公共卫生研究摘要 (2025-09-12)
共收录 54 篇研究文章
1. Mpox Among Pregnant Women and Their Infants in the U.S. Outbreak, 2022-2023.
期刊: Obstetrics and gynecology 发表日期: 2025-Sep-12 链接: PubMed
摘要
To describe pregnancy and treatment outcomes among pregnant and recently pregnant women with mpox and their infants reported during the clade II mpox outbreak in the United States. Maternal, pregnancy, and infant outcomes related to mpox were monitored through the use of the enhanced methods of SET-NET (Surveillance for Emerging Threats to Mothers and Babies Network), a pregnant woman-infant-linked surveillance program. Thirteen state and local health departments collected data on pregnant or recently pregnant women with laboratory-confirmed mpox reported during August 1-December 31, 2022. Demographics, maternal health history, laboratory results, treatment, and pregnancy and infant outcomes were abstracted from medical records and linked data sources such as birth certificate data and Investigational New Drug registries. Twenty-six pregnant or recently pregnant women with mpox in the United States were reported to the Centers for Disease Control and Prevention. Trimester of infection was known for 23 women: six (24.0%) infections occurred in the first trimester, nine (36.0%) in the second trimester, and eight (32.0%) in the third trimester. Among 23 pregnant women with known outcome, 19 had live births, three of whom delivered preterm, and four had pregnancy losses. Fourteen pregnant women received tecovirimat to treat mpox under an Investigational New Drug protocol with no adverse effects reported. Two neonates were diagnosed with mpox within 2 weeks of life; in these cases, the mothers tested positive for mpox at 2 and 12 days after delivery. Both neonates received tecovirimat, and one neonate also received vaccinia immune globulin intravenous. No adverse effects were reported after neonatal tecovirimat administration except for a suspected drug-related rash in one neonate. The association between tecovirimat and outcomes could not be evaluated because of insufficient sample size. In this descriptive report of pregnant and recently pregnant women with clade II mpox, there were no adverse maternal outcomes. Two neonates were diagnosed with mpox among 23 pregnancies with known outcomes. There were no reported adverse events related to tecovirimat administration in pregnant mothers.
2. Health Care Disparities in Patients Undergoing Surgery for Pelvic Floor Disorders: A Systematic Review.
期刊: Obstetrics and gynecology 发表日期: 2025-Sep-11 链接: PubMed
摘要
To explore how patient characteristics related to health care disparities are associated with access to care and clinical outcomes among patients receiving surgical treatment for pelvic floor disorders in the United States. We searched MEDLINE, EMBASE, and ClinicalTrials.gov through March 25, 2024. Patient characteristics related to health care disparities included race, ethnicity, geographic location, and insurance status, among others. Outcomes included access to surgery, surgical outcomes, and patient-reported outcomes. Eligible studies reported multivariable regression analyses that included at least one patient characteristic related to health care disparities and an included study outcome. For each outcome, we describe the consistency (in direction), strength of association, and number of studies of the patient characteristic related to health care disparities. Meta-analysis was not performed because of study heterogeneity. This review was conducted by the Systematic Review Group of the Society of Gynecologic Surgeons. Of 6,853 abstracts screened, 42 studies with a total of 84 multivariable analyses were included. Characteristics associated with decreased access to apical suspension during prolapse surgery included being from a rural area or of Hispanic ethnicity, and Black racial identity was associated with decreased access to mesh augmentation. Black racial identity and Hispanic ethnicity were also associated with decreased access to reconstructive prolapse repair compared with obliterative procedures and hemorrhage during prolapse repair; older age and having Medicare insurance were associated with increased risk of overall complications. Not being from the Northeast was associated with increased risk of overall complications after prolapse surgery. Patients from a minority race were less likely to undergo reoperation after stress urinary incontinence (SUI) surgery. Black race was not associated with complications after SUI surgery. Patients in minoritized groups in the United States, those with Medicare insurance, and those not from the Northeast were more likely to have health care disparities related to surgical treatment for pelvic floor disorders. PROSPERO, CRD42021234511.
3. A Youth-Centered Digital Infographic on Vaping Risks (What's in a Vape?): Mixed Methods Study.
期刊: JMIR formative research 发表日期: 2025-Sep-11 链接: PubMed
摘要
As youth engagement with traditional public health warnings declines, innovative strategies are needed. Visually compelling, youth-driven digital content such as interactive infographics may help bridge knowledge gaps, enhance risk perception, and support more informed decision-making. Despite this potential, limited research has assessed its effectiveness in conveying vaping-related harms to youth. To address this gap, this study evaluated the impact of a codeveloped, youth-informed digital infographic (What’s in a Vape?) on enhancing vaping education and improving youth understanding of vaping-related harms. A convergent parallel mixed methods design was used to assess the impact of a youth-informed digital infographic. The infographic was created in collaboration with youth coresearchers and youth advisory councils to ensure relevance. Participants were recruited through community partners, school boards, and youth networks. By May 2024, we had enrolled 63 high school students aged 14 to 19 years (mean age 16.5, SD 1.2 years) primarily from Ontario and British Columbia. The survey evaluated baseline knowledge of vaping, engagement with the infographic, and postexposure perceptions on whether the content contributed to increased awareness or understanding of vaping. Data collection took place between April 2024 and May 2024. Quantitative analysis showed that 87% (55/63) of participants agreed that the infographic effectively communicated key information, and 86% (54/63) gained new knowledge about vaping. In addition, 73% (46/63) found that the infographic was presented in an easy and meaningful way, whereas 52% (33/63) indicated that they would definitely share it with others, reflecting strong engagement. However, over half (33/63, 52%) also found the amount of information excessive, and 17% (11/63) found it difficult to digest, indicating variation in youth information preferences. Thematic analysis of qualitative feedback revealed four key themes: (1) the visual content enabled gaining new insights into and knowledge of vaping, (2) the visual design had a positive impact on engagement with information, (3) sourced information enhanced the credibility of the infographic information, and (4) the digital design of the infographic made complex information more understandable. Qualitative insights contextualized and supported the quantitative findings, highlighting both benefits and areas for improvement. This study demonstrates that youth-driven digital infographics may serve as useful health communication tools. Findings highlight the importance of peer-led design; evidence-based content; and interactive, visually compelling formats in enhancing youth comprehension and receptiveness to health messaging. By integrating youth feedback into development and prioritizing digital engagement, the infographic bridged knowledge gaps while reinforcing the credibility of its content. Variability in feedback about content overload suggests that future versions should consider more layered or modular designs. Results suggest that such approaches may complement broader public health strategies to curb youth vaping and inform future educational interventions. Continued research is warranted to assess long-term impacts on attitudes and behavior.
4. Association Between Household Livestock Ownership and Stunting in Children Younger Than 5 Years in Central Rural India: Protocol for a Case-Control Study.
期刊: JMIR research protocols 发表日期: 2025-Sep-11 链接: PubMed
摘要
In resource-constrained environments where malnutrition in children is common, people coexist closely with livestock. Undernutrition, which can result in stunting, wasting, and being underweight, is still a major public health issue for children in India. Livestock serves as a direct source of protein through animal-source foods such as meat, milk, and eggs, which significantly reduce undernutrition in children younger than 5 years. The association between livestock ownership and stunting in children has not been explored well in Maharashtra, India. This study evaluates the relationship between stunting among children younger than 5 years in central India and livestock ownership by using the Tropical Livestock Unit (TLU) score. A community-based, case-control study will be conducted for 12 months among 614 children aged 6-59 months in a few rural blocks of Wardha district, Maharashtra. A predesigned semistructured questionnaire will collect data from the informant (either parent). Anthropometric measurements will be plotted on World Health Organization (WHO) standard growth charts for z scores for stunting and wasting. TLU will be used to represent the livestock count of all species. The categorical variables (stunted and nonstunted) will be analyzed using the Fisher exact test to find significant associations between different risk factors. All confounding variables will be analyzed using multivariable logistic regression. Associated risks will be identified and tabulated using the odds ratio with confidence intervals. This study protocol will provide a comprehensive understanding of the associations of livestock ownership with childhood stunting and wasting among children aged 6-59 months in central rural India. This study will be conducted from October 2025 to September 2026. Currently, necessary approvals are obtained, and data collection is planned to begin from November 2025 to May 2026. Our findings will show the prevalence of the current stunting, wasting, and underweight rates among Indian children younger than 5 years and the association of these rates with livestock ownership by using the TLU index. These results will be instrumental in building new public health policies, integrated programs, and nutritional interventions. Clinical Trials Registry - India CTRI/2024/05/066865; https://tinyurl.com/y3zvh5t7. PRR1-10.2196/66576.
5. Decline in Rate of Radical Hysterectomies Performed by Gynecologic Oncologists in the United States.
期刊: Obstetrics and gynecology 发表日期: 2025-Sep-11 链接: PubMed
摘要
Trends in cervical cancer epidemiology and physician workforces have converged to make radical hysterectomy an increasingly rare procedure for gynecologic oncologists practicing in the United States. Using data from the National Cancer Database and the Centers for Disease Control and Prevention’s United States Cancer Statistics and published gynecologic oncology workforce data, we assessed trends in radical hysterectomy performed in the United States from 2004 to 2020. Over this period, the annual rate of radical hysterectomies per gynecologic oncologist declined significantly, by an average of 6.9% per year (95% CI, 6.4-7.5), corresponding to a decrease from 4.5 to 1.5 cases per oncologist per year. The increasing rarity of radical hysterectomy may pose a challenge to those seeking to acquire and maintain competency in this complex operation.
6. Health-Related Concerns of Anti-LGBTQ+ Legislation: Thematic Analysis Using Social Media Data.
期刊: JMIR infodemiology 发表日期: 2025-Sep-11 链接: PubMed
摘要
There has been a recent proliferation of anti-LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning) legislation being proposed in the United States, including more than 500 bills across 42 states in 2024. Many of the studies examining the impact of anti-LGBTQ+ legislation have focused specifically on the association with mental health outcomes. The objective of this study was to use social media data to more broadly explore health-related concerns of anti-LGBTQ+ legislation among sexual minority men in the United States. We leveraged a dataset containing 70 million tweets that were posted by 23,276 users in the United States who self-reported on Twitter that they are sexual minority men. First, we searched these tweets for keywords related to LGBTQ+ legislation. Next, we developed a codebook for identifying those that expressed health-related concerns of anti-LGBTQ+ legislation. Then, we developed a coding scheme to categorize these concerns into one or more themes by using an inductive approach. Finally, we automatically identified the users’ geographic location and age for subgroup analyses. Among 8486 keyword-matched tweets, 493 (5.8%) tweets expressed health-related concerns due to anti-LGBTQ+ legislation and were posted by 288 sexual minority men in the United States: 112 (38.9%) who posted about health care, 84 (29.2%) about safety, 64 (22.2%) about mental health, 62 (21.5%) about general harm, 49 (17%) about human rights, and 40 (13.9%) about support. Health care was the top concern overall and across the United States and age groups. In contrast, the higher prevalence of mental health was driven by the larger number of users in the South, as it was less of a concern in other regions. Similarly, mental health was less of a concern among older age groups. Safety was as much of a concern as mental health overall and across the United States and most age groups. Our findings may inform a broader range of health interventions and approaches for targeting them at specific populations of sexual minority men. By demonstrating that these concerns are expressed on social media, our findings can be leveraged by advocacy groups to amplify voices and rally public support for countering anti-LGBTQ+ bills.
7. Child and Adolescent Virtual Mental Health Care and Duration of Treatment: Retrospective Cohort Study.
期刊: JMIR mental health 发表日期: 2025-Sep-11 链接: PubMed
摘要
Due to public health restrictions, the COVID-19 pandemic required significant changes in the delivery of child and adolescent mental health services. The use of virtual care for balancing access with treatment needs requires a shared decision between clients, caregivers, and clinicians. One aspect for consideration is the length of treatment necessary to achieve desired outcomes and whether it differs by treatment modality. Insights gained from the comparison of treatment duration between modalities may improve our understanding of the effectiveness of virtual care and help to inform clinical decision-making and effective use of resources. We sought to improve our understanding of how treatment modality impacts treatment duration for children and adolescents accessing Community Mental Health and Addictions services at IWK Health following the rapid implementation of virtual care in March 2020. In this study, we aimed to compare the duration of treatment within episodes of care by treatment modality and determine whether client characteristics, system factors, or time period influenced any associations between treatment modality and treatment duration. Episodes of care were created using administrative data collected by the IWK Mental Health and Addictions program and used as the unit of analysis. A multilevel mixed-effects negative binomial model and time-to-event analysis were used to model the association between treatment modality and treatment duration, both in visits and days, adjusting for client and system characteristics. Virtual episodes of care had more visits than in-person episodes between April 1, 2020, and March 31, 2021 (incidence rate ratio [IRR] 1.59, 95% CI 1.38-1.83), and April 1, 2021, and March 31, 2022 (IRR 1.22, 95% CI 1.10-1.35), whereas between April 1, 2022, and March 31, 2023, virtual episodes of care were associated with fewer visits (IRR 0.82, 95% CI 0.74-0.91). Comparable results were seen for treatment duration in days (2020-2021: hazard ratio [HR] 0.64, 95% CI 0.54-0.76; 2021-2022: HR 0.80, 95% CI 0.70-0.90; and 2022-2023: HR 1.10, 95% CI 0.97-1.25). These differences by time period relative to the onset of the COVID-19 pandemic and switch to virtual care were consistent after adjusting for client and system characteristics. To our knowledge, this is the first study to examine the association between virtual or in-person treatment modality and treatment duration. While initially longer than in-person episodes of care, both in numbers of visits and length in days, over time the average length of episodes conducted mainly virtually had attenuated. These findings may be due to growing comfort with the technology or client factors not adequately captured in administrative data. This information can be valuable to clinicians, clients, and their families regarding expected treatment timelines and aid in informing service planning.
8. End Points for the Next-Generation Bladder-Sparing Perioperative Trials for Patients With Muscle-Invasive Bladder Cancer.
期刊: Journal of clinical oncology : official journal of the American Society of Clinical Oncology 发表日期: 2025-Sep-11 链接: PubMed
摘要
The evolving treatment landscape of muscle-invasive bladder cancer (MIBC) increasingly warrants novel trial design to evaluate perioperative strategies aimed at bladder preservation. To establish standardized outcome measures for evaluating organ preservation strategies in MIBC, the International Bladder Cancer Group (IBCG) and the Global Society of Rare Genitourinary Tumors (GSRGT) assembled an international, multidisciplinary consensus panel. The IBCG and GSRGT gathered global bladder cancer experts and patient advocates to establish a framework for risk-adapted bladder-sparing treatment approaches for MIBC. Working groups reviewed the literature and developed draft recommendations, which were discussed at a live meeting in December 2024 in Milan. This was followed by voting by the members using a modified Delphi process. Recommendations achieving ≥75% agreement during the meeting were further refined and presented. Clinical complete response (cCR) definition should encompass the absence of high-grade malignancy on pathology and malignant cells on urine cytology and no evidence of local or metastatic disease on cross-sectional imaging. Although cCR remains immature as a primary or coprimary end point in registrational trials, it could serve as a suitable end point in early-phase studies and risk-adapted investigations. Event-free survival (EFS) remains the preferred primary end point as it could reliably capture the durability of clinically meaningful benefit after omittance of surgical consolidation or chemoradiation. Given the composite nature of EFS, events should be prespecified, evaluated in an intention-to-treat approach, and meticulously collected. Continuous assessment of individual patient preferences should begin at the outset of perioperative therapy discussions, with informed decision making prioritized throughout. The consensus definition of cCR and the framework presented in this study can serve as a foundation for thorough testing of risk-adapted bladder-sparing treatment paradigms for MIBC.
9. Hardship and Hope: The Relationship Between Unconditional Prenatal and Infant Cash Transfers, Economic Stability, and Maternal Mental Health and Well-Being.
期刊: American journal of public health 发表日期: 2025-Sep-11 链接: PubMed
摘要
Objectives. To examine the impact of Rx Kids-a community-wide and unconditional prenatal and infant cash transfer program in Flint, Michigan-on economic stability, maternal mental health, and well-being. Methods. Using a difference-in-differences framework, we compared outcomes for surveyed Flint mothers who gave birth before and after Rx Kids implementation to those outside the city. Results. Relative to comparisons, mothers exposed to Rx Kids saw improvements in hardship, mental health, and well-being-notably, a 4.2-percentage-point reduction in the risk of eviction (P < .05) and a 14.0-percentage-point reduction in screening positive for postpartum depression (P < .05). Program exposure was associated with increased trust in institutions and feeling loved, hopeful, respected, and valued. Conclusions. Rx Kids, the United States’ first, to our knowledge, community-wide prenatal and infant cash transfer program, is associated with improved economic stability, mental health, and well-being. Rx Kids’ place-based scale provides a replicable model for efficiently addressing perinatal poverty and improving health. (Am J Public Health. Published online ahead of print September 11, 2025:e1-e10. https://doi.org/10.2105/AJPH.2025.308244).
10. Prevalence of systemic lupus erythematosus in Peru and its association with environmental and healthcare factors: An ecological study.
期刊: Lupus 发表日期: 2025-Sep-11 链接: PubMed
摘要
ObjectiveTo estimate the prevalence of Systemic Lupus Erythematosus (SLE) in Peru in 2017 and its association with altitude, environmental temperature, and physician density.MethodsThis ecological study was performed using population data from the 2017 Peruvian census. The number of SLE cases for each department was obtained from the National Health Registries using the ICD-10 code M32. Altitude, environmental temperature and physician density were obtained for each department from the National Institute of Statistics and Informatic (Instituto Nacional de Estadística e Informática) registries. The prevalence for each department was calculated adjusting for age and sex. Then a negative binomial regression was performed to estimate the prevalence ratio (PR) and evaluate factors associated with the prevalence of SLE.ResultsThe national prevalence of SLE was 40.2 per 100,000 people. Two age groups had the highest prevalence: 12-17 years and 30-59 years. Females exhibited a higher prevalence than males, particularly in the 30-59 age group (113.9 vs 16.1 per 100,000, respectively). An inverse relationship was observed between the age- and sex-adjusted prevalence in each department and altitude (PR 0.97; 95% CI: 0.94-0.99). On the other hand, there was a direct relationship with physician density (PR: 1.04; 95% CI: 1.01-1.07). No association was found between the adjusted prevalence and environmental temperature or latitude.ConclusionThe prevalence of SLE in Peru aligns with global estimates. The inverse relationship with altitude and the direct association with physician density suggest that environmental and healthcare access factors may influence disease distribution. Further research is needed to explore the underlying mechanisms driving these associations.
11. A New Program for Determining Abnormal Growth Curves in School Health Checkups.
期刊: The Journal of school health 发表日期: 2025-Sep-11 链接: PubMed
摘要
In Japan, school health examinations frequently utilize growth curves. This study aimed to develop and validate a custom-designed program that enables the rapid and accurate detection of growth abnormalities in children and adolescents. We created a novel screening tool named the Growth Assessment Program for Schools (GAPS), implemented using Visual Basic for Applications (VBA) in Microsoft Excel. Using the 2021 school health checkup data (IZUMO 2021; 12,573 students, aged 6-15 years) from Izumo City, we validated the program’s accuracy against both the frequently used abnormal growth curve determination program (V4) and an expert review committee. The GAPS tool enables one-click generation of individualized growth curves and automated identification of abnormal patterns. It successfully detected growth disorders, including cases such as precocious puberty, that were initially overlooked by tV4 (341 cases, 2.9%). Compared to V4, the GAPS tool demonstrated improved sensitivity (0.99) and positive predictive value (0.16), though with a higher false positive rate (0.24). GAPS allows for immediate application by school personnel, including non-specialist school physicians, enabling real-time health surveillance and improving the quality of school-based pediatric care. We developed and validated GAPS, a user-friendly and highly efficient tool for detecting abnormal growth curves in school health settings in Japan. It offers advantages in speed, accuracy, and usability over existing programs. This program also holds potential use in broader populations, provided population-specific growth data are available.
12. Geographic Disparities in Obstetric Care Access in the United States.
期刊: Obstetrics and gynecology 发表日期: 2025-Sep-11 链接: PubMed
摘要
Understanding the distribution of obstetrician-gynecologists (ob-gyns) is crucial to combatting inequities in care access throughout the United States. In this cross-sectional study, we used data from the Health Resources & Services Administration to characterize counties with and without ob-gyns. Of the 3,143 U.S. counties analyzed, 1,473 (46.9%) did not have a single ob-gyn. Counties without ob-gyns were more likely to be nonmetropolitan (57.5% vs 44.6%, P<.01), have a lower median household income ($52,989 vs $59,470, P<.01), and have a greater proportion of White residents (87.6% vs 79.0%, P<.01). Notably, only 103 (7.0%) counties without an ob-gyn had any midwives. Inequities in maternity care provision remain a significant issue in the United States, creating a need for creative policy solutions to improve access.
13. Economic Evaluation of a Multicomponent mHealth Intervention for Stroke Management in Rural China: Cluster-Randomized Trial With 6-Year Follow-Up.
期刊: JMIR mHealth and uHealth 发表日期: 2025-Sep-11 链接: PubMed
摘要
To bridge the gap between clinical guidelines and suboptimal stroke management in rural settings, we conducted an implementation trial using evidence-based, mobile health-enabled strategies to empower primary care providers in rural China. The system-integrated and digital technology-enabled model of care (SINEMA) model was shown to significantly reduce blood pressure and mortality among people with stroke in rural China. This study aimed to evaluate the cost-effectiveness of the SINEMA intervention within both the active trial and the post-trial observational periods and its budget impact for potential nationwide scalability. In the cluster-randomized implementation trial (the SINEMA trial), 50 villages were randomized to either a 1-year intervention (2017-2018) or usual care, with 1299 patients with stroke followed up until 2022-2023-6 years after the trial baseline. The incremental cost-effectiveness ratios (ICER) for systolic blood pressure reduction and quality-adjusted life year gains were estimated from a health sector perspective. Both probabilistic and deterministic sensitivity analyses were conducted to assess the robustness of the findings. Additionally, a budget impact analysis was performed from a public payer perspective to estimate the per-capita and total costs of national scale-up under 2 scenarios: a standalone intervention and integration into the existing basic public health service system. The ICER per 1 mmHg systolic blood pressure reduction was $8.4 for the within-trial estimation. The ICER per quality-adjusted life year gained was $837.9 within-trial and $727.9 post-trial, both highly cost-effective relative to any commonly adopted thresholds and robust in sensitivity analyses. The first-year budget impact ranged from $115.6 million to $197.7 million in the 2 scenarios, reducing to $46.6 million to $78.7 million by year 5, with a per-capita cost of $0.03-$0.06. Our findings demonstrate that the SINEMA intervention was cost-effective during the trial period and remained so throughout the 6-year sustainability observation period. These results highlight the potential of adopting similar health system-integrated, mobile health-enabled strategies to enhance the management of stroke and other chronic diseases in resource-limited settings. ClinicalTrials.gov NCT0318585, ClinicalTrials.gov NCT05792618; https://clinicaltrials.gov/study/NCT03185858 and https://clinicaltrials.gov/study/NCT05792618. RR2-10.3389/fneur.2023.1145562.
14. Horizon Scanning Methods for Health Care Technology Innovation Identification: Rapid Scoping Review of Patent Research Studies.
期刊: Interactive journal of medical research 发表日期: 2025-Sep-11 链接: PubMed
摘要
Patents are an early sign of innovation, yet their role in horizon scanning for health care remains unclear. This study investigates the role of, and methods for, patent analysis in advancing health care technology innovation in a sector that is characterized by diverse health care technologies and significant research investment. Patents are critical early indicators of innovation, supporting horizon scanning and weak signal detection. The study aimed to identify intellectual property sources, evaluate methods for patent retrieval and analysis, and outline objectives for using patent data to anticipate trends and inform health care strategies. A rapid scoping review was conducted following Cochrane Rapid Review Methods recommendations and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, with a preregistered protocol on the Open Science Framework. Searches in Embase, IEEE Xplore, and Web of Science targeted records published 2020 onward to capture the most recent sources, methods, and tools. Three independent reviewers screened studies using Rayyan (Qatar Computing Research Institute). We included any study type published since 2020 that provided patent sources data, methods, and tools applied to the study of health care technologies. Our data extraction included bibliographic details, study characteristics, and methodological information. Risk of bias assessments were not undertaken. Narrative and tabular methods, supplemented by visual charts, were used to synthesize findings. Our searches identified 1741 studies, of which 124 were included after title, abstract, and full-text screening, with 54% being original research, 43.5% reviews, and the remainder being conference abstracts (2.5%). Most studies (68%) relied solely on patent databases, while others searched the gray and published literature. Research objectives of the included studies were grouped into 10 themes, with trend analysis (50%) and the provision of recommendations for future research, policy, and strategy development (20%) being the most common. Our review identified up to 47 patent databases, with 27% of studies using multiple sources. Whenever time limits were reported, the mean time horizon for patent searches was 24.6 years, ranging from 1900 to 2019. Automated approaches, used in 33% (n=43) of studies, frequently used tools such as Gephi (Gephi Consortium) for network visualization. Disease mapping based on National Institute for Health and Care Excellence classification indicated that cancer (19%) and respiratory conditions (16%), particularly COVID-19, were key areas. Patent data are valuable for identifying technological trends and informing policy and research strategies. While patents provide crucial insights into emerging technologies, inconsistent deduplication practices across studies pose the risk of data inflation, accentuating the need for transparency and rigor. Finally, this review emphasized the importance of data transformation and visualization in detecting emerging trends, with Python and R being the most commonly used programming languages for developing custom tools.
15. Reducing Hallucinations and Trade-Offs in Responses in Generative AI Chatbots for Cancer Information: Development and Evaluation Study.
期刊: JMIR cancer 发表日期: 2025-Sep-11 链接: PubMed
摘要
Generative artificial intelligence (AI) is increasingly used to find information. Providing accurate information is essential to support patients with cancer and their families; however, information returned by generative AIs is sometimes wrong. Returning wrong information is called hallucination. Retrieval-augmented generation (RAG), which supplements large language model (LLM) outputs with relevant external sources, has the potential to reduce hallucinations. Although RAG has been proposed as a promising technique, its real-world performance in public health communication remains underexplored. This study aimed to examine cancer information returned by generative AIs with RAG using cancer-specific information sources and general internet searches to determine whether using RAG with reliable information sources reduces the hallucination rates of generative AI chatbots. We developed 6 types of chatbots by combining 3 patterns of reference information with 2 versions of LLMs. Thus, GPT-4 and GPT-3.5 chatbots that use cancer information service (CIS) information, Google information, and no reference information (conventional chatbots) were developed. A total of 62 cancer-related questions in Japanese were compiled from public sources. All responses were generated automatically and independently reviewed by 2 experienced clinicians. The reviewers assessed the presence of hallucinations, defined as medically harmful or misinformation. We compared hallucination rates across chatbot types and calculated odds ratios (OR) using generalized linear mixed-effects models. Subgroup analyses were also performed based on whether questions were covered by CIS content. For the chatbots that used information from CIS, the hallucination rates were 0% for GPT-4 and 6% for GPT-3.5, whereas those for chatbots that used information from Google were 6% and 10% for GPT-4 and GPT-3.5, respectively. For questions on information that is not issued by CIS, the hallucination rates for Google-based chatbots were 19% for GPT-4 and 35% for GPT-3.5. The hallucination rates for conventional chatbots were approximately 40%. Using reference data from Google searches generated more hallucinations than using CIS data, with an OR of 9.4 (95% CI 1.2-17.5, P<.01); the OR for the conventional chatbot was 16.1 (95% CI 3.7-50.0, P<.001). While conventional chatbots always generated a response, the RAG-based chatbots sometimes declined to answer when information was lacking. The conventional chatbots responded to all questions, but the response rate decreased (36% to 81%) for RAG-based chatbots. For questions on information not covered by CIS, the CIS chatbots did not respond, while the Google chatbots generated responses in 52% of the cases for GPT-4 and 71% for GPT-3.5. Using RAG with reliable information sources significantly reduces the hallucination rate of generative AI chatbots and increases the ability to admit lack of information, making them more suitable for general use, where users need to be provided with accurate information.
16. The direct and indirect costs of osteoporosis in the Iranian population: an economic analysis from a social perspective.
期刊: Expert review of pharmacoeconomics & outcomes research 发表日期: 2025-Sep-11 链接: PubMed
摘要
Osteoporosis is defined as a systematic skeletal disease and has a high prevalence in Iran. This study aimed to calculate the economic burden of osteoporosis in patients referred to the Bone Mineral Densitometry referral center at Shahid Motahari Clinic, anonymized, in 2023. This study was a cost-of-illness study conducted cross-sectionally from a societal perspective in Shiraz in 2023. Overall, 252 patients with osteoporosis were examined through a census approach. For the cost data, both a prevalence-based approach and a bottom-up approach were employed. Cost data were obtained using information from patient records and insurance bills, as well as based on self-reports from patients or their companions. The human capital approach was used to calculate the cost of work productivity. The results showed that the annual cost of this disease per patient was $5,223 PPP. The largest share of costs was attributed to direct medical expenses (42.75%), with hospitalization costs accounting for the highest proportion of these expenses (53.93% of total healthcare costs). The shares of Direct non-medical costs and Cost of work productivity were 38.51% and 18.74%, respectively. Furthermore, the economic burden of the disease in the country for this year was estimated at $15,749,838,044 PPP. According to the results, osteoporosis can impose a significant economic burden on society and the patients and their families. Therefore, it is recommended to manage treatment strategies, implement preventive measures, and use better insurance coverage for osteoporosis medications to reduce the costs.
17. Unburden American science.
期刊: Science (New York, N.Y.) 发表日期: 2025-Sep-11 链接: PubMed
摘要
Science is one of the greatest engines of health, prosperity, and security across the world. Yet, in the United States, the enterprise is now under tremendous stress from an array of pressures, including threats to federal support for both the direct and indirect costs of research. But funding instability is not the only issue. One major problem is that regulatory and policy requirements force researchers to spend nearly half of their research time on paperwork associated with receiving federal grants and contracts, not on discovery. The situation is made worse when research institutions themselves layer on additional requirements to ensure compliance. The administrative tasks are unnecessarily complex, duplicative, and, in some cases, contradictory. They also waste taxpayer dollars intended for scientific discovery and innovation. Given the current political focus on streamlining federal regulations, there is a clear opportunity to finally solve this burdensome problem.
18. Caregiver Neglect in Older Adults With Cognitive Impairment: Characteristics and Themes From a Large Registry of Cases.
期刊: Journal of applied gerontology : the official journal of the Southern Gerontological Society 发表日期: 2025-Sep-11 链接: PubMed
摘要
Cognitively impaired older adults are at risk for caregiver neglect, but characteristics of these neglected older adults and their circumstances have not been well described. We quantitatively and qualitatively examined case records from an emergency department/hospital-based elder mistreatment response team, analyzing data from 146 cognitively impaired older adults experiencing caregiver neglect. Nearly half of cases involved suspicion of multiple forms of mistreatment. The neglecting caregiver was most often the patient’s child. We identified nine key themes from these cases: (1) caregiver impairment, (2) conflict between caregivers, (3) sudden appearance of relative or new “friend” offering to help, (4) inadequate supervision or care, (5) unsafe physical home environment, (6) isolation from family and friends, (7) delays in seeking medical care, (8) interference with care, and (9) attempts to honor patient preferences. The wide range of situations that may lead to neglect emphasizes the need for multifaceted interventions.
19. Employee health index based on health checkups and its association with future absent workdays.
期刊: Journal of occupational and environmental hygiene 发表日期: 2025-Sep-11 链接: PubMed
摘要
Employee health is an important factor that influences the productivity and economic success of companies. The goal of health management in companies is to improve employee health by implementing different kinds of interventions, including checkups (voluntary preventive health examinations) that cover a broad set of tests and questions, to give a comprehensive snapshot of the employee’s health and uncover priorities for prevention and health promotion. By analyzing health checkup information on a company-wide level, subgroups with increased need for health management interventions may be identified before productivity loss occurs. This study thus analyzed data from a company’s health checkup to form an employee health index (EHI) using principal component analysis (PCA) to adequately summarize the data. Additionally, this study investigated whether EHI values were associated with the number of absent workdays on the department level. The study population consisted of employees of a German automotive company. In total, data from 71,054 voluntary health checkups conducted between 2006 and 2016 were analyzed. PCA resulted in five components in three different health aspects (musculoskeletal disorders, mental health, and physiology). Based on these components, departments were categorized as having low, medium, and high needs for health management interventions. Poisson regression was used to analyze differences in absent workdays between departments with low compared to medium or high need for health management interventions. Components describing musculoskeletal disorders and physiology were associated with a change in the rate of absent days per employee. However, results were inconsistent over different time intervals. Therefore, although the presented EHI was to a certain extent associated with future absent workdays, using checkup data to investigate more specific health problems and outcomes related to individual job-related activities or tasks instead of general measures seems to be a more appealing approach.
20. Patient Satisfaction Survey for Inpatient Tobacco Cessation Treatment.
期刊: American journal of health promotion : AJHP 发表日期: 2025-Sep-11 链接: PubMed
摘要
PurposePatient satisfaction is a key principle of high-quality care, important to all health systems. While evidenced-based guidelines recommend tobacco use counseling to all hospitalized patients who use tobacco, scant knowledge exists about patient satisfaction with these services. The Satisfaction with Inpatient Tobacco Treatment Study (1) proposes a novel survey tool to measure patient satisfaction with inpatient tobacco treatment and (2) provides survey results from our hospital’s Tobacco Treatment Program.DesignCreation and administration of an 8-item Likert scale survey to assess inpatient tobacco use counseling.Setting/SubjectsA random sample of inpatients who received remote inpatient tobacco use treatment at UNC Health’s Tobacco Treatment Program were selected for participation. The survey was administered by telephone and email.MeasuresSurvey items assessed constructs of patient satisfaction, resource availability pre- and post-discharge, the perceived benefits of inpatient tobacco treatment counseling, and patient-reported smoking cessation.AnalysisSurvey responses were analyzed using descriptive statistics and Fisher’s Exact Tests.ResultsThe majority of respondents reported satisfaction with tobacco use counseling. 92% strongly agreed or agreed that the consultations improved their overall hospital experience and 90% said they quit or cut down on their tobacco use after discharge. Results did not vary significantly by race, insurance status, or gender.ConclusionPatient satisfaction with inpatient tobacco cessation treatment was high across multiple domains, as was patient-reported smoking cessation. The survey instrument can be further validated and adapted for program assessment and quality improvement in other tobacco treatment programs.
21. An 8-Month Follow Up of the Mindless to Mindful (M2M) Self-Regulation Intervention on Fat Mass Loss.
期刊: American journal of health promotion : AJHP 发表日期: 2025-Sep-11 链接: PubMed
摘要
PurposeTo assess the maintenance of fat mass loss and increases in exercise self-control and self-compassion at 8-months follow-up to the Mindless to Mindful (M2M) program.DesignThis was a single-group follow-up case study.SampleFor the analysis, 79 of the original 195 M2M participants (n = 40.51%) participated.InterventionThe eight-week M2M program provided goal-setting, group exercise, and goal monitoring to promote fat mass loss.MeasuresParticipants completed measures of body fat, the brief self-control scale, and the self-compassion scale-short form.AnalysisPaired sample t-tests were used to determine differences within and between groups (P-value < .05).ResultsThere was a significant increase in fat mass from post-test to follow-up (t(78) = 3.105, P = .001, d = .349), but participants did not revert to baseline. There was a significant decrease in self-control (t(78) = -3.381, P < .001, d = -.380) and self-compassion (t(78) = -2.670, P = .005, d = -.300). Further, team participants gained significantly more fat mass (M = 3.46, SD = 7.41), had diminished self-control (M= -2.87, SD =5.83), and decreased self-compassion (M= 0.16, SD= 0.38) when compared to individual participants.ConclusionParticipants maintained some fat mass loss at eight-month follow-up.
22. Oxygen-Generating Bioscaffold for the Treatment of Skin Anaerobic Infections.
期刊: Biomacromolecules 发表日期: 2025-Sep-11 链接: PubMed
摘要
In response to the difficulties posed by anaerobic bacterial infections in wound healing, particularly in light of the increasing prevalence of antibiotic-resistant strains and the complex nature of wound environments, this study introduces a meticulously planned oxygen-generating tissue engineering scaffold to address these obstacles. This scaffold is realized from silk fibroin (SF), poly(vinyl alcohol) (PVA), and calcium peroxide (CPO) by ice crystal-induced self-assembly combined with the ice template method, aiming at a synergistic balance of hydrophilicity, structural stability, mechanocompatibility with biological tissues, controllable oxygen-releasing behavior, and antianaerobic bacterial properties. In particular, the oxygen-generating scaffold containing 2.5% CPO exhibits excellent antianaerobic properties by destroying C. perfringens through a mechanism that disrupts bacterial cell membranes and DNA, as well as promotes the generation of reactive oxygen species. Meanwhile, significant cytotoxic or hemolytic effects were avoided. Subsequent results demonstrated that the oxygen-generating scaffold accelerated the healing process of C. perfringens-infected wounds with results similar to those of amoxicillin. These results emphasize the promise of this new platform in clinical practice for the treatment of anaerobic bacterial infections and establishing a basis for advanced therapeutic strategies.
23. Effect of Date (Phoenix dactylifera) Extracts in Alleviating PCOS-Induced Myocardial Toxicity in Female Albino Mice (Mus musculus): In Silico and In Vivo Approaches.
期刊: Chemistry & biodiversity 发表日期: 2025-Sep-11 链接: PubMed
摘要
The current research work aims to characterize and evaluate cardioprotective and anti-lipidemic effects of Ajwa date extracts on testosterone enanthate (TE)-induced polycystic ovary syndrome (PCOS) in female albino mice. The phyto-profilling of date extracts was analyzed using high-performance liquid chromatography (HPLC) following standard methods. The PCOS was experimentally induced in the mice by intramuscular infusion of TE for 35 days. Ajwa date seed extract (ADSE) and Ajwa date whole extract (ADWE) were administered for 14 days at two different doses: 1 and 2 g/kg/BW. Serum creatine kinase myocardial band (CK-MB) and lipid profiles were measured. The results showed that PCOS group exhibited elevated activities of serum CK-MB and altered lipid profiles. Histological analysis of G2 (PCOS group) showed altered architecture of cardiac tissues. The molecular docking was also performed to support the results of in vivo studies. The HPLC characterization revealed that both extracts contained various polyphenols, quercetin, gallic acid, catechin (was found maximum in ADWE), and rutin (was found maximum in ADSE). The biochemical results revealed a significant decrease (p < 0.001) in CK-MB levels and lipid profile, including cholesterol, triglycerides, and low-density lipids, and an increase in high-density lipids after the administration of both extracts. Ajwa treatment normalized the cardiac tissue structure by reducing fibrosis and hemorrhagic zones and bettering fiber muscle organization. Notably, the higher doses of G5 and G6 (2 g/kg/BW) for both ADSE and ADWE provided superior myocardial protection and morphological preservation compared to the 1 g/kg/BW dose. Computation confirmation revealed that the detected bioactive compounds of extracts exhibited inhibitory potential against angiotensin receptor 1 and cyclooxygenase 2, which causes the cardiotoxicity. Especially, the rutin showed maximum inhibitory potential with binding energies of -9.2 and -9.8 kcal/mol against angiotensin receptor 1 and cyclooxygenase 2, respectively. It is concluded that both ADSE and ADWE contained polyphenolic compounds that are involved in preventing the PCOS-induced cardiotoxicity.
24. Perinatal outcome after single intrauterine death in monochorionic twin pregnancy: systematic review and meta-analysis.
期刊: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology 发表日期: 2025-Sep-11 链接: PubMed
摘要
To report perinatal and neurodevelopmental outcomes in monochorionic twin pregnancy after single intrauterine fetal death (IUFD), according to gestational age at single IUFD and the presence of twin-twin transfusion syndrome (TTTS). MEDLINE, EMBASE and The Cochrane Library were searched for studies reporting the outcome of monochorionic twin pregnancy complicated by single IUFD. The collected outcomes included preterm birth (PTB) < 34, < 32 and < 28 weeks’ gestation, cotwin IUFD and neonatal death (NND), cerebral anomaly detected at follow-up prenatal ultrasound examination, fetal magnetic resonance imaging (MRI) or postnatal imaging (ultrasound or MRI) and adverse neurodevelopmental outcome. Subgroup analyses were conducted according to the presence of TTTS and gestational age at single IUFD. We reported the association of various risk factors, namely signs of fetal anemia, TTTS and selective fetal growth restriction (sFGR), with the risk of abnormal brain imaging. Random-effects meta-analysis of proportions was used to analyze the data, and results were reported as pooled proportions or odds ratios (ORs) with 95% CI. Twenty-three studies, comprising 1294 monochorionic twin pregnancies complicated by single IUFD, were included. PTB < 34, < 32 and < 28 weeks’ gestation occurred in 45.8% (95% CI, 34.0-57.8%), 28.0% (95% CI, 16.3-41.4%) and 10.9% (95% CI, 5.6-17.6%) of cases, respectively. Cotwin IUFD and NND were reported in 6.2% (95% CI, 2.6-11.0%) and 4.1% (95% CI, 2.6-5.9%) of cases, respectively. Cerebral anomaly at fetal MRI was reported in 20.0% (95% CI, 14.2-26.4%) of cases, most of which were severe. Adverse neurodevelopmental outcome was documented in 11.0% (95% CI, 4.7-19.6%) of infants, but in none of those with normal prenatal imaging. When comparing pregnancies without TTTS to those with TTTS that did not undergo laser therapy, PTB < 34 weeks occurred in 47.7% (95% CI, 29.8-65.9%) and 40.0% (95% CI, 17.2-65.4%), respectively. The corresponding figures for cotwin IUFD were 7.3% (95% CI, 1.4-17.3%) and 5.7% (95% CI, 0.4-23.2%); those for cotwin NND were 2.5% (95% CI, 0.6-5.6%) and 13.9% (95% CI, 3.9-28.7%); and those for adverse neurodevelopmental outcome were 34.5% (95% CI, 5.1-73.3%) and 34.5% (95% CI, 12.5-60.8%). Signs of fetal anemia in the surviving fetus were associated with significantly higher odds of abnormal brain imaging (OR, 4.3 (95% CI, 1.7-10.9); P = 0.003), while TTTS (P = 0.104) and sFGR (P = 0.283) were not associated with higher odds of cerebral anomaly on imaging. Single IUFD in monochorionic twin pregnancy is associated with high risks of PTB, abnormal brain imaging and adverse neurodevelopmental outcome in the surviving cotwin, although the risks are lower than those reported previously. All cotwins with normal prenatal imaging had normal neurodevelopment, highlighting the prognostic role of prenatal brain assessment after single IUFD. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.
25. Examining Trends in Substance Use Behaviors Among Women With Primary and Secondary Syphilis: United States, 2018-2023.
期刊: American journal of public health 发表日期: 2025-Sep-11 链接: PubMed
摘要
Objectives. To examine recent trends in substance use among women with primary and secondary (P&S) syphilis in the United States. Methods. We reviewed case notifications sent to the Centers for Disease Control and Prevention via the National Notifiable Diseases Surveillance System for women and girls aged 15 years and older with P&S syphilis from 2018 to 2023. We calculated percentages of behaviors associated with substance use during the past year (having sex while intoxicated or high, having sex with a person who injects drugs, or methamphetamine use) by year, race/ethnicity, and region. Results. Our analysis included 51 209 P&S syphilis cases. Most women and girls (86%) were of reproductive age. Behaviors were stable temporally and regionally, but methamphetamine use was highest in the West (30%). All behaviors were reported more frequently among non-Hispanic White women than non-Hispanic Black or Hispanic women. Conclusions. Although substance use behaviors were frequently reported, trends were stable, indicating that the proportion of women reporting these behaviors did not scale with recent national increases in P&S syphilis among women. Universal syphilis screening of reproductive age women and girls could be evaluated as an option to reduce syphilis among them along with adverse outcomes, including congenital syphilis. (Am J Public Health. Published online ahead of print September 11, 2025:e1-e9. https://doi.org/10.2105/AJPH.2025.308254).
26. Caregiver-Reported Sugar-Sweetened Beverage Consumption and Cavities in Children Aged 1 to 5 Years, National Survey of Children's Health 2021-2022.
期刊: Preventing chronic disease 发表日期: 2025-Sep-11 链接: PubMed
摘要
Dental cavities are a common chronic disease among US children. Sugar-sweetened beverages (SSBs) are the leading contributor of added sugars in children’s diets. We assessed the prevalence and adjusted odds of a caregiver-reported cavity in the past 12 months by SSB consumption among children aged 1 to 5 years. We used data from the 2021-2022 National Survey of Children’s Health. Our sample comprised children aged 1 to 5 years who had seen an oral health provider in the past 12 months. An adult caregiver reported whether the child had a cavity in the past 12 months and how frequently they consumed SSBs in the past 7 days. Models were adjusted for age, sex, race and ethnicity, highest level of education among adults in the household, and household federal poverty level. We used multivariable logistic regression to examine the relationship between cavities and SSB consumption. Among 23,023 US children in our sample, 11.6% had a caregiver-reported cavity in the past 12 months. Approximately 37.3% of children were reported to drink no SSBs, 39.5% drank SSBs 1 to 3 times in the past week, and 23.3% drank SSBs 4 or more times in the past week. Compared with children who drank no SSBs, those who drank SSBs 1 to 3 times in the past week or 4 or more times in the past week had 1.7 (95% CI, 1.4-2.2) times and 2.8 (95% CI, 2.1-3.6) times higher adjusted odds, respectively, to have a caregiver-reported cavity. Frequent SSB consumption is common among children aged 1 to 5 years and is associated with higher odds of having a cavity. These findings highlight the need for public health and dental professionals to promote the reduction of SSB intake and encourage healthier choices among very young children and their caregivers to help mitigate oral health issues.
27. Mapping review of musician well-being literature.
期刊: Journal of occupational and environmental hygiene 发表日期: 2025-Sep-11 链接: PubMed
摘要
While musician health literature has grown significantly in the past three decades, a holistic understanding of musician well-being remains lacking. This mapping review aimed to create a topographical review of existing literature on musician well-being to identify key knowledge gaps. This review sought to identify the aspects of musician well-being that have recently been studied, the musician populations that have been studied, and the study designs that have been used to assess musician well-being. This mapping review design was informed by the Focused Mapping Review and Synthesis (FMRS) approach. Studies were categorized and visualized based on study design, type of musician sampled (i.e., profession, instrument, musical genre), and well-being determinants, using the Ecology of Musical Performance (EMP) Model as a foundational framework. This review found that the majority of well-being studies identified focused on musculoskeletal health. Additionally, few intervention studies were identified, and all involved samples of music students in intervention studies were in K-12 or higher education programs. While the EMP model proposes a holistic approach to understanding musician well-being, many crucial well-being determinants highlighted by the model have not been recently studied within the musician health research. Addressing these gaps will provide a more comprehensive foundation for improving the health and well-being of all musicians.
28. Occupational exposures to chemicals in dentistry: A scoping review.
期刊: Journal of occupational and environmental hygiene 发表日期: 2025-Sep-11 链接: PubMed
摘要
The dental workforce comprises a variety of professions, most of which are predominantly occupied by women. Dental workers can be exposed to numerous toxic chemicals such as mercury, methacrylate polymers, and silica. This scoping review aims to synthesize the scientific literature on quantified chemical exposures and to identify research gaps in occupational chemical hazards faced by dental professionals. This review followed the Joanna Briggs Institute approach and PRISMA-ScR guidelines, using three concepts to search PubMed, Embase, and Web of Science: workers, dental care, and chemicals. Studies from high-income countries, published in French or English between 2000 and 2024 and reporting direct quantitative exposure data, were included. A descriptive analysis presents exposures measured in urine, blood, and air samples for the most assessed chemicals. Thirty articles were included in the review, with two-thirds focused on exposures of dentists and none of denturists. Exposure assessments most often focused on mercury (n = 17 studies), followed by nitrous oxide (n = 6), methacrylate compounds (n = 4), and silica (n = 3). Most studies showed exposure levels below occupational exposure standards; however, certain aerosol-releasing tasks could exceed recommended occupational exposure limits of 0.025 mg/m³ for mercury and silica. Dental students in a simulation laboratory were exposed to a 4-hr mercury vapor level up to 3 mg/m3, and dentists’ exposure in clinics reached 0.45 mg/m³. Silica concentrations were below occupational exposure limits in dental clinics but reached twice the standard in a dental laboratory during prosthodontics polishing activities. The review emphasizes the need for comprehensive exposure assessments among dental workers and highlights the lack of focus on denturists, dental technicians, and dental assistants. To adequately assess the overlooked risks posed by multi-exposures to chemicals among dental workers, future studies need to analyze and report on exposures and risks stratified by occupation, task, and sex.
29. Occupational exposures to halogenated waste anesthetic gases in healthcare professionals.
期刊: Journal of occupational and environmental hygiene 发表日期: 2025-Sep-11 链接: PubMed
摘要
Waste anesthetic gases (WAGs) are anesthetic gases and vapors that are released or leaked into the surrounding environment during the delivery of anesthesia to patients and anesthesia recovery. In the last few decades, considerable efforts have been made to reduce WAG exposure for healthcare professionals who work in operating rooms (ORs) by using control measures such as scavenging systems and enhanced ventilation. Limited information is available regarding exposure assessment for healthcare workers in postanesthetic care units (PACUs) in hospitals. WAGs are associated with several adverse health effects, including reproductive-related health outcomes. However, previous studies have reported conflicting findings regarding the association between reproductive outcomes and WAG exposure. Before researching the associations between WAG exposures among PACU workers and health risks, it is essential to assess the current levels of exposure to WAGs in PACUs. This review paper describes the existing status of healthcare workers’ exposure to WAGs in PACUs, discusses knowledge gaps, and provides recommendations on future research priorities.
30. Quantitative microbial risk assessment of drug-resistant tuberculosis exposure from wastewater systems across Sub-Saharan Africa.
期刊: The Science of the total environment 发表日期: 2025-Sep-10 链接: PubMed
摘要
Tuberculosis (TB), especially in its drug-resistant form, remains a critical public health challenge in sub-Saharan Africa, where conventional airborne transmission has been well-characterized. However, wastewater systems prevalent across urban centres may serve as overlooked environmental reservoirs for Mycobacterium tuberculosis, posing occupational and environmental health risks. Despite this, the health implications of wastewater exposure remain underexplored, particularly in high TB-burden settings. To address this research gap, we applied the Quantitative Microbial Risk Assessment (QMRA) framework, incorporating Disability-Adjusted Life Years (DALYs), to assess the health risks of exposure to drug-resistant TB pathogens in wastewater. Our study uniquely focuses on three exposure scenarios: untreated wastewater at the head of works, aerosols from aeration tanks, and reuse of treated wastewater for irrigation, across six African countries: Ghana, Nigeria, Kenya, Uganda, Cameroon, and South Africa. The study found the highest concentrations of M. tuberculosis in Ghana, with rifampicin-resistant strains present at lower levels across all countries. Infection risks ranged from 3 % to 100 %, with irrigation posing the highest median infection risk (0.77). The greatest disease burdens were observed at the head of works (112.46 DALYs) and during irrigation (105.31 DALYs). Our findings highlight wastewater as a significant and previously underestimated route for TB transmission. This study underscores the urgent need for enhanced treatment technologies, occupational safety protocols, and environmental surveillance. Integrating wastewater-based epidemiology into national TB monitoring could provide a valuable early-warning system, especially in regions reusing wastewater for agriculture, and may significantly strengthen global TB control strategies.
31. Drugs as contaminants of emerging concern: preventive approaches beyond detection, regulatory aspects and remediation.
期刊: The Science of the total environment 发表日期: 2025-Sep-10 链接: PubMed
摘要
Scientific literature has recently focused systematically on pollution deriving from environmental spreading of drugs thanks to advances in techniques which allows a better and more accurate detection of pollutants as well as the increase of the regulatory pressure, especially for the substances with endocrine and antimicrobial activities. The issues related to the pharmaceutical micropollutant can be addressed with a multidisciplinary approach which includes advanced analytical chemistry, biology, environmental and pharmaceutical sciences as well as public health-related disciplines. Their integration allows a better understanding and evaluation of the environmental risk associated to pharmaceutical micropollutants and the development of effective solutions for its management and mitigation. In this review detection methods, regulatory aspects and post-emission water-(bio) remediation technologies are considered in an instrumental manner to open the way to the critical analysis of the innovative pharmaceutical technological approaches to contrast the environmental release of drugs and their harmful transformation products. The focus is on the emerging new formulations and drug delivery technologies aimed at preventing the release of drugs in their active form into the environment. The synergy between modern analytical techniques, preventive technologies, and global regulatory systems for the environmental and health risk assessment must become a non-secondary driver in the developments of next generation, safe, effective and greener medicinal products in the context of the One Health approach.
32. Micro- and nano-plastic contamination in foods and potential risk to human health.
期刊: Ecotoxicology and environmental safety 发表日期: 2025-Sep-10 链接: PubMed
摘要
The ubiquitous presence of micro- and nano-plastics (MNPs) has made their pollution a global concern, as it leads to human exposure. Dietary exposure represents a major route for human exposure to MNPs, which have the potential to impact human health. This paper aims to review the source, occurrence, characteristics, and analytical methods of MNPs in food. The challenges and limitations involved in assessing the human health risks associated with MNPs through food consumption were also discussed. Studies have found that various foods, particularly seafood, are contaminated with MPs. However, limited data are available on MPs in other commonly consumed food items such as meat, vegetables, and fruits. Furthermore, there is a lack of investigation into the characteristics of nanoplastics (NPs, <1 µm) and oligomer polymers (low molecular weight polymers) which are more prone to entering human body because of smaller sizes. MNPs are possibly introduced into food through different pathways, including raw food materials, food processing and production, packaging and containers, as well as preparation and dining processes. The complexity of food matrix poses challenges to the development of methodologies to investigate MNPs, hindering comprehensive data acquisition and human exposure assessment. Additionally, the lack of epidemiological, clinical, and toxicological data related to environmental MNPs makes it difficult to conduct accurate hazard identification and characterization. These limitations impede the feasibility of conducting health risk assessment. Therefore, we urgently call for a better understanding of health risks of MNPs, achieved through the improvement of methodologies and the expansion of available data.
33. Molecular characterization of Human T-cell Lymphotropic Viruses 1 and 2 (HTLV-1 and HTLV-2) in samples from blood donation candidates in the state of Pará, Brazilian Amazon.
期刊: The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases 发表日期: 2025-Sep-10 链接: PubMed
摘要
The Human T-Lymphotropic Virus (HTLV) is a retrovirus belonging to the Retroviridae family and the Deltaretrovirus genus, which has a tropism for T lymphocytes. Despite being the first human retrovirus identified, knowledge about its infection remains limited, highlighting the need for further research, especially in Northern Brazil.. This study aimed to phylogenetically characterize HTLV-1 and HTLV-2 samples identified in blood donors from the state of Pará. The phylogenetic characterization was performed using DNA samples from blood donors at the HEMOPA Foundation, collected between January 2015 and December 2021. The 5’LTR regions of HTLV-1 and HTLV-2 were amplified using specific primers with Nested PCR. The amplified products were purified and sequenced using the dideoxynucleotide method, with the same primers used in the Nested PCR, for subsequent phylogenetic analysis and the construction of a sequence database, as well as deposits in GenBank. The phylogenetic analysis of the 5’LTR sequences of HTLV-1 from this study, compared with isolates available in GenBank, showed that 100 samples clustered with Cosmopolitan subtype isolates, Transcontinental subgroup, while 2 samples clustered with Cosmopolitan subtype isolates, Japanese subgroup. Regarding the phylogenetic analysis of HTLV-2 from this study in comparison with other GenBank isolates, most of the isolates clustered with strains described as HTLV-2c, and only three samples clustered with strains described as HTLV-2a. The epidemiological profile found in the analyzed samples consisted mainly of women, with an average age of 40 years and a low level of education. The molecular characterization of the viral genome provides information about the viral subtypes circulating in the population. This information may be important for increasing investments in screening and monitoring individuals infected with HTLV, thereby contributing to prophylactic practices related to infection and the dissemination of knowledge about HTLV.
34. Vacuum ultraviolet-induced degradation of polyethylene and polyvinyl chloride micro/nanoplastics enhances their cytotoxicity and lipid peroxidation level.
期刊: Ecotoxicology and environmental safety 发表日期: 2025-Sep-10 链接: PubMed
摘要
Plastic particles smaller than 5 mm, termed microplastics, have raised concerns regarding their potential impact on human health. Even smaller particles (<1 µm), classified as nanoplastics, also warrant further investigation. Since these plastic particles have been detected in various human tissues, their biological effects must be thoroughly evaluated. These plastics originate from diverse polymer types and exhibit complex physicochemical properties such as size, shape, and surface degradation in the environment. However, current studies mainly utilize polystyrene beads, which may not exist widely in the environment. Therefore, the use of environmentally relevant micro- and nanoplastics for safety assessments is crucial. Focusing mainly on surface degradation, this study aimed to elucidate detailed mechanisms of cell death caused by micro- and nanoplastics and assess their universality across different polymer types, including polyethylene (PE) and polyvinyl chloride (PVC). Surface-degraded samples of PE and PVC with different particle sizes, including microplastics and nanoplastics, were prepared and their cell death mechanisms were evaluated in murine macrophage RAW264.7 cells. Transcriptomic analysis revealed that degraded PE microplastics upregulated ferroptosis-related gene expressions and increased reactive oxygen species level and lipid peroxidation. Cell death and lipid peroxidation induction were also examined in other polymer types, including PVC microplastics as well as PE and PVC nanoplastics. Notably, only the degraded samples induced cell death and lipid peroxidation for all tested particles. Given the role of lipid peroxidation in various diseases such as neurological dysfunction and ischemia-reperfusion injury, our findings highlight the potential health risks of environmental micro- and nanoplastics.
35. Dual impact of microplastic exposure in a mouse model: Impaired uterine receptivity and altered maternal-offspring metabolism.
期刊: Journal of hazardous materials 发表日期: 2025-Sep-09 链接: PubMed
摘要
With the increasing environmental presence of microplastics (MPs), concerns about their potential health risks have intensified. Our previous study detected MP deposition in the human uterus. However, its impact on uterine receptivity and the underlying mechanisms remains poorly understood, and the systemic metabolic consequences of MP exposure are yet to be elucidated. In this study, we investigated the reproductive and metabolic consequences of MP exposure using a mouse model. Female C57BL/6 mice were orally administered polystyrene microplastics (PS-MPs) at 50 mg/kg/day for 14 days (n = 30 per group), while control mice received an equivalent volume of saline. MP accumulation was observed in uterine tissues, consistent with our human findings. Following exposure, mice exhibited impaired uterine receptivity and unideal implantation, potentially driven by inflammatory pathway activation, as revealed by transcriptomic analysis. In addition, metabolomic profiling of maternal and offspring blood samples revealed significant metabolic disturbances, with overlapping alterations across generations, raising the possibility of intergenerational effects. These multi-omics datasets were generated by CapitalBio Technology and further analyzed using MetaboAnalyst. These findings highlight the urgent need to further investigate the biological threats of MP exposure and to develop strategies to mitigate its adverse health effects.
36. Anthropogenic gadolinium as a tracer of urban impact in the Chinese Capital Economic Circle: Distribution, sources, and sustainable remediation perspectives.
期刊: Journal of hazardous materials 发表日期: 2025-Sep-09 链接: PubMed
摘要
As cities expand, anthropogenic gadolinium (Gdanth), mainly from medical contrast agents, is emerging as a significant pollutant in urban rivers. Rapid urbanization and rising medical wastewater discharge have accelerated the accumulation of REEs, particularly Gdanth, posing new ecological and health challenges. This study investigated two representative urban rivers in the Chinese Capital Economic Circle to elucidate how human activities shape REE behavior in megacity river, and the environmental factors driving these changes. By combining land use classification, buffer zone extraction, and Spearman correlation analysis, a strong positive correlation was revealed between urban land use proportion and Gdanth. By integrating Gdanth with NO3⁻/Na⁺ and Cl⁻/Na⁺, an innovative tracing system was developed to effectively trace pollution sources such as wastewater treatment plants, industrial facilities, hospitals, and farmland. To address this issue, this study proposes an innovative treatment strategy tailored for medical wastewater in megacities. The system conceptually integrates guava seeds as a sustainable carbon source, TiO2 as a photocatalyst, and hybrid membrane technology to synergistically enhance the removal of gadolinium-based contrasting agents (GBCAs) and coexisting contaminants. This conceptual approach provides a novel technical pathway and theoretical foundation for wastewater reuse, pollutant recovery, and sustainable environmental management in highly urbanized regions.
37. Selenium solubilization by Bacillus sp. S01: Mechanistic insights and environmental implications in paddy soils.
期刊: Journal of hazardous materials 发表日期: 2025-Sep-09 链接: PubMed
摘要
Selenium (Se) is an essential micronutrient for humans, and crop Se biofortification presents a global health strategy to ensure safe dietary Se intake. However, low Se bioavailability in paddy soils limits Se uptake by rice (Oryza sativa L.), hindering agronomic Se biofortification. Although microorganisms play a pivotal role in mediating Se transformation within soil biogeochemical cycles, the underlying mechanisms remain to be fully elucidated. In this study, a Se-tolerant bacterium, Bacillus sp. S01, was isolated from high-Se soil and demonstrated the ability to convert Se(0) into bioavailable Se species. Integrated metabolomic and genomic analyses putative Se(0)-solubilizing genes in strain S01, including sulfur assimilation-related genes (gene1757, gene2869, and gene1971). Heterologous expression confirmed that gene1757, gene2869, and gene1971 enhanced Se(0) dissolution in Escherichia coli. Soil microcosm and pot experiments revealed that inoculation with strain S01 increased soluble and exchangeable Se fractions while reducing residual Se content. Additionally, it significantly improved soil pH, enzyme activities (sucrase, acid phosphatase, catalase, urease), and reshaped the rhizosphere microbial community, with Bacillus, Fonticella, and Lutispora identified as key taxa driving Se activation and bioavailability. These changes collectively enhanced rice biomass, yield, and enhanced grain Se content by 91 %. In summary, strain S01 likely transform Se(0) into bioavailable forms via sulfur metabolism pathways while improving Se bioavailability through modulation of soil properties and rhizosphere microbiota. These findings advance our understanding of microbial Se cycling and highlight the potential of Se-solubilizing bacteria in sustainable Se biofortification.
38. Dealing with Autism Spectrum Disorders: Journey from Traditional Methods to Artificial Intelligence.
期刊: Annals of neurosciences 发表日期: 2025-Sep-08 链接: PubMed
摘要
World Health Organisation (WHO) in 2024 identified that approximately one in 100 children globally has autism spectrum disorder (ASD). ASD is a collection of neurodevelopmental disorders that impact a person’s ability to socially interact and communicate, which can typically be noticed in early childhood. While ‘autism’ as a term was initially used for schizophrenic patients, later psychiatrists Dr. Kanner and paediatrician Dr. Asperger introduced it as a syndrome in children with behavioural differences in social interaction and communication with restrictive and repetitive interests. In today’s time, the umbrella term ‘ASDs’ is used to describe a clinically heterogeneous group of neurodevelopmental disorders (NDDs). To examine the role of traditional approaches and the potential effectiveness of artificial intelligence (AI) methods in dealing with ASDs for improving the accuracy in its diagnosis and treatment. The study adopts a narrative review approach to understand the application of AI in ASD. For this purpose, around a hundred research articles were selected from the years 2010-2024. Inclusion and exclusion criteria were identified. The review is organised and grounded on the medical treatment, occupational remedy, vocational remedy, psychology, family remedy and recuperation engineering. The results show the undisputed role of AI and its ability to identify early indicators of autism, in accordance with the UN Sustainable Development Goal 3 (Good Health and Well-being) and Goal 16 (Peace, Justice and Strong Institutions). Further, healthcare sectors which are using a variety of AI analyses on data sources, genetics, neuroimaging, behavioural patterns and electronic medical records are able to early detect for individualised evaluation of ASD. The significance of timely interventions with the help of machine learning (ML) algorithms demonstrates high accuracy in differentiating ASD from neurotypical development and other developmental disorders.AI-driven therapeutic interventions expand social interactions and communication skills in people with ASD in the form of virtual reality-based training, augmentative communication systems and robot-assisted therapies. Thus, the future of AI in ASD holds promise for improving diagnostic accuracy, implementing telehealth platforms and customising treatment plans, despite obstacles such as data privacy and interpretability.
39. Behavior, mechanisms and hazardous changes of interactions with microplastics when heterogeneous pollutants coexist: Arsenic and thiram.
期刊: Journal of hazardous materials 发表日期: 2025-Sep-06 链接: PubMed
摘要
Microplastics (MPs), as emerging pollutants, have attracted significant attention from researchers due to their inherent characteristics and the potential synergistic effects with other types of pollutants. Therefore, this study selected six types of MPs and used As3 + and thiram degraded from tuzet as representative mixed pollutants to investigate the adsorption behavior, adsorption mechanisms and potential hazards. The adsorption processes of As3+ and thiram on MPs both conform to pseudo-second-order kinetic model and Langmuir model. The adsorption processes primarily involve physical diffusion and chemical adsorption, with monolayer adsorption being the dominant mechanism. The adsorption processes are spontaneous endothermic processes. When As3+ and thiram are adsorbed by MPs simultaneously, their adsorption processes are both competitive and synergistic. The adsorption performance of MPs depends on the combined effects of the characteristics of MPs, the characteristics of adsorbate, and external environment. The adsorption mechanisms primarily include hydrophobic interactions, electrostatic interactions, and other non-covalent interactions. After being adsorbed, As3+ and thiram do not significantly increase the acute toxicity to the environment, but they pose a stronger potential hazard to human health. In summary, this study provides a theoretical basis for subsequent research on the toxicology of MPs, as well as their control and removal.
40. Mixed exposure to lithium-battery related metals and menstrual health among young Chinese women: A cross-sectional study.
期刊: Journal of hazardous materials 发表日期: 2025-Sep-05 链接: PubMed
摘要
Environmental contamination from lithium battery waste poses health risks, but the impacts of constituent metals (Li, Ni, Co, Mn) on menstrual health are unclear. This study investigated associations between blood concentrations of these metals and menstrual characteristics in 504 healthy young women. Metals concentrations in whole blood were measured using inductively coupled plasma mass spectrometry. The qgcomp, BKMR, and SHAP models were used to analyse the association and contribution of mixed metal exposure to menstrual outcomes. The average concentrations of whole blood Ni, Li, Co, and Mn of participants reached 1.16, 0.94, 0.27, and 2.87 ng·mL-1. Single-metal analyses showed that Co and Mn were significantly negatively correlated with menstrual cycle, while Li was positively correlated with menstrual bleed duration. The overall metal mixture demonstrated negative associations with menstrual cycle and positive associations with menstrual bleed duration. Specifically, increasing Co (25th to 50th percentile) significantly decreased cycle length (-0.684 days [95 %CI: -1.025, -0.341]), while increasing Li significantly increased duration (0.557 days [95 %CI: 0.133, 0.981]), with other metals fixed at the 25th percentile. These findings highlight environmentally relevant Co and Li exposure as potential modifiable risk factors for female reproductive health disturbances.
41. Socioeconomic inequalities in developing cardiometabolic diseases and transition to depression: A trajectory analysis of large-scale population-based study.
期刊: Social science & medicine (1982) 发表日期: 2025-Sep-04 链接: PubMed
摘要
Existing evidence demonstrates a high risk of developing depression in patients with cardiometabolic diseases (CMDs). However, it remains unclear whether socioeconomic inequality exacerbates the progression. We aimed to quantify the role of socioeconomic status (SES) in the progression from healthy to CMDs and their transitions to depression. A total of 376 610 participants (age 37-73 years) free from CMDs of interest, including type 2 diabetes (T2D), coronary heart disease (CHD) and stroke, from the ongoing UK Biobank study between 2006 and 2010 were included at baseline. Potential various SES groups were derived from latent class analysis using family income level, employment status and education attainment. In latent class analysis, three distinctive levels of SES (low, medium, and high) were identified. During the 15-year follow-up, we found significant associations were found between low SES and different progression stages of CMDs. In multivariate models, the hazard ratios (95 % confidence intervals) for low SES vs. high SES were 1.62 (1.53-1.71), 1.23 (1.17-1.29) and 1.25 (1.13-1.38) for transitions from healthy to T2D, CHD and stroke, and 2.17 (2.03-2.30), 1.63 (1.30-2.03), 1.62 (1.30-2.03), 1.70 (1.11-2.60) for risk of transition to depression from healthy, T2D, CHD and stroke, respectively. Socioeconomic inequalities were associated with almost all transition stages from healthy to CMDs, subsequently to depression, with different magnitude of associations. These findings support the need for targeted screening programs for depression in CMD patients, and policy interventions addressing socioeconomic inequalities through improved access to healthcare, education, and economic opportunities for disadvantaged populations.
42. Donor preferences for recipient control of international development aid.
期刊: Social science & medicine (1982) 发表日期: 2025-Sep-01 链接: PubMed
摘要
More than 90 % of health aid remains tied to projects that reflect donor rather than recipient priorities. This has a material impact on aid effectiveness and is inconsistent with the stated aims of development partners to ‘decolonise aid’ and prioritise ‘locally led development’. Relatively little attention has been given to constraints that might account for this divergence between donor rhetoric and action. The present study considers whether the preferences of donor country citizens (donors) are consistent with recipient control of aid programs. Using Indonesia as the recipient country setting, we conducted a discrete choice experiment amongst 1523 Australians aged 18+ to describe donor preferences for recipient control and nine other characteristics of Australia’s health aid program. We found that donors have a strong aversion to recipient control and are unwilling to cede control of either aims or implementation. Despite evidence of pervasive preference heterogeneity, we were unable to identify a class or preference ‘type’ with a preference for recipient control. Importantly, donor resistance to decolonisation was pervasive under experimental control for the institutional quality of recipient governments, suggesting that preferences for donor control are unlikely to reflect an attempt to compensate for political instability and government ineffectiveness in recipient countries. The implications of these findings are significant. This fundamental misalignment challenges international commitments to locally led development. For governments aiming to reflect their constituencies’ preferences, emphasizing donor control over aid objectives may garner greater public support, but risks undermining international commitments to increase recipient ownership and decolonise aid.
43. Occurrence characteristics, distribution patterns and neurological health risk assessment of liquid crystal monomers in indoor multi-media in a campus from North China.
期刊: Journal of hazardous materials 发表日期: 2025-Aug-30 链接: PubMed
摘要
Liquid crystal monomers (LCMs) are prevalent in indoor environments; however, their occurrence characteristics, distribution patterns, and neurological exposure risks across various indoor media remain inadequately understood. This study systematically monitored the concentration levels of 70 LCMs in indoor air, particulate matter, and dust within a campus situated in northern China, examining their distribution across these media. Subsequently, the neurological exposure risks associated with LCMs were evaluated by estimating daily intake (EDI) and employing an endpoint-oriented methodology. The findings revealed that 3,4-Difluoro-4’-(4-ethylcyclohexyl) biphenyl (2cHdFB, concentration range from non-detectable to 20.9 pg/m³), trans,trans-3,4-Difluoro-4’-(4’-pentylbicyclohexyl-4-yl)biphenyl (5bcHdFB, non-detectable to 438.1 pg/m³), and trans,trans-4-(4-Ethoxy-2,3-difluorophenyl)-4’-n-propylbicyclohexyl (2OdFP3bcH, non-detectable to 376.7 ng/g) were the predominant LCMs identified in indoor air, particulate matter, and dust, respectively. Moreover, the Li-Ma-Yang (L-M-Y) model exhibited superior predictive capabilities within the air-particle partitioning framework. The analysis of air-dust partitioning revealed that LCMs are more prone to transition from dust into the air. The risk assessment findings identified dust as the primary medium of exposure, with fluorinated biphenyls and their analogs (FBA) representing the predominant exposure category among LCMs. Notably, the EDI values were higher for children and women, indicating a potentially elevated risk of neurological exposure for these groups. This study represents the first comprehensive evaluation of the occurrence characteristics and distribution of LCMs in indoor air, particulate matter, and dust, while also providing a differentiated assessment of neurological exposure risks across various populations. Consequently, this research advances our understanding of the pollution levels, distribution patterns, and associated neurological exposure risks of LCMs in indoor multi-media environments.
44. Dietary Risk Factors and Associated Disease Burden Among Chinese Adults Aged 25 Years and Older: Systematic Analysis of the Global Burden of Disease Study 2021.
期刊: JMIR public health and surveillance 发表日期: 2025-Aug-25 链接: PubMed
摘要
With rapid economic development and lifestyle changes, diet-related diseases have become a major public health concern globally. China is experiencing significant dietary transitions. From 2001 to 2021, the intake of staple foods declined, while the consumption of animal-based foods and ultraprocessed foods increased significantly. But comprehensive assessments of major dietary risk factors and the long-term health impacts of shifting dietary patterns in China remain unclear. This study aims to assess the disease burden attributable to dietary risk factors in China using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 (GBD 2021), and to examine long-term trends over the past 3 decades. In addition, it provides an in-depth analysis of the 3 major diet-related disease categories in China: cardiovascular diseases, neoplasms, and diabetes and kidney diseases. We extracted data from GBD 2021, focusing on diet-related health outcomes in China across 33 provinces and regions. Measures included deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs), stratified by age, sex, and region. Age-standardized rates (ASRs) were calculated, and temporal trends were analyzed using estimated annual percentage change (EAPC). In 2021, dietary risk factors accounted for 1.70 million deaths and 38.39 million DALYs among Chinese adults aged 25 years and older. The leading contributors were high sodium intake, low fruit consumption, and low whole grain intake. Cardiovascular diseases were the largest contributors to diet-related DALYs. The burden was more pronounced in males than in females and highest among older adults aged 80 years and older. Substantial regional variation was observed, with the Northeastern and Western regions showing higher burden. From 1990 to 2021, overall disease burden due to dietary risks declined steadily, as reflected by decreasing ASR-DALYs (EAPC= -1.76), YLLs, and death rates. In contrast, YLDs showed a slight upward trend (EAPC=0.75), indicating a shift toward increased years lived with disability. In addition, the relative contributions of specific dietary risk factors changed considerably. Low vegetable intake, once ranked the third in 1990, dropped to the 12th by 2021, while high red meat consumption rose from the 15th to 7th place. Although the ranking of high-sugar beverage consumption did not change, the ASR-DALYs rate increased significantly, with a percentage change of 689.14% between 1990 and 2021. In China, the burden of diet-related diseases remains substantial. While the overall age-standardized disease burden has declined, marked regional and demographic disparities persist. Certain dietary risks, such as high red meat and sugar-sweetened beverage consumption, are rising, and high sodium intake remains a serious concern. These trends highlight the urgent need for comprehensive, adaptable, and evidence-based nutrition policies to be implemented to address the evolving diet-related disease burden across diverse populations in China.
45. The Effect of Nitrogen Fertilization on the Expression of Slow-Mildewing Resistance in Knox Wheat.
期刊: Phytopathology 发表日期: 2025-Aug 链接: PubMed
摘要
Powdery mildew development on the slow-mildewing wheat cultivar Knox was compared to that on the susceptible cultivar Vermillion over a period of 4 yr in the field at Lafayette, Indiana. Cultivars received three levels of nitrogen fertilizer to determine if high levels of N affected the expression of slow-mildewing in Knox wheat. Knox’s resistance was evident under conditions favoring moderate to severe disease on Vermillion. Under low nitrogen fertility or unfavorable weather there was little difference in level of mildew on the two cultivars; under more favorable conditions disease severity increased greatly on Vermillion but increased little on Knox. The area under the disease progress curve had a lower error variance than statistics associated with the logit transformation of severity data and hence was a superior measurement of slow-mildewing. Slow-mildewing remains effective under the highest rates of nitrogen fertilization likely to be applied to wheat. In breeding for slow-mildewing, high rates of N provide optimal conditions for recognition of this resistance.
46. In-Clinic Activity Promotion for Children With Congenital Heart Disease: Randomized Clinical Trial.
期刊: CJC pediatric and congenital heart disease 发表日期: 2025-Jun 链接: PubMed
摘要
An effective in-clinic physical activity counseling intervention is needed to increase physical activity motivation and participation among children with moderate or severe congenital heart disease and enable clinicians to comply with activity promotion recommendations. This pragmatic, single-blind multicenter randomized clinical trial evaluated the intervention feasibility/efficacy among children aged 5-17 years. Clinicians delivered key messages, encouraged activity questions and discussion, and provided kinesiologist support. The primary outcome was daily activity (PiezoRx pedometer steps), assessed after the clinic visit and then monthly for 6 months. Clinic visit length, % counseled, patient/family perceptions, and kinesiology referral assessed health care system impacts. A total of 155 children (60 female, 10.8 ± 3.6 years of age) with moderate (n = 119) or severe (n = 36) diagnoses were included in this study. Initial daily step counts, adjusted for age, did not differ between the groups (mean difference = 776 ± 515 steps per day, P = 0.13). Typically active intervention participants’ mean daily steps over 6 months (adjusted for baseline age, sex, season, and steps) were stable above 12,000 steps per day. Typically active control steps declined, becoming significantly below intervention participants by month 5 (P = 0.006). Highly active participants at baseline (>14,000 steps per day) in both study groups maintained their activity (P = 0.91). Virtually all (97%) intervention participants were counseled, and the clinic visit duration did not differ by group (P = 0.95). Over 6 months, participants receiving a brief, standardized in-clinic activity counseling intervention with on-going kinesiology support were more likely to achieve the recommended daily physical activity. Counseling was feasible for clinicians to deliver during a routine clinic visit enabling compliance with recommended practice. ClinicalTrials.gov #NCT03435354. Une intervention efficace consistant à prodiguer aux enfants atteints d’une cardiopathie congénitale modérée ou sévère des conseils sur l’activité physique pendant leur visite à la clinique est nécessaire pour les motiver à faire de l’exercice en plus de permettre aux cliniciens de répondre aux recommandations sur la promotion de l’activité physique. Cet essai à répartition aléatoire multicentrique à simple insu pragmatique visait à évaluer la faisabilité/efficacité d’une telle intervention auprès des enfants de 5 à 17 ans. Les cliniciens ont livré les messages clés aux patients et les ont invités à poser des questions sur l’activité physique et à en discuter. Ils les ont également dirigés vers un kinésiologue. Le principal critère d’évaluation était l’activité quotidienne (nombre de pas au podomètre PiezoRX) évaluée après la visite à la clinique puis chaque mois pendant 6 mois. La durée de la visite à la clinique, le pourcentage de patients conseillés, les perceptions du patient et de la famille ainsi que l’orientation vers un kinésiologue ont permis d’évaluer les effets sur le système de santé. Au total, 155 enfants (60 filles, 10,8 ± 3,6 ans) dont la maladie diagnostiquée est modérée (n = 119) ou sévère (n = 36) ont été évalués. Le nombre de pas initial, ajusté en fonction de l’âge, n’était pas différent entre les groupes (différence des moyennes = 776 ± 515 pas/jour, p = 0,13). Sur une période de 6 mois, le nombre moyen de pas effectués chaque jour par les participants normalement actifs ayant fait l’objet de l’intervention (ajustés en fonction de l’âge initial, du sexe, de la saison et des pas) était stable, soit au-dessus de 12 000 pas/jour. Par contre, au 5e mois, le nombre de pas du groupe témoin normalement actif avait décliné de façon significative sous le niveau de celui des participants ayant bénéficié de l’intervention (p = 0,006). Les participants très actifs au départ (> 14 000 pas/jour) dans les deux groupes de l’étude ont maintenu leur niveau d’activité (p = 0,91). Pratiquement tous (97 %) les participants ayant fait l’objet de l’intervention ont reçu des conseils, et la durée des visites à la clinique n’était pas différente entre les groupes (p = 0,95). Sur une période de 6 mois, les participants qui ont fait l’objet d’une brève intervention normalisée durant leur visite en clinique, qui comprenait des conseils sur la pratique d’activité physique et un accompagnement en kinésiologie, étaient plus susceptibles d’atteindre les recommandations en matière d’activité physique quotidienne. Il a été possible pour les cliniciens de formuler les conseils pendant une consultation clinique normale et de répondre ainsi aux recommandations en la matière. Clinicaltrials.gov #NCT03435354.
47. Global Spatiotemporal Trends and Modifiable Risk Factors for Female Infertility: An Age-Period-Cohort Using Global Burden of Disease Study 2021 and Mendelian Randomization Analysis.
期刊: International journal of women’s health 发表日期: 2025 链接: PubMed
摘要
This study aims to describe the global burden of female infertility, analyze its spatial and temporal trends, and offer targeted epidemiological insights to support the prevention and management of female infertility. Drawing on insights from the GBD 2021 study, we analyzed age-standardized prevalence rates (ASPR) of female infertility (1990-2021) across global regions and Socio-Demographic Index (SDI) categories. We quantified temporal trends using estimated annual percentage change (EAPC) and Age-Period-Cohort analyses across age groups and geographic regions. Furthermore, the causal relationships between 16 modifiable risk factors, 10 serum biomarkers, and female infertility were assessed by two-sample Mendelian randomization (MR) and mediation analysis. Globally, the ASPR of female infertility exhibited an increasing trend over the study period. Across all SDI regions, infertility prevalence peaked at ages 35-40. MR analysis identified poor general health (IVW OR, 1.94; 95% CI, 1.49-2.52; PFDR = 1.24×10-5), elevated waist-to-hip ratio (WHR) (IVW OR, 1.12; 95% CI, 1.04-1.20; PFDR = 3.26×10-3), and neuroticism (IVW OR, 1.10; 95% CI, 1.04-1.15; PFDR = 1.25×10-3) as significant risk factors, whereas higher educational attainment (IVW OR, 0.95; 95% CI, 0.93-0.97; PFDR = 3.26×10-4), greater body fat percentage (IVW OR, 0.67; 95% CI, 0.52-0.85; PFDR = 4.10×10-3) and napping (IVW OR, 0.63; 95% CI, 0.45-0.89; PFDR = 1.94×10-2) had protective effects. Mediation analysis demonstrated that HbA1c and triglycerides (TG) partially mediated the relationship between WHR and infertility, while TG mediated the effect of educational attainment on female infertility. Age-Period-Cohort modeling suggests that shifts in reproductive age patterns, environmental exposures, and cohort-specific risk profiles are key contributors to observed disparities. Targeted public health interventions, including educational promotion, lifestyle modifications, and routine metabolic screening, are essential to mitigate the rising infertility burden in the coming decades.
48. Smoke-Free School Zone Policy and Its Association with Attitudes Toward Smoking and Secondhand Smoke Exposure Among School-Aged Children and Key Stakeholders.
期刊: Risk management and healthcare policy 发表日期: 2025 链接: PubMed
摘要
Smoke-free zone policies in school settings have been widely implemented; however, evidence regarding their impact on smoking-related attitudes and secondhand smoke (SHS) exposure remains limited. This study aimed to examine the association between a smoke-free zone policy implemented along school commuting routes and attitudes toward smoking and SHS exposure among elementary school students, their parents, and school staff in Seoul, South Korea. A cross-sectional study was conducted. Participants were 210 students, 272 parents, and 137 school staff from the five schools randomly selected according to the criteria of regional deprivation index and prevalence of designated smoke-free zones from all the 25 districts of Seoul, South Korea. “Attitudes toward smoking” and “exposure to SHS” were the outcome variables, and the “presence of a smoke-free zone along the school commuting route” was the predictor variable. All variables were assessed using self-reported questionnaires. Data were collected between November 2020 and December 2020. The multiple logistic regression analysis was performed to test main hypotheses. Students and school staff in schools with designated smoke-free zones along school commuting routes were significantly less likely to be exposed to SHS along those routes, compared to their counterparts without such zones (odds ratio [OR] = 0.29; 95% confidence interval [CI], 0.098-0.853; p =0.025 for students; OR = 0.09; 95% CI, 0.008-0.939; p =0.044 for school staff). However, the presence of smoke-free zones along school commuting routes was not significantly associated with attitudes toward smoking among students, parents, or school staff. Designation of smoke-free zones along school commuting routes may be effective in reducing exposure to SHS among students and school staff. The active and consistent enforcement of smoke-free policies within school settings may play a critical role in further reducing SHS exposure among children and related stakeholders.
49. Designing and validating a health promotion program for women with endometriosis: a mixed-methods study protocol.
期刊: Frontiers in reproductive health 发表日期: 2025 链接: PubMed
摘要
Endometriosis is a benign and chronic gynecological estrogen-dependent disease. Research has shown that endometriosis can affect various dimensions of women’s lives. It is recommended that programs be developed to improve the quality of life and promote the health of affected women. However, no existing studies have written programs to achieve these goals. Therefore, the present study aims to “design and validate a health promotion program using a logical model”. A mixed-methods explanatory design will be used to conduct this study in three phases. The first phase (quantitative phase) is a descriptive-analytical cross-sectional study on 200 reproductive-age women with an endometriosis diagnosis. The Health-Promoting Lifestyle Profile (HPLP-II) and Endometriosis Impact Questionnaire (EIQ) will be used to collect quantitative data. The second phase (qualitative phase) will explain women’s perceptions and experiences of the health-promoting lifestyle. In this phase, the conventional content analysis approach will be used to analyze the data. In the third phase (design of the health promotion program), findings of the quantitative and qualitative phases, the literature review, and focus group discussion (FGD) with a panel of experts will be used to develop a health promotion program based on a logical model, and its validation will be conducted using the Delphi method. This is the first study to use a mixed-methods approach for designing a health promotion program for women with endometriosis. This study can reveal hidden issues in the attitude of patients, medical staff, and those involved in providing health services and provide a better understanding of the factors related to improving the health and quality of life of affected women. In addition, the results of research can be effective in formulating a suitable strategy that can be used by policymakers, planners, and health staff as well as respond to the needs of affected women.
50. Enterprise characteristics and occupational health literacy among essential service workers in Guangdong Province, China: a cross-sectional study.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
Essential service workers are exposed to significant occupational health risks. Low occupational health literacy (OHL) has been linked to increased risks of occupational injuries and work-related illnesses. However, limited evidence exists regarding the OHL of essential service workers and the impact of enterprise characteristics on OHL. This study aimed to examine the associations between enterprise characteristics and OHL among essential service workers in Guangdong Province, China. Cross-sectional study. A cross-sectional survey was conducted among 2,640 essential service workers from the environmental sanitation (n = 880), transportation (n = 880), and express and food delivery industries (n = 880), using multi-stage cluster random sampling. OHL was assessed using the National Occupational Health Literacy Monitoring Questionnaire, which measures four dimensions: knowledge of occupational health laws, knowledge of occupational health protection, skills of occupational health protection, and healthy work patterns and behaviors. Multivariable logistic regression was used to examine associations between enterprise characteristics (scale, ownership, industry) and OHL, with stratified analyses by monthly income. The overall OHL level among essential service workers was 52.8%. Working in small and micro enterprises (adjusted OR = 1.42, 95% CI: 1.17-1.72) and private enterprises (adjusted OR = 1.28, 95% CI: 1.05-1.55) was associated with higher OHL, while employment in the express and food delivery industry was associated with lower OHL (adjusted OR = 0.64, 95% CI: 0.49-0.82). Monthly income significantly moderated these associations, with stronger effects observed in higher-income groups. Enterprise characteristics significantly influence OHL among essential service workers. Targeted OHL promotion strategies should be developed based on enterprise characteristics, with particular attention to large, state-owned enterprises and express and food delivery workers.
51. Low prevalence of helminth infection in Ugandan children hospitalized with severe malaria.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Co-infection by intestinal helminths and Plasmodium spp. may be common in endemic communities. In 2003, Uganda instituted a national deworming program, with anti-helminth medication provided twice annually to children 6 months to 5 years of age, but few follow-up studies have been conducted. Several studies have identified a relationship between helminth infection, Plasmodium spp. infection and malaria severity. However, the relationship is not well defined, and results are inconclusive. We analyzed 177 stool samples from a cohort of children with severe malaria enrolled in two hospitals in Uganda from 2014-2017. All children were 6 months to 48 months of age and had a clinical presentation of and laboratory confirmation for severe malaria. We also analyzed 25 stool samples from community children who were negative for malaria via rapid diagnostic test and were enrolled from the same household or neighborhood and matched by age, sex, and time of enrollment. We investigated if intestinal helminth infection modified risk of severe malaria. We extracted nucleic acids from stool and tested them for six helminth species (Anyclostoma duodenale, Ascaris lumbricoides, Necator americanus, Strongyloides stercolaris, Trichuris trichiura, Shistosoma mansoni) using highly sensitive quantitative PCR. We found a low prevalence of infection by ≥1 intestinal helminth species in children with severe malaria (5.1%, n = 9/177) and community control children (4.0%, n = 1/25). Helminth infection did not increase or decrease the risk of severe malaria in this cohort (aRR = 1.0, 95% Confidence Interval = 0.82, 1.3, p = 0.78). In these areas of Uganda, the national deworming campaign has been highly successful, as stool-based helminth infection was rare even when using sensitive methods of detection and helminths were not associated with severe malaria in this study.
52. Epigenetic signatures of phthalate exposure and potential risks: a DNA methylation analysis using Infinium MethylationEPIC BeadChip.
期刊: Environmental epigenetics 发表日期: 2025 链接: PubMed
摘要
Phthalates are common environmental pollutants known to disrupt various regulatory systems and are associated with several health issues, such as impaired immune response, developmental toxicity, hormonal disruption, and type 2 diabetes. Epigenetic modifications, such as DNA methylation, can serve as early indicators of environmental toxicant exposure due to their rapid alteration in response to varying environmental factors without altering the underlying DNA sequence. To investigate the impact of phthalate exposure on human health and the affected regulatory mechanisms, this study analysed a DNA methylation dataset generated using the Illumina Infinium MethylationEPIC BeadChip (EPIC BeadChip) array, along with the concentrations of 15 urinary phthalate metabolites from 389 participants. The results revealed sex-specific differences in phthalate concentrations, with females exhibiting relatively higher levels than males. These differences may reflect a combination of factors, including lifestyle behaviours and potential differences in exposure sources. Furthermore, differentially methylated CpG sites (DMCs) were identified only in the mono-ethylhexyl phthalate (MEHP) dataset, where a total of 53 DMCs were detected, including 11 that were consistently detected across multiple MEHP concentration comparisons. Additionally, the functional analysis showed that these DMCs are primarily involved in protein and nucleotide binding, immune response, ion channel regulation, and membrane-associated pathways. This study provides high-potential phthalate-related methylation markers, their associated genes, and the functions they are involved in. These findings offer valuable insights for the research on environmental toxicants and epigenetics, while supporting clinical applications related to phthalates.
53. Assessing exposure from different vehicular antennas in military applications: a computational study.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
Military personnel frequently operate in close proximity to electromagnetic (EM) sources such as vehicular communication antennas. Despite this occurrence, detailed evaluations of exposure scenarios remain limited. This study bridges this gap by examining EM exposure from military vehicular antennas, covering a broad spectrum of frequencies (high frequency-HF, very high frequency-VHF, ultrahigh frequency-UHF), power levels, and positions. The study used computational modeling to simulate realistic military scenarios, including personnel partially outside armored vehicles and equipped with personal protective equipment. Simulations accounted for a broad spectrum of frequencies (HF, VHF, and UHF) as well as different power levels, antenna types and locations. The analysis revealed substantial variability in EM exposure levels depending on the configuration and conditions. While all simulated scenarios complied with the ICNIRP Basic Restrictions (BR), certain cases exceeded the Reference Levels (RL), particularly under specific positioning and frequency combinations. These findings, based on a detailed case-specific analysis, suggest that personnel safety in military contexts is generally maintained, even in the presence of variable exposure conditions and elevated levels of radiated E-field. Considering the basic structure of the radiating source (i.e., monopole) and the nature of near-field interactions, this paper suggests that safe exposure conditions could be expected to persist across a range of antenna-operator positioning configurations, and building on previous preliminary research on this topic, it provides relevant insights for operational instructions and improving safety regulations in the military field.
54. Why and how the interpersonal stressors influence nurses' intention to stay and job satisfaction: the JD-R model perspective.
期刊: Journal of health organization and management 发表日期: 2024-Nov-13 链接: PubMed
摘要
Interpersonal stressors are a major source of stress for East Asian workers. It is still a major management issue in hospital management. This study focuses on clarifying the stress response processes of interpersonal stressors. The moderating effects of gratitude and employee assistance programs were considered. Questionnaires were distributed to hospital workers in a regional hospital in the city; a total of 288 valid and matched surveys were collected. The results showed interpersonal stressors negatively affected job satisfaction, and interpersonal resources positively affected intention to stay and job satisfaction. In addition, gratitude had a moderating effect on the relationship between interpersonal stressors and emotional burnout, and awareness of employee assistant programs had a moderating effect on the relationship between interpersonal resources and work engagement. This study seeks to elucidate the working conditions of nurses and may serve as a reference for hospitals in implementing or drafting labor conditions and policies for stress management.