公共卫生研究摘要 (2025-08-28)
共收录 54 篇研究文章
1. A post-marketing safety surveillance study on vaccines in Chongqing, China from 2006 to 2021: Using a nationwide spontaneous reporting database with multiple data mining methods.
期刊: Human vaccines & immunotherapeutics 发表日期: 2025-Dec 链接: PubMed
摘要
The Chinese National Adverse Events Following Immunization Information System (CNAEFIS) is the national-level passive vaccine safety surveillance system. This study aims to identify post-marketing vaccine adverse reaction signals in Chongqing through systematic analysis of 15-year AEFI data, verify the safety profile of locally recommended vaccines, and provide localized evidence for clinical practice and immunization policy formulation. The study included all 36 marketed vaccines in mainland China and collected all rare adverse reactions (RAR) reported in Chongqing through CNAEFIS from 2006 to 2021. Proportional Reporting Ratio (PRR), Reporting Odds Ratio (ROR), Bayesian Confidence Propagation Neural Network (BCPNN), and Empirical Bayes Gamma-Poisson Shrinker (GPS) were employed to mine potential safety signals within the database. From 2006 to 2021, approximately 90.1 million vaccine doses were recorded in Chongqing, China, and 20,195 individual cases of Adverse Events Following Immunization (AEFIs) were reported. Of these, 3,110 cases (15.4%) were linked to RAR, at an incidence rate of 32.2 per 100,000 doses. Allergic reactions were the most prevalent, with 2,743 cases (88.2% of the RAR), and the Measles-Rubella Vaccine (MR) had the highest IR of allergic reactions, reaching 267.1 cases per 100,000 doses administered. A total of 23 suspicious signals were identified through the combined use of PRR, ROR, GPS, and BCPNN methods. The corresponding clinical diagnoses were mainly non-serious diseases such as angioedema, Henoch-Schönlein purpura, and local abscess. The warning signals of severe diseases such as anaphylactic shock and laryngeal edema, which could be life-threatening due to improper clinical treatment, were weak. The overall safety of vaccines in Chongqing is satisfactory. Vaccine manufacturers should optimize the production process to enhance vaccine tolerability.
2. Evolutionarily conserved grammar rules viral factories of amoeba-infecting members of the hyperdiverse Nucleocytoviricota phylum.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Sep-02 链接: PubMed
摘要
Despite sharing fewer than 10 core genes, the hyperdiverse Nucleocytoviricota phylum (ranging from poxviruses to giant viruses) universally assembles viral factories (VFs) resembling biomolecular condensates. Regardless, it is unclear how these viruses achieve such a level of functional conservation without clear conserved genetic information. We demonstrate that the VFs produced by amoeba-infecting viruses have liquid-like properties and identify a conserved molecular grammar governing viral factory scaffold protein: charge-patterned intrinsically disordered regions that drive phase separation independently of sequence homology. This grammar predicts functional scaffold proteins across the 15 viral families, revealing evolutionary constraints invisible to sequence or structural analysis. Strikingly, VFs exhibit subcompartmentalization analogous to nuclei, segregating transcription and mRNA processing (inner condensates) from replication (interphase zones) and translation (host cytoplasm). Our work establishes phase separation as a fundamental organizational principle bridging extreme genomic diversity, explaining how biological complexity emerges without gene conservation. This grammar is likely also conserved in non-amoeba-infecting members of the phylum and thus may represent a primordial solution for organelle-like organization, with broad implications for antiviral targeting.
3. Gut-brain nexus: Mapping multimodal links to neurodegeneration at biobank scale.
期刊: Science advances 发表日期: 2025-Aug-29 链接: PubMed
摘要
Alzheimer’s disease (AD) and Parkinson’s disease (PD) are influenced by genetic and environmental factors. We conducted a biobank-scale study to (i) identify endocrine, nutritional, metabolic, and digestive disorders with potential causal or temporal associations with AD/PD risk before diagnosis; (ii) assess plasma biomarkers’ specificity for AD/PD in the context of co-occurring gut related traits and disorders; and (iii) integrate multimodal datasets to enhance AD/PD prediction. Our findings show that several disorders were associated with increased AD/PD risk before diagnosis, with variation in the strength and timing of associations across conditions. Polygenic risk scores reveal lower genetic predisposition for AD/PD in individuals with co-occurring disorders. Moreover, the proteomic profile of AD/PD cases was influenced by comorbid gut-brain axis disorders. Last, our multimodal prediction models outperform single-modality paradigms in disease classification. This endeavor illuminates the interplay between factors involved in the gut-brain axis and the development of AD/PD, opening avenues for therapeutic targeting and early diagnosis.
4. Integrated behavioral and metabolically flexible responses of wild orangutans to ecologically driven dietary variation.
期刊: Science advances 发表日期: 2025-Aug-29 链接: PubMed
摘要
Diet and nutrition are critical factors influencing energetics and health. Laboratory studies show that organisms adjust to changes in nutrient intake through flexible metabolic responses such as fuel switching. While the physiological effects of nutrient balance in humans have been studied, data from closely related species living in nature are lacking. We integrate macronutrient regulation and metabolic flexibility to elucidate how wild orangutans (Pongo pygmaeus wurmbii) are buffered against natural fluctuations in nutritional resources. We found that these orangutans regulate protein and regularly switch between exogenous and endogenous nutritional substrates as preferred food resource availability declines. When total caloric, lipid, and carbohydrate intake declined during episodes of fruit scarcity, orangutans drew on fat and endogenous amino acids for energy. This strategy is beneficial only in the context of alternating periods of fruit scarcity and abundance. We discuss our findings in relation to the current global obesity pandemic, which has arisen with transitions in human diets toward low-cost, energy-dense, protein-dilute foods.
5. Seasonal Variation in Public Interest in Gout: Longitudinal Infodemiology Study Using Google Trends (2014-2024).
期刊: Journal of medical Internet research 发表日期: 2025-Aug-27 链接: PubMed
摘要
Gout, the most common inflammatory arthritis worldwide, shows clear seasonal variation in flares. Traditional epidemiology provides important insights but often lacks real-time resolution. Digital behavior, such as online search patterns, offers a scalable, timely complement that can capture seasonal trends in disease-related activity. This study aimed to determine whether public interest in gout, as expressed through Google (Google LLC) search queries, exhibits seasonal variation across countries, US states, and metropolitan areas, and to assess the influence of symptom- and language-specific search terms. We evaluated whether a bimodal (semiannual) seasonal pattern better described certain queries, providing further insight into complex behavioral rhythms. We retrieved monthly Google Trends data for gout-related queries from January 1, 2014, to December 31, 2024, covering 70 countries, all 50 US states, and 36 major cities in the United States and Canada. Queries included generic terms, symptom descriptors, and language-specific translations in 14 languages. We applied cosinor modeling to assess seasonality and calculated the amplitude and phase of fitted sinusoidal curves. Significance was assessed using P values and adjusted for multiple comparisons using the Benjamini-Hochberg false discovery rate (FDR) within and across subgroups, and the Bonferroni method. To explore bimodal patterns, we compared 12- and 6-month harmonics using changes in Akaike and Bayesian information criteria. We found robust seasonal variation in gout-related search interest across multiple geographic and linguistic categories. Statistically significant seasonality (original P<.05) was detected in 41 of 70 countries using English terms, with 36 remaining significant after within-group FDR correction and 39 under pooled FDR; only 7 remained significant after Bonferroni adjustment. Among 20 countries using language-specific queries, 15 showed consistent seasonality across all 3 non-Bonferroni methods, while 2 met the Bonferroni threshold. In the United States, 49 out of 50 states and 33 out of 36 cities demonstrated significant seasonality (Bonferroni-adjusted significance in 9 and 10 units, respectively). For symptom- and treatment-related search terms, 18 of 21 exhibited seasonality under multiple correction methods. Peaks in search volume generally occurred in late spring or early summer in the northern hemisphere, with corresponding seasonal shifts in the southern hemisphere. Bimodal patterns were uncommon but identified for terms such as “obesity” and “swollen big toe,” suggesting more complex cyclic interest in certain contexts. Google search activity reflects the seasonal dynamics of gout flares, highlighting infodemiology as a population-scale complement to traditional surveillance. This approach may anticipate care needs, guide digital health strategies, and improve preparedness for seasonal, climate-sensitive conditions, while emphasizing the importance of geographic, climatic, and linguistic context in interpreting trends.
6. Prolotherapy in the Academy: A Mixed Methods Survey Study.
期刊: Journal of integrative and complementary medicine 发表日期: 2025-Aug-27 链接: PubMed
摘要
Context: Safe, effective treatment for chronic pain is needed. Prolotherapy is an injection-based complementary and integrative therapy supported by emerging peer-reviewed evidence. It is anecdotally used in clinical care, yet it is not part of medical society practice guidelines. It is unclear how many medical training programs practice and teach prolotherapy, limiting research and clinical optimization. Objective: To assess the use and teaching of prolotherapy in U.S. medical training programs (residencies and fellowships) in specialties that treat chronic pain. Design and Analysis: A mixed-methods, 21-item cross-sectional anonymized survey was sent to directors of the Accreditation Council for Graduate Medical Education (ACGME) residency and fellowship programs in 11 specialties treating chronic pain. Analysis was by descriptive statistics, ANOVA, and qualitative inductive content analysis. Results: From 1852 mailed surveys, we received 854 responses (46.1%). Two-hundred eleven (24.7%) programs reported prolotherapy use, and 119 (13.9%) reported prolotherapy-focused education. Prolotherapy use was most frequently reported by Osteopathic Manipulative Medicine/Neuromusculoskeletal Medicine (OMM/NMM) and Physical Medicine and Rehabilitation (PM&R) residencies and by Sports Medicine and Musculoskeletal Radiology fellowships. Prolotherapy-focused teaching was most frequently provided by OMM/NMM and PM&R residencies and Sports Medicine Fellowships. Among the 119 programs teaching prolotherapy, educational efforts most commonly addressed knee (91; 76.5%), shoulder (86; 72.3%), and elbow (80; 67.2%) pathology, and most (97; 81.5%) include ultrasound guidance at least some of the time. Qualitative analysis revealed mixed perspectives about the use and teaching of prolotherapy. Non-adopters cited limited peer-reviewed evidence and awareness, while adopters noted supportive evidence, a favorable safety profile, and appreciation of alternative treatment options. Conclusions: This is the first study to assess the practice and teaching of prolotherapy for chronic pain in U.S. ACGME-accredited medical training programs. Prolotherapy appears to be used and taught by a substantial minority of responding programs; results should be interpreted with caution due to potential self-selection bias. Findings suggest more research about the use and training, and the efficacy and effectiveness, of prolotherapy is warranted.
7. Invasive Meningococcal Disease Outbreak Management.
期刊: The Pediatric infectious disease journal 发表日期: 2025-Aug-27 链接: PubMed
摘要
8. Medicaid Education and Eligibility Planning for Caregivers: Website Usability and Validation Study.
期刊: JMIR aging 发表日期: 2025-Aug-27 链接: PubMed
摘要
Most older Americans have not saved enough to cover long-term care costs. Medicaid-a public health care program for low-income individuals-can help Americans with qualifying care needs pay for assistance in a nursing home or for services in the home. Determining financial eligibility for Medicaid is complicated, and the application process is often managed by family caregivers with limited knowledge of Medicaid programs. A one-stop digital solution is needed to help family caregivers plan for the cost of long-term care services and learn about getting help paying for services through Medicaid. We aimed to develop a web application that (1) educates informal caregivers about Medicaid programs and eligibility criteria, (2) informs them about the cost of home and institutional care in their local area with and without Medicaid coverage, and (3) uses a custom algorithm to provide personalized financial eligibility information based on the care recipient’s income, assets, and monthly spending. We first interviewed aging services providers and informal family caregivers, then developed a web application that was refined based on user experience interviews with English- and Spanish-speaking caregivers. In the final validation phase, asynchronous usability sessions were recorded with 109 informal caregivers who completed a series of tasks. Participants viewed and rated animated Medicaid “explainer” videos, input financial information to enable the custom algorithm to determine the care recipient’s eligibility for Medicaid, adjusted settings on a care cost calculator to estimate the regional cost of home and institutional care services, and completed a Medicaid knowledge quiz before and after using the website. After engaging with the website and watching the videos, scores on a Medicaid knowledge quiz increased by 61.2% (2-tailed t92=12.9, P<.001). Participants found it easy to enter the care recipient’s financial information to determine Medicaid eligibility (out of 7; mean 5.9, SD 1.3) and perceived the care cost calculator as very helpful (out of 7; mean 6.3, SD 1.2). The website received a very high System Usability Scale rating of 88.3 out of 100 (SD 13.1). Caregivers verbalized wanting more education on complex financial concepts that impact Medicaid eligibility and asset preservation. A comprehensive Medicaid planning website can significantly improve caregivers’ knowledge of Medicaid and provide them with a personalized roadmap for accessing care services. The custom algorithm powering the Medicaid eligibility determination could be further refined to account for state-based exceptions. This application may reduce caregiver burden and help support the long-term care planning process.
9. Assessment of Mental and Chronic Health Conditions as Determinants of Health Care Needs and Digital Innovations for Women With Sexual Dysfunction: Cross-Sectional Population-Based Survey Study in Germany.
期刊: Journal of participatory medicine 发表日期: 2025-Aug-27 链接: PubMed
摘要
A chronic health condition (CHC) is a recognized risk factor for experiencing problems in sexual function (PSF). According to the International Classification of Diseases, 11th Revision (ICD-11), the development of severe symptoms of sexual distress is the defining criterion for clinically relevant sexual dysfunction. Data on the contribution of specific CHCs to clinically relevant sexual dysfunction symptoms and related health care needs are limited, hindering targeted interventions. This study examines the prevalence of PSF, sexual dysfunction, and sexual distress; assesses associations with CHC status; evaluates sexual dysfunction diagnoses; and explores health care preferences. Data collection in this cross-sectional population-based survey study was based on a questionnaire developed with patient and public involvement and administered by YouGov to a representative sample of adults in Germany. Analyses included 1970 women with and without CHCs and different CHC subgroups (mental health-related, gynecological, cardiovascular and metabolic, infectious and inflammatory, cancer, pain-related, and neurological). The outcomes measured were PSF, clinically relevant sexual dysfunction symptoms, sexual distress (Female Sexual Distress Scale-Desire/Arousal/Orgasm [FSDS-DAO]), and self-reported sexual dysfunction diagnoses. Multivariable regression and network analysis explored associations among CHC subgroups, PSF, sexual dysfunction, and FSDS-DAO scores. Among 1970 cisgender women (mean age 49.6, SD 16.0 years), 1186 (60.2%) reported CHCs. The 6-month PSF prevalence was 75.2% (820/1090) in women with CHCs and 62.5% (399/638) in women without CHCs. Clinically relevant sexual dysfunction symptoms were less prevalent (CHC: 202/1046, 19.3% vs no CHC: 68/601, 11.3%). Multivariable regression models showed an association between sexual dysfunction and CHCs (odds ratio [OR] 2.56, 95% CI 1.90-3.49), which was the strongest for women with mental health-related CHCs (OR 2.31, 95% CI 1.70-3.13) and cancer CHCs (OR 2.00, 95% CI 1.45-2.78). Being in a relationship was a protective factor for clinically relevant distress among women with CHCs. Network analysis showed positive associations of PSF with gynecological and mental health-related CHCs and of sexual dysfunction with mental health-related, gynecological, and cancer CHCs. Women with sexual dysfunction symptoms reported low rates of sexual dysfunction diagnosis (CHC: 39/200, 19.4% vs no CHC: 6/55, 10.7%) and treatment (CHC: 16/146, 11.0% vs no CHC: 3/40, 7.0%). Gynecologists were the preferred health care providers for sexual dysfunction. The most commonly reported unmet need was a lack of information. Digital solutions, such as apps and websites with exercises, were desired as health care innovations. The burden of CHCs on women’s sexual health extends beyond functional sexual impairment, with high rates of clinically relevant sexual distress. Cancer and mental health conditions are the strongest predictors of sexual dysfunction. Despite the high prevalence of sexual dysfunction in women with CHCs, access to diagnosis and treatment is limited. Digital offerings could help address these unmet needs.
10. Factors Predicting Readmission to the Emergency Department After a Diagnosis of Acute Respiratory Infection: A Two-year Experience at a Pediatric Tertiary Care Hospital in Italy.
期刊: The Pediatric infectious disease journal 发表日期: 2025-Aug-27 链接: PubMed
摘要
Acute respiratory infections (ARI) are among the leading causes of pediatric emergency department (ED) visits. The rate of unplanned returns to pediatric ED is an important quality indicator, and it is associated with factors such as age and clinical complexity. This study aims to identify the determinants associated with the risk of return to the ED, for any cause, within 7 days of discharge home with a diagnosis of ARI. A retrospective cohort study was conducted in a tertiary care children’s hospital in Italy, including all ED visits with a primary diagnosis of ARI and discharge to home between July 1, 2021, and June 30, 2023. The study aimed to estimate the risk of return to ED in terms of variables related to the access, patient characteristics, and pharmacological treatment, by fitting a multivariate multilevel logistic regression model. During the study period, 2987 returns to the ED occurred within 7 days of discharge, representing 8.8% of the 33,933 ARI-related ED visits with discharge to home. Multivariate analysis revealed several statistically significant predictive factors, including triage code, age, diagnosis of acute bronchiolitis, absence of symptoms on arrival, prescription of systemic antibacterials in the ED, and presence of a secondary diagnosis. Readmissions to the ED for pediatric ARI in the postpandemic period have a multifactorial nature. Contributing factors range from the initial severity of the clinical condition to the specific characteristics of the patients. Recognizing and understanding these determinants offers an opportunity to develop targeted interventions aimed at optimizing the discharge process.
11. Association Between Alcohol Consumption and Psoriasis: Exploratory Analysis of Crowdsourced Web Search Data in Sweden.
期刊: JMIR formative research 发表日期: 2025-Aug-27 链接: PubMed
摘要
The nature of the relationship between psoriasis and alcohol consumption has been the topic of discussion for many years. Some studies have found that a higher intake of alcohol may be associated with a more severe manifestation of the disease. At the same time, patients with psoriasis often demonstrate elevated levels of alcohol consumption. It has not yet been fully established whether alcohol abuse serves as a trigger for psoriasis or if patients with psoriasis are simultaneously more prone to alcohol abuse. The objective of this study was to employ Google Trends as a tool for crowdsourcing data on a national level to explore the relationship between psoriasis and the consumption of alcohol in Sweden. This study examines crowdsourced web search data related to psoriasis and other skin disease-related search terms (such as utslag [rash]) as well as search interest in different types of alcohol. The analysis covers a 5-year period from 2018 to 2023 in Sweden, focusing on search behavior and correlations across this period. The search behavior regarding psoriasis and alcohol-related search terms showed seasonal variations throughout the year. The relative search volume for psoriasis peaked in February, while alcohol-related searches, particularly Systembolaget and vodka, peaked in December and June. Our statistical analysis revealed relationships between the search interest regarding psoriasis and terms related to alcohol consumption, with disparities between different types of alcohol. The term “psoriasis” was negatively correlated with “Systembolaget” (r=-0.210), “vitt vin” (r=-0.224), and “vodka” (r=-0.220) (all P<.001), while the term “utslag” showed positive correlations with these same alcohol-related terms (r=0.278-0.347; P<.001). Crowdsourced data can offer valuable insights into population-level behavior. The observed negative correlations between psoriasis and alcohol-related searches suggest complex interactions, possibly reflecting reduced disease awareness or care during periods of higher alcohol consumption. The direction and strength of the correlations with psoriasis were not consistent across the different types of alcohol investigated in this study, which poses the question whether the relationship might be influenced by the type of beverage consumed. Further research is warranted to explore underlying mechanisms and validate these findings in clinical populations.
12. Misleading Results in Posttraumatic Stress Disorder Predictive Models Using Electronic Health Record Data: Algorithm Validation Study.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-27 链接: PubMed
摘要
Electronic health record (EHR) data are increasingly used in predictive models of posttraumatic stress disorder (PTSD), but it is unknown how multivariable prediction of an EHR-based diagnosis might differ from prediction of a more rigorous diagnostic criterion. This distinction is important because EHR data are subject to multiple biases, including diagnostic misclassification and differential health care use resulting from factors such as illness severity. This study aims to compare predictive models using the same predictors to predict an EHR-based versus semistructured interview-based PTSD diagnostic criterion, quantify model performance discrepancies, and examine potential mechanisms that account for performance differences. We compared the performance of several machine learning models predicting EHR-based PTSD diagnosis to models predicting semistructured interview-based diagnosis in a nationwide sample of 1343 US veterans who completed Structured Clinical Interview for DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) (SCID-5) interviews and had clinic visit data extracted from the Veterans Affairs (VA) EHR. We developed 2 sets of predictive models using 3 algorithms (elastic net regression, random forest, and XGBoost), with a nested cross-validation scheme consisting of an initial train-test split and 10-fold cross-validation within the training set for each type of model. All models used a nearly identical set of predictors including 29 EHR-based visit count variables and 8 demographic variables. Diagnostic concordance between EHR-based PTSD diagnosis and SCID-5-based PTSD diagnosis was 73.3%, with 17.8% false negatives and 8.9% false positives for EHR-based diagnosis. Models predicting EHR-based PTSD performed very well (area under the receiver operating characteristic curve [AUC] .85-.9; Matthews correlation coefficient [MCC] .58-.69), whereas those predicting interview-based PTSD performed only moderately well overall (AUC .71-.76; MCC .24-.28). Sensitivity analyses showed that participants’ frequency of VA visits played a role in these differences, such that the density of EHR data (proportion of nonzero visit counts across EHR variables) was more associated with EHR-based PTSD diagnosis (b=-0.18, SE 0.02, P<.001) than with SCID-5 interview-based PTSD diagnosis (b=-0.06, SE 0.01, P<.001). Predictive models of PTSD built using only EHR data demonstrated inflated performance metrics relative to models predicting diagnosis from a rigorous structured clinical interview. This performance discrepancy appears driven by circular relationships between health care use patterns and EHR-based diagnosis that do not affect external diagnostic criteria. Researchers building clinical prediction models should not assume that diagnosis in the EHR is a sufficient proxy for the true criterion of interest. Clinicians and researchers should be cautious in interpreting clinical prediction models using only EHR data, as their real-world utility may be less than performance metrics suggest.
13. Objectively and Subjectively Measured Physical Activity and Their Associations With Cardiometabolic Risk in the UK Biobank: Retrospective Cohort Study.
期刊: JMIR mHealth and uHealth 发表日期: 2025-Aug-27 链接: PubMed
摘要
The association between physical activity (PA) behavior and cardiometabolic risk factors has depended largely on questionnaire-based reporting. More studies are turning to mobile health (mHealth) device solutions to measure PA. While there are differences between self-reported activity levels and objectively measured accelerometer-based activity, how these differences manifest in disease risk is unknown. Here, we sought to evaluate these differences between self-reported and mHealth-based PA and to model the impact on their association with cardiometabolic factors. Our study provides a framework to assess the quality of relationships measured by mHealth technologies, which is generalizable to other sensors or activity-measuring devices. We assessed PA using both wrist-worn accelerometer data and self-reported questionnaires in 16,000 participants of the UK Biobank (UKB) between 2013 and 2015, focusing on walking, sleeping, sedentary, and moderate-to-vigorous physical activity (MVPA). We compared the concordance between self-reported and objective measures of PA. We also compared the association between objectively measured or self-reported PA and future clinical biomarker levels (eg, BMI, pulse rate, glucose control, and cholesterol). Participants underestimated their weekly sedentary duration on average of 2.86 hours, and the coefficient of correlation (r) between subjective and objective activity was 0.12 for sedentary time, 0.16 for MVPA, 0.18 for walking, and 0.13 for sleeping. We found an inverse association between objectively measured MVPA and cardiometabolic biomarkers such as BMI and pulse rate, but found no association between subjectively reported activity and cardiometabolic biomarkers. We estimated that there is a 6% larger association between subjectively measured MVPA and BMI in healthy adults (vs the objective counterpart). We also estimated a 2%-3% difference on a healthy adult heartbeat (healthy range: 60-100 bpm) if relying on subjectively reported observations instead of measured PA. These findings suggest that the association based on self-reported activity is likely overestimated and biased compared with objectively measured PA. Therefore, care should be taken when assessing the effects of self-reported PA on key cardiometabolic factors, such as BMI and pulse rate. We emphasize that while the associations are biased when comparing PA modalities, we cannot conclude which method more closely reflects the daily activity load.
14. RESNA position on assistive technology for lying posture care management.
期刊: Assistive technology : the official journal of RESNA 发表日期: 2025-Aug-27 链接: PubMed
摘要
The purpose of this RESNA position paper on assistive technology for lying posture care management (LPCM) serves to align academic research and clinical best practices. Lying posture, although critical in postural care, is under-addressed in both policy and clinical settings to assist practitioners in decision-making and justification of LPCM recommendations. The Position Paper frames LPCM within the 24-hour posture care management (PCM) model, highlighting its role in preventing body shape distortions, reducing health complications, and enhancing participation for individuals with limited mobility.
15. Racial and Ethnic Disparities Along the Treatment Cascade Among Medicare Fee-for-Service Beneficiaries With Metastatic Breast, Colorectal, Lung, and Prostate Cancers.
期刊: Journal of clinical oncology : official journal of the American Society of Clinical Oncology 发表日期: 2025-Aug-27 链接: PubMed
摘要
This study evaluated racial and ethnic disparities along the treatment cascade for Medicare fee-for-service patients with metastatic breast, colorectal, lung, and prostate cancers and disparities in overall survival by treatment receipt and quantified factors contributing to these disparities. Medicare fee-for-service beneficiaries with newly diagnosed metastatic hormone receptor-positive/human epidermal growth factor receptor 2-negative breast, colorectal, non-small cell lung, and prostate cancers from the SEER-Medicare-linked database (2016-2020) were studied. We used multivariable logistic regression to evaluate disparities along the treatment cascade, multivariable Cox regressions to evaluate disparities in overall survival by treatment receipt, and Oaxaca-Blinder decomposition to quantify the contribution of factors related to disparities. Of 18,652 White, 1,898 Black, and 1,465 Hispanic beneficiaries, within 2 months of diagnosis, 78% of patients were alive and 87% saw a medical oncologist-without consistent disparities. There were disparities in receiving any systemic therapy: breast (59% of Black patients received systemic therapy, 60% Hispanic, 68% White, P = .021), colorectal (23% Black, 31% Hispanic, 34% White, P < .001), lung (26% Black, 37% Hispanic, 39% White, P < .001), and prostate (56% Black, 76% Hispanic, 77% White, P < .001) cancers. For every cancer, <35% of patients received guideline-directed systemic therapy. After restricting to patients who received any systemic therapy within 2 months of diagnosis, overall survival disparities were no longer significant. Across all malignancies, low-income subsidy status-of which 87.6% was dual-eligible-contributed most to explaining disparities in treatment (20%-45% of the disparity). Care delivery and policy interventions intended to narrow racial and ethnic overall survival disparities in Medicare patients with metastatic cancer should target disparities in not receiving first-line systemic therapy and address the unique needs of beneficiaries with low-income subsidy status or dual eligibility.
16. Effects of Scalable, Wordless, Short, Animated Storytelling Videos on Flu Vaccine Hesitancy in China: Nationwide, Single-Blind, Parallel-Group, Randomized Controlled Trial.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-27 链接: PubMed
摘要
Low influenza vaccination rates in China pose a serious public health threat. The vaccination prevents infection, but widespread vaccine hesitancy remains a significant barrier. Short, animated storytelling videos may help by conveying health messages in an engaging, culturally neutral format that transcends literacy barriers. We aim to investigate whether scalable, short, animated storytelling videos, using different storytelling techniques-humor, analogy, and emotion-could reduce influenza vaccine hesitancy among Chinese adults. In this single-blind, parallel-group, randomized controlled trial, we recruited adults in China through quota sampling. Participants were randomly assigned to 1 of 3 short, animated storytelling video intervention groups, each using a different storytelling technique (humor, analogy, or emotion) or a control group in a 1:1:1:1 ratio. After watching the video or being assigned to the control group, participants completed the questionnaire. Influenza vaccine hesitancy was compared between each intervention group and the control group, respectively, as well as between different intervention groups, with P values adjusted for multiple comparisons. A total of 12,000 participants met the inclusion criteria. Participants in any scalable animated storytelling video group showed lower hesitancy than controls (mean difference -0.41, 95% CI -0.60 to -0.23; P<.001). Specifically, both intervention groups with humor (video A) and analogy (video B) storytelling techniques resulted in significantly lower hesitancy compared to the control group, with mean differences of -0.44 (99.17% CI -0.75 to -0.13; P<.001) for video A and -0.55 (99.17% CI -0.86 to -0.24; P<.001) for video B. However, the intervention group with emotion video (video C) did not show significant effects compared to the control group, nor were there significant differences compared with the other 2 intervention groups. In subgroup analyses, video A effectively reduced vaccine hesitancy among urban residents and participants from southern and southwestern China. Video B was effective within participants aged 40-49 years, both sexes, both urban and rural residents, those with a college education or higher, households with an income of CN ¥90,000-180,000 (the 2021 official exchange rate of CN ¥1=US $0.155 was used for reference, based on World Bank data), and participants from the southwestern region and the western economic belt. Our study showed that storytelling videos, especially with humor and analogy, reduced hesitancy among Chinese adults. Our results highlight the importance of selecting appropriate narrative strategies for health communication, particularly for vaccine hesitancy across various demographic and regional contexts. Given the scalability, low cost, and high accessibility of short, animated storytelling videos, integrating them into national health campaigns could enhance vaccine uptake and mitigate hesitancy in underserved populations. Future research should explore the long-term impacts of these interventions on vaccine uptake and their adaptability to other preventive health measures.
17. The Implementation of Advanced Practice Nursing in Primary Health Care: A Comparative Qualitative Study of Enablers and Barriers.
期刊: Journal of advanced nursing 发表日期: 2025-Aug-27 链接: PubMed
摘要
To explore the enablers of and barriers to implementing advanced practice nursing in primary health care in Germany and Brazil. A qualitative cross-country comparative study. Nine focus groups were conducted: 4 in Brazil and 5 in Germany with 48 participants (23 primary health care policy stakeholders and 25 nurses practicing in primary health care and general practitioners) between May 2022 and June 2023. The data were analysed by content analysis using a deductive-inductive approach. Our findings reveal a need for clarity around the concept, specific roles and responsibilities of advanced practice nurses in primary health care. Although there is still no regulation in place for practising advanced practice nursing in either country, clear drivers can be observed, with Germany strengthening community health nursing and Brazil following clinical protocols in nursing practice. Dialogue among stakeholders-at both the policy and practitioner levels-is essential to bridge communication gaps. Additionally, involving patients in the implementation process is crucial for the holistic integration of advanced nursing roles. Political, organisational and financial barriers persist, such as the need to establish both legal foundations and regulatory frameworks, enhance political participation within the nursing profession, and involve stakeholders in dialogue and consensus-building efforts. Giving advanced practice nursing a higher priority on political and research agendas-with policy adjustments and input from practitioners-can help integrate advanced practice nursing into primary health care. Our findings highlight that actively involving nursing as an equal partner in political discourse is seen by stakeholders as crucial to drive the implementation process forward sustainably. This study addresses the lack of data on the enablers and barriers to implementing advanced practice nursing in primary health care in Germany and Brazil. It underscores the need for clearer definitions of advanced practice nursing in primary health care, as well as sufficient regulation and funding. Dialogue is essential to bridge gaps and foster mutual understanding. The findings support future practice development and research, especially in countries that have introduced advanced nursing practice roles in primary health care. The COnsolidated criteria for REporting Qualitative research (COREQ). No involvement of patient and public contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Our study highlights the growing adoption of expanded nursing responsibilities even in countries that have not yet formally implemented advanced practice nursing roles.
18. Parathyroidectomy and Risk of Incident Diabetes in Patients With Primary Hyperparathyroidism.
期刊: JAMA surgery 发表日期: 2025-Aug-27 链接: PubMed
摘要
Primary hyperparathyroidism (PHPT) is linked to insulin resistance, glucose intolerance, and diabetes. Whether parathyroidectomy is associated with lower risk of diabetes has not been evaluated in a large cohort. To examine the independent association between parathyroidectomy and the risk of incident diabetes in patients with PHPT. Patients diagnosed with PHPT between January 2006 and December 2023 were identified from a territorywide electronic health database in Hong Kong and classified into surgical and nonsurgical groups based on presence of subsequent parathyroidectomy. They were followed up with from the index date (first diagnosis of PHPT), until the outcome of interest (incident diabetes), death, or end of the study period (December 2023), whichever came first. Parathyroidectomy vs nonsurgical management. The primary outcome of this study was incident diabetes. Inverse probability of treatment weighting was used to balance all baseline characteristics. Cox proportional hazards regression was used to evaluate the hazard of incident diabetes associated with parathyroidectomy. A total of 3135 patients with PHPT were included (596 [19.0%] surgical and 2539 [81.0%] nonsurgical). The mean (SD) age was 67.5 (14.2) years, and 2211 (70.5%) individuals were female. A total of 518 patients in the nonsurgical group developed incident diabetes during a median (IQR) follow-up of 2.2 (0.9-4.3) years, compared to 156 patients in the surgical group during a median (IQR) follow-up of 5.5 (3.3-8.0) years. Parathyroidectomy was associated with lower risk of incident diabetes (hazard ratio [HR], 0.68 [95% CI, 0.65-0.71]; P < .001). Results were consistent across multiple sensitivity analyses. Subgroup analyses revealed more prominent protective associations among younger patients (age ≤65 years vs >65 years: HR, 0.64 [95% CI, 0.60-0.68] vs HR, 0.68 [95% CI, 0.63-0.72]; interaction P < .001) and those with more severe PHPT (parathyroid hormone [PTH] > twice the upper limit of normal vs PTH ≤ twice the upper limit of normal: HR, 0.58 [95% CI, 0.53-0.63] vs HR, 0.73 [95% CI, 0.69-0.77]; calcium > 2.8 vs calcium ≤ 2.8 mmol/L : HR, 0.58 [95%CI, 0.54-0.63] vs HR, 0.69 [95%CI, 0.66-0.73]; interaction P < .001). In this cohort of patients with PHPT, parathyroidectomy was associated with a lower risk of incident diabetes. The association was more prominent in younger patients and those with more severe PHPT. These results may suggest potential additional metabolic benefits of parathyroidectomy in PHPT.
19. Occupational noise exposure of ushers during National Hockey League games in an indoor arena.
期刊: Journal of occupational and environmental hygiene 发表日期: 2025-Aug-27 链接: PubMed
摘要
Workers employed in recreational settings, such as sporting events, may be potentially exposed to hazardous noise levels, increasing the risk of temporary and permanent hearing loss. The purpose of this study was to assess the occupational noise exposures of ushers employed in an indoor arena during 12 National Hockey League games in eastern North Carolina. Participants were monitored for personal noise exposure during games using noise dosimeters. Area noise monitoring was conducted at arena level 1 using a sound level meter and in a production office using a noise dosimeter. Ten of 12 games (83.3%) had at least one 8-hr TWA noise exposure measurement that exceeded the ACGIH® TLV® of 85 dBA, while one (8.3%) exceeded the OSHA PEL of 90 dBA. The differences in Lavg and 8-hr TWA noise levels by game were statistically significant (p < 0.01) for both ACGIH and OSHA noise metrics. All of the 8 arena sections (100%) had at least one 8-hr TWA noise exposure measurement that exceeded the ACGIH TLV, while one (12.5%) exceeded the OSHA PEL. The differences in Lavg, 8-hr dose and 8-hr TWA by arena seating level were not statistically significant (p = 0.11 to 0.36) for both OSHA and ACGIH metrics. Although the overall 8-hr TWA noise exposure levels (76.5 ± 4.6 dBA using OSHA metric; 83.7 ± 3.7 dBA using ACGIH metric) did not exceed the OSHA PEL or ACGIH TLV, respectively, employees during professional hockey games may be exposed to hazardous noise as demonstrated by the percentages of 8-hr TWA noise measurements exceeding the OSHA PEL (1.1%) and ACGIH TLV (24.2%). Study findings may be beneficial for identifying practical and feasible control measures to reduce noise exposures of workers at the arena during professional hockey games and may be used to estimate attendee noise exposures and to improve arena design for noise reduction.
20. Pressure-Activated Breathable Liquid-Metal Electrodes for Long-Term Sleep Electroencephalogram Monitoring.
期刊: Langmuir : the ACS journal of surfaces and colloids 发表日期: 2025-Aug-27 链接: PubMed
摘要
Sleep electroencephalography monitoring has become an effective strategy for health evaluation. However, conventional gel electrodes suffer from inherent limitations such as moisture loss and poor breathability, compromising long-term signal stability and wear comfort. Here, we present a facile strategy for fabricating breathable, biocompatible liquid-metal electrodes with enhanced interfaces. Eutectic gallium-indium particles fabricated via ultrasonication are coordinated with (3-mercaptopropyl) triethoxysilane and patterned onto a fiber matrix. During ambient drying, thiol-silane dehydration and condensation generates a polymer network that entangles with the fiber matrix while encapsulating the liquid-metal droplets. When pressure is applied, the encapsulated liquid metal exudes to form the interface-enhanced electrode, demonstrating exceptional tolerance to water washing, air exposure, and mechanical deformations, along with superior skin compatibility and lower interface impedance compared with those of commercial gel electrodes. As a proof of concept, the integrated head-worn epidermal electrodes achieved continuous sleep electroencephalography monitoring for 6 h, highlighting their potential for unobtrusive and long-term wearable health surveillance.
21. Promoting Equity in Parent Presence and Participation in Neonatal Intensive Care: Protocol for a Prospective Cohort Study.
期刊: JMIR research protocols 发表日期: 2025-Aug-27 链接: PubMed
摘要
Parents of infants born preterm experience many barriers to their presence in the neonatal intensive care unit (NICU) and participation in infant caregiving. Parents from historically marginalized backgrounds or with limited social or economic resources may experience even more profound barriers, creating a significant source of health inequity for these parents and their infants. While the specific barriers and facilitators of parent presence and participation (PPP) in caregiving are unknown, PPP may be critical for improving clinical outcomes and neurodevelopment for infants born preterm. This study aims to (1) longitudinally determine the barriers and facilitators affecting PPP specific to parents with diverse sociodemographic characteristics, (2) determine the effect of PPP on infant clinical outcomes and neurodevelopment and the potential mediating effect of parent-infant responsiveness, and (3) determine the moderation effect of PPP on the relationship between infant stress exposure and infant clinical outcomes and neurodevelopment. We hypothesize that barriers and facilitators of PPP will vary based on sociodemographic characteristics and will change over the duration of a NICU hospitalization. We expect that higher levels of PPP will be associated with better infant outcomes. Parents (N=375) of infants born preterm, at <32 weeks’ gestational age, will be enrolled in a prospective cohort study. The parents will complete a daily survey documenting the amount of time spent in the NICU and the caregiving activities performed. The parents will also complete surveys at regular intervals during their infant’s admission to report barriers and facilitators of PPP, NICU-related stress, depressive symptoms, experiences of discrimination, and engagement with NICU staff. Additional data will be collected throughout each infant’s hospitalization, including invasive procedures, infant clinical data, and nursing documentation of PPP. The parents will complete the maternal-infant responsiveness instrument at the time of NICU discharge and at 3 months’ corrected age (CA). Infant clinical outcomes include the achievement of feeding milestones and the length of NICU stay. The infants will be assessed at 3 months’ CA using the test of infant motor performance and at 12 months’ CA using the Bayley scales of infant and toddler development, fourth edition. Funding was awarded in August 2024. Data collection and analysis are expected to be completed by July 2029. By identifying the important barriers and facilitators of PPP over the duration of hospitalizations of infants born preterm and differences in these factors based on sociodemographic characteristics, time- and population-targeted interventions can be developed to remove system-level barriers and enhance facilitators. These efforts may increase PPP and promote health equity for diverse families. PRR1-10.2196/71930.
22. Group concept mapping to develop a salon-based HPV self-collection intervention.
期刊: Cancer causes & control : CCC 发表日期: 2025-Aug-27 链接: PubMed
摘要
Black women in the US face higher cervical cancer mortality rates due to delayed diagnoses linked to lower screening rates. Contributing factors include provider bias, costs, and limited access, particularly affecting women aged 40-64. While innovative approaches like clinical and home-based HPV self-collection exist, equitable dissemination remains challenging. Distributing HPV self-collection kits in unconventional sites like hair salons may offer a solution. Using concept mapping, we gathered community insights to design a salon-based cervical cancer screening intervention. We employed groupwisdom™ and REDCap platforms for community-based participatory intervention development. Participants included members of the Black Community Advisory Council of Tucson (Black CACTus), comprising hairstylists (n = 3), salon clients (n = 4), and healthcare providers(n = 3), all identifying as Black women aged 23-53. Concept mapping included: 1) Brainstorming statements, 2) Sorting statements into thematic clusters, 3) Rating importance and feasibility, 4) Reviewing the cluster map, and 5) Evaluating a draft intervention. Brainstorming produced 39 statements, forming six clusters: 1) Program Promotion, 2) Insurance, Cost & Benefits, 3) Communication Considerations, 4) Information and Education, 5) Overall Logistics and Process, and 6) Sample Collection. Communication Considerations and Sample Collection were rated most important, with Communication Considerations also ranking highest for feasibility. Communication Considerations, Information and Education, and Sample Collection were the highest rated when importance and feasibility were considered together. Engaging community perspectives is essential for adapting cancer screening from clinical settings to community spaces like hair salons. This collaborative concept mapping approach identified strategies to enhance cervical cancer screening access and uptake among Black women.
23. Impact of kidney function and leisure activities on disability risk among community-dwelling older adults.
期刊: Clinical and experimental nephrology 发表日期: 2025-Aug-27 链接: PubMed
摘要
Impaired kidney function has been shown to be associated with both leisure activity participation and disability incidence. However, whether kidney function could influence the association between leisure activity and disability incidence in older adults remains unclear. Therefore, in the present study, we aimed to examine the influence of kidney function on the association between leisure activities and incident disability among community-dwelling older adults. We enrolled 16,354 community-dwelling older adults from the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes. The estimated glomerular filtration rate (eGFR) was determined based on creatinine levels; the participants were classified into two categories: eGFR ≥ 60 mL/min/1.73 m2 and eGFR < 60 mL/min/1.73 m2. Participants’ engagement in 15 leisure activities was assessed through interviews. Disability incidence was determined using data from Japan’s long-term care insurance system. Overall, 786 (5.0%) patients developed a disability within 24 (interquartile range 24-24) months. Using Cox proportional hazards regression models adjusted for potential confounders, low leisure activity participation was identified as a significant factor for increased risk of disability (hazard ratio 1.25; 95% confidence interval 1.04-1.50) independent of eGFR. No significant interaction was observed between eGFR and leisure activity participation (P = 0.66). In this study, leisure activity was associated with the risk of disability incidence independent of kidney function among community-dwelling older adults. These findings suggest that assessing leisure activity might be important for identifying the risk of disability in this population.
24. Biguanides are associated with decreased early mortality and risk of acute kidney injury in hospitalised patients with COVID-19: a nationwide retrospective cohort study in Japan.
期刊: Clinical and experimental nephrology 发表日期: 2025-Aug-27 链接: PubMed
摘要
The most prescribed oral glucose-lowering medication worldwide is biguanide (BG), which shows potential for further therapeutic applications. The coronavirus disease 2019 (COVID-19) pandemic is a global public health emergency. Nevertheless, low-cost treatments against COVID-19 have not been established, with varying morbidity and mortality rates in each country. From the inpatient databases in Japan from September 2021 to March 2023, which includes the era following the development of COVID-19 vaccines, we extracted data from 168,370 patients with COVID-19 aged 20- < 80 years with diabetes mellitus treated with oral antidiabetic agents. The primary and secondary outcomes were 100-day in-hospital mortality and incidence of acute kidney injury (AKI) during hospitalisation, respectively. We compared outcomes in patients who received BG with those who did not using a logistic regression analysis and Cox proportional hazards under both propensity score-unmatched and matched cohorts. The incidence of in-hospital death was significantly lower in the BG group (1.18%) compared with the non-BG group (2.41%) (P < 0.001). Similarly, the incidence of AKI during hospitalisation was significantly lower in the BG group (0.66%) compared to the non-BG group (1.12%) (P < 0.001). Kaplan-Meier analysis from the propensity score-matched cohort showed a significantly better survival rate in the BG group (adjusted HR, 0.619; 95% CI, 0.545-0.702; P < 0.001). In patients with COVID-19, oral biguanide use may be associated with reduced in-hospital mortality and AKI risk.
25. Incidence and risk of cancer emergence among patients post-kidney transplantation in Japan.
期刊: Clinical and experimental nephrology 发表日期: 2025-Aug-27 链接: PubMed
摘要
Cancer is one of the most common complications after kidney transplantation and an important cause of mortality. However, no large, nationally representative study has investigated cancer incidence post-kidney transplantation. This study aimed to determine the standardized incidence ratio (SIR) for cancer after kidney transplantation using the National Database of Health Insurance Claims (NDB). We used NDB from April 2013 to March 2022; patients were included if they had been on dialysis for at least one year, were diagnosed with cancer related to post-kidney transplantation, and were prescribed immunosuppressant drugs in FY2014 or FY2015. We defined patients with cancer as those who were coded as ICD-10 for cancer in FY2016 or later. The number of patients and SIRs were tabulated according to the duration after kidney transplantation and cancer type. The total number of patients was 4484 (males: 2879; females: 1605). The SIRs of all cancers from the first to the seventh year after kidney transplantation were 232/291/235/248/257/187/149, respectively, showing a gradual downward trend over time. The predilection sites of cancer in both men and women were post-transplant lymphoproliferative disease, Kaposi sarcoma, and the kidney. This observational study, which followed over 100 million people, is the first large-scale research to track kidney transplant recipients for under 10 years. It incorporates an unprecedented sample size and uniquely identified short-term cancer risk trends following kidney transplantation.
26. Effectiveness of NVX-CoV2373 and BNT162b2 COVID-19 Vaccination in South Korean Adolescents.
期刊: The Pediatric infectious disease journal 发表日期: 2025-Aug-27 链接: PubMed
摘要
Adolescents can have severe/chronic outcomes from COVID-19. Real-world data on relative vaccine effectiveness between mRNA- and protein-based vaccines are limited, and more data are needed on disease outcomes in this age group. The K-COV-N database, COVID-19 vaccine registry and health insurance claims were retrospectively reviewed to identify adolescents (12- to 18-year-olds) in South Korea who received a homologous primary series of NVX-CoV2373 or BNT162b2 and a heterologous or homologous third vaccine dose. Vaccine recipients were propensity score matched to reduce confounding baseline factors. Adjusted hazard ratios (aHRs) for any medically attended COVID-19 postvaccination (starting 14 days after primary series and 7 days after a third dose) were calculated to assess relative vaccine effectiveness every 30 days through a 180-day risk window. From February to December 2022, 3174 and 6253 doses of NVX-CoV2373 and BNT162b2, respectively, were administered to South Korean adolescents. Individuals who received NVX-CoV2373 tended to be older, have a disability, and/or have a prior SARS-CoV-2 infection. Propensity score matching resulted in 107 individuals in each primary series group and 701 and 1417 individuals in the NVX-CoV2373 and BNT162b2 third-dose groups, respectively. The aHR (95% CI) for NVX-CoV2373 compared with BNT162b2 for medically attended COVID-19 in the 180-day risk window was 0.57 (0.31-1.05) for the primary series and 0.68 (0.54-0.84) for the third dose. These results suggest that NVX-CoV2373 may provide more robust protection against medically attended COVID-19 as a third dose, compared with BNT162b2. While the aHR for the primary series also indicated lower risk with NVX-CoV2373, this difference was not statistically significant.
27. Digital Catalysts for Noncommunicable Disease Prevention Serious Games and Gamified Applications: Framework Design Study.
期刊: JMIR serious games 发表日期: 2025-Aug-27 链接: PubMed
摘要
Unhealthy behaviors can cause so-called noncommunicable diseases (NCDs), which are on the rise. Notable examples include chronic respiratory diseases, diabetes, cardiovascular diseases, and various types of cancer. They are responsible for approximately 41 million deaths annually, which accounts for a staggering 74% of all global deaths. Major risk factors include physical inactivity, the use of tobacco, unhealthy diets, the harmful use of alcohol, and poor mental health, which can be classified as modifiable behavioral risk factors. Other factors include metabolic and environmental risk factors, such as air pollution. Many individuals struggle to make informed decisions about their health, which contributes to the risk factors mentioned earlier and, ultimately, can lead to the development of one or more NCD. This research presents design and standardization considerations to enable the exchange of medical and game data to maximize their impact and usefulness. Serious games and gamified applications that strategically use behavior change techniques and educational content can help users change their behavior on a lasting basis, thereby reducing the aforementioned NCD risk factors. Still, each of them is currently independently designed and cannot interact with other applications. We previously developed serious games and gamified applications to prevent NCDs. These served as the foundation of an interoperable framework for NCD prevention games and applications. On the basis of a comprehensive analysis, 6 key areas were identified, ultimately leading to a framework definition that was then evaluated against the already-developed games and applications. This paper presented a novel interoperable framework to support the design and development of serious games and gamified applications that enable individuals to achieve sustainable behavior change and improve their overall health and well-being by defining 6 key areas, emphasizing interoperability, and exchanging meaningful medical and game data. The framework presented in this study covers the major design and implementation aspects of NCD prevention games and applications in 6 key areas. Therefore, researchers should consider these guidelines when creating novel serious games and applications in those areas. The framework also intensively encourages the use of standards in the domain of medical informatics to ensure the semantic interoperability of patients’ data produced. Thus, it promotes the exchange of meaningful data to improve patient care and anonymous data use for research.
28. Gender-Specific Moderating Role of Physical Fitness and Cardiovascular Risk Factors in the Relationship Between BMI and C-Reactive Protein: Cross-Sectional Study.
期刊: JMIR public health and surveillance 发表日期: 2025-Aug-27 链接: PubMed
摘要
Physical fitness and cardiovascular risk factors may affect C-reactive protein (CRP) levels by influencing BMI. However, the extent to which these factors influence CRP through BMI remains unclear. This study aims to explore how indicators related to physical fitness and cardiovascular risk factors affect the relationship between BMI and CRP levels. This study selected 453 participants from 518 individuals at a sports hospital in Jiangsu Province, including 231 (51%) males and 222 (49%) females. Using interaction effect analyses, CRP served as the dependent variable and BMI as the independent variable. Physical fitness and cardiovascular risk factors (body morphology, blood pressure, blood lipids, and blood glucose) were categorized into quartiles from the lowest (Q1) to the highest (Q4) and treated as effect modifiers for interaction effect analyses. Sex-specific analyses were conducted to explore the influence of BMI on CRP across different genders, based on physical fitness and cardiovascular risk factor-related indicators. BMI was positively associated with CRP (β=0.203, 95% CI 0.163-0.243; P<.001). After adjusting for confounding factors, this association remained significant (β=0.206, 95% CI 0.164-0.248; P<.001). In the stratified gender analysis, interaction effect analyses showed that in females, waist circumference (median 110.5, IQR 93-128; β=0.342, 95% CI 0.232-0.452; P<.001), hip circumference (median 120, IQR 104-136; β=0.361, 95% CI 0.260-0.462; P<.001), waist-hip ratio (median 1.08, IQR 0.9-1.25; β=0.291, 95% CI 0.204-0.378; P<.001), diastolic blood pressure (median 101, IQR 85-117; β=0.344, 95% CI 0.252-0.436; P<.001), triglycerides (median 1.41, IQR 1.13-1.68; β=0.313, 95% CI 0.216-0.409; P<.001), triglyceride-rich lipoprotein cholesterol (median 0.64, IQR 0.51-0.76; β=0.365, 95% CI 0.249-0.481; P<.001), 20-49 years one-leg standing time with closed eyes (median 3, IQR 1-5; β=0.371, 95% CI 0.276-0.466; P<.001), and 20-49 years grip strength (median 6.5, IQR 6-7; β=0.369, 95% CI 0.270-0.467; P<.001) significantly influenced the effect of BMI on CRP. In males, etotal cholesterol, glucose, one-leg standing time with closed eyes, sit-and-reach, and grip strength demonstrated trends in the effect of BMI on CRP (P>.05). This study demonstrates a positive correlation between BMI and CRP with gender-specific characteristics. In females, multiple body morphology, physiological, and physical fitness indicators significantly influence the effect of BMI on CRP, while some indicators in males also exhibit trends. These findings suggest the necessity of developing health management strategies tailored to different genders, particularly for female populations. Such strategies should consider body morphology indicators such as waist circumference and hip circumference, physiological indicators including blood pressure and blood lipids, and physical fitness metrics such as one-leg standing time with closed eyes. This comprehensive approach can better regulate the impact of BMI on CRP and promote overall health.
29. Long term follow-up outcomes in congenital thrombotic thrombocytopenic purpura.
期刊: Blood 发表日期: 2025-Aug-27 链接: PubMed
摘要
Congenital thrombotic thrombocytopenic purpura (cTTP) is an ultra-rare thrombotic microangiopathy mediated through inherited deficiency in ADAMTS13 (a disintegrin and metalloprotease with a thrombospondin type 1 motif, member 13). To date more than 200 ADAMTS13 genetic variants have been associated with cTTP. We report longitudinal follow up from the UK TTP registry in 104 confirmed cTTP cases (91 consented for follow-up) in a large multi-ethnic national cTTP patient cohort, including a large Black African cTTP cohort. 71 ADAMTS13 variants were identified, with N-terminal variants associated with earlier age at presentation. During the follow-up period (median 63 months (range 1-179), 80.2% of patients received regular (plasma derived) prophylaxis which reduced end-organ damage, including stroke/TIA (19.0% to 1.5%) and renal impairment during follow-up. Post presentation acute TTP episodes were reduced with prophylaxis (0.68 vs 0.06 acute episodes/follow-up year) Despite regular prophylaxis, symptom control remained apparent on plasma-derived therapy (including headache 42.6%, depression/anxiety 13.2%, fatigue 16.2% and abdominal pain 13.2%). The majority of cTTP patients in the UK have now switched to recombinant ADAMTS13 (n=43, 58.9%), owing to inadequate symptom control (53.5%), plasma reactions (30.2%), or subclinical disease activity (16.3%). This work shows the breadth of ADAMTS13 genetic variants in cTTP, and demonstrates efficacy of regular prophylaxis in (i) reducing acute TTP episodes, and (ii) preventing end organ damage, but despite advances, cTTP related symptoms and the use of blood products, remained problematic.
30. Environmental Triggers of Specific Subtypes of Agitation in People With Dementia: Observational Study.
期刊: JMIR formative research 发表日期: 2025-Aug-27 链接: PubMed
摘要
Among the most critical behavioral and psychological symptoms of dementia, agitation can lead to decreased quality of life of people with dementia and their caregivers. Monitoring triggers of agitation and its subtypes could enable early detection or prediction of agitated moments, which could be used to guide preventive or mitigating interventions. However, at this point in time, limited research exists on quantifying environmental triggers of agitation or its subtypes. In this paper, we aim to quantify the relationships between specific environmental factors and agitation as well as specific agitation subtypes, such as motor and verbal agitation. Using a cross-sectional repeated measures design, 37 people with dementia, admitted to a specialized neuropsychiatric ward for patients with dementia and severe behavioral and psychological problems, were each included for 1 week. During this period, the Pittsburgh Agitation Scale was filled in by the nurses on the ward following an experience sampling methodology to assess a patient’s agitation level on a momentary basis. Continuous environmental data (light, sound, and temperature) were collected from fixed sensors mounted on the ward. Generalized linear mixed models were used to quantify relationships between environmental variables and outcome variables (agitation, motor agitation, and verbal agitation). These models accounted for the hierarchical nature of our dataset as well as confounding factors, such as time of day and the room-level location of the patient. The time window for analysis was selected through a comparison of β coefficient estimates across various window lengths. Models were built up sequentially, per outcome variable, using selected features per environmental modality. We found that different environmental factors captured in the window of 33 to 12 minutes before the agitation moment were most informative for different subtypes of agitation: mean light level (β=-0.61, 95% CI -1.12 to -0.10; P=.02) for motor agitation and SD of sound level (β=0.68, 95% CI 0.34-1.02; P<.001) for verbal agitation. Contextual factors such as time of day (β range=0.51-0.94; P<.05 to <.001) and room-level location (β range=0.85-1.08; P<.01 to <.001) were also significant predictors of agitation. Integrating the key differences between predictors of verbal and motor agitation, respectively, the higher SD in sound level and the lower mean light level, in a model predicting the occurrence of subtype-specific agitation, could substantially improve model performance. Overall, these findings can aid in the development of predictive models for agitation based on environmental data and enable subsequent just-in-time interventions, improving the quality of life for both patients and caregivers.
31. mHealth Support in Cardiac Care Pathways for Patient Self-Management During Transitions From Hospital to Rehabilitation: Exploratory Field Study.
期刊: JMIR cardio 发表日期: 2025-Aug-27 链接: PubMed
摘要
Cardiac rehabilitation (CR) is essential for recovery from cardiovascular disease. However, patients often encounter challenges in navigating the transition from acute hospital care to CR. Mobile health (mHealth) technologies may support this critical phase; however, evidence regarding their clinical practice remains limited. The HERO app (developed by REDOX GmbH) was developed to address the needs of patients with cardiovascular disease for orientation, emotional support, and motivation during this transition. This study aims (1) to explore how mHealth technologies tailored for patients with cardiovascular disease can support their needs regarding orientation, emotional balance, and motivation during the transition from the acute hospital to CR and (2) to evaluate the user experience and acceptance of the HERO app as targeted pathway support. A mixed methods study was conducted with patients with cardiovascular disease using study diaries, questionnaires, and semistructured interviews. Participants were purposively recruited in acute hospitals and rehabilitation settings. Quantitative data were analyzed descriptively, and qualitative data were analyzed using content analysis after Mayring. Eight participants used the app for an average of 14 (range 4-23) days. The app was perceived as a helpful short-term resource. It supported patients in understanding their condition, planning for CR, and regaining motivation. Participants highlighted the value of combining objective information with peer experiences. Suggestions for improvement included more personalized self-management guidance and a precise onboarding process to increase accessibility and usability. Based on the findings, we propose 4 pillars of mHealth support for cardiac care transitions, including timely access, actionable guidance, peer support, and short-term usability. These pillars could inform the design of patient-centered mHealth tools for care transitions.
32. Quantitative headform fit evaluation and predictive modeling to assist with selecting N95 filtering facepiece respirators to mitigate respiratory hazards.
期刊: Journal of occupational and environmental hygiene 发表日期: 2025-Aug-27 链接: PubMed
摘要
Ensuring that respiratory protection is effective for all can be difficult if limited resources are available to assist with selecting a well-fitting respirator model and user guidance. To better understand how various N95® filtering facepiece respirator models fit on a variety of face sizes, a quantitative fit evaluation was performed on 12 different N95 respirators distributed by the Strategic National Stockpile using five manikin headform sizes representative of most of the U.S. worker population (540 total tests). Manikin fit factor results varied depending on the respirator model and headform combination. Four respirator models achieved passing fit results across all headform sizes. Predictive modeling was then initiated, where the headform most closely aligned to an individual’s facial dimensions is determined and then used to identify N95 respirators that may provide an acceptable fit. A multinomial logistic regression model was trained and tested using NIOSH’s 2003 Anthropometric U.S. Survey and was found to have an accuracy of 85%. To address potential risks associated with predicting only a single headform size, a modified model allowing for multiple headform size predictions was also assessed and found to have an improved accuracy rate of 98%. With further human subject validation and field testing, this modeling approach could be used as a tool to aid in making the fit testing process more efficient, less burdensome, and better enable individuals to use respirators that fit more effectively, thereby adequately protecting them from hazards.
33. Defining Human Thermoregulation Limits: A Critical Evaluation of Predictive Models using Healthy Young Adults.
期刊: American journal of physiology. Regulatory, integrative and comparative physiology 发表日期: 2025-Aug-27 链接: PubMed
摘要
Background: The core temperature inflection point (CTIP) method (also known as humidity-ramp protocol) and biophysical modeling are widely used to determine human thermoregulation limits, yet their validity under prolonged heat exposure remains unverified. Methods: This study evaluated their predictive accuracy by exposing 36 healthy young adults (20 males & 16 females) to five counterbalanced 8-hour indoor heat trials in a controlled chamber (36°C/74.5%RH, 40°C/55.0%RH, 44°C/29.2%RH, 47°C/35.6%RH, 50°C/24.5%RH). These conditions were selected based on prior CTIP and biophysical model predictions of human thermoregulation limits. Participants engaged in sedentary office tasks (1.29-1.67 METs), wore standardized summer clothing (0.39-0.40 clo), and had ad libitum access to an electrolyte drink, with a 500-kcal sandwich provided at midday. Rectal temperature (Trec) was continuously monitored. Results: Contrary to model predictions, all five conditions remained compensable (Trec rise rate ≤ 0.1 °C/h), with mean peak Trec well below heatstroke thresholds (38.2 ± 0.4 °C). At 44°C/29.2%RH, females exhibited significantly lower Trec than males (p < 0.05); however, no sex differences in steady-state Trec responses were observed across other conditions (all p > 0.10). All exposures were compensable, aligning with the broader literature indicating minimal sex-based variability under such conditions. Conclusions: Collectively, CTIP and biophysical models substantially underestimated human thermoregulation limits, leading to overpredicted heat risk across all trials. These findings challenge the reliability of current predictive methods, suggesting human tolerance may exceed existing estimates. Refining these models is essential for improving heat risk assessment and informing public and occupational health guidelines in a warming climate.
34. Artificial Intelligence Meets Accreditation to Modernize Nursing Education.
期刊: Nurse educator 发表日期: 2025-Aug-27 链接: PubMed
摘要
Large language models, also known as artificial intelligence (AI) models, have become more sophisticated and pervasive in recent years. AI models have many uses and can help nursing faculty in their complex roles. Current literature addresses AI model uses, guidelines, benefits, and challenges for nursing education. However, most literature focuses on the teaching role, with few authors providing guidance for using AI models during quality improvement (QI) activities. These faculty responsibilities are critical yet difficult and could be aided by AI models. However, faculty need guidance to use AI models effectively for these initiatives. Using available literature and author expertise, this article provides guidance for faculty when completing QI and accreditation-related activities, including AI model cautions, ways to maximize output, and approaches for use. AI models have the potential to help faculty modernize nursing education as they enhance program monitoring, quality, and student outcomes.
35. Factorial Validity of the 32-Item World Health Organization Disability Assessment Schedule 2.0 in Persons With Stroke.
期刊: Journal of neurologic physical therapy : JNPT 发表日期: 2025-Aug-27 链接: PubMed
摘要
The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a well-established tool for assessing disability. However, diverse factor structures complicate its interpretation, necessitating further validation. This study examined the factorial validity of the 32-item WHODAS 2.0 in persons with stroke using 1-factor, 6-factor, and 2-level hierarchical structures. A cross-sectional design was used with data from 1343 persons with stroke in the Taiwan Databank of Persons with Disabilities. Confirmatory factor analysis (CFA) was used to determine the valid structure of the 32-item WHODAS 2.0. The 1-factor structure exhibited poor model fits, while the 6-factor and the overall 2-level hierarchical structure had acceptable model fits. However, the relationships between domains and overall score of the 2-level structure yielded poor fits. Excellent internal consistencies (Cronbach’s α ≥ 0.90) were obtained for the 6 domain scores and the overall score. Our results revealed poor model fit for the 1-factor model, whereas the 6-factor structure and the overall 2-level hierarchical structure were both acceptable. However, the relationships between domains and the overall score within the 2-level structure were poor. The 6-factor model is preferable due to its better fit and alignment with WHODAS 2.0’s design to assess multiple life perspectives. The 6-domain structure appears the most robust for persons with stroke. Thus, the 6 domain scores of the 32-item WHODAS 2.0 are recommended.
36. Healthcare workers' exposure to aerosolized medications while crushing oral tablets.
期刊: Journal of occupational and environmental hygiene 发表日期: 2025-Aug-27 链接: PubMed
摘要
Crushing oral tablets can potentially aerosolize active ingredients in the medication and expose healthcare workers to drug particulates. Few studies have quantified aerosolized particulate matter generated during tablet crushing. Inhalation of patient medications can result in negative health effects to the healthcare worker, especially if hazardous medications are being crushed. This study evaluated four different pill crusher and pill container combinations to assess particulate exposure risks and examine whether particulate levels varied depending on the pill crusher, container type, and crushing method. The pill crushers included MAXCRUSH, Silent Knight, and SafeCrush. The MAXCRUSH pill crusher was used with paper pill cups and unit-dose packaging. Factors influencing aerosolized particle generation included the method and intensity of crushing, and the type of pill crusher and container used. An optical particle counter was used to record particle counts in the breathing zone. The highest number of particles was produced when tablets in unit dose packaging were crushed with the MAXCRUSH pill crusher. An aggressive and vigorous procedure significantly increased the number of aerosolized particles generated across devices (p < 0.001) except MAXCRUSH with paper pill cups (p = 0.14). Most of the aerosolized particulate matter was produced when the crushed tablet was poured from its container into a cup of water. To minimize exposure, recommended control measures include substituting tablet medications with liquid forms, having pills crushed by the pharmacy, using a pill crushing syringe, limiting vigorous pouring of crushed medications from pill containers, and wearing a fit-tested N95 respirator.
37. Cost and Budget Impact of Layering Depression Care Onto Existing HIV and Noncommunicable Disease Care Services in Western Kenya.
期刊: Value in health regional issues 发表日期: 2025-Aug-26 链接: PubMed
摘要
The World Health Organization Mental Health Action Plan aims to increase mental healthcare coverage by half, by 2030. Reaching this target requires context-specific financial assessments. We estimated the cost and budget impact of integrating depression care into HIV, diabetes, and hypertension care programs in county-level health facilities in Kenya. We modeled the additional health system costs to provide depression care within chronic disease programs in 6 counties in western Kenya. We estimated per-patient-per-visit costs under 4 scenarios: a facility-based additive scenario; 2 economies of scale and scope scenarios: group session psychotherapy (GSP) delivered by a trained provider within a group of 5 to 10 patients, with and without artistic therapy; and a community-based task-shifting scenario with chronic disease care provided by psychiatry nurses. For each scenario, we estimated the annual budget impact of increasing service coverage for depression to 50% of each county’s eligible population. Offering facility-based GSP without artistic therapy was the least expensive scenario in all counties, with a pooled median per-patient cost of $6.74 (95% CI 6.08-7.40) per depression care visit. Facility-based GSP with artistic therapy was the most expensive scenario with a median per-patient-per-visit cost of $9.79 (8.83-10.7). An additional 3.54% (3.36-3.72) of 2023 county health budgets would be needed to increase mental health service coverage by 50% by 2030. Integrating facility-based GSP within chronic disease care platforms offers a low-cost strategy for depression care provision. Reaching mental health service targets in Kenya may require 3% more of current health budgets.
38. Quantitative Methods for Evaluating Antibody Responses to Pneumococcal Vaccines: A Scoping Review.
期刊: Tropical medicine and infectious disease 发表日期: 2025-Aug-21 链接: PubMed
摘要
Streptococcus pneumoniae remains a leading cause of invasive diseases, particularly affecting young children and the elderly. Currently, two main types of pneumococcal vaccines are commercially available: polysaccharide vaccine (PPSV23) and conjugate vaccines (e.g., PCV20). Of over 100 identified pneumococcal serotypes, vaccines targeting 24 serotypes covered by PPSV23 and PCV20 (19 serotypes overlap between the two vaccines) have been developed, with serotype distribution varying by geography, age, and time. The immune response to pneumococcal vaccines differs across serotypes, vaccine types (polysaccharide vs. conjugate), and host factors. Quantitative methods for antibody assessment-particularly newer high-throughput assays-have emerged since 2000 to address limitations in conventional approaches. However, these methods have not been comprehensively reviewed. This scoping review aimed to systematically map the existing literature on quantitative methods used to assess antibody responses to pneumococcal vaccines. Specific objectives included the following: 1. summarizing conventional and novel quantitative immunoassays; 2. evaluating the current state of validation and application of these methods; 3. identifying knowledge gaps and methodological challenges. We followed the PRISMA-ScR guidelines. We included the following: 1. peer-reviewed, open-access papers related to immunoassays used for pneumococcal antibody assessment; 2. articles written in English; 3. Studies published between 2000 and 2023. We excluded the following: 4. studies focusing on other pathogens, employing different analytical methods, or using animal models. Articles meeting the eligibility criteria were primarily retrieved from PubMed and Scopus. If free full-text versions were unavailable there, Google Scholar or the original journal databases were consulted. All references were exported to EndNote 20 for further management. At the beginning of the review, a data-charting form was developed based on prior studies and commonly addressed themes. Additional charts were created to accommodate newly identified variables during the review. All charting tools were reviewed and finalized through discussion among all research team members. The included studies were classified into five thematic groups: 1. general descriptions of quantitative assessment methods, 2. assay development and validation, 3. comparative studies, 4. technical details of assay development, 5. interpretation of assay application findings. Of 1469 articles from PubMed and 2946 articles from Scopus initially identified, 55 articles met the inclusion criteria. The earliest methods included radioimmunoassays, later replaced by WHO-standardized ELISA. While ELISA remains the gold standard, it is limited by labor, cost, and throughput. Multiplex immunoassays (MIAs), including Luminex-based platforms, have demonstrated advantages in efficiency and scalability. However, many MIAs did not initially meet WHO validation criteria. More recent assays show an improved performance, yet interlaboratory variability and lack of standardized protective thresholds remain major limitations. This review provides the first comprehensive mapping of quantitative antibody assessment methods for pneumococcal vaccines. Although ELISA continues to serve as the benchmark, MIAs represent a promising next-generation approach. Continued efforts are needed to harmonize assay validation protocols and establish global standards for protective thresholds, which will enhance the reliability of vaccine efficacy monitoring across diverse populations.
39. Assessing online search results for misinformation about reduced fetal movements.
期刊: European journal of obstetrics, gynecology, and reproductive biology 发表日期: 2025-Aug-18 链接: PubMed
摘要
Reduced fetal movements (RFM) is a warning sign during pregnancy and must be assessed immediately. As pregnant women search online for RFM information before consulting with healthcare professionals, the accuracy of online information is crucial. Misinformation can lead to delayed medical attention and adverse outcomes. The study aimed to examine the accuracy of RFM online information by analysing Google search results for misinformation. Seven misinformation targets were identified. Google searches were conducted to identify webpages with RFM content. Webpages were evaluated against each target. Half of the search results contained misinformation driven by commercial US webpages. The most common misinformation targets were advice to conduct a kick count, claims that a set number of kicks in a timeframe indicates the baby is well and suggestions for ways to stimulate movements, appearing in 49.5%, 43.2% and 25.0% of the results, respectively. Public health websites from the UK and Ireland appeared less frequently but were more accurate and appeared higher in the search results than less accurate webpages. The poor quality of online information about RFM is concerning. The commonality of kick counting content on US commercial webpages might be due to the lack of US clinical guidelines. To improve the quality of online information, Google should deprioritise webpages containing misinformation, add a warning to RFM searches and have medical experts vet results. Healthcare providers should offer accurate information and advise against using commercial webpages. Public health and professional organisations should collaborate with websites to counter misinformation.
40. Developing Requirements for a Standardized System to Return Individual Research Results Back to Study Participants: Narrative Review.
期刊: Interactive journal of medical research 发表日期: 2025-Aug-18 链接: PubMed
摘要
The increasing prevalence of smart devices has created vast amounts of untapped data, presenting new opportunities for data sharing across various fields, such as environmental sciences, health management, and astrophysics. While a significant portion of the public is willing to donate personal data, we need to better understand how to obtain information about which data assets a person may hold and the risks, benefits, and potential uses of this data exchange mechanism. Developing a trusted data-sharing platform may increase participants’ willingness to donate data and researchers’ ability to return personalized results from research findings. This study aimed to develop a preliminary list of core requirements, which can be used to develop design recommendations for standardizing the return of individual research results to study participants across research disciplines. We conducted a narrative literature review of existing platforms used to return research results to study participants. The search strategy included English-language articles published between May 2013 and May 2023. Concepts related to returning, disseminating, and sharing research results were searched for in (1) published research reports on Web of Science and MEDLINE, (2) gray literature, and (3) the bibliographies of included articles. Screening and data extraction were performed by 2 independent reviewers using Covidence. Inclusion criteria required that the study (1) included human participants, (2) returned information based on data collected from or by participants, (3) was published in English, and (4) included a description of a results-sharing system. Articles that met all 4 inclusion criteria were included in the review; articles that met the first 3 were also presented as supplementary articles. Results and requirements were synthesized thematically. Overall, 6608 abstracts were screened, and 266 articles underwent full-text review to identify 8 articles describing the development and evaluation of 7 different return of results systems. In total, 7 of the 8 articles reported the use of multimodal dissemination methods, including a combination of physical documents, emails, phone calls, and digital platforms to support text and graphical data representations. One article outlined accessibility features to serve the specific participant population. None of the articles described in detail how results were or were not anonymized. A total of 4 studies relied on an expert or clinician to share results on behalf of the research team. Additional educational or contextual materials were included alongside results in four studies, including specific materials designed for follow-up with experts and clinicians. Participants were not hesitant to receive unfavorable results and instead aimed to incorporate such information into their lives via lifestyle changes, clinical intervention, or seeking community. Return of results systems should support multiple modes of dissemination for text-based results. Additional educational and lay-language materials are helpful for participants to understand and use information gained from receiving results.
41. Astaxanthin Attenuates Chlorpyrifos-Induced Pulmonary Cytotoxicity by Modulating Mitochondrial Redox and Inflammatory Pathways.
期刊: Current issues in molecular biology 发表日期: 2025-Aug-17 链接: PubMed
摘要
Chlorpyrifos (CPF), an organophosphate pesticide, is known to induce pulmonary toxicity through oxidative stress, mitochondrial dysfunction, and inflammation. Astaxanthin (ASX), a xanthophyll carotenoid derived primarily from marine microalgae (Haematococcus pluvialis), possesses strong antioxidant properties and has demonstrated cellular protective effects in numerous oxidative stress studies. However, its efficacy against CPF-induced lung cell damage remains uncharacterized. This study revealed the protective role of ASX, as a pretreatment and co-treatment, against CPF-induced cytotoxicity in human A549 lung adenocarcinoma cells by assessing cell viability, intracellular reactive oxygen species (IROS), total oxidative status (TOS), total antioxidant capacity (TAC), mitochondrial membrane potential (MMP), intracellular calcium ions (Ca2+), lactate dehydrogenase (LDH) release, malondialdehyde (MDA) levels, glutathione peroxidase (GPx) activity, superoxide dismutase (SOD) activity, DNA fragmentation, and apoptosis/inflammation-associated gene expression. CPF treatment significantly decreased cell viability and TAC, while elevating IROS, TOS, MMP, intracellular Ca2+, and LDH release. CPF also increased MDA levels and suppressed GPx and SOD activities. DNA fragmentation and quantitative polymerase chain reaction (qPCR) analysis revealed upregulation of pro-apoptotic and inflammatory markers such as BCL2-associated X protein (BAX), caspase-3 (CASP3), tumor protein p53 (TP53), tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), nuclear factor kappa B (NFκB), and voltage-dependent anion-selective channel protein 1 (VDAC1) and suppression of anti-apoptotic B-cell lymphoma 2 (BCL2) and antioxidant defense genes nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1). ASX treatment, particularly when administered as a pretreatment, significantly reversed CPF-induced oxidative and inflammatory responses by restoring SOD, GPx, and TAC levels, reducing IROS, TOS, MDA, and LDH release, and downregulating apoptotic and inflammatory gene expressions. ASX pretreatment notably decreased MMP and intracellular Ca2+ levels, indicating protection against mitochondrial dysfunction and calcium dysregulation. ASX upregulated Nrf2 and HO-1 expression and restored the BCL2/BAX balance, suggesting inhibition of mitochondrial-mediated apoptosis. Additionally, ASX significantly attenuated CPF-induced anti-angiogenic effects in the in ovo Hen’s Egg Test Chorioallantoic Membrane (HET-CAM) assay. These findings demonstrate, for the first time, that ASX exerts a broad spectrum of protective effects against CPF-induced cytotoxicity in lung cells, mainly through the stabilization of mitochondrial redox status and modulation of apoptosis- and inflammation-related gene pathways, highlighting ASX as a promising candidate for further therapeutic development. Furthermore, the pronounced efficacy observed in the pretreatment regimen suggests that ASX can be evaluated as a potential nutritional preventive strategy in high-risk populations with occupational or environmental CPF exposure.
42. A Narrative Review of Heavy Metals and Sperm Quality: The Interplay with Antioxidant Imbalance and Reactive Oxygen Species.
期刊: Current issues in molecular biology 发表日期: 2025-Aug-13 链接: PubMed
摘要
Reproductive infertility is characterized by the inability to achieve pregnancy after a year or more of unprotected sexual intercourse. This review highlights the significant impact of exposure to both types of heavy metals (essential and non-essential) on the reproductive performance of various species, particularly humans. Heavy metals present a high atomic density and weight, including lead, mercury, cadmium, nickel, chromium, and arsenic, and are delivered into the environment through natural and human activities, posing a threat to ecological systems and human reproductive health. These heavy metals have the potential for bioaccumulation and can adversely affect male fertility and sperm quality due to their role in disrupting endocrine functions, altering hormone levels responsible for sperm production, and inducing oxidative stress. The elevated production of reactive oxygen species (ROS) exceeds the capability of antioxidants and can lead to the alteration of sperm quality. Seminal fluid contains antioxidants like vitamin C, vitamin E, zinc, and selenium to counteract the impacts of ROS and also to preserve the sperm function. This review aims also to explore the impact of heavy metals on sperm quality and their relationship with antioxidant imbalance and ROS. The exposure to heavy metals whether through occupational or environmental means increases the production of ROS and therefore leads to an imbalance of antioxidants production. All these factors have no doubt an impact on male reproductive health.
43. Is meningococcal B vaccination needed in the post-COVID-19 world?
期刊: Biomedica : revista del Instituto Nacional de Salud 发表日期: 2025-Aug-11 链接: PubMed
摘要
Neisseria meningitidis is the main cause of bacterial meningitis worldwide and is transmitted through respiratory secretions. Meningitis is a serious public health problema because of its high morbidity and mortality rates and the risk of causing epidemics. Although vaccines are available to prevent meningococcal disease, serogroup B infections are still challenging, given that many countries do not include meningococcal B vaccines in their national immunization programs. In addition, recent data suggests somewhat sustained N. meningitidis B infections during the COVID-19 pandemic and increasing levels of meningococcal disease after its control. These findings agree with previous observations indicating that respiratory viruses facilitate respiratory bacterial infections. This essay intends to present epidemiological data on meningococcal disease and discusses studies exploring why the prevention of bacterial and viral infections is an intricate subject.
44. Bothropic snakebite in preterm pregnancy: Antivenom and clinical outcome in mother and newborn in Cúcuta, Colombia.
期刊: Biomedica : revista del Instituto Nacional de Salud 发表日期: 2025-Aug-11 链接: PubMed
摘要
Snakebite envenomation remains a neglected public health problem in many tropical and subtropical countries. It mainly affects rural populations and has a higher incidence in men. Most cases have been reported in Africa, Latin America, and Asia. More than 300 species of snakes have been identified in Colombia, of which around 18% are of medical importance. This fact places the country as the third with the highest number of cases in the region, with 6,231 reported by 2023. Snakebite envenomation in pregnant women is a rare event, and it implies a higher risk of fetal and neonatal death. We report the case of a newborn with neonatal hypoxia and fetal distress, resulting from a cesarean section of a 22-year-old primigravida at 36 weeks of gestation after an ophidian accident involving a bite in the dorsum of her left hand. The newborn was admitted to the intensive care unit in critical condition and with progressive clinical deterioration. However, following the timely administration of antivenom and mechanical ventilation, the infant showed a remarkable recovery and was discharged after only 12 days of hospitalization. We underline the need to improve the availability of antivenoms and to strengthen pharmacovigilance systems to ensure their effectiveness and safety. In conclusion, this clinical case highlights the importance of an early consultation, the availability and prompt administration of the antivenom, and the expertise of healthcare workers in managing this event in pregnant women and neonates.
45. Brief Manual for Multi-Modal Motion-Assisted Memory Desensitization and Reconsolidation Therapy for the Treatment of Post-traumatic Stress Disorder.
期刊: Psychiatry and clinical psychopharmacology 发表日期: 2025-Aug-11 链接: PubMed
摘要
Multi-Modal Motion-Assisted Memory Desensitization and Reconsolidation (3MDR) is an innovative exposure-based immersive psychotherapeutic intervention for the treatment of post-traumatic conditions such as post-traumatic stress disorder (PTSD) and other related trauma disorders. This manual reviews the theoretical foundations, protocol, and key therapeutic processes of 3MDR, emphasizing its applicability across clinical and research settings. Developed to overcome barriers to traditional trauma-focused psychotherapies, 3MDR combines immersive virtual reality (VR), motion-assisted engagement, and personalized trauma cues to facilitate memory processing and emotional reconsolidation. The 3MDR integrates VR technology, treadmill-assisted movement, and dual-attention tasks to create a dynamic and interactive therapeutic environment. The intervention consists of 3 phases: pre-platform preparation, platform exposure, and post-platform reconsolidation, allowing for structured and progressive trauma processing. Patients engage with self-selected trauma-related images and music, guided by a therapist, to confront distressing memories, reduce avoidance, and foster emotional regulation. The dual-attention task and affect labeling enhance cognitive and emotional integration, while walking promotes a sense of agency and movement through trauma. Clinical research demonstrates 3MDR’s efficacy in reducing PTSD symptoms, depression, and anxiety, with high acceptability and low dropout rates among military personnel, veterans, and first responders. Emerging evidence suggests its adaptability for diverse populations, including civilians and individuals with complex trauma histories. This manual provides detailed guidance for implementing 3MDR, underscoring the importance of therapist training, ethical considerations, and continued research to optimize its application and expand access to this promising intervention. This manual should be seen as a companion and not a replacement for training.
46. Linguistic Analysis of Patients' Labels During 3MDR Psychotherapy.
期刊: Psychiatry and clinical psychopharmacology 发表日期: 2025-Aug-11 链接: PubMed
摘要
Background: This study explores the role of linguistic labels expressed by patients during Motion-assisted Multi-modal Memory Desensitisation and Reconsolidation (3MDR) therapy for post-traumatic stress disorder (PTSD). Labels represent a patient’s key emotional, cognitive, and physical reactions to images associated with traumatic experiences. By analyzing labels, the goal is to provide insights into their progress throughout the therapeutic process. Methods: Data were collected from 6 patients who underwent 3MDR therapy across 6 sessions. A total of 1060 labels associated with trauma-related images were analyzed, with 91.3% of the data included after excluding irrelevant or ambiguous responses. Patient-generated labels were categorized and analyzed based on emotional tone, somatosensory processes, verb tense, and word count. The Friedman test was used to perform the statistical analysis. In case of significance, further comparisons were performed with the Wilcoxon signed-rank test. Results: The linguistic analysis revealed observable trends in patient progress. Use of present verb tense increased, indicating a shift towards present-moment awareness. Sentence word count also steadily increased, reflecting patients’ improved ability to articulate their emotions. Results of positive and negative emotional tone, past and future verb tense usage, somatosensory processes, and single words were not significant, suggesting that further exploration of these aspects with a larger dataset could give further insights into their importance. Conclusion: This study demonstrates that linguistic analysis of patient-generated labels during 3MDR therapy can offer valuable insights into patient progress. The findings suggest that as therapy progresses, patients become more expressive and articulate, and are able to live more in the present. Further research with larger datasets is recommended to better understand the role of language in PTSD therapy and its potential for predicting therapeutic outcomes.
47. Government Housing Assistance and Risk of Medical Financial Hardship Among Cancer Survivors.
期刊: JAMA network open 发表日期: 2025-Aug-01 链接: PubMed
摘要
This cross-sectional study examines the association between housing assistance and medical financial hardship among renters with a history of cancer.
48. Automated Tobacco Cessation Intervention for Parents in Pediatric Primary Care: A Cluster-Randomized Clinical Trial.
期刊: JAMA network open 发表日期: 2025-Aug-01 链接: PubMed
摘要
Treatment for tobacco use for parents in pediatric primary care settings is rarely provided but may support cessation and reduce childhood tobacco smoke exposure. To study the integration of the automated Clinical Effort Against Secondhand Smoke Exposure (eCEASE) tobacco cessation intervention into pediatric primary care via the electronic health record (EHR). This cluster-randomized clinical trial was conducted from July 16, 2021, to August 15, 2023, at 12 pediatric primary care practices in the Philadelphia, Pennsylvania, region. Participants included parents who used combusted tobacco in the past 7 days and attended a child’s preventive health care visit. In all practices, household members completed EHR previsit questionnaires about tobacco use. Parents in intervention practices were proactively offered eCEASE (automated delivery of nicotine replacement therapy [NRT], quitline and/or SmokefreeTXT enrollment, and navigator support). Control practice parents received usual care. The primary outcome was biochemically confirmed 7-day abstinence from combusted tobacco use by parents at the 1-year follow-up. Secondary outcomes included NRT and quitline and/or SmokefreeTXT use and recent quit attempts. Changes in cigarettes per day and smoking frequency (daily or nondaily) from baseline to 1-year follow-up were also examined. Of 817 enrolled smoking parents (672 [82.3%] female), 323 of 408 (79.2%) in the intervention arm (6 practices) and 326 of 409 (79.7%) in the control arm (6 practices) were mothers; mean (SD) age was 36.17 (8.67) years. The follow-up survey was completed by 367 of 408 parents (90.0%) in the intervention arm and 368 of 409 (90.0%) in the control arm. Biochemically confirmed 7-day abstinence rates were 34 of 408 (8.3%) in the intervention arm vs 26 of 409 (6.4%) in the control arm (adjusted odds ratio, 1.34; 95% CI, 0.79-2.29). Among those who completed follow-up, 177 of 367 (48.2%) in the intervention arm vs 59 of 368 (16.0%) in the control arm reported using NRT; 93 of 367 (22.8%) and 8 of 368 (2.2%), respectively, reported using quitline and/or SmokefreeTXT messaging; and 294 of 367 (80.1%) vs 258 of 368 (70.1%), respectively, reported a quit attempt in the last 3 months. Compared with control practices, intervention practices reported a greater reduction in the mean (SD) number of cigarettes smoked daily (-3.32 [5.39] vs -1.81 [5.84]) and a greater reduction in the mean (SD) percentage of daily smokers (-35.2% [2.6%] vs -25.8% [2.6%]). In this cluster-randomized clinical trial of an automated intervention to treat parental tobacco use in pediatric practices, the intervention did not significantly improve the primary outcome of quit rate at 1 year. Findings in this trial demonstrated increased treatment engagement and reductions in cigarette consumption, but additional strategies are needed to improve quit rates. ClinicalTrials.gov Identifier: NCT04974736.
49. Integrating Multi-Omics Data Using Machine Learning to Explore New Therapeutic Targets for Acute Kidney Injury.
期刊: Journal of cellular and molecular medicine 发表日期: 2025-Aug 链接: PubMed
摘要
Renal ischemia-reperfusion (I/R) injury is an unavoidable complication associated with renal transplantation, and currently, there are no targeted therapeutic interventions. The objective of this study was to explore the molecular mechanisms that contribute to I/R-induced acute kidney injury (I/R-AKI) and to discover potential targets for effective renal safeguarding. Bioinformatics techniques were employed to analyse critical genes regulating I/R-AKI at the single-cell level and to develop diagnostic models. Additionally, key pharmacological agents that inhibit the expression of target genes were identified for subsequent experimental validation. Pathological changes in the kidneys of I/R mice and patients with AKI were observed using immunofluorescence, western blotting, immunohistochemistry and transmission electron microscopy. We developed and validated a robust diagnostic model for I/R-AKI. The results suggest that ADAMTS1 acts as a promoter of renal I/R-AKI. In I/R-AKI, ADAMTS1 was significantly upregulated in renal tubular epithelial cells. Furthermore, apoptosis mediated by the mitochondrial pathway was a critical factor in the progression of renal I/R injury. In mouse models of I/R-AKI, the inhibition of ADAMTS1 with troglitazone significantly reduced both functional and histological damage. The diagnostic model can serve as a valuable instrument for diagnosing I/R-AKI. Furthermore, troglitazone can significantly contribute to managing I/R-AKI by inhibiting the expression of ADAMTS1. This study provides critical insights that may inform future research on therapeutic targets for renal ischaemia-reperfusion injury.
50. From Amyloid to Synaptic Dysfunction: Biomarker-Driven Insights into Alzheimer's Disease.
期刊: Current issues in molecular biology 发表日期: 2025-Jul-22 链接: PubMed
摘要
Alzheimer’s disease (AD) is the most prevalent neurodegenerative disorder and represents a major public health challenge. With increasing life expectancy, the incidence of AD has also increased, highlighting the need for early diagnosis and improved monitoring. Traditionally, diagnosis has relied on clinical symptoms and neuroimaging; however, the introduction of biomarkers has revolutionized disease assessment. Traditional biomarkers, including the Aβ42/Aβ40 ratio, phosphorylated tau (p-Tau181, p-Tau217, and p-Tau231), total tau (t-tau), and neurofilament light chain (NfL), are fundamental for staging AD progression. Updated guidelines introduced the ATX(N) model, which extends biomarker classification to include additional promising biomarkers, such as SNAP-25, YKL-40, GAP-43, VILIP-1, progranulin (PGRN), TREM2, IGF-1, hFABP, MCP-1, TDP-43, and BDNF. Recent advancements have allowed for the detection of these biomarkers not only in CSF but also in plasma and neuron-derived exosomes, offering less invasive and more accessible diagnostic options. This review explores established and emerging biomarkers and emphasizes their roles in early diagnosis, patient stratification, and precision medicine.
51. Systematic review and meta-analysis of the global prevalence and infection risk factors of Trichomonas vaginalis.
期刊: Parasite (Paris, France) 发表日期: 2025 链接: PubMed
摘要
Trichomoniasis is a globally prevalent sexually transmitted disease; however, comprehensive data on its global prevalence and incidence are relatively limited. In this study, we systematically retrieved relevant articles from PubMed, Google Scholar, Scopus, Ovid-Medline, and Web of Science to analyze the prevalence of Trichomonas vaginalis and its association with various infection risk factors. Among 5,437 publications released between 1992 and 2023, 425 articles focusing on the epidemiology of T. vaginalis were identified. The results revealed a global prevalence rate of T. vaginalis of 8% (95% CI: 7%-10%), with country-specific rates ranging from 1% to 35%. The prevalence of T. vaginalis was significantly higher in the behavioral subgroups, including smoking, drug use, and not using condoms, compared to the non-infection group, with a pooled odds ratio (OR) of 1.67 (95% CI: 1.39-2.0). Furthermore, the prevalence of T. vaginalis was significantly higher in the group with other sexually transmitted infections (STIs), including HIV, HSV, and Chlamydia infection compared to the non-infection group, with a pooled OR of 2.01 (95% CI: 1.48-2.72). Finally, socioeconomic factors such as being unmarried, having a low income, and unstable employment were associated with an increased risk of T. vaginalis infection, with a pooled OR of 1.36 (95% CI: 1.10-1.66). This study has significant public health relevance for the prevention and control of trichomoniasis. Revue systématique et méta-analyse de la prévalence mondiale et des facteurs de risque de l’infection à Trichomonas vaginalis. La trichomonase est une maladie sexuellement transmissible répandue dans le monde. Cependant, les données complètes sur sa prévalence et son incidence mondiales sont relativement limitées. Dans cette étude, nous avons systématiquement extrait des articles pertinents de PubMed, Google Scholar, Scopus, Ovid-Medline et Web of Science afin d’analyser la prévalence de Trichomonas vaginalis et son association avec divers facteurs de risque d’infection. Parmi 5 437 publications publiées entre 1992 et 2023, 425 articles portant sur l’épidémiologie de T. vaginalis ont été identifiés. Les résultats ont révélé un taux de prévalence mondial de T. vaginalis de 8% (IC à 95 % : 7% - 10%), avec des taux spécifiques à chaque pays allant de 1 % à 35 %. La prévalence de T. vaginalis était significativement plus élevée dans les sous-groupes comportementaux incluant le tabagisme, la consommation de drogues et la non-utilisation de préservatifs par rapport au groupe non infecté, avec un rapport de cotes (RC) groupé de 1,67 (IC à 95 % : 1,39 - 2,0). De plus, la prévalence de T. vaginalis était significativement plus élevée dans le groupe avec d’autres infections sexuellement transmissibles (IST) incluant le VIH, le VHS et l’infection à Chlamydia par rapport au groupe non infecté, avec un RC groupé de 2,01 (IC à 95 % : 1,48 - 2,72). Enfin, des facteurs socio-économiques tels que le célibat, un faible revenu et un emploi instable étaient associés à un risque accru d’infection à T. vaginalis, avec un RC groupé de 1,36 (IC à 95 % : 1,10 - 1,66). Cette étude est pertinente en matière de santé publique pour la prévention et le contrôle de la trichomonase.
52. Evaluating advance peace in Fresno, California: An interrupted times series analysis of a community-based gun violence intervention.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Gun violence is a critical public health issue, contributing to the disproportionate burden of health inequities among racially and economically marginalized populations. Advance Peace, a community-driven gun reduction program that integrates street outreach workers to interrupt conflicts with trauma-informed programming to provide mentorship and support for young people at the center of urban gun violence, may be a strategy to reduce gun violence and build healthy communities. We assessed whether the implementation of Advance Peace in Fresno, California was associated with a reduction in gun-related violence, including homicides and assaults. We hypothesized that post-implementation of Advance Peace, there would be a reduction in both gun-related homicides and assaults. Leveraging crime statistics from the Fresno Police Department on gun-related homicides and assaults between January 2014 and June 2023, we evaluated the impact of Advance Peace programming, implemented beginning in July 2021, on gun violence in Fresno. Descriptive analysis assessed average gun violence rates over time. We used interrupted time series models to assess the rates of gun violence associated with the implementation of Advance Peace in Fresno. In Fresno, there was evidence of a reduction in crime rates following the introduction of Advance Peace intervention. Two years post-intervention, there was a 46% decrease in the rate of all gun-related crimes, including both homicides and assaults (rate ratio: 0.54, 95% CI: 0.36-0.81). The intervention was also associated with a reduction in the rate of gun-related homicides (RR = 0.45, 95% CI: 0.21-0.95) and the rate of gun-related assaults (RR = 0.58, 95% CI: 0.38-0.89). Findings from this study demonstrate that Advance Peace may be an effective strategy to reduce gun violence.
53. Adoption of pandemic treaty is historic: Compliance and accountability must now follow.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
54. The relationship between social support and physical and mental health in an older male population: Evidence from China Health and Retirement Longitudinal Study (CHARLS).
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
In the context of increasing population aging and decreasing birth rate, it is of great practical significance to explore the impact of social support on the health of elderly men, which is of great practical significance to smoothly promote the strategy of healthy China and actively implement the strategy of population aging. Using the newly released 2020 China Health and Retirement Longitudinal Study (CHARLS) data for a total of 1,510 study participants, this paper analyzes the impact of social support on the health of elderly men using the Oder Probit, OLogit, and PSM models, and then explores the variability across age stages and literacy levels, and eliminates the propensity score matching modeling by endogeneity problems caused by sample selectivity bias. The study shows that social support significantly improves the health of older men in the context of a deepening aging process, showing positive improvements in both self-assessed health and mental health. The robustness test (by replacing the econometric model) further confirmed the reliability of the findings. Heterogeneity tests, on the other hand, revealed significant differences in the impact of social support on the health of male older adults: its health-enhancing effect was more pronounced in less literate male older adults compared to the more literate group. The results of the endogeneity analysis showed that the PSM model effectively mitigated the endogeneity problem of the model. Failure to deal with endogeneity would lead to underestimation of two aspects: first, the health-enhancing effect of social support on self-assessed health of male older adults; and second, its improvement effect on mental health. Therefore, the Chinese government should pay more attention to the key role of social support in improving the health of male older adults, and take diversified and innovative initiatives to focus on enhancing social support in order to more effectively promote the goal of healthy aging.