIR research protocols 发表日期: 2025-Aug-19 链接: PubMed

摘要

The prevalence of neurodegenerative conditions is expected to continue to rise, with current treatments largely focused on the management of symptoms and not disease progression. Exercise is a therapy that has significant favorable effects on several of the modifiable risk factors that influence the development/progression of some neurodegenerative conditions. However, there are significant barriers to exercise for this population, warranting consideration of alternative or adjunct therapies. Blood plasma transfusion is an emerging nonpharmaceutical/nonexercise therapy that may have positive benefits on people and animal models with neurodegenerative conditions. The aim of this study was to investigate and synthesize the literature on the impacts of young or exercised blood plasma transfusions in people and animal models with neurodegenerative conditions. We will include studies that have explored the impacts of young or exercised blood plasma transfusions in adults or animal models with neurodegenerative conditions. PubMed Central, MEDLINE, Cochrane Database of Systematic Reviews, Scopus, ProQuest, SPORTDiscus, PROSPERO, and multiple unpublished sources, including book chapters, conference papers, and theses, will be searched to include literature from January 2004 to May 2024, written in English. Studies will be screened by 2 independent reviewers; a third reviewer will be used to resolve any conflicts. Data will be extracted into a modified charting tool and will be presented in a graphical or tabular format combined with the appropriate narration. As of June 2024, the literature search has been completed. After searching listed databases, 3646 citations and 13 gray literature studies were identified, of which 1432 duplicates were removed. To the best of our knowledge, this study will be the first study with the aim of investigating the literature on the impacts of young or exercised blood plasma transfusions in individuals with neurodegenerative conditions. DERR1-10.2196/65935.

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16. Hypertension Prevalence Among People Lifted Out of Poverty in China in 2018-2023: Retrospective Spatiotemporal Analysis.

期刊: JMIR public health and surveillance 发表日期: 2025-Aug-19 链接: PubMed

摘要

Hypertension is a significant global public health concern, with particular concern in China due to its widespread prevalence. The spatial distribution of hypertension varies significantly, revealing important regional disparities that may impact public health strategies and interventions. This study aimed to investigate the temporal trends and spatial distribution characteristics of hypertension prevalence among individuals lifted out of poverty in China, covering the period from 2018 to 2023. We used data from the National Health Poverty Alleviation Dynamic Management System to analyze hypertension prevalence among people lifted out of poverty from 2018 to 2023. Long-term trends were assessed using the Joinpoint regression model. Spatial distribution characteristics were examined through global and local spatial autocorrelation, cluster and outlier analyses, and trend surface analyses. These methods provided insights into the spatial aggregation and variability of hypertension prevalence across different regions. From 2018 to 2023, the prevalence of hypertension among people lifted out of poverty in China increased from 2.71% to 7.29%. The highest rates were observed in the northeast, with Jilin Province ranking first for 3 consecutive years (2020-2023), reaching 27.19% in 2023. Linxi County in Inner Mongolia had prevalence rates exceeding 40% for 5 years (2019-2023), peaking at 47.99% in 2022. Among the 22 provinces containing poverty-stricken counties, 9 showed significant annual increases, with Guangxi having the highest annual percentage change at 27.9018% (95% CI 7.4095%-52.3038%). Spatial analysis identified high-high clusters in northern provinces such as Hebei, Jilin, and Inner Mongolia, and low-low clusters in southwestern provinces such as Yunnan and Guizhou. Trend surface analysis revealed a distinct spatial gradient, with the northeast highest and the southwest lowest. The study revealed a generally increasing trend in hypertension prevalence among people lifted out of poverty in China from 2018 to 2023. The highest prevalence rates were concentrated in northeastern poverty-alleviated counties, while southwestern counties exhibited the lowest prevalence rates.

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17. Addressing Tobacco-Related Disparities Among Youth Experiencing Homelessness by Engaging Youth Collaborators in Intervention Research: Protocol for a Multimethod, Community-Based Participatory Research Study.

期刊: JMIR research protocols 发表日期: 2025-Aug-19 链接: PubMed

摘要

Youth experiencing homelessness and housing instability exhibit disparities in tobacco use and co-use of tobacco and cannabis products compared to their stably housed peers. Interventions to address these disparities have had limited success to date. This may be related to a lack of fit between intervention approaches and the unique needs and preferences of this marginalized population. Leveraging strategies to facilitate authentic engagement of youth in intervention research, including collaborating with youth in the cocreation of intervention goals and strategies, presents an opportunity to overcome challenges of previous research to mitigate tobacco-related disparities among youth experiencing homelessness and housing instability. This protocol aims to engage youth collaborators in intervention research to address tobacco-related disparities among youth experiencing homelessness and housing instability. It outlines strategies to recruit and partner with youth to cocreate a strengths-based, expressive arts intervention to reduce harms associated with tobacco use and tobacco/cannabis co-use and evaluate our youth engagement strategies. The community and academic partners leading this intervention study developed a structure that allows for two levels of youth collaboration. This structure, developed through consultation with a youth action board, facilitates youth (aged between 14 and 26 years) involvement in intervention design, implementation, and pilot testing. At the higher collaboration level, youth will join the intervention research team as “co-researchers,” engaging weekly with study-related tasks and contributing equitably to the research processes (eg, selecting intervention strategies and supporting data analysis) in alignment with their personal and professional goals. At the lower collaboration level, youth will engage with the research team as “advisors,” providing targeted feedback at key points during intervention development. Brief surveys, field notes, ethnographic memos, focus group discussions, and semistructured interviews will be used to evaluate our process and impact among the engaged youth. To date, we have engaged 7 co-researchers who have participated in several capacity-building and professional development activities, including research ethics training and tobacco prevention advocacy training. Co-researchers have contributed to intervention development brainstorming sessions, evaluated available interventions to address youth tobacco use, and developed materials to expand the group of co-researchers and advisors. Preliminary data suggest sufficient youth engagement (study goal of engaging 10 co-researchers in a 2-year study period) and that engagement processes are highly acceptable to youth collaborators. Lessons learned to date have helped us to improve and refine our engagement processes (eg, technological barriers). This protocol describes a holistic approach to equitably and authentically engaging youth as collaborators in intervention research to address tobacco-related disparities among youth experiencing homelessness and housing instability. The approach may serve as a useful model that can be adapted for other youth-focused intervention research. DERR1-10.2196/69441.

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18. Exploring the Perspectives of Pediatric Health Care Providers, Youth Patients, and Caregivers on Machine Learning Suicide Risk Classification: Mixed Methods Study.

期刊: Journal of medical Internet research 发表日期: 2025-Aug-19 链接: PubMed

摘要

Suicide was the second leading cause of death for youth aged between 10 and 24 years in 2023, necessitating improved risk identification to better identify those in need of support. While machine learning (ML) applied to electronic health records shows promise in improving risk identification, further research on the perspectives of these tools is needed to better inform implementation strategies. These findings incorporate 2 studies aimed to explore patient, caregiver, and pediatric health care provider perspectives on suicide risk models and associated clinical practices. We sought to use these findings to inform the design and implementation of a suicide risk model and associated clinical workflow to improve the quality of care provided to at-risk youth. We conducted a convergent mixed methods study to evaluate pediatric provider perspectives by quantitatively surveying and qualitatively interviewing provider participants. The provider study was guided by the Consolidated Framework for Implementation Research, and data were analyzed descriptively and using a template analysis for quantitative and qualitative data, respectively. Qualitative interviews conducted among youth patients and caregivers as part of a sequential mixed methods study, guided by the Theoretical Framework of Acceptability, were analyzed using template analysis as well. The integration of quantitative and qualitative data was achieved through a joint display, and results were interpreted through a narrative review. Forty-five providers completed the first section of the survey (risk model clinical preferences), while 44 completed the second section (risk model usability perspectives) and 38 completed the third section (Consolidated Framework for Implementation Research barriers and facilitators). Eight pediatric providers were interviewed. Ten semistructured qualitative interviews were conducted among 9 patient participants aged between 8 and 25 years and 1 caregiver. Overall, providers, patients, and caregivers expressed interest in applying ML methods to improve suicide risk identification. Providers felt that these tools could address current challenges in suicide-related care, such as inadequacies in manual suicide screeners or communication across care teams. Patients and caregivers saw potential for these tools to facilitate discussions regarding suicide and promote early intervention for patients who might otherwise be missed by current care practices. However, providers also expressed concerns about increased demand for mental health services, implications for patient confidentiality, coercive care, inaccurate diagnosis and response, and medical-legal liability. Ethical concerns shared by patients and caregivers spanned data safety practices and privacy regulations, respect for patient autonomy and informed consent, and decreased future health care engagement due to poor implementation. There is conditional acceptability and enthusiasm among providers, patients, and caregivers for ML-based suicide risk models. Successful implementation requires the incorporation of provider perspectives in a user-led fashion to build trust and empower clinicians to respond appropriately to risk flags, while upholding youth and caregiver perspectives to adequately accommodate patient needs.

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19. An Overview on Methods, Evidence, and Study Quality of Health Economic Evaluation Studies for Independently Usable Digital Health Apps: Rapid Review.

期刊: Journal of medical Internet research 发表日期: 2025-Aug-19 链接: PubMed

摘要

While research on the efficacy of digital health applications (DiHA) is progressing, health economic evaluations (EEs) remain limited but are urgently needed to guide reimbursement and coverage decisions. Existing health policy frameworks frequently overlook cost-effectiveness considerations, and many studies presuppose cost savings without sufficient empirical validation. Although previous reviews have assessed digital health interventions more broadly, none has specifically focused on the cost-effectiveness of those intended for independent patient use. This rapid review aims to summarize the current economic evidence and the methods used in health EEs, including modeling practices, and assess the quality of health economic studies on independently usable DiHA for patients. A systematic search was conducted in 4 electronic databases (PubMed, Cochrane Library, EconBiz, and Web of Science), supplemented by both systematic and unsystematic hand searches. Studies were included on predefined inclusion criteria, considering only complete health EEs of DiHA intended for independent patient use. Data were narratively synthesized. Risk of bias (RoB) was assessed using the Cochrane risk of bias tool 2 (RoB 2), and methodological quality was evaluated using the Consensus on Health Economic Criteria (CHEC) checklist and the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). The review adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for implementation and reporting. A total of 3841 results were identified. After screening the full texts of 82 publications, 7 studies were included in the final analysis. Four of the studies concluded that the app under review was cost-effective compared to the chosen control group. Most of the studies that provided economic evidence incorporated indirect costs and used a societal perspective. All studies used cost-utility analyses (n=7), with the majority based on randomized controlled trials (RCTs) (n=5), considering the health care payer perspective (n=3). Standard care was the most common comparator (n=5). Health outcomes were primarily measured using the EQ-5D (n=3) and condition-specific instruments (n=7). The incremental cost-effectiveness ratio, reported as costs per quality-adjusted life year, was the most frequently reported outcome (n=4). Overall, the quality of the EEs was rated positively using the CHEERS 2022 and CHEC checklists. However, more than half of the underlying RCTs exhibited a high RoB. DiHA have the potential to be cost-effective, and evaluations of these are of increasing interest. However, health EE is not yet routinely applied in their assessment. Improved reporting of RCT outcomes and greater consistency in modeling practices are needed to support robust EEs in this domain, which could advance evidence-based decision-making and reimbursement policies. This review focused on studies of indication-specific apps, which may have excluded broader applications, highlighting opportunities for more comprehensive research as the field evolves.

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20. Acceptability and Feasibility of a Prototype Regional Disaster Teleconsultation System for COVID-19 Pandemic Response: Pilot Field Test.

期刊: JMIR formative research 发表日期: 2025-Aug-19 链接: PubMed

摘要

Disaster telehealth can be used to provide rapid access to remote specialty expertise and virtual surge capacity for overwhelmed local clinicians. The Regional Disaster Health Response System (RDHRS) is developing a disaster teleconsultation system for cross-jurisdictional care in the United States. In 2020, the Region 1 RDHRS provided Massachusetts hospitals access to disaster teleconsultation services with out-of-state critical care experts during the first wave of the COVID-19 pandemic response. We aimed to field-test (1) the acceptability and feasibility of using a prototype, web-based disaster teleconsultation platform with minimal-to-no user training and (2) the feasibility of deploying a national volunteer expert pool to access out-of-state expertise. This was a prospective, mixed methods, observational study. We recruited field clinicians from Massachusetts hospitals and out-of-state critical-care physicians as experts for a 2-week pilot (June 2020). Experts were trained to use a prototype platform, while field clinicians received a just-in-time tool. Field clinicians requested teleconsultations for hospitalized patients with COVID-19 (clinical call) or simulated patients (test call). We collected demographics, call performance data, and Telehealth Usability Questionnaire (TUQ) ratings to measure acceptability (primary outcome; total usability score ≥6 of 7) and feasibility (secondary outcome; interface, interaction quality, and reliability items), and interviewed participants. We report descriptive statistics and key themes using the Technology Acceptance Model framework. Ten experts from 6 states and 17 field clinicians from 4 hospitals participated. All experts and 10 field clinicians completed postpilot questionnaires (74% response overall). Of these, 20% had previously used telemedicine in a disaster. In total, 50 test calls and no clinical calls were logged. Most (70%) made ≥1 call; 22% (95% CI 10%-34%) connected successfully. The median time to connect was 1.6 (IQR 3.2) minutes. Among field clinician respondents, 50% used smartphone devices, 40% hospital desktop computers, and 10% laptop computers to access RDHRS teleconsultation services. Calls failed due to platform routing errors (49%), hospital computers without cameras or microphones (10%), firewalls (8%), and expert notification failures (5%). The mean total usability score was 5.6 (SD 1.3). TUQ item scores were highest in usefulness (mean 6.0, SD 1.1) and ease-of-use (mean 6.0, SD 1.4), and lowest in reliability (mean 2.4, SD 1.4). Participants were comfortable using the platform. Those with difficulty identified discomfort with technology as the cause. All experts were willing to participate in a national expert registry and obtain emergency licensure, and most (80%) were willing to serve on a volunteer, unpaid basis. Clinicians found the prototype platform acceptable, but the workflow requires revision to reduce call failure and improve feasibility and reliability for future use with minimal-to-no training. Using familiar clinical workflows for emergency consultation and mobile devices with camera and microphone capabilities could improve call performance and reliability.

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21. Microorganisms Linked to Health Care-Associated Infections: Modernization of Terminology Resources for Reporting to the National Healthcare Safety Network.

期刊: JMIR public health and surveillance 发表日期: 2025-Aug-19 链接: PubMed

摘要

The National Healthcare Safety Network (NHSN) of the Centers for Disease Control and Prevention (CDC) needed a modernized approach to manage resources containing standardized terminology that specify microorganism data submitted electronically for legacy reporting. Health care-associated infections (HAIs) reported to NHSN require the submission of data regarding specific microorganisms attributed to the patient’s condition. Data on microorganisms submitted to the NHSN electronically must use the SNOMED CT terminology standard. Terminology artifacts that guide submission of microorganism data have been maintained in spreadsheets that have become increasingly challenging to manage. This case report details the initial use case for the implementation of off-the-shelf software within the NHSN to modernize the maintenance of terminology assets. Resources that guide reporting microorganisms for HAIs were used as a prototype to demonstrate how a software application can be practically implemented to streamline the maintenance of complex terminology assets. Mission-critical artifacts have been reconciled and consolidated into a single source of truth knowledgebase using an off-the-shelf software solution. This report shares progress and lessons learned regarding the modernization of NHSN’s Pathogen Codes resource and its derivative artifacts. A model is now available that can be replicated across other NHSN legacy artifacts. Our experience can be applied to other public health use cases and information systems facing similar challenges with attachments to legacy terminology resources and systems.

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22. Effectiveness of a Self-Guided Digital Intervention for Mental Health and Psychological Well-Being in University Students: Pre- and Postintervention Study.

期刊: Journal of medical Internet research 发表日期: 2025-Aug-19 链接: PubMed

摘要

University students frequently face mental health challenges due to academic pressures, lifestyle changes, and developmental factors. Digital interventions, such as Doing What Matters in Times of Stress (DWM), a psychosocial e-mental health intervention developed by the World Health Organization (WHO), offer scalable approaches to address these issues. These data emerging from the literature provide the framework for the CAMPUS (Characterize and Address Mental health Problems in University Students) study aimed at supporting the mental health of students attending the University of Verona. This study aimed to assess the effectiveness and implementability of DWM as a psychological strategy for effective mental health prevention and promotion, as well as for reducing psychological symptoms and distress and improving well-being in university students. During the study period (October 2023-June 2024), we conducted a prospective hybrid type-1 nonrandomized follow-up study, with a pretest-posttest design. The study population consisted of students attending the University of Verona, who were recruited through university communication channels and participated via web-based platforms. Data were collected at baseline (T1) and after the intervention (T2) using an ad hoc sociodemographic information page and self-reported tools assessing psychological distress with the Kessler-10 (K-10), depressive symptoms with the Patient Health Questionnaire-9 (PHQ-9) depression scale, anxiety symptoms with the Generalized Anxiety Disorder-7 (GAD-7) scale, and psychological well-being with the WHO-5 Well-Being Index (WHO-5). In addition, at postintervention, the implementability was assessed. Statistical analyses included Wilcoxon matched pairs signed rank tests and logistic regression models to identify associated factors. Out of 2296 interested students, 1498 (65.24%) completed all DWM sessions and assessments. At T1, students exhibited mild psychological distress, anxiety, and depressive symptoms with moderate well-being. Significant improvements were observed postintervention: the K-10 scores decreased from 22.41 (SD 6.54) to 19.86 (SD 5.96), the GAD-7 scale scores decreased from 8.27 (SD 4.31) to 6.57 (SD 3.76), and the PHQ-9 scores decreased from 8.28 (SD 7.73) to 6.75 (SD 4.37; all P<.001). The WHO-5 well-being scores increased from 11.73 (SD 4.65) to 13.26 (SD 4.68; P<.001). Satisfaction was high, with 90.72% (1359/1498) of participants agreeing or strongly agreeing on satisfaction, 77.37% (1159/1498) agreeing or strongly agreeing on appropriateness, and 94.99% (1423/1498) finding the program easy to use. No significant differences in clinical outcomes were associated with sociodemographic or baseline mental health variables. The DWM intervention demonstrated positive effects on students’ mental health, showing reductions in distress, anxiety, and depressive symptoms, alongside improved well-being. The program’s high levels of acceptability, appropriateness, and feasibility highlight its potential for broader application as a digital mental health strategy for university students.

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23. Does Achieving Gait Symmetry During Split-Belt Adaptation Reflect Corticospinal Involvement in Stroke Survivors?

期刊: Journal of neurophysiology 发表日期: 2025-Aug-19 链接: PubMed

摘要

This study explored the relationship between gait parameters (i.e., center of mass-center of pressure [CoM-CoP] angle, step length, and double-support time) and corticospinal activity in stroke survivors across two phase types: final symmetry during late adaptation (LA) and changes from baseline to LA. Twenty-two stroke survivors participated in the study. Gait adaptation was assessed using three-dimensional motion analysis and surface electromyography to measure muscle activity and movement patterns. Recordings were obtained from the bilateral tibialis anterior (TA), soleus, and medial gastrocnemius muscles. Intermuscular coherence in the beta band between the bilateral TA muscles was quantified. Stroke survivors who re-established CoM-CoP angle symmetry during the LA phase exhibited strong interdependence between the affected and unaffected TA signals, reflecting enhanced neural coordination. These findings suggest that changes in CoM-CoP angle symmetry are more closely linked with neural gait control mechanisms than step length or double-support time.

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24. Analysis of acute glomerulonephritis disease burden and incidence trends in China, 1990-2021.

期刊: International urology and nephrology 发表日期: 2025-Aug-19 链接: PubMed

摘要

To analyze and discuss the epidemiological characteristics and disease burden of acute glomerulonephritis in China from 1990 to 2021, predict its incidence in China from 2022 to 2036, and provide a reference for developing treatment and prevention strategies. Data on acute glomerulonephritis in China were collected from the 2021 Global Burden of Disease database. The Joinpoint regression model was used to analyze the average annual percentage change and annual percentage change of age-standardized rates, years of life lost due to premature mortality, years lived with disability, and disability-adjusted life years. The age-period-cohort model was used to analyze the incidence from 1992 to 2021, and the Bayesian age-period-cohort method was used to predict the incidence from 2022 to 2036. Standardized incidence and mortality rates of acute glomerulonephritis in China showed a downward trend from 1990 to 2021, with average annual decreases of 4.157% and 3.861%, respectively. In 2021, the incidence and mortality rates were 7.70 (95% UI 6.55-9.01) and 0.31 (95% UI 0.21-0.40) per 100,000, respectively. The years of life lost, years lived with disability, and disability-adjusted life years also decreased. The age-period-cohort model indicated increased risk in the 0-14 and 80-99 age groups. The period effect showed a downward trend in risk from 1992 to 2021 but a slight increase since 2017. Birth cohort analysis revealed higher risks for some persons. By 2036, the male incidence may decrease to 7.38 per 100,000 while females may increase to 8.47 per 100,000. We observed an overall decline in disease burden and risk. However, some age groups remain at risk. We also observed a slight increase since 2012. Future projections suggest rising female incidence. Targeted interventions for high-risk groups like children, adolescents, the elderly, and females are needed to reduce the disease burden.

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25. Development and validation of 3D super-resolution convolutional neural network for 18F-FDG-PET images.

期刊: EJNMMI physics 发表日期: 2025-Aug-19 链接: PubMed

摘要

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26. [Impact of a national policy change on rapid diagnostic testing for HIV, hepatitis C and syphilis by lay providers in community-based organisations and local public health centres: a cross-sectional study].

期刊: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 发表日期: 2025-Aug-19 链接: PubMed

摘要

To improve the diagnosis of undetected infections with the Human Immunodeficiency Virus (HIV), the Hepatitis C Virus (HCV) and syphilis infections among key populations, Section 24 of the Infection Protection Act was amended. Since 1 March 2020, non-medical staff have also been permitted to perform rapid tests. This study aims to examine the impact of the legal change in low-threshold AIDS and drug services as well as in public health offices. In a cross-sectional survey, 274 drug services, 100 member organisations of the German AIDS Service Organisation and 342 public health offices were invited to take part in an online questionnaire. Topics included facility structure, service provision and the acceptance, implementation and effects of the legal change. Data were analysed descriptively; where sample size allowed, results were differentiated by facility type. Of the 716 facilities contacted, 286 participated. After the legal change, 80 (28%) introduced rapid testing by non-medical staff. Facilities with existing testing services were more likely to adopt testing by non-medical staff than those without prior experience (56.8% vs. 13.6%). The average monthly number of HIV, HCV, and syphilis rapid tests increased significantly. The number of reactive test results remained unchanged. The legal change shows positive effects but there is still potential for broader implementation. Existing test infrastructure appears to support uptake. Additional support measures are needed to expand testing by non-medical staff. However, this alone is not sufficient to detect undiagnosed infections. Expansion and promotion of outreach testing services remain essential. HINTERGRUND: Zur besseren Diagnostik bislang unerkannter Infektionen mit dem Humanen Immunschwäche-Virus (HIV), dem Hepatitis-C-Virus (HCV) und mit Syphilis in besonders betroffenen Gruppen wurde § 24 Infektionsschutzgesetz geändert. Seit dem 01.03.2020 darf auch nichtärztliches Personal Schnelltests durchführen. Ziel der Studie ist es, die Auswirkungen dieser Gesetzesänderung in niedrigschwelligen Aids- und Drogenhilfeeinrichtungen sowie im öffentlichen Gesundheitsdienst (ÖGD) zu untersuchen. In einer Querschnittsbefragung wurden 274 Drogenhilfen, 100 Mitgliedsorganisationen der Deutschen Aidshilfe und 342 ÖGD-Einrichtungen zur Teilnahme an einer Online-Befragung eingeladen. Themen waren Einrichtungsstruktur, Leistungsangebot sowie Akzeptanz, Umsetzung und Auswirkungen der Gesetzesänderung. Die Daten wurden deskriptiv ausgewertet, bei ausreichender Fallzahl auch nach Einrichtungstyp differenziert. Von 716 kontaktierten Einrichtungen nahmen 286 teil. 80 (28 %) führten nach der Gesetzesänderung Schnelltests durch nichtärztliches Personal ein. Einrichtungen mit bereits bestehendem Testangebot implementierten dies deutlich häufiger als solche ohne Vorerfahrung (56,8 % vs. 13,6 %). Die durchschnittliche Anzahl monatlich durchgeführter HIV-, HCV- und Syphilis-Tests stieg signifikant an. Die Zahl reaktiver Tests blieb unverändert. Die Gesetzesänderung zeigt positive Effekte, jedoch besteht weiteres Potenzial. Eine vorhandene Testinfrastruktur begünstigt die Umsetzung. Es bedarf zusätzlicher Unterstützung, um Schnelltests flächendeckend zu etablieren. Allein reichen sie jedoch nicht aus – insbesondere aufsuchende Testangebote müssen ausgebaut und gefördert werden.

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27. Evaluation of Coronavirus Disease 2019 and Influenza-like Illness Surveillance Case Definitions in a Prospective Cohort of Healthcare Personnel in Peru.

期刊: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 发表日期: 2025-Aug-19 链接: PubMed

摘要

Public health agencies employ case definitions for influenza virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections to optimize surveillance, monitor disease trends, and inform decision-making, particularly in limited resource settings. Using a prospective healthcare personnel cohort in two hospitals in Lima, Peru (July 2022-June 2023), we compared and evaluated the performance of three symptom profiles of three common surveillance case definitions to identify influenza and SARS-CoV-2 infections: influenza-like illness, coronavirus disease 2019-like illness (CLI), and acute respiratory infection. Participants with an acute respiratory illness reported symptom progression twice weekly. Participants self-collected nasal swabs for SARS-CoV-2 and influenza reverse transcription real-time polymerase chain reaction testing. Sensitivity, specificity, and positive and negative predictive values of each case definition were evaluated. Of 1623 participants enrolled, 1450 illness episodes were reported; 92 (6%) were positive for influenza, 350 (24%) for SARS-CoV-2, and 3 (0.2%) were positive for both. For the four influenza-like illness case definitions evaluated, all yielded low sensitivity for detection of influenza (points estimate range, 23%-35%) and SARS-COV-2 (range, 21%-29%), but high specificity (83%-90% and 86%-92%, respectively). In contrast, the acute respiratory infection and coronavirus disease 2019-like illness definitions both yielded high sensitivity (83%-100%) and low specificity (2%-41%) for detection of both influenza and SARS-CoV-2. The performance of case definitions was similar for influenza and SARS-CoV-2 supporting the use of the same definitions by surveillance networks. The substantial differences in sensitivity and specificity across the case definitions necessitate surveillance objectives and cost considerations in selecting a case definition fit for purpose.

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28. Fulcrum Occupancy-Leverage Perturbation Strategy Enables Rapid Discovery of Potent CDK2-Cyclin A2 Interaction Inhibitors.

期刊: Angewandte Chemie (International ed. in English) 发表日期: 2025-Aug-19 链接: PubMed

摘要

Traditional strategies for developing small-molecule inhibitors of protein-protein interactions (PPIs) are time-consuming and often yield low success rates due to the flat and dynamic interfaces of PPIs. To enable the rapid design of highly potent PPI inhibitors, we proposed a novel strategy named “Fulcrum Occupancy-Leverage Perturbation (FOLP)”. In this strategy, high-affinity fragments serve as the “Fulcrum” by binding to the orthosteric pocket, while suitable moieties extend into allosteric sites near the PPI interface as “Leverage” to modulate the protein-protein interaction. As a proof of concept, the potent CDK2-Cyclin A2 PPI inhibitor LC-K2CAin-3, which fits the “FOLP” paradigm, was discovered with an IC50 of 32.1 nM for inhibiting the interaction. Molecular dynamics simulations and cryptic pocket identification were employed, revealing the activation loop (A-loop) of CDK2 was flexible and targetable. X-ray crystallography and hydrogen deuterium exchange mass spectrometry (HDX-MS) analysis showed that LC-K2CAin-3 indeed bound to and stabilized the A-loop. LC-K2CAin-3 effectively inhibited the CDK2-Cyclin A2 interaction in CDK2 highly expressed melanoma cells, leading to cell cycle arrest and apoptosis and inhibition of CDK2 mediated signaling. In conclusion, the “FOLP” strategy offers a novel approach for PPI inhibitor discovery and could accelerate the development of PPI inhibitors.

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29. A Mixed Methods Study to Identify Characteristics and Practices of Effective Student Health Advocates.

期刊: American journal of health promotion : AJHP 发表日期: 2025-Aug-19 链接: PubMed

摘要

PurposeStudents can serve as key advocates for healthier environments in their schools. This study employs the Youth Advocacy for Obesity Prevention Framework to investigate associations between advocacy skills for environmental and policy change and both self-efficacy and health behaviors, and explores applications of advocacy skills for health among 9-15 year-old elementary and middle schoolers.DesignConvergent, nested mixed-methods approach.SettingElementary and middle schools in a mid-Atlantic U.S. state.Subjects457 low-income elementary and middle students.MeasuresValidated questionnaires were administered to 457 students attending 33 elementary or middle schools serving low-income communities in 5 school districts, assessing self-efficacy for physical activity (PA) and healthy eating (HE), PA and HE behaviors, and advocacy skills. Semi-structured interviews with a subset of 199 students explored advocacy applications.AnalysisHierarchical linear regressions assessed associations between students’ self-efficacy for PA and HE, PA and HE behaviors, and advocacy scores, accounting for school-level clustering and controlling for student factors (eg, gender, race, and BMI category). Integrated analysis of quantitative and qualitative data explored conceptualizations of advocacy skills.ResultsSelf-efficacy for PA (b = .24; P < .001), self-efficacy for HE (b = .39; P < .001), and engagement in PA (b = .10; P < .001) were associated with higher advocacy scores. Mixed methods findings further operationalized advocacy skills including leadership participation and history, self-efficacy for health promotion, and assertiveness in advocacy.ConclusionPromoting youth self-efficacy for health behaviors may enhance advocacy efforts for healthier school environments. Future research should further explore methods to foster youth advocacy and assess its impact on promoting healthier school environments.

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30. Layilin inhibits integrin activation, and its loss results in platelet hyperactivation via Rac1 in inflammatory bowel disease.

期刊: Blood 发表日期: 2025-Aug-19 链接: PubMed

摘要

Platelets are specialized cells for hemostasis that circulate in close contact to the glycocalyx, an extracellular layer of interwoven glycoproteins, proteoglycans, and glycosaminoglycans that maintain vascular homeostasis. Platelets survey their circulating environment, balancing inhibitory signals that prevent inappropriate activation with activating signals that initiate thrombus formation. Disease can disrupt this delicate balance of endogenous inhibitory signaling, leading to an increased risk of thrombosis as in patients with inflammatory bowel disease (IBD). In this study, we demonstrate that physiological concentrations of hyaluronan (HA), an essential component of the glycocalyx, acts as an inhibitor of activation and aggregation in human platelets. Using a combination of affinity chromatography, and functional assays of platelets from humans and genetically modified mice, we identify layilin as the receptor for HA and an endogenous inhibitor of platelet activation. LAYN KO platelets display agonist-induced hyperactivation of αiiBβ3 and increased adhesion to fibrinogen under venous shear. Loss of layilin results in dysregulation of Rho GTPase family members-RAC1, Cdc42, RhoA, and Ras-like Rap1,- via layilin’s binding partner, merlin, and downstream PAK1. Furthermore, IBD patient platelets contain reduced layilin protein levels correlating with heightened basal Rac1-GTP levels and increased reactivity. Finally, although IBD platelets show enhanced sensitivity to activation, pharmacological inhibition of RAC1 effectively reduces platelet hyperactivity in IBD patient platelets. These findings highlight a novel role for layilin and HA in the maintenance of platelet homeostasis that becomes disrupted in patients with IBD.

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31. Associations of glycaemia-related risk factors with dementia and cognitive decline in individuals with type 2 diabetes: A systematic review and meta-analysis.

期刊: Diabetic medicine : a journal of the British Diabetic Association 发表日期: 2025-Aug-19 链接: PubMed

摘要

To quantify prospective associations of glycaemia-related factors with cognitive decline and all-cause dementia and its subtypes in people with type 2 diabetes. We systematically searched Embase and MEDLINE (January 2000-October 2024) for studies in people with diabetes reporting longitudinal associations of a relevant exposure (i.e. hypoglycaemia, HbA1c, HbA1c variability or diabetes duration) with any of these outcomes: cognitive decline, all-cause dementia, Alzheimer’s disease (AD) or vascular dementia (VaD). Data were meta-analysed using a random-effects model followed by meta-regression if appropriate. Forty studies representing 7,076,724 individuals with diabetes were included. Hypoglycaemia was significantly associated with 49% and 31% higher risks of all-cause dementia and AD, respectively. The pooled effect size did not significantly vary according to age, sex, diabetes duration, smoking, follow-up length, comorbid hypertension, kidney disease, dyslipidaemia or stroke (all p > 0.05). A positive association existed between hypoglycaemia frequency and all-cause dementia, with maximum hazard ratios (HRs) of 2.36-2.60 in the highest exposure group. HbA1c showed a positive risk gradient for all-cause dementia, with maximum significant HRs of 1.40-3.88 for the highest category, while only three studies were available for meta-analysis, with a pooled HR (95% CI) of 1.18 (0.97, 1.45). HbA1c variability and diabetes duration were each significantly associated with a higher risk of dementia. Limited evidence supported a relationship between glycaemia-related factors and cognitive decline. Having a history of hypoglycaemia, longer diabetes duration, and higher HbA1c levels and variability were related to higher dementia risk in people with type 2 diabetes.

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32. Effectiveness of a Digital Peer-Supported App Intervention in Promoting Smoking Cessations: Nonrandomized Controlled Trial.

期刊: JMIR mHealth and uHealth 发表日期: 2025-Aug-19 链接: PubMed

摘要

Smoking cessation has become a global priority, with peer support interventions shown to improve abstinence rates. However, no studies have examined the effectiveness of a group-based digital peer-supported app combined with nicotine gum for smoking cessation among working populations. This study aimed to assess whether adding a digital peer-supported app to standard nicotine gums improves 12-week smoking abstinence rates among current working smokers in employment-based settings. A nonrandomized comparison trial was conducted with current working smokers in Japan. Eligible participants smoked at least 1 cigarette per day, owned a smartphone (iOS or Android), and were enrolled in their company’s health insurance program. Participants were self-selected into one of the two intervention groups (digital peer-supported app + nicotine gums) or a control group (nicotine gums only). The digital peer-supported app creates a group chat for up to 5 people aimed at smoking cessation, where participants can anonymously post counts, photos, and comments daily. Logistic regression analyses adjusted for demographic and smoking-related variables were used to estimate the odds ratios for smoking cessation. Engagement with the app (usage days and posting frequency) was analyzed within the intervention groups. A total of 451 participants were included in the per-protocol analysis (260 in the intervention groups and 191 in the control group). The 12-week abstinence rate was significantly higher in the digital peer-supported app + nicotine gum group compared to the gum-only group (59.2% [154/260] vs 38.7% [74/191]). The adjusted odds ratio of smoking cessation was 2.41 (95% CI 2.07-2.81), indicating a significant impact of digital peer support. Both higher duration of digital peer-supported app usage and increased posting frequency were positively associated with cessation success (P for trend <.001). The addition of a digital peer-supported app to nicotine gum use significantly improved smoking cessation outcomes among working smokers. These findings provide preliminary evidence for the feasibility and effectiveness of integrating group-based digital peer support into smoking cessation interventions.

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33. Temporal dynamics between COVID-19 cases and particulate matter in Bangkok: Impact of lockdown policies on air quality and disease transmission.

期刊: Journal of the Air & Waste Management Association (1995) 发表日期: 2025-Aug-19 链接: PubMed

摘要

This study investigates the relationship between COVID-19 transmission and ambient air pollution in Bangkok, Thailand, during multiple pandemic waves from January 2020 to January 2022. The objectives were to quantify correlations between COVID-19 cases and criteria air pollutants (PM2.5, PM10, CO, NO2, O3) across pandemic phases, analyze relationship variations during different waves and control periods, delineate temporal and seasonal trends, and evaluate lockdown effects on disease transmission and air quality. We employed comprehensive time-series analysis using data from six air quality monitoring stations and daily COVID-19 case records. Air quality parameters were measured using reference-grade instrumentation including Beta-attenuation monitors for particulate matter, non-dispersive infrared spectroscopy for CO, chemiluminescence for NO2, and ultraviolet photometry for O3. Statistical analyses included Pearson correlation with Bonferroni correction, multiple linear regression with assumption verification, and Seasonal Autoregressive Integrated Moving Average (SARIMA) forecasting, stratified by seasonal variations, lockdown periods, and viral variant periods. During the first lockdown (March-June 2020), moderate positive correlations existed between COVID-19 cases and particulate matter (PM2.5: r = 0.159; PM10: r = 0.093), with both infection rates and pollution levels decreasing significantly (PM2.5 declined 18.7%). During Delta variant prevalence (July-August 2021), correlations shifted negative (PM2.5: r = -0.073; PM10: r = -0.125), indicating variant dynamics superseded environmental influences. Multiple regression revealed nitrogen dioxide from vehicular sources as the primary PM2.5 predictor (β = 0.682, p < 0.001), explaining 72.4% of variation. Seasonal analysis showed particulate pollution peaked during winter months, with average PM2.5 levels (36.54 ± 18.73 μg/m3) exceeding WHO guidelines. This research demonstrates that Bangkok’s air quality improvements during COVID-19 restrictions resulted primarily from reduced vehicular emissions rather than industrial changes, suggesting targeted traffic emission reduction strategies could substantially improve air quality while highlighting complex environmental-disease transmission relationships during pandemics.Implication StatementThis study examines the relationship between air pollution and COVID-19 transmission in Bangkok, Thailand, providing important findings for air quality management in large cities. The research shows that lockdown measures significantly reduced air pollution levels, with the largest decrease in nitrogen dioxide (42.3%) and carbon monoxide (27.8%), both primarily from vehicle emissions.The findings indicate that traffic is the main source of particulate matter pollution in Bangkok. Nitrogen dioxide levels were the strongest predictor of PM2.5 concentrations, suggesting that controlling vehicle emissions would be an effective approach to reduce overall air pollution. During the study period, PM₂.₅ levels exceeded World Health Organization guidelines on 95.8% of days in winter, demonstrating the severity of the pollution problem.The seasonal patterns observed in this study highlight the need for different pollution control strategies throughout the year. Winter months showed the highest pollution levels, while the rainy season had the lowest concentrations due to natural cleaning processes. This information can help authorities plan targeted interventions during high-risk periods.For air quality managers and public health officials, these results support the implementation of policies that reduce vehicle emissions, such as promoting public transportation and electric vehicles. The study also demonstrates the value of integrating air quality monitoring with health surveillance systems to better understand pollution impacts on public health.The research methodology and findings can be applied to other tropical cities facing similar challenges with air pollution and public health management. The results provide evidence that environmental policies can have immediate benefits for both air quality and public health outcomes.

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34. Urbanisation is associated with changes in stable isotopes across multiple trophic levels.

期刊: Isotopes in environmental and health studies 发表日期: 2025-Aug-19 链接: PubMed

摘要

The increase in urbanisation imposes important threats to biodiversity through habitat destruction, reduced availability of preferred food resources and higher pollution. To support future urban planning, it is necessary to gather more knowledge on how the ecology of organisms from different trophic levels varies across the urbanisation gradient. In our study, we employed carbon and nitrogen stable isotope analysis to investigate the relationship between increasing urbanisation and δ13C and δ15N values across a tri-trophic system of trees (birch and oak), invertebrates (aphids, other Hemiptera, and caterpillars) and a model avian species for urban ecology (the blue tit Cyanistes caeruleus). For the blue tits, we measured the isotopic niche to assess how urbanisation affect niche width at different life stages (adults and nestlings). We observed higher δ15N values in all taxa in urban areas and δ13C values were also higher in urban trees and blue tit nestlings. Exposure to increased air pollution in urban areas, mainly derived from anthropogenic NOx gas emissions, is one of the main causes of the increase in δ15N in urban organisms. Furthermore, in urban areas covered by impervious surfaces there is greater water scarcity in the soils, leading to physiological responses in plants that increase the δ13C in leaves. We observed that the isotopic niche of urban blue tits is 4.5-18 times smaller in adults and nestlings, respectively, than that observed for forest individuals. Forest blue tits exhibit broader niches, likely reflecting a greater availability and diversity of optimal resources in less disturbed habitats. Conversely, urban blue tits exhibited narrower isotopic niches, suggesting an impact associated with lower diversity and abundance of profitable prey in urbanised habitats. Our study highlights that urbanisation can affect organismal physiology across different trophic levels in similar fashion.

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35. Longitudinal Continuous Glucose Monitoring Study in Young Children With Presymptomatic Type 1 Diabetes Followed in the Environmental Determinants of Islet Autoimmunity (ENDIA) At-Risk Cohort Study.

期刊: Diabetes care 发表日期: 2025-Aug-19 链接: PubMed

摘要

To characterize longitudinal continuous glucose monitoring (CGM) data in young children with presymptomatic type 1 diabetes. Between 2021 and 2024, children in the Australian ENDIA study with persistent multiple islet autoimmunity underwent blinded CGM assessments every 3-6 months. CGM-derived metrics (SD sensor glucose, coefficient of variation, mean sensor glucose, and percent CGM time >7.8 mmol/L [140 mg/dL]) were determined for each child by time from islet autoantibody detection. A total of 178 CGM assessments were analyzed for 36 children (median [Q1, Q3] age at first assessment 4.5 [3.5, 6.0] years) who underwent a median of 5.5 (2.0, 7.0) assessments of 11 (9, 15) days duration each. High within-person variability was observed in serial CGM metrics, including percent CGM time >7.8 mmol/L (140 mg/dL) (intraclass correlation coefficient 0.30). Further research is needed to inform interpretation of CGM-derived metrics in young children with presymptomatic type 1 diabetes.

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36. Perception of AI Use in Youth Mental Health Services: Qualitative Study.

期刊: Journal of participatory medicine 发表日期: 2025-Aug-19 链接: PubMed

摘要

Artificial intelligence (AI) technology has made significant advancements in health care. A key application of using artificial intelligence for health (AIH) is the use of AI-powered chatbots; however, empirical evidence on their effectiveness and feasibility remains limited. This study explored interest group perceptions of integrating AIH in youth mental health services, focusing on its potential benefits, challenges, usefulness, and regulatory implications. This qualitative study used semistructured in-depth interviews with 23 mobile health stakeholders, including youth users, service providers, and nonclinical staff from an integrated youths’ service network. We used an inductive approach and thematic analysis to identify and summarize common themes and subthemes. Participants identified AIH’s potential to support education, navigation, and administrative tasks in health care, as well as to create safe spaces and mitigate health resource burdens. However, they expressed concerns about the lack of human elements, such as empathy and clinical judgment. Key challenges included privacy issues, unknown risks from rapid technological advancements, and insufficient crisis management for sensitive mental health cases. Participants viewed AIH’s ability to mimic human behavior as a critical quality standard and emphasized the need for a robust evaluation framework combining objective metrics with subjective insights. While AIH has the potential to improve health care access and experience, it cannot address all mental health challenges and may exacerbate existing issues. While AIH could complement less-complex services, it could not replace the therapeutic value of human interaction at this time. Co-design with end users is critical for successful AI integration. Robust evaluation frameworks and an iterative approach to build a learning health system are essential to refine AIH and ensure it aligns with real-world evolving needs.

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37. Evaluating the relationship between noise reduction and object thickness in scatter correction processing.

期刊: Radiation protection dosimetry 发表日期: 2025-Aug-19 链接: PubMed

摘要

Physical grids (PGs) are used in portable bedside radiography to reduce scattered X-rays that reach the detector. Because the use of PGs degrades image quality due to oblique incidence of X-rays or deviation of the center line on the grid, scatter correction (SC) processing is often used instead of PGs. This study aimed to evaluate the relationship between object thickness and noise reduction in SC processing. Polymethyl methacrylate (PMMA) phantoms of different thicknesses (16, 20, 26, and 30 cm) were used as objects. The Burger phantom was placed at the center of the thickness direction of the PMMA phantoms. Images were acquired with PGs, without PGs, and with SC processing which consists of contrast improvement processing and noise reduction processing. Contrast and noise were evaluated. Contrast of images without PG improved when SC processing was used. However, the effect of noise reduction process decreased with increase in the thickness of PMMA, and significant decrease was observed when the thickness of PMMA was ≥26 cm. In SC processing, the effect of noise reduction decreased with the increase in object thickness. These findings suggest that the applicability of SC processing may be limited, particularly in large patients.

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38. Prognostic value of right ventricular ejection fraction using three-dimensional echocardiography in patients with ischemic and dilated cardiomyopathy.

期刊: Journal of echocardiography 发表日期: 2025-Aug-19 链接: PubMed

摘要

There are few studies reporting the prognostic value of three-dimensional echocardiography (3DE)-derived right ventricular ejection fraction (RVEF) in patients with ischemic cardiomyopathy (ICM) and dilated cardiomyopathy (DCM). 120 ICM and 107 DCM patients who underwent 3DE were retrospectively selected and analyzed using 3DE speckle tracking software. The primary endpoint was a composite of cardiac events, including cardiac death, heart failure hospitalization, myocardial infarction, or ventricular tachyarrhythmia. During a median follow-up of 24.3 and 53.6 months, 45 patients in ICM and 39 patients in DCM, respectively, reached the primary endpoint. Univariate analysis showed that RVEF was statistically significantly associated with cardiac events in both groups [ICM, hazard ratio (HR): 0.92, 95% confidence interval (CI) 0.89-0.95; DCM, HR: 0.90, 95% CI 0.86-0.93, respectively]. In multivariable analysis, RVEF (HR: 0.89-0.92, p < 0.001) was also statistically significantly associated with cardiac events in both ICM and DCM, even after adjustment for clinical factors, left ventricular (LV) systolic and diastolic parameters, or RV systolic parameters. Kaplan-Meier curves, divided into four groups by RVEF ≥ 45% and < 45% and E/e’ ≥ 14 and < 14, showed significant risk stratification for both ICM (p = 0.0068) and DCM (p < 0.0001). RVEF had incremental prognostic value over age, E/e’, and conventional RV systolic parameters, in both ICM and DCM. This study confirms the independent and incremental prognostic value of RVEF over conventional echocardiographic parameters in patients with ICM and DCM and allows detailed risk stratification of cardiac events by RVEF and E/e’.

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39. Impacts of the Jaco robotic arm on user satisfaction with performance in everyday activities.

期刊: Disability and rehabilitation. Assistive technology 发表日期: 2025-Aug-19 链接: PubMed

摘要

Assistive technology (AT) such as the Jaco robotic arm (JRA) provides significant benefits for individuals with upper extremity disabilities (UED). Despite these advantages, barriers including funding limitations, lack of awareness, and insufficient evidence of efficacy can hinder access. This study examined the effectiveness of the JRA by evaluating user performance and satisfaction with occupational performance (OP) before and after device use. A non-experimental retrospective mixed-method study was employed. Participants completed interviews via Zoom using the Canadian Occupational Performance Measure (COPM). Interview data were analyzed and member checking was conducted to ensure accuracy. A convenience sample of JRA users in North America, aged 18 years and older, was recruited in collaboration with Partners in Medicine, the device’s North America distributor. The COPM identified challenges in self-care, productivity, and leisure, as well as corresponding performance and satisfaction ratings prior to and following JRA use. Twelve users, aged 30-58, who had used the JRA for 3 weeks to 8 years, participated. Common OP problems included opening and closing doors, retrieving items, drinking, manipulating phones, eating, community mobility, and repositioning body parts. Participants consistently reported meaningful improvements after acquiring the JRA. Individual average performance score change ranged from 3.2 to 8.3, while satisfaction scores ranged from 3.0 to 7.7. This study demonstrated that the JRA was a beneficial AT intervention for study participants. The findings of this study have the following implications for rehabilitation professionals.Rehabilitation professionals can consider the JRA as a useful intervention for those who live with UED.Our research supports previous studies which indicate that the JRA improves performance and satisfaction with performance in meaningful activities for its users.JRA users in this study report experiencing increased independence, health and wellness, social participation and mobility after obtaining the device.Rehabilitation professionals can include outcome assessments, such as the COPM, in their service provision to document the impact of their interventions.

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40. Psychological resources and mental health: Understanding academic engagement and performance of students in HEIs during COVID-19.

期刊: Acta psychologica 发表日期: 2025-Aug-18 链接: PubMed

摘要

Research on psychological outcomes of COVID-19 has predominantly examined mental health problems, with limited focus on well-being and psychological resources. This research, in two studies, examines the salient indicators of psychological distress and well-being in the overall mental health network and further the role of psychological resources and affective well-being in young adults’ academic outcomes during adversity. Study 1 explores the mental health network during COVID-19, employing a network analysis approach on a sample of 407 students in two higher educational institutions (HEIs) in India. Results reveal both well-being and psychological distress indicators, such as engagement, satisfaction with life, meaning and purpose, negative emotions, and hopelessness, remained central in the mental health network. In Study 2, using 1-year longitudinal data (four waves), two models explored the influence of reciprocal associations between affect balance and psychological resources (PsyCap and mindfulness) on psychological distress, academic engagement, and academic performance. Data were collected from 164 students in 4 different time periods. Findings show that while PsyCap and mindfulness indirectly decrease psychological distress by improving affect balance and academic engagement, academic performance is only improved through an increase in academic engagement. Improvements in affect balance did not improve academic performance. Also, experiencing more positive emotions builds PsyCap and mindfulness, which in turn improve academic performance and academic engagement. Thus, the research provides insights that both subjective and psychological well-being indicators, along with negative emotions, hopelessness, and worthlessness, are salient for the mental health of young adults and can act as protective and risk factors. Furthermore, it also shows how PsyCap, mindfulness, and positive emotions reinforce one another over time to foster healthy mental states and academic outcomes. These insights can guide education and mental health policy, research, and practice.

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41. Genetic risk in telomere biology disorders: it adds up.

期刊: The Journal of clinical investigation 发表日期: 2025-Aug-15 链接: PubMed

摘要

For many conditions, genotyping aids in clinical decision making. However, interpreting the clinical significance of genetic variants remains challenging, in part because a single risk variant does not always lead to disease, and variant carriers experience variable outcomes. One hypothesis underlying these phenomena, which are known as incomplete penetrance and variable expressivity, respectively, is that additional common genetic variation beyond the primary variant influences the presence and severity of disease. In this issue of JCI, Poeschla et al. present a compelling argument that common variants linked to telomere length act together with high-risk telomere biology disorder variants to scale outcomes. These data support a model in which many variants interact to shape cumulative risk.

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42. Nonimmunocompromised Children With Adenovirus Infection-Clinical Role and Therapeutic Interventions: A Short Systematic Review.

期刊: The Pediatric infectious disease journal 发表日期: 2025-Aug-15 链接: PubMed

摘要

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43. Chronic diseases alter the platelet rheostat to promote hyperreactivity and thrombosis.

期刊: The Journal of clinical investigation 发表日期: 2025-Aug-15 链接: PubMed

摘要

Platelet hyperreactivity, defined as enhanced sensitivity to activation in response to classical agonists, contributes to the increased risk of arterial thrombosis associated with chronic inflammatory diseases. In this issue of the JCI, Kong and colleagues used an unbiased proteomic approach to identify elevated SEC61B in platelets from patients with diabetes and from hyperglycemic mice. Typically, SEC61B participates in protein transport within the endoplasmic reticulum (ER), but it can also act as an ion channel that allows calcium to leak from ER to cytoplasm. The authors showed that elevated SEC61B expression caused increased calcium leak, elevated basal cytoplasmic calcium concentrations, and platelet hyperreactivity. In vitro and in vivo pharmacological interventions to alter calcium homeostasis through this pathway affected platelet reactivity. The results of this work are consistent with those of previous studies showing that platelets from patients with chronic diseases behaved differently than those from healthy participants. These findings identify potential disease-specific targets to prevent and treat arterial thrombosis.

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44. SEC61B regulates calcium flux and platelet hyperreactivity in diabetes.

期刊: The Journal of clinical investigation 发表日期: 2025-Aug-15 链接: PubMed

摘要

Platelet hyperreactivity increases the risk of cardiovascular thrombosis in diabetes and failure of antiplatelet drug therapies. Elevated basal and agonist-induced calcium flux is a fundamental cause of platelet hyperreactivity in diabetes; however, the mechanisms responsible for this remain largely unknown. Using a high-sensitivity, unbiased proteomic platform, we consistently detected over 2,400 intracellular proteins and identified proteins that were differentially released by platelets in type 2 diabetes. We identified that SEC61 translocon subunit β (SEC61B) was increased in platelets from humans and mice with hyperglycemia and in megakaryocytes from mice with hyperglycemia. SEC61 is known to act as an endoplasmic reticulum (ER) calcium leak channel in nucleated cells. Using HEK293 cells, we showed that SEC61B overexpression increased calcium flux into the cytosol and decreased protein synthesis. Concordantly, platelets in hyperglycemic mice mobilized more calcium and had decreased protein synthesis. Platelets in both humans and mice with hyperglycemia had increased ER stress. ER stress induced the expression of platelet SEC61B and increased cytosolic calcium. Inhibition of SEC61 with anisomycin decreased platelet calcium flux and inhibited platelet aggregation in vitro and in vivo. These studies demonstrate the existence of a mechanism whereby ER stress-induced upregulation of platelet SEC61B leads to increased cytosolic calcium, potentially contributing to platelet hyperreactivity in diabetes.

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45. Pain and suicidality during adolescence: a Danish National Cohort Study.

期刊: Pain 发表日期: 2025-Aug-13 链接: PubMed

摘要

Pain has been suggested as an important risk factor for suicidality in adolescents. We examined the association between pain at age 11 years and suicidality until age 18 years. Second, we assessed whether psychiatric diagnoses might mediate this association. We used data from the Danish National Birth Cohort’s 11-year follow-up (DNBC-11) and 18-year follow-up (DNBC-18). Self-reported head, stomach, neck, and back pain at age 11 years were examined as exposures. Outcomes were formed from data on self-reported suicidal ideation and suicide attempts from the DNBC-18 and hospital-recorded suicide attempts by age 18 years. We used multinomial logistic regressions and mediation analyses, adjusting for covariates and incorporating sampling weights. Among 28,465 eleven-year-olds, 13.5% reported any frequent pain, which was associated with increased risks of suicidal ideation (adjusted relative risk ratio [aRRR] = 1.6, 95% confidence interval [CI]: 1.5-1.7) and suicide attempts (aRRR = 2.4, 95% CI: 2.0-2.8). Individuals who had reported 3 or more pain sites at age 11 years had a higher risk of suicide attempt (aRRR = 6.4, 95% CI: 3.9-10.4) compared with those with no frequent pain. Pain-related functional interference and recurrent pain were associated with significantly elevated risks of suicidal ideation and suicide attempts. Affective and anxiety/stress-related disorders diagnosed between age 11 and 18 years significantly mediated the association between frequent pain and suicidal ideation (14%-16%), as well as between frequent pain and suicide attempts (37%-48%). Frequent pain is a common concern in 11-year-olds in Denmark and prospectively associated with an increased risk of suicidality by age 18 years. Suicide preventive strategies may consider targeting youth with frequent pain.

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46. Temporal Trends and Regional Disparities in Rotavirus Vaccine Coverage for Children Under 1-Year-old in Shandong Province, China.

期刊: The Pediatric infectious disease journal 发表日期: 2025-Aug-13 链接: PubMed

摘要

Rotavirus vaccine is the most effective measure for preventing rotavirus-related diarrhea. The study aims to identify the coverage and trend of the rotavirus vaccine, providing insights for improving vaccination programs. Rotavirus vaccination data from 2005 to 2024 were collected and analyzed using Joinpoint regression to identify trends and significant changes over time. The analysis was stratified by economic status and service density to assess regional disparities. Annual percentage changes (APC) and average annual percentage changes (AAPC) were calculated. Rotavirus vaccination coverage increased from 0.09% in 2005 to 24.25% in 2023, with higher coverage in regions with high economic status and low service density. The overall time trend of vaccination coverage shows an upward trend (AAPC = 22.51%; 95% CI: 18.17-36.62), with 3 turning points in 2012, 2017 and 2020. The coverage rate increased in 2005-2012 (APC = 39.50%; 95% CI: 21.50-112.51). After a decline in 2012-2017 (APC = -28.24%; 95% CI: -60.61 to -14.16), it surged and steadily increased in 2017-2020 (APC = 162.39%; 95% CI: 89.43-274.58) and 2020-2024 (APC=7.59%, 95% CI: 11.16-18.86), respectively. The AAPC was higher in areas with low Gross Domestic Product and high service density, but there was a gap in the average growth rate among regions. Rotavirus vaccination coverage varies depending on economic level and service density. And the low coverage of rotavirus vaccination among Chinese children means that socially disadvantaged children still bear a higher risk of disease burden, especially in regions with low Gross Domestic Product and high service density.

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47. Both Corticosteroids and Intravenous Immunoglobulin Protect From Aneurysms in Children With Multisystem Inflammatory Syndrome (MIS-C): A Multicenter Ambispective Study.

期刊: The Pediatric infectious disease journal 发表日期: 2025-Aug-12 链接: PubMed

摘要

Multisystem inflammatory syndrome in children (MIS-C) is a post-COVID-19 condition resembling Kawasaki disease, including developing coronary aneurysms. Optimal treatment remains uncertain. This study aims to identify effective therapies for preventing aneurysms in MIS-C and associated risk factors. This multicenter, ambispective study included hospitalized patients 0-18 years old with MIS-C between March 2020 and June 2023 from cohorts in Poland, Spain, Catalonia and Colombia. Logistic regression analyzed aneurysm risk factors. Treatment efficacy was assessed using Kaplan-Meier and Cox proportional hazards models, with post hoc Tukey’s tests for pairwise comparisons. Among 853 patients, 33 (4%) developed aneurysms, with a median age of 5.86 years (interquartile range, 3.00-11.7). All immunomodulatory treatments reduced aneurysm risk compared with no immunomodulatory treatment: corticosteroids + intravenous immunoglobulin (IVIG) [odds ratio (OR): 0.29; 95% confident interval (CI): 0.13-0.68], corticosteroids alone (OR: 0.27; 95% CI: 0.04-1.02) and IVIG alone (OR: 0.49; 95% CI: 0.18-1.28). Kaplan-Meier analysis showed a significantly lower 7-day aneurysm-free probability without immunomodulatory treatment (92%; 95% CI: 87%-96%, P = 0.011). Hazard ratios indicated a reduction in aneurysm risk with corticosteroids+IVIG [hazard ratio (HR) = 0.29; 95% CI: 0.13-0.65], corticosteroids alone (HR = 0.25; 95% CI: 0.06-1.13) and IVIG alone (HR = 0.49; 95% CI: 0.19-1.25), but no significant differences were observed between these treatments. No additional aneurysm risk factors were identified. Corticosteroids, IVIG and their combination appear to be protective against aneurysms in children with MIS-C compared with no immunomodulatory treatment. Although the 3 therapies showed no significant differences when compared with each other, only the combination significantly reduced the risk. Corticosteroids may still be a useful option when IVIG is limited.

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48. Prevalence and correlates of "undiagnosed pain"-Evidence from the US national Medical Expenditure Panel Survey.

期刊: Pain 发表日期: 2025-Aug-11 链接: PubMed

摘要

There are no nationally representative studies examining both the frequency and correlates of “undiagnosed pain”-pain without a formal diagnosis. To identify the magnitude of this healthcare gap, we performed cross-sectional secondary analyses of the Medical Expenditure Panel Survey (MEPS), 2016-2019 data. The primary study outcome is “being undiagnosed”: the absence of diagnoses for pain-related conditions among participants reporting pain-related interference (PRI). Pain-related interference was established using the SF36 pain question embedded in MEPS, with 10,954 individuals reporting any PRI within 4 weeks of the interview and 4,902 individuals reporting at least moderate PRI. Participants with PRI were assigned as “being undiagnosed” if the following conditions were met: (1) the participant did not have medical records for any pain-related conditions in both the previous and current year of the interview and (2) did not report having any pain-related priority conditions from a list provided during the MEPS interviews. Among those reporting any PRI, about 21.1 million people (9.3%; 95% confidence interval [CI], 8.6%-10.0%) were without diagnoses for either primary pain conditions identified using MEPS clinical classification codes or conditions where pain would be a secondary symptom (eg, hypertension and immunity disorders). From multivariable logistic regression modeling, we determined that younger and middle-aged adults, males, racial and ethnic minority groups, foreign-born populations, people without insurance, and people with better perceived health are more likely to have their pain undiagnosed. Our findings underscore the need for improved access to care and better patient-provider communications in those suffering from underdiagnosed pain.

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49. Current Challenges and Future Directions for RSV Prevention Strategies in Japan.

期刊: The Pediatric infectious disease journal 发表日期: 2025-Aug-06 链接: PubMed

摘要

Respiratory syncytial virus (RSV) remains a leading cause of lower respiratory tract infections in infants, particularly those under 6 months of age. In Japan, RSV seasonality in temperate regions has recently shifted from traditional winter peaks to more year-round circulation, with this change most pronounced in higher latitude areas such as Hokkaido, where outbreaks increasingly peak in summer. Japan has recently approved 2 RSV prevention tools: nirsevimab for infants and a maternal vaccine. However, challenges remain: maternal vaccines require out-of-pocket payment, and nirsevimab is reimbursed only for high-risk infants under national insurance and must be administered during the RSV season. These limitations call for policy and system-level improvements to ensure equitable access. A season-independent, risk-based prevention strategy-such as maternal vaccination at or after 28 weeks’ gestation and nirsevimab for preterm or otherwise unvaccinated infants-may help optimize protection while minimizing overlap. Adapting implementation strategies to Japan’s shifting epidemiology will be essential to efficiently protect all infants. Japan’s experience may also provide insights for other countries facing changes in RSV transmission patterns and planning broader prevention approaches.

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50. Epidemiology and Outcomes of Pediatric Multidrug-resistant Tuberculosis in Namibia: A Retrospective Review of National Registry Data From 2013 to 2023.

期刊: The Pediatric infectious disease journal 发表日期: 2025-Aug-06 链接: PubMed

摘要

Multidrug-resistant (MDR) and rifampin-resistant (RR) tuberculosis (TB) is challenging the national response to tuberculosis in Namibia. The recent introduction of Xpert MTB/RIF (Cepheid, Sunnyvale, CA) and the use of new and repurposed drugs have the potential to improve both management and outcomes. Retrospective review of Namibian national registry data from 2013 to 2023 of children 0-14 years with MDR/RR-TB. National census data were used to estimate annual case notification rates (aCNRs). Totally 205 episodes were available for analysis. The median age was 4 years [interquartile range (IQR) 1-10]. Ninety (43.9%) were female and 20 (9.8%) were living with HIV. The aCNR increased by two-thirds from 1.2 in 2013 to 2.0 per 100,000 population in 2023. One region, Ojotzondjupa, notified 58 (28.3%) of all cases with a median aCNR of 7.1 per 100,000 population while the national median aCNR was 1.8 per 100,000 population. Ninety individuals (58.1%) received a treatment regimen containing injectables, whereas 65 (41.9.6%) received an all-oral treatment regimen containing two or more World Health Organization class A drugs and/or delamanid. Outcome was unfavorable in 46 (24.1%) individuals, and 18 (9.4%) died. No decrease in the proportion of children with unfavorable outcomes was observed over the study period. The epidemiology and outcome of children with MDR/RR-TB in Namibia are in keeping with the limited international data available; however, the geographical distribution of children with MDR/RR-TB poses a major challenge to the national TB response.

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51. Perioperative Antibiotic Prophylaxis for Heart Transplantation at Children's Hospitals in the United States.

期刊: The Pediatric infectious disease journal 发表日期: 2025-Aug-06 链接: PubMed

摘要

Data on perioperative antibiotic use for pediatric heart transplantation are scarce. Such information can help identify opportunities for improvement and/or standardization. We performed a retrospective analysis using the Pediatric Health Information System database. Children aged <18 undergoing heart transplantation at hospitals performing 50 or more transplantations over a 20-year period were included. Primary outcomes of interest were perioperative antibiotics other than cefazolin monotherapy and prolonged postoperative duration (>1 day). The primary exposure of interest was heart transplantation volume in the hospital, classified by the quartiles of case counts, with the first quartile including the lowest-volume hospitals. Cefazolin monotherapy was used in >50% of cases at 11 of 28 hospitals (39.3%). Twelve of 28 hospitals (42.9%) used multiple perioperative antibiotics in >50% of cases. Antibiotics were continued for >1 calendar day in more than two-thirds of transplantations (69.4%). Antibiotic regimens other than cefazolin monotherapy were less likely to be used at higher-volume hospitals (odds ratio: 0.45; 95% confidence interval: 0.38-0.53 for the fourth quartile hospitals). Antibiotics were continued for >1 calendar day in more than two-thirds of transplantations (69.4%) with a median postoperative duration of 2 calendar days (interquartile range: 1-3). Perioperative antibiotic use for heart transplantation varies substantially across children’s hospitals, and adherence to national guidelines seemed suboptimal. The insights gained through this study should serve as an initial step for identifying opportunities for improvement and/or standardization to identify the best clinical practice.

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52. Prospective and Multicenter Evaluation of Community Fecal Carriage of Carbapenemase-Producing Enterobacterales in French Children (2022-2024).

期刊: The Pediatric infectious disease journal 发表日期: 2025-Aug-01 链接: PubMed

摘要

Community fecal carriage of carbapenemase-producing Enterobacterales in 637 French children (6-24 months) was 0.5%, with no typical risk factors identified (antibiotics, hospitalization, recent travel). Of note, one isolate of Escherichia coli ST38 with blaOXA-244 and blaCTX-M-27 belonging to a clonal group with high diffusion was found, highlighting the need for enhanced surveillance.

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53. Cardiovascular Disease Update: Coronary Artery Disease Risk Assessment and Noninvasive Testing.

期刊: FP essentials 发表日期: 2025-Aug 链接: PubMed

摘要

Cardiovascular disease risk assessment is an evolving field with new research indicating that more recommendations tailored to and personalized for patients are possible. Pooled cohort equations continue to be the foundation of risk assessment in patients 40 to 75 years of age, with the PREVENT (Predicting Risk of Cardiovascular Disease Events) calculator emerging as a successor to the 2013 American College of Cardiology/American Heart Association pooled cohort equation. All major calculators have similar predictive outcomes in longitudinal studies. Lipoprotein(a) is a readily available biomarker that is useful in patients with a strong family history of early major adverse cardiovascular events or treatment-resistant dyslipidemia. Current guidelines discourage the use of routine screening electrocardiography for risk stratification. Coronary artery calcium scoring is useful in intermediate-risk patients to reclassify the risk of coronary artery disease based on the presence and burden of coronary atherosclerosis. However, there are limited data on how it improves patient outcomes. No functional or radiographic studies are recommended for screening purposes; their primary role is in the diagnostic evaluation of patients presenting with nonacute chest pain. Treatment goals for primary prevention continue to emphasize a low-density lipoprotein cholesterol reduction of 50% from baseline in patients determined to be candidates for statins based on risk assessment.

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54. Coated nanoparticles enhance immune efficacy of Helicobacter pylori outer membrane vesicles by activating Th1/Th2/Th17 responses.

期刊: The Journal of pharmacology and experimental therapeutics 发表日期: 2025-Jul-29 链接: PubMed

摘要

Antibiotic resistance has emerged as a pressing global public health crisis. The development of a safe and efficient Helicobacter pylori vaccine has become an important measure to eradicate Hpylori infection. Outer membrane vesicles (OMVs) secreted by Gram-negative bacteria are immunogenic and have received increasing attention in the development of vaccines against bacterial infections. In this study, Hpylori was used as a model pathogen, Hpylori outer membrane vesicle (HM) as an antigen, and dendritic mesoporous organosilica nanoparticles (DMON) as a carrier to load lipopolysaccharide (LPS) as an adjuvant to obtain a stable LPS@DMON@HM vaccine. The nanovaccine markedly enhanced the phagocytosis of macrophages and the secretion of IL-4, IFN-gamma, and IL-17A in vitro. In vivo, LPS@DMON@HM can significantly increase the specific antibody titer, and the serum-specific IgG antibody titer after vaccine immunization can reach 1:12,800, which is 16 times that of free HM immunization. Further studies indicated that the levels of Th1, Th2, and Th17 cytokines in spleen cells were induced to show a marked elevation. The results showed that LPS@DMON@HM had stronger immunogenicity and induced higher levels of humoral immunity, mucosal immunity, and Th1/Th2/Th17 cellular immune responses compared with free HM. The vaccine exhibited no toxicity at the tested doses. This study establishes a mechanistic foundation for developing next-generation Hpylori vaccines with optimized safety-efficacy profiles and simultaneously offers a reference for the development of vaccines against other Gram-negative pathogens. SIGNIFICANCE STATEMENT: Infection with Helicobacter pylori is closely associated with a wide range of gastrointestinal diseases; however, antibiotic resistance has been significantly undermining its therapeutic efficacy. The LPS@DMON@HM nanovaccine developed in this study can induce high levels of anti-Hpylori IgG after immunization of mice and can also induce mucosal immunity and Th1/Th2/Th17 mixed immune responses. It is anticipated to be further investigated as a nonantibiotic therapeutic option for Hpylori infection.

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55. Evaluation of Hepatotoxicity and Nephrotoxicity of Fenitrothion on Ultrastructural, Immunohistochemical, Histopathological, and Biochemical Changes: Protective Role of Gallic Acid.

期刊: Microscopy and microanalysis : the official journal of Microscopy Society of America, Microbeam Analysis Society, Microscopical Society of Canada 发表日期: 2025-Jul-15 链接: PubMed

摘要

Fenitrothion is a known environmental contaminant used in public health and agriculture. Gallic acid is a phenolic compound found in numerous plants. This study analyzed the hepatotoxic and nephrotoxic effects of Fenitrothion and evaluated the possible protective effect of gallic acid. Fenitrothion (32 mg/kg body weight/day) and gallic acid (50 mg/kg body weight/day) were administered to male rats by gavage for 28 days. In the present study, the renal (blood urea nitrogen, creatinine, and uric acid levels) and liver (albumin, total protein, aspartate aminotransferase, alanine aminotransferase, total cholesterol, triglyceride, lactate dehydrogenase) function markers in the blood, acetylcholinesterase activities, antioxidant enzyme activities and malondialdehyde level as markers of oxidative stress, and ultrastructural/histopathological/immunohistochemically changes were researched in liver and kidney tissues. Additionally, while superoxide dismutase, catalase, glutathione-S-transferase, and glutathione peroxidase activities were decreased in the liver and kidney tissue of rats treated with fenitrothion, malondialdehyde level was significantly increased. Histopathological and immunohistochemical analyses showed many injuries in the renal and hepatic tissue of fenitrothion-treated animals. Also, the supplementation of gallic acid with fenitrothion significantly improved fenitrothion-induced alterations in renal and liver function markers, antioxidant enzyme activities, acetylcholinesterase activities, malondialdehyde levels, and histological features of tissues.

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56. Prevalence and subtype distribution of Blastocystis infections among community participants in Thailand: a systematic review and meta-analysis.

期刊: Parasite (Paris, France) 发表日期: 2025 链接: PubMed

摘要

A comprehensive understanding of the prevalence and subtype distribution of Blastocystis infections among community participants in Thailand is essential to inform targeted public health interventions. This systematic review and meta-analysis aimed to estimate the overall prevalence of Blastocystis infections and to determine the distribution of subtypes among community participants in Thailand. Relevant studies on Blastocystis infections in community participants in Thailand were searched in PubMed, Embase, Scopus, Ovid, ProQuest, and the Thai-Journal Citation Index. The methodological quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal tools. Prevalence estimates and subtype distributions were calculated using random-effects models. A total of 947 articles were identified, with 60 studies included in the systematic review and meta-analysis. The meta-analysis led to an estimated overall prevalence of Blastocystis infections in community participants in Thailand at 8.34% (95% CI: 5.48%-12.51%; I2: 98.2%; number of studies: 60; number of participants: 33,101). Meta-regression analysis showed no significant temporal trends in infection prevalence. The highest prevalence rates were observed in Eastern Thailand (13.54%) and Western Thailand (10.09%). Subtype analysis identified ST3 and ST1 as the most common subtypes, accounting for 50.05% and 23.50% of positive samples, respectively. The highest prevalence was reported in military personnel (29.87%), followed by orphans (29.01%). Improved use of molecular and culture-based diagnostic methods is recommended to enhance detection accuracy. Public health interventions should prioritize high-risk groups, such as military personnel and orphans, and address regional disparities to reduce the burden of Blastocystis infections. Prévalence des infections à Blastocystis et distribution des sous-types chez les participants communautaires en Thaïlande : revue systématique et méta-analyse. Une compréhension approfondie de la prévalence des infections à Blastocystis et de la distribution des sous-types chez les participants communautaires en Thaïlande est essentielle pour éclairer les interventions de santé publique ciblées. Cette revue systématique et méta-analyse visait à estimer la prévalence globale des infections à Blastocystis et à déterminer la distribution des sous-types parmi les participants communautaires en Thaïlande. Des études pertinentes sur les infections à Blastocystis chez les participants communautaires en Thaïlande ont été consultées dans PubMed, Embase, Scopus, Ovid, ProQuest et le Thai-Journal Citation Index. La qualité méthodologique des études incluses a été évaluée à l’aide des outils d’évaluation critique du Joanna Briggs Institute. Les estimations de prévalence et les distributions des sous-types ont été calculées à l’aide de modèles à effets aléatoires. Au total, 947 articles ont été identifiés, dont 60 études incluses dans la revue systématique et la méta-analyse. La méta-analyse a estimé la prévalence globale des infections à Blastocystis chez les participants communautaires en Thaïlande à 8,34 % (IC à 95 % : 5,48 %–12,51 % ; I2 : 98,2 %; nombre d’études : 60 ; nombre de participants : 33 101). L’analyse de méta-régression n’a montré aucune tendance temporelle significative dans la prévalence de l’infection. Les taux de prévalence les plus élevés ont été observés dans l’est (13,54 %) et dans l’ouest de la Thaïlande (10,09 %). L’analyse des sous-types a identifié ST3 et ST1 comme les sous-types les plus courants, représentant respectivement 50,05 % et 23,50 % des échantillons positifs. La prévalence la plus élevée a été signalée chez le personnel militaire (29,87 %), suivi des orphelins (29,01 %). Une meilleure utilisation des méthodes de diagnostic moléculaire et basées sur la culture est recommandée pour améliorer la précision de la détection. Les interventions de santé publique devraient donner la priorité aux groupes à haut risque, tels que le personnel militaire et les orphelins, et s’attaquer aux disparités régionales pour réduire le fardeau des infections à Blastocystis.

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57. Impact of COVID-19 restrictions on incidence of gastrointestinal protozoal infections in Mexico and their association with environmental and socioeconomic risk factors.

期刊: Parasite (Paris, France) 发表日期: 2025 链接: PubMed

摘要

Gastrointestinal infections caused by protozoan parasites remain a significant public health concern worldwide, particularly during the health crisis caused by the COVID-19 pandemic, which led to severe economic and social crisis that highlighted the inadequacy of healthcare services in many countries. In this study, we analyzed changes in the incidence of cases of amebiasis, giardiasis, and other gastrointestinal protozoal infections before (2017-2019) and during (2020-2022) the pandemic. Our findings indicate a decrease in the incidence of these infections, with no significant variations in incidence by gender or age, and a higher incidence during months with elevated temperature and humidity. Sociodemographic factors, including residence in homes with earthen floors, poverty, limited access to healthcare services, inadequate nutrition, unemployment, and overcrowded living conditions, were associated with an increased risk of infection. Additionally, our results highlight the impact of public health policies on disease control, demonstrating that COVID-19 containment measures - such as international travel restrictions, workplace closures, event cancellations, stay-at-home mandates, and enhanced hand hygiene - also contributed to reducing parasitic infections. The persistent prevalence of protozoal infections in both periods underscores the urgent need to improve sanitation, personal hygiene, and public health education, particularly in developing countries, to mitigate their high burden. Impact des restrictions liées à la COVID-19 sur l’incidence des infections gastro-intestinales à protozoaires au Mexique et leur association avec les facteurs de risque environnementaux et socio-économiques. Les infections intestinales causées par des protozoaires parasites demeurent un problème de santé publique majeur dans le monde entier, en particulier pendant la crise sanitaire provoquée par la pandémie de COVID-19, qui a entraîné une grave crise économique et sociale mettant en évidence l’insuffisance des services de santé dans de nombreux pays. Dans cette étude, nous avons analysé l’évolution de l’incidence des cas d’amibiase, de giardiase et d’autres infections gastro-intestinales à protozoaires avant (2017-2019) et pendant (2020-2022) la pandémie. Nos résultats indiquent une diminution de l’incidence de ces infections, sans variations significatives selon le sexe ou l’âge, et une incidence plus élevée pendant les mois où la température et l’humidité sont élevées. Des facteurs sociodémographiques, notamment le fait de vivre dans un logement au sol en terre battue, la pauvreté, un accès limité aux services de santé, une alimentation inadéquate, le chômage et le surpeuplement, étaient associés à un risque accru d’infection. De plus, nos résultats soulignent l’impact des politiques de santé publique sur la lutte contre la maladie, démontrant que les mesures de confinement liées à la COVID-19 – telles que les restrictions de voyages internationaux, la fermeture des lieux de travail, l’annulation d’événements, le confinement et le renforcement de l’hygiène des mains – ont également contribué à réduire les infections parasitaires. La prévalence persistante des infections à protozoaires au cours des deux périodes souligne l’urgence d’améliorer l’assainissement, l’hygiène personnelle et l’éducation en santé publique, en particulier dans les pays en développement, afin d’atténuer leur lourd fardeau.

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58. Efficient multi-station air quality prediction in Delhi with wavelet and optimization-based models.

期刊: PloS one 发表日期: 2025 链接: PubMed

摘要

The swift decline in the air quality in South Asian mega cities, especially Delhi, presents significant threats to human health owing to elevated concentrations of particulate matter (PM2.5) resulting from dense populations, heavy traffic, and industrial emissions. Precise and efficient prediction of air quality is essential for successful mitigation and policy formulation. This research introduces an innovative predictive framework, AquaWave-BiLSTM, that combines sophisticated feature extraction and optimization methods to enhance multi-station air quality forecasting in Delhi. Hourly air quality and meteorological data were gathered from six monitoring sites from June 2018 to October 2019. The proposed model integrates Wavelet Transform for frequency pattern extraction, Principal Component Analysis (PCA) for dimensionality reduction, and A hybrid Aquila Optimizer and Arithmetic Optimization (AOAOA) for the selection of pertinent features. A Bidirectional Long Short-Term Memory (Bi-LSTM) network is utilized to simulate temporal interdependence. The AquaWave-BiLSTM framework demonstrated exceptional predictive accuracy, with a Mean Squared Error (MSE) of 0.00065, a Mean Absolute Error (MAE) of 0.04566, a Root Mean Square Error (RMSE) of 0.02523, and an R² value of 0.9494, surpassing conventional methodologies. Furthermore, the model exhibited computational efficiency with an average execution time of 20.57 seconds. The Wilcoxon Signed-Rank Test statistically validated the relevance of the suggested feature extraction and selection method for all monitoring stations. The AquaWave-BiLSTM framework enables efficient, interpretable air quality forecasting, with SHAP clarifying feature contributions.

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59. Utilization of borax and its impact on the income and the livelihood of miners and other stakeholders: A case of Uganda.

期刊: PloS one 发表日期: 2025 链接: PubMed

摘要

Mineral wealth serves as a crucial driver of economic growth and infrastructure development in many countries, including Uganda. Artisanal and Small-Scale Gold Mining (ASGM) plays a significant role in enhancing incomes and livelihoods. However, ASGM remains largely informal in Uganda, not reflected in the country’s Gross Domestic Product (GDP). Many methods of gold processing are available around the globe. The borax method has become one of the favorable methods for extracting gold due to its lower operating cost, higher recovery, human and environmental consideration. This study aimed to assessing the impact of borax utilization in gold processing on the income and livelihoods of miners and stakeholders in Buhweju, Busia and Kassanda districts in Uganda where the Free Your Mine project is being implemented. A cross-sectional study using mixed methods was employed between October 2022 and January 2023 with data collected from 161 miners through semi-structured questionnaires, Key Informant Interviews (KIIs), Focus Group Discussions (FGDs), and observations. Analysis was conducted using Atlas ti version 7.0 and Stata Version 15.0. Findings indicate low adoption of borax and limited training coverage on the use of borax. While 80.1% of respondents saved money attained from gold mining activities, only 21.5% had investments. FGDs revealed that miners often resort to mercury use for quick income as using mercury takes little time compared to mercury-free methods, while KIIs emphasized the need for government intervention and need for policies to promote safer gold processing methods for sustainable livelihoods. Study underscores need for awareness, policy to improve safety in Uganda’s ASGM sector. In addition, there is need for funding to support scale up the Free Your Mine Project to other gold mining districts in Uganda.

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