公共卫生研究摘要 (2025-08-30)
共收录 57 篇研究文章
1. Association of tailpipe-related and nontailpipe-related air pollution exposure with neuroimaging outcomes.
期刊: Environmental epidemiology (Philadelphia, Pa.) 发表日期: 2025-Oct 链接: PubMed
摘要
Long-term exposure to air pollution may be related to neural atrophy or cerebrovascular pathology. A major source of air pollution is vehicle traffic, which is modifiable. In this study, we estimated associations between four traffic-related air pollutants and five neuroimaging biomarkers. We analyzed data from a subset (N = 817) of participants in the Chicago Health and Aging Project (1993-2012) who underwent a structural magnetic resonance imaging (MRI) scan between 2002 and 2012. Using previously developed air pollution models, we predicted participant-level exposure to the tailpipe pollutants oxides of nitrogen (NOX) and nitrogen dioxide (NO2), plus the nontailpipe pollutants copper and zinc found in coarse particulate matter (PM10-2.5,Cu and PM10-2.5,Zn, respectively) over the 3 years before each participants’ first MRI scan date. Using linear regression, we estimated cross-sectional, covariate-adjusted associations between each pollutant with total cerebral volume, total hippocampal volume, total lateral ventricle volume, total white matter hyperintensity volume, and cortical thickness. These models incorporated inverse probability weights to account for potential selection biases driven by differences between participants who did and did not undergo an MRI scan after being offered one. Exposure to NOX and NO2 was associated with less cortical thickness on average (-0.06 mm, 95% confidence interval [CI] = -0.09, -0.02 per 7.8 ppb NOX; -0.04 mm, 95% CI = -0.07, -0.01 per 2.7 ppb NO2). All other associations were consistent with no effect. These results are not indicative of large adverse associations between traffic-related air pollution exposures and indicators of neural atrophy or cerebrovascular pathology.
2. Features of Prodromal Parkinson Disease and Dopaminergic Neurotransmission in Community-Dwelling Older Adults.
期刊: Neurology 发表日期: 2025-Sep-23 链接: PubMed
摘要
Parkinson disease (PD) pathology begins years before clinical diagnosis. Identifying individuals in this prodromal period is of high priority because they are candidates for clinical trials. Several characteristics of the PD prodrome have been described, but many are nonspecific. Among community-dwelling older adults unselected for PD risk, their relationship to objective measures of nigrostriatal dopaminergic nerve terminal density has not been studied in vivo. We determined prevalence of PD risk factors and prodromal signs/symptoms in community-dwelling older adults, examined their relationship with dopaminergic nerve terminal density, and explored prevalence and distribution of other possible prodromal features. This was a cross-sectional observational study of community-dwelling older adults without diagnosed neurologic disorders in Southwestern Pennsylvania. Participants were assessed for 5 PD risk markers and ≤8 prodromal signs/symptoms, and underwent dopaminergic imaging with dihydrotetrabenazine (11C-α-DTBZ)-PET to assess nigrostriatal dopamine terminal density. Probability of prodromal PD based on Movement Disorders Society criteria was calculated. Possible prodromal PD (pPD) was defined as an estimated posterior probability for prodromal PD of >30%. The relationship between prodromal probability and age-adjusted and sex-adjusted [11C]DTBZ striatal binding was examined. A total of 231 participants were included, mean (SD) age 75.1 (4.5) years, 94 (40.7%) men. More than 1 prodromal sign/symptom was present in 131 (56.7%), with cognitive deficit being the most common. pPD was present in 18 (7.8%) of the sample. Compared with the not pPD group, the pPD group had lower mean age-adjusted and sex-adjusted predicted [11C]DTBZ posterior putamen binding (2.45 [0.119] vs 2.38 [0.150], p = 0.014) and greater left-right asymmetry (0.027 [0.006] vs 0.030 [0.007], p = 0.014). Hyposmia was significantly associated with lower posterior putamen binding compared with normosmia (β = -0.179, 95% CI -0.332 to -0.026, p = 0.022). Prodromal nonmotor and motor signs/symptoms of PD are common in community-dwelling older adults. Increased probability of prodromal PD is associated with decreased dopaminergic nerve terminal density of the posterior putamen that is also more asymmetric. Our findings support the use of composite measures of prodromal features to identify individuals at the population level who may be at risk for PD.
3. What about the caregivers? Rethinking chronic illness support in the age of transplantation.
期刊: World journal of transplantation 发表日期: 2025-Sep-18 链接: PubMed
摘要
Caregivers play an essential but often unacknowledged role in healthcare, particularly in chronic illness and post-transplantation scenarios. We highlight the profound emotional, physical, and logistical challenges caregivers face, as illuminated by recent studies, including the work of Virches et al about liver transplantation. Pre-transplant caregiving is marked by heightened stress, depression, and emotional strain, as caregivers navigate the unpredictability of conditions like cirrhosis. While liver transplantation significantly alleviates caregiver burden by stabilizing patient health, caregiving evolves rather than ends, requiring ongoing vigilance for post-transplant care, medication adherence, and lifestyle adjustments. We examine the disproportionate impact of caregiving on the family, due to entrenched cultural and gender norms and highlight how these disparities reinforce systemic neglect. Caregiving, often viewed as a familial duty, carries financial, mental, and physical health costs, perpetuating inequities and marginalization. We argue that caregivers are integral to healthcare outcomes and must be included in systemic frameworks to improve patient care. We also advocate for a paradigm shift from patient-centered to family-centered care, emphasizing caregiver inclusion as a core healthcare priority. Policy recommendations related to financial support, respite care, education, and mental health services should be tailored for caregivers. By addressing caregiver needs, healthcare systems can improve patient outcomes, reduce costs, and foster equity. This editorial underscores that caregivers are not ancillary but central to healthcare’s success. Recognizing and supporting them is both an ethical responsibility and a practical necessity for sustainable healthcare.
4. Major adverse cardiovascular events and hyperuricemia as an effect-modifying factor in kidney transplant recipients.
期刊: World journal of transplantation 发表日期: 2025-Sep-18 链接: PubMed
摘要
Major adverse cardiovascular (CV) events (MACEs) are the primary cause of morbidity and mortality in kidney transplantation (KT) recipients. The risk for MACEs is impacted by an array of traditional and transplant-related non-traditional CV risk factors. To investigate the association between potential CV risk factors related to KT and MACEs, and their potential modification by hyperuricemia (HU). The relationship between CV risk factors related to KT and MACEs was examined in a cohort of 545 patients who underwent transplantation between 2008 and 2019. The mean age of patients at KT was 55.0 years ± 14.2 years (range 15.0-89.0 years). Univariate and multivariate logistic regression models were constructed to identify risk factors influencing MACEs. To explore the potential effect modification by uric acid (UA), patients were categorized into groups based on UA levels: (1) Low (< 356 μmol/L); (2) Normal (356-416 μmol/L); (3) High (416-475 μmol/L); and (4) Very high (> 475 μmol/L). MACEs occurred in 145 of 545 (26.6%) KT recipients. The most prevalent comorbidities were hypertension (87%), dyslipidemia (78%), secondary hyperparathyroidism (68%), HU (63%) and anemia (33%). In the multivariate logistic regression model, the most significant factors associated with MACEs were previous CV events [odds ratio (OR) = 70.6, 95%CI: 24.9-200.1], left ventricular hypertrophy (LVH) (OR = 12.6, 95%CI: 2.7- 58.3), HU treatment (OR = 4.3, 95%CI: 2.4-7.6), and anemia (OR = 5.3, 95%CI: 2.9-9.8). Effect modification by the presence of HU revealed that independent factors associated with MACEs were age (OR = 1.03, 95%CI: 1.0-1.1), previous CV events (OR = 41.7, 95%CI: 13.6-127.6), LVH (OR = 15.3, 95%CI: 2.0-116.6), HU treatment (OR = 2.5, 95%CI: 1.3-4.6) and anemia (OR = 5.4, 95%CI: 2.8-10.5). Effect modification by UA levels dichotomized at 475 μmol/L (very high level of UA) revealed that HU treatment was not associated with MACEs in groups with or without very high UA levels. A very high level of UA was observed to act as an effect-modifying factor for MACEs, especially when combined with other risk factors such as age, previous CV events, LVH, and anemia.
5. Depiction of a Novel Patient Navigator Program to Support Delayed Discharges Among Older Adults Admitted to Acute Care.
期刊: Canadian geriatrics journal : CGJ 发表日期: 2025-Sep 链接: PubMed
摘要
A novel Patient Navigator Program (PNP) was introduced at a Canadian hospital’s Reactivation Care Centre (RCC) to support transitions by helping older adults navigate the complexities of delayed discharge stays by improving their transition from hospital to home. The PNP was comprised of a community agency patient navigator who was embedded into the RCC setting to support transitions in care, and who followed patients up to 90 days post-hospital discharge. The purpose of this study was to describe the PNP, which included detailing the needs of patients (i.e., socio-demographics, case-mix, delayed discharge), the scope of service provision (i.e., referral process, follow-up duration), and patient outcomes (i.e., post-discharge location). A cohort observational design was used to collect data on the PNP mainly via the patient navigator’s clinical tracking sheet, and secondly via the hospital’s administrative system. Data analysis included the use of frequencies and descriptive statistics. Between November 2021 and October 2022, 100 patients were referred to the PNP, with 70 patients (39% male; 61% female; median age of 81 years) being admitted to the patient navigator’s caseload. The patient navigator provided follow-up care for a median of 58 days, and supported 76% of the patients (n=53) to return to their next point of care (e.g., homes or to a supportive housing setting). The PNP led to a high proportion of patients being discharged back to the community. This study provides insights to providers and decision-makers interested in implementing PNP care models in a hospital in partnership with a community agency.
6. Medical Information Provided by Transgender and Gender-Diverse Content Creators on YouTube: Descriptive Content Analysis.
期刊: JMIR formative research 发表日期: 2025-Aug-29 链接: PubMed
摘要
Transgender and gender-diverse (TGD) individuals frequently turn to social media to find community, express their identities, and access essential information. These platforms are easily accessible to TGD people and enable health information-seeking in anonymous, identity-affirming spaces outside of traditional health care systems. As a result, social media has become a critical source of health information on topics like gender-affirming care for TGD individuals, specifically for TGD youth. YouTube, one of the most widely used social media platforms, is especially popular for its long-form videos made by content creators who have built dedicated followings on the platform. Among them are TGD content creators, many of whom make content documenting their medical transition and gender identity journey and provide general information about TGD topics. TGD creator content therefore makes YouTube an important platform for health education for TGD individuals. This study aims to describe the health-related content shared by TGD content creators on YouTube. Specifically, we characterize the medical topics addressed, the frameworks used to discuss these topics, and the valence of creators’ health care experiences. A descriptive content analysis was performed on 2485 videos posted by 42 self-identified TGD YouTube content creators. Videos were systematically evaluated for mentions of gender-affirming care and other health-related topics. We also examined whether creators framed medical information using personal narratives or an informational approach and if they characterized their medical experiences as positive, negative, or neutral. Most videos (n=1724, 69.4%) created by TGD content creators did not include discussions related to gender identity or transitioning. However, among the videos that did address gender identity (n=761, 30.6%), mentions of medical topics were prevalent (n=554, 72.8%). Of videos that discussed medical topics, gender-affirming surgeries (n=356, 64.3%) and hormone replacement therapy (n=307, 55.4%) were the most frequently discussed. Other commonly discussed medical topics included mental health (n=131, 23.6%) and sexual health (n=96, 17.3%). Videos covering medical topics primarily centered on personal experiences (n=411, 74.2%), with content creators often characterizing these experiences positively (n=224, 73.2%). This study highlights the breadth of health-related information shared by TGD content creators on YouTube. Our findings underscore the role of long-form video content on YouTube as an educational resource for TGD people, offering health information that is both easy to access and grounded in lived experience. Clinicians can use these findings to better understand the health information that their TGD clients are likely to encounter online, fostering more informed and supportive conversations about gender-affirming care.
7. A Robot-Delivered Training Program to Improve Children's Mental Health and Resilience in Dutch Primary Schools: Pilot Intervention Study.
期刊: JMIR formative research 发表日期: 2025-Aug-29 链接: PubMed
摘要
Mental health problems often start at an early age and can persist into adulthood, leading to physical and mental health problems such as substance abuse, sleep problems, depressive disorders, and suicidal tendencies. Therefore, it is important to invest in the mental health of young people through, for example, initiatives focused on mental health promotion and prevention. The ePartners robot buddy offers children training modules focused on enhancing resilience and mental health, specifically targeting self-image and social skills and/or addressing unhelpful feelings and thinking patterns in children’s daily life situations. The study primarily aims to assess the feasibility, acceptability, and usability of the intervention according to the children and their teachers and secondarily aims to evaluate its potential effects on the mental well-being (general mental well-being, quality of life [QoL], and self-efficacy) of children. A single-arm, 6-week, pre-post pilot intervention study involving children and their teachers was conducted in 3 primary schools in the Netherlands. Outcomes were assessed using questionnaires. Primary outcomes were assessed postintervention and included feasibility and acceptability for teachers and acceptability and usability for children. Secondary outcomes included self-reported general mental well-being and self-efficacy and teacher-reported general mental well-being and were assessed at baseline and postintervention. Data showed that the intervention was generally perceived as moderately feasible according to the Feasibility of Intervention Measure (mean 17.3, SD 2.6; on a scale from 4 to 20) and showed relatively high acceptability (mean 16.9, SD 3.8; on a scale from 4 to 20) according to teachers (n=7). Additional feasibility questions showed that teachers found it generally feasible to guide children who had few questions about using the robot. Feasibility was moderate due to limited time for integration, many content-related questions from children, and the substantial learning needed to select themes. Children (n=73) reported high perceived usability of the intervention (mean 15.2, SD 2.4; on a scale from 4 to 20). The perceived acceptability of the intervention by children was also relatively high, with a mean of 12.0 (SD 2.3) on a scale from 3 to 15. Teacher-reported QoL of children improved significantly from baseline (mean 36.0, SD 4.6) to postintervention (mean 37.2, SD 3.8; t64=2.77; P=.01); however, the children’s self-reported QoL did not significantly change over time. No significant changes in general mental well-being and self-efficacy scores were found. This study provides valuable insights into the feasibility, acceptability, and usability of a robot-delivered mental health-promoting intervention within a primary school setting. Further research is needed to fully understand its potential benefits and address existing limitations associated with the implementation of such interventions in the school setting.
8. Mapping and Assessing Existing Digital Skills Training Programs for Health Care Professionals and Health Managers in Europe: Expert-Based Survey for Investigating the Landscape, Accessibility, and Effectiveness of Training Initiatives.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-29 链接: PubMed
摘要
Digital skills training in health is crucial to ensure that the health care workforce is equipped to leverage the potential of digital technologies in delivering efficient and effective care. Identifying existing training programs can be valuable to describe gaps and opportunities for acceleration in the digital age. This study aimed to map and assess existing continuous education and professional development training options in digital skills in health. As part of the EU-funded project entitled “TRANSiTION - Digital Transition and Digital Resilience in Oncology,” an expert-based approach was implemented to identify training programs in 14 European countries. The data were collected via an online survey that was developed for the purpose of this study and consisted of 23 questions categorized in 5 domains: general information, reaction, learning, behavior, and results. The analysis was performed using the 4-level Kirkpatrick model and the Digital Competence Framework for Citizens. The analysis of the data showed that 39.6% (19/48) of cases reported no official training in digital skills for the health care workforce, despite the fact that in 95.8% (45/47) of the cases digital solutions were used in the daily practice. Digital skills were a professional qualification in 31.3% (4.38/14) of the countries, and 32 out of 57 programs were provided by academic institutions. Half of the countries scored lower than the mean in the overall performance status according to the Kirkpatrick model, which reflects the gap in knowledge and skills of the workforce. Countries scored at the average or lower in all models’ domains: reaction 92.9% (13/14), behavior 78.6% (11/14), learning 71.4% (10/14), and results 50% (7/14). The quality of the programs was poor, as less than half of the competencies were met, and the evaluation reflects the great need for improving health workforce education in digital skills and the application of health technologies in practice. There was variance in the availability and quality of digital skills training across Europe. The development of a comprehensive training program targeted to improve health care professionals’ and health managers’ knowledge and skills, as well as the incorporation of digital tools into practice, is crucial.
9. Mapping Vaccine Sentiment by Analyzing Spanish-Language Social Media Posts and Survey-Based Public Opinion: Dual Methods Study.
期刊: JMIR infodemiology 发表日期: 2025-Aug-29 链接: PubMed
摘要
The internet and social media have been considered useful platforms for obtaining health information. However, critical and erroneous content about vaccines on social media has been associated with vaccination delays and refusal. This study aimed to examine how social networks influence access to and perceptions of vaccine-related information. We sought to (1) quantify the proportion of individuals engaging with vaccine-related content on social media and to characterize their demographic and behavioral profiles through an internet-based population survey conducted in Spain and (2) to analyze vaccine-related sentiments and opinions in Spanish and Catalan posts on X (X Corp [formerly Twitter, Inc] and geolocate them using artificial intelligence. Two complementary methodologies were applied. First, an observational study was conducted via a self-administered internet-based questionnaire among adults in Spain in 2021. Second, we analyzed Spanish- and Catalan-language posts from X, collected between March and December 2021. Sentiment analysis was performed using a workflow developed in Orange Data Mining (Bioinformatics Laboratory, Faculty of Computer and Information Science, University of Ljubljana). Geolocation was based on user-defined locations and visualized using Microsoft Power Business Intelligence. Social network analysis was conducted with NodeXL Pro (Social Media Research Foundation) to identify and characterize the 5 largest user communities discussing vaccines. Although based on independent data sources, the 2 approaches provided complementary methodological insights. Among the 1312 respondents in the survey, 85.7% (1124/1312) stated that they were regular social network users, and 66% (850/1287) reported having encountered antivaccine information on social networks. Of these, 24.3% (205/845) experienced doubts about receiving recommended vaccines, and out of those with doubts, 13.3% (27/203) refused at least 1 vaccine proposed by a health care professional. A total of 479,734 Spanish and Catalan posts on X were analyzed, with 54.44% (n=261,183) posts classified as negative, 28.18% (n=135,194) as neutral, and 17.37% (n=83,357) as positive. Sentiment varied across regions, with more negative posts appearing to derive from South America, with a mix in Europe and more positive posts in North America. Analysis of the topic words and key themes allowed the grouping of the predominant themes of the 5 study groups, which were (1) vaccination efforts during the COVID-19 pandemic, (2) issues of vaccine theft and struggles in managing and securing the vaccine supply, (3) campaigns in the State of Mexico, (4) vaccination efforts for older adults, and (5) the vaccination campaign in Colombia to combat COVID-19. High proportions of exposure to antivaccine content were reported by the surveyed population. Sentiment analysis and geolocation of posts on the social network X suggested a notable presence of Spanish-language posts categorized as negative, predominantly from South America. The thematic analysis of conversations on X may provide valuable insights into the population’s opinions about vaccines.
10. Decoding HIV Discourse on Social Media: Large-Scale Analysis of 191,972 Tweets Using Machine Learning, Topic Modeling, and Temporal Analysis.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-29 链接: PubMed
摘要
HIV remains a global challenge, with stigma, financial constraints, and psychosocial barriers preventing people living with HIV from accessing health care services, driving them to seek information and support on social media. Despite the growing role of digital platforms in health communication, existing research often narrowly focuses on specific HIV-related topics rather than offering a broader landscape of thematic patterns. In addition, much of the existing research lacks large-scale analysis and predominantly predates COVID-19 and the platform’s transition to X (formerly known as Twitter), limiting our understanding of the comprehensive, dynamic, and postpandemic HIV-related discourse. This study aims to (1) observe the dominant themes in current HIV-related social media discourse, (2) explore similarities and differences between theory-driven (eg, literature-informed predetermined categories) and data-driven themes (eg, unsupervised Latent Dirichlet Allocation [LDA] without previous categorization), and (3) examine how emotional responses and temporal patterns influence the dissemination of HIV-related content. We analyzed 191,972 tweets collected between June 2023 and August 2024 using an integrated analytical framework. This approach combined: (1) supervised machine learning for text classification, (2) comparative topic modeling with both theory-driven and data-driven LDA to identify thematic patterns, (3) sentiment analysis using VADER (Valence Aware Dictionary and sEntiment Reasoner) and the NRC Emotion Lexicon to examine emotional dimensions, and (4) temporal trend analysis to track engagement patterns. Theory-driven themes revealed that information and education content constituted the majority of HIV-related discourse (120,985/191,972, 63.02%), followed by opinions and commentary (23,863/191,972, 12.43%), and personal experiences and stories (19,672/191,972, 10.25%). The data-driven approach identified 8 distinct themes, some of which shared similarities with aspects from the theory-driven approach, while others were unique. Temporal analysis revealed 2 different engagement patterns: official awareness campaigns like World AIDS Day generated delayed peak engagement through top-down information sharing, while community-driven events like National HIV Testing Day showed immediate user engagement through peer-to-peer interactions. HIV-related social media discourse on X reflects the dominance of informational content, the emergence of prevention as a distinct thematic focus, and the varying effectiveness of different timing patterns in HIV-related messaging. These findings suggest that effective HIV communication strategies can integrate medical information with community perspectives, maintain balanced content focus, and strategically time messages to maximize engagement. These insights provide valuable guidance for developing digital outreach strategies that better connect healthcare services with vulnerable populations in the post-COVID-19 pandemic era.
11. Differences in Challenges to Using Telehealth Among Older Adult Video and Telephone Users With Frailty: Retrospective Observational Study.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-29 链接: PubMed
摘要
The shift to video care during the COVID-19 pandemic exacerbated disparities in health care access, especially among high-need, high-risk older adults with frailty. The objective of this study was to quantify the ability of high-need, high-risk older veterans to use video visits for health care and identify factors associated with successful video visit completion. Veterans in a Veterans Affairs Frailty Intervention and Treatment (FIT) clinic underwent a physical, functional, psychological, social, and technology assessment at baseline. During the pandemic, the FIT clinic switched to televisits. We sorted patients into 4 groups: video visit, telephone visit, reached but no visit, and unable to contact. We performed a t test to compare normal variables and a chi-square test to compare categorical variables to identify factors associated with completing a video visit versus a telephone visit. We attempted to contact 110 patients from the FIT clinic. They were 73.5 (SD 5.6) years old on average. A total of 46 (41.8%) patients were White, 46 (41.8%) patients were Black, and 17 (15.5%) patients were Hispanic. Sixty-seven (60.9%) patients had at least some college education, and 49 (44.5%) patients were very confident in filling out medical forms. Of the 110 patients, 72 patients were reached, and 65 patients agreed to a televisit. Of the 65 patients who agreed to a televisit, 19 (29.2%) patients completed a video visit, while 37 (57%) completed a telephone visit. A total of 19 patients out of 25 (76%) of those who scheduled a video visit completed it successfully. Compared with those who completed a telephone visit, veterans who completed a video visit were more likely to have access to a computer with a camera, microphone, and high-speed internet/data plan, as well as the ability to use email and be confident in internet use. They were more likely to have a higher health literacy score and be cognitively intact with a Montreal Cognitive Assessment score of ≥26, and were less likely to experience issues with walking, stepping, and balance. Our study found that completing a video visit requires access to technology, the ability to use it, and a willingness to do so. Among older veterans with frailty, only a quarter completed a video visit, and this group comprised patients who already had access to video-capable technology, used it, and were comfortable with it. They were also more often physically and cognitively intact compared with those who used telephone visits. Strategies to expand the use of video visits in the care of older adults include screening older adults to identify individuals most likely to succeed and increasing access to simple home telehealth technology.
12. The Mexican Version of the Interactive mHealth App Usability Questionnaire (Mx-MAUQ) in Women With Breast Cancer: Instrument Validation Study.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-29 链接: PubMed
摘要
Successful eHealth applications require careful assessment to ensure their ease of use, usefulness, and user satisfaction. Responsive web applications are eHealth tools that operate on any internet-enabled device across all browsers. Psychometrically valid assessment tools are essential for effectively evaluating these applications, yet no validated eHealth questionnaire exists for assessing their usability and user satisfaction in Mexico. The objective of this study is to adapt the mHealth App Usability Questionnaire (MAUQ) for responsive web application assessment in Mexico and validate adapted Mx-MAUQ content, construct validity, internal consistency, and its ability to distinguish between patient subgroups. We conducted a psychometric validation study of Mx-MAUQ with women aged 20 to 75 diagnosed with stage I-III breast cancer who had begun neoadjuvant or adjuvant treatment within the last six weeks and used the responsive “OncoMama App” for 1 month. The study excluded women with stage IV breast cancer, illiterate women, and those with blindness, cognitive disability, or severe depression. Participants were recruited from oncology services at 4 hospitals belonging to the Mexican Institute of Social Security between August 2023 and November 2024. The study involved translating and adapting the MAUQ while evaluating its content through expert panels and cognitive interviews with women. The Mx-MAUQ construct was assessed through exploratory factor analysis (EFA), internal consistency via Cronbach α, and Mx-MAUQ’s capacity to distinguish between subgroups of patients with breast cancer using the Wilcoxon rank sum test. A total of 210 women participated, with 75.2% (n=158) aged 60 or younger and 64.3% (n=135) having high school education. The expert panel granted all Mx-MAUQ items a content validity index (CVI) above 0.7. Experts have found that the MAUQ questions are general enough to be relevant not only to mobile apps or specific medical conditions but also to a variety of digital platforms, including responsive web applications and different health conditions. The cognitive interviews revealed 3 unclear terms in the questionnaire; consequently, we defined “application interface” and changed “social settings” to “social environments” and “manage my health” to “take care of my health.” EFA identified 2 factors explaining 91.6% of the variance and retaining all items. The first factor, “Ease of Use,” consists of 9 items and has a Cronbach α of .94. The second factor, “Satisfaction, Usefulness, and System Information Arrangement,” includes 12 items and has a Cronbach α of .97. Women with higher education levels scored significantly higher for both factors, as well as the overall Mx-MAUQ score, than those with lower educational attainment. Mx-MAUQ showed satisfactory psychometric properties based on EFA, internal consistency, and discriminant analysis, making it a suitable tool for a comprehensive assessment of the usability of interactive web-based eHealth applications for women with breast cancer in Mexico.
13. An Enhanced Social Network Strategy to Increase the Uptake of HIV Services: Protocol for Type I Hybrid Implementation Study (Carolinas RESPOND).
期刊: JMIR public health and surveillance 发表日期: 2025-Aug-29 链接: PubMed
摘要
In the United States, persisting new HIV diagnoses among gay, bisexual, and other cisgender men who have sex with men (GBMSM) and transgender women make it unlikely that the United States will meet the Ending the HIV Epidemic’s (EHE) goal to reduce new HIV diagnoses by 90% by 2030. Innovative strategies are needed to address this challenge, particularly in the US South, where Black and Latinx GBMSM and transgender women are disproportionately impacted by HIV. Social network approaches have led to increased HIV testing uptake. Social network interventions that are responsive to individuals’ needs among disproportionately impacted groups could also increase engagement across the HIV prevention and care continuum. This hybrid type 1 effectiveness-implementation study will evaluate an enhanced social network strategy (eSNS) intervention designed to increase engagement in HIV services (HIV testing, pre-exposure prophylaxis [PrEP] use, and HIV care) by groups disproportionately affected by HIV. From 2025 to 2027, eSNS will be delivered in the Charlotte, North Carolina (NC) region, which includes Mecklenburg County, a priority EHE jurisdiction. The study’s phase 1 was a formative period of mixed methods data collection to operationalize enhancements to the Centers for Disease Control and Prevention’s social network strategy (SNS). In Phase 2, the intervention will be integrated into standard NC Partner Services for people diagnosed with HIV and their sexual or social contacts, which is routinely performed by disease intervention specialists (DISs). We will identify network recruiters (ambassadors) who are 18 years and older and are either reached by study team DIS (DIS coaches) performing partner services or referred at community sites. Over 2-6 weeks, DIS coaches will guide ambassadors to identify and refer people in their network (peers) for HIV services and will facilitate peers’ referrals to HIV services. Finally, Phase 3 will evaluate the eSNS’s effectiveness in increasing HIV services uptake compared to standard-of-care partner services in the Raleigh, NC region. This project was funded by the National Institutes of Health and initially approved by the University of North Carolina at Chapel Hill’s Institutional Review Board in 2022. Phase 1 concluded in August 2024. Implementation of eSNS (Phase 2) was launched in March 2025. Based on phase 1 findings, the study was modified to include Ambassadors of any race or ethnicity and gender (originally only Black GBMSM and transgender women) and expand identification of ambassadors through community sites (in addition to partner services). Substantial reductions in new HIV diagnoses depend on public health approaches that effectively reach people with a higher likelihood of acquiring HIV. Our protocol proposes integrating existing strategies with an innovative intervention (eSNS) to reduce social barriers to disproportionately affected groups’ engagement in the full HIV prevention and care continuum.
14. Natural Language Processing and ICD-10 Coding for Detecting Bleeding Events in Discharge Summaries: Comparative Cross-Sectional Study.
期刊: JMIR medical informatics 发表日期: 2025-Aug-29 链接: PubMed
摘要
Bleeding adverse drug events (ADEs), particularly among older inpatients receiving antithrombotic therapy, represent a major safety concern in hospitals. These events are often underdetected by conventional rule-based systems relying on structured electronic medical record data, such as the ICD-10 (International Statistical Classification of Diseases and Related Health Problems 10th Revision) codes, which lack the granularity to capture nuanced clinical narratives. This study aimed to develop and evaluate a natural language processing (NLP) model to detect and categorize bleeding ADEs in discharge summaries of older adults. Specifically, the model was designed to distinguish between “clinically significant bleeding,” “severe bleeding,” “history of bleeding,” and “no bleeding,” and was compared with a rule-based algorithm using ICD-10 codes. Clinicians manually annotated 400 discharge summaries, comprising 65,706 sentences, into four categories: “no bleeding,” “clinically significant bleeding,” “severe bleeding,” and “history of bleeding.” The dataset was divided into a training set (70%, 47,100 sentences) and a test set (30%, 18,606 sentences). Two detection approaches were developed and evaluated: (1) an NLP model using binary logistic regression and support vector machine classifiers, and (2) a traditional rule-based algorithm relying exclusively on predefined ICD-10 codes. To address class imbalance, with most sentences categorized as irrelevant (“no bleeding”), a class-weighting strategy was applied in the NLP model. Model performance was assessed using accuracy, precision, recall, F1-score, and receiver operating characteristic (ROC) curve analyses, with manual annotations as the gold standard. The NLP model significantly outperformed the rule-based approach across all evaluation metrics. At the document level, the NLP model achieved macro-average scores of 0.81 for accuracy and 0.80 for F1-score. Precision was particularly high for detecting severe (0.92) and clinically significant bleeding events (0.87), demonstrating strong classification capability despite class imbalance. ROC analyses confirmed the model’s robust diagnostic performance, yielding an area under the curve (AUC) of 0.91 when distinguishing irrelevant sentences from potential bleeding events, 0.88 for identifying historical mentions of bleeding, and notably, 0.94 for differentiating clinically significant from severe bleeding. In contrast, the rule-based ICD-10 model demonstrated high precision (0.94) for clinically significant bleeding but poor recall (0.03) for severe bleeding events, reflecting frequent missed detections. This limitation arose due to its reliance on commonly used ICD-10 codes (eg, gastrointestinal hemorrhage) and inadequate capture of rare severe bleeding conditions such as shock due to hemorrhage. This study highlights the considerable advantage of NLP over traditional ICD-10-based methods for detecting bleeding ADEs within electronic medical records. The NLP model effectively captured nuanced clinical narratives, including severity, negations, and historical bleeding events, demonstrating substantial promise for improving patient safety surveillance and clinical decision-making. Future research should extend validation across multiple institutions, diversify annotated datasets, and further refine temporal reasoning capabilities within NLP algorithms.
15. Integrated Model of Cancer Control for Early Detection and Treatment in Adolescents and Young Adults Living With HIV: Protocol for a Cluster Randomized Controlled Trial.
期刊: JMIR research protocols 发表日期: 2025-Aug-29 链接: PubMed
摘要
Zambia has one of the highest prevalence rates of HIV among adolescents and young adults (AYA) living with HIV in sub-Saharan Africa, which accounts for half of all new HIV cases as of 2023. Compared to their peers who are not living with HIV, AYA living with HIV are more likely to develop cancer. The most frequently diagnosed cancers among AYA living with HIV in Zambia are cervical cancer, Kaposi sarcoma, and non-Hodgkin lymphoma. Premature cancer mortality among AYA living with HIV is driven by late-stage presentation and poor treatment adherence. We aim to develop and test an integrated model of cancer control for AYA living with HIV that can be delivered as an embedded component in existing HIV treatment programs in primary care facilities and linked with specialized treatment at cancer centers. We propose a cluster randomized controlled trial to compare the AYAHIV Role-Based Responsibilities for Oncology-Focused Workforce (ARROW) program with a one-time education campaign. The ARROW program consists of interventions at the individual, health care provider, and health system levels. Peer counselors will educate AYA living with HIV through one-on-one and group education sessions and offer care coordination and linkages with clinicians. The HIV and oncology workforce will receive collaborative education and training. The ARROW Health Care Collaborative will connect administrators and policy makers to address system-level barriers. The study will recruit AYA living with HIV between the ages of 15 and 39 years who have been on antiretroviral therapy for at least 6 months and are not pregnant; the cancer treatment cohort will enroll AYA living with HIV who have been diagnosed with cervical cancer, Kaposi sarcoma, or non-Hodgkin lymphoma in Lusaka, Zambia. Half of the 18 HIV facilities have been randomly assigned to a one-time educational campaign and the other half to the ARROW intervention. Participants in the cancer treatment cohort will be randomized into 1 of the 2 study arms. We will conduct economic evaluations to assess the cost-effectiveness of the ARROW program. We will use an intent-to-treat approach to test the hypothesis that AYA living with HIV in the ARROW program will have higher uptake of diagnostic services, increased adherence to treatment, and improved outcomes compared to those receiving one-time education. As of March 2025, early detection cohort recruitment concluded with 3442 participants and cancer treatment cohort enrollment is ongoing, with 105 participants thus far. Results pertaining to the 12-month end points will be available in early 2026. If successful, the ARROW program will offer a model to improve cancer prevention, early diagnosis, and treatment through improved integration between HIV and cancer services. Furthermore, ARROW can provide a framework for implementing expanded services, such as survivorship care, for AYA living with HIV. DERR1-10.2196/68254.
16. Impact of Knowledge Access on Risky Sexual Behaviors Among Chinese Youths to Improve HIV Prevention: Cross-Sectional Study.
期刊: JMIR public health and surveillance 发表日期: 2025-Aug-29 链接: PubMed
摘要
HIV infection significantly challenges Chinese youth, with most infections resulting from risky sexual behaviors. Health communication is critical in preventing risky behaviors. Different HIV-related information sources exhibit unique characteristics, affecting young adults’ perception of HIV and sexual behaviors. This study aimed to examine the relationship between knowledge accesses and risky behaviors, analyzing the mediating effects of HIV-related knowledge to provide evidence for more effective HIV knowledge dissemination and the reduction of risky behaviors among youth. A questionnaire on HIV-related knowledge and behavior of young students was used for the online survey. Knowledge accesses included school education, mass communication, and interpersonal communication. HIV-related knowledge was categorized into fundamental and behavioral guidance knowledge. Risky behavior was defined as multiple sexual partners or unprotected sex. Binary logistic regression was used to analyze the relationship between knowledge accesses, HIV-related knowledge, and risky behaviors. Multiple mediation models constructed by the Process macro (version 4.1) were conducted to determine whether the knowledge level mediated the relationship between knowledge accesses and risky behaviors. Totally 20,602 respondents participated, with 9541 (46.31%) males and 11,061 (53.69%) females, averaging 20.14 (SD 1.91) years. Mass communication reached 19,030 (92.37%) students, school education reached 17,949 (87.12%), and 11,274 (54.72%) accessed interpersonal communication. Among the 2423 sexually active students, 363 (14.98%) had multiple sexual partners, and 830 (34.26%) engaged in unprotected sex. School education (odds ratio [OR] 0.60, 95% CI 0.46 to 0.78), mass communication (OR 0.64, 95% CI 0.47 to 0.87) and behavioral guidance knowledge (OR 0.79, 95% CI 0.69 to 0.90) were negatively associated with multiple sexual partners, while interpersonal communication (OR 1.41, 95% CI 1.13 to 1.75) was positively associated. School education (OR 0.75, 95% CI 0.62 to 0.91) and behavioral guidance knowledge (OR 0.81, 95% CI 0.73 to 0.89) were negatively correlated with unprotected sexual behaviors, while interpersonal communication (OR 1.27, 95% CI 1.09 to 1.46) and fundamental knowledge (OR 1.17, 95% CI 1.08 to 1.28) were significantly positively correlated. Knowledge accesses indirectly influenced risky behaviors through fundamental and behavioral guidance knowledge. School education had opposing indirect effects of -0.02 and 0.02 through behavioral guidance and fundamental knowledge, mass communication showed effects of -0.04 and 0.01, while interpersonal communication demonstrated indirect effects of 0.01 and 0.01 for both pathways. Students acquiring HIV knowledge from school education and mass media are less likely to engage in risky behaviors than those learning through interpersonal communication. We should fully leverage the advantages of school education and mass communication, and an emphasis should be placed on behavioral guidance knowledge to promote changes in risky behavior. Knowledge access primarily influences risky behaviors by shaping cultural values and behavioral norms, rather than transmitting information.
17. A Mobile App (CareFit) Supporting Physical Activity for Informal Carers of People With Dementia: Mixed Methods Feasibility and Adaptation Study.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-29 链接: PubMed
摘要
Informal carers are critical in looking after people with dementia. The value of all informal care as a total in the United Kingdom is now estimated to be £184 billion (US $249 billion). However, many carer groups are inadequately supported and face poor mental and physical health with limited opportunities for physical activity. There is a public health priority to address such challenges and a lack of innovation regarding approaches to promote physical activity. This study aimed to co-design, adapt, and explore the feasibility of a novel cross-platform approach to support physical activity among carers of people with dementia. Project stages included a co-design phase followed by a feasibility study guided by both the reach, effectiveness, adoption, implementation, and maintenance and Medical Research Council complex intervention frameworks. Co-design involved 3 development “sprints,” gaining feedback from a range of stakeholders (eg, carers, support professionals, charities, researchers, and developers) and identifying priority areas. Our feasibility study involved the evaluation of our recruitment, intervention, and outcome approaches over 8 weeks (target population: N=50) with participants. Participants were recruited from local community networks in Scotland as well as research study registries. We successfully co-designed, developed, and user tested the CareFit app. Final app design included a simplified navigation system and increased delivery of video content as well as a more personalized delivery approach. In total, 41 carers of people with dementia were recruited, with 21 (51%) completing the 8-week study. Study retention was considerably lower for carers with higher levels of physical activity at baseline as opposed to those with lower levels (5/14, 36% vs 16/27, 59%, respectively). CareFit was rated as “acceptable” on the System Usability Scale, and we observed common user patterns of behavior (eg, an initial focus on the Learn section). The feasibility study results demonstrated that the intervention appeared safe for use (no adverse events reported) and the video content for carers was well received. A greater depth of social elements appears critical for future development. Although professional stakeholders did not reach consensus on the outcome of greatest utility, the outcome measures tested were largely suitable for future use in this group, including novel sedentary behavior and muscle and balance measures. Many carers of people with dementia do not have the same access to physical activity as noncarers. Our findings show key challenges regarding recruitment and retention. Although we cannot currently recommend progression to a randomized controlled trial, we conclude that further work is needed to better understand the “active ingredients” of the intervention outlined. This includes exploring the delivery of a preventative intervention earlier in the carer trajectory-something critical for adoption and long-term use. RR2-10.2196/53727.
18. Social Skills and Connectedness in School-Age Children From Vulnerable Backgrounds Who Stutter.
期刊: Journal of speech, language, and hearing research : JSLHR 发表日期: 2025-Aug-29 链接: PubMed
摘要
Exploring the psychosocial experiences of school-age children from vulnerable backgrounds who stutter allows for a better understanding of the compounding impacts of stuttering and challenging familial factors. Data were drawn from Wave 5 of the Future of Families and Child Wellbeing Study (FFCWS). This study evaluated social adaptability among children from vulnerable backgrounds who do stutter (CVBWS) and children from vulnerable backgrounds who do not stutter (CVBWNS) using two scales: the Social Skills Rating System (SSRS) and the Connectedness at School Scale (CSS). A comparison of means and regression analyses were used to compare the groups controlling for heterogeneity in diverse demographics. This study utilized survey-specific analytic tools in SAS 9.4 that account for the sampling framework, survey design, and reporting structure of the FFCWS. Of the 3,345 caregivers (unweighted count), 106 reported that their child stuttered or stammered. CVBWS reported lower CSS (2.97, SD = 1.06) than the CVBWNS (3.08, SD = 0.97)-a statistically significant difference (t = 2.51, p = .013). CVBWS also exhibited poorer social skills as indicated by a lower average SSRS rating (48.15 points, SD = 10.99) compared to CVBWNS (54.11 points, SD = 12.96; t = -3.77, p < .001). When working with CVBWS, it is important that baseline and posttreatment measures encompass more than just speech production outcomes. Current findings support this position, as some CVBWS experience more negative social interactions within their school than CVBWNS. Therefore, it is critical that additional attention be paid to the social and emotional development of CVBWS.
19. Essential competencies of Chief Wellness executives in higher education.
期刊: Journal of American college health : J of ACH 发表日期: 2025-Aug-29 链接: PubMed
摘要
The evolving landscape of health and well-being in higher education has underscored the critical need for strategic leadership roles, such as Chief Wellness/Well-being Officers (CWOs/CWBOs), to promote campus-wide resilience and holistic health. In response to the growing complexity of institutional wellness efforts following the COVID-19 pandemic, the American College Health Association’s Health and Well-being Executive Leaders (HWEL) Section conducted a national needs assessment to identify essential competencies, and development priorities for wellness executives. With input from over 60% of section members, findings revealed key gaps in systems thinking, strategic planning, data literacy, and organizational influence. This article proposes a foundational competency framework tailored to the unique demands of higher education leadership, with actionable recommendations for professional development, mentorship, and institutional advocacy. By formalizing competency expectations, ACHA aims to support the growth of a robust, professionalized pipeline of well-being leaders capable of integrating wellness into the core mission and operations of colleges and universities nationwide.
20. Setting Goals and Accepting Challenges for Behavior Change-Analysis of Participants' Interactions With a Digital Multiple Health Behavior Intervention: Mixed Methods Study.
期刊: JMIR human factors 发表日期: 2025-Aug-29 链接: PubMed
摘要
Digital interventions are effective in promoting healthy behaviors and are recognized as one of many strategies for achieving healthier populations. These interventions often include goal-setting, but the practical application and fidelity of goal setting, especially when targeting multiple health behaviors, remain underexplored. In a factorial randomized trial, we included goal-setting as one of six behavior change components in the digital intervention “Buddy,” targeting university and college students’ alcohol, diet, physical activity, and smoking behaviors. However, we found no strong and consistent evidence of an effect of goal-setting alone on any of the outcomes, highlighting the need to investigate how participants used this component. This case study of Buddy aimed to gain insight into participants’ interactions with the goal-setting component. Specific objectives were to identify the characteristics of participants who used this component and to analyze participants’ self-authored content. This study combined fidelity and effectiveness findings and involved 1704 participants from 18 universities and colleges in Sweden. Self-authored goals and challenges were analyzed using summative content analysis. Logistic and negative binomial regression analyses were conducted to estimate the odds of setting a goal, selecting or self-authoring a challenge, to estimate the odds of setting a goal with respect to a specific behavior, and to estimate the frequency of selecting or self-authoring different behavioral challenges. Of the 850 participants given access to the goal setting and challenges component, 427 (50%) set at least one goal and 403 (47%) selected or self-authored at least one challenge. A total of 607 goals were set, with most participants setting one goal (336/427, 79%). Goals primarily targeted physical activity (n=302), dietary behavior (n=140), and multiple health behaviors (n=53), typically combining physical activity with diet, alcohol, smoking, or sleep. Other goals included study performance, mental health, sleep, and mobile phone use (n=73). Fewer goals concerned alcohol (n=19) or tobacco (n=17). Participants selected 1506 challenges from 41 premade challenges, with dietary behavior challenges being most popular (667/1506, 44%). An additional 170 challenges were self-authored. Participants’ baseline characteristics were associated with the odds of setting goals targeting specific behaviors and the frequency of selecting or self-authoring challenges targeting specific behaviors. Our analyses suggest that, while goal-setting is theoretically grounded, and participants used Buddy in ways that suited their personal needs, this did not translate to measurable behavior change in the study population. The self-authored content showed how participants used the component and provided insights into how they articulate behavior change in terms of personal goals, challenges, strategies for action, motivation plans, and rewards. Future research should explore the conditions under which goal-setting may be more or less effective, to better understand its nuances and potential benefits.
21. Developing a Health Education Program for the Prevention and Control of Infectious Diseases Culturally Adapted to Ethnic and Rural Communities: Co-Design Study Using Participatory Audiovisual Methods.
期刊: Journal of participatory medicine 发表日期: 2025-Aug-29 链接: PubMed
摘要
Infectious diseases disproportionately affect rural and ethnic communities in Colombia, where structural inequalities such as limited access to health care, poor sanitation, and scarce health education worsen their effects. Education is essential for preventing and controlling infectious diseases, fostering awareness of healthy behaviors, and empowering communities with the knowledge and skills to manage their health. Participatory and co-design methods strengthen educational programs by ensuring cultural relevance, enhancing knowledge retention, and promoting sustainable community interventions. This study aims to describe the co-design process and evaluate the capacity building of an education program for the prevention and control of infectious diseases using participatory audiovisual methods culturally adapted to ethnic communities and rural contexts in Colombia. A qualitative case study approach was used. 15 community leaders contributed to the program’s design, implementation, and evaluation. Nominal groups and a participatory social diagnosis identified key topics, while theoretical-practical sessions with visual methods guided the cocreation of workshops and audiovisual materials. Evaluation combined qualitative analysis of participants’ perceptions and quantitative assessment of knowledge acquisition. Qualitative data were coded through content analysis, while multiple-choice questionnaires (initial and final) categorized knowledge acquisition into 3 levels (low, medium, and high), with percentage distributions used for comparative analysis. The co-design process resulted in 12 theoretical and practical workshops in infectious diseases and 3 audiovisual products: an animation about malaria, a comic book about cutaneous leishmaniasis, and a puppet show about tuberculosis. The quantitative evaluation applied to the 15 participants revealed substantial improvements, with the proportion that achieved excellent scores in pedagogy increasing from 40% (6/15) to 93% (14/15), in leadership from 13% (2/15) to 27% (4/15). In terms of health knowledge, excellent scores increased from 40% for leishmaniasis, 60% for malaria, and 13% for tuberculosis, reaching 80% for all three diseases. The qualitative evaluation showed positive results in terms of the participants’ perceptions of both the methodology and the co-design process outcomes. The co-design process was driven by 3 key factors: (1) active community participation at every stage; (2) knowledge exchange between multidisciplinary technical expertise and practical local knowledge; and (3) the use of innovative, culturally adapted pedagogical tools tailored to the rural context and population. This co-design process proved to be an effective method for meaningful capacity building among populations experiencing vulnerability in complex settings, and has the potential to contribute significantly to the improvement of infectious disease prevention and control.
22. First-generation N-terminal domain supersite public antibodies retain activity against Omicron-derived lineages and protect mice against Omicron BA.5 challenge.
期刊: mBio 发表日期: 2025-Aug-29 链接: PubMed
摘要
Monoclonal antibodies to SARS-CoV-2 can offer prophylactic and therapeutic protection against severe disease, with particular utility for immunosuppressed and vulnerable populations. With the constant emergence of new variants, understanding the neutralizing potency of monoclonal antibodies to dynamic spike protein epitopes is crucial. We show that a set of VH1-24-derived N-terminal domain (NTD)-directed antibodies, isolated from a convalescent donor early in the pandemic, displayed remarkable neutralization resilience against many Omicron SARS-CoV-2 variants, including BA.2, BA.5, and BQ.1.1. Neutralization potency to these Omicron variants is associated with slower off-rates to the spike protein. Structural characterization of the most potent NTD antibody, WRAIR-2008, revealed a conserved mode of interaction shared with other antibodies of the same multi-donor class. WRAIR-2008 protected mice from weight loss following BA.5 challenge and reduced infectious viral titers in the lungs. Our study highlights the retention of neutralization activity and protection of first-generation VH1-24-derived NTD-directed antibodies to specific Omicron variants and provides valuable insights into the shifting landscape of SARS-CoV-2 variants that are vulnerable to select monoclonal antibodies. As SARS-CoV-2 circulating variants evolve, it is important to understand the vulnerabilities of these viruses to neutralizing antibodies. Within this manuscript, we describe first-generation antibodies isolated following infection with WA-1 that retain viral neutralization to subsequent Omicron variants by targeting a site of viral vulnerability called the NTD. This work highlights the shifting landscape of SARS-CoV-2 variants and provides mechanistic insights into how antibodies from prior infections may play a role in preventing subsequent SARS-CoV-2 variant infections.
23. Chemical Composition and Insecticidal Activity of Pastinaca sativa L. Essential Oils Against Two Storage Insects.
期刊: Chemistry & biodiversity 发表日期: 2025-Aug-29 链接: PubMed
摘要
Essential oils (EOs) derived from certain medicinal plants present a potential alternative to synthetic insecticides for managing stored-product insects. Two major insects, Tribolium castaneum (TC) Herbst (Coleoptera: Tenebrionidae) and Lasioderma serricorne (LS) (Coleoptera: Ptinidae), are key targets for EO control. Pastinaca sativa L. has medicinal and industrial uses and shows potential as a biopesticide. EOs were extracted from P. sativa aerial parts (A1) and fresh roots (R1-R3 obtained sequentially) via hydrodistillation. Gas chromatography-mass spectrometry (GC-MS) analysis showed 3-carene, 2,6-dimethyl-1,3,5,7-octatetraene, E,E-, and myristicin as dominant components in A1 EO, R1 EO and R2, R3 EOs. Four EOs exhibited both contact toxicity and repellent activity. R1-R3 EOs demonstrated strong efficacy compared to A1, showing the LD50 values: 8.25 µL/adult for R1 EO against TC and 14.31 µL/adult for R3 EO against LS. EO’s repellent effects were comparable to N,N-diethyl-3-methylbenzamide (DEET) at the highest concentrations. As the concentration decreased, the repellent effect gradually turned into an attractant effect. Generally, four EOs exhibited stronger repellent effects against TC than LS. This research confirmed that P. sativa EOs possessed insecticidal potential and offered scientific guidance for its efficient extraction, demonstrating its promise as a novel eco-friendly insecticide.
24. Integrating serotyping, MLST, and phenotypic data: decoding the evolutionary drivers of Salmonella pathogenicity and drug resistance.
期刊: Applied and environmental microbiology 发表日期: 2025-Aug-29 链接: PubMed
摘要
Global surveillance of Salmonella enterica reveals dynamic evolutionary forces shaping pathogenicity and antimicrobial resistance (AMR), yet the integration of serotyping, multilocus sequence typing (MLST), and phenotypic landscapes remains unexplored. Here, we dissect 935 Salmonella isolates, collected from both clinical and food chain sources, through integrated genomics and phenomics to resolve population structure, spatiotemporal dynamics, and evolutionary drivers. Salmonella Typhimurium (18.7%) and Salmonella Enteritidis (17.1%) dominate the serotype landscape, while MLST uncovers ST34 (20.7%) as the pivotal sequence type bridging multiple serotypes. Temporal tracking (2018-2022) exposes alarming AMR trajectories: ciprofloxacin resistance doubled (15.3% to 30.4%) by 2020, and tetracycline resistance peaked at 77.3%. The serotype-specific epidemiology reveals that S. Typhimurium declined and then stabilized, S. Enteritidis fluctuated due to vaccination, and S. Derby emerged persistently (+69%). Network analysis reveals two evolutionary clusters: one anchored by S. Typhimurium/S. Enteritidis-ST34/ST11 and another harboring diverse STs associated with S. Derby. Notably, ST34 acts as a genetic backbone for serotype switching. Notably, S. Typhimurium exhibits the highest AMR gene burden (median: 4.2 genes/isolate) and virulence arsenal (spvB: 85.1%; pefA: 75.4%), which correlates with invasive disease. Geographic heterogeneity results in distinct serotype distributions: S. Enteritidis dominates in Xinyu (28.4%), S. Typhimurium prevails in Shangrao (31.5%), and Ganzhou exhibits balanced diversity. Our findings establish that clonal expansion, horizontal gene transfer, and regional ecologies are key factors jointly driving Salmonella evolution. This necessitates genotype-phenotype-integrated surveillance to preempt the emergence and widespread dissemination of resistance and virulence.IMPORTANCESalmonella enterica is a globally significant foodborne pathogen, whose pathogenicity and antimicrobial resistance (AMR) evolution are driven by complex mechanisms. This study provides a comprehensive analysis of 935 Salmonella isolates from clinical and food chain sources, integrating genomic and phenotypic data to elucidate population structure, spatiotemporal dynamics, and key evolutionary drivers. We reveal critical resistance trends, including a concerning doubling of ciprofloxacin resistance by 2020 and sustained high tetracycline resistance. Our comparative analysis of serotypes (e.g., S. Typhimurium and S. Enteritidis) highlights associations between AMR gene burden and virulence factors and identifies ST34 as a pivotal genetic element facilitating serotype switching. These findings underscore the imperative for integrated genotypic-phenotypic surveillance to predict resistance evolution and inform “One Health”-based interventions. By disrupting AMR dissemination across the animal food chain, this research offers novel strategies for global Salmonella control and improved public health outcomes.
25. Caspase cleavage of Kaposi sarcoma-associated herpesvirus proteins: a role for K5 in preventing caspase-mediated cell death during lytic replication.
期刊: Journal of virology 发表日期: 2025-Aug-29 链接: PubMed
摘要
Viral infections lead to caspase activation as a cellular defense response. Some viruses overcome this response by encoding viral proteins that undergo caspase cleavage and, by various mechanisms, aid in cell survival. Kaposi sarcoma-associated herpesvirus (KSHV) latency-associated nuclear antigen acts as a pseudo-substrate for caspases-1 and -3, thereby interfering with the inflammatory and apoptotic response. Here, we screened the KSHV proteome for additional caspase cleavage sites. Using SitePrediction, many KSHV proteins with potential caspase cleavage sites were identified. Among the highest-scoring proteins was the early lytic protein, K5. Treatment of BJAB-K5-FLAG-expressing cells with ⍺Fas led to caspase processing of K5-FLAG. Using mass spectrometry, we determined that caspase cleavage of K5 occurs at D222. K5 was also cleaved by caspases when KSHV was induced to lytic replication. Interestingly, the expression of K5-FLAG significantly inhibited ⍺Fas-induced caspase-mediated cell death. To determine if K5 plays a protective role in KSHV-infected cells, iSLK cells infected with wild-type or K5-knockout BAC16 virus were induced to lytic replication. Although lytic induction showed no significant effect on the viability of wild-type-infected cells, the viability of K5-knockout cells decreased by 25%. Thus, K5 may protect KSHV-infected cells from caspase-mediated cell death during lytic replication. Interestingly, cleavage of K5 by caspases did not affect its previously reported ability to downregulate immune surface markers. These data suggest that K5 not only downregulates immune surface markers to help avoid immune recognition but plays an additional role in mitigating caspase-mediated cell death during lytic replication.IMPORTANCEKaposi sarcoma-associated herpesvirus (KSHV) is the etiological agent for Kaposi sarcoma, primary effusion lymphoma, multicentric Castleman’s disease, and KSHV inflammatory cytokine syndrome. Understanding how KSHV thwarts host defense responses is necessary to help develop strategies to treat these rare, yet deadly, diseases. We profiled potential caspase cleavage sites in the viral proteome in silico and found many viral proteins with high-scoring caspase cleavage sites. We follow up on this by demonstrating that K5 is, in fact, a substrate for caspases in vitro and in cellulo and provide data to suggest that K5 plays a role in obviating caspase-mediated cell death during lytic replication. The work described here furthers our understanding of the roles that KSHV proteins, like K5, play to prevent or divert the host apoptotic defense responses that involve host caspase activation that normally would lead to cell death.
26. Risk mitigation strategies for children and young people admitted with mental health crisis to acute paediatric care: A systematic review with narrative synthesis.
期刊: Journal of child health care : for professionals working with children in the hospital and community 发表日期: 2025-Aug-29 链接: PubMed
摘要
Globally, the number of Children and Young People (CYP) that experience mental health crisis and access paediatric acute hospital settings continues to increase. Many of these CYP present with thoughts and behaviours of self-harm and/or suicide and often experience severe and fluctuating emotional states. It is therefore important that the risk of self-harm/suicide is assessed during an inpatient admission and strategies implemented to mitigate risk. This study aimed to identify self-harm and suicidality risk management pathways that have been developed and evaluated for use with CYP admitted to acute hospital settings with mental health crisis. A systematic review was conducted. Eight online academic database were searched up to February 2022. The critical appraisal skills programme tool was used to assess the methodological rigour of included studies. Online searches identified 120 potential studies. Five studies met the predefined inclusion criteria. Six risk mitigation strategies were identified; safety huddles, urgent full mental psychiatric review within 2-h of assessment, feedback on screening responses, motivational and barrier-reducing intervention, 1:1 constant observations and environmental safety. All included strategies targeted environmental, family, and individual CYP involving modifications to equipment, surveillance, and communication to enhance safety.
27. Recognizing Skateboard and Kickboard Commuting Behaviors Using Activity Trackers: Feasibility Study Using Machine Learning Approaches.
期刊: JMIR formative research 发表日期: 2025-Aug-29 链接: PubMed
摘要
Active commuting, such as skateboarding and kickboarding, is gaining popularity as an alternative to traditional modes of transportation such as walking and cycling. However, current activity trackers and smartphones, which rely on accelerometer data, are primarily designed to recognize symmetrical locomotive activities (eg, walking and running) and may struggle to accurately identify the unique push-push-glide motion patterns of skateboarding and kickboarding. The primary objective of this study was to evaluate the feasibility of classifying skateboard and kickboard commuting behaviors using data from wearable sensors and smartphones. A secondary objective was to identify the most important sensor-derived features for accurate activity recognition. Ten participants (4 women and 6 men; aged 12-55 y) performed 9 activities, including skateboarding, kickboarding, walking, running, bicycling, ascending stairs, descending stairs, sitting, and standing. Data were collected using wearable sensors (accelerometer, gyroscope, and barometer) placed on the wrist and the hip, as well as in the pocket to replicate the sensing characteristics of commercial activity trackers and smartphones. The signal processing approach included the extraction of 211 features from 10- and 20-second sliding windows. Random forest classifiers were trained to perform multiclass and binary classifications, including distinguishing skateboarding and kickboarding from other activities. Wrist-worn sensor configurations achieved the highest balanced accuracies for multiclass classification (range 84%-88%). Skateboarding and kickboarding were identified with high sensitivity, ranging from 93% to 99% and 97% to 99%, respectively. Hip and pocket sensor configurations showed lower performance, particularly in distinguishing skateboarding (range 49%-58% sensitivity) from kickboarding (78% sensitivity). Binary classification models grouping skateboarding and kickboarding into a push-push-glide superclass achieved high accuracies (range 91%-95%). Key features for classification included low- and high-frequency accelerometer signals, as well as roll-pitch-yaw angles. This study demonstrates the feasibility of recognizing skateboard and kickboard commuting behaviors using wearable sensors, particularly wrist-worn devices. While hip and pocket sensors showed limitations in differentiating these activities, the broader push-push-glide classification achieved acceptable accuracy, suggesting its potential for integration into activity tracker software. Future research should explore sensor fusion approaches to further enhance recognition performance and address the question of energy expenditure estimation.
28. Integration of Environmental Data Into Electronic Health Records for Clinical and Public Health Decision Making: A Viewpoint on Expanding Development in the United States.
期刊: Journal of medical Internet research 发表日期: 2025-Aug-29 链接: PubMed
摘要
Electronic health records are often extracted and combined with environmental data to conduct research or public health surveillance. However, to date, electronic health record systems do not integrate environmental data to aid real-time decision-making that could mitigate the health impacts of environmental hazards, including those related to climate change. Pursuing this goal requires enhancements to health record systems and modifications to the financial incentives driving health care innovation and delivery.
29. A Versatile and Bioinspired Hierarchical Nanoflower Coating for Enhanced Photodriven Antimicrobial Efficacy against Foodborne Pathogens.
期刊: ACS applied bio materials 发表日期: 2025-Aug-29 链接: PubMed
摘要
Contamination by pathogenic microbes frequently occurs on the surfaces of solid materials, posing serious threats to food safety and human health. To mitigate the spread of pathogens and reduce the risk of antimicrobial resistance, there is an urgent need for nanostructured surface modification materials that offer high bactericidal efficiency without relying on conventional antimicrobial agents or antibiotics. In this study, we report a green and facile approach for fabricating antimicrobial nanoflower (PDA-Cu NFs) coatings on solid substrates, including polystyrene, glass, and stainless steel via one-step biomimetic mineralization. The resulting coatings exhibited uniform nanoflower morphology, strong substrate adhesion, and superhydrophilicity (contact angle = 0°). Under ultraviolet A (UV-A) irradiation, the PDA-Cu NFs coatings demonstrated excellent bactericidal efficacy against Listeria innocua and Escherichia coli, achieving more than 4 log CFU/cm2 of reduction within 1 h of treatment. This enhanced antimicrobial performance is attributed to a triple-mode synergistic combination of photothermal effects, photoinduced reactive oxygen species generation, and the hierarchical nanoflower structure, which increases bacterial contact with copper ions and induces physical membrane disruption. Durability testing revealed that the coatings maintained their hydrophilic properties even after five cycles of mechanical abrasion with only partial structural damage observed. These findings present a robust and substrate-independent strategy for developing durable, superhydrophilic, and UV-activated antimicrobial coatings, offering significant potential for applications in healthcare, food processing, and environmental sanitation.
30. Combination of serology and PCR analysis of environmental samples to assess Coxiella burnetii infection status in small ruminant farms.
期刊: Applied and environmental microbiology 发表日期: 2025-Aug-29 链接: PubMed
摘要
Coxiella burnetii, the causative agent of Q fever, accumulates on dust of farm premises with infected animals, but the interpretation of PCR detection on dust is challenging. To investigate whether bacterial load in environmental dust together with the within-flock seropositivity could be indicative of the C. burnetii infection status in small-ruminant flocks, 249 farms (202 sheep, 18 goats, and 29 sheep-goat mixed) in the Balearic Islands were investigated. Dust samples were analyzed by real-time PCR targeting C. burnetii IS1111, and C. burnetii loads (genome equivalents/mg dust) were estimated by quantitative real-time PCR amplification of com1 to categorize the farms into four levels. Sera from 546 yearlings and 1,002 adult females in 79 flocks were tested by ELISA. Despite a widespread distribution of C. burnetii in environmental dust, only 6.0% and 16.1% had high (>1,000) or moderate (100-1,000) C. burnetii loads, respectively. These same farms had significantly higher within-flock percentage of C. burnetii seropositive animals (~35%) than flocks with low loads or C. burnetii-negative. These results and the positive correlation observed between within-flock percentage of seropositive animals and C. burnetii environmental contamination indicate that dust PCR followed by serological analysis of flocks with high and moderate loads could be used to identify herds potentially infected with C. burnetii. SNP genotyping of Coxiella PCR-positive dust samples identified SNP-6 as the predominant genotype in small ruminants in the Balearic Islands, along with the sporadic presence of SNP-4-a clearly different genotype distribution than in northern Spain, where the clinical spectrum of human Q fever is clearly different.IMPORTANCEThe identification of flocks with active C. burnetii infection is crucial to implement control measures and prevent human Q fever cases. This study demonstrates the relevance of combining dust PCR with serology to identify C. burnetii-infected herds, a strategy that could help to identify the animal source of human Q fever outbreaks and define priority countermeasures. This study also provided, for the first time, an overview of C. burnetii infection in sheep and goats in the Balearic Islands and identified the factors associated with higher risk of environmental C. burnetii contamination. Strain characterization allowed the identification of the most prevalent C. burnetii genotypes in this region of eastern Spain, showing clear differences in genotype distribution with the northern area, which could explain the different clinical spectrum of human Q fever cases in both geographical areas.
31. Impact of Parental or First-Degree Family History of Diabetes on Diabetes Incidence and Progression During Long-term Follow-up in the Diabetes Prevention Program Outcomes Study.
期刊: Diabetes care 发表日期: 2025-Aug-29 链接: PubMed
摘要
To determine the effects of first-degree family history of diabetes on diabetes incidence in Diabetes Prevention Program (DPP) and Diabetes Prevention Program Outcomes Study (DPPOS) participants. In the DPP, adults with prediabetes were randomized to an intensive lifestyle intervention, metformin, or placebo and followed for incident diabetes. On study completion 88% of eligible DPP participants reenrolled in DPPOS for long-term follow-up. The present analysis includes all 3,072 participants with family history information through DPPOS, with a median follow-up of 21 years (1,975 had parental history of diabetes [PH] [312 biparental, 947 maternal, 716 paternal], 226 had only sibling history [SH], and 871 denied any family history). The primary outcome is incident diabetes based on American Diabetes Association criteria, with adjustment for demographic and clinical variables, DPP randomization arm, and polygenic risk score (PRS). Adjusted hazard ratio (HR) was 1.21 (95% CI 1.06, 1.38) for any family history, 1.19 (1.04, 1.35) for PH, and 1.15 (0.91, 1.44) for SH. Biparental history conferred greater hazard (HR 1.44 [95% CI 1.22, 1.69]) than maternal (1.22 [1.08, 1.38]) or paternal (1.22 [1.08, 1.39]) diabetes history alone. PRS explained 32% of the association of any family history with diabetes risk. PH increased type 2 diabetes risk after DPP treatment group was controlled for. That effect was only partially explained by PRS, suggesting that rare gene variants, familial, and environmental factors may contribute to type 2 diabetes risk in people with prediabetes.
32. Applying the Communication Bill of Rights to Enact Principles of Diversity, Equity, Inclusion, and Accessibility.
期刊: American journal of speech-language pathology 发表日期: 2025-Aug-29 链接: PubMed
摘要
This article situates the revised Communication Bill of Rights (National Joint Committee for the Communication Needs of Persons with Severe Disabilities, 2024) within a Diversity, Equity, Inclusion, and Accessibility (DEIA) framework. With an emphasis that diversity should be inclusive of disability, this work postulates the interconnectedness of DEIA and the communication rights of individuals with severe disabilities. The full set of communication rights is presented, followed by a deeper discussion of four rights that address dignity and respect in interactions, meaningful conversations that are culturally and linguistically appropriate, services across the lifespan, and access to functioning augmentative and alternative communication and other assistive technology to support communication. A DEIA implementation framework is applied to illustrate the actualization of these rights. Communication rights cannot be realized in isolation. The intersecting identities of individuals with severe disabilities must be understood and responded to in practice. The actualization of communication rights fits within the larger context of honoring DEIA.
33. Spaced learning versus traditional learning for pharmacists implementing β-lactam therapeutic drug monitoring.
期刊: American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists 发表日期: 2025-Aug-29 链接: PubMed
摘要
No consistent recommendations exist on how best to educate pharmacists to facilitate implementation of new evidence-based practices. This study aimed to determine whether spaced learning was more effective than traditional education when learning a new evidence-based practice (β-lactam therapeutic drug monitoring, or TDM). β-lactam TDM was implemented in a phased fashion at Mayo Clinic in Rochester. Two go-lives took place, separated by 6 months, which allowed for a natural experiment to test education delivery methods (traditional education in the first go-live group of pharmacists vs spaced learning in the second go-live group of pharmacists). Each group received the same base educational package, with pharmacists in the spaced learning group also offered monthly in-person sessions for 6 months before go-live to discuss key considerations and cases with experts. There was no difference between the spaced learning group and the traditional education group when assessing appropriate use of TDM as defined by (1) appropriate patient selection; (2) correct ordering of laboratory testing; (3) appropriate clinical action; and (4) completed documentation. Assessments of secondary knowledge transfer also showed no difference between the groups. Pharmacists in the different education groups had similar satisfaction scores related to the effect and utility of the education. Both spaced learning and traditional education were part of a comprehensive implementation plan for β-lactam TDM, which might have influenced the outcomes. Spaced learning for future pharmacist education efforts needs further study. As part of a greater β-lactam TDM implementation effort, altering the education delivery method did not impact the degree of knowledge transfer.
34. Cost-effectiveness of including herpes zoster vaccines into the national immunization program in the Republic of Korea.
期刊: Vaccine 发表日期: 2025-Aug-28 链接: PubMed
摘要
Herpes zoster (HZ) vaccination is not publicly funded in Korea. This study aimed to assess the cost-effectiveness of introducing recombinant zoster vaccine (RZV) and zoster vaccine live (ZVL) into Korea’s national immunization program (NIP). A decision tree Markov model was used to estimate expected costs and quality-adjusted life years (QALYs) by comparing the lifetime cost-effectiveness of NIP vaccination strategies with RZV and ZVL to that of voluntary ZVL vaccination. We analyzed people aged 50, 55, 60, 65, 70, and 75 years. The primary outcome measure was the incremental cost-effectiveness ratio (ICER) from a societal perspective. We assumed inoculation rates of 70 % for NIP and 10 % for voluntary vaccination. Under the voluntary vaccination strategy, the lifetime incidence of HZ was estimated at 20.78 % at the age of 70 years, whereas it was 9.04 % for the NIP with RZV and 18.04 % for the NIP with ZVL. The ICERs for the NIP RZV strategy ranged from 15.38 to 27.87 million Korean Won (KRW) per QALY compared to voluntary vaccination, whereas the ICERs for the NIP ZVL ranged from -8.42 to 14.39 million KRW per QALY. The results were most sensitive to changes in the HZ incidence, NIP vaccine price, vaccine efficacy, and illness-related cost. NIP vaccination with RZV yields a significantly greater reduction in the incidence of HZ compared to vaccination with ZVL in Korea. However, NIP vaccination with ZVL is more cost-effective than vaccination with RZV, primarily due to the significantly lower cost of ZVL compared to RZV in Korea. Decisions regarding NIP vaccination policies should consider multiple factors, including cost-effectiveness, social needs, and financial sustainability, to ensure an optimal and sustainable immunization strategy.
35. Medicines Policy in Action: The Impact on Volume and Cost of Biologic Medicines After Biosimilar Introduction.
期刊: Value in health regional issues 发表日期: 2025-Aug-28 链接: PubMed
摘要
Rapid growth in indications and costs for biologic medicines challenges payers to balance patient access with finite health budgets. Once patents for reference products expire, introducing less expensive biosimilar medicines is one initiative to provide access to necessary medicines while maintaining the affordability of funding schemes. This study aims to describe the impact on volume and cost of biosimilars on the Australian biologics market. Australian sales data for selected biologic medicines with at least 1 biosimilar on the market for 12 months were extracted from IQVIA-MIDAS. Expenditure (USD) and volume (standardized units [SU]) were measured (2010-2020). Differences in reference product and total market expenditure, SU, and average SU price were calculated for 12 months before and after biosimilar market entry, as well as the most recent 12-month period. Twelve months after biosimilar entry, total expenditure for biologic reference products was reduced by 38.3% in a market of minimal increasing use (5%). Average SU reference product price decreased by 30% to 40%, and biosimilar SU prices were up to 40% lower than reference product price. Short-term differences in biosimilar market share, were identified between earlier introduction (etanercept [2.0%] and infliximab [1.8%]) and more recent introductions (rituximab [21.8%] and trastuzumab [9.3%]). By 2020, biosimilars accounted for 30% of the biologic market. Biosimilar introduction reduced overall market expenditure and SU price of reference products. Sales data suggest that Australia’s medicines policies create potential for greater medicines access for patients by reducing expenditure and releasing capital to fund more medicines.
36. Altered immune responses to mRNA vaccination against SARS-COV-2 are characterized by an impaired cross-talk between humoral and T-cellular immune compartments in patients with hematologic diseases.
期刊: Vaccine 发表日期: 2025-Aug-28 链接: PubMed
摘要
Patients with hematologic diseases frequently develop insufficient humoral immunity following mRNA vaccination against SARS-COV-2. Data on the T-cellular immune response to SARS-COV-2 mRNA vaccination and its impact on the humoral compartment in this patient population is limited. Here, we performed a detailed analysis of T-cellular immune responses 21-28 days after the second dose of mRNA vaccination in hematologic patients suffering from different disease entities using ELISpot assay and flow cytometry. Anti-SARS-CoV-2 spike receptor-binding domain antibody assays were performed to describe humoral B-cell response. To complement our cellular analysis, we quantified T- and B-cell subsets by immunophenotyping. We show that SARS-CoV-2 mRNA vaccination elicits T-cell responses in patients suffering from hematologic diseases, but the orchestrated process of T-cell activation with a uniform involvement of CD4+ and CD8+ T-cells as seen in healthy controls was highly altered. Moreover, we observed that humoral immune response in hematologic patients was uncorrelated with T-cell effector function and immune cell composition. Our data show disturbed T-cellular immunity and a loss of cross-talk between humoral and T-cellular immune compartments following mRNA vaccination in hematologic patients.
37. A novel intron variant is associated with emerging pfdhps mutant haplotypes in West and Central African Plasmodium falciparum.
期刊: International journal for parasitology. Drugs and drug resistance 发表日期: 2025-Aug-26 链接: PubMed
摘要
Sulfadoxine-pyrimethamine plays a key role in Plasmodium falciparum chemoprevention across Africa, yet the protective efficacy of SP is undermined by mutations conferring resistance in the genes encoding dihydrofolate reductase (pfdhfr) and dihydropteroate synthase (pfdhps). The emergence and spread of the pfdhps 431V mutation suggests that this may confer resistance and be selected by drug use. Here, we report a non-coding mutation a548383t, which expands a di-nucleotide repeat in the first intron of pfpppk-dhps. The first intron and second exon of the pfdhps gene were analysed by target amplicon sequencing of 929 P. falciparum-positive blood samples from Nigeria, Cameroon, Tanzania, The Democratic Republic of Congo, and Côte d’Ivoire. The intron mutation was found in Nigeria, Côte d’Ivoire, and Cameroon in association with the 431V mutation. In particular, the intron mutation was most highly associated with the VAGKGS haplotype (OR = 211.7, P < 0.001), followed by the VAGKAS (OR = 39.2, P < 0.001), and VAGKAA (OR = 33.6, P < 0.001) haplotypes. Additionally, a reduced di-nucleotide repeat diversity was observed in 431V-positive variants. The intron variant is significantly associated with the 431V mutation which is consistent with previous reports of selective sweeps around VAGKGS. The association of the 548383t mutation with both VAGKGS, VAGKAS and VAGKAA might indicate these lineages either have a common ancestor or that the intron variant 548383t has a functional association with 431V. More research is needed to determine if the association is simply genetic hitchhiking, or if the intron variant confers a phenotypic advantage.
38. Promoting Healthy Habits in Well-Child Visits: Advancing Weight-Neutral Health Promotion in Diverse Pediatric Populations.
期刊: American journal of lifestyle medicine 发表日期: 2025-Aug-26 链接: PubMed
摘要
Integrating effective health behavior change discussions in childhood preventative medical visits is a challenging and important means to support families in the creation and maintenance of healthy habits over the lifespan. The 9-5-2-1-0 model is a tool to identify healthy habits and guide conversation at well-child visits in primary care. Diverse families in a family medicine residency clinic met with a member of the interprofessional team during preventive medical visits between July 2015-March 2020 to discuss current health habits and goal setting. Data were collected at follow up visits to determine whether patients who set goals made progress towards these goals. Seventy two percent of families who met with the team were willing to set a goal at the initial encounter. Of those who set a goal, 53% reported they had partially or fully attained these goals at follow up. The presence of an interpreter did not significantly impact willingness to set a goal, overall goal attainment or add to the length of the intervention. While there are limitations to this study design, the results suggest that an interprofessional 9-5-2-1-0 intervention offers a promising approach for engaging diverse families in health habit conversations and goal setting in primary care.
39. Adverse childhood experiences and mental health of sexual and gender minorities in Canada, USA, and Japan.
期刊: Psychiatry research 发表日期: 2025-Aug-25 链接: PubMed
摘要
Sexual and gender minorities have an increased risk for adverse childhood experiences (ACEs) and worsening mental health. However, cross-country research on varying levels of social acceptance remains limited. We compared the impact of sexual and gender minority status on ACEs and poor mental health between Canada, USA, and Japan. This cross-sectional study included 50,628 adults in 2022. Sexual and gender minority individuals included those identifying as lesbian, gay, bisexual, transgender, or non-binary. Poor mental health was defined as experiencing not good mental health for ≥ 14 days in the past 30 days in USA, and scoring ≥ 13 on the Kessler 6-item Psychological Distress Scale in Canada and Japan. ACEs included witnessing domestic violence, experiencing physical abuse, and experiencing sexual assault. Social acceptance was assumed high in Canada, moderate in USA, and low in Japan based on Global Acceptance Index 2017-2020. Sexual and gender minorities reported experiencing sexual assault more frequently (odds ratio = 1.68, 95 % confidence interval = 1.17-2.42). Sexual and gender minorities in USA had a higher risk for sexual assault compared to those in Japan (1.71, 1.06-2.74). After adjusting for presence of ACEs, sexual and gender minorities reported more frequent poor mental health (1.77, 1.40-2.24). Sexual and gender minorities in Canada had a higher risk for poor mental health compared to those in Japan (1.85, 1.21-2.80). Sexual and gender minorities faced a higher risk of ACEs and poor mental health regardless of country. Further research is needed to understand the underlying mechanisms of the increased risk.
40. Improving the Performance of a Syndromic Surveillance Definition for Sexual Violence.
期刊: Journal of public health management and practice : JPHMP 发表日期: 2025-Aug-25 链接: PubMed
摘要
Timely and representative data for sexual violence surveillance in the United States are lacking. To address this gap, we aimed to improve the identification of sexual violence in syndromic surveillance emergency department (ED) visit data through evaluation of the latest Centers for Disease Control and Prevention (CDC) sexual violence surveillance definition (CDC V3) using North Carolina (NC) syndromic surveillance data and development of an enhanced definition (V4). We created a gold standard dataset of visits representing incident sexual violence, history of sexual violence, or no sexual violence through manual review, developed an enhanced V4 definition based on this review, and then compared the performance of the CDC V3 and V4 definitions against the gold standard. North Carolina. Emergency department visits in NC, 1/1/2016-6/3/2024. We compared the precision measures (Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value, and F1) of the CDC V3 and new V4 definitions for sexual violence. We applied both definitions to NC ED visit data for 2019-2023 to compare demographics and crude rates. The CDC V3 sexual violence definition proved highly specific. The V4 definition identified a 6% increase in incident sexual violence ED visits compared to the CDC V3 definition, with additional chief complaint search terms and the selective incorporation of triage notes. Trends in patient sex, age group, race, and ethnicity were similar across both definitions. The F1 score showed improvement for the V4 definition compared to the CDC V3 definition, suggesting that it better optimizes the need to comprehensively identify ED visits for sexual violence while minimizing false positives. Syndromic surveillance ED visit data provide timely, population-based data on this complex topic. Building upon the CDC V3 definition and incorporating triage notes where available allowed us to develop a more sensitive and accurate surveillance definition for incident sexual violence.
41. Prevalence, risk factors, and protective factors of tobacco use among school-going adolescents at drug-abuse hot-spots in Malaysia.
期刊: Addictive behaviors 发表日期: 2025-Aug-21 链接: PubMed
摘要
The high prevalence rate of tobacco consumption among teenage school students has become a global issue with profound implications for their developmental trajectory. Research conducted at drug-abuse hot-spots as a proximal factor related to tobacco use has been limited. Therefore, the present study examined the prevalence, risk factors, and protective factors of tobacco use among adolescents at drug-abuse hot-spots in Malaysia. Through stratified random sampling, the nationwide sample comprised 3382 school-going adolescents (71.4% male; mean age = 15.35 years [SD = 2.79]). The prevalence of tobacco use was 19.0% for current use and 28.5% for lifetime use. Stepwise logistic regression analysis showed that being male, being an older adolescent, living in urban areas, living many years in the hot-spot area, parental divorce, and having a high external locus of control were significant risk factors for tobacco use. High internal locus of control and good problem-coping skills were protective factors for tobacco use. Policy implications and suggestions for future research are discussed for the prevention and intervention of tobacco use among school-going adolescents.
42. Effects of short-term climatic conditions on the risk of bovine respiratory disease in preweaned calves on California dairies.
期刊: Preventive veterinary medicine 发表日期: 2025-Aug-15 链接: PubMed
摘要
Bovine Respiratory Disease (BRD) significantly impacts dairy calf health and economics, yet the relationship between short-term weather patterns and BRD risk remains poorly understood, particularly across different seasons and regions in California. We explored the effects of short-term climatic conditions on BRD in preweaned dairy calves using machine learning approaches. Data from 11,470 calves across five California dairy farms were analyzed using tree-based models to investigate associations between BRD status and climate variables, including temperature, humidity, and temperature-humidity index (THI) over one to three days prior to diagnosis. The gradient boosting model achieved the best performance with an area under the receiver operating characteristic curve of 0.720 (sensitivity: 0.71, specificity: 0.73). Maximum relative humidity two days prior and maximum THI three days before BRD diagnosis were the most important short-term climatic predictors of BRD risk along with the region of California and calf age. The analysis indicated that summer conditions in Southern California were associated with higher BRD risk 48 h post-exposure; maximum THI below 75 in winter increased BRD risk 72 h post-exposure across all regions; and calves aged 20-30 days in Southern California showed higher BRD risk compared to Northern California across all seasons. These findings provide novel insights into how short-term weather patterns influence BRD development, potentially supporting the development of region-specific prevention strategies.
43. Manual Versus Hammer Percussion Frequency-Domain Acoustic Screening for Hip Fracture: A Comparative Study.
期刊: Cureus 发表日期: 2025-Aug 链接: PubMed
摘要
Introduction Delayed diagnosis of hip fracture (HF), one of the most common fractures encountered in clinical practice, is associated with serious complications or adverse outcomes. However, these fractures are frequently missed on radiography. Auscultatory percussion, a simple screening method that compares percussion sounds between lower limbs using a stethoscope, has limitations owing to its subjective evaluation, which can lead to unstable diagnostic accuracy. Therefore, this study aimed to verify whether objective frequency analysis of percussion sounds could overcome this issue to achieve high-accuracy diagnosis. We further compared the diagnostic performance of manual percussion versus percussion with a tendon hammer. Materials and methods This case-control study enrolled 40 patients with HFs (fracture group) and 20 hospitalized patients without fractures (control group). All patients underwent percussion of the pubic symphysis using manual percussion and a tendon hammer, and sounds were recorded from both patellae. The absolute value of the sound pressure difference between the sides was calculated across 512 frequency bands (0-24,000 Hz). Diagnostic performance was evaluated using group comparisons (Mann-Whitney U test), receiver operating characteristic (ROC) analysis with bootstrap internal validation, decision curve analysis (DCA), and multivariate logistic regression analysis. Results Manual percussion demonstrated the highest diagnostic performance at the 2718.75-Hz band, with an optimism-corrected area under the curve (AUC) of 0.923 (95% confidence interval: 0.845-0.979). At a cutoff value of 1.28 dB, the sensitivity and specificity were 97.5% and 69.8%, respectively, yielding an extremely low negative likelihood ratio of 0.04. Hammer percussion also showed good performance in the 421.88-Hz band (AUC: 0.861), although the difference in diagnostic performance between the two methods was not statistically significant. DCA confirmed the clinical utility of both methods. In multivariate analysis, the sound pressure difference for both methods was a significant independent predictor of fracture. Furthermore, exploratory subgroup analysis suggested the diagnostic performance of manual percussion was stable across key patient subgroups. Conclusion These results indicate that objective frequency-domain analysis of percussion sounds, particularly with manual percussion, represents a simple and effective screening tool for ruling out HFs, given its high sensitivity and excellent negative likelihood ratio. This study revealed new scientific insight that the diagnostically effective frequency band depends on the physical properties of percussion. These findings overcome the challenges of conventional subjective diagnostic methods and could contribute to the future development of accessible, objective, and non-invasive fracture diagnosis technologies.
44. Genetic Consequences of Tree Planting Versus Natural Colonisation: Implications for Afforestation Programmes in the United Kingdom.
期刊: Evolutionary applications 发表日期: 2025-Aug 链接: PubMed
摘要
The United Kingdom aims to dramatically accelerate the establishment of new woodlands by 2050, yet the impact of different afforestation strategies on landscape genetic diversity and resilience remains unclear. This study integrates environmental data, whole-genome sequencing and phenotypic assessments to compare bioclimatic envelopes, genetic diversity and plant health indicators in naturally colonised versus planted populations of pedunculate oak and silver birch. We found that registered seed stands significantly under-represent the wild bioclimatic envelopes of both species, as well as those of 21 out of 39 UK native species assessed, potentially limiting adaptive diversity in planted populations. Yet, genetic diversity metrics (π, H O and A R) based on genome-wide markers in planted populations were comparable to naturally colonised woodlands. Planted populations exhibited higher within-group coancestry and moderate genetic homogenisation among sites, possibly reducing adaptive differentiation. Naturally colonised populations showed higher inbreeding coefficients (F ROH) in both species, potentially due to fragmentation of source populations. Genotype-environment associations based on redundancy analysis revealed divergent selection at functionally relevant loci, indicating distinct selective pressures in commercial tree production versus natural colonisation. Health indicators revealed reduced browsing in planted trees, and differences in mildew and leaf-spot incidence, suggesting potential selection divergence between afforestation strategies. These findings support a role for both afforestation strategies in enhancing the resilience of future woodlands while highlighting pathway-specific risks of introducing unintended impacts on forest diversity.
45. Retraction: Exploring Occupational Health Challenges in Pathology: A Cross-Sectional Survey of Indian Pathologists.
期刊: Cureus 发表日期: 2025-Aug 链接: PubMed
摘要
[This retracts the article DOI: 10.7759/cureus.75264.].
46. A Call to Action: Advancing Research, Practice, and Policy for Middle Aged and Older Transgender and Nonbinary Communities.
期刊: International journal of transgender health 发表日期: 2025-Jul-01 链接: PubMed
摘要
47. Influences of Chemical and Nonchemical Stressors on Health and Quality of Life in Fenceline Communities: A Community-Based Participatory Research Survey in Southeastern Pennsylvania.
期刊: Environmental justice (Print) 发表日期: 2025-May-14 链接: PubMed
摘要
Community organizers in Southern Delaware County, PA, expressed a desire to collect comprehensive data on environmental, health, and social conditions in their neighborhoods to inform advocacy efforts to prompt public health action. Using a community-based participatory research (CBPR) approach, our team of academic and community coinvestigators developed an online community health survey to characterize residents’ health concerns and the strengths, burdens, and needs of fenceline communities in Southern Delaware County. We included questions on chemical exposures, sources of pollution, financial stressors, health care, medical conditions, and priorities for policymakers. Participants reported experiencing adverse effects of poor air quality, odors, and noise in their communities. Eighty-six percent of participants reported experiencing at least two nonchemical stressors, such as poor housing conditions, food insecurity, and experiences of racism and discrimination. We found high proportions of reported asthma diagnoses and symptoms in participants and the children living in their households. Symptoms of asthma, depression, and anxiety were more common than clinician diagnoses of these conditions. Participants also commonly reported decreased quality of life or functioning associated with physical and mental health issues. Our findings highlight the importance of characterizing chemical and nonchemical stressors among residents in fenceline communities and expanding consideration of health to include acute symptoms, well-being, and quality of life. Our study was strengthened by our CBPR approach. Our work demonstrates the value of assessing cumulative impacts and employing CBPR approaches in fenceline communities.
48. Combining multiple sources of relationships in a network to advance understanding of physicians' beliefs regarding peer-effects.
期刊: Health services & outcomes research methodology 发表日期: 2025-Mar-20 链接: PubMed
摘要
Patient-sharing physician networks are increasingly recognized as valuable tools for examining physician relationships in healthcare research. However, very few studies have examined the reliability of such networks and summary measures derived from them in relation to directly measured physician relationships. In this paper, we evaluate the level of congruence between a survey-based network derived from survey responses to specific name-generator questions and a patient-sharing network derived from claims data. We also examine the association of summary measures derived from either network with physicians’ beliefs about peer influence in medical practice. Statistical models with hierarchical and multiple-membership structures were used to estimate the strength of the associations. We found that a survey measure indicating whether a physician was nominated by others was statistically significantly associated with their survey reported beliefs about peer influence. We also observed notable associations between the physicians’ structural importance in the network reflected in their eigenvector and betweenness centrality in the patient-sharing network and their beliefs about peer influence. This study of multi-source network relational information advances our understanding of physician survey responses and yields more precise predictions of physician beliefs toward peer-influence than either data source alone. Overall, we found that patient-sharing networks are an important alternative to directly measured survey-based name-generator questions in health services research and other applications. While patient-sharing networks recover some of the information in directly measured peer physician nominations, they also contain distinct information that is helpful for interpreting healthcare insights.
49. Alternatives to antibiotics for sustainable livestock production in the context of the One Health approach: tackling a common foe.
期刊: Frontiers in veterinary science 发表日期: 2025 链接: PubMed
摘要
The discovery of the growth promoting effects of antibiotics in the 1940s contributed to the economic efficacy of the livestock industry. In response to increased animal protein demand from the 1950s, antimicrobial use at sub-therapeutic levels for growth promotion and disease prevention (antimicrobial growth promoter, AGP) improved feed-to-weight ratio, meat quality and overall health of livestock. These benefits encouraged the heavy use of AGPs such that about 70% of global use of antimicrobials was for food animals. Despite the numerous benefits of AGPs, the emergence of antimicrobial resistance (AMR) associated with their use and impact on human and livestock health, establishes AMR as a global health plague, affecting man, animal and the environment. Although many countries have banned the use of AGPs in livestock production, efforts to identify effective alternatives have yielded inconsistent findings and only few effective alternative products are currently available. This highlights the need to intensify efforts toward identifying more effective AGP alternatives. While current strategies focus on evaluating the efficacy of single products/class of products that can enhance productivity and health, future strategies should focus on combining multiple approaches. It is also important to acknowledge that no single alternative can fully replicate the same mechanism of action attributed to antimicrobials. This comprehensive review presents recent research findings on AGP use trend before and after bans in many countries, the benefit/mode of action of reported AGP alternatives, the economic impact of AGP alternatives in the context of the One Health approach, the factors militating the search for effective AGP alternatives, research gaps and future action plans for AGP-free animal farm management.
50. Phenotypic and genomic analyses of the probiotic Enterococcus casseliflavus SHAMU-QH-02.
期刊: Frontiers in microbiology 发表日期: 2025 链接: PubMed
摘要
The past few years have witnessed burgeoning interest in the potential beneficial role of probiotics in multiple fields. This study aimed to explore the probiotic properties and analyze the genomic information of the Enterococcus casseliflavus SHAMU-QH-02 strain, isolated from the human biliary tract. The SHAMU-QH-02 strain was identified using 16S rRNA gene and whole-genome sequencing. The strain exhibited antagonistic activity against most gram-positive cocci, gram-positive bacilli and gram-negative bacilli, especially foodborne pathogens, such as Bacillus cereus, Listeria monocytogenes, Salmonella enteritidis, Vibrio fluvialis, Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. Antioxidant activity was assessed by ABTS+ scavenging assay and determination of ROS levels. Both the cell-free extract (CFE) and cell-free supernatant (CFS) of the SHAMU-QH-02 strain exhibited strong ABTS+ scavenging ability. Moreover, the CFS demonstrated a higher scavenging ability of ROS. Besides, the SHAMU-QH-02 strain could markedly decrease the production of interleukin-1β (IL-1β) in lipopolysaccharide (LPS)-stimulated RAW264.7 cells, indicating anti-inflammatory activity. Safety assessments indicated no cytotoxicity and susceptibility to 12 common antibiotics. Gastrointestinal stability assessment revealed high tolerance to intestinal pH and bile, yet limited ability to adhere to intestinal epithelial cells. Genomic analysis revealed the presence of hypothetical bacteriocin production genes (n = 2), virulence factor genes (n = 4), and antibiotic resistance genes (n = 23); however, none were located within the eight phage sequences. Importantly, the crude extract obtained using XAD-16HP resin could tolerate extreme pH values, 121°C, and multiple proteases. Taken together, the SHAMU-QH-02 strain exhibits probiotic attributes and presents as a notably promising probiotic candidate, potentially contributing to the food industry, health promotion and disease prevention.
51. Making a living and zoonotic disease risk management in coloured broiler poultry farms in Northern Viet Nam.
期刊: Agriculture and human values 发表日期: 2025 链接: PubMed
摘要
This paper asks what influences farmers’ adherence to national and international zoonotic disease intervention efforts and argues that development and promotion of biosecurity interventions must take into account the economic and social context informing how livestock sectors operate and how those who work in them are making a living. Specifically, we explore how poultry farms in Viet Nam are managed amidst global efforts to combat disease and national ambitions to sustain growth. The growth of Viet Nam’s livestock sector has been accompanied by a range of disease outbreaks that have caused the deaths of animals and humans, threatened businesses, and led to the introduction and ongoing revisions to biosecurity efforts. Despite a strict national (and international) agenda focusing on disease control through biosecurity strategies, on farms disease management is implemented in various ways and to varying degrees. Based on fieldwork in three provinces of Northern Viet Nam and in-depth interviews with actors working on farms and across the commercial poultry sector, we reflect on social, financial and political factors shaping the country’s biosecurity narratives and discuss key practices farming households engage in that influence their disease management efforts. Our findings reveal that strict adherence to biosecurity guidelines is often practically unfeasible for commercial poultry farming households to implement where zoonotic diseases are not a concern related to bird and human health so much as a potential risk to a household’s living, that exists among a range of diverse opportunities and uncertainties shaping farming operations in Viet Nam’s changing livestock sector.
52. Environmental surveillance of soil-transmitted helminths and other enteric pathogens in settings without networked wastewater infrastructure: Environmental surveillance for STH and other enteric pathogens.
期刊: PLOS water 发表日期: 2025 链接: PubMed
摘要
Soil-transmitted helminths (STH) are one of the most prevalent enteric infections world-wide. To control STH-related morbidity, the World Health Organization recommends targeted deworming and improvements in water, sanitation and hygiene. Current surveillance strategies for STH focus on identifying and quantifying eggs in stool samples via microscopy, which exhibits poor specificity and sensitivity, especially in settings with low-intensity infections. Wastewater-based epidemiology is a surveillance tool used to monitor pathogen circulation and could replace stool-based approaches for STH detection. However, sampling strategies for settings lacking networked sanitation outside large urban settlements are not well developed. Here, we report evaluation of sampling strategies for soil and wastewater STH surveillance in rural and peri-urban settings without networked sanitation. We used multi-parallel qPCR assays to detect STH DNA in soil collected from high foot-traffic locations and three types of wastewater samples (passive Moore swabs, grab samples, and sediment from drainage ditches) in Comé, Benin and Timiri and Jawadhu Hills in Tamil Nadu, India. We detected STH in soil (India = 32/95, Benin = 39/121) and wastewater (India = 24/60, Benin = 8/64) with a detection frequency across all sample types of 36% in India and 25% in Benin. We evaluated which sample locations and types allowed for more sensitive detection of STH DNA and determined that STH prevalence varied by sample site but did not vary significantly within a given sample site location (e.g., samples collected from multiple locations within one market). Further, we determined that wastewater sediment samples outperformed grab and Moore swab sample types for STH detection. Finally, we expanded our methods to include detection of other enteric pathogens using multiplexed qPCR for wastewater samples. Our results establish sampling strategies for environmental and wastewater surveillance of a wide range of enteric pathogens in settings without networked sanitation.
53. Bardoxolone methyl improves survival and reduces clinical measures of kidney injury in tumor-bearing mice treated with cisplatin.
期刊: AAPS open 发表日期: 2025 链接: PubMed
摘要
Acute kidney injury (AKI) occurs in approximately one-third of patients treated with cisplatin and there is an outstanding need for mitigation strategies to decrease the frequency and severity of cisplatin-induced AKI. This study evaluated bardoxolone methyl (BARD) as a nephroprotectant in a multidose, tumor-bearing mouse model of cisplatin-induced AKI. BARD is an attractive therapeutic intervention due to its ability to protect against cisplatin-induced nephrotoxicity by activating Nrf2 and previous reports suggesting anti-tumorigenic effects. In this study, CMT167 tumor-bearing mice were treated with four weekly doses of cisplatin with or without BARD and evaluated for survival, tumor growth, and clinical and histological measures of AKI. Kidney injury and/or function were evaluated by quantification of urinary kidney injury molecule-1 (KIM-1) and serum creatinine (SCr) levels as well as histopathology. Compared to mice receiving cisplatin alone, co-treatment with BARD significantly enhanced survival (p = 0.01). Moreover, BARD prevented elevation of urinary KIM-1 concentrations as early as one week after cisplatin treatment (p < 0.01) - a response that was observed throughout the 4-week study period. Cisplatin increased SCr concentrations by four weeks, which was prevented by BARD co-administration (p < 0.01). Cisplatin treatment significantly decreased tumor burden compared to vehicle-treated mice (p < 0.05 after two cisplatin doses) - a response that was not altered by BARD co-treatment. Overall, the results of this study demonstrate that BARD has the potential to improve survival and reduce clinical measures of kidney injury in tumor-bearing mice treated with cisplatin, suggesting it could be used as a nephroprotectant to mitigate cisplatin-induced AKI.
54. Environmental and occupational risks to reproductive health in women service members and veterans.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
Women have played a vital role in the U.S. military for decades, with their presence steadily increasing. However, despite this growth, research on the unique occupational and environmental exposures they face remains limited, highlighting the need for greater understanding to improve reproductive health outcomes. Chemical exposures such as burn pit emissions, airborne particulates, heavy metals, and pesticides can disrupt hormone regulation and pose risks for fertility, miscarriage, preterm birth, and congenital anomalies. Additional risks include unsafe water sources, contaminated soil, increased vaccinations, and extreme environmental conditions. However, studies on these exposures remain inconsistent, with some indicating significant reproductive risks while others show minimal or no impact. This mini review highlights what is currently known about the impact of military-related environmental and occupational exposures on women’s reproductive health and identifies key gaps in the literature. Further research is essential to determine high-risk exposures, guide policy development, and support early intervention strategies. Addressing the long-term impact of military-related environmental exposures is crucial for ensuring better health outcomes and facilitating access to care for female service members and veterans.
55. "You do what you have to do, and you don't ask for help": American Indian Reservation Community Talking Circles about Barriers to Palliative Care.
期刊: Qualitative research reports in communication 发表日期: 2024-Dec-06 链接: PubMed
摘要
Great Plains American Indians living in reservation communities suffer some of the highest mortality disparities in the US, but culture-centric palliative care can ease the burdens of serious illness and improve end-of-life decision-making. Common misunderstandings about palliative care, as well as historical and cultural barriers, stand as obstacles to its widespread use. Therefore, the aims of this interdisciplinary report (American Indian and non-American Indian researchers) are to share results from reservation community Talking Circles used to guide the design of a culture-centric message to promote and educate about palliative care within three Great Plains Tribal communities. This deductive content analysis employed the three characteristics of Larkey and Hecht’s (2010) narrative as culture-centric health promotion model: engaging stories, engaging characters, and cultural embeddedness. Our participants’ narratives corresponded with all three tenets of the model and may serve as an effective guide for creating palliative care messages. Therefore, the model served as a valuable mechanism to gather stories that can serve in the development of culture-centric messages that promote and educate about palliative care for these three Great Plains Tribal communities.
56. Predicting Respiratory Diseases Attributed to PM2.5 Air Pollution in Nairobi County Using Random Forest Model.
期刊: International journal of innovative science and research technology 发表日期: 2024-Jul 链接: PubMed
摘要
This study investigates the predictive capability of a Random Forest model in identifying respiratory diseases attributed to PM2.5 exposure in Nairobi County. Leveraging a comprehensive dataset encompassing demographic and air quality variables, the model demonstrated robust performance metrics, achieving an accuracy of 79.97% and an area under the curve (AUC) of 0.872. These results highlight the model’s effectiveness in distinguishing between respiratory and cardiovascular conditions. The model’s sensitivity and specificity were 81.88% and 73.27%, respectively, indicating a strong ability to correctly identify both true positives and true negatives. Analysis of feature importance revealed that age and PM2.5 concentrations were the most influential factors in predicting health outcomes, emphasizing the significant impact of air pollution and demographic factors on respiratory and cardiovascular health. Furthermore, the consistent train and test error rates across varying training set sizes suggest the model’s stability and generalizability. This study underscores the importance of addressing air quality issues to mitigate the health impacts of PM2.5 exposure in urban settings.
57. Integrated watershed management solutions for healthy coastal ecosystems and people.
期刊: Cambridge prisms. Coastal futures 发表日期: 2023 链接: PubMed
摘要
Tropical coastal ecosystems are in decline worldwide due to an increasing suite of human activities, which threaten the biodiversity and human wellbeing that these ecosystems support. One of the major drivers of decline is poor water quality from land-based activities. This review summarises the evidence of impacts to coastal ecosystems, particularly coral reefs, from sediments, nutrients, chemicals and pathogens entering coastal zones through surface and groundwater. We also assess how these pollutants affect the health of coastal human populations through: (1) enhanced transmission of infectious diseases; (2) reduced food availability and nutritional deficit from decline of fisheries associated with degraded habitat; and (3) food poisoning from consumption of contaminated seafood. We use this information to identify opportunities for holistic approaches to integrated watershed management (IWM) that target overlapping drivers of ill-health in downstream coastal ecosystems and people. We demonstrate that appropriate management requires taking a multi-sector, systems approach that accounts for socio-ecological feedbacks, with collaboration required across environmental, agricultural, public health, and water, sanitation and hygiene sectors, as well as across the land-sea interface. Finally, we provide recommendations of key actions for IWM that can help achieve multiple sustainable development goals for both nature and people on coasts.