公共卫生研究摘要 (2025-09-03)
共收录 56 篇研究文章
1. Development of core outcome set for healthy aging treatment in primary care settings.
期刊: Integrative medicine research 发表日期: 2025-Dec 链接: PubMed
摘要
Healthy aging is a global public health priority, with increasing interest in the promotion of functional ability and well-being among older adults. South Korea’s rapidly aging population highlights the need for standardized evaluation tools for interventions. This study aimed to develop a Core Outcome Set (COS) for healthy aging treatment in primary care. The COS was developed following the COS-STAD guidelines and through a multiphase process, including a literature review and a modified Delphi consensus. A project management group (PMG) reviewed studies related to health promotion programs and generated an initial list of outcomes. This list was refined through two rounds of Delphi surveys involving 16 experts. Consensus was assessed using content validity ratio, degree of consensus, and convergence. Twenty-six studies informed the initial outcome list, resulting in 24 outcomes for the Delphi evaluation. Two Delphi rounds and a final review by the PMG established a COS comprising 12 outcomes. These included EQ-5D, Geriatric Depression Scale, Instrumental Activities of Daily Living, body weight, blood pressure, blood glucose, blood lipids, liver function, kidney function, Korean Frailty Index, Self-rated Health, and Kidney-Deficiency Score. The COS provides a standardized set of outcomes for evaluating healthy aging interventions in primary care. Its application in primary care and health promotion programs may enhance comparability across studies and support evidence-based decision making. Future revisions are recommended based on clinical applications and emerging research findings.
2. Enhancing cognitive function through blood flow restriction: An effective resistance exercise modality for middle-aged women.
期刊: Journal of exercise science and fitness 发表日期: 2025-Oct 链接: PubMed
摘要
Cognitive decline progresses more rapidly in women than in men, with a higher prevalence of neurodegenerative diseases observed in females. Exercise has been shown to enhance cognitive function through the upregulation of neurotrophic factors such as brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF) and insulin-like growth factor-1 (IGF-1). However, high-load resistance exercise may not be suitable for all populations, particularly middle-aged women. Low-load resistance exercise with blood flow restriction (LLBFR) has emerged as an effective alternative. This study investigated the acute effects of LLBFR on neurotrophic factors and cognitive function in middle-aged women. Fifteen healthy middle-aged women completed a randomized crossover trial involving four conditions: control (CON), low-load resistance exercise (LLRE), LLBFR, and moderate-load resistance exercise (MLRE). Cognitive function was assessed before and after each session using the color-word matching Stroop task (CWST). Blood samples were analyzed for serum levels of BDNF, VEGF, and IGF-1, and lactate concentrations were measured to evaluate metabolic responses. Only the LLBFR condition showed significant improvements in CWST reaction time (p = 0.002) with no changes in error rates, indicating enhanced cognitive performance. Serum BDNF and VEGF levels increased significantly following both LLBFR (p < 0.001, p = 0.014, respectively) and MLRE (p < 0.001, p = 0.004, respectively), whereas IGF-1 levels remained unchanged across conditions. Increases in lactate concentrations were positively correlated with changes in BDNF and VEGF (p < 0.001 for both), but not with IGF-1. A single session of LLBFR improved cognitive function and upregulated neurotrophic factors, particularly BDNF and VEGF, in middle-aged women. These findings suggest that LLBFR may be an effective intervention for promoting cognitive health in this population.
3. Bilateral Coordination is Improved at 10-km Race Speed in Trained Runners.
期刊: International journal of sports medicine 发表日期: 2025-Sep-02 链接: PubMed
摘要
In the last decades, gait variability (GV) has provided new insight into motor control. No study, though, quantified the GV together with bilateral symmetry at different running intensities in runners. For this aim, 16 male runners (35±6 y), after a simulated 10-km time trial (average speed, TT), performed randomly three 15-minute running bouts at TT running speed, 10% slower, and 10% faster than TT. Metabolic, perceptive, and spatiotemporal parameters with phase coordination index (PCI) were collected across all trials. The TT was 14.16±1.65 km·h-1, rating of perceived exertion of 8.94±0.36 a.u. and 95.25±5.83% of the maximum heart rate. The PCI was lower at TT speed than at other speeds (p=0.002). The energy cost of running was higher at slower speeds in comparison to TT speed and higher speed conditions (p=0.029 and p=0.017, respectively). The ratings of perceived exertion, heart rate, oxygen consumption, flight time, and stride length increased according to the speed (p<0.05). The finding that the PCI is better at 10-km race speed suggests that improved ability to modulate the right-left stepping control is related to an energetic optimization process impacting positively the talent development and performance in trained runners. Although the metabolic cost estimates are grounded in a robust theoretical framework, these findings necessitate further empirical verification.
4. Assessment of patients' awareness of the significance of x-ray warning signs in Nigerian tertiary hospitals: A cross-sectional study.
期刊: Journal of radiological protection : official journal of the Society for Radiological Protection 发表日期: 2025-Sep-02 链接: PubMed
摘要
X-rays play a crucial role in modern medical practice, enabling more accurate diagnoses of diseases and injuries. However, despite its clinical significance, X-rays have been associated with potentially harmful biological effects if not properly managed; hence, the need for radiation optimization and adherence to safety protocols. This study evaluates patients’ awareness of the significance of X-ray warning signs, their understanding of the signs used, and their knowledge of the effects of radiation on biological cells. Methods: This prospective cross-sectional study was conducted between January and June 2025 at the radiology departments of the University of Nigeria Teaching Hospital (UNTH) and the National Orthopaedic Hospital Enugu (NOHE) in Enugu, Nigeria. Well-structured questionnaires consisting of 20 questions and three sections were adopted. Data was analyzed using the Chi-square test and descriptive statistics, with statistical significance set at p < 0.05. Results: 186 questionnaires were received and analyzed, and the gender distribution was equal (50% male, 50% female). Most patients (69.9%) were aware of the warning signs, with the X-ray indicator light being the most seen (56.2%). Fewer recognized warning labels (35.4%) or radiation symbols (32.3%). The majority (57.5%) reported no difficulty understanding the X-ray warning light, signal/signs, and 67.2% obeyed the warning observed. Conclusion: Patients in the studied hospitals demonstrated good knowledge of the significance of X-ray warning signs. However, there is a need for hospitals to initiate a laid-down policy to educate patients on radiation safety protocols, improve their understanding of warning signs, and ultimately prevent accidental radiation exposure. 
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5. What's the point? The functional role of claws in pad-bearing taxa (Gekkota: Diplodactylidae).
期刊: Proceedings. Biological sciences 发表日期: 2025-Sep 链接: PubMed
摘要
Morphological adaptations facilitate effective movement within habitats. Claws are among the most common adaptations enabling organisms to use inclined and vertical surfaces. However, some taxa have evolved adhesive pads in addition to claws, with claws suggested to be more effective at gripping coarse surfaces, while pads attach better to fine-grained surfaces. Using test surfaces that represented the range of surface roughness used by six species of diplodactylid geckos in nature, we quantified the role of claws and pads acting together, and of pads alone. We examined two functional traits, attachment (on inclines, 45° and vertical surfaces, 90°) and clinging ability (on inclines only). Claws were critical to attachment on vertical surfaces, and attachment declined linearly with decreasing surface roughness. Although attachment was lowest on fine-grained surfaces, this was where claws had the greatest functional contribution. Clinging ability also declined linearly with decreasing surface roughness, where claws played an additive role. Our study highlights novel results describing the function of gecko adhesive systems on different surfaces and suggests a clade-specific interaction of claws and pads. Specifically, we highlight that pads alone can be capable of attachment on rough surfaces, with claws contributing more on fine-grained surfaces.
6. Cellular, bone-like tissue in the bucklers and thorns of the thornback ray Raja clavata (Batoidea, Chondrichthyes).
期刊: Proceedings. Biological sciences 发表日期: 2025-Sep 链接: PubMed
摘要
Chondrichthyans (cartilaginous fishes) have lost the cellular bone characteristic of other jawed vertebrate skeletons. However, we identify cellular bone-like tissue in modified scales with enlarged bases, called ‘bucklers’ and ‘thorns’, which are distinctive for one group of extant batoids (rays). As placoid scales, they possess spines of orthodentine and osteodentine, but a unique basal structure. This consists of a cell-rich material, previously misidentified as an acellular tissue. Newly formed basal tissue grows appositionally and episodically from a cell-rich periosteum-like layer and closely resembles cellular bone, with entombed cells situated between bundles of attachment fibres anchoring the scale to the underlying dermal tissue and the ‘periosteum’ to the scale surface. In histologically more mature tissue, the cell spaces and attachment fibres are remodelled, forming enlarged, elongated spaces. The result is a unique mineralized tissue in these rays, initially sharing similarities with cellular bone, but with a mature state where cell spaces are modified throughout the base, by proposed remodelling of the matrix. Our findings of cellular bone forming the attachment tissues in ray scales demonstrate the chondrichthyan capacity to deposit bone-like tissues within the odontode module, contrary to previous understandings of hard tissue evolution in vertebrates.
7. The implications of COX-2 and HER2 protein expression for the prognosis of colorectal cancer patients: An exploratory study from the North African region.
期刊: Revista espanola de patologia : publicacion oficial de la Sociedad Espanola de Anatomia Patologica y de la Sociedad Espanola de Citologia 发表日期: 2025-Sep-01 链接: PubMed
摘要
The prognostic value of COX-2 and HER2 protein overexpression in colorectal cancer remains controversial and has not previously been evaluated in North Africa. In this study, we investigated the association between COX-2 and HER2 overexpression, clinicopathological features and patient survival. Seventy patients with stage I-IV colon adenocarcinoma were prospectively and retrospectively included in this study between 2016 and 2021. The expression of COX-2 and HER2 proteins was evaluated using tissue microarrays (4μm). Overall survival (OS) and recurrence-free survival (RFS) outcomes were compared according to COX-2 and HER2 expression status using the Kaplan-Meier method. Positive expression of COX-2 and HER2 proteins was observed in 58 (82.9%) and 2 (2.9%) cases, respectively. COX-2 expression was associated with female sex, vascular invasion, lymph node metastasis, distant metastasis, TNM stage, and poor overall survival. HER2 expression was mainly associated with younger age, presence of positive LN and LN ratios, increased recurrence, and lower recurrence-free survival rate. This study highlights the prognostic impact of COX-2 and HER2 expression in patients with colorectal cancer. The association of clinicopathological features with COX-2 and HER2 expression suggests the need to incorporate these two biomarkers into the pathomolecular classification of colorectal cancer. Based on survival analysis, COX-2 and HER2 expression were associated with shorter overall survival and recurrence-free survival in patients with colorectal cancer.
8. Factors predicting incidence of nontuberculous mycobacteria in an era of climate change and altered ecosystems in the United States.
期刊: The Science of the total environment 发表日期: 2025-Sep-01 链接: PubMed
摘要
Nontuberculous mycobacteria (NTM) are ubiquitous environmental bacteria that cause chronic pulmonary disease. Incidence patterns have risen globally over the last several decades. Prior studies suggest that climate change may have a role in increasing incidence patterns. We analyzed NTM incidence from two US-based populations: Medicare beneficiaries and persons with cystic fibrosis (pwCF). We identified predictors of NTM incidence with time-lagged meteorological and severe weather event covariates across US climate zones. The average annual incidence of NTM was 30.4 per 100,000 for the Medicare population and 2071.4 per 100,000 pwCF, with both populations showing rising incidence over the study period. We found that several factors predicted NTM incidence risk for the Medicare population and pwCF. In the Southeastern US particularly, floods were predictors of NTM incidence risk and across the mid-latitude US, dust storms were predictors of incidence. Air pressure, cloud cover, precipitation, and the number of days above various temperature thresholds were consistent predictors of NTM incidence across climate zones. The lag time between predictive meteorological variation or weather events and NTM incidence varied by zone and population studied. Geographic heterogeneity exists in the meteorological and severe event factors predictive of NTM incidence, evidenced by data from two high-risk study populations in the US. The role of continued climate change in the spatial and temporal distribution of NTM incidence merits further research.
9. Stroke risk after head and neck cancer diagnosis and treatment in a Real-World clinical cohort: Running title: Treatment in a Real-World clinical cohort.
期刊: Oral oncology 发表日期: 2025-Sep-01 链接: PubMed
摘要
Head and neck cancer (HNC) patients are at an elevated risk of stroke, necessitating targeted research to better understand and mitigate their risk. Among 8,469 HNC patients, with mean age of 63.3 years, in the Flatiron Health database that includes electronic medical record (EMR) data from 280 cancer centers across the United States from 2003 to 2019, the age-adjusted stroke incidence rate, using Poisson regression model, was 307 events per 100,000 person-years, 1.7 times higher than in the general population (184 events per 100,000 person-years). Overall, the incidence among smokers was 445.1 events per 100,000 person-years. Among those who developed stroke within 1 year post HNC diagnosis, 93.94 % were smokers and 6.06 % were non-smokers. Stroke risk was 1.7-fold times higher among older (>60 years) compared to younger patients (<=49 years) after adjusting for covariates. Patients receiving radiation therapy exhibited a higher stroke incidence (2358.5 events per 100,000 person-years) compared to those undergoing chemotherapy alone (237.5 events per 100,000 person-years) suggesting a potential association between treatment modality and stroke risk. Patients with both hypertension and diabetes had a 7.4-fold (95 % CI: 3.727, 14.732, p < 0.0001) greater risk of stroke occurrence and those with hypertension alone had a 3.6-fold (95 % CI: 2.067, 6.252) higher risk of stroke, compared to those without hypertension or diabetes (p < 0.0001). These findings underscore the importance of integrating stroke evaluation into follow-up care for HNC patients, particularly in individuals with high risk factors.
10. Experiences and Needs in the Dietary Management of Chronic Kidney Disease: A Qualitative Study of Patient, Caregiver and Healthcare Professionals' Perspectives.
期刊: Nursing & health sciences 发表日期: 2025-Sep 链接: PubMed
摘要
Dietary management is crucial in the disease management of patients with chronic kidney disease (CKD). However, there is still a lack of research on the genuine experiences and needs of patients, caregivers, and healthcare professionals involved in CKD dietary management, especially in the Chinese context. To explore the experiences and needs of Chinese patients with CKD, caregivers, and healthcare professionals regarding dietary management. A descriptive qualitative study was conducted to gather data using semi-structured in-depth interviews, with data examined by thematic analysis. A total of 36 participants were involved in the interviews. Five themes were identified in the study: (1) Dilemmas: disease threat perception; (2) Practice divide: obstacles to the implementation of the guide; (3) Disease adaptation: reconstruction of dietary identity; (4) Precision education: demand-driven educational strategies; (5) Multilevel collaboration: building support networks. These findings establish a scientific foundation for policy formulation and enhancements in medical practice. Future research should evaluate the practicality of dietary guidance frameworks and develop intelligent assistive tools to support dietary decision-making, thereby promoting sustainable improvements in patients’ dietary management.
11. Sex Differences in Cardiovascular Health Status and Long-Term Outcomes in a Primary Prevention Cohort.
期刊: JACC. Advances 发表日期: 2025-Sep-01 链接: PubMed
摘要
Poor cardiovascular health quantified by 8 health behaviors and factors is associated with incident cardiovascular disease (CVD). However, it is not clear if this association differs between women and men. The aim of the study was to determine whether the association between cardiovascular health status and incident CVD events differs by sex. Adults enrolled in the Ontario Health Study (March 2009-December 2017) with no prior CVD were included. Cardiovascular health was assessed based on the presence of ideal diet, sleep, physical activity, smoking, body habitus, blood glucose, blood cholesterol, and blood pressure. CVD events were ascertained to March 31, 2023. The association between ideal, intermediate, and poor health and outcomes was assessed using age-adjusted, cause-specific models, including interaction terms for sex. The cohort consisted of 175,098 individuals (61.4% women, mean age 47 years). Compared to men, more women had ideal cardiovascular health (9.1% vs 4.6%), while fewer women had poor cardiovascular health (21.9% vs 30.5%). Compared to ideal cardiovascular health, the age-adjusted HR for intermediate cardiovascular health was 2.31 (95% CI: 1.72-3.11) in women, which was greater than the HR of 1.57 (95% CI: 1.16-2.11) in men. Similarly, the HR for poor cardiovascular health was 5.08 (95% CI:3.78-6.84) in women and nearly double the HR of 2.54 (95% CI: 1.89-3.41) in men (P < 0.01 for interaction). In this primary prevention cohort, as cardiovascular health status declined, the relative impact on the future rate of CVD was greater for women than for men. This supports sex-specific health promotion strategies to improve health status and outcomes.
12. Factors influencing HPV vaccine initiation and intentions among Central American immigrant fathers in the United States: An exploratory cross-sectional study.
期刊: Vaccine 发表日期: 2025-Sep-01 链接: PubMed
摘要
Research on HPV vaccine uptake among Latino populations is growing, yet Central American immigrant fathers remain underrepresented. This exploratory cross-sectional study examined HPV vaccine knowledge, attitudes, and behaviors (KAB) among Central American fathers from El Salvador, Guatemala, and Honduras residing in the U.S. It aimed to identify sociodemographic, cultural, and health-related factors associated with vaccine initiation and intentions, with a focus on length of U.S. residence. A convenience sample of 76 fathers completed a telephone-administered survey assessing HPV-related KAB. Descriptive and inferential statistics were used to examine differences by years in the U.S. (<19 vs. ≥19), and multivariable logistic regression assessed predictors of vaccine initiation and intentions. Overall awareness of HPV (72.4 %) and the HPV vaccine (64.5 %) was moderate, with no significant differences by length of residency. HPV-related knowledge was generally high, though recent immigrants were more likely to know condom use reduces HPV transmission, while long-term residents were more likely to reject common misconceptions. Despite favorable attitudes, concerns about safety and timing remained high, especially among long-term residents. Only 13.2 % of children had received the vaccine, and just 14.5 % of fathers reported a provider recommendation. Recent immigrants reported higher vaccination intentions, particularly for sons. Multivariable analysis showed that positive attitudes-but not knowledge-significantly predicted vaccine initiation. No factors significantly predicted vaccine intention. These findings underscore the need for culturally tailored interventions that build trust, address hesitancy, and engage providers. Involving fathers is critical to improving HPV vaccine uptake and reducing disparities in Central American immigrants.
13. Neurodevelopmental effects of perinatal exposure to cannabis on progeny: A narrative review.
期刊: Drug and alcohol dependence reports 发表日期: 2025-Sep 链接: PubMed
摘要
The certainty of effects on neurodevelopmental outcomes resulting from perinatal cannabis exposure is yet to be established. This review synthesizes current clinical and preclinical evidence on neurodevelopment and related functional outcomes in offspring exposed to cannabis during pregnancy or early childhood. Additionally, gaps in the literature and suggestions to bridge these gaps are provided. A PubMed database search identified highest level of evidence studies focusing on in utero and early childhood cannabis exposure using keywords broadly describing outcomes alongside informal, spontaneous, and reference searches to supplement search hits. Priority was given to recent clinical studies. Findings were categorized into cognitive measures (memory, attention, and executive functioning), and diagnosis of mental health disorders (including: autism spectrum disorder [ASD], Attention deficit and hyperactivity disorder [ADHD], depression, anxiety, learning delays, and school-related performance). `. Findings on effects on cognition, autism, and learning are not consistent; however, compared to children who were unexposed, prenatally exposed children consistently have higher ADHD risk, and no significant association with anxiety and depression. Exposure to higher concentrations of tetrahydrocannabinol was found to be associated with more aggressive behavior in males compared to females. Most findings on perinatal cannabis exposure remain inconclusive. To enhance our understanding of associated neurodevelopmental effects, future research should reassess exposure over time, employ standardized cognitive measures, use reliable exposure assessments, and methods that consider cannabis concentration and composition across generations.
14. VR- or lecture-based training? The role of culture in safety training outcomes.
期刊: Applied ergonomics 发表日期: 2025-Sep-01 链接: PubMed
摘要
Virtual reality (VR) training provides immersive, risk-free experiences that leverage multisensory integration to improve memory retention, presence and embodiment to strengthen engagement and attention, and situational learning to promote transfer of training to real-world contexts. Adding gamification through serious games (SG) further enhances engagement and active learning. This study validates a VR-SG safety training previously evaluated in Colombia, now applied to 74 professional roofers in Germany comparing ViStra (VR-SG) with LeStra (lecture-based with problem-based learning). Using Kirkpatrick’s model, we assessed reaction, cognitive and attitudinal outcomes, self-reported behavior, and safety climate through validated questionnaires. Both programs improved cognitive and attitudinal outcomes, with no significant differences. No effects were found for behavior or safety climate. Thus, ViStra matched LeStra’s effectiveness. Post hoc comparison with Colombian data suggests cultural factors influence some outcomes, highlighting the importance of adapting training strategies to cultural contexts for future safety training strategies in diverse work environments.
15. Prospective long-term follow-up of patients with idiopathic environmental intolerance attributed to electromagnetic fields after a provocation trial.
期刊: Ecotoxicology and environmental safety 发表日期: 2025-Sep-01 链接: PubMed
摘要
Previous short-term follow-ups of idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) found no patients recovered after receiving provocation trials, and only a small portion were willing to consider something else caused their symptoms, although levels of their symptoms and concerns decreased. Few long-term follow-ups have been conducted, so we conducted a study to fill the data gap. We recruited participants of the initial provocation trial between 2010 and 2015 to assess changes in symptoms and concerns related to EMFs and the reversibility of IEI-EMF. The same questionnaire used in the trial was administered through telephone interviews. Of the 147 participants recruited, 70 completed the follow-up, including 35 IEI-EMF patients and 35 referents. Of the patients, 60 % were willing to consider something else caused their symptoms, and 62.9 % reported recovery from IEI-EMF after the trial in 1.80 years on average, among whom 86.4 % reported idiopathic recovery. Most of the proportions of symptoms and concerns related to EMFs among patients decreased after the trial although changes in concerns between the study groups did not reach significant differences. In conclusion, different from the previous short-term follow-ups, most patients recovered in our long-term follow-up. Most of recovered cases were idiopathic, indicating IEI-EMF is self-limited in most cases given sufficient time. Most of patients were willing to consider something else caused their symptoms, indicating most cases of IEI-EMF might be attributable to nocebo effects. Our findings suggest a possible therapeutic effect of provocation trials, which needs to be confirmed by further randomized controlled intervention studies.
16. Current status and regional differences in disaster planning and preparedness for home oxygen therapy: Insights of the Japanese White Paper on Home Respiratory Care 2024.
期刊: Respiratory investigation 发表日期: 2025-Sep-01 链接: PubMed
摘要
Disaster planning and preparedness for home oxygen therapy (HOT), including regional variations, have not been fully clarified in Japan. Herein, we analyzed data from the Japanese White Paper on Home Respiratory Care 2024 to investigate the current status regarding this. Data from medical institutions administering HOT (physician survey), patients receiving HOT (patient survey), and employees of HOT service providers (provider survey) who answered questions regarding disaster were analyzed. Data from 398 hospitals and clinics (physician survey), 280 patients (patient survey), and 297 employees from HOT service providers (provider survey) were examined. The physician survey showed that 8.8 % of medical institutions had developed plans for disaster management, and 24.9 % had provided instructions on disaster management. No regional differences in the physician survey were detected. The patient survey showed that 28.9 % of patients had prepared for a disaster, and 21.1 % had received instructions on self-management. Regional differences in patient preparedness and education were observed. Moreover, the percentage of patients who prepared for disaster was significantly higher when patients received instructions (p < 0.0001). Based on the provider survey, 77.1 % and 97.0 % of the employees had used a disaster response system and developed a manual for disaster response, respectively, and 77.4 % responded that stockpiled cylinders were adequately arranged. No regional differences in the provider survey were detected. Effective disaster response, resilience building, and continuity of care for patients receiving HOT require coordinated integration of medical institutions, patients, and HOT service providers, along with active collaboration from local governments.
17. Deploying ambient clinical intelligence to improve care: A research article assessing the impact of nuance DAX on documentation burden and burnout.
期刊: Future healthcare journal 发表日期: 2025-Sep 链接: PubMed
摘要
Occupational burnout among clinical care providers, due in part to documentation burden, has reached crisis level. This study measured the effect of using new clinical documentation software, an ‘ambient clinical intelligence’ (ACI) program, to reduce the documentation workload and improve provider wellbeing. This was a randomised, control study with a step-wedge design. Providers were randomly assigned to use ACI early or late in the study. Medical records metadata captured time spent on documentation. Measures of burden and burnout were collected monthly. ACI significantly reduced documentation burden, provider frustration and burnout. Providers spent less documentation time each day, and 2.5 h less per week of off-hours documentation. This study demonstrates that the use of ACI does indeed relieve the documentation burden and had both subjective and objective benefits. The widespread use of ACI has the potential to alleviate the crisis of physician burnout.
18. Obesity, metabolic health, and brain health: Insights from a prospective cohort study.
期刊: Journal of affective disorders 发表日期: 2025-Aug-31 链接: PubMed
摘要
Metabolically healthy obesity (MHO) has been linked to an increased risk of cardiovascular disease, but its link to neurological and mental health remains unclear. This cohort study explored associations between metabolic-obesity phenotypes and multiple brain-related disorders. This population-based prospective cohort study included 318,103 UK Biobank participants with a median follow-up of 13.2 years. MHO was defined as BMI ≥ 30 kg/m2 and at least four of six metabolic biomarkers. Outcomes included stroke, anxiety, depression, bipolar disorder, dementia, and Parkinson’s disease (PD) that were defined by ICD-10 codes. Cox regression models were performed to examine associations of metabolic-obesity phenotypes with neurological and mental disorders. Compared to metabolically healthy non-obesity (MHN) individuals, MHO participants had significantly elevated risks of stroke (HR, 1.11; 95 % CI: 1.03-1.20), anxiety (HR, 1.16; 95 % CI: 1.08-1.23), and depression (HR, 1.43; 95 % CI: 1.34-1.52). Elevated stroke risks were also observed in metabolically unhealthy non-obese (MUN) and metabolically unhealthy obese (MUO) groups. Similar patterns were found for anxiety and depression. Furthermore, stratified analyses showed significantly increased dementia risk in MUN (HR, 1.35; 95 % CI: 1.18-1.55) and MUO (HR, 1.27; 95 % CI: 1.10-1.47) among participants aged under 65, but not in older individuals. The study found that MHO and MUO are significantly associated with elevated risks of brain-related disorders, including stroke, anxiety, and depression, while dementia risk is more likely linked to metabolically unhealthy states, irrespective of obesity. These findings highlight the importance of both metabolic health and normal weight to improve brain health.
19. Mutation profiling, evolution analysis, molecular dynamics simulation, and functional characterization of Omicron sub-strains.
期刊: Virus research 发表日期: 2025-Aug-31 链接: PubMed
摘要
The ongoing mutation and evolution of SARS-CoV-2 have posed a severe threat to global health, and their functional impact remains to be further characterized. Here, we analyzed the selection pressure from 49 Omicron sub-strains at the gene and amino acid levels. We also examined the impact of mutations on the binding affinity between the receptor binding domain (RBD) and angiotensin-Converting Enzyme 2 (ACE2) and evaluated the immune escape ability of RBD responding to the monoclonal antibodies (mAbs) through molecular dynamics simulation on eight representative Omicron sub-variants (B.1.1.529, BA.2, XBB.1.5, BA.2.86, JN.1, KP.2, KP.3, and KP.3.1.1). We identified 12 positive selection mutation sites on the viral S protein, including 11 mutation sites in the N-terminal domain (NTD) and RBD regions. A large number of accumulated mutation sites led to an increase in the receptor binding affinity of B.1.1.529 and BA.2.86. In particular, the “saltatory” evolution of BA.2.86 reached to its maximum binding affinity. The E484K mutation exhibited the highest binding affinity in the BA.2.86 and its descendants. New mutation sites either did not affect the binding affinity (R346T, L455S and F456L) or decrease the affinity (K356T and Q493E), reflecting the fluctuation of total receptor binding force. Mutations and shortened conformational epitopes on RBD may mediate the immune escape in the variants of BA.2.86. Moreover, we revealed that the ABBV-47D11 monoclonal antibody could widely bind to the RBD mutation sites of various mutant strains. Our findings may help understand the evolution of SARS-CoV-2 variants and develop novel strategies against SARS-CoV-2 infection.
20. From waste to water savior: Fe-Mn-boosted waste-derived cellulose for sustainable tetracycline treatment.
期刊: International journal of biological macromolecules 发表日期: 2025-Aug-31 链接: PubMed
摘要
Selective removal of tetracycline (TC) from antibiotic-contaminated wastewater represents one of the most effective strategies for promoting environmentally sustainable ecosystems, given the increasing persistence of tetracycline effluents from wastewater treatment processes. Unlike conventional strategies aimed at developing adsorbents with high adsorption capacities for the removal of TC from aqueous solutions, there is a growing interest in designing and creating environmentally friendly, cost-effective adsorbents made from readily available waste materials. Hence, an environmental-friendly adsorbent prepared from newspaper waste as source of cellulose and covering provided cellulose with Fe and Mn cluster nanostructures (FeMn NCs/ waste-derived cellulose) through a series of universally applicable methods. From a selectivity standpoint, prepared adsorbent indicated that in the presence of competing anions have maintained TC adsorption efficiency above 80 %. Thanks to the presence of Fe and Mn NCs, which facilitate fast adsorption kinetics and enhance mass transport of TC to the active sites of the adsorbent, along with their acceptable regeneration ability (maintaining a removal efficiency of over 80 % after four cycles), the FeMn NCs/waste-derived cellulose achieved a maximum adsorption capacity for TC of 103 mg g-1, utilizing 0.3 g L-1 of adsorbent and 10 mg L-1 TC. It can be inferred that enhancing porous properties, introducing various and abundant functional groups, and creating a high-alkalinity adsorption microenvironment on the surface of the adsorbent highlight the crucial role of Fe and Mn NCs. Overall, this study pioneers a promising frontier in the design of cost-effective and environmentally friendly adsorbents, showcasing remarkable potential to enhance the performance of adsorption systems across a wide range of applications.
21. Treeshrews as a Potential Reservoir: First Detection of Dengue Virus Serotype 2 in Malaysian Treeshrew Faeces.
期刊: Journal of virological methods 发表日期: 2025-Aug-31 链接: PubMed
摘要
Arboviruses are transmitted to humans and animals by arthropods and can be fatal. Dengue fever remains a major mosquito-borne disease in tropical regions, primarily spread by Aedes aegypti and Aedes albopictus. Despite vector control and vaccine efforts, dengue virus (DENV) continues to pose serious public health challenges in Malaysia. While non-human primates are known reservoirs in sylvatic cycles, the role of other mammals like treeshrews (Tupaia glis) is poorly understood. This study screened wild treeshrews in suburban Semenyih, Malaysia, for DENV and its serotype. From 2023 to 2024, fecal and urine samples were collected and pooled for molecular screening. Viral RNA was extracted and tested via RT-PCR targeting the Capsid-Premembrane (C-prM) region. Of 11 samples, three (27.3%) were positive for DENV-2. Sequence analysis revealed the cosmopolitan genotype II, typically linked to human transmission, rather than sylvatic strains. Virus isolation in Vero and C6/36 cells showed cytopathic effects, though contamination hampered results. These findings suggest treeshrews may serve as incidental reservoirs or amplifying hosts of DENV-2, highlighting the need for wildlife surveillance to better understand dengue transmission and guide public health responses.
22. Norovirus Genomes Detected from the Guillain Barre Syndrome (GBS) Cases in a community outbreak in Pune, India, 2025.
期刊: The Journal of infection 发表日期: 2025-Aug-31 链接: PubMed
摘要
In 2025, Pune, India, witnessed an unprecedented surge in Guillain-Barré Syndrome (GBS) cases, raising urgent public health concerns. GBS, a rare neurological condition often linked to infections, demanded immediate epidemiological and molecular scrutiny. Evidence from earlier studies points to infectious agents like Campylobacter jejuni, cytomegalovirus, and enteric viruses as common triggers. Environmental conditions and regional pathogen variations were considered potential contributors to the outbreak. To uncover the cause, a broad molecular screening was initiated to detect any known or emerging infectious agents. A comprehensive molecular screening was conducted for 19 pathogens, including established GBS-linked and enteric pathogens. Advanced genomic techniques, including phylogenetic and mutation analysis, were employed to characterize the detected pathogens. Two major pathogens, Campylobacter jejuni and Norovirus, were identified by using molecular methods. Whole-genome sequencing of 12 representative strains using genotying tool revealed their classification into genogroup II within three major genotypes: GII.16[P16] (n=9, GBS-associated), GII.17[P17] (n=2), and GII.4 Sydney[P16] (n=1). Phylogenetic analysis based on VP1 and RdRp genes confirmed genotyping and revealed that all norovirus strains from GBS patients clustered within a potential distinct Indian sub-lineage, closely related to strains reported from the Russia, USA and Germany, suggesting possible global dissemination. The GII.17 strains belonged to the globally dominant Romania-2021-like lineage, while the GII.4 strain clustered with the pandemic Sydney[P16] variants. Mutation analysis revealed genotype-specific patterns. GII.17 strains had the highest number of non-synonymous mutations (>160), mostly in ORF1 (RdRp; RNA-dependent RNA polymerase), suggesting replication adaptation. In contrast, GBS-associated GII.16 strains showed increased mutations in ORF2 (VP1; major capsid protein), likely driven by immune selection pressures. These findings highlight the importance of genomic surveillance to identify emerging norovirus lineages and their potential clinical significance. Continued monitoring is vital to understand norovirus evolution and its possible connection to GBS. Indian Council of Medical Research-National Institute of Virology, Pune, India (No. EVI 2401).
23. Clinical Outcomes of Periodontal Regeneration Using Biologic Agents Alone or in Combination with Graft Materials for Intrabony Defects: A Systematic Review and Meta-Analysis.
期刊: Journal of dentistry 发表日期: 2025-Aug-31 链接: PubMed
摘要
This systematic review with meta-analysis investigated whether combining bone grafts with biologic agents enhances clinical outcomes compared to biologic agents alone in the regenerative treatment of periodontal intrabony defects. Electronic searches were conducted in PubMed, Web of Science, and Scopus up to December 18, 2024, following PRISMA guidelines. Manual screening of major periodontal journals complemented the search. Randomized controlled trials with ≥6 months follow-up were included if they compared biologic agents alone (e.g., enamel matrix derivative, platelet-rich fibrin, recombinant growth factors) to their combination with bone grafts in the treatment of intrabony defects. Primary outcomes were probing pocket depth (PPD) reduction, clinical attachment level (CAL) gain, and radiographic bone level (RBL) gain. Twenty-one RCTs (739 patients, 828 defects) met inclusion criteria. Combination therapy resulted in significantly greater PPD reduction (mean difference: 0.38 mm; p = 0.02) and RBL gain (0.81 mm; p = 0.003). CAL gain showed a favorable but non-significant trend (0.30 mm; p = 0.22). Gingival recession was slightly lower in the graft group, while BoP and PI were unaffected. Subgroup analyses suggested that PRF and growth factors derive more benefit from grafting, whereas enamel matrix derivatives (EMD) offered comparable outcomes with or without grafts. Limited yet measurable improvements in regenerative outcomes are obtained with the addition of graft materials to PRF and growth factors, while EMD seems to yield comparable outcomes regardless of grafting. These findings suggest that while grafting can enhance certain clinical parameters, its added value may depend on the specific biologic agent used, supporting a selective rather than systematic use in periodontal regenerative procedures.
24. Genetic evidence supports trialling IL-6 inhibition in influenza.
期刊: The Journal of infection 发表日期: 2025-Aug-31 链接: PubMed
摘要
25. Endocrine Disrupting Chemicals and Female Sexual Health: An Emerging Research Priority.
期刊: Environmental research 发表日期: 2025-Aug-31 链接: PubMed
摘要
Female sexual function is important for positive sexual expression, relationship satisfaction, and overall health and wellbeing. Female sexual dysfunction (FSD), which affects ∼40% of premenopausal women, may manifest as issues with sexual desire, arousal, orgasm, or pain during intercourse. The etiology of FSD is multifactorial but remains incompletely characterized, and endocrine disrupting chemicals (EDCs) may play an underappreciated role in its development. In this commentary, we identify female sexual function as a health outcome of interest for environmental health scientists by providing a high-level overview of the physiological systems underpinning sexual health, describing the hypothesized toxicological effects of EDCs on sexual function, and discussing research needs to advance science in this area. Female sexual function is understudied in environmental health research as an important and distinct health endpoint. Limited toxicological and epidemiological evidence suggests that EDCs may influence sexual health given their ability to dysregulate neurological and hormonal processes underlying female sexual function. Focusing future research efforts on EDCs and female sexual function will help to inform clinical practice, policies, and public health interventions with important implications for female sexuality, health, and well-being.
26. Long-Term Aspirin Use and Heart Failure Incidence: A Patient-Level Pooled Analysis Study.
期刊: The American journal of medicine 发表日期: 2025-Aug-31 链接: PubMed
摘要
The effect of chronic aspirin use on the development of heart failure remains uncertain, and no prior observational study has evaluated it as a time-dependent exposure. We analyzed data from four prospective cohort studies involving 26,941 individuals free of cardiovascular disease but at risk for heart failure. The baseline mean age was 60.7 years; 55.6% were female and 65.4% were White. Time-dependent information on aspirin use and heart failure risk factors was systematically collected, and participants were longitudinally followed for incident heart failure. Using the parametric g-formula, we estimated the effect of two hypothetical interventions-consistent aspirin use and never using aspirin-on heart failure incidence. Covariates included baseline age, sex, race, smoking, alcohol consumption, study-related factors, and time-dependent variables such as body mass index, systolic blood pressure, low-density lipids, triglycerides, blood glucose, creatinine, and medication use (anti-hypertensive, anti-diabetic, lipid-lowering, and anticoagulant). Over a median follow-up of 14.8 years (IQR: 8.5-22.5), 5,899 heart failure cases occurred. At year 32, as estimated by the model and compared with the natural course (no intervention), continuous aspirin use increased heart failure risk by 7% (risk ratio [RR] 1.07, 95% CI 1.05-1.08), while never using aspirin decreased risk by 6% (RR 0.94, 95% CI 0.92-0.95). These effects persisted in subgroup analyses by sex and by baseline age (<60/≥60 years). Long-term aspirin use increased the risk of heart failure in individuals free of cardiovascular disease, as estimated through a hypothetical intervention using the g-formula.
27. Early Advanced Therapies and Real-World Outcomes in Crohn's Disease: A Population-Based Comparison of Two Incident Cohorts in Navarra.
期刊: Gastroenterologia y hepatologia 发表日期: 2025-Aug-31 链接: PubMed
摘要
The introduction of biologic therapies has transformed the management of Crohn’s disease (CD), yet few studies have evaluated their impact on real-world outcomes over time. We aimed to compare two population-based cohorts of CD patients in Navarra, Spain, diagnosed in 2001-2003 (cohort A) and in 2017 (cohort B), to assess whether early use of advanced therapies has altered disease trajectory. This prospective, multicentre cohort study included adult patients with confirmed CD from two periods. Clinical characteristics, treatments, hospitalizations, and surgical outcomes were analysed over five years. Time-to-event analyses were performed using Kaplan-Meier curves and Cox regression models. A total of 128 patients were included (83 in cohort A, 45 in cohort B). At diagnosis, immunomodulators were used in 1.2% of cohort A vs. 21% in cohort B, and biologics in 0% vs. 51%, respectively. Initiation of immunomodulators (hazard ratio [HR]: 1.94; 95% CI: 1.11-3.39) and biologics (HR: 5.42; 95% CI: 2.57-11.42) occurred earlier in cohort B. Hospitalization at diagnosis was more frequent in cohort A (47% vs. 22%), and five-year hospitalization rates were significantly lower in cohort B (34% vs. 63%; HR: 0.52; 95% CI: 0.28-0.96). No significant differences in intestinal or perianal surgery rates were observed between cohorts. Earlier and more widespread use of advanced therapies in CD has been associated with reduced hospitalization over time, although surgical rates have remained stable. These findings suggest a shift toward earlier and more intensive treatment strategies in routine clinical practice.
28. Amyloid beta biosensors in neurodegenerative disease.
期刊: Clinica chimica acta; international journal of clinical chemistry 发表日期: 2025-Aug-31 链接: PubMed
摘要
The accumulation of amyloid beta (Aβ) peptides in the brain is a hallmark of several neurodegenerative diseases, particularly Alzheimer’s disease. Early and accurate detection of Aβ is crucial for timely intervention and effective management of these conditions. This paper explores the role of biosensors in detecting amyloid beta, highlighting recent advancements in sensor technology that enhance sensitivity, specificity, and real-time monitoring capabilities. We discuss various biosensor platforms, including electrochemical, optical, and nanomaterial-based sensors, and their applications in both research and clinical settings. Furthermore, we examine the challenges faced in the development and implementation of these biosensors, such as biocompatibility, integration with existing diagnostic tools, and regulatory considerations. By providing a comprehensive overview of the current state of biosensor technology for Aβ detection, this study aims to underscore the potential of these innovative tools in improving neurodegenerative disease management and facilitating the development of targeted therapeutic strategies.
29. OGG1-driven pathogenesis in Kawasaki Disease: Identification and pharmacological regulation of a molecular marker validated in transgenic mice and clinical models.
期刊: Pharmacological research 发表日期: 2025-Aug-31 链接: PubMed
摘要
Kawasaki Disease (KD) is an acute systemic vasculitis affecting children and leads to severe coronary artery complications, such as aneurysms. The cause of KD remains elusive, with infections suspected as potential triggers. Diagnosis is largely dependent on clinical symptoms due to the lack of specific laboratory molecular markers. This study investigates the potential of Ogg1, a gene involved in DNA repair and inflammatory processes, as both a molecular marker and a pharmacological target for KD. Utilizing bioinformatics and molecular biology techniques, the study examined OGG1’s role in KD. Clinical validation involved total RNA sequencing of blood samples from KD patients and healthy controls, with differential gene expression analyzed. Further validation included qPCR on samples from KD patients pre- and post-treatment. Molecular docking and bio-layer interferometry explored interactions and identified regulators of OGG1. The study highlighted that Kushenol C (KC), a prenylated flavonoid from Sophora flavescens, regulates OGG1. BLI and molecular docking confirmed KC’s interaction with OGG1. In an acute Lactobacillus casei cell wall extract (LCWE)-induced KD model, KC reduced inflammation and prevented coronary artery complications in wild-type mice. Combining KC with intravenous immunoglobulin enhanced anti-inflammatory effects. Moreover, KC’s efficacy was reduced in Ogg1-knockout mice, highlighting OGG1’s dual role as a target and molecular marker. These findings suggest that OGG1 could be a promising molecular marker and pharmacological target for KD, and the identification of KC as an OGG1 regulator presents a novel therapeutic strategy that could potentially mitigate vascular complications associated with KD, opening avenues for further targeted therapy development.
30. Early Reoperations After Gastrectomy: Impact on Morbidity, Mortality, and Long-Term Oncologic Outcomes.
期刊: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract 发表日期: 2025-Aug-31 链接: PubMed
摘要
Gastrectomy is central to the curative treatment of gastric cancer but carries substantial postoperative risks. Early reoperations represent severe complications, yet their impact on long-term oncologic outcomes remains unclear. Understanding this relationship is crucial for optimizing cancer care and patient counseling. We conducted a retrospective cohort study of 466 patients who underwent gastrectomy for gastric adenocarcinoma between 2012 and 2022 at a tertiary center. Early reoperation was defined as any unplanned return to the operating room during the initial hospitalization or within 90 days of discharge from the hospital. The primary aim was to evaluate the impact of early reoperation on long-term oncologic outcomes, specifically overall survival and disease-free survival. Secondary outcomes included perioperative morbidity, mortality, and factors influencing the delivery of adjuvant therapy. Reviewer 1, Comment 1. Survival outcomes were assessed using Kaplan-Meier analysis and multivariate Cox regression. Among 466 patients, 48 (10.3%) required early reoperation, most commonly due to anastomotic leaks or bleeding. While these patients exhibited significantly worse short-term outcomes including higher rates of major complications (100% vs. 6.2%, p < 0.001), ICU admission (62.5% vs. 23.9%, p < 0.001), 90-day mortality (14.9% vs. 2.2%, p < 0.001), and reduced resumption of chemotherapy (24.4% vs. 39.6%, p = 0.047), the primary oncologic endpoint analysis revealed that reoperation was not independently associated with overall survival (HR 1.115, 95% CI: 0.711-1.751; p = 0.635) or disease recurrence (HR 0.805, 95% CI: 0.453-1.432; p = 0.461). Independent predictors of poorer long-term outcomes included postoperative infection, poor tumor differentiation, and advanced stage. Early reoperation has a significant impact on perioperative outcomes but does not independently affect long-term oncologic prognosis. Tumor biology and infectious complications are the primary drivers of survival and recurrence. These findings suggest that patients requiring early reoperation should not be considered to have compromised long-term cancer outcomes solely based on the need for surgical reintervention, emphasizing the importance of preventing major complications while maintaining focus on optimal oncologic care.
31. Progress in Antisenescence Biomaterials for Improved Osteoarthritis Therapy.
期刊: Acta biomaterialia 发表日期: 2025-Aug-31 链接: PubMed
摘要
Osteoarthritis (OA) is a degenerative joint disease closely associated with aging for which current treatments are limited primarily to symptomatic relief and fail to reverse pathological progression. A growing body of evidence indicates that the accumulation of senescent cells is a central driver of OA pathogenesis. This review systematically summarizes the latest advancements in antisenescence biomaterials for OA therapy, emphasizing their potential to overcome the limitations of conventional approaches by improving drug targeting, prolonging drug release kinetics, and increasing bioavailability. We categorize these biomaterials on the basis of their antisenescence mechanism and delivery platform, including polymeric nanoparticles (NPs), nanozymes, lipid nanoparticles (LNPs), extracellular vesicles (EVs), hydrogels, and composite hydrogels. These systems have demonstrated efficacy in selectively eliminating senescent cells through various molecular mechanisms such as modulating mitochondrial dysfunction, inflammatory signaling, DNA damage, mechanical overload and autophagy. Furthermore, this review proposes innovative strategies that integrate cellular reprogramming, organelle-targeted therapy, the artificial intelligence (AI)-guided design of antisenescence materials, and stem cell/organoid technologies to address challenges such as barriers to drug delivery and the heterogeneity of the aging microenvironment. Although these biomaterials still require further validation regarding safety, scalability, and regulatory approval for their clinical translation, antisenescence biomaterials represent multidimensional and sustainable therapeutic options for OA and hold promise for reshaping the therapeutic landscape of degenerative joint diseases by targeting the root causes of tissue degeneration. STATEMENT OF SIGNIFICANCE: Osteoarthritis (OA) is an age-related joint disease for which current therapies provide only symptom relief without halting progression. Increasing evidence shows that senescent cells drive OA development. This review summarizes recent advances in antisenescence biomaterials, including nanoparticles, nanozymes, lipid carriers, extracellular vesicles, and hydrogels. These systems improve drug targeting, prolong release, and enhance bioavailability while selectively eliminating senescent cells through mechanisms such as regulating mitochondrial dysfunction, inflammation, and DNA damage. We also highlight innovative approaches integrating cellular reprogramming, organelle-targeted therapy, AI-guided design, and stem cell technologies. Although further validation is required, antisenescence biomaterials offer sustainable strategies that target OA at its root, reshaping future treatment of degenerative joint diseases.
32. A Single Amino Acid in PBP1a Drives High-Level Penicillin and Amoxicillin Resistance in Streptococcus suis.
期刊: International journal of antimicrobial agents 发表日期: 2025-Aug-31 链接: PubMed
摘要
Streptococcus suis is an important zoonotic pathogen that causes severe diseases in both humans and pigs, with β-lactam antibiotics serving as the primary treatment. However, resistance to penicillin and amoxicillin has been steadily increasing, and the mechanisms underlying their resistance remain poorly understood. In this study, we analyzed 534 S. suis strains collected from diseased and healthy pigs in China between 2005 and 2024. Among them, 123 strains exhibited high-level resistance to penicillin (minimum inhibitory concentration (MIC) ≥ 8 µg/mL), and 78 also displayed co-resistance to amoxicillin. Amino acid sequence alignment of penicillin-binding proteins (PBPs), molecular docking, acylation efficiency assays, site-directed mutagenesis, and MIC testing revealed that the S695A mutation in PBP1a significantly reduces its binding affinity to penicillin and amoxicillin, contributing to high-level resistance. Substituting alanine (A) with serine (S) at position 695 in the highly resistant S. suis strain YS682 resulted in a 64-fold reduction in penicillin resistance (MIC decreased from 128 µg/mL to 2 µg/mL) and a 16-fold reduction in amoxicillin resistance (MIC decreased from 32 µg/mL to 2 µg/mL). Furthermore, 95.56% (366/383) of penicillin-susceptible strains carried S at position 695 of PBP1a. This study provides new insights into the molecular mechanisms driving penicillin and amoxicillin resistance in S. suis.
33. Differential life cycle toxic effects and molecular mechanisms of Di(2-ethylhexyl) phthalate (DEHP) exposure on the female reproductive system.
期刊: Toxicology 发表日期: 2025-Aug-31 链接: PubMed
摘要
Di(2-ethylhexyl) phthalate (DEHP), the most prevalent plasticizer worldwide, can enter the human body via various exposure pathways, including ingestion, inhalation, skin contact, and medical applications. It has been observed to exhibit characteristic patterns of accumulation in the female reproductive system. Research has demonstrated that DEHP poses a threat to reproductive health in females across various life stages. Exposure during childhood has been demonstrated to induce central precocious puberty (CPP). Exposure during reproductive age has been shown to be closely associated with reduced fertility, reproductive system tumors, polycystic ovary syndrome (PCOS), and increased risk of endometriosis. Furthermore, exposure during the perinatal period has been demonstrated to increase the risk of embryo implantation failure, placental dysfunction, and abnormal ovarian development in offspring. The toxic effects of DEHP exhibit transgenerational transmission characteristics, with its metabolic products’ endocrine-disrupting activity and oxidative stress-inducing capacity being the core toxic factors. This study integrates toxicological evidence linking DEHP exposure to female reproductive damage, providing important references for environmental health risk assessment and the prevention and control of female reproductive diseases.
34. Intra-day and inter-day variations of methylmercury and inorganic mercury concentrations in breast milk.
期刊: Environmental research 发表日期: 2025-Aug-31 链接: PubMed
摘要
There is little information regarding the concentrations and variability of methylmercury (MeHg) in breast milk. This study examines the variations in the concentrations of total mercury (THg), MeHg, and inorganic mercury (IHg) in breast milk and suggests a method for collecting breast milk samples for MeHg research. Breast milk samples were obtained from 11 lactating women, 3-5 months after birth. Mercury species in breast milk were measured by high-performance liquid chromatography with inductively coupled plasma mass spectrometry. Breast milk was examined for foremilk and hindmilk, intra-day (morning, afternoon, evening), and inter-day (morning for three consecutive days) variations. The variation in concentration among individuals was measured using the intraclass correlation coefficient (ICC). The mean maternal age was 33.1 years, 45.5% of children were first children, and 63.6% were male. The median MeHg in foremilk was 0.18 (0.05-0.55) ng/g and in hindmilk was 0.58 (0.18-1.18) ng/g. The variation between foremilk and hindmilk was significant for MeHg and THg but minor for IHg. Intra- and inter-day variations in mercury were analyzed using ICC, and all concentrations were >0.9, indicating high reliability. MeHg to THg ratios were 66.7% and 75.9% in foremilk and hindmilk. This study found variations in THg and MeHg concentrations between foremilk and hindmilk samples. To assess MeHg levels in breast milk, collect both foremilk and hindmilk for analysis. No intra- or inter-day variations were observed for MeHg or IHg. More infant exposure info is useful for precise analysis.
35. Autism spectrum disorder: overdiagnosis or are we facing a new pandemic?
期刊: Jornal de pediatria 发表日期: 2025-Aug-30 链接: PubMed
摘要
To critically analyze the factors influencing prevalence estimates of Autism Spectrum Disorder (ASD), considering methodological, clinical, etiological, and sociocultural determinants that shape epidemiological data and diagnostic practices. In recent decades, a substantial increase in ASD prevalence has been observed globally. This phenomenon is shaped by a combination of factors, including changes in diagnostic criteria, improved detection methods, expanded access to health services, and greater public awareness. However, it also raises concerns about possible overdiagnosis, particularly in complex clinical contexts. The interpretation of prevalence data is influenced by methodological designs, population characteristics, and sociocultural dynamics. The absence of biological markers, the high rate of psychiatric comorbidities, and disparities in access to qualified professionals further complicate the diagnostic process. These elements highlight the need for caution when comparing data across studies, time periods, or geographic regions. The ASD prevalence reflects a multifaceted process that demands careful and comprehensive interpretation. A deeper understanding of this scenario requires critical reflection on how diagnoses are established, interpreted, and applied. Strengthening diagnostic practices and epidemiological approaches is essential to ensure more accurate data and support informed decision-making in health policies.
36. β blockers after myocardial infarction with mildly reduced ejection fraction: an individual patient data meta-analysis of randomised controlled trials.
期刊: Lancet (London, England) 发表日期: 2025-Aug-29 链接: PubMed
摘要
The effects of β-blocker therapy on clinical outcomes in patients with myocardial infarction and mildly reduced (40-49%) left ventricular ejection fraction (LVEF) are largely unknown. Four recently conducted randomised trials tested the efficacy of β blockers after a recent myocardial infarction in patients without reduced LVEF (LVEF ≥40%). However, none were individually powered to assess these effects in the subgroup of patients with mildly reduced LVEF. We aimed to assess the efficacy of β blockers in patients with myocardial infarction and mildly reduced LVEF during the index hospitalisation. We conducted an individual patient-level meta-analysis of patients with mildly reduced LVEF and no history or signs of heart failure from four recent clinical trials. These studies were included because they were randomised controlled trials testing long-term effects (median follow-up >1 year) of oral β-blocker therapy in patients who recently had a myocardial infarction (randomisation within 14 days) and had mildly reduced LVEF. No further studies were found in a systematic review (Jan 1, 2020 to June 26, 2025). A one-stage, fixed-effects, Cox proportional hazards regression model was used to assess the treatment effect of β blockers on the predefined primary composite endpoint of all-cause death, new myocardial infarction, or heart failure. All endpoints were independently adjudicated. This meta-analysis was registered with PROSPERO (CRD420251023480). 1885 patients with myocardial infarction and mildly reduced LVEF were included in the meta-analysis: 979 from the REBOOT trial, 422 from the BETAMI trial, 430 from the DANBLOCK trial, and 54 from the CAPITAL-RCT trial. Overall, 991 patients were assigned to β blockers and 894 to control (no β blockers). The primary composite endpoint occurred in 106 patients (32·6 events per 1000 patient-years) in the β-blocker group and 129 patients (43·0 per 1000 patient-years) in the no β-blocker group (hazard ratio 0·75 [95% CI 0·58-0·97]; p=0·031). No heterogeneity between the trials (trial-by-treatment pinteraction=0·95) or between countries of enrolment was observed (pinteraction=0·98). In patients with acute myocardial infarction with mildly reduced LVEF without history or clinical signs of heart failure, β-blocker therapy was associated with a reduction in the composite of all-cause death, new myocardial infarction, or heart failure. These results extend the known benefits of these agents in patients with myocardial infarction with reduced LVEF to the subgroup with mildly reduced LVEF. Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Danish Heart Foundation, Novo Nordisk Foundation, South-Eastern Norway Regional Health Authority, and Research Council of Norway.
37. Vericiguat across the heart failure spectrum.
期刊: Lancet (London, England) 发表日期: 2025-Aug-29 链接: PubMed
摘要
38. Vericiguat for patients with heart failure and reduced ejection fraction across the risk spectrum: an individual participant data analysis of the VICTORIA and VICTOR trials.
期刊: Lancet (London, England) 发表日期: 2025-Aug-29 链接: PubMed
摘要
Following completion of the VICTORIA trial, vericiguat was approved for the treatment of worsening heart failure with reduced ejection fraction (HFrEF) and received a class IIb recommendation in European and North American guidelines. The subsequent VICTOR trial evaluated the use of vericiguat in patients with HFrEF and no recent worsening. We aimed to assess the effect of vericiguat on clinical endpoints through pooled analyses of patient-level data from the VICTORIA and VICTOR trials. This prespecified, pooled individual participant-level analysis was conducted on data from two trials: VICTORIA, which was active from Sept 25, 2016, to Sept 2, 2019 in 42 countries, and VICTOR, which was active from Nov 2, 2021, to Feb 5, 2025 in 36 countries. The VICTORIA trial enrolled adult (aged ≥18 years) participants with HFrEF with recent worsening (defined as either hospitalisation for heart failure within the previous 6 months or outpatient use of intravenous diuretics within the previous 3 months) and increased NT-proBNP concentrations; the VICTOR trial had similar eligibility criteria but participants had no recent worsening of heart failure. Participants in both trials received contemporary background guideline-directed heart failure therapy as appropriate. The primary endpoint was a composite endpoint of cardiovascular death or hospitalisation for heart failure (also assessed individually). This study is registered with PROSPERO, CRD420251065636. Data from 11 155 patients (5050 in the VICTORIA trial and 6105 in the VICTOR trial) were included in the pooled analysis. The primary endpoint of cardiovascular death or hospitalisation for heart failure occurred in 1446 (25·9%) of 5579 patients in the vericiguat group and 1556 (27·9%) of 5576 patients in the placebo group (hazard ratio [HR] 0·91 [95% CI 0·85-0·98]; p=0·0088), with similar reductions in its individual components of cardiovascular death (0·89 [0·80-0·98]; p=0·020) and hospitalisation for heart failure (0·92 [0·84-1·00]; p=0·043) as first events. Vericiguat reduced the risk of hospitalisation for heart failure and cardiovascular death in patients with HFrEF across a broad range of clinical severity, including those receiving contemporary guideline-directed medical therapy. Vericiguat might be suitable as an additional treatment option for selected patients with HFrEF. Merck Sharp & Dohme (a subsidiary of Merck) and Bayer.
39. Influenza vaccination to improve outcomes for patients with acute heart failure (PANDA II): a multiregional, seasonal, hospital-based, cluster-randomised, controlled trial in China.
期刊: Lancet (London, England) 发表日期: 2025-Aug-28 链接: PubMed
摘要
Influenza vaccination is widely recommended to prevent death and serious illness in vulnerable people, including those with heart failure. However, the randomised evidence to support this practice is limited and few people are vaccinated in many parts of the world. We aimed to determine whether influenza vaccination can improve the outcome of patients after an episode of acute heart failure requiring admission to hospital in China. We undertook a pragmatic, multiregional, parallel-group, cluster (hospital)-randomised, controlled, superiority trial over three winter seasons in China. Participating hospitals were located in the counties of 12 provinces with the capability of establishing a point-of-care service to provide free influenza vaccination to a sufficient number of patients before their discharge, if allocated to the intervention group. No such service was used in hospitals allocated to usual care (control) but patients were informed of fee-for-service influenza vaccination being available at local community medical centres, as per usual standard of care. Hospitals were randomised (1:1) in each year, stratified by province and up to three times (ie, new randomisation for each season), to include eligible adult (aged ≥18 years) patients with moderate to severe heart failure (New York Heart Association class III or IV) and no contraindication to influenza vaccination. Patient enrolment was conducted over three consecutive winter seasons, from October in each year to March of the following year, between 2021 and 2024. All patients received usual standard of care and were followed up at 1, 3, 6, and 12 months after their hospital discharge by trained study personnel using a standardised protocol. The primary outcome was a composite of all-cause mortality or any hospital readmission over 12 months, excluding events that occurred within 30 days after hospital discharge at all sites and in the summer season only for sites in northern China. The effect of the intervention was assessed at an individual level in the modified intention-to-treat population (all randomly assigned patients with available information until the time of last follow-up, excluding censored events) with a two-level hierarchical logistic regression model that included study period (year) as a fixed effect, and hospital and hospital-period as random effects, with the censored events excluded. The trial is registered at the Chinese Clinical Trial Registry (ChiCTR2100053264). Of 252 hospitals assessed for eligibility, 196 hospitals agreed to join and were randomised in three batches at the beginning of each winter season from October, 2021, but 32 hospitals subsequently withdrew before any patients were included. Overall, 7771 participants were enrolled at 164 hospitals in each winter season between Dec 3, 2021, and Feb 14, 2024, with 3570 assigned to the influenza vaccination group and 4201 to the usual care (control) group. The primary outcome occurred in 1378 (41·2%) of 3342 patients in the vaccination group and in 1843 (47·0%) of 3919 patients in the usual care group (odds ratio 0·83 [95% CI 0·72-0·97]; p=0·019). The result was consistent in the sensitivity analysis. The number of participants with a serious adverse event was significantly lower in the vaccination group (1809 [52·5%] of 3444) than the usual care group (2426 [59·0%] of 4110; odds ratio 0·82 [0·70-0·96]; p=0·013). Influenza vaccination during a hospital admission in patients with acute heart failure can improve their survival and reduce likelihood of readmission to hospital over the subsequent 12 months. The integration of influenza vaccination into inpatient care could offer a widely applicable strategy for an underserved high-risk patient group, that is relevant to resource-limited and possibly resource-rich settings. Sanofi and the Chinese Society of Cardiology.
40. At the crossroads of policy and technological logics: Audiologists practicing hearing-aid fitting in Israel.
期刊: Social science & medicine (1982) 发表日期: 2025-Aug-26 链接: PubMed
摘要
Logics are forces driven by stakeholders’ expectations, identities, and values, and shape the professional field. Changes such as technological advancements, healthcare regulations, market demands, and an aging population can significantly impact the logics that organize professions and practices within a professional field. A qualitative research, conducted in Israel (January 2019-October 2021), explored the repercussions of these changes on the constellation of logics in the field of Israeli audiologists who practice hearing rehabilitation for adults using hearing aids. Data was collected using three focus-groups with sixteen hearing aid users, and interviews with five audiologists and nineteen other hearing rehabilitation stakeholders. Using grounded theory, data analysis revealed a dynamic constellation of logics that shapes audiologists’ work environment: the logics of the profession, regulation, the private sector (local hearing-centers and employers), technology, and the hearing rehabilitation process. Impacted by regulatory paradigms over recent decades, competitive relationships have shifted the power balance among these logics. These conflicting logics challenge audiologists, who provide complex clinical services without having control over the conditions that organize their field of practice. This research provides new insights regarding a health profession that has been underexamined, highlighting key characteristics of its field and the processes shaping it. The study proposes the attributes of coexisting logics within a field, including the nature of their influence, the extent of that influence, and its intensity. These attributes may help to unpack changes occurring within a constellation of logics in a defined field over time and may also apply to other professions.
41. Serum Galectin-9 and Decorin in relation to brain aging and the green-Mediterranean diet: A secondary analysis of the DIRECT PLUS randomized trial.
期刊: Clinical nutrition (Edinburgh, Scotland) 发表日期: 2025-Aug-23 链接: PubMed
摘要
We explored whether changes in serum proteomic profiles differed between participants with distinct brain aging trajectories, and whether these changes were influenced by dietary intervention. In this secondary analysis of the 18-month DIRECT PLUS trial, 294 participants were randomized to one of three arms: 1) Healthy dietary guidelines (HDG); 2) Mediterranean (MED) diet (+440 mg/day polyphenols from walnuts); or 3) low red/processed meat green-MED diet (+1240 mg/day polyphenols from walnuts, Mankai plant, and green tea). We measured 87 serum proteins (Olink-CVDII). We used Magnetic-Resonance-Imaging (MRI)-assessed 3D-T1-weighted brain scans for brain age calculation (by convolutional neural network) to identify protein markers reflecting the brain age gap (BAG; deviation of MRI-assessed brain age from chronological age). At baseline, lower weight, waist circumference, diastolic blood pressure, and HbA1c parameters were associated with a younger brain age than expected. Specifically, higher levels of two proteins, Galectin-9 (Gal-9) and Decorin (DCN), were associated with accelerated brain aging (larger BAG). A proteomics principal component analysis (PCA) revealed a difference in PC1 between the two time-points for participants with accelerated brain aging. Between baseline and 18 months, Gal-9 significantly decreased among individuals who completed the intervention with attenuated brain aging, while DCN significantly increased among those who completed the trial with accelerated brain aging. A significant interaction was observed between the green-MED diet and proteomics PCA, resulting in a beneficial change compared to the HDG. Participants in the green-MED diet significantly decreased Gal-9 compared to the HDG diet and from baseline. Higher serum levels of Gal-9 and DCN may indicate an acceleration of brain aging and could be reduced by a green-MED/high-polyphenol (green tea and Mankai) and low-red/processed meat diet. NCT03020186.
42. Identification and validation of chronic critical illness subphenotypes using urea-creatinine ratio trajectories.
期刊: Clinical nutrition (Edinburgh, Scotland) 发表日期: 2025-Aug-22 链接: PubMed
摘要
Chronic critical illness (CCI) is common in intensive care units (ICUs) and is highly heterogeneous. We utilized urea-creatinine ratio (UCR) trajectories to develop and validate subphenotypes and reveal the heterogeneous treatment effects of medical nutrition therapy. This retrospective study included all CCI patients from three public critical care databases. Group-based trajectory modeling (GBTM) was applied to the UCR for subphenotype development and validation. A multivariate Cox regression model was used to assess the independent associations of these subphenotypes with mortality. Generalized estimation equations were used to reveal the potential heterogeneity in medical nutrition therapy between survivors and nonsurvivors in different subphenotypes. A total of 4047 CCI patients were divided into three subphenotypes on the basis of their UCR trajectories. Stable low subphenotype had a low UCR with a slight upwards trend, the youngest age, and the fewest comorbidities. Intermediate subphenotype was characterized by a medium UCR. Stable high subphenotype had a high UCR with a rapid increase and the highest ICU mortality (14.72 %), hospital mortality (36.20 %) and 28-day mortality (39.26 %) (p < 0.05). In the multivariate Cox regression with Stable low subphenotype as control, Stable high subphenotype had increased risks of hospitalization mortality (HR: 2.74; 95 % CI: 2.01-3.72; P < 0.001), 28-day mortality (HR: 3.20; 95 % CI: 2.36-4.34; P < 0.001) and ICU mortality (HR: 2.78; 95 % CI: 1.71-4.52; P < 0.001). In CCI patients, the dose of nutritional intake within 5 days after CCI diagnosis were greater in the survival group (P < 0.05), especially survivors in Intermediate and Stable high subphenotypes. We demonstrated that longitudinal UCR trajectories during the first 10 days of ICU admission serve as robust biomarkers for predicting CCI into three distinct subphenotypes to understand patient heterogeneity. For CCI patients, higher doses of enteral nutrition and protein intake after CCI diagnosis may improve prognosis, especially for patients in the subphenotypes with the higher baseline UCR values showing an upward trend and poorer prognosis. A prospective study is needed to validate these findings, inform practice and guide future research on personalized care.
43. Clinical Characteristics and Outcomes of First Diagnosed Atrial Fibrillation: Insights from Two Prospective Registries in Europe and Asia.
期刊: Heart rhythm 发表日期: 2025-Aug-08 链接: PubMed
摘要
Clinical characteristics and outcomes in patients with atrial fibrillation (AF) vary from diagnosis to advanced stages. To assess differences in characteristics and outcomes between patients with first diagnosed AF and known AF. A post-hoc analysis of two prospective registries from Europe and Asia. The primary outcome was a composite of all-cause death and major adverse cardiovascular events (MACE), including thromboembolic events, cardiovascular death, acute coronary syndromes. Among 15,762 AF patients, those with first diagnosed AF (n=2,081, age 68±12 years, 41%female) were younger, more often female, with lower cardiovascular burden but higher prevalence of obesity, smoking, cancer. After a median follow-up of 693 days (IQR 365-735), first diagnosed AF was associated with a higher risk of the composite outcome (HR 1.311, 95%CI 1.115-1.543), all-cause death (HR 1.389, 95%CI 1.153-1.673), MACE (HR 1.269, 95%CI 1.022-1.575), thromboembolic events (HR 1.495, 95%CI 1.043-2.145). Risk of the composite outcome in first diagnosed AF patients was higher in late follow-up phase compared to early phase and among those enrolled in hospital settings than in outpatient settings. Patients with first diagnosed AF had a composite outcome risk similar to those with permanent AF (HR 0.921, 95%CI 0.771-1.101), but higher than those with paroxysmal (HR 0.650, 95%CI 0.535-0.790) and persistent AF (HR 0.676, 95%CI 0.554-0.826). A rhythm control strategy was associated with better outcomes than rate control. The higher risk of first diagnosed AF patients underscores the need for personalized, integrated management strategies that consider the heterogeneity of this arrhythmia to improve outcomes.
44. New hormonal agents and integrated strategies for non-metastatic, hormone-sensitive prostate carcinoma: the orphan setting?-a narrative review.
期刊: Chinese clinical oncology 发表日期: 2025-Aug 链接: PubMed
摘要
Most of newly diagnosed prostate carcinomas (PCas) present as non-metastatic disease, with approximately 15% of them presenting with characteristics predicting for a high-risk of relapse. Hence, specific focus has to be placed on patients affected by localised or locally advanced disease, whose chances of cure are notably higher than those of patients in advanced settings. With androgen receptor pathway inhibitors (ARPIs) and docetaxel chemotherapy improving treatment efficacy outcomes when compared to traditional androgen deprivation therapy (ADT) in the metastatic disease, clinical trials are currently investigating the activity of ARPI for clinical management of localised or locally advanced prostate patients, with the aim of preventing the cancer from spreading systemically. To provide further insight into the biological and clinical rationale of an early treatment intensification, here we review and enlist promising studies on the treatment of localised, locally advanced, and biochemically relapsed disease. Finally, we briefly review the latest experimental treatments for these early stages-including novel agents and combinations which are believed to shape the future practice. PubMed and MEDLINE databases were searched for trials focusing on the treatment of localised/locally advanced PCa, and which included the use of second-generation ARPIs. Also, proceedings from major oncology and uro-oncology meetings were screened. Our analysis has not yielded significant results supporting the implementation of second-generation ARPIs in the perioperative or neoadjuvant treatment of localised PCa. However, the data suggest these drugs may offer benefits in the adjuvant setting, following both radical prostatectomy (RP) and primary radiotherapy (RT). The design of clinical trials that explore surrogate endpoints like metastasis-free survival (MFS) or employing multi-arm trials with genomic testing could facilitate further advancements in this field, as well as research on combining ARPI treatment with inhibition of other pathways or exploiting the immune response beyond PD-1/CD276.
45. Association between long-term total sleep duration and physical activity trajectories and cardiovascular diseases among middle-aged and older adults: a 9-year longitudinal study.
期刊: Journal of geriatric cardiology : JGC 发表日期: 2025-Jul-28 链接: PubMed
摘要
It remains unclear whether sleep duration and physical activity (PA) trajectories in middle-aged and older adults are associated with different risks of cardiovascular diseases (CVDs). This study aimed to explore the trajectories of total sleep duration and PA among middle-aged and older Chinese adults and their impact on CVD risk. This study was based on the China Health and Retirement Longitudinal Study. 12009 adults aged 45 years and older from five waves were included. CVD events were measured by self-reports of heart disease and stroke. We first used group-based trajectory modeling to identify total sleep duration and PA trajectories from 2011 to 2020, and then employed logistic regression models to analyze their risk for CVD. We identified three sleep duration and PA trajectories. The risk of heart disease increased by 33% (OR = 1.31, 95% CI: 1.12-1.53) for the short sleep duration trajectory (vs. moderate sleep duration trajectory), by 40% (OR = 1.40, 95% CI: 1.06-1.84) for the high decreasing PA trajectory, and by 20% (OR = 1.20, 95% CI: 1.01-1.42) for the low stable PA trajectory (vs. high stable PA trajectory), respectively. Similar results for stroke and CVD as the outcomes were also observed, but the higher risk of stroke in the high decreasing PA trajectory group was not statistically significant. The joint effects of sleep and PA showed lower risks of heart disease and stroke in trajectories with moderate or long sleep duration and high stable PA compared with short sleep duration and a low stable PA trajectory. Short total sleep duration, high decreasing PA, and low stable PA trajectories could increase the risk of CVDs among middle-aged and older adults. Long-term moderate to long total sleep durations and high stable PA trajectories might be optimal for preventing CVDs.
46. The Dynamic Impacts of Serial Prevention-and-Control Policies Against COVID-19 Pandemic on Residents' Emergency Medical Service Demands in China Pre- and Post-Reopening: An Observational Study.
期刊: The Journal of emergency medicine 发表日期: 2025-Jul-14 链接: PubMed
摘要
China has implemented serial prevention-and-control policies against COVID-19 pandemic pre- and post-reopening, yet it was unclear whether these policy adjustments resulted in changes in residents’ emergency medical services (EMS) demands. We aimed to assess the impacts of gradual loosening and reopening policies against the COVID-19 pandemic on residents’ EMS demands. We conducted an observational study using a data set of 42,909 EMS call records from Nanning Emergency Medical Center during November 2022 to January 2023. We used joinpoint regression to reveal the temporal trends in the daily volume of EMS calls, and interrupted time series analysis to assess the dynamic impacts of serial policies against COVID-19 on the daily volume of EMS calls. The daily volume of EMS calls declined by an average of 2.378 calls per day during the period of “dynamic zero-COVID” policy. During the period of “20 new rules” policy, the daily volume of EMS calls slightly increased by an average of 5.362 calls per day. During the period of “10 new measures” policy, the daily volume of EMS calls significantly increased, by an average of 32.566 calls per day. During the “Adjustment 1” policy, the daily volume of EMS calls dramatically decreased by an average of 33.411 calls per day. During the “Adjustment 2” policy, the daily volume of EMS calls significantly continued to decrease by an average of 4.381 calls per day. Residents’ EMS demands slightly decreased during the “dynamic zero-COVID” policy, slightly increased during the “20 new rules” policy, rapidly increased during the reopening “10 new measures” policy, dramatically decreased during the “Adjustment 1” policy, and continued to decrease during the “Adjustment 2” policy.
47. Perioperative antihypertensive medications and effects on functional decline and mortality in non-cardiac surgery.
期刊: European heart journal open 发表日期: 2025-Jul 链接: PubMed
摘要
The association between perioperative antihypertensive drugs and mortality as well as physical function in non-cardiac surgeries remains unclear. We aimed to clarify the association between six antihypertensive classes and postoperative outcomes. This observational cohort study involved adults undergoing non-cardiac surgeries between 2014 and 2019 using an administrative claims database. We recruited 408 810 patients who continuously used any class of antihypertensive medication both pre- and postoperatively and 2 190 064 non-continuous users aged ≥50 years who underwent five different types of non-cardiac surgeries. The risk for overall death or functional decline, defined as a ≥20% decrease in the Barthel Index score during hospitalization, was determined using multivariable logistic regression models. All-cause deaths or functional decline occurred in 4228 (1.0%) users and 17 978 (0.8%) non-users or 20 625 (5.0%) users and 66 218 (3.0%) non-users, respectively. Among single-class users, angiotensin-converting enzyme inhibitors (ACEis) or angiotensin II receptor blockers (ARBs) showed a multivariable odds ratio (OR) of 0.74 [95% confidence interval (CI) 0.62-0.89 vs. thiazide/thiazide-like diuretics (TH)] for the composite of mortality and functional decline. Among recipients of two medication classes, calcium receptor blockers (CCBs)/ACEi or ARB usage was associated with the lowest risk for composite outcome (OR, 0.86; 95% CI, 0.81-0.91 vs. TH/CCBs). The combinations of the ≥3 classes, including TH/CCB/ACEi or ARB, displayed the lowest odds for the composite outcome. In orthopaedic surgery and gastrointestinal resection, ACEis or ARBs were associated with better survival and physical function. Perioperative use of ACEis or ARBs is associated with favourable outcomes in non-cardiac surgeries.
48. Older adults living with dementia enrolled in similar Medicare Advantage plans compared to those without dementia.
期刊: Alzheimer’s & dementia. Behavior & socioeconomics of aging 发表日期: 2025-Jun 链接: PubMed
摘要
Medicare Advantage (MA) plan selection may differ between older adults with or without dementia in unexplored ways. This study aims to characterize MA plan choice among those with dementia. We used the 2010 to 2018 waves of the Health and Retirement Study with linked Medicare enrollment data to identify MA respondents ≥ 65 years, with and without dementia. Conditional logit models examined how characteristics of MA plans affected choice. Among respondents overall, there were no differences between those with versus without dementia regarding how plan out-of-pocket cost, star rating, and type affected choice. Among the dual eligible group, those with versus without dementia were more likely to choose Special Needs Plans (difference in log odds: 0.804, p = 0.007). There were few differences in how MA plan characteristics affected choice among older adults with and without dementia. Older adults with dementia may make similar MA plan choices as those without.
49. The BrainHealth Databank: a systems approach to data-driven mental health care and research.
期刊: Frontiers in neuroinformatics 发表日期: 2025 链接: PubMed
摘要
Mental health care is undermined by fragmented data collection, as incomplete datasets can compromise treatment efficacy and research. The BrainHealth Databank (BHDB) at the Centre for Addiction and Mental Health (CAMH) establishes the governance and infrastructure for a Learning Mental Health System that integrates digital tools, measurement-based care, artificial intelligence (AI), and open science to deliver personalized, data-driven care. Central to the BHDB’s approach is its comprehensive governance framework, which actively engages clinicians, researchers, data scientists, privacy and ethics experts, and patient and family partners. This codesigned approach ensures that digital health technologies are deployed ethically, securely, and effectively within clinical settings. By aligning data collection with clinical and research goals and harmonizing over 12 million data points from 33,000 patient trajectories, the BHDB enhances data quality, enables real-time decision support, and fosters continuous improvement. The BHDB provides a model for integrating AI and digital tools into mental health care, as well as research data collection, analyses, storage, and sharing through the BHDB Portal (https://bhdb.camh.ca).
50. The power of microbial life for the transformation towards a sustainable planet: key messages from the 2024 IUMS Congress in Florence, the city of the Renaissance.
期刊: microLife 发表日期: 2025 链接: PubMed
摘要
The 2024 International Union of Microbiological Societies Congress was held in Florence, the city of Renaissance. The theme was to increase the awareness of the power of microbial life, recognizing that it can lead the transformation towards a sustainable planet. The meeting gathered over 1400 experts from more than 90 countries and focused on the transformative potential of microbiology in addressing global challenges and aligning microbial science with the Sustainable Development Goals. Six roundtable discussions explored the pivotal role of microbiology in mitigating climate change, preparing for pandemics, producing sustainable energy, promoting a One Health approach, understanding microbiome dynamics, and developing data infrastructure. The discussions revealed that microbes are still overlooked agents in sustainable solutions. Expert panellists at the roundtables discussed microbial innovations in hydrogen and biofuel production, conversion of greenhouse gases, biomanufacturing, and soil restoration, the role of microbiome in immune health, the importance of cross-kingdom interactions, and the integration of food, environmental, and microbiomes under the One Health framework. Panels stressed the need for equitable access to vaccines, diagnostics, and data sharing, especially in the face of antimicrobial resistance. The importance of global collaboration, data repositories, and regulatory alignment, was repeatedly emphasized. The congress invited calls for the formation of an international microbiology coalition, need for interdisciplinary partnerships, increased investment in microbial technologies, updating of regulatory frameworks, and integration of microbiome science into public health and environmental policy. Microorganisms are the oldest architects of nature, able to build a sustainable future for the planet.
51. From Brain to Lung: Emerging Insights into Mesenchymal Stem Cell-Derived Extracellular Vesicle-Associated Cargos in Ischemia-Reperfusion Injury.
期刊: Journal of inflammation research 发表日期: 2025 链接: PubMed
摘要
Ischemic stroke represent major global health challenges due to their high incidence and debilitating consequences. Similarly, lung ischemia-reperfusion injury has gained increasing attention in the medical research community. The emerging concept of the lung-brain axis has shed new light on the complex interplay between these two organ systems during pathological injury, demonstrating that their interaction can significantly exacerbate ischemia- reperfusion damage. Although these conditions exhibit distinct pathophysiological characteristics, they share remarkable similarities in their genetic responses to tissue injury. Recent advancements in regenerative medicine have highlighted the therapeutic potential of mesenchymal stem cells (MSCs) in addressing both ischemic stroke and lung ischemia-reperfusion injury. Particularly, extracellular vesicles (EVs) derived from MSCs have emerged as a promising therapeutic avenue. These MSC-derived EVs exert their protective effects through multiple mechanisms, including immunomodulation, anti-inflammatory actions, anti-apoptotic effects, oxidative stress regulation, and promotion of angiogenesis. This comprehensive review aims to systematically examine the therapeutic roles of MSC-derived EVs in both cerebral and pulmonary ischemia-reperfusion injuries, while emphasizing their shared pathological mechanisms. By elucidating these common pathways, we hope to provide novel perspectives and research directions for both clinical and basic investigations into lung-brain ischemia-reperfusion injury.
52. Formulation optimization of a sucrose-free probiotic dark chocolate; rheological characteristics and viability of Saccharomyces boulardi.
期刊: Current research in food science 发表日期: 2025 链接: PubMed
摘要
The use of polyols as sucrose-replacer in chocolate formulation has increased in the last years because of the high occurrence of the metabolic syndrome. Furthermore, chocolate is a qualified vehicle of functional ingredients such as probiotics that improve health in people with diabetes. The first objective of this study was to evaluate the optimal formulation of sucrose-free dark chocolate (SFDC) using a mixture design. The impact of polyols (maltitol, lactitol, and xylitol) as sucrose replacers on the main quality properties of SFDC was determined. In the second stage, Saccharomyces boulardii was incorporated in the optimized formulation of SFDC as a probiotic product. Chocolates were stored at two temperatures (4 °C and 20 °C) for 180 days and the viability of probiotics was determined. The optimization data revealed that using 29.49 % maltitol, 51.46 % lactitol, and 19.05 % xylitol ended in the optimum SFDC with the highest desirability. The number of probiotics were retained at the functional amount after maintenance for 6 months. The highest probiotic viability was determined in the chocolates stored at 4 °C. The SFDCs possessing probiotics showed to be a promising sucrose-free functional chocolate.
53. The optimal system of care for the management of delayed sleep onset in adult ADHD in the UK: a modified Delphi consensus.
期刊: Frontiers in psychiatry 发表日期: 2025 链接: PubMed
摘要
Sleep-related disorders affect a significant number of individuals with ADHD, the most common of which has been found to be delayed sleep phase syndrome/delayed sleep onset. The presence of a sleep disorder can exacerbate ADHD symptoms and impair cognitive functions. Despite the significance of these issues, they are often overlooked, potentially leading to unsafe self-medication practices and illicit substance abuse. While the literature supports the efficacy of melatonin in treating delayed sleep onset among children and adolescents with ADHD, evidence in adults is less well-established. This consensus study aims to establish consensus among healthcare professionals regarding the overall management of adults with ADHD experiencing delayed sleep onset in the UK, with the aim of guiding good clinical practice. The process employed a modified Delphi methodology. A literature review was conducted to understand the current evidence base. A steering group of seven experts from the UK attended a virtual meeting in April 2024. During this meeting, facilitated by an independent moderator, the group identified six primary domains. Based on these domains, 40 statements were developed into an online survey for testing with a wider panel of peers.Stopping criteria for consensus rounds were established as a survey duration of four months, a target of 200 responses, and the requirement that at least 90% of the statements achieve the consensus threshold of ≥75% agreement. A total of 212 responses were received from healthcare professionals experienced in managing adult patients with ADHD and sleep disorders in the UK. All proposed statements achieved consensus, with 90% of statements achieved ≥90% agreement (n=36/40). Based on the agreement levels achieved, the steering group developed a series of recommendations for the management of delayed sleep onset in adult ADHD in the UK. Given the prevalence of sleep disorders in this population, a comprehensive management approach is essential. This should include effective treatments, such as melatonin, which could be initiated in primary care and monitored by general practitioners for newly diagnosed patients. It is also important that treatment for delayed sleep onset is continued as individuals transition from childhood into adulthood.
54. Factors Contributing to the Burden of Depression Amongst Patients Receiving Hemodialysis at Public and Private Dialysis Centres.
期刊: Indian journal of nephrology 发表日期: 2025 链接: PubMed
摘要
Chronic kidney disease poses significant morbidity on patients and subjects them to stressors in financial, occupational, and social aspects, making them vulnerable to mental health problems. We estimated the prevalence of depression in CKD patients undergoing maintenance hemodialysis (MHD) and evaluated the factors affecting it. This cross-sectional survey included 282 patients from four Apex Kidney Care centers, Mumbai. Their mental health was assessed using PHQ-9 survey, a validated questionnaire for identifying depression. Categorical variables were compared using the Chi square test and continuous variables with the Mann Whitney U test. Logistic regression was used for multivariate analysis and odds ratios were calculated. Females constituted 36.52% of the study population. There was an equal distribution of patients from charitable centers (142 patients) and private centers (140 patients). The current analysis focused on those patients (n = 60) with significant depression i.e. a PHQ-9 score of 10 or greater, and these were compared to the rest of patients (n = 222). In logistic regression, female gender (p = 0.002), catheter as access (p = 0.025), stress of food restriction (p < 0.0001) showed statistically significant positive association, whereas being employed (p = 0.022) showed statistically significant negative association with depression. The distribution of patients with significant depression in both public (21.10%) and private (21.40%) centers was equal. The prevalence of depression in MHD patients is substantial. Employment status, catheter access, and food restrictions are the modifiable factors influencing mental health. A focused approach on maximizing arterio-venous fistula creation, diet counseling, employment friendly shift adjustments, and mental health counseling can help mitigate this challenge.
55. Editorial: Editors' showcase: mental health occupational therapy.
期刊: Frontiers in psychiatry 发表日期: 2025 链接: PubMed
摘要
56. Correction: Timing matters? The effects of two different timing of high protein diets on body composition, muscular performance, and biochemical markers in resistance-trained males.
期刊: Frontiers in nutrition 发表日期: 2025 链接: PubMed
摘要
[This corrects the article DOI: 10.3389/fnut.2024.1397090.].