公共卫生研究摘要 (2025-08-31)
共收录 51 篇研究文章
1. Rural Community-Based Interventions to Improve the Mental Health and Wellbeing of Children and Young People: A Rapid Scoping Review of the Quantitative and Qualitative Evidence.
期刊: Journal of community psychology 发表日期: 2025-Sep 链接: PubMed
摘要
This study synthesised evidence on community-based interventions targeting the mental health and wellbeing of children and young people in rural and remote locations. Scoping review methodology was employed. Searches of six databases were conducted. Titles and abstracts (N = 6457) were screened against inclusion and exclusion criteria, followed by full text screening (N = 61). Twelve publications reporting 10 unique interventions were identified. Interventions varied in design and delivery, with the majority targeting adolescents and focusing on either prevention (e.g., suicide) or improvement of mental health or wellbeing. Themes identified in the synthesis of intervention outcomes included mood and self-esteem, resilience and coping, and belonging and social connectedness. Barriers and facilitators to intervention implementation were also identified. Initial evidence suggests positive impacts on youth mental health, wellbeing, and community relationships. However, further research into rural community-based interventions is needed.
2. Age-Varying Patterns of Total Cholesterol by Modifiable Lifestyle Factors Across Mid to Late Adulthood: Applying Time-Varying Effect Modeling.
期刊: American journal of human biology : the official journal of the Human Biology Council 发表日期: 2025-Sep 链接: PubMed
摘要
Total cholesterol is a risk factor for cardiovascular disease, yet little is known about how its age-related trajectory differs by lifestyle factors across adulthood. We analyzed data from 8758 adults aged 40-80 years using NHANES from 2011 to 2020. Total cholesterol was measured via enzymatic analysis of serum samples. Physical activity was assessed using the Global Physical Activity Questionnaire, with participants classified as meeting or not meeting physical activity guidelines (≥ 150 min/week of moderate-to-vigorous activity). Weight status was determined by body mass index (BMI), categorized as healthy BMI (18.5-24.9 kg/m2) or overweight BMI (≥ 25.0 kg/m2). Time-varying effect modeling (TVEM) was used to estimate total cholesterol across age, stratified by physical activity and BMI category. TVEM indicated that there were no significant differences in total cholesterol levels between physical activity groups across age. In contrast, individuals with an overweight BMI had higher total cholesterol levels than those with a normal BMI, with significant differences observed between ages 63 and 69. These findings highlight late midlife as a turning point when excess body weight may exert a stronger influence on cholesterol regulation. Age-specific approaches to weight management may enhance cardiovascular disease prevention efforts.
3. Cell wall-related glycosyltransferases and wall architecture in the model liverwort Marchantia polymorpha.
期刊: The Plant journal : for cell and molecular biology 发表日期: 2025-Sep 链接: PubMed
摘要
The liverwort Marchantia polymorpha has emerged as an important plant model for developmental studies and may become central to elucidate the complex process of cell wall polysaccharide biosynthesis. This study comprehensively analyses the composition and structure of cell wall glycans across eight different M. polymorpha tissue types. We show that while the cell walls largely mirror known land plant cell wall composition, they also exhibit some unique characteristics. For example, M. polymorpha cell walls displayed a remarkably low overall pectin content, yet the relative abundance of pectic α-(1,5)-arabinan in sporophytes hints at its putative role in the evolution and complexity of spermatophyte cell walls. Furthermore, through comparative analyses of glycosyltransferase (GT) families across plant species, we found that while M. polymorpha generally has low genetic redundancy in most cell wall-related GT families, it also exhibits a diversified GT repertoire in four families, indicating uniqueness in certain cell wall biosynthesis pathways. To support research underpinning cell wall biosynthesis, we developed a Gateway compatible compendium of 87 M. polymorpha GTs, providing a valuable resource for genetic and functional studies. Our study thus works as a foundation to drive new insights into cell wall evolution, structure and function across the plant kingdom.
4. Physical Performance Tests in 8008 Competitive Youth Tennis Players-A Systematic Review and Meta-Analysis of Normative Values.
期刊: European journal of sport science 发表日期: 2025-Sep 链接: PubMed
摘要
Normative values for physical performance tests (PTESTs) offer insights into athletes’ profiles on strengths and weaknesses to enhance performance and mitigate injury risks. However, such data for youth tennis players have not previously been compiled in a systematic review. We conducted a systematic review of 17 popular PTESTs covering speed, agility, strength, and power in healthy, competitive youth tennis players under the age of 8-18 years. A search for eligible studies indexed in the PubMed, Web of Science, Scopus, and Cochrane Library databases was conducted on the 26th of March 2023. Forty-five studies (8008 players) were included and meta-analyzed. The analysis accounted for age, sex, and the use of dominant/nondominant sides. Many of the results were associated with a high level of statistical heterogeneity likely due to variations in test procedures. Data for players under the age of 8-10 years were generally lacking, and males were studied more than females. Higher age, male gender, and the use of the dominant side were generally associated with higher performance levels. In male players, the internal rotation of the dominant shoulder appeared to decrease with age, which may lead to injury. The review offers preliminary references for coaches, clinicians, and researchers to identify players’ strengths and weaknesses, potentially aiding the enhancement of performance and the prevention of injuries.
5. Exposure to Bovine Viral Diarrhea Virus Disrupts Intestinal Barrier Function via NLRP3/Caspase-1-Mediated Pyroptosis and Gut Microbiota Dysbiosis.
期刊: Journal of agricultural and food chemistry 发表日期: 2025-Aug-30 链接: PubMed
摘要
Bovine viral diarrhea virus (BVDV) is a major global pathogen that causes severe economic losses in dairy herds due to diarrhea, reproductive disorders, and reduced milk yield. Despite its well-documented systemic effects, the mechanism of BVDV-induced intestinal damage remains unclear. In our study, BVDV triggered cytopathic effects in intestinal epithelial cells, including cell death, goblet cell depletion, and disruption of barrier proteins. Although BVDV alters gut microbiota by activating the NLRP3/caspase-1 inflammasome pathway and thereby causing pyroptosis and intestinal injury, fecal microbiota transplantation mitigated those effects by suppressing NLRP3/caspase-1’s activation. Those findings reveal key pathways in BVDV’s pathogenesis and suggest novel therapeutic strategies to combat livestock infections.
6. External radiation dose reconstruction for settlements near the Semipalatinsk nuclear test site, Kazakhstan, in the international multicenter study: a detailed review and comparative analysis of the initial data.
期刊: Journal of radiation research 发表日期: 2025-Aug-30 链接: PubMed
摘要
Studies on health effects of radiation exposure to residents around the Semipalatinsk nuclear test site (SNTS), Kazakhstan, are necessary for epidemiological assessment of radiation-related health risks after low-dose irradiation. Radiation dose estimates are the principal point for radiation epidemiological studies. These estimates should be based on the most reliable initial data, used for dose estimations. The comparative critical analysis of various available archival and published initial data, namely values of historical exposure dose rates and values of soil contamination by 137Cs in considered settlements, including information about dates, times and locations of measurements, was performed with the aim to select most reliable and realistic initial data necessary for estimation of settlement-average accumulated external doses for some settlements located in the vicinity of radioactive clouds’ trajectories related to the most significant tests at the SNTS. Results of estimation of accumulated external radiation dose to air, based on these selected initial data, are presented for 18 settlements. Calculated accumulated external doses were compared with retrospective instrumental dose estimates for settlements, where data on TL/OSL luminescence retrospective dosimetry with quartz-containing samples or electron spin resonance (ESR) dosimetry with tooth enamel were available. Estimation of settlement-average external radiation dose to air is the first important step necessary for the next step-individualized radiation dose estimations among different age, professional and ethnic-specific groups of population lived in the study settlements considering behavior, shielding, location and relocation factors in each population group. This is a subject of future work.
7. Invasive whistling frogs (Eleutherodactylus johnstonei) act as a reservoir for antimicrobial-resistant Enterobacteriaceae in Latin America's most populous city.
期刊: Veterinary research communications 发表日期: 2025-Aug-30 链接: PubMed
摘要
Invasive species represent a significant threat to ecological balance and the maintenance of native populations. Besides, these have been associated with the emergence of pathogens of public health importance, including multidrug-resistant bacteria. This study aimed to screen and describe the antimicrobial resistance profile of clinically important Enterobacteriaceae species isolated from whistling frogs (Eleutherodactylus johnstonei), an invasive anuran species in São Paulo, Brazil. Clinically relevant Enterobacteriaceae strains (n = 35) were isolated from oral and skin swabs of 19 whistling frogs and tested for antimicrobial susceptibility and antimicrobial resistance encoding genes. Resistance to amoxicillin + clavulanate and cefoxitin were the most frequent (16.67%; 4/24), followed by cefotaxime (5.71%; 2/35), ceftriaxone (2.86%; 1/35), and tetracycline (2.86%; 1/35). Among the antimicrobial resistance genes screened, blaCTX-M group 8, blaTEM, and blaCMY were identified. The whole genome of the blaCTX-M group 8-positive E. coli strain was assessed and confirmed blaCTX-M-8 presence and phylogenetic analysis. Given the synanthropic behavior of whistling frogs, these amphibians may act as carriers of antimicrobial-resistant bacteria.
8. Title: Medium-Term Lag-Response Associations Between PM10 Exposure and All-Cause Mortality in Valencia and London: A Time-Stratified Case-Crossover Study.
期刊: Journal of epidemiology and global health 发表日期: 2025-Aug-30 链接: PubMed
摘要
Air pollution is among the top five environmental risk factors for human health worldwide. However, our understanding of the physiological responses to PM10 exposure over medium-term lag periods remains limited. This study aims to examine the medium-term lag-response associations-using lagging time windows of up to 21 days-between PM10 exposure and all-cause mortality in Valencia and London from 2002 to 2006. We used a time-stratified case-crossover design; building on the methodologies of Tobias et al. and Bhaskaran et al., we applied a fixed-effects conditional quasi-Poisson regression model to quantify the association between PM10 exposure and all-cause mortality. We also analyzed three different temporal lag methodological models for the exposure-mortality relationships. We found distinct differences in the relative risk (RR) patterns of PM10 exposure and all-cause mortality. In Valencia, the RR varied significantly, with confidence intervals that were wider than in London, where the RR remained more stable, fluctuating closely around 1. Significant associations were observed at early lag periods in both cities, consistent with Tobias et al. Notably, Valencia showed a significant peak in RR at lag 14, which was not observed in London. Subgroup analysis in Valencia also indicated delayed effects in younger populations. Scenario 3 (cumulative lag model) is conceptually closer to the cumulative progression of health risks associated with PM10 exposure and produces higher RR estimates compared to Scenario 1 and 2. This study highlights the critical importance of addressing medium-term lag-response associations and methodological variations in environmental epidemiology. The findings have important clinical and public health implications and offer insights for risk assessment, healthcare planning, and the development of policies to mitigate the health impacts of PM10 exposure.
9. Association Between Opioid Analgesics and Suicide Attempts: A Nationwide French Case-Crossover Study.
期刊: CNS drugs 发表日期: 2025-Aug-30 链接: PubMed
摘要
The rising prescription rates and opioid-related harms in France highlight the need for local data. Evaluating this association may help identify vulnerable subgroups and guide safer prescribing practices. This study aimed to assess the association between opioid analgesic dispensation and the risk of suicide attempt in the French population. Secondary objectives included evaluation of a dose-response relationship and examination of the potential additive effects of co-prescriptions with benzodiazepines or gabapentinoids. We conducted a nationwide, population-based case-crossover study using data from the French National Health Insurance Database (Système National des Données de Santé, SNDS), covering 98.8% of the French population. Adults aged 18 years or older who were hospitalized for a first suicide attempt between 1 January 2013 and 31 December 2020, and who had received at least one opioid analgesic dispensation in the preceding year (excluding buprenorphine and methadone) were included. Opioid analgesic exposure during the 84 days before the attempt was compared with three earlier 84-day control periods. Among 158,400 patients (mean age 47.0 years; 64.0% women), opioid analgesic dispensation was associated with a higher risk of suicide attempt (odds ratio [OR] = 1.26; 95% confidence interval 1.25-1.28). The risk was greater for strong opioid analgesics (OR = 1.73) and higher morphine-equivalent doses. Co-prescription with benzodiazepines or gabapentinoids further increased risk. Opioid analgesic use, especially at higher doses or in combination with benzodiazepines or gabapentinoids, was associated with an increased risk of suicide attempt. Clinical vigilance is warranted when prescribing these medications. NCT04211077, registered 3 January 2020 (retrospectively registered).
10. The German Center for Child and Adolescent Health - A new structure for translational research in pediatrics shaping the health of children today and future generations.
期刊: Molecular and cellular pediatrics 发表日期: 2025-Aug-30 链接: PubMed
摘要
The new German Center for Child and Adolescent Health (DZKJ) founded as part of the German Centers for Health Research provides an unprecedented and unique opportunity for internationally outstanding research that contributes to the health and well-being of children and adolescents by creating a sustainable, multidisciplinary translational research center with a wide spectrum of clinical and scientific disciplines. The DZKJ attracts and motivates some of the best basic and clinical scientists in Germany inside and outside the field of pediatrics to jointly dedicate their research and creativity to unravelling the causes of both common and rare diseases and to developing innovative therapies and prevention strategies. All DZKJ partner sites will join forces for a pivotal, networked lighthouse for clinical and translational science in pediatrics in Germany and beyond.
11. Modeling the Effects of Temperature and Resource Quality on the Outcome of Competition Between Aedes aegypti and Aedes albopictus and the Resulting Risk of Vector-Borne Disease.
期刊: Bulletin of mathematical biology 发表日期: 2025-Aug-30 链接: PubMed
摘要
The community composition of vectors and hosts plays a critical role in determining risk of vector-borne disease transmission. Aedes aegypti and Aedes albopictus, two mosquito species that both transmit the viruses that cause dengue, chikungunya, and Zika, share habitat requirements and compete for resources at the larval stage. Ae. albopictus is generally considered a better competitor under many conditions, while Ae. aegypti is able to tolerate higher temperatures and is generally a more competent vector for many pathogens. We develop a stage-structured ordinary differential equation model that incorporates competition between the juvenile stages of two mosquito populations. We incorporate experimental constraints on competition coefficients for high and low quality food resources and explore differences in the potential outcomes of competition. We then incorporate temperature-dependent fecundity rates, juvenile development rates, and adult mortality rates for each species, and we explore competition outcomes as a function of temperature. We show that regions of coexistence and competitive exclusion depend on food quality and relative values of temperature-dependent life history parameters. Finally, we investigate the combined impacts of temperature and competition on the potential for dengue transmission, and we discuss our results in the context of present and future risk of mosquito-borne disease transmission.
12. Impact of age and treatment-related adverse events on financial toxicity among patients with breast cancer: a systematic review.
期刊: Journal of cancer survivorship : research and practice 发表日期: 2025-Aug-30 链接: PubMed
摘要
Increasing incidence of breast cancer among young adults (YA), defined by the National Comprehensive Cancer Network (NCCN) as age < 40 years, has amplified concerns over financial toxicity (FT) in this demographic. This systematic review sought to clarify the association between YA status and FT. We queried bibliographic databases for full-text English language publications between 2010 and 2024 reporting FT using validated patient-reported outcome metrics among patients with stage I-III breast cancer. Two reviewers screened and extracted data between June and September 2024. Variables of interest included age and treatment-related adverse events (secondary outcome of interest). Of 4023 articles screened, 66 were included for review. Sixty-four were excluded for including in situ or metastatic disease, multiple cancer histologies, or FT as a parameter of a larger scale without validation for stand-alone use. While no studies compared FT using the NCCN YA threshold (i.e., < 40 versus ≥ 40 years), two studies demonstrated that younger age was associated with worse FT. One study compared patients age ≥ 65 to < 65 years using the Comprehensive Score for Financial Toxicity, and the other considered age as a continuous variable using the Psychological Sense of Economic Hardship Scale. The latter also reported treatment-related symptoms were associated with greater FT after adjusting for age. No study identified the multidimensional domain of FT as a primary outcome among YA versus non-YA women with non-metastatic invasive breast cancer. Two studies showed younger age was associated with greater FT. As FT has been shown to negatively impact patient outcomes, further investigations are needed to support policy efforts and to improve care for younger breast cancer survivors.
13. Association of Eliminating Waiting Periods for the Children's Health Insurance Program with Children's Enrollment.
期刊: Maternal and child health journal 发表日期: 2025-Aug-30 链接: PubMed
摘要
Prior to the Affordable Care Act (ACA), over two-thirds of states mandated that children had to be uninsured for set periods of time before enrolling in the Children’s Health Insurance Program (CHIP), referred to as waiting periods. The ACA required that waiting periods could not exceed 90 days, leading states to reduce and eliminate waiting periods in response. This study aimed to examine the association between state waiting period elimination under the ACA with children’s enrollment in CHIP. We used 2010-2019 annual state enrollment data from the Centers for Medicare & Medicaid Services to calculate the proportion of children enrolled in CHIP among 20 states that eliminated waiting periods compared to 14 who maintained them. We estimated difference-in-difference models to assess the association between waiting period elimination with children’s CHIP enrollment. In states that eliminated waiting periods, there were significant increases from 10.86% (95% CI: 9.51-12.21) of children enrolled in CHIP in the pre-policy period to 13.43% (95% CI: 12.21-14.66) after the ACA policy change. In adjusted difference-in-difference models, state waiting period elimination was associated with a 1.75% point (95% CI: 0.43-3.11) increase in children’s enrollment in CHIP relative to states that maintained waiting periods, representing a 16% enrollment increase from pre-policy baseline levels. Waiting period elimination under the ACA led to modest but significant increases in CHIP enrollment among children. Our results suggest potential CHIP enrollment benefits from the elimination of waiting periods that were maintained in 9 states.
14. Healthcare Costs and Carbon Emissions of Stage III Melanoma Surveillance Imaging.
期刊: Applied health economics and health policy 发表日期: 2025-Aug-30 链接: PubMed
摘要
The aim of this study was to estimate the health system cost and carbon emissions of diagnostic imaging tests undertaken by patients on different surveillance schedules for follow-up of stage III melanoma. We also aimed to demonstrate how different monetary valuations of carbon emissions affect overall cost. We conducted a retrospective analysis of administrative data from the Melanoma Institute Australia’s Melanoma Research Database for patients diagnosed with stage III melanoma between 2000 and 2014 and followed them until 2023. Imaging tests (computed tomography [CT], positron emission tomography [PET], PET-CT, ultrasound, X-ray, and magnetic resonance imaging [MRI]) undertaken during follow-up were described. Healthcare costs were estimated per patient-year using data from the Medicare Benefits Schedule. Carbon emissions from tests and transport were estimated per patient-year using life cycle assessment and valued using New South Wales carbon values. Overall, 553 patients were included in this study: 115 in the 3-6-monthly surveillance imaging group, 273 in the 12-monthly surveillance imaging group, and 165 in the no routine imaging surveillance group. Healthcare costs and carbon emissions were highest in the 3-6-monthly group (Australian dollar [AUD] $1098 and 226 kg carbon dioxide equivalent emissions [CO2-e] per patient-year) followed by the 12-monthly imaging group (AUD $767 and 150 kg CO2-e per patient-year), and the no routine imaging group (AUD $319 and 50 kg CO2-e per patient-year). When carbon emissions were valued in Australian dollars they accounted for 1.8-2.6% of total costs. More frequent surveillance imaging of patients with stage III melanoma is associated with higher healthcare costs and environmental impacts, the latter of which are responsible for a small proportion of total costs when valued in dollars.
15. The Economics of Antibiotic Resistance: A Systematic Review and Meta-analysis Based on Global Research.
期刊: Applied health economics and health policy 发表日期: 2025-Aug-30 链接: PubMed
摘要
Antibiotic resistance (ABR) is a growing global health threat; reliable evidence on its impact is crucial for prioritising public health interventions. This study provides an updated, systematic review and meta-analysis to determine the true effect size of resistant infections on economic and clinical outcomes. It also evaluates methodologies used in ABR economic literature, offering recommendations for improving future research. Following PRISMA guidelines, 11,252 articles published between 2000 and 2022 were reviewed from several databases. Studies were included if they reported the economic costs of ABR in humans and compared resistant with susceptible infections. Meta-analyses were conducted using random intercept models; standardised mean difference (SMD) was used for length of stay, and odds ratio (OR) for mortality. The Mantel-Haenszel method was applied to obtain pooled estimates. Results showed that 73% of the studies were conducted in high-income economies, the majority were performed at tertiary care settings (71%) and 67% employed only a hospital perspective. The available evidence indicated that the attributable cost of resistant infections ranged from EUR2022 - 21,629 to EUR2022 74,452 per patient episode (with Pseudomonas spp. causing the highest costs). The majority of studies (93%) found that patients with ABR incurred higher costs than their susceptible counterparts (72% report statistically significantly higher costs). Results from meta-analysis indicated that, on average, the excess in hospital stay attributable to resistant infections was 8.72 days (95% confidence interval (CI) [6.42; 11.02], SMD = 0.91) and the odds of premature death were significantly higher in the resistance group, with a risk increase of 65% (OR 95% CI [1.44; 1.88]). Conclusion The findings of this study take the first steps in providing reliable evidence; they could be valuable to researchers, policymakers and clinicians involved in ABR control and health promotion across countries. Similarly, the reported estimates may prove useful for future modelling studies aimed at assessing the long-term economic impact of ABR.
16. RSV Vaccine Effectiveness Against Hospitalization Among US Adults Aged 60 Years or Older During 2 Seasons.
期刊: JAMA 发表日期: 2025-Aug-30 链接: PubMed
摘要
Respiratory syncytial virus (RSV) vaccines for adults aged 60 years or older became available in 2023. One dose is recommended for all adults aged 75 years or older and those aged 60 to 74 years at increased risk of severe RSV; however, duration of protection is unknown. To evaluate RSV vaccine effectiveness against RSV-associated hospitalization among adults aged 60 years or older during 2 RSV seasons. A total of 6958 adults aged 60 years or older were included in this test-negative, case-control study if they were hospitalized with acute respiratory illness at any of 26 hospitals in 20 US states during the October 1, 2023, to March 31, 2024, or October 1, 2024, to April 30, 2025, RSV seasons and had respiratory virus testing within 10 days of illness onset. Case patients tested positive for RSV only; control patients tested negative for RSV, SARS-CoV-2, and influenza. Demographic and clinical data were obtained through patient interview and electronic health records. Receipt of 1 RSV vaccine dose at least 14 days before illness onset. Multivariable logistic regression was used to compare the odds of RSV vaccination among hospitalized cases and controls. Models were adjusted for age, sex, race and ethnicity, geographic region, and calendar month and year. Vaccine effectiveness was estimated as (1 - adjusted odds ratio) × 100%. Analyses were stratified by timing of RSV vaccine receipt (same vs prior season) relative to illness onset. Of 6958 adults aged 60 years or older, 821 (11.8%) were RSV cases and 6137 (88.2%) were controls. A total of 1438 patients were Black (20.1%) and 4314 were White (62.0%); 3534 were female (50.8%). Median age was 72 years (IQR, 66-80 years) and 1829 adults (26.3%) were immunocompromised. A total of 63 cases (7.7%) and 966 controls (15.7%) were vaccinated. Estimated vaccine effectiveness against RSV-associated hospitalization was 58% (95% CI, 45%-68%) during 2 seasons and 69% (95% CI, 52%-81%) for same-season vaccination vs 48% (95% CI, 27%-63%; P = .06) for prior-season vaccination. Estimated vaccine effectiveness during 2 seasons was significantly lower among immunocompromised adults (30%; 95% CI, -9% to 55%) than immunocompetent adults (67%; 95% CI, 53%-77%; P = .02) and among those with cardiovascular disease (56%; 95% CI, 32%-72%) vs without (80%; 95% CI, 62%-90%; P = .03). Respiratory syncytial virus vaccines prevented RSV-associated hospitalization during 2 seasons, although effectiveness was lower in patients with immunocompromise and cardiovascular disease than in those without these conditions. Ongoing monitoring is needed to determine the optimal RSV revaccination interval.
17. Trauma-Informed Care as Structural Disruption: Social Work at the Frontlines of Systems Transformation.
期刊: Journal of evidence-based social work (2019) 发表日期: 2025-Aug-30 链接: PubMed
摘要
Trauma-Informed Care (TIC) is frequently conceptualized as a clinical intervention targeting individual psychological harm. While valuable in clinical contexts, this framing restricts TIC’s broader capacity for systemic and structural transformation. This article reframes TIC as a structural disruption strategy-an equity-driven, systems-level intervention that redefines how health is understood, delivered, and governed. Drawing from social work’s integrative approach across clinical, community, and policy domains, the article situates trauma as a predictable outcome of structural violence rather than an individual pathology. Analysis centers on health system fragmentation, particularly the entrenched separation of behavioral and physical health, as a form of systemic harm. The article highlights liberatory innovations that demonstrate TIC’s transformative potential, including healing-centered schools, trauma-informed telehealth, and peer-based emergency response models. These examples illustrate pathways for addressing systemic inequities while fostering relational accountability and community-centered care. A paradigm shift is needed-from models of integrated care toward liberatory health systems rooted in justice, equity, and structural transformation. By reframing TIC as a disruption strategy, health and social work can move beyond symptom management to advance structural change.
18. Prevalence, Determinants, and Time Trends of Cardiovascular Health in the WHO African Region.
期刊: JAMA cardiology 发表日期: 2025-Aug-30 链接: PubMed
摘要
The distribution and determinants of cardiovascular health (CVH) in the World Health Organization (WHO) African Region have been limited to single-country studies. To estimate the distribution and determinants of CVH score in the WHO African Region, which comprises Algeria and countries in Sub-Saharan Africa. The secondary objective was to estimate time trends in CVH over 20 years. This study constituted repeated nationwide and subnational cross-sectional WHO STEPS (STEPwise Approach to Noncommunicable Disease Risk Factor Surveillance) surveys from 2003 to 2022 in 22 countries in the WHO African Region. Participants included nonpregnant adults aged 18 to 69 years without known cardiovascular disease (CVD). Individual factors (age, sex, education level, and marital status) and contextual data from the United Nations Development Programme and the World Bank databases. The primary outcome was the weighted prevalence of the Life’s Simple 7 score categories (0-7, 8-11, and 12-14 indicating poor, intermediate, and ideal CVH, respectively) and the factors associated with CVH status. The study population included 73 024 individuals free of CVD (mean [SD] age, 35.4 [12.9] years; 49 505 female [weighted, 49.4%]) and representing 95 million people across 22 countries and 25 surveys. The weighted prevalence of ideal, intermediate, and poor CVH was 26.2% (95% CI, 25.7%-28.0%), 57.9% (95% CI, 54.8%-59.0%), and 15.9% (95% CI, 15.1%-17.0%), respectively. Older age, female sex, lower education, and heavy alcohol consumption were associated with lower odds of achieving intermediate or ideal CVH scores (females vs males: odds ratio [OR] for intermediate CVH, 0.77; 95% CI, 0.67-0.89; OR for ideal CVH, 0.80; 95% CI, 0.64-0.92; ages 55-69 vs 18-25 years: OR for intermediate CVH, 0.14; 95% CI, 0.10-0.20; OR for ideal CVH, 0.06; 95% CI, 0.04-0.09; no education vs tertiary: OR for ideal CVH, 0.63; 95% CI, 0.43-0.92; heavy episodic drinking vs nondrinking: OR for ideal CVH, 0.51; 95% CI, 0.39-0.67). Country-level contextual factors, particularly higher mean years of schooling (β = 0.24; 95% CI, 0.17-0.32), higher education percentage (β = 0.01; 95% CI, 0-0.02), and higher prevalence of undernourishment (β = 3.14; 95% CI, 0.63-5.65), were associated with higher CVH scores. The spatial-temporal model did not reveal any statistically significant trend in the weighted prevalence of CVH score categories between 2003 and 2022, overall and by sex. This situational analysis of cross-sectional WHO STEPS surveys of CVH status region identified actionable factors of the CVH status across 22 countries in the WHO African Region. This information is crucial for guiding policy efforts in CVD prevention in countries of the WHO African Region.
19. Comparative Analysis of Anthocyanins and Vitamin C Content, Antioxidant Potential, and Antimicrobial Activity of Eight Black Currant (Ribes nigrum L.) Varieties Juices.
期刊: Chemistry & biodiversity 发表日期: 2025-Aug-30 链接: PubMed
摘要
This study aimed to compare the juices of eight black currant (Ribes nigrum L.) varieties: Ben Nevis, Ben Lomond, Bona, Čačanska crna, Öyebin, Silmu, Tsema, and Titania. The comparison focused on their dominant anthocyanin content, vitamin C levels, and their antioxidant and antimicrobial properties. The highest total vitamin C content was found in the juice of the Ben Nevis variety. The two most abundant anthocyanins were delphinidin-3-O-rutinoside and cyanidin-3-O-rutinoside, with only slight variations between the varieties. The juices from the Ben Nevis and Silmu varieties contained the largest amounts of individual anthocyanins. Furthermore, Tsema juice demonstrated the highest antiradical and antilipoperoxidant activities, as assessed by the 1,1-diphenyl-2-picrylhydrazyl (DPPH) and β-carotene/linoleic acid methods. The variety showing the strongest antimicrobial activity was Ben Lomond. This juice stood out from the others due to its nearly equal amounts of dominant anthocyanins. The juices from the tested varieties of black currant have demonstrated significant antioxidant activity, suggesting they could play an important role in preventing diseases linked to oxidative stress. Additionally, these juices may help stabilize herbal remedies and food products. The results emphasize the need for more robust promotion of black currants to increase consumer awareness of their health benefits.
20. Population pharmacokinetics and pharmacodynamics of meropenem in critically ill patients with renal impairment or on continuous renal replacement therapy.
期刊: European journal of clinical pharmacology 发表日期: 2025-Aug-30 链接: PubMed
摘要
This study aimed to characterize the pharmacokinetics (PK) of meropenem in patients with renal impairment or on continuous renal replacement therapy (CRRT), investigate the factors contributing to PK variability, and evaluate the performance of different dosing regimens to optimize the pharmacokinetics/pharmacodynamics PK/PD) targets. This study enrolled patients with severe infections and renal impairment who received meropenem treatment at the Second Affiliated Hospital of Soochow University. Participants were grouped according to whether CRRT was used. Meropenem concentrations were quantified using liquid chromatography-tandem mass spectrometry (LC/MS-MS). A population pharmacokinetic (PPK) model for meropenem was developed using a nonlinear mixed-effects modeling (NONMEM) approach. Monte Carlo simulations were performed to evaluate the likelihood of achieving PK/PD targets and the risk of adverse events across various dosing regimens. A total of 54 patients were included in the study. A two-compartment model was used as a structural model and CRRT was identified as a significant covariate of clearance (CL). The estimated typical value of CL was 2.47 L/h. Under physiological conditions, renal impairment usually leads to a decrease in meropenem clearance. Compared with patients with renal impairment (estimated glomerular filtration rate < 45 mL/min/1.73 m2), CRRT can increase meropenem clearance by 2.1 times. Monte Carlo simulations suggested that for patients undergoing CRRT, the administration regimen of 0.5 g q6h (3 h infusion) is recommended; whereas for non-CRRT patients with renal impairment, the regimen of 0.5 g q8h (1 h infusion) was advised. The study identified that CRRT significantly affected the exposure of meropenem in patients with renal impairment. Therefore, individualized medication for CRRT patients is of great importance.
21. Advancing Traditional Chinese Medicine Research through Network Pharmacology: Strategies for Target Identification, Mechanism Elucidation and Innovative Therapeutic Applications.
期刊: The American journal of Chinese medicine 发表日期: 2025-Aug-30 链接: PubMed
摘要
Traditional Chinese medicine (TCM) is characterized by its multi-component, multi-target, and multi-pathway properties, which make it an ideal candidate for network pharmacology applications. This approach provides a comprehensive framework for understanding the therapeutic effects of TCM in managing complex diseases. This review highlights recent advancements in network pharmacology as applied to TCM, and focuses on key achievements such as the identification of core bioactive components, target prediction, and the elucidation of mechanisms of action. Notable studies, including network pharmacology research on artemisinin and Compound Danshen Droplet Pills, demonstrate the practical application of this methodology in drug discovery and disease management. Furthermore, this review explores the integration of network pharmacology with omics technologies, and enables a more holistic understanding of TCM’s efficacy. These advancements are crucial in promoting the modernization of TCM and enhancing its integration into contemporary medicine. In conclusion, network pharmacology is advancing TCM research, providing a scientific basis for its clinical application, and paving the way for its global acceptance.
22. Ivabradine in Patients Undergoing Noncardiac Surgery: a Randomized Controlled Trial.
期刊: Circulation 发表日期: 2025-Aug-30 链接: PubMed
摘要
Perioperative beta-blockade lowers heart rate and decreases the risk of myocardial infarction but increases the risk of hypotension, death, and stroke. Ivabradine, a selective heart rate-lowering agent, may prevent prognostically important myocardial injury after noncardiac surgery (MINS) without causing hemodynamic instability. In this multicenter, double-blind, placebo-controlled trial, we assigned patients aged ≥45 years with, or at risk of, atherosclerotic disease undergoing noncardiac surgery to receive ivabradine (5 mg orally twice daily for up to 7 days, starting 1 hour before surgery) or placebo. The primary outcome was MINS within 30 days from randomization. All of 2101 participants who underwent randomization were included in the intention-to-treat population. MINS occurred in 178 of 1050 patients (17.0%) in the ivabradine group and in 159 of 1051 patients (15.1%) in the placebo group (relative risk [RR], 1.12; 95% confidence interval [CI], 0.92 to 1.37; p=0.25). Enrollment was halted at the prespecified interim analysis due to a conditional power of 6%, below the futility boundary of 20%. The intraoperative mean heart rate was lower in the ivabradine group by 3.2 beats per minute than in the placebo group (95% CI, -4.07 to -2.36), with no difference in intraoperative mean arterial pressure. Among patients undergoing noncardiac surgery, ivabradine did not reduce the occurrence of MINS.
23. Modeling influenza transmission and control: epidemic theory insights across Mexico, Italy, and South Africa.
期刊: Theory in biosciences = Theorie in den Biowissenschaften 发表日期: 2025-Aug-30 链接: PubMed
摘要
A mathematical analysis of influenza virus transmission is undertaken, combining rigorous theoretical development with numerical simulations informed by real-world data. The terms in the equations introduce parameters which are determined by fitting the model for matching clinical data sets using nonlinear least-square method. Wave patterns, critical illness factors, and forecasts of influenza transmission at national levels in Mexico, Italy, and South Africa are examined, alongside evaluations of the effectiveness of existing control measures and proposals for alternative policy interventions. Data for 120 weeks from October 2021 to March 2023 are used to fit the model. Numerical simulations and sensitivity analysis reveal the effectiveness of various prevention strategies. We performed data fitting using Latin hypercube sampling, sensitivity indices, Partial Rank Correlation Coefficient (PRCC), and p values to estimate the basic reproduction number R 0 and validate the model with data from these countries. Leveraging this validation, we identify optimal control strategies involving antiviral treatment protocols to suppress viral spread, reduce new infections, and minimize systemic costs. The existence and uniqueness of the optimal control pair are rigorously established, with the derived optimality system solved numerically. Additionally, we investigated the qualitative behavior of the threshold quantity, which determines whether the disease dies out or persists in the population. Finally, numerical experiments illustrate the impact of key parameters on transmission dynamics, corroborating theoretical predictions.
24. Mitochondrial dysfunction in hepatocellular carcinoma: from metabolism to targeted therapies.
期刊: Molecular and cellular biochemistry 发表日期: 2025-Aug-30 链接: PubMed
摘要
Globally, liver cancer is reported to be the third leading cause of cancer-related mortality. The most common type of these cancers is hepatocellular carcinoma (HCC). Current preventive strategies, including lifestyle modifications, antiviral therapies, and surveillance, are limited in their effectiveness. Mitochondria play critical roles in regulating cellular metabolism, oxidative stress, and apoptosis. Mitochondrial dysfunction can accelerate HCC progression, particularly in patients with liver diseases such as metabolic-associated fatty liver disease (MAFLD) and metabolic dysfunction-associated steatohepatitis (MASH). In this review, we discuss the mechanisms of mitochondrial dysfunction in HCC from a molecular point of view, including oxidative stress, mitophagy dysregulation, mitochondrial dynamics dysregulation, and mitochondrial DNA (mtDNA)-mediated dysregulation of innate immune responses. Additionally, we explore molecular-targeted therapies aimed at restoring mitochondrial function. Critical approaches include targeting reactive oxygen species pathways through agents such as iridium (III) complexes and Mito Rh S, which induce cancer cell death through apoptosis and ferroptosis. Other compounds, including dehydrocrenatidine, enhance oxidative phosphorylation and promote apoptosis. Inhibitors of dynamin-related protein 1 (Drp1) target mitochondrial fission to reduce tumor growth. Furthermore, mitophagy modulators, such as SIRT1 activators, improve mitochondrial quality control, minimize the negative effects of oxidative stress, and reduce cancer development. Clinical trials are ongoing for the mitochondrial enzyme-targeting agents CPI-613 and Gamitrinib, a heat shock protein-targeting agent, which have hence shown great promise for these therapies. With further investigation, mitochondrial-targeted interventions could be promising for preventing or reducing HCC incidence and recurrence, increasing long-term survival, and improving the quality of life of patients with advanced-stage disease.
25. A Comprehensive Review on Pulmonary Fibrosis (PF): Histological Spectrum, Diagnosis, Risk Factors, Pathogenesis, Molecular Pathophysiology, and Current Treatment Options.
期刊: Chemistry & biodiversity 发表日期: 2025-Aug-30 链接: PubMed
摘要
Pulmonary fibrosis (PF) results from progressive lung tissue damage, which resembles the lung tissue scarring that disrupts gas exchange, leading to lower oxygen exchange capabilities. Various environmental dangers and autoimmune illnesses, together with specific infections and particular medications, serve as primary causes for PF development. This review intends to provide an overview of PF with respect to the tissue changes, diagnostic methods, risk factors, underlying biological mechanisms, and current treatment options. Preclinical studies indicate that herbal remedies together with natural products demonstrate anti-inflammatory and antifibrotic properties, but clinical use remains difficult without adequate evidence. Additional research must be undertaken to validate and optimize these complementary PF management strategies for their future use.
26. From allergens to epigenetics: how histone acetylation shapes immune gene expression in allergic diseases.
期刊: Epigenomics 发表日期: 2025-Aug-30 链接: PubMed
摘要
Allergic diseases are a significant global health concern. These disorders result from abnormal immune responses to environmental allergens, influenced by genetic, environmental, and epigenetic factors. Among these, histone acetylation has emerged as a key epigenetic mechanism influencing immune gene expression. Histone acetylation modulates chromatin structure and gene transcription, linking environmental exposures to immune responses. In this review, we explore how histone acetylation mechanisms regulate immune gene activation and contribute to the pathophysiology of allergic diseases and detail the role of histone acetylation in asthma, food allergy, atopic dermatitis, and other allergic conditions. Finally, we discuss therapeutic strategies targeting histone acetylation, highlighting their potential to mitigate allergic inflammation and improve patient outcomes. Understanding histone acetylation’s role in allergic diseases provides a basis for developing epigenetic therapies, offering promising new approaches to managing these conditions.
27. Machine learning-based prediction of drinking water quality index in Western Tehran using KAN, MLP, and traditional models.
期刊: Environmental monitoring and assessment 发表日期: 2025-Aug-30 链接: PubMed
摘要
In this study, the water quality index (WQI) was calculated using multivariate statistics, incorporating physical, chemical, and microbiological analysis of water samples taken from water supply networks in the western district of Tehran from 2021 to 2024. The principal drinking water parameters such as pH, total hardness, turbidity, lead (Pb), chloride (Cl), fluoride (F), total dissolved solids (TDS), sulfate (SO4), nitrate (NO3), nitrite (NO2), calcium (Ca), magnesium (Mg), arsenic (As), mercury (Hg), cadmium (Cd), fecal coliform and total residual chlorine (Ch) were selected according to Iranian national water standards. The WQI index was predicted using various machine learning algorithms, including multiple linear regression (MLR), support vector machine (SVM) regression, extreme gradient boosting (XGBoost), Random Forest (RF) regression, multilayer perceptron (MLP), and Kolmogorov-Arnold networks (KAN). The results showed that the traditionally computed WQI values ranged from 75 to 86, indicating that water quality varied from fair to good for drinking purposes. The prepared WQI maps revealed that the water quality of 71% of the evaluated areas between 2021 and 2022 was in the good range, whereas the water quality of 50% and 87% of the locations was rated as good in the subsequent years. Moreover, excellent prediction results were obtained, with an R2 of 0.901 and root mean squared error (RMSE) of 0.286 for the MLP model, and an R2 of 0.9527 and RMSE of 0.197 for the KAN model. The results obtained indicate that both the KAN and MLP models are effective for accurately predicting the WQI.
28. Sex-specific hepatotoxicity in zebrafish (Danio rerio) induced by Roundup WG® exposure.
期刊: Environmental science and pollution research international 发表日期: 2025-Aug-30 链接: PubMed
摘要
The widespread use of glyphosate-based herbicides (GBH), particularly Roundup®, in agriculture, poses a significant risk of contaminating surface and groundwater sources, raising concerns about its impact on non-target organisms like fish. While the harmful effects of Roundup® are well documented, sex-specific responses to environmentally relevant concentrations are less investigated. This study aimed to evaluate the sex-specific cellular toxicity of Roundup WG® (RWG) on the liver of Danio rerio (zebrafish). Adult fish were divided into three groups: control, 0.065 mg/L, and 6.5 mg/L of glyphosate concentrations, and exposed for 7 and 15 days. Liver tissue structure was analyzed by light microscopy, while hepatocyte ultrastructure was examined under transmission electron microscopy. Additionally, histochemical analyses were conducted to detect acid/neutral polysaccharides and proteins. Our results indicated sex-specific hepatotoxicity induced by RWG. Males were more susceptible at the lowest concentration after 7 days, while females exhibited toxicity mostly after 15 days. Conversely, the highest concentration seems to be more cytotoxic. These findings emphasize the importance of understanding sex-specific responses to toxicants, particularly regarding liver function and its broader implications for other organs like the gonads. Therefore, this research provides valuable insights into environmental health and the risks associated with this globally used herbicide.
29. Association between safety climate, safety participation, safety compliance, and occupational injuries among workers in large-scale building construction projects in Ethiopia.
期刊: International archives of occupational and environmental health 发表日期: 2025-Aug-30 链接: PubMed
摘要
The construction industry is widely acknowledged as one of the most hazardous sectors for workers. This study examined the associations between safety climate and safety behaviour on self-reported injuries in large-scale construction sites in Ethiopia. A cross-sectional study was conducted from January to May 2023 among 1203 workers from 22 large-scale construction sites. Study participants from each site were selected using a proportional-to-the-size approach. The Nordic Safety Climate Questionnaire (NOSAQ-50) was administered using interviews. Binary logistic regression analysis was performed to identify the relationship between safety climate, safety behaviour, and other factors of self-reported injuries. The prevalence of self-reported injuries in the last twelve months was 35.7% [95% CI (33.0, 38.4)]. Over one-third (35%) of the victims missed more than three workdays due to occupational injuries. Factors affecting self-reported injuries included being a carpenter [AOR = 2.86, 95% CI (1.91-4.28)], being an iron bender [AOR = 1.58, 95% CI (1.02-2.44)], having less than 5 years of work experience [AOR = 1.54, 95% CI (1.18-2.01)], lack of training [AOR = 2.16, 95% CI (1.27-3.72)], low safety climate [AOR = 1.53, 95% CI 1.06-2.21)], low safety participation [AOR = 2.16, 95% CI 1.64-2.86)], and low safety compliance [AOR = 2.32, 95% CI 1.79-3.02)]. This study revealed a high magnitude of injuries and identified a relationship between safety climate, safety behaviors, and occupational injuries in the construction industry. Ensuring the work sites’ safety climate and improving compliance with safety rules and procedures is essential.
30. Promoting safety performance in safety-critical organizations: unleashing the potential of psychological capital.
期刊: International journal of occupational safety and ergonomics : JOSE 发表日期: 2025-Aug-30 链接: PubMed
摘要
Objectives. Despite the implementation of various interventions in safety-critical organizations (SCOs), occupational accidents and injuries remain persistently frequent in industrialized countries. Consequently, promoting occupational safety continues to pose a major challenge in the field of occupational health and safety (OHS). This time-lagged study investigates the potential of psychological capital (PsyCap) - a higher-order construct comprising self-efficacy, hope, optimism and resilience - to directly enhance workers’ safety performance (i.e., safety compliance and safety participation) and indirectly through the mediation of safety knowledge and safety motivation. Methods. The research involved 134 workers (93.3% male) from Italian SCOs who completed three questionnaires. The data were analysed via path analysis. Results. The results highlight the pivotal role of PsyCap in improving safety compliance and safety participation over time, both directly and indirectly through safety knowledge but not through safety motivation. Conclusion. These findings highlight PsyCap as a crucial positive personal resource for shaping safety behaviours in SCOs. The results suggest opportunities to develop innovative OHS training programmes that enhance PsyCap within these organizations.
31. The Influence of workload measures by weight, repetition and height during one-handed handling.
期刊: International journal of occupational safety and ergonomics : JOSE 发表日期: 2025-Aug-30 链接: PubMed
摘要
This study aimed to evaluate the workload effect of weight, repetition and height between muscle activity and fatigue, and perceived fatigue during one-handed handling. Twenty-five right-handed male subjects performed lifting and lowering tasks for 10 min under varying conditions: weight (1, 4 and 7 kg), repetition (2, 6 and 10 cycles/min) and height (30, 60 and 90 cm). Electromyography signals were recorded from the anterior deltoid, posterior deltoid and upper trapezius muscles. Instantaneous energy (IE), instantaneous mean power frequency (IMPF) and perceived fatigue were analyzed. Results showed that increased height led to a 172.3% rise in mean IE, higher repetition reduced IMPF by 6.0% and increased weight raised perceived fatigue by 283.6%. Height primarily affected muscle activity, repetition influenced fatigue and weight impacted subjective fatigue. These findings highlight the importance of considering individual risk factors in relation to different workload measures.
32. Effectiveness and safety of rivaroxaban vs. apixaban in patients with atrial fibrillation and peripheral artery disease.
期刊: European heart journal. Cardiovascular pharmacotherapy 发表日期: 2025-Aug-30 链接: PubMed
摘要
To assess whether rivaroxaban is associated with a decreased risk of major adverse limb events (MALE), stroke, systemic embolism (SE), and major bleeding (MB) among patients with non-valvular atrial fibrillation (NVAF) and peripheral artery disease (PAD), compared with apixaban. We conducted a population-based cohort study using the UK Clinical Practice Research Datalink. Patients aged ≥45 years with incident NVAF and PAD who initiated rivaroxaban or apixaban between 2013 and 2021 were included. Primary effectiveness outcomes were MALE, and a composite of ischaemic stroke, transient ischaemic attack (TIA), or SE. The primary safety outcome was MB. The risk of major cardiovascular events (MACE) was assessed as a secondary outcome. Confounding was addressed using propensity score fine stratification and weighting. Weighted Cox proportional hazards models estimated hazard ratios (HRs) with 95% confidence intervals (CIs). The cohort included 6170 new users of rivaroxaban and 9990 new users of apixaban (44% female; mean [SD] age 78.5 [9.2] years). Incidence rates were similar for MALE (6.7 vs. 5.6/1000 person-years; adjusted HR (aHR): 1.20; 95% CI 0.87-1.65), stroke/TIA/SE (24.5 vs. 21.3/1000 person-years; aHR: 1.15; 95% CI 0.97-1.36), and MACE (40.1 vs. 35.9 per 1000 person-years; aHR 1.10: 95% CI 0.94-1.28). Major bleeding rates were higher with rivaroxaban (46.1 vs. 29.8/1000 person-years; aHR: 1.55; 95% CI 1.36-1.77). In patients with NVAF and PAD, rivaroxaban was associated with a similar risk of MALE and stroke/TIA/SE, but a higher risk of MB compared with apixaban. These findings support apixaban as a potentially safer anticoagulant in this high-risk population.
33. Patterns of sexual minority men's lifestyle and healthcare related activity spaces in Los Angeles.
期刊: Health & place 发表日期: 2025-Aug-29 链接: PubMed
摘要
For gay, bisexual, and other sexual minority men (SMM), geo-social exposures in residential and non-residential places are important to consider for health, as home, social, sexual, substance use, and healthcare-related locations may be different. We use survey data from a sample of 219 Black and Hispanic SMM within Los Angeles County to examine the places that individuals visit for eight specific activities, categorized as either lifestyle or healthcare-related. Spatial clustering techniques are used to identify hotspots, or places where individual’s activities are clustered in space, for each activity. We then use descriptive statistics to characterize each hotspot based on the socio-demographic characteristics of individuals who engaged in activities within the hotspot, and then assess whether activity-based hotspots overlap in space. We find unique spatial patterns of hotspots, distinct by activity. Additionally, lifestyle activity space hotspots are spatially patterned by socio-demographic characteristics, primarily along race and ethnic categories, whereas healthcare-related hotspots are not. The overlap, or spatial congruence of hotspots, is higher than we hypothesized, as hotspots of residential locations contained the majority of sex hotspots and substance use hotspots. Our work ultimately identifies four distinct areas of Los Angeles County in which activities are clustered among men in the sample, and health interventions can be tailored to the individuals and their activities in those places. Our findings demonstrate the importance of geographically and demographically targeted interventions, at a fine spatial scale, for health promotion among SMM, as interventions and policy to provide equitable care to reduce racial disparities in health among SMM are sorely needed.
34. Liveable regional places for people with disabilities: exploring intersections and priorities.
期刊: Health & place 发表日期: 2025-Aug-29 链接: PubMed
摘要
35. Investigation of the accumulation and sources of polycyclic aromatic hydrocarbons (PAHs) and mercury (Hg) in marine fish from the northern Bay of Bengal using a multi-tool approach.
期刊: Marine pollution bulletin 发表日期: 2025-Aug-29 链接: PubMed
摘要
This study investigated Polycyclic Aromatic Hydrocarbons (PAHs) and total Mercury (Hg) in commonly consumed seafoods from the northern Bay of Bengal. The PAHs were analyzed using GC-MS, and a Direct Mercury Analyzer was employed for total Hg. The results showed that total PAHs concentration ranged between 78.68 and 1000.33 ng/g (ww) and 3-ring and 4-ring PAHs dominated (>85 %). On the other hand, total Hg concentration ranged between 3.88 ± 1.71 to 67.69 ± 1.34 ng/g. The results highlighted a complex interplay between the feeding zone and habit to influence the contaminant accumulation pattern in marine fish. Among the studied species, pelagic fish demonstrated higher PAHs accumulation. However, Hg accumulation was higher in benthopelagic an demersal fish. In this study, the risk from non-cancer-causing PAHs remained <1, while the cancer threat associated with carcinogenic PAHs and Hg was negligible. Monte Carlo simulation on source-specific total cancer risk also demonstrated similar output by exhibiting very low simulated cancer risk with very low frequency and probability. The source apportionment analysis, conducted using Hierarchical Cluster Analysis and a Pearson Correlation Matrix, coupled with two receptor modeling approaches (PMF and Unmix), indicated that mixed combustion, petroleum pollution, and industrial activities were the primary contributors to the introduction of PAHs and Hg into marine fish. This investigation highlights the importance of source-specific control measures in mitigating marine pollution and protecting public health. Overall, this study underscores the importance of integrating bio-monitoring with ecological and receptor model-based approaches to form public health protection and marine environmental management.
36. Interprofessional, risk-adapted medication management in older patients with cancer (IrMa).
期刊: Journal of geriatric oncology 发表日期: 2025-Aug-29 链接: PubMed
摘要
Older patients with cancer are at increased risk for adverse drug events due to chronic conditions and complex medication regimens often leading to polymedication. A pharmacist-led medication review has the potential to reduce drug-related problems and enhance medication safety. Oncogeriatric scores are effective in predicting chemotherapy-associated toxicity. However, risk scores are only of benefit for the patient if the results lead to therapeutic consequences. This study aimed to develop and evaluate an interprofessional risk-adapted medication management intervention (IrMa) to reduce the symptom burden caused by adverse drug events in older patients with cancer. The individualized care approach entailed adapting the intensity of care to the toxicity risk of each patient. This was determined prior to tumor therapy by using the Cancer and Aging Research Group (CARG) score and existing polymedication. Based on their individual risk, patients were divided into different groups and received either standard care (“low-risk patients”), or, for high-risk patients, symptom counseling, medication review, or both. Feasibility and acceptability of the intervention were investigated as primary outcome. Toxicity and patient-reported symptom burden were documented and analyzed as secondary outcomes. A non-inferiority analysis was conducted to assess whether high-risk patients who received the IrMa intervention experienced a similar level of toxicity or symptom burden as low-risk patients, despite their higher risk. This analysis aimed to identify preliminary efficacy signals. The intervention was feasible and well accepted. Out of 101 enrolled patients, 96 patients aged between 70 and 88 years were stratified. Implementation rates were 100% for medication reviews and 74% for symptom counseling. Of the identified drug-related problems requiring intervention, 73.9% were resolved. In the first cycle, the overall toxicity rate (CTCAE grade ≥ 3) was 67.5% in low-risk patients and 80.4% in high-risk patients. Preliminary efficacy signals were identified for patient-reported mucositis, vomiting, constipation and diarrhea in the first cycle but not for toxicity grade ≥ 3. The interprofessional, risk-adapted medication management for older patients with cancer is a feasible and accepted approach to improve patient safety. Patient-reported outcomes indicate a preliminary efficacy in reducing symptoms that can be influenced by appropriate supportive care.
37. Estimating the likelihood of cigarette maintenance and dual use among people using e-cigarettes for cigarette cessation: Analysis of the Population Assessment of Tobacco and Health Study Waves 5 and 6.
期刊: Addictive behaviors 发表日期: 2025-Aug-29 链接: PubMed
摘要
This study longitudinally describes the relationship between frequency of e-cigarette use and past-month cigarette abstinence, dual use, and maintenance of cigarette smoking among adults in the US who ever used e-cigarettes for cigarette cessation. Data were from the US Population Assessment of Tobacco and Health Study Waves 5 (2018/19; baseline) and 6 (2021; follow-up). The sample was restricted to adults who used cigarettes and e-cigarettes in the past-month and ever used e-cigarettes to quit smoking at baseline. The primary predictor was baseline daily e-cigarette-use, and outcomes at follow-up were past-month cigarette abstinence, and multiple past-month cessation outcomes: a. cigarette maintenance; b. dual use; c. dual abstinence; and, d. past-month cigarette abstinence. We used weighted multivariable logistic and multinomial regression models, adjusting for demographics and baseline daily cigarette smoking. Among adults who ever used e-cigarettes to quit cigarettes, more daily e-cigarette users than non-daily (36.7 % vs 8.4 %) were cigarette abstinent and had higher odds of cigarette abstinence at follow-up (AOR:1.9, 95 % CI:1.1, 3.2). Daily e-cigarette (vs. non-daily) users had a higher likelihood of cigarette abstinence than cigarette maintenance (RRR:7.1, 95 % CI:3.8, 13.0). Compared to dual use, there was a higher likelihood of cigarette abstinence among daily e-cigarette users (vs. non-daily) (RRR:2.7; 95 % CI:1.5,4.9). Daily e-cigarette use among individuals who used e-cigarettes to quit cigarette smoking predicts past-month cigarette abstinence. Daily e-cigarette use is associated with a higher likelihood of cigarette abstinence than cigarette maintenance, and a higher likelihood of cigarette abstinence than dual use at follow-up.
38. The role of the coagulation-fibrinolysis system in airway and lung remodeling.
期刊: Respiratory investigation 发表日期: 2025-Aug-29 链接: PubMed
摘要
The coagulation and fibrinolytic systems are distinct biological processes yet intricately interconnected through various regulatory mechanisms. The coagulation cascade not only serves to prevent blood loss from damaged vessels but also acts as a defense mechanism against invading pathogens and initiates vascular repair. This physiological response culminates in the formation of a fibrin mesh through a well-orchestrated cascade of enzymatic reactions. Conversely, the fibrinolytic system functions to dissolve thrombi formed by the coagulation system. Its principal effector, plasmin, degrades the fibrin network and activates a range of bioactive molecules involved in diverse physiological responses. The coagulation and fibrinolytic pathways and associated inflammatory and wound-healing processes are tightly regulated and mutually influential. Airway and pulmonary remodeling typically refer to pathological alterations in lung tissue, including inflammation, fibrosis, emphysema, and alveolar damage. These changes can be driven by chronic disease, acute inflammation, or environmental factors. Significantly, a localized procoagulant state or dysfunction in the fibrinolytic system within the respiratory tract may contribute to these remodeling processes, ultimately impairing respiratory function and leading to significant health consequences. Despite the promising effects of conventional anticoagulant therapies in animal models, clinical translation in humans has often failed to yield clear therapeutic benefits. This discrepancy is likely attributable to the inherent complexity and dual roles of the coagulation-fibrinolysis axis and the persistent risk of bleeding associated with systemic anticoagulation. Therefore, continued investigation into the underlying mechanisms and the development of novel, targeted anticoagulant strategies are warranted to achieve effective and safe therapeutic outcomes.
39. Targeting the mPGES-PGE2-EP4 pathway with MF63, MK886, and Grapiprant as a potential therapeutic strategy for Escherichia coli-induced endometritis in dairy cows.
期刊: Theriogenology 发表日期: 2025-Aug-27 链接: PubMed
摘要
Escherichia coli (E. coli) is the primary causative agent of endometritis in dairy cows. Antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs) are the main treatments; however, prolonged antibiotic use promotes bacterial resistance, while NSAIDs can delay ovulation and impair reproduction. Safer and more effective alternative therapies are needed to control infection while minimizing adverse effects. In the bovine uterine microenvironment, prostaglandin E2 (PGE2) plays a key role by activating the EP4 receptor. However, the therapeutic potential of microsomal prostaglandin E synthase-1 (mPGES-1) inhibitor (MF63), mPGES-1 regulator (MK886) and the EP4 receptor antagonist (Grapiprant) in bacterial endometritis remains unclear. This study investigates the therapeutic potential of MF63, MK886 and Grapiprant in mitigating E. coli-induced endometritis in dairy cow. Molecular docking showed that MF63 and MK886 efficiently bind to mPGES-1, while Grapiprant stably binds to the EP4 receptor. Additionally, these inhibitors significantly suppressed PGE2 secretion in E. coli-infected bovine endometrial tissues. Hematoxylin and eosin staining and immunofluorescence analysis demonstrated that MF63, MK886, and Grapiprant significantly reduced E. coli-induced tissue damage and the expression of damage-associated molecular patterns, such as HMGB-1 and HABP-2. Furthermore, these treatments decreased pro-inflammatory cytokines (TNF-α, IL-6, IL-1β) and the chemokine IL-8 while increasing IL-10 expression. In conclusion, targeting the mPGES-PGE2-EP4 pathway may offer a safer, more effective alternative for managing E. coli-induced endometritis in dairy cows.
40. A participatory systems approach in community health promotion: Lessons learnt from an overall evaluation of a program to reduce health inequities.
期刊: Evaluation and program planning 发表日期: 2025-Aug-26 链接: PubMed
摘要
To address the complexity and multi-level dynamics in health promotion, participatory and systems approaches have recently gained attention. We combined these into a participatory systems approach, which actively involves stakeholders in the planning, implementation, and evaluation of health promotion initiatives. This approach promotes cross-sector collaboration, shared understanding, joint decision-making, empowerment, and acknowledges the dynamic, interconnected factors that influence health over time. However, practical guidance on how to implement and evaluate such complex programs remains limited, particularly on aligning implementation and evaluation. We applied a participatory systems approach to the planning and implementation of an overall evaluation of a program aimed at enhancing the health of families in vulnerable positions in the Netherlands, with the goal of sharing lessons learnt from this process. From the program, four projects in four municipalities were selected for this study. We studied the processes and results of the overall evaluation in four iterative steps: conducting participatory action research with the four projects, semi-structured interviews with the four case managers, three consortium reflection and learning sessions and document analysis. We identified five themes: flexibility; research and practice needs; research capacity; roles of stakeholders and defining boundaries. The main lessons from our participatory systems approach are: flexibility is needed to realise stakeholder participation; balance research with practice; ensure adequate research capacity; define the roles of stakeholders and explore system boundaries continuously. The implementation of these lessons is supported by a reflection and learning culture. These lessons are relevant for practitioners, researchers, policymakers and citizens in effectively planning, implementing and evaluating health promotion programs.
41. The fabrication of N, S co-doped carbon dots and cascade sensing Hg2+ and bovine serum albumin in food with reversible strategy.
期刊: Food chemistry 发表日期: 2025-Aug-25 链接: PubMed
摘要
High-performance effective and precise detection of Hg2+ possesses great significance for ensuring environmental, food safety and public health, but still a great challenge. Here, efficient fabrication of NS-doped carbon dots (NS-CDs) were achieved and applied as fluorescent probe for cascade sensing Hg2+ and BSA. NS-CDs emitted green emission at 500 nm under 355 nm excitation. The sensing performance of Hg2+ and bovine serum albumin (BSA) of NS-CDs was evaluated using a reversible “on-off-on” strategy, yielding detection limits of 16.5 nM and 17.0 nM. Further, the smartphone assisted sensing reproduced the reversible performance with visual and intelligent readout. Satisfied recoveries were attained in detection in real water and foods, enabled on-site evaluation of Hg2+ and BSA levels. The proposed cascade sensing strategy and reversible logic-gate illustration exhibited an innovative idea for designing CDs, and broaden their potential applications in multivariate sensing, which promoted the development of multi-functional CDs and promising application.
42. Temporal trends in youth emergency department visits involving suicidal ideation and deliberate self-harm, 2016-2023.
期刊: General hospital psychiatry 发表日期: 2025-Aug-24 链接: PubMed
摘要
43. Monte Carlo evaluation of occupational exposures in equine radiology procedures.
期刊: Applied radiation and isotopes : including data, instrumentation and methods for use in agriculture, industry and medicine 发表日期: 2025-Aug-21 链接: PubMed
摘要
Portable X-ray equipments are commonly used in diagnostic radiology of equine patients. Despite its benefits, the exposure to ionizing radiation can pose a health risk to workers as physical restraint of patients is typically required. In this context, the aim of this study was to apply Monte Carlo simulation to investigate occupational exposure in the diagnosis of horses. The simulations were carried out by the Monte Carlo N-Particle 6.2 (MCNP6.2) code. The workers were represented by a FASH3 (female) and MASH3 (male) virtual anthropomorphic phantoms. To simulate the horse, a realistic virtual anthropomorphic phantom was created by voxelizing a commercially available 3D model. The spectra were calculated using the SpekCalc program with parameters: 90 and 100 kV, anode angle of 20°, filtration of 2.7 mmAl and field of view of 43×35cm2. In the first simulated scenario, workers do not utilize personal protective equipment (PPE). In the second scenario, workers use PPE (lead apron, thyroid protector and lead glasses) and accessories to increase the distance from the patient/X-ray. The results are presented as conversion coefficients for Equivalent Dose (CC[HT]) and Effective dose (CC[E]) normalized by the Air Kerma. Without protection, the most exposed organs/tissues of the assistants were: thyroid, for the woman, and breasts, for the man. In the most critical scenario, the assistant CC[E] values are higher than tube operators by a factor of 28. The combination of PPE use and increased distance reduced these CC[HT] by at least 99% for the assistants and 97% for tube operators.
44. Rape bee pollen outperforms camellia bee pollen in enhancing gut health and antioxidant capacity of wanxi white goose.
期刊: Poultry science 发表日期: 2025-Aug-19 链接: PubMed
摘要
Bee pollen is rich in nutrients and bioactive compounds, exhibiting properties such as antioxidant effects, immune enhancement, and promotion of growth and development. However, there are limited studies on the use of bee pollen in goose breeding. This study aimed to investigate the effects of rape bee pollen (RBP) and camellia bee pollen (CBP) on production performance, intestinal morphology, digestive enzyme activity, antioxidant and immune indices, and gut microbiota in Wanxi white goose. In this study, 180 30-day-old Wanxi white goose with similar body weight were randomly divided into three groups with three replicates containing 20 goose each replicate. The control group was fed a basal diet, RBP group received the basal diet supplemented with 200 mg/kg RBP, and CBP group received the basal diet supplemented with 200 mg/kg CBP. The experiment lasted for 60 days, with sampling conducted at 60 and 90 days of age. The results revealed that RBP could significantly increase the full eviscerated rate of Wanxi white goose. Additionally, RBP and CBP significantly improved the structure of small intestine tissue, enhanced antioxidant capacity and digestive enzyme activity, and regulated the cecal microbial community structure of Wanxi white goose, with RBP demonstrating superior effects compared to CBP. Taken together, RBP and CBP significantly improved serum biochemical indices, intestinal function and the composition of intestinal flora in Wanxi white goose, with RBP demonstrating superior effects compared to CBP.
45. Preferences of Adolescents and Young Adults With Epilepsy and Caregivers on Reproductive Health Counseling by Neurologists: A Concept Mapping Study.
期刊: Pediatric neurology 发表日期: 2025-Aug-11 链接: PubMed
摘要
To ascertain reproductive health counseling priorities of adolescent and young adult women with epilepsy (AWWE) and caregivers during neurology visits. We recruited AWWE aged 14-26 years and caregivers from institutional neurology clinics, a research registry, and epilepsy listservs for a Concept Mapping study. Participants (1) brainstormed topics important for counseling of AWWE about reproductive health, (2) sorted topics into categories and rated their importance (on a five-point Likert scale) for AWWE aged 14-17 and 18-26 years, and (3) met to interpret study findings. We included a small subset of the participants in the interpretation meeting to allow meaningful discussion. Thirty-four AWWE and 20 caregivers generated 37 topics, which were sorted/rated by 35 AWWE and 23 caregivers; seven AWWE and nine caregivers attended the interpretation meeting. Consensus categories included “Hormonal Changes,” “Contraception,” “Sex & Epilepsy,” “Preparing for Pregnancy,” “Pregnancy with Epilepsy,” and “Parenthood & Epilepsy.” For ages 14-17 years, categories rated at least 4.00 for importance included “Hormonal Changes,” “Contraception,” “Sex and Epilepsy,” and “Preparing for Pregnancy.” For ages 18-26 years, all categories were rated at least 4.00. In the interpretation meeting, participants proposed a previsit checklist tool to indicate topics of interest. AWWE want counseling about reproductive health from neurologists that is tailored by age and more comprehensive than current American Academy of Neurology recommendations. Use of a previsit checklist tool may help identify individual patient and family counseling priorities.
46. Linear correlation between white blood cell counts and the progression and prognosis of acute kidney injury.
期刊: The Journal of international medical research 发表日期: 2025-Aug 链接: PubMed
摘要
IntroductionWhite blood cell count, a cost-effective blood test marker, is used extensively for the diagnosis and prognosis of diseases. Nevertheless, its association with the progression and prognosis of acute kidney injury remains unclear.MethodsA retrospective analysis was conducted using data from a multicenter randomized trial on an acute kidney injury early warning system. Univariate analysis, multivariate logistic regression, and smooth curve fitting were used to evaluate the association between the white blood cell count and the progression and prognosis of acute kidney injury.ResultsA total of 5471 patients were included in the study. White blood cell counts were significantly associated with 14-day acute kidney injury progression (adjusted odds ratio: 1.04, 95% confidence interval: 1.02-1.06, P < 0.01) and 14-day mortality (adjusted odds ratio: 1.06, 95% confidence interval: 1.04-1.09, P < 0.01). However, white blood cell counts were not associated with 14-day dialysis (adjusted odds ratio: 1.01, 95% confidence interval: 0.97-1.05, P = 0.77). Further curve fitting analysis found a linear correlation between white blood cell counts and 14-day acute kidney injury progression and 14-day mortality.ConclusionWhite blood cell counts had a significant linear correlation with 14-day acute kidney injury progression and 14-day mortality, but not with 14-day dialysis.
47. Exploring optimal serum selenium range for heart failure prevention: A U-shaped association and mediation by hepatic steatosis in US adults.
期刊: The Journal of international medical research 发表日期: 2025-Aug 链接: PubMed
摘要
ObjectiveThe relationship between serum selenium levels and heart failure risk remains unclear. This study aimed to investigate the potential nonlinear association between serum selenium level and heart failure risk and explore whether hepatic steatosis and dyslipidemia mediate this relationship.MethodsData from 6969 adults in the National Health and Nutrition Examination Survey 2017-2020 cohort were analyzed. Logistic regression, restricted cubic spline, and random forest models were used to assess associations between serum selenium level and heart failure risk. Mediation analysis was used to evaluate the indirect effects of hepatic steatosis and lipid parameters. Mendelian randomization was used to infer causality.ResultsA U-shaped association was identified between serum selenium level and heart failure risk (P for nonlinearity = 0.003), with the lowest risk observed at 150-160 µg/L. Both low and high selenium levels were associated with increased heart failure risk. Hepatic steatosis and lipid markers partially mediated this association. Mendelian randomization analysis suggested a potential causal effect of genetically predicted serum selenium level on heart failure risk.ConclusionThese findings highlight a nonlinear association between selenium exposure and heart failure and suggest possible metabolic pathways underlying this association. However, further research is needed before any clinical recommendations can be made.
48. THE IMPORTANCE OF PROMOTING BREASTFEEDING-MATERNAL NUTRITION DURING LACTATION.
期刊: Georgian medical news 发表日期: 2025-Jun 链接: PubMed
摘要
Despite the availability of extensive information and numerous clinical studies confirming the benefits of breastfeeding, breastfeeding rates remain a significant challenge globally, including in Georgia, according to the World Health Organization (WHO). In our consultations with mothers, many-particularly those living in regional areas-expressed concern that breastfeeding requires strict dietary restrictions. In response, we developed a medical brochure designed to be accessible, easy to understand, and practical. We believe it will be effective, as a similar guide created previously for pregnant women proved successful. This topic was also discussed in an article I published in your journal one year ago. In the current article, I present a new initiative and research project that I consider highly important-both as a pediatrician and nutritionist-and view as a meaningful step toward promoting breastfeeding in Georgia.
49. KNOWLEDGE, ATTITUDE, AND PRACTICE TOWARD PROSTATE CANCER AND ITS SCREENING METHODS IN QASSIM REGION.
期刊: Georgian medical news 发表日期: 2025-Jun 链接: PubMed
摘要
Prostate cancer is a significant health concern globally, and in Saudi Arabia, it is the sixth most prevalent type of cancer among adult males over the age of 75. However, awareness and attitudes towards prostate cancer screening vary widely. This study aimed to assess the knowledge, attitudes, and practices (KAP) regarding prostate cancer and its screening methods in the Qassim region of Saudi Arabia. This descriptive cross-sectional study involved 384 male participants aged 20 years and above. Data were collected using an online Arabic questionnaire. Knowledge scores were calculated, and participants were classified as having good or poor knowledge. The Chi-squared test and Spearman’s correlation analysis were used for statistical analysis. Most participants (42.8%) were aged 20-29 years, and 90.3% were Saudi nationals. Only 61.6% had heard of prostate cancer, and 30.4% were aware of both the prostate-specific antigen (PSA) blood test and rectal exam. Knowledge about risk factors was poor, with smoking identified by 42.3% and obesity by 23.9%. Symptoms were better recognized, with 67.9% identifying blood in urine or semen. Only 10.9% had ever had a prostate exam, and 6.3% had a PSA test. Knowledge was significantly associated with age, educational level, occupational status, and working in the health-care field. The study revealed gaps in knowledge, attitudes, and practices regarding prostate cancer and its screening methods. Region-specific public health education strategies, particularly focusing on men under 40 and those outside health-care professions, are urgently needed.
50. Building Capacity and Trust through Community Engagement: Lessons Learned from a Research in Health Equity Symposium.
期刊: Journal of primary care & community health 发表日期: 2025 链接: PubMed
摘要
Academic medical centers frequently recognize the importance of community engagement for advancing health equity. Yet, they often lack the infrastructure and skills needed for sustained collaboration. The 2025 Department of Medicine Research in Health Equity Symposium at the University of Rochester directly addressed this issue by focusing on community-engaged research. The 2025 symposium was designed to foster community engagement through 4 core strategies: (1) selecting a focused health equity topic; (2) issuing a call for community-engaged research abstracts; (3) featuring a panel of community experts; and (4) implementing targeted outreach and accessibility efforts to encourage diverse attendance. Evaluation data were collected via a post-event Continuing Medical Education survey. The symposium drew 220 registrants across academic and community sectors. Survey results (n = 53) indicated an improved understanding of health disparities and increased knowledge of best practices for community engagement. Attendees reported greater motivation to foster community engagement in their work and identified best practices, such as centering lived experiences and reducing participation barriers. Qualitative comments indicated a desire for similar events to be hosted throughout the year. This symposium offers a replicable model for growing community-engaged research in an academic medical center. The event contributed to advancing long-term goals of health equity by building institutional capacity building and community connections. The organizing team is taking continued steps to advance community engagement, including conducting a community-engaged research landscape analysis and developing a longitudinal project to build capacity for community and clinician researchers.
51. Knowledge on breastfeeding and improving cardiometabolic disease following a major complication of pregnancy: A qualitative analysis.
期刊: Women’s health (London, England) 发表日期: 2025 链接: PubMed
摘要
Maternal complications of pregnancy such as preeclampsia and gestational diabetes are independent risk factors for developing premature cardiovascular disease. Breastfeeding may improve immediate cardiometabolic health in these patients; however, women with pregnancy complications are less likely to initiate breastfeeding and more likely to cease breastfeeding early. It is still not known if women understand that breastfeeding can improve cardiovascular disease risk following a pregnancy complication, and if this knowledge would influence breastfeeding outcomes. To assess women’s awareness of breastfeeding and cardiovascular disease risk reduction following a pregnancy complication. Qualitative, descriptive study. Women with previous complications of pregnancy completed self-administered questionnaires and attended focus group style or one-to-one interviews at a tertiary hospital in Adelaide, South Australia. The following themes were discussed: experience with breastfeeding following a complication of pregnancy, knowledge on the benefit of breastfeeding for reducing heart disease, support for women to breastfeed for 6 months postpartum and integrated support during postpartum cardiovascular risk counselling. Interviews were transcribed, and deductive thematic analysis was undertaken with NVIVO V12. Eight women attended interview sessions, with all women being aware that breastfeeding improves heart disease risk factors. However, only 75% of women knew that breastfeeding was particularly beneficial for women with a previous complication of pregnancy. Women reported attachment and guilt as major barriers to breastfeeding, and that breastfeeding support could be improved with individualised counselling prior to discharge, more frequent postpartum visits and explaining that breastfeeding can reduce cardiometabolic disease. These patient-reported barriers and areas of improvement are important to consider when tailoring lactation counselling support for women with previous complications of pregnancy. Women’s understanding of breastfeeding and improving heart health after a pregnancy complicationWomen who experience a complication of pregnancy like preeclampsia or gestational diabetes have a greater risk of developing heart disease later in life. Breastfeeding for at least six months can reduce this risk, but women who have complications of pregnancy often also experience difficulties breastfeeding. We asked eight women who delivered their babies from 2021–2022, experienced a major complication of pregnancy and attended the postpartum lifestyle clinic for women with pregnancy complications at the Lyell McEwin Hospital what they knew about their risk of developing heart disease and how breastfeeding can help. We also asked what challenges they faced while breastfeeding, how they overcame these challenges and how women might be supported in future. Before the interviews, women were also given a questionnaire asking about their breastfeeding experience and understanding of breastfeeding and heart health. All interviewees agreed that ‘breastfeeding for at least 6 months can improve a mother’s blood pressure, weight and blood sugar’, however, only six agreed that this was also true for women who experienced a hypertensive disorder of pregnancy of gestational diabetes. Further, only six women had a health practitioner recommend breastfeeding for their health and not only to benefit their babies. Women reported a mix of positive and negative experiences about breastfeeding. The most common positive experience was women bonding with their baby. Women experienced the most common difficulty with getting an effective latch, especially when their babies were in the special care nursery. Women reported that the support they received that was beneficial and received by a variety of resources, including midwives, lactation consultants, family health nurses and online resources. Overall women reported that more support was needed greater support from health care professionals before leaving the hospital to improve breastfeeding confidence.