公共卫生研究摘要 (2025-09-09)
共收录 50 篇研究文章
1. Trends in Status Epilepticus-Related Mortality Disparities in the United States, 1999-2020.
期刊: Neurology 发表日期: 2025-Oct-07 链接: PubMed
摘要
Status epilepticus (SE) is a life-threatening neurologic emergency. Although health disparities in epilepsy are well-documented, disparities in SE mortality are not fully understood. This study analyzes mortality trends and demographics in the United States from 1999 through 2020. This was a retrospective study of national data from the Center for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research platform. We identified annual deaths due to SE for the years 1999 through 2020, stratified by age and by race and ethnicity. From 1999 through 2020, there were 16,491 deaths due to SE in the United States. Overall, there was nearly a 2-fold increase in the age-standardized mortality due to the SE rate from 1999 to 2020 (0.13 per 100,000 persons [95% CI 0.11-0.15] in 1999 to 0.25 per 100,000 persons [95% CI 0.23-0.27] in 2020). This increase was most pronounced among older individuals (aged 75 years and older, followed by ages 50-74 years), and in non-Hispanic Black or African American individuals. Over the past 2 decades, deaths attributed to SE have increased. This increase was most pronounced among individuals aged 75 years or older and Black or African Americans. Investigation into the underlying causes of SE-related mortality and reasons for these disparities is needed.
2. Addressing Missingness in Predictive Models That Use Electronic Health Record Data.
期刊: Annals of internal medicine 发表日期: 2025-Sep-09 链接: PubMed
摘要
Electronic health record (EHR) data are increasingly used to develop prediction models that guide clinical decision making at the point of care. These include algorithms that use high-frequency data, like in sepsis prediction, as well as simpler equations, such as the Pooled Cohort Equations for cardiovascular outcome prediction. Although EHR data used in prediction models are often highly granular and more current than other data, there is systematic and nonsystematic missingness in EHR data as there is with most data. Despite growing use for clinical decisions, algorithms implemented in EHRs are mostly unregulated and are often opaque to the user. Guidelines about the development, validation, implementation, and reporting on clinical prediction models are sparse in their recommendations regarding missing data. This article characterizes missingness in EHR data, summarizes methods for attending to missing data when developing prediction models, makes recommendations about validation and implementation of models in practice when data are missing, and identifies research needs in this field.
3. The Potential Impact of Ending the Ryan White HIV/AIDS Program on HIV Incidence: A Simulation Study in 31 U.S. Cities.
期刊: Annals of internal medicine 发表日期: 2025-Sep-09 链接: PubMed
摘要
With antiretroviral therapy, people with HIV can live a normal lifespan and not transmit HIV. The Ryan White HIV/AIDS Program provides care for over half of people with HIV in the United States. To estimate how many HIV infections could result from cessation of Ryan White services or interruptions lasting 18 to 42 months. A compartmental HIV transmission model was used to simulate epidemics and Ryan White service use. The researchers calibrated model transmission to surveillance data from the U.S. Centers for Disease Control and Prevention in each city and calibrated the number of Ryan White clients to program reports. Ryan White clinic directors and administrators were surveyed to estimate how many clients would lose viral suppression if services stopped. Simulated HIV epidemics in 31 high-burden U.S. cities. Through 2030. Not applicable. The researchers projected HIV incidence under the following 4 scenarios: continued services, cessation in July 2025, interruption until January 2027, and interruption until January 2029. Projected excess HIV infections from 2025 to 2030. Ending Ryan White services in July 2025 could result in 75 436 additional infections (95% credible interval [CrI], 19 251 to 134 175 infections) through 2030-a 49% (95% CrI, 12% to 86%) increase. Increases ranged from 9% (Riverside, California) to 110% (Baltimore, Maryland). Interruptions of 18 and 42 months yielded 19% and 38% more infections, respectively. A “conservative” analysis with lower simulated loss of suppression from observational studies projected 34 051 excess infections (95% CrI, 23 902 to 45 147 infections). The loss of suppression if Ryan White services end may be misestimated by survey responses and observational studies. Disrupting Ryan White services could sharply increase HIV incidence, highlighting their critical public health value. None.
4. Chronic Kidney Disease.
期刊: Annals of internal medicine 发表日期: 2025-Sep-09 链接: PubMed
摘要
Nearly 14% of Americans have chronic kidney disease (CKD), which includes persistent decrements in glomerular filtration rate or the presence of albuminuria. Although CKD is commonly attributed to diabetes or hypertension, there is growing awareness of the interplay among cardiovascular, kidney, and metabolic health. Progression of CKD can result in metabolic abnormalities and end-stage kidney disease, but cardiovascular events are even more common. The main goals of CKD treatment include slowing the decline in kidney function, preventing cardiovascular disease, and treating metabolic complications. Recent pharmacologic advancements have yielded effective therapeutic agents capable of concurrently addressing all of these objectives.
5. Directory of Public Datasets for Youth Mental Health to Enhance Research Through Data, Accessibility, and Artificial Intelligence: Scoping Review.
期刊: JMIR mental health 发表日期: 2025-Sep-08 链接: PubMed
摘要
Youth mental health issues have been recognized as a pressing crisis in the United States in recent years. Effective, evidence-based mental health research and interventions require access to integrated datasets that consolidate diverse and fragmented data sources. However, researchers face challenges due to the lack of centralized, publicly available datasets, limiting the potential for comprehensive analysis and data-driven decision-making. This paper introduces a curated directory of publicly available datasets focused on youth mental health (less than 18 years old). The directory is designed to serve as critical infrastructure to enhance research, inform policymaking, and support the application of artificial intelligence and machine learning in youth mental health research. Unlike a systematic review, this paper offers a brief overview of open data resources, addressing the challenges of fragmented health data in youth mental health research. We conducted a structured search using 3 approaches: targeted searches on reputable health organization websites (eg, National Institutes of Health [NIH] and Centers for Disease Control and Prevention [CDC]), librarian consultation to identify hard-to-find datasets, and expert knowledge from prior research. Identified datasets were curated with key details, including name, description, components, format, access information, and study type, with a focus on freely available resources. A curated list of publicly available datasets on youth mental health and school policies was compiled. While not exhaustive, it highlights key resources relevant to youth mental health research. Our findings identify major national survey series conducted by organizations such as the NIH, CDC, Substance Abuse and Mental Health Services Administration (SAMHSA), and the U.S. Census Bureau, which focus on youth mental health and substance use. In addition, we include data on state and school health policies, offering varying scopes and granularities. Valuable health data repositories such as ICPSR, Data.gov, Healthdata.gov, Data.CDC.gov, OpenFDA, and Data.CMS.gov host a wide range of research data, including surveys, longitudinal studies, and individual research projects. Publicly accessible health data are essential for improving youth mental health outcomes. Compiling and centralizing these resources streamlines access, enhances research impact, and informs interventions and policies. By improving data integration and accessibility, it encourages interdisciplinary collaboration and supports evidence-based interventions.
6. A pilot study on the impact of wearing powered air-purifying respirators on speech intelligibility.
期刊: Journal of occupational and environmental hygiene 发表日期: 2025-Sep-08 链接: PubMed
摘要
Powered air-purifying respirators (PAPR) have become an increasingly utilized form of respiratory protection against highly infectious aerosols. In the United States, PAPRs have been used in high-level clinical isolation settings to care for patients infected with viral hemorrhagic fevers and, more recently, during the COVID-19 pandemic. PAPRs have long been used for biocontainment care and experienced increased use during the pandemic because they provide full-face visibility and eye and respiratory protection. Despite their extended use, limited studies have explored the operational usability and limitations of these devices, especially during patient care and communication. For this pilot study, the speech intelligibility of two commonly used PAPR brands was examined in a clinical setting using some requirements from the National Institute for Occupational Safety and Health (NIOSH) standard testing procedure (NIOSH TEB-CBRN-APR-STP-0313 Determination of Communication Performance Test For Speech) for determining communication performance for speech conveyance in PAPRs. A total of 19 study participants were split into 17 speakers and two listeners. Speakers were assigned to test groups. Each speaker was provided with a word list, while listeners were provided with a response list. A modified rhyme test (MRT) was conducted to determine the communication performance rating of each PAPR brand. The 3M PAPR had a higher performance rating than MAXAIR across all test groups, despite having a 5 dBA higher internal noise. The difference in the mean performance rating of 3M (75) was significantly higher than that of MAXAIR (59) (95% CI: -23.66-9.09). Overall, the 3M PAPR was strongly preferred among study participants in terms of comfort, fit, and noise level. Interventions such as incorporating communication devices are of interest for future study, and an assessment of additional limitations is needed to optimize PAPR use in clinical care activities.
7. Dengue Epidemiology in 7 Southeast Asian Countries: 24-Year, Retrospective, Multicountry Ecological Study.
期刊: Interactive journal of medical research 发表日期: 2025-Sep-08 链接: PubMed
摘要
Dengue fever remains the most significant vector-borne disease in Southeast Asia, imposing a substantial burden on public health systems. Global warming and increased international mobility may exacerbate the disease’s prevalence. Furthermore, the unprecedented COVID-19 pandemic may have influenced the epidemiological patterns of dengue. This study aimed to evaluate epidemiological changes in dengue incidence in Southeast Asia. We conducted a retrospective, multicountry ecological study analyzing trends in dengue incidence in 7 Southeast Asian countries from January 2000 to December 2023. Data were extracted from official World Health Organization reports and national health department databases. Countries with data that were incomplete, inconsistent, or not publicly available were excluded from the final analysis. Annual incidence rates were analyzed, and linear trends were calculated to assess long-term patterns. Epidemiological data from 7 Southeast Asian countries, comprising Thailand, Singapore, Vietnam, Malaysia, the Philippines, Cambodia, and Taiwan, were analyzed across the 24-year study period. A notable nadir in dengue cases was observed coinciding with the COVID-19 pandemic. Significant increasing trends in dengue incidence were identified in Singapore, Vietnam, Malaysia, and the Philippines (slopes: 8.243, 6.513, 8.737, and 8.172; R2 values: 0.14, 0.34, 0.345, and 0.46, respectively, all P<.05). Dengue fever continues to pose a significant public health challenge in Southeast Asia. Our analysis demonstrates a substantial increase in dengue cases in several countries over the study period. While a temporary decline was observed during the COVID-19 pandemic, a subsequent resurgence of cases highlights the persistent threat of dengue in the region. These findings underscore the critical need for sustained surveillance and innovative control strategies to mitigate the impact of dengue in Southeast Asia.
8. The Burden of Cancer and Precancerous Conditions Among Transgender Individuals in a Large Health Care Network: Retrospective Cohort Study.
期刊: JMIR cancer 发表日期: 2025-Sep-08 链接: PubMed
摘要
Disparities in cancer burden between transgender and cisgender individuals remain an underexplored area of research. This study aimed to examine the cumulative incidence and associated risk factors for cancer and precancerous conditions among transgender individuals compared with matched cisgender individuals. We conducted a retrospective cohort study using patient-level electronic health record (EHR) data from the University of Florida Health Integrated Data Repository between 2012 and 2023. Transgender individuals were identified using a validated, computable phenotype algorithm that used structured data and clinical notes. They matched 1:10:10 by age and calendar year of index date with cisgender women and cisgender men. The index date was the first transgender-related record for transgender individuals and a matched diagnosis date for cisgender controls. Primary outcomes included new-onset cancers associated with human papillomavirus, human immunodeficiency virus, tobacco, alcohol, lung, breast, and colorectal sites. Secondary outcomes were precancerous conditions related to the same cancer types. We calculated cumulative incidence rates and conducted time-to-event analyses using the Fine-Gray method, treating all-cause death as a competing risk, to assess associations between gender identity and the presence of cancer or precancer, adjusting for demographic and clinical covariates. Interaction analyses evaluated if associations between cancer risk factors and precancer differed by gender identity. We identified 2745 transgender individuals (mean age at index date 25.1, SD 14.0 years) and matched them with 27,450 cisgender women and 27,450 cisgender men from the same health care system. The cumulative incidence of cancer did not differ significantly between transgender and cisgender cohorts (transgender n=28, 1.0% vs cisgender women, n=358, 1.3%; P=.13 and cisgender men, n=314, 1.1%; P=.64). However, transgender individuals exhibited significantly higher risks for precancerous conditions compared to cisgender women (subdistribution hazard ratios [sHRs] 1.1, 95% CI 1.0-1.3) and cisgender men (sHR 1.3; 95% CI 1.2-1.5). Specifically, transgender individuals were more likely to develop colorectal precancer (sHR 1.2; 95% CI 1.1-1.4) compared to cisgender women, as well as human papillomavirus-related precancer (sHR 1.8; 95% CI 1.4-2.3) and colorectal precancer (sHR 1.4; 95% CI 1.2-1.6) compared to cisgender men. Subgroup analyses showed similar patterns in both female-to-male and male-to-female individuals compared with their matched cisgender counterparts. Interaction analyses revealed stronger protective effects of private insurance or Medicare against precancers in transgender individuals than in cisgender peers, while being non-Hispanic Black or having substantial comorbidities were stronger risk factors among transgender individuals. Transgender individuals showed a similar cancer incidence yet significantly higher precancer incidence compared with cisgender individuals, suggesting underdiagnosis or delayed detection. These findings highlight the need for tailored preventive care strategies, including targeted screenings and risk reduction interventions, to address cancer disparities in the transgender population.
9. Structure-Activity Relationships of 3-Hydroxypropanamidines (HPAs) with Potent In Vivo Antimalarial Activity.
期刊: Journal of medicinal chemistry 发表日期: 2025-Sep-08 链接: PubMed
摘要
New treatment strategies are required to combat the spread of drug-resistant Plasmodium falciparum malaria. The synthesis and preclinical evaluation of novel 3-hydroxy-propanamidines (HPAs), with modifications of the phenanthrene and the 4-fluorobenzamidine moieties, has yielded several analogs exhibiting excellent in vitro growth inhibition of drug-sensitive or resistant P. falciparum fresh clinical isolates and culture-adapted strains. No cytotoxicity in the human HepG2 cell line was observed, demonstrating notable parasite selectivity. The most active HPA 7d, which features a 4-bromobenzamidine moiety, inhibited the formation of synthetic hemozoin (β-hematin) with IC50 values lower than chloroquine and the lead compound TKK130. Additionally, 7d showed a killing rate comparable to chloroquine. In initial in vivo pharmacokinetics, 7d displayed a favorable pharmacokinetic profile, with a fast onset and slow elimination phase. In vivo, 7d demonstrated dose-dependent curative activity after oral administration in the Plasmodium berghei mouse model, without apparent signs of toxicity.
10. Experiences of Formal and Informal Support Among Adult-Daughter Caregivers of People With Dementia in Sweden: A Qualitative Study.
期刊: Dementia (London, England) 发表日期: 2025-Sep-08 链接: PubMed
摘要
People with dementia are living longer in the community and reliance on informal caregivers is increasing. Few studies have focused on the experiences of adult-daughter caregivers (daughter caregivers), who may have increased risk of depression and lack of support compared with spousal caregivers. We aimed to explore the experiences of accessing and receiving formal and informal support among daughter caregivers of people living with dementia in Sweden. We conducted semi-structured interviews with 23 daughter caregivers. A topic guide was used to explore experiences of accessing and receiving formal and informal support in their caregiving role. We analyzed the interviews using reflexive thematic analysis. We generated two themes: Types of support, and Mismatched support. The first theme, with subthemes Sharing experiences, Professional support, and Getting some relief, captured the caregiver support context with different types of support accessed and received by daughter caregivers, with peer support and informational support identified as important components of caregiver support. The second theme, with subthemes Lack of tailoring to daughter caregivers’ needs and Difficulties navigating support, captured how daughter caregivers perceived existing support to be inadequate to meet their specific needs and the complex structure of available support limited their opportunities to access support. Daughter caregivers experience a mismatch between the type of support accessed and received and their specific support needs. Support better tailored to the needs and situation of daughter caregivers of people with dementia in Sweden is required. The potential of utilizing peer support for caregivers warrants further research.
11. Impact of Commercial Food Environments on Local Type 2 Diabetes Burden: Cross-Sectional and Ecological Multimodeling Study.
期刊: JMIR public health and surveillance 发表日期: 2025-Sep-08 链接: PubMed
摘要
Neighborhoods resulting from rapid urbanization processes are often saturated with eateries for local communities, potentially increasing exposure to unhealthy foods and creating diabetogenic residential habitats. We examined the association between proximity of commercial food outlets to local neighborhood residences and type 2 diabetes (T2D) cases to explore how local T2D rates vary by location and provide policy-driven metrics to monitor food outlet density as a potential control for high local T2D rates. This cross-sectional ecological study included 11,354 patients with active T2D aged ≥20 years geocoded using approximate neighborhood residence aggregated to area-level rates and counts by subdistricts (mukims) in Penang, northern Malaysia. We used the National Diabetes Registry complemented with data from medical records across 29 primary care clinics throughout the state. Food establishment data were retrieved from the Open Data Portal sourced through the Penang GeoHub, and urbanization indicators were retrieved from MyCensus 2020. We executed point-level proximity- and density-based area-level analysis through multimodel aspatial and spatial regression methods. Our final hierarchical linear regression revealed that the distance to food complexes, hawker markets, kopitiams (a type of coffee shop), 24-7 convenience stores, fast food outlets, and public markets showed statistically significant associations (P<.05) with the age and BMI of patients with T2D. In the multiscale geographically weighted regression model, the adjusted R2 values ranged from 0.15 to 0.62, with lower values observed across the mainland. The multiscale geographically weighted regression model yielded average β coefficients for densities of kopitiams (β=0.256), fast food outlets (β=-0.061), 24-7 convenience stores (β=0.028), supermarkets (β=0.122), public markets (β=0.067), and nasi kandar (a type of rice dish) restaurants (β=-0.064), urban growth rate (β=0.189), and population density (β=-0.080; t65.835≥1.96 in all cases). We established population-attributable fractions suggesting that, if local neighborhoods underwent township restructuring to remove food complexes, hawker markets, or kopitiams, an estimated reduction of 0.21%, 0.27%, and 0.09%, respectively, in the risk of T2D cases in Penang would be anticipated. However, if local neighborhoods underwent township restructuring to add hawker complexes, nasi kandar restaurants, fast food outlets, 24-7 convenience stores, public markets, or supermarkets, an estimated reduction of between 0.07% and 0.64% in the number of residents with risk of T2D was estimated. The reported variations provide insights into the associations between high neighborhood T2D rates and the density of a range of food outlets. We observed that these associations varied by place, providing insight into potential monitoring and policy considerations. This work provides evidence for interpretation at the individual and aggregate levels, shifting public health interventions from a generic to a targeted approach and prompting township planners to restructure food outlet accessibility or availability in local neighborhoods and to develop health behavior interventions for local communities for healthy food purchase and consumption.
12. Associations Between Sleep Duration and Cognitive Function Among Older Adults: Cross-Sectional Study.
期刊: JMIR human factors 发表日期: 2025-Sep-08 链接: PubMed
摘要
Sleep duration plays a crucial role in cognitive health and is closely linked to cognitive decline. However, the relationship between sleep duration and cognitive function in the Chinese population remains poorly understood. This study aims to evaluate the association between sleep duration and cognitive function among middle-aged and older adults in China. Using data from 15,526 participants in the 2020 China Health and Retirement Longitudinal Study, we used 3 composite indicators, encompassing episodic memory, mental acuity, and overall cognitive function to evaluate cognitive performance. Sleep duration per night, self-reported through face-to-face interviews, was also obtained. Adjustments were made using multiple generalized linear regression models, accounting for demographic, lifestyle, and health-related covariates. Among the 15,526 respondents analyzed, 53.02% (8232/15,526) were female and 46.98% (7294/15,526) were male, with an average age of 61.5 (SD 9.27) years. Those reporting sleep durations of 4 hours or less (β=-1.85, 95% CI -2.07 to -1.62), 5 hours (β=-0.55, 95% CI -0.78 to -0.33; P<.001), 9 hours (β=-1.78, 95% CI -2.17 to -1.39), and 10 hours or more (β=-3.01, 95% CI -3.39 to -2.63) per night had a significant negative relationship with cognitive function. In the adjusted model, the negative impact of long sleep (≥10 hours) on overall cognitive function became more pronounced (β=-3.01, 95% CI -3.39 to -2.63; P<.001), followed closely by extremely short sleep (≤4 hours; β=-1.85, 95% CI -2.07 to -1.62; P<.001). This study reveals an inverted U-shaped relationship between sleep duration and global cognitive decline, indicating that cognitive function should be closely monitored in individuals with both short and long sleep durations. Consequently, public health strategies should prioritize the promotion of moderate sleep to mitigate the cognitive risks associated with aging, particularly in culturally specific contexts.
13. Changes in Sarcopenia Status and Subsequent Cardiovascular Outcomes: Prospective Cohort Study.
期刊: JMIR aging 发表日期: 2025-Sep-08 链接: PubMed
摘要
Sarcopenia is associated with cardiovascular diseases (CVDs). However, whether changes in sarcopenia status affect CVD risk remains unclear. In addition, how indoor fuel use impacts the sarcopenia transition process is less well studied. This study prospectively examined the association of sarcopenia transitions with CVD risk, while exploring the effect of indoor fuel on these transitions. In this prospective observational study, we used data from the China Health and Retirement Longitudinal Study waves 1 to 4 (2011 to 2018). In total, 8739 participants with complete data on sarcopenia and indoor fuel use were included for the indoor fuel use and sarcopenia transition analysis, and 6385 participants without previous CVDs were included for the sarcopenia transition and CVD risk analysis. Sarcopenia transition was defined according to the sarcopenia status at wave 1 (2011) and wave 2 (2013). Incident CVDs included heart diseases, stroke, and composite CVDs. Information on indoor fuel use was obtained at wave 1. Cox proportional hazards models were used to examine the effect of sarcopenia transition on incident CVDs. Logistic regression models were used to investigate the impact of indoor fuel use on these transitions. During a median of 7.0 years of follow-up, 1233 incident CVDs were documented. Compared to stably normal participants, progressing from a normal state to possible or confirmed sarcopenia brought increased risk of incident CVD (hazard ratio 1.42, 95% CI 1.15-1.77). Conversely, recovering to a normal state was associated with decreased risk (hazard ratio 0.72, 95% CI 0.55-0.95) for baseline participants with possible sarcopenia. In addition, clean fuel use increased the odds of achieving a possible-to-normal transformation (odds ratio 1.32, 95% CI 1.06-1.64), while both solid cooking and heating fuel use were associated with a higher risk of deterioration in sarcopenia status. An unfavorable transition in sarcopenia status is associated with higher CVD risk, while reversion from possible sarcopenia to a normal state could reduce the risk. Therefore, early intervention for sarcopenia is imperative for CVD prevention, and promoting clean indoor fuel use is recommended.
14. Enhancing Team Strategies and Tools to Enhance Performance and Patient Safety Performance Through Medical Movies, Massive Open Online Courses, and 3D Virtual Simulation-Based Interprofessional Education: Mixed Methods Double-Blind Quasi-Experimental Study.
期刊: Journal of medical Internet research 发表日期: 2025-Sep-08 链接: PubMed
摘要
The interprofessional educational curriculum for patient and personnel safety is of critical importance, especially in the context of the COVID-19 pandemic, to prepare junior multiprofessional teams for emergency settings. This study aimed to evaluate the effectiveness of an innovative interprofessional educational curriculum that integrated medical movies, massive open online courses (MOOCs), and 3D computer-based or virtual reality (VR) simulation-based interprofessional education (SimBIE) with team co-debriefing to enhance interprofessional collaboration and team performance using Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS). This study addressed 3 key questions. First, it aimed to examine the impact of 3D computer-based and VR SimBIE with co-debriefing following medical movies and MOOCs on improving TeamSTEPPS competencies compared to 3D computer-based SimBIE without preparation or debriefing. Second, it explored learners’ perceptions of TeamSTEPPS effectiveness using the New World Kirkpatrick model. Third, it assessed differences in Simulator Sickness Questionnaire scores between the 3D and VR SimBIE formats. This mixed methods, prospective, double-blinded (raters and statistician) quasi-experimental study was conducted at a university hospital from August 2022 to September 2023 and involved 87 clinical undergraduate students from various disciplines, including medicine, nursing, pharmacy, radiology, and medical technology. Students were divided into 3 arms: arm A (control) received 3D computer-based SimBIE without debriefing; arm B received a medical movie, MOOCs, 3D computer-based SimBIE, and co-debriefing; and arm C received the same as arm B but with VR-based SimBIE. The validated Modified TeamSTEPPS Team Performance Observation Tool was used to measure team performance. A 60- to 90-minute focus group discussion with semistructured interview questions, based on the New World Kirkpatrick model and aligned with the TeamSTEPPS framework, was conducted with subsequent thematic analysis. In total, 87 participants were enrolled in this study. TeamSTEPPS’ performance was significantly higher (P<.001) in arms B and C, which received comprehensive training with medical videos, MOOCs, and 3D computer-based or VR-based SimBIE with co-debriefing, compared to the control group. Additionally, the analysis of focus group discussions based on Kirkpatrick’s model levels 1 to 3 indicated positive effects on satisfaction, engagement, knowledge, skills, attitude, and confidence, enriched by game practice and debriefing sessions. Simulator Sickness Questionnaire scores increased significantly in arm C (VR; Δ=21.0; P=.001) but not in arm B (computer; Δ=5.3; P=.44). Integrating TeamSTEPPS with medical movies, MOOCs, 3D computer-based or VR-based SimBIE training, and co-debriefing effectively improved interprofessional collaboration and team performance in emergency medicine. We recommend adopting these novel instructional designs as standard preparation of undergraduate health care professionals for better clinical practice to improve patient and personnel safety and patient outcomes.
15. Evaluating the Preliminary Efficacy of the TRUST Intervention on Alone-Time and Communication During Well-Adolescent Visits: Quasi-Experimental Study.
期刊: JMIR pediatrics and parenting 发表日期: 2025-Sep-08 链接: PubMed
摘要
Alone time with health care providers is critical for adolescents, and several professional organizations recommend it. Alone time with providers promotes better utilization of health services, empowers adolescents to manage their health, and facilitates discussions on sensitive issues. However, only 40% of adolescents have private conversations with clinicians during visits. The advancement of mobile health technology provides an excellent opportunity to deliver effective interventions to promote adolescent-provider alone time with adolescents, parents, and providers. This pilot study aims to explore the preliminary efficacy of a technology-based intervention designed to increase alone time with providers during well-adolescent visits and its impact on trustworthiness, parent-adolescent communication, sexual risk communication, parental monitoring, and parental support before and after the intervention. A pre- and postintervention design was used. Participants were recruited through local clinics. After obtaining consent, participants accessed a study website to complete a baseline survey, independently interact with 4 educational modules on a website or cellphone, and complete a post-test survey 1 month after their well-adolescent visits. The surveys assessed alone time with providers, trustworthiness, parent-adolescent communication, sexual risk communication, parental monitoring, and parental support. Mixed model analysis and effect sizes were used to evaluate changes in these outcomes from pre- to postintervention. Thirty-two dyads (38 adolescents and 32 mothers) participated in this pilot study. About 86% (n=33) of adolescents and 87% (n=28) of mothers completed the pre- and post-test assessments and the intervention. This study found a trend toward an increase in alone time from 81.6% to 84.4%, albeit not statistically significant. Adolescents initiating alone time with providers rose from 6.45% (n=2) to 18.5% (n=5). Over 90% (n=26) of adolescents reported feeling comfortable in one-on-one interactions with providers postintervention. Mixed model analysis revealed significant improvements among adolescents in parental monitoring (z=2.93, P<.001), sexual risk communication (z=3.11, P<.001), parent-adolescent communication (z=3.11, P<.001), open family communication (z=2.00, P=.04), and parental support (z=2.87, P<.001). For mothers, significant improvements were found in parental monitoring (z=2.45, P<.001) and problem family communication (z=2.24, P=.03). This pilot study demonstrates promising results regarding the preliminary efficacy of a technology-based intervention to increase alone time with providers during well-adolescent visits and to enhance communication and parenting practices. Improving access to alone time and strengthening communication between parents and adolescents facilitates discussions about sensitive topics, including parental monitoring, sexual and reproductive health, and may strengthen overall satisfaction with health care. ClinicalTrials.gov NCT07064070; https://clinicaltrials.gov/study/NCT07064070.
16. Feasibility, Acceptability, and Preliminary Outcomes of a Mobile Adaptation of a Relational Savoring Intervention to Prevent Loneliness in College Students: Mixed Methods Pilot Study.
期刊: JMIR formative research 发表日期: 2025-Sep-08 链接: PubMed
摘要
Rates of loneliness have risen sharply since the onset of the COVID-19 pandemic, largely due to disruptions in social relationships and daily routines, with college students experiencing some of the greatest increases. While prevention programs targeting loneliness have been developed, their success has been limited. One promising approach may lie in enhancing the quality of existing relationships rather than simply increasing social interactions during periods of acute loneliness. Relational savoring, an intervention rooted in attachment theory and positive psychology, aims to deepen feelings of connection by encouraging individuals to reflect on positive interpersonal experiences. This study aimed to evaluate the feasibility, acceptability, and preliminary outcomes of a mobile health adaptation of relational savoring, termed mSavorUs (developed by Amir Rahmani), designed to prevent and reduce loneliness among college students. A randomized controlled pilot study was conducted with a diverse sample of 29 college students (43.3% Latinx, 40% Asian American, and 16.7% White). The intervention leveraged a smart ring, smartwatch, and smartphone app to enable just-in-time delivery of relational savoring prompts, alongside continuous monitoring of loneliness-related indicators (eg, physiological activity, sleep, and behavior). Aim 1 involved a thematic analysis of participant feedback regarding the utility, benefits, and challenges of both mSavorUs and the monitoring tools. Aim 2 examined the intervention’s effects on loneliness and perceived connectedness. For aim 1, qualitative findings suggested that participants found the content of mSavorUs (developed by Amir Rahmani) rewarding and helpful; however, the timing of the intervention was often experienced as disruptive. For aim 2, quantitative analyses revealed no significant reductions in loneliness or increases in connectedness, indicating the need for adjustments to the intervention delivery method. Although participants found the intervention content valuable, the just-in-time delivery format may have limited its effectiveness. Future iterations should consider alternative timing or delivery strategies to maximize program benefits.
17. Digital Hostility Toward LGBTQIA+ Research Recruitment on Social Media Using Topic Modeling and Sentiment Analysis of Facebook Comments: Quantitative Content Analysis Study.
期刊: Journal of medical Internet research 发表日期: 2025-Sep-08 链接: PubMed
摘要
Lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual (LGBTQIA+) researchers and participants frequently encounter hostility in virtual environments, particularly on social media platforms where public commentary on research advertisements can foster stigmatization. Despite a growing body of work on researcher virtual hostility, little empirical research has examined the actual content and emotional tone of public responses to LGBTQIA+-focused research recruitment. This study aimed to analyze the thematic patterns and sentiment of social media comments directed at LGBTQIA+ research recruitment advertisements, in order to better understand how virtual stigma is communicated and how it may impact both researchers and potential participants. A total of 994 publicly visible Facebook comments posted in response to LGBTQIA+ recruitment advertisements (January to April 2024) were collected and analyzed. Text preprocessing included tokenization, stop-word removal, and lemmatization. Latent Dirichlet allocation was used to identify latent themes across the dataset. Sentiment analysis was conducted using the Bing Liu and National Research Council lexicons, with scores ranging from -1 (most negative) to 1 (most positive). Linguistic Inquiry and Word Count was used to quantify psychological and moral language features. Comments were also manually coded into four audience target groups (researchers, LGBTQIA+ community, general public, and other commenters), and language category differences were analyzed using 1-way ANOVAs with Bonferroni corrections. Topic modeling identified three key themes: (1) “Transitions, Health, and Gender Dysphoria,” (2) “Polarized Debate and Response,” and (3) “Religious and Ideological Debates.” Topic 2 had the highest average prevalence (average γ=0.486, SD 0.21). Sentiment analysis revealed negative mean sentiment scores for all three topics: Topic 1 (-0.41, SD 0.48), Topic 2 (-0.21, SD 0.44), and Topic 3 (-0.35, SD 0.46). No topic exhibited a statistically significant predominance of positive sentiment. A 1-way ANOVA showed significant differences in linguistic tone across target groups: negative tone (F3,990=12.84; P<.001), swearing (F3,990=16.07; P<.001), and anger-related language (F3,990=9.45; P<.001), with the highest levels found in comments directed at researchers. Comments targeting LGBTQIA+ individuals showed higher references to mental illness, morality, and threats to children. While affirming responses were less frequent and typically appeared within confrontational contexts, their presence highlights significant moments of solidarity and resistance. This study documents a persistently hostile virtual environment for LGBTQIA+ research, where researchers are frequently dehumanized and LGBTQIA+ identities are pathologized. These findings reinforce stigma communication models and suggest a need for institutional responses that include mental health support, enhanced moderation tools, and policy advocacy. Future research should investigate how hostile discourse affects researchers’ well-being and recruitment outcomes, and evaluate interventions to foster more respectful engagement with LGBTQIA+ studies.
18. Effectiveness, Usability, and Acceptability of ChatGPT With Retrieval-Augmented Generation (SIV-ChatGPT) in Increasing Seasonal Influenza Vaccination Uptake Among Older Adults: Quasi-Experimental Study.
期刊: Journal of medical Internet research 发表日期: 2025-Sep-08 链接: PubMed
摘要
Older adults are more vulnerable to severe consequences caused by seasonal influenza. Although seasonal influenza vaccination (SIV) is effective and free vaccines are available, the SIV uptake rate remained inadequate among people aged 65 years or older in Hong Kong, China. There was a lack of studies evaluating ChatGPT in promoting vaccination uptake among older adults. This study aimed to evaluate the effectiveness of ChatGPT with retrieval-augmented generation in increasing SIV uptake among older adults over a 3-month study period in Hong Kong, China. Participants in an ongoing observational cohort study conducted in the same period served as the comparison group. A quasi-experimental study was conducted between November 2024 and April 2025. Participants were (1) aged ≥65 years, (2) possessed a Hong Kong ID, (3) able to speak and comprehend Cantonese, (4) smartphone users, and (5) had no SIV uptake for the approaching flu season. Those with a diagnosis of cognitive impairment or dementia, blindness or deafness, or known contraindications to the SIV were excluded. Participants were recruited through random telephone calls. There were 45 and 55 participants in the SIV-ChatGPT group and the comparison group, respectively. All participants completed follow-up surveys at T1 (1 month after the baseline survey, for the SIV-ChatGPT group only) and T2 (3 months after the baseline survey, for both groups). Participants in the SIV-ChatGPT group gained access to SIV-ChatGPT in the format of a web-based app after completion of the baseline survey. They could use SIV-ChatGPT repeatedly throughout a 1-month intervention period and were free to spend as much time as they wanted with SIV-ChatGPT. Intention-to-treat analysis was used for outcome analyses. At T2, the SIV uptake rate was higher in the SIV-ChatGPT group than the comparison group (15/45, 33% vs 8/55, 14.3%; adjusted odds ratio 2.72, 95% CI 1.01-7.35, P=.048). All participants were able to provide receipts to validate their SIV uptake. In the SIV-ChatGPT group, 40.5% (15/37) of participants who used SIV-ChatGPT at least once reported a SIV uptake at T2, which was significantly higher than nonusers (0/8, 0%; P=.04). Among the 37 SIV-ChatGPT users, the mean score of the System Usability Scale was 67.1 (SD 14.9). Levels of subjective behavioral and cognitive engagement with SIV-ChatGPT were relatively high, while the affective engagement was moderate. SIV-ChatGPT was feasible and acceptable and demonstrated preliminary effectiveness in increasing SIV uptake among people aged 65 years or older. This study also provided implications to improve the performance of SIV-ChatGPT. A full-powered randomized controlled trial should be considered to evaluate its efficacy. ClinicalTrials.gov NCT06679647; https://clinicaltrials.gov/study/NCT06679647.
19. Pay-It-Forward 23-Valent Pneumococcal Polysaccharide Vaccination Among Older Adults: Protocol for a Randomized Controlled Trial.
期刊: JMIR research protocols 发表日期: 2025-Sep-08 链接: PubMed
摘要
The 23-valent pneumococcal polysaccharide vaccine reduces the risk of pneumonia among adults by 38% to 46%. However, only a few older adults in resource-limited areas of China have received the pneumococcal vaccination. Pay-it-forward is a social innovation that offers participants free or subsidized health services and a community-engaged message, with an opportunity to donate to support subsequent recipients. This study aims to assess the effectiveness and cost-effectiveness of the pay-it-forward intervention in encouraging the uptake of the 23-valent pneumococcal polysaccharide vaccine in adults aged ≥60 years. A 2-arm, parallel randomized controlled trial will be conducted in 4 community health centers in Nanning city, Guangxi province, China. We will use a block randomization design. A total of 204 older adults will be randomly allocated in a 1:1 ratio to either the pay-it-forward group or the standard-of-care group. Each participant will complete a web-based questionnaire. The standard-of-care group will be required to pay for the vaccine themselves. In contrast, the pay-it-forward group will receive a 150 RMB (US $20.7) vaccination subsidy, postcards, and the opportunity to donate. The participants in both groups will be followed up in the second and fourth weeks after enrollment. The primary outcome will be uptake of the 23-valent pneumococcal polysaccharide vaccine, as determined by administrative data. Secondary outcomes include costs, pneumococcal vaccination knowledge, attitudes toward the vaccine, perceptions of gratitude, incidence of adverse reactions and adverse events, and the likelihood of recommending pneumococcal vaccination to others. Participant recruitment and follow-up were conducted from January 2024 to September 2024. A total of 220 participants were enrolled. Finalized results are expected in June 2026. This study will provide evidence on the effectiveness and economic costs of the pay-it-forward strategy for pneumonia vaccination among older adults. The findings could have implications for vaccination policy and offer a new approach for increasing vaccination in resource-limited areas. Chinese Clinical Trial Registry ChiCTR2400079410; https://www.chictr.org.cn/showprojEN.html?proj=213999. DERR1-10.2196/70246.
20. Health Equity Innovation Pilot Grants: A Collaborative Mechanism to Promote Advocacy, Career Development, and Sustainable Change.
期刊: Academic medicine : journal of the Association of American Medical Colleges 发表日期: 2025-Sep-08 链接: PubMed
摘要
In 2019, Brigham and Women’s Hospital Department of Medicine (BWH-DOM) established the Health Equity Innovation Pilot (HEIP) program to fund grants led by BWH-DOM faculty members that aimed to address inequities in hospital-based care delivery or outcomes. One-year grants of up to $40,000 total were cofunded by this BWH-DOM program and by the applicant’s BWH-DOM division to support health equity research or care innovation interventions. Recipients participated in a learning collaborative, which included community-building, health equity research and advocacy-related educational sessions, and midterm and final presentations. Between 2019 and 2024, the program received 77 applications and funded 46 projects (60%), with more than $1.3 million committed and with most BWH-DOM divisions participating. Thirty-four of the 46 funded projects (74%) included mentorship of medical students, residents, and/or fellows. The impact of the HEIP program was observed within 5 key categories: advancing knowledge, capacity building, informing policies, health and health sector benefits, and broad socioeconomic benefits. A survey conducted among grantees from 2019 to 2021, with 26 of 27 project teams responding, demonstrated that there were 16 publications, 68 presentations, 6 workshops led, and 19 new clinical innovations and/or initiatives implemented. HEIP-funded projects have resulted in numerous presentations at the local and national levels, advocacy for nationwide policy changes (e.g., removal of the estimated glomerular filtration rate race modifier, redefinition of the Duffy null-specific absolute neutrophil count reference range), development of educational materials, redesign of hospital admission pathways, and more than 20 publications. The HEIP program demonstrates the impact of an action-oriented, health equity-focused initiative to promote sustainable change at a large academic medical center.
21. Genetic causality of circulating inflammatory proteins and plasma metabolites in coronary atherosclerosis.
期刊: Postgraduate medical journal 发表日期: 2025-Sep-08 链接: PubMed
摘要
Coronary atherosclerosis is a leading cause of cardiovascular disease and death worldwide. Despite progress in understanding its pathogenesis, the roles of circulating inflammatory proteins and plasma metabolites are complex and not fully elucidated. Existing Mendelian randomization (MR) studies often target isolated biomarkers, lacking comprehensive and mechanistic insights. This study uses MR to clarify the genetic causal relationships between circulating inflammatory proteins, plasma metabolites, and coronary atherosclerosis, and to explore potential mediation pathways. Two-sample MR identified causal associations, while mediation analysis assessed whether plasma metabolites mediate the effects of inflammatory proteins on coronary atherosclerosis. Sensitivity analyses included Cochrane’s Q test and MR-Egger intercept. Our analysis identified 11 circulating inflammatory proteins and 102 plasma metabolites associated with coronary atherosclerosis. Additionally, the genetic variants associated with elevated levels of eukaryotic translation initiation factor 4E-binding protein 1 (OR = 1.0590, 95% CI: 1.0050-1.1170) were found to increase the risk of coronary atherosclerosis through modulation of octadecanedioate and octadecanedioylcarnitine (C18-DC) levels, while leukemia inhibitory factor receptor (OR = 0.9400, 95% CI: 0.8890-0.9930)-associated variants reduced its risk through modulation of campesterol levels. Mediation analyses revealed that octadecanedioate levels (Mediated pro-portion = 18.5%), C18-DC levels (Mediated proportion = 21.6%) and campesterol levels (Mediated proportion = 26.7%) mediated these effects. This study provides new insights into the genetic and metabolic mechanisms underlying coronary atherosclerosis, extending beyond traditional biomarkers. The findings highlight potential therapeutic targets of coronary atherosclerosis and related metabolic disorders. Key messages What is already known on this topic: Coronary atherosclerosis, a leading cause of cardiovascular disease, has been linked to inflammatory proteins and plasma metabolites. However, the complexity of these relationships, particularly the genetic and metabolic mechanisms underlying the disease, remains poorly understood. Existing studies have largely focused on individual biomarkers and their associations with atherosclerosis, lacking comprehensive assessments and insights into potential mediation pathways. What this study adds: This study utilizes Mendelian randomization to identify genetic causal relationships between 11 circulating inflammatory proteins and 102 plasma metabolites with coronary atherosclerosis. It provides novel insights into the mediation roles of metabolites like octadecanedioate, C18-DC, and campesterol in the disease’s progression. How this study might affect research, practice, or policy: By uncovering genetic and metabolic pathways involved in coronary atherosclerosis, this study lays the groundwork for future therapeutic interventions targeting these pathways. It highlights potential biomarkers and novel therapeutic targets, offering a new perspective on prevention and treatment strategies for coronary atherosclerosis and related metabolic disorders.
22. Neutrophil-to-Lymphocyte Ratio (NLR) as a Biomarker in Clinically Stable Chronic Obstructive Pulmonary Disease: SPIROMICS cohort.
期刊: Annals of the American Thoracic Society 发表日期: 2025-Sep-08 链接: PubMed
摘要
Inflammation is central to chronic obstructive pulmonary disease (COPD) pathogenesis but incompletely represented in COPD prognostic models. Neutrophil to lymphocyte ratio (NLR) is a readily available inflammatory biomarker. To explore the associations of NLR with smoking status, clinical features of COPD, and future adverse outcomes. We analyzed NLR calculated from the complete blood count of participants who currently or formerly smoked (n = 2,624) and tobacco-naïve controls (n = 187) in the SPIROMICS multicenter observational cohort study. We assessed the stability of NLR at 6 weeks and 1 year, the association with select blood biomarkers, and the impact of smoking on NLR and cell counts. We stratified participants by NLR quartiles to compare cross-sectional clinical features at enrollment, prospectively observed exacerbations at 1 year, and mortality during longitudinal follow-up. Higher NLR quartiles were broadly associated with more severe clinical features of COPD. NLR values were repeatable at 6 weeks (ICC=0.74) and 1 year (ICC=0.62). The impact of smoking on NLR varied with the severity of airflow limitation, mediated by an interaction between smoking, FEV1 % predicted, and neutrophil counts but not lymphocyte counts. The highest NLR quartile (>3.11) was associated with an increased risk of exacerbation over 1-year (adjusted OR=1.51 95%CI 1.18, 1.92) and increased risk of mortality (adjusted HR=1.41, 95%CI 1.20, 1.66) compared to quartiles 1-3. Elevated NLR in stable COPD is a widely available biomarker associated with increased risk for exacerbation and death. The impact of cigarette smoking on NLR varies with disease severity.
23. People-centered strategies to mobilize people living with disabilities due to Neglected Tropical Diseases (PD-NTDs) to influence policy and programs: a mixed-methods study in Côte d'Ivoire.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Sep-08 链接: PubMed
摘要
Neglected tropical diseases (NTDs) are a priority in the public health agenda for Côte d’Ivoire, with persons living with disabilities due to NTDs (PD-NTDs) experiencing many challenges in their daily lives. Current policies do not sufficiently support PD-NTDs, thereby highlighting the need to identify opportunities for policy improvement. This study was carried out in two phases: first to identify the current needs (formative phase) and then to develop a pilot strategy (implementation phase). In the formative phase, pertinent current legislation was reviewed. Then, interviews of PD-NTDs and their caregivers were conducted and analyzed quantitatively. Thematic analysis of focus groups with key community stakeholders was also completed. In the implementation phase, a pilot strategy was developed to address the identified issues. 172 PD-NTDs and their caregivers were surveyed through this study. 99% of PD-NTDs expressed a need for rehabilitation, healthcare and psychosocial support. More than 80% endorsed the need for healthcare services and free medications, 92% expressed the need for educational services, and 83% reported economic difficulties. Furthermore, 30% of PD-NTDs reported limited awareness of specialized care services available in the community, 25% endorsed limited knowledge of current legislation that protects the rights of people living with disabilities, and 38% faced significant stigma and discrimination within the past 12 months. Fifty-six interviews with key informants further echoed these gaps. A pilot strategy was developed with four pillars to (1) increase community advocacy, (2) combat stigma, (3) promote mutual support among PD-NTDs, and (4) improve the sustainability of the effort. Forty-one out of 49 activities were completed. This project represents a comprehensive effort to identify policy opportunities to effectively support PD-NTDs. This approach may be used by other organizations that plan to develop initiatives to target the needs of PD-NTDs in their local communities.
24. Value-conscious leadership actions in developing a health-promoting work environment.
期刊: Nursing ethics 发表日期: 2025-Sep-08 链接: PubMed
摘要
BackgroundNurse leaders play a vital role in fostering a health-promoting work environment. Despite the increasing recognition of the importance of their roles, studies focusing specifically on the actions they employ to foster such environments remain limited.Research aimThe aim of this study is to explore and enhance understanding of the actions nurse leaders employ to develop a health-promoting work environment.Research designThis study used a qualitative design inspired by Gadamer’s philosophical hermeneutics. Four semi-structured focus group interviews were conducted between August and December 2024. The data were analyzed using reflexive thematic analysis.Participants and research contextFourteen nurse leaders from hospitals and nursing homes in northern Norway participated in this study.Ethical considerationsThe study was approved by the Norwegian Agency for Shared Services in Education and Research. Both oral and written informed consent was obtained from the participants.FindingsThe actions employed by leaders to develop a health-promoting work environment are imbued with an overarching theme: “value-conscious leadership in action,” and four interwoven themes: (1) promoting justice by leading with equity and flexibility, (2) promoting relationships by cultivating an inclusive community, (3) respecting employees by fostering their empowerment and autonomy, and (4) facilitating professional growth by promoting a learning environment.ConclusionsThe basic values should be articulated, consciously integrated, and embodied through the nurse leader’s actions, choices, and way of being. To implement the basic values, it is important to establish supportive networks for leaders and to conduct regular ethical reflections together with employees in the workplace.
25. Personalized Interactive Music Systems for Physical Activity and Exercise: Exploratory Systematic Review and Meta-Analysis.
期刊: JMIR human factors 发表日期: 2025-Sep-08 链接: PubMed
摘要
Personalized Interactive Music Systems (PIMSs) are emerging as promising devices for enhancing physical activity and exercise outcomes. By leveraging real-time data and adaptive technologies, PIMSs align musical features, such as tempo and genre, with users’ physical activity patterns, including frequency and intensity, enhancing their overall experience. This exploratory systematic review and meta-analysis evaluates the effectiveness of PIMSs across physical, psychophysical, and affective domains. Searches across 9 databases identified 18 eligible studies, of which 6 (comprising 17 intervention arms) contained sufficient data for meta-analysis. Random-effects meta-analyses and meta-regression were performed to assess outcomes for physical activity levels, physical exertion, ratings of perceived exertion, and affective valence. Results showed significant improvements in physical activity levels (g=0.49, CI 0.07 to 0.91, P=.02, k=4) and affective valence (g=1.65, CI 0.35 to 2.96, P=.01, k=4), with faster music tempo identified as a significant moderator (P=.03). No significant effects were observed for ratings of perceived exertion (g=0.72, CI -0.13 to 1.58, P=.10, k=3) or physical exertion (g=0.78, CI -0.55 to 2.11, P=.25, k=5). Substantial heterogeneity and limited study quality indicate the need for more robust, randomized controlled trials to establish the efficacy of PIMSs in diverse populations.
26. In Brief November 2025.
期刊: American journal of health promotion : AJHP 发表日期: 2025-Sep-08 链接: PubMed
摘要
27. Factors associated with health worker adoption of facial and environmental hygiene promotion in the 'SAFE strategy' for trachoma elimination in Western Province, Zambia.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Sep-08 链接: PubMed
摘要
Trachoma is responsible for the blindness or visual impairment of about 1.9 million people and causes about 1.4% of all blindness worldwide. In Zambia, trachoma is endemic and Western Province is one of the most affected provinces. The SAFE (surgery, antibiotics, facial cleanliness and environmental improvement) strategy is recommended for elimination of trachoma. In many settings, interventions particularly for facial cleanliness and environmental improvement are sub-optimally adopted due to lack of prioritization and inadequate funding of intervention activities. This study sought to establish the level of, and factors associated with adoption of facial and environmental hygiene promotion in the SAFE strategy among health workers in Western Province, Zambia. This was a cross-sectional study involving 24 health facilities selected from three districts using stratified random sampling. A total of 388 health workers comprising environmental health officers, community health assistants and community health workers were randomly selected. Adoption of facial and environmental hygiene promotion was self-reported, defined as participation in community distribution of information, education and communication (IEC) materials or community demonstrations of correct hand and face washing methods or both, within the past six months. Multiple logistic regression was used to identify the factors associated with adoption using STATA Version 15. The study was conducted in March and April 2023. Adoption of facial and environmental hygiene promotion was low at 47.68%. Having readily available transport (AOR = 3.06. 95% CI = [1.38, 6.80]), perceiving the intervention as relevant for trachoma prevention (AOR = 7.78, 95% CI = [4.38, 13.82]), having been trained in F and E (AOR = 2.17, 95% CI = [1.24, 3.78]) and availability of information, education and communication materials (AOR = 3.04, 95% CI = [1.69, 5.46]) were associated with higher odds of adoption of facial and environmental hygiene promotion among health workers. There was low adoption of facial and environmental hygiene promotion among health workers influenced by training, transport availability, IEC material availability and perceived relevance and complexity of the intervention. To increase adoption of facial and environmental hygiene promotion, program implementers must ensure that they consider the identified factors in the planning of the intervention activities.
28. Usefulness of hydrocortisone prophylaxis for oxaliplatin-induced hypersensitivity reactions: A retrospective study.
期刊: Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners 发表日期: 2025-Sep-08 链接: PubMed
摘要
IntroductionOxaliplatin is a platinum-based drug widely used for treating colorectal cancer. However, its use is often complicated by hypersensitivity reactions and other adverse effects, including peripheral neuropathy and myelosuppression. We evaluated the efficacy of prophylactic hydrocortisone administration in preventing hypersensitivity reactions during oxaliplatin therapy in patients with colorectal cancer.MethodsPatients who received oxaliplatin between January 2017 and December 2023 were retrospectively analyzed. Among them, 53 received 100 mg of hydrocortisone as a preventive measure when the cumulative oxaliplatin dose exceeded 400 mg/m2 or if they experienced a treatment interruption of >8 weeks. We compared the incidence and severity of hypersensitivity reactions, as well as cumulative oxaliplatin dose, between patients who received routine premedication only (the Routine group) and those who received additional hydrocortisone prophylaxis (the Prophylaxis group).ResultsOverall, 370 patients were included in the study. Hypersensitivity reactions occurred in 23 patients (18 in the Routine group and 5 in the Prophylaxis group), with a significantly higher cumulative dose of oxaliplatin in the Prophylaxis group (644 vs. 1383 mg/m2, p = 0.0032). Severe reactions were observed only in the Routine group. Treatment discontinuation owing to hypersensitivity reactions was more common in the Routine group (five patients) than in the Prophylaxis group (one patient).ConclusionsProphylactic administration of hydrocortisone may promote oxaliplatin treatment continuation. This approach is proposed as a potential strategy for preventing oxaliplatin-induced hypersensitivity reactions.
29. Knowledge of and attitudes towards vegan and vegetarian diets amongst students at a university located in rural Poland.
期刊: Nutrition and health 发表日期: 2025-Sep-08 链接: PubMed
摘要
Background: Healthy plant-based diets, such as vegan and vegetarian diets, as well as planetary health diets, meet the recommendations of sustainable dietary patterns and are healthier for both the planet and humans. The adoption of these dietary patterns may depend on socio-demographic factors and individual motivations. Aim: This study aimed to analyse the association between socio-demographic factors and knowledge and attitudes towards vegan and vegetarian diets amongst university students. Methods: This anonymous survey included 241 students from a university in rural Poland. The association between respondents’ socio-demographic factors and the investigated categorical variables was analysed. Results: Only three respondents followed a vegan or vegetarian diet during the study. In general, the respondents were unwilling to reduce their meat consumption (55.9%). The willingness to do so was significantly higher amongst women than men (39.4% vs. 15.1%; p = 0.0002), meat avoiders than omnivorous respondents (68.4% vs. 25.0%; p < 0.0001) and health discipline students than non-medical students (47.7% vs. 23.0%; p = 0.0004). Higher awareness of the benefits of plant-based diets was confirmed amongst women, health discipline students and those who avoided meat. Vegan and vegetarian diets were perceived amongst the total number of respondents as more expensive (56.9%) and more difficult to follow compared to omnivore diets (74.7%); in turn, substitutes for animal products were as easily accessible (61.8%). The term ‘planetary health diet’ was used by only 13.7% of the students surveyed. Conclusions: Promoting the benefits of plant-based diets is important, especially in small, traditional communities, where previously acquired patterns mostly determine dietary choices. The inclusion of issues involving planetary health and sustainable diets into curricula and non-medical fields will enable their promotion amongst young adults in general.
30. Effectiveness of Medical Nutrition Therapy in the Management of Patients with Obesity and Endometriosis: from the Mediterranean Diet To the Ketogenic Diet, Through Supplementation. The Role of the Nutritionist in Clinical Management.
期刊: Current obesity reports 发表日期: 2025-Sep-08 链接: PubMed
摘要
This review aimed to summarize current evidence on the effectiveness of medical nutrition therapy (MNT) in the management of obesity and endometriosis, with a focus on dietary patterns such as the Mediterranean and Ketogenic diets, as well as nutritional supplementation. Additionally, it highlights the central role of the clinical nutritionist in implementing individualized, evidence-based interventions within multidisciplinary care. Although the literature reports the existence of an inverse relationship between risk of endometriosis and body mass index, clinical evidence jointly reports that a condition of obesity is associated with greater disease severity. This, therefore, implies the need to identify the different phenotypes of patients with endometriosis at which to target a precision MNT. Several dietary patterns and supplements have been investigated for their role in endometriosis management. The Mediterranean diet-rich in anti-inflammatory nutrients, fiber, and antioxidants-has been associated with decreased pain and improved quality of life. More recently, ketogenic diets have shown potential in modulating insulin signaling and inflammatory pathways, though clinical evidence remains limited. Supplementation with omega-3 fatty acids, N-acetylcysteine, resveratrol, vitamins C and E, and probiotics has demonstrated promising anti-inflammatory and antioxidative effects in both preclinical and clinical studies. Furthermore, attention is being directed toward the gut microbiota and its interaction with the immune and endocrine systems in women with endometriosis. Endometriosis is a chronic gynecological condition characterized by ectopic endometrial tissue, estrogen dependence, and persistent inflammation. It affects approximately 10% of women of reproductive age and is associated with pelvic pain, infertility, and reduced quality of life. While conventional treatment focuses on hormonal therapy and surgery, MNT is emerging as a non-invasive, supportive approach. Nutritional interventions can target key pathophysiological mechanisms of endometriosis, such as systemic inflammation, oxidative stress, and hormonal imbalance, offering potential symptom relief and improved clinical outcomes.
31. Association of work-family conflict with turnover intention among hospital ophthalmologists in Japan: a cross-sectional study.
期刊: Japanese journal of ophthalmology 发表日期: 2025-Sep-08 链接: PubMed
摘要
To examine the associations between work-family conflict, implicit gender bias, and turnover intention among hospital ophthalmologists. Cross-sectional study. We conducted a web-based questionnaire survey between January and February 2024. The participants were full-time ophthalmologists working in 37 hospitals in the Kanto region of Japan. We assessed the associations between work-family conflict, implicit gender bias, and turnover intention using multivariable regression analysis, with adjustments for job fit and position. We analyzed data from 74 ophthalmologists (mean age: 41.5 years, standard deviation: 10.8; 51.4% women). The median intention to leave score was 2.50 (interquartile range: 2.00-3.00). Work interference with family was significantly associated with turnover intention (adjusted difference: 0.30; 95% confidence interval: 0.075-0.53; p=0.010). However, family interference with work and implicit gender bias were not significantly associated with turnover intention. This is the first study to examine the associations between work-family conflict, implicit gender bias, and turnover intention among Japanese hospital ophthalmologists. Work interference with family was associated with increased turnover intention but not with family interference with work or implicit gender bias.
32. Computational modeling for PPE filtration: Informed by material characterization, microbial penetration, and particle mechanics.
期刊: Journal of occupational and environmental hygiene 发表日期: 2025-Sep-08 链接: PubMed
摘要
This work assesses the current characterization framework of single-use personal protective equipment (PPE) per recognized consensus standards and presents a novel quantitative approach to refining characterization of barrier materials and predicting PPE performance. Scanning electron microscopy (SEM) and image analysis software (Diameter J) were used to examine the microscopic fiber and pore structure of filter layers of surgical N95 filtering facepiece respirators, before and after exposure to chemicals used in decontamination modalities (vaporized hydrogen peroxide or ozone). The effect of porosity on penetration was assessed by bacterial filtration efficiency (BFE) testing. Results from these experiments were incorporated into a physics-based computational model of overall filtration efficiency (OFE). Material thickness, fiber thickness, and packing density were introduced as inputs into a sequence of mathematical expressions to calculate OFE for filtration layers from surgical N95 respirators. OFE derived from the computational model was compared with experimental data for Staphylococcus aureus filtration (per ASTM F2101-23). The resulting output from the model is conservative and predictive when compared with experimental results to assess OFE and filtration efficiency relative to specific particle-size ranges. The model functions may be used to help inform or expedite design or manufacturing decision-making on surgical N95 respirators.
33. Evaluating the Effect of a Molecular Point-of-Care Test on Acute Respiratory Infections in General Practice: Protocol for a Cluster Randomized Trial.
期刊: JMIR research protocols 发表日期: 2025-Sep-08 链接: PubMed
摘要
Acute respiratory infections (ARIs) are frequent reasons for medical consultations in general practice and can lead to unnecessary recontacts. Introducing new point-of-care (POC) polymerase chain reaction (PCR) diagnostic equipment may offer an attractive and efficient way of providing a more precise and exact microbial diagnosis. Successful uptake of POC PCR equipment could potentially lead to a reduction in recontacts with benefits for both staff and patients. However, introducing new diagnostic technology is a complex intervention and several contextual factors may impact the implementation. This study aims to evaluate the effect of POC PCR test availability in general practice on the subsequent (1) number of recontacts to the general practitioner (GP) for patients with symptoms of ARIs (primary outcome) and (2) hospital admissions, deaths, antibiotic prescriptions, health-related quality of life, GP and patient satisfaction, costs, cost-effectiveness, and contextual facilitators and barriers conditioning the implementation process (secondary outcomes). This study is a cluster-randomized, crossover, nonblinded superiority trial with a 1:1 allocation ratio between usual care (control) and POC PCR test availability (intervention). Questionnaire data are collected at day 0, 7, 14, and 28 after the initial contact (health-related quality of life, absenteeism and presentism among patients, and patient satisfaction) and after finalization of the study period (GP satisfaction). Data on recontacts, hospital admissions, redeemed antibiotic prescriptions, costs, and deaths will be retrieved from the Danish national registries. The implementation process will be evaluated based on data from interviews with users of POC PCR tests (i.e., GPs, staff, and patients) and from observations in the clinics in line with Medical Research Council guidelines. As per the randomized crossover design carried out during September 2023 to March 2024 investigating a sample of 100 GP clinics, we expect to obtain an in-depth and multifaceted understanding of the effects of the availability of the POC PCR test equipment in general practice. This study will provide valuable information about the diagnostic conditions and possibilities in general practice and provide insights into the organization of primary health care. ClinicalTrials.gov NCT06120153; https://clinicaltrials.gov/study/NCT06120153. DERR1-10.2196/72842.
34. A Macroporous Cyclodextrin Monolith for Continuous Removal of Per- and Polyfluoroalkyl Substances from Water.
期刊: Journal of the American Chemical Society 发表日期: 2025-Sep-08 链接: PubMed
摘要
Per- and polyfluoroalkyl substances (PFASs) are environmentally persistent, bioaccumulative, and toxic chemicals that contaminate global drinking water resources. Their ubiquity and potential impact on human health motivate large-scale remediation. Conventional materials used to remove PFASs during drinking water production are functionally inefficient or energetically expensive, motivating the discovery of new materials and technologies. Here, we introduce cyclodextrin-based monoliths, featuring a highly permeable, mechanically robust porous architecture that enables rapid and continuous PFAS removal from water. The monolith was directly polymerized into flow-through columns and showed water permeability similar to packed sand due to its interconnected macroporous structure. Compared to leading benchmarks under equivalent sorbent mass or contact time, the monolith demonstrated superior PFAS sorption with later breakthroughs for most PFASs. We show the hierarchical morphology of a monolith is more efficient use of sorbent mass than particle-based sorbents, as its macropores enable facile diffusion of PFAS to meso- and microporous sorption sites. The significance of hierarchical pore design was demonstrated by instant PFAS breakthrough passing through the pulverized monolith, where the water primarily flows through interparticle pathways with limited access to sorption sites. After treating 150 L of water spiked with 25 PFAS for 37 days, 47 mg of monolith was regenerated through alcohol wash, with near-complete mass balance of adsorbed PFASs. The regenerated monolithic sorbent treated another 170 L of water for 39 days with comparable removal. The monolith offers a novel morphology with simple and direct synthesis in columns for water treatment and provides superior PFAS removal, regeneration and reuse.
35. Erratum: A Modified Trier Social Stress Test for Vulnerable Mexican American Adolescents.
期刊: Journal of visualized experiments : JoVE 发表日期: 2025-Sep-08 链接: PubMed
摘要
This corrects the article 10.3791/55393.
36. Geostatistical analysis to guide treatment decisions for soil-transmitted helminthiasis control in Uganda.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Sep-08 链接: PubMed
摘要
Soil-transmitted helminth (STH) infections remain a public health problem in Uganda despite biannual national deworming campaigns implemented since the early 2000s. Recent surveys have indicated a heterogeneous STH infection prevalence, suggesting that the current blanket deworming strategy may no longer be cost-effective. This study identified infection predictors, estimated the geographic distribution of STH infection prevalence by species, and calculated deworming needs for school-age children (SAC). Bayesian geostatistical models were applied to STH survey data (2021-2023) for each species (i.e., Ascaris lumbricoides, hookworm, and Trichuris trichiura). Climatic, environmental, and socioeconomic predictors were obtained from remote sensing sources, model-based databases, and demographic and health surveys. Prevalence was predicted on a 1 × 1 km2 grid across Uganda, and district-level estimates were used to classify each district into treatment frequency categories and to determine its deworming tablet requirements. The national prevalence of A. lumbricoides, T. trichiura, and hookworm was estimated at 5.0% (95% Bayesian credible interval [BCI]: 0.8-11.8%), 3.5% (0.7-9.3%), and 7.2% (0.55.7-32.911.1%), respectively. The overall prevalence of any STH infection was 14.3% (9.6-21.8%). High intra-district variation in prevalence was observed. Of 146 implementation units (136 districts and 10 cities), 49 require twice-year treatment, 34 once-yearly treatment, 61 every other year treatment, and 2 had a prevalence <2%, indicating treatment suspension or event-based treatment. Approximately 17million tablets will be needed for preventive chemotherapy aimed at SAC in 2025. The prevalence of STH infection has declined considerably across Uganda compared to the early 2000s. However, deworming needs remain heterogeneous across districts. Through geostatistical modeling, districts were classified according to the latest World Health Organization’s (WHO) treatment guidelines. This approach optimizes treatment distribution and allows for prioritization of populations with the greatest needs. We estimated that tablet requirements are approximately 40% lower compared to the current twice-a-year deworming regimen, which contributes towards WHO’s goal of halving the number of tablets required for PC by 2030.
37. Silence please! How school noise affects the well-being of school teachers.
期刊: International journal of occupational safety and ergonomics : JOSE 发表日期: 2025-Sep-08 链接: PubMed
摘要
As noise is one of the most significant stress factors in the teaching profession, its impact in real classroom situations was investigated in Study 1. Noise levels (N = 56) were measured, and teachers were surveyed afterward. In Study 2, assumed correlations between school-specific noise sources, noise perception and strain were quantified in a sample of 820 teachers via online survey. The results show significant correlations between measured sound levels during classroom teaching and teachers’ perceived loudness and annoyance. Noise annoyance turned out to be an important predictor for teachers’ perceived strain and varied depending on the school-specific noise, with an important role of verbal student behavior. The results highlight the need for tailored noise prevention measures in schools to reduce noise-related strain among teachers. Furthermore, they indicate that existing regulations for workplace noise may not be always applicable to schools as measured ‘ear-safe’ volumes also cause noise-related strain.
38. Development of the SCI-BodyMap-Measuring Mental Body Representations in Adults With Spinal Cord Injury: Protocol for Item Generation, Reliability, and Validity Testing.
期刊: JMIR research protocols 发表日期: 2025-Sep-08 链接: PubMed
摘要
Approximately 69% of Americans with spinal cord injury (SCI) have neuropathic pain. Research suggests that impairments in mental body representations (MBRs; ie, representations of the body in the brain) likely contribute to neuropathic pain. Clinical trials in adults with SCI, focused on restoring MBR, led to improvements in sensation and movement as well as neuropathic pain relief. Scales measuring aspects of MBR exist, but none of them assess SCI-related MBR impairments. As our first aim, we will generate items for a new MBR scale for adults with SCI (the SCI-BodyMap). As our second aim, we will assess the interrater reliability, test-retest reliability, concurrent validity, face validity, and utility of the SCI-BodyMap. Our preliminary work will encompass initial item generation by SB, an Italian physical therapist (PT) specialized in cognitive multisensory rehabilitation, which is a therapeutic approach that focuses on restoring MBR in adults with neurological disorders and chronic pain. Further item refinements will be carried out by Italian PTs (n=7) and Brazilian PTs (n=3) specialized in cognitive multisensory rehabilitation. In aim 1, American PTs or occupational therapists (n=8) and adults with SCI (n=8) will provide feedback on the SCI-BodyMap. Next, American PTs or occupational therapists (n=3) will administer the SCI-BodyMap to adults with SCI (n=3) and provide more feedback during an in-person visit. In aim 2, four assessors will administer the SCI-BodyMap to adults with SCI (n=30) for interrater reliability. The self-report items will be administered at 2 separate time points to assess test-retest reliability. We will also administer the SCI-BodyMap to uninjured adults (n=30) to identify whether healthy adults score statistically different on the scale than adults with SCI. We will assess concurrent validity through correlations between the MBR scale, the Revised Body Awareness Rating Questionnaire, and the Multidimensional Assessment of Interoceptive Awareness-2. As of August 2025, we have enrolled 8 PTs or occupational therapists and 8 adults with SCI for aim 1 as well as 29 adults with SCI and 13 uninjured adults for aim 2. A reliable and valid MBR scale is needed to identify MBR deficits and evaluate intervention effects on MBR outcomes in adults with SCI. Improving MBR can lead to safer, more efficient day-to-day activities (eg, transfers); promote functional independence and quality of life; reduce neuropathic pain and spasms; and improve sensorimotor function. DERR1-10.2196/72370.
39. An assessment of occupational exposure to inhalable aerosols and airborne proteins in food manufacturing plants.
期刊: Journal of occupational and environmental hygiene 发表日期: 2025-Sep-08 链接: PubMed
摘要
As the range of allergens continues to expand and the food industry evolves, there is a growing need for more efficient, affordable, and comprehensive methods to monitor protein exposures. This study aimed to assess the concentrations of inhalable aerosols and soluble proteins (SP) in food manufacturing environments. Additionally, the study sought to optimize the extraction methods for determining SP across diverse food matrices. One hundred forty-six participants from 12 different dry food production facilities were included in the study. The mass of inhalable aerosols was determined using gravimetric analysis, and the concentration of SP was determined using a bicinchoninic acid (BCA) protein assay kit. A mixed-effects Tobit regression model was employed to assess the relationship between aerosol and SP concentrations across different production environments and work tasks. The optimized SP extraction method proved effective across a wide range of powder food matrices, although variability in relative extraction efficiency across matrices highlighted the importance of using multiple extraction rounds for accurate protein quantification. Significant differences in SP concentrations were found across production environments. Confectionery and chocolate production (p < 0.001) and snacks, nuts, and chips production (p = 0.007) were associated with significantly lower SP concentrations compared to bakery production. Tasks such as grinding and milling (p = 0.037) and weighing and mixing (p = 0.019) showed significantly higher SP concentrations. The positive association between inhalable aerosol and SP concentrations suggests that higher aerosol concentrations generally correspond to higher protein exposure, but the strength of this relationship varied across productions and tasks. This study demonstrates the feasibility and potential value of measuring SP concentrations as an addition to aerosol measurements in food manufacturing environments. Given the health risks associated with inhaled proteins, particularly in provoking allergic reactions and respiratory problems, measuring total SP concentrations may serve as a more reliable indicator of occupational exposures, especially during tasks and in production types where the relationship between inhalable aerosols and proteins is weak.
40. Evaluating Long-Term Effectiveness of Cystic Fibrosis Modulator Therapies After Rapid Adoption: A Dual-Approach Study.
期刊: Annals of the American Thoracic Society 发表日期: 2025-Sep-08 链接: PubMed
摘要
Modulator therapies like ivacaftor have revolutionized clinical management of cystic fibrosis (CF), showing marked short-term benefits in trials but heterogeneous findings in long-term observational studies. Since newer modulators have become the standard of care for the majority living with CF in the U.S., characterizing long-term effectiveness with real-world data is increasingly difficult due to the lack of contemporary comparator groups for performing between-subjects analyses. To determine the extent to which ivacaftor preserves long-term lung function and compare the results of within- and between-subject analyses for evaluating its real-world effectiveness. This retrospective cohort study used data from the US Cystic Fibrosis Foundation Patient Registry (2003-2016). We employed two approaches to evaluate ivacaftor effectiveness on percent predicted forced expiratory volume in 1s (ppFEV1): i) within-subject comparisons of ppFEV1 before and after ivacaftor initiation and ii) comparisons between ivacaftor-treated and untreated individuals with similar disease pathology. We modeled data from 560 ivacaftor-treated individuals with the G551D variant. For between-subject comparisons, we used propensity scores to match the treated group with 2,800 untreated F508del homozygous individuals. Modulator initiation bias was assessed and accounted for in each model. Our results showed an initial average improvement in ppFEV1 in ivacaftor-treated children and adults (ranging from 4.54 to 6.53% predicted based on within-subject comparison of before vs. after ivacaftor initiation). There was a slower decline in adults, compared to children. These ivacaftor-treated cohorts experienced less decline relative to their F508del homozygous counterparts (between-group differences in treated vs. control ranged from 0.36 to 0.64% predicted). Both the within- and between-subject comparisons demonstrated similar levels of ivacaftor effectiveness. However, small differences between the two approaches were observed in younger individuals. Ivacaftor was associated with improved ppFEV1 across all age groups, with the magnitude of improvement roughly 50% of that observed in clinical trials. The results support the need to account for modulator initiation bias and the use of within-subject analysis in future CFTR modulator effectiveness studies, but caution is advised in younger individuals due to developmental changes that may affect pre- and post-treatment comparability.
41. Microfluidic paper-based analytical devices for food spoilage detection: emerging trends and future directions.
期刊: Talanta 发表日期: 2025-Sep-06 链接: PubMed
摘要
Food spoilage poses a global challenge with far-reaching consequences for public health, economic stability, and environmental sustainability. Conventional analytical methods for spoilage detection though accurate are often cost-prohibitive, labor-intensive, and unsuitable for real-time or field-based monitoring. Microfluidic paper-based analytical devices (μPADs) have emerged as a transformative technology offering rapid, portable, and cost-effective solutions for food quality assessment. This review critically examines the principles, fabrication methods, and detection mechanisms underlying μPADs, with a focus on their applications in monitoring spoilage-related biomarkers such as volatile nitrogenous compounds and biogenic amines. We highlight recent advances, including the integration of μPADs with different mechanisms such as colorimetry, fluorescence, wireless sensor, electrochemistry, electrochemiluminescence, and Surface-Enhanced Raman Spectroscopy (SERS). Furthermore, emerging trends such as nanotechnology, smartphone-enabled analysis, and machine learning-enhanced diagnostics are discussed in the context of real-time data acquisition and decision-making. Key limitations such as reproducibility, sensitivity, and regulatory barriers are addressed alongside prospective solutions. This comprehensive overview underscores the immense potential of μPADs to revolutionize food safety monitoring, particularly in decentralized and resource-limited environments.
42. TRIM39 reinforces E2-ESR1 signaling through SUMOylation of ESR1 to hinder the progression of aortic dissection.
期刊: Atherosclerosis 发表日期: 2025-Sep-03 链接: PubMed
摘要
Aortic dissection (AD) is one of the most dangerous and tricky diseases in the field of cardiovascular surgery, severely affecting public health. Recent studies have found that SUMOylation is linked to the pathogenesis of cardiovascular diseases. However, we know very little about the molecular mechanisms of SUMOylation in AD. Clinical samples of AD and normal aorta were collected for transcriptome sequencing analysis. qPCR and Western blot were utilized to examine the expression of TRIM39 in clinical samples. AD mouse model and cell model were constructed to test the effect of TRIM39 overexpression on the progression of AD. With the help of bioinformatics analysis tools UBIBROWSER, BIOGRID, and GPS-SUMO, the substrate protein ESR1 of TRIM39 was predicted. Combined with CO-IP, we verified whether TRIM39 SUMOylated ESR1 and how SUMOylation affected ESR1 protein. TRIM39 was greatly downregulated in AD samples, and ESR1 is a downstream target protein of TRIM39. In vivo and in vitro experiments revealed that TRIM39 overexpression alleviated the phenotype of AD by changing the contractile phenotype and cell function of aortic smooth muscle cells, and this process depended on the activation of ESR1 by E2. Mechanistically, TRIM39 mediated the SUMOylation of ESR1, thereby enhancing its protein stability and strengthening E2-ESR1 signaling. TRIM39 modifies ESR1 through SUMOylation and enhances its stability, facilitating E2-ESR1 signaling and alleviating AD progression.
43. Understanding Burnout in Orthopaedic Surgery Residency: A Guide to Making Impactful Changes.
期刊: JBJS reviews 发表日期: 2025-Sep-01 链接: PubMed
摘要
» Physician burnout is an occupational crisis that consists of emotional exhaustion, depersonalization, and reduced perceived sense of personal accomplishment. It is highly prevalent among orthopaedic surgeons, with the highest rate seen in residents.» Burnout can have a detrimental impact on resident mental and physical health, patient care through medical errors and poor patient interactions, and the healthcare system.» Orthopaedic residency programs should direct resources toward initiatives that can combat burnout and improve well-being through screening, education, cultural changes, and access to physical, social, and mental health resources.» Orthopaedic surgery residents should recognize the signs of burnout and its impact, take responsibility for their physical and mental health, support their peers, collaborate with faculty leadership to identify areas of improvement, and propose tangible solutions that will benefit the residency.
44. Evaluation of alternative clinical samples for the detection of SARS-CoV-2 and influenza virus by automated multiplex RT-PCR.
期刊: Journal of infection in developing countries 发表日期: 2025-Aug-31 链接: PubMed
摘要
The aim of this study was to compare the performance of different clinical specimens-nasopharyngeal (NP) swabs collected by healthcare professionals (HCP-NP), self-collected nasal swabs (Sc-N), and saliva samples (S)-in diagnostic tests for investigating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA and influenza A/B RNA. These clinical samples were collected from 404 symptomatic cases and tested with the SARS-CoV-2 and influenza A/B RNA tests on the cobas 6800 System of Roche Molecular Systems (Roche Molecular Systems, Pleasanton, USA). The SARS-CoV-2 or influenza virus infection status was determined for all patients based on the predefined criteria and corresponding algorithms. Positive and negative predictive values (PPV, NPV), sensitivity, specificity, coefficient of variation (CV), interrater reliability, correlation, ,and days of sample collection of these three sample types were analyzed. There was almost perfect agreement between the these sample types for the diagnosis of SARS-CoV-2 and influenza A. The overall performance (PPV, NPV, sensitivity) and reproducibility (CV ≤ 6%) were favorable. Additionally, they showed similar trends for days of sample collection. Diagnostic detection of SARS-CoV-2 and influenza RNA from Sc-N and S samples was comparable to HCP-NP samples. Using these samples would provide an advantage in diagnosing SARS-CoV-2 and influenza A infection, as they can be easily collected without the need for viral transport media.
45. Seven candidate interventions to address abuse of older people.
期刊: Age and ageing 发表日期: 2025-Aug-29 链接: PubMed
摘要
The Abuse of Older People - Intervention Accelerator (AOP-IA) project aims to accelerate the development of effective interventions to prevent and reduce AOP aged 60 and older within the framework of the United Nations Decade of Healthy Ageing (2021-2030). The AOP-IA was launched in response to the global need for interventions with proven effectiveness, as few existing approaches have been rigorously evaluated. This paper focuses on the first two phases of the AOP-IA project, which involved conducting a systematic search, screening and evaluation process to identify candidate interventions ready to be rigorously evaluated in future stages of the project, as well as establishing a network of intervention developers. The identification of interventions included an initial screening of 13 926 records and two rounds of evaluations by an expert panel. From this process, 89 promising interventions were identified, and subsequently, seven candidate interventions were selected for more rigorous scientific testing and evaluation. An adapted version of the Systematic Screening and Assessment Method was used to identify these interventions. The AOP-IA project demonstrates that interventions to prevent and reduce abuse of older adults exist in a variety of settings and countries, and that several interventions are ready for a rigorous evaluation to support continual programme improvement by intervention developers and long-term sustainability and scale-up globally.
46. Modulation of T Cell Regulation by Interleukin-2 Agonists: Mechanisms and Clinical Implications.
期刊: Critical reviews in immunology 发表日期: 2025 链接: PubMed
摘要
IL-2 agonists significantly modulate T cell regulation, impacting activation, proliferation, differentiation, and immune homeostasis. Interleukin-2 (IL-2) is crucial for T cell growth and function, binding to the IL-2 receptor to trigger signaling pathways that balance immune responses. IL-2 promotes the expansion of effector T cells and enhances regulatory T cells (Tregs), preventing autoimmune responses. This review examines the mechanisms of IL-2 agonists on T cell regulation, including their roles in cytotoxic T cells and Tregs proliferation, and immune homeostasis. Clinically, IL-2 agonists show promise in treating autoimmune diseases by boosting Treg function and in cancer immunotherapy by enhancing cytotoxic T cell activity. Optimizing IL-2 therapies to balance these effects is ongoing. IL-2 agonists are pivotal in modulating T cell responses with significant therapeutic potential for autoimmunity and cancer. Understanding IL-2 signaling is crucial for developing targeted treatments leveraging this cytokine’s benefits.
47. Immunomodulatory Roles of Tonsil-Derived Mesenchymal Stem Cells.
期刊: Critical reviews in immunology 发表日期: 2025 链接: PubMed
摘要
Stemming from human immune organs, tonsil-derived mesenchymal stem cells (TMSCs) hold unique strengths in differentiation potential and immune regulatory functions. These characteristics make them valuable for therapeutic applications, particularly in regenerative medicine and autoimmune disease treatment, as they can modulate immune responses and promote tissue repair. Their ability to interact with various cell types and secrete a range of bioactive molecules further enhances their role in orchestrating healing processes, making them a promising avenue for innovative therapies aimed at restoring balance in the immune system and facilitating recovery from injury or disease. TMSCs are crucial elements of the tonsillar microenvironment, playing a key role in preserving the balance of the immune system. They regulate immune responses by producing cytokines and growth factors, influencing neighboring immune cells, and facilitating communication within tonsillar tissue to maintain a controlled response to pathogens and prevent excessive inflammation. As understanding of TMSCs continues to evolve, their integration into clinical practices could revolutionize approaches to treating a wide array of conditions, highlighting the importance of continued investigation in this promising field.
48. Estimating the associations between women's maltreatment in childhood and inflammatory biomarker levels prior to and during pregnancy.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Maternal childhood maltreatment has been associated with higher risk of adverse neurodevelopment in offspring. Chronic systemic inflammation has been associated with childhood maltreatment and has been identified as a gestational risk factor for adverse neurodevelopment in offspring. Thus, inflammation may be a mechanism by which maternal exposure to maltreatment affects offspring neurodevelopment. To estimate associations between women’s childhood maltreatment and four inflammatory biomarkers, C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha receptor 2 (TNF-R2), and interferon gamma (IFN-γ), among women prior to or during pregnancy. A sub-study of the Nurses’ Health Study 3, a prospective cohort, included 329 women, 204 who were contemplating pregnancy and 124 who were pregnant. Approximately 90% of participants were non-Hispanic White and over 60% had a Master’s degree or higher. Maltreatment was assessed using the validated 28-item Childhood Trauma Questionnaire. Associations were calculated using generalized estimating equations. Fifty participants (15.2%) were not exposed abuse (n = 28 contemplating pregnancy; n = 22 pregnant) and 81 participants (24.6%) were exposed to moderate or severe abuse (n = 55 contemplating pregnancy; n = 26 pregnant). Childhood maltreatment was not associated with the four inflammatory biomarkers either among participants contemplating pregnancy or among pregnant participants. No statistically significant associations were identified between childhood maltreatment and selected inflammatory biomarkers in this sample of well-educated, primarily non-Hispanic White women. These findings should be interpreted with caution given the limited statistical power and measurement variability. Further investigation of these associations in more vulnerable populations might enhance our understanding of biological mechanisms linking maternal childhood abuse to adverse neurodevelopment in offspring.
49. A structural equation modeling approach to examine determinants of nutritional status in Palestinian children 6-59 months.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Undernutrition remains a persistent public health concern among young children in Palestine, shaped by a range of socioeconomic and dietary factors. This study applies a Structural Equation Modeling (SEM) approach to explore both direct and indirect determinants of child growth among children aged 6-59 months in the West Bank. Data were drawn from a 2022 cross-sectional survey involving 300 children selected from 1,400 households. Child growth was assessed using anthropometric indicators (HAZ, WAZ, MUAC) and dietary adequacy via the Mean Nutrient Inadequacy Ratio (MNIR). Latent constructs were developed for socioeconomic status, food insecurity, dietary intake (macro- and micronutrients), feeding practices, neonatal health, and food availability. SEM was used to examine interrelationships and the pathways influencing child nutritional status. Descriptive analysis showed substantial variation in undernutrition and nutrient intake across regions, family size, and parental education. SEM results showed that macronutrient intake had the strongest direct effect on child growth, followed by socioeconomic status and neonatal health. Infant feeding practices and micronutrient intake also contributed positively, though their effects were primarily indirect. Food availability acted as a significant mediator, linking structural access issues to poor dietary diversity and feeding behavior. The model demonstrated good fit across multiple indices. Child nutrition in Palestine is shaped by interrelated determinants of dietary intake, caregiver practices, food access, and early-life health conditions. Effective interventions must target both nutritional quality and the broader social and environmental context to improve growth outcomes. SEM offers a powerful framework to understand these pathways and guide evidence-based policy design.
50. Effects of aging and risk-taking behaviors on fatal injuries among old motorcyclists in Taiwan: Evidence from 2011 to 2022.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Fatality rates of motor vehicle crashes among the old population have risen, primarily in association with age-related declines in health and functional abilities. Comparatively little research has been conducted to examine the impacts of risk-taking behaviors (such as unhelmeted, unlicensed, and drunk riding) on fatalities among old motorcyclists. This study employed the Taiwan National Traffic Crash Dataset from 2011 to 2022 to investigate fatal injuries among old motorcyclists. To identify risk factors associated with injury fatality, chi-square tests were employed. Subsequently, stepwise logistic regression models incorporating multiple variables were constructed to examine these factors. To explore potential interactions between aging and specific behavioral variables, joint effect analysis was performed, followed by a subgroup analysis specific to very old motorcyclists (75 years or above). The analyzed dataset comprised 338,231 crashes involving old motorcyclists, of which 2,703 were fatal and 335,528 were nonfatal. A linear relationship was observed between the risk of fatal injuries and increasing age. The adverse effect of aging on fatalities was exacerbated among unhelmeted (AOR = 4.46; CI = 3.79-5.26), unlicensed (AOR = 1.76; CI = 1.55-1.99), and drunk riders (AOR = 5.35; CI = 4.06-7.06). Our subgroup analysis revealed similar detrimental effects of these three behaviors among very old motorcycles when they were unhelmeted (AOR = 3.67; CI = 3.09-4.36), unlicensed (AOR = 1.31; CI = 1.13-1.50) and intoxicated (AOR = 3.06; CI = 2.31-4.06). Further stratification by geographic location demonstrated that certain risk-taking behaviors, such as unhelmeted and drunk riding, were consistently associated with higher fatality rates. Notably, the magnitude of the effects of drunk riding in rural settings on fatal injuries was higher. The study established a linear relationship between age and the risk of fatal injuries among old motorcyclists. The three risk-taking behaviors apparently are risk factors for fatal injuries, and evident when motorcyclists were very old. This underscores the importance of tailored interventions targeting individuals aged 75 years or above who engage in unlicensed riding, which remains an important area for continued research.