公共卫生研究摘要 (2025-08-27)
共收录 63 篇研究文章
1. Geographic Heterogeneity in Epilepsy Specialist Distribution.
期刊: Neurology 发表日期: 2025-Sep-23 链接: PubMed
摘要
Geographic location significantly affects health care access. This descriptive study quantifies the supply of epilepsy-certified physicians across the United States. We performed a cross-sectional study using data from the American Board of Psychiatry and Neurology’s verifyCERT system to identify active epilepsy-certified physicians as of October 24, 2024. Physician locations were matched to county-level Federal Information Processing Standard codes and assigned Area Deprivation Index (ADI) scores and Urban Influence Codes. We aggregated physicians at regional, state, and county levels and calculated patient-to-physician ratios using state-level estimates of active epilepsy cases. Of 2,284 physicians with epilepsy certification, 2,169 were active. There were zero epilepsy-certified physicians in Montana, and only 1 in each of Arizona, Vermont, and Wyoming. California, New York, and Texas had the highest physician supply. The South had the highest number of epilepsy cases and highest patient-to-physician ratios. Most epilepsy physicians were in metropolitan areas, but many of these counties lacked any epilepsy-certified physicians. Counties with more physicians had lower ADI scores, reflecting worse access to care in areas with higher levels of socioeconomic deprivation. Our study highlights geographic heterogeneity in supply of epilepsy-certified physicians. The distribution of epilepsy subspecialists should inform interventions that improve quality of care.
2. A late HIV diagnosis in the age of COVID-19: Urging screening awareness.
期刊: JAAPA : official journal of the American Academy of Physician Assistants 发表日期: 2025-Sep-01 链接: PubMed
摘要
Global health emergencies such as the COVID-19 pandemic have revealed the fragility of medical infrastructure in the US and elsewhere. Specifically, the pandemic insidiously targeted the relationship between public health and medicine by affecting the screening for and prevention of communicable diseases, such as HIV. This case report focuses on a patient with a problematic and late HIV diagnosis amid the pandemic and discusses HIV history, pathogenesis, epidemiology, and current screening guidelines. Although the negative implications of the pandemic are yet to be fully unraveled, health professionals can combat its ill effects on disease screening and prevention by proactively educating their patients on best health practices, including safe sex and sexually transmitted infection (STI) screening, as well as on when to seek care.
3. Children's Measured Sugar-Sweetened Beverages in Quick-Service Restaurants: Interactions with Neighborhood Food Swamp Exposure and Race/Ethnicity.
期刊: Childhood obesity (Print) 发表日期: 2025-Sep 链接: PubMed
摘要
Objective: This study examined the association between neighborhood food swamp environments and sugar-sweetened beverage (SSB) consumption in quick-service restaurants (QSRs) and whether ethnicity and race moderated this association. Methods: Observational data were collected from parent-child dyads patronizing four QSRs in Massachusetts (n = 82 dyads) and New Hampshire (n = 67 dyads), including children’s SSB consumption (measured by plate waste) categorized as high (>25 g) versus lower sugar. The neighborhood food environment of each QSR was categorized as food swamp versus nonfood swamp based on the ratio of unhealthy to total food outlets in the neighborhood. Logistic regression analysis was used to test the relationship between food swamps, ethnicity/race, and SSB consumption. Results: Of the 149 children (49% Latinx, 58% between the ages of 7 and 12), most visited QSRs located in food swamps (63%). All children consumed a beverage in QSRs, and 83% consumed high-sugar SSBs. Children patronizing QSRs in food swamps did not differ significantly in the likelihood of consuming high SSBs relative to children in QSRs in nonfood swamps [82% vs. 83%, adjusted odds ratio (aOR) = 0.8, 95% confidence interval (CI): 0.3-2.2]. However, Latinx children were more likely than non-Latinx children to consume high-sugar SSBs in QSRs (93% vs. 72%, aOR = 3.4, 95% CI: 1.1-10.5). SSB consumption did not differ significantly between racial minority and White children. SSB consumption in food swamps did not differ by ethnicity/race. Conclusions: Regardless of the neighborhood food environment, children consume high-sugar SSBs in QSRs. Latinx children had higher odds of consuming high-sugar SSBs in QSRs. These findings support incentives promoting healthier beverage options for children across all food outlets.
4. Challenges in Breastfeeding Faced by the Lactating Gynecologic Surgeon.
期刊: Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine 发表日期: 2025-Aug-27 链接: PubMed
摘要
Objectives: Characterize the experiences of lactating gynecologic surgeons, identify common challenges, and propose solutions to address barriers. Methods: In this mixed-methods, cross-sectional study, a novel survey was electronically distributed to measure lactation experiences among gynecologic surgeons. Descriptive statistics were used to analyze quantitative data, and thematic analysis was used for the qualitative data analysis. Results: Eighty-six survey respondents reported having been pregnant and met the eligibility criteria. The rate of breastfeeding was 95% (n = 82) among women who had given birth, and 91% (n = 75) of surgeons breastfed after returning to work. Of the 66 surgeons who shared lactation experiences, 97% (n = 64) reported challenges faced at work, and 86% (n = 57) faced more than one challenge. Most respondents were fellowship trained (85%, n = 56) and half delivered within the last 2 years (48%, n = 32). Analysis yielded eight themes and nine subthemes. The most common themes were time constraints (n = 48), difficulty balancing clinical responsibilities (n = 53), and pumping logistics (n = 59). Surgeons suffered from emotional distress (n = 14) and physical challenges included decreased supply, engorgement, and leakage (n = 16). Conclusions: Gynecologic surgeons face multiple challenges when lactating at work. This research highlights the lack of protection and support for the lactating surgeon. We propose solutions to address these workplace inequities, including allotted time for milk expression, adequate facilities, institutional and national policy and protections, and creation of a culture of support.
5. Impact of a pre-visit glaucoma video/question prompt list intervention on Black patient eye drop adherence during a 12-month period: A randomized controlled trial.
期刊: Optometry and vision science : official publication of the American Academy of Optometry 发表日期: 2025-Aug-27 链接: PubMed
摘要
Black patients with glaucoma who received the pre-visit question prompt list/video intervention and asked one or more questions during visits were significantly more likely to take the percentage of correct prescribed doses each day and the percentage of correct number of doses each day on schedule over a 12-month period. The study aimed to examine the impact of a randomized, controlled trial to test the effectiveness of a pre-visit glaucoma video/question prompt list intervention on Black patient glaucoma medicine adherence over a 12-month period. One hundred eighty-nine Black patients with glaucoma were enrolled and randomized to either a usual care or pre-visit video/question prompt list intervention. Patients who reported being nonadherent on one of two measures were enrolled into the trial. Baseline and 6-month visits were audio-taped, and patients were interviewed afterwards. This manuscript focuses on the longitudinal 12-month adherence data, which has not been reported previously. Patients’ eye drops were placed in prescription vial(s) at baseline with Medication Event Monitoring System caps to electronically measure adherence over a 12-month period. Patients in the intervention group who asked any questions at baseline or 6 months were significantly more likely to take the percentage of correct number of doses each day during the 12-month follow-up period than patients in the intervention group who did not ask any questions (35% compared with 16%, p=0.0004). The video/question prompt list intervention was not significantly associated with whether patients were 80% or more adherent during the 12-month follow-up period. An interesting finding was that Black patients in the intervention group who asked any questions during visits were more likely to take the percentage of correct prescribed doses each day and the percentage of correct number of doses each day on schedule over a 12-month period than those in the intervention group who did not ask any questions. Future work needs to figure out ways to motivate more patients who receive the question prompt list/video intervention to ask questions during their visits.
6. Assessment of dry eye disease and convergence insufficiency symptoms in e-commerce workers using validated questionnaires: A cross-sectional study.
期刊: Optometry and vision science : official publication of the American Academy of Optometry 发表日期: 2025-Aug-27 链接: PubMed
摘要
This study highlights the significant symptom presence of dry eye disease (DED) (27%) and convergence insufficiency (CI) (34%) among e-commerce workers (14% had both), underscoring their unique ocular health risks from prolonged screen exposure. It emphasizes the need for targeted workplace interventions and optometric screening to safeguard the digital workforce’s visual health. To investigate the prevalence of DED and CI symptoms in e-commerce workers. One hundred fourteen e-commerce workers (out of 140 distributed links, response rate = 81%) were surveyed via the Ocular Surface Disease Index (OSDI) and Convergence Insufficiency Symptom Survey (CISS) questionnaires online in the Porsline surveyor. A total of 30 questions were assigned to each individual, comprising demographic, OSDI, and CISS questions, all in Persian. The survey was carried out online. The mean age was 29.2 ± 7.2 years (range: 18-50), and 55% of participants were female. The mean OSDI score was 9.3 ± 5.2, and the mean CISS score was 18.4 ± 9.6. Among all participants, 31 individuals had an OSDI score greater than 12, indicating the presence of DED symptoms. In all of these cases, the severity was categorized as mild; no moderate or severe cases were observed. Additionally, 39 individuals among participants had CISS scores higher than 21, showing symptoms of CI. There was no statistically significant difference in the mean scores of OSDI and CISS between males and females (p=0.54 and p=0.064, respectively). The results showed a significant positive correlation between daily hours of digital screen use and DED symptoms (p<0.001), as well as a significant correlation between CI and dry eye symptoms (p<0.001, 14% of the participants [n = 16]). E-commerce workers exhibit a notable prevalence of symptoms for both mild DED and CI, based on symptom survey results. Symptom scores from these surveys were highly correlated, suggesting that the symptoms of the two different conditions are similar and could be mistaken for one another.
7. Evaluation of an Integrated Multicomponent Wellness Curriculum With Perceived Stress Levels in Physician Assistant Students.
期刊: The journal of physician assistant education : the official journal of the Physician Assistant Education Association 发表日期: 2025-Aug-27 链接: PubMed
摘要
In response to an Accreditation Review Commission on Education for the Physician Assistant Standards, 5th edition requirement for instruction on provider personal wellness, evidence-based multicomponent wellness programming was integrated into didactic and clinical phases of a physician assistant (PA) education program. This study aimed to examine whether PA students’ perceived stress declined from before to after their participation in each semester’s wellness programming and to gauge students’ perceptions of programming acceptability and success. Three cohorts of students enrolled in mandatory wellness programming were invited to complete pre- and post-programming assessments over 4 semesters. Linear mixed models were used to examine change in perceived stress from pre- to post-phase programming over time. Mean satisfaction ratings and thematic analysis of qualitative data were used to examine acceptability, success, and students’ program improvement recommendations. There were 121 pre- and 87 post-assessments completed with 110 (95%) of students completing at least one assessment; 43 students from 2 cohorts rated program satisfaction and 34 provided open-ended feedback. On average, perceived stress declined by about 5.7% from before to after programming. Decline in perceived stress did not differ based on gender, program phase, or cohort. Female students had higher perceived stress compared with male students on average over time. Students’ average program satisfaction was “neutral.” They recommended more autonomy and personalized wellness programming. This research suggests that multicomponent wellness programming is associated with a small decline in students’ perceived stress. Increasing students’ autonomy to select and engage in personally relevant programming may improve outcomes.
8. Survival Variations Based on Hospice Qualifying Condition: A Retrospective Review.
期刊: The American journal of hospice & palliative care 发表日期: 2025-Aug-26 链接: PubMed
摘要
BackgroundPatients are enrolled into hospice for a variety of conditions. There are few recent data on the differences of survival duration after hospice enrollment, particularly regarding age, sex, and reason for hospice admission.MethodsUsing previously obtained data, we calculated age at enrollment, reported sex, and classified patients into nine classes of hospice-qualifying conditions (HQC). We then applied Wilcoxon rank-sum analysis comparing median survival and the percent of patients surviving at least 6 months.Findings53.38% of patients were female. The median age was 83.03 years. The median survival duration overall was 17.36 days (Inter-quartile range 5.35-62.08). Median survival was lowest for “Infectious” HQC (4.69d) and highest for “Other” (28.53d). Women survived longer than men (19.34 vs 15.37 days). Those older than median survived longer (20.51 days vs 15.03). Overall, 9.47% of enrollees survived at least 6 months. This was more common for women (10.99%), those older than 83 (12.44%), and those enrolled for dementia (16.46%).DiscussionRelevant information of what can be expected after hospice enrollment is crucial for families and patients. These differences also indicate potential bias in assessment of hospice applicability, enrolling women, older patients, and patients with specific diagnoses earlier in their disease course.
9. Arabidopsis ecotype screening reveals novel sources of clubroot resistance.
期刊: Plant disease 发表日期: 2025-Aug-26 链接: PubMed
摘要
Clubroot, caused by Plasmodiophora brassicae, poses a persistent threat to Brassicaceae crops, particularly in regions where resistant cultivars are under strong selection pressure. To identify new sources of resistance and better understand the underlying genetic mechanisms, we evaluated 60 Arabidopsis thaliana ecotypes against the highly virulent Canadian pathotype 3A. Using stringent phenotyping criteria, pathogen DNA quantification, and survival analysis, we identified eight resistant ecotypes, including two novel sources, Marce-1 and DraII-6. DraII-6 exhibited exceptionally low disease symptoms and a high survival rate. While the clubroot resistant gene RPB1/WeiTsing was detected in many ecotypes, DraII-6 exhibited uniquely high expression of RPB1 at early infection stages, suggesting a possible role in impeding pathogen establishment. However, the observed resistance pattern implies the involvement of additional genetic or regulatory factors beyond RPB1 alone. Given the urgent need to diversify resistance sources and the growing complexity of clubroot epidemiology, we present these findings as a foundation for further mechanistic studies. The rapid release of this work as a Short Communication reflects both its significance for the field and its potential to guide future resistance breeding in Brassica crops.
10. Genomic and Pathogenic Insights into the Geographic Range Expansion of Wheat Blast into Uruguay.
期刊: Plant disease 发表日期: 2025-Aug-26 链接: PubMed
摘要
Wheat blast, caused by Magnaporthe oryzae pathotype Triticum (MoT), is one of the most destructive and emerging diseases affecting global wheat production. Although it is endemic to South America and has significantly affected Brazil, Paraguay, and Bolivia, it had not been reported in Uruguay until 2023. During that season, climatic conditions similar to those associated with Brazilian MoT outbreaks, particularly in northwestern Uruguay, prompted intensive monitoring of this disease. In October 2023, 17 wheat spike samples with blast-like symptoms were collected from 11 fields; nine were positive for M. oryzae based on morphology. Four monosporic isolates were recovered, and three were subjected to molecular and genomic characterization. PCR confirmed their identity as MoT, and pathogenicity tests demonstrated their ability to cause disease in both leaves and spikes of susceptible wheat genotypes. Phylogenetic comparisons among 57 Triticum, Lolium, and Eleusine M. oryzae strains, including strains from the B71 branch responsible for outbreaks in Bangladesh and Zambia, indicated that the Uruguayan strains are closely related to some Brazilian strains and are genetically distinct from the B71 branch. Specifically, PyrUy10.1 and PyrUy14.1 shared 99.9% of their SNPs, whereas PyrUy11.1 showed only 73% similarity to these strains, suggesting more than one introduction of the pathogen into Uruguay and the presence of distinct lineages. These findings confirm the presence of MoT in Uruguay and suggest that its introduction likely occurred through airborne dispersal due to its geographic proximity to Brazil. This study highlights the need for continuous surveillance and monitoring in Uruguayan regions with conducive environmental conditions for wheat blast, as the detection of multiple genetic lineages suggests the presence of strains with distinct adaptations. This genetic diversity poses a significant challenge for effective wheat blast management in Uruguay and may have important implications for national wheat production as the pathogen continues to evolve locally.
11. A "Pandemic-Proof" Methodology for Outbreak Detection Adapted From COVID-19's Impact on Notifications of Infectious Diseases in the Netherlands: Surveillance Study.
期刊: JMIR public health and surveillance 发表日期: 2025-Aug-26 链接: PubMed
摘要
Reporting of notifiable infectious diseases was overall impacted by the COVID-19 pandemic. This could affect disease surveillance and thus, outbreak detection, as it is based on historical data. For effective outbreak detection, it is crucial that communicable disease control professionals can rely on accurate and valuable alarm thresholds to ensure timely and adequate response to potential outbreaks. In this study, we take the first steps in the development of a methodology that adjusts for the impact of the COVID-19 pandemic on the number of notifications of notifiable infectious diseases and provides corrected alarm thresholds for outbreak detection. We identify which infectious diseases were affected by the COVID-19 pandemic, assess the duration of these effects, and explore potential correction methods to improve outbreak detection. We analyzed cases of 25 notifiable infectious diseases reported from 2015-2023 in the Netherlands. Negative binomial regression was used to calculate the incidence rate ratios for each period: pre-COVID-19 pandemic, COVID 2020, COVID 2021, COVID 2022, and post-COVID-19 pandemic. To address the decrease in notifications during the COVID-19 pandemic, we tested 3 correction methods: (1) recoding COVID-19 years as missing; (2) imputing with the last pre-COVID-19 pandemic observation; and (3) imputing the historical moving average. Between 2015-2023, a total of 74,990 notifications were reported in the Netherlands, of which 9,836 notifications (13%) occurred during the COVID-19 pandemic. Malaria, typhoid fever, hepatitis A, meningococcal infection, paratyphoid fever, Q-fever, shigellosis, measles, mumps, and pertussis had significantly lower notifications during the COVID-19 pandemic, but the duration and magnitude of the effect differed among the infections. The effect of the COVID-19 pandemic on the notifications of malaria (incidence rate ratio [IRR] 0.17, 95% CI 0.08-0.36) and typhoid fever (IRR 0.12, 95% CI 0.02-0.55) was only seen in 2020, while the notifications for measles (IRR 0.34, 95% CI 0.15-0.75) and pertussis (IRR 0.34, 95% CI 0.20-0.60) were still significantly lower in the post-COVID-19 pandemic period. In addition, the newly calculated alarm thresholds showed a noticeable difference compared with the original unadjusted alarm thresholds. However, the variation among the 3 different corrected alarm thresholds was not substantial. During the COVID-19 pandemic, notifications of 10 infectious diseases declined significantly. The duration of this decline varied among infections, highlighting the need for pattern-specific adjustments. Our study demonstrates that accounting for the reduced notifications impacts alarm threshold calculations for outbreak detection. We therefore recommend amending the alarm thresholds to account for this impact to ensure reliable outbreak detection, so that communicable disease control professionals can act in a timely and data-driven manner. The next step in the development of the “pandemic-proof” methodology is to determine which correction method is most suitable. Further validation by communicable disease control professionals is essential to assess the applicability of the adjusted alarm thresholds for outbreak detection.
12. Risk of lymphomas among people with HIV in the United States during 2001-2019.
期刊: Journal of the National Cancer Institute 发表日期: 2025-Aug-26 链接: PubMed
摘要
Lymphomas are among the most common malignancies in people with HIV (PWH). Although the widespread use of combination antiretroviral therapy has significantly reduced the risk of lymphoma among PWH, data on specific lymphoma subtypes remain limited and outdated. Using data from the HIV/AIDS Cancer Match Study, a U.S. cohort linking cancer and HIV registries and including 822,702 PWH, we assessed the relative risks of 14 lymphoma subtypes by calendar period and age group during 2001-2019. We estimated the risk of lymphoma subtypes using standardized incidence ratios (SIRs) adjusted for age, sex, race, ethnicity, and registry. Trends of SIRs for lymphoma subtypes across calendar periods were estimated using Poisson regression overall and by age groups. There were 6,577 non-Hodgkin lymphomas (NHL) and 1,783 Hodgkin lymphomas (HL) during 2001-2019. SIRs declined significantly over time for most NHL subtypes including diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma (BL), peripheral T-cell lymphoma (PTCL), central nervous system (CNS) NHL, and follicular lymphoma. During 2015-2019, lymphoma subtypes with elevated risk among PWH included DLBCL (SIR = 5.38, 95%CI = 5.02-5.76), BL (15.1, 12.6-17.9), PTCL (1.68, 1.26-2.20), CNS lymphoma (8.85, 7.05-11.0), nodular sclerosis HL (4.04, 3.22-5.02), and other classical HL (8.99, 8.00-10.1). For most lymphoma subtypes, SIRs for the 20-39-year-old-group were higher than 40-59-year-old and 60-84-year-old groups. The risk of lymphomas among PWH in the US declined during 2001-2019, with variations across histological subtypes and age groups. Despite overall declines, several NHL subtypes and HL risk remained elevated recently, underscoring the continued lymphoma burden among PWH.
13. An Aboriginal women-led approach to design a maternal and child health model when cardiometabolic complications are experienced in pregnancy in South Australia.
期刊: The Medical journal of Australia 发表日期: 2025-Aug-26 链接: PubMed
摘要
To develop a culturally responsive maternal and child health model, centred on Aboriginal and Torres Strait Islander women’s knowledge of health, wellbeing and expressed health priorities, to address gaps in care for those who experience cardiometabolic complications in pregnancy. Health services and systems co-design. Health services in South Australia providing maternal and child primary, acute and chronic disease management care. Nineteen Aboriginal women from urban, regional and remote areas of South Australia participated in 2024, with most having personal experience of cardiometabolic complications in pregnancy and some contributing professional experience. Development of a culturally responsive, evidence-based model of care to support Aboriginal women with cardiometabolic complications in pregnancy. Through a collaborative approach and an iterative co-design process, participants shared lived experiences, identified systemic issues and developed solutions to address gaps in maternal and child health care. Culturally safe spaces enabled deep reflection, open dialogue and collective decision making. With this, we developed a model of care that included a vision statement, guiding principles, a conceptual framework and 18 priority areas. In addition, eight health system enablers were identified to support implementation. This project demonstrates the value of Aboriginal women’s leadership in shaping health systems. This process highlights the value of culturally grounded, community-led co-design approaches to health service and system reform. For health systems and service providers and managers, this is an opportunity to foster meaningful change by listening to and acting on the voices of Aboriginal women. In doing so, they will meet their responsibility to address inequities. Researchers and health organisations must do more than amplify these voices; rather, they must listen, act and ensure that systems respond to what women say they need. This is a pivotal moment to drive systemic change for equitable and culturally safe maternal and child health care.
14. From Circularity to Spirality: An Integrated, Systems-Level Approach to Address the Plastics Problem.
期刊: Journal of the American Chemical Society 发表日期: 2025-Aug-26 链接: PubMed
摘要
Plastics offer significant benefits but pose growing environmental and health concerns due to low recycling rates and continued reliance on fossil-derived feedstocks. While plastics circularity has emerged as a key strategy to reduce plastic waste and impacts, current mechanical recycling pathways face major limitations in maintaining material quality over repeated cycles. Advanced methods like chemical recycling and dissolution show promise but raise questions about environmental impacts, scalability, and cost. In this perspective, we introduce the concept of spirality as a more realistic model than perfect circularity, acknowledging the inevitable degradation of plastic quality over consecutive recycling cycles and the need for tiered recycling strategies. We emphasize the importance of early stage integration of mechanical property benchmarking, life cycle assessment (LCA), and techno-economic analysis (TEA) to evaluate emerging chemistry-enabled solutions for plastics recycling. In parallel, we underscore the critical role of high-quality data, and the need for multidisciplinary collaboration to align chemistry, materials science, engineering, systems analyses, and policy for sustainable transitions. Spirality, combined with robust assessment frameworks, can guide innovation toward more pragmatic and sustainable solutions in polymer design and end-of-life management.
15. An Integrated Methodological Approach to Address Immigrants' Complex Health Issues: Lessons From the CAN-HEAL Study.
期刊: Community health equity research & policy 发表日期: 2025-Aug-26 链接: PubMed
摘要
Community-based participatory research (CBPR) and integrated knowledge translation (IKT) are methodological approaches that emphasize the value of equitable partnerships between researchers and community partners. The main difference between these approaches is that CBPR is advocacy-centered and aims at addressing inequities by instigating systemic and policy changes, whilst IKT is application- and upstream solution-oriented especially within the context of health and social care improvement. Previous studies that have used a collaborative approach mainly focused on either CBPR or IKT to a lesser extent.The CAN-HEAL project employed an innovative methodological approach that integrates CBPR and IKT to address mental health needs among Arab immigrants and refugees in Ontario, Canada. Integral to this approach are three pillars: (1) establishment of a multi-level community partnership; (2) adherence to cultural sensitivity principles; and (3) commitment to social justice and application. The use of an CBPR-IKT approach led to numerous successes, including the co-development of a holistic upstream-downstream-based health promotion action plan to tackle inequities. This approach was associated with different challenges (e.g., limited resources), which were mitigated by employing certain enablers (e.g., assistance from community leaders). Based on lessons from this project, recommendations are made for governmental agencies and academic institutions to advance CBPR-IKT research to promote the sustainability and well-being of communities.
16. Reversible oxidative modifications partially cause myofibrillar active and passive force decline in early phase of immobilization.
期刊: American journal of physiology. Cell physiology 发表日期: 2025-Aug-26 链接: PubMed
摘要
Muscle immobilization leads to a decrease in muscle fiber size and contractile function, partly due to a decline in myofibrillar force. In this study, we examined the effects of reversible oxidative modifications on the decline of myofibrillar function during the early phase of immobilization. One leg of male C57BL6 mice was immobilized for 3 and 7 days, while contralateral leg was used as a non-treated (NT) control. After the given immobilization periods, mechanically skinned fibers were prepared from gastrocnemius muscle, and myofibrillar active and passive forces were assessed. Myofibrillar specific force decreased after 7 days of immobilization, although myofibrillar Ca2+ sensitivity remained unchanged. The decreased specific force was partially restored by a treatment with dithiothreitol (DTT), a reducing regent, only when applied to non-activated fibers, not activated fibers. Additionally, 3-morpholinosydnonimine (Sin-1) and peroxinitrite (ONOO-) decreased maximal force in non-activated fibers from NT but not immobilized (Im) muscles. Myofibrillar passive force decreased after 7 days of immobilization. DTT treatment increased passive force in both NT and Im fibers, with a greater improvement seen in Im fibers. Furthermore, treatment with oxidized glutathione prior to DTT treatment decreases passive force in both NT and Im fibers, with a greater reduction seen in NT fibers. These results suggest that reversible oxidative modifications partially contribute to the impairments in both myofibrillar active and passive forces, at least in the early phase of immobilization. Specifically, ONOO- and S-glutathionylation likely play an important role in active and passive force, respectively.
17. Use of Biometrics for Records Deduplication: Case Study of the National Data Repository in Nigeria.
期刊: Online journal of public health informatics 发表日期: 2025-Aug-26 链接: PubMed
摘要
Nigeria has made significant investments in client-level electronic health systems, including the Nigeria Medical Record System (NMRS) and the National Data Repository (NDR), with funding from the US President’s Emergency Plan for AIDS Relief through the US Centers for Disease Control and Prevention (US CDC). A biometric system was used across the US CDC-supported program in Nigeria to consistently track and monitor service uptake by people living with HIV during this period. The system was used to conduct deduplication analysis with the goal of preventing double counting and improving data integrity across all the US CDC-supported treatment sites (health facilities and community sites). We describe the fingerprint biometric system in Nigeria and the process used for deduplicating health records of people living with HIV, including preliminary results. The fingerprint biometric system leveraged the availability of the electronic NMRS at health facilities and the NDR. The integration of the fingerprint biometric module into the NMRS enabled fingerprints capture using SecuGen devices. Stakeholder engagement and capacity building were conducted with people living with HIV and health facility staff for fingerprint capture, storage, and transmission of the fingerprint templates to the NDR. Deduplication of the fingerprint templates was conducted in the automated biometric information system that is integrated with the NDR. We implemented fingerprint capture for 1,538,971 people living with HIV to deduplicate records from 1,141 treatment sites to improve the reliability and uniqueness of the system of records. Preliminary data showed that of the 1,538,971 records assessed by 30th June 2024, 1,520,187 of the active records (98.78%) had valid fingerprints, and 1,264,299 (83.17%) of the records with valid fingerprints were unique. The implementation of a biometric system using fingerprint data allowed the identification of potentially duplicate records for resolution, thereby improving the quality of HIV treatment data for HIV program planning.
18. Electronic health records-based algorithms to screen for U.S. Centers for Disease Control and Prevention tier 1 genetic diseases: a scoping review.
期刊: Journal of the American Medical Informatics Association : JAMIA 发表日期: 2025-Aug-26 链接: PubMed
摘要
Missed diagnosis of genetic conditions is a persistent challenge in clinical care, particularly for familial hypercholesterolemia (FH), hereditary breast and ovarian cancer (HBOC), and Lynch syndrome-conditions designated by the U.S. Centers for Disease Control and Prevention (CDC) as Tier 1 genomic applications. This scoping review summarizes evidence on the use of electronic health record (EHR)-based algorithms to identify individuals with these conditions. We conducted a scoping review using the JBI Manual for Evidence Synthesis and reported results according to PRISMA-ScR guidelines. We searched Ovid MEDLINE, Embase, and Web of Science through October 2024 for studies evaluating EHR-based algorithms to identify individuals with FH, HBOC, or Lynch syndrome. Eligible studies addressed (1) performance of algorithms in detecting clinically or genetically confirmed cases or (2) outcomes from the implementation of algorithms in unselected populations with follow-up to identify new diagnoses. Of 598 articles screened, 22 met inclusion criteria. Most studies (20/22) focused on FH. Fourteen FH studies assessed algorithm performance, and 7 reported prospective implementation. FH algorithm performance varied widely (AUROC range 0.78-0.95), with machine learning models outperforming rule-based approaches. Implementation studies reported positive predictive values ranging from 11% to 67%. Only two studies addressed HBOC or Lynch syndrome, both using rules-based algorithms with limited sensitivity. Machine learning models consistently outperform rules-based algorithms relying on clinical criteria, but limited evidence exists for HBOC and Lynch syndrome. Early identification of CDC Tier 1 genetic conditions through EHR-based screening algorithms holds promise but will require both technical and implementation advances to realize improved patient care and outcomes.
19. Platelet Heterogeneity: Variety Makes Immune and Vascular Function Better.
期刊: Blood 发表日期: 2025-Aug-26 链接: PubMed
摘要
Platelets are dynamic cells that perform vital roles both in thrombosis and in immune regulation. Platelets are activated through well described signaling pathways following injury to the vascular wall to prevent excess bleeding and initiate vascular repair. However, platelet functions extend beyond this initial physical phase of platelet activation, through their expression and secretion of angiogenic factors and immune mediators that initiate wound healing and recruit leukocytes to prevent infection. Not only do activated platelets induce inflammation and vascular repair but circulating resting platelets maintain vascular integrity and immune homeostasis. Furthermore, many studies have shown that platelets are not homogenous, demonstrating transcriptomic and proteomic differences that associate with platelet phenotypes and functions in multiple disease states. Platelets are produced by megakaryocytes that are found not only in the bone marrow but also in the lungs and spleen. Megakaryocytes within the bone marrow are heterogeneous, which may contribute to platelet heterogeneity. Additionally, lung megakaryocytes are immune-differentiated compared to those in other tissues and proportionately produce more platelets at times of increased demand, perhaps adding to platelet heterogeneity in disease contexts. In this review, we will discuss underlying mechanisms that may lead to platelet heterogeneity impacting both health maintenance and disease.
20. Therapeutic Uses of Dietary Organosulfur Compounds in Response to Viral (SARS-CoV-2)/Bacterial Infection, Inflammation, Cancer, Oxidative Stress, Cardiovascular Diseases, Obesity, and Diabetes.
期刊: Chemistry & biodiversity 发表日期: 2025-Aug-26 链接: PubMed
摘要
Phytonutrients are widely recognized for their protective health benefits in humans. Mounting studies suggest that dietary organosulfur compounds play a significant role in preventing various pathological conditions. Organosulfur compounds, such as diallyl disulfide, diallyl trisulfide, alliin, allicin, S-allyl cysteine, and sulforaphane, possess broad pharmacological activities, making them versatile therapeutic agents. Their antiviral, antibacterial, anti-inflammatory, anticancer, and antioxidant properties, along with their effectiveness in managing cardiovascular diseases (CVDs), obesity, and diabetes, highlight their potential as single-drug solutions for multiple health issues simultaneously. Plants belonging to Allium genus and Brassicaceae family are the most predominant sources of these compounds. This review aims to summarize the different natural sources and bioavailability of various organosulfur compounds as well as discuss the therapeutic potential of various organosulfur compounds in response to viral/bacterial infection, inflammation, cancer, oxidative stress, CVDs, obesity, and diabetes with special emphasis on SARS-CoV-2. This review also includes the effective doses as well as the mode of action underlying the therapeutic potential of specific organosulfur compound against respective pathophysiology. The outcome of this review will open new avenue for further investigation of organosulfur compounds against different pathophysiology and that will be helpful for the development of innovative therapeutics with promising health benefits.
21. New-Onset Atrial Fibrillation Following Isolated Coronary Artery Bypass Grafting: Is Pulmonary Hypertension a Risk Factor?
期刊: Brazilian journal of cardiovascular surgery 发表日期: 2025-Aug-26 链接: PubMed
摘要
This study aimed to clarify whether pulmonary hypertension is a risk factor for postoperative new-onset atrial fibrillation (NOAF) following isolated coronary artery bypass grafting (CABG). Data of 4,782 patients were retrospectively examined from clinical database, and data of isolated CABG performed patients (n = 854) with preoperative echocardiography including pulmonary artery pressure (PAP) measurement were enrolled in study. While 115 patients had post-CABG NOAF (atrial fibrillation [AF] group), 739 did not have AF (non-AF group). Demographic, clinical, and treatment-related parameters were compared between groups, and independent clinical predictors of NOAF were identified by multivariate analysis. Patients of AF group were significantly older and had higher European System for Cardiac Operative Risk Evaluation (EuroSCORE) points, significantly elevated mean systolic PAP, and more pulmonary hypertension. Multivariate regression analysis revealed that mean systolic PAP (odds ratio [OR]: 1.027, 95% confidence interval [CI]: 1.006 - 1.048) and pulmonary hypertension (≥ 30 mmHg; OR: 1.659, 95% CI: 1.093 - 2.518) were independent risk factors for post-CABG NOAF. Chronic obstructive pulmonary disease (COPD) (OR: 2.033, 95% CI: 1.265 - 3.268) and mean duration of ventilation support (OR: 1.059, 95% CI: 1.017 - 1.104) were additionally determined as risk factors for post-CABG NOAF. This study identified patients’ age, high EuroSCORE points, presence of COPD, prolonged ventilation support, and increased PAP as predictors of post-CABG NOAF. Understanding the risk factors will provide better guidance in preventing this complication and its potential consequences. Prospective randomized controlled trials are required to further validate these findings and provide more robust evidence.
22. Use of Cinnamon Essential Oil Nanoemulsions to Manage Gray Mold in Tomato.
期刊: Plant disease 发表日期: 2025-Aug-26 链接: PubMed
摘要
Gray mold, caused by the fungus Botrytis cinerea, significantly reduces tomato yield and quality. The use of essential oils (EOs), here formulated as nanoemulsions, offers a safe and eco-friendly strategy to manage gray mold without conventional pesticide application. This study evaluated the antifungal effect of cinnamon essential oil nanoemulsion (EONE) against B. cinerea in vitro, and its impact on plant physiological health and gray mold suppression in planta. EONE-treated media significantly reduced B. cinerea mycelial growth area compared to non-treated controls, with greatest inhibition observed at three days post-inoculation (PDA: 88.67%, p<0.01; V8: 54.57%, p<0.01). In tomato plants, roots were treated with EONE prior to foliar inoculation with B. cinerea. EONE showed no adverse effects on physiological parameters of non-inoculated plants. Inoculated plants exhibited reduced Fv/Fm, chlorophyll content, and NDVI compared to non-inoculated plants, but these effects were mitigated in EONE-treated plants, particularly at 200 µL application volume. Cinnamon EONE, applied at volumes ranging from 200 to 2000 µL (5.98 to 59.38 mg/L cinnamon EO), suppressed gray mold lesion area by up to 44.50% compared to the B. cinerea-inoculated control. Evaluation of individual EONE components showed that inert ingredients had no significant plant-protective nor disease-suppressive effects. While unformulated EO was more effective in suppressing disease lesion area in the short term (plants inoculated 24 h post-treatment), EONE provided longer-lasting protection when inoculated five days post-treatment. These findings suggest that cinnamon EONE is a promising tool for managing B. cinerea, with potential for a long-term protective effect in disease management.
23. Epigenetic impact of endocrine-disrupting chemicals on atherosclerosis.
期刊: Essays in biochemistry 发表日期: 2025-Aug-26 链接: PubMed
摘要
Atherosclerotic cardiovascular disease (CVD) is the leading cause of mortality and morbidity worldwide. Recent studies have implicated a novel link between exposures to endocrine-disrupting chemicals (EDCs) and CVD. EDCs are a group of persistent compounds that can interfere with the body’s natural hormonal processes, posing significant risks to both environment and human health. However, the impact and underlying mechanisms of EDC exposures on atherosclerosis are poorly understood, making it difficult to conduct rational exposure assessments. EDCs can affect CVD risk through multiple mechanisms, and epigenetic mechanisms are key mechanisms for environmental factor-elicited chronic diseases. Further, EDC-elicited epigenetic alterations may not only affect atherosclerosis development in exposed individuals but also lead to increased CVD risk in their descendants. In this review, we mainly focus on the current understanding of EDC-mediated epigenetic regulation and epigenetic inheritance of CVD. In addition, EDC-carrying microplastics and nanoplastics have emerged as significant environmental pollutants, and humans are ubiquitously exposed to these particles. We also discuss the potential impact of co-exposures of EDCs and small plastic particles on atherosclerosis and CVD.
24. Technical Description of eHealth Tools in an Environmental Exposure Chamber: Implementation Study.
期刊: JMIR formative research 发表日期: 2025-Aug-26 链接: PubMed
摘要
Environmental exposure chambers (EECs) provide a controlled and reproducible setting for studying allergic rhinitis, allowing standardized exposure to aeroallergens. However, real-time symptom monitoring remains challenging, particularly as patients must be observed remotely while inside the chamber. This study aimed to design, implement, and evaluate an integrated eHealth system that leverages digital tools for data collection and real-time clinical monitoring during EEC exposures. The goal was to streamline workflow, enhance data reliability, and improve patient safety during allergen challenges. We conducted a prospective pilot study in a validated EEC at Ramón y Cajal University Hospital. A total of 34 provocation tests were conducted: 27 in patients with confirmed grass pollen allergy and 7 in nonallergic controls. All exposures took place outside the pollen season using standardized Phleum pratense (grass pollen) at concentrations of 940±100 grains/m³. Clinical data were collected using REDCap (Research Electronic Data Capture; Vanderbilt University), a secure electronic data capture platform. Surveys were automatically scheduled and included standardized instruments: Visual Analog Scale (VAS), Total Nasal Symptom Score (TNSS), Total Ocular Symptom Score (TOSS), asthma symptom questionnaires, peak expiratory flow (PEF), and peak nasal inspiratory flow (PNIF). Data were visualized in real time using Power BI dashboards (Microsoft Corp). Among allergic patients, 85% had a positive response to the allergen exposure, with a median TNSS of 6 (IQR 6-7), while controls showed no positive reactions. Mean exposure time for positive cases was 48.9 minutes (SD 28.3), as patients were withdrawn early upon reaching symptom thresholds. The REDCap system was configured to collect symptom surveys at 15-minute intervals, allowing up to 6 entries per patient during exposure, depending on clinical tolerance. This setup enabled consistent symptom monitoring and integration with Power BI for real-time visualization. All records were successfully synchronized between REDCap and Power BI. Informal feedback from medical staff highlighted improved workflow and usability. The integration of REDCap with Power BI enabled automated, real-time tracking of symptoms during EEC exposures. This eHealth solution enhanced clinical oversight, supported timely decision-making, and ensured patient safety. The platform provides a flexible and reproducible model for use in allergen exposure studies and other clinical settings requiring structured remote monitoring. Clinical response data are reported in a separate validation study.
25. HIV Removal by MOF-Based Microspheres: A Potential Adsorbent for Hemoadsorption.
期刊: ACS biomaterials science & engineering 发表日期: 2025-Aug-26 链接: PubMed
摘要
At present, AIDS remains a significant global health issue that requires ongoing attention. Although there is no practical cure for AIDS, hemoadsorption can effectively remove the virus from the blood and may serve as a promising treatment strategy. In this research, cellulose acetate/metal-organic framework composite beads (CA/MIL-125) with interconnected macropores were first fabricated using a one-step phase inversion method and then applied as a viral hemoadsorbent for the treatment of AIDS. The results showed that CA/MIL-125 exhibited excellent specific surface areas (221.17 m2 g-1) and an interconnected macropore structure, which allows HIV molecules to be transported freely within the pores of the beads. The CA/MIL-125 composite beads reached a 97.37% adsorption rate of HIV in plasma, which was 90 times higher than that of pure cellulose acetate (CA) microspheres, demonstrating that MIL-125 played a dominant role in HIV adsorption. Furthermore, the adsorption of CA/MIL-125 on HIV primarily obeys the pseudo-second-order kinetics and Freundlich model, with a maximum adsorption capacity (Qm) of 642.2 ng g-1. Tests for hemolysis, coagulation time, and cytotoxicity confirmed that CA/MIL-125 had good blood compatibility and biocompatibility. This study presents an effective strategy for HIV adsorption through hemoperfusion, suggesting a promising new treatment approach for AIDS.
26. The Prevalence and Risk Factors of Physical Restraint Among Patients Under Palliative Care in Taiwan.
期刊: Journal of palliative medicine 发表日期: 2025-Aug-26 链接: PubMed
摘要
Background: Physical restraint for patients approaching their end of life may induce distress and impair dignity. Limited studies have been reported on the frequency and factors influencing restraint application during terminal phases of patients in hospital settings. Objective: We aimed to study the occurrence and factors that predict utilization of physical restraints in hospitalized terminally-ill adults. Setting/Subjects: We collected data from a single regional hospital in central Taiwan. All terminally ill patients admitted to the palliative care unit (PCU) from January 2019 to September 2023 were enrolled. Measurements: Physical restraint was defined as being physically restrained during hospitalization for >8 hours under medical order. We retrospectively identified potential risk factors for restraint use from a number of variables, including the type of primary diagnosis, medications used including benzodiazepine (BZD) and strong opioid, procedures involving nasogastric (NG) tube, Foley insertion, reason of discharge, and the specialty of attending physician. Multivariate logistic regression was used to analyze the risk factors predicting the use of physical restraint. Results: From 2019 to 2023, 688 patients with an average age of 82.1 years (standard deviation: 13.1) were included for the final analysis. Of them, 69% were male, and 9.5% received physical restraint during hospitalization. After adjusting for multiple confounding factors, the use of BZD (odds ratio [OR]: 2.34, 95% confidence interval [CI]: 1.32-4.15) and NG tube (OR: 2.53, 95% CI: 1.38-4.65) were identified as significant risk factors predicting the application of physical restraint. Subgroup analyses showed that female gender with cancer (OR: 5.43, 95% CI: 1.01-29.05) was another significant risk factor, apart from the use of BZD and NG tube. Conclusions: This is the first study on risk factors predicting the use of physical restraint in a palliative care setting. Palliative care professionals should carefully deliberate the use of BZD and NG tubes among terminally ill patients in PCU.
27. Recovery attributions and future expectations for antibiotics after precautionary prescribing.
期刊: European journal of public health 发表日期: 2025-Aug-26 链接: PubMed
摘要
Antibiotic overuse is a significant public health challenge, and antibiotics are often prescribed as a precaution. While precautionary prescribing often aims to meet perceived patient expectations, it can unintentionally reinforce the belief that antibiotics are necessary and effective. This study examines how the communication of precautionary antibiotic prescribing shapes patients’ beliefs in what actually made them better and how these causal beliefs, in turn, affect their expectations for antibiotics in future illness situations. In the two preregistered online experiments with UK adults (N = 252 and N = 2448), participants imagined having an ear infection, receiving a precautionary prescription, taking antibiotics, and recovering shortly thereafter. We manipulated whether participants received statistical information about the likelihood of a self-limiting recovery (base-rate information) before the prescription. Participants then evaluated what caused their recovery and whether they expected to receive antibiotics for a future, unrelated illness. Across both studies, participants generally attributed their recovery to the antibiotics, even when told that the infection was likely to resolve on its own. This attribution was associated with stronger expectations of receiving antibiotics for future illnesses. However, participants who received base-rate information more accurately attributed their recovery, suggesting that statistical context can partially correct causal beliefs. Precautionary prescribing can unintentionally shape patients’ beliefs about antibiotic efficacy, which, in turn, reinforces future demand. Providing patients with brief information on self-limiting infections may help reduce inappropriate antibiotic expectations and support prudent and more sustainable prescribing practices.
28. Enhancement of environmental microplastics (MPs) degradation via bacteria under stress conditions: key enzymes, pathways, and mechanisms.
期刊: World journal of microbiology & biotechnology 发表日期: 2025-Aug-26 链接: PubMed
摘要
Microplastics (MPs) are an emerging pollutant that needs effective bioremediation strategies. Strategies, including microbial implementation, enzymes, and insect-mediated degradation, have been effectively deployed and reviewed for the biodegradation of MPs. Thus, this review focused on utilizing multiple stressors (biotic and abiotic) to enhance MPs biodegradation. MPs degradation mechanism, major enzymes involved, and stress-mediated bacterial responses are highlighted. The key routes for MPs biodegradation under various stress are covered. Furthermore, the applications of stresses on wastewater treatment plants (WWTPs) for real-world application are also considered. Thermus sp. is reported to remediate polystyrene (PS) by 43.7% at 40-80 °C stress, whereas pH stress showed enhanced low-density polyethylene (LDPE) biodegradation (9.9%) under B. krulwichiae. Salinity up to 3 M NaCl, when applied to Bacillus sp., showed 48 times higher protease content. Radiation UV-C on P. aeruginosa increased polyethylene/polystyrene (PE/PS) protease activity by 75.47%. The bacterial response to stress was reported to be mediated by enzyme upregulation, biofilm formation, and metabolic shifts. Targeted stress enhanced MPs biodegradation through specific bacterial adaptations and enzymatic activity. Particular stress requires a specific mechanism to accelerate bacterial MPs degradation. Future research should aim to explore the synergistic effects of combined stressors, conduct comprehensive ecological risk assessments, and implement large-scale field trials to ensure the sustainability and ecosystem compatibility of stress-mediated MPs bioremediation.
29. Reduced lung function among non-smoking workers in the paper industry in Ethiopia: a comparative cross-sectional study.
期刊: International archives of occupational and environmental health 发表日期: 2025-Aug-26 链接: PubMed
摘要
Exposure to paper dust in the workplace might increase the risk of reduced lung function. This study aims to evaluate the relationship between paper dust exposure and lung function among workers in the paper industry in Ethiopia. A comparative cross-sectional study assessed lung function in workers exposed to dust in the paper industry and compared them with controls from the water bottling industry. Lung function tests were conducted using a portable spirometer. A job exposure matrix was developed to estimate cumulative exposure to inhalable paper dust. Analysis of covariance was performed to compare mean lung function between exposed and control groups and multivariate linear regression analysis was carried out for workers exposed to paper dust. There was a significant difference in forced expiratory volume in one second (FEV1) between the groups. FEV1 was 2.62 l in the exposed group, compared to 2.97 l in the control group. The multiple linear regression analysis revealed that cumulative paper dust exposure was associated with a reduction in both FEV1 and forced vital capacity (FVC). Each unit increases in dust exposure (measured in mg year/m2) was associated with a 0.010 l decrease in both FEV1 and FVC in females and a 0.005-liter decrease in males. The findings indicate a significant exposure-response relationship between cumulative paper dust exposure and a decline in lung function with the effect being more pronounced among female workers than among males. Based on these results, we recommend the paper industry to implement effective dust control strategies.
30. Enhancing Toxicity Prediction of Synthetic Chemicals via Novel SMILES Fragmentation and Interpretable Deep Learning.
期刊: Journal of chemical information and modeling 发表日期: 2025-Aug-26 链接: PubMed
摘要
Toxicity prediction and identification of structural alerts (SAs) for synthetic chemicals are critical for assessing risks to environmental and human health. Traditional methods, which rely heavily on molecular descriptors, often suffer from poor interpretability. Here, we introduce a novel framework that integrates SMILES fragmentation strategies with a 1D convolutional neural network deep learning model (denoted as the SFDL) for predicting chemical toxicity and associated SAs. Four distinct fragmentation methods, single-atom, single-symbol, atom-centered, and symbol-centered, were evaluated to generate tokenizers (denoted as GenTok) from 581537 high-interest PubChem compounds. The symbol-centered fragmentation approach demonstrated superior performance on the ISSSTY AMES mutagenicity data set (AUC = 0.87, PRAUC = 0.90). This SFDL-GenTok strategy demonstrated robust predictive performance across 6 out of the 10 toxicity end points (AUC = 0.81∼0.93, PRAUC = 0.70∼0.94). Based on these models, toxicity predictions were conducted for 28160 synthetic chemicals. Potential toxic compounds were subsequently categorized into three groups: endocrine disruption, mutagenicity, and mitochondrial toxicity. SAs analysis revealed that halogenated fragments, nitro or phenolic groups, and reactive electrophilic motifs are critical contributors to endocrine disruption, mitochondrial toxicity, and mutagenicity. This study provides an interpretable tool for toxicity and SAs identification of synthetic chemicals.
31. Does gender, health enterprise, and safety performance induce research and development expenditure in firms in Hong Kong, China?
期刊: African journal of reproductive health 发表日期: 2025-Aug-26 链接: PubMed
摘要
This paper explores the relationship between expenditure on research and development, gender and health and safety performances in enterprises in Hong Kong, China. Using nationally representative survey datasets from the Hong-Kong-SAR-China-2023-survey data, responses of 598 workers were considered. Descriptive statistics and probit regression were used to identify the associating impacts of adherence to health, safety and environmental performance on research and development expenditure in enterprises. The findings revealed that investment on research and development have positive association with manufacturing and retail business and among enterprises with compliance with energy use and occupational safety measures. Although gender have insignificant negative effect, yet female-led enterprises have lower performance than their male counterparts on the association of employers-gender role effect on expenditure on research and expenditure while enterprises that undergo training and adequately audit their account have positive and significant association with expenditure on research and development. This study suggests the need to consider safety and health measures in research and development expenditure for fostering innovation and enhancing adequate introduction of new markets and the enhancement of business enterprises. It also calls for female led enterprises to consider innovative and occupational safety programmes for workers health and increased productivity. Cet article explore la relation entre les dépenses de recherche et développement, le genre et les performances en matière de santé et de sécurité au travail dans les entreprises de Hong Kong, en Chine. À partir de données d’enquête représentatives au niveau national issues de l’enquête de 2023 menée dans la RAS de Hong Kong, en Chine, les réponses de 598 travailleurs ont été prises en compte. Des statistiques descriptives et une régression probit ont été utilisées pour identifier les impacts du respect des normes de santé, de sécurité et d’environnement sur les dépenses de recherche et développement des entreprises. Les résultats ont révélé que les investissements en recherche et développement sont positivement associés aux activités manufacturières et de vente au détail, ainsi qu’aux entreprises respectant les mesures de consommation d’énergie et de sécurité au travail. Bien que le genre n’ait qu’un effet négatif négligeable, les entreprises dirigées par des femmes affichent des performances inférieures à celles de leurs homologues masculins concernant l’association entre l’influence du rôle des employeurs et celle du genre sur les dépenses de recherche et développement, tandis que les entreprises qui suivent des formations et auditent correctement leurs comptes présentent une corrélation positive et significative avec les dépenses de recherche et développement. Cette étude souligne la nécessité de prendre en compte les mesures de sécurité et de santé dans les dépenses de recherche et développement afin de favoriser l’innovation, de favoriser l’introduction de nouveaux marchés et de renforcer les entreprises. Elle appelle également les entreprises dirigées par des femmes à envisager des programmes innovants de sécurité au travail pour la santé des travailleurs et une productivité accrue.
32. Effects of sitting posture and duration on lumbosacral nerve root function: A case-control study.
期刊: Journal of back and musculoskeletal rehabilitation 发表日期: 2025-Aug-26 链接: PubMed
摘要
PurposeThis study aimed to investigate the effects of different sitting postures and prolonged sitting on lumbosacral nerve root function by measuring the amplitude of the soleus (SOL) Hoffmann reflex (H-reflex).MethodsThis study included 30 healthy individuals who were selected through convenience sampling and divided according to daily sitting duration over the past year into a prolonged sitting group (≥6 h/day) and a control group (≤4 h/day). The SOL H-reflex amplitude was recorded in erect, slumped, slouched, and supine positions. Ischial pressure was evaluated in all sitting postures to assess spinal loading.ResultsSlouched sitting significantly lowered ischial pressure (p < 0.0005) and produced higher H-reflex amplitudes (p < 0.0005), which were not significantly different from those in the supine position (p = 0.362). In contrast, (p < 0.0005) erect and slumped (p < 0.0005) postures showed increased ischial pressure and significantly reduced H-reflex amplitudes (p < 0.0005 for both postures). Participants in the prolonged sitting group demonstrated significantly lower SOL H-reflex amplitudes than those in the control group (p = 0.008, ηp² = 0.23).ConclusionVarious sitting postures and durations exert different effects on the lumbosacral spine and nerve roots. Slouched sitting reduces spinal stress and lower nerve root compression compared to erect and slumped seated positions. Extended sitting duration may partially compress the lumbosacral nerve root, thereby potentially contributing to postural low back pain over time.
33. Health literacy mediates the association of education levels with engagement in leisure-time physical activity and muscle-strengthening exercise: a population-based study of Korea.
期刊: Postgraduate medical journal 发表日期: 2025-Aug-26 链接: PubMed
摘要
Health literacy is recognized as a major determinant of wellbeing. We examined how health literacy links the association of educational level with participation in leisure-time physical activity (LTPA) and muscle-strengthening exercise (MSE). We analyzed a nationwide sample of 5248 adults. Education attainment was grouped into four groups: elementary school, middle school, high school, and college. Health literacy was assessed using the Health Literacy Index for the Community (HLIC). The Global Physical Activity Questionnaire was also employed, with engagement in ≥150 min of moderate-to-vigorous LTPA per week and MSE ≥ twice weekly defined as meeting recommended levels. Counterfactual-based mediation analyses were conducted to estimate the natural indirect effects (NIE), presented as odds ratios (ORs) with 95% confidence intervals (CIs). Among the participants, 20.5% and 25.2% met the recommended LTPA and MSE levels, respectively. Compared with those with an education attainment of elementary school or below, ORs (95% CI) for the NIE of education level on LTPA, mediated through the HLIC, were 1.06 (1.02-1.09) for middle school, 1.10 (1.04-1.15) for high school, and 1.14 (1.06-1.21) for college or above, accounting for 65.8%, 19.5%, and 16.4% of the total effects, respectively. For MSE, the ORs (95% CI) of the NIE were 1.06 (1.03-1.10) for middle school, 1.12 (1.07-1.17) for high school, and 1.16 (1.10-1.24) for college or above, accounting for 31.8%, 27.1%, and 24.8% of the total effects. Health literacy may serve as a key mechanism contributing to disparities in physical activity across different educational levels. Key messages What is already known on this topic: Health literacy has garnered considerable public health interest as a key determinant of health disparities. Although previous studies have reported that health literacy is positively associated with engagement in physical activity, research on its mediating role in the association between educational attainment and leisure-time physical activity (LTPA) and muscle-strengthening exercise (MSE) is scarce in the literature. What this study adds: This study demonstrated that health literacy mediates a meaningful proportion of the link between high educational attainment and engagement in the recommended levels of LTPA or MSE. This suggests that health literacy can be an important factor underlying disparities in physical activity across varying education levels. How this study might affect research, practice, or policy: Our findings suggest that proactive policy interventions are required to enhance health literacy among individuals with low educational levels and to promote physical activity.
34. Systematic review: The impact of virtual reality interventions on stress and anxiety in intensive care units.
期刊: Journal of critical care 发表日期: 2025-Aug-25 链接: PubMed
摘要
35. Mapping the evaluation of Brazil's national electronic health system for primary care (PEC e-SUS APS): a scoping review.
期刊: Computers in biology and medicine 发表日期: 2025-Aug-25 链接: PubMed
摘要
In 2013, the Brazilian Ministry of Health launched the e-SUS Primary Care Strategy, which included Brazil’s National Electronic Health System for Primary Care (PEC e-SUS APS). This initiative aimed to structure and unify Primary Health Care information. Despite its widespread use in primary healthcare and challenges related to implementation, integration, and utilization, no comprehensive review has yet been conducted to identify and analyze studies that evaluate the PEC e-SUS APS. To answer the research question, formulated using the PCC acronym, sought to systematically address, “How has the PEC e-SUS APS electronic health record been evaluated?”. A high-sensitivity search across multiple databases was performed without language restrictions and with a time filter set from 2013 onwards. Three reviewers independently enforced eligibility criteria in a two-phase selection process, with two reviewers then extracting and cross-checking data. The synthesis was conducted through descriptive analysis. Out of 2729 studies screened, 11 were selected for synthesis. These studies primarily employed qualitative research methods involving a diverse group of healthcare professionals, mostly focusing on perceptions, experiences, and challenges associated with the PEC e-SUS APS system. A notable lack of theoretical frameworks and the absence of established standards were common among most studies. Additionally, the included studies did not cover issues such as functionality, reliability, usability, efficiency, and portability. This review highlights substantial gaps and methodological diversity in evaluating PEC e-SUS APS, underscoring the necessity to develop standardized tools to enhance consistency and reliability in future research.
36. Effectiveness and safety of perampanel by concomitant antiseizure medications: Insights from the real-world PERMIT Extension study.
期刊: Epilepsy & behavior : E&B 发表日期: 2025-Aug-25 链接: PubMed
摘要
The PERMIT Extension study is the largest pooled analysis of perampanel (PER) clinical practice data to date. A post-hoc analysis of PERMIT Extension assessed the effectiveness and tolerability of PER with different concomitant antiseizure medication (ASM) regimens. Effectiveness was assessed by evaluating responder and seizure freedom rates at the last observation for each participant (‘last visit’), and tolerability was assessed by evaluating adverse events. The analysis included 5144 people with epilepsy who had only focal (n = 4347) or only generalised (n = 797) seizures when PER was initiated, and whose type of concomitant ASM regimen at that time was known. Effectiveness and tolerability varied considerably depending on the pharmacology and mechanism of action (MoA) of concomitant ASM regimens. For example, in individuals with focal seizures receiving only one concomitant ASM at baseline, seizure freedom rates were significantly higher if the concomitant ASM was one that binds to synaptic vesicle glycoprotein 2A (SV2A) versus one that does not bind to SV2A (41.7 % vs. 24.8 %; p < 0.001), and significantly lower if the concomitant ASM was a sodium channel blocker versus a non-sodium channel blocker (23.2 % vs. 35.6 %; p < 0.001); whereas, in those with generalised seizures receiving one concomitant ASM at baseline, there were no significant differences in seizure freedom rates according to the concomitant ASM’s MoA. In individuals with focal and generalised seizures, tolerability appeared to be less affected by the pharmacology and MoA of concomitant ASM regimens. The findings from this study may help inform the use of rational polytherapy in clinical practice.
37. Safety and immunogenicity of the ChAdOx1 nCoV-19 (AZD1222) vaccine in children aged 6-17 years: Final results of a phase 2, single-blind, randomised controlled trial (COV006).
期刊: Vaccine 发表日期: 2025-Aug-25 链接: PubMed
摘要
Paediatric COVID-19 vaccination programmes were initiated in response to the coronavirus pandemic declared by the World Health Organisation (WHO) in 2020. Ten COVID-19 vaccines received WHO Emergency Use Listing, however, only five were approved for use in children. ChAdOx1 nCoV-19 (AZD1222) was approved in adults in a two-dose regimen. We previously reported interim findings of a phase 2 study of ChAdOx1 nCoV-19 in children with immunogenicity, comparable with adults. Final results after 12 month follow-up are reported. Single-blind, randomised controlled trial across four UK centres, recruiting 261 children and adolescents (aged 6-17 years). Participants received either two doses of ChAdOx1 nCoV-19 or Bexsero vaccine (controls). The primary outcome was safety (adverse events for 28 days following vaccination and serious adverse events throughout), and secondary outcome was immunogenicity (measured by SARS-CoV-2 anti-spike enzyme-linked immunosorbent assay (ELISA) and enzyme-linked immunosorbent spot (ELISpot)). Five serious adverse events and four adverse events of special interest were reported. None were related to study vaccinations, and there were no deaths. Geometric mean titres (GMTs) from an anti-spike (Wuhan) ELISA in participants aged 6-11 years were 1 EU/ml (95% CI 1-2) at baseline versus 796 EU (95% CI 161-3948, n =4) at D364. In participants aged 12-17 years, GMTs were 1 EU/ml (95% CI 1-2, n=3) at baseline versus 1432 EU/ml (95% CI 2337-6083; n=6) at D364 (2 dose regimen at 112-day interval), compared to 3 EU/ml (95% CI 0-62) at baseline versus 392 EU/ml (95% CI 24, 6493; n=3) at D364 (2 dose regimen at a 28-day interval). A two-dose regimen of ChAdOx1 nCoV-19 was immunogenic and safe in the trial population. No vaccine-related serious adverse events were reported. Immune responses persisted to 12 months in participants who did not experience breakthrough infection, This trial was registered with ISRCTN, trial number 15638344. The study was funded by the Department of Health and Social Care, through the National Institute for Health Research, and AstraZeneca.
38. "Single-dose versus 24-hour antibiotic prophylaxis in reduction mammaplasty: a randomized controlled trial".
期刊: Plastic and reconstructive surgery 发表日期: 2025-Aug-25 链接: PubMed
摘要
This trial aimed to compare the influence of administering a single dose or 24h of prophylactic antibiotics on surgical site infection (SSI) rates after reduction mammaplasty. This is a randomized, non-inferiority, parallel-arm clinical trial with a 1:1 allocation ratio. One hundred forty-six participants undergoing reduction mammaplasty were randomly assigned to the placebo group (PG), which received cefazolin 1g at the time of anesthesia induction (n=73), or to the antibiotic group (AG), which received cefazolin 1g at the time of anesthesia induction and every 6h for 24h (n=73). No antibiotics were prescribed to any of the participants after this period. SSI occurrence was evaluated using criteria and definitions from the Centers for Disease Control and Prevention. The participants were assessed weekly for 30 days by a surgeon blinded to group allocation. There were no significant differences between the groups in terms of main characteristics. The median age, body mass index, weight of excised breast tissue, and surgery time of the 146 participants were 33 years, 25.2 Kg/m², 925 g, and 220 min, respectively. Superficial dehiscence occurred in 30 patients (20.5%), with 16 in the placebo group and 14 in the antibiotic group (P=0.682). Eight participants (5.5%) had SSI, with four in each group (P=1.000). In all cases, SSI was classified as superficial incisional. Our results suggest that extending antibiotic prophylaxis beyond a single dose administered during anesthesia induction does not significantly reduce the incidence of SSIs or wound dehiscence in reduction mammaplasty. Clinicaltrials.gov. NCT04079686.
39. Optimized two-step gradient PCR for efficient clinical screening of vector-borne hemoparasites in goats.
期刊: Research in veterinary science 发表日期: 2025-Aug-22 链接: PubMed
摘要
Vector-borne pathogens pose a significant threat to the optimal production performance of farm animals in tropical endemic regions like South India. Early clinical diagnosis and timely administration of targeted chemotherapy are crucial for developing effective control strategies against these vector-borne diseases (VBDs). Although arthropod vectors transmit various pathogens, the major VBDs affecting goats can be categorized into hemotropic bacteria (Anaplasma/Ehrlichia and Mycoplasma spp.) and hemoprotozoans (Theileria, Babesia, Hepatozoon, and Trypanosoma spp.). The simultaneous detection of these six genera typically requires multiple PCR protocols with entirely different thermal conditions, and attempts to standardize multiplex PCR often fail due to this variation. We developed an optimized screening method using the gradient function of a PCR thermocycler, enabling simultaneous genus-specific detection. Blood DNA was extracted, and validated primers from the literature were applied in a two-step process: initial screening with universal primers (16S, 18S, apicomplexan rRNA), followed by genus-specific PCR. The gradient function of the thermocycler was employed in both steps to accommodate varying annealing temperatures, enabling simultaneous amplification of target sequences from different genera within the same PCR run. This approach reduces testing time, enhances detection in clinical samples, and facilitates precise, narrow-spectrum therapy, thereby minimizing treatment failures and mitigating the risk of drug resistance. This protocol provides a rapid and broadly adaptable diagnostic tool for the simultaneous detection of multiple hemoparasite genera, supporting timely, targeted treatment and improved management of VBDs in clinical settings.
40. Targeted next-generation sequencing (tNGS): An upcoming application for pathogen identification in clinical diagnosis.
期刊: Journal of infection and public health 发表日期: 2025-Aug-21 链接: PubMed
摘要
Rapid and efficient detection of pathogens is a goal for clinical laboratories. Traditional methods such as post-culture identification, smear microscopy, antigen-antibody detection, and polymerase chain reaction cannot perform hundreds of high-throughput tests simultaneously. With the development of genetic engineering, next-generation sequencing technology has gradually been introduced into clinical testing. The new technology of targeted next-generation sequencing (tNGS) has the advantages of high sensitivity, high efficiency, and relatively low cost. This review of articles on tNGS published in the past two decades summarizes tNGS workflow and clinical applications, compares it with traditional culture and metagenomic next-generation sequencing (mNGS), and highlights its role in detecting multiple pathogens in mixed infections and drug-resistance genes. It also elaborates on the latest guidelines and the quality control process. By highlighting the practical clinical use of tNGS, it offers insights for optimizing the detection of multiple pathogens in polymicrobial infections to enhance diagnostic accuracy and efficiency.
41. Prophylactic antibiotic use in closed basilar skull fractures: A nationwide cohort study.
期刊: The journal of trauma and acute care surgery 发表日期: 2025-Aug-21 链接: PubMed
摘要
The effectiveness of prophylactic antibiotics for preventing meningitis in patients with closed basilar skull fractures remains controversial. This nationwide cohort study aimed to evaluate the association between prophylactic antibiotic use and the incidence of meningitis in patients with closed basilar skull fractures using Korean national claims data. A retrospective cohort study was conducted with basilar skull fractures between 2002 and 2019 using International Classification of Diseases, Tenth Revision, code S021. Data were obtained from the National Health Insurance Service sample cohort database in South Korea. The primary outcome was the cumulative incidence of meningitis following closed basilar skull fractures, and those with open fractures or those who underwent surgery during hospitalization were excluded. Of the 1,173 patients included, 537 (45.8%) received prophylactic antibiotics and 636 (54.2%) did not. Patients who received antibiotics were significantly older and had higher rates of intensive care unit admission. Antibiotic use was more common in the elderly group (65 years or older) compared with pediatric (younger than 18 years) and adult (18-64 years) groups. Among those who received antibiotics, 15 cases of meningitis (2.6%) were reported, with no clear association between the type or duration of antibiotic and meningitis occurrence. The cumulative incidence of meningitis was extremely low in both groups, and there was no statistically significant difference in meningitis risk between the antibiotic and non-antibiotic groups across all observation periods. Adjusted hazard ratios indicated no significant association between antibiotic use and meningitis risk, and this finding was consistent in subgroup analyses by age. This study found no significant association between prophylactic antibiotic use and reduced risk of meningitis in patients with closed basilar skull fractures. These findings suggest that routine prophylactic antibiotic administration may not provide additional benefits in preventing meningitis. Retrospective Study; Level III.
42. Healthcare pathways and social experiences of Lewy body dementia and Alzheimer's disease in Ireland.
期刊: Social science & medicine (1982) 发表日期: 2025-Aug-20 链接: PubMed
摘要
This study examines how social and healthcare structures in Ireland shape the experiences of individuals diagnosed with Lewy body dementia (LBD) and Alzheimer’s disease (AD), with particular attention to diagnostic pathways, care access, and social constructions of dementia. Twenty-three participants with mild to moderate dementia resulting from LBD (n = 12) and AD (n = 11) participated in in-depth interviews between September 2022 and February 2023. Using a descriptive phenomenological approach informed by social constructivist perspectives, interviews were analysed to understand how institutional, geographical, and social factors influence experiences of diagnosis, post-diagnostic support, and public awareness. Healthcare structures and social understanding of dementia created divergent experiences for individuals with LBD and AD. While AD participants generally encountered established diagnostic pathways aligned with dominant cultural understanding of dementia as memory loss, LBD participants faced structural barriers due to complex symptomatology and limited specialist knowledge. Geographic inequalities in accessing specialised diagnostic services particularly affected rural LBD participants. Post-diagnosis, LBD participants encountered greater institutional barriers in accessing appropriate support, reflecting systemic gaps in service provision. Both groups highlighted how societal misconceptions about dementia shaped their lived experiences, with LBD participants particularly affected by the cultural dominance of the Alzheimer’s narrative. This study demonstrates how social structures, healthcare systems, and cultural understandings of dementia create inequitable experiences for individuals with different forms of dementia in Ireland. Findings highlight the need for structural changes in healthcare delivery, increased professional education about LBD, and broader societal awareness to address these disparities.
43. Blood-based DNA methylation profiles in major depressive disorder, bipolar disorder, and schizophrenia spectrum disorders.
期刊: Comprehensive psychiatry 发表日期: 2025-Aug-20 链接: PubMed
摘要
Alterations in DNA methylation (DNAm) profiles have been implicated in affective and psychotic disorders. However, no comprehensive understanding of peripheral DNAm profiles associated with diagnostic groups, course of illness, and other clinical variables has emerged yet. In particular, studies exploring commonalities and differences across diagnoses are lacking. Here we conducted a systematic epigenetic characterization of the transdiagnostic German FOR2107 cohort, including individuals with major depressive disorder (MDD, n = 342), bipolar disorder (BD, n = 99), or a schizophrenia spectrum disorder (SSD, n = 101) and healthy controls (HC, n = 339). For 183 MDD cases and 178 HC, we assessed additional DNAm data from the two-year follow-up study visit. To explore DNAm differences between and across diagnostic groups, case-control and case-case methylome-wide association studies were performed. Our sample was further characterized using methylation risk scores (MRS) for MDD and SSD. Finally, epigenetic age acceleration was examined and compared to a measure of brain age acceleration. We identified few methylome-wide significant associations with diagnostic groups. MRS for MDD did not differ between diagnostic groups, and an increase in MRS for SSD in SSD compared to HC did not remain significant when adjusting for smoking behavior and BMI. An increase in epigenetic age acceleration was most evident for SSD compared to HC, which did not remain significant when adjusting for covariates. No correlation between epigenetic and brain age acceleration was observed. Our findings emphasize the relevance of potential confounding factors in epigenetics research in psychiatry and contribute to a growing body of studies on DNAm profiles across affective and psychotic disorders.
44. Food insecurity through the lens of multidimensional poverty: Evidence from Chile.
期刊: Social science & medicine (1982) 发表日期: 2025-Aug-19 链接: PubMed
摘要
This article explores the connection between food insecurity (FI) and multidimensional poverty (MDP) in Chile using household survey data from 2017 to 2022. We analyze the relationship between the Food Insecurity Experience Scale (FIES) and five dimensions of MDP-education, work, health, housing, and social networks-. The study employs ordered probit and instrumental variable models to assess how these dimensions influence FI, and also provides a comprehensive public policy review. Our findings reveal that the work, housing, and social network dimensions have the strongest impact on increasing FI, while health and education have a lesser effect. Current public policies in the country focus predominantly on education and health, highlighting a misalignment between policy efforts and the primary drivers of FI. Our results indicate a need for more multisectoral and effective public policy interventions in Chile that can be scaled to other developing countries.
45. Computation drug design for ACE inhibitor for high blood pressure management and assessment of pharmacokinetics and toxicity of promising compounds isolated from Gymnema sylvestre.
期刊: Bioorganic chemistry 发表日期: 2025-Aug-19 链接: PubMed
摘要
This study employs computational drug design approaches to identify and optimize ACE inhibitors from G. sylvestre’s isolated compounds, assessing their pharmacokinetic and toxicity profiles. The receptor (PDB: 1o86) was retrieved from RCSB, prepared, and analyzed for active binding sites. Ligands were prepared and docked using AutoDock. Results were analyzed, visualized, and further evaluated through MD simulations, pharmacokinetics analysis, and toxicity. The molecular docking analysis of 12 compounds isolated from G. sylvestre revealed that oleanolic acid (7), β-amyrine (6), and betulinic acid (9) exhibited the strongest binding affinities to ACE, with binding energies of -10.2, -9.1, and - 9.0 kcal/mol, respectively. Furthermore, MDS confirmed the stability and specificity of these compounds. Additionally, oleanolic acid (7) exhibits a promising pharmacokinetic profile and relatively low toxicity, as indicated by its high intraperitoneal LD50 value, suggesting its potential as a safe and effective compound for food formulation and hypertension management. The acute toxicity predictions for 20S-hydroxy-4,6,24(28)-ergostatrien-3-one (3), β-amyrine (6), oleanolic acid (7), and betulinic acid (9) show promising results, particularly for intraperitoneal and oral administration. 20S-hydroxy-4,6,24(28)-ergostatrien-3-one (3) has an intraperitoneal LD50 of 928,700 mg/kg and oral LD50 of 1,679,000 mg/kg, while β-amyrine (6) and oleanolic acid (7) exhibit even higher intraperitoneal LD50 values of 1749,000 mg/kg, indicating low toxicity and suggesting these compounds are relatively safe for use via these routes. Computational drug design and pharmacokinetic/toxicity evaluation identified G. sylvestre-derived oleanolic acid (7) and β-amyrine (6) as promising ACE-inhibitors for hypertension management. These natural compounds exhibit potential for improved safety and efficacy profiles compared to existing synthetic ACE inhibitors.
46. Mpox among people reporting being unhoused or engaging in transactional sex within a multijurisdictional case-control study of sexually and gender minoritized individuals- United States, August 2022-March 2024.
期刊: Social science & medicine (1982) 发表日期: 2025-Aug-15 链接: PubMed
摘要
Since May 2022, a clade II multinational mpox outbreak has disproportionately affected certain sexually and gender minoritized individuals (SGM). Beyond infectious disease risks, SGM populations face social and structural inequities that may increase their likelihood of experiencing homelessness or engaging in transactional sex (TS). Research on the impact of homelessness and TS on risk of mpox is limited, especially among SGM. This study examined the risk of mpox among people who reported homelessness and/or TS from a survey of SGM participants. We conducted a secondary analysis of data from a vaccine effectiveness case-control study among SGM conducted between August 2022-March 2024 across 12 U.S. jurisdictions. Case-patients had a confirmed or probable mpox virus or orthopoxvirus diagnosis and control patients visited a sexual health clinic but never received an mpox diagnosis. Our analysis included 1295 participants who self-reported their housing status and engagement in TS. We used multilevel logistic regression models to determine whether housing status and TS were associated with increased odds of mpox. Models included a random intercept for jurisdiction and time, adjusting for race/ethnicity. We included a product term between housing status and TS to determine if there was an interaction effect. Among participants, 63 (4.9 %) were unhoused, 61 (4.7 %) engaged in transactional sex, and 20 (1.5 %) reported both. Experiencing homelessness (aOR: 2.4, 95 % CI: 1.35-4.36) and engaging in TS (aOR: 2.4, 95 % CI: 1.35-4.31) were both associated with higher odds of mpox. The product term between housing status and TS was not statistically significant (aOR: 0.8, 95 % CI: 0.21-3.32). People who experienced homelessness and engaged in TS had increased odds of mpox, within a sample of SGM individuals; these populations should be considered for tailored interventions, such as vaccine outreach, housing support, and low barrier access to care.
47. Aligning personalized biomarker trajectories onto a common time axis: a connectome-based ODE model for Tau-Amyloid beta dynamics.
期刊: Medical image analysis 发表日期: 2025-Aug-15 链接: PubMed
摘要
Abnormal tau and amyloid beta are two primary imaging biomarkers used to assist in the diagnosis of Alzheimer’s disease (AD). Recent efforts have focused on developing mechanism-based biophysical models to explain the spatiotemporal dynamics of these biomarkers. In this study, we adopt a connectome-based ODE model to capture the dynamics of tau and amyloid beta (Aβ), aiming to predict personalized future values of these biomarkers. The ODE model includes diffusion, reaction, and clearance terms, and accounts for tau-Aβ interactions. Additionally, it assumes a sparse initial condition (IC) of abnormalities, based on the assumption of localized initiation. Besides tau and Aβ, brain atrophy is used as a marker of neurodegeneration. We discuss the mathematical model of atrophy integrated into the tau-Aβ model. A common limitation in popular models is the use of chronological age as the time axis, which prevents the unification of subject trajectories onto a common time scale and hinders comprehensive cohort analysis. To address this issue, we use a normalized disease age that relates chronological age to biomarker values. In the ODE model, we use the disease age to track time and the biomarker dynamics. Furthermore, our analysis of region-of-interest-wise tau-Aβ temporal correlation reveals that different regions of interest (ROIs) play distinct roles across various disease stages.
48. Post-COVID-19 symptoms in a community sample: Exploratory study in two Chilean cities, 2023-2024.
期刊: Journal of infection and public health 发表日期: 2025-Aug-14 链接: PubMed
摘要
SARS-CoV-2 infection affects health, well-being, and the economy, especially considering the persistence of symptoms following an acute episode. This study aims to (1) estimate the frequency of symptoms following SARS-CoV-2 infections, (2) characterize symptoms compatible with post-COVID-19 conditions, and (3) explore risk factors for persistent symptoms among individuals from two Chilean cities diagnosed with COVID-19 at least once. This cross-sectional exploratory study involved a convenience sample of individuals who participated in a prior seroprevalence study in Chile. Participants were recruited by phone between November 2023 and January 2024, and self-reported persistent COVID-19 symptoms using the modified Yorkshire Rehabilitation Scale, which assessed symptom severity and functional disability across three dimensions. Bivariate analysis explores the association between sociodemographic and health variables and reported symptoms using the Mann-Whitney-Wilcoxon and Kruskal-Wallis tests. Two Negative binomial models (Model 1: clinical factors and Model 2: clinical plus sociodemographic factors) evaluated factors associated with the severity of post-COVID-19 symptoms. Of the 144 participants successfully contacted, 83 met the inclusion criteria. A total of 80.7 % reported symptoms consistent with post-COVID-19. The most frequently reported symptoms were sleep disturbances (59.7 %), anxiety (59.7 %), and memory problems (58.2 %). Only three participants had received a formal post-COVID diagnosis, and none were receiving care through Chile’s universal post-COVID program. Symptom severity was significantly higher in women (p = 0.04), individuals with two or more COVID-19 episodes (p = 0.04), and those with comorbidities (p = 0.02). Negative binomial regression analysis indicated that multiple COVID-19 episodes were associated with greater symptom severity. A high percentage of participants experienced post-COVID-19 symptoms. Despite the high symptom burden, access to formal diagnosis and care was minimal, highlighting the need to strengthen diagnostic and management protocols within the Chilean healthcare system.
49. Integrative analysis of microbial 16S gene and shotgun metagenomic sequencing data improves statistical efficiency in testing differential abundance.
期刊: Journal of the American Statistical Association 发表日期: 2025-Aug-05 链接: PubMed
摘要
The most widely used technologies for profiling microbial communities are 16S marker-gene sequencing and shotgun metagenomic sequencing. Surprisingly, many microbiome studies have performed both experiments on the same cohort of samples. The two sequencing datasets often reveal consistent patterns of microbial signatures, suggesting that an integrative analysis of both datasets could enhance the testing power for these signatures. However, differential experimental biases, partially overlapping samples, and uneven library sizes pose tremendous challenges when combining the two datasets. In this article, we introduce the first method of this kind, named Com-2seq, that combines the two datasets for testing differential abundance at the genus level as well as the community level while overcoming these difficulties. Our simulation studies demonstrate that Com-2seq substantially enhances statistical efficiency over analysis of a single dataset and outperforms two ad hoc approaches to integrative analysis. In analysis of real microbiome data, Com-2seq uncovered scientifically plausible findings, namely, the association of Butyrivibrio, Gemella and Ignavigranum with prediabetes status, which would have been missed by analyzing a single dataset. Butyrivibrio failed to reach the significance level in the analysis of each dataset despite showing a consistent trend; Gemella and Ignavigranum failed to produce adequate data in the 16S experiment.
50. Rural-urban disparities in stroke outcomes: unveiling quality of life, self-efficacy and healthcare utilization patterns of stroke patients in Türkiye.
期刊: Rural and remote health 发表日期: 2025-Aug 链接: PubMed
摘要
Stroke is a leading cause of disability globally, significantly impacting patients’ quality of life and self-efficacy. Research from various countries indicates that rural stroke patients face challenges such as reduced access to healthcare services and lower quality of life than their urban counterparts. The aim of the study was to examine how the residential location in Türkiye affects the quality of life and self-efficacy levels of stroke patients. A cross-sectional study was carried out among stroke patients in Türkiye, examining the differences between individuals living in rural and urban areas. Information regarding population characteristics, use of healthcare services, and self-reported evaluations, including the stroke-specific quality-of-life scale (SSQoL) and stroke self-efficacy questionnaire (SSEQ), was collected. There was no difference in demographic and disease-related characteristics between the two groups. Patients from urban areas had notably fewer emergency department visits (p<0.001) as well as fewer appointments at physical medicine and rehabilitation clinics (p<0.001) and family practitioner clinics (p<0.001) in the previous year. Additionally, rural patients demonstrated lower SSEQ scores (p=0.036) and poorer SSQoL scores (p<0.001) than urban patients, while also having significantly greater access to rehabilitation services (p=0.027). The results of this study show that people living in rural areas experience reduced quality of life and confidence in managing their stroke compared to those residing in urban areas. Rural individuals with strokes often depend more on family physicians, urgent care facilities, and rehabilitation services for medical support. To improve the wellbeing and outcomes of stroke patients in rural regions, it is essential to address the limited access to rehabilitation services, healthcare infrastructure, resources, and medical professionals through policy changes and innovative strategies such as telerehabilitation.
51. Depression among people with low back pain: a cross-sectional descriptive survey of Irish musculoskeletal triage physiotherapists' screening and referral practices.
期刊: Physiotherapy 发表日期: 2025-Jul-31 链接: PubMed
摘要
Low back pain (LBP) is associated with a poorer prognosis when there is concomitant depression. Musculoskeletal (MSK) triage physiotherapists clinically assess a significant proportion of LBP referrals to public hospital outpatient waiting lists. To establish depression screening and referral practices of MSK triage physiotherapists, and to compare confidence in depression screening to red flag (e.g. cauda equina syndrome) and yellow flag (e.g. fear avoidance beliefs) screening. Using a descriptive cross-sectional design, a bespoke e-survey was distributed to MSK triage physiotherapists in adult public hospital outpatient services in Ireland following ethical approval. Thirty-six surveys were completed and submitted (55% response rate). A minority of respondents (3/36, 8%) directly ask all patients with LBP about depression, while more than one third (13/36, 36%) never screened for depression. Reported barriers included lack of training or skill, time constraints, and absence of referral pathways. Confidence in screening for depression was lower than for red flags or yellow flags. There was some indication that a day or more of training improved depression screening confidence and practice. This study provides insight into current depression screening practices for people with LBP and the factors influencing decision-making among MSK triage physiotherapists working in advanced practice roles. Few MSK triage physiotherapists in this sample directly screen for depression, and screening confidence was low. Understanding the current processes and determinants of practice, including the potential positive impact of targeted training, may support strategies to improve depression screening practices. CONTRIBUTION OF THE PAPER.
52. Multilevel Syndemic Profiles Impacting Optimal ART Adherence among Trans Women Living with HIV in Mumbai and New Delhi, India: A Latent Class Analysis.
期刊: International journal of transgender health 发表日期: 2025-Jul-03 链接: PubMed
摘要
Antiretroviral therapy (ART) adherence is essential for maintaining viral suppression and reducing HIV transmission risk. However, data on adherence rates among trans women living with HIV in India are scarce, hindering effective intervention efforts. Understanding multilevel syndemic factors, including harmful drinking, depressive symptoms, HIV, and trans women-related stigma, and access to gender-affirmative care, is crucial for improving HIV treatment outcomes in this population. Trans women living with HIV (N=150) in Mumbai and New Delhi, India, completed a one-time self-reported assessment of sociodemographic and psychosocial factors and ART adherence and provided recent viral load test results in the ART booklet. Latent class analysis (LCA) identified multilevel syndemic classes. Then, in logistic regression models, we assessed the relationship between syndemic classes and optimal ART adherence (defined as 90% or higher adherence as prescribed). Optimal ART adherence (defined as 90% or higher adherence to prescribed doses) was reported by 63% of participants. Among those with suboptimal adherence (n=93), common barriers included lack of medication while traveling, forgetting, and alcohol use. The LCA identified two syndemic classes: Class 1, characterized by unidimensional stigma and moderate multilevel syndemic barriers, and Class 2, characterized by intersectional stigma and high multilevel syndemic barriers. In the bivariate analysis, participants in Class 2 had significantly lower odds of optimal ART adherence [OR: 0.27 (95% CI: 0.11 - 0.61), p = 0.003]. After controlling for potential confounders (i.e., city, monthly income, stable housing, and history of sex work), participants in Class 2 still had significantly lower odds of optimal ART adherence [aOR: 0.26 (95% CI: 0.09 - 0.64), p = 0.009]. Findings highlight substantial disparities in ART adherence among trans women living with HIV in India, driven by intersectional stigma and multilevel syndemic barriers. Addressing these factors, particularly HIV and trans women-related stigma, is critical for improving ART adherence and HIV treatment outcomes in this population.
53. Social Support and Mutual Aid During a Pandemic: Experiences of African American, Latina, and White Sexual Minority Women.
期刊: Sexual and gender diversity in social services 发表日期: 2025-Jul-02 链接: PubMed
摘要
The COVID-19 pandemic created barriers to social support for sexual minority women (SMW), which is vital to the promotion of mental and behavioral health resilience when confronting prolonged and/or excessive stress. We used phenomenological analysis to characterize ways SMW experienced and fostered social support during the pandemic. Seventeen Black, Latina, and White SMW completed Zoom and telephone interviews about their experiences during the initial months of the COVID-19 pandemic, including changes in support from family, friends, partners, neighbors, colleagues, and the LGBTQ+ community. Study findings highlight the importance of social support and mutual aid for SMW’s resilience and wellbeing during the pandemic.
54. Formative research for an innovative digital application to strengthen healthy food access and resilience in food pantries: The Support Application for Food PAntrieS (SAFPAS) study.
期刊: Journal of hunger & environmental nutrition 发表日期: 2025-Apr-01 链接: PubMed
摘要
We conducted formative research to inform the design of the mobile Support Application for Food PAntrieS (SAFPAS) app, which digitally integrates and enhances food pantry management, client food choice, and emergency preparedness. In-depth interviews (N=60) were conducted with coordinators, volunteers, and neighbors in Baltimore, Maryland and Detroit, Michigan. Screen mockups were shown to interviewees to solicit feedback on the form and function of existing and desired features. Overall, participants reacted positively and suggested features for consideration. Concerns centered around accessibility and adaptability of the application. The insights gleaned from this work will inform future development and implementation of SAFPAS nationwide.
55. Feelings about abortion at time of care: Findings from an Ohio abortion facility.
期刊: Sexuality research & social policy : journal of NSRC : SR & SP 发表日期: 2025-Feb-21 链接: PubMed
摘要
Prevailing abortion stigma may contribute to how people feel prior to receiving an abortion, and these feelings may influence healthcare decision making. We analyzed data from a patient intake questionnaire regarding feelings at the time of first abortion appointment. We described responses, co-occurrence of sentiments, and associations between responses and abortion characteristics. We abstracted data from a random 20% sample of medical charts at an abortion facility in Ohio for patients who sought abortions from 2014-2018 (N=762). We analyzed data from an intake questionnaire used to assess patients’ sentiments prior to their abortion. The questionnaire had 10 intake items to which patients could respond “yes,” “maybe,” or “no.” The questionnaire also asked, “How are you feeling today?” and listed several emotions for patients to select. About 37% of patients responded with exclusively positive emotions, 27% with mixed emotions, and 27% with exclusively negative emotions. Reporting mixed (adjusted odds ratio [95%CI]: 0.33[0.16-0.71]) and negative only (0.38[0.18-0.32]) sentiments was associated with a decreased odds of receiving an abortion. Responding “yes” (vs. “no”) to being afraid an abortion will hurt was associated with a decreased odds of having a procedural abortion vs. a medication abortion (0.62[0.40-0.96]). Responding “yes” to “I am not sure if I am making the right decision” was associated with a longer time between consultation and the abortion (adjusted incident rate ratio [95%CI]: 2.16[1.48-3.16]). Sentiment toward abortion is complicated and deserves nuanced attention, rather than being grouped into a strictly positive or negative experience. Assessing patient sentiment prior to an abortion procedure may be valuable for providing patient-centered abortion care.
56. Automated Parameter Selection in Singular Spectrum Analysis for Time Series Analysis.
期刊: Communications in statistics: Simulation and computation 发表日期: 2025-Jan-28 链接: PubMed
摘要
In spite of wide applications of the singular spectrum analysis (SSA) method, understanding how SSA reconstructs time series and eliminates noise remains challenging due to its complex process. This study provided a novel geometric perspective to elucidate the underlying mechanism of SSA. To address the key issue of conventional SSA that requires a fixed window length and a given threshold for determining the number of groups, we proposed a sequential reconstruction approach that averages reconstructed series from various window lengths with a stopping rule based on a symmetric test. Three main advantages of the proposed method were demonstrated by the simulations and real data analysis of 7-day heart rate data from an e-cigarette user: 1) requiring no prior knowledge of the window length or group number; 2) yielding smaller values of root mean square error (RMSE) than the conventional SSA; and 3) revealing both local features and sudden changes related to events of interest. While conventional SSA excels in extracting stable signal structures, the proposed method is tailored for time series with varying structures such as heart rate data from smartwatches, and thus will have even wider applications.
57. Aqueous Synthesis of Poly(ethylene glycol)-amide-Norbornene-Carboxylate for Modular Hydrogel Crosslinking.
期刊: Advanced materials interfaces 发表日期: 2025-Jan-05 链接: PubMed
摘要
Poly(ethylene glycol)-norbornene (e.g., PEGNB) is a versatile macromer amenable to step-growth thiol-norbornene photopolymerization and inverse electron demand Diels-Alder (iEDDA) click reaction. The translational potentials of PEGNB-based hydrogels have been realized in the areas of stem cell differentiation, in vitro disease modeling, implantable therapeutic devices, and controlled release of therapeutics. Even with these advances, prior methods for synthesizing PEGNB all required heavy use of organic solvents that pose significant environmental and personal health burdens. Here, we report an all-aqueous synthesis of PEG-amide-norbornene-carboxylate (PEGaNBCA) via reacting carbic anhydride (CA) with multi-arm amino-terminated PEG. Like previously reported ester-bearing counterparts (i.e., PEGNB and PEGeNBCA), PEGaNBCA was readily crosslinked into modular hydrogels by either thiol-norbornene photopolymerization or tetrazine-norbornene iEDDA click reaction. Unlike its ester-bearing counterparts, PEGaNBCA crosslinked thiol-norbornene hydrogels provided long-term hydrolytic stability. However, through blending PEGaNBCA with hydrolytically labile PEGeNBCA, hydrogels could be engineered to undergo tunable hydrolytic degradation. The versatility of PEGaNBCA was further demonstrated via high-fidelity digital light processing (DLP) printing and in situ encapsulation and maintenance of human induced pluripotent stem cells (hiPSCs).
58. Modelling in-hospital length of stay: A comparison of linear and ensemble models for competing risk analysis.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Length of Stay (LoS) for in-hospital patients is a relevant indicator of efficiency in healthcare. Moreover, it is often related to the occurrence of hospital-acquired complications. In this work, we aim to explore time-to-event analysis for modelling LoS. We employed competing risk models (CR), as we considered two mutually exclusive outcomes: favorable discharge and deterioration. The explanatory variables included the patient’s sex, age, and longitudinal vital signs collected from a dataset comprising [Formula: see text] admissions. To address sparse measurements, we transformed longitudinal vital signs into cross-sectional statistics. Our approach involves data pre-processing, imputation of missing data, and variable selection. We proposed four types of CR models: Cause-specific Cox, Sub-distribution hazard, and two variants of Random Survival Forests, with both generalised Log-Rank test (cause-specific hazard estimates) and Gray’s test (cumulative incidences estimations) as node splitting rules. Performance in LoS CR models was evaluated over a time frame from 2 to 15 days. Additionally, we considered baselines with two well-established clinical early warning scores the National Early Warning Score (NEWS) and the Modified Early Warning Score (MEWS). The best model was Random Survival Forest using Gray’s test split, with Integrated Brier Score[×100] of 0.386, C-Index above 99%, and Brier Score below 0.006, along the entire time frame. Employing cross-sectional statistics derived from vital signs, along with rigorous data pre-processing, outperformed the degree of correctness of modelling LoS, compared to NEWS and MEWS.
59. Using Ecological Momentary Assessment (EMA) to understand occupation from the perspective of the experiencing self: An illustrative example in workers with type 1 diabetes.
期刊: Journal of occupational science 发表日期: 2024-Dec-03 链接: PubMed
摘要
In people, the experiencing, remembering, and believing selves are distinct modes of being that co-exist, though at any particular moment one mode can be dominant. While qualitative methods are effective for querying the remembering and believing selves, Ecological Momentary Assessment (EMA) methods may be better suited to capture the perspective of the experiencing self. Using EMA to investigate occupation allows participants to engage in their regular occupations in their natural environments, pausing to record information about experiences that occurred seconds or minutes prior. To demonstrate the use of EMA to capture the experiencing self (the ‘I’ in the present moment not occupied with memories or beliefs), we examined associations between working, recovering, and various aspects of being (e.g., mood) in secondary analyses using EMA data from workers with type one diabetes (T1D, n=92). Densely repeated sampling of workers’ experiences through EMA allowed for a correspondingly comprehensive representation of how both working and recovering were associated with various aspects of being, yielding insights relevant to the clinical needs of workers with T1D and to understanding their experiencing self’s view of work and recovery generally. The potential benefits of EMA for occupational science include allowing a more comprehensive understanding of the immediate experience of occupation, enabling investigation of the experiencing self at different timescales (e.g., experience of work in the moment, versus average experience of work over a day), and providing additional means through which to inform occupation centered interventions in populations with chronic conditions.
60. Children's Exposure Factors and Risk Perception of Sanitation Challenges Along the U.S.-Mexico Border.
期刊: Journal of borderlands studies 发表日期: 2024-Nov-27 链接: PubMed
摘要
In the rural U.S. - Mexico border towns, transboundary sanitary sewage overflows (SSOs) are of concern. The high concentrations of pathogens present in SSOs poses a threat to the shared ecosystem and communities’ health and well-being. Concerns related to an SSO effluent situated adjacent to a school in Naco, Arizona led to a academic-government-school partnership to assess children’s exposure factors, environment and health related risk perceptions, and risk communication preferences. A survey administered to school staff (n=9 and parents (n=31) observed a lower hand/object-to-mouth behavior for children ages 4-6 compared to values in the literature, and the need to further assess exposure factors for children over six. While there was a general negative risk perception to SSOs, approximately half of respondents did not have/were not sure of any SSO related events. Using Bioregion/One Health and cross-border governance frameworks, this study highlights the governing barriers that exist during SSO events and underscores the need for community participation, effective intervention, and risk communication strategies.
61. Sex Differences in State Level Prevalence of Alcohol Use among Black Women and Men in the United States.
期刊: Journal of substance use 发表日期: 2024-Sep-24 链接: PubMed
摘要
To investigate the differences in alcohol use among Black adults by sex across U.S. states the Behavioral Risk Factor Surveillance System. Measured any alcohol use, heavy drinking (8+/15+ for women/men in a 7-day period), and binge drinking (4+/5+ in one session). Weighted prevalence estimates were age-standardized to the 2000 US population. Binge drinking among Black men in the Midwest was highest ranging from 40% in Minnesota to 45.8% in Iowa. Black women in southern states had 6-10 percentage point higher prevalence of heavy drinking than Black men. Prevalence in Southern states was higher than expected, especially among Black women.
62. Mapping Dialectical Behavior Therapy Skills to Clinical Domains Implicated in Contemporary Addiction Research: A Conceptual Synthesis and Promise for Precision Medicine.
期刊: Cognitive and behavioral practice 发表日期: 2024-Sep-07 链接: PubMed
摘要
Recent addiction research has identified clinical domains that are central to the development and maintenance of alcohol use disorder (AUD). Yet existing psychotherapy approaches are not typically organized around these clinical domains and are often limited in scope. Dialectical behavior therapy (DBT) is an intensive, multicomponent cognitive behavioral treatment that includes individual psychotherapy, group-based skills training, phone coaching, and consultation team for DBT therapists. Despite its efficacy on various mental health conditions, access to full DBT is often a challenge. In this paper, we describe how the skills training component of DBT can be flexibly applied to target clinical domains that underlie the three stages of the addiction cycle or impair quality of life during recovery from AUD. Using three clinical case vignettes, we illustrate how DBT skills can be mapped onto addiction clinical domains (e.g., Dialectical Abstinence and Clear Mind on executive function, STOP and TIP skills on incentive salience, Check the Facts and Opposite Action on negative emotionality, and ABC PLEASE skill on quality of life). Based on this integrated framework, we offer practical recommendations for case conceptualization, stigma reduction, and implementation through multiple delivery options. Implications on precision medicine are also discussed. Together, this conceptual synthesis serves as a bridge for practitioners to learn about contemporary addiction theories and for addiction researchers to appreciate the value of DBT in substance use treatment. The promotion of DBT skills training as a stand-alone or adjunctive intervention may help address the significant treatment gap in alcohol and substance use behaviors.
63. Patterns of Service Needs and Use by Subgroups of Youth Experiencing Homelessness.
期刊: Journal of social distress and the homeless 发表日期: 2024-Apr-22 链接: PubMed
摘要
Service use predicts exit from homelessness and improvements in physical and mental health among youth experiencing homelessness (YEH). However, service use among YEH remains low. This study uniquely examined youths’ reported needs and patterns of service use during and after the COVID-19 pandemic. Baseline data were examined from a large opioid prevention project conducted in a midwestern, service-rich metropolitan area. YEH (n = 240), between the ages of 18-24 years, were recruited from a drop-in center and other non-service locations. Youth completed self-report questionnaires about their service needs and utilization over the prior three months. The most common services YEH needed were housing (n = 233, 97.5%), drop-in center (n = 194, 81.2%), identification and birth certificates (n = 118, 49.6%), medical care (n=110, 46.0%), dental care (n = 106, 44.4%), employment counseling (n = 97, 40.6%) and mental health and emotional life counseling (n = 91, 38.1%). Most service needs were unfulfilled. Youth showed extreme service need overall, but other than drop-in centers, the youth reported limited use of most services. The limited use of needed services underscores the importance of future efforts toward improving service use for those in need.