公共卫生研究摘要 (2025-09-05)
共收录 54 篇研究文章
1. Linking the edible plant microbiome and human gut microbiome.
期刊: Gut microbes 发表日期: 2025-Dec 链接: PubMed
摘要
The edible plant microbiome, which includes microbes in raw-eaten plants, has been recently recognized as a vehicle delivering microbes to the gut. Fruits and vegetables can carry thousands to billions of microorganisms with diverse genetic capacities on each serving. Since the ‘edible plant microbiome’ concept was introduced in 2014, notable progress has been made in understanding its microbial diversity, factors influencing it, functional traits and biomarkers, and its interconnection with the human gut microbiome. The discovery of the link between microbes in plants consumed raw and the gut microbiome establishes a possible continuum from farm to fork and health.
2. Testis expressed 50 is essential for maintaining sperm acrosome integrity during epididymal transit.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Sep-09 链接: PubMed
摘要
In mammals, sperm formation is completed in the seminiferous tubules within the testis, and sperm maturation occurs during the epididymal transit of the spermatozoa. Sperm morphology drastically changes when abnormal spermatozoa migrate from the testis to the epididymis. Detailed molecular mechanisms for sperm survival in the epididymis have not been determined yet. Globozoospermia is a cause of male infertility and is characterized by round-headed spermatozoa without acrosomes, an abnormal sperm nuclear membrane, and sperm midpiece defects. Testis expressed 50 (Tex50) is a testis-enriched gene that is expressed in mice and humans. Using CRISPR-Cas9, we generated Tex50 knockout (KO) mice and found that the KO males were sterile due to epididymal sperm malformations and impaired sperm motility. Surprisingly, electron microscopy, sperm morphology, and globozoospermia-related protein expression and localization in the KO testis were all normal. To understand this phenotype in more detail, we created TEX50-mCherry knockin mice to determine the localization of the TEX50 protein during spermatogenesis. The mCherry signals detected a ring-shaped structure surrounding the sperm acrosome and migrated to the posterior region of the sperm head. After the acrosome reaction, most of the spermatozoa retained mCherry signals. These results indicate that the Tex50 KO globozoospermia phenotype occurs after the migration of spermatozoa from the testis to the epididymis. We found that sperm membrane protein TEX50 is a putative key molecule to survive against globozoospermia-like malformations in the epididymis. It is essential for complete sperm formation and male fertility in mice.
3. Allostatic Load Mediates Associations Between Race and Ethnicity and Hypertensive Disorders of Pregnancy.
期刊: Obstetrics and gynecology 发表日期: 2025-Sep-04 链接: PubMed
摘要
To evaluate whether chronic stress exposure, measured by allostatic load (a biological measure of chronic stress embodiment, including stressors exacerbated by structural inequities [eg, structural racism]) and patient-reported perceived stress in the first trimester of pregnancy, mediates the association between self-identified race and ethnicity and hypertensive disorders of pregnancy (HDP). This was a secondary analysis of data from nuMoM2b (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be), a large prospective cohort study. We evaluated self-identified race and ethnicity as an independent variable (non-Hispanic Black, Hispanic, Asian, non-Hispanic White), and our outcome of interest was HDP (ie, gestational hypertension, preeclampsia or eclampsia). Allostatic load was operationalized with regression- and count-based approaches. Perceived stress was collected with the Cohen perceived stress scale. We investigated allostatic load and perceived stress and used causal mediation analyses with a counterfactual approach to evaluate whether they mediated the association between self-identified race and ethnicity and HDP, adjusting for age and tobacco use. Mediation analyses were conducted for each minoritized racial and ethnic group compared with non-Hispanic White participants. The sample included 645 participants who developed HDP and 2,438 participants without HDP or other adverse pregnancy outcome. Allostatic load and perceived stress varied by race and ethnicity; HDP varied by allostatic load but not perceived stress. Allostatic load was a partial mediator exclusively in the comparison of non-Hispanic Black and non-Hispanic White participants (0.027, 95% CI, 0.013-0.040, P<.001; 28.9%). Perceived stress was not a significant mediator. First-trimester allostatic load mediated the association between self-identified race and ethnicity and HDP for non-Hispanic Black and non-Hispanic White participants. This mediation effect was not observed in other racial and ethnic comparisons. These results demonstrate a physiologic pathway through which racism may contribute to adverse pregnancy outcomes and suggest that interventions targeting allostatic load reduction could help address racial and ethnic disparities in HDP.
4. Periodic Assessment of Trajectories of Housing, Homelessness, and Health Study (PATHS): Protocol for a Prospective Cohort Study of People Experiencing Homelessness.
期刊: JMIR research protocols 发表日期: 2025-Sep-04 链接: PubMed
摘要
The past decade has seen a substantial increase in the number of people experiencing unsheltered homelessness. The unsheltered population faces heightened health and social risks, yet research on their experiences remains limited. This paper presents the protocol for the Periodic Assessment of Trajectories of Housing, Homelessness, and Health Study (PATHS), a longitudinal study that leverages mobile phone technology and web-based surveys to track the housing and health trajectories of people experiencing unsheltered homelessness in Los Angeles County. Participants were recruited from the Los Angeles County Homeless Count Demographic Survey, an annual representative survey of the county’s unsheltered population. Eligibility criteria included being aged ≥18 years, having stayed in an unsheltered location or homeless shelter for at least 1 night in the past month, and residing in Los Angeles County. The study uses a web-based survey platform accessible via mobile phones and provides electronic gift card incentives for participation. Data on housing, health, and social outcomes are collected monthly using trauma-informed, equity-sensitive surveys, designed for diverse literacy levels with a user-friendly interface that includes buffers for sensitive topics. Since the study launched in December 2021, a total of 2058 individuals have been screened and found eligible. In total, 57.43% (n=1182) of participants completed the baseline survey, of whom 75.47% (n=892) completed at least 1 monthly survey. By December 2024, participants had contributed 7585 monthly surveys (average of 8.5, SD 8.36 per respondent and median of 6, IQR 2-11). Compared to the unsheltered population of Los Angeles County, the PATHS sample overrepresents younger adults aged <40 years (641/1182, 54.23% vs 38.64%) and female participants (507/1182, 42.89% vs 27.74%). Furthermore, the PATHS cohort reports a high burden of health risks relative to the housed population, with 47.3% (422/892) reporting symptoms of anxiety (vs 19.1%), 45.1% (402/892) reporting symptoms of depression (vs 16.4%), 35% (312/892) reporting a disability (vs 12.9%), and 69.4% (619/892) experiencing food insecurity (vs 15.7%). PATHS offers an innovative platform for real-time monitoring of the housing, health, and service needs of people experiencing unsheltered homelessness in Los Angeles County. By leveraging continuous, in-depth data collection via mobile surveys, PATHS provides valuable insights into the evolving challenges faced by this population. Addressing critical gaps in longitudinal research, PATHS has the potential to drive more informed policy decisions and interventions that improve outcomes for this population considered vulnerable. DERR1-10.2196/74266.
5. Aerosolization of Azithromycin, Ofloxacin, and Co-occurring Antibiotic Resistance Genes during Municipal Wastewater Treatment.
期刊: Environmental science & technology 发表日期: 2025-Sep-04 链接: PubMed
摘要
To effectively combat antibiotic resistance, it is critical to understand antibiotic usage patterns and their environmental dissemination. Wastewater treatment plants (WWTPs) are well-documented sources of antibiotics discharged into aquatic environments, but their role in releasing antibiotics via bioaerosols has not previously been investigated. In this study, seasonal air and liquid samples were collected throughout 2019 from a midsize WWTP employing both mechanical surface agitation and fine bubble aeration of activated sludge. Azithromycin and ofloxacin were detected in bioaerosols collected near aeration tanks at concentrations ranging from below detection limits up to 29 pg L-1 air, suggesting that bioaerosols may represent a previously underappreciated route of environmental and occupational antibiotic exposure. Metagenomic analysis confirmed the co-occurrence of antibiotic resistance genes (ARGs) conferring resistance to macrolides and fluoroquinolones in both air and liquid samples. These findings highlight bioaerosols as an important yet overlooked pathway for the dissemination of antibiotics and ARGs, emphasizing the necessity of integrating airborne pathways into environmental antibiotic resistance surveillance programs, especially given the global scale of WWTP operations.
6. Progression From Cutaneous Abscess to Hidradenitis Suppurativa: A Retrospective Analysis.
期刊: Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 发表日期: 2025-Sep-04 链接: PubMed
摘要
Hidradenitis suppurativa (HS) is often diagnosed late in disease course after irreversible scarring, and other modifiers of quality of life have occurred. Identifying HS earlier may help reduce long-term impact. This study examines how often patients diagnosed with cutaneous abscesses are later identified as having HS, time to HS diagnosis, and demographic factors associated with diagnosis. The study was conducted at Atrium Health Wake Forest Baptist from 2012 to 2023. Data on demographics, clinical history, abscess and lesion locations, HS diagnosis, and time to HS diagnosis were collected. Chi-squared and t-tests were conducted to compare outcomes. Four hundred seventy-one patients, predominantly women [70.1%], met inclusion criteria. Seventy-one patients were diagnosed with HS, predominantly women [80.3%]. HS patients were more likely (35.6%) to have abscesses in the axillae (χ2 = 28.3, p < .0001), inframammary region (χ2 = 18.7, p < .0001), or inguinal folds (χ2 = 12.2, p = .005) than those with boils in nontypical locations (5.4%) (χ2 = 66.8, p < .0001). The heterogeneous nature of HS makes early definitive diagnosis challenging. The anatomic location of abscesses may help identify patients for early intervention and treatment of this debilitating condition.
7. Ethical dimensions in nursing care for individuals with intellectual disabilities.
期刊: Nursing ethics 发表日期: 2025-Sep-04 链接: PubMed
摘要
BackgroundIndividuals with intellectual and developmental disabilities (IDD) face significant health disparities, often exacerbated by ethical and legal complexities in nursing care. Nurses are frequently challenged to balance autonomy, informed consent, patient safety, and human rights, especially in settings with unclear guidelines or insufficient training. This narrative review explores the ethical and legal considerations in nursing care for individuals with IDD, aiming to highlight challenges and propose best practices.MethodsA narrative review methodology was employed to synthesise evidence from qualitative, quantitative, mixed-methods studies, theoretical articles, and grey literature. A comprehensive search was conducted across PubMed, EBSCO, Embase, Scopus, and Web of Science, using keywords related to ethical issues, legal rights, nursing, and intellectual disability. Studies were included if they addressed the ethical or legal dimensions of nursing care for people with IDD. Data were synthesised narratively and visually mapped using conceptual mapping techniques. Quality was assessed using the SANRA scale.ResultsEighteen studies met the inclusion criteria. The findings reveal ethical tensions in obtaining informed consent, maintaining autonomy, and ensuring dignity against communication barriers and behavioural challenges. Nurses reported experiencing an emotional burden and ethical uncertainty when institutional constraints limit person-centred care. The overuse of restrictive practices and limited access to tailored healthcare were recurrent concerns. Legal challenges included complexities in guardianship, consent to treatment, and discriminatory practices. Emerging issues, such as the ethical use of artificial intelligence in care planning, were also noted.ConclusionNursing care for individuals with IDD requires ethically grounded, legally informed, and person-centred approaches. Best practices include accessible communication, interdisciplinary collaboration, tailored education, and advocacy. Nurses must receive support through training and organisational frameworks to navigate complex ethical decisions and uphold the dignity and rights of individuals with IDD. These findings have direct implications for nursing practice and policy, offering actionable guidance to improve ethical decision-making, communication, and inclusive care delivery for individuals with intellectual disabilities.
8. "It's a Mixed Bag": An Interpretive Description of the Person-Centred Mental Health Nursing Care Received by Individuals During an Inpatient Hospitalization.
期刊: Issues in mental health nursing 发表日期: 2025-Sep-04 链接: PubMed
摘要
The aim of this study was to explore individuals’ perspectives on the person-centred nursing care they received during a recent mental health inpatient hospitalization. Eight individuals who were admitted to an inpatient unit in the previous 12 months participated in the study. The study was guided by the Person-centred Practice Framework and used the methodology of Interpretive Description. The constant comparative method supported the analysis resulting in three themes: 1) The rare, but precious, moments of person-centred care, 2) The relationship with my nurse: A fluctuating connection, and 3) The pearls and perils of the care environment. Those interviewed described few person-centred experiences. The fragile relationships between participants and their nurses and the fear experienced in the care environment may have contributed to this finding. Our findings are consistent with existing evidence, as the challenges of implementing person-centred care are broad in scope and not easily managed. Study results may encourage nurses to critically reflect on their own practice and consider meaningful changes in how they work. Further, health organizations may consider how they can better support nurses in the delivery of person-centred care through policy development, staff training, and creating environments that foster shared decision-making, safety, and meaningful engagement.
9. The National Dementia Workforce Study: The Plan for Organization Sample Frames and Data Collection.
期刊: Journal of the American Geriatrics Society 发表日期: 2025-Sep-04 链接: PubMed
摘要
The National Dementia Workforce Study was designed to improve our understanding of the individuals and systems who care for people with dementia, but designing and implementing such a study is challenging due to the large number of patient care organizations, clinical and direct care roles, and locations in which care is provided. Specifically, developing a probability sample of organizations and staff caring for people with dementia is a complex and difficult process. While there are national sampling frames available for federally certified nursing homes (i.e., via data from the Center for Medicare and Medicaid Services), there are no national sampling frames for assisted living communities or home care agencies. The latter frames must be developed through querying state-level regulatory agencies and through other, supplemental strategies such as working with professional organizations, large employers, and organizations that provide services (e.g., payroll services) to this sector. Further, since there are no national sampling frames that allow for direct sampling of staff working in any of these types of organizations, we opted for a two-stage design. In the first stage, organizations are identified, sampled, recruited to participate in an organizational-level survey, and asked to provide a roster of eligible staff. In the second stage, individual staff members are recruited for a staff-level survey. We describe the plan for sampling and recruitment procedures to be used in each stage and discuss limitations, including implications for coverage of the target population. Data collected through these surveys will be available to the research community.
10. Extreme weather events and dengue in Southeast Asia: A regionally-representative analysis of 291 locations from 1998 to 2021.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Sep-04 链接: PubMed
摘要
Climate change, leading to more frequent and intense extreme weather events (EWEs), could significantly impact dengue transmission. However, the associations between EWEs and dengue remains underexplored in the Southeast Asia (SEA) region. We investigated the association between selected EWEs (i.e., heatwaves, extremely wet, and drought conditions) and dengue in the SEA region. Monthly dengue case reports were obtained from 291 locations across eight SEA countries between 1998 and 2021. Heatwaves are defined as the monthly total number of days where temperatures exceed the 95th percentile for at least two consecutive days. Droughts and extremely wet conditions are defined by a self-calibrating Palmer Drought Severity Index (scPDSI). We implemented a generalized additive mixed model coupled with a distributed lag non-linear model to estimate the association between each EWE and dengue. Months with fewer than 12 heatwave days increased dengue risk with delayed effect after two months lag, compared with months without any heatwave. Highest dengue risk is at 7 heatwave days (RR = 1·28; 95%CI: 1·19,1·38). Compared to normal conditions (i.e. scPDSI = 0), drought conditions (i.e. scPDSI = -4) were positively associated with dengue risk (RR = 1·85; 95%CI: 1·73,1·99), while extremely wet conditions (i.e. scPDSI = 4) have reduced dengue risk (RR = 0·89; 95%CI: 0·87,0·91). Although the findings of this study are significant, its limitations arise from the inconsistency of dengue case reporting, which might complicate dengue risk estimation. This study shows that the delayed effect of heatwaves and drought conditions magnifies the risk of dengue in the SEA region. The findings highlight the need for public health interventions to mitigate the potential dengue risks posed by EWEs in the context of climate change in SEA. Future research should investigate the factors influencing variations in the EWE-dengue association across the region to support the development of tailored, location-specific mitigation and prevention strategies.
11. Lewy body dementia promotion by air pollutants.
期刊: Science (New York, N.Y.) 发表日期: 2025-Sep-04 链接: PubMed
摘要
Evidence links air pollution to dementia, yet its role in Lewy body dementia (LBD) remains unclear. In this work, we showed in a cohort of 56.5 million individuals across the United States that fine particulate matter (PM2.5) exposure raises LBD risk. Mechanistically, we found that PM2.5 exposure led to brain atrophy in wild-type mice, an effect not seen in α-synuclein (αSyn)-deficient mice. PM2.5 exposure generated a highly pathogenic αSyn strain, PM2.5-induced preformed fibril (PM-PFF), with enhanced proteinase K resistance and neurotoxicity, resembling αSyn LBD strains. PM2.5 samples from China, the United States, and Europe consistently induced proteinase-resistant αSyn strains and in vivo pathology. Transcriptomic analyses revealed shared responses between PM2.5-exposed mice and LBD patients, underscoring PM2.5’s role in LBD and stressing the need for interventions to reduce air pollution and its associated neurological disease burden.
12. Mycobacterium tuberculosis impairs protective cytokine production via transcription factor MafB manipulation.
期刊: PLoS pathogens 发表日期: 2025-Sep-04 链接: PubMed
摘要
Although an increased expression of the transcription factor v-maf avian musculoaponeurotic fibrosarcoma oncogene homolog B (MAFB) has been reported in patients with active tuberculosis (TB), its potential role in Mycobacterium tuberculosis infection remains unknown. Herein, we report that MafB in macrophages is a regulator of the pro-inflammatory cytokines, TNF-α and IL-12p40, which are crucial for host defense against M. tuberculosis infection. Cell-based luciferase assays showed that MafB inhibited TNF-α and IL-12p40 transcriptional activity in a dose-dependent manner. At the molecular level, MafB interacted with IFN regulatory factor (IRF)-5 and PU.1 and inhibited IRF-5- and PU.1-mediated transactivation, via the basic-leucine zipper domain. Analysis using gene-deficient macrophages demonstrated that the suppressed pro-inflammatory cytokine production during M. tuberculosis infection depends on MafB expression. Finally, in vivo studies indicated that M. tuberculosis-mediated increase of MafB expression was responsible for the exacerbation of M. tuberculosis infection. Thus, our results provide a functional view of MafB as a cytokine regulator as well as novel insights into host factors involved in TB susceptibility.
13. GITalk: Communication Skills Training for Gastroenterology Fellows Improves Self-Assessed Preparedness for Serious Illness Conversations.
期刊: Journal of palliative medicine 发表日期: 2025-Sep-04 链接: PubMed
摘要
Background: Despite caring for patients with serious illnesses, gastroenterology (GI) fellows rarely receive training in serious illness conversations (SIC). Objectives: To describe the development, implementation, and assessment of GITalk, a novel SIC training for GI fellows. Design: GITalk was based on the REMAP framework and involved two simulated encounters. One case involved a patient with decompensated cirrhosis, and the other case was about feeding tube placement in someone with moderate to severe dementia. Setting and Subjects: GI fellows in an academic medical center in the USA. Measurements: Demographics of the participants, evaluation of the course content, and self-assessed preparedness for SIC. Results: A total of 23 GI fellows participated over 4 consecutive years. Participants had significantly higher mean post-training self-assessed preparedness scores compared to pre-training across all 9 survey questions. 91% of participants strongly agreed with the statement: “I would recommend this training to other fellows.” Conclusions: Participants in GITalk reported substantial improvement in self-assessed preparedness for navigating SIC.
14. Risk Perceptions Regarding Tuberculosis Among Hispanic Adults - United States, 2020-2022.
期刊: American journal of health promotion : AJHP 发表日期: 2025-Sep-04 链接: PubMed
摘要
PurposeRisk perception for tuberculosis (TB) and previous receipt of a TB test and/or vaccine were assessed to inform TB prevention efforts.DesignCross-sectional.SettingThe 2020, 2021, and 2022 Estilos survey data.Subjects2837 U.S. Hispanic adults (≥18 years).MeasuresSelf-reported receipt of a TB test and/or vaccine, perceived risk for TB, and demographic characteristics.AnalysisWeighted proportions and 95% Confidence Intervals (CIs) were calculated. Associations between demographic characteristics and TB questions were assessed using chi-square tests. Multinomial logistic regression was used to examine perceived risk for TB among those who received a TB test and/or vaccine vs those who did not.ResultsOverall, 7.2% (95%CI [4.8, 10.5]) of U.S. Hispanic adults reported receiving a TB test but not a vaccine, 15.3% (95%CI [12.5, 18.7]) reported receiving a vaccine but not a test, and 28.3% (95%CI [24.7, 32.2]) reported receiving both a TB test and TB vaccine. Respondents who reported previous receipt of a TB test, with or without previous receipt of a TB vaccine, had a significantly higher odds of feeling any risk for TB than those without previous receipt of a TB test or vaccine (aOR = 2.79, 95% CI = 1.19-6.52 for those tested but not vaccinated; aOR = 1.89, 95% CI = 1.11-3.20 for those both tested and vaccinated).ConclusionFindings can help inform education and interventions to raise awareness and encourage TB testing for those at risk for TB.
15. Silicosis Surveillance in California, 2019-2024: Tracking an Epidemic.
期刊: American journal of public health 发表日期: 2025-Sep-04 链接: PubMed
摘要
Objectives. To characterize the nature, burden, and trends of silicosis among California workers, including workers with engineered stone exposures. Methods. We conducted multisource public health surveillance and generated descriptive statistics, compared engineered stone cases to cases with other silica exposures, and examined the utility of various data sources for silicosis surveillance. Results. We received 1817 reports of possible silicosis for 648 individuals from 2019 to 2024 and confirmed 296 (46%) cases, including 243 (82%) associated with engineered stone exposures. Engineered stone cases were more likely to be younger, men, Latino, and from Los Angeles County than were non-engineered stone cases. Of engineered stone cases, at least 15 (6%) were known to have died, and 60 (25%) were referred for lung transplant, including 30 (12%) who received transplants. There was limited overlap between reporting mechanisms. Conclusions. Multisource surveillance was effective for identifying a large number of individuals with silicosis, including people exposed to engineered stone. Outcomes were severe, and many patients had advanced disease. Results illustrate that worker screening and silica exposure mitigation are essential to prevent morbidity and mortality in the engineered stone countertop fabrication industry. (Am J Public Health. Published online ahead of print September 4, 2025:e1-e9. https://doi.org/10.2105/AJPH.2025.308225).
16. Photochemical Production of Singlet Oxygen by Toronto Road Dust.
期刊: Environmental science & technology 发表日期: 2025-Sep-04 链接: PubMed
摘要
Road dust, which consists of brake and tire wear, pavement particles, crustal material, semivolatile vehicle exhaust components, and natural organic matter, can contribute to both airborne particulate matter and urban runoff. To date, research has mainly focused on the health impact of road dust, but little work has been conducted to characterize its role as a reactive surface in the environment. Our group has previously shown that illuminated road dust is a source of singlet oxygen, an important environmental oxidant. Here, we report the singlet oxygen steady state concentration ([1O2]ss) of illuminated aqueous suspensions and aqueous extracts of road dust samples collected from three different road types (local, arterial, and expressway) in Toronto, Canada. We find that the [1O2]ss generated by aqueous extracts of road dust samples spans less than an order of magnitude and there is no clear trend in the [1O2]ss with road type, but that road dust [1O2]ss depends on organic content and light absorbance. The median singlet oxygen apparent quantum yield of the road dust extracts is 5.4% (UV-A), which is more than double the median reported values (UV-A) for river, lake, soil and wastewater samples. Comparisons of road dust aqueous extracts with aqueous road dust suspensions reveal that suspended road dust has a much higher [1O2]ss, emphasizing the need to examine singlet oxygen production by the insoluble components in particulate matter. Overall, our results highlight the potential of road dust to transform pollutants in the atmosphere and in urban runoff.
17. Application of Toxicologically Informed Relative Potency Factors to Examine Associations between Water Disinfection Byproducts and Birth Defects.
期刊: Environmental science & technology 发表日期: 2025-Sep-04 链接: PubMed
摘要
We used toxicologically informed relative potency factors (RPFs) to compare RPF-weighted versus unweighted epidemiologic analyses of five birth defects (atrial septal defect [ASD], ventricular septal defect [VSD], tetralogy of Fallot [TOF], cleft palate without cleft lip, and obstructive genitourinary defects [OGD]) and various disinfection byproduct (DBP) mixtures in drinking water. We derived RPFs for four trihalomethanes (THMs) and nine haloacetic acids (HAAs) from published animal developmental bioassays using benchmark dose models at 10% responses, estimated adjusted odds ratios (aORs) for RPF-weighted quintile 5 (vs 1) DBP mixture sums, and compared the RPF-weighted and unweighted aORs. RPFs were generally higher for brominated DBP species (e.g., HAA RPF10s from mouse whole embryo culture dysmorphogenesis data: monobromoacetic acid [MBAA] = 1.00, trichloroacetic acid [TCAA] = 0.0011, and dichloroacetic acid [DCAA] = 0.0005), which occurred at lower concentrations than chlorinated species. For THM mixtures, aORs changed <10% with RPF weighting, except for TOF (+19%) for the sum of brominated THMs (tribromomethane + bromodichloromethane + dibromochloromethane). We detected >10% aOR changes for HAA3 (TCAA + DCAA + dibromoacetic acid) with TOF and OGD; HAA5 (HAA3 + monochloroacetic acid + MBAA) with ASD, TOF, and OGD; HAA6 (all brominated HAAs) with TOF; and HAA9 (HAA5 + tribromoacetic acid + bromochloroacetic acid + bromodichloroacetic acid + dibromochloroacetic acid) with OGD. The results suggest that unweighted DBP metrics may reasonably estimate risks of regulated DBPs, but this should be examined elsewhere based on individual-level estimates, which should be prone to less exposure measurement error.
18. Prenatal Nitrogen Oxide (NOx) and Its Potential Impact on Infant Metabolism during the First Month of Life: Evidence from Two Distinct Cohorts─The Atlanta African American Maternal-Child Cohort and the Southern California Mother's Milk Study.
期刊: Environmental science & technology 发表日期: 2025-Sep-04 链接: PubMed
摘要
Exposure to traffic-related air pollution (TRAP) during pregnancy has been linked with adverse health outcomes, yet the biological mechanisms remain poorly understood. High-resolution metabolomics offers a promising approach to examine how TRAP influences infant health. However, few studies have focused on Black and Latino populations, who are disproportionately exposed to TRAP. This study aims to assess the association between prenatal exposure to TRAP and the infant metabolome in two distinct, geographically independent populations: the prospective Atlanta African American Cohort and the Southern California Mother’s Milk Study (MMS). This study provides novel evidence that prenatal nitrogen oxides (NOx), a major component of TRAP, are associated with perturbations in the infant circulating and fecal metabolome during the first month of life. We found that prenatal NOx exposure was linked with the intensity of 8 and 16 level-1 metabolites in the ATL AA and MMS, respectively. Metabolites associated with NOx included several involved in lipid and xenobiotic metabolism. In analyses including untargeted metabolic features, we found that prenatal NOx was associated with perturbations in metabolic pathways including oxidative stress and inflammatory response. These findings provide novel insight into the biological mechanisms by which prenatal TRAP may influence infant health and development.
19. Interprofessional Communication in Psychiatric Units: Barriers, Prerequisites, and Its Role in Shaping Person-Centered Practices - A Vignette Study.
期刊: Issues in mental health nursing 发表日期: 2025-Sep-04 链接: PubMed
摘要
Interprofessional communication is fundamental in healthcare, particularly where patient needs demand coordination and shared understanding. It fosters role clarity, care coordination, and team cohesion. However, unclear hierarchies, heavy workloads, and interpersonal conflicts can disrupt collaboration, affecting professional relationships and patient outcomes. This study explores experiences of and reflections on prerequisites for and barriers to interprofessional communication in psychiatric outpatient settings. While previous research has described barriers, few studies have examined how communication itself constitutes professional roles, boundaries, and collaborative practices. To address this gap, the study applies the Four Flows framework-membership negotiation, self-structuring, activity coordination, and institutional positioning-as an interpretive lens. Using vignettes and semi-structured interviews with 11 clinicians in psychiatric outpatient units, the study analyzed how communication shapes and is shaped by interprofessional collaboration. Analysis identified four key categories: systemic barriers and organizational challenges; social dynamics and interprofessional relationships; supportive leadership and team culture; and patient focus and involvement. These categories intersect across the Four Flows, illustrating how communication acts as a structuring process rather than a neutral tool. The overarching theme,” From Separate Paths to Shared Care,” highlights how clinicians enact person-centered collaboration through communicative practice in psychiatric outpatient settings.
20. The Impact of War on Asthma, a Systematic Review and Meta-Analysis: An EAACI Task Force Report.
期刊: Allergy 发表日期: 2025-Sep-04 链接: PubMed
摘要
Wartime events have been followed by an increase in asthma prevalence, which is believed to result from a combination of environmental hazards and psychological trauma. This systematic review and meta-analysis aimed to investigate this relationship by pooling available data on various wartime exposures, such as occupational, environmental, and psychological factors. MEDLINE, Scopus, and Cochrane databases were searched for articles that measure the effect of war-related exposures on asthma. Risk of bias was assessed using the Effective Public Health Practice Project tool. The retrieved effects were then used to fit meta-analytical models. A total of 48 studies, corresponding to 90 effect measures, were included. War-related post-traumatic stress disorder showed the strongest association with asthma outcomes (OR [95% CI] = 2.25 [1.04, 4.89]), followed by experiencing at least one life-threatening event (1.96 [1.18, 3.26]) and depression (1.56 [1.02, 2.37]). Although environmental exposures were also associated with an increased asthma risk in subgroup analysis (1.64 [1.32, 2.04]), this effect was mitigated when psychological variables were included in the models. The study’s results show that wartime events and conflicts may increase asthma prevalence and outcomes associated with asthma. The management of asthma symptoms, lung function, and mental health seems fundamental in individuals who have experienced psychological trauma in war zones. Trial Registration: PROSPERO registration number: CRD42023444101.
21. Exam resource availability and student outcomes: an exploratory analysis in Occupational Therapy Students.
期刊: Advances in health sciences education : theory and practice 发表日期: 2025-Sep-04 链接: PubMed
摘要
Written examinations are commonly used to assess learning. Different resources made available during testing (closed-note, open-note, and cheat-sheet) may influence student learning. The effect of resource availability on long-term knowledge application is unknown. Understanding the effects of exam resource availability on long-term knowledge application is needed, as application is essential in applied fields such as Occupational Therapy. To explore differences in short-term knowledge retention (course one overall score, midterm exam, and final exam) and long-term knowledge application (course two summative assessment) among occupational therapy students who had different types of exam resource availability during course one (closed-note, open-note, cheat-sheet). Data were extracted from four consecutive cohorts (n = 73) as they completed two sequential occupational therapy courses. Exam resource availability was the independent variable (k = 3), with course one midterm and final exams and overall course grade, and course two summative assessment grade as dependent variables. Kruskal-Wallis tests compared differences across conditions. Concerning short-term retention, no significant differences were observed between groups for course one midterm exam grade or overall course one grade. Course one final exam grades were significantly higher in the cheat sheet condition compared to closed note (3.9%, p = .009). Concerning long-term application as measured by the course two summative assessment grade, the closed note condition scored significantly higher than open note (6.25%, p = .01). No other comparisons were significantly different. In this sample we observed a small difference in short-term knowledge retention in favor of a cheat sheet condition and moderate difference in long-term application in favor of a closed note condition. While results suggest possible differences in performance across exam conditions, findings should be interpreted cautiously due to the small, convenience-based sample. This exploratory analysis offers preliminary insights and identifies directions for future research on the pedagogical impact of exam design.
22. Long-Term Effects of Annual Intensive Rehabilitation in Patients with Hereditary Pure Cerebellar Ataxia: A 7-year Follow-up Study.
期刊: Cerebellum (London, England) 发表日期: 2025-Sep-04 链接: PubMed
摘要
Although intensive rehabilitation has achieved short-term benefits in patients with spinocerebellar degeneration, long-term outcomes of periodic intervention remain unclear, particularly in patients with pure spinocerebellar ataxia types 6 (SCA6) and 31 (SCA31). To investigate the longitudinal effects of annual intensive rehabilitation on ataxic symptoms and balance function in patients with pure cerebellar type SCA6 and SCA31. Seven patients with genetically confirmed SCA6 or SCA31 participated in annual 4-week intensive rehabilitation programmes. Each programme consisted of daily physical therapy, occupational/speech therapy, and self-directed balance training. The participants were assessed annually at pre-intervention, post-intervention, and the 6-month follow-up using the Scale for the Assessment and Rating of Ataxia (SARA) and Balance Evaluation Systems Test (BESTest). Changes were analysed using linear mixed-effect models. SARA scores were stable, indicating slower progression than the expected natural history, through year 6, with significant improvement observed post-intervention in year 2 (p = 0.04). Significant deterioration occurred at year 7 based on pre-intervention scores (p = 0.01), suggesting prolonged sustained benefits for coordination. The BESTest scores revealed an earlier decline, with significant deterioration from year 3 (p = 0.04), which progressed until year 7 (p < 0.01). Annual intensive rehabilitation effectively slowed the progression of ataxic symptoms (SARA) for up to six years, while balance function (BESTest) showed a significant decline from the third year. These findings indicate that an annual rehabilitation schedule is valuable for maintaining coordination but may be insufficient to prevent the progressive decline of balance function in patients with pure cerebellar ataxia.
23. Neurodegenerative Diseases in Male Former First-Class New Zealand Rugby Players.
期刊: Sports medicine (Auckland, N.Z.) 发表日期: 2025-Sep-04 链接: PubMed
摘要
Growing concern surrounds the risk of neurodegenerative diseases in high-level collision sports, but research on Rugby Union’s connection to these diseases is limited. This study sought to examine the long-term neurodegenerative disease risk associated with participation in high-level Rugby Union (‘rugby’), utilising whole-population administrative records. This retrospective cohort study in New Zealand compared males born between 1920 and 1984 who were active in high-level (provincial or higher) rugby between 1950 and 2000 (n = 12,861) with males from the general population (n = 2,394,300), matched by age, ethnicity, and birthplace. We used Cox proportional hazards models to assess risks of Alzheimer’s disease, Parkinson’s disease, motor neuron disease, and other dementias, ascertained using mortality and hospitalisation records from January 1988 to June 2023. A higher percentage of rugby players (6.5%) than males in the general population (5.2%) developed neurodegenerative diseases, with hazard ratios indicating players showed increased risks for any neurodegenerative disease (1.22; 95% confidence interval [CI] 1.14-1.30), Alzheimer’s disease (1.61; 95% CI 1.42-1.83), and other dementias (1.23; 95% CI 1.14-1.33). Significant differences were not observed for Parkinson’s disease (1.05; 95% CI 0.89-1.22) and motor neuron disease (1.16; 95% CI 0.83-1.63). In general, this increased risk among players compared to the general population began around the ages of 70-79 years. Compared to the general population, small to moderate increased risks of any neurodegenerative disease were observed for a backline playing position, provincial and/or amateur players, international and/or professional players, participation in ≥ 2 years of play, and participation in five or more matches. High-level rugby participation amongst males in New Zealand is associated with a small to moderate increase in neurodegenerative disease rates compared to the general population.
24. Validity and reliability of the pediatric pressure ulcer prediction and evaluation tool in the Turkish population: Comparison with Braden QD-T.
期刊: Journal of pediatric nursing 发表日期: 2025-Sep-03 链接: PubMed
摘要
To evaluate the validity and reliability of the Pediatric Pressure Ulcer Prediction and Evaluation Tool (PPUPET) in the Turkish population and compare it with Braden QD-T. The study was conducted methodologically to test the validity and reliability of PPUPET in Turkish on 228 pediatric patients hospitalized in the pediatric intensive care unit of a public hospital in the Southeastern Anatolia Region of Turkey. Data were collected from pediatric patients and their files who were hospitalized in the pediatric intensive care unit of the hospital under investigation for at least 3 days between July 2023 and October 2023, and using a Personal Information Form, PPUPET, and the Braden QD-T Scale. Kaiser-Meyer-Olkin (KMO) analysis, exploratory factor analysis, and confirmatory factor analysis (CFA) were performed, and CFA fit indices were evaluated to assess the construct validity of the scale. Internal consistency (item-total correlation coefficient and Cronbach alpha value) and interobserver consistency were evaluated as reliability analyses using the parallel form method and ROC curve analysis to evaluate the discriminative feature. Guidelines for reporting reliability and agreement studies (GRRAS) were adhered to in the study. Half (50.9 %) of the children included in the study were male, 66.7 % were not at risk of pressure injuries according to the Braden QD-T Scale, and 64.9 % were not at risk of pressure injuries according to PPUPET. The content validity index of the scale items for which language validity was evaluated using the Davis method ranged between 0.80 and 1.00, and the content validity ratio was found as 0.92. The KMO coefficient was found as 0.791 and the Bartlett sphericity test χ2 value was 226.354 (p < 0.001). In our study, the Cronbach alpha reliability coefficient was 0.835 and the internal consistency coeffiecient value between observers was 0.992. In the study, it was determined that PPUPET was a valid and reliable assessment tool for the Turkish population.
25. The impact of socioeconomic status on the management of epilepsy: a qualitative study.
期刊: Epilepsy & behavior : E&B 发表日期: 2025-Sep-03 链接: PubMed
摘要
Socioeconomic status (SES) is a recognised determinant of epilepsy outcome, yet it remains unclear whether epilepsy management is effectively contextualised to meet the needs of individuals across different SES backgrounds. This study explored how adults with epilepsy perceive the influence of SES on their care and self-management. In-depth, semi-structured videoconference or telephone interviews were conducted until data saturation with fifteen adults (11 women, 18-75 years) recruited through national epilepsy charities. SES was classified with the “MacArthur Subjective Social Status ladder” and “Social Determinants of Health” indicators, yielding eight low/lower‑middle (“lower‑SES”) and seven upper‑middle/high (“higher‑SES”) participants. Two researchers analysed transcripts inductively using reflexive thematic analysis. Member checking confirmed analytic credibility. Eight interrelated themes emerged: support networks and relationships; financial implications and access to care; employment and economic stability; transportation and independence; treatment and medication adherence; interactions with the healthcare system; perceived power imbalance and stigma; and trust and future care decisions. In every theme, lower-SES participants reported a more significant number of - and more disruptive - barriers than higher-SES participants. They described issues regarding obtaining transport and medicines, navigating opaque benefit systems, lacking dependable social support, limited access to specialist care, and feeling dismissed or stigmatised by clinicians, which eroded trust and prompted disengagement from care. Higher-SES participants, while not immune to challenges, more often mobilised resources to buffer their impact. Lower socioeconomic status intensifies financial, informational, and relational barriers to managing epilepsy effectively, undermining adherence and care consistency. Routine SES assessment, tailored education, and integrated social-support interventions are crucial to reduce these inequities and improve outcomes for socioeconomically disadvantaged people with epilepsy.
26. Influenza vaccination hesitancy and decision between parental and grandparental caregivers of preschoolers: a comparative study.
期刊: Vaccine 发表日期: 2025-Sep-03 链接: PubMed
摘要
Grandparents are increasingly involved in childcare, yet their role in childhood vaccination remains understudied. Generational differences shaped by historical and social experiences may influence vaccine attitudes, highlighting the need to compare parents and grandparents in addressing vaccine hesitancy. This study conducted a field survey in five Chinese cities in 2024, collecting data from childhood caregivers. Propensity score matching (1:3) was applied to compare influenza vaccine hesitancy (IVH) between 225 grandparents and 675 parents. The IVH scale was developed, and the matrix of vaccine hesitancy determinants was used to examine factors influencing vaccine attitudes and decisions. Among 225 grandparents and 675 parents included, the parents had higher IVH scores (32 [IQR: 28-36]) than grandparents (30 [IQR: 25-33]), indicating that grandparents held more positive attitudes toward influenza vaccination (p < 0.001). Mandatory vaccination policies positively influenced both parents’ (β = -1.60, p = 0.016) and grandparents’ (β = -1.79, p = 0.044) attitudes toward influenza vaccination. Adequate influenza vaccine supply was a common promoting factor for both groups among vaccination-specific issues (Parents: β = -3.28, p < 0.001; Grandparents: β = -2.60, p = 0.014). Furthermore, interaction analyses revealed that the effect of mandatory policies was stronger among parents (interaction β = 2.18, p < 0.001), while prior vaccination experiences (interaction β = -2.03, p = 0.024) and perceived vaccine benefits (interaction β = -1.15, p = 0.034) had greater influence on grandparents. Grandparental caregivers of children aged ≤3 years exhibited greater hesitancy due to social media influence (β = 6.14, p = 0.019) and perceived influenza risk (β = 4.52, p = 0.009). Despite grandparents’ generally more positive attitudes, Sankey diagram analysis revealed that IVH levels didn’t fully align with vaccination decisions, suggesting additional influencing factors. Grandparents exhibit more positive attitudes and decisions regarding influenza vaccination for both themselves and children. Enhancing grandparents’ involvement in children’s vaccination decisions could effectively reduce inequities in childhood vaccine access.
27. Differences in incidence of post-induction hypotension depending on the time of day: a post-hoc propensity score matched analysis.
期刊: Journal of clinical anesthesia 发表日期: 2025-Sep-03 链接: PubMed
摘要
Many physiological processes show a diurnal rhythm, including sympathetic and parasympathetic tone, adrenal hormone secretion and blood pressure. Since these physiological rhythms may affect the sensitivity to anaesthesia, we hypothesised that the time of day when anaesthesia induction occurs may affect the incidence of post-induction hypotension. This was a post-hoc propensity score matched analysis of prospectively collected blood pressure data of 760 elective non-cardiac surgery patients receiving general anaesthesia. The primary endpoint was the incidence of post-induction hypotension, defined as mean arterial pressure < 65 mmHg for at least one minute. Secondary endpoints were a > 30 % decrease in mean arterial pressure, and baroreflex sensitivity. In the analysis of 237 propensity score matched pairs, post-induction hypotension was more frequent if anaesthesia induction occurred in the morning (08:00 AM - 12:00 PM) (odds ratio (OR) 1.48, 95 % confidence interval (CI): 1.00-2.20, p = 0.049). Secondary analyses of the matched cohort showed that a > 30 % decrease in mean arterial pressure was likewise more frequent in the morning than the afternoon (12:00 PM - 17:00 PM) (OR 1.45, 95 % CI: 1.00-2.11, p = 0.0499), but no differences in instantaneous baroreflex sensitivity were observed. Post-induction hypotension was more frequent in the morning compared to the afternoon. While this finding is in line with the presumed physiological mechanisms, it may be affected by unmeasured confounding. These findings should be replicated in larger, preferably randomised, studies to confirm whether a causal relationship between the time of day of anaesthesia induction and post-induction hypotension exists. Clinical registration number This study was registered in the Dutch Medical Research in Humans (OMON) register on 18 June 2019 (ID: NL7810). The study was approved by the Medical Ethics Committee of the Amsterdam UMC, location AMC, Netherlands in December 2018 (NL 6748.018.18; 2018).
28. Competing coalitions in alcohol policymaking in Malawi: a retrospective case study analysis of the alcohol sachet ban.
期刊: The International journal on drug policy 发表日期: 2025-Sep-03 链接: PubMed
摘要
Harmful alcohol consumption has significant public health implications across Africa and disproportionately affects vulnerable populations. In Malawi, the emergence of alcohol sachets - small, affordable plastic packets containing high-strength spirits - and their consumption, has raised substantial public health concerns. In particular, the resulting access and consumption amongst young people, led to a ban on those products by the Malawi Government in 2017. This study focuses on the policy process of the sachets ban, from agenda setting, to formulation and covers the modalities for implementation. Retrospective policy case study involving a documentary analysis of all key regulatory documents and in-depth interviews with thirteen policy stakeholders and key informants. The Advocacy Coalition Framework was used to guide the analysis. The findings reveal a long and contested process involving two primary coalitions. The pro-ban coalition (NGOs, civil society organizations, religious leaders, and government representatives), which used empirical and local evidence on sachet alcohol-related harms, particularly among young people, to emphasize the need to regulate. The opposing coalition (spearheaded by alcohol and plastics manufacturers) mounted multiple legal challenges, stalling the policy formulation of the ban. Ultimately, a strong enduring public health coalition, a high court ruling and a decisive government decision facilitated a final and complete ban in 2017. This analysis demonstrates how public health advocates successfully countered industry interference through evidence-based advocacy, community engagement, and strategic coalition-building. The Malawi case offers valuable lessons for other African countries considering similar alcohol control measures, highlighting the role of coalitions, the importance of framing alcohol regulations as public health protections, and of developing robust implementation mechanisms.
29. Emergency department workplace violence: Clinician-endorsed strategies informing prevention mandates.
期刊: Nursing outlook 发表日期: 2025-Sep-03 链接: PubMed
摘要
State legislation such as the Pennsylvania Healthcare Worker Violence Prevention Act would mandate hospital reporting of workplace violence (WPV) incidents and require committees that advance safety measures. Since it is unknown what interventions should be prioritized by hospital committees if such legislation were passed, we described strategies that hinder or facilitate the prevention and de-escalation of WPV. Qualitative, descriptive study using individual and focus group interviews with emergency department (ED) nurses and physicians (n = 23) at a level I trauma center ED in Pennsylvania between August 2023 and February 2024. Five clinician-informed themes were identified: a) clinical protocols, b) clinician conflict in addressing WPV, c) social vulnerability in emergency care, d) resources and throughput, and e) the presence and responsibility of security. Priority interventions included WPV clinical protocols; holding hospital administrators accountable to support clinician decision-making during WPV events, safe nurse staffing levels, and cross-disciplinary training of security personnel.
30. Cannabis in the wild: Analysis of street cannabis and cannabinoid composition in Australia.
期刊: The International journal on drug policy 发表日期: 2025-Sep-03 链接: PubMed
摘要
Australia has one of the highest rates of cannabis use globally, yet the concentration of Δ9-tetrahydrocannabinol (THC) of illicit street cannabis has not been formally assessed in over a decade. We aimed to comprehensively profile the concentration of THC, cannabidiol (CBD) and other cannabinoids in contemporary illicit street cannabis in regional Australia, assess variation over time, and examine how the amount of THC relates to consumer’s perceived product strength. Participants donated two 1-gram samples of cannabis at 3 different timepoints (i.e., 6 samples total) ∼9-weeks apart, over 5 months. High-performance liquid chromatography quantified the concentrations of THC, CBD, cannabigerol, cannabichromene, cannabinol, tetrahydrocannabivarin, and their plant-based carboxylic acid precursors (THCA, CBDA, CBGA, CBNA, THCVA) in percentage and milligrams. Thirty-seven participants donated 127 cannabis samples. On average, one cannabis gram contained 34.8 mg THC (6.96 Standard THC units), 12.00 % total THC (THC+(THCA0.877)), and 0.30 % total CBD (CBD+(CBDA0.877)). THC concentrations remained stable across participants’ current and past samples over time (p > 0.05). Finally, no correlation was found between participants’ subjective assessments of cannabis strength and THC or total THC content in the same product (p > 0.05). Contemporary illicit street cannabis in regional Australia is high in THC and low in CBD. The concentration of THC is lower than international trends but appears to have increased compared to reports on illicit Australian cannabis collected over 10 years ago, while low concentrations of CBD have remained stable over time. Perceived cannabis strength may be influenced by factors beyond measurable THC concentrations, such as individual tolerance, consumption methods, or consumer expectations.
31. Bacterial pneumonia co-infection in adult inpatients with coronavirus disease 2019 during the Omicron variants epidemic in Okinawa, Japan: risk factors and clinical outcomes.
期刊: Respiratory investigation 发表日期: 2025-Sep-03 链接: PubMed
摘要
The clinical characteristics and risk factors for bacterial pneumonia co-infection in patients with coronavirus disease 2019 (COVID-19) since the epidemic of Omicron variants remain unclear. This retrospective study included adult inpatients with COVID-19 at four tertiary hospitals in Okinawa, Japan, between May and July 2023. Bacterial pneumonia co-infection was diagnosed on the basis of new infiltrates on chest radiography, the presence of neutrophils on sputum Gram stain with a positive culture, and the requirement for antimicrobial therapy. We evaluated patient characteristics, detected microbes, assessed patient outcomes, and analyzed the risk factors for bacterial pneumonia co-infection. Among 458 patients initially considered, 358 were eligible (median age 77 years; 55 % male, and 19 % unvaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Bacterial pneumonia was identified in 60 patients (17 %). The most common pathogens were Klebsiella pneumoniae, Staphylococcus aureus, and Haemophilus influenzae, with oral flora detected in 40 % of cases. Mortality was significantly higher in patients with bacterial pneumonia than in those without. Multivariate analysis identified age, male sex, cerebrovascular disease, delayed antiviral therapy, and lower oxygen saturation to fraction of inspired oxygen ratio as independent risk factors for bacterial pneumonia co-infection. Co-infection with bacterial pneumonia significantly affected the outcomes of patients with COVID-19 during the XBB Omicron variant epidemic. Early antiviral therapy and targeted prevention strategies, particularly for patients with cerebrovascular disease, can help reduce the risk of bacterial pneumonia-associated complications.
32. Adopting the estimand framework in prophylactic vaccine trials.
期刊: Vaccine 发表日期: 2025-Sep-03 链接: PubMed
摘要
The estimand framework as outlined in ICH E9(R1) has been extensively discussed and implemented in clinical trials of therapeutic products. However, there is limited literature on the application of the framework in preventive vaccine trials, which has many unique characteristics, including emphasis on estimating the per-protocol or “biological” effect. We provide a comprehensive review of the application of the framework to preventive vaccine trials evaluating clinical outcome and immunogenicity, focusing on commonly encountered intercurrent events including but not limited to: noncompliance with vaccination schedule and blood sampling window, infection not meeting protocol definition, death, and use of prohibited products. We discuss various considerations in choosing strategies to handle intercurrent events in terms of their utility in addressing the scientific questions. Finally, we provide considerations and examples for summarizing study estimands and data handling which may be incorporated into the protocol and statistical analysis plan.
33. Screen first, vaccinate later: Enhancing tuberculosis vaccination safety through newborn immunodeficiency screening.
期刊: Vaccine 发表日期: 2025-Sep-03 链接: PubMed
摘要
Tuberculosis (TB) remains a global health challenge, with around 10 million new cases reported annually and multidrug-resistant strains complicating control efforts. Although incidence has declined in many high-income regions, neonatal populations remain vulnerable, underscoring the continued role of Bacillus Calmette-Guérin (BCG) vaccination. BCG vaccination provides strong protection against severe forms of TB in infancy, though its efficacy against pulmonary disease in adolescents and adults is modest. However, the BCG vaccine carries a risk of disseminated infection in immunocompromised newborns, emphasizing the importance of integrating immunodeficiency screening into vaccination strategies. Slovenia introduced universal newborn screening for inborn errors of immunity (IEI) in 2024 and, in 2025, revised its neonatal BCG vaccination protocol to incorporate screening results before vaccination. Under this approach, blood sampling occurs at ≥48 h, results are available by days 5-7, and BCG is administered between 7 and 14 days of life. This model balances timely TB protection with safety for at-risk infants. The Slovenian experience exemplifies a precision vaccination strategy that integrates real-time immunogenetic data with targeted BCG administration. This approach aligns with World Health Organization goals to modernize TB prevention while awaiting next-generation vaccines and may serve as a guide for other low-incidence countries.
34. Path analysis of medication adherence in schizophrenia patients based on the extended theory of planned behavior: A cross-sectional study.
期刊: Journal of psychosomatic research 发表日期: 2025-Sep-02 链接: PubMed
摘要
Medication adherence is a significant challenge among community-dwelling patients with schizophrenia. Understanding the influencing factors through the lens of behavioral theory can provide valuable guidance for designing effective interventions to improve medication adherence. This study aimed to identify the factors associated with medication adherence and the underlying mechanisms, based on the extended Theory of Planned Behavior (TPB), among community-dwelling patients with schizophrenia in China. Medication adherence was measured using the seven-day recall method. Medication attitudes were assessed using the Drug Attitude Inventory-10-Item Version, perceived behavioral control was measured with the Self-Efficacy for Appropriate Medication Use Scale, and subjective norms, intention, and supervision were evaluated using self-developed items. Path analysis was conducted to test the hypotheses based on the extended TPB. A total of 468 community-dwelling patients with schizophrenia were surveyed, and 81.20 % of them demonstrated adherent. Intention (standardized effect: 0.897) and supervision (standardized effect: 0.084) were directly associated with medication adherence. Attitude (standardized effect: 0.268, computed as 0.299 × 0.897), subjective norms (standardized effect: 0.283, computed as 0.316 × 0.897), and perceived behavioral control (standardized effect: 0.187, computed as 0.208 × 0.897) were indirectly associated with medication adherence through intention. The extended TPB is a suitable model for predicting medication adherence among community-dwelling patients with schizophrenia in China. It provides a robust framework for designing interventions targeting attitude, subjective norms, perceived behavioral control, and supervision to enhance medication adherence.
35. 1,10-phenanthroline enhances the antiparasitic activity and selectivity of Cu(II) and Zn(II) metal complexes with coumarin-thiosemicarbazone hybrid ligands.
期刊: Journal of inorganic biochemistry 发表日期: 2025-Sep-01 链接: PubMed
摘要
Chagas disease, caused by Trypanosoma cruzi, remains a major public health concern with limited therapeutic options and significant toxicity associated with current treatments. In this work, eight novel heteroleptic complexes of the type [M(L)(phen)], where M = Cu(II) or Zn(II), L = coumarin-thiosemicarbazone hybrid ligands, and phen = 1,10-phenanthroline, were synthesized and fully characterized in the solid state and in solution. For comparison, some homoleptic [Cu(HL)₂], [Zn(HL)₂], and [CuCl(HL)] complexes were also prepared. All compounds were evaluated in vitro against Trypanosoma cruzi trypomastigotes. The presence of the phenanthroline co-ligand markedly enhanced trypanocidal activity in both metal series. The [Cu(L)(phen)] complexes showed the highest potency, with submicromolar half-maximal inhibitory concentration values and favourable selectivity indexes. Mechanistic studies revealed that these copper complexes increased intracellular reactive oxygen species and caused mitochondrial membrane depolarization, leading to necrosis as the primary mechanism of parasite death. The redox-active nature of copper likely contributes to this enhanced activity. These findings underscore the relevance of phenanthroline in modulating antiparasitic efficacy and support further development of copper-based complexes bearing this ligand as potential agents for Chagas disease treatment.
36. Assessing the relationship between anthropometric indices and visceral adipose tissue: A cross-sectional study in a Qatari population.
期刊: The Journal of international medical research 发表日期: 2025-Sep 链接: PubMed
摘要
ObjectiveTo evaluate how body mass index, waist circumference, waist-to-hip ratio, and waist-to-height ratio reflect visceral adipose tissue as measured by dual-energy X-ray absorptiometry and how these associations differ by sex and age in a Qatari adult population.MethodsIn this cross-sectional study of 5897 Qatari adults aged 18-88 years from the Qatar BioBank, we assessed the correlation between anthropometric indices and dual-energy X-ray absorptiometry-derived visceral adipose tissue percentage. Analyses included sex-stratified Spearman’s correlations and linear regression models adjusted for age. Model performance was assessed using standardized beta coefficients, R2, adjusted R2, Akaike Information Criterion, and Bayesian Information Criterion.ResultsAmong females, waist circumference and waist-to-height ratio had the strongest correlations with visceral adipose tissue (r = 0.70), followed by waist-to-hip ratio (r = 0.68), whereas body mass index showed a moderate correlation with visceral adipose tissue (r = 0.54). Among males, waist-to-hip ratio showed the highest correlation with visceral adipose tissue (r = 0.71). Regression analyses confirmed waist-to-hip ratio as the strongest predictor in males and waist circumference as the strongest in females. Interaction models showed that associations between central adiposity indices and visceral adipose tissue strengthened with age.ConclusionAnthropometric indices reflecting central adiposity, waist-to-hip ratio, waist circumference, and waist-to-height ratio outperformed body mass index in predicting visceral adipose tissue in a sex- and age-specific manner. These findings may support the clinical utility of incorporating waist-based measures for visceral adipose tissue risk assessment.
37. Relationship of the neutrophil-to-high-density lipoprotein cholesterol ratio with sarcopenia: A cross-sectional study.
期刊: The Journal of international medical research 发表日期: 2025-Sep 链接: PubMed
摘要
ObjectiveSarcopenia poses a significant global public health burden, underscoring the urgency of identifying reliable risk markers for early detection and intervention. This study aimed to elucidate the association between the neutrophil-to-high-density lipoprotein cholesterol ratio and sarcopenia as well as explore how various covariates modify this relationship.MethodsA cross-sectional analysis was performed using data from 9040 individuals who participated in the National Health and Nutrition Examination Survey 2011-2018, of whom 721 were diagnosed with sarcopenia. Multivariable logistic regression models were employed to estimate the odds ratios and 95% confidence intervals for the association between the neutrophil-to-high-density lipoprotein cholesterol ratio and sarcopenia. Restricted cubic spline regression analysis was utilized to assess the nonlinear relationship between the neutrophil-to-high-density lipoprotein cholesterol ratio and sarcopenia risk. Subgroup analysis was performed to identify the relationship between different subgroups of neutrophil-to-high-density lipoprotein cholesterol ratio and sarcopenia. Considering the conflict between the lower age threshold and the diagnostic criteria for sarcopenia, we conducted sensitivity analysis among participants aged ≥40 years.ResultsMultivariable logistic regression analysis revealed that the neutrophil-to-high-density lipoprotein cholesterol ratio was positively associated with sarcopenia risk (odds ratio = 1.16, 95% confidence interval: 1.11-1.22, P < 0.0001). Restricted cubic spline regression analysis demonstrated a nonlinear relationship between the neutrophil-to-high-density lipoprotein cholesterol ratio and sarcopenia risk (nonlinear P < 0.05). Subgroup analyses indicated that sex, race, and hyperlipidemia significantly modified the association between the neutrophil-to-high-density lipoprotein cholesterol ratio and sarcopenia risk (P for interaction <0.05).ConclusionsAn elevated neutrophil-to-high-density lipoprotein cholesterol ratio is associated with a high risk of sarcopenia, indicating that the ratio can effectively assess the risk of sarcopenia and may contribute to early diagnosis and preventive intervention.
38. Immunoprofiling at an Institutional Scale Reveals That High Numbers of Intratumoral CD8+ and PD-1+ Cells Predict Superior Patient Survival Across Major Cancer Types Independent of Major Risk Factors.
期刊: JCO precision oncology 发表日期: 2025-Sep 链接: PubMed
摘要
Retrospective studies have found associations between the number of intratumoral immune cells and patient outcomes for specific cancers treated with targeted therapies. However, the clinical value of routinely quantifying intratumoral immune biomarkers using a digital pathology platform in the pan-cancer setting within an active clinical laboratory has not been established. We developed ImmunoProfile, a daily clinical workflow that integrates automated multiplex immunofluorescence tissue staining, digital slide imaging, and machine learning-assisted scoring to quantify intratumoral CD8+, PD-1+, CD8+PD-1+, and FOXP3+ immune cells and PD-L1 expression in formalin-fixed, paraffin-embedded tissue samples in a standardized and reproducible manner. We prospectively applied ImmunoProfile to biopsies collected from 2,023 unselected patients with cancer over a 3-year period in the clinical laboratory and correlated the results with patient survival. In the pan-cancer cohort, patients with high numbers of intratumoral CD8+ or PD-1+ cells in had significantly lower risks of death compared with those with low numbers (CD8+: high v low hazard ratio [HR], 0.62 [95% CI, 0.48 to 0.81], Wald P = .002; PD-1+: high v low HR, 0.65 [95% CI, 0.51 to 0.83]; P = .0009) after adjusting for risk factors, including cancer type. In subset analyses, patients with high numbers of intratumoral CD8+, PD-1+, and/or CD8+PD-1+ cells showed lower risks of death from non-small cell lung, colorectal, breast, esophagogastric, head and neck, pancreatic, and ovarian cancers after considering clinical risk factors, including American Joint Committee on Cancer stage, and despite varying therapies (all P < .05). Routinely quantifying intratumoral CD8+ and PD-1+ cells with a clinically validated digital pathology platform predicts patient survival across major cancer types, independent of clinical stage and despite diverse treatment regimens.
39. Ninety-day surgery-related outcomes of laparoscopic hysterectomy, bilateral salpingo-oophorectomy and sentinel node mapping in apparent early-stage endometrial cancer: a secondary analysis of a prospective single-arm study.
期刊: European journal of obstetrics, gynecology, and reproductive biology 发表日期: 2025-Aug-30 链接: PubMed
摘要
Limited prospective data are available on the outcomes and performance of sentinel node mapping (SNM) in patients with endometrial cancer (EC). This study aimed to describe the surgical outcomes related to laparoscopic staging and the performance of SNM in patients with apparent early-stage EC. This is a secondary analysis of a prospective single-arm study focusing on predictors of nodal disease in apparent early-stage EC. This analysis focused on 90-day surgical outcomes of patients undergoing laparoscopic surgery, including hysterectomy, bilateral salpingo-oophorectomy and SNM. Overall, 210 patients were evaluated: 178 (84.8 %) patients had endometrioid EC and 32 (15.2 %) patients had non-endometrioid EC. No conversions to open surgery were reported at the time of SNM. Two (1 %) patients converted to open surgery for completion of hysterectomy. Unilateral mapping was achieved in all patients (n = 210, 100 %), with a bilateral pelvic detection rate of 93.8 % (n = 197). Sentinel nodes in the para-aortic area were detected in 19 patients (9 %). The majority of sentinel nodes were located in the external iliac area (55.7 % on the right side and 58.6 % on the left side), followed by the obturator area (26.1 % on the right side and 22.9 % on the left side) and internal iliac area (11.9 % on the right side and 8.1 % on the left side). Overall, 41 patients (19.5 %) had positive nodes detected, with low-volume disease observed in 21 (10 %) patients. Eight (3.8 %) patients had moderate (grade 2) 90-day complications. Three (1.4 %) patients had severe (grade 3) 90-day complications. Laparoscopic surgical staging for apparent early-stage endometrial cancer is safe and effective. Long-term data are needed to assess oncological outcomes.
40. Comparing health outcomes and costs of home and community-based services (HCBS) versus institutional care (IC) for long-term care insurance beneficiaries in South Korea: Can the less severe benefit more?
期刊: Health policy (Amsterdam, Netherlands) 发表日期: 2025-Aug-29 链接: PubMed
摘要
It is often considered that home and community-based services (HCBS) are better than institutional care services (IC) in terms of person’s preferences and costs in long-term care (LTC) settings. However, this may not always be the case depending on the baseline health status of the person. Using nationally representative data from South Korea, we examined whether the effects of HCBS versus IC on health outcomes and costs differ according to the individual’s baseline health status. Entropy balancing weights were applied to achieve a good balance of baseline covariates. These covariates included variables derived from a comprehensive needs assessment, as well as historical health status and healthcare utilization trends obtained from claims-based administrative data, thereby supporting the parallel trend assumption between the treated and control groups. Our results indicated that, in general, HCBS were associated with better health outcomes and lower formal care costs compared to IC (5.7 %p less death, 0.55 point less decline of activities of daily living, and USD 6242 less formal care costs during a 1-year follow-up). However, these differences diminished among individuals with severe functional limitations at the baseline. To the best of our knowledge, this is the first study to investigate the heterogenous effects of choosing HCBS over IC on older adult’s health outcomes and costs due to baseline health status, using a nationally representative data from South Korea where universal access to LTC services is available.
41. Sleep, physical activity, and pregnancy symptoms: Factors associated with cognitive performance in early pregnancy.
期刊: Midwifery 发表日期: 2025-Aug-28 链接: PubMed
摘要
Women often report disruptions in cognitive performance during pregnancy. Though substantiated by objective assessments, findings have been inconsistent and potential contributing factors are not well understood. The objective of this study was to examine the cross-sectional associations between maternal mood, stress, pregnancy-related symptoms and device measured 24-hour activity behaviors with cognitive performance in the first trimester of pregnancy. Pregnant women (N=90) were assessed in the first trimester. Non-pregnant controls (N=73) were assessed 1-5 years after pregnancy. Depressive symptoms, (Center for Epidemiological Studies Depression Scale), stress (Perceived Stress Scale), and pregnancy-specific health related quality of life (Nausea and Vomiting during Pregnancy Health-Related Quality of Life) were evaluated using validated questionnaires, and 24-hour activity measured via actigraphy (activPAL, Actiwatch Spectrum Plus). Cognitive performance was evaluated using tests of memory, processing speed, and executive function. Pregnant women performed lower on memory tests compared with non-pregnant women. Neither depressive symptoms nor stress were associated with lower cognitive performance in pregnancy. Physical symptoms of pregnancy (e.g., nausea, vomiting) were related to lower memory scores (β=0.32, P=0.02). Longer sleep duration was associated with better executive function performance (β=1.4, P=0.03). This study demonstrates lower memory performance in the first trimester of pregnancy compared with non-pregnant controls and indicates that pregnancy symptoms and shorter sleep duration may be contributing factors.
42. Enhancing microglial antioxidant capacity via the ascorbate transporter SVCT2 delays onset and modifies disease progression in mouse models of Alzheimer's disease.
期刊: Redox biology 发表日期: 2025-Aug-28 链接: PubMed
摘要
Despite clear evidence that vitamin C levels are depleted in the brains of Alzheimer’s disease (AD) patients, dietary supplementation has consistently failed in clinical trials, suggesting a critical bottleneck not in systemic supply, but in its transport into brain cells. Here, we identify this bottleneck as a progressive downregulation of the ascorbate transporter, Slc23a2, also known as SVCT2, in microglia. Then we hypothesized that bypassing this cellular deficiency via targeted SVCT2 overexpression in microglia could either prevent the onset of pathology or rescue established functional deficits. Indeed, overexpressing SVCT2 in microglia before disease onset in 5xFAD mice triggered a profound redox reprogramming, resulting in a unique “hybrid” neuroprotective microglial phenotype that co-expressed both homeostatic and disease-associated markers. Functionally, this leads to decreased amyloid plaque burden and strengthens the synaptic bioenergetic capacity, which consequently prevents the development of synaptic and memory deficits. Strikingly, when employed after disease establishment, SVCT2 overexpression rescued synaptic plasticity and memory performance despite not affecting the existing amyloid burden. This rescue was driven by changes in the microglial secretory pathways. Collectively, these findings resolve a long-standing clinical paradox by establishing that neuroprotection depends not on systemic vitamin C intake but on the brain’s cellular uptake machinery. This offers a mechanistic explanation for the failure of dietary supplementation in AD and identifies SVCT2 as a promising therapeutic target against the neurodegenerative process in AD.
43. Arbovirus surveillance detects mosquito-borne viruses in central South Africa.
期刊: Virology 发表日期: 2025-Aug-27 链接: PubMed
摘要
Surveillance plays an important role in early detection of circulating arboviruses with potential to cause outbreaks of disease. In South Africa (SA) there are several endemic mosquito-borne viruses of medical and veterinary importance associated with outbreaks of disease in humans and domestic animals (livestock and horses) usually occurring after heavy rainfall. In addition, there are historical reports of viruses that were isolated from mosquitoes during vector surveillance studies with demonstration of antibodies in human populations during serosurveys. However, for many of these viruses detected historically there is no recent evidence of their circulation in the country. This study was initiated to screen mosquitoes in central South Africa for evidence of known and less common mosquito-borne viruses. Mosquitoes were collected from selected sites including two urban sites, a rural and a conservation area in central South Africa and were screened for arboviruses from the families Togaviridae, Orthoflaviviridae and Peribunyaviridae. A total of 10 332 mosquitoes were collected between November 2019 and March 2023. Most of the collection was obtained from the two urban sites in Bloemfontein, 8 236/10 332 (79.7 %), 1 075/10 332 (10.4 %) from the conservation site and 1 021/10 332 (9.9 %) from the rural site. Mosquito pool homogenates were screened using nested in-house RT-PCR. The nucleotide sequence of each amplicon of predicted size was determined using Sanger sequencing or Oxford Nanopore sequencing, and the virus identification confirmed using BLASTn analysis. Partial genes for Sindbis virus (SINV) genotype 1 were detected in three mosquito pools, for Middelburg virus (MIDV) in two pools, for Germiston virus (GERV) in one pool, for bunyamwera virus (BUNV) in four pools, for West Nile virus (WNV) lineage 2 in four pools, for Bagaza virus (BAGV) in one pool, and an insect specific virus was detected in one pool. Due to the short length of sequence data obtained, cluster maps were used to determine relationships with previous isolates using sequence data retrieved from GenBank. Cluster maps confirmed that none of the isolates were newly introduced but closely related to isolates previously detected in the country. Sindbis virus genotype 1 and WNV lineage 2 are known to cause outbreaks of human disease after heavy rainfall, favoring an increase in mosquito populations. Middelburg virus has been associated with neurological disease in horses and some recent evidence in humans. Bunyamwera virus has previously been associated with mild febrile disease and GERV with laboratory acquired infections, but the public health significance is not well known and similarly with BAGV. This study confirmed the current circulation of mosquito-borne viruses other than the common viruses and suggest further investigation to determine the medical significance would be important.
44. Effectiveness of nurse-led smoking cessation interventions in smoking patients: A systematic review and network meta-analysis of randomized controlled trials.
期刊: International journal of nursing studies 发表日期: 2025-Aug-27 链接: PubMed
摘要
Tobacco use reduces quality of life and life expectancy in all patients. Nurse is the largest group of healthcare professionals, and nurse-led smoking cessation interventions are effective for smoking patients. To evaluate and compare the effectiveness of various nurse-led interventions on smoking cessation among patients. PubMed, Web of Science, CINAHL, Embase, PsycINFO, Scopus, and the Cochrane Central Register of Controlled Trials were searched from inception until May 10, 2025. Randomized controlled trials (RCTs) conducted in smoking patients who received nurse-led smoking cessation interventions were included. Primary outcome was self-reported or validated tobacco abstinence prevalence at the last follow-up. Secondary outcomes included abstinence within or beyond 6 months. The revised Cochrane risk-of-bias tool was used to assess the risk of bias and the credibility of evidence using the CINeMA. Risk ratios (RR) were used to compare the effect sizes of different comparisons. Network meta-analyses were performed with random-effect models. This study was reported following the PRISMA Extension Statement for Reporting of Systematic Reviews Incorporating Network Meta-analyses of Health Care Interventions. Of 3512 studies initially identified, 26 RCTs with 14,367 smoking patients were included, and eight intervention combinations were identified. Intensive counseling + varenicline (RR = 2.78, 95 % CI [1.95, 3.95], moderate certainty), intensive counseling + family-based intervention (RR = 2.68, 95 % CI [1.63, 4.39], moderate certainty), intensive counseling + nicotine replacement therapy (RR = 1.38, 95 % CI [1.08, 1.77], low certainty), and intensive counseling (RR = 1.17, 95 % CI [1.01, 1.36], very low certainty) were superior to brief advice. Brief advice (RR = 1.51, 95 % CI [1.12, 2.02]) and brief counseling (RR = 1.54, 95 % CI [1.13, 2.09]) were superior to usual care with low evidence. The surface under the cumulative ranking curve showed that intensive counseling + varenicline (99.6 %) and intensive counseling + family-based intervention (99.7 %) are the strongest intervention to increase tobacco abstinence prevalence within and beyond 6 months, respectively. Nurses should incorporate brief advice or brief counseling in their routine care for smoking patients. Intensive counseling plus varenicline, nicotine replacement therapy or family-based intervention are the optimal nurse-led interventions for smoking cessation. The certainty of evidence for these interventions was generally very low to moderate. More high-quality research is warranted to ascertain the findings. The study protocol was registered at PROSPERO (Registration number: CRD42023479985).
45. Effects of a nurse-led diabetes self-management programme for people with type 2 diabetes receiving insulin injection therapy: A randomised controlled trial with qualitative process evaluation.
期刊: International journal of nursing studies 发表日期: 2025-Aug-27 链接: PubMed
摘要
Many people with type 2 diabetes eventually require and benefit from insulin injection therapy, but only a minority of people receiving such therapy meet their glycaemic targets. Thus, effective diabetes self-management programmes are needed to support this cohort. To examine the effects of a nurse-led diabetes self-management programme on self-efficacy, self-management behaviours, glycaemic control, and diabetes-related distress of Chinese people with type 2 diabetes receiving insulin injection therapy, and to collect their experiences and perceived benefits of and feedback on the programme. A prospective, two-arm, assessor-blinded, randomised controlled trial with repeated measures and qualitative process evaluation. Participants were recruited from a public community health service centre. One hundred and two participants (mean age: 64.03 years, standard deviation = 9.77 years) were recruited and then randomly assigned to the intervention group or the attention control group. The intervention group (n = 51) received a 6-week nurse-led diabetes self-management programme. This intervention was underpinned by Bandura’s theory of self-efficacy and consisted of one individual interview session, three group-based education sessions, and two telephone-based maintenance sessions. The attention control group (n = 51) received parallel 6-week attention control contact. Outcome variables were measured at baseline (T0), upon completion of the intervention (T1), and at 3 months post-intervention (T2). At T0, there were no significant between-group differences in characteristics, except for education level, and no significant between-group differences in any outcome variables. At T1, compared with the attention control group, the intervention group exhibited significantly enhanced self-efficacy (β = 17.341, p< 0.001), improved self-management behaviours (β = 0.696, p< 0.001), and reduced diabetes-related distress (β = -0.160, p = 0.015). However, at T2, compared with the attention control group, the intervention group did not demonstrate significant improvement in any outcome variables (all p> 0.05). No adverse effects were reported by the participants. Qualitative interviews of 21 participants of the intervention group generated responses that could be categorised under four themes, namely perspectives on receiving the intervention, benefits of the intervention, barriers to behavioural change, and areas for improvement. The nurse-led programme was effective in enhancing self-efficacy, improving self-management behaviours, and alleviating diabetes-related distress in Chinese people with type 2 diabetes receiving insulin injection therapy. Based on the findings of the qualitative evaluation, suggestions are made regarding modifications and large-scale implementation that can be explored in future research. Chinese Clinical Trial Registry (ChiCTR); ChiCTR2100046342 (https://www.chictr.org.cn/showproj.html?proj=126516). May 14, 2021.
46. Research on the construction method and characterization of neutralizing mouse-canine chimeric antibody against canine distemper virus.
期刊: Virology 发表日期: 2025-Aug-26 链接: PubMed
摘要
Canine distemper (CD) is an acute infectious disease that poses significant health risks to canines. Neutralizing monoclonal antibody (mAb) therapy has demonstrated substantial efficacy in prevent CDV infection. However, immune rejection reactions prevent the use of mouse-derived mAbs in the prophylactic protection of CD. Based on the previously developed neutralizing mAb 9-7B targeting the CDV-H protein, this study successfully utilized both single and dual expression vector strategies to integrate the variable regions of mouse-derived mAb with the constant regions of canine-derived mAb, yielding M-C-H/L and M-C-L-H mouse-canine chimeric antibodies through the CHO expression system. The SDS-PAGE and WB results indicate that both chimeric antibodies possess the correct antibody structure. Both chimeric antibodies specifically recognized the CDV-H protein and CDV in indirect ELISA and indirect immunofluorescence experiments and their neutralizing effect on CDV was confirmed in neutralization assays. This study constructed mouse-canine chimeric antibodies against CDV using two methods for the first time, which provides significant guidance for research on prophylactic CD antibody-based drugs.
47. Influenza vaccine effectiveness over 17 seasons in a large Japanese cohort: Analyses by age, virus type, underlying diseases and seasons before the COVID-19 pandemic.
期刊: Journal of infection and public health 发表日期: 2025-Aug-25 链接: PubMed
摘要
As populations age and influenza reemerges post-COVID-19, evaluating vaccine effectiveness (VE) across age groups, comorbidities, virus types, and seasons is increasingly important. A prospective multicenter cohort study was conducted annually by the Japan Physicians Association. Outpatients were registered with vaccination status before each influenza season and reported rapid antigen test results afterward. This analysis included 148,108 patients from 543 facilities across Japan during the 2002-2003 to 2018-2019 seasons. VE was estimated using unadjusted and adjusted logistic regression. Adjusted analyses showed significant protection in children ≤ 15 years and adults < 65 years, with VE of 56 % and 51 %, respectively. VE remained significant through the 40 s (20-47 %) but declined in those ≥ 50 and was nearly absent in individuals ≥ 80, especially ≥ 90. VE was lower in patients with underlying diseases (24 %) than in those without (47 %), with non-overlapping 95 % confidence intervals. An exception was children with bronchial asthma: incidence in unvaccinated children with asthma was higher (24.2 %) than in those without comorbidities (12.9 %), and VE was also high (60 %). Adjusted VE against influenza A remained significant through the 40 s (35-56 %) and against influenza B through the 20 s (27-49 %). Unadjusted VE against influenza A declined from 40 % (2002-2009) to 15 % (2010-2019), possibly due to antigenic drift or egg adaptation. Seasonal influenza vaccines showed moderate effectiveness, especially in individuals < 40 years and those without comorbidities. Effectiveness declined with age, underscoring the need for improved vaccines and targeted strategies for older adults.
48. Psychotic-like experiences, sleep problems, and loneliness: A population-based study.
期刊: Psychiatry research 发表日期: 2025-Aug-24 链接: PubMed
摘要
Research indicates that psychotic-like experiences (PLEs) are associated with sleep problems, which in turn may contribute to negative outcomes in individuals with PLEs. This study examined the association between sleep problems and PLEs in the Japanese general population, and whether sleep problems are linked to loneliness among individuals with PLEs. Data were analyzed from 3717 adults aged 18 and above who participated in an online survey in 2023. PLEs were assessed with the PRIME Screen-Revised (PS-R), while a single-item self-report measure was used to assess the intensity of sleep problems. Logistic regression analyses were conducted to examine the associations. In an analysis that was adjusted for sociodemographic, physical, and mental health variables, compared to those with no sleep problems, only individuals who reported extreme sleep problems had significantly higher odds of PLEs (OR: 2.93, 95 %CI: 1.38-6.23). An analysis examining the role of sleep problems in the association between PLEs and loneliness showed that PLEs were significantly associated with loneliness only when accompanied by extreme sleep problems (OR: 4.45, 95 % CI: 1.12-17.70), with no significant association observed in their absence (OR: 1.12, 95 % CI: 0.74-1.69). Extreme sleep problems are associated with PLEs in Japanese adults. Furthermore, among adults with PLEs, extreme sleep problems may contribute to loneliness. These findings suggest that identifying and treating sleep difficulties in Japanese adults with PLEs may yield benefits that extend beyond sleep outcomes alone.
49. Feasibility of Intravaginal Artesunate as an Adjuvant HPV & Cervical Precancer Treatment Among Women Living With HIV in Kenya: Study Protocol for a Phase II Clinical Trial.
期刊: Cancer control : journal of the Moffitt Cancer Center 发表日期: 2025 链接: PubMed
摘要
IntroductionCervical cancer disproportionately affects women in low- and middle-income countries (LMICs), who account for 90% of deaths from the disease. Human papillomavirus (HPV) is responsible for 99% of cervical cancer cases. Women living with HIV (WLWH) have a higher risk of persistent HPV infection and a greater likelihood of developing cervical cancer. Prevention of cervical cancer requires effective screening and precancer treatment programs. In LMICs, the common treatment method for cervical precancer is thermal ablation. However, for WLWH, thermal ablation is associated with high rates of persistent HPV infection following treatment, a key risk factor for precancer recurrence. Adjuvant topical treatments with cytotoxic or antiviral properties may reduce HPV persistence following ablation. Preclinical and early-phase clinical trials indicate that topical artesunate is active against HPV-associated anogenital lesions, including cervical precancer, and can induce HPV clearance. Consequently, intravaginal artesunate may improve HPV clearance following thermal ablation, although no clinical trials have investigated this.MethodsWe are conducting a phase II, double-blind, randomized, placebo-controlled trial among 120 HIV seropositive women in Kenya to investigate the feasibility of self-administered intravaginal artesunate pessaries as adjuvant therapy following thermal ablation treatment for cervical precancer. The primary outcome is type-specific HPV clearance 6 months after randomization. Secondary outcomes are safety, adherence, acceptability, uptake, and retention. Participants will be enrolled at least 4 weeks after ablation and will self-administer pessaries on weeks 1, 3, and 5, with alternating drug-free weeks. Study follow-up will extend to 24 weeks after randomization.ConclusionHigh rates of persistent HPV infection in WLWH is a key limitation of thermal ablation, the most accessible cervical precancer treatment in LMICs. This trial will investigate the feasibility of repurposing topical artesunate as an adjuvant therapy to improve HPV clearance following thermal ablation in WLWH.Trial RegistrationClinicalTrials.gov identifier: NCT06519994.
50. Consumption of sorghum-based products and their impact on blood glucose and satiety in adult patients: A protocol for systematic review and meta-analysis.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The consumption of sorghum-based foods has been associated with reduced postprandial blood glucose levels and increased satiety in previous studies. Sorghum’s low glycemic index, high fiber content, and rich profile of bioactive compounds may contribute to improved health outcomes. Nutritional strategies incorporating sorghum could serve as a valuable tool for the prevention of diabetes, obesity, as well as other non-communicable diseases. To identify and evaluate the evidence on the effectiveness of the sorghum-based foods in modulating blood glucose levels and promoting satiety in adults. This systematic review protocol was developed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. We will include randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) published through February 2025 that assess the effects of sorghum-based food consumption. Qualitative studies, guidelines, and reviews will be excluded. Six electronic databases-MEDLINE/PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, and ScienceDirect-will be systematically searched. Additional sources will include ClinicalTrials.gov, The British Library, Google Scholar, International Diabetes Federation, and American Diabetes Association (ADA). No restrictions on language or publication date will be applied. Two independent reviewers will perform study selection, data extraction, and risk of bias assessment according to the study design. A qualitative synthesis will be presented. Statistical heterogeneity will be assessed using the I² statistic. If appropriate, a meta-analysis will be conducted using a random-effects model. To the best of our knowledge, this will be the first systematic review to specifically address the impact of sorghum-based food consumption on glycemic response and satiety. The findings are expected to provide robust evidence to inform future research and support nutritional strategies involving sorghum-based products for health promotion. CRD42023431520.
51. Impact of health promotion strategies on HPV vaccination uptake: A descriptive epidemiological study (2019-2024).
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The effectiveness of vaccines depends not only on resource availability but also on broad public acceptance and the uptake of widely accessible vaccines. A vaccination campaign is a strategically coordinated initiative designed to enhance vaccine coverage within a specific population. This study evaluated the impact of health promotion strategies (HPS), including social marketing and education, on human papillomavirus (HPV) vaccine uptake among adolescents aged 9-19 years in City of Novi Sad, Serbia (population ~300,000). Since 2020, efforts have transitioned from individual to organized, publicly funded initiatives. A descriptive epidemiological study was conducted using anonymized data from the electronic immunization registry (2019-2024). Data on HPS implementation were obtained from the Institute of Public Health of Vojvodina. Statistical analyses included Mann-Whitney U test, ANOVA, correlation, and multiple regression with time lag. From 2019 to 2024, 6,395 adolescents received the HPV vaccine, with sharp increases in 2023-2024. Among the different strategies analyzed, health promotion through educational media content delivered by physicians (TV, radio, social networks) and the implementation of the “Open Door” initiative had the most consistent and positive association with increased vaccination coverage. Vaccination uptake was strongly associated with frequent and accessible promotional activities, especially the “Open Door” initiative (r =.668, p <.01; β =.687, p <.001). Media activities showed moderate effects (r =.270, p <.05). Educational activities show only a weak or non-significant correlation with vaccination rates, except for their modest association with website updates (r =.282, p <.05). Accessible, action-oriented interventions, particularly “Open Door” days, were the most effective strategy for increasing adolescent HPV vaccination. Social marketing combining convenience and multi-channel communication significantly enhanced uptake. These findings support the implementation of targeted, barrier-reducing public health strategies to improve vaccine coverage.
52. The relation between sensation seeking, aggression and self-confidence with Needle stick and Sharp injuries among nurses.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
One of the most important occupational injuries experienced by nurses is needle sticks. The causes and factors of needle sticks are not fully known. This study was conducted with the aim of investigating the relationship between sensation-seeking, aggressiveness, and self-confidence with needle stick and Sharp injuries among nurses in a children’s and women’s hospital. This cross-sectional study was conducted on 143 nursing personnel of a children’s and women’s hospital in Iran. To collect data, people were asked to complete several questionnaires, including a demographic questionnaire, Arnett questionnaire of Sensation Seeking, aggression characteristics questionnaire (AGQ), and Rosenberg’s self-confidence questionnaire. They were also asked about the number of injuries caused by nurses’ needles and Sharp injuries in the last 12 months. Data analysis was done using SPSS software (version 22). The results of this study showed, no relationship was between sensation seeking, aggression, and self-confidence with Needle sticks and Sharp injuries among nurses (P-value>0.05). Age and work experience have the inverse significant relationship with sensation seeking (P-value<0.05). The most common cause of needle sticks and sharp injuries was syringes (52.9%). There is no relationship between sensation seeking, aggression, and self-confidence with Needle sticks and Sharp injuries among nurses. Nurses with high age and more work experience show less sensation-seeking. Needle sticks and Sharp injuries in nurses were mostly caused by syringes.
53. Examining self-employment policies for persons with disabilities in South Africa: Perspectives from policy actors.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Despite robust global and national efforts to promote inclusive development, a significant gap persists in countries such as South Africa’s self-employment policies for persons with disabilities. The existing legislative framework, although well-intentioned, lacks clear and comprehensive guidance on self-employment as a viable placement option for persons with disabilities. Consequently, this ambiguity hinders effective policy implementation, limiting economic empowerment and social inclusion. This research aimed to explore the existence of self-employment-specific policies for persons with disabilities and policy actors’ involved in South Africa. The participants (n = 47) had an average of 10 years of experience in self-employment for persons with disabilities, holding qualifications ranging from no formal education to master’s degrees. This qualitative study ensured transparent and systematic reporting using the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Purposive and snowball sampling were utilised to recruit participants. Data were collected using a piloted question guide and analysed using the NVIVO software. Data was analysed thematically. Ethics clearance, relevant gatekeepers’ permission and informed written consent from participants were obtained. Two themes emerged, namely, theme one: The status quo on self-employment-specific policies for persons with disabilities. Participants reported on the absence of explicit policies on self-employment for persons with disabilities, the lack of effectiveness in inclusive South African legal frameworks and their lack of impact on promoting self-employment opportunities. Theme two: policy actors’ involvement in self-employment-specific policies for persons with disabilities. Participants reported on the roles and responsibilities of policy actors and strategies to promote self-employment opportunities for persons with disabilities through policy reforms. The research revealed a complex policy landscape where the absence of self-employment-specific policies for persons with disabilities coexists with potentially leverageable inclusive frameworks. These coexist with potential policy actors who have the potential to facilitate implementation. Leveraging existing policies through effective implementation and targeted policy reforms would ensure the full participation of persons with disabilities in self-employment. Key policy actors should familiarise themselves with the existing legal framework and emphasise enforcement and consequence management to ensure policies are implemented effectively. Furthermore, a coordinated approach is necessary, involving: a single or integrated system or database to streamline policy implementation and monitoring; a targeted approach that prioritises persons with disabilities in self-employment; and policies that allow for target setting, accurate measurement of targets, and effective monitoring and evaluation. Thus, a policy brief outlining the key findings should be considered, drafted, and submitted to the relevant government department (e.g., Department of Employment and Labour) for further action.
54. Correction: The internet of things deployed for occupational health and safety purposes: A qualitative study of opportunities and ethical issues.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
[This corrects the article DOI: 10.1371/journal.pone.0315671.].