公共卫生研究摘要 (2025-09-02)
共收录 55 篇研究文章
1. Childhood cancer risk in offspring of mothers occupationally exposed to hydrocarbon solvents.
期刊: European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) 发表日期: 2025-Sep-01 链接: PubMed
摘要
Little is known about maternal occupational exposure to hydrocarbons and offspring cancer risk. We aimed to estimate childhood cancer risk associated with maternal exposure to aliphatic/alicyclic, aromatic, and chlorinated hydrocarbons, and methylene chloride, trichloroethylene, 1,1,1-trichloroethane, and toluene. In this case-control study, all cancer cases (N = 10 442) diagnosed at less than 20 years (born 1968-2016) in Denmark were matched to 261 050 cancer-free controls (25 : 1 matching ratio). Maternal exposure during pregnancy was determined from a job-exposure matrix. We performed unconditional logistic regression to estimate cancer risks from hydrocarbon exposures, adjusting for maternal age, maternal birthplace, and the child’s birthplace. For medulloblastoma, we observed strong associations with maternal occupational exposure to chlorinated hydrocarbons [adjusted odds ratio (aOR): 2.33, 95% confidence interval (CI): 1.29-4.20] including the individual solvents: trichloroethylene (aOR: 1.76, 95% CI: 1.08-2.88) and methylene chloride (aOR: 1.62, 95% CI: 0.98-2.68). The risk of medulloblastoma also increased with maternal exposure to aliphatic/alicyclic hydrocarbons (aOR: 1.78, 95% CI: 0.99-3.20), aromatic hydrocarbons (aOR: 1.64, 95% CI: 0.93-2.89), and toluene (aOR: 1.83, 95% CI: 1.04-3.22). The risk of non-Hodgkin lymphoma (NHL) increased with exposure to chlorinated hydrocarbons (aOR: 1.95, 95% CI: 1.09-3.51). The strongest association with acute lymphoblastic leukemia (ALL) was observed for aromatic hydrocarbons (aOR: 1.35, 95% CI: 1.07-1.71). We saw increased risks in medulloblastoma, NHL, and ALL in offspring of mothers occupationally exposed to solvents in pregnancy over a span of 50 years in Denmark. We encourage maternal workplace safety measures that reduce exposures in pregnancy to improve children’s health.
2. Efficacy and Safety of Neuroendoscopy versus Craniotomy for Spontaneous Supratentorial Intracerebral Hemorrhage: An Updated Meta-Analysis of Randomized and Non-Randomized Studies.
期刊: Brain and behavior 发表日期: 2025-Sep 链接: PubMed
摘要
Spontaneous supratentorial intracerebral hemorrhage (ICH) is a critical condition with high morbidity and mortality rates warranting urgent surgical evacuation. This systematic review and meta-analysis compare the safety and efficacy of neuro-endoscopy (NE) versus traditional craniotomy (CR) for managing ICH. From inception until July 2024, a comprehensive literature search was undertaken on PubMed, Cochrane Central, ScienceDirect, and Clinicaltrials.gov. Risk ratios (RR) and weighted mean differences (WMD) were pooled for categorical and continuous outcomes under the random effects model in Review Manager software. 5.4.1. Leave-one-out sensitivity analysis, Egger’s regression, GRADE assessment, and meta-regression were performed to evaluate the heterogeneity, publication bias, certainty of evidence, and effect size variability, respectively. Our meta-analysis included eight clinical trials and 20 cohort studies with 9,437 patients. NE outperformed CR in terms of favorable neurological outcomes (RR = 1.59, 95% CI: [1.30,1.94]; p < 0.00001; I2 = 90%), mortality (RR = 0.62, 95% CI:[0.48,0.81]; p < 0.0004; I2 = 51%), hematoma evacuation rate (WMD = 7.17, 95% CI: [4.68,9.65]%; p < 0.00001; I 2 = 94%) operating time (WMD = -102.08 min, 95 CI: [-120.29,-83.87]; p < 0.00001; I2 = 98%), blood loss (WMD = -255.51 mL, 95% CI: [-383.61,-127.41]; p < 0.0001; I2 = 100%), length of hospital stay (WMD = -3.34 days, 95% CI: [-5.05,-1.64] days; p < 0.0001; I2 = 62%), ICU stay (WMD = -2.85, 95% CI: [-5.13,-0.57] days; p < 0.01; I2 = 96%), meningitis (RR = 0.58, 95% CI: [0.36,0.95]; p < 0.03; I2 = 10 %), infections (RR = 0.49, 95% CI: [0.35,0.67]; p < 0.0001; I2 = 51%), residual hematoma volume (MD = -2.22; 95% CI: [-3.37,-1.07]; p < 0.0002; I2 = 90%) and overall complications (RR = 0.52, 95% CI: [0.40-0.67]; p < 0.00001; I2 = 70%). In addition, re-bleeding was found to be comparable between the CR and NE groups (p = 0.08). NE treatment for spontaneous intracerebral hemorrhage (ICH) is associated with favorable neurological outcomes, decreased mortality, shorter operating time, reduced blood loss and residual volume, shorter length of hospital and intensive care unit (ICU) stay, and fewer infections, meningitis, and overall complications; however, the re-bleeding rate was found to be comparable.
3. Utility of whole-slide imaging for rapid evaluation of thyroid FNA: A multireader prospective study.
期刊: Cancer cytopathology 发表日期: 2025-Sep 链接: PubMed
摘要
Rapid on-site evaluation (ROSE) of thyroid fine-needle aspiration biopsy (FNAB) improves diagnostic adequacy and facilitates ancillary molecular testing. In this prospective, multireader study, the authors evaluated the feasibility of using whole-slide images (WSIs) for ROSE to determine specimen adequacy and preliminary categorization (according to The Bethesda System for Reporting Thyroid Cytopathology [Bethesda]) of image-guided thyroid FNABs compared with conventional light-microscopic (LM) examination of the same specimens in a referral cancer center. The authors evaluated 98 ultrasound-guided thyroid FNAB cases. Smears were stained with Papanicolaou and Diff-Quik and were scanned at ×20 magnification using a Leica Aperio CS2 scanner. Five cytopathologists evaluated specimen adequacy and Bethesda categorization using WSI followed by LM assessment after a 2-week washout. Intraobserver and interobserver agreements were calculated using Cohen and Fleiss kappa (κ) statistics. Scan time, interpretation time, and the need for ×40 magnification or z stacking were recorded. In total, 463 slides were scanned, with mean scan time of 5.48 minutes. WSI quality was acceptable in most cases. Z stacking and ×40 magnification were requested in 23% and 14% of reviews, respectively. Intrareader agreement between WSI and LM examination was excellent (κ = 0.86-0.95). Inter-reader agreement was moderate for both WSI (κ = 0.48) and LM examination (κ = 0.56). Concordance was highest for Bethesda categories I and VI and lowest for categories III-V. Interpretation with WSI took significantly longer than with LM examination (p < .0001). WSI is a feasible alternative to LM examination for ROSE of thyroid FNABs, with high intrareader agreement and comparable inter-reader agreement. The limited need for high magnification and z stacking supports its practical utility.
4. Self-Assessment Organisational Readiness Tool (SORT) for Nursing Research Capacity Development: Results of a UK Delphi Study.
期刊: International nursing review 发表日期: 2025-Sep 链接: PubMed
摘要
This Delphi study aimed to develop the Self-assessment Organisational Readiness Tool (SORT), a prototype designed to assess healthcare organisations’ capacity to support nursing engagement in research activities. Nurses are pivotal to evidence-based healthcare, yet organisational barriers frequently hinder their engagement in research. Existing frameworks often lack the precision needed to evaluate organisational readiness to support nurses in research capacity building, leadership development and digital innovation. This study aims to bridge this gap through the development of the SORT framework. A structured Delphi consensus-building process was conducted over three iterative rounds and supplemented by four expert working group workshops. Participants, identified through purposive sampling, included 43 professionals with expertise in research and development, evidence-based practice and clinical and research leadership. Quantitative data were analysed using consensus thresholds (≥70% agreement), while qualitative feedback informed the iterative refinement of the tool. Consensus was achieved on 67 statements across five thematic areas: People-centred research, releasing potential, research systems, careers and digitally enabled research. Key items highlighted the importance of skills development, organisational leadership and collaboration with academia and patient/public involvement. Limited consensus in areas such as monitoring progress and digital research highlights the need for further refinement. SORT demonstrated strong face validity, with plans for reliability testing and factor analysis in future work. SORT is designed to be used by nursing and R&D leaders, healthcare executives, managers and policymakers to evaluate and improve organisational readiness to support research aiming nurses in healthcare settings. It can inform strategic planning, workforce development and performance benchmarking within healthcare institutions. It will also serve as a guide to individual nurse respondents by increasing their awareness of various initiatives in their organisations that they should know about. SORT provides a practical framework for embedding research within healthcare organisations to support nursing practice. It offers organisations a tool to identify strengths and gaps in research capacity, informing workforce development and infrastructure planning. Policymakers can use SORT to benchmark readiness and align strategies with national objectives. While developed in the UK, SORT has the potential to support global efforts to advance nursing research capacity, as this is the first tool developed specially to measure organisational readiness to support nurses for research and has already generated interest in other countries and professions. SORT represents a significant step towards fostering a research culture within healthcare organisations. By aligning with the Chief Nursing Officer strategy in the UK context, it supports evidence-based practice and enhances nursing’s contribution to healthcare quality and innovation. Future work will focus on validating SORT’s reliability and expanding its applicability across diverse healthcare settings.
5. Mass Trauma in Children: Expanding the Concept of Exposure in the Context of the COVID-19 Pandemic.
期刊: Current psychiatry reports 发表日期: 2025-Sep-01 链接: PubMed
摘要
This review examined the concept of exposure in children in the context of the COVID-19 pandemic. Recognizing the varied effects of the pandemic on children across a range of experiences, the review departed from the frequently-used analytic framework based on the stressor criterion for a diagnosis of posttraumatic stress disorder (PTSD). In addition to the more traditional types of exposure such as personal infection, illness or death of loved ones, and the experiences of children whose parents were essential workers, the review identified experiences among children in the general population as they adjusted to public health mandates, consumed pandemic media coverage, and dealt with the many changes in their daily lives. While many COVID-19 experiences would not qualify as exposure for a diagnosis of PTSD, the research recognizes the importance of these experiences and their influence on various outcomes in children.
6. Paracetamol Concentrations and Time-Course of Ductus Arteriosus Diameter in Extremely Preterm Neonates: A Population Pharmacokinetic-Pharmacodynamic Analysis.
期刊: Clinical pharmacokinetics 发表日期: 2025-Sep-01 链接: PubMed
摘要
Patent ductus arteriosus is a common complication of extreme prematurity. Prophylactic treatment with indomethacin or ibuprofen has shown efficacy on ductus closure but without reducing mortality and morbidity. Prophylactic treatment by paracetamol could be a safer alternative. The aim was to build a pharmacokinetic-pharmacodynamic (PKPD) model describing the effect of paracetamol on the time-course of the ductus arteriosus diameter. Extremely preterm neonates of 23-26 weeks of gestational age were recruited within 12 h after birth and were treated with prophylactic intravenous paracetamol for 5 days (two dose levels: 20 mg/kg followed by 7.5 mg/kg or 25 mg/kg followed by 10 mg/kg every 6 h). The diameter of ductus arteriosus was determined by echocardiography performed daily until day 7. The PKPD model was built using an Imax model with effect compartment and exponential disease progression model. Concentrations of paracetamol in the effect compartment were simulated with different doses over time for 500 virtual patients. A total of 29 extremely preterm neonates with median birth weight of 800 g (IQR: 670-860) were included in the study. Between-subject variability was estimated on transfer rate constant between the central compartment and the effect compartment (ke0) and maximum drug inhibition (Imax) parameters. Two subpopulations with different Imax values were identified: 99% for a first subpopulation of 10 patients and 42% for the second subpopulation of 19 patients. A negative effect of maximum fraction of inspired oxygen (FiO2) used during transfer to intensive care unit and a positive effect of intubation and ventilation during treatment were significant on ke0. Simulations showed that both dose levels generally enabled patients to reach the concentration needed to achieve 95% of maximal inhibition by the end of treatment. However, the second dose level enabled more than 90% of patients to reach this inhibition threshold as early as day one. The relationship between paracetamol and the time-course of ductus arteriosus diameter has been described in extremely preterm neonates. Intravenous paracetamol treatment with a loading dose of 25 mg/kg within 12 h after birth followed by 10 mg/kg every 6 h appears to be effective to accelerate time to ductus closure with limited benefit of a further dose increase.
7. Optimizing the role of virtual care in emergency medicine: a CAEP position statement.
期刊: CJEM 发表日期: 2025-Sep-01 链接: PubMed
摘要
8. Assessing the burden and trends of pancreatitis in India from 1990-2021: An analysis of the global burden of disease database.
期刊: Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology 发表日期: 2025-Sep-01 链接: PubMed
摘要
Pancreatitis poses a growing health concern globally, yet its burden in India has not been comprehensively assessed over time. This study aimed to quantify the national and sub-national trends in incidence, prevalence, mortality and disability burden of pancreatitis in India from 1990 to 2021, using Global Burden of Disease (GBD) 2021 data. Data on six core indicators: incidence, prevalence, deaths, disability-adjusted life years (DALYs), years of life lost (YLLs) and years lived with disability (YLDs) were extracted from the GBD database. Age-standardized rates (ASRs) per 100,000 population were analyzed across 31 Indian states and union territories. Trends were evaluated by age, sex and region. From 1990 to 2021, incident cases rose from 229,614 (95% UI: 190,053-274,618) to 523,074 (95% UI: 435,284-625,178) and prevalence rose from 249,067 (95% UI: 169,900-342,317) to 547,618 (95% UI: 369,410-750,696). The age-standardized incidence rate increased modestly from 32.78 (95% UI: 27.25-38.72) to 36.76 (95% UI: 30.52-43.44), while the prevalence rate rose from 37.83 (95% UI: 25.53-51.76) to 39.70 (95% UI: 26.84-54.45). The ASR for deaths declined from 2.24 (95% UI: 1.57-3.12) to 1.71 (95% UI: 1.27-2.25) and the DALY rate from 77.69 (95% UI: 57.42-111.80) to 56.82 (95% UI: 43.50-73.46). Male ASRs remained consistently higher than female. Higher Socio-Demographic Index (SDI) states showed increased YLDs and reduced premature mortality. The pancreatitis burden in India has increased substantially, with notable regional and sex-based differences. These findings point out the need for early diagnosis, targeted interventions in high-burden states and improved outpatient care to manage chronic morbidity.
9. Epidemiology and Course of Clostridioides difficile Infections in Germany: Retrospective Analysis of German Health Claims Data.
期刊: Infectious diseases and therapy 发表日期: 2025-Sep-01 链接: PubMed
摘要
Clostridioides difficile infection (CDI) is the leading cause of healthcare-associated infectious diarrhea, with recurrence rates of 15-20% after standard treatment and ≥ 30% after a second relapse. In Germany, reliable epidemiological data remain limited. A retrospective claims data analysis of the period 2017-2022 was performed using the German Analysis Database for Evaluation and Health Services Research (DADB), which covers 4.1 million insured individuals. Incident CDI cases, recurrent cases, and mortality were assessed and stratified by diagnosis setting. A propensity-score-matched control group without CDI adjusted for age, sex, and comorbidities was created. Cox proportional hazards models were used to determine mortality risk factors. CDI incidence decreased from 119 to 66 per 100,000 (2017-2022). First-recurrence rate declined from 15% to 11% and second-recurrence rate from 20% to 15%. Of all recurrences, 43% were managed in the outpatient setting. In 2022, severe CDI accounted for 38% of extrapolated statutory health insurance (SHI) cases. Metronidazole use in outpatients decreased from 79% to 53% for incident cases, while vancomycin prescriptions increased from 18% to 39%. In 2022, 72% of first CDI recurrences were treated with vancomycin, 20% with metronidazole, and 2% with fidaxomicin. Despite guideline recommendations, only 8% of patients with a second recurrence received fidaxomicin. In 2021, the 30-day mortality rate for secondary inpatient CDI cases was 20%, compared with 8% for primary inpatient cases and 4% for outpatient cases. Corresponding 1-year mortality rates were 44%, 32%, and 16%. In patients with CDI, 1-year mortality was 1.9 to 2.1 times higher than in controls (p < 0.001), with advanced age (≥ 65 years) being the strongest predictor (hazard ratio [HR] 12.21; 95% confidence interval [CI] 10.91-13.67). Despite declining incidence and recurrence rates, CDI remains a major health burden in Germany, especially for older adults. High severity, limited adherence to treatment guidelines, and excess mortality underscore the need for targeted prevention, individualized therapy, and improved guideline implementation.
10. International Trends in Opioid Prescribing by Age and Sex from 2001 to 2019: An Observational Study Using Population-Based Databases from 18 Countries and One Special Administrative Region.
期刊: CNS drugs 发表日期: 2025-Sep-01 链接: PubMed
摘要
To characterize multinational trends and patterns of opioid analgesic prescribing by sex and age. We studied opioid analgesic prescribing from 2001 to 2019 with common protocol using population-based databases from eighteen countries and one special administrative region. We measured opioid prescribing by geographical region, sex and age, estimating annual prevalent, incident, and nonincident opioid prescribing per 100 population with a 95% confidence interval (CI) and meta-analyzed the multinational and regional opioid prescribing with a random-effects model. Time trends were reported through average annual absolute changes, estimated using linear mixed models. We further explored the effect of sex and age on prevalent opioid prescribing in the multivariable analysis. Over 248 million individuals were included. Pooled multinational opioid prescribing prevalence was 9.0% amongst included countries/regions. Opioid prescribing prevalence in 2015 ranged from 2.7% in Japan to 19.7% in Iceland. Average annual absolute changes in opioid prescribing prevalence per year ranged from - 1.53% (95% CI - 2.06, - 1.00; United States Medicaid) to + 1.24% (95% CI 1.02, 1.46; South Korea). Pooled multinational incident opioid prescribing (4.9%; 95% CI 4.1, 5.9) was higher than pooled multinational nonincident opioid prescribing (3.7%; 95% CI 2.9, 4.8). The female sex and older age were associated with higher opioid prescribing. Main limitations of this study include the absence of data from study duration or individuals not covered by the data sources and the lack of information on medication adherence and indication. Opioid prescribing remains unbalanced across geographical regions; however, results suggest a tendency to convergence across countries/regions. Differences in opioid prescribing by sex and age were identified.
11. Postoperative ileus after emergency surgery for acute bowel obstruction: a case-control study of predictors and impact on recovery.
期刊: Langenbeck’s archives of surgery 发表日期: 2025-Sep-01 链接: PubMed
摘要
Acute bowel obstruction (ABO) is a common indication for emergency abdominal surgery, often performed on a severely dilated intestine with compromised barrier function. The recovery of bowel motility in this acute setting differs from elective surgery and remains insufficiently investigated. Yet, its understanding is crucial for improving perioperative care in surgical emergencies. This study aimed to identify risk factors for postoperative ileus (POI) after emergency surgery for ABO and to explore its impact on postoperative outcomes. We retrospectively analyzed 466 patients who underwent emergency surgery for ABO between 2014 and 2020, of whom 156 developed POI. POI was defined as the absence of postoperative bowel movement requiring intravenous prokinetic therapy following an insufficient response to initial conservative measures, including oral laxatives. Perioperative predictors for POI were identified by univariate and multivariate logistic regression. The association between POI and adverse postoperative outcomes was examined using correlation analysis. Multivariate analysis revealed male sex (p = 0.0009), chronic steroid therapy (p = 0.0064), high postoperative SOFA score (p = 0.0037), and elevated CRP levels on postoperative day two (p = 0.048) as independent predictors for POI. Patients with POI had significantly higher rates of postoperative respiratory (p < 0.0001) and surgical complications (p = 0.0014). Our findings suggest sex-dependent differences and an involvement of inflammatory processes in bowel function recovery following emergency surgery for ABO. POI in this setting is associated with increased risk of postoperative respiratory complications and surgical morbidity. These results highlight the need for targeted preventive strategies and form a solid foundation for future prospective studies aimed at optimizing perioperative care and reducing POI-related morbidity in surgical emergencies.
12. Comparing surgical outcomes of robotic and laparoscopic or open ileal pouch-anal anastomosis: a systematic review and meta-analysis.
期刊: Journal of robotic surgery 发表日期: 2025-Sep-01 链接: PubMed
摘要
Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the standard surgical approach for patients with ulcerative colitis (UC) or familial adenomatous polyposis (FAP) seeking bowel continuity. While laparoscopy improves recovery, robotic-assisted surgery may offer advantages in pelvic procedures. However, its comparative efficacy remains unclear. This systematic review followed PRISMA guidelines to compare short-term outcomes of robotic-assisted IPAA with laparoscopic and open techniques. Literature was searched across PubMed, Embase, Web of Science, and the Cochrane Library for studies from January 2000 to June 2025. Included studies compared adult patients (≥ 18 years) undergoing IPAA for malignancy, UC or FAP. Primary outcomes were operative time, blood loss, hospital stay, and complications; secondary outcomes included conversion to open surgery, readmission, and reoperation. Meta-analysis was performed using pooled odds ratios, mean difference and 95% confidence intervals. Ten studies including 3,166 patients met inclusion criteria. Robotic IPAA was associated with a shorter length of stay (WMD - 1.1 days, 95% CI - 1.8 to - 0.3) and a non-significant trend toward fewer conversions to open surgery (OR 0.33, 95% CI 0.10-1.13). However, robotic procedures had longer operative times. Estimated blood loss did not differ significantly, and no significant differences were found in postoperative complications, anastomotic leaks, readmissions, or reoperations. Robotic-assisted IPAA is a safe and viable alternative to laparoscopic and open surgery, offering benefits in shorter hospital stay and conversion rates. Although operative times are longer, morbidity is comparable. Further prospective studies are needed to confirm these findings and evaluate long-term functional outcomes.
13. Nested PCR detection of JC polyomavirus large T-antigen in prostate cancer tissues: a case-control analysis in a Sudanese population.
期刊: Journal of the Egyptian National Cancer Institute 发表日期: 2025-Sep-01 链接: PubMed
摘要
The potential involvement of JC polyomavirus (JCPyV) in prostate cancer (PCa) remains a subject of debate, as existing in vitro studies have produced conflicting results. Understanding the viral oncogenic mechanisms underlying prostate cancer could offer valuable insights into its etiology. This study aimed to explore the association between JCPyV infection and prostate cancer by detecting the viral large T-antigen gene in prostate tissue specimens. A case-control study was conducted from February 2022 to March 2023, including 100 participants: 50 diagnosed with prostate cancer (cases) and 50 with benign prostatic hyperplasia (BPH) as controls. Formalin-fixed paraffin-embedded (FFPE) prostate tissue samples were collected from all participants. Nested polymerase chain reaction (PCR) was employed to detect JCPyV large T-antigen DNA using specific primers. Demographic and clinical data were obtained via a structured questionnaire. Statistical analysis was carried out using SPSS version 20, and associations between JCPyV presence and prostate cancer were analyzed using logistic regression. The mean age of the prostate cancer group was 67.5 ± 10.9 years, compared to 70.9 ± 8.9 years in the control group. JCPyV large T-antigen DNA was detected in 29 out of 50 (58%) prostate cancer cases, compared to 19 out of 50 (38%) controls (P = 0.045; odds ratio = 1.45; 95% confidence interval: 1.011 to 5.019). Within the prostate cancer group, patients testing positive for the JCPyV T-antigen had a mean age of 73.3 ± 8.7 years, significantly higher than T-antigen-negative patients, whose mean age was 67.0 ± 8.3 years (P = 0.029). The prevalence of JCPyV large T-antigen gene was significantly higher in prostate cancer patients than in individuals with benign prostatic hyperplasia. These findings suggest that JCPyV infection may be linked to an increased risk of prostate cancer, reinforcing prior studies that imply a potential oncogenic role for the virus in prostate carcinogenesis. Further investigations are necessary to elucidate the molecular mechanisms driving this association and its potential clinical implications.
14. Association of cancer with racial disparities in financial health: a national cohort study.
期刊: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 发表日期: 2025-Sep-01 链接: PubMed
摘要
The impact of a cancer diagnosis on racial differences in financial well-being and treatment related financial toxicity has not been well characterized. The purpose of this study was to compare relative disparities in financial distress by race among respondents with and without a history of cancer. We performed a retrospective cohort study based on the National Health Interview Survey (2010 to 2018). Primary outcomes included financial hardship questions about medication adherence, worry about medical costs, and worry about monthly bills. Multivariable logistic regression analysis examined the association of a cancer diagnosis and racial disparities in financial hardship using an interaction term of race and history of cancer. We included 204,754 participants without a history of cancer and 19,094 cancer survivors. Black participants with a history of cancer reported higher rates of medication modification due to financial constraints (9.2%), compared to Black participants without cancer (4.8%) and White participants with (5.1%) or without (3.8%) cancer. By multivariable analysis, a history of cancer significantly worsened Black-White disparities in financial-related medication adherence measures and problems with medical bills, with Black patients more likely to report that they took less medicine to save money (OR 1.48, 95% CI 1.17-1.88, P = 0.001), delayed filling prescriptions to save money (OR 1.42, 95% CI 1.13-1.77, P = 0.002), and asked for lower-cost medications to save money (OR 1.27, 95% CI 1.07-1.50, P = 0.005), had problems paying medical bills (OR 1.29, 95% CI 1.08-1.53, P = 0.003), paid off medical bills over time (OR 1.45, 95% CI 1.24-1.69, P < 0.001), and delayed medical care because of worry about cost (OR 1.31, 95% CI 1.03-1.66, P = 0.023). Black-White disparities in self-reported medical financial hardship among insured adults are worsened by a diagnosis of cancer. Policy- and system-level interventions are required to improve long-term financial distress among Black cancer survivors.
15. Transforming Population Health Screening for Atherosclerotic Cardiovascular Disease with AI-Enhanced ECG Analytics: Opportunities and Challenges.
期刊: Current atherosclerosis reports 发表日期: 2025-Sep-01 链接: PubMed
摘要
To define the emerging role of artificial intelligence-enhanced electrocardiography (AI-ECG) in advancing population-level screening for atherosclerotic cardiovascular disease (ASCVD), we provide a comprehensive overview of its role in predicting major adverse cardiovascular events and detecting subclinical coronary artery disease. We also outline the clinical, methodological, and implementation challenges that must be addressed for widespread adoption. State-of-the-art AI-ECG models exhibit high accuracy, correctly re-classifying patients deemed ‘low risk’ by traditional risk models. They also compress the prediction horizon from a decade to just a few years, suggesting opportunities for early detection and more personalized intervention. However, validation remains largely retrospective and hospital-based, with referral and ascertainment biases limiting generalizability. There is no evidence thus far for an externally validated AI-ECG model that can either define or improve the detection of ASCVD outcomes independent of standard risk factors. AI-enhanced ECG interpretation has the potential to transform a universal, inexpensive test into a powerful screening and prognostication tool for ASCVD. Realizing this potential will require prospective studies to confirm that AI-ECG-guided ASCVD screening improves patient outcomes across diverse populations. Earning trust among physicians and patients will require addressing key logistical challenges, including robust data governance, seamless workflow integration, and ongoing performance monitoring. Technological innovation, such as algorithms for single-lead ECGs on wearable and portable devices, could help enable the scalability needed for global impact on cardiovascular health.
16. Comprehensive analysis of KRT18 as a novel prognostic biomarker and potential target in lung adenocarcinoma.
期刊: Clinical and experimental medicine 发表日期: 2025-Sep-01 链接: PubMed
摘要
The expression characteristics of Keratin 18 (KRT18) in lung adenocarcinoma (LUAD) remain incompletely elucidated. This study aims to investigate the expression pattern of KRT18 in LUAD and its prognostic significance. We analyzed the expression status of KRT18 in LUAD and its association with prognosis. Utilizing the UALCAN and STRING databases, we systematically evaluated the clinical phenotypic parameters of KRT18 and its protein-protein interaction network. Through enrichment analysis, we clarified its biological functions and associated signaling pathways, and simultaneously deciphered the association patterns between the tumor immune infiltration landscape and immune checkpoint molecules. High expression of KRT18 was associated with poor prognosis in LUAD patients and was closely correlated with tumor stage and pathological stage. Functional enrichment analysis revealed that KRT18 was significantly enriched in epithelial cell differentiation and intermediate filament pathways. Immune infiltration analysis showed that the expression of KRT18 was associated with tumor immune cell infiltration and immune checkpoints. Immunohistochemistry further confirmed the high expression of KRT18 in LUAD tissues. Therefore, KRT18 may serve as a biomarker for the prognosis and diagnosis of LUAD and also represents a potential target for immunotherapy.
17. Activities of Daily Living and Importance of Sex Among Midlife and Older Adults.
期刊: Journal of applied gerontology : the official journal of the Southern Gerontological Society 发表日期: 2025-Sep-01 链接: PubMed
摘要
A large portion of U.S. adults are estimated to have a disability with a higher disability prevalence for those 50 years and older. However, few U.S. studies have assessed the sexual health of midlife and older adults with disabilities. The current study used Wave 3 data from the National Social Life, Health, and Aging Project to examine the relationship between activities of daily living (ADL) and importance of sex. Descriptive, bivariate, and multivariate analyses were conducted for a nationally representative analytic sample of 4371 participants. We found that participants with three or more ADL limitations were significantly less likely to report sex as important compared to participants with no limitations or 1-2 limitations. Other factors associated with the importance of sex included age, gender, educational attainment, race/ethnicity, marital status, and overall health. Future research should continue to explore the relationship between disability and sexual health among midlife and older adults.
18. The Association Between Infertility Treatment and Birth Outcomes for Nulliparous Persons Who Gave Birth 35 Years and Older: Findings from 2022 National Vital Statistics System Natality Data.
期刊: Maternal and child health journal 发表日期: 2025-Sep-01 链接: PubMed
摘要
This study uses 2022 National Vital Statistics System natality data to identify characteristics associated with infertility treatment among nulliparous individuals 35 years or older, comparing pregnancy and birth outcomes between no infertility treatment and assisted reproductive technology (ART) or fertility-enhancing drugs or intrauterine insemination (IUI). The likelihood of infertility treatment was estimated after controlling for maternal age, education, race and ethnicity, insurance status, Women, Infants and Children (WIC) support, pre-pregnancy body mass index (BMI), chronic hypertension, diabetes, and smoking during pregnancy. Maternal outcomes (gestational diabetes, hypertensive disorders of pregnancy, cesarean birth, maternal morbidity) and neonatal outcomes (preterm birth, low birth weight, neonatal intensive care, and congenital anomalies) were compared for singleton and multifetal births separately. Among 173,399 births, 13.6% had infertility treatment (10.9% ART, 2.4% IUI). As compared to people who identified as white or Asian, infertility treatment was over one-third less likely for non-Hispanic Black and Hispanic individuals and 2.4 times more likely for those with a graduate degree as compared to those with less than high school. Infertility treatment was associated with significantly higher rates of all adverse maternal and neonatal outcomes, and among multifetal births, ART was associated with a higher rate of maternal morbidity and more frequent gestational diabetes. Disparities in infertility treatment exist. ART was associated with modest but significantly worse outcomes, particularly for singleton births. Continued monitoring of infertility treatment selection and birth outcomes is needed for informed clinical and public policy decisions.
19. Hypertension and Polycystic Ovary Syndrome Among Women in a Nationwide Electronic Health Records Dataset in the United States.
期刊: Maternal and child health journal 发表日期: 2025-Sep-01 链接: PubMed
摘要
Both hypertension and polycystic ovary syndrome (PCOS) are risk factors for future cardiovascular diseases among women of reproductive age (18-44 years). We constructed an electronic health record (EHR)-based PCOS phenotype, reported PCOS prevalence, and investigated the association of PCOS and hypertension in the United States (US). This cross-sectional study used 2022 IQVIA’s Ambulatory Electronic Medical Record (AEMR)-US data (May 2023 release). We constructed a phenotype for PCOS and reported PCOS prevalence for eligible women. We then described hypertension prevalence and hypertension control estimates stratified by PCOS status. Lastly, we calculated adjusted prevalence ratios (aPR) for hypertension and hypertension control by PCOS status, adjusting for age, race, and body mass index (BMI). We analyzed records for 1,301,425 eligible women, with mean (standard deviation) age of 31.5 (7.9) years. The prevalence of PCOS was 2.1%, but increased with weight category, reaching 6.7% among those with class 3 obesity (BMI ≥ 40 kg/m2). Women with PCOS had 50% higher prevalence of hypertension than those without PCOS (aPR 1.50; 95% confidence interval [CI]: 1.48-1.52; p < 0.001), and slightly higher hypertension control prevalence (aPR 1.14; 95% CI: 1.12-1.17; p < 0.001). Using a nationwide EHR dataset, we observed that women with PCOS had substantially higher hypertension prevalence than those without PCOS. PCOS prevalence was lower than previous estimates from global surveys. Following guideline-recommended blood pressure screening for women with PCOS could reduce the risk of long-term cardiovascular disease.
20. Components of Family-Focused Interventions that Have Common Impacts Across Parental Domestic Violence and Abuse, Mental Ill-Health, and Substance Misuse: An Intervention Components Analysis.
期刊: Journal of prevention (2022) 发表日期: 2025-Sep-01 链接: PubMed
摘要
Support for families experiencing domestic violence and abuse (DVA), mental ill-health (MH) and substance misuse (SU) is often delivered in siloes, despite the frequent co-occurrence of these public health issues. Little evidence-based guidance exists on which interventions best support families experiencing a combination of these problems. Identifying intervention components with common impacts across parental DVA, MH and SU could inform policy and practice. We conducted an Intervention Components Analysis (ICA) to identify intervention components that have common impacts across parental DVA, MH and SU. We searched ten databases for randomised controlled trials of family-focused interventions targeting, and measuring an impact on, one or more of these issues. We developed an initial coding framework using open coding to guide the coding of subsequent studies. Descriptive analyses identified common components across target outcomes (DVA/MH/SU) and robust variance meta-regressions explored the relationship between intervention components and treatment effects. A Lived Experience Advisory Group informed our presentation and interpretation of the results. We identified 164 interventions: 40 focused on a combination of DVA, MH and SU and 124 addressed one issue alone. None of the 20 components identified were unique to any specific outcome and no single component was associated with meaningful improvement in outcomes. Interventions aiming to provide integrated support across outcomes were less successful at improving MH and SU outcomes than those targeting single issues. We found no evidence of commonly effective intervention components. Better alignment between components and underlying processes driving DVA/MH/SU, and alternative intervention designs, are needed.
21. U.S. Public Opinion About Immigration Enforcement in Sensitive Locations.
期刊: Journal of immigrant and minority health 发表日期: 2025-Sep-01 链接: PubMed
摘要
In 2011, the Director of U.S. Immigration and Customs Enforcement (ICE) issued a memorandum titled, “Enforcement Actions at or Focused on Sensitive Locations.” The memorandum stated that immigration enforcement actions should not occur at specified sensitive locations, which included schools, healthcare facilities, places of worship, sites of public religious ceremony, and sites of public demonstration. These policies were rescinded in January 2025, creating the possibility of enforcement actions in these locations. The aim of this study was to investigate U.S. public opinion regarding immigration enforcement in sensitive locations. We conducted an online survey of 3,563 American adults with quotas implemented on gender, age, race, and geographic location. The survey ran from January 23 to February 3, 2025. 3,563 individuals completed the survey. Age and political identification were the most consistent predictors of support for rescinding sensitive locations policy, as well as in the belief that such enforcement would not deter care seeking. Sympathy towards immigrants was also a predictor of support for sensitive locations policy. Our findings suggest that the majority of Americans do not think that ICE’s sensitive locations policy should be rescinded and believe that rescinding this policy will deter undocumented immigrants from seeking needed medical care for themselves and their children. A lack of support for rescinding this policy suggests that it should be reinstated, a move that would help to protect healthcare access for undocumented people and their families.
22. A reappraisal of association between ventilator-associated events and mortality among critically ill patients using marginal structural model: multicenter observational study.
期刊: Intensive care medicine 发表日期: 2025-Sep-01 链接: PubMed
摘要
Ventilator-associated events (VAEs), developed by the US Centers for Disease Control and Prevention (CDC), are considered a new medical quality indicator associated with poor outcomes. However, previous studies failed to adjust for changes in patient severity, leaving open the possibility that VAEs are just a surrogate for severity. This study aimed to reevaluate the association between VAEs and mortality, adjusting for changes in severity over time. This multicenter observational study was conducted in 18 ICUs in Japan between May 2020 and December 2022. Patients aged ≥ 12 years who received mechanical ventilation for ≥ 3 consecutive days were eligible. VAE was diagnosed according to the CDC definition. The primary outcome was 30-day in-hospital mortality, whose association with VAE was estimated by the inverse probability weighted proportional hazards model, with temporal changes in patient severity treated as time-dependent confounders. Among 1,094 subjects, 106 VAEs (9.7%) were identified, giving an incidence rate of 10.0 per 1,000 ventilation days. VAEs were significantly associated with increased 30-day hospital and ICU mortality (HR 2.00; 95% CI 1.23-3.26 and HR 1.92; 95% CI 1.03-3.57), and longer hospital and ICU length of stay (HR 0.72 95% CI 0.54-0.97 and HR 0.47; 95% CI 0.23-0.96). The population attributable risk fraction of VAE-related mortality was 8.8% for in-hospital deaths and 8.2% for ICU deaths. VAEs were associated with an increased risk of mortality after adjustment for severity, as a time-dependent confounder.
23. Public mental health: a WPA priority and key opportunity to address implementation failure.
期刊: Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater 发表日期: 2025-Sep-01 链接: PubMed
摘要
Mental health conditions (MHCs) account for a large proportion of global disease burden and result in broad impacts and associated economic costs. Despite the existence of effective public mental health (PMH) interventions, only a minority of individuals with MHCs receive treatment, far fewer receive interventions to prevent associated impacts, and there is negligible coverage of interventions to prevent MHCs or promote mental wellbeing and resilience. This implementation failure results in population-scale preventable suffering, broad impacts and associated economic costs, which are far greater in low- and middle-income countries. The gap also breaches the right to health and statutory legislation in some countries. The World Psychiatric Association has prioritised PMH and highlighted how a set of coordinated actions can improve PMH implementation, including by effectively making the PMH case, PMH practice, PMH training and improved population knowledge, settings-based and integrated approaches, digital technology, maximising existing resources, use of interventions with a large population impact, a rights approach and legislation, and implementation-focused research. Improved implementation results in broad population impacts, achievement of policy objectives across sectors and sustainable reduction in the impact of MHCs and promotion of population wellbeing. The associated economic benefits make PMH a key part of sustainable economic development. Psychische Erkrankungen inklusive subklinischer Syndrome sind weltweit Ursache für einen großen Anteil krankheitsbezogener Belastungen, die mit negativen Folgen und relevanten Kosten einhergehen. Obwohl wirksame Public-Health-Interventionen verfügbar sind, erhält nur eine Minderheit psychisch Erkrankter eine entsprechende Behandlung oder Interventionen, um die negativen Folgen zu vermeiden. Maßnahmen zur Prävention, zur Verbesserung von Wohlbefinden oder Stärkung der Resilienz werden noch seltener angeboten. Dieser Mangel an Umsetzung verursacht vermeidbares Leid, negative Krankheitsfolgen sowie beträchtliche Kosten, die in Ländern mit mittlerem oder geringem Einkommen höher sind als in Ländern mit hohem Einkommen. Das stellt auch eine Verletzung des Rechts auf Gesundheit dar. Der Weltverband für Psychiatrie (WPA) hat Public Mental Health zur Priorität erklärt und eine Reihe von koordinierten Schritten beschrieben, welche die Implementierung von Public-Mental-Health-Maßnahmen verbessern können, wie beispielsweise Ausbildung in Public Mental Health, Verbesserung des Wissens in der Bevölkerung, digitale Technologien, Vermehrung von Ressourcen, Interventionen mit großen populationsbezogenen Effekten, Anpassung der Gesetze und Forschung zur Implementierung. Eine verbesserte Umsetzung hat Wirkung in breiten Teilen der Bevölkerung und fördert eine nachhaltige Reduktion der negativen Folgen psychischer Erkrankungen sowie das Wohlbefinden in der Bevölkerung. Die damit verbundenen ökonomische Vorteile machen Public Mental Health zu einem wesentlichen Baustein einer nachhaltigen wirtschaftlichen Entwicklung.
24. Improving oral health in Ireland: a dental and public health nurse collaborative quality improvement initiative.
期刊: Journal of public health (Oxford, England) 发表日期: 2025-Sep-01 链接: PubMed
摘要
The Health Service Executive in Ireland has piloted dentist-led initiatives targeting children aged 4-5. These initiatives involved an intra-oral check by dentists in the school setting, and a subsequent dental clinic appointment if dental decay was identified. The aim of this project was to explore the best method of delivering school-based, intra-oral examinations, by piloting a programme to identify children with dental decay with allied health professionals. A quality improvement framework (Plan Do Study Act) was used for this oral health improvement project. The intervention included an oral health promotion session and an intra-oral check by a dentist or non-dental health professional. Those identified with cavitated dental decay were given an appointment with a dentist. In total, 122 children were targeted. There was an increased uptake of this programme when public health nurse (PHN)-led and this phase was lower cost as a PHN was already present in the school. PHNs were able to identify dental decay and provide referrals for further assessment in a high-risk population. PHNs could therefore play a role in the screening of children nationally for dental decay. This pathway may be helpful in identifying children or families not engaging with dental services.
25. A comprehensive review of Drynariae rhizoma: botany, traditional applications, and active flavonoid components.
期刊: The Journal of pharmacy and pharmacology 发表日期: 2025-Sep-01 链接: PubMed
摘要
Drynaria fortunei, a species within the Drynaria genus, is a widely distributed medicinal plant with abundant resources. Its rhizome, Drynariae rhizoma, has been extensively utilized in traditional Chinese medicine for its therapeutic efficacy in promoting wound healing, alleviating pain, tonifying the kidneys, and strengthening bones. With a well-documented historical presence in classical texts, Drynariae rhizoma has played a significant role in traditional medical systems across various cultures. Recent phytochemical investigations have identified a diverse array of compounds in Drynariae rhizoma, including flavonoids, phenolic acids, lignans, steroids, and glycosides. Among these, flavonoids represent the principal active constituents, attracting considerable research attention due to their extensive pharmacological activities. This review systematically integrates and critically analyzes the recent research progress in this field,providing a comprehensive overview of the current research landscape,with the aim of identifying promising future directions for Drynariae rhizome. This review leveraged a wide range of online databases, including SciFinder, PubMed, SpringerLink, Baidu Scholar, Google Scholar, ScienceDirect, American Chemical Society (ACS) Publications, Web of Science, and China National Knowledge Infrastructure (CNKI), to collect relevant literature. Comprehensive searches were conducted using keywords such as “Drynariae Rhizoma”, “flavonoids”, “extraction”, “chemical constituents”, “analytical characterization”. To ensure the scientific accuracy of this study, the botanical name of the plant was meticulously cross-verified using authoritative platforms such as “World Flora Online” and “The Plant List.” This article provides a comprehensive overview of the botany (including characteristics, distribution, and origin) and traditional applications (such as its historical evolution, botanical sources, and multi-ethnic as well as cross-national therapeutic practices) of Drynariae rhizoma. Additionally, it highlights the latest research advancements on its flavonoid compounds, encompassing extraction methods (e.g. solvent extraction, ultrasound-assisted extraction, and microwave-assisted extraction), analytical characterization (e.g. ultraviolet spectroscopy, high-performance liquid chromatography, and nuclear magnetic resonance), chemical constituents (with 60 flavonoid compounds identified to date), biological activities (e.g. anti-osteoporosis, anti-osteoarthritis, renal protection, dental health promotion, neuroprotection, lipid-lowering, and immunomodulation), and clinical applications. Furthermore, the review discusses current quality control strategies, highlighting the impact of geographical origin and processing methods on flavonoid content. Further in-depth studies are essential to comprehensively explore these areas, paving the way for enhanced understanding and application of Drynariae rhizoma in both traditional and modern medicines. A comprehensive analysis of existing literature reveals that the flavonoid constituents of Drynariae rhizoma exhibit remarkable therapeutic potential owing to their structural diversity and extensive pharmacological properties. Nevertheless, current understanding of its pharmacodynamic material basis and quality control parameters remains inadequate, highlighting the urgent need for more rigorous investigations to facilitate its broader applications in both traditional and contemporary medical practices. This review is anticipated to provide a rigorous scientific basis for subsequent investigations and clinical translation of therapies based on Drynariae rhizoma.
26. Effectiveness of a School-Based Health Education Using Social Networking Media to Promote Health Behaviors in Elementary School Students: A Quasi-Experimental Study.
期刊: The Journal of school nursing : the official publication of the National Association of School Nurses 发表日期: 2025-Sep-01 链接: PubMed
摘要
This study examined the effectiveness of an 8-week “Health Education using Social Networking Service (HE-SNS)” intervention, led by school health teachers, on perceived social support and health behaviors among elementary school students in South Korea. Using a quasi-experimental design with class-level random assignment, 90 students from six classes were assigned to the HE-SNS group, health education (HE) group, or control group. The HE-SNS intervention, led by a school nurse, integrated classroom health education with social networking activities involving students, teachers, and parents. Linear mixed model analysis revealed significant group-by-time interaction effects on social support (F = 20.13, p < .001) and health behavior scores (F = 24.69, p < .001). Post hoc Bonferroni tests showed that the HE-SNS group demonstrated greater improvements than the HE and control groups. These findings suggest that school nurse-facilitated SNS-based health education interventions may enhance social support and health behaviors among elementary school students.
27. Bringing Trial Activities to Participants-The Trials@Home RADIAL Proof-of-Concept Trial Investigating Decentralization of Trials.
期刊: Clinical pharmacology and therapeutics 发表日期: 2025-Sep-01 链接: PubMed
摘要
The interest in trials in which activities are being moved to the participants’ direct environment, that is, decentralized, has increased in recent years, but limited research has been conducted into the feasibility and acceptability of such approaches. The Trials@Home RADIAL proof-of-concept (PoC) trial aims to assess the scientific and operational feasibility and quality of a fully decentralized and hybrid trial approach compared to a conventional, site-based approach. RADIAL is a three-arm parallel-group, open-label, multi-center low-intervention phase IV trial conducted in people living with Type 2 diabetes mellitus in six European countries (DE, DK, ES, IT, PL, UK). The RADIAL trial compares three arms with the same clinical intervention (Insulin Glargine 300 U/mL) but differing degrees of decentralization (the methodological intervention), including online recruitment, remote consenting, remote visits, home-shipment of Investigational Medicinal Product and study materials, home-based biological sample collection, app-reported events/ePROs, and home-devices for data collection. Key Performance Indicators regarding recruitment, retention, diversity, site satisfaction, participant satisfaction, cost, safety oversight, treatment adherence, and data quality are the main outcomes of the trial. This paper discusses the set-up of RADIAL, describing the design, endpoint selection, and decentralized elements evaluated, as well as discussing insight from RADIAL for future PoC trials. This is the introductory paper in a series of six papers in which we share the lessons learned during set-up, regulatory submission, and conduct of RADIAL. By sharing these insights, we aim to support clinical trial designers, technology developers, and other stakeholders to successfully implement decentralized elements into clinical trials. This trial was registered with identifier NCT05780151 in clinicaltrials.gov and under 2022-500,449-26-00 in the Clinical Trials Information System (CTIS) clinical trial database.
28. Shaping the WHO Sexual Health Assessment of Practices and Experiences Questionnaire: a descriptive study on the real-world example from Portugal.
期刊: Sexual and reproductive health matters 发表日期: 2025-Sep-01 链接: PubMed
摘要
Sexual health is a major dimension of global health and wellbeing. Yet, evidence regarding its assessment at a worldwide level is scarce. Most population-based studies are conducted in a limited number of countries from the Global North using specific measures that do not allow for country comparison. The World Health Organization (WHO) led a process to create a global survey called the Sexual Health Assessment of Practices and Experiences (SHAPE) to assess sexual practices and behaviours that impact on health. This article aims to describe the application and feasibility of this questionnaire in an extended real-world context. It presents the results of the implementation process in Portugal, the first country to use it with a nationally representative sample. This descriptive study was conducted between 14th June and 15th October 2023, involving a sample of 2010 individuals (52% women) living in Portugal, aged 18-95 (mean = 49.6 years). 1426 participants responded online and 584 by telephone. Overall response rate was 30.9% (79.5% online, 12.4% by telephone) and 94% of responses were valid. The original SHAPE questionnaire took 17.7 minutes to answer on average (16.6 minutes online and 20.3 minutes by telephone). Including module G (assessing sexual problems), average time was 29.2 minutes. The relatively short response time and choice of formats suggest this tool provides a comprehensive picture of sexual health. It is hoped that it will be widely used in different health and research contexts, to enhance the global evidence base for the development of policies that promote sexual health.This article aims to describe the application and feasibility of this questionnaire in an extended real-world context. Recognising the importance of assessing health behaviours related to sexual and reproductive health, a group led by experts from the World Health Organization (WHO) has created the SHAPE questionnaire. This tool aims to assess sexual practices and behaviours that have an impact on health. Portugal was the first country in the world to address this questionnaire to a representative sample of people. Our study investigated the implementation process. Data were collected from a sample of 2010 people of both sexes, using online and telephone methodology. The overall response rate was 30.9%. 94.7% of responses were valid. The average length of time taken to answer the original SHAPE questionnaire was 17.7 minutes. These results reinforce the quality and feasibility of using this tool which could be applied in different contexts. This would allow for innovative comparative studies.
29. Colchicine for the Secondary Prevention of Cardiovascular Diseases: A Cumulative-Dose Meta-analysis of Randomized Controlled Trials including 31,397 Subjects Worldwide.
期刊: American journal of cardiovascular drugs : drugs, devices, and other interventions 发表日期: 2025-Sep-01 链接: PubMed
摘要
Colchicine has been incorporated into major clinical guidelines for the secondary prevention of cardiovascular disease (CVD). However, recent randomized trials have presented contradictory results. We aimed to synthesize the current evidence on colchicine in secondary CVD protection, using a cumulative-dose approach. We conducted a meta-analysis incorporating all randomized controlled trials (RCTs) globally. RCTs directly comparing colchicine versus placebo/standard care for the secondary prevention of cerebrovascular or coronary vascular disease were included. Odds ratios (OR) were derived for the primary outcome, defined as the prospective occurrence of major adverse cardiovascular events (MACE). Secondary outcomes included mortality, individual components of MACE, C-reactive protein, and adverse effects. In total, 14 RCTs including 31,397 participants were included. Colchicine significantly reduced MACE (OR 0.80; 95% confidence interval [CI] 0.68-0.94) in both acute atherothrombotic CVD and all CVD (OR 0.72; 95% CI 0.60-0.86) and resulted in significant prospective reductions in C-reactive protein. The threshold effect was apparent, with a protective benefit of colchicine against MACE at higher cumulative exposure ≥ 90 mg-days (OR 0.66; 95% CI 0.52-0.84). Colchicine resulted in no differences in cardiovascular or non-cardiovascular mortality. Colchicine significantly reduces MACE in both acute atherothrombotic and all CVD across multiple ethnicities, with a threshold protective effect that clinically corresponds to treatment with 0.5 mg daily for at least 6 months. Importantly, there was no signal of increased all-cause mortality. PROSPERO identifier no. CRD420251003142.
30. Frailty, malnutrition risk, and kidney function impairment in older adults: Singapore longitudinal ageing study.
期刊: GeroScience 发表日期: 2025-Sep-01 链接: PubMed
摘要
Kidney function declines progressively with age, with chronic kidney disease (CKD) affecting more than half of community-dwelling older adults. Identifying risk factors beyond the established ones (such as diabetes and hypertension) is crucial for prevention. Frailty and malnutrition are prevalent in older adults, yet the effect of these factors on their decline of kidney function remains underexplored. This study aimed to elucidate the associations between frailty, malnutrition, and renal function among community-dwelling older adults. In this prospective cohort study, we analysed the data of 2,292 Chinese older adults aged 55 and above from the Singapore Longitudinal Ageing Study. Frailty was assessed using the Cardiovascular Health Study criteria, and malnutrition risk was evaluated using the Nutritional Screening Initiative questionnaire. Kidney function was measured using estimated glomerular filtration rate (eGFR). Baseline and follow-up (3-5 years) associations between frailty, malnutrition, and kidney function, controlling for known confounding risk factors were examined. At baseline, malnutrition was associated with lower eGFR (β = -5.42; 95% CI -8.83–2.01) and higher CKD prevalence (OR = 2.24; 95% CI 1.13-4.46). The combined risk of frailty-malnutrition was also significantly associated with lower eGFR (β = -5.29; 95% CI -9.93–1.65) and CKD prevalence (OR = 3.05; 95% CI 1.22-7.60). At follow-up, malnutrition (aOR = 3.21; 95% CI 1.60-6.44) but not physical frailty (aOR = 0.70; 95% CI 0.19-2.55), was associated with significant kidney function decline. The results suggest that malnutrition plays a vital role in kidney function decline among community-dwelling older adults, more so than frailty. Integrating nutritional screening timely may optimise the long-term kidney health in this population.
31. The Impact of the COVID-19 Pandemic on Iodine Nutrition Status of Pregnant Women and Infants/Toddlers: Repeated Cross-Sectional Studies in Zhengzhou, China.
期刊: Biological trace element research 发表日期: 2025-Sep-01 链接: PubMed
摘要
Iodine nutrition in pregnant women and infants/toddlers is a critical public health indicator, yet the impact of the COVID-19 pandemic on iodine status remains unclear. Using data (2014-2022) from 139,163 pregnant women and 30,761 infants/toddlers aged 0-2 years in Zhengzhou, we explored effects of the pandemic on iodine nutrition through stratified inter-group analyses and seasonal autoregressive integrated moving average (SARIMA) modeling. Pregnant women and infants/toddlers had adequate iodine, with urinary iodine concentration (UIC) of 192.66 μg/L and 213.19 μg/L, respectively, both exceeding WHO thresholds for iodine sufficiency (150 μg/L for pregnant women and 100 μg/L for infants/toddlers). During the pandemic, significantly lower UICs were observed in urban pregnant women aged ≤ 30 years (2nd/3rd trimesters), rural pregnant women (1st/2nd trimesters), and rural infants (0-12 months) on formula/mixed feeding, compared with those in pre-pandemic. Notably, rural breastfed infants/toddlers had higher UICs during the pandemic than those before. Pre-pandemic data (2014-2019) yielded well-fitting SARIMA models, SARIMA(2,0,3)(2,1,2)12 for pregnant women and SARIMA(2,1,3)(1,2,2)12 for infants/toddlers, but incorporating pandemic data (2020-2022) worsened their fits, indicating that UIC patterns during the pandemic deviated from the pre-pandemic trends predicted by the model. These findings suggest that UICs of urban pregnant women aged ≤ 30 years in their 2nd/3rd trimesters, rural pregnant women in their 1st/2nd trimesters, and rural infants/toddlers were likely affected by the COVID-19 pandemic, highlighting the need for targeted monitoring during similar events.
32. Characteristics of Visual Attention in Young Children with Autism During A Hide-And-Seek Video Viewing Task.
期刊: Journal of autism and developmental disorders 发表日期: 2025-Sep-01 链接: PubMed
摘要
By implementing eye tracking technology to a hide-and-seek game, this study aimed to provide empirical evidence for characteristics of visual attention in children with autism spectrum disorder (ASD). One hundred and seventy-six children (aged between 18 and 48 months) with ASD (n = 58), global developmental delay (GDD, n = 59), and typical developing (TD, n = 59) watched a video in which a boy hid himself and popped out from an opaque screen. The boy made three facial expressions (i.e., neutral, smiling, and funny) after popping out from the screen. Smiling and funny expressions elicited significantly more visual fixations on the boy’s face and mouth. As compared to children with TD, children with ASD looked significantly less at the boy’s face and more at the body after he popped out from the screen. No significant differences in all eye tracking measures were found between the ASD and GDD groups. This study offers new perspectives on the visual attention patterns of young children with ASD during a hide-and-seek game viewing task. The inclusion of GDD provides valuable insights into identifying unique patterns of visual attention in ASD, while the lack of a significant ASD-GDD difference underscores the need for future tasks to identify visual behaviors specific to ASD. Additionally, our results suggest that facial expressions play a critical role in visual attention, highlighting their potential importance in the development of targeted interventions aimed at improving social engagement in children with ASD.
33. Metabarcoding-Based Seasonal Assessment of Airborne Microbial Communities in PM₁₀ Samples from a Semi-Urban Region in Tamil Nadu, India.
期刊: Environmental monitoring and assessment 发表日期: 2025-Sep-01 链接: PubMed
摘要
Airborne microbial communities show marked seasonal variability, with implications for both environmental processes and public health. In this study, metagenomic sequencing was applied to characterize airborne microbiota across four distinct seasons in India-winter (Sw), summer (Ss), southwest monsoon (Ssw), and northeast monsoon (Sne). Distinct shifts in dominant bacterial taxa were observed. Sne was dominated by Pseudomonas (42.3%) alongside sulfur-oxidizing Thiobacillus and Stenotrophomonas, likely influenced by lower temperatures and anthropogenic inputs. In Ss, Thiobacillus (72.9%) prevailed, followed by Pseudomonas (8.06%) and Sphingosinicella (6.68%), reflecting adaptation to arid, UV-intense conditions. Ssw featured Thiobacillus (58%) and Pseudomonas (18.5%) with additional plant-associated Lactobacillus and Clostridium, suggesting enhanced biogenic emissions. Sw was distinct for Enterococcus (21.9%) dominance and reduced Thiobacillus (16.2%), associated with high humidity and precipitation. Species richness followed the order Ssw > Sw > Ss > Sne, with the highest diversity during Ssw and Sw as indicated by Chao1, Fisher, Shannon, and Simpson indices. Kruskal-Wallis tests revealed no statistically significant differences in alpha diversity across seasons. Canonical Correspondence Analysis (CCA) highlighted strong seasonal structuring linked to environmental parameters such as temperature, humidity, and UV exposure. Dendrogram clustering showed greatest dissimilarity between Sne and Sw, while Ss and Ssw formed a closely related group. Ordination analyses (PCA, PCoA, NMDS) further confirmed seasonal distinctions. Seasonal variations in dominant bacterial taxa indicate potential public health risks in semi-urban tropical environments. Thiobacillus, prevalent in summer and the southwest monsoon, is generally non-pathogenic. In contrast, Pseudomonas species, abundant during the northeast monsoon and winter, are metabolically versatile, encompassing environmental strains and opportunistic pathogens known to cause respiratory and wound infections, especially in immunocompromised individuals. Winter also saw the presence of Enterococcus faecalis, a gut commensal and opportunistic pathogen linked to hospital-acquired infections and notable for multi-drug resistance. These seasonal shifts highlight varying exposure risks, emphasizing the need for public health attention to airborne microbial dynamics across different seasons.
34. Coupling electrochemical and spectroscopic methods for river water dissolved organic matter characterization.
期刊: Environmental monitoring and assessment 发表日期: 2025-Sep-01 链接: PubMed
摘要
Monitoring dissolved organic matter (DOM) in surface waters is essential for assessing ecosystem health and detecting pollution. However, conventional spectroscopic techniques often provide limited information about the electrochemical behavior of DOM. This study integrates electrochemical impedance spectroscopy (EIS) with classical methods such as UV-Vis absorption and fluorescence spectroscopies to improve DOM characterization in river water samples. In particular, this coupling provides additional insights into the electrochemical properties of DOM, which are not captured by conventional spectroscopic techniques. This study combined multiple data sources, including physicochemical parameters (e.g., water temperature, pH, conductivity), EIS spectral scores, fluorescence indices, and DOM fractions resolved by multivariate curve resolution-alternating least squares (MCR-ALS) applied to excitation-emission matrix (EEM) fluorescence data. The results from these different methods were then merged into a single dataset for a global principal component analysis (PCA), which allowed us to identify shared patterns and correlations across methods. The results revealed that low-altitude rivers showed the highest DOM content, followed by mid-altitude rivers, while high-altitude rivers presented the lowest. The PCA model indicated that low-frequency regions in the EIS spectra correlated with higher DOM content, whereas mid- to high-frequency regions were associated with lower DOM levels. These frequency-dependent patterns reflected differences in charge transfer and dielectric behavior of DOM in the river samples, which are not accessible through optical techniques. This highlights the potential of EIS as a complementary tool that provides electrochemical information on DOM composition for better water quality assessment.
35. The irrigation impacts of treated wastewater over 35 years on soil properties and crop production.
期刊: Environmental monitoring and assessment 发表日期: 2025-Sep-01 链接: PubMed
摘要
The use of treated wastewater (TWW) for crop irrigation has increased worldwide as an alternative to preserving freshwater resources. However, choosing this alternative still requires more data about its impact on the environment, crop quality, and human health. In this regard, the present study aimed to assess the irrigation impact with TWW for a long time (35 years) on soil properties and on cereal and bean yield. To evaluate this effect, two sites were studied: the first one irrigated with TWW (S1) and the second irrigated with tap water (S2). Soil analysis from S1 revealed higher salinity and high levels of inorganic and organic pollutants compared to FAO standards (3.39 ± 0.45 µg/g MS for Cd and 68 ± 1.9 µg/g MS for Cu, respectively). In TWW, the concentrations were 1.15 ± 0.05 µg/L for Cd, 0.32 ± 0.18 µg/L for Ni, and 1.11 ± 0.01 µg/L for Pb, respectively. Additionally, high concentrations of organochlorine compounds were detected with chromatography coupled with mass spectrometry (GC-MS) in TWW, such as Aldrin (0.01 µg/mL) and γ-HCH (0.016 µg/mL), as well as in soil (0.883 µg/g). These compounds exceeded the Tunisian standards (NT: 106.03) and the FAO guidelines for irrigation. Also, irrigation with TWW over 35 years increased the aerial biomass of Triticum turgidum and Hordeum vulgare but negatively affected the plant growth of Medicago sativa L. Organic contaminants, such as pesticides, reduced soil fertility and biodiversity. Furthermore, mineral pollutants accumulated in soil, such as heavy metals, affect plant growth, which poses a risk directly for the food chain and indirectly for human health. Continuous irrigation with wastewater alters the physicochemical properties of the soil and leads to the accumulation of inorganic pollutants in food crops. This alteration depends not only on the soil’s physical and chemical properties but also on the duration of irrigation. Based on this study, long-term irrigation with TWW poses significant risks to both human health and ecosystems. Therefore, continuous monitoring and proper management of TWW irrigation are crucial to mitigate these potential risks and ensure the long-term sustainability of agricultural practices.
36. Hyperthermia during open water swimming: risks, monitoring and mitigation strategies.
期刊: European journal of applied physiology 发表日期: 2025-Sep-01 链接: PubMed
摘要
The environmental conditions in open water swimming (OWS) can impair thermoregulation. Here we explored and discussed four interrelated topics concerning the disruption of thermal homeostasis, in parallel with the underlying physiological mechanisms, during OWS competitions in hot climates: (i) potential health risks; (ii) possible impacts on performance; (iii) technical feasibility of core temperature (Tc) measurement; and (iv) cooling strategies applicable to this context. An integrative review was conducted. A systematic search of PubMed, SCOPUS, EMBASE, and Web of Science was performed, yielding 4610 studies. After screening and excluding duplicates, 42 studies underwent full-text review, resulting in 20 studies included. Water temperatures (Tw) close to the upper limit established by World Aquatics (31 °C) negatively affect performance and increase health risks for open water swimmers. Thermal stress during competitions, caused by prolonged exposure to hot water, impairs thermoregulation, leading to dehydration, increased Tc, and cardiovascular strain. Cooling strategies such as pre-cooling and per-cooling showed potential to mitigate heat strain, although their application in open water swimming events remains challenging due to logistical constraints. Modern strategies of post-cooling have been primarily designed for pre-hospital or emergency care settings. Wearable technologies for real-time Tc monitoring emerged as a promising tool for improving athlete safety and performance management during competitions. The rise in Tc during open water swimming in hot water is a worrying phenomenon caused by impaired cooling mechanisms, is exacerbated by prolonged exposure to solar radiation, and negatively impacts performance and increases health risks. Cooling strategies such as pre-cooling and per-cooling are key strategies to mitigate heat strain. Wearable physiological monitoring now allows for better modeling of individual thermophysiological profiles, improving both competitive strategies and safety.
37. metagRoot: a comprehensive database of protein families associated with plant root microbiomes.
期刊: Nucleic acids research 发表日期: 2025-Sep-01 链接: PubMed
摘要
The plant root microbiome is vital in plant health, nutrient uptake, and environmental resilience. To explore and harness this diversity, we present metagRoot, a specialized and enriched database focused on the protein families of the plant root microbiome. MetagRoot integrates metagenomic, metatranscriptomic, and reference genome-derived protein data to characterize 71 091 enriched protein families, each containing at least 100 sequences. These families are annotated with multiple sequence alignments, CRISPR elements, hidden Markov models, taxonomic and functional classifications, ecosystem and geolocation metadata, and predicted 3D structures using AlphaFold2. MetagRoot is a powerful tool for decoding the molecular landscape of root-associated microbial communities and advancing microbiome-informed agricultural practices by enriching protein family information with ecological and structural context. The database is available at https://pavlopoulos-lab.org/metagroot/ or https://www.metagroot.org.
38. Effects of microplastics in soil on the regulation of cadmium bioavailability by biochar.
期刊: Environmental geochemistry and health 发表日期: 2025-Sep-01 链接: PubMed
摘要
Given the widespread and persistent presence of microplastics (MPs) in soil, their coexistence with cadmium (Cd) poses significant environmental risks. Biochar (BC) serves as an economically viable and environmentally sustainable amendment for soil remediation. However, the existing research on BC application in Cd-contaminated soil has yet to adequately consider the influences of the presence of MPs. Therefore, based on the analysis of Cd sorption characteristics on BC and MPs, the soil incubation and pot experiments were conducted in Cd-contaminated soil to elucidate the effects of polyethylene MPs and corn straw BC on Cd availability and accumulation in Chinese cabbage. After 60 days of incubation, the application of BC led to a considerable decline in the available Cd contents in the soil, with decreases of 47.3% and 42.4% for DTPA-Cd and acid-soluble Cd respectively, while the presence of MPs partially weakened the immobilization effect of BC on Cd. The BC promoted plant growth, but the combined presence of MPs and BC inhibited it, which was attributed to the adverse effects of MPs. Compared with the sole BC application, the BC-MPs treatment hindered the accumulation of Cd from the contaminated soil to the plant. The results of this study provide a certain theoretical basis for the remediation ability of BC for MPs-Cd co-contaminated soils.
39. Innovative Nanotechnology and Molecular Probes for Real-time Monitoring and Therapeutic Modulation of Pyroptosis in Cancer and Inflammatory Diseases.
期刊: Cell biochemistry and biophysics 发表日期: 2025-Sep-01 链接: PubMed
摘要
40. Initial diagnosis patterns of coexisting mental health and neurodevelopmental conditions in autistic children and youth: Evidence from a nationally representative sample in Canada.
期刊: Journal of child psychology and psychiatry, and allied disciplines 发表日期: 2025-Sep-01 链接: PubMed
摘要
Elevated prevalence of coexisting health conditions has been observed in autistic people, yet how the timing of their initial diagnoses varies by sex and age of autism diagnosis remains understudied. Using a person-centered approach, we examined the patterns of initial diagnosis for mental health and neurodevelopmental conditions among autistic children and youth identified from the general population. The sample was drawn from the 2019 Canadian Health Survey on Children and Youth (CHSCY) cohort (N = 47,781), consisting of 776 5-17-year-olds (82% assigned-male-at-birth) with a caregiver-reported diagnosis of autism. Multigroup latent class analysis was used to identify subgroups based on ages of initial diagnoses of autism, anxiety, mood, learning, and attention-deficit/hyperactivity disorders stratified by sex assigned at birth. Functional difficulties and multimorbidity status, including the number and types of coexisting conditions, were compared across the subgroups. Four latent subgroups were identified for each sex group, primarily differentiated by the age of autism diagnosis. The most prevalent class (46%) was characterized by an initial autism diagnosis at ages 3-5 years. The remaining subgroups, with autism diagnosed primarily before age 3, at 6-8, and at 9-17 years, each comprised ~20% of the sample. Subgroups with autism diagnosed after age 6 tended to have more coexisting conditions, with females showing heightened probabilities of mental health diagnoses across age windows from birth to age 17 years. The temporal order of coexisting diagnoses relative to autism diagnosis varied across subgroups, with sex differences more evident for anxiety and attention-deficit/hyperactivity disorders. There were nuanced variations in the timing of initial diagnoses of coexisting conditions based on the age of autism diagnosis. The sex-varying patterns highlight the importance of continuous monitoring and evaluation of the neurodevelopmental and mental health needs of autistic children and youth, with supports tailored to sex and the timing of autism diagnosis.
41. Nasal mucosa micronuclei as early biomarkers of effect in workers exposed to airborne pollutants: a literature overview.
期刊: Archives of toxicology 发表日期: 2025-Sep-01 链接: PubMed
摘要
Occupational exposure to air pollutants poses a serious health concern for workers, particularly due to potential genotoxic effects. The micronucleus (MN) test is widely recognized as a reliable biomarker of early genetic damage. Although commonly applied to lymphocytes or buccal epithelial cells, the nasal mucosa, being the first site of contact for inhaled toxicants, has received relatively limited attention. This review aims to evaluate the scientific literature on the use of MN in exfoliated nasal epithelial cells as a biomarker of early genotoxic effects in workers exposed to air pollutants. We conducted a comprehensive literature search using PubMed and gray literature sources. Seventeen studies were identified that examined the frequency of MN in nasal cells of exposed workers, with or without comparison with other biomarkers, such as buccal or blood cells. Most studies have reported a significant increase in MN frequency in nasal cells following exposure to substances, such as FA, heavy metals, wood dust, and industrial chemicals. In some cases, nasal MNs appeared more sensitive than other cellular targets. However, data heterogeneity, lack of standardized protocols, and limited control for confounding factors (e.g., smoking, diet) hinder in-depth comparisons and meta-analyses. Nasal MN testing offers a promising, non-invasive tool for biomonitoring genotoxic exposure in occupational settings. However, further research is needed to develop standardized protocols, control for confounding factors, and clarify the relationship between MN frequency, exposure characteristics, and other biomarkers of effect.
42. The interplay of alcohol use symptoms and sociodemographic factors in the HELIUS study: A network perspective.
期刊: Social psychiatry and psychiatric epidemiology 发表日期: 2025-Sep-01 链接: PubMed
摘要
Research on alcohol use disorder has exclusively focused on either its symptom-level mechanisms-the network perspective or sociodemographic determinants-epidemiological research. Moreover, such research failed to stratify analyses for important person-level factors (e.g., sex or ethnicity). Here, we combine network and epidemiological research and stratify analyses by person-level factors. Using Bayesian inference, we estimated (1) a logistic regression model predicting past-year alcohol consumption from various sociodemographic factors within a large, multiethnic, urban sample in the Netherlands (complete sample: N = 22,164), (2) a cross-sectional network model of alcohol use symptoms and sociodemographic factors among alcohol drinkers of the same sample (drinkers: N = 10,877), and (3) stratified networks at the sex- and ethnic- levels in the same drinkers subsample. All of our examined sociodemographic factors predicted past-year alcohol consumption (in order of magnitude: religion, sex, education, employment, perceived ethnic discrimination, and age). Our Bayesian analysis of networks revealed three notable patterns. First, religion was uniquely and negatively related to adverse alcohol use problems (such as having an injury due to drinking). Second, socioeconomic proxies (education and employment) were positively related to binge drinking, but negatively related to its adverse effects (such as ‘needing a drink in the morning’). Finally, employment and education were particularly negatively related to alcohol use symptoms within male and female networks, respectively. Our results suggest that alcohol use symptoms are differentially related to sociodemographic factors and that these effects are moderated by sex and ethnicity. Our highlighted network links and Bayesian methodologies could prove useful for future research and prevention and intervention efforts on alcohol use disorders.Word count: 4198 words.
43. Multidimensional Fatigue Assessment of High-Altitude Electrical Workers: A Comprehensive Analysis Based on Physiological and Psychological Indicators : Electrical Workers: A Comprehensive Analysis.
期刊: Applied psychophysiology and biofeedback 发表日期: 2025-Sep-01 链接: PubMed
摘要
High-altitude electrical work is a high-risk and physically demanding occupation that has received limited empirical investigation, particularly regarding the physiological and psychological fatigue experienced during operations. This study provides an initial empirical exploration into fatigue among high-altitude electrical workers by examining the relationship between subjective fatigue perception and multiple physiological indicators in realistic working environments. Thirty professional high-altitude electrical workers participated in field-based measurements conducted during routine summer operations. A combination of subjective (Fatigue Severity Scale) and objective indicators-such as LF/HF, grip strength, reaction time, and critical flicker frequency-was used to assess fatigue. The experimental protocol was designed to closely mirror actual work conditions, and over 1,200 valid data points were collected across repeated measures. Spearman correlation and multiple regression analyses were employed to evaluate the association between physiological indicators and subjective fatigue ratings. Significant correlations were observed between subjective fatigue levels and several physiological indicators, particularly LF/HF (β = -0.523, p < 0.001), grip strength (β = -1.076, p < 0.001), CFF (β = -4.138, p < 0.001), and RT (β = 2.984, p < 0.001). These findings suggest these indicators may be sensitive to short-term fatigue fluctuations under operational stress. In contrast, ETCO2 did not show a significant relationship with subjective fatigue, likely due to its physiological stability and limited responsiveness in non-clinical field conditions. This study offers preliminary evidence supporting the feasibility of combining multiple physiological and psychological indicators for fatigue monitoring in high-altitude electrical work. The results underscore the multifaceted nature of fatigue and highlight the importance of context-specific evaluation frameworks. Future studies should further refine these indicators and expand the sample scope to enhance generalizability and practical applicability in occupational health management.
44. Socio-cultural considerations of home modifications from the perspective of people with spinal cord injury in Iran.
期刊: Disability and rehabilitation. Assistive technology 发表日期: 2025-Sep-01 链接: PubMed
摘要
The main purpose of this study was to investigate the socio-cultural considerations for home modifications among individuals with spinal cord injury (SCI) in Iran. A descriptive qualitative design was employed, involving semi-structured interviews with 18 participants. Data were analyzed using reflexive thematic analysis to identify key themes and subthemes. Three main themes were identified: (1) Holding out hope for recovery from SCI, (2) Absence of home modifications led to unique solutions but potential risks, and (3) Occupational therapy recommendations regarding home modifications need to be culturally safe. Participants often received misinformation about their prognosis, leading to delayed or avoided home modifications. The findings underscore the importance of providing accurate information regarding SCI prognosis to facilitate the implementation of needed home modifications. Occupational therapists and other health care professionals are advised to consider cultural factors, including practices related to values such as privacy, to ensure that recommendations are client-centered, effective, and culturally adaptable. This study highlights the necessity of developing culturally sensitive guidelines for home modifications and emphasize the critical role of involving in decision-making process, and improving access to appropriate assistive technology. Cultural sensitivity in home modificationRehabilitation professionals should consider cultural values and practices when recommending home modifications.Enhanced communication and educationThere is a need for better communication and education about the typical trajectory of spinal cord injury and the importance of home modification. Providing clear, accurate information to both clients and their families can help manage expectations and reduce resistance to necessary changes.Support for assistive technology accessGiven the low availability of assistive technology in low- and middle- income countries, efforts should be made to improve access to these products.Empowering caregiversCaregivers often take on significant responsibilities, leading to burnout and over dependence of the person with SCI. Rehabilitation programs should include support for caregivers, providing them with the necessary tools and knowledge to manage their roles effectively without compromising their well-being.Tailored occupational therapy interventionsOccupational therapists should focus on practical, user-centered recommendations that align with the specific needs and preferences of individuals with SCI.
45. Best Practices for Addressing Differences in Antimicrobial Resistance Through Quality Improvement Projects in Antimicrobial Stewardship in Low-Resource Settings.
期刊: Mayo Clinic proceedings 发表日期: 2025-Sep-01 链接: PubMed
摘要
46. Identification of cystatin C as a new marker of glomerular filtration rate, and of shrunken pore syndrome - a new kidney disorder defining selective glomerular hypofiltration syndromes - calls for expansion of the international KDIGO guidelines.
期刊: Scandinavian journal of clinical and laboratory investigation 发表日期: 2025-Sep-01 链接: PubMed
摘要
Cystatin C was identified as a marker of glomerular filtration rate (GFR) in 1979, and the parallel analysis of cystatin C and creatinine led to the identification of shrunken pore syndrome (SPS) - a new kidney disorder - in 2015. Since then, it has been shown that cystatin C in many aspects is superior to creatinine as a marker of GFR and cardiovascular risk. SPS, an entity within the selective glomerular hypofiltration syndromes (SGHS), has been demonstrated to be associated with a strong increase in morbidity and mortality in several populations. Despite the seriousness of SPS and SGHS, and the availability of potential treatments, many patients with these conditions remain undiagnosed, due to the limitations of the international Kidney Disease Improving Global Outcomes Organization (KDIGO) guidelines. Given the significant clinical advantages of cystatin C in diagnosing and treating kidney disorders, there is a need to expand the KDIGO guidelines to include cystatin C measurements alongside creatinine at least in the initial patient evaluation but also in follow-up evaluations. This would improve the early detection and management of patients with kidney diseases, ultimately enhancing patient outcomes. The present discourse summarizes the development of this understanding from the original observations in 1979 and 2015 to the latest findings.
47. Hematotoxicity and expression of genes involved in hematological malignancies in Mexican children environmentally exposed to benzene.
期刊: Journal of environmental science and health. Part. B, Pesticides, food contaminants, and agricultural wastes 发表日期: 2025-Sep-01 链接: PubMed
摘要
There is growing evidence that environmental benzene exposure is a risk factor for developing some hematological disorders, leukemia included. The aim of this study was to assess the variation in mRNA expression of a regulatory set of hematopoietic genes in children exposed to benzene and hematological parameters. In this study, 67 healthy children between the ages of 3 and 12 voluntarily participated. Trans,trans-muconic acid was analyzed in urine samples using high-performance liquid chromatography, and gene expression of AhR, BCL2, CD38, PTEN, and RUNX1 was assessed in blood samples by RT-qPCR. We observed elevated benzene exposure levels (GM = 326.3 ± 42.3 µg/g creatinine), with 20% of children exceeding the occupational threshold of 500 µg/g creatinine. Additionally, benzene exposure was significantly associated with RUNX1 mRNA expression (r = 0.27, p < 0.05). Our finding show that benzene could contribute to hematopoietic effects developed in highly exposed children. These results highlight the necessity of implementing environmental policies aim at reducing benzene exposure in children.
48. Prevalence and risk factors of low back pain among auto rickshaw drivers in urban settings: A cross-sectional study.
期刊: Journal of back and musculoskeletal rehabilitation 发表日期: 2025-Sep-01 链接: PubMed
摘要
BackgroundLow back pain (LBP) is a leading cause of disability worldwide, particularly among professional drivers due to prolonged sitting and whole-body vibrations. Auto rickshaw drivers in India represent a vulnerable occupational group lacking ergonomic support and healthcare.ObjectiveThis study aimed to determine the prevalence of persistent LBP and its associated ergonomic, demographic, and lifestyle factors among auto rickshaw drivers in an urban setting.MethodsA cross-sectional study was conducted during March-April 2024 among 353 auto rickshaw drivers aged 20-55 years. Data were collected via questionnaires on sociodemographic, occupational, and lifestyle factors and health status. Pain severity was measured on a 10-point scale. Statistical analyses, including chi-square, t-tests, and regression, were done using JASP (p < 0.05).ResultsThe prevalence of persistent LBP was 48.16%. Key predictors included male sex (OR = 10.659, p = 0.002), longer driving hours (OR = 1.152, p = 0.042), and family history of musculoskeletal disorders (OR = 7.667, p < 0.001). Ergonomic factors like lumbar support and vehicle vibration increased LBP prevalence. Smoking and physical inactivity showed significant associations, though no single factor predicted LBP severity.ConclusionNearly half of urban auto rickshaw drivers experience persistent LBP, influenced by occupational and ergonomic factors. The findings highlight the need for targeted interventions, including improved seating, rest breaks, and posture education. Public health strategies promoting physical activity and addressing smoking may reduce LBP risk. Future studies should explore unmeasured psychosocial factors affecting LBP severity.
49. AUPRC: a metric for evaluating the performance of in-silico perturbation methods in identifying differentially expressed genes.
期刊: Briefings in bioinformatics 发表日期: 2025-Aug-31 链接: PubMed
摘要
In silico perturbation models, computational methods that can predict cellular responses to perturbations, present an opportunity to reduce the need for costly and time-intensive in vitro experiments. Many recently proposed models predict high-dimensional cellular responses, such as gene or protein expression to perturbations such as gene knockout or drugs. However, evaluating in silico performance has largely relied on metrics such as $R^{2}$, which assess overall prediction accuracy but fail to capture biologically significant outcomes like the identification of differentially expressed (DE) genes. In this study, we present a novel evaluation framework that introduces the AUPRC metric to assess the precision and recall of DE gene predictions. By applying this framework to both single-cell and pseudo-bulked datasets, we systematically benchmark simple and advanced computational models. Our results highlight a significant discrepancy between $R^{2}$ and AUPRC, with models achieving high $R^{2}$ values but struggling to identify DE genes, as reflected in their low AUPRC values. This finding underscores the limitations of traditional evaluation metrics and the importance of biologically relevant assessments. Our framework provides a more comprehensive understanding of model capabilities, advancing the application of computational approaches in cellular perturbation research.
50. Danhong Injection targets CaMKII through Dihydrotanshinone I to alleviate cardiomyocyte death and inflammation in viral myocarditis.
期刊: Science China. Life sciences 发表日期: 2025-Aug-28 链接: PubMed
摘要
Viral myocarditis, an inflammatory heart disorder caused by viral infections, often leads to poor outcomes due to the lack of effective prevention and treatment strategies. Despite the characteristic feature of cardiomyocyte death in this condition, the underlying mechanisms and potential therapeutic approaches remain poorly understood. Traditional Chinese medicine (TCM), despite its extensive history in treating various diseases, has not yet been approved for the treatment of viral myocarditis. Here, we screened six TCM patent injections recommended by clinical practice guidelines for treating cardiovascular diseases and discovered that Danhong Injection (DHI) markedly reduced cardiomyocyte death induced by Coxsackievirus B3 (CVB3). Additionally, in a CVB3-infected mouse model of viral myocarditis, DHI treatment notably alleviated cardiomyocyte death (including apoptosis, necroptosis and pyroptosis), as well as inflammation, cardiac dysfunction, and mortality. Mechanistically, DHI exerted its protective effects by inhibiting CaMKII through its active monomer Dihydrotanshinone I (Dih-I), identified as a CaMKII inhibitor. In viral myocarditis patients, CaMKII phosphorylation was upregulated in the hearts. The anti-inflammatory properties and CaMKII inhibition effects of DHI were further validated in primary human peripheral blood mononuclear cells. Our findings not only demonstrate the central role of CaMKII-mediated cardiomyocyte death in the progression of viral myocarditis, but also highlight DHI as a promising therapeutic intervention for managing viral myocarditis-induced cardiac injury and related pathological response.
51. Decoding adenomyosis pathogenesis using an assembloid model.
期刊: Science China. Life sciences 发表日期: 2025-Aug-28 链接: PubMed
摘要
Adenomyosis remains a challenging gynecological disorder to investigate due to the absence of in vitro models that accurately replicate endometrial tissue dynamics across the menstrual cycle. To address this gap, we established an endometrial assembloid model that faithfully mimics cycle-dependent endometrial responses and captures key cellular and molecular hallmarks of adenomyosis, including ectopic lesion- specific epithelial and stromal heterogeneity. Single-cell transcriptomics revealed that ectopic epithelial cells shift toward a luminal- dominant, glandular-deficient transcriptional profile during the secretory-like phase. This transition correlated with ectopic stromal reorganization-specifically, loss of BMP4+ stromal cells and an accumulation of CRYAB+IL15+ stromal cells-which impaired BMP-mediated stromal-epithelial signaling while enhancing WNT activation. Additionally, ectopic epithelial and stromal cells demonstrated increased immunity and angiogenesis activities. Our assembloid platform not only provides a physiologically relevant model for investigating adenomyosis pathogenesis but also implicates aberrant WNT signaling as a potential therapeutic target, offering new opportunities for mechanism-driven treatment strategies.
52. High-fat diet-induced obesity-related hypertension via altered gut microbiota-mediated histone butyrylation.
期刊: Science China. Life sciences 发表日期: 2025-Aug-28 链接: PubMed
摘要
Hypertension is a chronic cardiovascular disease that significantly impacts human quality of life. Gut microbiota and its metabolites have been reported to be involved in lipid metabolism and blood pressure regulation, but the specific alterations and pathogenic mechanisms of gut microbiota in obesity-related hypertension (OrHTN) remain unclear. In this study, we observed a significant proliferation of Desulfobacterota and Proteobacteria, while a decrease in the abundance of several butyrate-producing bacterial genera, accompanied by decreased fecal and plasma butyrate levels in high-fat diet (HFD)-induced OrHTN rats. Histone 3 lysine 9 butyrylation (H3K9bu) modification in the kidney of OrHTN rats was reduced and downregulated the expression of the hypertension-related gene MAS1. Subsequent transplantation of cecal contents from OrHTN rats on HFD into recipient rats on a normal chow diet resulted in hypertension but without obesity. Furthermore, in vitro experiments suggested that sodium butyrate increased H3K9bu modification and the expression of MAS1 in a concentration-dependent manner. In conclusion, our findings suggest that gut microbiota may contribute to the development of OrHTN by altering the expression of hypertension-related genes through butyrate-mediated histone butyrylation. This work may provide new insights into the prevention and treatment of hypertension by targeting the regulation of gut microbiota and metabolites.
53. The role of high-protein diets in the management of glycaemic control in people with type 2 diabetes.
期刊: Current opinion in clinical nutrition and metabolic care 发表日期: 2025-Aug-20 链接: PubMed
摘要
Type 2 diabetes is a complex and multifactorial disease with dietary treatment often recommended as the first line management strategy. Whilst caloric restriction remains the most-effective means of obtaining diabetes remission, high-protein diets (25-35% of energy intake) have garnered interest for their potential role in optimizing postprandial and longer-term glycaemic control. High-protein diets are not currently an established recommendation for people with diabetes and here we discuss the recent evidence for high-protein diets and glycaemic control. This review highlights the evidence demonstrating improved postprandial glycaemia after acute protein ingestion due to increased insulin secretion, and whether this translates into longer-term dietary intervention trials. The impact of the source of protein is clear within acute postprandial studies, but appears less relevant over longer periods. We also discuss the caveats surrounding high-protein diets, including the weight-loss independent benefits and the accompanying reduction in dietary carbohydrate. High-protein diets, in combination with a reduction in carbohydrate intake, may be a useful dietary strategy in the management of glycaemic control in people with type 2 diabetes.
54. Quelle recherche pour l'avenir de la promotion de la santé ?
期刊: Global health promotion 发表日期: 2025-Jun 链接: PubMed
摘要
55. Setting the health promotion research agenda for the future.
期刊: Global health promotion 发表日期: 2025-Jun 链接: PubMed