公共卫生研究摘要 (2025-08-26)
共收录 51 篇研究文章
1. Engagement in Medical Care Among People Living with HIV in Rhode Island, 2019-2024.
期刊: Rhode Island medical journal (2013) 发表日期: 2025-Sep-02 链接: PubMed
摘要
2. Assessment of Obstetric Providers' Practice Surrounding Vaccine Counseling and Administration for Non-Birthing Partners.
期刊: Rhode Island medical journal (2013) 发表日期: 2025-Sep-02 链接: PubMed
摘要
Society guidelines recommend caregivers of neonates, including both co-parents, be up to date on Tdap, COVID-19, and influenza vaccines before delivery to prevent primary transmission of vaccine-preventable diseases to the infant. However, only one third of reproductive-age individuals are up to date on recommended vaccinations. Pregnant individuals often receive recommended vaccines during prenatal care, but limited research has investigated if prenatal care can also provide opportunities to increase vaccination rates among non-birthing partners/co-parents. We administered an anonymous survey to outpatient prenatal care providers, including Obstetricians, Family Medicine physicians, Certified Nurse Midwives, and Nurse Practitioners, to assess practice patterns and opinions regarding vaccine counseling and in-office vaccination for the non-birthing partners of pregnant patients. Of the 200 obstetric providers surveyed, 112 responded (56%). Of these, 42% (n=77) reported counseling non-birthing partners on vaccine recommendations less than half the time. Only 4% (n=4) of respondents report vaccinating non-birthing partners who are not already patients in their practice. Nearly half of providers who do not offer non-birthing partner vaccination had never considered the practice (46%, n=44). The majority of respondents desired more education on non-birthing partner vaccination (58%, n=55). Respondents identified multiple implementation barriers to vaccinating non-birthing partners, including difficulties with registration, staffing, and time constraints. If barriers were addressed, 68% (n=65) of providers expressed willingness to incorporate non-birthing partner vaccination into their practice. This study demonstrates willingness of key stakeholders to incorporate non-birthing partner vaccination into prenatal care, a unique mechanism to increase parental vaccination rates and protect neonates from vaccine-preventable illness.
3. De novo rates of a Trypanosoma-resistant mutation in two human populations.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Sep-02 链接: PubMed
摘要
Mutation rates have long been measured as averages across many genomic positions. Recently, a method to measure the rates of individual mutations was applied to a narrow region in the human hemoglobin subunit beta (HBB) gene containing the site of the hemoglobin S (HbS) mutation as well as to a paralogous hemoglobin subunit delta (HBD) region, in sperm samples from sub-Saharan African and northern European donors [Melamed et al., Genome Res. 32, 488-498 (2022)]. The HbS mutation, which protects against malaria while causing sickle-cell anemia in homozygotes, originated de novo significantly more frequently in the HBB gene in Africans compared to the other three test cases combined (the European HBB gene and the European and African HBD gene). Here, we apply this approach to the human apolipoprotein L1 (APOL1) gene containing the site of the G1 1024A→G mutation, which protects against African sleeping sickness caused by Trypanosoma brucei gambiense while causing a substantially increased risk of chronic kidney disease in homozygotes. We find that the 1024A→G mutation is the mutation of highest de novo origination rate and deviates most from the genome-wide average rate for its type (A→G) compared to all other observable mutations in the region and that it originates de novo significantly more frequently in Africans than in Europeans-i.e., in the population where it is of adaptive significance. The results are unexpected given the notion that the probability of a specific mutational event is independent of its value to the organism and underscore the importance of studying mutation rates at the individual-mutation resolution.
4. Comparison of an Energy-Reduced Mediterranean Diet and Physical Activity Versus an Ad Libitum Mediterranean Diet in the Prevention of Type 2 Diabetes : A Secondary Analysis of a Randomized Controlled Trial.
期刊: Annals of internal medicine 发表日期: 2025-Aug-26 链接: PubMed
摘要
Limited research has been done to evaluate the combined effect of energy reduction, Mediterranean diet (MedDiet), and physical activity on type 2 diabetes incidence. To evaluate whether an energy-reduced MedDiet (erMedDiet) plus physical activity reduces diabetes incidence compared with a standard MedDiet. Prespecified secondary outcome analysis in the PREDIMED (Prevención con Dieta Mediterránea)-Plus randomized, single-blinded, controlled trial. (ISRCTN Registry: ISRCTN89898870). 23 centers across Spain. 4746 adults aged 55 to 75 years with metabolic syndrome and overweight or obesity, without prior cardiovascular disease or diabetes. Participants were randomly assigned 1:1 to an intervention group receiving an erMedDiet (planned reduction of 600 kcal per day), increased physical activity, and behavioral strategies for reducing weight, or a control group receiving ad libitum MedDiet advice. Diabetes incidence was based on the American Diabetes Association criteria. Anthropometric measurements were obtained annually. Cox regression models were used to assess the intervention effect. The 6-year absolute risk was 12.0% (95% CI, 11.9% to 12.1%) in the control group (349 cases) and 9.5% (CI, 9.4% to 9.5%) in the intervention group (280 cases). Over a median 6-year follow-up, diabetes incidence was 31% (CI, 18% to 41%) relatively lower in the intervention group compared with the control group, with an absolute risk reduction of -2.6 cases (CI, -2.7 to -2.4) per 1000 person-years. The intervention group attained better adherence to the erMedDiet, higher physical activity levels, and greater reductions in body weight and waist circumference. Secondary outcome, single-blinded design, and self-reported dietary adherence. An intensive intervention with the MedDiet adding caloric reduction, physical activity, and modest weight loss was more effective than only an ad libitum MedDiet in reducing diabetes incidence in overweight/obese persons with metabolic syndrome. Instituto de Salud Carlos III.
5. High-Concentration Delta-9-Tetrahydrocannabinol Cannabis Products and Mental Health Outcomes : A Systematic Review.
期刊: Annals of internal medicine 发表日期: 2025-Aug-26 链接: PubMed
摘要
Rapid changes in the legalized cannabis market have led to the predominance of high-concentration delta-9-tetrahydrocannabinol (THC) cannabis products. To systematically review associations of high-concentration THC cannabis products with mental health outcomes. Ovid MEDLINE through May 2025; EMBASE, Allied and Complementary Medicine Database, Cochrane Library, Database of Abstracts of Reviews of Effects, CINAHL, and Toxicology Literature Online through August 2024. Two reviewers independently selected studies with high-concentration THC defined as greater than 5 mg or greater than 10% THC per serving or labeled as “high-potency concentrate,” “shatter,” or “dab.” Outcomes included anxiety, depression, psychosis or schizophrenia, and cannabis use disorder (CUD). Results were categorized by association direction and by study characteristics. Therapeutic studies were defined by use of cannabis to treat medical conditions or symptoms. Ninety-nine studies (221 097 participants) were included: randomized trials (42%), observational studies (47%), and other interventional study designs (11%); more than 95% had moderate or high risk of bias. In studies not testing for therapeutic effects, high-concentration THC products showed consistent unfavorable associations with psychosis or schizophrenia (70%) and CUD (75%). No therapeutic studies reported favorable results for psychosis or schizophrenia. For anxiety and depression, 53% and 41% of nontherapeutic studies, respectively, reported unfavorable associations, especially among healthy populations. Among therapeutic studies, nearly half found benefits for anxiety (47%) and depression (48%), although some also found unfavorable associations (24% and 30%, respectively). Moderate and high risk of bias of individual studies and limited evaluation of contemporary products. High-concentration THC products are associated with unfavorable mental health outcomes, particularly for psychosis or schizophrenia and CUD. There was some low-quality evidence, inconsistent by population, for therapeutic benefits for anxiety and depression. Colorado General Assembly, House Bill 21-1317.
6. Reducing Diabetes Risk Through the Mediterranean Diet.
期刊: Annals of internal medicine 发表日期: 2025-Aug-26 链接: PubMed
摘要
7. Carrier-free Nano-Tetrandrine (PURE-T) for Psoriasis Treatment: Significant Therapeutic Efficacy and Its Regulatory Mechanism on Stratum Corneum Inflammation.
期刊: ACS applied materials & interfaces 发表日期: 2025-Aug-25 链接: PubMed
摘要
As an incurable systemic autoimmune disease, psoriasis is in urgent need of safe and effective treatment strategies. As a natural product extracted from Chinese herbs, Tetrandrine (Tet) has a wide range of pharmacological effects. In this study, we developed a carrier-free nano Tet topical formulation (PURE-T) by antisolvent method, and verified that it could selectively attenuate the toxicity of HaCaT cells in the normal state and potentiate the efficacy of HaCaT cells in the inflammatory state in vitro, and in vivo experiments verified that it could normalize the epidermal layer of the skin of imiquimod (IMQ)-induced psoriasis-like mice, and reduce the infiltration of inflammatory cells in the superficial layer of the dermis; mechanistic studies suggested that PURE-T may achieve therapeutic treatment of psoriasis through the GSDMC-mediated noninflammatory pyroptosis pathway. This safe, effective, carrier-free topical nanoformulation has potential for clinical translation and large-scale production.
8. Physician Use of Large Language Models: A Quantitative Study Based on Large-Scale Query-Level Data.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-25 链接: PubMed
摘要
Generative artificial intelligence (GenAI) has rapidly emerged as a promising tool in health care. Despite its growing adoption, how physicians make use of it in medical practice has not been qualitatively studied. Existing literature has largely focused on theoretical applications or experimental validations, with limited insight into real-world physician engagement with GenAI technologies. The aim of this study was to leverage a fine-grained dataset at the query level to quantitatively examine how physicians incorporate GenAI into their clinical and research workflows. The primary objective was to analyze usage patterns over time and across physician demographics. A secondary goal was to assess potential risks to patient privacy arising from physicians’ interactions with GenAI platforms. This study collected 106,942 query-and-answer pairs by 989 physicians between August 29, 2023, and April 16, 2024. We performed topic classification to identify the most prevalent use cases, examining how these use cases evolved over time and across demographics. We also developed sensitivity classifiers to detect personally identifiable information in physicians’ queries to explore the potential privacy breach risks around physicians’ use of GenAI. Approximately 40% (396/989) of the enrolled physicians were female, 45.9% (454/989) were younger than 25 years, and 54.1% (535/989) were between 25 and 56 years of age. The majority of them worked in clinical departments (680/989, 68.8%) or medical technology departments (127/989, 12.8%). Our classification-based quantitative analyses suggest the following. First, physicians use GenAI predominantly for medical research (64,379/106,942, 60.2%) rather than clinical practice (13,100/106,942, 12.25%). Second, physicians focus more on health care-related questions (rising from 64,165/106,942, 60% to 83,415/106,942, 78%) within the first 15% (16,041/106,942) of their query sequence. Third, the use of GenAI differed across physician demographics and features. Specifically, female physicians asked a larger proportion of clinical questions (female: 0.154 vs male: 0.108; P<.001) and administration questions (female: 0.027 vs male: 0.018; P<.001) than male physicians; younger physicians posed more clinical questions (age ≤25: 0.146 vs age ∈ (25, 40]: 0.115 vs age >40: 0.103; P<.001) but fewer research questions (age ≤25: 0.580 vs age ∈ (25, 40]: 0.607 vs age >40: 0.664; P<.001) than senior physicians; and physicians accessing GenAI via computers asked more research questions (computer: 0.637 vs mobile: 0.296; P<.001), whereas physicians using mobile devices asked more clinical questions (computer: 0.107 vs mobile: 0.264; P<.001). Fourth, only 2.68% (2866/106,942) of physician queries contained sensitive information, the majority of which were primarily derived from writing and editing. Physicians are actively integrating GenAI into their professional routines, primarily leveraging it for research but also increasingly for clinical support. Usage patterns vary significantly across demographic lines, including gender, age, and device preference. Despite the presence of sensitive information in some queries, the risk of privacy breaches appears to be low.
9. What to Consider When Developing Multidomain Mobile Health Interventions for Lifestyle Management.
期刊: JMIR mHealth and uHealth 发表日期: 2025-Aug-25 链接: PubMed
摘要
Mobile health (mHealth) interventions can transform health care delivery and improve public health. At the same time, the evidence on lifestyle interventions continues to grow. They show promising results in preventing and treating noncommunicable diseases and enhancing health-related quality of life. These factors highlight the potential of multidomain mHealth interventions for lifestyle management. This viewpoint paper focuses on drawing valuable lessons from past experiences and providing guidance to developers of mHealth interventions for lifestyle management. We underscore the critical role of sharing practical insights to advance innovation in the field of mHealth interventions. We used an iterative consensus process to derive lessons learned, identify challenges, and reflect on possible actions. Our insights are based on our experience in developing 2 smartphone-based lifestyle interventions. Challenges and corresponding options in the following areas are presented: target population (preferences, personalization, and delivery), user involvement and testing, human support, and multidomain interventions (interdisciplinarity, flexibility, and core team). The development of multidomain mHealth interventions for lifestyle management requires a participatory and iterative approach involving relevant stakeholders (including end users) so that the right people get the right content at the right time. Additionally, it is crucial to consider established frameworks, guidelines, and regulations; allocate appropriate resources; and form a core team committed to the project’s aims and open to working in an interdisciplinary team.
10. Implementation Status and Usability of Digital Health Interventions Among Health Care Workers and End Users at the Primary Health Care Level in Chandigarh, North India: Cross-Sectional Study.
期刊: JMIR formative research 发表日期: 2025-Aug-25 链接: PubMed
摘要
Digital health interventions (DHIs) refer to the use of information and communication technologies to support or facilitate the achievement of health objectives. The Government of India has launched various DHIs at the primary health care level to improve health services and health-seeking behaviors. However, there is a paucity of evidence on the effectiveness of implementing these interventions and the user response from target end-users within the government health system setting. This study aimed to assess the implementation status of DHIs and the user response of target end users, that is, the general population and health care workers (HCWs), in health and wellness centers (HWCs) in Chandigarh, India. A cross-sectional study was conducted to assess the implementation status of 9 DHIs: the Electronic Vaccine Intelligence Network (eVIN), Reproductive and Child Health (RCH), Health Management Information System (HMIS), HWC portal, Comprehensive Primary Health Care-Noncommunicable Disease (CPHC-NCD), Family Planning-Logistics Management Information System (FP-LMIS), eSanjeevani, Integrated Disease Surveillance Program-Integrated Health Information Program (IDSP-IHIP) portal, Aarogya Setu, and the COVID-19 Vaccine Intelligence Network (CoWIN) app. Data were collected from 4 purposively selected HWCs using a pretested data extraction form and observation checklist from June to September 2022. The implementation status of these DHIs was evaluated by categorizing indicators into input, process, and output components and estimating cumulative percentage scores using a score-based logic model framework. Pretested interview schedules were used to assess awareness and user response of DHIs among 120 target end users (clients visiting HWCs) and 120 HCWs (auxiliary nurse midwives, data entry operators, and medical officers). The prevalence of user response was then estimated. The implementation status scores of the eVIN and RCH portals ranged from 70% to 90%. The HMIS portal, HWC portal, CPHC-NCD portal, and FP-LMIS scored between 25% and 50%, while eSanjeevani and the IDSP-IHIP portal scored between 51% and 70%. Community awareness of DHIs was poor, ranging from 1% to 18.3%, except for Aarogya Setu (94/120, 78.3%) and the CoWIN app (43/120, 35.8%), despite 86.7% (104/120) of participants having access to a mobile phone. Low awareness of DHIs was significantly associated with lower socioeconomic status (P=.02) and lower education levels (P=.04). In total, 66% (80/120) of HCWs reported that working with DHIs was easy; however, 89.2% (107/120) stated that dual data entry increased their workload. Frequent technical glitches were most commonly reported for the Auxiliary Nurse Midwife OnLine app (78/80, 97%) by HCWs. Help desk or feedback options in DHIs were rarely used by auxiliary nurse midwives/multipurpose workers (0%-3.8%). The RCH and eVIN portals were effectively implemented, eSanjeevani was moderately implemented, while the HMIS, HWC portal, CPHC, and FP-LMIS were poorly implemented. Community awareness of DHIs was low, except for the Aarogya Setu and CoWIN apps. Although HCWs found DHIs easy to use, increased workload due to dual data entry and frequent technical issues was a key concern.
11. Navigating Visibility on Weibo Among People Living With HIV: Qualitative Study.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-25 链接: PubMed
摘要
By the end of 2022, 1.223 million people were living with HIV in China. Beyond medical challenges, they often face stigma and social exclusion. In China, Sina Weibo (Sina Corporation), with over 582 million monthly active users as of 2022, has emerged as a critical space for people living with HIV, many of whom identify as “A-friends.” They navigated these complex dynamics of visibility. In this context, visibility, understood as both the capacity to be seen and the power relations it entails, is a central affordance of social media. This study aimed to explore how A-friends navigate their visibility on Weibo, focusing on the dual-edged nature of visibility. It examines how visibility can empower marginalized groups while also exposing them to risks. The study highlights the tension between these dynamics and aims to inform the creation of supportive digital environments that balance empowerment with protection from harm. We conducted nonparticipant observation and semistructured interviews with 30 A-friends, recruited through opportunistic and snowball sampling on social media platforms. The data were analyzed thematically using NVivo 11.0 (QSR International). Among the participants, 86.67% (26/30) were interviewed via internet-based voice chat, 10% (3/30) offline, and 3.33% (1/30) by text. To confirm theoretical saturation, 3 additional interviews were coded separately, yielding no new themes. As shown by the data, the majority of participants (56.67%, 17/30) were aged between 30 years and 40 years, with 43.33% (13/30) holding a bachelor’s degree or higher. Most participants (46.67%, 14/30) were diagnosed with HIV 1-5 years ago, and all participants were asymptomatic. After coding the interviews, we identified 2 overarching themes during the development of the coding framework, each comprising 3 subcategories, resulting in a total of 6 subcategories. Theme 1 highlighted the positive implications of visibility, referred to as the Climb Effect, which included (1) self-reconstruction through illness narratives, (2) relational bonding and community building, and (3) public advocacy to challenge stigma. Theme 2 focused on the negative consequences, termed the Slide Effect, which encompassed (1) the reproduction of social exclusion and limited public empathy, (2) privacy concerns and risks of unintended disclosure, and (3) ego depletion. This study highlights the layered and cyclical nature of visibility in online health communities, which we conceptualize through a visibility ladder model. Self-visibility promotes personal growth, health self-management, and psychological resilience but also introduces risks of self-stigmatization and emotional exhaustion. Social visibility strengthens peer support and shared identity while exposing individuals to privacy breaches and misinformation. Public visibility empowers collective action and advocacy, yet is constrained by persistent societal stigma and platform algorithms that limit audience reach. Future efforts should prioritize enhancing eHealth literacy, strengthening privacy protections, and promoting inclusive, stigma-reducing digital environments to optimize the benefits of visibility and mitigate its potential harms.
12. First report of adult Taenia solium in human brain with neurocysticercosis: illustrative case.
期刊: Journal of neurosurgery. Case lessons 发表日期: 2025-Aug-25 链接: PubMed
摘要
This report presents the first documented case of a live, adult Taenia solium tapeworm discovered within the human brain-a finding that challenges the conventional understanding of neurocysticercosis (NCC), a parasitic disease typically caused by larval cysts. A 54-year-old woman with a history of breast cancer presented with seizures, headaches, and photophobia. Initial suspicion of a metastatic brain tumor led to serial MRI studies, which revealed a migrating lesion in the right temporal lobe. During craniotomy, a motile helminth was surgically excised from the brain parenchyma. Histopathological analysis confirmed that the organism was an adult T. solium tapeworm, with taeniid eggs identified within the specimen, marking the first evidence of intracranial adult taeniasis and ectopic cerebral oviposition. The patient’s prior oncological treatments, including mastectomy and postoperative therapies, raise hypotheses about immune or anatomical changes facilitating parasitic neuroinvasion. The discovery underscores critical gaps in diagnostics, as the lesion mimicked metastatic cancer radiologically, and therapeutics, as standard cysticidal drugs target larval stages, not adult worms. This report highlights the urgent need to investigate interactions between parasitic infections and oncological interventions. It calls for updated clinical guidelines to address this novel pathogenic mechanism and emphasizes the importance of integrating parasitological expertise into neurological care. https://thejns.org/doi/10.3171/CASE25370.
13. Assessing an eHealth Intervention on Quality of Life in Patients With Chronic Lymphocytic Leukemia and Myelodysplastic Syndromes: The MyPal Randomized Controlled Trial.
期刊: JCO oncology practice 发表日期: 2025-Aug-25 链接: PubMed
摘要
The MyPal study (ClinicalTrials.gov identifier: NCT04370457) is a randomized controlled clinical trial assessing an eHealth intervention on the quality of life (QoL) of patients with chronic lymphocytic leukemia (CLL) and myelodysplastic syndromes (MDS). Patients who were receiving or had previously received treatment for CLL or MDS were randomly assigned (1:1) to access the MyPal digital health platform versus standard of care. The MyPal platform included a smartphone application used to report QoL status and symptoms via standardized questionnaires or spontaneous reporting. The primary end point was QoL at 12 months, assessed by the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 General Questionnaire and the EuroQol EQ-5D-3L. Secondary end points included physical and emotional functioning, measured by the Integrated Palliative Care Outcome Scale (IPOS) scale, satisfaction with care, measured by the EORTC PATSAT-C33, and overall survival (OS). Additionally, the Edmonton Symptom Assessment System (ESAS), Brief Pain Inventory (BPI), and Emotion Thermometers (ET) QoL questionnaires were assessed only in the intervention group. A total of 171 patients (97 and 74 in the control and intervention arms, respectively) who answered multiple questionnaires were analyzed. The intervention group reported a significant decrease in pain (β2 = -0.48 [-0.77 to -0.19], P < .001) compared with the control group (β1 = 0.3 [0.09 to 0.5], P = .01). Communication and pain measured by IPOS reduced equally in both groups (β2 = 0 [-0.03 to 0.02], P = .82; β2 = -0.01 [-0.02 to 0], P = .1, respectively). Family involvement significantly increased over time only for the intervention group. The other items of EORTC QLQ-C30, EuroQol EQ-5D-3L, IPOS, and PATSAT-C33 remained unchanged in both groups. The intervention group displayed a significant improvement in all ESAS, BPI, and ET scales. OS was similar in both groups. The MyPal intervention improved several QoL aspects and led to a statistically significant decrease in pain compared with the control group.
14. Leveraging Smartphone Mobility Data to Understand HIV Risk Among Rural South African Young Adults: Feasibility Study.
期刊: JMIR mHealth and uHealth 发表日期: 2025-Aug-25 链接: PubMed
摘要
Smartphones provide a precise method to study human mobility at an unprecedented scale, allowing researchers to explore the links between mobility, HIV risk, and treatment outcomes. However, leveraging smartphone technology to study HIV risk in rural settings presents unique challenges and opportunities. This study assessed the feasibility of using smartphone GPS technology to collect mobility data from young adults in rural KwaZulu Natal, South Africa. We also present key lessons learned during the study. The study was conducted in 2 phases (June 2021-May 2023) with males and females aged 20-30 years old. In phase I, participants received smartphones with a customized study app (Avicenna research software). In phase II, they used their personal smartphones and installed the study app. The app used Android location services to record the smartphone location every 30 minutes and send it to a secure study server hourly. Participants were followed up for 6 months (26 wk). If location data were missing for 48-72 hours, participants were contacted for troubleshooting. Engagement strategies, including reverse billing and gamification (Wheel of Fortune), were implemented to address internet connection barriers and aid data collection. A total of 207 participants were enrolled (phase I: 163; phase II: 44) with 204 providing mobility data. Participants recorded 27.6 million location points with a median number of 74,865 (IQR 28,471-186,578) per participant. The mean weekly location points recorded was 95.3 out of 336 possible half-hour intervals (28.4%). Phase II saw more stable data collection in the latter half of the study, due to increased user engagement with the app. Challenges included phone-related issues (screen malfunctions, lost and broken phone), app terminations, and limited internet connectivity. Reverse billing and gamification strategies improved location data collection through increased user engagement. This study demonstrates that the use of smartphone-based GPS technology is feasible among young adults in a rural South African setting. Although only 28.4% (95.3/336) of expected weekly location data were collected, the study offers insights into engagement strategies that can be used to enhance location data collection in similar contexts. Continuous troubleshooting identified challenges and informed solutions to data collection gaps. Reverse billing system and gamification resulted in significant increases in location data received. These findings underscore the potential of integrating mobile health tools into health systems to better support high-risk mobile populations.
15. Web-Based Assessment of Cognition and Dementia Risk Factors in Over 3000 Norwegian Adults Aged 50 Years and Older: Cross-Sectional PROTECT Norge Study.
期刊: JMIR aging 发表日期: 2025-Aug-25 链接: PubMed
摘要
With the growing number of older adults in the Norwegian population and the associated rapid rise in dementia and cognitive impairment, novel and more efficient methodologies are needed to facilitate research, improve diagnostic triage, and deliver effective brain health interventions in the community. Platform for Research Online to Investigate Genetics and Cognition in Ageing Norge (PROTECT Norge) is a web-based, remote research platform on the aging brain, culturally adapted from the UK PROTECT study, incorporating a Norwegian cohort of adults aged 50 years and older, where participants complete study activities via a dedicated website. Data were collected through study activities, which included self-reported questionnaires and a computerized neuropsychological test battery. The study aimed to assess associations between dementia risk factors, including obesity, hypertension, smoking, and hearing loss, and cognition using baseline data from the PROTECT Norge study. Data from the PROTECT Norge study were used to assess associations between dementia risk factors and cognition. These associations were assessed using independent-sample t tests for each of the cognitive tests, which included paired associate learning, self-ordered search, digit span, and verbal reasoning tasks. During the first 2 years of data collection, records from 3214 participants were obtained. Associations between established risk factors and cognitive performance were found, with significant detriments to cognitive performance on the computerized neuropsychological test battery. In the PROTECT Norge cohort, consisting of 74.5% females, the mean age was 64.1 (SD 7.7), and 94% of participants provided consent for contact regarding future research. These data show the associations between dementia risk factors and cognition and attest to the excellent feasibility of the PROTECT Norge cohort, with over 3000 participants included over a period of 2 years and accessibility for people with early cognitive impairment. This, combined with the cohort’s willingness to participate in future studies (94%), positions PROTECT Norge as a tremendous opportunity for cost-efficient, large-scale brain health research and potentially for clinical digital cognitive health programs.
16. More Than a Code: Getting the Epidemiology of Fibrotic Interstitial Lung Disease Right.
期刊: Annals of the American Thoracic Society 发表日期: 2025-Aug-25 链接: PubMed
摘要
17. Digital Tools for People Without an Alzheimer Disease or Dementia Diagnosis: Scoping Review.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-25 链接: PubMed
摘要
The field of Alzheimer disease (AD) has been moving toward earlier detection, personalized assessment of dementia risk, and dementia prevention. In the near future, a gap is expected between the growing demand for Alzheimer-related health care and a shrinking workforce. Responsibility is increasingly assigned to individuals to take an active role in their own brain health management and dementia prevention. Digital tools are thought to offer support regarding these processes. The aim of this scoping review is to create an overview of digital tools published in scientific literature in the context of AD and dementia aimed at people without an AD or dementia diagnosis as primary end users interacting with these digital tools. Additionally, we aim to gain insight into study sample diversity, the stage of maturity and evaluation of these tools, and recommended future directions. PubMed, IEEE Xplore, Ovid, and Web of Science were searched in January 2023, using terms related to AD and dementia, (pre-)disease stages, digital tools, and various purposes of digital tools. Two independent reviewers screened the titles and abstracts of 2811 records and subsequently 408 full-text articles, based on inclusion and exclusion criteria. Articles on tools targeting those with an AD or dementia diagnosis were excluded. Data extraction included information on the sample characteristics, the digital tool, stage of maturity and evaluation, and future (research) directions. We included 39 articles, which were aimed at primary prevention (14/39, 36%), secondary prevention (11/39, 28%), daily life support (8/39, 21%), self-administered screening (4/39, 10%), or decision-making (2/39, 5%). Variation in the study sample emerged regarding cognitive abilities (healthy: 11/39, 28%; mild cognitive impairment: 12/39, 31%; [subjective] cognitive impairment: 9/39, 23%; “no dementia”: 1/39, 3%; and variation of cognitive abilities: 6/39, 15%). Less variation was found regarding sex (>50% female: 27/39, 69%), education (>50% high education: 13/39, 33%), and age (>50% >60 y: 23/39, 59%). Few articles reported on ethnicity (12/39, 31%) and digital literacy (11/39, 28%). Most tools were in an early evaluation and maturity stage (31/39, 80%), comprising preprototyping (1/35, 3%), prototyping (15/35, 43%), pilot testing (19/35, 54%), efficacy testing (18/40, 45%), usability testing (12/40, 30%), and feasibility testing (10/40, 25%). Future (research) directions comprised the need for further tool development, attention to diversity, and study advancements, such as large-scale longitudinal studies. Almost 80% of tools as reported on in academic literature are in early development comprising early stages of maturity and evaluation. Studies and evidence gathered for digital tools developed in the context of AD or dementia aimed at people without an AD or dementia diagnosis are thus preliminary and further development, research, and policy are required before these tools can be implemented for assessing, supporting, and preventing cognitive decline.
18. Comprehensive at-home sexually transmitted and blood borne infection (STBBI) testing program: A pilot study.
期刊: International journal of STD & AIDS 发表日期: 2025-Aug-25 链接: PubMed
摘要
BackgroundRates of sexually transmitted and blood borne infections (STBBI) are rapidly increasing. Despite the high diagnostic accuracy of self-testing, no fully remote STBBI testing programs are available in Canada. We aimed to evaluate the feasibility and acceptability of a fully-remote, web-based, at-home STBBI testing (self-collection) program in Calgary, Canada.MethodsParticipants who were Alberta residents aged ≥16 years self-enrolled into a web-based platform between February 2023 and March 2024 and completed consent and intake questionnaires consisting of demographic and sexual health data. Kits were mailed, and samples were self-collected including swabs, urine and dried blood spot cards. Results of processed kits were communicated securely to participants. Surveys to assess the feasibility and acceptability of the process were completed.ResultsOf the 156 participants (39.7% men, 37.3 ± 10.5 years) from diverse sex and gender backgrounds who completed the intake, 43% (n = 67) participants returned their testing kits. In the cohort, there was low reported condom use in more than 50%, and 40% had not had STBBI testing in the past 12 months. There were six participants (9.0%) with new positive tests for an STBBI and all were connected with appropriate treatment. Participants largely reported satisfaction with the web-based platform and testing process as well as ease with testing modalities with the except for dried blood spot testing which presented collection challenges.ConclusionsOur web-based comprehensive testing pilot was feasible and acceptable, demonstrating the value of such remote approaches to diminishing the threat of rising STBBI rates.
19. Evaluating COVID-19 vaccination policy in Québec (Canada) using a data-driven dynamic transmission model.
期刊: PLoS computational biology 发表日期: 2025-Aug-25 链接: PubMed
摘要
During the COVID-19 pandemic, decision-makers had imperfect information and faced resource constraints (i.e., vaccine availability). Public health decisions at the time may not have been optimal for minimizing disease burden. Here, we perform counterfactual evaluations of the impact of various vaccination strategies in Québec (Canada) on the COVID-19 burden from March 2020 to November 2021. In particular, we evaluate the effect of alternative age-specific prioritization sequences of vaccine dose roll-out and assess the impacts of vaccine hesitancy. To achieve this, we develop and calibrate a deterministic, compartmental dynamic transmission model, stratified according to age, susceptibility to infection, viral variant, and issue-specific immunity. The initial conditions and parameters of the model are obtained through a combination of population-based surveillance data and Approximate Bayesian Computation Sequential Monte Carlo (ABC-SMC) parameter estimation methods. We find that, using our calibrated model, the vaccination prioritization policies implemented at the start of the pandemic, where age groups at highest risk were sequentially prioritized, was only outperformed by prioritizing the vaccination of younger, more socially connected groups together with higher-risk individuals aged 50+ (3% fewer hospitalizations compared to the baseline strategy). These results hold when we account for vaccine hesitancy. Specifically, we generally observe the fewest hospitalizations for the optimal strategies at the highest uptake rates (i.e. with the least vaccine refusal). However, certain sub-optimal strategies show higher hospitalization rates for higher vaccine uptake as a result of reduced vaccine dose redistribution to more interconnected age groups. Overall, our findings illustrate how the impact of vaccination strategies depends on population factors (e.g. contact patterns, vaccine uptake, and degree of immunity), age-specific risk of severe disease and transmission dynamics. Understanding these dependencies are important for guiding future decision-making related to priority vaccine administration in the face of known and emerging pathogens and potential shortage of doses.
20. Shared decision-making and deprescribing to support anti-thrombotic therapy (dis)continuance for persons living with cancer in their last phase of life: A realist synthesis.
期刊: PLoS medicine 发表日期: 2025-Aug-25 链接: PubMed
摘要
Patients with cancer are at increased risk of thrombotic complications from both the disease and its treatments, with antithrombotic therapy (ATT) usually continued in the last phase of life where the benefit is less clear and there is high risk of harms. Physiological changes toward the end of life increase the risk that ATT will cause serious bleeding events, but discussion between clinicians and patients of ATT risks and benefits is sub-optimal. This realist synthesis explores shared decision-making (SDM) to: (a) provide insights into why prescribing continues in end-of-life care; (b) build a conceptual platform for optimizing ATT prescribing for persons living with cancer towards end-of-life. We conducted a realist synthesis using context-mechanism-outcome configurations and ‘if…then’ statements. A total of 17,036 citations identified across 10 databases (Medline, EMBASE, APA PsycInfo, CINAHL Complete, CDSR, CENTRAL, EPISTEMONIKOS, Web of Science Core Collection, Assia, Google Scholar). Ninety-one papers included following reverse chronology quota record screening (from: database searches (n = 56), consortium experts (n = 35)). Included papers: quantitative (n = 40), qualitative (n = 17), mixed-methods (n = 2), evidence syntheses (n = 16), commentaries (n = 9), case reports (n = 7). Exclusion criteria: persons <18 years, non-English language, not focused on SDM or deprescribing in palliative care. An analytic appraisal journal was used with realist logic to synthesize insights from included papers (contents from 43/91 included in this paper). The concept of ‘prescribing inertia’ was used to formulate explanatory theories about clinician reluctance to deprescribe and the mechanisms underpinning SDM, including (a) the meaning medications have to end-of-life patients (e.g., ‘life preserving’ or ‘symptom management’) and public awareness of medications (e.g., high-profile chemotherapy versus low-profile ATT) are determinants of: (i) clinician motivation to engage patients around deprescribing, (ii) patient understanding, volition and participation in SDM; (b) SDM for ATT deprescribing requires sensitive engagement with patients and families without removing positivity around survival and continuing clinician interest in their welfare; (c) multi-disciplinary clinical decision-making about timing and suitability of deprescribing in end-of-life care requires specialized consensus-driven processes and evidence-based decision support tools; (d) if patients are healthy enough, empowerment interventions outside clinical encounters (e.g., health literacy apps) may increase patient and family readiness to engage in deprescribing conversations; (e) organizational investments can facilitate discussion of deprescribing (e.g., improved electronic medical record prompts, clinician communication skills training, data presentation to clinicians of actual ATT risks). Limitations: despite robust screening and selection, the sample of included papers does not reflect the entirety of eligible source material and did not include a systematic search for papers focusing on low- and middle-income country countries. Implementation of ATT deprescribing is enabled or constrained by (a) the meaning of medications to patients; (b) clinician engagement and understanding; (c) multi-disciplinary clinical decision-making processes (including support tools); (d) patient empowerment; (e) organizational investment. Addressing these multi-level factors, including the development of SDM tools, can address the prescribing inertia that may cause devastating impacts on patients and their families as well as moral distress amongst healthcare staff. This study was performed as part of the Horizon-Europe funded SERENITY project.
21. How hot is too hot for people? A review of empirical models of perceptual, physiological and functional limits of human heat tolerance.
期刊: Experimental physiology 发表日期: 2025-Aug-25 链接: PubMed
摘要
How hot is too hot for people? This is a question that human thermal physiologists are asked often by a variety of knowledge users across the public and private sectors, who have grown aware of the negative impact of global warming on people’s health and quality of life. The aim of this paper is to provide a narrative review of models that quantify the limits of human heat tolerance across perceptual, physiological and functional domains. Several models exist that have identified critical environmental limits for heat tolerance across the perceptual, physiological and functional domains. However, no model is currently available that has evaluated all domains of heat tolerance concurrently and in the same participant cohort. Hence, by combining evidence from these models, here we propose a new holistic framework of heat tolerance that can help more comprehensively characterise the full spectrum of possible human responses to heat stress under free-living conditions. This framework highlights that human heat tolerance varies largely across the perceptual, physiological and functional domains, and that it is conceptually organised in line with the human body’s ability to regulate body temperature via behavioural and autonomic responses. While our new framework presents limitations in its generalisability beyond healthy young adult cohorts, we hope that it will inspire the design of new holistic research on human heat tolerance in a broader range of participant cohorts, to better inform person-centred heat resilience policies and interventions that protect human health and life quality under a warming climate.
22. Mapping Hot Spots and Global Research Trends in Exergaming Between 1997 and 2024: Bibliometric Analysis.
期刊: Interactive journal of medical research 发表日期: 2025-Aug-25 链接: PubMed
摘要
Exergaming, the combination of exercise and gaming, has emerged as an important area in physical activity (PA) research. By leveraging advances in video game technology, exergaming supports both physical and mental health. This growing interest in exergaming has increasingly attracted researchers over the years. Examining the development of exergaming research with a bibliometric approach is thought to offer valuable perspectives to researchers by revealing the trends and main contributions in the field. This study aims to identify the most researched concepts and topics in the field of exergaming; track the changes of trending topics over the years; identify the most influential journals as well as the authors who have contributed the most to the field; identify groundbreaking studies and neglected topics that shape future work; and reveal the countries, institutions, and collaborations that have contributed the most to the field. It also aims to identify research gaps in the field of exergaming and provide important recommendations for future research. A bibliometric analysis covering studies between 1997 and 2024 was conducted using the Web of Science database. The R-based Bibliometrix package and the Biblioshiny web interface were used for data analysis and visualization. The analysis included original research papers and reviews. These analyses provided insights into research trends, citation metrics, and thematic developments. A total of 1626 studies were analyzed, and the results indicated a steep rise in exergaming research since 2015, peaking in the years 2020-2021. Major high-impact journals publishing in this area include Games for Health Journal and International Journal of Environmental Research and Public Health. Researchers who have contributed significantly and enriched the knowledge base of the exergaming field included Gao Zan, Eling de Bruin, and Zeng Nan. The most cited studies were classified into 2 different clusters, namely, cluster 1 that focuses on the concepts of PA, exercise, energy expenditure, and children, while cluster 2 focuses on rehabilitation, balance, adults, and aging. Medicine, information technology, and intention are some of the emerging themes. From a research productivity perspective, there is an undisputed front-runner, the United States, but substantial contributions have definitely come from either the Swiss Federal Institute of Technology or the Karolinska Institute. Despite significant growth in exergaming research over the last decade, research gaps remain, particularly in understanding how exergaming can be effectively integrated into long-term PA promotion and broader health outcomes. These gaps were identified by the absence or low representation of relevant keywords (eg, “cost-effectiveness,” “community-based intervention,” and “long-term health outcomes”) in thematic mapping and keyword trend analyses and limited citation density in these areas. Future work should explore these issues more systematically to advance the field.
23. "I'd rather die": Patients' will and decision-making practice in Japanese community psychiatry.
期刊: Medical anthropology quarterly 发表日期: 2025-Aug-25 链接: PubMed
摘要
Recent mental health reforms have embraced patient autonomy and shared decision-making, where care unfolds through collaboration between clinicians and patients. However, how decision-making can improve in marginalized psychiatric clinics remains unclear. This paper examines how social psychiatrists at a Japanese community clinic engage with patients’ will-especially when it appears resistant, ambivalent, or self-destructive. At Sakura Clinic in Kanagawa, the challenge lies in navigating “strong will” (tsuyoi ishi)-instances where patients reject treatment, defy medical logic, or say, simply, “I’d rather die.” Here, decision-making stretches across time, shaped by evolving attunement between patients, clinicians, and their environments. When patients make risky choices, psychiatrists face an urgent ethical question: is this will an existential stance to be respected, or the mark of structural violence to be refused?
24. Young adult perspectives on dignity in mental healthcare.
期刊: Nursing ethics 发表日期: 2025-Aug-25 链接: PubMed
摘要
BackgroundThe promotion of human dignity lies at the core of ethical patient-centered healthcare and encompasses the inherent worth, value, and respect that patients deserve. Little is known about how this concept applies to the distinct needs and challenges faced by young adults (young adults) seeking mental healthcare.ObjectiveThis study hopes to provide deeper insights into young adults perspectives about the factors that contribute to and hinder their sense of human dignity within the mental healthcare system.Research designA descriptive qualitative approach was used to explore participant perspectives through semi-structured interviews. Thematic analysis was performed on the interview transcripts by three coders.Participants and research contextThirteen young adults patients attending an ambulatory mental health clinic for mood and anxiety disorders in London, Ontario participated in this study.Ethical considerationsThis study was conducted in accordance with the Declaration of Helsinki. It was approved by the Health Sciences Research Ethics Board at the University of Western Ontario.Findings/resultsYound adults interviewed emphasize equality and equity as crucial aspects of dignity, value agency and involvement in healthcare decision-making as well as opportunities to engage with peers, and recognize system wide constraints as a barrier to feeling as though they have dignity within the healthcare system.ConclusionsWhile the young adults interviewed acknowledged that dignity is inherent to all people, they emphasized that all people are not treated as though they have dignity either in mental healthcare or in broader society based on their social location. To provide dignity affirming mental healthcare for young adults, clinicians should: approach their relationship with clients from a lens of cultural humility to provide individualized care, directly involve clients in their treatment plans, encourage client connection with their peers and communities, and actively consider and address systemic challenges that impact client wellbeing and sense of dignity at the societal level.
25. Exercise-induced effects on atherogenesis and tryptophan catabolism via the kynurenine pathway in an HIV-associated atherosclerosis mouse model.
期刊: Experimental physiology 发表日期: 2025-Aug-25 链接: PubMed
摘要
A mouse model of HIV-associated atherosclerosis (Tg26+/-ApoE-/-) exhibited increased plaque area compared with the ApoE-/- mouse, linked to elevated indoleamine 2,3-dioxygenase (IDO) activity. IDO catalyses the conversion of tryptophan (TRP) into kynurenine (KYN), measured by the KYN-to-TRP ratio. As a biomarker of inflammation, IDO has been implicated as a risk factor for cardiovascular disease. To investigate the effect of exercise training on atherogenesis and IDO activity in Tg26+/-ApoE-/- mice, nine Tg26+/-ApoE-/- and 18 ApoE-/- male mice were fed an atherogenic diet and randomized into exercised or control groups. The exercised groups underwent an 8-week treadmill protocol at moderate intensity (five times per week at 60% maximum velocity). Concentrations of KYN, TRP and cytokines were measured using ELISA, immune expression by flow cytometry, and lipid profile by a biochemistry analyser. Aortas were harvested post mortem for en face analysis. Tg26+/-ApoE-/- mice showed ∼40% larger plaques than ApoE-/- mice (P = 0.01), with slightly higher neutrophil (P = 0.05) and monocyte expression (P = 0.06). Plaque area was reduced by 40% in exercised ApoE-/- mice (P = 0.04), but by only 12% in exercised Tg26+/-ApoE-/- animals (P = 0.85). Exercised Tg26+/-ApoE-/- mice showed higher IDO activity than exercised ApoE-/- mice (58.57% ± 6.88% vs. -4.62% ± 17.20%, P = 0.01), which was positively correlated with plaque area (R = 0.99, P = 0.02). Exercised ApoE-/- mice showed significantly lower triglyceride levels compared with exercised Tg26+/-ApoE-/- mice (75.8 ± 14.8 vs. 165.2 ± 43.6 mg/dL; P = 0.02). Unlike ApoE-/- mice, moderate-intensity aerobic training did not reduce plaque area in mice with HIV-associated atherosclerosis. Moreover, exercise training appeared to increase inflammation in Tg26+/-ApoE-/- mice, as indicated by elevated IDO activity.
26. Structural characterization of newt tendon regeneration after complete transection: In vivo two-photon imaging and transmission electron microscopy.
期刊: Journal of anatomy 发表日期: 2025-Aug-25 链接: PubMed
摘要
Mammalian tendons, including human tendons, possess limited regeneration capability, and its healing results in scar tissue formation. However, it was recently shown that tendons of newts, amphibians that exhibit regeneration capacity in various tissues and organs, achieve full regeneration, structurally and functionally, following complete transection. The present study was performed to characterize newt tendon regeneration structurally at both micro- and nanoscales following transection surgery. In particular, we observed the progress of tendon regeneration in the same newt by developing a unique, live, in vivo imaging technique. Initial cell infiltration and formation of granulation-like tissue were evident between residual tendon stubs during the first week of regeneration. This newly formed tissue bridged tendon stubs by 3 weeks. This was followed by remodeling of the initial matrix to new tendon from the 6th to 12th week, during which the mechanical properties of regenerated tendon reached levels equivalent to those of normal tendons. These microscopic structural changes were associated with ultrastructural maturation. Collagen fibril density and fibril area fraction at the nanoscale were significantly improved from the 3rd to 6th week, and fibril area fraction at the microscale was significantly improved from 6 to 12 weeks. Such changes were not observed in a mouse model. These experimental findings suggest that newt tendon regeneration can be divided into two phases: the early phase (<6 weeks) and the late phase (≥6 weeks). The early phase involves an initial response to tendon transection, such as bleeding, accumulation of initial extracellular matrix, and an increase in the cell population at the transection site, leading to re-connection of transected tendon stubs, whereas the late phase is dedicated to maturation of regenerated collagenous tissue into new tendon. This is the first study to reveal structural mechanisms of newt tendon regeneration following transection. It warrants further study to explore molecular mechanisms that might achieve such regeneration in mammalian tendon.
27. Perceiving facial emotions in context: The intertwined roles of emotional valence and consciousness.
期刊: Emotion (Washington, D.C.) 发表日期: 2025-Aug-25 链接: PubMed
摘要
Facial emotion perception in real life is inevitably influenced by the affective context, such as the expressions on nearby people’s faces. However, to what extent and how the expressions of others exert a contextual influence on our interpretation of target facial emotions remains largely unclear. Using psychophysical methods, we demonstrated that the emotional facial context alone (i.e., without any evident social interaction cues) is sufficient to bias the perceived expression of an ambiguous target face (N = 160, healthy Asian college students, 2017-2025). Intriguingly, the contextual effect induced by faces with fearful, but not happy, expressions was regulated by observers’ awareness of the context. For fearful contexts, the contextual effect showed a dissociation between nonconscious and conscious conditions, occurring only when the contextual face was not consciously perceived. By contrast, contextual faces expressing happiness biased emotion perception regardless of awareness. These findings broaden our understanding of the affective contextual effect in situations without explicit social relationships. More crucially, they unveil the intertwined roles of emotional valence and consciousness in emotional information integration, offering valuable insights into the intricate mechanisms whereby affective context shapes facial emotion perception. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
28. Use of undergloves to assess pathways leading to contamination on firefighters' hands.
期刊: Journal of occupational and environmental hygiene 发表日期: 2025-Aug-25 链接: PubMed
摘要
Firefighters (FFs) are occupationally exposed to many carcinogens, including polycyclic aromatic hydrocarbons (PAHs). Previous studies have evaluated PAH contamination on FFs’ personal protective equipment (PPE), including fire gloves; however, there is a need to better understand PAH contamination that may break through fire gloves during active firefighting, donning, and doffing of PPE. Researchers in this study aimed to understand the potential contamination of FFs’ hands during firefighting activities. A pilot study was conducted with 23 FFs, asking them to wear up to 3 separate sets of newly opened cotton undergloves during (1) donning, (2) simulated firefighting activities conducted in a smoky environment, and (3) doffing activities (donning and firefighting were combined for some samples). Samples were taken from the palm, index finger, and thumb areas of the cotton gloves and analyzed for PAHs. Overall, it was found that fire gloves were relatively effective at minimizing PAH exposure on the hands (undergloves) during active firefighting operations, though some PAH contamination was still present. PAH contamination was highest during the doffing of PPE and was significantly higher on the thumb and finger relative to the palm (p values < 0.05). PAH contamination was found in the cotton gloves during donning, even though FFs’ self-contained breathing apparatuses were cleaned and the turnout gear was previously laundered, using commercial extractors. Future research could explore the potential for contaminated, decontaminated, and/or laundered gear to present contamination risks to fire personnel and investigate the use of undergloves as additional protection for FFs’ skin.
29. Risk of Incident Diabetes and Cardiovascular Diseases: Prevention Opportunities With the American Heart Association's Life's Essential 8 in Individuals With Prediabetes Bearing Different Genetic Predisposition.
期刊: Journal of the American Nutrition Association 发表日期: 2025-Aug-25 链接: PubMed
摘要
The aim of this research was to investigate the effects of cardiovascular health (CVH), genetic predisposition, and their interactions on new-onset type 2 diabetes (T2D) and cardiovascular diseases (CVD) among individuals with prediabetes. We assessed 26,962 individuals with prediabetes from the UK Biobank. Life’s Essential 8 (LE8) was utilized to measure CVH. LE8 score encompasses 4 health behaviors (diet, physical activity, nicotine exposure, sleep) and 4 health factors (body mass index, blood lipids, blood glucose, blood pressure). Polygenic risk score (PRS) was utilized to evaluate genetic predisposition. Cox regression analyses were applied to explore the associations of LE8 score and PRS with new-onset T2D, CVD, myocardial infarction (MI), and stroke. Higher LE8 score was associated with lower risk of adverse outcomes (hazard ratios [HRs] ranging from 0.26 to 0.72) after multivariate adjustment. Even a 1-point increment in LE8 score was significantly linked to decreased risk of adverse outcomes in participants with prediabetes (HRs ranging from 0.97 to 0.99). A substantial proportion of incident T2D (70.47%) and CVD (45.12%) cases could be attributable to low LE8 score. Higher PRS was significantly associated with higher risk of adverse outcomes (HRs ranging from 1.38 to 3.68). Compared with those who had a low LE8 score and high PRS, participants with a high LE8 score and low PRS had lower risk of T2D, CVD, MI, and stroke. Participants with low PRS benefited more from adherence to LE8 concerning incident T2D. Besides, further analysis suggested that BMI, blood pressure, and nicotine exposure have the greatest contribution to incident T2D and CVD during the prediabetes stage. Ideal CVH was associated with lower risk of incident T2D and CVD among individuals with prediabetes, irrespective of their genetic predisposition. If all metrics could not be improved at once, achieving ideal status of BMI and blood pressure and avoiding nicotine exposure should be prioritized.
30. High-Entropy Alloy Electron-Penetrated Nitrogen-Doped Carbon Interface Breaking Activity-Stability Trade-off in Acidic Oxygen Reduction to H2O2.
期刊: The journal of physical chemistry letters 发表日期: 2025-Aug-25 链接: PubMed
摘要
The electrocatalytic two-electron oxygen reduction reaction (2e- ORR) has emerged as an environmentally friendly approach for on-demand H2O2 production. In acidic H2O2 electrosynthesis, the active interfaces react with both oxygen-containing intermediates and oxidative acid, resulting in an activity-stability trade-off. Herein, we propose to construct a high-entropy alloy electron-penetrated and stable nitrogen-doped carbon interface for acidic electrosynthesis of H2O2. As a proof of concept, a typical catalyst with the MoNiCuCoIn high-entropy alloy encapsulated in few-layer nitrogen-doped carbon (MoNiCuCoIn@CN) is developed. The experimental results and theoretical calculations confirm that the MoNiCuCoIn core activates the outer carbon layer via interfacial electronic penetration, which generates optimal adsorption of an oxygen-involved intermediate and thus high 2e- ORR activity. The robustness of the catalyst structure of MoNiCuCoIn@CN ensures remarkable 2e- ORR stability in acid. Therefore, the catalyst delivers a record-high acidic performance with a H2O2 Faradaic efficiency (FEH2O2) of >90% from -50 to -300 mA cm-2 and a sustained FEH2O2 of up to 120 h at a high current density of -250 mA cm-2. This work highlights the multimetal-carbon interface for addressing the activity-stability trade-off in harsh electrocatalysis, providing fundamental insights for the design of a next-generation catalyst.
31. High-resolution analysis of seasonal spatial variation for urban air pollution: Implications for exposure assessment.
期刊: Journal of the Air & Waste Management Association (1995) 发表日期: 2025-Aug-25 链接: PubMed
摘要
Exposure to air pollutants is associated with significant health effects. Accurate exposure assessment remains a critical yet challenging aspect of environmental health research. Although air quality monitoring station (AQMS) data are commonly used as a surrogate for personal exposure, diverse spatial-temporal variations can lead to significant exposure misclassification. This study aimed to identify the seasonal spatial variation of five air pollutants (PM2.5, PM10, NO2, CO, and O3) at city and small spatial scales (1 km2) in Seoul, Korea, using data from AQMSs and in-situ monitoring sites (IMSs) for high-resolution measurements. Measurements were conducted across four seasons over one year, covering city-, district-, and small-scale spatial units, with a detailed focus on a 1 km2 area within one administrative district. The air pollutant concentrations were obtained from 25 AQMSs in each district. Fine-scale measurements were carried out at eight IMSs within a 1 km2 area surrounding a single AQMS in Guro-gu, Seoul. To enable direct comparison, measurements from AQMS and IMS were simultaneously collected following standard monitoring protocols. Moran’s index was used as an indicator of spatial autocorrelation to identify the homogeneity and heterogeneity of air pollutants by spatial units. Concentrations of pollutants at IMSs were overall higher than those at nearby AQMS, except for O3 concentrations in spring and summer. Seasonal spatial autocorrelation patterns in city-scale areas did not reflect variations in small-scale areas. These findings highlight the limitations of relying solely on AQMS data for exposure assessment and underscore the value of integrating high-resolution data to reduce estimation errors. This study provides a framework for enhancing air quality management and exposure assessment strategies by accounting for spatial-temporal variations, especially in areas lacking dense monitoring networks.Implication StatementThis study integrates city-scale air quality monitoring station data with high-resolution in-situ measurements to reveal discrepancies in seasonal spatial patterns of air pollutants across different spatial scales in Seoul, Korea. By directly comparing AQMS and IMS data using standard monitoring methods, it demonstrates that commonly used AQMS-based exposure estimates may significantly underestimate pollution levels in small-scale urban environments. This high-resolution approach highlights the critical need for incorporating fine-scale monitoring to improve personal exposure assessment in areas with sparse monitoring coverage.
32. Evaluating United States Air Force hearing conservation educational materials for compliance, readability, understandability, and actionability.
期刊: Journal of occupational and environmental hygiene 发表日期: 2025-Aug-25 链接: PubMed
摘要
Noise-induced hearing loss and tinnitus are two of the most prevalent service-connected disabilities of United States military veterans. Educational materials meant for hearing conservation program-eligible Airmen were evaluated from active-duty, continental United States (CONUS) Air Force bases for compliance with US Air Force (USAF), Department of Defense (DoD), and Occupational Safety and Health Administration (OSHA) regulations. Understandability and actionability were assessed using the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V), while readability was assessed with Flesch-Kincaid Grade Level (FKGL). Educational materials were received from 44 of 61 (72%) active-duty, CONUS bases, with 27 bases sending one item and 17 bases sending multiple items, for a total of 67 educational materials, which were evaluated by three evaluators. Educational materials were categorized into one of four types: (A) supervisor’s guide to hearing conservation (n = 21); (B) new worker hearing conservation training (n = 20); (C) two-page hearing conservation program training pamphlet (n = 14); and (D) other (n = 12). Overall mean compliance was 84% (CI: 63,100) (USAF), 83% (CI: 62,100) (DoD), and 88% (CI: 67,100) (OSHA), respectively. Overall mean understandability was 75% (CI: 63,87) and actionability was 89% (67,100). There was good agreement between the three evaluators for each of the criteria (87-90%). Overall mean readability was grade level 10.68 ± 1.68 on the FKGL scale. For educational materials, 65 of the 67 (97%) were above the recommended 6th-grade reading level, and 62 of the 67 (93%) educational materials were above the average American 8th-grade reading level. This study established compliance, understandability, actionability, and readability scores for educational materials that military service members receive upon entry into the hearing conservation program, gathered from active-duty, CONUS Air Force bases. Using the determined scores, recommendations, such as providing active feedback and condensing information, were given to improve future hearing conservation educational materials.
33. Forecasting Neonatal Mortality in Ethiopia to Assess Progress Toward National and International Reduction Targets Using Classical Techniques and Deep Learning: Time-Series Forecasting Study.
期刊: Online journal of public health informatics 发表日期: 2025-Aug-25 链接: PubMed
摘要
Neonatal disease and its outcomes are important indicators for a responsive health care system and encompass the effects of socioeconomic and environmental factors on new-borns and mothers. Ethiopia is working to achieve the Sustainable Development Goal target for the reduction of 12 or less per 1000 birth by 2030 and 21 per 1000 livebirths by 2025 as part of the second Ethiopian Health Sector Transformation Plan. This study aimed to compare the performance of classical time-series models with that of deep learning models and to forecast the neonatal mortality rate in Ethiopia to verify whether Ethiopia will achieve national and international targets. Data were extracted from the official World Bank database. Classical time-series models, such as autoregressive integrated moving average (ARIMA) and double exponential smoothing, and neural network-based models, such as multilayer perceptron, convolutional neural network, and long short-term memory, have been applied to forecast neonatal mortality rates from 2021 to 2030 in Ethiopia. During model building, the first 21 years of data (from 1990 to 2010) were used for training, and the remaining 10 years of data were used to test model performance. Model performance was evaluated using R², mean absolute percentage error (MAPE), and root mean squared error (RMSE). Finally, the best model was used to forecast the neonatal mortality rate over the next 10 years from 2021 to 2030, with a 95% prediction interval (PI). The results showed that the double exponential smoothing model was the best, with a maximum R2 of 99.94% and minimum MAPE and RMSE of 0.002 and 0.0748, respectively. The worst performing among the 5 models was the CNN, with an R2 of 93.71% and a maximum RMSE of 0.79. Neonatal mortality in Ethiopia is forecasted to be 23.20 (PI 22.20-24.40) per 1000 live births in 2025 and 19.80 (PI 17.10-22.80) per 1000 live births in 2030. This study revealed that national and international targets for neonatal mortality cannot be realized if the current trend continues. This highlights the need for urgent interventions to strengthen the health system to fasten the decline rate of neonatal mortality and collaborative effort with concerned stakeholders for improved and responsive neonatal and child health services in order to achieve these targets.
34. Smartphone App-Guided Pulmonary Rehabilitation in Chronic Respiratory Diseases: Randomized Controlled Trial.
期刊: JMIR mHealth and uHealth 发表日期: 2025-Aug-25 链接: PubMed
摘要
Pulmonary rehabilitation improves exercise capacity, dyspnea, quality of life, and survival in patients with chronic respiratory disease. However, center-based pulmonary rehabilitation programs remain unavailable in many health care facilities due to several barriers. To address this, we developed a smartphone app that enabled individuals to perform pulmonary rehabilitation at home. We aimed to evaluate the efficacy of smartphone app-guided pulmonary rehabilitation in improving exercise capacity in individuals with chronic respiratory diseases. This was a multicenter prospective, single-blind, randomized controlled trial conducted in 2022. A total of 100 participants with chronic respiratory disease, including chronic obstructive pulmonary disease, asthma, and lung cancer, were recruited, with equal distribution (50:50) between the intervention group and the control group. The intervention group followed a 12-week app-guided rehabilitation program, while the control group received standard outpatient treatment. The primary outcome was the 6-minute walk test distance (6MWD) after the 12-week rehabilitation period. Secondary outcomes included quality of life questionnaires and health care usage. Among the 100 participants included, 88 completed the follow-up visit (41 in the intervention group and 47 in the control group). Their median age was 68.0 years, and 72 (81.8%) were men. Most participants (n=70, 79.5%) had a smoking history, with a median of 40.0 pack-years. Their forced expiratory volume in 1 second was a median of 63.0% (IQR 50.5-71.5). Most participants (n=85, 96.6%) had chronic obstructive pulmonary disease. After the 12-week rehabilitation program, 6MWD was not different between the intervention and control group (median 490.0, IQR 468.8-556.3 vs 485.0, IQR 440.0-527.3 m). Assuming a clinically minimal effective change of 25 meters in 6MWD, only 7 out of 41 participants among the intervention group achieved the minimal clinically important differences after the rehabilitation program. Quality of life questionnaire scores, including the St George’s Respiratory Questionnaire and Hospital Anxiety and Depression Scale, did not differ between groups. In addition, none of the participants experienced hospitalization or emergency room visits during the study period. Regarding the service satisfaction questionnaire, more than 3-quarters of the intervention group (34/41) rated their scores as ≥17/20. In this study, smartphone app-guided pulmonary rehabilitation failed to improve exercise capacity and quality of life in patients with chronic respiratory diseases. However, the results indicated that older adults with chronic respiratory conditions can safely use smartphone app-guided pulmonary rehabilitation. Thus, smartphone app-guided pulmonary rehabilitation may be a feasible option for older adults with chronic respiratory disease.
35. Estimation of Benchmark Dose Ratio Distributions for Subchronic-to-Chronic Extrapolation Using Meta-Analysis.
期刊: Toxicological sciences : an official journal of the Society of Toxicology 发表日期: 2025-Aug-25 链接: PubMed
摘要
Recently, the International Programme on Chemical Safety (IPCS) developed a unified probabilistic framework for deriving reference values, and a software tool, Approximate Probabilistic Analysis (APROBA), to help implement this framework. The distributions of multiple sources of uncertainty and variability were estimated, including uncertainty when extrapolating from subchronic to chronic data. The subchronic-to-chronic distribution was estimated using ratios between subchronic and chronic benchmark doses (BMD) and was determined to be approximately lognormal, with parameter values reported by IPCS. These parameters were estimated largely from historical data on body and organ weights from toxicological studies. We estimated the distribution using a larger collection of data, including histopathological and clinical endpoints. Our analysis determined that key assumptions of the method and the default values in APROBA are consistent with the results from the new data. However, the uncertainty of predictions for dichotomous response data was greater than assumed in APROBA, and the reference values derived using our new results were lower than those derived from APROBA (by 25% in an example case). Also, APROBA’s default parameter values do not account fully for the uncertainty of predicted chronic BMDs. Most importantly, uncertainty of the prediction can be much greater than assumed in APROBA if BMDs are accepted when they fall well outside the observed dose range or when an upper confidence limit is not quantifiable. Careful evaluation of dose-response model fit, including a number of indicators of model suitability in addition to standard goodness-of-fit statistics, is necessary to improve quantification of uncertainty.
36. Navigating Complexity in Modern Toxicology: The Role of Omics in Short-Term In Vivo Studies.
期刊: Toxicological sciences : an official journal of the Society of Toxicology 发表日期: 2025-Aug-25 链接: PubMed
摘要
Toxicology is shifting toward predictive, mechanism-based approaches that support quicker, more human-relevant risk assessments and reduce reliance on animal testing. Central to this shift are short-term in vivo studies enriched with omics endpoints which provide early molecular indicators of toxicity. These data enable the derivation of molecular points of departures (mPODs) and other biologically anchored metrics that can inform potency ranking, hazard identification, and risk assessment. This commentary summarizes insights from the 2025 Society of Toxicology (SOT) session of the same name and highlights the importance of aligning technical advances with regulatory needs. Next Generation Risk Assessment (NGRA) is a safety evaluation approach that incorporates emerging tools such as in vitro methods, computational models, and omics data to inform decision-making for human health or the environment, while aiming to reduce dependence on traditional animal testing. NGRA frameworks, while potentially generic in principle, must be tailored to the specific regulatory requirements and exposure contexts of different product sectors, including pharmaceuticals, industrial chemicals, agrochemicals, and cosmetics. Short-term mechanistic animal studies serve as a bridge between traditional long-term animal testing and new approach methodologies (NAMs). From a technical standpoint, the generation, analysis, and interpretation of omics data have matured considerably, bringing regulatory acceptance within reach. Remaining challenges include standardizing bioinformatics pipelines, building confidence through validation against apical endpoints, and expanding training. Addressing these gaps through collaborative science and flexible regulatory frameworks will be key to realizing the full potential of omics-enabled hazard profiles to support NGRA.
37. The National Prevalence of Neurodevelopmental Disorders and Their Associations With Health Conditions Among General Junior High School Students in China: Findings From the China Education Panel Survey.
期刊: Autism research : official journal of the International Society for Autism Research 发表日期: 2025-Aug-25 链接: PubMed
摘要
Neurodevelopmental disorders (NDDs) remain poorly understood in adolescents, particularly in middle-income countries like China. To assess NDDs prevalence and their associations with health conditions among Chinese general junior high school students, data from the China Education Panel Survey (CEPS, 2013-2015) were used. A total of 8324 junior high school students were included. Validated questionnaires and tests assessed NDDs (autism spectrum disorder [ASD], language disorder [LD], and attention-deficit/hyperactivity disorder [ADHD]) and health conditions (physical health through overweight/obesity and myopia; mental health through anxiety symptoms and depression symptoms; cognitive functioning through academic performance and cognitive ability; adherence to social norms). Of 8324 participants, 299 (4.59%) had NDDs. Students with NDDs showed higher rates of anxiety symptoms and poor cognitive ability compared to those without NDDs. Specific NDD associations included anxiety symptoms with LD and ADHD, depression symptoms with ASD and ADHD, and poor cognitive ability with ASD and LD. Sex-specific disparities were observed in the associations: the link between NDDs and depression symptoms was evident solely in boys, whereas the association between NDDs and academic performance was significant only in girls. Increased surveillance of NDDs prevalence nationwide and improved support services through better integration of families, schools, and society are needed.
38. Preventing maritime accidents: The role of human factors and cognitive performance.
期刊: Work (Reading, Mass.) 发表日期: 2025-Aug-25 链接: PubMed
摘要
BackgroundThe maritime industry, despite rigorous safety measures, remains a high-risk sector due to persistent human errors.ObjectiveThis study aims to assess mental workload, accuracy, and attention across various mental states and explore the relationships among key variables affecting cognitive performance through a Bayesian network (BN) analysis.MethodsData were collected from 51 officers at a maritime training center using demographic surveys and the NASA Task Load Index (NASA-TLX) mental workload index. Participants were then subjected to three different simulation scenarios, during which their physiological responses and brain waves were recorded.ResultsResults indicated that effort scored the highest and failure the lowest among the dimensions assessed. Notably, the average heart rate increased from 74.33 beats per minute at rest to 85.92 after the second scenario, signifying heightened physiological stress. Post-scenario analyses showed an increase in attention and alertness levels compared to the resting state, while meditation levels decreased. Physiological responses, including heart rate and blood pressure, were found to elevate after rest periods, correlating with decreased attention and increased mental workload, as evidenced by the BN findings.ConclusionsThese results underscore the intricate interplay between physiological responses and cognitive performance, highlighting the critical need for targeted strategies to mitigate human errors in maritime operations.
39. The use of telehealth in the management of people with spinal cord injury in Low-Middle-Income Countries during COVID-19 pandemic.
期刊: Work (Reading, Mass.) 发表日期: 2025-Aug-25 链接: PubMed
摘要
BackgroundThe COVID-19 pandemic posed unprecedented challenges to healthcare systems globally, particularly in Low- and Middle-Income Countries (LMICs), making it difficult to provide regular care to people with SCI.ObjectiveThis paper aims to present the perspectives of healthcare professionals from LMICs on the use of telehealth and/or telerehabilitation in SCI care during the COVID-19 pandemic, highlighting its scope, tools, barriers, facilitators and future implications.MethodsA qualitative approach was employed to gather insights from seven leading SCI healthcare professionals from Bangladesh, India, Nepal, Pakistan, and South Africa through structured interviews and an online questionnaire. Secondary data from government reports, and peer-reviewed articles were also analyzed to contextualize the findings. This study focuses on narrative reporting without formal data analysis.ResultsHealthcare professionals utilized telehealth and/or telerehabilitation services for follow-ups, occupational therapy, physiotherapy, nursing care and other rehabilitation services (home modifications, peer counseling, and yoga). Commonly tools included WhatsApp, Facebook Messenger, Skype, Zoom and other video conferencing softwares. Barriers included poor internet connectivity, lack of standardized teleassessments and tele protocols, reimbursement issues, legal and privacy concerns.ConclusionsTelehealth and/or Telerehabilitation services have demonstrated their critical role in SCI care during COVID-19 pandemic in LMICs, offering ways to connect and maintain continuity of care through commonly used social media tools. To integrate telehealth as a viable and long-term model for future health crises in SCI care, it is essential to develop supportive policies, improve infrastructure, provide professional training, and establish standardized assessment measures and guidelines.
40. Political parties' occupational health and safety promises in Turkey: An analysis of the 2023 general election manifestos.
期刊: Work (Reading, Mass.) 发表日期: 2025-Aug-25 链接: PubMed
摘要
BackgroundOccupational health and safety (OHS) is a vital dimension of labor policy, yet its presence in political discourse, particularly in party manifestos, remains underexplored. In democratic systems, election manifestos reflect the political will and priorities of parties, including their commitment to workers’ welfare and workplace safety.ObjectiveThis study aims to investigate how political parties in Turkey addressed OHS in their 2023 general election manifestos. It seeks to evaluate the specificity, relevance, and feasibility of OHS-related promises and their alignment with international labor standards.MethodsA qualitative content analysis was conducted on the official 2023 general election manifestos of major Turkish political parties. The analysis focused on the presence, depth, and practical orientation of OHS-related discourse, examining textual data through thematic coding aligned with international policy frameworks.ResultsThe findings reveal a spectrum of approaches to OHS, ranging from general symbolic statements to concrete policy proposals. Some parties emphasized regulatory reforms, institutional capacity building, and expert-driven policy, while others provided limited or ambiguous references to worker safety. Discrepancies in terminology, focus areas, and implementation strategies were notable.ConclusionsThe study concludes that OHS remains inconsistently addressed across political platforms. Ensuring institutional stability, appointing qualified experts, and adopting evidence-based, internationally compatible strategies are essential for advancing OHS policy in Turkey. A more standardized and rights-based discourse is required for effective policy continuity and worker protection.
41. Analysis of the Spatiotemporal Distribution and Evolutionary Trends of Scrub Typhus in Jiangsu Province from 2006 to 2023.
期刊: Journal of epidemiology and global health 发表日期: 2025-Aug-25 链接: PubMed
摘要
This study aims to analyze the epidemiological characteristics, spatial and temporal distribution patterns, and trends in the evolution of scrub typhus (ST) in Jiangsu Province from 2006 to 2023. Scrub typhus was chosen for this study due to its increasing incidence in Jiangsu Province, its substantial health burden on rural populations, and its relevance as a vector-borne disease influenced by environmental and seasonal factors. Data on ST cases in Jiangsu Province from 2006 to 2023 were obtained from the China Disease Control and Prevention Information System. Descriptive statistics were used to summarize the overall epidemiological trends. Spatial autocorrelation analysis (Global and Local Moran’s I) assessed the overall and local distribution patterns of ST cases. while spatial-temporal hotspot analysis identified regions with significant clustering of cases over time, providing insights into potential high-risk areas. A total of 16,998 ST cases were reported in Jiangsu Province, with an average annual incidence rate of 1.13 per 100,000. The gender distribution showed a male-to-female ratio of 1:1.20. The ages of affected individuals ranged from 3 months to 97 years, with a mean age of 60 years. Farmers represented the largest occupational group, accounting for 84.68% of the cases. The incidence rate showed a significant upward trend (χ²trend = 8484.517, p < 0.001). Peak incidence occurred primarily between October and November. The global Moran’s I index ranged from 0.071 to 0.345. Local autocorrelation analysis revealed that Yancheng and Nantong cities were high-high clustering areas. Spatial-temporal hotspot analysis revealed that hotspots were predominantly located in the northern and central regions of Jiangsu, while the southern region was identified as a cold spot. These hotspots displayed oscillating patterns, with new hotspots emerging in specific areas. Standard deviation ellipse analysis indicated that the epidemic spread continued to expand along the north-south axis, while the east-west axis showed relative stability. Spatial-temporal scanning analysis identified four high-incidence spatial-temporal clustering zones. The incidence of ST in Jiangsu Province exhibited a significant upward trend, with distinct seasonal peaks between October and November. The epidemic demonstrated a pronounced transmission along the north-south axis, spatial-temporal clustering, and a shifting center of gravity. It is recommended to strengthen surveillance in high-risk areas and implement targeted prevention and control measures during high-risk seasons, particularly for vulnerable populations, to effectively curb the spread of the epidemic.
42. Validation of a parent HPV vaccine misperceptions scale and its association with children's HPV vaccination status.
期刊: Vaccine 发表日期: 2025-Aug-24 链接: PubMed
摘要
Human papillomavirus (HPV) infection is the cause of nearly all cervical and anal cancers and the majority of vaginal, oropharyngeal, vulvar, and penile cancers in the United States (US). A safe and effective vaccine for the most common cancer-causing HPV types has been available in the US since 2006; however, uptake among age-eligible children remains below that of vaccines administered at similar ages. Hesitancy fueled by misperceptions about the HPV vaccine may contribute to this gap. We assessed HPV vaccine misperceptions using a 12-item Likert scale in a population health assessment in a large county in California. We validated the scale using exploratory factor analysis and exploratory graph analysis. We further assessed concurrent validity by examining parent report of youth vaccination through weighted logistic regression. The HPV Vaccine Misperceptions scale had high internal consistency (Cronbach’s alpha = 0.94) and a strong primary dimension. Further, the 12-item scale sum score was associated with increased odds (Odds Ratioper SD = 2.09; 95 % Confidence Interval = 1.26-3.45) of age-eligible children being unvaccinated for HPV in multivariable-adjusted logistic regression models. This Parent HPV Vaccine Misperceptions Scale can be used to identify parent barriers to vaccination for tailored health education to increase uptake of the HPV vaccine in age-eligible children.
43. Global burden of lower respiratory infections attributable to PM2.5 across global, regional, national level and China from 1990 to 2021 and predictions to 2035: A cross-sectional study.
期刊: Ecotoxicology and environmental safety 发表日期: 2025-Aug-24 链接: PubMed
摘要
Particulate matter (PM) based air pollution closely linked to lower respiratory infections (LRIs). PM2.5 air pollution is identified as the leading risk factor for LRIs. This study examined deaths and disability-adjusted life years (DALYs) associated with PM2.5-related LRIs to understand and prevent their impact. Using Global Burden of Disease Study 2021 data, we analyzed PM2.5’s effects on LRIs globally, regionally, and in China across different socio-demographic index (SDI) regions. Autoregressive integrated moving average (ARIMA) modeling predicted 15-year trends in age-standardized mortality rates (ASMR) and disability-adjusted life year rates (ASDR). PM2.5 contributed to 0.65 million deaths and 29.1 million DALYs from LRIs in 2021. An inverse relationship existed between PM2.5-related LRIs and SDI, with males showing higher vulnerability. Age-specific rates followed a V-shaped distribution in global and lower SDI regions. Mortality peaked in those over 95, while DALYs were highest in children under 5. ASMR and ASDR projections show slight decreases over 15 years. China’s burden approaches high-middle SDI levels. Higher SDI areas show lower disease burden, while PM2.5-related LRIs remain substantial in lower SDI regions. This necessitates targeted preventive strategies for vulnerable populations, particularly in less developed regions.
44. Health Professional Students' Knowledge About FDA Drug and Medical Device Regulation.
期刊: Academic medicine : journal of the Association of American Medical Colleges 发表日期: 2025-Aug-22 链接: PubMed
摘要
Given the common use of Food and Drug Administration (FDA)-regulated drugs and medical devices, clinicians need to understand FDA regulation and clinical trial interpretation to provide optimal and informed patient care. Medical and pharmacy school curriculum guidelines recommend education on these topics, but no studies have assessed health professional student knowledge of FDA approvals. This study assessed knowledge about FDA regulation and clinical research evidence interpretation among final-year health professional students. The authors designed a 24-item survey questionnaire that asked trainees to self-report (1) exposure to learning about FDA drug and medical device approval processes, (2) understanding of FDA approval evidence requirements, and (3) ability to critically interpret trial design and evidence. After pretesting, all 333 final-year students in the medical, pharmacy, and family nurse practitioner schools at the University of California San Francisco were invited to complete the survey between January and April 2024. Of 175 respondents (91 medical, 62 pharmacy, and 22 family nurse practitioner; response rate, 53%), 124 (71%) reported receiving teaching about FDA drug approvals, although 107 (90%) of these respondents described it as basic or cursory and 69 (58%) desired more teaching. Only 23 (14%) reported receiving teaching about medical device approvals. Despite 62 students (38%) rating their understanding of FDA drug approvals as moderately or extremely well, 5 (3%) correctly answered that drug approval requires neither statistically nor clinically significant results. Regarding clinical trial interpretation, only 25 students (17%) recognized the superiority of all-cause mortality end point data over surrogate measures and other end points. Health professional students have limited understanding of the FDA approval process and the quality of evidence in studies of new medical products. Improving education about regulatory topics may strengthen how these future clinicians make decisions and communicate with patients about drugs and medical devices.
45. Surfactants, cellulose nanocrystals, and chitosan: Their contributions to pesticide delivery systems.
期刊: Advances in colloid and interface science 发表日期: 2025-Aug-21 链接: PubMed
摘要
Improving pesticide utilization efficiency is vital for environmental sustainability, economic growth, and the protection of human and animal health, particularly in water-based formulations. Numerous studies have shown that surfactants can enhance pesticide encapsulation and improve deposition efficiency on plant surfaces. This review examines the roles of surfactants in pesticide formulations from the perspective of their structural classifications, including conventional, gemini, trimeric, and polymeric surfactants, with a particular focus on how molecular structure influences the droplet behavior and delivery performance. We highlight the applications and functional roles of sustainable, biodegradable, and renewable biomaterials, specifically cellulose nanocrystals (CNC), chitosan, and their derivatives, in foliage- and soil-applied pesticide delivery systems. While both CNC and chitosan possess excellent carrier properties, attaining high deposition efficiency on plant surfaces continues to be a significant challenge. Combining the biomaterials with surfactants offers an effective strategy to improve pesticide utilization. Additionally, this review outlines the current understanding of droplet dynamics on hydrophobic and superhydrophobic plant surfaces, highlighting the mechanisms and formulation strategies used to control droplet behavior and enhance deposition. Finally, we outline key challenges and future directions for the development of next-generation pesticides that integrate high efficacy, reduced environmental impact, and long-term sustainability, thereby advancing the future of eco-friendly crop protection systems.
46. NOTCH3 p.R544C variant in vascular Parkinsonism: Clinical and imaging correlates in a Taiwanese cohort.
期刊: Parkinsonism & related disorders 发表日期: 2025-Aug-19 链接: PubMed
摘要
Vascular parkinsonism (VP) is a heterogeneous syndrome caused by cerebrovascular pathology. While generally distinguishable from Parkinson’s disease (PD), overlap may occur in some cases. The genetic basis of VP remains unclear. The role of the NOTCH3 p.R544C variant-common in East Asian cerebral autosomal dominant arteriopathy with subcortical infarct and leukoencephalopathy (CADASIL) cohorts-in VP has not been systematically evaluated. We conducted a prospective study of 253 patients with parkinsonism (idiopathic PD, VP, or atypical parkinsonism), who underwent clinical evaluation, brain MRI, and testing for the NOTCH3 p.R544C variant. A comparison cohort of 48 patients with cerebral small vessel disease (CSVD) and the same variant but without parkinsonism was also included. The NOTCH3 p.R544C variant was significantly more prevalent in VP (30.2 %) than in PD (1.7 %) or atypical parkinsonism (0 %). Among VP patients, variant carriers more often exhibited severe deep white matter hyperintensities (WMHs), external capsule involvement, prior stroke, and family history of stroke. In the CSVD variant-positive cohort, parkinsonism was independently associated with older age and family history of stroke. Compared with PD patients with CSVD, those with VP showed more severe WMH, more frequent external capsule involvement, cerebral microbleeds, cognitive decline, prior stroke, and family history of stroke. NOTCH3 p.R544C variant is common in VP and linked to distinct clinical and imaging features. Findings suggest targeted genetic testing may improve diagnostic precision in selected VP patients. However, due to the ethnic specificity of the NOTCH3 p.R544C variant, findings may not be generalizable beyond East Asian populations.
47. Functional study on the regulation of lignin formation and disease resistance by the CpARF22 gene in Cucurbita pepo L.
期刊: Plant physiology and biochemistry : PPB 发表日期: 2025-Aug-13 链接: PubMed
摘要
The hull-less Cucurbita pepo L., also known as the naked-seeded pumpkin, is a relatively rare natural variant whose seeds closely resemble shelled pumpkin kernels, hence its name. The Fusarium wilt, caused by Fusarium oxysporum f. sp. cucumerinum, is a highly destructive soil-borne disease that poses a significant threat to the hull-less C. pepo industry. Therefore, delving into the disease-resistant gene resources of hull-less C. pepo is important for preventing and controlling Fusarium wilt. In this study, the CpARF22 gene was cloned from hull-less C. pepo. The expression profile and disease resistance mechanism of the CpARF22 gene were analyzed and validated through overexpression genetic transformation in Arabidopsis thaliana and Virus-Induced Gene Silencing (VIGS) technology. These approaches provided insights into the functional role of CpARF22 in conferring resistance to Fusarium wilt, contributing to the broader understanding of disease resistance mechanisms in hull-less C. pepo and offering potential strategies for crop improvement and disease management. Bioinformatics analysis revealed that the gene has a CDS length of 1953 bp, encoding 650 amino acids. Protein interaction analysis indicated that it interacts with 10 IAA proteins. An overexpression vector was constructed, and transgenic Arabidopsis plants overexpressing CpARF22 were obtained. Following inoculation with Foc, the overexpression lines displayed milder disease symptoms compared to wild-type plants, disease index decreased by 23.39 %. These plants also exhibited higher levels of photosynthetic parameters, defense enzyme activities, cell wall synthesis-related metabolites, and lignin biosynthesis-related gene expression, while malondialdehyde (MDA) and pectinase contents were lower than in wild-type plants. The staining of tissue sections further confirmed that the lignin content in overexpression lines was indeed higher than in wild-type plants. These results demonstrate that overexpression of CpARF22 enhances disease resistance. Additionally, gene-silenced plants (with a silencing efficiency of 60 %) were generated using a silencing vector. After inoculation, the silenced lines showed more severe disease symptoms and disease index increased by 45.93 %. Reduced expression of key resistance-related indicators and lignin biosynthesis genes compared to wild-type plants. Histochemical staining analysis clearly demonstrated that the lignin content in gene-silenced plants was significantly lower than that in wild-type plants. These findings further confirm the functional role of CpARF22 in conferring resistance to Fusarium wilt in hull-less C. pepo.
48. Five-day ski camp could enhance postural stability in young adults: A quasi-experimental study.
期刊: Physiological reports 发表日期: 2025-Aug 链接: PubMed
摘要
This study investigated whether a 5-day ski camp could improve postural stability in young adults. It was hypothesized that skiing would reduce postural sway. In this quasi-experimental design, 43 undergraduate students who participated in a 5-day ski camp (approximately 20 h of skiing) were compared to 35 peers who did not attend. Postural stability was assessed using the modified Clinical Test of Sensory Integration and Balance protocol of the Balance Tracking System, which evaluates sway under four standing conditions: eyes open or closed, and on stable or unstable surfaces. Quade nonparametric ANCOVAs were used to compare percentage change scores between groups, controlling for age. No significant group differences emerged for standard, proprioceptive, or vestibular postural stability (p > 0.05). However, a statistically significant group effect was found for visual postural stability (p = 0.006), with improvement observed only in females (p = 0.003), not in males (p = 0.961). A 5-day ski camp significantly enhanced visual postural stability in females but did not affect males or other postural domains. These findings suggest a potential sex-specific adaptation to skiing and highlight the need for further research into the mechanisms underlying balance improvement.
49. The "room to share": An ecological perspective on mental health disclosure at work.
期刊: Journal of occupational health psychology 发表日期: 2025-Aug 链接: PubMed
摘要
How organizations address employee mental health conditions (MHCs) is an increasingly important topic in occupational health psychology. A key focus of this literature is on understanding how and why employees disclose their MHCs to colleagues. Concealing a stigmatized identity, such as a MHC, can cause distress, while disclosure has been associated with improved well-being and access to proper accommodations. However, employees who disclose a MHC also risk discrimination and mistreatment. Given such competing dynamics, past research has largely framed disclosure through a concerted decision-making lens, where employees weigh the benefits and risks before revealing their condition. Yet the disclosure process can be more complex than these models suggest, with scholars recognizing that no “one-size fits all.” To investigate this complexity, we conducted an in-depth narrative interview study with 27 employees living with a MHC. Our findings challenge the assumption that MHC disclosure is typically premeditated. We develop the concept of disclosure opportunities-situations that enable employees to share their MHC at work. We also identify four key elements of the work environment-time and space, bureaucratic structure, social structure, and mental health programs-that shape these opportunities. These elements can either facilitate or constrain disclosure, depending on how they interact. Using these insights, we propose an ecological model of MHC disclosure that complements and extends existing decision-based models, offering a more complex and nuanced understanding of how disclosure unfolds at work. We then explain how this model can inform the practice of occupational health psychology. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
50. A longitudinal study of the association between the teachable moment heuristic and smoking of head and neck cancer patients.
期刊: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine 发表日期: 2025-Jan-04 链接: PubMed
摘要
The Teachable Moment Heuristic (TMH) posits that change in its three components (ie, affective response, risk perception, and social role/self-concept) could increase motivation and confidence for health promotion, such as smoking cessation. For patients with cancer, smoking cessation can extend survival, while persistent smoking causes numerous problems (eg, cancer recurrence). This intensive longitudinal study with cancer patients aimed to evaluate the link between TMH constructs and smoking outcomes. Participants included 42 newly diagnosed head/neck cancer patients who reported smoking in the past month. Participants completed a baseline questionnaire before a 30-day daily assessment. Single-item measures were used for all constructs. Participants who perceived more benefits of quitting smoking smoked fewer cigarettes, P < .05. Also, participants who reported less cancer worry smoked fewer cigarettes, P = .03. Within-persons, less cancer worry than one’s personal average predicted decreases in cigarettes the next day, P = .01. Perceiving greater benefits of quitting, and social support than one’s average predicted lower motivation but higher confidence to quit the same day, Ps < .05. Greater cancer worry than one’s average predicted day-to-day increases in cigarettes smoked, P < .01. Perceiving greater benefits of quitting and greater social support than one’s average predicted smoking fewer cigarettes that day, Ps < .05. Components of the TMH are associated with favorable smoking cessation outcomes after a cancer diagnosis. Interventions to aid cancer patients with smoking cessation should focus on the benefits of quitting, bolster social support, and reduce cancer-related worry.
51. Supervisor experience and cybersecurity response in aviation organizations using a two-wave exploratory design.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
As cybersecurity threats continue to intensify across safety-critical industries, the aviation sector faces unique challenges due to its high digital dependency and human-centered operational environments. This study investigates how aviation supervisors in Türkiye perceive and respond to cybersecurity incidents involving employees, focusing on the psychological dimensions of leadership under pressure. Using a two-wave mixed-method design, data were collected from 300 supervisors through structured surveys and open-ended reflections on recent cybersecurity-related incidents. Thematic analysis identified common incident types such as phishing, password negligence, and unauthorized device use, along with eight distinct supervisory response strategies. Supervisors rated their actions on stressfulness and effectiveness, and K-means cluster analysis revealed three psychological response profiles. Multinomial logistic regression showed that psychological distress and time pressure were significant predictors of unfavorable experiences, while organizational cybersecurity support reduced the likelihood of high stress and low perceived effectiveness. These findings contribute to psychosocial risk and critical incident theory by highlighting cybersecurity incidents as emotionally significant events and underscore the need for supervisor training that integrates emotional resilience and cyber preparedness.