公共卫生研究摘要 (2025-08-22)
共收录 59 篇研究文章
1. Letter to the Editor.
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
2. Mycoplasma pneumoniae: Extrapulmonary Manifestations in Children With Focus on Mucocutaneous Disease.
期刊: The Pediatric infectious disease journal 发表日期: 2025-Aug-22 链接: PubMed
摘要
3. Second-season Impact of Nirsevimab: Clinical Outcomes of RSV Disease in Patients Immunized During Their First Season.
期刊: The Pediatric infectious disease journal 发表日期: 2025-Aug-22 链接: PubMed
摘要
Nirsevimab provides passive immunization against respiratory syncytial virus, yet concerns exist regarding its long-term impact. This study analyzed respiratory syncytial virus-associated lower respiratory tract infection severity in hospitalized children immunized with nirsevimab more than 6 months prior. No significant differences were found compared with nonimmunized children. Findings suggest no increased risk in the following season, supporting nirsevimab’s safety as a preventive strategy.
4. Adverse Maternal Outcomes Among People With Human Immunodeficiency Virus (HIV) Using Antiretroviral Therapy in Botswana.
期刊: Obstetrics and gynecology 发表日期: 2025-Aug-21 链接: PubMed
摘要
This study aimed to evaluate maternal outcomes in a large cohort with high prevalence of human immunodeficiency virus (HIV) infection in Botswana after implementation of a treat-all policy. In this retrospective cohort study, data were collected from the medical record at the time of discharge from November 2021 to December 2023. Outcomes were recorded in the Tsepamo Birth Outcomes Surveillance and Safe Birth studies at Princess Marina Hospital in Botswana. We evaluated maternal mortality and obstetric morbidities by HIV status, including preeclampsia, eclampsia, hemorrhage, infection, and acute pulmonary or cardiac conditions at the time of hospital discharge. We included 11,754 participants; 2,201 (18.7%) were pregnant people with HIV infection. Ninety-seven percent (2,135) were on antiretroviral therapy (ART) at time of delivery; 1,996 (93.5%) of those with a known ART regimen were on dolutegravir, tenofovir disoproxil fumarate, and lamivudine. Of the 1,090 people with HIV infection with known CD4 counts, 757 (69.4%) had more than 500 cells/microliter, and only 42 (3.9%) had fewer than 200 cells/microliter. Of 1,524 people with HIV infection with known viral loads, 1,436 (94.2%) were undetectable on initial testing. There were no statistically significant differences in incidence of hemorrhage (90 [4.1%] vs 370 [3.9%], adjusted risk ratio [RR] 0.93, 95% CI, 0.73-1.17), infection (38 [1.7%] vs 126 [1.3%], adjusted RR 1.56, 95% CI, 0.97-2.51), eclampsia (6 [0.3%] vs 28 [0.3%], adjusted RR 1.12, 95% CI, 0.50-2.53), acute pulmonary or cardiac conditions (15 [0.7%] vs 43 [0.4%], adjusted RR 1.22, 95% CI, 0.65-2.27), transfusion of 2 or more units of packed red blood cells (33 [36.7%] vs 110 [29.8%], P=.21), additional uterotonics (48 [53.3%] vs 173 [47.1%], P=.29), use of tranexamic acid (31 [ 34.4%] vs 106 [29.0%], P=.31), intensive care unit admission (4 [0.2%] vs 10 [0.1%], P=.31), mechanical ventilation (3 [0.1%] vs 6 [0.1%], P=.38), pressor support (2 [0.1%] vs 2 [0.0%], P=.16), or mortality (5 [0.2%] vs 11 [0.1%], adjusted RR 1.44, 95% CI, 0.46-4.57) in people with HIV infection compared with those without HIV infection. There were few notable differences, including a slightly reduced risk of preeclampsia (184 [8.4%] vs 818 [8.6%], adjusted RR 0.84, 95% CI, 0.71-0.98) and, although rare, an increased risk of uterine rupture (12 [0.5%] vs 8 [0.1%], adjusted RR 6.54, 95% CI, 2.33-18.33) in people with HIV infection compared with those without HIV infection. There was little difference in adverse maternal obstetric outcomes between people with and those without HIV infection in the treat-all era with integrase strand inhibitors (primarily dolutegravir); notable exceptions included a slightly reduced risk of preeclampsia and, although rare, an increased risk of uterine rupture in those with HIV infection.
5. The Impact of Health Warnings in e-Cigarette Content on Instagram on Adults' e-Cigarette Cognitions: Online Between-Subjects Experiment Study.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-21 链接: PubMed
摘要
e-Cigarette use is a growing public health concern, with e-cigarettes being marketed by social media influencers on Instagram. Influencers promote e-cigarettes using misleading relative harm claims, portraying them as safer than regular cigarettes while overstating benefits and selectively omitting information on the harms. To counter this, the US Federal Drug Administration requires influencers to include a nicotine warning label in their sponsored posts, similar to the ones used on e-cigarette packages. However, research on their effectiveness remains limited, leaving questions about when, how, and for whom these warnings work. This study examined how (1) relative harm claims and (2) health warnings in influencers’ sponsored e-cigarette content influence health outcome expectations and intentions to use e-cigarettes. In addition, we investigated whether user status (ie, smoking cigarettes or vaping e-cigarettes vs nonuse) moderates these effects. Participants (n=597 age: mean 40.84, SD 11.93 years) were recruited through a survey company using a quote-based sample of German adults aged between 18 and 60 years, stratified by age, gender, and education. We conducted a preregistered 2 (relative harm claim: absent or present) × 2 (health warning: absent or present) between-subjects experiment. Participants viewed Instagram profiles of 2 influencers and separate posts including sponsored e-cigarette content. Relative harm claims in sponsored e-cigarette posts were manipulated by adding captions stating that e-cigarettes are healthier than cigarettes, with misleading information about why this could be the case. Neutral captions described product features in the relative harm claim absent condition. Health warnings appeared as a black text on a white background containing a nicotine warning statement. Participants then reported measures on attitudes, outcome expectations, intentions, and personal e-cigarette and cigarette use. Multivariate analysis of covariance and moderated mediation analyses were used to test the direct and interaction effects of misleading relative harm claims and health warnings. Misleading relative harm claims significantly influenced health outcome expectations (F1,551=5.88, P=.02, η2p=0.011), with participants exposed to harm claims about e-cigarettes reporting lower negative outcomes (mean 5.25, SD 0.09) compared to those who did not (mean 5.58, SD 0.10). Health warnings had no statistical significant effect on attitudes, health outcome expectations, or intentions. No interaction effect between health warnings and relative harm claims was observed. Overall user status (ie, cigarette or e-cigarette use vs nonuse) did not moderate these effects. Health warnings as mandated by the Federal Drug Administration were ineffective in reducing the persuasive impact of influencers’ appealing e-cigarette content, regardless of an individual’s own experiences with cigarettes or e-cigarettes. Policy makers should consider tailoring warnings that address audience-specific consequences to make them more effective. In addition, media literacy interventions are essential to counter misleading relative harm claims and appealing influencers’ e-cigarette content.
6. Hemodynamic Assessment of Arterial Perfusion by Using the Ultrasonographic Hand Acceleration Time: Protocol for a Cross-Sectional Prospective Descriptive Study.
期刊: JMIR research protocols 发表日期: 2025-Aug-21 链接: PubMed
摘要
Several noninvasive methods can be used to assess hand perfusion, but none have been standardized for diagnosing chronic upper limb ischemia. One potentially useful diagnostic tool for this purpose is the ultrasonographic hand acceleration time (HAT), although it still requires characterization and validation. This study aims to describe the technique for assessing hand perfusion through HAT while quantifying it in patients with chronic upper limb ischemia and healthy volunteers. This prospective, cross-sectional, and descriptive study evaluates HAT measurements by using vascular duplex ultrasound (DUS), a novel technique for assessing hand arterial perfusion. This study includes adult patients with chronic upper limb ischemia and healthy volunteers without cardiovascular risk factors. HAT was measured in 4 different hand arteries. A standard descriptive analysis was performed, along with comparisons using the Mann-Whitney U test, when applicable. This study received institutional review board approval, and no study-related procedures were performed prior to signing the written informed consent. This research complied with the Declaration of Helsinki, Good Clinical Practice guidelines, and Spanish regulatory requirements. As of June 2023, 30 participants were enrolled in the study, comprising 15 patients and 15 healthy volunteers, resulting in a total of 15 ischemic and 30 nonischemic hands. Data analyses were concluded in late November 2023, and results were sent for publication in February 2024. The manuscript containing the results was accepted in May 2024 and published online in July 2024, becoming available in PubMed in December 2024. The results have already been made available to the scientific community prior to the submission of this protocol. This study protocol was submitted for publication in July 2024 to enhance transparency and to offer comprehensive methodological insight into the HAT technique. No additional analyses beyond those reported in the published study are planned. This study presents the first systematic evaluation of HAT measurements by using vascular DUS as a novel diagnostic tool for chronic upper limb ischemia. By comparing ischemic and nonischemic hands, this study aims to establish preliminary cutoff values that may aid clinical decision-making. Although prior studies have only reported HAT measurements in case reports, this study provides quantitative data on its feasibility and potential clinical application. Despite its small sample size, which limits subgroup analysis and generalizability, the study serves as a foundation for future research by providing essential data for refining cutoff values and informing sample size calculations for larger studies. Although examiner dependence could introduce systematic bias, the standardized methodology ensures consistency across all measurements. Ultimately, HAT may emerge as a quick, noninvasive diagnostic tool for chronic upper limb ischemia, potentially complementing existing nonstandardized methods such as the digital-brachial index, digital pressures, and plethysmography. ClinicalTrials.gov NCT05977725; https://clinicaltrials.gov/study/NCT05977725. RR1-10.2196/64450.
7. Severe Perioperative Surgical Morbidity With Cesarean Delivery.
期刊: Obstetrics and gynecology 发表日期: 2025-Aug-21 链接: PubMed
摘要
To evaluate the prevalence and risk factors for severe perioperative surgical morbidity among patients undergoing cesarean delivery. This was a retrospective cross-sectional study of patients who underwent cesarean delivery in any California hospital between 2016 and 2021. Linked birth certificate and maternal discharge data identified cesarean delivery hospitalizations. We constructed a composite index for severe perioperative surgical morbidity, including intra-abdominal or pelvic visceral and vascular injuries, hysterectomy, pelvic or retroperitoneal hematoma, wound complications, ileus or bowel obstruction, acute peritonitis, and shock. Severe perioperative surgical morbidity prevalence was quantified overall and stratified by prelabor and intrapartum cesarean deliveries. We developed a multivariable Poisson log-linear regression model to identify independent risk factors for severe perioperative surgical morbidity. In secondary analyses, severe perioperative surgical morbidity prevalence and risk factors were assessed separately by prelabor and intrapartum cesarean delivery. Among 594,655 cesarean deliveries, 10,182 (171/10,000, 95% CI, 168-175) had severe perioperative surgical morbidity. The most common categorized morbidities were wound complications (59/10,000, 95% CI, 57-61); bladder, genitourinary, or pelvic injury (45/10,000, 95% CI, 43-47); ileus or bowel obstruction (33/10,000, 95% CI, 32-35); shock (15/10,000, 95% CI, 14-16); and intraoperative bowel injury (14/10,000, 95% CI, 13-15). Severe perioperative surgical morbidity prevalence was higher among patients undergoing intrapartum compared with prelabor cesarean delivery (203/10,000, 95% CI, 198-209 vs 146/10,000, 95% CI, 142-150). Patients with placenta accreta spectrum disorder had the highest severe perioperative surgical morbidity risk (adjusted risk ratio 15.3, 95% CI, 14.0-16.7). Nearly 1 in 60 patients who undergo cesarean delivery in California experienced severe perioperative surgical morbidity, with a higher prevalence occurring among intrapartum compared with prelabor cesarean deliveries. These findings underscore the need for systematic measurement and evaluation of surgical quality of care among patients undergoing cesarean delivery to identify opportunities for morbidity reduction.
8. A Population Health and Lifestyle Survey of a Coastal City in England (Health Counts 2024): Protocol for a Cross-Sectional Study.
期刊: JMIR research protocols 发表日期: 2025-Aug-21 链接: PubMed
摘要
Health and lifestyle population surveys are important in public health to identify trends, provide data to monitor the effectiveness and reach of public health initiatives and policies, and help allocate health resources more equitably. Surveys are a methodologically robust way of examining the inequalities in health outcomes or access to resources across a number of sociodemographic groups in a defined geographic area. This particular public health survey will provide information that cannot be obtained from other sources. The aim of the study is to generate comprehensive public health-relevant data from an adult population in a defined geographic coastal area of South East England. A cross-sectional, noninterventional (observational) health and lifestyle population survey was developed using a mobile-first design approach to recruitment, with the content drawing on a previous iteration of the survey in 2012. Previous Health Counts surveys in this region have been conducted approximately every 10 years since 1992 to provide data about trends over time. Extensive rounds of consultation and testing took place between October 2023 and February 2024. The final survey comprised 102 questions structured around 13 contemporary public health-related issues in the United Kingdom. Survey distribution was carried out in 2 rounds of SMS text messaging through all general practices in Brighton and Hove involving all adults registered with a general practice and having a mobile phone who had not opted out of communications. Advertising across a range of public-facing initiatives was also used, as well as targeted outreach activities for potentially marginalized groups, for example, in public libraries and community groups. Enrollment took place between March 18, 2024, and April 28, 2024. A total of 26,014 eligible people responded. Data analysis has started, and results will be reported later in 2025. Understanding trends in population inequalities over time as well as gaining insights into new areas for the very first time, Health Counts 2024 data can inform decision-making on strategies to improve health and reduce inequalities by local authorities in not only England and the National Health Service but also potentially across other European cities through the effective dissemination and sharing of promising practices as an integral part of evidence-based public health. DERR1-10.2196/64001.
9. Public Attention to Mpox in China During the Pandemic: Qualitative Analysis of TikTok Data Using Latent Dirichlet Allocation Topic Modeling.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-21 链接: PubMed
摘要
Mpox has reemerged as a global public health concern. With the growing reliance on social media for health information dissemination, understanding public perception through these platforms is essential for designing effective health promotion strategies. This study analyzes TikTok data related to mpox using Latent Dirichlet Allocation (LDA) topic modeling. This paper aims to extract key topics and inform targeted health promotion strategies for mpox prevention and control. Using the “Aisou Jisou” system, we collected TikTok data containing the keyword “Mpox” from April 1, 2022, to March 31, 2025. The dataset comprised 25,672 text data and associated search terms. We analyzed trends in the Search Index and Target Group Index (TGI) across time, gender, age groups, and provinces. LDA topic modeling was applied to identify latent topics within the text data, and topic evolution was examined during 4 peak months of the Search Index. A total of 4 major Search Index peaks were identified on TikTok in China, which are May 2022, July 2023, August 2024, and February 2025. These peaks aligned with key global and national mpox events, including WHO’s declaration of a global mpox outbreak in May 2022 and the detection of the clade Ib Mpox in China in January 2025. TGI analysis revealed that users aged 18-23 years exhibited the highest engagement. Spatially, Beijing, Tianjin, and Jilin recorded the highest cumulative TGI values (5922.38, 5692.41, and 3579.90, respectively). LDA topic modeling identified 8 primary topics, including transmission and prevention, vaccine concerns, and misinformation, etc. Public attention evolved from general disease knowledge toward issues of stigmatization and vaccine distrust over time. Sankey diagrams illustrated shifts in public attention across topics at different Search Index peaks, with “Mpox Transmission and Prevention” receiving the most attention in May 2022 and “Mpox Vaccination and Infection Prevention” in February 2025. TikTok provides real-time insights into public attention during mpox outbreaks, but can also propagate misinformation and stigmatizing narratives. Public health authorities should leverage these platforms for timely communication, actively address misinformation, and mitigate social bias. Tailored strategies are needed to enhance health literacy, minimize stigma, and strengthen outbreak preparedness and response. This study highlights the dual role of social media as both an information source and a potential vector for misinformation, emphasizing the necessity for active monitoring and regulation by health authorities to ensure the accuracy and reliability of disseminated health information.
10. Impact of two dual active ingredient long-lasting insecticidal nets on pregnancy birth outcomes in Benin.
期刊: Transactions of the Royal Society of Tropical Medicine and Hygiene 发表日期: 2025-Aug-21 链接: PubMed
摘要
The WHO recently recommended the widespread use of new classes of long-lasting insecticidal nets (LLINs) to control malaria, but there is little evidence of their efficacy in pregnant women. This study aimed to assess the impact of two dual active ingredient (AI) LLINs on poor birth outcomes under pragmatic conditions. A community-based cross-sectional survey was conducted during March-May 2023 in 1644 women of reproductive age who delivered in the 3 y following net distribution. Multivariate logistic regression models with random effects were used to assess the dual AI LLINs effects on poor pregnancy birth outcomes. Poor birth outcomes prevalence during pregnancy was 21.9%. Dual AI LLINs did not provide protection against poor birth outcomes in comparison with standard LLINs. However, among women who reported using allocated study nets, the odds of poor pregnancy birth outcomes were reduced in the pyriproxyfen-pyrethroid LLIN (adjusted OR [aOR] 0.50, 95% CI 0.31 to 0.82) and chlorfenapyr-pyrethroid LLIN (aOR 0.67, 95% CI 0.43 to 1.04) groups. Poor birth outcomes were similar for women living in the dual AI LLIN groups and those in the pyrethroid-only LLIN group, regardless of the type of net used. However, women using allocated dual AI LLINs were better protected than those using standard LLINs. National malaria control programmes should consider these new-generation LLINs for malaria control during pregnancy.
11. Cost Effectiveness of Over-the-Counter Availability of Progestin-Only Contraceptive Pills in Abortion-Restrictive and Abortion-Protective Settings.
期刊: Obstetrics and gynecology 发表日期: 2025-Aug-21 链接: PubMed
摘要
To determine the cost effectiveness of a policy change making a progestin-only contraceptive pill available over-the-counter (OTC). We created a decision analytic model to determine the cost effectiveness of making an OTC progestin-only contraceptive pill available in the United States in two distinct policy environments: one in which abortion is legal and available and one in which abortion is restricted. Our theoretical population included 1,000,000 women at risk of unintended pregnancy over 1 year. We adopted the societal and payer perspective and obtained probabilities, utilities, and costs from the literature. We set the cost-effectiveness threshold at a standard $100,000 per quality-adjusted life-year (QALY). Our primary outcome was the incremental cost-effectiveness ratio. In a theoretical cohort of 1,000,000 women at risk of unintended pregnancy, having an oral contraceptive pill available OTC was a dominant strategy in both settings; it reduced costs and improved QALYs. In settings in which abortion was available, having an OTC progestin-only contraceptive pill was associated with a $976-million reduction in costs and an increase of 14,153 QALYs. An OTC progestin-only contraceptive pill strategy would no longer be cost effective if more than 70% of OTC progestin-only contraceptive pill users discontinued usage; OTC progestin-only contraceptive pills would be cost effective for insurers to cover until the monthly cost exceeds $250 per pill pack in an abortion-protective setting. The availability of an OTC progestin-only contraceptive pill is a cost-effective strategy in abortion-protective and abortion-restrictive settings.
12. Single-Stage Versus 2-Stage Facial Reanimation With a Free Functional Muscle Flap: Protocol for a Systematic Review.
期刊: JMIR research protocols 发表日期: 2025-Aug-21 链接: PubMed
摘要
Facial paralysis is a condition that has several etiologies and is associated with significant physical and psychosocial complications. Classically, 2-stage facial reanimation was used to treat patients with unilateral facial paralysis; however, single-stage facial reanimation has seen an increase in use. Studies comparing both techniques are limited, and to the best of our knowledge, no systematic reviews have compared these techniques. We aim to perform a systematic review that explores how the outcomes of single-stage facial reanimation with a free functional muscle flap compare against those of 2-stage facial reanimation. This systematic review protocol has been written according to the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) and NICE (National Institute for Health and Care Excellence) guidelines. The search strategy will involve 3 stages: electronic databases (MEDLINE, Embase, and Web of Science Core Collection), trial registers (ClinicalTrials.gov), and snowballing. Studies published from 1995 to 2025 will be screened using inclusion and exclusion criteria. Data will be extracted into a standardized spreadsheet, and the risk of bias and quality of evidence will be assessed. Two reviewers will screen, extract, and assess the included studies. Discrepancies will be discussed and rectified with a third reviewer, if needed. A narrative synthesis of the findings will be performed and presented with descriptive and statistical analyses, where possible, using GraphPad Prism (GraphPad Software). The review formally began in February 2025 and will be performed and reported according to this protocol and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A PRISMA flow diagram and checklist have been used to summarize the current search and study selection. A narrative synthesis and tables will be used to summarize the results of the included studies. Where possible, statistical analyses will be presented using graphs and figures. The final systematic review is expected to be published in December 2025. This systematic review will aim to summarize the outcomes of the single-stage and 2-stage facial reanimation techniques and explore the differences between these surgical techniques, if any. The results will provide updated information for patients and clinicians. Moreover, the review may help identify potential areas for further research and policy development. PROSPERO CRD42024556255; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024556255. PRR1-10.2196/64009.
13. User Satisfaction With Pregnancy Management Apps in Mainland China: User-Generated Content Analysis and Text Mining Study.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-21 链接: PubMed
摘要
China’s 3-child policy has increased the demand for scientific and personalized pregnancy health management. The convenience of mobile health has promoted the use of pregnancy management apps among pregnant women. User satisfaction has a significant impact on continued use intention. Systematically evaluating user satisfaction with pregnancy management apps is of great significance in promoting the digital transformation of maternal-infant health care. This study aimed to explore user satisfaction with pregnancy management apps by mining user-generated content and analyzing the differences in user satisfaction among different operating systems. Under the guidance of Herzberg two-factor theory, this study explored the demand structure in user experience and investigated the influencing factors on satisfaction from 2 aspects: user satisfaction and dissatisfaction, providing reference for the development of mobile health apps for pregnancy management. We screened pregnancy management apps from the app stores of 5 mobile phone manufacturers in mainland China and collected the app-based reviews and ratings posted by users. We performed topic clustering and semantic parsing using the latent Dirichlet allocation and DeepSeek-R1 models. Influencing factors for satisfaction and dissatisfaction were identified using the Tobit regression model. The Kano model was used to classify the factors as basic or attractive. The Wald test was applied to analyze the differences in the effects across various factors. We examined 86 pregnancy management apps, amounting to 180,107 reviews in total. The overall satisfaction rate with pregnancy apps was relatively high (72.34%). Android users had higher satisfaction rates than iOS users (89.32% vs 60.75%). User reviews were clustered into 12 themes, categorized into 3 types: technical security support, basic service experience, and maternal-infant scenarios. The basic factors causing dissatisfaction included system login (β=2.829; P<.001) and privacy disclosure (β=1.955; P<.001). Attractive factors boosting satisfaction included storage optimization (β=0.220; P<.001), page design (β=0.223; P<.001), function provision (β=0.023; P=.001), platform feedback (β=0.222; P<.001), physicians’ inquiries (β=0.356; P<.001), menstrual management (β=0.209; P<.001), pregnancy guidelines (β=0.306; P<.001), parenting science popularization (β=0.238; P<.001), growth record (β=0.401; P<.001), and maternal-infant community (β=0.307; P<.001). There were significant differences in user satisfaction between the iOS and Android platforms, reflecting the heterogeneity of responses to user demands in different technological ecosystems. Twelve themes showed the multilevel needs of pregnant women for pregnancy management apps, forming a progressive service chain: security guarantee to demand satisfaction to experience improvement. Twelve factors had asymmetric correlations with user satisfaction and dissatisfaction with pregnancy management apps. Two factors were related to basic attributes of the apps and 10 factors to attractive attributes. By distinguishing between basic and attractive factors, the use of pregnancy management apps may be improved.
14. Improving Hypertension Control in Southern Arizona: A Collaboration Between Community Health Centers and Local Health Departments.
期刊: American journal of public health 发表日期: 2025-Aug-21 链接: PubMed
摘要
Federally qualified health centers and local health departments in three Southern Arizona counties formed a partnership in 2023 to address unrecognized and undertreated high blood pressure in the region. By augmenting primary care infrastructure with the surveillance, communication, and policy functions of local health departments, the partnership seeks to improve population health outcomes by sharing clinical best practices, increasing community awareness, enhancing connections to primary care, and coordinating public health department strategic activities. (Am J Public Health. Published online ahead of print August 21, 2025:e1-e5. https://doi.org/10.2105/AJPH.2025.308196).
15. Oversight of Physician and Allied Health Graduate Education Programs: Our Experience With an Integrated Model.
期刊: Military medicine 发表日期: 2025-Aug-21 链接: PubMed
摘要
The growing demand for healthcare services highlights the need for diverse, well-trained healthcare professionals beyond physicians. To address the forecasted shortage of U.S. physicians, healthcare systems increasingly rely on allied health professionals, including nurse anesthetists, physician assistants, and various other specialists, such as pharmacists, psychologists, occupational therapists, and physical therapists. These professionals require training in Graduate Allied Health Education (GAHE) programs, yet there is limited guidance for structuring these programs alongside traditional Graduate Medical Education (GME). This article discusses a comprehensive model for integrating GME and GAHE oversight at the institutional level, exemplified by San Antonio Uniformed Services Health Education Consortium (SAUSHEC). Key elements include policy alignment, accreditation considerations, resource allocation, and interprofessional training. Through SAUSHEC’s parallel oversight committees for GME and GAHE, we demonstrate how structured integration enhances training and patient outcomes, benefiting trainees, healthcare team members, and patients. Our model promotes an inclusive, interprofessional environment where allied health professionals and physicians train collaboratively, ultimately improving patient care quality and institutional efficiency.
16. Students Having Their Say: Novel Approaches and Solutions to Current and Emerging Public Health Problems.
期刊: Preventing chronic disease 发表日期: 2025-Aug-21 链接: PubMed
摘要
17. Insulinoma diagnosis and characterization with intratumoral heterogeneity employing [18F]FB(ePEG12)12-exendin-4 PET/MRI.
期刊: European journal of nuclear medicine and molecular imaging 发表日期: 2025-Aug-21 链接: PubMed
摘要
18. Effect of an intensive smoking cessation intervention on smoking cessation and disease activity in patients with rheumatoid arthritis: a randomised controlled trial.
期刊: Rheumatology (Oxford, England) 发表日期: 2025-Aug-21 链接: PubMed
摘要
To compare the effect of a 6-week individual intensive smoking cessation intervention in patients with rheumatoid arthritis, relative to treatment-as-usual, on the co-primary outcomes 1) successful smoking cessation and 2) achievement of EULAR clinical response (improvement in DAS28-CRP of > 0.6) three months post intervention. Secondary outcomes were number of swollen joints, tender joints, CRP, patient and physician global assessment, pain, fatigue, flare, physical function, and health related quality of life. A multicentre, open label, two-arm, parallel-group, randomised trial included daily smokers in rheumatoid arthritis remission or having low-to-moderate disease activity (DAS28-CRP ≤ 5.1). The control group received usual care, while the intervention group received in five individual counselling sessions over six weeks with a smoking cessation counsellor, and complimentary nicotine replacement therapy). Smoking cessation was defined as self-reported and confirmed by exhaled carbon monoxide. Patients were followed 3-, 6-, and 12-months postintervention. Among 94 patients, 49 were randomised to the intervention group, 45 to usual care. At 3-months’ follow-up, nine (18%) intervention versus two (4%) control group patients achieved smoking cessation, OR = 4.84 [95%CI 0.99 to 23.76]). In contrast to 12% versus 20% experiencing a EULAR clinical response (0.56 [0.18 to 1.72]). Among the secondary outcomes DAS28-CRP, tender joint count and CRP favoured the control group, whereas the remaining outcomes were similar between groups. Patients receiving an intensive smoking cessation intervention achieved numerically higher cessation rates. In contrast, EULAR clinical response rates and several secondary outcomes tended to favor the control group. ClinicalTrials.gov; NCT02901886.
19. Correlates of adherence to the Mediterranean diet among preschool-age and school-age children living in Mediterranean countries: a systematic review.
期刊: European journal of nutrition 发表日期: 2025-Aug-21 链接: PubMed
摘要
In recent years, children in Mediterranean countries have shown low adherence to Mediterranean Diet (MD) with a shift toward a Western diet. This study aims to understand the reasons behind moving away from the MD among children, by providing an overview of the different correlates influencing MD adherence among preschool and school-age children (3-8 years old). A systematic review was conducted and reported in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and registered in the Prospero database (CRD42023370607). Literature was searched in PubMed, Web of Science and PsycINFO databases for studies, without restrictions on publication date. Inclusion criteria were preschool and school-aged children, studies conducted in Mediterranean countries, and statistical analyses of the association between the different correlates and MD adherence quantified by a validated dietary assessment. Studies that did not provide sub-analyses for the specified age group were excluded. A quality analysis of the included studies was performed using the National Collaborating Centre for Methods and Tools (NCCMT) scale. A total of 12 studies were included, primarily from European Mediterranean countries, with fewer studies from the Middle East and North Africa. The vast majority of the included studies reported on interpersonal correlates related to the parent’s influence on MD adherence, while child’s age and sex, physical activity, and time spent on video games were classified as individual, and only the place of residence was classified as an environmental correlate. The quality assessment generally showed weak scores. The primary factors influencing MD were interpersonal correlates related to parents, indicating that interventions should target both children and parents to effectively reinforce MD adherence.
20. Hesperetin Protects from Palmitic-Acid-Induced Lipotoxicity through the Inhibition of Glutaminolysis, mTORC1 Signaling, and Limited Apoptosis.
期刊: Journal of agricultural and food chemistry 发表日期: 2025-Aug-21 链接: PubMed
摘要
Palmitic acid-induced lipotoxicity contributes to the development of nonalcoholic fatty liver disease (NAFLD). Hesperetin has been reported to alleviate oxidative stress, inflammation, and cell death in NAFLD, while its potential to mitigate palmitic acid-induced lipotoxicity remains unexplored. This study investigates the protective effects of hesperetin on palmitic-acid-stimulated lipotoxicity and elucidates the underlying molecular mechanisms. Our results showed that hesperetin decreased palmitic acid-activated lipotoxicity through inhibition of the intrinsic apoptosis pathway and promotion of autophagic flux. Metabolomics analysis and stable-isotope-tracing data indicated that hesperetin treatment restored the aberrant tricarboxylic acid cycle caused by palmitic acid exposure, accompanied by a decrease in anaplerotic flux from glutamine to α-ketoglutarate. The reduction of α-ketoglutarate resulted in the inhibition of mTORC1 signaling, which in turn activated autophagy and limited apoptosis. Furthermore, hesperetin activated AMPK, which coordinated with mTORC1 to regulate autophagy. Additionally, hesperetin reinstated the activation of AKT and Nrf2, further protecting the cell against the deleterious effects of lipotoxicity. These data highlight the role of glutaminolysis as a survival mechanism for preventing lipotoxicity upon hesperetin treatment.
21. Silver Nanoparticles and Houttuynin Sodium-Based Fibrous Poly(L-lactide-co-glycolide)/Gelatin-Based Dressings for Infectious Wound Healing.
期刊: Small (Weinheim an der Bergstrasse, Germany) 发表日期: 2025-Aug-21 链接: PubMed
摘要
Bacterial infections present debilitating challenges for skin repair, particularly in managing complex microbial colonization and persistent inflammation that delay healing. To address this clinical gap, a dual-functional electrospun dressing (PG@AgH) was developed by incorporating silver nanoparticles (Ag NPs) and houttuynin sodium (H) into poly(L-lactide-co-glycolide)/gelatin (PG) fibers. Compared to conventional dual-agent systems, PG@AgH achieves spatiotemporally controlled release. Ag NPs provide rapid antibacterial action against multidrug-resistant pathogens (e.g., S. aureus, E. coli), while H sustains anti-inflammatory modulation through macrophage polarization regulation. In vitro studies confirmed cytocompatibility and broad-spectrum antimicrobial efficacy against bacterial (S. aureus, E. coli) and fungal (C. albicans) strains. Moreover, the PG@AgH dressings promoted rapid wound closure, enhanced collagen deposition, and reduced bacterial load at the wound site in S. aureus-infected full-thickness excisional defect model in rats. Taken together, this multifunctional approach overcomes the limitations of single-mechanism dressings, offering a clinically translatable strategy for infectious wound management.
22. Effect of a Mediterranean Diet Adapted to the Mexican Population on Indicators of Metabolic Risk in Patients With Obstructive Sleep Apnea: Protocol for a Randomized Controlled Trial.
期刊: JMIR research protocols 发表日期: 2025-Aug-21 链接: PubMed
摘要
Obstructive sleep apnea (OSA) is characterized by episodes of intermittent airway obstruction during deep sleep or REM (rapid eye movement). It is associated with cardiometabolic risk diseases. The base treatment is continuous positive airway pressure (CPAP), to which not all patients are able to adapt. The Mediterranean diet (MD) has proven to be effective in reducing cardiovascular risk markers; however, it must be adapted to different populations. Among patients with OSA, it can effectively reduce clinical entity and cardiometabolic risk, while improving quality of life and sleep. We aimed to evaluate the effect of an MD adapted to the Mexican diet versus a standard nutritional treatment on metabolic risk indicators in patients with OSA. A randomized, 2-arm clinical trial will be conducted with patients with OSA from the Hospital, Mexican Social Security Institute (Instituto Mexicano del Seguro Social) in Mexico. Patients will be randomly included in the group with MD adapted to Mexican foods. With a personalized diet plan adapted from the Mediterranean diet, prototype menus with Mexican foods adapted from the MD will be included for a higher consumption of fruit, vegetables, fiber-rich cereals, and reduction of red meat. In addition to an illustrative plate to improve adherence. The standard diet (SD) group will receive standardized nutritional counseling for patients with OSA. Fasting blood samples will be drawn after 6 and 12 months to identify glucose levels and lipid profiles. Anthropometric and body composition measurements will be taken, and adherence to diet will be recorded after 3, 6, and 12 months. Sleep quality, physical exercise, and life quality will be recorded basally and after 12 months. A multivariate logistic regression analysis will be performed, including the achievement of metabolic indicator control goals, sleep quality, and quality of life as outcome variables. This analysis will be adjusted for other variables that may be statistically significant in the bivariate analysis, such as sex, age, and comorbidities, among others. Statistically significant differences between groups will be considered when the value of P<.05. The protocol was authorized in 2024, and funding is being sought for patient follow-up. All 120 patients (60 per group) will be included in 2025; recruitment will begin in March 2025. The clinical trial is expected to be completed in April 2026. The results of this study will contribute to evaluate the effect of a nutritional intervention adapted to patients with OSA, seeking to reduce cardiovascular risk indicators in patients, improve their clinical condition, reduce OSA symptoms, and improve patients’ quality of life. ClinicalTrials.gov NCT06278571; https://clinicaltrials.gov/study/NCT06278571. PRR1-10.2196/72513.
23. Wearable Technology, Smart Home Systems, and Mobile Apps for the Self‑Management of Patient Outcomes in Dementia Care: Systematic Review.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-21 链接: PubMed
摘要
The dementia landscape has evolved, with earlier diagnoses, improved prevention understanding (eg, modifiable factors), and new treatments. Emerging digital technologies (eg, wearables, smart home systems, and mobile apps) offer self‑management opportunities; yet, gaps persist regarding integration into the care needs and preferences of people with dementia. Broader gaps remain concerning intervention design; adaptation; and implementation, including effectiveness, study quality, and accessibility. This systematic review aims to synthesize and critically appraise existing literature on digital self-management technologies (wearables, smart home systems, and mobile apps) intended to reduce dementia-associated behaviors, enhance self-management, and improve quality of life (QoL). It evaluates intervention characteristics, effectiveness, accessibility, study design, and methodological quality according to international standards. A systematic search across 9 databases (PubMed, Scopus, ACM Digital Library, CINAHL, PsycInfo, Web of Science, IEEE Xplore, Embase, and MEDLINE) identified relevant English‑language studies published between January 1, 2013, and September 30, 2023. Search terms covered dementia, QoL, behavioral and self‑management strategies, and digital technologies. Eligible studies involved adults with dementia using wearable, smart home, or mobile technologies targeting QoL, behavior, and autonomy. Two reviewers independently appraised study design, hardware, and intervention purpose. Outcomes were mapped to the Nursing Outcomes Classification and benchmarked against National Institute for Health and Care Excellence quality standard 184. Accessibility was evaluated by availability, cost, usability, and context. Bias mitigation included a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)‑guided strategy and PROSPERO registration. Methodological quality and bias were assessed using the Mixed Methods Appraisal Tool, the Critical Appraisal Skills Program, and a bespoke characterization framework. Twenty-four studies evaluated interventions based on wearables, smart home systems, or apps for people with dementia and carers. Outcomes centered on neurocognition (24/24, 100%), self-care (17/24, 71%), and health behavior (13/24, 54%). Identified needs included managing distress (15/24, 62%) and supporting carers (15/24, 62%). Technologies included commercial tools (activity trackers, health-based wearables, and digital prompters) but were often inaccessible due to complex setup requirements and ongoing support needs. Substantial methodological heterogeneity precluded meta-analysis, necessitating narrative synthesis. Study quality was generally good to excellent, but samples were small, reporting incomplete, and outcomes unblinded. Only 1 (17%) of 6 randomized controlled trials reported effect sizes, indicating moderate decline in QoL at 24 months; effectiveness in other studies remains uncertain. Research on digital technologies for dementia self‑management shows benefits, particularly with off‑the‑shelf devices and mobile apps supporting person‑centered outcomes. Notable limitations include inadequate participant diversity (eg, atypical dementias and minoritized populations) and insufficient high‑quality research on QoL and behavioral outcomes, such as symptom management and self‑control. Future research must prioritize innovative solutions enhancing accessibility and usability, emphasizing simplified configuration, personalized adaptability, and effective training and support structures. PROSPERO CRD42023461841; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023461841.
24. Optimized detection and inference of immune cell type names in single-cell RNA sequencing data.
期刊: Journal of immunology (Baltimore, Md. : 1950) 发表日期: 2025-Aug-21 链接: PubMed
摘要
Accurate identification of immune cell subsets in single-cell RNA sequencing (scRNA-seq) data is critical for understanding immune responses in autoimmune diseases, infections, and cancer. One caveat of scRNA-seq is the inability to properly assign rare immune cell subsets due to gene dropout events. To circumvent this caveat, we here developed optimized detection and inference of names in scRNA-seq data (scODIN). scODIN uses an informed holistic 2-step approach combining expert knowledge with machine learning to rapidly assign cell type identities to large scRNA-seq datasets. First, scODIN uses key lineage-defining markers to identify a set of core cell types. Second, scODIN compensates for dropout events by integrating a k-nearest neighbors algorithm. We additionally programmed scODIN to detect dual and transitional phenotypes, which are usually overlooked in conventional analyses. Consequently, scODIN may enhance our understanding of immune cell heterogeneity and provide comprehensive insights into immune regulation, with broad implications for immunology and personalized medicine.
25. Abortion Restrictions and Infant Mortality in the United States, 2018-2023.
期刊: American journal of public health 发表日期: 2025-Aug-21 链接: PubMed
摘要
Objectives. To evaluate the impact of state-level abortion restrictions enacted between 2018 and 2023 on infant mortality in the United States, comparing mortality trends across restricting and nonrestricting states. Methods. Using a difference-in-differences approach, we drew infant mortality data from the Centers for Disease Control and Prevention’s WONDER (Wide-ranging Online Data for Epidemiologic Research) database and categorized deaths by age and cause, incorporating information on abortion restrictions and legal exceptions from the Center for Reproductive Rights and the Kaiser Family Foundation. We calculated estimates at the state-year level. Results. Infant mortality increased by 7.2% in restricting states. The increase is predominantly attributable to early (aged < 1 day) and late (aged 1 month to 1 year) infant deaths. Effects were largest for perinatal and noncongenital causes of death. Health exceptions did not significantly moderate the effects. Conclusions. Curtailing abortion access increases infant deaths. Fetal and maternal health exceptions do not moderate this effect. Excess deaths are not exclusively attributable to congenital abnormalities. Further work is needed to understand how restrictions contribute to late deaths and the long-term effects of infant deaths on families and communities. (Am J Public Health. Published online ahead of print August 21, 2025:e1-e8. https://doi.org/10.2105/AJPH.2025.308228).
26. The synergy of environmental awareness, occupational physical activity and effects of climate change in German craftspeople.
期刊: International journal of occupational safety and ergonomics : JOSE 发表日期: 2025-Aug-21 链接: PubMed
摘要
Objectives. Craftspeople are exposed to climatic changes while engaging in high levels of occupational physical activity. The purpose of this study is to investigate the synergies of occupational physical activity, effects of climate change and tangibility concerning the working conditions and health of German craftspeople. Methods. A questionnaire survey was conducted with 1830 responding German craftspeople using computer-assisted telephone interviews (CATIs). Quantitative analyses included physical activity, environmental awareness and the impact of climate change on daily work. An open question was assessed using qualitative content analysis. Results. The effects of climate and environmental change on daily work are most noticeable for men (30.6%), older workers (age 50-59 years, 31.7%), construction site workers (41.9%) and those who engage in physically demanding work (35.2%). The participants reported extreme weather conditions in combination with occupational physical activities as the most tangible effects of climate change with physical health effects. Conclusions. Craftspeople do feel the effects of climate change in their daily work and at the same time have a high level of environmental awareness. Given the prevalence of high levels of work-related physical activity, more attention should be paid to health risks and preventive measures should be taken.
27. RttA, a Zn2-Cys6 transcription factor in Aspergillus fumigatus, contributes to azole resistance.
期刊: Microbiology spectrum 发表日期: 2025-Aug-21 链接: PubMed
摘要
Aspergillus fumigatus is a common environmental fungus and the leading cause of aspergillosis, an opportunistic infection in humans and animals. The mortality rate of aspergillosis remains high despite antifungal treatments, with azole antifungals, such as voriconazole, being the primary treatment. However, resistance to azoles is increasing, partly because of environmental exposure to agricultural fungicides. In a previous study, we identified the protein RttA to be involved in azole susceptibility. To further understand the role of RttA in azole resistance, we conducted RNA-Seq analysis and functional analyses by constructing RttA deletion and overexpression strains. The transcriptome data revealed that RttA contains a Zn2-Cys6 domain and may function as a transcription factor. Furthermore, six genes, including a γ-glutamyl transpeptidase gene (ggtA) and a homolog of factor C (facC), were shown to be putatively regulated by RttA. These findings suggest that RttA is involved in azole resistance by regulating several genes, highlighting its potential as a target for developing antifungal strategies against A. fumigatus.IMPORTANCEThis study identified RttA as a Zn2-Cys6 transcription factor in Aspergillus fumigatus, a critical pathogen that causes aspergillosis. RttA influences azole susceptibility. Our results demonstrated that the deletion of RttA increases susceptibility to azoles, whereas its overexpression enhances resistance. This discovery is crucial because the mechanism underlying azole resistance has not yet been fully elucidated. Hence, understanding the role of RttA provides insights into resistance mechanisms and potential targets for new therapeutic strategies, thereby addressing the urgent need for effective treatments against azole-resistant A. fumigatus strains.
28. Distinct routes to thermotolerance in the fungal pathogen Cryptococcus neoformans.
期刊: Genetics 发表日期: 2025-Aug-21 链接: PubMed
摘要
Increasing temperatures associated with climate change have the potential for far-reaching impacts on human health and disease vectors, including fungal pathogens. Pathogenic fungi occupy a wide range of environments across the world, and their ranges have been slowly expanding in recent decades due, in part, to climate change. Despite these links between increasing temperature and higher prevalence of fungal disease, the direct effects of rising environmental temperatures on the evolution of pathogenic fungi remains unclear. In this study, we investigated how increasing temperatures drive adaptive evolution in the human fungal pathogen Cryptococcus neoformans. First, we performed serial passages of a C. neoformans environmental isolate with gradual changes in temperature over the course of 38 days. Through this approach we identified several distinct thermally adapted isolates with competitive growth advantages over the parental strain at high temperatures. We then characterized the phenotypic and genetic changes acquired in these evolved isolates, which include alteration of cell size, colony morphology, and, notably, antifungal resistance. Our genetic analyses further revealed distinct genes that facilitate thermoadaptation in different populations-identifying new molecular players in the regulation of this trait and revealing that there are multiple independent routes to gaining thermotolerance. These results highlight the remarkable flexibility of fungi to adapt rapidly to new environments and raise pressing questions about the impacts of rising environmental temperatures on the future of infectious diseases and human health.
29. Magnesium Depletion, Metabolic Impairment, and Cardiac Alterations: The NAKO-MRI Study with Mendelian Randomization.
期刊: The Journal of clinical endocrinology and metabolism 发表日期: 2025-Aug-21 链接: PubMed
摘要
Magnesium deficiency may contribute to subclinical cardiac changes, particularly metabolic diastolic cardiomyopathy. To investigate the association between magnesium depletion, metabolic syndrome (MetS), and MRI-derived cardiac alterations in a population-based sample. We cross-sectionally analyzed N = 9568 participants from the baseline examination of the German National Cohort (NAKO) who underwent whole-body MRI. Associations of serum magnesium and magnesium depletion score (MDS) with MetS and cardiac alterations were assessed using multivariable logistic and linear regression, respectively. Two-sample Mendelian Randomization was performed to evaluate the potential causal relationship between serum magnesium and MRI-derived cardiac parameters. Our analysis revealed no correlation between serum magnesium and MDS (Spearman’s rho = 0.065; p < 0.001). A 1-SD increase in serum magnesium was associated with lower MetS prevalence (OR 0.93 [95% CI: 0.88, 0.99]) and reduced left and right ventricular systolic and diastolic volumes. Higher MDS, indicating magnesium deficiency, was linked to increased MetS prevalence (OR per 1-unit 1.32 [95% CI: 1.23, 1.41]) and its individual components. Furthermore, higher MDS was associated with increased LVRI (Estimate 0.012 g/mL [95% CI: 0.008, 0.017]) and decreased left ventricular end-diastolic volume (Estimate -1.132 mL/m2 [95% CI: -1.538, -0.727]), indicating concentric hypertrophy. Two-sample Mendelian Randomization suggested no causal relationship between serum magnesium and MRI-derived cardiac markers. Magnesium depletion may serve as an early indicator of cardiac impairment. However, Mendelian Randomization results do not support a causal role of serum magnesium on cardiac structure and morphology.
30. Increasing global human exposure to wildland fires despite declining burned area.
期刊: Science (New York, N.Y.) 发表日期: 2025-Aug-21 链接: PubMed
摘要
Although half of Earth’s population resides in the wildland-urban interface, human exposure to wildland fires remains unquantified. We show that the population directly exposed to wildland fires increased 40% globally from 2002 to 2021 despite a 26% decline in burned area. Increased exposure was mainly driven by enhanced colocation of wildland fires and human settlements, doubling the exposure per unit burned area. We show that population dynamics accounted for 25% of the 440 million human exposures to wildland fires. Although wildfire disasters in North America, Europe, and Oceania have garnered the most attention, 85% of global exposures occurred in Africa. The top 0.01% of fires by intensity accounted for 0.6 and 5% of global exposures and burned area, respectively, warranting enhanced efforts to increase fire resilience in disaster-prone regions.
31. Workplace hazards and compliance with OHS regulations among certified refrigeration and air conditioning technicians in Manila, Philippines.
期刊: International journal of occupational safety and ergonomics : JOSE 发表日期: 2025-Aug-21 链接: PubMed
摘要
This study assessed the association between knowledge of workplace hazards and perceived compliance with occupational health and safety (OHS) regulations among certified refrigeration and air conditioning (RAC) technicians. A cross-sectional survey was conducted from June to December 2021. The study ascertained from 204 technicians their knowledge of workplace hazards and perceived compliance with OHS regulations using a self-administered questionnaire. In addition, the association between the technician’s knowledge of workplace hazards and their perceived compliance with OHS was estimated using Poisson regression models with log-link, adjusted for confounding factors. Effect size estimates were expressed as crude (cPR) and adjusted (aPR) prevalence ratios with 95% confidence interval (CI). With a 75% workplace hazards benchmark for RAC technicians, the crude and adjusted model analysis (cPR 1.75; 95% CI [1.39, 2.21]; p < 0.001) and 58% (aPR 1.58; 95% CI [1.23, 2.04]; p < 0.001), respectively, indicated a likelihood of perceiving themselves as compliant with OHS regulations compared to RAC technicians with average and below-average industry knowledge of workplace hazards. With knowledge of workplace hazards likely influencing certified RAC technicians, its integration into the technical and vocational education and training (TVET) curriculum as a competency may strengthen OHS compliance.
32. Religious belief in a sample of trauma-exposed firefighters: Mitigating occupational stress and enhancing posttraumatic growth.
期刊: Psychological services 发表日期: 2025-Aug-21 链接: PubMed
摘要
A religious lifestyle can be a powerful factor in predicting and promoting healthy functioning following trauma exposure. Previous research has demonstrated that higher levels of religiosity significantly predict posttraumatic growth following exposure to trauma. Firefighters are a population associated with routine exposure to potentially traumatic events, as well as high levels of occupational stress. While the relationship between religiosity and posttraumatic growth is well documented, the interaction of religious belief, occupational stress, and posttraumatic growth is less clear. The objective of this secondary analysis was to determine if religious belief moderates the relationship between occupational stress and posttraumatic growth in a sample of firefighters. The sample for this analysis was comprised of 109 firefighters who were assessed at various time points before fire service and throughout their first 3 years of fire service. A religious lifestyle did moderate the relationship between occupational stress and overall posttraumatic growth. However, a religious lifestyle and occupational stress were not significantly related. A religious lifestyle did moderate the relationship between occupational stress and the subdomains of spiritual enhancement and appreciation of life. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
33. Editor's note.
期刊: European journal of cardiovascular nursing 发表日期: 2025-Aug-21 链接: PubMed
摘要
34. Investigation of the relationship between sexual developmental characteristics of individuals with intellectual disabilities in adolescence and sexual communication skills of their parents.
期刊: Journal of pediatric nursing 发表日期: 2025-Aug-20 链接: PubMed
摘要
The study aimed to determine the relationship between the sexual developmental characteristics of individuals with intellectual disabilities in adolescence and their parents’ sexual communication skills. The descriptive, cross-sectional, and correlational design study conducted between January and March 2024 included the parents of 115 individuals with intellectual disabilities aged 10-19 years studying in a special education and rehabilitation center. The mean total score of the sexual communication scale for parents was 71.00 ± 13.73, and the mean total score of the sexual development characteristics scale for children with intellectual disabilities in adolescence was 111.51 ± 15.24. There was no positive and significant relationship between content, body language, anxiety scores, and sexual development characteristics scale score (p > 0.05), while there was a positive and significant relationship between the sub-dimension score of managing the process (r = 0.19; p < 0.05) and the sexual communication scale score for parents (r = 0.20; p < 0.05) and the sexual development characteristics scale score of children with intellectual disabilities. It was found that parents’ sexual communication skills had a significant but weak effect on their children’s sexual development.
35. Accuracy of the ABFW ‒ Screening for speech disorders in early childhood.
期刊: Brazilian journal of otorhinolaryngology 发表日期: 2025-Aug-20 链接: PubMed
摘要
To verify the accuracy of a protocol for the Brazilian population of the ABFW ‒ Adapted Child Language Test, named ABFW Triagem. This was a diagnostic accuracy study carried out at the speech therapy outpatient clinic of one of Brazil’s leading public universities. Through the database, protocols were selected for patients aged between 0 and 5 years and 11-months who visited the outpatient clinic between 2016 and 2019 with any speech and hearing complaint. A follow up was carried out in 2024 to find out whether the speech therapy hypothesis was assertive or not. 188 protocols were selected and only 43 caregivers answered the researcher’s call. The ABFW Screening protocol showed 72.1% accuracy and 64.3% balanced accuracy. Of all the hypotheses, the main one was language alteration characteristic of autism spectrum disorder (88.89%) with a sensitivity of 94.12% and specificity of 92.31%. The ABFW protocol adapted for speech and hearing screening proved to be a tool with the potential to make significant contributions to Brazilian public policies of interest to Primary Health Care. We suggest a greater volume of other speech therapy diagnostic hypotheses so that it can be validated and used by specialists, thus fulfilling the methodological rigor and development essential for its quality. Is this diagnostic or monitoring test accurate? (Diagnosis) ‒ Level 2 (Individual cross-sectional studies with consistently applied reference standard and blinding).
36. Widespread Proteomic Changes Observed in a Cohort of Neonates and Infants Undergoing Cardiopulmonary Bypass.
期刊: JACC. Advances 发表日期: 2025-Aug-20 链接: PubMed
摘要
37. Social Determinants of Health and Mortality in Cardiovascular-Kidney-Metabolic Syndrome.
期刊: JACC. Advances 发表日期: 2025-Aug-20 链接: PubMed
摘要
38. Trends in Risk Factor Prevalence and Incidence of Acute Myocardial Infarction in Young Adults.
期刊: JACC. Advances 发表日期: 2025-Aug-20 链接: PubMed
摘要
Contemporary trends in traditional and nontraditional risk factors (RFs) among young adults with acute myocardial infarction (AMI) are not well understood. This study sought to determine differences and trends in the prevalence of traditional and nontraditional RFs among young and older adults hospitalized with incident AMI. Incident AMI hospitalizations were analyzed from 2011 to 2021 from the National Inpatient Sample and stratified by age (young adults 18-54 years of age and older adults >54 years of age). Overall RF prevalence and trends in traditional (eg, hypertension) and nontraditional (eg, psychosocial factors) RFs were assessed. Subgroup analysis by sex and race/ethnicity was performed. Among 4,431,901 incident AMI hospitalizations, 974,521 (22%) were young adults. Hypertension (64.8%) and tobacco use (57.8%) were the most prevalent RFs in young adults overall. Among 5 traditional RFs, tobacco smoking and obesity were significantly higher in young adults compared to older adults. Among 12 nontraditional RFs, lowest income quartile, family history of ischemic heart disease, and psychiatric disorders were significantly higher in young adults. Within young adults, women and non-Whites had a higher prevalence of both traditional and nontraditional RFs. Across the study period, the prevalence of most traditional and nontraditional RFs in young adults increased significantly (Ptrend < 0.050 for all). Young adults with AMI have a different and increasing burden of both traditional and nontraditional RFs compared to older adults. These findings could help guide strategies for primary prevention of AMI.
39. Frailty, Pitavastatin, and Major Adverse Cardiovascular Events Among People With HIV.
期刊: JACC. Advances 发表日期: 2025-Aug-20 链接: PubMed
摘要
People with HIV (PWH) are at increased risk for atherosclerotic cardiovascular diseases (ASCVDs) and geriatric syndromes, including frailty. REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV) demonstrated a 36% reduction in major adverse cardiovascular events (MACE) with pitavastatin vs placebo but the role of statins for ASCVD prevention among frail PWH is not known. The purpose of this study was to evaluate whether frailty is associated with MACE and whether pitavastatin prevents MACE regardless of frailty. We conducted a post hoc analysis of the REPRIEVE trial, a randomized, blinded trial of pitavastatin 4 mg vs placebo. Participants included PWH without ASCVD, aged 40 to 75 years. Frailty was measured with a 32-item frailty index. Cox proportional hazards models were used to estimate cause-specific hazard of MACE by frailty status. Pitavastatin effect modification by frailty status was assessed via interaction with treatment. Of 7769 REPRIEVE participants, 7,740 (>99%) had sufficient data to calculate frailty index. Median age was 50 years (Q1, Q3: 45, 55), 67% were nonfrail, 29% prefrail, and 4% frail at baseline; median follow-up was 5.6 years. Adjusted for age, sex, ASCVD risk score, and treatment group, MACE hazard increased with frailty (P < 0.0001): HR: 1.76 (95% CI: 1.35-2.30) among prefrail, and 2.14 (95% CI: 1.33-3.45) among frail compared to nonfrail. There was no evidence that pitavastatin effect differed by frailty status (P = 0.44). Frailty was associated with markedly higher hazard of MACE. Though frailty did not appear to modify the protective effects of pitavastatin seen in the primary trial, the efficacy in frail PWH remains uncertain due to the limited number of frail individuals.
40. The Heartline Experience: Achieving Long-Term Participant Engagement in Digital Health Technology Trials.
期刊: JACC. Advances 发表日期: 2025-Aug-20 链接: PubMed
摘要
Digital health technologies can potentially improve clinical research efficiency and increase participant diversity but have challenges with long-term participant engagement. The Heartline Study evaluated the impact of a mobile app-based heart health engagement program with the Irregular Rhythm Notification (IRN) and electrocardiogram features of the Apple Watch on diagnosis, treatment, and outcomes of atrial fibrillation in U.S. participants aged ≥65 years. Participants were randomized 3:1 to the watch group (vs no watch control group), stratified by prevalent atrial fibrillation. Participants interfaced with the study via a custom, app-based engagement program designed to facilitate participant enrollment, post-IRN follow-up, and electronic patient-reported outcome (ePRO) collection. To ensure users would respond to app-based reminders to complete ePROs and follow-up with providers after a potential IRN, targeted engagement strategies based on behavioral science principles were incorporated, including human-centered design, curated health education, and points-based incentives. Of 34,244 enrolled Heartline participants, 32,299 (94%) started the program. High, longitudinal participant engagement was seen, with 93% actively engaged with the app at least weekly after 1 year, and 86% after 2 years. ePRO completion rates were 82% at 1 year and 76% at 2 years. Upon study completion, participants reported high satisfaction with the study and their personal investment. Study adherence in Heartline was high and sustained through 2-year follow-up, using a purposely designed engagement program delivered by a mobile app. Participants in this older population remotely and regularly submitted study information through the app and reported high study satisfaction (A Study to Investigate if Early Atrial Fibrillation [AF] Diagnosis Reduces Risk of Events Like Stroke in the Real-World; NCT04276441).
41. Adaptation and Development of the Equity Mapping Tool for Community Care Organizations Responding to the COVID-19 Pandemic.
期刊: Journal of public health management and practice : JPHMP 发表日期: 2025-Aug-20 链接: PubMed
摘要
The Equity Mapping Tool (EMT), a set of integrated tools providing rapid up-to-date COVID-19 data was previously developed for local health departments and health care systems in Franklin County, Ohio, to guide decisions about mobile vaccination. We aimed to engage, extend, and enhance the EMT to 12 Pathway Community HUBs (HUBs) in Ohio, connecting at-risk individuals to health and social services across 61 counties. This was an innovation demonstration project in HUBs to increase community resiliency during the COVID-19 pandemic. One of the project goals was to provide Community Health Workers (CHWs) working with HUBs with local data for local decisions to advance the health of all Ohioans by engaging, extending, and enhancing the EMT. We used a continuous improvement process called the Engagement, Analytics, Translation (EAT) Framework to engage, extend, and enhance the EMT for HUBs. Engagement activities consisted of focus groups with HUB staff and consultation with CHW Advisory Council, facilitated the co-creation of EMT tools for HUBs and their subsequent enhancement. These activities guided analytics tasks by identifying data requirements, curation, and guiding the development of reports and dashboard for the extended EMT. In translation phase, EMT products were disseminated to HUBs, whose feedback during subsequent engagement activities guided further analytical workflows to enhance EMT. Engagement activities resulted in the identification of shared goals. Public health data needs of HUBs were centered around their populations served, health disparities of focus, and services provided. The capacity to access the EMT interactive dashboard and PDF reports was extended to all 12 HUBs. The collaboration between academic, public health, and community health partners was critical to extending and enhancing the EMT to HUBs. Cycles of EAT helped to be responsive to HUBs’ need for data and build their capacity for improving community resiliency.
42. Primary Prevention Aspirin, Lipoprotein(a), and Cardiorenal Outcomes in Chronic Kidney Disease: Chronic Renal Insufficiency Cohort.
期刊: JACC. Advances 发表日期: 2025-Aug-19 链接: PubMed
摘要
Chronic kidney disease (CKD) is a risk-enhancing factor for cardiovascular disease (CVD) and is associated with higher lipoprotein(a) (Lp[a]) levels. While aspirin may reduce Lp(a)-related prothrombotic risk, the role of primary prevention aspirin for persons with CKD and elevated Lp(a) is unclear. The aim of the study was to assess the association of aspirin use with cardiovascular, renal, and bleeding outcomes stratified by Lp(a) level among individuals with CKD without clinical CVD. There were 2,552 participants without clinical CVD in the Chronic Renal Insufficiency Cohort. Lp(a) was measured at baseline and not reported to clinicians. Aspirin use was self-reported and longitudinally assessed at each follow-up visit. Cox proportional hazards regression assessed the association of aspirin use with myocardial infarction (MI), stroke, end-stage renal disease (ESRD), and major bleeding events, stratified by Lp(a) ≥50 vs <50 mg/dL. Mean age was 55.8 years, 48% were women, 34% reported aspirin use at baseline, 27% had Lp(a) ≥50 mg/dL, and mean estimated glomerular filtration rate was 47 mL/min/1.73 m2. Over a median follow-up of 15.7 years, aspirin use was associated with a 38% lower risk of MI (HR: 0.62; 95% CI: 0.42-0.91) and a 28% lower risk of ESRD (HR: 0.72; 95% CI: 0.59-0.89) among individuals with Lp(a) ≥50 but not Lp(a) < 50 mg/dL (MI, HR: 1.38; 95% CI: 1.07-1.77; ESRD, HR: 0.98; 95% CI: 0.84-1.15). Aspirin use was not significantly associated with stroke or major bleeding in either Lp(a) group. Individuals with CKD and elevated Lp(a) without clinical CVD may derive net benefit from low-dose aspirin for the primary prevention of MI and ESRD.
43. A Scoping Review on the Ethics of Wastewater Surveillance for COVID-19.
期刊: Journal of public health management and practice : JPHMP 发表日期: 2025-Aug-19 链接: PubMed
摘要
Wastewater surveillance (WWS) emerged as a tool to monitor public health during the COVID-19 pandemic. Wastewater surveillance is generally undertaken voluntarily by public health and wastewater treatment agencies. Therefore, public trust and support is essential to its sustainability. Development and implementation of ethically informed practices may contribute to public support for expansion of WWS to other public health applications. We conducted a scoping review of existing publications on the ethics of WWS for COVID-19. We characterized these publications and identified research gaps. This scoping review was based on searches through Scopus and PubMed for the period January 2020 to December 2023 focusing on four concepts: wastewater, surveillance, ethics, and COVID-19. We included studies published in journals, reports, and books and identified 31 publications. Publications were coded thematically as well as by approach, region, discipline, and publication type. The majority of publications focused on the need to develop ethical guidelines that promote long-term public support for WWS. A number of publications proposed ethical guidelines and also emphasized that these considerations are context-specific and dynamic, requiring an ongoing system for input as new situations, endpoints, and technologies evolve. Themes included protection of privacy, potential to stigmatize communities with high COVID-19 signals, the importance of effective communication, equitable application of WWS, community engagement, and high standards for data quality. There were few empirical studies of diverse populations’ preferences for WWS. Ethical considerations may vary across communities and countries and as new applications of wastewater surveillance emerge. We provide an overview of the emerging principles for ethical practice of WWS and identify gaps in knowledge. These findings may guide future research and consideration of ethics as decisionmakers consider new monitoring endpoints (eg, pharmaceuticals, illegal drugs, infectious diseases, and indicators of population health).
44. Metal-free photoinduced ROMP-enabled electrochemical aptasensor for ultrasensitive detection of endotoxin.
期刊: Talanta 发表日期: 2025-Aug-18 链接: PubMed
摘要
Accurate diagnosis of Gram-negative bacterial infections hinges critically on endotoxin detection, with ultrasensitive quantification playing a pivotal role in clinical diagnosis, precision therapy, food safety and environmental monitoring. Herein, we pioneer an electrochemical aptasensing platform based on metal-free photoinduced ring-opening metathesis polymerization (MF photo-ROMP) for endotoxin analysis. Specifically, the aptamer is employed for selective capture of endotoxin, whose glycan chain is then modified with 4-formylphenylboronic acid via boronate affinity. This interaction enables anchoring of hundreds of 3-aminopropanol vinyl ether photoinitiators through aldehyde-amine condensation, followed by blue light (λ = 470 nm)-triggered MF photo-ROMP of cyclopentenyldiferrocene (CFc) monomers, generating polymer chains each loaded with over 1,000 electroactive probes for signal amplification. This metal-free system effectively circumvents residual ruthenium catalyst contamination inherent in conventional ROMP, aligning with green chemistry principles. The platform exhibits an ultralow detection limit (0.37 fg/mL) and a broad linear range (1.0 fg/mL to 1.0 ng/mL), coupled with simplicity, high specificity, cost-effectiveness, and exceptional interference resistance. The versatile framework that integrates “aptamer recognition, glycan-targeted modification, and MF photo-ROMP amplification” extends beyond low-abundance endotoxin analysis to ultrasensitive screening of glycoproteins and tumor biomarkers (e.g., AFP, CA19-9), highlighting significant potential for early clinical diagnosis, foodborne endotoxin screening, and environmental microbial monitoring.
45. Hierarchical flower-like Co3O4/Al2O3 as headspace solid-phase microextraction fiber coating for enrichment and detection of polychlorinated biphenyls.
期刊: Talanta 发表日期: 2025-Aug-18 链接: PubMed
摘要
Polychlorinated biphenyls (PCBs) are known to pose serious risks to human health, including carcinogenicity, neurotoxicity and endocrine disruption. Due to these hazards to human health, development of sensitive and reliable methods for analysis of PCBs attracts considerable attention. Herein, a hierarchical flower-like Co3O4/Al2O3 composite was employed as new coating material of headspace solid-phase microextraction (HS-SPME) for the first time. The Co3O4/Al2O3 composite was synthesized via thermal annealing of a cobalt-aluminum layered double hydroxide (CoAl-LDH) precursor in air. Among synthesized materials, the Co3O4/Al2O3-2 composite demonstrated exceptional thermal stability, high specific surface area, and well-defined porous structure. These properties facilitate superior enrichment performance of trace PCBs. When coupled with gas chromatography-flame ionization detection (GC-FID), the Co3O4/Al2O3-2-coated fiber achieved detection limits of 0.0003-0.001 ng mL-1 and enrichment factors of 10238-11768, which was a significant improvement over existing methods. The method exhibited a wide linear range (0.001-30 ng mL-1), spiked recoveries of 86.70-113.69 %, and relative standard deviations not exceeding 11.39 %, demonstrating exceptional adsorption performance. This work introduces an effective SPME coating while expanding the environmental monitoring applications of Co3O4/Al2O3 composites.
46. Ultrasound-assisted gram-scale synthesis of nano-tubular ag-MOF and its hybridization with yellow/green carbon quantum dots: membrane-based turn-on fluorescence recognition for procaterol.
期刊: Spectrochimica acta. Part A, Molecular and biomolecular spectroscopy 发表日期: 2025-Aug-15 链接: PubMed
摘要
Procaterol, a third-generation long-acting β₂-adrenergic receptor agonist, is widely used in asthma and chronic obstructive pulmonary disease (COPD) treatment. Rapid and sensitive detection of Procaterol is essential for both clinical monitoring and environmental surveillance. This study presents a facile and gram-scale synthesis of tubular silver-based Metal-organic framework (MOF) MONT by employing an ultrasonic-assisted green synthesis strategy (20 kHz ultrasound, 100 W power, 30 min). Meanwhile, carbon quantum dots (CQDs) that emit yellow or green fluorescence can be synthesized by the hydrothermal method and dialysis purification. These two materials were hybridized to construct an Ag-MOF/CQDs hybrid material system, and further detection systems based on MONT@Y-CDs and MONT@G-CDs were developed. In the composite system, MONT can interact with procaterol and transfers energy to CQDs, amplifying the fluorescent detection signal, which enables highly efficient procaterol detection with detection limit to 17.63 nM and detection sensitivity (2.66 × 103 M-1) superior to other materials. Moreover, mixed matrix membranes based on Ag-MOF@CQDs have been prepared. As the concentration of procaterol increases, the membrane exhibits a gradual color change from blue to cyan under UV light, offering a visual method for on-site rapid screening. This study integrates ultrasonic synthesis, gram-scale amplification and functional membrane design, addressing key issues of low synthesis efficiency, scalability difficulties, and insufficient detection visualization of MONT materials. The developed detection system, with its high sensitivity and fast response, provides an innovative solution for real-time monitoring of β₂-receptor agonists like procaterol, as well as for drug quality control and environmental pollution prevention and control.
47. Effects of anorexia nervosa on structural morphometry of the brain in adolescents and adults after weight recovery: A systematic review.
期刊: Psychiatry research. Neuroimaging 发表日期: 2025-Aug-11 链接: PubMed
摘要
To systematically review the evidence for 1) the effect of acute anorexia nervosa and weight recovery on aspects of structural morphometry of the brain, and 2) how these effects may differ between adolescents and adults. We used the PRISMA guidelines for systematic reviews. We searched online databases (Web of Knowledge, PubMed, and PsychINFO) and identified relevant studies. Eligible studies were longitudinal and included a healthy control group. Thirteen articles met the inclusion criteria. Studies often demonstrated global and regional grey matter volumes among individuals with acute anorexia nervosa compared to healthy controls, which increased following weight recovery. Grey matter volumes normalized in adolescents following weight recovery but remained smaller in recovered adults relative to their healthy controls. White matter volumes (globally and regionally) were largely unaffected by either phase of anorexia nervosa (e.g., acute and recovered). Cerebrospinal fluid (CSF) volumes were elevated in individuals with anorexia compared to healthy counterparts, but volumes normalized following weight recovery. However, the decrease in CSF volume was only found for adolescents. The structural morphometry of the brains of adults and adolescents with anorexia appears to be differentially affected by weight restoration. Future longitudinal research is needed that uses a consistent definition of recovery, and more diverse participants.
48. Barriers to Immune Checkpoint Inhibitor Access for Patients With Cancer in Southeast Asia: Challenges and Policy Implications.
期刊: JCO global oncology 发表日期: 2025-Aug 链接: PubMed
摘要
49. How Risky Pregnant Women Achieve Positive Antenatal Experience: A Cross-Sectional Study of Examination of the Sense of Coherence, Prenatal Distress, and Pregnancy Acceptance.
期刊: Journal of evaluation in clinical practice 发表日期: 2025-Aug 链接: PubMed
摘要
Antenatal care incorporating a health-promoting approach should focus on positive pregnancy experiences. This approach can bring pregnant women closer to the health dimension. To examine the effects and explanatory power of sense of coherence and prenatal distress on pregnancy acceptance among high-risk pregnancies. A descriptive cross-sectional survey was conducted between April and October 2023. The sample included 219 high-risk pregnant women who had high-risk pregnancies and were admitted to prenatal clinics at a state hospital. t-tests, ANOVA, Pearson’s correlation coefficients, and hierarchical linear multiple regression were performed using IBM SPSS software version 23.0. This study indicated that high-risk pregnant women exhibited moderate levels of sense of coherence (54.43 ± 7.49), high acceptance of pregnancy (24.53 ± 5.83), and low levels of prenatal distress (11.63 ± 4.96). The research findings showed that acceptance of pregnancy was influenced by the wanted pregnancy status (β = 0.231, p = 0.002), prenatal distress (β = 0.275, p = 0.000), and sense of coherence levels of women (β = -0.206, p = 0.001). The explanatory power of the model was 34% (F = 5.250, p = 0.000). The research revealed a strong link between the acceptance of pregnancy and factors such as the desired status of the pregnancy, prenatal stress, and a sense of coherence. These findings highlight key psychosocial predictors of pregnancy acceptance in high-risk pregnancies.
50. Feasibility of integrating human and animal disease surveillance and reporting in Rwanda: Insights from a mobile reporting pilot and veterinarians' perspectives - a multi-method study.
期刊: PLOS digital health 发表日期: 2025-Aug 链接: PubMed
摘要
The Rwandan veterinary health system lacks reliable animal disease surveillance data, hindering effective response to zoonotic diseases and other animal health events, including pathogen spillovers with pandemic potential. To address this gap, we piloted a mobile phone reporting system among veterinarians to (1) collect data on animal and human health events and (2) gather insights for future implementations, strengthening the reporting system’s operationalization. A multi-method approach was employed with 14 veterinarians equipped with smartphones. We developed a real-time reporting questionnaire synchronized with a central server and trained the veterinarians to use it during regular field visits. To evaluate the pilot, 11 in-depth interviews were conducted. Quantitative data were analyzed using descriptive statistics, while thematic analysis identified key qualitative themes. Over the study period, veterinarians submitted 1,181 reports through the mobile system, documenting 1,232 cattle disease cases. Common symptoms included inappetence (56.4%) and fever (53.3%). Suspected diseases were primarily East Coast Fever (36.8%) and anaplasmosis (17.4%), with diagnostic tests performed in only 3.6% of cases. Among 3,337 cattle owners, 354 self-reported illness, with 72.6% seeking medical attention. Mobile reporting proved feasible, improving veterinarians’ record-keeping, communication, and collaboration. Key implementation facilitators included training, financial allowances, and technical support, while challenges involved phone capacity and network coverage. Veterinarians leveraged community trust to gather human health data, describing the process as both educational and empowering, and strongly supported the system’s continued use and enhancements. This pilot highlighted the potential of mobile reporting systems to enhance veterinary practice and zoonotic disease surveillance in remote areas. Positive experiences from veterinarians underscore its feasibility, though scaling up requires investments in training, support, incentives, and addressing technological barriers. Future research should evaluate cost-effectiveness and stakeholder readiness to optimize adoption.
51. Goals and Priorities of Community Members Regarding the Federally Mandated Medicaid Sterilization Policy.
期刊: Obstetrics and gynecology 发表日期: 2025-Jun-27 链接: PubMed
摘要
To describe the opinions of community members who are potentially eligible for Medicaid insurance regarding the 30-day sterilization waiting period. This mixed-methods study consisted of 10 informed deliberation sessions with 85 Michigan residents with low income (aged 21-51 years) between April and June 2024 to explore and describe their thoughts about the waiting period and suggested revisions to the policy. The deliberation sessions included policy education, expert questions and answers, facilitator-led discussion, and a small-group exercise on potential policy options. Participants completed presurveys and postsurveys measuring knowledge and opinions about contraception and the Medicaid sterilization policy and validated scales regarding contraceptive autonomy, health care experience, and discrimination. Deliberators favored replacing the current policy with a revised policy that includes a reduced or eliminated waiting period that applies to all individuals, not solely to those with Medicaid insurance. They also recommended revising the informed consent process for clarity, accessibility, openness to discussion, and timeliness. Groups with low income who engaged in informed deliberations recommended replacing the current policy, indicating that the policy does not serve the goals of the communities most affected.
52. Maternal Human Immunodeficiency Virus and Preeclampsia Among a Combined Cohort of Zambian Women.
期刊: Obstetrics and gynecology 发表日期: 2025-Jun-12 链接: PubMed
摘要
To evaluate the association between maternal HIV infection and preeclampsia. We hypothesized that maternal HIV infection would be associated with a lower risk of preeclampsia, potentially due to HIV-related immunomodulatory effects. We combined participants from one observational cohort and two randomized trials conducted at the same facilities in Lusaka, Zambia between 2015 and 2022. The exposure of interest was maternal HIV infection, and the primary outcome was preeclampsia, defined as 1) new-onset (at or after 20 weeks of gestation) hypertension (systolic blood pressure [BP] 140 mm Hg or higher or diastolic BP 90 mm Hg or higher) with concurrent proteinuria (1+ or higher), 2) new onset proteinuria (1+ or higher) in participants with chronic hypertension in the absence of urinary tract infection, or 3) diagnosis of severe preeclampsia. We defined severe preeclampsia as 1) new-onset severe-range BP (systolic 160 mm Hg or higher or diastolic 110 mm Hg or higher), 2) eclamptic seizure, or 3) clinician-initiated preterm delivery (before 37 weeks of gestation) for preeclampsia. Using marginal standardization (parametric g-formula), we estimated the risk of preeclampsia associated with HIV infection. Antiretroviral therapy (ART) exposure and HIV disease severity (viral load, CD4 counts) were assessed as effect modifiers. Of 4,078 women included in the combined cohort, 186 (4.6%) were diagnosed with preeclampsia, including 43 (2.7%) of 1,590 women with HIV infection and 143 (5.8%) of 2,488 women without HIV infection. Of those with HIV infection, 73.2% were on prepregnancy ART, and 56.7% had an undetectable viral load at study enrollment (median 15 weeks). In analyses standardizing for maternal age, nulliparity, and calendar time of enrollment, HIV infection was associated with lower preeclampsia risk (relative risk 0.42; 95% CI, 0.26-0.59; risk difference -3.5%; 95% CI, -4.9 to -2.1). This reduced risk persisted when stratifying by prepregnancy ART exposure, detectable viral load, and CD4 count at enrollment; findings were similar when applying the more stringent definition of severe preeclampsia. In this well-phenotyped cohort, women with HIV infection were less likely to have preeclampsia compared with those without HIV infection.
53. Depression Prevalence in Adolescents and Adults: United States, August 2021-August 2023.
期刊: NCHS data brief 发表日期: 2025-Apr 链接: PubMed
摘要
This report presents the most recent depression prevalence estimates in adolescents and adults, ages 12 years and older, based on the August 2021-August 2023 National Health and Nutrition Examination Survey (NHANES). Depression symptoms are measured using the Patient Health Questionnaire. Prevalence of depression was estimated using August 2021-August 2023 NHANES data. Depression was defined by score of 10 or greater on the Patient Health Questionnaire (PHQ-9), a validated screening instrument used to assess depression symptoms in the past 2 weeks. Standard errors of percentages were estimated using Taylor series linearization. A t statistic was used to test for differences between groups. Linear and nonlinear trends were evaluated using the orthogonal polynomials. The significance level for statistical testing was p < 0.05. During August 2021-August 2023, depression prevalence was 13.1% in adolescents and adults ages 12 years and older and decreased with increasing age. Depression prevalence decreased with increasing family income overall and in males and females. From 2013-2014 to August 2021-August 2023, the prevalence of depression increased overall, and in males and females. Among adolescents and adults with depression, 87.9% reported at least some difficulty with work, home, or social activities due to their depression symptoms, and a higher percentage of females (43.0%) than males (33.2%) reported receiving therapy or counseling in the past 12 months.
54. A within-subject, double-blind, placebo-controlled randomized evaluation of the combined effects of cannabidiol and hydromorphone in a human laboratory pain model.
期刊: Pain 发表日期: 2025-Feb-28 链接: PubMed
摘要
Preclinical and epidemiological evidence supports that cannabinoids may have opioid-sparing properties and could be one strategy to decrease opioid use and associated harms like overdose and extramedical use. The objective of this within subjects, double-blind, double-dummy, randomized human laboratory trial was to examine whether cannabidiol (CBD) increases opioid analgesic effects and whether there are corresponding increases in other opioid mediated effects. Healthy participants (N = 31) attended 5 outpatient sessions where they received the following drug conditions: (1) placebo + placebo, (2) 4 mg hydromorphone + placebo, (3) 4 mg hydromorphone + 50 mg CBD, (4) 4 mg hydromorphone + 100 mg CBD, and (5) 4 mg hydromorphone + 200 mg CBD. Before and at multiple time points after drug administration, participants completed (1) quantitative sensory testing, which induced and assessed acute and chronic laboratory models of pain; (2) standard assessments, which queried acute subjective drug effects; and (3) tasks, which assessed psychomotor performance. When combined with a dose of hydromorphone that did not reliably produce analgesic effects on its own, CBD increased the analgesic effects for some laboratory acute pain outcomes but none of the laboratory chronic pain outcomes. At the highest dose of CBD (200 mg), there were concurrent increases in self-report Bad Effects and adverse effects that were not observed at lower doses of CBD (50 mg). Cannabidiol mitigated psychomotor impairment observed with hydromorphone alone. These findings suggest that lower doses of CBD (50 mg) may have utility for enhancing acute analgesic properties of opioids without having corresponding increases in bad effects.
55. Effectiveness of a multilevel intervention to improve mental health of hospital workers: The SEEGEN multicenter cluster randomized controlled trial.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Hospital workers are at high risk for stress-related mental health issues and are considered a vulnerable workforce in most Western countries. Although multilevel interventions that address individual and organizational factors show promise, there is limited robust evidence of their effectiveness in hospital settings. This study evaluated the SEEGEN trial, a cluster-randomized controlled trial conducted in the German healthcare sector, to assess the effectiveness of a structured multilevel intervention designed to reduce psychosocial stress and to promote mental well-being among hospital employees. The intervention included five modules that targeted different hierarchical levels, sources of interpersonal and structural stress, and potentially vulnerable life stages. These modules were: (i) top management training, (ii) dilemma management - coping by taking responsibility, (iii) promoting stress-preventive relational leadership competence, (iv) reconciling work and family life, and (v) staying healthy at work. The study was conducted at three clinical centers in Germany and included 18 clusters with a total of N = 415 participants. The clusters were randomly assigned to either an intervention or a wait-list control group. The primary outcome was psychological strain (Irritation Scale; IRR), and the secondary outcomes were mental well-being (WHO-5) and perceived psychosocial safety climate, (PSC-12). Intervention effects were estimated using a two-level linear analysis of covariance. Changes from baseline to the 11-month follow-up were analyzed. The intervention had no statistically significant effect on the primary or secondary outcomes. The lack of significant effects may be attributed to low participation rates, an insufficient intervention dosage, and contextual factors, such as the SARS-CoV-2 pandemic and staffing shortages in the participating hospitals. Although the intervention cannot currently be recommended for widespread implementation, the study provides valuable insights into developing, delivering, and overcoming the challenges of multilevel workplace interventions in healthcare settings.
56. The effect of telerehabilitation on activity performance and participation in daily life in children with developmental coordination disorder: A randomized controlled trial.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Developmental Coordination Disorder (DCD) is a neurodevelopmental condition that adversely impacts motor skills, sensory processing, and daily activity participation. Telerehabilitation has recently emerged as a promising method to improve therapy access and foster family involvement. This study investigated the effects of integrating telerehabilitation with sensory-based intervention on motor performance, sensory processing, and participation in children with DCD. This randomized controlled trial included 20 children aged 3-7 years with a confirmed diagnosis of DCD. Participants were randomly assigned to either a sensory-based intervention (SBI) group or a telerehabilitation sensory-based intervention (TBSI) group. Both groups received weekly face-to-face sensory-based therapy for eight weeks. Additionally, the TBSI group participated in 30-minute weekly home-based telerehabilitation sessions. Outcome measures included the Canadian Occupational Performance Measure (COPM), the Functional Independence Measure for Children (WeeFIM), and the Dunn Sensory Profile. Both groups demonstrated statistically significant improvements; however, the TBSI group showed greater gains in WeeFIM motor, cognitive, and total scores as well as COPM performance and satisfaction scores (p < 0.01). Furthermore, larger improvements and greater effect sizes were observed in the sensory processing subdomains of the TBSI group. Parental training and active participation appeared to enhance the effectiveness of the telerehabilitation program. Telerehabilitation is an effective intervention for improving motor and cognitive functions, sensory processing, and daily life participation in children with DCD. The findings support the integration of telerehabilitation into sensory-based approaches as part of a holistic model of care in occupational therapy practice. Clinicaltrials.gov NCT06977256.
57. Contemporary Evaluation of Work-Life Integration and Well-Being in US Surgical Residents: A National Mixed-Methods Study.
期刊: Journal of the American College of Surgeons 发表日期: 2024-Dec-01 链接: PubMed
摘要
The demands of surgical training present challenges for work-life integration (WLI). We sought to identify factors associated with work-life conflicts and to understand how programs support WLI. A cross-sectional national survey conducted after the 2020 American Board of Surgery In-Training Examination queried 4 WLI items. Multivariable regression models evaluated factors associated with (1) work-life conflicts and (2) well-being (career dissatisfaction, burnout, thoughts of attrition, and suicidality). Semistructured interviews conducted with faculty and residents from 15 general surgery programs were analyzed to identify strategies for supporting WLI. Of 7,233 residents (85.5% response rate), 5,133 had data available on work-life conflicts. A total of 44.3% reported completing noneducational task work at home, 37.6% were dissatisfied with time for personal life (eg hobbies), 51.6% with maintaining healthy habits (eg exercise), and 48.0% with performing routine health maintenance (eg dentist). In multivariable analysis, parents and female residents were more likely to report work-life conflicts (all p < 0.05). After adjusting for other risk factors (eg duty-hour violations and mistreatment), residents with work-life conflicts remained at increased risk for career dissatisfaction, burnout, thoughts of attrition, and suicidality (all p < 0.05). Qualitative analysis revealed interventions for supporting WLI including (1) protecting time for health maintenance (eg therapy), (2) explicitly supporting life outside of work (eg prioritizing time with family), and (3) allowing meaningful autonomy in scheduling (eg planning for major life events). Work-life conflicts are common among surgical residents and are associated with poor resident well-being. Well-designed program-level interventions have the potential to support WLI in surgical residency.
58. The Effect of Breast Cancer Risk Reduction Program Applied to Women With High Breast Cancer Risk on Participation in Screening, Health Beliefs, and Behavior: A Randomized Controlled Trial.
期刊: Cancer nursing 发表日期: 链接: PubMed
摘要
Women with a family history of breast cancer at an early age (≤50 years) have an increased risk of breast cancer themselves. To evaluate the effectiveness of a Breast Cancer Risk Reduction Program (BrCaRRP) on increasing risk reduction behaviors, developing health beliefs, and screening participation in high-risk women with a family history of breast cancer. This is a single-center, single-blind, parallel-group, randomized controlled trial. First-degree biological relatives of breast cancer patients (aged ≤50 years) were divided into intervention (n = 38) and control (n = 39) groups. The intervention (BrCaRRP) group received multiple interventions including education, counseling, case management, and surveillance via face-to-face and telephone interviews throughout a 12-week period, within the framework of the Health Belief Model and Health Promotion Model. The control group was given an information note, and the routine practice of the clinic was performed. Results were measured at baseline and at week 12 when the interventions were finished. The probability of participation in breast cancer screenings in the BrCaRRP group was 5.11 times higher. Health motivation was found to have increased in the intervention group. There was no difference in susceptibility and nutritional behavior between the groups. Health responsibility and physical activity increased in the intervention group. The frequency of consulting genetic counseling increased in the BrCaRRP group. Breast Cancer Risk Reduction Program increased participation in screening in women and positively affected their health beliefs and behaviors. Breast Cancer Risk Reduction Program could alter screening and health-promoting behaviors. However, other interventions are still needed to reduce the high level of fear.
59. Burden of laryngeal cancer attributable to occupational asbestos exposure in China: A comprehensive analysis from 1990 to 2021.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Laryngeal cancer attributable to occupational asbestos exposure remains a significant public health concern, particularly in industrialized regions. This study analyzes the burden, trends, and contributing factors of laryngeal cancer due to asbestos exposure in China from 1990 to 2021. Data were obtained from the Global Burden of Disease Study (1990-2021). We analyzed age-standardized death rates, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs). Temporal trends were assessed using joinpoint and decomposition analyses, and an age-period-cohort (APC) model was applied to examine mortality and DALY trends across different cohorts. In 2021, there were 234 deaths and 4,430 DALYs due to laryngeal cancer attributable to occupational asbestos exposure, predominantly affecting males. Mortality rates declined from 1990 to 2008, followed by a rise until 2012, and a subsequent decline. YLDs showed a consistent increase over time. APC analysis revealed higher mortality and DALY rates in older age groups and earlier birth cohorts. Decomposition analysis indicated that epidemiological changes were the largest driver of increased deaths in men, followed by population growth and aging. For DALYs, aging and population growth were key drivers, while epidemiological changes mitigated the burden. The burden of laryngeal cancer attributable to asbestos exposure has declined overall, but disability rates continue to rise, particularly among males. Effective strategies targeting prevention, early detection, and management of asbestos exposure are needed to reduce the disease burden in China.