公共卫生研究摘要 (2025-08-29)
共收录 57 篇研究文章
1. A Global and Some National Perspectives on the Current Evidence of Interventions on Fruit and Vegetable Intake in Low-, Middle-, and High-Income Countries.
期刊: Food and nutrition bulletin 发表日期: 2025-Sep 链接: PubMed
摘要
Adequate amounts of fruit and vegetables (F&V) are an important part of a healthy diet, yet intake is suboptimal in most population groups worldwide. To better understand the evidence of strategies aiming to improve F&V intake, we conducted a scoping review of interventions assessing the impact on F&V intake, including those aiming to improve F&V intake explicitly and those targeting diet, health, lifestyle, or food environment generally. Among all eligible interventions reviewed, most of which were implemented in high-income countries, about half reported a significant positive impact on fruit and/or vegetable intake. Interventions that used a multicomponent strategy (61%) and those that focused on F&V specifically (72%) were most likely to find a significant increase in fruit and/or vegetable intake. Detailed summaries are provided in 2 accompanying articles. In the present article, we put these findings into perspective. Specifically, we considered the evidence for 4 target countries of the Fruit and Vegetables for Sustainable Healthy Diets Initiative: Benin, the Philippines, Sri Lanka, and Tanzania. When considering available evidence at the national level, there is a paucity of information from intervention trials despite evidence of inadequate F&V intakes in each of these countries. When considering available evidence at the global level, and especially for low-and-middle income countries, there is a critical need to strengthen the evidence across various intervention strategies, particularly related to targeting, timing, intensity, duration, frequency, and other key characteristics, to better understand how to enhance their impact on F&V intake in various population groups and contexts. Eating enough fruit and vegetables is important for health, but most population groups worldwide do not eat enough. To better understand the evidence of strategies aiming to improve fruit and vegetable intake, we conducted a scoping review of interventions assessing the impact on fruit and vegetable intake. We considered intervention strategies that aimed to improve fruit and vegetable intake specifically and also those targeting diet, health, lifestyle, or food environment generally. Most of the eligible interventions were conducted in high-income countries. About half of all eligible interventions reviewed reported a significant positive impact on fruit and/or vegetable intake. Interventions that used a multicomponent strategy (61%) and those that focused on F&V specifically (72%) were most likely to find a significant increase in fruit and/or vegetable intake. Detailed summaries are provided in 2 accompanying articles. Here, we put these findings into perspective. Specifically, we considered the evidence for 4 target countries of the Fruit and Vegetables for Sustainable Healthy Diets Initiative: Benin, the Philippines, Sri Lanka, and Tanzania. When considering available evidence at the national level, there is limited information from intervention trials despite evidence of inadequate fruit and vegetable intakes in each of these countries. When considering available evidence at the global level, and especially for low-and-middle income countries, there is a critical need to strengthen the evidence across various intervention strategies, particularly related to targeting, timing, intensity, duration, frequency, and other key characteristics, to better understand how to enhance their impact on fruit and vegetable intake in various population groups and contexts.
2. Processes for Developing Plain Language Versions of Guidelines Recommendations: A Scoping Review.
期刊: Journal of evaluation in clinical practice 发表日期: 2025-Sep 链接: PubMed
摘要
Plain language recommendations (PLRs) offer clear and understandable statements based on trustworthy guidelines. We aimed to synthesise methodological evidence for developing PLRs in the health care context. We followed the JBI methodology for scoping review development and the PRISMA-ScR guidelines for scoping review reporting. PLRs in the context of health care guidelines or patient versions of guidelines were included. A systematic search was run in MEDLINE (Ovid), Embase (Ovid), and the repositories of guideline developers until November 2023. Due to the research´s longitudinal nature, the search was updated in May 2025 to verify findings gathered so far. Reviewers extracted data independently and synthesised evidence narratively. In total, 2512 citations and 66 repositories of guideline developers were screened. Nine articles from databases and eight documents representing seven sources of evidence from guideline developers’ repositories were included in the final synthesis. Information about PLRs, their development, and methodology were summarised. Various infographics are used when creating PLRs. The target groups of PLRs are, e.g. patients, policymakers, the public, and healthcare providers. The patients could be involved in creating PLRs. The developers can draw from the GIN Public Toolkit, RIGHT-PVG checklist or DISCERN. Although these methodologies generally cover the development of knowledge translation tools and patients’ version of guidelines (PVGs). Numerous tools can be used to translate scientific language and to formulate PLRs. We propose policy support for the conduct and implementation of PLRs for healthcare guidelines drawn from available evidence-based resources identified by our review. It is desirable to report approaches for communicating recommendations from healthcare guidelines and verify the actionability and understandability of these formats.
3. The development of a Community Service Announcement to raise awareness of the Home Medicines Review health service program.
期刊: Australasian journal on ageing 发表日期: 2025-Sep 链接: PubMed
摘要
Home Medicines Reviews (HMRs) conducted by credentialed pharmacists in response to referrals from medical practitioners are funded by the Australian government to improve the quality use of medicines. In late 2023, a grassroots group of credentialed pharmacists created a Community Service Announcement (CSA) to raise consumer awareness of the HMR program. Community Service Announcements are allocated airtime by mainstream media (e.g. television and radio stations) for promoting messaging in the public interest, such as health services. The HMR awareness CSA was funded by 250 donors through a GoFundMe campaign. Two days of filming with pharmacists, doctors and patients across three rural and regional areas resulted in a 28-s video and corresponding radio sound bites. The CSA aired on major national Australian broadcast networks with coverage during both on-peak and off-peak times across all states and territories. The total value of the television advertising was estimated at AUD1.65 million. Radio messages were aired 36 times over a week on stations nationwide, reaching an estimated 1,911,300 listeners, approximately 8% of the Australian population. This CSA campaign illustrated the potential of health professional initiatives to raise awareness of government health programs. By leveraging crowdfunding and community support, this activity demonstrated a model for other health professionals seeking to promote similar health promotion and awareness initiatives.
4. Caesarean section rate trend in the Calabria Region according to Robson's Ten Group Classification System: a population-based study.
期刊: Recenti progressi in medicina 发表日期: 2025-Sep 链接: PubMed
摘要
The global increase in caesarean section (CS) rates raises concerns about maternal and neonatal outcomes. Italy, with one of the highest CS rates in Europe, especially in the Calabria Region, faces challenges in reducing this trend. The Calabria Region has joined the “Easy-Net” Network Program (NET-2016-02364191) for the evaluation of audit & feedback (A&F) interventions to reduce CS rate. This study aims to analyze past trends, describe maternity unit (MU) characteristics, and provide a baseline assessment of CS rates using the Robson’s Ten Group Classification System (TGCS). This population-based cross-sectional study analyses CS rates using data from National and Regional Birth Registers, categorizing women with the Robson’s TGCS. From 2017 to 2020, 54,041 births were registered in the Calabria Region. The results reveal a fluctuating CS rate (36.2%-38.1%) with variations from different Robson groups. Group 5 (previous CS) consistently increased, impacting overall rates, while Group 1 (nulliparous, cephalic, spontaneous labor) decreased. The groups 2b (6.8%-4.8%) and 4b (2.5%-1.8%), which represent respectively nulliparous and multiparous women with pre-labour CS, showed high rates despite their reduction over the years. In 2020, variations in CS rates across 11 MUs highlighted complexities, emphasizing the need for localized interventions. The study highlights the critical issue of high CS rates in the Calabria Region. It is advisable to monitor and reduce unnecessary CSs through evidence-based interventions, taking advantage of the Robson classification and an A&F strategy. These findings guide future efforts to enhance CS appropriateness and improve maternal and child health outcomes.
5. New Zealand 1986 Very Low Birthweight Follow-up Study: the third decade.
期刊: The New Zealand medical journal 发表日期: 2025-Aug-29 链接: PubMed
摘要
Exposures in utero and in early life have the potential to influence health across the lifespan through neurological, epigenetic and other physiological processes. Very low birthweight (VLBW; <1,500g) and very preterm (VP; <32 weeks gestation) births constitute around 2% of live births but have significant child, family and public health impacts neonatally and longer term. Parents/caregivers, funders and society want to know the quality of that survival across the lifecourse. The New Zealand 1986 Very Low Birthweight Follow-up Study is a population-based, longitudinal study that has followed a national cohort of individuals from birth in 1986 across childhood and into adulthood. At a mean 28.5 years, 250 VLBW adults (77% survivors; 25% Māori) and 100 term-born controls participated in follow-up, with 229 VLBW adults and all controls attending a 2-day medical and neurocognitive assessment. The aim of this report is to give an overview of the published major findings from the 28-year assessments. The majority of VLBW young adults were living healthy productive lives, similar to their term-born peers. Biomedical measurements were mostly in the normal range, although between-group mean differences tended to favour the controls, suggesting potential risk of premature organ function decline within the VLBW group. We compare our results with other emerging international data and discuss the implications for future research and possible interventions across the lifecourse to optimise outcomes for this vulnerable group.
6. Ambulatory sensitive hospitalisations among people accessing mental health and addiction services: a retrospective cross-sectional study using national population data.
期刊: The New Zealand medical journal 发表日期: 2025-Aug-29 链接: PubMed
摘要
Ambulatory sensitive hospitalisations (ASHs) are hospital admissions for conditions potentially avoidable through timely and effective primary healthcare. ASH rates can indicate healthcare quality and access. This study examines ASH rates among people accessing mental health and addiction (MHA) services in Aotearoa New Zealand. Retrospective analyses of national MHA service use linked to hospital admission records, compared to total population between 1 July 2012 and 30 June 2018, were conducted. The MHA cohort includes people aged 45-64 with at least one MHA service contact during the study period or 2 years prior. MHA service users were most commonly hospitalised for angina (26.0%) and chronic obstructive pulmonary disease (COPD; 11.6%). Adjusting for age and ethnicity, the MHA cohort’s ASH rate was 2.38 times that of the total population, with higher rates for epilepsy (adjusted rate ratio [ARR]=5.96), COPD (ARR=4.32), diabetes (ARR=3.47) and angina (ARR=2.40). Findings indicate potentially preventable physical health disparities within and between people accessing MHA services, highlighting the need to improve primary care access. Practice implications include integrated care, prevention and workforce development to reduce ASH and health disparities for people using MHA services.
7. The one-hundred women study: characteristics of New Zealand women with severe mental illness.
期刊: The New Zealand medical journal 发表日期: 2025-Aug-29 链接: PubMed
摘要
Severe mental illness (SMI) and adverse childhood experiences are associated with chronic physical illness and complex health and welfare needs. In this 100-women study, we aimed to identify health-related characteristics of women referred to community mental health clinics (CMHCs) to inform interventions in primary and specialist health services in supporting optimal health. Data were collected from healthcare records of a randomised sample of 100 women using a REDCap questionnaire, designed to collate information on psychiatric diagnoses, trauma experiences, treatment and healthcare use. Statistical analyses were performed to determine differences between ethnic groups. One-third had two or more psychiatric diagnoses, one-third were under mental health legislation and 81% reported suicidal ideation. Traumatic experiences were documented in 90% and 32% reported four or more adverse childhood experiences. Fourteen percent of mothers in the study had children who were not in their care. More than one-quarter (27%) were migrants or refugees. This research reveals adversity associated with women who are in the care of CMHCs, which confer substantial household vulnerability. The intergenerational effects of poor maternal mental health influence and shape the lives of children. The 100-women study presents compelling reasons to invest in women’s health and early in their children’s life trajectory. Clinicians need to consider women’s complex array of needs at all points of health service access. We recommend routine enquiry and more precise documentation about women’s health issues, pregnancy, parenting and adverse childhood experiences. Women with SMI are a strategic target for integrated, holistic, trauma-informed interventions with potential intergenerational impact.
8. Recovery indicators from the perspective of patients with chronic low back pain: a cross-sectional survey.
期刊: Pain management 发表日期: 2025-Aug-28 链接: PubMed
摘要
In low back pain (LBP) research, recovery is commonly used as an outcome measure. However, there is no method used to measure recovery or acceptable definition for recovery. This research aims to investigate patients’ perceptions of recovery from LBP. A cross-sectional survey was conducted in which 350 patients with chronic LBP participated. Demographic and clinical information was collected by a comprehensive and inclusive questionnaire. A checklist of improvement indicators was given to the patients and completed by them. It was aimed to identify the most important criteria for recovery in patients with chronic LBP. The results showed that pain reduction alone is not a reliable indicator of recovery. The patients’ view about the recovery from chronic LBP includes a wide range of factors in different areas of symptomatic improvement, fear of recurrence injury, functional disability, fatigue and reduced energy level. Also, a significant correlation was observed between recovery indicators and pain duration, body mass index, and pain intensity in patients with chronic LBP. The framework of recovery for patients with chronic LBP is complicated and is a highly individual structure. It is determined by the impact of symptoms on activities of daily living factors. Low back pain (LBP) is described as pain, muscle stiffness localized at the edges of the lower ribs and above the gluteal. Even after 1 year, more than one-third of patients have persistent symptoms. These findings suggest that either we lack effective treatments or we are measuring inappropriate outcomes. This study explores patients’ perceptions of recovery from LBP, about which little is known. A checklist of improvement indicators was administered to patients with LBP to identify the most important criteria for recovery. The results showed that pain reduction alone is not the most important indicator of recovery. The patients’ view about the recovery from LBP includes reducing the symptoms of disease, fear of recurrence injury, disability, fatigue and reduced energy level. It is determined by assessing the impact of different symptoms of LBP on daily activities and social life, as well as quality of life.
9. Plant-Based Dietary Patterns Associated With Reduced Risk of All-Cause Mortality in Diabetes Subgroups: A Prospective Cohort Study From the UK Biobank.
期刊: Diabetes care 发表日期: 2025-Aug-28 链接: PubMed
摘要
To investigate the association between adherence to a plant-based dietary index (PDI), healthy PDI, and unhealthy PDI with all-cause mortality in people with type 2 diabetes and to assess whether associations varied by diabetes subgroups. We included 4,829 UK Biobank participants with type 2 diabetes and at least two 24-h dietary recalls. We generated overall, healthy, and unhealthy scores. Multivariable Cox regression estimated hazard ratios (HRs) and 95% CIs for all-cause mortality, comparing the highest tertile (T3) with the lowest T1 of adherence to PDI, a healthy PDI, and an unhealthy PDI. Interactions between PDI adherence and diabetes subgroups (HbA1c, waist circumference, age at diagnosis, diabetes duration) were assessed by two-dimensional B-splines and by including product terms into the model. During a mean follow-up of 11.3 years, 679 deaths occurred. Individuals with the highest PDI adherence, compared with those with lowest, were at lower risk of all-cause mortality (T3 vs. T1: HR 0.79 [95% CI 0.63; 0.99]), and a similar direction was observed for those with a healthy PDI (0.82 [0.67; 1.02]) but the 95% CI included the null value. Unhealthy PDI was associated with increased mortality risk (1.24 [1.00; 1.54]). The associations of PDI, healthy PDI, and unhealthy PDI with all-cause mortality risk were more pronounced for those with poorer glycemic control, higher waist circumference, diagnosis earlier in life, and longer diabetes duration. Higher PDI adherence was associated with decreased mortality risk and higher unhealthy PDI adherence with an increased mortality risk. There was an indication for differences in these association depending on diabetes subgroups.
10. Lived Experiences of Families Navigating Safety Net Expansions and Retractions During the Pandemic: A Qualitative Study.
期刊: American journal of public health 发表日期: 2025-Aug-28 链接: PubMed
摘要
Objectives. To understand the experiences of families with low income in California with pandemic safety net support expansions and retractions, including barriers to program access. Methods. Using open-ended questions, we explored the self-reported experiences of pandemic-era safety net expansions and expirations between January and June 2023 among a group of caregivers of young children (n = 44). We used the Immersion-Crystallization technique to analyze the data, creating a codebook and identifying themes as they emerged. Results. We identified 4 main themes, including appreciation for safety net expansions, varied experiences due to timing of supports, challenges meeting basic needs after expirations, and administrative burdens significantly impairing program access. Conclusions. The study themes highlighted how expansions to policies like the Child Tax Credit and Supplemental Nutrition Assistance Program improved food and housing security, and that unpredictable benefits, although appreciated, also added stress. Public Health Implications. State and federal policymakers should consider the poverty reduction and food and housing security benefits of expansions to pandemic-era supports that have expired when crafting future policy. They should pay special attention to addressing administrative barriers to reduce poverty-related health inequities. (Am J Public Health. Published online ahead of print August 28, 2025:e1-e12. https://doi.org/10.2105/AJPH.2025.308201).
11. The case for stronger regulation of deceptive nutrition-related claims on unhealthy food.
期刊: PLoS medicine 发表日期: 2025-Aug-28 链接: PubMed
摘要
Deceptive nutrition-related claims are pervasive on unhealthy packaged foods. This Perspective describes the potential for these claims to harm consumer health, and advocates for tighter regulation of misleading claims to empower individuals to make more nutritious choices.
12. Human gut microbiota-derived antimicrobials against Salmonella Typhi: diversity, mechanisms, and therapeutic potential.
期刊: Archives of microbiology 发表日期: 2025-Aug-28 链接: PubMed
摘要
Salmonella enterica serovar Typhi (S. Typhi) is a strictly human-restricted Gram-negative pathogen and the causative agent of typhoid fever, a major global health concern. Current treatment relies heavily on antibiotics, however, the rapid emergence of multidrug-resistant strains has severely compromised their efficacy, underscoring the urgent need for alternative therapeutic strategies. The human gut microbiota has emerged as a promising source of antimicrobial molecules, including both peptide and non-peptide compounds. These microbiota-derived agents can inhibit Gram-negative pathogens through diverse mechanisms, such as direct bactericidal activity, modulation of host immune responses, and promotion of colonization resistance. Recent advances in artificial intelligence (AI) and multi-omics technologies have further accelerated the discovery and functional characterization of gut-derived antimicrobials with potent activity against drug-resistant bacteria. In this review, we summarize current understanding of S. Typhi pathogenesis and resistance, highlight the diversity and mechanisms of gut microbiota-derived antimicrobials, and explore their translational potential as innovative therapeutic options for typhoid fever.
13. Nanoparticle Drug Delivery Systems for Atherosclerosis: Precision Targeting, Inflammatory Modulation, and Plaque Stabilization.
期刊: Advanced science (Weinheim, Baden-Wurttemberg, Germany) 发表日期: 2025-Aug-28 链接: PubMed
摘要
Atherosclerosis remains a leading contributor to cardiovascular morbidity and mortality, presenting considerable therapeutic challenges due to its multifaceted and complex pathogenesis. This review systematically explores the pathophysiological mechanisms underlying atherosclerosis and examines recent advances in nanoparticle drug delivery systems (NDDSs) tailored for atherosclerosis treatment. NDDS has many advantages in this setting. It can precisely modulate the cellular activities critical to atherosclerotic progression, and by using targeted delivery strategies directed at lesion-specific biomarkers and incorporating stimulus-responsive drug release mechanisms responsive to the plaque microenvironments, it can significantly increase therapeutic efficacy while minimizing adverse systemic and off-target effects. Thus, NDDS effectively addresses the limitations of traditional pharmacological treatments, enabling personalized interventions that can attenuate disease progression, stabilize vulnerable plaques, and facilitate plaque regression. This review highlights the transformative possibilities of NDDSs, emphasizing their potential to redefine current therapeutic paradigms and improve patient outcomes in atherosclerosis.
14. Midodrine exposure trends and outcomes reported to United States poison centers: 2000-2023.
期刊: Clinical toxicology (Philadelphia, Pa.) 发表日期: 2025-Aug-28 链接: PubMed
摘要
Midodrine is an oral alpha-1 adrenergic agonist used to treat orthostatic hypotension. Its vasoconstrictive properties can lead to hypertension and reflex bradycardia. We characterized midodrine exposures reported to United States poison centers from 2000 to 2023. We performed a retrospective analysis of single-substance midodrine exposures reported to the National Poison Data System®. Descriptive statistics were used to characterize temporal trends, demographics, exposure reasons, level of healthcare, and medical outcomes. National estimates of retail outpatient midodrine prescriptions during 2002-2023 were obtained from IQVIA Total Patient Tracker. The number of patients dispensed midodrine from retail pharmacies increased 695%, from 55,300 in 2002 to 439,659 in 2023. There were 1,935 midodrine exposures reported to the National Poison Data System® from 1 January 2000 to 31 December 2023. Exposures increased 714%, from 21 calls in 2000 to 171 calls in 2023. The most common features reported were hypertension in 277 (14.3%) and bradycardia in 197 (10.2%). Therapeutic errors accounted for most cases in most age groups except adolescents aged 13-19 years, in which suspected suicide was the most commonly reported reason (50.2%). Most exposures were managed at home. Among 866 patients who sought medical care, 437 (50.5%) were treated/evaluated and released, but 115 (13.3%) were admitted to a critical care unit. Midodrine exposures increased over time, particularly among individuals aged 20-59 years and 60 years and older, with a concomitant increase in retail midodrine dispensing. Although most exposures were managed at home, severe adverse effects have been reported, especially among patients with suspected suicidal ingestions compared to those with therapeutic errors. The National Poison Data System® is limited by its passive surveillance design, and not all exposures are reported. Better understanding of midodrine exposures and associated outcomes can inform poison center triage and medical management. Improved surveillance and clinician awareness may reduce morbidity and mortality associated with midodrine toxicity.
15. Patterns of Life-Sustaining Treatment Preferences Among Seriously Ill Veterans.
期刊: Journal of the American Geriatrics Society 发表日期: 2025-Aug-28 链接: PubMed
摘要
Goals of care conversations and documentation of life-sustaining treatment (LST) preferences through durable, portable medical orders are critical for aligning care with patient values. The stability of patient preferences over time remains uncertain, particularly among community-dwelling adults. The Department of Veterans Affairs Life-Sustaining Treatment Decisions Initiative provides a unique opportunity to examine preference trajectories among seriously ill Veterans using longitudinal real-world data. This analysis aimed to: identify cardiopulmonary resuscitation (CPR) preference trajectories, describe Veterans’ characteristics by trajectory, and examine associations between trajectories and demographic/clinical factors. This longitudinal observational analysis used VA Corporate Data Warehouse data to identify the population of Veterans with completed LST templates as of October 1, 2019 (N = 161,725). CPR preference (full code or do-not-resuscitate [DNR]) over 39 months was analyzed for stability using sequence analysis, and CPR preference trajectories were identified. Veterans’ characteristics were compared across trajectories, and multinomial logistic regression was used to assess associations with trajectory membership. Four CPR preference trajectories were identified: (1) persistent preference for DNR (39.8%), (2) code status fluctuation with early mortality (8.7%), (3) code status fluctuation with later mortality (7.3%), and (4) persistent preference for full code (44.3%). Older Veterans were more likely to persist in DNR preferences, while younger Veterans were in full code. Veterans having higher baseline comorbidities, chronic conditions such as heart failure, and higher hospitalization rates were at greater risk of having fluctuating preferences. Those with dementia had a greater likelihood of persistent DNR. This analysis provides critical insights into the complexity of CPR preference trajectories among Veterans, highlighting the need for nuanced, patient-centered approaches to advance care planning. By addressing dynamic clinical factors, leveraging hospitalizations as strategic opportunities, and incorporating culturally sensitive communication, healthcare providers can improve the alignment of treatment preferences with patients’ evolving goals and values.
16. Relapse rates in stable obsessive-compulsive disorder after antidepressant discontinuation versus maintenance: A systematic review and meta-analysis.
期刊: Psychological medicine 发表日期: 2025-Aug-28 链接: PubMed
摘要
The optimal duration for maintaining antidepressant treatment in individuals with obsessive-compulsive disorder (OCD) who achieve symptom stabilization remains unclear. This systematic review and pairwise meta-analysis of double-blind randomized placebo-controlled trials (DBRPCTs) compared antidepressant maintenance and antidepressant discontinuation groups in terms of relapse rate at each DBRPCT study endpoint (primary outcome), OCD symptom improvement, all-cause discontinuation, and adverse event-related discontinuation. Furthermore, relapse rates at 4, 8, 12, 16, 20, and 24 weeks were compared between the groups. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated. The absolute risk reduction (ARR) and number needed to treat to benefit (NNTB) for relapse rates were also estimated. Nine trials (n = 1084; mean age: 32.8 years; proportion of males: 53.3%) were included. The antidepressant maintenance group had lower relapse rates at each DBRPCT study endpoint (RR [95% CI] = 0.53 [0.42-0.68]; ARR = 21.0%; NNTB = 5) and lower all-cause and adverse event-related discontinuation rates than the antidepressant discontinuation group. The maintenance group also exhibited lower relapse rates at 4 weeks (RR [95% CI] = 0.47 [0.31-0.70]; ARR: not significant; NNTB: not significant), 8 weeks (0.42 [0.31-0.57]; 12.0%; 8), 12 weeks (0.43 [0.32-0.56]; 18.0%; 6), 16 weeks (0.41 [0.32-0.52]; 25.0%; 4), 20 weeks (0.43 [0.34-0.53]; 26.0%; 4), and 24 weeks (0.42 [0.33-0.52]; 27.0%; 4) than the discontinuation group. Moreover, the maintenance group outperformed the discontinuation group regarding OCD symptom improvement. Individuals with OCD may benefit from continued antidepressant treatment, provided that it is well tolerated.
17. Digital Health Interventions Providing Behavioral Assessment and Goal Prioritization Support: Scoping Review.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-28 链接: PubMed
摘要
Affordability of health care systems depends on populations’ engagement in preventive health behavior and appropriate self-management of long-term conditions. Digital health interventions (DHIs) could facilitate this by prompting and supporting individual health behavior change. Behavior change is often undermined by suboptimal prioritization of goals. Therefore, DHIs aiming to promote behavior change should help users identify behavior patterns that need changing and scaffold goal prioritization. This scoping review explores the extent to which DHIs are supporting users to identify and prioritize goals relevant to managing and improving health. The review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Web of Science (Core Collection), Scopus, Ovid (Embase, MEDLINE, PsycINFO, and Global Health), and EBSCOHOST (Academic Search Complete and CINAHL Complete) were searched for literature on the development and evaluation of digital interventions that (1) assess users’ current health or health-related behaviors and (2) offer support on prioritization of health-related goals. Fifty-six papers were included. These identified 19 unique DHIs. Targeted populations included the general population (n=10), those at risk of or diagnosed with cardiovascular disease (n=4), those at risk of or diagnosed with diabetes (n=2), those diagnosed with cancer (n=2), or those diagnosed with HIV (n=1). One DHI targeted preconception among African American women. All DHIs targeted physical activity and most (n=17) targeted diet and smoking, closely followed by alcohol use (n=15) and mental health (n=13). Social wellbeing (n=5), sleep (n=4), and pain (n=1) were less commonly included. All 19 DHIs included a health risk assessment with feedback identifying health domains in need of improvement, but only four asked users to select a prioritized change goal. Outcome evaluations were conducted for most (n=14), with nine DHIs evaluated using at least one randomized control trial (RCT). Almost half of all DHIs (n=9) reported at least one evaluation of behavioral outcomes, mostly employing RCTs (7/9). Six of 19 reported at least one evaluation of psychological health outcomes, again mostly employing RCTs (5/6). Among the seven DHIs for which behavioral outcomes were evaluated using a RCT, effects were mixed, with only one DHI showing significant effects across all assessed behavioral outcomes. Three found significant effects for some, but not all, outcomes or timepoints, and three found no significant effects. Although all 19 DHIs provided some advice about which health-related goals to prioritize, most did not actively prompt users to set such priorities. DHIs showing the most promise in terms of health behavior change were those that explicitly promoted users to prioritize changing specified health behaviors. This review highlights how DHIs could provide greater behavior change support and provides the basis for designing more effective DHIs.
18. Political Polarization During Disease Outbreaks: A Meta-Analysis of Archival Survey Data From Polio to COVID-19.
期刊: American journal of public health 发表日期: 2025-Aug-28 链接: PubMed
摘要
Objectives. To assess how political polarization during COVID-19 compares with that in past disease outbreaks in the United States. Methods. Using random-effects meta-analyses and mixed-effects meta-regressions, we searched the Roper Center for Public Opinion Research and estimated the association between polarization during COVID-19 and during non-COVID-19 disease outbreaks. Results. The study included 170 polls spanning 13 outbreaks over nearly 70 years. Polarization during COVID-19 was 5 and 12 times greater than in past disease outbreaks in terms of concern about infection and vaccine hesitancy, respectively. After we controlled for survey-level characteristics, COVID-19 was associated with 20.23 (95% confidence interval [CI] = 12.30, 28.17) and 25.89 (95% CI = 6.63, 45.16) additional percentage points of polarization regarding concern about infection and vaccine hesitancy, respectively-far higher than historical trends would predict. Conclusions. In terms of concern about infection and vaccine hesitancy, polarization during COVID-19 was substantially higher than in any other disease outbreak in modern American history for which we have relevant data. Public Health Implications. High levels of polarization do not appear endemic to disease outbreaks, suggesting such division may be preventable in the future. (Am J Public Health. Published online ahead of print August 28, 2025:e1-e13. https://doi.org/10.2105/AJPH.2025.308226).
19. Heavily polluted Tijuana River drives regional air quality crisis.
期刊: Science (New York, N.Y.) 发表日期: 2025-Aug-28 链接: PubMed
摘要
Industrial chemicals and untreated sewage have polluted the Tijuana River for decades, recently causing >1300 consecutive days of California beach closures. In summer 2024, wastewater flows surged to millions of gallons per day despite no rain, enhancing water-to-air transfer of hydrogen sulfide (H2S) and other toxic gases at a turbulent hotspot. High wastewater flows and low winds led to nighttime H2S peaks, reaching 4500 parts per billion (ppb)-exceeding typical urban levels of <1 ppb. H2S levels and community malodor reports were strongly correlated (correlation coefficient r = 0.92), validating long-dismissed community voices and highlighting an environmental injustice. This study demonstrates that poor water quality can substantially affect air quality-although rarely included in air quality models and health assessments-with far-reaching implications as polluted waterways increase globally.
20. Reproductive and Female Health in the Australian Defence Force 2002-2023: A Systematic Review and Synthesis.
期刊: Military medicine 发表日期: 2025-Aug-28 链接: PubMed
摘要
Military service involves potential exposure to a range of physical, chemical, and biological hazards that could impact reproductive health. Females represent 20% of Australian Defence Force (ADF) members and, like many military services, the ADF is prioritizing their recruitment and retention. However, given that females have different physiology and anthropometry, specific female occupational research is essential. This systematic review aimed to retrieve and summarize the findings of research involving currently serving ADF personnel with outcomes relevant to male or female reproductive health or any aspect of female health. Reproductive and female health studies between January 2002 and April 2023 that included serving ADF members were identified through a systematic search of 5 scientific databases. Data were extracted and synthesized, alongside a risk of bias assessment following PRISMA-ScR guidelines. Overall, 8 studies relating to reproductive health and 14 studies related to female health were identified. Studies were methodologically heterogeneous: few studies were at low risk of bias and few covered the same health outcome, preventing pooling of data. Four studies of males concluded that deployment to the Middle East was not associated with risk of infertility or birth defects. Female reproductive health studies provided very limited data. Other female health research primarily covered musculoskeletal disorders and injuries from basic training. Studies of reproductive and female health in ADF members do not currently provide a cohesive or comprehensive body of evidence in either area. This review serves as a systematic map of the existing evidence to identify gaps and set future strategic research agendas. More high-quality longitudinal studies with sex-stratified analyses are urgently needed, as is a strategic focus on health outcomes that may affect military preparedness and fitness for deployment.
21. Wearable Acquisition of Objective Military Environmental Exposures: Clinical Considerations for Delivery of Veterans Affairs Exposure-Informed Care.
期刊: Military medicine 发表日期: 2025-Aug-28 链接: PubMed
摘要
Wearables that characterize personal exposures are likely to play a critical role in the assessment of environmental health effects on military personnel and Veterans. The military operational environment has complex and often transient exposures that are extremely challenging to capture accurately through self-report, underscoring the need to measure environmental exposures more objectively at the individual level. In conjunction with area environmental monitoring, collecting wearable data as well as conducting clinical symptom assessments at the time of exposure, offers additional tools to estimate individual military exposure levels linked to risks of disease or injury. Specifically, wearables offer the ability to detect and identify the concentration of an exposure that can then be utilized to determine an exposure dose estimate when combined with measures of exposure frequency and duration (e.g., identification of the length of time of the exposure), its effect on the body or intensity (e.g., biological response during and after the exposure), as well as moderating effects (e.g., use of personal protective equipment (PPE), distance/shielding measures). Analysis of objective exposure data could improve the accuracy of these exposure dose estimates and therefore, enhances exposure disease risk paradigms and toxicity classification. This commentary emphasizes the growing need to study objective exposure data collection using wearable devices and the potential application of the data to inform clinical care.
22. Barriers and Facilitators to Disseminating Quality Improvement and Patient Safety Research: A Scoping Review.
期刊: International journal for quality in health care : journal of the International Society for Quality in Health Care 发表日期: 2025-Aug-28 链接: PubMed
摘要
Despite an abundance of Quality Improvement (QI) and Patient Safety (PS) research and on-the-ground initiatives, patients continue to suffer from iatrogenic harm. Addressing shortcomings in the dissemination of QI and PS research is one important step to improving patient care outcomes. The objective of this scoping review is to identify the barriers and facilitators, and related strategies/targets, to disseminating QI/PS research. The current review was conducted according to the JBI methodology for scoping reviews and PRISMA extension for scoping reviews (PRISMA-ScR). A protocol was registered on the Open Science Framework website (doi : 10.17605/OSF.IO/RT57F). Databases searched included Medline, CINAHL, and Embase. Studies detailing barriers and facilitators, or solutions, to QI/PS research published between 2001 and March 2024 were included. Data on barriers and facilitators were coded deductively according to the Theoretical Domains Framework (TDF). Searches identified 5,848 articles, of which 16 articles were included. Among studies seeking to understand (68.8%) barriers and facilitators to QI/PS dissemination, the TDF domain, environmental context and resources (ECR), was cited most frequently (68.8% of studies; e.g. availability of SQUIRE guidelines), followed by skills (43.8%; e.g. poor reporting of QI/PS work), belief about consequences (37.5%; e.g. clearly highlighting the potential outcomes of dissemination) and goals (31.3%; e.g. early planning for dissemination). Studies seeking to address factors influencing dissemination (31.3% of studies) applied structured mentorship and curricular interventions to improve QI/PS dissemination, and suggested/enacted strategies were most commonly related to the individual’s ECR (25%; e.g. provision of a writing coach), behavioural regulation (25%; e.g. improved rates of publication), and knowledge (25%; e.g. workshop introducing QI tools). Organisational commitment and resourcing, access to QI/PS tools, programmes and reporting guidelines, and dedicated time, funding and resources are needed, alongside training programmes that target QI/PS knowledge and skills, and promotional pathways that nurture QI/PS activity. Research is required to cultivate effective QI/PS training programmes for qualified healthcare professionals, examine the identified factors in PS research specifically, and to develop a consensus QI taxonomy to support the dissemination of QI research.
23. Exposome factors associated with multi-morbidity in older adults: a discovery-based cross-sectional analysis in the Longitudinal Aging Study Amsterdam.
期刊: European journal of public health 发表日期: 2025-Aug-28 链接: PubMed
摘要
Ageing populations and longer life expectancies challenge healthcare systems due to rising noncommunicable diseases (NCDs) and multi-morbidity. Designing healthier living environments may reduce population risks of NCD onset, but knowledge is needed on environmental factors related to NCDs in older adults. We therefore examined associations between residential neighbourhood built, physico-chemical, and sociodemographic environmental factors and NCD prevalence in the Netherlands among older adults. Cross-sectional data from 1578 older adults from the Longitudinal Aging Study Amsterdam (2008-09) were matched with environmental data from the Dutch Geoscience and Health Cohort Consortium (GECCO). Multivariable logistic regression analyses were conducted to assess the odds of having a single NCD versus no NCD and multi-morbidity versus no NCD, adjusted for sociodemographic factors. Participants had a mean age of 73.2 years, 55% were female, and 77% reported at least one NCD. Multi-morbidity was more common in women, who were also older and had lower education and income. Higher green space density within 500 m was significantly associated with lower odds of single NCD [odds ratio (OR): 0.52, 95% confidence interval (CI): 0.33-0.83]. A higher number of cars in a household also showed lower odds of single NCD (OR: 0.14, 95% CI: 0.04-0.55). No significant associations were observed for physico-chemical exposures. Results were consistent in sensitivity analyses. The findings underscore the need for urban planning and policies that support healthy ageing while embracing a longevity-ready perspective, accounting for the built, physico-chemical, and sociodemographic environments across the life-course.
24. Lysine demethylase 4A is a centrosome-associated protein required for centrosome integrity and genomic stability.
期刊: The FEBS journal 发表日期: 2025-Aug-28 链接: PubMed
摘要
Centrosomes play a fundamental role in nucleating and organizing microtubules in the cell and are vital for faithful chromosome segregation and maintenance of genomic stability. Loss of structural or functional integrity of centrosomes causes genomic instability and is a driver of oncogenesis. Here we identify lysine demethylase 4A (KDM4A), an epigenetic ‘eraser’ of chromatin methyl marks, as a centrosome-localized protein, visualized at the nanometer-scale resolution. We additionally uncovered that KDM4A demethylase enzymatic activity is required to maintain centrosome homeostasis and integrity; a previously unknown functionality unlinked to altered expression of genes regulating centrosome number. We find that KDM4A interacts with and localizes to the centrosome in all stages of mitosis, where it maintains centrosome numbers and centriole engagement during mitosis. Loss of KDM4A results in supernumerary centrosomes and accrual of chromosome segregation errors including chromatin bridges and micronuclei, markers of genomic instability. In summary, these data highlight a previously unknown role for an epigenetic ‘eraser’ regulating centrosome integrity, mitotic fidelity, and genomic stability at the centrosome.
25. Assessing carbon emissions in oculoplastics: blepharoplasty practices in diverse surgical settings.
期刊: Orbit (Amsterdam, Netherlands) 发表日期: 2025-Aug-28 链接: PubMed
摘要
Climate change poses a significant threat to global public health, with the healthcare sector contributing substantially to greenhouse gas emissions. Ophthalmic surgeries, particularly in operating rooms (ORs), generate significant waste and carbon emissions. This study compares the environmental impact of a single bilateral upper lid blepharoplasty performed in a privately owned versus a hospital-based ambulatory surgery center (ASC). A material flow analysis and waste audit were conducted for blepharoplasty procedures performed between June and July 2024 in two surgical settings: a privately owned ASC and a hospital-based ASC. Surgical supply inventories and utility usage were recorded through direct observation and post-operative audits. A cradle-to-grave life cycle assessment (LCA), following ISO 14,040 standards, was used to evaluate environmental impact in kilograms of carbon dioxide equivalents (kg CO₂e). Impact equivalencies were calculated for context. The hospital-based ASC generated 2,744.5 grams of waste per blepharoplasty versus 1,429.6 grams in the privately owned ASC - a 47.9% reduction. Carbon emissions were 9.7 kg CO₂e per case at the hospital-based ASC (equivalent to burning 12.1 pounds of coal), versus 5.0 kg CO₂e at the privately owned ASC (6.3 pounds of coal) - a 48.5% decrease. The hospital-based ASC produces more waste and emissions per blepharoplasty than the privately owned ASC.
26. Estrogen signaling is necessary for the sex difference in simulated jet lag in mice.
期刊: American journal of physiology. Endocrinology and metabolism 发表日期: 2025-Aug-28 链接: PubMed
摘要
The circadian system coordinates 24-hour cycles of internal biological processes with the environmental light-dark cycle. Abrupt shifts in the timing of the light-dark cycle misalign internal circadian clocks with the environment and cause jet lag until resynchronization occurs. The objective of this study was to investigate the sex difference in simulated jet lag in mice. Female mice resynchronized faster than male mice to 6-hour advances of the light-dark cycle that mimicked eastward travel. Circulating estradiol was necessary and sufficient for rapid resynchronization in female mice since ovariectomized females resynchronized slower than mice treated with estradiol. Disabling estrogen receptor alpha (ERα), but not ERβ or G-protein coupled estrogen receptor 1 (GPER1), abolished the sex difference in resynchronization. To investigate ERα-dependent mechanisms that regulate the rate of resynchronization, we measured the endogenous circadian period and the magnitudes of phase shifts to light pulses in male and female wild-type and ERα knockout mice. Wild-type females had shorter periods and greater phase delays in response to light pulses given in the early subjective night than male mice. Disabling ERα abolished the these sex differences by lengthening circadian period and reducing the magnitudes of phase delays. Together these data suggest that ERα alters the rate of resynchronization to shifted light-dark cycles by regulating period length and phase shift magnitude in female mice. Understanding the mechanisms underlying the sex difference in resynchronization to shifted light-dark cycles can be used to develop strategies to alleviate jet lag and circadian misalignment.
27. Understanding the Link Between Physical Activity and Work Ability in University Staff: Protocol for a Gender-Sensitive Cross-Sectional Study.
期刊: JMIR research protocols 发表日期: 2025-Aug-28 链接: PubMed
摘要
Physical inactivity represents a significant public health issue with substantial socioeconomic costs. In the autonomous Community of Madrid, 39.17% of the population does not meet the World Health Organization recommendations for physical activity (PA). Gender, sex, and occupational factors are well-established determinants of leisure-time physical activity (LTPA); yet, few studies have examined these factors among university staff. This study aims to analyze the relationship between LTPA and work ability among university staff in the autonomous Community of Madrid, considering the potential modifying effect of occupational PA. Secondary objectives include examining associations between LTPA, musculoskeletal disorders, health-related quality of life, physical and mental workload, and working conditions, with a focus on sex and gender differences. A cross-sectional study was designed involving 885 university staff members from the University of Alcalá, Madrid, Spain. Participants will complete an online survey, including sociodemographic questions and validated instruments: the Global Physical Activity Questionnaire, Work Ability Index, Nordic Musculoskeletal Questionnaire, Short Form-12 Health Survey, and the National Aeronautics and Space Administration Task Load Index. Descriptive and inferential statistics will be performed to assess the associations between LTPA, occupational PA, and work ability, adjusted for relevant covariates. This study was approved by the ethics committee of the University of Alcalá in November 2024. Recruitment began in December 2024 and will continue until June 2027. Data analysis will be conducted progressively. Results will be disseminated in peer-reviewed journals and presented at scientific conferences following gender-sensitive and transparent reporting standards. Understanding the determinants of PA and their interaction with work ability and gender may inform the development of targeted, culturally sensitive interventions to reduce sedentary behavior and its associated health and economic burdens in university staff. ClinicalTrials.gov NCT06723808; https://clinicaltrials.gov/study/NCT06723808. DERR1-10.2196/80298.
28. Potential of the Job Demands and Accommodation Planning Tool for Individuals Working With Mild Cognitive Impairment or Dementia.
期刊: Dementia (London, England) 发表日期: 2025-Aug-28 链接: PubMed
摘要
Individuals living with young onset dementia or mild cognitive impairment are typically working when cognitive decline emerges. Inability to maintain job demands can lead to loss of employment, loss of purpose and identity, financial instability, and withdrawal from social networks. The Job Demands and Accommodation Planning Tool was developed to identify workplace supports for individuals with episodic disabilities. The aim of this study was to explore the applicability of the Job Demands and Accommodation Planning Tool for individuals working with young onset dementia or mild cognitive impairment. Semi-structured interviews were conducted with 23 individuals: 11 in Canada, 7 in Finland and 5 in Sweden, where they described job demands and workplace challenges they faced. A secondary analysis of interview data was conducted using content analysis and a framework approach to code, categorize, and examine overlap with the Job Demands and Accommodations Planning Tool. Results showed that the Job Demands and Accommodation Planning Tool aligns well with the experiences of individuals living with young onset dementia or mild cognitive impairment. The Job Demands and Accommodation Planning Tool could inform workplace supports for people with young onset dementia or mild cognitive impairment to maintain their presence in the workforce.
29. Transitioning into informal care and occupational self-efficacy : A difference-in-differences propensity score matching analysis using representative German employee data.
期刊: Zeitschrift fur Gerontologie und Geriatrie 发表日期: 2025-Aug-28 链接: PubMed
摘要
Due to demographic ageing, the number of care receivers has been rising, while the number of caregivers is decreasing in many countries. Informal caregiving often begins while still in active employment often leading to role conflicts. The dual burden can negatively affect job performance and lead to changes in occupational self-efficacy. Despite being of high relevance for individuals, organizations and society, there is a research gap concerning occupational self-efficacy, which may serve as a mechanism for reduced working hours or exit from the labor market after taking on care responsibilities. Thus, this article analyzes the impact of transitioning into informal caregiving on occupational self-efficacy longitudinally. This study included the 2017, 2019 and 2021 waves of the Federal Institute for Occupational Safety and Health (BAuA) Working Time Survey, which is a representative panel study of employees in Germany. For each respondent, two waves were used (n ≥ 3052). Difference-in-differences (DiD) models with the transition into informal care with distinctions of different care frequencies as the treatment variables were calculated. To control for selection bias, propensity score matching (PSM) was applied. Based on the DID models, transitioning into at least occasionally caregiving had a negative effect on occupational self-efficacy, leading to a significant deterioration in composure in the face of occupational difficulties, ideas for solving problems at work and the ability to cope with most occupational demands. The results based on PSM supported these findings. With respect to, e.g., skilled labor shortages and challenges for welfare systems, sustaining employees’ working ability including occupational self-efficacy is of utmost relevance in ageing societies. HINTERGRUND: Der demografische Wandel führt in vielen Ländern zu mehr Pflegebedürftigen bei gleichzeitig sinkender Zahl pflegender Angehöriger. Informelle Pflege beginnt oft parallel zur Erwerbstätigkeit und kann zu Rollenkonflikten führen. Die Doppelbelastung kann sich negativ auf die Arbeitsleistung auswirken und zu Veränderungen in der beruflichen Selbstwirksamkeitserwartung führen. ZIEL: Trotz hoher gesellschaftlicher Relevanz gibt es eine Forschungslücke in Bezug auf die berufliche Selbstwirksamkeitserwartung, die als Mechanismus für eine reduzierte Arbeitszeit oder den Ausstieg aus dem Arbeitsmarkt nach der Übernahme von Pflegeaufgaben dienen kann. In diesem Artikel wird daher untersucht, wie sich der Übergang in die informelle Pflege auf die berufliche Selbstwirksamkeit auswirkt. Grundlage der Analyse sind die Wellen 2017, 2019 und 2021 der BAuA-Arbeitszeitbefragung, einer repräsentativen Panelstudie unter Erwerbstätigen in Deutschland. Pro Person wurden zwei Zeitpunkte betrachtet (n ≥ 3052). Für die Analyse wurden Difference-in-Differences-Modelle (DiD) mit dem Übergang in die Pflege als Treatment-Variable (inkl. Pflegehäufigkeit) verwendet. Zur Kontrolle von Selektionsverzerrungen wurde Propensity Score Matching (PSM) eingesetzt. Der Übergang in mindestens gelegentliche informelle Pflege wirkt sich negativ auf die berufliche Selbstwirksamkeitserwartung aus. Es zeigen sich signifikante Einbußen im Umgang mit beruflichen Schwierigkeiten, in der Entwicklung von Problemlösungen und in der Bewältigung beruflicher Anforderungen. Die PSM-Ergebnisse unterstützen diese Befunde. Vor dem Hintergrund von Fachkräftemangel und Belastungen der Sozialsysteme ist es essenziell, die Arbeitsfähigkeit – einschließlich der beruflichen Selbstwirksamkeit – in alternden Gesellschaften zu stärken.
30. Subjective language disturbances in young patients at ultra-high risk for psychosis (UHR): what relevance for clinical prognosis? A 2-year follow-up study.
期刊: European archives of psychiatry and clinical neuroscience 发表日期: 2025-Aug-28 链接: PubMed
摘要
Language impairment has the potential to predict the onset and progression of psychosis. However, it was mainly examined using automated extraction of quantitative linguistic features and their associations with observable psychopathological aspects of psychosis (e.g., formal thought disorders). Little interest has been paid to subjective language disturbances that should phenomenologically anticipate these more objective clinical features. Therefore, the aim of this examination was to investigate subjective language disorders in a Ultra-High Risk (UHR) sample and their associations with clinical and functional outcomes along 2 years of follow-up. 170 UHR participants (88 [51.8%] females; mean age = 19.52 ± 6.03 years) were assessed for a broad range of clinical outcomes, including psychosis transition, clinical and functional remission measured with the Positive and Negative Syndrome Scale and the Social and Occupational Functioning Assessment Scale. Comparisons between patients with or without baseline subjective language disorders (specifically explored with the Schizophrenia Proneness Instrument) were analyzed using Chi-Square and Mann-Whitney tests, Kaplan-Meier survival analysis, and binary logistic regression analysis. Across the follow-up, the UHR subgroup with language disorders at entry (n = 80) showed higher and more enduring severity in psychopathology (especially negative and disorganized features), as well as poorer socio-occupational functioning over time. The presence of subjective language disturbances at baseline identifies a subgroup of UHR youths with poorer psychopathological and functional prognosis. Further studies examining their association with quantitative linguistic biomarkers are needed, especially to better predict the onset and progression of psychosis.
31. Proteomic profile at the time of surgery correlates with disease stage and surgical outcome in periprosthetic joint infection.
期刊: mBio 发表日期: 2025-Aug-28 链接: PubMed
摘要
Periprosthetic joint infection (PJI) is the most common and difficult to treat form of arthroplasty failure. While treatment with debridement, antibiotics, and implant retention (DAIR) is preferable to one- or two-stage implant exchange based on morbidity and cost, outcomes are not successful in all cases selected for this management strategy. DAIR is currently recommended when infection is perceived to be in an “acute” phase, based on symptom duration; despite this selection strategy, DAIR failure rates are high. A more objective means of predicting DAIR success could improve patient outcomes by limiting DAIR failures. To explore this possibility, advanced proteomic analysis of sonicate fluid samples from 95 subjects with PJI was performed using proximity extension assay (PEA), with 77 samples additionally undergoing complementary proteomics analysis with liquid chromatography with tandem mass spectrometry (LC-MS/MS). Sparse partial least squares differentiation analysis (sPLS-DA) separated samples from patients who underwent DAIR with known outcomes (n = 19) into successful or unsuccessful groups, predicting DAIR surgical outcome (area under the curve [AUC]: 1; mean “leave one out” AUC: 0.6). Proteins predictive of DAIR surgical outcome were significantly enriched for the “protein repair” Gene Ontology (GO) pathway (P-adj = 0.02). Additionally, proteomic signatures associated with symptom duration in PJI categorized samples into short and long symptom duration PJI. In summary, an investigation of 7,261 unique human proteins separated PJI-associated samples based on symptom duration and identified a proteomic profile predictive of DAIR success.IMPORTANCEChronic infections are generally understood to last months to years, with acute infections lasting days to weeks. The transition from acute to chronic infection is, however, poorly understood. Periprosthetic joint infection (PJI) has been considered more challenging to treat when “chronic” than when “acute.” A surgery preferred for its recovery time and cost-debridement, antibiotics, and implant retention (DAIR)-is recommended for PJI management when symptom duration is short; yet, even in this select patient group, DAIR is associated with a high treatment failure rate. A means to better identify those predicted to have a successful outcome if they undergo DAIR is needed. Here, over 7,000 proteins from human clinical PJI samples were measured and shown to be able to separate samples based on symptom duration. Importantly, a proteomic profile predictive of DAIR success was identified.
32. Constraint-Induced Movement Therapy With or Without Neuromuscular Electrical Stimulation Versus Conventional Therapy for Upper Extremity Function in Chronic Stroke Survivors: Protocol for a Cluster Randomized Controlled Trial.
期刊: JMIR research protocols 发表日期: 2025-Aug-28 链接: PubMed
摘要
Motor impairment is a common consequence of stroke, significantly impacting patients’ daily functioning and quality of life. More than 80% of stroke survivors experience upper extremity (UE) motor impairments, which severely impact their ability to carry out daily living activities. Combining motor rehabilitation techniques, such as constraint-induced movement therapy (CIMT), with sensorimotor stimulation methods, such as neuromuscular electrical stimulation (NMES), may be beneficial in enhancing UE functional recovery after a stroke. This combined approach could activate a broader range of brain regions, improving motor control. However, evidence for the effectiveness of these interventions when combined is still lacking. In this randomized controlled trial, we aim to determine the effectiveness of CIMT combined with NMES, CIMT alone, and conventional therapy in rehabilitating UE function in chronic stroke survivors. We will compare 3 intervention groups, 2 experimental groups (CIMT combined with NMES group and CIMT group) and 1 control group (conventional therapy), in this assessor-blinded, cluster randomized controlled trial. A total of 42 participants will be recruited and randomly assigned to 1 of the 3 groups. Participants in the CIMT group will undergo 6 shaping practice tasks (50 repetitions for each task, totaling 300 repetitions per session). The combined CIMT/NMES group will perform tasks similar to those carried out by the CIMT-only group, and a biofeedback electrical stimulator for NMES will also be provided. The control group will receive conventional neurodevelopmental therapy. All groups will receive 1 session per day of treatment for 3 consecutive days a week for 4 weeks. A blinded assessor will measure the interventions’ outcomes using standardized tests, including UE motor function, motor impairment, perceived motor function, and upper limb self-efficacy. All data will be analyzed descriptively, presenting the means and SDs. We will conduct inferential tests using a 2-way mixed ANOVA to evaluate the effects of the interventions and compare them between and within groups. Funding for this study was provided by the Research and Ethics Committee of the Universiti Kebangsaan Malaysia (the National University of Malaysia) starting in November 2023. Between January 2023 and May 2023, we developed the initial ethics proposal and recruited research staff. Research ethics applications were submitted to the Research and Ethics Committee of the Universiti Kebangsaan Malaysia from May 2023 to November 2023. We anticipate publishing the study results in September 2025. This trial will provide insights into the effectiveness of CIMT combined with NMES, CIMT alone, and conventional therapy for UE rehabilitation in stroke survivors. Findings will be published in a peer-reviewed journal, and any updates based on emerging evidence will be provided. Any changes to the study methods will be documented in the final publication. Australian New Zealand Clinical Trials Registry ACTRN12624000564550; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=387308.
33. Corrigendum to "Gestational weight change patterns in pregnant people with obesity class I, II, and III receiving care from community-based health care centers" [Ann Epidemiol 110 (2025) 95-101].
期刊: Annals of epidemiology 发表日期: 2025-Aug-27 链接: PubMed
摘要
34. Exploring lingering COVID-19 vaccine hesitancy in three diverse U.S. states: Alabama, Illinois, and Texas.
期刊: Vaccine 发表日期: 2025-Aug-27 链接: PubMed
摘要
During the COVID-19 pandemic, vaccine uptake was slower than expected, with some people experiencing concern about the safety and effectiveness of the COVID-19 vaccine even after being vaccinated. This manuscript explores a phenomenon called lingering hesitancy, or the concern that people experience even after receiving an initial dose of a vaccine. Leveraging survey findings from three individual Prevention Research Centers (PRCs) in Alabama, Illinois, and Texas, we compare the attitudes of individuals across three vaccine status groups: those who received their complete COVID-19 vaccine series, those who received an initial dose but no subsequent doses (lingering hesitancy), and those who remained unvaccinated. We compare these three groups using the 3C model, examining differences in their attitudes around concern, complacency, and convenience. We control for contextual factors, including geographic location, political view, rural/urban setting, and racial/ethnic composition, as we examine the relationship between vaccine status and lingering hesitancy. We find that the partially vaccinated individuals do not differ significantly from fully vaccinated individuals in their perceptions of social responsibility to get the vaccine or the vaccine’s importance. However, there is a statistically significant difference between the fully and partially vaccinated individuals regarding their perceptions of vaccine safety. This suggests that partially vaccinated individuals may have different attitudes toward the vaccine than either fully or unvaccinated individuals. We offer recommendations for public health professionals as they develop messaging for ongoing and future vaccination efforts.
35. Discourses of addiction in the construction of people whose drinking affected others in narratives about alcohol harms to others.
期刊: The International journal on drug policy 发表日期: 2025-Aug-27 链接: PubMed
摘要
While research in alcohol harms to others (AHTO) has described the characteristics of people whose drinking affects others, few studies have investigated the construction of the affecting drinkers from the perspectives of those who have been affected. Drawing on data gathered through qualitative interviews with people who reported having been affected by others’ drinking, a discourse analysis was conducted to examine how they constructed the drinkers who affected them in the stories about their experiences. The study focuses on stories about AHTO occurrences related to repeated, long-lasting harms that involve people who engaged in ‘problematic’ drinking that affected others, as framed by the affected persons. The discourse analysis showed how participants drew on three dominant discourses about addiction as disease, as choice, and as a social condition, to account for their experiences. Findings demonstrated the multiplicity of discourses in stories of AHTO, which participants conformed, challenged, and negotiated with to (re)construct the people whose drinking affected them as either the ‘perpetrator’, ‘victim’, or both. Findings contribute to understanding of the ways in which affected persons make sense of their experiences of AHTO and attribute blame and responsibility. The flexible uses of multiple discourses in context also have implications for clinical settings to encourage agency while destigmatising alcohol use disorder.
36. 5F-AKB48: A synthetic cannabinoid presenting an emerging public health concern in France.
期刊: The International journal on drug policy 发表日期: 2025-Aug-27 链接: PubMed
摘要
5F-AKB48 is a potent synthetic cannabinoid with psychoactive effects. This study aimed to describe the sociodemographic and clinical characteristics of 5F-AKB48 exposures reported to French Poison Control Centers (PCCs). We conducted a retrospective analysis of all acute 5F-AKB48 exposure cases reported to French PCCs from 2017 to 2024. Collected data included patient demographics, symptoms, and outcomes. Poisoning severity was assessed using the Poison Severity Score (PSS). A total of 304 cases were identified, mostly in adolescent males (median age: 16.5 years; sex ratio: 4.4). Most exposures occurred in northern France. 5F-AKB48 was used alone in 91 % of cases. Of these, 59 % presented with mild symptoms, 35 % with moderate symptoms, and 4 % with severe symptoms (including seizures, coma, and agitation). More severe outcomes were observed in cases involving multiple substances. No fatalities were reported, though the outcome was unknown in 36 % of cases. 5F-AKB48 appears to be an emerging recreational drug among adolescents in France, probably due to its discreet use in liquid forms compatible with e-cigarette. While most cases were mild to moderate, the potential for serious toxicity, particularly with co-exposure, should not be overlooked. The associated risks call for stronger public health measures, including stricter e-cigarettes regulation and drug education initiatives in educational settings.
37. Nationwide descriptive epidemiological study of epistaxis treatment using the national database of Japan.
期刊: Auris, nasus, larynx 发表日期: 2025-Aug-27 链接: PubMed
摘要
The aim of this study was to analyze nationwide patterns of epistaxis treatment in Japan, including temporal trends, demographic distributions, and regional variations. This was a nationwide descriptive observational study using a national administrative database. We analyzed open data of the National Database of Health Insurance Claims from fiscal years 2019-2022 to examine two treatment procedures for epistaxis: hemostasis with gauze packing and cauterization. Treatment patterns were evaluated by month, age, sex, and prefecture of residence. The standardized claim ratio was calculated using indirect standardization for regional comparisons RESULTS: During the study period, 870,819 gauze-packing procedures and 523,591 cauterization procedures were recorded. Both procedures exhibited consistent seasonal patterns, peaking in winter (December to February). Age distribution followed a bimodal pattern, with higher incidence in children and older adult individuals, and a male predominance across all age groups. Pediatric patients were more likely to receive gauze packing. Geographic analysis showed a preference for gauze packing in Western Japan, whereas cauterization was more frequently performed in Northern Japan, suggesting a potential association with higher latitudes. This is the first nationwide study to identify distinct seasonal, demographic, and regional variations in epistaxis treatment in Japan. These findings suggest that factors beyond climate may influence treatment selection.
38. Intraocular pressure values in the Iberian Peninsula: epidemiological study and influencing factors.
期刊: Journal of optometry 发表日期: 2025-Aug-27 链接: PubMed
摘要
The aim of this study is to provide an update on the intraocular pressure measurements in Iberian Peninsula in order to elucidate their relationships with other clinical factors. A multicentric cross-sectional prospective study was carried out on patients attending General Optica centres in Spain and Portugal in collaboration with the University of Valladolid. This study included healthy patients with 18 years and older. Intraocular pressure measurements were taken with different air tonometers for one week. A descriptive statistical analysis of the collected data was then performed to discover possible correlations with intraocular pressure. Statistically significant differences in the intraocular pressure of the right eye and left eye between patients under 35 years of age and those over 64 years of age were found. An increase in intraocular pressure was also observed in the group with a family history of glaucoma (p < 0.01) and aged over 45 years. Furthermore, intraocular pressure was significantly higher in patients with high blood pressure in the 45-65 age range. The standardised coefficients of variation showed that the variables most strongly related to intraocular pressure were time, followed by a family history of glaucoma and high blood pressure. The variables that had a statistically significant correlation with the intraocular pressure value were the time of measurement and a history of glaucoma. Intraocular pressure increases with age, and among the variables studied, high blood pressure and family history of glaucoma were the most important risk factors.
39. Appearance of 2-MMC and 3-MMC on the illicit drug market in the Netherlands: A systematic narrative review of the prevalence and risks.
期刊: The International journal on drug policy 发表日期: 2025-Aug-27 链接: PubMed
摘要
Use of the synthetic methylmethcathinones 2-MMC and 3-MMC (2/3-MMC) is emerging, especially among young people, but their health risks remain unclear. A systematic narrative review was conducted on studies describing the availability, pharmaco-toxicological profile, and user characteristics of 2/3-MMC, with a focus on the situation in The Netherlands. Among nightlife youth (16-35 yrs.) in The Netherlands, reported past-year 3-MMC use increased almost four-fold within two years,and in 2022 became the third most commonly used substance (33.7 %), after cannabis and MDMA. 2/3-MMC appears to have a pharmaco-toxicological profile similar to 4-MMC (mephedrone), with similar dopaminergic but less serotonergic activity. Their shorter duration of action may lead to increased craving and more frequent re-dosing compared to 4-MMC. Low price, high availability and positive recommendations on social media have attracted (very) young (aged 14-17), who are often particularly vulnerable. Despite a legal ban on 3-MMC in 2021, the number of individuals seeking treatment for problematic 3-MMC use in the Netherlands rose from 33 in 2021 to 330 in 2023. Most cases involved polydrug users. In general, 2/3-MMC appear to be less toxic and harmful than other illicit substances though their use may result in more craving, more frequent re-dosing and, thus, to more dependence than 4-MMC. The number of treatment seeking problematic 3-MMC users is increasing. Drug regulation may help prevent a further rise in 2/3-MMC use, although a shift to other cathinones cannot be ruled out. Mental health organisations should therefore remain vigilant to monitor problematic 2/3-MMC use, especially among vulnerable (very) young users.
40. Artificial Intelligence in Depression-Medication Enhancement (AID-ME): A Cluster Randomized Trial of a Deep-Learning-Enabled Clinical Decision Support System for Personalized Depression Treatment Selection and Management.
期刊: The Journal of clinical psychiatry 发表日期: 2025-Aug-27 链接: PubMed
摘要
Background: There has been increasing interest in the use of artificial intelligence (AI)-enabled clinical decision support systems (CDSS) for the personalization of major depressive disorder (MDD) treatment selection and management, but clinical studies are lacking. We tested whether a CDSS that combines an AI which predicts remission probabilities for individual antidepressants and a clinical algorithm based on treatment can improve MDD outcomes. Methods: This was a multicenter, cluster randomized, patient-and-rater blinded and clinician-partially-blinded, active-controlled trial that recruited outpatient adults with moderate or greater severity MDD. All patients had access to a patient portal to complete questionnaires. Clinicians in the active group had access to the CDSS; clinicians in the active-control group received patient questionnaires; both groups received guideline training. Primary outcome was remission (<11 points on the Montgomery-Asberg Depression Rating Scale [MADRS]) at study exit. Results: Forty-seven clinicians were recruited at 9 sites. Of 74 eligible patients, 61 patients completed a postbaseline MADRS and were analyzed. There were no differences in baseline MADRS (P = .153). There were more remitters in the active (n = 12, 28.6%) than in the active-control (0%) group (P = .012, Fisher’s exact). Of 3 serious adverse events, none were caused by the CDSS. Speed of improvement was higher in the active than the control group (1.26 vs 0.37, P = .03). Conclusions: While limited by sample size and the lack of primary care clinicians, these results demonstrate preliminary evidence that longitudinal use of an AI-CDSS can improve outcomes in moderate and greater severity MDD. Trial Registration: ClinicalTrials.gov identifier: NCT04655924.
41. Explainable machine learning for discontinuation of therapeutic antibiotics in intensive care patients.
期刊: Journal of critical care 发表日期: 2025-Aug-26 链接: PubMed
摘要
The threshold for initiating lifesaving antibiotics for intensive care patients is low while determining when to stop remains challenging: prolonged administration increases antibiotic resistance and occurrence of side effects, while premature discontinuation may lead to resurgence of infection. Explainable machine learning may predict for which ICU patients antibiotics will be reinitiated. We retrospectively collected data on all adult ICU patients treated with antibiotics in two tertiary academic hospitals in the Netherlands. We included monitor data, laboratory data, selective decontamination strategy, medication, and culture results as predictors. We trained logistic regression, lightGBM and AutoPrognosis models to predict the primary outcome of restarting antibiotics within 72 h. We included data on 2,486 patients receiving 3,645 therapeutic antibiotic courses between October 2015 and January 2022. The primary outcome occurred 708 (19.4 %) times, of which the same subgroup was restarted in 468 (66.10 %) cases and the exact same combination in 278 (39.27 %). Cultures were collected in 80.4 % and positive in 43.3 % of cases. 90-day mortality was higher in the reinitiation group (39.8 % vs. 25.0 %). The best performing model was logistic regression (AUROC 0.675). The most important predictors were the use of penicillins and the treatment duration of the last started antibiotic. Although prediction of reinitiation remained challenging, the most important and consistent predictor for reinitiation of antibiotics was a shorter duration of the last started antibiotic. The same antibiotic was restarted frequently, and 90-day mortality was higher in the reinitiation group, illustrating potential for data-driven decision support on when to discontinue antibiotics.
42. A rapid screening method for detection of ampicillin residues in dairy milk.
期刊: Research in veterinary science 发表日期: 2025-Aug-26 链接: PubMed
摘要
The extended use of antibiotics in dairy animals for the growth promotion and disease prevention is directly linked with the development of antimicrobial resistance. This study reports the development of a quick method for the detection of ampicillin residues in dairy milk, using the principle of Lateral Flow Assay (LFA). In this study, hapten against ampicillin was prepared by conjugation with bovine serum albumin. Primary antibodies against this hapten were raised in rabbits and purified. Total protein (IgG) in hyperimmune serum was measured and evaluated by direct ELISA. Gold nanoparticles were conjugated with primary antibodies and impregnated on the conjugate pad of a multi-layered residue detection strip, placed in plastic cassette with clear demarcations of test and control lines on nitrocellulose membrane. The LFA developed using polyclonal antibodies demonstrated the rapid detection of maximum residue limits (MRL) of ampicillin (5 ppb) in milk samples within 8 to 10 min. The kit developed in this study can be used for screening ampicillin residues in milk samples throughout the supply chain, starting from production to consumers’ doorstep.
43. Prediction recurrence in stage I epidermal growth factor receptor-mutated non-small cell lung cancer using multi-modal data.
期刊: Lung cancer (Amsterdam, Netherlands) 发表日期: 2025-Aug-25 链接: PubMed
摘要
Integrated recurrence prediction models that combine clinical, imaging, and genetic data are lacking for epidermal growth factor receptor (EGFR)-mutated stage I non-small cell lung cancer (NSCLC). We developed a recurrence prediction model for Stage I EGFR-mutated NSCLC by integrating clinical, radiological, and whole-exome sequencing (WES) data. A total of 306 patients with Stage I EGFR-mutated NSCLC were stratified into training (n = 206) and validation (n = 100) cohorts using stratified random sampling. Cox proportional hazards models combined binary labels of clinical and radiological factors from univariate analysis, machine-learning-derived MultiGenes labels (determined by multiple gene mutations) from WES data, and high-impact gene mutations. Predictive performance was assessed using the concordance index (C-index), time-dependent area under the curve (AUC), and receiver operating characteristic curves. The top three models by category were evaluated using a survival analysis. Three optimal models were identified; the clinicoradiological model (Model 17) achieved a C-index of 0.70, the model incorporating clinicoradiological factors and MultiGenes (Model 28) achieved 0.69, and the clinicoradiological model with TP53 mutations (Model 39) demonstrated the best performance, with 0.73. In Model 17, the 60-month recurrence-free survival (RFS) rates were 59.1 % for the high-risk group and 83.2 % for the low-risk group (hazard ratio [HR] = 3.47; 95 % confidence interval [CI]: 1.60-8.00). Model 39, which incorporated TP53 mutations, demonstrated superior performance, with 60-month RFS rates of 57.1 % for the high-risk and 87.1 % for the low-risk groups (HR = 4.79; 95 %CI: 1.96-11.69). Clinical and radiological factors are effective predictors of recurrence risk in Stage I EGFR-mutated NSCLC, and incorporating TP53 mutation data further improves the prognostic accuracy.
44. Engineered Salmonella Enteritidis vector targeting innate immune molecules provides protection against Salmonella Enteritidis and Salmonella Typhimurium.
期刊: Poultry science 发表日期: 2025-Aug-24 链接: PubMed
摘要
Targeting the innate immune response is a critical factor in vaccine success. There are numerous serotypes of Salmonella, and cross-reactivity among different serotypes or even strains within the same serotype is limited. This makes it difficult for vaccines to provide broad protection, posing a challenge to effective prevention and control. In this study, a Salmonella Enteritidis (S. Enteritidis) candidate vaccine strain, rSC0163, with high immunogenicity, was constructed by introducing the Salmonella mRNA interferase-regulating vector (SIRV) system. The rSC0163 strain, enhanced by the SIRV system, targets the host’s innate immune cyclic GMP-AMP synthase (cGAS) molecule, triggering downstream immune pathways and significantly increasing levels of antibodies (IgA and IgY) and cytokines (IFN-γ and IL-4) in the peripheral blood of immunized chickens. Compared with the control strain rSC0162, the antiserum from chickens immunized with rSC0163 showed significantly enhanced opsonophagocytic activity. The highest opsonophagocytic assay (OPA) titers against the S. Enteritidis C50041 strain, S. Enteritidis CVCC3949 strain, and Salmonella Typhimurium (S. Typhimurium) UK-1 strain reached 1:256, 1:128, and 1:64, respectively. Furthermore, rSC0163 provided 100 % and 83 % protection against lethal doses of the C50041 and CVCC3949 strains, respectively, and 66 % protection against the heterologous S. Typhimurium UK-1 strain. These protection rates were significantly higher than those induced by rSC0162. In conclusion, integrating the SIRV system into the attenuated S. Enteritidis vector enhances both innate and adaptive immune responses, offering a basis for developing cross-serotype protective vaccines and Salmonella-based delivery platforms targeting other pathogens.
45. Investigating the impact of edge weight selection on the pig trade network topology.
期刊: Epidemics 发表日期: 2025-Aug-22 链接: PubMed
摘要
Traceability of animal movements and robust surveillance are crucial for prevention and control of animal diseases. While network analysis has emerged as a powerful tool for identifying higher-risk holdings through centrality metrics, its effectiveness depends on two methodological choices: (1) edge-weighting schemes (movement frequency vs. animal volume) and (2) centrality metric selection. This study investigates how alternative edge-weighting approaches (frequency vs. volume) influence network topology and node centrality rankings in a pig movement network. Using 2021 pig movement data from Upper Austria (5,766 holdings; 92,914 movements), we: (1) quantify how edge-weighting schemes (frequency vs. volume) affect network topology and community structure, and (2) evaluate node ranking robustness across three centrality metrics (strength, betweenness, closeness) against epidemic simulation rankings. Our analysis reveals distinct edge weight distributions: frequency-based network exhibited a bimodal pattern, while volume-based was more uniform. We observed strong positive correlations (τ> 0.42-0.84; p<0.001) in node rankings across all centrality metrics (strength, closeness, betweenness), with consistent patterns observed both: (i) between frequency- and volume-weighted networks, and (ii) within each network representation. Strength centrality exhibited the highest correlation with the simulation-based rankings, particularly for the top 5% highest-ranked nodes (τb= 0.51 for frequency-based and τb= 0.5 for volume-based). These findings highlight that strength centrality provides a computationally efficient and field-practical alternative to epidemic simulations for identifying high-risk holdings. This enables resource-efficient, data-driven surveillance while maintaining epidemiological relevance.
46. Limited impact of real-world evidence in medical oncology: How can AI turn the tide.
期刊: European journal of cancer (Oxford, England : 1990) 发表日期: 2025-Aug-15 链接: PubMed
摘要
Real-world evidence (RWE), derived from real-world health data (RWD) generated during routine clinical practice, is increasingly recognized as a valuable complement to traditional clinical trial data in medical oncology. While randomized controlled trials remain the gold standard for evidence-based medicine, they often face limitations due to rising costs, ethical constraints, and the inability to cover all treatment combinations and diverse patient populations. The current impact of RWE is limited by several challenges, including data inconsistency, quality issues, and burdensome data collection processes. Despite its role in specific areas like accelerating drug development in rare cancers, RWE has yet to achieve its full potential due to these limitations. Artificial intelligence (AI), particularly through natural language processing and large language models (LLMs), presents a transformative opportunity for RWE. AI technologies can streamline data collection, extraction, cleaning, and analysis, making the process more efficient and accurate. LLMs, for instance, can extract structured data from unstructured text and facilitate the integration of diverse data sources. This automation can significantly reduce the workload on clinicians and improve the consistency and reliability of RWD. These tools can address existing challenges and unlock the full potential of RWD, ultimately leading to improved patient outcomes and more robust oncology research.
47. Sex differences in (poly)phenol intake patterns and cardiovascular risk in Spanish adult population at high risk of cardiovascular disease: Cross-sectional findings.
期刊: Nutrition (Burbank, Los Angeles County, Calif.) 发表日期: 2025-Aug-05 链接: PubMed
摘要
Men and women tend to follow different dietary patterns, but this is often disregarded when relating diet to health outcomes. Our aim was to analyze (poly)phenol intake patterns and their association with cardiovascular risk (CVR) according to sex. 6633 participants were included in this cross-sectional study. The intake of 26 (poly)phenol classes/subclasses was included in the factor analysis obtaining for the total sample, men and women. Linear regression models were performed with the estimation of absolute CVR (Framingham equation) as the dependent variable, and each (poly)phenol pattern categorized into quintiles as the independent variable. For the total sample, (poly)phenol pattern three (olives and olive oil) was positively associated with CVR (βQ5vs.Q1 = 2.71%, 95% CI = 1.45, 3.96), presenting a higher risk of diabetes prevalence, smoking more and consuming more salt. In men, pattern three (olives and olive oil) was also positively associated with CVR (βQ5vs.Q1 = 3.17%, 95% CI = 1.58, 5.64), exhibiting higher prevalence of diabetes and higher sodium intake. Also in men, pattern four (coffee) was positively associated (βQ5vs.Q1 = 1.99 %, 95% CI = 0.26, 3.73) presenting a higher diabetes and current smokers prevalence and higher sugar intake. In women, greater adherence to pattern four (coffee) was associated with higher CVR (βQ5vs.Q1 = 2.19%, 95% CI = 1.05, 3.34). We found sex differences in (poly)phenol intake patterns and in their associations with CVR. These differences may be explained by the fact that subjects at higher risk at baseline may be motivated to improve their dietary habit (reverse causality). The trial was registered at the International Standard Randomized Controlled Trial (ISRCTN89898870).
48. Integrating the Safer Together National Action Plan to Improve Nurse-Led Models Focused on Patient Safety.
期刊: Nursing administration quarterly 发表日期: 链接: PubMed
摘要
Patient safety remains an elusive goal for health care systems despite 2 decades of reports, strategies, tools, and revamped health professions education. These actions alone have lowered many targeted areas of preventable harm, particularly hospital-acquired conditions, yet evidence indicates better outcomes depend on “total system” approaches that embed patient safety in the core of care delivery. The first national patient safety plan, Safer Together: A National Action Plan to Advance Patient Safety from the Institute for Health Care Improvement, presents 4 recommendations to achieve total system safety. For decades, the Quality and Safety Education for Nurses (QSEN) competencies and the American Nurses Credentialing Center Magnet Recognition Program guided nursing care to ensure safe and high-quality care to pursue nursing excellence. By intertwining with Safer Together, the 3 re-envision a nursing practice model ensuring safe quality patient care. This paper describes integrating the 4 pillars defined by Safer Together into a nursing model with the Magnet Framework fueled by a nursing workforce grounded in the QSEN competencies. Nurses are in frontline positions for leading a total systems safety approach but need guidance for integrating these recommendations into effective professional practice models that define values, structures, and processes for delivering safe quality care.
49. The Digital Future of Nursing: Implications for Practice.
期刊: Nursing administration quarterly 发表日期: 链接: PubMed
摘要
Commissioned by Health Education England, the country’s organization for education and workforce development, the Phillips Ives Review on the Digital Future of Nursing highlighted the requisite priorities of person-centered care in digital health innovations and the required changes in nursing education to ensure competent practice in the digital age. Findings from this unpublished review, shared in the Health Service Journal and Nursing Times, bring attention to emerging care models such as virtual nursing and the critical importance of embedding person-centered nursing into the design and implementation of technology. Additionally, the importance of equipping nurses with skills in genomics, artificial intelligence, and data science was essential to delivering the benefits of these advancements. The review, along with other key policy initiatives including the International Council of Nursing (ICN) Position Statement on Digital Transformation illustrates increasing awareness amongst nurse leaders globally that these issues must be addressed. This article builds on the Phillips Ives Review, emphasizes new nurse-led innovations in various healthcare organizations, and examines key themes highlighted in these policy papers, namely person-centered care and the rise of virtual care. It further discusses implications for nurse education and clinical practice and examines how policies are emerging from professional nursing organizations including the American Nurses Association, the American Organization for Nursing Leadership, in addition to the ICN.
50. Feasibility and accuracy of In Vivo and Ex Vivo XRF bone lead assessment wild birds: An example with black vultures, Coragyps atratus.
期刊: Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS) 发表日期: 2025-Aug-22 链接: PubMed
摘要
Lead (Pb) contamination in wildlife remains a critical environmental concern, particularly for scavenger species, which are at high risk due to ingestion of lead-contaminated carrion. Portable XRF (pXRF) systems can be useful to evaluate lead concentration of wild animals in vivo. However, the accuracy of these systems has never been validated for living birds. We evaluated differences in the quantification of lead in the tarsometatarsus (TMT) and femur bones of 19 wild-caught black vultures (Coragyps atratus) by portable (pXRF) and benchtop X-ray fluorescence (XRF) systems with validation against inductively-coupled plasma mass spectrometry (ICP-MS). We found a strong correlation between benchtop XRF and ICP-MS (R² = 0.92-0.95), and lower correlation between pXRF and ICP-MS (R² = 0.62-0.67), primarily because pXRF systematically underestimated lead concentrations. When compared to ICP-MS, Intraclass Correlation Coefficients (ICC) further confirmed better performance of benchtop XRF in measuring femur and TMT lead (ICC = 0.959-0.968) compared to pXRF (ICC = 0.739-0.742). pXRF in vivo TMT lead concentrations were highly correlated (R² = 0.85) to ex vivo results with the same instrument, with the soft tissue on the living animal having minimal effect on the measurement. Although pXRF offers critical advantages in field applications, its limitations necessitate careful interpretation of results. Future research could improve pXRF optimization and extend this approach to other wildlife populations. This work contributes valuable data on lead exposure in vultures and illustrates a mechanism by which lead exposure of birds can be evaluated in vivo in wild or captive populations.
51. Alterations in ether lipid metabolism in obesity revealed by systems genomics of multi-omics datasets.
期刊: PLoS biology 发表日期: 2025-Aug 链接: PubMed
摘要
Ratios between two metabolites are sensitive indicators of metabolic changes. Lipidomic profiling studies have revealed that plasma ether lipids, a class of glycero- and glycerophospho-lipids with reported health benefits, are negatively associated with obesity. Here, we utilized lipid ratios as surrogate markers of lipid metabolism to explore the processes underlying the inverse relationship between ether lipid metabolism and obesity. Plasma lipidomics data from two independent human cohorts (n = 10,339 and n = 4,492) were integrated to assess the associations between 82 lipid ratios and obesity-related markers in males and females. Results were externally validated using mouse transcriptomics data from the Hybrid Mouse Diversity Panel (n = 152-227 across 74 strains). Genome-wide association studies using imputed genotypes from a population cohort (n = 4,492) were performed to examine the genetic architecture of the ratios. Findings showed that waist circumference (WC), body mass index, and waist-hip ratio were inversely associated with total plasmalogens relative to total phospholipids in both sexes. Ratios comprising product-substrate pairs positioned either side of enzymes involved in plasmalogen synthesis and degradation showed positive and negative associations with WC, respectively. Branched-chain fatty acids negatively correlated with WC, while omega-6 polyunsaturated fatty acids exhibited differing associations depending on their position within the pathway. Mouse transcriptomics corroborated these results. Genomics data showed strong associations between ratios containing choline-plasmalogens and single-nucleotide polymorphisms in the transmembrane protein 229B (TMEM229B) gene region. This work demonstrates the utility of lipid ratios in understanding lipid metabolism. By applying the ratios to multi-omic datasets, we identified alterations in enzymatic activity and genetic variants likely affecting ether lipid synthesis in obesity that could not have been obtained from lipidomics data alone. Additionally, we characterized a potential role for TMEM229B, offering new perspectives on ether lipid metabolism and regulation.
52. Healthcare-related transmission of mobile genetic elements co-carrying bla NDM and 16S rRNA methyltransferase genes in multiple Enterobacterales.
期刊: Microbial genomics 发表日期: 2025-Aug 链接: PubMed
摘要
Aminoglycosides are used in the treatment of serious infections with Gram-negative bacteria, especially those resistant to beta-lactams and carbapenems. 16S rRNA methyltransferases (16S-RMTase) are capable of conferring resistance to nearly all aminoglycosides. They are sometimes detected in combination with bla NDM. This study describes the mobile genetic elements associated with bla NDM and 16S-RMTase (co-)carriage in Enterobacterales from Ireland in the period 2019-2023. All isolates (n=58) carrying both bla NDM and a 16S-RMTase gene between 2019 and 2023 were obtained from the CPE National Reference Laboratory Service. Short-read sequences were generated for all isolates, and long-read sequences were generated for a subset of isolates (n=27). MOB-recon was used to distinguish plasmid-derived contigs from draft assemblies. The containment distance and DCJ-indel distance were used to find clusters of related plasmids. Isolates carrying bla NDM-1 were associated with armA (n=31) but also rmtC (n=6) carriage. These genes were co-localized most frequently on IncFIB/HI1B (n=12), IncM2 (n=10) and IncC (n=8) plasmids. Closely related plasmids were identified in multiple species (range: 2-5) and at different sites around Ireland; however, the IncM2 plasmids were largely associated with a single hospital. Isolates carrying bla NDM-5 were associated with rmtB1 (n=28) carriage. The majority (n=15) were carried on a diverse range of mosaic IncF-type plasmids. Two discrete clusters of IncM1 (n=3) and IncFII (n=4) type plasmids were also detected. The study highlights the diverse plasmids co-carrying carbapenem and aminoglycoside resistance genes in Ireland. Detection of plasmids across multiple species and hospitals suggests dissemination driven by antimicrobial selective pressure and environmental reservoirs within healthcare networks. The co-dissemination of these genes on highly mobile plasmids poses a significant public health concern and emphasizes the need for greater awareness that chains of transmission of antimicrobial resistance in the healthcare setting may involve multiple species.
53. Low Th2 and high PD1+ TFh cells in blood predict remission after CTLA-4Ig treatment for 48 weeks in early rheumatoid arthritis.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
To determine whether baseline CD4+ T helper (Th) cell subset proportions in blood may serve as predictive biomarkers for achieving remission 48 weeks after initiating CTLA-4Ig, anti-tumor necrosis factor (TNF), or anti-interleukin 6 receptor (IL6R) treatment in patients with early rheumatoid arthritis (eRA). This study included 60 untreated eRA patients from the larger randomized treatment trial NORD-STAR. They were treated with methotrexate (MTX) combined with either CTLA-4Ig (n = 17), anti-TNF (n = 22), or anti-IL6R (n = 21). Disease activity was assessed by clinical disease activity index (CDAI), C-reactive protein, and erythrocyte sedimentation rate. The primary outcome was remission (CDAI ≤ 2.8) at week 48, and the secondary outcomes were time to reach remission or sustained remission during the 48-week follow-up. CD4+ T cell subset proportions were analyzed fresh by flow cytometry at baseline and at 24 and 48 weeks. In CTLA-4Ig + MTX-treated patients, baseline Th2 together with PD1+ T follicular helper (TFh) cell proportions predicted CDAI remission at week 48 (AUC: 0.986, 95% CI 0.94-1.0). Survival analysis revealed that patients with Th2 proportions below 16.8% or PD1+ TFh proportions above 7.6% at baseline were more likely to achieve remission (log-rank p = 0.002 and p = 0.007, respectively), and sustained remission (log-rank p = 0.01 and p = 0.001, respectively), over the 48-week follow-up. CD4+ T cell subset proportions did not predict remission in patients treated with anti-TNF + MTX or anti-IL6R + MTX. Only CTLA-4Ig treatment reduced PD1+ TFh and PD1neg TFh fractions after 48 weeks. Circulating Th2 and PD1+ TFh cell proportions at baseline may serve as predictive biomarkers for achieving CDAI remission after 48 weeks of CTLA-4Ig treatment in eRA.
54. Contextualizing future maternal RSV vaccination acceptance and trust among pregnant and lactating women in Kenya: A latent class analysis.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
Maternal vaccination, or vaccination in pregnancy, offers a critical opportunity to provide protection to pregnant women and simultaneously confer passive immunity to infants in the first months of life, when infections are particularly serious and their immune systems are still developing. Respiratory syncytial virus (RSV) is one such serious infectious disease for newborns, but a newly approved and recommended vaccine for respiratory syncytial virus has been designed to be given to pregnant women to protect their newborns from severe RSV disease when they are most vulnerable. While maternal vaccination has been used for tetanus, pertussis, influenza, COVID-19, and other diseases, vaccination in pregnancy can present unique challenges related to hesitancy and delivery, particularly in lower-resourced settings. Using data from a cross-sectional survey of 400 pregnant and lactating women in Nakuru and Mombasa Counties in Kenya, we examined perspectives related to maternal vaccination and RSV. We conducted a latent class analysis on 12 dichotomized knowledge, attitude, and belief items and then examined factors associated with class membership using a binary logistic regression. We identified two distinct archetypes among study subjects, maternal vaccine “questioners” and maternal vaccine “acceptors.” There was a notable difference in perceived vaccination-enabling social norms between “questioners” and “acceptors,” and participants using private health facilities were more likely to be in the “questioner” class compared to those using public facilities (aOR: 2.99, 95% CI: 1.32-6.77). This respondent-driven approach to identify groups that may require different communication strategies can help to shape efforts to target preparations for future RSV vaccine introduction in Kenya. Recognizing that “questioners” accounted for nearly one in four participants, these learnings can help to inform tailored health promotion strategies to support informed, confident maternal vaccination decision-making among providers, communities, and pregnant women and mitigate vaccination hesitancy and refusal.
55. Exercise Behavior to Prevent Osteoporosis.
期刊: Nursing research 发表日期: 链接: PubMed
摘要
Although the benefits of exercise in osteoporosis prevention are well documented, research indicates that women’s engagement in physical activity remains suboptimal. The aim of this study was to assess the Health Belief Model constructs and the self-regulation concept derived from Social Cognitive Theory concerning exercise behaviors for osteoporosis prevention. The study used a cross-sectional survey of 250 women who were premenopausal (ages 30-49 years). The data collection instruments were comprised of health beliefs, self-regulation, awareness, and exercise behavior questionnaires. The average score for exercise behavior was notably low. Within the integrated model, exercise behavior was significantly linked to increased levels of perceived benefits, perceived susceptibility, self-efficacy, health motivation, and self-regulation, as well as decreased levels of perceived barriers. In the final model, perceived benefits and self-efficacy emerged as the most influential predictors of exercise behavior. Therefore, implementing strategies to improve effectiveness in practice, such as boosting self-efficacy through motivational counseling and educating individuals on the advantages of the recommended behavior, is likely to result in more successful health promotion initiatives for middle-aged women aimed at preventing osteoporosis.
56. Unraveling the after-hours dilemma: Consequences of overworking among teleworkers-A scoping review protocol.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Telework, also referred to as telecommuting, remote work, flexible work, and virtual work, involves working from a location different from the traditional office and often uses online communication technologies. Despite the numerous advantages associated with teleworking, it also raises concerns about work-life balance and health implications due to working after hours (WAH). This proposed study aims to understand the health consequences of teleworkers working beyond their scheduled hours. This review will search seven online databases (APA PsycINFO, Medline, Embase, Scopus, Business Source Premier, CINAHL, and Sociological Abstracts) to gather relevant articles. The inclusion criteria will encompass peer-reviewed studies published from 2010 onwards, focusing on WAH among teleworkers and reporting mental and physical health consequences. The exclusion criteria will include non-peer-reviewed articles, grey literature, and studies involving patients with pre-existing conditions. This review will provide valuable insights into the mental and physical health consequences of WAH among teleworkers, underscoring the urgent need for strategies to mitigate these risks and promote overall well-being. Future efforts, including collaborations between researchers, industry leaders, and policymakers, can guide the development of targeted interventions and evidence-based policies that improve telework environments and support long-term worker health and productivity.
57. Adolescent Feet Are Not Small Adult Feet.
期刊: Journal of the American Podiatric Medical Association 发表日期: 2025 链接: PubMed
摘要
Many arch structure classification methods exist, but arch structure may be influenced by factors such as age and physical activity. It is unknown if previous arch structure classifications from adult populations are appropriate for adolescents. The purpose of our study was to compare arch structure classifications between adolescent-specific and previously published classification systems. We enrolled 141 uninjured adolescents who participated in long-distance running activities. We measured arch height index (AHI) for both feet in seated and standing positions and classified arch structure as cavus, rectus, or planus. We calculated kappa and percent agreement to compare arch structure classification for our participants with previously published classifications. We performed one-sample t tests to compare mean AHI values from our participants with previously published values. We performed Pearson correlation and percent agreement for arch structure classification for AHI measured in seated and standing for our participants. We observed no to weak and unacceptable agreement (κ = -0.008 to 0.702; P < .001 to .77; 29-72%) for seated and standing AHI between our classification and most prior classifications. Our seated and standing mean AHI values differed from most prior studies (P < .001 to .99; d = 0.00-1.52). We observed a very large positive correlation (r = 0.90; P < .001) with moderate and acceptable classification agreement (κ = 0.641; P < .001; 83%) between mean AHI values measured in seated and standing positions. Arch structure classification varied based on classification system and showed poor agreement between most previously reported classification systems. Mean AHI values were significantly different for adolescent runners in our study compared with most previously reported mean values. Researchers and clinicians may classify arch structure in a seated or standing position if position-specific criteria are applied. Special care should be taken before extrapolating classification systems originating from populations with different characteristics, such as age, sport participation, and health status.