公共卫生研究摘要 (2025-08-24)
共收录 61 篇研究文章
1. Enhancing influenza vaccination uptake: a systematic review and meta-analysis of intervention strategies.
期刊: Expert review of vaccines 发表日期: 2025-Dec 链接: PubMed
摘要
Despite extensive efforts, global influenza vaccination rates remain suboptimal, particularly among high-risk populations. We conducted a comprehensive literature search up to April 2023. Experimental studies assessing the effectiveness of interventions on influenza vaccination uptake were included, expressed as risk ratios (RR) with 95% confidence intervals (CI). Random-effects meta-analysis models were utilized for pooled estimates, with heterogeneity assessed through I2. Subgroup analyses and meta-regressions were performed. This meta-analysis includes 180 studies involving 2,390,119 participants and comprehensively evaluates the effectiveness of recipient-, provider-, health system-based, and multitarget interventions. Overall, interventions significantly increased vaccination rates, with a pooled RR of 1.26 (95% CI, 1.21 to 1.32). Notably, provider-based interventions were more effective for healthcare workers (RR = 1.56; 95% CI, 1.46 to 1.66), whereas recipient-based interventions were more efficacious for pregnant women (RR = 1.42; 95% CI, 1.09 to 1.85). Multitarget strategies were the most effective among older adults (RR = 2.10; 95% CI, 1.61 to 2.72) and population under age of 18 (RR = 1.53; 95% CI, 1.23 to 1.90). These findings provide critical insights for optimizing public health strategies, underscoring the need for innovative and tailored approaches to enhance global vaccination uptake.
2. Integrating Crime Prevention and Health Promotion Programs for School-Aged Children to Decrease Anti-Social Behaviours.
期刊: Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals 发表日期: 2025-Oct 链接: PubMed
摘要
The interaction between crime prevention and health promotion programs and their impact on crime rates and antisocial behaviours in school-aged children is a complex and multifaceted subject. This literature review examines 10 research articles to discern recurring themes, challenges, and potential synergies in addressing these intricate dynamics. It emphasises the crucial role of socioeconomic factors, mental health, and community environments in shaping the effectiveness of interventions. The intersection of crime prevention and health promotion emerges as a promising avenue for comprehensive strategies. However, challenges such as attendance rates and demographic variations underline the need for tailored approaches. The implications for policy, as well as potential directions for future research, are thoroughly discussed.
3. Situational analysis of osteoradionecrosis of the jaw management in older adults among dentists in community hospitals.
期刊: Australasian journal on ageing 发表日期: 2025-Sep 链接: PubMed
摘要
Older patients undergoing radiotherapy for head and neck cancers may develop osteoradionecrosis (ORN) of the jaw. Dentists in community hospitals serve as primary health-care providers and play a vital role in early detection and initial management for ORN in older patients. This study aimed to investigate current situations, barriers, knowledge and attitudes relating to ORN management, and to identify factors associated with adequate knowledge and positive attitudes among dentists working at community hospitals in Thailand. A cross-sectional survey was conducted among community hospital dentists in Thailand, utilising a semi-structured questionnaire addressing the current situation or barriers, knowledge and attitudes related to ORN management. Necessary support was also assessed. The Fisher’s exact test was performed to identify factors related to the development of adequate knowledge and positive attitudes towards ORN management. The level of significance was set at p < .05. One hundred and seventy dentists responded to the questionnaire (21% response rate). Notably, a high immediate referral rate to specialists upon ORN diagnosis (86%) was found. The barriers reported were mostly ageing-related. Most dentists demonstrated knowledge of ORN pathophysiology by Marx and recognised that ORN could be observed during dental procedures. Additional education about ORN showed a significant association with adequate knowledge and a positive attitude towards ORN management. Osteoradionecrosis in older patients remains challenging to manage by dentists in community hospital settings. Strengthening management requires improved emerging knowledge and confidence through ongoing training, and a national policy framework is necessary to support timely referral and coordinated care.
4. Preventing Alcohol-Related Harm: Effective Strategies and the Role of Health Professionals.
期刊: British journal of hospital medicine (London, England : 2005) 发表日期: 2025-Aug-25 链接: PubMed
摘要
Clinicians and other health and medical professionals are increasingly dealing with the harms of alcohol consumption across the UK. Briefly charting the history of consumption, attempts to regulate drinking, and alcohol’s contribution to injury and disease, this narrative review highlights that reducing overall alcohol consumption across the population is most effective in reducing alcohol-related harm. Health professionals can play a role in reducing harm across the community by advocating for effective population-level prevention policies assisting individuals in reducing alcohol-related harm. Public health measures that have been shown to have the greatest impact on alcohol consumption and related harms focus on price, marketing and accessibility, and there is evidence supporting alcohol screening, brief intervention and referral to treatment in health settings.
5. Prediction Model and Assessment of Work-Related Musculoskeletal Disorders Among Nurses in Tertiary Hospitals in China: A Cross-Sectional Study.
期刊: British journal of hospital medicine (London, England : 2005) 发表日期: 2025-Aug-25 链接: PubMed
摘要
Aims/Background Work-related musculoskeletal disorders (WMSDs) significantly impact the health and work efficiency of nurses. This study aimed to investigate factors influencing WMSD risk among nurses, including protective measures, physical activity, and biomechanical factors. Methods This cross-sectional study surveyed 3500 nurses from tertiary hospitals to assess musculoskeletal disorder risk factors, yielding 3380 valid responses. The dataset was randomly split into a training set (n = 2350) and a validation set (n = 1030). Univariate analysis and binary logistic regression were applied to develop a predictive model, which was evaluated based on its area under the curve (AUC), sensitivity, and specificity. Results Binary logistic regression analysis identified significant risk factors for WMSDs, including a higher movement and assistance of hospital patients (MAPO) Index (odds ratio (OR) = 1.579, 95% confidence interval (CI): 1.431-1.742, p < 0.001), quick exposure check (QEC) score (OR = 1.028, 95% CI: 1.021-1.034, p < 0.001), work-family interference (OR = 1.016, 95% CI: 1.008-1.023, p < 0.001), lack of protective measures (OR = 1.571, 95% CI: 1.075-2.296, p = 0.020), severe pelvic rotation (OR = 1.746, 95% CI: 1.229-2.480, p = 0.002), and older age (≥50 years, OR = 1.885, 95% CI: 1.171-3.036, p = 0.009). Conversely, higher job satisfaction was associated with a lower risk of WMSDs (OR = 0.807, 95% CI: 0.786-0.828, p < 0.001). Nurses who never exercised (OR = 1.608, 95% CI: 1.127-2.295, p = 0.009) or engaged in ≥16 hours of household labour per week (OR = 1.878, 95% CI: 1.305-2.703, p = 0.001) had an elevated WMSD risk. The nomogram model demonstrated excellent predictive performance, with an AUC of 0.822 (95% CI: 0.803-0.840, p < 0.001) in the training set and 0.810 (95% CI: 0.775-0.845, p < 0.001) in the validation set. Calibration plots and decision curve analyses confirmed its reliability and clinical applicability. Conclusion Implementing comprehensive protective measures, promoting regular physical activity, and ensuring even foot pressure distribution can significantly mitigate WMSD risk. In contrast, a higher MAPO Index, elevated QEC scores, extended household labour, and work-family interference contribute to increased susceptibility. The developed predictive model provides a valuable tool for nurse health risk screening and personalized intervention planning, supporting early identification and prevention of WMSDs among nurses in clinical settings.
6. A Scoping Review on Goals of Care Discussions in Surgery: How Are We Doing and How Can We Do Better?
期刊: World journal of surgery 发表日期: 2025-Aug-23 链接: PubMed
摘要
Discussing GOC is essential to ensuring that patients’ treatment recommendations and care plans are aligned with their preferences, priorities, and values. This review aims to characterize the existing literature on the quality, practices, and frameworks of goals of care (GOC) discussions in surgery to identify gaps and propose strategies for improvement. MEDLINE, MEDLINE In-Process/ePubs, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science, Scopus, and ClinicalTrials.Gov were searched using terms related to GOC, surgery, and best practices or education. The search strategy was run from inception to July 29, 2022. Studies regarding the quality of GOC discussions in surgery were included. The search identified 14,254 articles from which 37 were included for review. Key findings included (1) the reactive nature of GOC discussions and initiating conversations in response to acute health changes, (2) ambiguity around patient autonomy and the surgeon’s duty to prioritize surgical treatment, (3) surgeons as curators of information, and (4) tendency of surgeons to provide a set of standard treatment pathways and determine specific care decisions rather than establish understanding of patients’ long-term goals. Further research is needed to determine best practices for caregiver and next-of-kin involvement and expand the diversity of reported experiences to include patients from diverse ethnic backgrounds and genders and individuals from rural and lower-resource communities. Findings from this review have important implications for improving GOC conversations to ensure they support patient-centered care.
7. Barriers and Facilitators of Implementing Workplace Interventions Supporting Young Workers' Safety, Work Environment and Health: A Scoping Review of Qualitative and Mixed-Method Studies.
期刊: Journal of occupational rehabilitation 发表日期: 2025-Aug-23 链接: PubMed
摘要
Young workers face higher risks of workplace accidents, mental health issues, and physical strain. This scoping review aims to identify and summarize available research literature on barriers and facilitators to implementing workplace interventions to support young workers’ safety, work environment and health. We conducted a comprehensive search in bibliographic databases including PubMed, Web of Science and PsycInfo for articles published from 2007-2022. The PICO strategy guided the assessment of relevant studies and the bibliographical search for qualitative and mixed-method studies on interventions where (1) participants were young workers (mean age 15-29 years), (2) interventions were initiated and/or carried out at the workplace, and (3) barriers or facilitators to the implementation of interventions to support young workers’ safety, work environment and health were described. We employed an iterative process to identify general thematic categories in the data. In total, 11 relevant studies were identified. Seven primary themes related to facilitators and barriers emerged from our analysis. Facilitators: fit the organizational context, organizational support, balance between efforts and gains, employee motivation, and employee involvement; Barriers: high workload and time pressure, shift work and irregular working hours. There is a lack of intervention studies on young workers focusing on factors for implementation. The studies we find, reveal several factors to be aware of when designing and implementing interventions to support young workers’ safety, work environment and health. The results emphasize a need for studies evaluating factors of importance for the successful implementation of workplace-based interventions among young workers. PROSPERO CRD42022324299 ( https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022324299 ).
8. Cost-Utility Analysis of Treatment Sequences for Moderate-to-Severe Crohn's Disease.
期刊: PharmacoEconomics 发表日期: 2025-Aug-23 链接: PubMed
摘要
The clinical pathway for patients with moderate-to-severe Crohn’s disease (CD) typically includes sequential pharmacologic treatment as well as surgery, but positioning of different therapies within these sequences remains challenging. Cost-utility analysis rarely captures these sequences and does not incorporate registry data on long-term effectiveness. In this study, we aim to overcome these limitations. We developed an individual state transition model with four health states (active disease, remission, and remission due to surgery and death), five sequential treatment lines, and surgery. Efficacy data from network meta-analyses (NMA) for biologic naive and biologic exposed patients were combined with Dutch registry data to forecast long-term benefit, calculate costs, and estimate utilities. Analyses had a Dutch societal perspective with a lifetime time horizon. Costs were reported in 2023 euros and discounted with 3%. Effects were reported in quality-adjusted life years (QALYs) and discounted with 1.5%. The cost-per-QALY threshold was €20,000. Deterministic analyses for the base case, three scenarios (including recently published trials or price declines for ustekinumab), and one-way sensitivity analysis were run with 30,000 patients. The probabilistic sensitivity analysis was conducted by sampling 1000 patients in 1000 model runs. When opting for step-up sequences, the most cost-effective sequence (out of 156 sequences) starts with either azathiopurine/6-mp or methotrexate and is followed by combination therapy (infliximab + azathioprine) when patients discontinue their first line owing to disease activity or discontinuation. The most cost-effective top-down sequence (out of 72) starts with combination therapy (infliximab + azathioprine). After two lines of treatment, differences in cost-effectiveness between biologics become smaller. To be equally cost-effective as anti-tumor necrosis factor (TNF) combination therapy, a price decline for ustekinumab (biosimilars) of 81% is required or 50% to become the preferred option after combination therapy. Validation against external data suggested good predictive capabilities of the model. Integrating NMA and registry data improves the quality of cost-effectiveness models for treatment sequences in CD. This open-source model can be easily updated for future therapies and holds the potential to become a standard model for use in clinical guideline development and the economic evaluation of new drugs.
9. Identification of Growth-Related SNPs and Candidate Genes in the Genome of Zig-Zag Eel (Mastacembelus armatus) by GWAS.
期刊: Marine biotechnology (New York, N.Y.) 发表日期: 2025-Aug-23 链接: PubMed
摘要
The zig-zag eel (Mastacembelus armatus) is an economically important aquaculture species in south China. Currently, the genome-wide association study (GWAS) for growth traits of zig-zag eel was first performed. A total of 175 zig-zag eels were measured for body height (BH), body length (BL), body weight (BW), body thickness (BT), head length (HL), and total length (TL) and genotyped using whole genome resequencing. After quality control, a total of 13,844,114 high-confidence SNPs were detected uniformly across 24 chromosomes. After GWAS, a total of 2, 1, 2, 2, 1, and 2 SNPs were significantly associated with BH, BL, BW, BT, HL, and TL traits, respectively. In addition, many candidate genes surrounding these SNPs have been shown to be closely associated with growth, including ppt1, cap1, lnr, and fgfr2. In all, these results lay a good foundation for exploring the molecular basis of growth regulation and molecular marker-assisted selection.
10. Adenoid cystic carcinoma brain metastases treated with stereotactic radiosurgery: A single institution retrospective cohort study and comprehensive literature review.
期刊: Neurosurgical review 发表日期: 2025-Aug-23 链接: PubMed
摘要
Adenoid cystic carcinoma (ACC) is a malignant neoplasm arising from the minor and major salivary glands that tend to spread by perivascular and perineural routes. Brain metastases (BM) secondary to ACC are extremely rare, and the standard management strategy has not been well reported due to the rarity. Notably, no previous study has specifically examined the efficacy of stereotactic radiosurgery (SRS) for BM from ACC. We retrospectively reviewed cases of BM from ACC treated with CyberKnife (CK) SRS at our institution between 1998 and 2024. A total of 40 lesions from 5 patients were included. Tumor control was defined based on radiological response to CK SRS as a complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) per response evaluation criteria in solid tumors (RECIST) guidelines. The median Follow-up duration was 11 months (Range: 3-51 months). The median age at treatment was 52 years with a male-to-female ration of 3:2. The median maximum diameter of the lesions was 7.mm. The median prescription dose delivered was 24 Gy. The treatment responses at the first follow-up were CR/PR/SD/PD: 9/19/12/0. At the last follow-up, 5 lesions had local progression, with one lesion at 39 months, and 4 lesions at 11 months after CK SRS, while 16 lesions remained CR. The cumulative 3-months, 6-months, and 12-months local control rates were 100%, 100%, and 89%, respectively. To date, this is the largest study examining the efficacy of SRS for ACC BM. Our results showed sufficient local control following the treatment.
11. Quantitative assessment of the associations between MTR and MTRR gene polymorphisms and glioma risk.
期刊: Discover oncology 发表日期: 2025-Aug-23 链接: PubMed
摘要
Previous research on the correlation between methionine synthase (MTR) and methionine synthase reductase (MTRR) gene polymorphisms and the susceptibility to glioma has yielded varied results. This study aims to elucidate the potential impact of MTR and MTRR polymorphisms as contributing factors in the development of glioma. A comprehensive review of the relevant literature was conducted across several major databases, encompassing records from their inception through April 2025. The data were then synthesized using meta-analysis techniques. No significant associations between the MTR rs1805087 polymorphism and glioma risk were identified under any genetic model across all populations (all p > 0.05). However, we found that MTRR rs1801394 polymorphism was significantly associated with the glioma risk for Asian population (all p < 0.05). In conclusion, our study indicates that the MTRR rs1801394 polymorphism serves as a protective factor in India populations but does not affect glioma risk in Caucasian population and Chinese population, which can be used as biomarkers for predicting glioma risk and can serve as targets for personalized treatments of glioma.
12. Comparative assessment of sleep quality in glaucoma and cataract patients: the need for developing appropriate treatment methods for chronodisruption.
期刊: International ophthalmology 发表日期: 2025-Aug-23 链接: PubMed
摘要
Glaucoma and cataract are the most frequent causes of blindness worldwide with very distinct etiology and pathogenesis. Sleep disturbances have been reported in both conditions with their etiology attributed not only to the particular underlying eye condition but to other comorbid conditions such as chronic diseases and old age. This study compares sleep quality in fifty primary open-angle glaucoma patients and fifty cataract patients of similar vision loss in order to determine the comparative impact of those eye disorders in sleep quality. The glaucoma patients group was comprised of 50 patients with bilateral primary open-angle glaucoma, of moderate stage (38 men and 12 women, mean age = 62.94 years, SD = 4.99 years). The cataract patient group was comprised of 50 gender-matched cataract patients with either cortical sclerotic or posterior sclerotic types of cataracts (mean age = 62.38 years, SD = 4.62 years). All cataract patients were receiving a pre-surgery evaluation at the time of the study and had cataract involvement of both eyes that necessitated cataract surgery. All patients were administered the Pittsburgh Sleep Quality Index (PSQI), a self-administered questionnaire designed to subjectively evaluate sleep quality over the preceding month, and their findings were statistically compared. Both groups had overall poor sleep quality but the glaucoma patients had worse PSQI total scores (p = .042), higher sleep latency (p = .005) and sleep disturbance (p = .002). Those findings suggest that among patients with comparable vision loss, glaucoma patients may be even more severely affected with disordered sleep than cataract patients. There is a need for the creation and testing of treatment modalities for chronodisruption in both patient groups.
13. FANMI ("My Family"): A Randomized Trial of Community Cohort Care for Adolescent Girls and Young Women Living with HIV in Haiti.
期刊: AIDS and behavior 发表日期: 2025-Aug-23 链接: PubMed
摘要
Adolescent girls and young women (AGYW) are the epicenter of the global HIV epidemic. The FANMI trial is an unblinded randomized-controlled trial which evaluated the effectiveness of a community-based model of cohort HIV care vs. standard clinic-based care among AGYW living with HIV in Haiti. Participants ages 16-24 years were randomized 1:1 to FANMI vs. standard care. In the FANMI intervention, cohorts of 5-10 participants attended monthly sessions in a community center for integrated HIV clinical care, group counseling, and social activities led by the same provider. The primary outcome was 12-month retention, defined as any visit 9-15 months from study enrollment. Secondary outcomes included viral suppression (< 1000 copies/ml), risk behaviors, and acceptability. 120 AGYW with HIV enrolled (60 per arm) between May 2018 and January 2021. 73% (44/60) in FANMI vs. 68% (41/60) in standard care achieved 12-month retention (RR = 1.07; 95% CI 0.85-1.35). Excluding participants who never returned after enrollment, 83% (38/46) in FANMI vs. 71% (41/58) in standard care (RR = 1.17; 95% CI 0.95-1.45) achieved 12-month retention. 47% (28/60) in FANMI and 43% (26/60) in standard care achieved 12-month viral suppression (p = 0.45). FANMI participants reported high acceptability, decreased stigma, and increased social support. There was no significant difference in 12-month retention between arms. The FANMI intervention was more effective for participants who self-presented to the clinic for HIV testing compared to those tested in a community-based setting. FANMI was highly acceptable to participants and offers promise as a complementary program for AGYW with HIV in low-income settings.
14. Assessing a Syndemic of Discrimination, Material Insecurity, Depression, Substance Use, and Violence Among Sexual and Gender Minorities in Nigeria Using Mixed Methods.
期刊: AIDS and behavior 发表日期: 2025-Aug-23 链接: PubMed
摘要
Sexual and gender minority people (SGM) in Nigeria experience disproportionate HIV burden, with an HIV prevalence four to ten times higher than the national average. Better understanding the factors that create HIV vulnerability in this population is important for designing effective interventions, particularly in a context largely hostile to SGM. We assessed a conceptual model describing a syndemic of discrimination, material insecurity, depression, substance use, intimate partner violence, and police and other violence among SGM in Abuja, Nigeria. As part of a larger, longitudinal study examining noncommunicable disease outcomes within this population, we conducted a mixed methods analysis using both quantitative intake data (n=515) as well as data from three focus groups (n=36), collected from July 2023 through May 2024. We tested for intercorrelations among syndemic components, and associations between a cumulative syndemic index and HIV status using modified Poisson regression. We also conducted a convergent qualitative assessment of the conceptual model in three focus group discussions. Finally, we examined co-prevalence of syndemic components highlighted in our qualitative findings. There were consistent intercorrelations among syndemic components, supporting the presence of a syndemic. After adjustment for sociodemographic factors, every quartile-unit increase in the syndemic index was associated with an 18% increase in prevalence of HIV (aPR=1.18, 95% CI 1.07, 1.29). Additionally, our qualitative findings highlighted relationships between discrimination, material insecurity, and depression as especially relevant among this population. When using our quantitative data to examine the co-prevalence of pairs of syndemic components identified as particularly salient in our qualitative analyses, nearly every relationship was significantly stronger than expected. We found strong evidence of a syndemic of discrimination, material insecurity, depression, substance use, intimate partner violence, and police and other violence among SGM in Abuja, Nigeria as salient to the health outcomes of SGM in Nigeria. Overall, our findings highlight the presence of a multilevel syndemic that informs multilevel intervention targets. Interventions must target not simply the individual level, but also incorporate larger scale social and structural change efforts.
15. Investigation into the Classification of Cough Sounds for Early Asthma Screening.
期刊: Current allergy and asthma reports 发表日期: 2025-Aug-23 链接: PubMed
摘要
This review aims to explore an effective and scalable approach for early asthma detection using cough sounds. The main objective is to evaluate whether a multi-model deep learning fusion framework can improve diagnostic accuracy and generalizability in real-world settings. Recent research in respiratory sound analysis has demonstrated the potential of deep learning models in detecting pulmonary diseases. However, most studies focus on single-network architectures and often overlook class imbalance and training stability, which can limit model performance in practical applications. This study presents an asthma detection model that integrates ResNet18, VGG16, and DenseNet121 through a fusion layer. SMOTE is used to address data imbalance, and a weighted cross-entropy loss enhances training robustness. Mixed precision training and StepLR scheduling further improve performance. The proposed model achieved 95.9% accuracy on the test set, demonstrating strong generalization and potential for real-time, non-invasive screening in clinical environments.
16. Long-term survival of a SMARCA4-deficient undifferentiated thoracic tumor with brain metastasis successfully treated with multimodal treatment: a case report and literature review.
期刊: Journal of cancer research and clinical oncology 发表日期: 2025-Aug-23 链接: PubMed
摘要
SMARCA4-deficient undifferentiated thoracic tumor (SMARCA4-UT) is a rare and highly aggressive malignancy characterized by early distant metastasis and a poor prognosis, with a median overall survival (OS) of only 4-7 months. Traditional therapies offer limited benefit, while emerging data suggest the efficacy of combined immunotherapy, chemotherapy, and anti-angiogenic approaches. We report a case of a 52-year-old male with a heavy smoking history who presented with loss of consciousness and limb convulsions. Imaging revealed brain metastasis and a thoracic tumor. After surgical removal of the brain lesion and a lung biopsy, the patient was diagnosed with SMARCA4-UT, showing no targetable driver mutations and a programmed death-ligand 1 (PD-L1) tumor proportion score (TPS) < 1%. The patient underwent first-line treatment with tislelizumab, bevacizumab, carboplatin, and paclitaxel. Despite discontinuation of bevacizumab due to a tumor cavity, the patient achieved partial remission (PR) after six cycles. Notably, consolidative thoracic radiotherapy (TRT) was administered following systemic disease control to enhance local control. After 5 months of maintenance therapy, oligoprogression of the primary lung lesion was detected and the progression-free survival (PFS) of first-line treatment reached 14 months. The patient then performed salvage surgery for local lesion and continued with maintenance treatment. As of May 2025, the patient has survived for 31 months since the initial diagnosis. Multimodal therapy integrating chemoimmunotherapy, anti-angiogenesis, consolidative radiotherapy, and salvage surgery achieved durable survival in SMARCA4-UT with brain metastasis. It highlights the potential of combining systemic and local therapies, providing valuable insights for managing this challenging disease.
17. Breast cancer as the first primary malignancy: clinical pathological characteristics of common cancer combinations.
期刊: Discover oncology 发表日期: 2025-Aug-23 链接: PubMed
摘要
With the continuous rise in breast cancer incidence and significant improvement in patient survival, the risk of developing Multiple Primary Malignancies (MPMs) has garnered increasing attention. As the most common malignant tumor in women, breast cancer has a complex pathogenesis involving multiple factors such as genetic predisposition, treatment exposure, and interactions between hormonal pathways. These tumors are often difficult to distinguish from metastases or recurrences in clinical practice, frequently leading to delays in diagnosis and treatment, thereby affecting patient prognosis. Therefore, predicting the occurrence of second primary cancer (SPC) in cancer survivors is important in clinical diagnosis and treatment. This review synthesizes evidence from global cohorts, with an emphasis on Asian populations where relevant, to provide a narrative review of the research progress on Breast Cancer First Primary Malignancy (BCFPM). It focuses on the epidemiological characteristics, mechanisms (including the field cancerization theory and multifocal origin theory), and clinicopathological features of common cancer combinations. The aim is to identify high-risk populations for breast cancer and propose follow-up strategies, providing a scientific basis for the development of clinical prevention and intervention strategies, as well as early diagnosis and treatment.
18. Discontinuation of treatment for alcohol use disorder during pregnancy and postpartum in the United States.
期刊: Alcohol, clinical & experimental research 发表日期: 2025-Aug-23 链接: PubMed
摘要
The degree of alcohol use disorder (AUD) treatment utilization during the perinatal period is unknown. We report the prevalence of preconception receipt of medications for AUD (MAUD) and psychosocial interventions (PSY), discontinuation during pregnancy, and postpartum resumption in a multi-state sample, comparing pregnant and nonpregnant people with AUD. Using MarketScan combined commercial and Medicaid claims (2016-2019), we identified individuals with AUD who had continuous insurance coverage throughout pregnancy, classifying those with a live birth as pregnant, and compared their MAUD and PSY patterns to nonpregnant peers matched by age, insurance type, and calendar time. All individuals had ≥1 claim for: (a) AUD diagnosis and (b) MAUD or PSY in the year preceding the study. Outcomes-filled MAUD prescriptions (naltrexone, acamprosate, and disulfiram) and receipt of PSY-were identified via claims. We computed rates of MAUD and PSY receipt, stratifying by five observation windows for pregnant individuals (12-week preconception; first, second, and third trimesters; 12 weeks postpartum) and nonpregnant peers (by corresponding windows). We assessed time to treatment discontinuation using multivariable Cox regression, adjusting for sociodemographics and comorbidities. Our sample consisted of 2080 pregnant persons with AUD and 7564 matched nonpregnant AUD peers. During pregnancy, MAUD receipt declined from 12.1% (preconception) to 0.3% (third trimester) among pregnant people and from 13.5% to 8.1% in nonpregnant peers during the equivalent time period (p < 0.001). Postpartum resumption of MAUD was uncommon in the pregnant cohort (pregnant = 1.9%; nonpregnant = 7.8%, p < 0.001). PSY declined for both the pregnant and nonpregnant cohorts yet remained modestly higher in the nonpregnant cohort (postpartum 10.3% vs. 13.8%, p < 0.001). In adjusted analyses, pregnant people were more likely to discontinue MAUD than nonpregnant peers (HR = 2.11 [1.71-2.60]) yet not more likely to discontinue PSY (HR = 1.01 [0.87-1.17]). Among pregnant people with preconception AUD receiving treatment, MAUD utilization is low and discontinuation is widespread, persisting postpartum.
19. Prevalence of gastrointestinal symptoms in the UK adult population and perceived effects of foods.
期刊: European journal of nutrition 发表日期: 2025-Aug-23 链接: PubMed
摘要
Globally adults are not consuming enough fibre. One barrier to higher fibre intake may be the experience or expectation of gastrointestinal (GI) symptoms including flatulence, bloating and abdominal pain. Identifying experiences of GI symptoms and perceptions of the role foods play could inform dietary advice to increase fibre consumption. An online questionnaire explored GI symptoms in UK adults and their perceived association with individual foods (vegetables, fruit, fibre-rich products and other commonly consumed foods/drinks). Of 516 respondents (85% female, median age 38 years), 72.1% reported no existing GI conditions, yet 86% experienced GI symptoms in the past month (flatulence (72%), bloating (64%) and abdominal rumbling (58%)). The most concerning (causing anxiety or worry) symptoms were bloating (18%), heartburn (16%) and abdominal pain (13%). Among those without declared GI conditions, 71% attributed symptoms to foods/drinks, with 42% avoiding specific items, notably dairy (17%) and vegetables (13%). Food avoidance was more common in respondents with IBS (78%, P < 0.05). The most common perceptions were that beans (34%) and Brussels sprouts (23%) cause flatulence, fatty and dairy foods cause bloating (17%) and carbonated soft drinks cause belching (17%). Although flatulence was attributed to some fermentable fibre-rich foods, this symptom did not worry most respondents. The most concerning symptoms (bloating, pain and heartburn) were more commonly associated with other food categories (fatty, dairy and spicy foods). Reassurance that higher fibre intakes are unlikely to cause worrying symptoms could be important in dietary advice to increase consumption.
20. Synthetic Peptides Suppress Nervous Necrosis Virus Absorption and Improve Survival Rates in European Sea Bass.
期刊: Marine biotechnology (New York, N.Y.) 发表日期: 2025-Aug-23 链接: PubMed
摘要
With few preventive strategies available against nodavirus (NNV) in aquaculture, therapeutic applications remain underexplored. This study aimed to peptide-based treatments disrupting critical stages of its viral life cycle. Thus, we designed and synthesized seven low-molecular-weight peptides (P1-P7) based on predicted binding regions of the capsid protein from the red-spotted grouper nervous necrosis virus (RGNNV) genotype to mimic viral capsid regions. Although in silico predictions suggested limited direct antiviral activity, in vitro assays using the E-11 cell line and in vivo trials in RGNNV-infected European sea bass (Dicentrarchus labrax) juveniles yielded promising results. The peptides, particularly when co-administered individually or as P3 + P4 and P5 + P6 combinations with the virus, disrupted RGNNV attachment in vitro. Moreover, they exhibited cross-reactivity against the striped jack nervous necrosis virus (SJNNV) genotype and both RGNNV/SJNNV and SJNNV/RGNNV reassortants. Treatment of RGNNV-infected sea bass significantly increased the relative percent survival, ranging from 81.3% for P4 to 62.5% for P3 and P3 + P4, while reducing viral load within 48 h post-treatment without altering systemic antiviral immune responses, tested through the transcriptional levels of mx gene in the head-kidney. Notably, peptide P4 partially inhibited viral replication in vitro at the same time-point when cells were pre-treated for 24 h, likely through modulation of host immune responses. These findings highlight the potential of targeted peptide-based therapies as a promising antiviral therapeutic strategy against NNV infections.
21. Differences in health state valuation for small, low-risk thyroid cancer between general population and cancer survivors: a cross-sectional analysis.
期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2025-Aug-23 链接: PubMed
摘要
A low-risk cancer characterized by slow growth and excellent prognosis, papillary thyroid microcarcinoma (PTMC) is increasingly managed with less invasive alternatives to surgical resection, including active surveillance and radiofrequency ablation. To inform shared decision-making and comparative-effectiveness models, treatment preferences/quality of life quantified by health utilities must be derived for PTMC. However, there is ambiguity regarding the population from which these should be elicited. We aimed to compare health state utility estimates for PTMC as derived from general population volunteers (GenPop) and thyroid cancer survivors (TCSurv). GenPop and TCSurv completed a time trade-off task for 10 PTMC health states described by clinical vignettes. Health utilities were compared between groups with univariate and multivariable linear regression, adjusting for age, sex, and income. Subgroup analysis was performed for health states with and without treatment complications. 70 GenPop and 72 TCSurv completed the surveys. GenPop reported lower utilities relative to TCSurv for all 10 health states, with an effect size of 0.044 attributed to participant group in the multivariable analysis (p = 0.01). This observation persisted in stratified analysis by treatment complication, with effect sizes 0.047 (p = 0.04) and 0.042 (p < 0.01) for uncomplicated and complicated groups, respectively. Health utilities were lower for complicated scenarios (effect size 0.067, p < 0.001) compared to uncomplicated scenarios. For 10 low-risk thyroid cancer health states, GenPop reported significantly lower health utilities than TCSurv. Health economists and healthcare delivery scientists should be aware of these differences when integrating health utilities into comparative-effectiveness research. Small, low-risk thyroid cancers have excellent survival rates, regardless of which treatment is chosen. Options include surgical removal of the thyroid, burning and killing the cancer with a needle inserted through the skin, and leaving the cancer in place and monitoring it with imaging. Understanding preferences for these treatment options is informative both to clinicians and to health care policy researchers. To quantify these preferences, we asked thyroid cancer survivors and general public volunteers to rate the quality of life of 10 hypothetical thyroid cancer treatment scenarios. To determine this rating, we asked: if you had a certain health problem and only had 10 years left to live, how much time would you give up out of those 10 years to live the rest of your life without the health problem? We found that for all scenarios, the general public volunteers were willing to give up more time (approximately 5 months out of the 10 years) than the cancer survivors. This finding suggests the general public perceived the quality of life in these thyroid cancer treatment scenarios to be lower than the cancer survivors did. Characteristics like age, income, race, sex, education level, and health insurance type did not affect this difference between groups. Since researchers use these value assessments when comparing the cost-effectiveness of treatments for low-risk thyroid cancer, they should be aware that the assessments may differ by the population that provides them.
22. The effect of alcohol withdrawal therapy on gut microbiota in alcohol use disorder and its link to inflammation and craving.
期刊: Alcohol, clinical & experimental research 发表日期: 2025-Aug-23 链接: PubMed
摘要
Alcohol use disorder (AUD) is linked to changes in the function and composition of the human gut microbiome (GM). The GM affects inflammation by producing anti-inflammatory molecules such as short-chain fatty acids (SCFA), in particular butyrate, which are linked to appetite regulation, a mechanism involved in alcohol craving. This study investigates changes in GM composition and functional capacity to produce SCFA during alcohol withdrawal and their link to inflammation and craving. Sixty-three patients (mean age 48, SD = 12) with AUD were enrolled. We collected stool (n = 63) and blood (n = 48) during the first 48 h (timepoint A) of withdrawal therapy and between Days 10-14 (timepoint B). Microbiota were analyzed using shotgun metagenomics along with bacterial load determinations. TNF-α, IL-6, IL-8, and IL-10 were measured in plasma. Bacterial diversity (species richness, Shannon Index) did not change significantly throughout withdrawal, while overall bacterial load increased. Abundances of several taxa changed, and the overall community composition during withdrawal was approaching those of healthy controls; the potential to synthesize butyrate, a key SCFA, increased. However, it remained at lower levels compared with controls. Both diversity parameters correlated with cell concentrations and the butyrate pathway at baseline. The latter was negatively associated with IL-6 at baseline. IL-8 and IL-10 levels decreased significantly during withdrawal, as did craving, which was linked to abundance alterations of six species and IL-8. Alcohol withdrawal affected GM composition and increased concentration of the butyrate pathway along with overall bacterial load. Changes in bacterial composition and the butyrate production capacity demonstrate a shift toward healthier microbiota during withdrawal therapy. Changes in some species and IL-8 were linked to alcohol craving, replicating findings of previous studies. Our study adds new findings helping to understand the microbiome-gut-brain axis.
23. Regarding "Stoma site extraction does not increase complication rates in robot-assisted colorectal surgery": a call for nuance in patient selection, long-term scrutiny, and methodological rigor.
期刊: Journal of robotic surgery 发表日期: 2025-Aug-23 链接: PubMed
摘要
This correspondence responds to the study by Stahl et al. on stoma site extraction (SSE) in robot-assisted colorectal surgery. While we commend the authors for addressing this important technical question, we raise critical concerns regarding the study’s methodological limitations. We argue that significant selection bias, particularly confounding by indication, may have led to an underestimation of complication risks in the SSE group. Furthermore, the 1-year follow-up period is insufficient to adequately assess the incidence of late complications such as parastomal hernia, a limitation exacerbated by the reliance on symptom-driven imaging for diagnosis. The reported reduction in operative time may also be confounded by surgeon-specific factors. We conclude that while SSE is a promising technique, its long-term safety and efficiency remain unproven. We advocate for future multi-center, prospective registries with mandated long-term follow-up, standardized imaging protocols, and inclusion of patient-reported outcomes to provide definitive evidence to guide clinical practice.
24. Family history of fracture and fracture risk: a meta-analysis to update the FRAX® risk assessment tool.
期刊: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 发表日期: 2025-Aug-23 链接: PubMed
摘要
In the largest meta-analysis of international cohorts to date, a family history of fracture is confirmed as a significant BMD-independent predictor of future fracture risk. Parental and sibling histories of fracture carry the same significance for future fracture, including the impact of family hip fracture on future hip fracture risk. We have undertaken a meta-analysis of international prospective cohorts to quantify the relationship between a family history of fracture and future fracture incidence. The analysis dataset comprised 350,542 men and women from 42 cohorts in 29 countries followed for 2.8 million person-years. We investigated the relationship between family history of hip fracture or any fracture and the risk of any clinical fracture, any osteoporotic fracture, major osteoporotic fracture (MOF), and hip fracture alone using an extended Poisson model in each cohort. Models were adjusted for current age, sex, BMD, and follow-up time. As no difference in influence of family history of fracture was seen between genders, results are presented for men and women combined. A parental history of hip fracture was associated with a higher risk of incident fracture across all fracture outcome categories, with a stronger relationship with future hip fracture (hazard ratios (HR, 95% CI) for hip and MOF 1.37, 1.23-1.52 and 1.19, 1.12-1.27, respectively). Associations were slightly reduced but remained significant when additionally adjusted for BMD and did not vary by baseline offspring age, follow-up time, or parent affected. In a more limited analysis, parental history of any fracture or a sibling history of hip or any fracture showed similar associations to those observed with parental history of hip fracture. A family history of fracture is confirmed as a significant BMD-independent predictor of future fracture risk. While parental hip fracture appears the strongest factor for future hip fracture, a family history of other fractures might be appropriate for inclusion in future iterations of the FRAX tool.
25. Ensuring Competent Care Provision for Children and Adolescents With Obesity in the Primary Care Setting.
期刊: Obesity reviews : an official journal of the International Association for the Study of Obesity 发表日期: 2025-Aug-23 链接: PubMed
摘要
Using guidelines from the Obesity Medical Education Collaborative (OMEC) of the Obesity Medicine Association, we highlight competencies needed for primary care health workers to manage obesity in children and adolescents. We discuss the training, policy, advocacy, and healthcare system requirements necessary for the development and maintenance of competent pediatric obesity care provision and to continuously monitor for quality improvement. PubMed, EBSCO, Web of Science, the Harvard Library, Google, and ScienceDirect were queried from January 2019 to August 2024 using medical subject headings (MeSH) terms and keywords such as obesity, pediatric, healthcare worker, competencies, primary care, best practice with filters for age (birth to 19 years), and language (English). Pediatric health workers in primary care settings must effectively (1) diagnose and manage obesity, (2) communicate with patients to promote engagement in improving health outcomes, (3) collaborate with specialists to implement treatment and address co-morbidities, and (4) commit to lifelong training and development within the field to maintain competent care provision. International, national, and regional professional organizations committed to pediatric health as well as health information industry experts (e.g., electronic health records) can assist in ensuring competencies are integrated into clinical care through policy and infrastructure supports to improve patient outcomes. Early and accurate diagnosis of obesity is critical to preventing and treating related co-morbidities and halting disease progression. Competencies in clinical and communication skills, team dynamics, and collaborative care are required throughout the lifelong learning process for successful treatment of pediatric obesity.
26. MetALD Was a More Notable Independent Risk Factor for Reflux Esophagitis Than MASLD: A Multicenter Cohort Study Using Directed Acyclic Graphs.
期刊: Hepatology research : the official journal of the Japan Society of Hepatology 发表日期: 2025-Aug-23 链接: PubMed
摘要
Metabolic abnormalities are recognized as risk factors for reflux esophagitis. Recently, the definition of MASLD and MetALD has been proposed. However, the effect of moderate alcohol consumption on its development remains unclear. We aimed to investigate independent risk factors for reflux esophagitis, including MASLD and MetALD. The present multicenter observational cohort study enrolled 5441 consecutive health check-up examinees between 2008 and 2021. Participants were classified into the non-SLD, MASLD, or MetALD groups. Independent risk factors for reflux esophagitis were evaluated using multivariate Cox regression analysis. Directed acyclic graphs were constructed to identify direct risk factors for reflux esophagitis. Age, male sex, and hiatus hernia were independent risk factors for reflux esophagitis. MASLD (HR 1.1534, 95% CI 1.0069-1.3213, p = 0.0395) and MetALD (HR 1.9026, 95% CI 1.3554-2.6707, p = 0.0002) were also identified as independent risk factors compared to non-SLD. Furthermore, the MetALD group showed a significantly higher risk than the MASLD group (HR 1.6495, 95% CI 1.1668-2.3319, p = 0.0046). The cumulative incidence in the MetALD group was significantly higher than in the MASLD group (85.1/1000 vs. 55.8/1000 person-years, p = 0.0111). Directed acyclic graphs revealed that moderate alcohol consumption was identified as a direct risk factor for reflux esophagitis. MASLD and MetALD were independent risk factors for reflux esophagitis. Patients with MetALD had a higher risk than patients with MASLD. Furthermore, moderate alcohol consumption was a direct risk factor for reflux esophagitis in patients with SLD. These findings highlight the importance of both MASLD and moderate alcohol consumption in the pathogenesis of reflux esophagitis.
27. Features of sarcopenic obesity in rheumatoid arthritis patients.
期刊: Geriatrics & gerontology international 发表日期: 2025-Aug-23 链接: PubMed
摘要
The present study aimed to determine the proportion of rheumatoid arthritis (RA) patients with sarcopenic obesity and to identify associated factors through assessments of physical function and patient-reported outcomes (PROs). A prospective cohort study of 321 RA patients aged 40-79 years was conducted. Participants were classified into four groups-Normal, Obesity, Sarcopenia, and Sarcopenic obesity-based on sarcopenia criteria, which included skeletal muscle mass index, grip strength, and physical function, as well as obesity criteria defined by body fat percentage. Baseline characteristics were analyzed, including evaluations of physical function, such as the Timed Up and Go (TUG) test, as well as PROs, such as the Health Assessment Questionnaire - Disability Index (HAQ-DI). Sarcopenia was found in 19.6% of participants. Proportions of participants by group were as follows: Normal, 28.7%; Obesity, 51.7%; Sarcopenia, 11.2%; and Sarcopenic obesity, 8.4%. The median disease activity score suggested that remission was achieved in all groups. The TUG and HAQ-DI scores were highest in the Sarcopenic obesity group, showing a significant difference compared with all other groups. Other physical function assessments and PROs were also worse in the Sarcopenic obesity group compared with all other groups. The proportion of sarcopenic obesity in the present study population of well-controlled RA patients was 8.4%. The Sarcopenic obesity group had significantly higher scores in TUG and HAQ-DI compared with all other groups. We observed not only reduced physical function but also a notable decline in quality of life, as evaluated by PROs, in patients with sarcopenic obesity. Geriatr Gerontol Int 2025; ••: ••-••.
28. Electron Transfer-Tailored D-Band Center to Boost Nanozyme Catalysis for Interpretable Machine Learning-Empowered Intelligent Biosensing.
期刊: Advanced science (Weinheim, Baden-Wurttemberg, Germany) 发表日期: 2025-Aug-23 链接: PubMed
摘要
The escalating global burden of infectious diseases demands biosensing technologies that transcend the complexity-sensitivity-accuracy trade-off in real-world applications. Herein, an interpretable machine learning-empowered multimodal biosensor synergizing electron transfer-enhanced nanozymes and aggregation-induced emission luminogens (AIEgens) for ultrasensitive pathogen detection is presented. By engineering aminophenol formaldehyde resin nanobowls anchored with monodisperse Pt nanoparticles, interfacial electron transfer (N→Pt→O) induces an upshift of Pt d-band center relative to the Fermi level, as validated by density functional theory. This electronic modulation optimizes H2O2 adsorption energy, lowers the energy barrier of the rate-determining step, and reduces activation energy, resulting in a 3.4-fold enhancement in peroxidase-like activity over conventional Pt nanozymes. Then, AIEgens are strategically integrated to generate cross-validated anti-interference signals, achieving a record-low detection limit for Salmonella typhimurium, surpassing classical immunoassays in sensitivity and accuracy. A SHapley Additive exPlanations (SHAP)-guided eXtreme Gradient Boosting (XGBoost) algorithm dynamically fuses multimodal signals, enhancing sensitivity by five fold over single-mode detection and delivering 100% diagnostic accuracy for positive samples. SHAP further deciphers the synergetic mechanism, revealing concentration-dependent signal contributions and validating decision logic. This work pioneers a nanozyme-AI co-design framework, bridging d-band-driven catalytic precision and machine learning-powered signal intelligence to redefine biosensing paradigms for combating public health emergencies.
29. The Regulatory Effect of Physical Activity on Perceived Fatigue from Digital Technology Use in Schools.
期刊: Health education & behavior : the official publication of the Society for Public Health Education 发表日期: 2025-Aug-23 链接: PubMed
摘要
The increased use of digital technologies in educational settings has raised concerns about their impact on students’ physical and mental well-being, particularly regarding perceived fatigue. This study explores the extent to which physical activity can regulate perceived fatigue associated with digital technology use among middle school students. Using an explanatory mixed-methods design, the study was conducted with 108 sixth-grade students (ages 11-12) who were assigned to exercise, nonexercise, and control groups. A quasi-experimental pretest-posttest control group design was applied in the quantitative dimension, and the Fatigue Severity Scale (FSS) was used to assess fatigue levels before and after the use of different digital devices (computer, smartphone, tablet PC). A 3 × 2 split-plot repeated-measures analysis of variance (ANOVA) revealed a statistically significant decrease in perceived fatigue levels among students who performed stretching exercises following digital device use, while fatigue levels increased in the nonexercising group. Qualitative data from the exercising group indicated that students found the exercises enjoyable, health-promoting, and expressed a willingness to integrate them into their daily routines. This study contributes to the literature by demonstrating that simple, school-based physical activity interventions can effectively mitigate the negative physiological and psychological effects of technology use in educational contexts. The findings emphasize the need to incorporate structured physical activity, such as short classroom-based stretching exercises, into daily school routines. This approach may promote student well-being and academic engagement in increasingly digital learning environments and has direct implications for updating health promotion policies and behavior-focused interventions in schools.
30. Novel Humanized Mouse Model for Steroid-Resistant Asthma.
期刊: Allergy 发表日期: 2025-Aug-23 链接: PubMed
摘要
31. Association of urinary LIF levels with disease prognosis and treatment response to methylprednisolone in IgA nephropathy.
期刊: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 发表日期: 2025-Aug-23 链接: PubMed
摘要
Leukemia inhibitory factor (LIF) has been implicated in the production of galactose-deficient IgA1 and development of renal fibrosis, and has emerged in several genome-wide association studies (GWAS) studies as a hotspot gene of IgAN. Therefore, we hypothesis that urinary LIF could predict the renal prognosis and/or treatment response to immunosuppressive therapy in IgAN patients. A prognostic study was conducted in a retrospective cohort of 506 biopsy-confirmed IgAN patients. Baseline urinary LIF concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Kidney disease progression was defined as a 40% decline in eGFR, progression to end-stage kidney disease, or death due to kidney disease. Additionally, a sub-cohort derived from the TESTING trial was used to investigate the association between changes in urinary LIF and the response to methylprednisolone therapy in IgAN patients. Over a median of 35 months of follow-up, 16.6% participants of the prognostic cohort reached the composite kidney progression event. After adjusting for sex, age, eGFR, proteinuria and SBP, elevated levels of urinary LIF/urinary creatinine (uLIF/Cr) were independently associated with an increased risk of kidney progression (per natural log [uLIF/Cr] increment: HR, 2.16; 1.13-4.13; P for trend 0.019). In TESTING sub-cohort, the methylprednisolone group showed a significant greater reduction in uLIF/Cr than the placebo group (41.9% vs. 25.4% at 6th month, P = 0.039; 59.2% vs. 19.8% at 12th month, P < 0.001). The LIF decline group exhibited a significant lower risk of kidney progression compared to LIF non-decline group (adjusted HR 0.431; 0.255-0.730; P for trend 0.002). This study provides strong initial evidence that uLIF/Cr levels are linked to renal prognosis in IgAN. Moreover, reductions in uLIF/Cr may indicate improved outcomes in patients receiving methylprednisolone. Collectively, our findings suggest uLIF/Cr levels may serve as a valuable biomarker for predicting both renal prognosis and treatment response in IgAN patients.
32. Sickle cell retinopathy in pediatric patients: exploring correlations and predictive factors.
期刊: Graefe’s archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie 发表日期: 2025-Aug-23 链接: PubMed
摘要
To analyze clinical, laboratory, and Doppler vascular parameters in pediatric sickle cell disease (SCD) patients and identify correlations and predictive factors for sickle cell retinopathy (SCR) and proliferative SCR (PSR). A retrospective study included pediatric SCD patients screened for SCR between December 2023 and August 2024. Systemic, transcranial-cervical Doppler, and ophthalmologic evaluations were performed. Correlation analyses explored relationships between clinical, laboratory, and ophthalmologic parameters and SCR. Logistic regression identified predictive factors for SCR and PSR. We included 172 eyes from 86 pediatric SCD patients (mean age: 11.1 years; 57% male). SCR was diagnosed in 20 patients (23.3%), including 15 with non-proliferative (NPSR) and 5 with PSR. SCR correlated significantly with higher vaso-occlusive crises (VOC) frequency (ρ = 0.379, p < 0.001), lower fetal hemoglobin (HbF) (ρ = -0.363, p = 0.001), older age (r = 0.295, p = 0.006), and glucose-6-phosphate dehydrogenase (G6PD) deficiency (ρ = 0.428, p < 0.001). Doppler evaluations showed reduced velocities associated with SCR (p < 0.05). Logistic regression identified G6PD deficiency (OR = 8.34, p = 0.014), increased VOC (OR = 2.22, p = 0.011), older age (OR = 1.26, p = 0.04), and lower HbF (OR = 0.89, p = 0.047) as predictors of SCR. An age cut-off of 11.5 years yielded 65% sensitivity and 64% specificity. For PSR, significant correlations included SC genotype (r = 0.728, p < 0.001) and higher hemoglobin (Hb) (r = 0.518, p = 0.019). Lower hydroxyurea doses were linked to PSR (r = -0.548, p = 0.012). Hb levels predicted PSR, with a 9.2 g/dL cut-off (80% sensitivity, 86% specificity). Early detection of SCR is crucial in pediatric SCD patients. Key risk factors include older age (cut-off 11.5 years), higher VOC frequency, G6PD deficiency, and lower HbF for SCR, and SC genotype, reduced hydroxyurea doses, and higher Hb (cut-off 9.2 g/dL) for PSR. Regular ophthalmologic screening and targeted management may help prevent vision loss and improve clinical outcomes.
33. Increased expression of OX40 on peripheral CD4+/CD8+ memory T lymphocytes in the pathogenesis of type 1 diabetes.
期刊: Acta diabetologica 发表日期: 2025-Aug-23 链接: PubMed
摘要
Autoreactive memory T cells are considered to be a primary contributor to chronic islet inflammation in individuals with type 1 diabetes (T1D). OX40-expressing T cells not only facilitate and sustain the presence of CD4+ memory T cells but also promote the generation of CD8+ memory T cells. We aimed to investigate the role of OX40+CD4+/CD8+ memory T lymphocytes in the pathogenesis of T1D. A total of 35 patients diagnosed with Type 1 diabetes and 40 healthy control individuals were enrolled in this study. Peripheral Blood Mononuclear Cells (PBMCs) were isolated from the study participants and analyzed by flow cytometry. Inflammatory cytokines in the plasma were quantitatively measured. The pancreatic islet autoantibodies as well as islet function were also evaluated. The frequencies and the mean fluorescence intensity (MFI) of OX40 on CD4+ effector memory T (Tem) cells significantly increased in patients with T1D compared to healthy controls. Importantly, the expression of OX40 on CD8+ Tem and central memory T (Tcm) cells was also significantly higher in T1D compared with healthy controls. However, the expression of OX40 on CD4+ Tem cells was not significantly higher in T1D with two or more autoantibodies than control group. Furthermore, the frequencies of OX40+CD8+ Tem cells significantly increased in T1D patients with two or more autoantibodies but not in those with one autoantibody, compared with control groups. Meanwhile, the frequencies of OX40+CD8+ Tcm cells were consistently higher across all three subgroups of T1D patients (AAb-, 1AAb, ≥2AAb) compared to the control group. Notably, both the frequencies of OX40+CD4+ and OX40+CD8+ Tem cells exhibited significant negative correlations with the serum C-peptide levels in T1D patients. Additionally, the expression levels of OX40 on peripheral CD4+/CD8+ memory T cells were positively correlated with the levels of plasma inflammatory cytokines in patients with T1D. The elevated expression of OX40 on CD4+/CD8+ memory T cells was associated with the autoimmune-mediated destruction of islet beta cells in T1D. Our findings indicate that the expression levels of OX40 on peripheral CD4+ and CD8+ memory T lymphocytes may serve as potential predictive biomarkers for the severity of T1D. Additionally, OX40 expression on memory T cells may serve as a potential biomarker for assessing the efficacy of immunotherapy in T1D patients.
34. Impact of a Care Bundle on Surgical Site Infections and Patient Comfort in Bariatric Surgery: A Randomized Prospective Study.
期刊: Obesity surgery 发表日期: 2025-Aug-23 链接: PubMed
摘要
This study evaluated the impact of an evidence-based care bundle on surgical site infection (SSI) rates and patient comfort in bariatric surgery. This randomized controlled trial (RCT) with a control group enrolled patients who underwent sleeve gastrectomy at a private hospital in Kayseri, Turkey between June 2023 and September 2023. A total of 93 patients were enrolled, 46 in the experimental group and 47 in the control group. The experimental group implemented the SSI prevention care bundle, while the control group received standard care. Data were collected in three phases: (1) preoperatively, (2) postoperatively until discharge, and (3) on day 30 postoperatively, with the final phase conducted by telephone. Comfort was measured within the first 8 h after surgery. Physiological parameters were assessed at all time points, and biochemical outcomes were monitored pre- and postoperatively. The study demonstrated a reduction in the superficial SSI rate from 7.52% in the control group to 2.15% in the intervention group (p = 0.074). The results suggest a marginally significant trend toward reduced SSIs in the intervention group. The intervention group showed a slightly higher comfort score. Identified risk factors for SSI included smoking, alcohol use, drainage, low preoperative hemoglobin, total bilirubin > 1, and type 2 diabetes mellitus. Among hyperglycemic patients, SSI occurred in 4 out of 18 patients in the control group, whereas normoglycemia was achieved in 12 hyperglycemic patients in the intervention group, with no cases of SSI observed (p > 0.05). SSI bundle implementation lowered infection rates and improved comfort. This article followed the CONSORT 2010 checklist guidelines for reporting randomized controlled trials. The trial has been registered on ClinicalTrials.gov (NCT05930639).
35. Association Between ABCG2 Polymorphism and Statin-Induced Adverse Events: A Meta-Analysis.
期刊: Cardiovascular toxicology 发表日期: 2025-Aug-23 链接: PubMed
摘要
Statins, widely used for preventing cardiovascular diseases due to their cholesterol-lowering effects, are associated with potential adverse reactions in some individuals, underscoring the need to understand the factors contributing to statin-related complications. The ATP-binding cassette subfamily G member 2 (ABCG2) gene, which encodes a multidrug transporter, has garnered attention due to its involvement in statin metabolism. Specifically, the rs2231142 polymorphism within ABCG2 has been implicated in altered drug metabolism and pharmacokinetics, potentially influencing statin-related toxicity. Despite previous investigations, findings regarding this association remain inconclusive. Thus, this systematic review and meta-analysis aimed to clarify the correlation between the rs2231142 polymorphism and statin-induced toxicity. Through a comprehensive literature search, seven eligible studies were identified and subjected to rigorous data extraction and quality assessment. Meta-analysis revealed a significant association between the rs2231142 polymorphism and an increased risk of overall statin-induced toxicity, including muscular and hepatic toxicity, with odds ratios of 2.6 and 2.7, respectively. These findings suggest a potential role for ABCG2 polymorphisms in statin-related adverse events and emphasize the importance of personalized treatment strategies in managing statin therapy.
36. Bloody diarrhea, STEC infection, and HUS in the molecular microbiology era.
期刊: Pediatric nephrology (Berlin, Germany) 发表日期: 2025-Aug-23 链接: PubMed
摘要
Hemolytic uremic syndrome (HUS) associated with Shiga toxin-producing Escherichia coli (STEC) infection remains a major individual and public health challenge throughout the world causing substantial personal, social, and economic burdens. In Western countries, bloody diarrhea (BD) in children is related to STEC infection in at least 6% of cases (rising to 15-20% in summer). This infection may turn into STEC-HUS in about 15% of patients. The widespread use of molecular microbiology leads to the diagnosis of STEC infection before the onset of HUS in an increasing number of patients. The anticipation of the diagnosis creates a window of preventive and/or therapeutic opportunities that include rehydration of dehydrated patients and/or volume expansion that have both proven to mitigate the severity of HUS. Traditionally, antibiotics are not recommended in STEC infections, but recent data suggest a promising potential preventive role for bacteriostatic agents (e.g., azithromycin), if they are given early in the course of the infection. It is recommended to test all children with BD for Shiga toxin (Stx) encoding genes, actively infuse Stx-positive patients with isotonic crystalloid solutions and carefully monitor them with urine dipstick for hemoglobinuria to early identify those who might eventually develop HUS. The suggested approach will increase the detection of STEC-infected patients thus enhancing our knowledge of the mechanisms of disease spreading. The early diagnosis of STEC infection combined with the mentioned therapeutic opportunities will hopefully decrease the number of children suffering from HUS, its case fatality rate and/or improve its short- and long-term outcomes.
37. Comparative study of liposomal amphotericin B, posaconazole, and micafungin for primary antifungal prophylaxis in pediatric patients with acute leukemia.
期刊: Journal of cancer research and clinical oncology 发表日期: 2025-Aug-23 链接: PubMed
摘要
Invasive fungal diseases (IFDs) are a significant cause of morbidity and mortality in pediatric patients with hematologic malignancies including acute leukemia. Our study aimed to compare the efficacy of liposomal amphotericin B (L-AMB), posaconazole or micafungin as primary antifungal prophylaxis (PAP) in pediatric patients with acute leukemia. This retrospective observational study enrolled 95 pediatric patients with acute lymphoblastic leukemia (n = 70) or acute myeloid leukemia (n = 25), undergoing chemotherapy, including those undergoing allogeneic hematopoietic stem cell transplantation at the Department of Pediatrics, Jena University Hospital, Jena, Germany. PAP regimens included L-AMB (1 mg/kg/day or 3 mg/kg twice weekly, intravenously), posaconazole (100-300 mg/day, according to blood concentration, orally or intravenously) and micafungin (1 mg/kg/day or 3 mg/kg twice weekly, intravenously). Thirty-four patients (35.8%) received L-AMB, 37 patients (38.9%) received posaconazole, and 24 patients (25.3%) received micafungin. Patients with a history of IFD or concurrent or changing PAP were excluded. The primary endpoint was the occurrence of breakthrough IFD, while secondary endpoint included IFD-free survival. Statistical analyses were performed using Kaplan-Meier survival analysis, Gray’s test and Cox regression to evaluate IFD-free survival. The overall incidence of IFD was 14.7% (14 of 95 patients). IFD developed in 10 of 33 patients (29.4%) receiving L-AMB, in 4 of 38 (10.8%) patients receiving posaconazole and in none of the patients receiving micafungin. IFD-free survival was 70.6% in the L-AMB group, 89.2% in the posaconazole group and 100% in the micafungin group (p = 0.005, log-rank test). Significant differences were also observed in the cumulative incidences of breakthrough IFDs (p = 0.006) assessed by Gray’s test. In multivariate Cox analysis, dichotomized prophylaxis regimes (posaconazole or micafungin vs. L-AMB) were independently associated with a reduced risk of IFD (HR = 0.244; 95% CI 0.076-0.777; p = 0.017). Age ≥ 10 years predicted inferior IFD-free survival (HR = 3.665; 95% CI 1.224-10.980; p = 0.020). We found a significant difference in efficacy between the three antifungal prophylaxis regimens. In our study, micafungin achieved the lowest IFD breakthrough rate. However, multicenter clinical studies would be needed to confirm the results.
38. Exposure of zebrafish larvae to bisphenol A, bisphenol S, di-(2-ethylhexyl) phthalate, and di-(2-ethylhexyl) adipate induces oxidative stress, resulting in hepatotoxicity and disruption in lipid metabolism.
期刊: Ecotoxicology (London, England) 发表日期: 2025-Aug-23 链接: PubMed
摘要
Bisphenol A (BPA), bisphenol S (BPS), di-(2-ethylhexyl) phthalate (DEHP), and di-(2-ethylhexyl) adipate (DEHA) are commonly used in plastic materials. Liver and lipid metabolism have been identified as being affected by these compounds but are primarily limited to rodents. In this study, hepatotoxicity and disruption in lipid metabolism of BPA, BPS, DEHP, and DEHA were assessed using zebrafish larvae as a model. After 96 h of exposure to BPA (0.13 ~ 1314 nM), BPS (0.11 ~ 1198 nM), DEHP (0.07 ~ 768 nM), and DEHA (0.08 ~ 809 nM) of test chemicals in water, zebrafish embryos were assessed for survival, growth, activities of liver enzymes including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP), triglyceride (TG) level, reactive oxidative stress (ROS), and transcription of genes related to peroxisome proliferator-activated receptor (PPAR), endoplasmic reticulum stress, and antioxidant enzymes. Growth retardation and significant increase in ALT and AST were observed in zebrafish larvae exposed to BPA, BPS, DEHP, and DEHA. Exposure to the test chemicals significantly increased ROS and the expression of chop, xbp1, eif2a, sod1, cat, and gpx1a genes. Pretreatment with N-acetylcysteine, one of the representative antioxidants, alleviated ALT and TG induced by the tested chemicals. Our results showed that BPA, DEHP and their substituted compounds caused oxidative stress and adversely affected the liver and lipid metabolism in zebrafish, leading to growth retardation. The results may provide new insights into the risk management of bisphenols and phthalates alternatives to aquatic organisms.
39. Natural radionuclides and oil products in river sediments and assessment of their impact on health in areas of intensive oil production (Timan-Pechora province of North-West Russia).
期刊: Environmental geochemistry and health 发表日期: 2025-Aug-23 链接: PubMed
摘要
The present article is devoted to the study of the distribution of natural radionuclides (238U, 234U, 226Ra, 228Ra, 40 K, 210Pb) and oil products in river bottom sediments of the Pechora basin of the Timan-Pechora oil and gas province (north-west Russia). In addition, an analysis of radiological hazard indices for human health is also provided. The region’s distinctive geology is characterised by a high concentration of oil and gas fields, the development of which has been linked to environmental concerns, including pollution. To date, the onshore part of the province has seen the discovery of over 268 hydrocarbon fields, of which more than 200 are oil fields. It is evident that the Kolva River (Komi Republic) is one of the most polluted rivers in the province. In order to identify the sources and regularities of radionuclide accumulation in bottom sediments, the total alpha- and beta-radiation activities, the content of organic matter and carbonates, as well as the granulometric composition of sediments were additionally evaluated. The study revealed that the highest activities of natural radionuclides are observed in the bottom sediments of the Kolva River. The activity of 226Ra in the bottom sediments of the Kolva River at certain points has been found to reach 89.0 ± 7.1 Bq kg-1. This is generally higher than the activity levels recorded in the bottom sediments of rivers in North-West Russia. Correlation analysis and calculation of 226Ra/228Ra and 226Ra/210Pb isotope ratios demonstrated that relatively high values of 226Ra activity in the bottom sediments of the Kolva River can be associated with oil and gas activity in the region. The following factors are of particular significance in this regard: the low (at the background level) uranium isotope content in bottom sediments, the increased content of oil products (up to 101.2 mg kg-1), and the very close correlation of 226Ra with the content of oil products in bottom sediments (R = 0.74). It is important to note that the elevated 226Ra activities detected in the sediments of the Kolva River may have a significant impact on the radioactive composition of the sediments of the Pechora River. Slightly elevated 226Ra activities have been detected in some samples from the Pechora River when compared to clark values and other rivers in the region. The identification of zones exhibiting elevated concentrations of natural radionuclides in the bottom sediments of the Pechora basin has informed an assessment of their radiation safety parameters, with particular regard to their potential impact on human health. The findings of the study indicated that the radioecological situation within the Pechora basin remains stable and at a safe level at present. However, the authors note the necessity of periodic radioecological monitoring on the territory of the Timan-Pechora province for the timely detection of contamination of environmental objects with natural radionuclides.
40. The Cost of Suffering: Providing Workplace Support for Individuals With Chronic Pain.
期刊: Workplace health & safety 发表日期: 2025-Aug-23 链接: PubMed
摘要
This article addresses the significant impact of chronic pain on the workplace, highlighting the substantial economic and human costs. According to a National Health Interview Survey, nearly a quarter of U.S. adults live with chronic pain, with a considerable percentage experiencing limitations in daily life and work. The article discusses how chronic pain negatively affects both employees and employers and argues that occupational and environmental health nurses play a crucial role in the development of a multi-faceted workplace support plan. Key strategies include fostering a safe and open environment, evaluating and implementing effective workplace accommodations, and creating tailored employee wellness programs. The article emphasizes the importance of education and awareness to reduce stigma and encourage open communication among colleagues. It concludes by highlighting valuable resources, such as the American Chronic Pain Association and the U.S. Pain Foundation, and the use of chronic pain mobile apps to provide individuals with the tools and support needed to manage their condition. The overarching goal is to create a supportive and understanding workplace that benefits both employees and employers.
41. Remote spatial memory deficits in mouse models of neuropsychiatric disorders with immature dentate gyrus phenotype.
期刊: The international journal of neuropsychopharmacology 发表日期: 2025-Aug-23 链接: PubMed
摘要
The hippocampal dentate gyrus (DG) is a critical region that contributes to recent and remote memory. Granule cells within this region, in which adult neurogenesis occurs, undergo dynamic and reversible maturation via genetic and environmental factors during adulthood. A pseudo-immature state of DG granule cells, called immature DG (iDG), has been observed in the adult mice of certain mutant strains, which are considered animal models of neuropsychiatric and neurodegenerative disorders, such as intellectual disability, schizophrenia, autism, and Alzheimer’s disease. However, the association between the iDG phenotype and recent and remote memories in the mouse models remains unclear. We assessed spatial memory in the Barnes circular maze task in five mutant mouse models of the disorders with the iDG phenotype, including Camk2a heterozygous knockout (HET KO), forebrain-specific Calcineurin conditional KO (cKO), Neurogranin KO, and Hivep2 (Schnurri-2) KO, and hAPP-J20 transgenic mice. Camk2a HET KO mice and J20 mice spent less time around the target than their wild-type control mice in the memory retention tests one day and four weeks after the last training session. Calcineurin cKO, Neurogranin KO, and Schnurri-2 KO mice showed no significant differences in the time spent around the target from wild-type mice in the retention test 1 day after the training session, but those mutants spent less time around the target than their wild-type mice in the retest conducted four weeks later. These results indicated that mouse models of neuropsychiatric and neurodegenerative disorders exhibiting the iDG phenotype demonstrate a common behavioral characteristic of remote spatial memory deficits, suggesting the potential involvement of the pseudo-immature state of DG granule cells in remote memory dysfunction.
42. Ex situ reared black-footed ferrets exhibit altered sperm DNA methylation.
期刊: The Journal of heredity 发表日期: 2025-Aug-23 链接: PubMed
摘要
Many endangered species rely on ex situ management for survival when external threats exist on the landscape. Yet ex situ settings pose challenges through space limitation, altered environment, and diet. This can lead to environmentally-determined inbreeding depression, where ex situ animals exhibit reduced reproductive fitness compared to their in situ counterparts, despite originating from the same genetic stock. We investigated epigenetic differences as a potential mechanism underlying environmentally-determined inbreeding depression in black-footed ferrets (Mustela nigripes), an North American endemic species reliant on ex situ conservation. More specifically, we explored how environmental context may influence sperm DNA methylation in samples collected from 12 ex situ and 5 in situ males. Average sperm DNA methylation was significantly higher in ex situ individuals. We additionally identified >500 differentially methylated regions between ex situ and in situ sperm samples that were enriched for gene ontology terms pertaining to reproduction and development. Putative genes of interest included NPR2, WEE2, SLC15A1, PDE10A, PIP5K1B, CACNA1E, and CACNA1A, all of which have previously been linked to spermatogenesis, sperm motility, or fertilization in mammals. Results suggest that environmental conditions may alter sperm DNA methylation in black-footed ferrets, with possible links to decreased reproductive success in ex situ settings. These findings provide valuable insights to the molecular mechanisms underlying environmentally-determined inbreeding depression in black-footed ferrets and other conservation-reliant species, and can serve as a foundation for future research on improving reproductive health in endangered wildlife.
43. Colchicine and the risk of major adverse cardiovascular events in patients with gout and Type 2 diabetes: A nationwide cohort study.
期刊: Journal of internal medicine 发表日期: 2025-Aug-23 链接: PubMed
摘要
Type 2 diabetes mellitus (T2DM) and gout are associated with an increased risk of cardiovascular events. Despite the approval for the secondary prevention of cardiovascular diseases by the United States Food and Drug Administration in 2023, evidence regarding the effectiveness of colchicine among T2DM population remains limited. We aimed to evaluate the association between the use of colchicine and the risk of major adverse cardiovascular events (MACE) among patients with gout and T2DM. We conducted a nationwide, population-based cohort study with active comparator, new-user design using nationwide claims data of South Korea (2010-2022). Patients with T2DM and gout who initiated colchicine or non-steroidal anti-inflammatory drugs (NSAIDs) from 2011 to 2022 were included. The primary outcome was MACE (myocardial infarction, ischemic stroke, and cardiovascular death). Secondary outcomes were each individual components of primary outcome and hospitalization due to heart failure. As-treated approach with 30-day grace period was applied. Before propensity score (PS) matching, 13,019 colchicine users and 111,594 NSAIDs users were included in the study cohort (mean age, 65.5 vs. 62.9; 35.0% vs. 29.8% female). After 1:2 PS matching, 12,908 colchicine users and 25,816 NSAIDs users remained (mean age, 65.7 vs. 65.7 years; 35.2% vs. 35.1% female). The PS-matched hazard ratio for MACE was 0.94 (95% confidence interval 0.65-1.36), and all secondary outcomes also resulted in null findings. Use of colchicine does not significantly reduce the risk of MACE compared with NSAIDs in a real-world population with T2DM and gout in South Korea between 2011 and 2022.
44. The Impact of Lunar Phases During Day and Night Cycles on Perinatal Outcomes: A Nationwide Cohort Study.
期刊: Birth (Berkeley, Calif.) 发表日期: 2025-Aug-23 链接: PubMed
摘要
Light changes during the lunar cycle affect rhythms in diverse species. Human studies focusing on whether the moon influences human health have so far neglected the effects of light/dark cycles. The purpose of this study was to investigate whether lunar phases impact perinatal outcomes by considering illumination levels due to day/night rhythms. To assess the influence of moon phases, this nationwide cohort study identified cases with a singleton pregnancy that involved daytime (06:00 a.m. to 08:59 p.m.) and nighttime (09:00 p.m. to 05:59 a.m.) delivery at ≥ 23 + 0 gestational weeks with a birthweight of ≥ 500 g. Data on women who underwent elective cesarean or labor induction were excluded from the analyses. The lunar cycle was categorized as full moon, new moon, or other lunar phases. The standardized birth ratio (SBR) was chosen as the primary outcome parameter, while the duration of labor and adverse neonatal short-term health (pH of < 7.2 and/or a 5-min Apgar score of < 7) were chosen as the secondary outcome variables. We identified a total case number of 462,947 births, of which 242,518 (52.4%) occurred during the day and 220,429 (47.6%) at night. Different moon phases did not appear to influence either the SBR or adverse neonatal outcomes. However, nighttime births may show a trend toward a prolonged maximum duration of labor related to moon phases (62 vs. 65 vs. 70 h for new/full/other moon phases, p = 0.05). Considering illumination levels, some moon phases may increase the risk for prolonged births during nighttime. However, assessing the effect of lunar phases on health variables is complex. Co-environmental agents should be incorporated into future analyses.
45. A New Paradigm for Autism Spectrum Disorder Discrimination in Children Utilizing EEG Data Collected During Cartoon Viewing With a Focus on Atypical Semantic Processing.
期刊: Autism research : official journal of the International Society for Autism Research 发表日期: 2025-Aug-23 链接: PubMed
摘要
Autism spectrum disorder (ASD) is characterized by impaired social interaction and communication skills, with semantic processing difficulties being a hallmark feature that significantly impacts social communication. While traditional neuroimaging studies have provided insights into language processing in ASD, ecological validity remains a challenge, particularly when assessing young children. This study introduces a novel approach to evaluate atypical semantic processing in children with ASD (aged 4-10 years) through electroencephalography (EEG) data collection during cartoon viewing, offering a more natural assessment environment. We developed an innovative methodology combining pretrained language models with regression techniques in a machine learning framework. The analysis incorporated the Six-dimensional Semantic Database system and EEG topographical mapping to investigate semantic processing preferences and neural mechanisms across various word dimensions. Our semantic processing model demonstrated robust performance with high sensitivity (91.3%) and moderate specificity (61.0%); findings successfully replicated in validation analysis. These results reveal distinct patterns in how children with ASD process semantic information, particularly in their integration and response to emotional semantic dimensions. These findings help us understand the language processing patterns in ASD and provide potential applications for auxiliary diagnosis in more natural settings, meeting important needs in clinical practice.
46. Reply: "Forget me not," an appeal from the mitral valve in the left ventricular assist device-supported circulation.
期刊: The Journal of thoracic and cardiovascular surgery 发表日期: 2025-Aug-22 链接: PubMed
摘要
47. Sexual and Reproductive Health Care Receipt Among Male Adolescents and Young Adults With Disabilities: Analysis of National Survey of Family Growth Data, 2011-2019.
期刊: The Journal of adolescent health : official publication of the Society for Adolescent Medicine 发表日期: 2025-Aug-22 链接: PubMed
摘要
Most research on sexual and reproductive health (SRH) care has focused on women with disabilities, leaving gaps in understanding SRH care among male adolescents and young adults. This study examines the associations of disability status and type with SRH service receipt among young males in the United States METHODS: We analyzed 2011-2019 data from the National Survey of Family Growth, focusing on males aged 15-25 years (n = 7,479). We used Chi-square tests and modified Poisson regression to explore SRH care receipt by disability among sexually active males, adjusting for sociodemographic characteristics. We found that, overall, young males with disabilities were more likely than those without disabilities to say their doctor had asked them about sexual orientation and number of sexual partners. However, those with sensory or physical disabilities were less likely to have been asked about condom use (adjusted prevalence ratio [aPR] 0.85; 95% confidence interval [CI]: 0.84-0.85). Receipt of HIV testing differed by age group; disabled young adults ages 22-25 were more likely than nondisabled peers to have been tested (aPR 1.31; 95% CI: 1.30-1.31), while disabled youth in other age categories were less likely to have received testing than nondisabled youth in the same age group (age 15-18 aPR 0.95; 95% CI: 0.94-0.97; age 19-21 aPR 0.96; 95% CI: 0.95-0.96). Young men with disabilities experience different patterns of SRH care than those without disabilities. Our findings suggest that, while some aspects of SRH dialog are more likely to occur for young men with disabilities, barriers remain in accessing comprehensive SRH services.
48. Comparison of Augmented Reality-Based and Conventional Training Methods for Radiographic Positioning in Second-Year Radiologic Technology Students in Japan.
期刊: Journal of medical radiation sciences 发表日期: 2025-Aug-22 链接: PubMed
摘要
In Japanese training schools for radiologic technologists, improving students’ practical skills presents an educational challenge. To address this issue, an augmented reality (AR)-based visual assistance tool for radiographic positioning training was developed. This study aimed to evaluate and compare the effectiveness of a previously developed AR tool with conventional training methods. Fifty-seven second-year radiologic technology students were randomly divided into two groups: an experimental group (n = 29) trained with AR and a control group (n = 28) trained with physical auxiliary tools. Both groups practised positioning the torso at 35° and 45° for 1.5 min each. The timeframe aligned with the typical time allocated to each student during traditional hands-on training. Proficiency tests were conducted 1 and 4 weeks after training to evaluate the accuracy of the angles. In the test conducted 1 week after training, the experimental group demonstrated significantly smaller errors than the control group (p = 0.002). However, in the test administered 4 weeks after training, although the experimental group continued to show smaller errors, the difference was not statistically significant (p = 0.066). AR-based training can enhance radiographic positioning training. However, a single brief session is considered insufficient for maintaining long-term learning effects. Continuous use of AR is warranted for achieving long-term educational effectiveness. Future research is needed to optimise AR training methods and determine the impact on students’ clinical training performance and postgraduate proficiency.
49. Physical activity, air pollution, and incident long-term conditions: a prospective cohort study.
期刊: BMC medicine 发表日期: 2025-Aug-22 链接: PubMed
摘要
Physical activity (PA) is consistently associated with lower risk of long-term conditions. Preliminary evidence suggested the associations could be modified by air pollution. This study aims to examine whether air pollution levels modify the associations of PA with all-cause mortality and incident cancer, major adverse cardiovascular events (MACE), type 2 diabetes, and chronic obstructive pulmonary disease (COPD). A total of 414,644 UK Biobank participants were included in the analyses. PA was self-reported and objectively measured using accelerometers. PA was self-reported with IPAQ and objectively measured using accelerometers. Annual PM2.5, PM10, and NO air pollutant concentrations in 2010 were measured using a European land use regression model. Cox proportional hazard models were used to examine the associations of PA and air pollution with health outcomes. Multiplicative and additive interactions were estimated. During the study period from 2006 to 2022, 31,765 (7.7%) died, 70,299 (17.0%) had incident cancer, 25,130 (8.5%) had type 2 diabetes, 33,284 (8.0%) had MACE, and 18,844 (4.5%) had COPD. Lower PA was associated with higher risk of all health outcomes. Higher concentration of PM2.5 was associated with all outcomes except for cancer. The associations of self-reported PA with mortality and cancer were stronger in areas with higher air pollution with significant additive and multiplicative interactions. There was no evidence of moderation for objectively measured PA. In the UK, air pollution should not be a factor inhibiting the promotion of PA.
50. Association of Pathogenic/Likely Pathogenic Inherited Cardiomyopathy Variants With Heart Failure: A TOPMed Multiancestry Analysis.
期刊: Mayo Clinic proceedings 发表日期: 2025-Aug-22 链接: PubMed
摘要
To evaluate the prevalence of pathogenic/likely pathogenic inherited cardiomyopathy variants and their association with heart failure in the (TOPMed) TransOmic for Precision of Medicine cohorts. A retrospective cohort study using the TOPMed cohorts, including multi-ancestry US adults (≥18 years of age) with sequencing data, was conducted. Pathogenic/likely pathogenic inherited cardiomyopathy variant carrier status was determined based on ClinVar variants classified with two or more stars of evidence. Individuals without pathogenic/likely pathogenic variants were used as the reference group. The primary outcome was heart failure , adjudicated by an expert panel. Cox proportional hazards models assessed the association between carrier status and heart failure risk, adjusting for sex, study cohort, coronary artery disease, and genetic ancestry. Age was used as the timescale to account for the effect of variants since birth, and interval censoring was used to handle the uncertainty in the timing of heart failure events. Among 30,977 individuals (median age, 61.0 years; 71.3% female; 37.0% non-European ancestry), 229 (0.7%) were identified as pathogenic/likely pathogenic inherited cardiomyopathy variant carriers. There were 3,298 events of heart failure (35 in carriers and 3,263 in non-carriers). The heart failure incidence rate was higher in variant carriers (2.06 per 1000 person-years) compared with noncarriers (1.40 per 1000 person-years), with an adjusted hazard ratio of 1.68 (95% CI, 1.29-2.22). Approximately 1 in 140 US adults carry a cardiomyopathy variant, which increases heart failure risk. Targeted genetic screening may facilitate early identification and preventive interventions to reduce heart failure risk in carriers.
51. Reliability and validity of the Bengali version of WHODAS 2.0 in individuals with spinal cord injury.
期刊: Disability and rehabilitation 发表日期: 2025-Aug-22 链接: PubMed
摘要
To assesses the reliability and validity of the Bengali version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0, 36-item) for individuals with spinal cord injury (SCI). A total of 144 participants (81% men) completed the WHODAS 2.0, the Spinal Cord Independence Measure (SCIM), and the SF-36 Health Survey, alongside socio-demographic and injury-related data. A sub-sample of 62 was reassessed after 8-10 days. Reliability was evaluated using Cronbach’s alpha and intra-class correlation coefficients (ICC). Validity was examined through internal structure, convergent validity (via correlations with SCIM and SF-36), discriminant validity (by comparing groups with tetraplegia and paraplegia), and Rasch analysis. Internal consistency ranged from questionable (α = 0.69 for getting around) to excellent (α = 0.92 for life activities). Test-retest reliability ranged from moderate (ICC = 0.58 for cognition) to excellent (ICC = 0.92 for self-care). Significant correlations with SCIM and SF-36 supported convergent validity, while group differences based on neurological level supported discriminant validity. All items in the Cognition domain failed to fit the Rasch model. The Bengali WHODAS 2.0 demonstrates acceptable reliability and validity for individuals with SCI, supporting its clinical use in resource-limited settings. Further validation in larger samples is recommended, particularly for the Cognition domain. The Bengali version of WHODAS 2.0 has demonstrated a reliable and valid tool for assessing disability in individuals with spinal cord injury, supporting its integration into rehabilitation programs.This psychometric evaluation reinforces the utility of WHODAS 2.0 for disability assessments and management, monitoring activity limitations, and facilitating personalized interventions.Evaluating the psychometric properties of WHODAS 2.0 in a low- and middle-income setting expands its global relevance, particularly for routine functional assessments in rehabilitation programs with limited resources.
52. Effectiveness and safety of interventions for fever-associated discomfort in children: A systematic review.
期刊: British journal of clinical pharmacology 发表日期: 2025-Aug-22 链接: PubMed
摘要
Fever is one of the most frequent reasons for paediatric consultations. While traditionally managed by reducing body temperature, recent guidelines emphasize alleviating discomfort as the primary therapeutic goal. Although different interventions have been described to manage fever-associated discomfort in children, their effectiveness and safety has never been systematically analysed. The aim of this study was to review the evidence on the effectiveness and safety of pharmacological and nonpharmacological interventions for managing discomfort in febrile children. A systematic review was conducted following PRISMA guidelines (PROSPERO: CRD420250655721). PubMed, Embase and Cochrane Library were searched up to 31 January 2025, for studies involving children aged 29 days to 18 years that assessed interventions for fever-associated discomfort. Randomized controlled trials and observational studies were included. Risk of bias was assessed using Cochrane and STROBE tools. Results were synthesized narratively and grouped according to the type of intervention. Eight studies (5 randomized controlled trials, 3 observational) involving 1877 children were included. Study designs, including dosage of antipyretics and quality varied across studies. Studies comparing ibuprofen and paracetamol provided conflicting results, while combination therapy (paracetamol + ibuprofen) appeared more effective than using a single drug in -one trial. Tepid sponging, despite reducing temperature, was associated with increased discomfort. No serious adverse events were reported. Pharmacological treatments appear effective and safe, whereas physical methods offer limited benefit. The available evidence is limited by the small number of studies, methodological heterogeneity, and concerns about risk of bias and outcome measurement inconsistency. New high-quality studies are needed to guide clinical practice for the management of fever-associated discomfort in children.
53. From student to nurse: exploring transition shock through stress, locus of control, and coping strategies in newly graduated nurses.
期刊: BMC psychology 发表日期: 2025-Aug-22 链接: PubMed
摘要
Newly graduated nurses often face a difficult transition from academic training to clinical practice, commonly experiencing “transition shock.” This period is characterized by heightened occupational stress, reduced coping capacity, and uncertainty about role identity. This study aimed to investigate the effects of occupational stress, coping strategies, and work locus of control on transition shock among newly graduated nurses. It also examined how marital status and clinical unit (critical vs. non-critical care) moderate these relationships. A cross-sectional and descriptive correlational design was adopted. The study was conducted in governmental and private hospitals in Cairo, Egypt. A total of 395 newly graduated nurses (with less than one year of clinical experience) participated. Data were collected using a demographic questionnaire and four validated instruments: the Transition Shock Scale, the Occupational Stress Scale, the Trait Coping Style Questionnaire, and the Work Locus of Control Scale. Data analysis was performed using SPSS and AMOS software. Statistical techniques included Pearson correlation, multiple linear regression, and a moderated mediation analysis. Occupational stress was tested as a mediator, and marital status and unit of assignment were examined as moderators. Transition shock showed a strong positive correlation with occupational stress (r = 0.66, p < 0.01) and external WLOC (r = 0.40, p < 0.01) and a negative correlation with positive coping (r = -0.39, p < 0.01). Mediation and moderation models confirmed occupational stress as a mediator and marital status and unit assignment as moderators of stress-to-shock pathways. The model explained 64.6% of the variance in transition shock (R² = 0.646). Enhancing positive coping and internal locus of control, while reducing stress, can help mitigate transition shock. Supportive workplace programs are essential for nurse retention and well-being.
54. Management of Dupuytren disease of the little finger.
期刊: Journal of orthopaedic surgery and research 发表日期: 2025-Aug-22 链接: PubMed
摘要
The surgical management of Dupuytren disease (DD) is associated with a high rate of complications. Recurrences are relatively common and may result in permanent disability, particularly when the little finger (LF) is involved. This study aims to provide both objective and subjective information, along with professionals’ experiences. A questionnaire survey, comprising both open and closed questions, was distributed to hand surgeons, physiotherapists, and occupational therapists engaged in the management of DD across five continents. The involvement and role of the LF in DD were extensively highlighted and emphasised. Only consistent answers were included. A total of 588 questionnaires were completed. 50% (n = 294) of the answers were from hand surgeons, 24% (n = 141) from physiotherapists and 26% (n = 153) from occupational therapists. 76.5% (n = 153) of the healthcare professionals (HCP) agreed that: “The LF does not necessarily benefit from good results. Rehabilitation, just like surgery, can be delicate and difficult.”. Different agreements were found between surgeons and occupational therapists (p = 0.007) and among surgeons, depending on their surgical experience (p = 0.008). No significant differences were seen between surgeons and physiotherapists. The LF in Dupuytren’s disease requires special attention during surgery and rehabilitation. All healthcare professionals (HCPs) should invest in patient education to ensure early referral and optimal adherence to treatments. Further high-quality research is warranted to achieve a definitive consensus on optimal treatment and rehabilitation.
55. Wearable device-based interventions in heat-exposed outdoor workers - a scoping review and an explanatory intervention model.
期刊: BMC public health 发表日期: 2025-Aug-22 链接: PubMed
摘要
Global climate change poses a challenge to the health prevention of heat-exposed outdoor workers. Interventions with mobile or wearable devices monitoring physiological and environmental parameters may be one solution to maintain and promote their health. Based on the recognized potential of wearables in mitigating heat stress, a detailed analysis of the contextual factors, mechanisms, and outcomes of wearable device-based interventions is lacking. A scoping review was carried out to address the objectives of contextual analysis, fundamental mechanisms, and an assessment of outcomes to propose an explanatory intervention model based on the findings. Web of Science and PubMed databases were searched by search strings related to (1) wearables (2), outdoor workers, and (3) heat stress. Study characteristics and relevant data regarding the context-mechanism-outcome configurations were extracted and analyzed. Out of 410 articles detected, 19 publications were eligible for in-depth review. Wearables are well-accepted for the prevention of heat stress symptoms. By recording relevant indicators, i.e., heart rate and temperature, real-time health alerts can be issued as risk-based early warnings, and personalized feedback or recommendations towards behavior adaptation can be generated. A high risk of occupational heat stress was identified for construction, agriculture, and groundwork workers. Heat-exposed outdoor workers were mainly young to middle-aged males and often overweight or obese, with increased heart and breathing rates in hot work environments. Wearable device-based interventions are particularly effective if a mindset of safety culture is present in the workplace and environmental health literacy is promoted to increase heat risk awareness and willingness to change work health behavior. Based on these findings, we developed an explanatory intervention model. This model draws on well-established frameworks, theories, and models. It helps to identify, describe, and explain what works, for whom, and under what circumstances in the context of wearable usage in heat-exposed outdoor workers. Incorporating environmental health literacy and precision prevention in occupational health approaches with continuous monitoring of environmental and physiological parameters will allow for real-time, tailored feedback, leading to more effective heat stress prevention.
56. BRCA Genetic Testing Utilization and Expenditures among Privately Insured Adults in the United States, 2013-2022.
期刊: Genetics in medicine : official journal of the American College of Medical Genetics 发表日期: 2025-Aug-19 链接: PubMed
摘要
Recent clinical guidelines have broadened the criteria for BRCA counseling and testing for women and men, including indications based on family history, personal history, and current diagnosis of breast, ovarian, pancreatic, and prostate cancer. Using claims data from 2013-2022, we identified BRCA testing using procedure codes to evaluate annual utilization, median expenditures per enrollee, and the percentage of zero out-of-pocket (OOP) expenditures by sex among enrollees aged 18-64 years continuously enrolled within calendar years. We examined BRCA utilization by metropolitan status, and indications RESULTS: Annual BRCA testing utilization among women (and men) increased 10.2% (44.5%) per year during 2014-2015 and 1.7% (10.0%) per year during 2016-2019, decreased 34.4% (44.8%) in 2020, rebounded 8.5% (22.3%) per year during 2021-2022, remaining below pre-pandemic levels in 2022. Median expenditures for comprehensive BRCA testing per enrollee decreased by 68% from 2013 to 2022, most of whom had zero OOP expenditures. Most BRCA testing was done based on family health history of breast, ovarian, or prostate cancer and among women aged 18-50 years. Healthcare providers who are knowledgeable about evolving indications for germline BRCA testing can help ensure that eligible individuals have access to germline BRCA testing as preventive service.
57. A brief international screening tool for traumatic birth and childbirth-related PTSD: the city BiTS-short form.
期刊: BMJ global health 发表日期: 2025-Aug-17 链接: PubMed
摘要
Screening to identify traumatic births and childbirth-related post-traumatic stress disorder (CB-PTSD) is critical for reducing the global burden of maternal mental health challenges. Despite this, no brief, validated tools exist for international use. This study therefore developed and validated a short version of the City Birth Trauma Scale (City BiTS) to provide a brief, globally relevant screening tool. The City BiTS-Short was developed in three stages. In stage 1, exclusive lasso statistical analyses were conducted on survey data of 11 302 postpartum women in 31 countries to identify the most effective items for the City BiTS-Short, ensuring all four CB-PTSD symptom domains were represented. In stage 2, stakeholder reviews were conducted with researchers, health professionals (midwives, health visitors, psychiatrist, psychologist) and representatives of women who experienced traumatic birth. In stage 3, the City BiTS-Short was finalised and psychometric properties examined across diverse geographical settings. The City BiTS-Short comprises one item assessing traumatic birth and four items assessing CB-PTSD symptoms: re-experiencing, avoidance, negative cognitions and mood and hyperarousal. The scale had strong psychometric properties, including good internal consistency (α=0.78) and high correlations with the original City BiTS (r=0.90), birth trauma ratings (r=0.50), distress (r=0.56), impairment (r=0.47) and CB-PTSD diagnoses (r=0.54). It identified 90% of participants with a CB-PTSD diagnosis. Women who had operative births (F(3,2174)=127.38, p<0.001), maternal complications (F(2,2163)=212.84, p<0.001), infant complications (F(2,1100)=138.93, p<0.001) or depression (t(3209.5)=-30.96, p<0.001) had higher scores. Psychometric properties were consistent across most international contexts, with stakeholders affirming its utility. The City BiTS-Short offers a brief, validated screening tool for identifying birth trauma and CB-PTSD symptoms. Its widespread adoption can enhance early detection and support for women, potentially reducing the global burden of birth trauma and improving maternal mental health outcomes worldwide. Further research is needed to explore its use in specific contexts.
58. Structuring and enriching the rearing environment in conventional broiler chicken production: effects on behavioral indicators, emotional states, and cecal microbiota composition.
期刊: Poultry science 发表日期: 2025-Aug-06 链接: PubMed
摘要
Providing a variety of elements in the rearing environment may offer a promising way to transition conventional broiler production towards more animal-friendly production systems. This study aimed to investigate the effect of a complex and structured rearing environment on broiler welfare by comparing three complex enriched rooms (E) with visual cues and multiple elements for resting or exploration, to three control rooms (C) with minimal enrichments. Each room housed 2450 Redbro chickens and received natural light. We evaluated how the rearing environment influenced chicken behavior, emotional state, and the cecal microbiota composition at the end of the rearing period. E chickens stood, foraged and moved more often than C chickens (e.g. 38% vs. 19% walking; 4% vs. 1% foraging, P < 0.001), while dustbathing frequency did not differ. In group-based tests, E chickens were more likely to approach and peck at a novel object or human (P < 0.05), suggesting reduced fearfulness and increased curiosity. In the detour test, E chickens exited the U-shaped area more frequently (P < 0.001) and vocalized less (P = 0.004), indicating greater exploratory motivation and possibly better spatial cognition. Microbiota analysis revealed no differences in alpha diversity, but beta diversity differed significantly between treatments (P < 0.001). E chickens had higher relative abundances of Bacteroidota, while C chickens had more Bacillota. Overall, the complex environment promoted natural behaviors, reduced emotional reactivity, and altered gut microbiota composition, supporting its potential to improve broiler welfare under semi-commercial conditions.
59. Learning from community narratives about the COVID-19 pandemic in Papua New Guinea.
期刊: Health promotion international 发表日期: 2025-Jul-01 链接: PubMed
摘要
In this paper we use constructivism to explore community members’ accounts of how socio-cultural and behavioral factors provided meaning to the COVID-19 pandemic in Papua New Guinea, adherence to “niupela pasin” (new normal), and vaccination acceptance. We purposively selected 50 participants including community members, leaders, and church representatives for semi-structured interviews from urban and rural areas of Madang and Eastern Highlands Provinces. Data were analyzed using inductive thematic analysis. The findings showed how people applied risk prevention strategies and actively sought localized solutions to deal with the pandemic. The pandemic also disrupted socio-cultural norms, such as communal gatherings, care for the sick, and attending funerals, leading to distress and interruptions of interpersonal relationships and extended family structures. Economic hardship, particularly during lockdowns, disproportionately affected those people from lower socioeconomic levels. Strong Christian faith and prayer played a key role in either adhering to “niupela pasin” and COVID-19 vaccine acceptance or rejection of the vaccine. Conspiracy theories and misinformation often propagated through social media, fueled fears and doubts about vaccine efficacy. By articulating and understanding these culturally informed findings, the paper demonstrates how people undertook ordinary theorizing about their worlds to contextualize, modify, or significantly change the policies and strategies developed by experts using conventional science. Preparation for future pandemics can be enhanced by adding to public health policies and guidelines community perspectives and health promotion principles from the Ottawa Charter for Health Promotion.
60. Everyday tensions: Bruxism as a reflection of 21st-century stress - narrative review of literature.
期刊: Wiadomosci lekarskie (Warsaw, Poland : 1960) 发表日期: 2025 链接: PubMed
摘要
Aim: This article aims to explore the complex relationship between stress and bruxism, examining how contemporary stressors contribute to the development and exacerbation of this condition. By reviewing the current literature, the aim is to provide a comprehensive understanding of the prevalence of bruxism, its relationship to stress, and the implications for health and well-being in the modern world. Materials and Methods: The publication is based on research available in PubMed and Google Scholar, and a comprehensive literature search was conducted for publications from 2013 to 2024 to provide an up-to-date and comprehensive review. Conclusion: By addressing the root causes of stress and promoting healthier behaviors, it is possible to mitigate the impact of this increasingly common condition, contributing to improved overall health and well-being.
61. Legislative and Regulatory Changes Affecting the US Transplant System.
期刊: Journal of the American Society of Nephrology : JASN 发表日期: 2024-Sep-01 链接: PubMed