公共卫生研究摘要 (2025-08-25)
共收录 56 篇研究文章
1. Current status of severe fever with thrombocytopenia syndrome in China (Review).
期刊: International journal of molecular medicine 发表日期: 2025-Nov 链接: PubMed
摘要
Severe fever with thrombocytopenia syndrome (SFTS) is a newly emerging tick‑borne infectious disease caused by the novel Bunyavirus/SFTS virus (SFTSV). The clinical manifestations mainly include fever, thrombocytopenia and multi‑organ dysfunction, with a fatality rate as high as 30%. Since its first report in China in 2009, cases have subsequently emerged in multiple countries across East and Southeast Asia. SFTS demonstrates clear seasonal trends from May to November and tends to cluster geographically, mainly in hilly and mountainous areas. The virus is transmitted through tick bites, animal contact and human‑to‑human transmission. Its genetic diversity and frequent genetic recombination exacerbate public health threats. Pathogenic mechanism studies have shown that SFTSV uses glycoproteins Gn/Gc to mediate host cell invasion. In the early stage, the virus uses its non‑structural protein NSs to inhibit innate immune signal transduction. Massive replication of the virus leads to excessive immune activation, triggering cytokine storms and abnormal platelet activation, and eventually resulting in bleeding and multiple organ failure. The clinical management primarily relies on supportive care, while broad‑spectrum antiviral drugs and neutralizing antibodies remain investigational. Although numerous vaccine candidates have been designed and developed, none have progressed to clinical trials. This review systematically integrates current knowledge spanning virology, epidemiology, pathogenic mechanisms, therapeutic interventions and vaccine development, offering actionable insights for public health strategies and clinical practice.
2. Takotsubo syndrome: Unraveling the mystery behind its triggers (Review).
期刊: International journal of molecular medicine 发表日期: 2025-Nov 链接: PubMed
摘要
Takotsubo syndrome (TTS) is a clinical condition characterized by left ventricular dysfunction, clinically mimicking acute coronary syndrome. Despite significant advancements in understanding TTS, more questions about its underlying pathological mechanisms remain unresolved. The present review offered current data on the underlying pathological mechanisms of TTS, including central nervous system structural and functional alterations, sympathetic nervous system overstimulation, excessive catecholamine secretion, shifts in adrenergic receptors (ARs) distribution and balance, hormone influences, epicardial vasospasm, endothelial dysfunction and genetic predispositions. For example, stressors from physical or emotional triggers induce central neurohumoral activation by influencing the hippocampus and amygdala, which results in excessive local or systemic secretion. This catecholamine surge affects the myocardium by altering cellular metabolism, disrupting signaling pathways and impairing endothelial function. The regional myocardial effects are influenced by the modified ARs distribution and the density of autonomic innervation, which are pivotal in the onset of TTS. These insights suggest potential therapeutic strategies, including cognitive behavioral therapy, endothelin A antagonists and β‑blockers. However, the complex interplay of these factors in TTS onset remains poorly understood. Further research is essential to elucidate the intricate mechanisms and interactions underlying this syndrome, paving the way for improved prevention and treatment approaches.
3. Notch3 mediated TGF‑β1 activation enhances epithelial‑mesenchymal transition and cancer stemness in non‑small lung cancer.
期刊: International journal of oncology 发表日期: 2025-Oct 链接: PubMed
摘要
Notch3 is a key regulator in various cancers, playing a crucial role in maintaining stemness and promoting epithelial‑mesenchymal transition (EMT). However, its differential expression and regulatory mechanisms in non‑small cell lung cancer (NSCLC) and cancer stem cells remain poorly understood. To investigate this, the present study examined Notch3 expression in NSCLC through Oncomine, The Cancer Genome Atlas and Gene Expression Omnibus databases and validated the results with immunohistochemistry, reverse transcription‑quantitative PCR and western blotting. EMT was induced by TGF‑β1 in NSCLC cells and functional assays (Transwell, wound healing and sphere formation) were performed to assess cellular changes. In vivo experiments using a xenograft mouse model were conducted to evaluate tumor growth and metastasis. The results showed that high Notch3 expression was associated with poor prognosis in NSCLC patients. Downregulation of Notch3 inhibited TGF‑β1‑induced EMT and CSC characteristics, resulting in reduced tumorigenic potential, whereas overexpression of the Notch3 intracellular domain enhanced these effects. Silencing Notch3 suppressed EMT and markedly inhibited tumor growth and metastasis in vivo. These findings demonstrated that Notch3 regulated EMT and CSC properties in NSCLC, promoting tumor recurrence and metastasis. Notch3 thus represents a promising therapeutic target and prognostic marker for NSCLC.
4. Complexity-based unsupervised machine learning for patient-specific VMAT quality assurance.
期刊: Medical physics 发表日期: 2025-Sep 链接: PubMed
摘要
Patient-specific quality assurance (PSQA) is essential to guarantee the requested accuracy and safety of high-precision radiotherapy treatments. With the widespread adoption of modulated-intensity techniques, there is a growing need for increased operational efficiency. The potential of machine learning (ML) to accurately predict PSQA results has been investigated in recent years. In particular, plan complexity metrics have been used as model input features to be related to the PSQA outcome results in a number of supervised ML models. However, an unsupervised cluster analysis, able to uncover hidden patterns or groupings in data, has not been yet performed. The primary aim of this research was to investigate the potential of different unsupervised ML methods to unravel hidden patterns and groupings in PSQA data based on a clustering analysis of plan complexity. A total of 1329 pretreatment verification data from 660 consecutive patients with different tumour sites treated using volumetric modulated arc therapy (VMAT) were analyzed using the modulation complexity score (MCS) and the dynamic log-files generated by the linac. Predicted and measured fluences were compared using γ-analysis in terms of mean γ-values (γmean) and γ-pass rate (γ%) at the 2%(local)/2 mm criterion. Three unsupervised clustering algorithms, including agglomerative hierarchical clustering (AHC), K-means (KM) and Gaussian mixture models (GMM), were implemented to investigate the existence of natural groupings or clusters based on plan complexity. In addition, we subsequently trained several supervised models to validate cluster assignments on an external cohort of 202 VMAT arcs. For each clustering algorithms, the silhouette scores and the dendrogram analysis indicate the optimal number of clusters is three. The GMM clustered 65 arcs (4.9% of total arcs) into cluster 1 with mean values of γ%, γmean and MCS of 76.7%, 0.85 and 0.112, respectively. 916 arcs (68.9% of total arcs) were grouped into cluster 2 with mean values of γ%, γmean and MCS of 86.5%, 0.58 and 0.209, respectively. Lastly, 348 arcs (26.2% of total arcs) were grouped into cluster 3 with mean values of γ%, γmean and MCS of 92.9%, 0.40 and 0.359, respectively. Cluster 1 was associated with overmodulated plans, providing a warning MCS cutoff value of 0.145 for prompt replanning. Similarly, cluster 3 was associated with PSQA optimality, providing a MCS cutoff value of 0.278, beyond which plans have an a-priori very high QA pass results and can avoid the pretreatment dosimetric verification. Head-and-neck cases reported the higher (12.0%) and the lower (4.0%) classification rates in clusters 1 and 3, respectively, suggesting a major increase of the complexity score for these plans. This study demonstrated the potential of clustering analysis to unravel hidden patterns of plan complexity in dosimetric quality assurance of VMAT treatments. The results suggested that a three-clusters classification scheme has a true basis in plan complexity, supporting the hypothesis that the MCS metric strongly underlies PSQA results.
5. Knowledge-based trade-off prediction for NSCLC treatment planning using multi-output regression.
期刊: Medical physics 发表日期: 2025-Sep 链接: PubMed
摘要
Knowledge-based planning (KBP) is a data-driven approach that utilizes the knowledge from previous high-quality treatment plans to predict dose-volume histogram (DVH) parameters for organs-at-risk (OARs) in new cases. Research has demonstrated that KBP enhances plan quality, minimizes inter-patient and inter-institution variability, and significantly boosts time efficiency. However, current state-of-the-art KBP approaches only generate one set of planning goals for one point on the Pareto optimal surface without considering potential planning trade-offs. The objective of this study is to develop a KBP trade-off prediction model that can effectively assist clinical decision-making during the treatment planning process for patients with locally advanced non-small cell lung cancer (NSCLC). We created 13 volumetric-modulated arc therapy (VMAT) plan variations for each patient in our dataset (n = 53), consisting of one balanced plan and 12 alternative plans with trade-off considerations. These trade-off plans incorporated three levels (0-2) of sparing priority for each OAR, including the esophagus, lungs, heart, and spinal cord. The first three principal components (PCs) of each OAR-specific DVH were used as target variables, while 26 anatomical features served as predictors. The patients were randomly divided into a training set (80%) and a test set (20%). A forward feature selection process identified the top five anatomical features, which were then used to train a random forest multi-output regression model to predict the first three DVH PCs for each of the 13 plan-OAR variations. We compared the performance of our trade-off prediction model with that of a balanced model trained on the balanced plan without any trade-off considerations. The evaluation metrics included root-mean-square error (RMSE) and mean absolute error (MAE) for key dose-volume metrics of the DVH curves. The trade-off prediction model significantly outperformed the balanced model in terms of average RMSE (5.32 vs. 27.3) compared to the planned DVHs for all 13 treatment plans. The trade-off model also achieved a lower MAE for all the clinical dose-volume metrics, including spinal cord Dmax (12.5 vs. 15.5 Gy, p < 0.01), esophagus Dmax (1.7 vs. 2.7 Gy, p < 0.01), left lung V20Gy (7.8% vs. 27.5%, p < 0.01), right lung V20Gy (7.4% vs. 27.8%, p < 0.01), and heart V30Gy (10.8% vs. 20.9%, p < 0.01). Our proposed KBP trade-off model reliably predicts plan tradeoff variations for the treatment of NSCLC patients. Incorporating this model into the pre-planning process may serve as a decision support tool for physicians and planners by providing feasible trade-off estimations, thereby improving the efficiency of the treatment planning workflow.
6. Operational efficiency and clinical safety of laser positioning-assisted CT-guided lung nodule biopsy: A single-center retrospective cohort study.
期刊: Medical physics 发表日期: 2025-Sep 链接: PubMed
摘要
CT-guided percutaneous lung nodule biopsy (CLNB) is a critical diagnostic tool for pulmonary lesions, yet traditional methods are limited by operator-dependent variability and higher complication risks. The dual-laser beam design of the laser positioning (LP) device, utilizing real-time trajectory correction, holds potential to improve puncture accuracy and reduce human error, but its clinical value in CLNB remains to be systematically validated. The purpose of this study was to retrospectively assess the advanced puncture efficacy and clinical safety of the LP device during CLNB. A total of 115 patients (61±12 [SD]years; 83 women) were included in this study. All patients were allocated into two groups: one group underwent CLNB without an LP device, while the other group used an LP device during the procedure. The efficacy of the procedures was assessed based on the success rate, the adjustments number and the puncture time. Additionally, safety evaluations focused on complications associated with the percutaneous surgery. The success rate of the first puncture in the LP group was significantly higher than in the CLNB group [88.70%(55/62) vs. 52.80%(28/53), p < 0.001]. The puncture time was significantly lower in the LP group (9.71±4.20 vs. 18.21±6.53 min, p < 0.001). When analyzing the skin-to-lesion distance, categorized into two ranges of 20-60 mm and > 60 mm, the LP group consistently required less time for the procedure (9.66±5.20 vs. 16.86±5.16 min, p < 0.001), (9.93±3.97 vs. 19.31±7.39 min, p < 0.001). Furthermore, the incidence of complications in the LP group was significantly lower than in the CLNB group [6.45% (4/62) vs. 50.94% (27/53), p < 0.001]. The LP device improved the puncture accuracy of CLNB, shortened the operation time, and reduced the incidence of complications.
7. Development of dual-ended readout PET detectors achieving high 3D position resolution and high timing resolution using NINO and PICO2023 ASICs.
期刊: Medical physics 发表日期: 2025-Sep 链接: PubMed
摘要
Time-of-flight (TOF) measurement in positron emission tomography (PET) scanner can significantly improve the signal-to-noise ratio of images. Despite the significant improvements of the timing resolution of PET detectors in recent years, further development is urgently needed. This work aims to develop a PET detector with high 3D position resolution and excellent timing resolution by using two high timing performance ASICs for whole-body and organ-specific TOF PET scanners. PET detector consisting of an 8 × 8 LYSO crystal array with a crystal size of 1.45 × $ \times $ 1.45 × $ \times $ 20 mm3 dual-ended read out by 4 × $ \times $ 4 SiPM arrays with an active pixel area of 3 × $ \times $ 3 mm2 are measured in this work. The signals of the SiPM arrays are read out and processed separately for the timing and energy, with the energy signals multiplexed by row or column summing circuits to generate only 2 position encoding energy signals for each SiPM array and the timing signals processed by the NINO and PICO2023 ASICs to obtain a high precision timing information. The detector achieved a flood histogram with all crystals clearly resolved, an average energy resolution of 10.7% and depth of interaction (DOI) resolution of 2.4 mm. The coincidence timing resolutions (CTR) of the detector achieved with the NINO and PICO2023 ASICs were 149 ± $\pm $ 3 ps and 142 ± $\pm $ 3 ps, respectively, if both SiPM arrays were used to measure the timing and the depth dependence of timing correction was performed. The CTRs were improved to 134 ± $\pm $ 4 ps and 129 ± $\pm $ 4 ps if only the single crystal interaction events were selected. Both NINO and PICO2023 ASICs can be utilized to achieve a high CTR in PET detectors. The detectors developed in this work have a crystal cross-section smaller and achieve a CTR better than those of the state of the art commercial PET scanners, and can be utilized in the development of high-performance PET scanners for both whole-body and organ-specific imaging.
8. Health and Economic Burden of Rabies in Northwest Ethiopia.
期刊: PharmacoEconomics - open 发表日期: 2025-Aug-24 链接: PubMed
摘要
Rabies remains a significant threat to both public health and economic stability across many developing countries. The challenge of effectively managing and preventing rabies is compounded by insufficient quantitative data regarding its financial and health consequences. Despite Ethiopia being one of the most-affected countries in the world, data on the public health and economic burden of rabies are limited. This research aimed to quantify both the health and economic burden of rabies in northwest Ethiopia. Follow-up and recording of potential rabies cases were conducted for 18 months in seven districts of northwest Ethiopia. Data were collected from potential rabies cases using a pre-planned checklist. The health and economic burden were quantified using deterministic models. The study primarily adopted a household/patient perspective, focusing on the direct financial burdens faced by individuals and families. In the follow-up period, approximately 353 individuals were recorded as rabies victims. Among them, 126 households with suspected rabies cases were treated with traditional medicine, while 60 individuals from 59 households received post-exposure prophylaxis. The annual premature death rate due to rabies was estimated to be 3.14 per 100,000 population. The annual years of life lost due to premature death was estimated to be 90.69 per 100,000 population. Years lived with disability due to rabies illness, disability due to post-exposure vaccine, and traditional treatment were estimated to be 0.68 per 100,000 population. The annual health burden of rabies was estimated to be 91.34 disability-adjusted life years per 100,000 people. The total cost for rabies control measures in humans was estimated to be United States (US) $11,474.66. On average, each household spent US $40.55 on post-exposure prophylaxis, with an annual cost of US $27.03 per household. Regarding livestock, the losses due to rabies were estimated to be US $29,599.85 annually, which translates to an approximate loss of US $274.07 per household per year. The findings emphasise the need for targeted interventions to mitigate rabies’ disproportionate impact on vulnerable communities, aligning with global efforts to eliminate the disease by 2030. A One Health approach that integrates rabies control in human and animal health is suggested.
9. Awareness and management of stage 3 chronic kidney disease among primary care practitioners in Italy: a nation-wide observational study.
期刊: Journal of nephrology 发表日期: 2025-Aug-24 链接: PubMed
摘要
Stage 3 chronic kidney disease (CKD) often remains undiagnosed until more severe symptoms appear. This study assessed awareness and management of CKD among Italian general practitioners (GPs), focusing on early detection and current practices. A nation-wide, retrospective observational study was conducted using data from The Health Improvement Network (THIN®) database. Each participant was required to have had at least one interaction with a GP for either medical or administrative purposes (considering the index date), and to have a minimum of three years of retrospective data available from January 2021 to June 2022. The study evaluated the proportion of individuals aged ≥ 40 years who underwent a second serum creatinine test after ≥ 90 days, referrals to nephrologists, and CKD diagnosis confirmation and categorization. Multivariable Poisson regression models analyzed data to identify associations between patient characteristics and outcomes, in both the overall cohort and in the sub-group with available urine albumin-to-creatinine ratio (uACR) measurement. Among 347,548 adults aged ≥ 40 years, 18,002 (5.2%) had an initial estimated glomerular filtration rate (eGFR) indicating possible stage 3 CKD (30-59 mL/min/1.73 m2), and 1495 of these had a concomitant uACR assessment. Data concerning follow-up testing and specialist referrals were inconsistent, and available only for 53.0% and 9.0% of the patients, respectively. Overall, 15.3% met the criteria for KDIGO stage 3 CKD, yet CKD ICD-9-CM diagnostic codes were recorded for only 905 (5.0%) patients. Factors associated with these outcomes were analyzed, including age, comorbidities, treatments, and laboratory values. Substantial gaps in GP awareness and adherence to CKD management guidelines were identified, particularly in follow-up testing, referral practices, and diagnostic coding. Targeted educational interventions and standardized care protocols are needed to enhance CKD detection and management in primary care, improving patient outcomes and healthcare system performance.
10. Disparities in Fungal Diagnostic Capacity Across Chinese Hospitals: A Nationwide Survey Highlighting Gaps in Molecular Testing and GDP-Linked Inequalities.
期刊: Mycopathologia 发表日期: 2025-Aug-24 链接: PubMed
摘要
With the increasing incidence of fungal infection in China, the need for rapid and accurate diagnosis of mycosis is crucial. Therefore, it is necessary to understand the diagnosis capacity for mycosis. A cross-sectional online survey was conducted across all 31 provincial-level regions in China from August 2023 to April 2024. The survey comprised 77 questions evaluating fungal diagnostic methods, including culture, microscopy, molecular tests, and related biomarkers. Data from 1,009 valid responses were stratified by hospital tier (tertiary A vs. non-tertiary A) and regional GDP levels to analyze on-site testing capacity and outsourcing patterns. Among the 1,009 respondents, 78.5% were from tertiary A hospitals. Mycology testing was more commonly performed in tertiary hospitals compared to other. Traditional mycological diagnostic methods showed no significant differences in application across regions, regardless of economic development. However, disparities emerged in novel tests, particularly molecular diagnostics: hospitals in low-GDP regions were more likely to outsource molecular testing or lack in-house capacity. China’s fungal diagnostic capacity remains concentrated in tertiary A hospitals and high-GDP regions. Future efforts should prioritize expanding molecular testing access and optimizing resource distribution across all healthcare settings.
11. Diagnostic utility and clinical relevance of anti-MCV and anti-CCP antibodies in rheumatoid arthritis.
期刊: Clinical and experimental medicine 发表日期: 2025-Aug-24 链接: PubMed
摘要
Rheumatoid arthritis (RA) is a persistent autoimmune disorder where serological biomarkers play a crucial role in diagnosis and monitoring disease activity. Antibodies targeting cyclic citrullinated peptides (anti-CCP), mutated citrullinated vimentin (anti-MCV), and rheumatoid factor are commonly used serological markers for RA. However, their respective diagnostic efficacies and potential for mutual complementation remain incompletely understood. This study investigates the diagnostic performance of these three antibodies and their association with disease progression in RA. A total of 257 RA patients who visited Jinhua Hospital Affiliated with Zhejiang University between March and December 2019 were enrolled. Serum specimens were analyzed for anti-CCP, anti-MCV antibodies, and RF levels using chemiluminescence immunoassay (CLIA) and rate nephelometry. The results indicated that the specificity of anti-CCP (94.2%) was higher than that of anti-MCV (84.4%) and RF (84.8%). Furthermore, anti-MCV antibody levels were significantly link to disease duration and morning stiffness. Additionally, anti-MCV and anti-CCP demonstrated differing associations with extra-articular manifestations of RA. The study suggests that anti-MCV antibodies hold significant potential as adjunctive biomarkers in RA, complementing anti-CCP antibodies to improve diagnostic accuracy and provide new insights for early diagnosis and disease monitoring in RA.
12. The metabolic pathway of THF-degrading composite bacteria and its immobilized microspheres.
期刊: Antonie van Leeuwenhoek 发表日期: 2025-Aug-24 链接: PubMed
摘要
Tetrahydrofuran (THF), as a typical recalcitrant organic pollutant, poses a serious threat to ecological security and human health due to its environmental persistence. This study aimed to systematically elucidate the metabolic pathway of THF degradation by efficient composite bacteria and develop immobilized enhancement technology to improve their degradation performance. First, the key metabolic pathway for THF degradation by the composite bacteria was analyzed using GC-MS. Second, sodium alginate-chitosan microspheres encapsulating the composite bacteria were prepared, and the preparation process parameters were systematically optimized through single-factor experiments and Box-Behnken response surface methodology. Metabolic pathway analysis revealed that THF undergoes hydroxylation-induced ring-opening catalyzed by monooxygenase, yielding 4-hydroxybutanal, which is subsequently oxidized to 4-hydroxybutyric acid, and ultimately mineralized to CO₂ and H₂O. Under varying THF initial concentrations (180-540 mg/L) and temperatures (25-40 °C), the immobilized composite bacteria demonstrated significantly higher degradation capability and environmental adaptability compared to free bacteria, with markedly improved degradation efficiency. Furthermore, the immobilized microspheres exhibited excellent reusability, maintaining efficient THF removal rates after 5 consecutive cycles. This research elucidated the metabolic mechanism of THF degradation by the composite bacteria and developed a highly efficient and stable preparation process for the immobilized bacterial agent.
13. Multi-dimensional Multi-omics Integrative Study to Identify Target Genes for Ischemic Stroke and Related Chronic Pain.
期刊: Cellular and molecular neurobiology 发表日期: 2025-Aug-24 链接: PubMed
摘要
Chronic pain is the most common complications and after-effects for ischemic stroke. Through exploring immune related cell death target genes of ischemic stroke is essential for understanding ischemic stroke and chronic pain complications. Referred to three types of immune related cell deaths’ marker genes, mRNA and microRNA transcriptomics data from mice MCAO model were firstly analyzed through multi algorithms. Then, screening common gene with brain chronic pain related dataset. At the single-cell level, we performed immune cell identification and differentially expressional analysis for entire stroke brain environment and pseudo-time analysis for candidate immune cells. Based on GWAS and eQTLs, colocalization analysis, and drug target mendelian randomization methods were used to evaluate causal relationships and drug target effects. Furthermore, to explore spatial characters spatial transcriptomic analysis was conducted. At last, PCR experiments in animal model were conducted. Cell death state is positively correlated with immune infiltration degree. Five core mRNAs, S100a6, Anxa3, Ncf4, Capg, and Arpc1b, and key microRNA, miR-298-5p, were screened as biomarkers for immune related cell death. Among them, S100a6 play key roles. Toll like receptor pathway and CD4+ _γδ T cells were identified as core immune pathway and cells. By comparing with chronic pain GWAS results, S100a6 is screened as promising target. In single-cell analysis, S100a6 participated in CD4+ _γδ T cells differentiation and immune activation on IS. Drug target MR analysis showed that activation of S100a6 was able to decrease 23-54% probabilities to develop into IS. Furtherly, S100a6 gene could balance the negative effects of Cd4 expressed immune cells and protect neuronal function in brain injury spatial zone. In PCR experiment, differentially expressed level of five core genes got proved. In conclusion, our study revealed S100a6 played causal protective roles for ischemic stroke and related chronic pain, could be seen as potential drug target.
14. Is prophylactic fundoplication necessary? Laparoscopic fundoplication after gastrostomy vs non-gastrostomy patients.
期刊: Pediatric surgery international 发表日期: 2025-Aug-24 链接: PubMed
摘要
Laparoscopic fundoplication is a standard surgical procedure for gastroesophageal reflux disease (GERD). In Japan, it is frequently performed in children with severe motor and intellectual disabilities (SMID), many of whom also require gastrostomy for enteral nutrition. Prophylactic fundoplication during gastrostomy remains controversial due to concerns about post-operative complications and the limited number of patients who subsequently require fundoplication. This study retrospectively analyzed 47 cases of fundoplication at Tsukuba University Hospital from 2013 to 2024, comparing patients who underwent fundoplication after gastrostomy (post-G group) with those undergoing primary fundoplication (Primary group). Outcomes including operative time, blood loss, and post-operative hospital stay showed no significant differences between both groups. No cases required open conversion, and post-operative complication rate was not significantly different. Our findings indicate that fundoplication can be safely performed after gastrostomy without increased surgical risks, contradicting concerns about adhesions or operative difficulties. Previous studies have also failed to establish a direct link between gastrostomy and GERD progression. Given the low incidence of GERD requiring fundoplication after gastrostomy, routine prophylactic fundoplication is unnecessary.
15. Synergistic Antibacterial Strategy of AIEgens Photosensitizer CPTQ for Photodynamic Therapy and Ferroptosis-like Bacterial Death to Prevent Dental Caries.
期刊: ACS applied materials & interfaces 发表日期: 2025-Aug-24 链接: PubMed
摘要
Dental caries, primarily caused by Streptococcus mutans (S. mutans) biofilms, remains a global health concern. Antimicrobial photodynamic therapy (aPDT) has shown promise in controlling cariogenic bacteria by generating reactive oxygen species (ROS), but the aggregation-caused quenching (ACQ) effect of traditional photosensitizers limits its efficacy. In this study, we developed a novel aggregation-induced emission (AIE) photosensitizer, CPTQ, with an enhanced photodynamic antibacterial efficacy and intrinsic antibacterial properties. CPTQ exhibited superior ROS generation, effective bacterial labeling, and strong membrane anchoring, leading to a significant disruption of bacterial membrane homeostasis and interference with bacterial metabolism. Moreover, CPTQ induced ferroptosis-like bacterial death by triggering lipid peroxidation and oxidative stress, providing a synergistic antibacterial strategy. In vitro results demonstrated that CPTQ effectively inhibited S. mutans growth, while in vivo studies in a rat dental caries model showed significant reductions in cariogenic bacterial load and caries progression. Given its excellent biocompatibility and dual antibacterial mechanisms, CPTQ offers a promising and innovative strategy for the prevention and treatment of dental caries.
16. Influence of Religion on Pro-Environmental Behavior: A Systematic Literature Review.
期刊: Journal of religion and health 发表日期: 2025-Aug-24 链接: PubMed
摘要
Religion is one of the major factors influencing pro-environmental behavior (PEB) to mitigate the climate crisis. However, previous studies have not provided a conclusive answer on how religion influences PEB. Additionally, it is crucial to consolidate a comprehensive understanding of trends and the influence of religion on PEB. Thus, the main objectives of this study are to find research trends regarding the relationship between religion and PEB and how religion affects PEB by using a systematic review process. The findings of this study suggest that the research design is predominantly driven by quantitative methodology, with the theory of planned behavior and the theory of reasoned action being the most commonly used frameworks. This study also found that most studies had the direct and indirect (moderating and mediating) influence of religion on PEB. Religion being a significant factor, it should therefore be considered crucial to integrate religious studies into the enviormental studies curriculum. It is also necessary to analyze diverse factors alongside religion for a proper understanding of PEB. This study is helpful for education policymakers, schools, and future researchers.
17. Mineralogical insights into the potentially toxic elements and health risks in lacustrine environments in the Lower Doce River, Southeastern Brazil.
期刊: Environmental geochemistry and health 发表日期: 2025-Aug-24 链接: PubMed
摘要
The collapse of the Fundão tailings dam in 2015 triggered widespread contamination across the Doce River basin, yet its long-term effects on lacustrine environments remain poorly understood. This study investigates how sediment mineralogy influences the retention and mobility of potentially toxic elements (PTEs) in shallow and deep lakes of the Lower Doce River. Between 2018 and 2019, bottom sediment samples (0-5 cm) were collected from three deep lakes (Limão, Nova, and Juparanã) and three shallow lakes (Areão, Areal, and Monsarás). Twenty-four sediment samples were analyzed for mineralogy (X-ray diffraction and Fourier-transform infrared spectroscopy) and PTE concentrations using sequential extraction followed by ICP-MS/MS. PTEs were fractionated through a six-step sequential chemical extraction designed to isolate soluble/exchangeable, carbonate-bound, Fe oxide-bound (including poorly crystalline and crystalline phases), and pyrite-associated fractions. The results show that goethite and hematite are the main Fe oxyhydroxides in lake sediments, suggesting the legacy of deposited tailings. Deep lakes contain well-crystallized, Al-substituted goethites that enhance the retention of As, Cr, and V in more stable geochemical fractions. In contrast, shallow lakes, especially Areal and Monsarás, exhibit slightly higher hematite content and goethites with lower Al substitution and specific surface area, indicating reduced stability and greater susceptibility to redox-driven dissolution. Additionally, PTEs such as Co, Cu, Ni, Pb, and Zn are primarily associated with poorly crystalline Fe phases like ferrihydrite and lepidocrocite, which are prone to dissolution under anoxic conditions. Risk assessments indicate higher carcinogenic risks from As, Cr, and Ni exposure in shallow lakes, especially for children.
18. Qualitative Analysis of Nutrition Educators' Experiences During Implementation of the New York State Healthy Pantry Initiative.
期刊: Journal of nutrition education and behavior 发表日期: 2025-Aug-23 链接: PubMed
摘要
Identify and examine factors influencing the implementation of the Healthy Pantry Initiative (HPI) in New York State. Prequalitative and postqualitative intervention. Forty-two food pantries. Fourteen Just Say Yes to Fruits and Vegetables nutrition educators. Policy, systems, and environmental change. Facilitators, strategies, and challenges to HPI implementation. Cyclical qualitative analysis employing, directed, emergent, and thematic coding techniques. Five themes emerged: (1) organizational readiness (capacity to implement changes), (2) operational/physical constraints (layout or operations), (3) JSY educator implementation strategies (techniques), (4) perceived outcomes of HPI participation (changes), and (5) maintenance and planned sustainability (ability to maintain the policy, systems, and environmental changes postimplementation). Collaboration and communication facilitated implementation, whereas challenges included staffing, open hours, and adequate supplies. Policies, systems, and environmental strategies in food pantries may improve client experiences and promote healthy food selection. Future research could investigate factors influencing staff buy-in and HPI maintenance and sustainability beyond the first year.
19. Cost-effectiveness of spinal manipulation, exercise, and self-management for spinal pain.
期刊: Chiropractic & manual therapies 发表日期: 2025-Aug-23 链接: PubMed
摘要
The United States spends more money on the care of back and neck pain than any other health condition. Despite this, the cost-effectiveness for many recommended treatments is unclear. Our primary objective for this project was to estimate the cost-effectiveness of spinal manipulative therapy (SMT), supervised exercise therapy (ET), and home exercise and advice (HEA) for spinal pain in the U.S. We analyzed cost and clinical outcome data from eight randomized trials conducted in the U.S. using an individual participant data meta-analysis approach. We calculated cost-effectiveness from the societal and healthcare perspective of various comparisons between SMT, ET, and HEA. Incremental cost-effectiveness ratios (ICERs) were calculated using quality-adjusted life years as the main outcome. The trials included a total of 1803 participants and 1488 (83%) provided complete data. Incremental cost-effectiveness ratios and probabilities of cost-effectiveness varied substantially between studies; thus, we did not conduct meta-analysis and report findings from individual trials. Cost-effectiveness findings were favorable for SMT compared to HEA for acute neck pain (ICERs below $50k/QALY) and when added to HEA for chronic back-related leg pain and chronic neck pain in older adults (better outcomes and lower costs). However, SMT was not likely cost-effective compared to HEA for chronic back pain in adults or when added to HEA for older adults (higher costs and worse outcomes). Findings for SMT were favorable when compared to ET in adults with chronic back pain and when added to ET for chronic neck pain in adults (better outcomes and lower costs) and chronic back pain in adolescents (ICERs below $50k/QALY). However, SMT is not likely cost-effective when compared to ET for chronic neck pain in adults (ICERs below $70k/QALY for exercise) and findings were inconsistent across outcomes in older adults with chronic back pain. Finally, ET may be cost-effective compared to HEA for adults with chronic neck pain (ICERs largely between $100-$200k/QALY), but not for chronic back pain or when added to HEA for older adults with chronic neck or back pain (higher costs and worse outcomes). Cost-effectiveness findings differed between populations based on pain location, duration, and age.
20. Health system responsiveness for maternal healthcare services in East Africa: a mixed-methods systematic review.
期刊: BMC pregnancy and childbirth 发表日期: 2025-Aug-23 链接: PubMed
摘要
Health system responsiveness (HSR) is the ability to respond to universal legitimate expectations of service consumers. This contributes to achieving short and long-term health sector goals, such as universal health coverage. However, no comprehensive summary of evidence exists on how HSR can achieve universal maternal health services. Therefore, we aim to examine the successes, challenges, and strategies of HSR toward universal maternity care in East Africa using a mixed-methods systematic review. We conducted a mixed-methods systematic review of studies published from 1 January 2020 to 8 June 2024. Articles were searched using six databases: Medline, Web of Science, Scopus, CINAHL, PsycINFO, and ProQuest. We used three main search terms: HSR, maternal health, and East Africa. A mixed-methods appraisal tool (MMAT) was used to assess the quality and methodological validity of the studies. We then analysed and synthesised the data using the World Health Organization (WHO) HSR framework components. A total of 72 articles (23 quantitative, 15 mixed-method, and 34 qualitative articles) were included. This review revealed that the responsiveness of obstetric services ranged from 45.8 to 75.6%. Challenges contributing to poor HSR, include limited decision-making autonomy, breaches of confidentiality, non-dignified care, poor communication, delay in care, and unhygienic maternity care. However, maintaining confidentiality, providing abuse-free care, permitting companions, and ensuring informed consent improved responsiveness of maternity care. The included studies reported wide ranges of the overall HSR and its specific domains for maternity care. Unresponsive health system remains a significant challenge for achieving universal access to maternal healthcare services. As such, HSR continues to hinder quality of maternal healthcare and its utilisation. Ensuring responsive maternity services requires continuous attention from policymakers, managers, and healthcare providers. Strengthening HSR will promote inclusive, effective, and respectful care that safeguards women’s rights and ensures equitable care regardless of their circumstances.
21. AAV-mediated MUC5AC siRNA delivery to prevent mucociliary dysfunction in asthma.
期刊: Gene therapy 发表日期: 2025-Aug-23 链接: PubMed
摘要
The main structural components of mucus produced in the lung are mucin 5B (MUC5B) and mucin 5AC (MUC5AC) where a relatively higher expression of MUC5B is typical in health. In the lungs of individuals with asthma, there is a shift from MUC5B to MUC5AC as the predominantly secreted mucin which has been shown to impair mucociliary clearance (MCC) and increase airway mucus plug formation. Given its role in asthmatic lung disease, MUC5AC represents a potential therapeutic target where a gene delivery approach could be leveraged to modulate its expression. For these purposes, we explored adeno-associated virus serotype 6 (AAV6), as a viral gene vector to transduce airway epithelial cells and reduce MUC5AC expression via siRNA delivery. We confirmed that AAV6 was able to transduce epithelial cells in vitro as well as in the airways of healthy mice in vivo with high transgene expression in mucus-secreting goblet cells. Using multiple particle tracking analysis, we observed that AAV6 was capable of penetrating both normal and MUC5AC-enriched mucus barriers. AAV6 carrying MUC5AC-targeting siRNA was evaluated as a prophylactic treatment in HAE cell cultures before IL-13 challenge. IL-13 stimulated HAE cultures treated with AAV6-MUC5AC siRNA had significantly reduced MUC5AC mRNA and protein expression compared to untreated controls. Mucociliary transport in IL-13 stimulated HAE cultures was also maintained and comparable to healthy controls following AAV6-MUC5AC siRNA treatment. Together, these findings support that AAV6 may be used as an inhaled gene therapy to suppress MUC5AC overexpression and restore normal airway clearance function in asthma.
22. Exploring the factors that influence engagement with and experiences of integrated care for adults at risk of cardiovascular disease and mild-to-moderate mental health concerns in the UK (OptICS): a systematic review protocol.
期刊: Systematic reviews 发表日期: 2025-Aug-23 链接: PubMed
摘要
Cardiovascular disease (CVD) is one of the leading causes of premature death globally. CVD is expensive to treat and therefore carries a significant cost for public healthcare systems and the people in them. Those most likely to develop CVD often report co-occurring mental health concerns such as depression and anxiety, in addition to behavioural factors (e.g. physical inactivity) and physical health conditions (e.g. hypertension, high cholesterol, obesity and diabetes). Due to these inter-connecting issues, healthcare provision for CVD patients necessitates a joined-up care pathway providing holistic, person-centred support. Despite the rapid emergence and growth in attempts to deliver such care, evidence concerning how it is experienced and how to promote engagement is fragmented. This review aims to capture the experiences and factors that influence integrated care engagement, reported by adults with CVD risk factors and mild-to-moderate mental health concerns. This systematic review protocol will be reported according to the updated Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA-P) guidelines. Proposed database searches will include Emcare, MEDLINE, PsycINFO (via OVID), CINAHL and preprint databases for grey literature. Articles of interest will include adults’ experiences of and factors that influence engagement with integrated care in the UK, specifically for support with CVD risk and mild-to-moderate mental health concerns. Any study design reporting qualitative primary data will be included (excluding conference abstracts). Data on study population (actors/targets), what they do (behaviours) care setting (context), care format (time) and participant experiences and perspectives will be extracted. Where appropriate, thematic synthesis of extracted data will be coded to the Theoretical Domains Framework (TDF), updated Consolidated Framework for Implementation Research (CFIR) and Action, Actor, Context, Target and Time (AACTT) framework. Findings from this review will provide foundation evidence for a behavioural systems map and recommendations for policymakers, commissioners and those involved or interested in integrated care for people at risk of CVD with mental health concerns. Such evidence can be used to develop future intervention strategies to assist the optimisation of integrated care. PROSPERO (CRD42024554282.
23. Patients' experiences of a standardized care pathway for suspected bladder cancer due to macroscopic hematuria.
期刊: BMC urology 发表日期: 2025-Aug-23 链接: PubMed
摘要
To explore patients’ experiences navigating the Standardized Care Pathway (SCP) for macroscopic hematuria through semi-structured interviews. An interview study was conducted to explore patients’ experiences of SCP for macroscopic hematuria. The study employed content analysis with an inductive approach, as described by Lundman and Graneheim, to explore both explicit and implicit patterns in the data. Informants were recruited from an outpatient clinic for investigation of macroscopic hematuria, with interview questions derived from literature and clinical experience. Researchers immersed themselves in the data through repeated readings of transcripts, identifying meaning units that were coded and analyzed to develop subcategories reflecting similarities and differences. Twelve patients, with a median age of 71 years (58% women), participated in the study. Among them, one was diagnosed with urinary bladder cancer (UBC). The findings highlight a mix of appreciation and questioning associated with the SCP process, as patients valued the efficiency of one stop policy for testing but also experienced heightened anxiety. A lack of detailed and patient-centred communication emerged as a key issue, with primary care centers providing insufficient information. Although SCP is effective, it prompts consideration of whether it is suitable for all patients. A more individually tailored approach might be more appropriate, prioritizing rapid evaluation for those with a high likelihood of cancer while directing others to a standard diagnostic route. Continuing the one-stop policy was seen as beneficial.
24. Development of a multifaceted implementation plan to guide falls prevention in residential aged care facilities.
期刊: BMC geriatrics 发表日期: 2025-Aug-23 链接: PubMed
摘要
Due to their serious consequences, falls are a well-documented problem in residential aged care facilities (RACFs). Although clinical practice guidelines (CPGs) on falls prevention in RACFs have been developed in many countries, their implementation remains challenging. Therefore, this study aimed to describe the development of a multifaceted plan for the implementation of a guideline on multifactorial falls prevention interventions in RACFs. An implementation plan was developed as part of a large-scale falls prevention implementation initiative in Flanders (Belgium). The development process was guided by prior research and Intervention Mapping, which includes six stages: 1) logic model of the problem, 2) logic model of change, 3) programme design, 4) programme production and testing, 5) programme implementation plan, and 6) evaluation plan. A stakeholder group of nine experts actively participated in this development process. The implementation plan was pretested in six RACFs and adjusted to better align with their context. A three-phase implementation plan divided into seven steps was finalised. The first phase is preparation (steps 1 to 3), during which RACFs undertake the necessary preparations to start the implementation process by enabling broad support within their organisation, mapping the baseline situation, defining objectives, and setting priorities. The second phase (steps 4 and 5) concerns the actual implementation, which outlines the development and performance of implementation actions. In the third phase (steps 6 and 7), RACFs evaluate and adjust actions, and aim to sustainably anchor the implemented falls prevention policy in their daily practice and quality management system. We were able to develop a comprehensive implementation plan for falls prevention in RACFs. This plan supports RACFs in the implementation of tailored falls prevention interventions and maximise sustainability. Future research should further focus on larger-scale implementation and evaluating the effectiveness of the implementation plan in combination with the support of an external implementation facilitator. This includes assessing its impact on determinants, and implementation and clinical outcomes.
25. Using the R = MC2 heuristic to assess whole-of-school physical activity implementation in elementary schools: a cross-sectional study.
期刊: The international journal of behavioral nutrition and physical activity 发表日期: 2025-Aug-23 链接: PubMed
摘要
Schools are recommended to use a whole-of-school (WOS) approach to promote physical activity opportunities before, during, and after school. Yet, the barriers and facilitators to implementing a WOS approach successfully are not well understood. The R = MC2 heuristic, which defines readiness for implementation as a combination of an organization’s motivation and capacity to implement, can enhance our understanding of implementation in the school setting. This study examines associations between constructs from the R = MC2 heuristic and schools’ implementation of a WOS approach. We conducted a secondary analysis of cross-sectional data from U.S. elementary schools participating in the NFL PLAY60 FitnessGram Project during the 2022-23 school year. From surveys administered to school staff, we created a WOS index (range = 0-12) comprising six physical activity practices: physical education, recess, before and after-school programs, classroom-based approaches, and active transport. We also assessed how six constructs from the R = MC2 heuristic (i.e., culture, implementation climate, leadership, priority, resources utilization, resource availability) impact physical activity implementation using a series of questions measured on a 5-point Likert scale. We used linear regression models to determine associations between R = MC2 constructs (independent variables) and WOS index scores (dependent variable), controlling for school-level characteristics (student enrollment, percentage of race/ethnicity and economically disadvantaged students served) and state-level clustering. The analytic sample consisted of 132 schools across 18 states. On average, school staff rated leadership (mean = 4.1, range = 1.5-5) and organizational culture (mean = 4.0, range = 2.25-5) the highest. The mean WOS index score was 6.1. Partially adjusted models indicated significant positive associations between each R = MC2 construct and WOS index scores. Fully adjusted regression models revealed priority (b = 0.88; p = 0.010; 95% CI = 0.19-1.56) and implementation climate (b = 0.69; p = 0.047; 95% CI = 0.07-1.32) were positively and significantly associated with WOS index scores. Our study provides insights into key implementation constructs associated with providing school-based physical activity opportunities. These findings can support the development of resources and implementation strategies which, in turn, can help schools address implementation-related disparities. This will help schools improve the quality and accessibility of opportunities for physical activity provided to students across the United States.
26. Spatial distribution and determinants of full package maternal health service utilization in Ethiopia using 2019 Mini Ethiopian Demographic Health Survey.
期刊: Scientific reports 发表日期: 2025-Aug-23 链接: PubMed
摘要
Antenatal Care, use of skilled delivery attendants, Institutional delivery and postnatal care services are key maternal health services that can significantly reduce maternal mortality. The objective of this study was to identify spatial distribution and factors that affect full package utilization of maternal health services in Ethiopia. Sampling weights were applied, and analyses were conducted using STATA version 17. Spatial statistics, including Moran’s I and Getis-Ord Gi*, were performed in ArcGIS to assess spatial autocorrelation and identify FPMHSU clusters. SaTScan software detected purely spatial clusters. Multilevel binary logistic regression identified individual- and community-level factors. Model selection was based on a significant log-likelihood ratio test and Variables with p < 0.05 were deemed significant, with adjusted odds ratios and 95% confidence intervals quantifying associations. The prevalence of in Ethiopia was 56.96% (95% CI: 55.41%, 58.51%) and exhibited significant spatial clustering (Moran’s Index = 0.686, P < 0.001). Women aged 20-24 years [AOR = 0.65, 95% CI: 0.44-0.97], high parity [AOR = 0.52, 95% CI: 0.40-0.69] and urban residents [AOR = 0.53, 95% CI: 0.31-0.89] reduce the outcome, while being married [AOR = 1.54, 95% CI: 1.04-2.30], Muslim religion [AOR = 2.25, 95% CI: 1.45-3.48], primary education [AOR = 2.04, 95% CI: 1.65-2.52], secondary education [AOR = 2.30, 95% CI: 1.53-3.45], higher education [AOR = 6.10, 95% CI: 2.43-15.07], awareness of pregnancy complications [AOR = 3.62, 95% CI: 3.00-4.36], poorer households [AOR = 1.77, 95% CI: 1.32-2.37], middle wealth category [AOR = 1.56, 95% CI: 1.13-2.14], richer households [AOR = 2.61, 95% CI: 1.84-2.71], and the richest households [AOR = 6.70, 95% CI: 3.96-11.56] increase the outcome. This study revealed significant disparities in in Ethiopia, with spatial clustering (Moran’s I = 0.686) and hotspots in Addis Ababa, Dire Dawa, Harari, and East Gojam. Women with higher education (primary, secondary, and higher), Muslim religion, awareness of pregnancy complications, better economic status (poorer, middle, richer, and richest wealth categories), and urban residence were more likely to utilize maternal health services. Addressing these disparities is crucial for improving maternal health outcomes and ensuring equitable access.
27. Nicotinamide mononucleotide protects ovarian function and oocyte developmental competence during chemotherapy.
期刊: Journal of ovarian research 发表日期: 2025-Aug-23 链接: PubMed
摘要
Cyclophosphamide (CTX)-induced ovarian dysfunction and infertility represent significant concerns for reproductive-age or younger female cancer patients. Although various fertility preservation techniques are currently accessible, there remains a pressing demand for an efficient, non-invasive strategy to protect ovarian function that can be employed concurrently with chemotherapy. Considering the significance of nicotinamide adenine dinucleotide (NAD+) in regulating DNA damage and apoptosis, we aimed to examine the protective effects of nicotinamide mononucleotide (NMN, an NAD+ precursor) on ovarian function against CTX-induced damage. Eight-week-old female C57 mice were underwent to a 14-day treatment protocol, receiving either saline, CTX, or CTX combined with NMN supplementation. The protective effects of NMN supplementation during CTX treatment on ovarian reserve, oocyte quality, and developmental competence were evaluated. NMN supplementation during CTX treatment increased NAD+ content in the ovary, improved ovarian reserve, enhanced endocrine function, reduced reactive oxygen species (ROS) levels, alleviated DNA damage, and reduced apoptosis. Furthermore, this supplementation improved the rates of two-cell embryo and blastocyst formation, increased total cell counts, while decreasing ROS levels, DNA damage, and apoptosis in blastocysts. Moreover, the protective mechanisms of NMN may involve key genes such as Banp and Rbm47 in the ovarian tissue, along with serum/glucocorticoid-regulated kinase 1 (Sgk1) in oocytes. Collectively, our results highlight the protective effects of NMN against CTX-induced damage to the reproductive function, thus addressing a critical gap in fertility preservation. We present a potential non-invasive strategy that does not interfere with cancer therapy timelines.
28. A systematic review of technology-infused physical activity interventions in K-12 school settings: effectiveness, roles, and implementation strategies.
期刊: The international journal of behavioral nutrition and physical activity 发表日期: 2025-Aug-23 链接: PubMed
摘要
Rapid technological advancements have rendered many prior reviews of technology-integrated physical activity (PA) interventions in K-12 schools obsolete. A comprehensive analysis examining both the effects of these interventions and the specific roles that technology plays has been notably lacking. This review aimed to systematically examine the effects of technology-infused PA interventions and identify the specific types, roles, and contextual applications of technology within K-12 schools. This systematic review adhered to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. A thorough search across seven electronic databases (CINAHL, ERIC/EBSCOhost, PsycINFO, PubMed/MEDLINE, Scopus, SPORTDiscus, and Web of Science) included studies published up to May 20, 2024. Only randomized controlled trials (RCTs), cluster-RCTs, or rigorous quasi-experimental designs with matched/statistically controlled comparisons (N-RCTs) examining technology-infused PA interventions for school-aged children and adolescents were considered. Fifty-eight studies met inclusion criteria. Wearable devices (e.g., accelerometers) were the most used for PA measurement. Other technologies like web-based platforms, mobile applications, and exergaming served as educational tools, communication platforms, or core intervention components. Interventions occurred primarily in classrooms, followed by physical education spaces, and extended to home/online environments, school breaks (e.g., recess), and before-school time. Overall, interventions positively affected PA levels and related outcomes (e.g., PA enjoyment), though effectiveness varied by technology type, design, and context. Technology holds substantial potential to enhance PA promotion in schools, but its effectiveness hinges on well-designed interventions that consider the specific types and applications of technology.
29. Association between tonsillectomy plus steroid pulse therapy and renal outcomes in patients with IgA nephropathy: a retrospective cohort study.
期刊: BMC nephrology 发表日期: 2025-Aug-23 链接: PubMed
摘要
IgA nephropathy (IgAN) is the most common disorder in chronic glomerulonephritis, and various treatment methods have been established. Tonsillectomy and steroid pulse therapy (TSP) are widely performed in Japan. However, their correlation with renal outcomes remains unclear. In this study, we aimed to examine the association between renal prognosis and steroid pulse therapy with or without tonsillectomy. In this retrospective cohort study, we identified patients diagnosed with IgAN between April 2002 and March 2021 using a Japanese healthcare records database. We selected patients with a prescription history of methylprednisolone for three consecutive days within one year of diagnosis and an estimated glomerular filtration rate (eGFR) of 30 mL/min/1.73 m2 or above. We categorized the patients into TSP and steroid pulse therapy (SP) groups based on whether they underwent tonsillectomy within one year of diagnosis. The primary outcome was the composite outcome of a 30% decline in eGFR and initiation of dialysis, and the secondary outcomes comprised the composite outcome of end-stage renal failure and initiation of dialysis and eGFR slope. Inverse probability of treatment weighting (IPTW) using propensity score, Kaplan-Meier survival analysis, and weighted Cox regression analysis by applying IPTW were performed. Overall, 550 patients were eligible for the main analysis, and approximately 40% underwent tonsillectomy within 1 year of IgAN diagnosis: 221 in the TSP group and 329 in the SP group. The primary outcome did not differ between the groups (hazard ratio, 0.58; [95% confidence interval: 0.22-1.54]; P = 0.28). The groups did not differ in terms of the secondary outcomes. Although we could not demonstrate the effectiveness of TSP on renal prognosis in patients with IgAN, this study may have been underpowered, and there are certain limitations due to the information available from the database, we were able to evaluate the association of TSP on renal outcomes using real-world data. Not applicable.
30. Environmental heavy metal exposure and altering anti-Mullerian hormone levels in women.
期刊: BMC women’s health 发表日期: 2025-Aug-23 链接: PubMed
摘要
Serum levels of anti-Mullerian hormone (AMH), a key indicator of ovarian aging, decrease with age. This decline may be accelerated by genetic and environmental factors. Accordingly, the present study investigates the relationship between serum AMH concentrations and exposure to heavy metals. This cohort study was conducted on 220 women with a median age of 42 years (Range: 37-45). Participants were reproductive-age women from the Tehran Lipid and Glucose Study (TLGS) that met our inclusion criteria. Serum concentration of heavy metals - including lead (Pb), cadmium (Cd), copper (Cu), aluminum (Al) and chromium (Cr) - as well as AMH levels, were measured using stored samples from the second and fifth follow-up visits with a time interval of approximately 10 years. A multivariate linear regression model was used to assess the relationship between AMH and heavy metals, adjusting for age, body mass index (BMI), smoking, physical activity, age at menarche, education, marital status and parity. The results indicated that serum AMH concentration in women classified within the fourth and third quartiles of Cu was reduced by -0.43 (95%CI: -0.73, -0.13) ng/ml and - 0.34 (95%CI: -0.65, -0.03) ng/ml, respectively. No statistically significant associations were observed between AMH levels and other heavy metals, including Pb, Al, and Cr (P > 0.05). These findings suggest a possible link between elevated Cu levels and diminished AMH concentrations in reproductive-age women. However, further research is needed to confirm these findings and to elucidate the underlying factors, particularly in younger age groups.
31. Pediococcus acidilactici GR-5 alleviates hyperuricemia by degrading purine nucleosides and improving gut microbiota metabolism.
期刊: NPJ science of food 发表日期: 2025-Aug-23 链接: PubMed
摘要
Reducing intestinal absorption by degrading purine nucleosides has been shown to alleviate hyperuricemia (HUA). The probiotic Pediococcus acidilactici GR-5, derived from the traditional food “Jiangshui”, achieved efficient degradation of purine nucleosides through its unique purine nucleoside phosphorylase-DeoD. In the purine nucleosides-induced HUA mouse model, GR-5 treatment reduced serum uric acid (UA) by about 52.17%. GR-5 may improves tissue inflammatory damage by inhibiting the NLRP3 inflammatory pathway, and restored the intestinal barrier by increasing tight junction proteins Occludin and ZO-1 expression, which outperforming the allopurinol. The mechanism of UA reduction may also involves inhibiting UA synthase activity and regulating UA transporters level. GR-5 colonization in intestine increased the abundance of Lactobacillus, improved the metabolism of purine, tryptophan and bile acid by gut microbiota, and increased the level of SCFAs. Overall, GR-5 may be a potential preventive agent for improving HUA and is expected to provide a healthy option for preventing diet-induced HUA.
32. Characteristics of Australian and New Zealand osteopaths who treat patients presenting with non-musculoskeletal complaints: outcomes from two practice-based research networks.
期刊: Chiropractic & manual therapies 发表日期: 2025-Aug-23 链接: PubMed
摘要
Australian and New Zealand osteopaths predominantly manage musculoskeletal complaints using a variety of modalities including manual therapy, exercise and lifestyle and occupational advice. There appears to be a small percentage of patients who seek osteopathy care for non-musculoskeletal issues such as conditions affecting the gastrointestinal tract. The evidence base for osteopathic treatment as part of the management of such conditions is equivocal. The aim of this study was to describe the practice of Australian and New Zealand osteopaths who report often treating patients with non-musculoskeletal complaints. This study is a secondary analysis of data from the Australian and New Zealand osteopathy practice-based research networks (PBRNs) collected in Australia from July to December 2016 and in New Zealand from August to December 2018. Respondents to the PBRN baseline surveys were asked to provide information about their demographic, patient and clinical management characteristics. One of these characteristics was the frequency of treating patients presenting with non-musculoskeletal complaints. Descriptive and inferential statistics were used to inform regression modelling of significant predictors of often managing non-musculoskeletal complaints. Of the 1254 osteopath participants from Australia and NZ, 13.5% (n = 170) reported often treating patients presenting with non-MSK complaints. Significant predictors of often treating patients presenting with non-MSK complaints were often using visceral (ORa 3.54 95%CI 2.15-5.85) and Osteopathy in the Cranial Field (OCF) (ORa 2.05 95%CI 1.20-3.51) techniques, and often treating patients up to the age of 3 years (ORa 3.05 95%CI 1.89-4.90). More than one in ten Australian and New Zealand osteopaths report often treating patients presenting with non-MSK complaints, with the dominant manual therapy approaches used being visceral techniques and OCF. This study provides a unique insight into the characteristics of osteopaths who often treat patients presenting with non-MSK complaints. Further research is required to examine if patients seek out care from an osteopath specifically for non-MSK complaints or primarily seek out care from an osteopath for MSK complaints but are managed for non-MSK complaints as a secondary consideration.
33. The practical year: a qualitative study on stressors, resources and proposed improvements among medical students.
期刊: BMC medical education 发表日期: 2025-Aug-23 链接: PubMed
摘要
The last academic year in medical faculties in Germany is the so-called practical year (PY), which is a combination of studying and on-the-job clinical training. Based on research documenting considerable stress among both medical students and resident physicians it can be assumed that PY students likewise experience high levels of stress. However, evidence remains sparse for medical students in the practical year in Germany and elsewhere. PY students at a German medical school were recruited via purposeful and snowball sampling and semi-structured qualitative interviews were conducted by telephone. Data collection was carried out until data saturation was reached. The interviews were voice-recorded, transcribed verbatim and content-analyzed using MAXQDA software (2020). Eighteen female and seven male participants (n = 25; mean age: 26.6 years; standard deviation (SD = 3.7)) were interviewed (mean duration = 36 min with SD = 7.6). Mentioned stressors included a lack of skills and knowledge, poor supervision, routine tasks (i.e., lack of learning experiences due to repetitive work), lack of appreciation (mainly on the part of superiors) and a heavy workload. Resources included working with patients and their appreciation, a positive learning and working atmosphere on the wards, learning and knowledge acquisition, one-on-one supervision by a medical colleague, clinical-practical training as well as a positive work-life balance with sufficient leisure time. Among other things, the PY students suggested a better pay and a change in absence regulations as well as the opportunity to take care of their own patients and to have structured PY teaching. PY students perceived multiple stressors, but also resources and suggested potential improvements. There is a subjective need for improvements of the working and training conditions in the PY. However, further studies are required to quantify and prioritize those needs and to explore the feasibility of the suggested interventions.
34. Bridging Gaps or Reinforcing Silos? Reflections on the ONCARE Virtual Oncology Course in Canadian Undergraduate Medical Education.
期刊: Journal of cancer education : the official journal of the American Association for Cancer Education 发表日期: 2025-Aug-23 链接: PubMed
摘要
The ONCARE initiative, as presented by Dou et al., represents a timely and commendable national effort to enhance oncology education within Canadian undergraduate medical curricula. In this letter to the editor, we critically appraise the study’s implications through critical appraisal and contextualize its findings within broader medical education paradigms. While ONCARE significantly improved self-perceived oncology knowledge and clinical communication skills, its limited long-term evaluation, potential selection bias, and underrepresentation of interdisciplinary and psychosocial content warrant discussion. Moreover, we highlight the broader need for oncology to be integrated meaningfully-not only as a specialty interest but as foundational knowledge-across undergraduate education. Drawing on global evidence and frameworks, this letter to the editor encourages stakeholders to consider not just educational access, but systemic curricular reform in oncology education.
35. Spatial and multilevel analysis of determinant factors for safely managed sanitation services in Ethiopia.
期刊: Scientific reports 发表日期: 2025-Aug-23 链接: PubMed
摘要
Access to safely managed sanitation services is a major public health concern, particularly in low- and middle-income countries like Ethiopia. Addressing the sanitation problem requires a comprehensive understanding of the spatial variation and determinant factors. This study aims to estimate the prevalence of unimproved sanitation services, identify hotspot areas, predict high-risk zones, detect spatial cluster and determinant factors in Ethiopia. A community-based cross-sectional study was conducted using the 2019 Mini-Ethiopian Demographic Health Survey. A total of 8,663 households were sampled using a stratified two-stage cluster sampling method. Arc-GIS version 10.7.1 software was used to visualize the spatial distribution of unimproved sanitation services. SaTScan version 10.2.5 software was used for detecting and analyzing clusters. To identify determinant factors of unimproved sanitation services, a multilevel logistic regression model was employed. In the multilevel analysis, those variables with a p-value < 0.05 were considered to be significant factors for the use of unimproved sanitation services. Approximately 80.23% [95% CI 79.4-81.1] of the population in Ethiopia uses unimproved sanitation services, with significant spatial differences across regions. Determinant factors for the use of unimproved sanitation services includes, households owning a television [AOR = 0.47; 95% CI 0.38, 0.58], households with a middle wealth index [AOR = 0.50; 95% CI 0.37, 0.67], households with a rich wealth index [AOR = 0.27; 95% CI 0.2, 0.36], being in a metropolitan region [AOR = 0.21; 95% CI 0.12, 0.37], living in rural areas [AOR = 5.52; 95% CI 3.28, 9.3], and households with water access within > 30 min [AOR = 2.13; 95% CI 1.56, 2.9] and ≤ 30 min [AOR = 2.67; 95% CI 2.02, 3.51]. Hotspot areas for the use of unimproved sanitation services were observed in the regions of Benishangul-Gumuz, SNNP, Amhara, Gambela, and some parts of Oromia. The primary cluster with low relative risks was found in Addis Ababa, Dire Dawa, and Harari. More than three-fourths of the Ethiopian population relies on unimproved sanitation services, with significant regional variations. Interventions such as media campaigns, investing in sanitation infrastructure, and establishing a monitoring system are highly recommended to address these issues.
36. Knowledge on HIV postexposure prophylaxis and associated factors among healthcare workers in Kigoma region, Tanzania.
期刊: Scientific reports 发表日期: 2025-Aug-23 链接: PubMed
摘要
HIV infection remains a major public health challenge globally. Healthcare workers (HCWs) face an increased risk of occupational exposure to HIV through their routine duties. Adequate knowledge on HIV postexposure prophylaxis (PEP) is imperative for preventing HIV infection following exposure to blood and body fluids. However, few studies have examined the level of knowledge on HIV PEP and the associated factors among this at-risk population of HCWs in Tanzania. The aim of this study was to assess the level of knowledge on HIV PEP and associated factors among HCWs in Kigoma Region, Tanzania. A cross-sectional study was conducted among HCWs at Kigoma Regional Hospital, Kibondo District Hospital and Kasulu Town Council Hospital from November to December 2022. Data was collected using interviewer-administered questionnaire. A total of nine questions were used to assess knowledge on HIV PEP. The total score was calculated by summing the correct responses, with a maximum possible score of 17. Knowledge of HIV PEP was classified as inadequate (score < 11, moderate (score 12-14), and adequate (score > 14). Bivariate analysis and multivariable logistic regression models were used to assess the association between the level of knowledge on HIV PEP (inadequate/moderate (score ≤ 14) vs. adequate (score > 14) and the independent variables. Data analysis was performed using Statistical Package for Social Scientists version 23.0 and p-value < 0.05 was considered statistically significant. Out of 377 study participants [female (200, 53.1%), mean age of 38.7 ± 9.1 years, nurse 129 (34.2)] the majority 234 (62.1%) had adequate knowledge on HIV PEP. HCWs from Kasulu Town Council Hospital (AOR = 1.4; 95% CI: 1.02-8.73) and those from facilities with HIV PEP services (AOR = 3.9; 95% CI: 2.41-6.29) had significant higher odds of having adequate knowledge on HIV PEP. A sizeable proportion of study participants had adequate knowledge on HIV PEP. Working in Kasulu Town Council Hospital and presence HIV PEP services within the facility were associated with adequate knowledge on HIV PEP. Healthcare authorities in the Kigoma region are advised to strengthen the implementation of formal HIV PEP training, timely access to HIV PEP service, and dissemination of updated information education communication materials alongside protocol guidelines to improve the knowledge of HCWs on HIV PEP in all healthcare facilities.
37. Endocannabinoid and N-acylethanolamine concentrations in hair of female patients with posttraumatic stress disorder - associations with clinical symptoms and outcomes following multimodal trauma-focused inpatient treatment.
期刊: Translational psychiatry 发表日期: 2025-Aug-23 链接: PubMed
摘要
While psychotherapeutic treatments for posttraumatic stress disorder (PTSD) show in general good responses in affected individuals, 30-40% of patients show limited improvement. On a biological level, the endocannabinoid system of the body may play a role in the aftermath of trauma, in PTSD, and in extinction processes. This study is a secondary analysis of a randomized-controlled trial including patients with PTSD over the course of trauma-focused inpatient treatment. It aimed to investigate whether endocannabinoid system alterations are associated with symptom severity and treatment response. Fifty-four female inpatients with PTSD provided hair samples and completed psychometric questionnaires at pre-treatment, post-treatment, and 3-month follow-up. Endocannabinoid (EC: AEA, 1-AG/2-AG) and N-acylethanolamine (NAE: SEA, PEA, OEA) concentrations were measured in scalp-near 3-cm hair segments, reflecting cumulative concentrations in the 3 months prior to sampling. At pre-treatment, higher depressive and anxiety symptoms were significantly associated with lower hair AEA levels, whereas higher PTSD symptoms (when controlling for depressive symptoms) and more traumatic experiences were significantly associated with higher hair AEA and NAE levels respectively. PTSD symptoms improved across treatment, remaining stable at 3-month follow-up, but were predicted neither by pre-treatment hair ECs/NAEs nor their changes across treatment and follow-up, which was confirmed in subgroup analyses. Our findings suggest that hair ECs/NAEs may be distinctly linked with trauma-related and affective and anxiety symptoms, however, do not predict treatment response in PTSD. This challenges expectations and highlights the complexity of endocannabinoid system alterations in stress-related psychopathology. Given the study’s limitations, including a female-only sample and lack of a control group, larger studies with control groups and multiple biomarkers are needed to identify intervention-related biomarkers in PTSD.
38. Fidelity, Implementation Determinants, and Patient-Level Outcomes Following Initial Implementation of NAVIGATE in the Early Psychosis Intervention-Spreading Evidence-Based Treatment (EPI-SET) Study.
期刊: Schizophrenia bulletin 发表日期: 2025-Aug-23 链接: PubMed
摘要
While early psychosis intervention (EPI) services are effective, care delivery is often inconsistent, particularly in recovery-oriented care. We hypothesized that facilitated implementation of NAVIGATE, an evidence-based, standardized model of coordinated specialty care, would increase fidelity to EPI standards and improve patient functioning in real-world settings. The Early Psychosis Intervention-Spreading Evidence-based Treatment (EPI-SET) study was a non-randomized effectiveness-implementation hybrid type III trial in 6 Ontario EPI programs. We used the First Episode Psychosis Services-Fidelity Scale-Revised (FEPS-FS-R) to measure fidelity to EPI standards at baseline (T0) and 12 months (T1). Scores ranged from 1 to 5, indicating poor (<3.5), fair (3.5-4), and good (≥4.0) adherence. The Heinrichs-Carpenter Quality of Life Scale (QLS) was used to determine change in functioning from baseline to 12 months (which roughly coincided with the T1 fidelity assessment). Implementation determinants were assessed using the Consolidated Framework of Implementation Research. FEPS-FS-R scores indicated good adherence for 19/29 items at T0 and 17/29 items at T1. Compared to T0, at T1, more psychosocial treatment items and fewer access and continuity items achieved fair or better adherence. Among the 100 participants who completed a baseline assessment, QLS total scores improved significantly (estimated change = 13.6, 95% CI: 9.6-17.7, P < .001) from T0 to T1. Implementation experiences varied across sites, with 4 of 6 organizations reporting overall positive experiences. Implementation of NAVIGATE was associated with improved fidelity to psychosocial components of care, with concomitant improvements in patient functioning. These findings can inform widespread implementation of NAVIGATE.
39. Effective Strategies in Disease Control and Prevention: A Systematic Review.
期刊: Infectious disorders drug targets 发表日期: 2025-Aug-21 链接: PubMed
摘要
Effective disease control and prevention are central to global public health, especially amid increasing chronic diseases, re-emerging infectious threats, and socioeconomic disparities. This systematic review aims to identify and synthesize key strategies that contribute to improved disease management outcomes worldwide. This systematic review was conducted using the keywords “disease management,” “disease prevention,” “public health strategies,” “surveillance,” “vaccination,” “vector control,” and “social determinants of health (SDOH)” in electronic databases including PubMed, Scopus, Web of Science, and Google Scholar from 2001 to 2024. The search strategy was based on the PRISMA statement, and the research question was designed and formulated using the PICO framework. Twenty-two articles were selected for inclusion in the study. Enhanced surveillance systems enable timely outbreak detection and inform public health responses. Vaccination strategies, including mobile units and public awareness campaigns, significantly improve coverage, especially in underserved areas. Environmental sanitation through WASH programs reduces disease transmission. Vector control using Integrated Vector Management has proven effective in controlling malaria and dengue. Addressing social determinants of health (SDOH) through targeted policies reduces health inequities. The One Health approach promotes cross-sector collaboration for controlling zoonotic diseases. Findings highlight the importance of combining epidemiological tools, community engagement, policy reform, and intersectoral collaboration. Socioeconomic and environmental contexts significantly influence health outcomes and the success of interventions. A multifaceted, integrated strategy is crucial for effective disease prevention and control. Public health systems must prioritize surveillance, vaccination, sanitation, equity-oriented policies, and cross-sectoral collaboration to improve global health resilience and reduce disparities.
40. Organic Fluorophores Conjugated with Pyridinium Acceptor: A Review on Design, Synthesis, and Application in Mitochondrial Imaging.
期刊: Current pharmaceutical design 发表日期: 2025-Aug-21 链接: PubMed
摘要
Mitochondria are known as the powerhouse of eukaryotic cells. They play a crucial role in several biological processes and maintain cellular health. The ideal condition of mitochondria depends not only on their morphology but also on various micro-environmental factors, including pH, polarity, and temperature. Changes in these factors or malfunctions of mitochondrial species, such as Reactive Oxygen Species (ROS), active nitrogen species, metal cations, anions, and protons, can lead to several diseases in humans, including heart failure, kidney disorders, diabetes, Alzheimer’s disease, and Parkinson’s disease. Therefore, monitoring Reactive Small Molecules (RSMs), maintaining micro-environmental factors, and estimating ROS levels in mitochondria are essential for understanding physiological behaviour and the pathogenesis of related diseases. Irregularities in mitochondrial function are closely linked to a range of clinical conditions, highlighting the importance of targeting mitochondria for therapeutic benefits. Over the last decade, numerous studies have focused on the development of small organic conjugated systems for mitochondrial imaging, utilizing optical signal transduction pathways. In this review, the design and synthetic strategies for small organic fluorophores conjugated with a pyridinium acceptor, their applications in mitochondrial imaging, and the detection of RSMs in mitochondria have been discussed. Studies have revealed that small-molecule fluorescent probes are being widely used for the detection and imaging of RSMs located in mitochondria. Moreover, this review covers the mechanistic insights, photophysical properties, biological characteristics of fluorophores, and therapeutic strategies targeting the mitochondria of human cells.
41. Advances in Nanotechnology for Targeted Drug Delivery in Alzheimer's Disease.
期刊: Current aging science 发表日期: 2025-Aug-18 链接: PubMed
摘要
Alzheimer’s Disease (AD) is a complex neurodegenerative disorder characterized by progressive cognitive decline and hallmark pathological features, such as amyloid-beta plaques and tau protein tangles. Despite substantial research, current therapeutic strategies remain primarily symptomatic, with limited success in preventing or reversing disease progression. One major challenge is the Blood-Brain Barrier (BBB), which restricts the delivery of therapeutic agents to the brain. Nanotechnology provides innovative solutions to these challenges by enabling the development of targeted drug delivery systems tailored to AD’s unique pathophysiology. Nanoparticles offer several advantages for AD therapy, including their small size, surface modifiability, and the ability to traverse the BBB. These carriers can enhance drug stability, prolong systemic circulation, and enable controlled drug release, reducing systemic toxicity while maximizing therapeutic efficacy. Among various approaches, nanoparticles functionalized with ligands targeting AD show promise in promoting the clearance of pathological aggregates, potentially slowing disease progression and alleviating neurotoxicity. Liposomes, polymeric nanoparticles, dendrimers, and exosomes are notable nanocarriers that have been successfully engineered to deliver a range of therapeutic agents, including anti-amyloid drugs, neuroprotective compounds, and gene therapies. Recent advancements also emphasize stimulus-responsive nanocarriers that release drugs in response to specific pathological cues, further enhancing treatment precision. This article delves into the most recent advancements in nanotechnology for AD therapy, and the potential of these innovative systems to overcome long-standing barriers in AD treatment and paving the way for more effective and targeted interventions.
42. Diverse Development Approaches for Xanthine Oxidase Inhibitors: Synthetic Chemistry, Natural Product Chemistry, and Drug Repositioning.
期刊: Current medicinal chemistry 发表日期: 2025-Aug-15 链接: PubMed
摘要
Xanthine oxidase (XOD) plays a crucial role in the biosynthesis of uric acid, and inhibiting its activity can effectively reduce the production of uric acid at its source. Currently, clinically used xanthine oxidase inhibitors (XODIs), such as allopurinol and febuxostat, are effective but associated with notable side effects. Allopurinol may induce hypersensitivity reactions, while febuxostat has been reported to potentially increase the risk of severe cardiovascular events. Therefore, the development of Xanthine oxidase inhibitors(XODIs) that lower serum uric acid levels through the inhibition of uric acid production has been a key focus in the research and development of anti-gout medications. This review is based on research literature from 2014 to 2025, sourced from multiple authoritative databases both domestically and internationally, including international databases such as Google Scholar, PubMed, Web of Science, Baidu Scholar, CNKI, Wanfang database. This review systematically summarizes 109 XODIs with urate-lowering or anti-gout pharmacological activities, categorized into chemical synthetic compounds, natural products and their derivatives, and repurposed drugs. The aim is to provide meaningful insights for the development of new therapeutic agents for gout and hyperuricemia. Notably, amides and carboxylic acids among chemically synthesized compounds exhibit promising prospects, while natural products with multiple mechanisms of uric acid reduction hold significant potential for the treatment of hyperuricemia.
43. Factors Associated with Positive Fecal Immunochemical Test Results for Colorectal Cancer Screening among At-Risk Populations in Southern Thailand: A Cross-Sectional Analytic Study.
期刊: Asian Pacific journal of cancer prevention : APJCP 发表日期: 2025-Aug-01 链接: PubMed
摘要
Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality globally. Early detection through Fecal Immunochemical Test (FIT) screening is essential, particularly among at-risk populations. However, evidence linking dietary consumption behavior to FIT test outcomes remains limited in Thailand, especially in the southern region. This study aimed to determine the prevalence of positive FIT results and to examine the association between dietary consumption behavior and sociodemographic factors with positive FIT results among at-risk individuals in Southern Thailand. A cross-sectional analytic study was conducted among participants aged 50-70 years who underwent FIT screening in primary healthcare units in Nakhon Si Thammarat Province between October 2023 and August 2024. Totally, 382 participants were included, 191 cases with positive- and 191 controls with negative-FIT results. The case-control ratio was 1:1. Data were collected using structured questionnaires assessing demographic characteristics, health risk factors, and dietary consumption behaviors. Crude and multivariate logistic regression analyses were performed to identify factors associated with a positive FIT result. The prevalence of positive FIT results was 13.77% (95% CI: 12.04-15.66). Multivariate analysis showed low dietary consumption behavior was prevalent (83.77%), it was not significantly associated with FIT positivity (AOR = 1.10, 95%CI: 0.71-1.68), after adjusting for confounders. However, lower education level (AOR = 0.50, 95%CI: 0.32-0.78), agricultural occupation (AOR = 0.45, 95%CI: 0.25-0.82), and monthly income between 3,000-8,000 Baht (AOR = 2.11, 95%CI: 1.27-3.49) were significantly associated with a positive FIT result. Education, occupation, and income were significantly associated with positive FIT results. Targeted education and risk-reduction strategies are recommended to improve CRC screening outcomes in at-risk populations.
44. Economic Burden of Breast Cancer on Patients and their Caregivers in a Regional Health Setting in Thailand: A Prevalence-Based Cost-of-Illness Study.
期刊: Asian Pacific journal of cancer prevention : APJCP 发表日期: 2025-Aug-01 链接: PubMed
摘要
This prevalence-based cost-of-illness study aimed to examine the cost of illness for breast cancer patients and their caregivers in Health Region 9, Thailand. Data were collected from 404 participants, comprising 202 pairs of breast cancer patients and their caregivers across Health Region 9 during six months from September 2024 to February 2025. Participants were recruited by the researcher, going to 10 areas in the region and personally visiting and obtaining formal permission from the appropriate health authorities. A questionnaire was developed and distributed through the primary care coordinators at the local health facilities, who served as intermediaries to explain the research objectives to participants and to coordinate data-collection schedules. All the patients were female with a mean age of 56.13 years. The majority of the caregivers were also female. Most caregivers were related to the patients, with the majority being the children or spouses. The average total cost of illness was USD 165.11 (95%CI: 119.44-210.78). Regarding the indirect costs, the average total costs for the patients and their caregivers were USD 80.10, with the highest proportion (at 48.52% of the total costs) accounted for by lost income due to leaving work due to sickness (USD 47.92 per month). This study shows that the economic impact of breast cancer treatment in a regional setting in Thailand was primarily due to productivity losses from missed work, which represents an indirect cost rather than a direct medical expense.
45. Health Outcomes and Symptom Intensity Over Time among Cancer Patients Receiving Palliative Care in Vietnam: A Prospective Cohort Study.
期刊: Asian Pacific journal of cancer prevention : APJCP 发表日期: 2025-Aug-01 链接: PubMed
摘要
In Vietnam, research on palliative care, particularly for cancer patients, remains limited. This gap reduces the practical relevance of research findings in shaping policies and strategies for palliative care tailored to Vietnam’s healthcare system. This study aimed to assess health outcomes in cancer patients receiving palliative care over a one-year period using the APCA African Palliative Outcome Scale (IPOS). The prospective cohort study was conducted over one year, with monthly interviews using IPOS scale to measure patient health outcomes. A multilevel linear mixed model was used to analyze changes in IPOS scores over time, and a Bonferroni-adjusted pairwise comparisons test was applied to compare mean IPOS scores of patients before death. Among the 134 patients included, mean IPOS scores along with physical, emotional, and communication symptoms decreased over time. The total IPOS score declined from 32.2 (95% CI: 30.3-34.1) to 11.4 (95% CI: 9.6-13.3) after one year, with the greatest reduction observed in physical symptoms. Patients in the 0-2 months before death group had significantly higher scores than those in the 3-5 months and 6 months before death groups. Physical symptoms, including pain, dyspnea, and weakness, worsened the most, while communication issues remained stable, peaking at 2 months and reaching their lowest point at 6 months before death. This study provides evidence of the benefits of palliative care in improving the health of cancer patients. Quality of life declines most in the final months, highlighting the need for early symptom management. This study also paves the way for further research into symptom progression before death.
46. GSTP1 rs1695 Variant and Colorectal Cancer Risk in Women Aged 50+: Insights from Iran's Largest Cohort and Meta-Analysis.
期刊: Asian Pacific journal of cancer prevention : APJCP 发表日期: 2025-Aug-01 链接: PubMed
摘要
To evaluate the association between GSTP1 rs1695 A>G polymorphism and colorectal cancer (CRC) risk in an Iranian cohort, and to validate findings through a systematic review and meta-analysis. A multicenter case-control study was conducted in Tehran hospitals, including CRC patients and matched controls. Demographic and clinical data were collected, and DNA was extracted from FFPE tissues and blood. Genotyping of GSTP1 rs1695 was performed using TaqMan® real-time PCR, with 5% of samples validated by direct sequencing. Logistic regression adjusted for age and gender was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), with Bonferroni correction applied. A systematic review and meta-analysis was performed following PRISMA guidelines using five databases, including studies up to January 2025. The study included 2,590 participants (1,038 CRC cases). CRC incidence was higher in individuals aged ≥50 years, with no significant gender difference. Colon cancer was more common, and most tumors were moderate or well differentiated at stages II-III. The GA genotype of GSTP1 rs1695 was significantly associated with increased CRC risk (p = 0.013), especially in those aged ≥50 years (p = 0.003). The combined AA + AG genotypes were also associated with increased risk (p = 0.016). Among females, the G allele showed higher CRC susceptibility, especially in older age (p = 0.0001). The meta-analysis of 30 studies (21,376 individuals) showed no overall association between rs1695 and CRC risk, but Iranian subgroup data indicated a modest association in AG vs. GG and AA+AG vs. GG models, which lost significance after Bonferroni correction. No publication bias was detected. The Iranian cohort showed an age- and gender-specific association between GSTP1 rs1695 and CRC risk. However, the meta-analysis did not support a consistent link, suggesting possible population-specific effects.
47. Causal Inference Methods Based on Pseudo-Observations: A Comparative Analysis of Treatment Types for Iranian Gastrointestinal Cancer Patients.
期刊: Asian Pacific journal of cancer prevention : APJCP 发表日期: 2025-Aug-01 链接: PubMed
摘要
This study investigates the effects of different treatments on the survival of patients with gastrointestinal cancer. One of the methods for causal inference, the doubly robust estimator, is easy to apply with complete data, but becomes complex with incomplete or censored data. To overcome these challenges, we used pseudo-observations. This historical cohort study included 602 patients residing in the provinces of Mazandaran and Golestan. The patients were followed up over a period of approximately 11 years. To evaluate the effects of surgical, radiotherapeutic, and chemotherapeutic treatments on survival, we used inverse probability weighting and the doubly robust estimator using pseudo-observations. The survival and pseudo packages of the R software were used for model fitting. The efficacy of the doubly robust estimator and inverse probability weighting was assessed by comparing survival estimates derived from both methods across different treatment types. In this study, there were 441 cases (73.26%) of deaths from gastrointestinal cancer. Our analysis included three time points: the first year, the eighth year and the fifteenth year. The results showed that the survival of patients with gastrointestinal cancer varied depending on the treatment method. In particular, surgical treatment showed a significant impact on survival at all three time points. In contrast, radiotherapy only showed a significant correlation at the first time point, while no significance was found at the two subsequent time points. A significant correlation was found for chemotherapy at all three time points. Using a doubly robust estimator with pseudo-observations is more efficient and simpler. Causal inference methods can serve as evaluation tools for different treatments in patients with gastrointestinal cancer.
48. Interleukin-13 (rs20541 A/G) Gene Polymorphism and Chance of Acquiring Hepatitis B in the Egyptian Population.
期刊: Asian Pacific journal of cancer prevention : APJCP 发表日期: 2025-Aug-01 链接: PubMed
摘要
An important worldwide health concern is infection with the hepatitis B virus (HBV), especially in underdeveloped nations. Gene polymorphisms encoding pro- and anti-inflammatory cytokines can influence how an HBV infection presents clinically. As mediators, cytokines play important functions in the immunological and inflammatory systems. A strong pleiotropic cytokine is interleukin-13 (IL-13). The research attempts to look into the relationship between HBV infection in Egyptians and variations in a single nucleotide in the IL-13 (rs20541 A/G) gene. One hundred and twelve hepatitis B cases and fifty control subjects were involved in the investigation. Utilizing an allelic discrimination test pre-validated TaqMan™ MGB probe (Applied Biosystem). To investigate the relationship between the SNP of (IL-13) (rs 20541 A/G) gene and HBV, we used real-time PCR. The IL13 (rs20541 A/G) gene polymorphism study identified more frequent occurrences of the A/G and A/A genotypes among the patients (OR = {62.536, 21.25}, CI = {[19.276-202.889], [3.055-147.8]}, P = {0.0001, 0.002}). In the patient group, the A allele frequency was markedly different from the control group’s (CI = 2.614-8.229, OR = 4.638, P < 0.0001). Nevertheless, the current investigation did not find a connection between HBV fibrosis and the gene polymorphism of IL-13(rs 20541 A/G). The rs20541 single nucleotide polymorphism (SNP) in IL-13 gene is linked to an increased risk of HBV.
49. Assessing Compliance and Challenges in Implementing Smoke-Free Zone Regulations in Indonesia.
期刊: Asian Pacific journal of cancer prevention : APJCP 发表日期: 2025-Aug-01 链接: PubMed
摘要
Kendari is located in Southeast Sulawesi Province, Indonesia, with an estimated population of approximately 350,000. This study aimed to evaluate compliance with implementation of Kendari City Regulation No. 16 of 2014 on Smoke Free Zones (Perda KTR) across various facilities (public places, workplaces, educational environments, places of worship, healthcare facilities, children’s play areas, sports facilities, and public transportation). This study also examines locating smoke advertising installation points around the observation area. This study employs a qualitative approach with a purposive sampling method to select 200 representative locations for observation and 11 informants to assess compliance with Perda KTR between August and September 2023. We evaluated the location regarding the criteria “No Smoking Area” signs, clear “No Smoking” signs, penalties for violators, presence of cigarette butts, designated smoking areas, and tobacco product promotion. The analysis was based on descriptive compliance analyses and QGIS was used to map the distribution of observation locations and tobacco advertising. Only 15 of the 200 locations (7,5%) fully complied with the Perda KTR. Healthcare facilities had the highest compliance (40%), followed by educational institutions (33%), while worship places, public transport, and sport facilities showed 6-7% compliance. About 92,5% of “No Smoking” signs lacked enforcement sanctions, and cigarette butts were found in 43,5% of locations. Additionally, 14,5% of stites showed visible tobacco advertisements, especially in the central district (Wua-Wua, Kadia, Kambu). Mandonga, Puuwatu, and Abeli have fewer observed tobacco advertisements, which may reflect different enforcement levels or commercial activity. Interviews revealed moderate public awareness but highlighted significant enforcement gaps. The smoke-free zone policy in Kendari has not been effectively implemented. Structural, cultural, and economic factors, limited signage, and weak enforcement contribute to low compliance. Strengthened policy dissemination and enforcement are essential to improving public adherence.
50. A Medical Anthropology Assessment of Community Liver Cancer Risks: Qualitative Comparisons of Communities with Different Risk Profiles in Thailand.
期刊: Asian Pacific journal of cancer prevention : APJCP 发表日期: 2025-Aug-01 链接: PubMed
摘要
Thailand has the highest incidence rate of cholangiocarcinoma (CCA) in the world, and a high rate of hepatocellular carcinoma. Although risk factors for these two types of liver cancer have been identified, gaps persist in models for prevention. This qualitative study examined community awareness of liver cancer risk factors and prevention in rural Thailand. Qualitative interviews were conducted with two groups from two villages in the north of Thailand. Village A (5 participants) has a high prevalence of CCA, while Village B (10 participants) has low prevalence. Open-ended questions were asked about social structures, farming practices, drinking water, diet, health care, and attitudes towards health promotion. Responses were tabulated and common themes were discerned, then stratified by village to examine their similarities and differences. In Village A, respondents were ethnic Thai with large families engaged in low-income farming and applying pesticides in unsafe manners. Village B was populated by the Mian ethnic group, where family sizes were smaller and higher incomes were derived from cash crops like coffee. Risky pesticide application practices were commonly reported. Diets were similar, except for intakes of freshwater crabs and crab paste in Village A (absent in Village B). However, the crabs had potentially high contamination of pesticide residues. Village A relied on surface water contaminated with pesticide runoff, in contrast to Village B that was upstream of point-source contamination. Furthermore, Village B emphasized healthy lifestyles and promoted the overall health of the community, supported by a network of social workers. Very few people there had ever experienced cancer. In contrast, Village A suffered from many liver cancer deaths and lacked a social worker network. These results inform community-tailored interventions in Thailand to promote safer pesticide practices, healthier diets, safer drinking water, and supportive community health for CCA prevention.
51. Knowledge, Attitudes and Practices of Cervical Cancer Screening among Women Attending Gynecology Clinics at Tertiary Care Hospitals in the Capital City of Pakistan: A Cross-Sectional Survey.
期刊: Asian Pacific journal of cancer prevention : APJCP 发表日期: 2025-Aug-01 链接: PubMed
摘要
This study aimed to assess the current level of knowledge, attitudes, and perceptions regarding cervical cancer (CC) screening among women visiting gynecology clinics in tertiary care hospitals of Pakistan, and to identify preferred health promotion methods to enhance access to CC screening and vaccination services. A descriptive cross-sectional survey was conducted among women aged 21-55 years attending outpatient departments of obstetrics and gynecology. The study employed purposive sampling and utilized a pre-validated questionnaire. Data were analyzed using SPSS 21, with bivariate analysis and binary logistic regression to identify predictors of good knowledge. The survey involved 370 women, revealing profound gaps in knowledge about CC, with 84.7% demonstrating poor understanding. A significant association was found between education, occupation, income, and knowledge of CC. Furthermore, nearly all respondents expressed a desire for more information on CC and preventive measures, with electronic social media identified as the preferred awareness-raising channel. Encouragingly, 99.7% of women showed willingness towards receiving HPV vaccination if provided free or at low cost. The findings underscore a critical need for enhanced awareness and educational interventions to bridge the knowledge gap on CC screening and prevention among Pakistani women. Despite high willingness to engage in preventive practices, barriers such as lack of awareness, limited healthcare access, and socioeconomic factors hinder effective screening uptake. Advocacy and tailored health campaigns are crucial for mobilizing resources and political support to combat CC in Pakistan.
52. Personalized Cancer Vaccines in Combination Therapies: Current Status and Future Prospects.
期刊: Asian Pacific journal of cancer prevention : APJCP 发表日期: 2025-Aug-01 链接: PubMed
摘要
Personalized cancer vaccines represent a promising advancement in cancer immunotherapy, designed to target tumor-specific mutations unique to individual patients. By stimulating a tailored immune response, these vaccines aim to enhance antitumor immunity while minimizing off-target effects. However, cancer is a complex disease, and single-modality treatments often face challenges such as immune evasion and tumor heterogeneity. To address these limitations, personalized cancer vaccines are increasingly being explored in combination with other therapeutic strategies, including immune checkpoint inhibitors, cytokine therapies, oncolytic viruses, and traditional chemotherapies. This review provides a comprehensive overview of the current status of personalized cancer vaccines, focusing on their development, clinical trials, and early outcomes. It also discusses the synergistic potential of combination therapies, offering insights into how these strategies could overcome immunosuppressive tumor microenvironments and improve patient outcomes. Finally, we explore future prospects, addressing challenges such as vaccine production, patient selection, and regulatory frameworks to outline the path forward for the successful integration of personalized vaccines into standard oncological care.
53. Carbon Monoxide Alleviates Cardiomyocyte Pyroptosis in Diabetic Cardiomyopathy by Downregulating the IL-33/ST2L Axis.
期刊: Immunity, inflammation and disease 发表日期: 2025-Aug 链接: PubMed
摘要
This study aimed to investigate whether carbon monoxide (CO) can alleviate cardiomyocyte pyroptosis by downregulating the IL-33/ST2L axis in diabetic cardiomyopathy (DCM). The diabetic mouse model was established and treated with CO-releasing molecule-2 (CORM-2) or invalid CORM-2 (iCORM-2). For in vitro studies, cardiomyocytes were treated with high glucose (HG). The HG-treated cardiomyocytes exhibited increased IL-33, ST2L, and pyroptosis-related protein expression compared with that in the control group (p < 0.05). Treatment with recombinant IL-33 further increased the expression of HG-induced pyroptosis-related proteins (p < 0.05). Compared with control mice, DCM mice showed reduced cardiac function and elevated expression of IL-33, ST2L, and pyroptosis-related proteins (p < 0.01). Intervention with CORM-2 ameliorated cardiac injury, and decreased the expression of IL-33, ST2L, and pyroptosis-related proteins in vivo and in vitro (p < 0.05). However, iCORM-2 had no effect both in vivo and in vitro. In conclusion, CO may inhibit cardiomyocyte pyroptosis by downregulating the IL-33/ST2L axis in DCM mice.
54. Phosphoprotein Profile of Ameloblastoma.
期刊: Asian Pacific journal of cancer prevention : APJCP 发表日期: 2025-Aug-01 链接: PubMed
摘要
Ameloblastoma (AM) is a well-known benign odontogenic tumor recognized for its aggressive nature, believed to originate from tooth-forming tissue or the dental follicle (DF). Phosphoproteins are crucial for cellular signaling, enabling intracellular communication and regulating various physiological processes. In cancer, phosphoproteins are fundamental to both pathogenesis and pathophysiology. However, studies on phosphoproteins in AM are still limited. This study aimed to compare phosphoprotein profile and identify the crucial phosphoproteins between AM and DF. The phosphoprotein profiles of seven AM and five DF were discovered using mass spectrometry, and their associated phosphosites were examined by Netphos 3.1. Biological functions were analyzed by Metascape database. Thirteen significant phosphoproteins were found in AM, and six in DF, all of which have phosphorylation sites. For example, among the proteins uniquely identified in AM were SENP1 (Sentrin-specific protease 1), DDX42 (ATP-dependent RNA helicase DDX42), LMBR1L (Protein LMBR1L), Cathepsin H (CATH), and Retinoblastoma-binding protein 5 (RBBP5), whereas those unique to DF included GC-rich sequence DNA-binding factor (GCF), Plexin-C1 (PLXC1), and proline/serine-rich coiled-coil protein 1 (PSRC1), PTHD3 (Patched domain-containing protein 3), and TPC6B (Trafficking protein particle complex subunit 6B). For biological analysis, the enriched terms included processing of capped intron-containing pre-mRNA, signaling by rho GTPases, establishment of organelle localization, signaling by receptor tyrosine kinases and cell morphogenesis. These phosphoproteomic findings provide essential insights into the pathogenesis of AM and warrant further investigation. This is crucial for advancing our understanding of AM biology and identifying potential therapeutic targets.
55. A Case-Control Study on Combined Effects of Base Excision Repair and Nucleotide Excision Repair Gene Polymorphisms in Gastrointestinal Cancer Susceptibility.
期刊: Asian Pacific journal of cancer prevention : APJCP 发表日期: 2025-Aug-01 链接: PubMed
摘要
Gastrointestinal (GI) cancer constitute a major global health problem influenced by genetic and environmental factors. Genetic variations within base excision repair (BER and) nucleotide exchange repair (NER) pathway genes can impact DNA repair capacity. Investigating the combined effects of BER and NER pathway genes offers a promising avenue for understanding their impact on cancer susceptibility. This study was aimed to address combined effects of genetic variants in BER and NER on the risk of developing GI cancer. Genetic polymorphisms within BER and NER genes were examined in two hundred histologically confirmed GI cancer cases, along with equal number of controls by the PCR-RFLP technique. Odds ratios (OR) with 95% CI and associated p-values were computed to assess an extent of association of these polymorphisms with GI cancer susceptibility, with statistical significance established at p ≤0.005. Regression analysis revealed compelling evidence of synergistic effects between specific variant genotypes. Notably, combinations involving variants of XPG (rs17655) and XRCC1 (rs1799782) (OR=2.20; 95% CI: 1.02-4.72; p=0.042) and XRCC1 (rs25487) (OR=2.56; 95% CI: 1.39-4.72; p=0.002) as well as XPD (rs238406) and XRCC1 (rs1799782) (OR=3.02; 95% CI: 1.60-5.70; p=0.0006) and XCC1 (rs25487) (OR=6.63; 95% CI: 3.63-12.10; p=0.0001) exhibited significant associations with increased GI cancer risk within the study population. These findings suggested combined influence of SNPs within XRCC1, XRCC3, and APE1, in combination with polymorphisms of XPC and XPD, on the development of GI cancer. Nonetheless, further investigations on larger scale are warranted to validate and expand upon these observations.
56. Common Mental Health Symptoms in Personnel Working in Helicopter Emergency Medical Services: A Systematic Review.
期刊: Air medical journal 发表日期: 2025 链接: PubMed
摘要
Helicopter emergency medical service (HEMS) personnel regularly respond to severe and life-threatening situations, often involving critically ill or injured patients. Yet limited research exists on their mental health outcomes compared with ground-based emergency medical services (EMS). This systematic review synthesizes empirical evidence on mental health symptoms among HEMS personnel, focusing on prevalence rates and key psychological outcomes. A systematic search of PubMed, PsycINFO, and Scopus identified original, quantitative studies in English or Scandinavian languages. Studies were included if they reported on at least 1 mental health outcome of interest in HEMS personnel. Study quality was rated using criteria adapted from the National Institute of Health’s Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. From 987 identified articles, 33 full texts were screened, and 9 studies were included, comprising 1 longitudinal and 8 cross-sectional designs. Six studies were rated as being fair quality, 2 as good, and 1 as poor. Outcomes evaluated included depression (5 studies), stress (5 studies), post-traumatic stress disorder/symptoms (PTSD; 3 studies), burnout (3 studies), anxiety (2 studies), secondary traumatic stress (1 study), and compassion fatigue (1 study). Across all studies, HEMS personnel reported low prevalence rates for mental health symptoms. However, burnout and depression were more frequently highlighted as concerns than PTSD. Despite regular exposure to traumatic stressors, HEMS personnel report low levels of stress, PTSD, anxiety, and secondary traumatic stress, whereas burnout and depression had slightly higher levels, suggesting the need for targeted preventive interventions and support mechanisms within HEMS environments.