公共卫生研究摘要 (2025-09-14)
共收录 59 篇研究文章
1. Screening for Hypertension and Diabetes in Laundromats in the Largest Hispanic-Majority City in the U.S.
期刊: American journal of health promotion : AJHP 发表日期: 2025-Sep-13 链接: PubMed
摘要
PurposeThis study aimed to assess the prevalence of hypertension and diabetes among laundromat users in San Antonio, Texas, and explore laundromats as a novel setting for health interventions regarding these 2 conditions.DesignThis descriptive, cross-sectional study involved demographic, blood pressure and HbA1c screenings to assess the health status of laundromat users.SettingThe study took place in 7 laundromats in low-income areas of San Antonio.SubjectsA total of 150 adults aged 18 and older who regularly used the laundromats and spoke either English or Spanish were eligible to participate.MeasuresHypertension was defined as a systolic BP ≥130 mmHg and/or diastolic BP ≥80 mmHg. Diabetes was defined as an HbA1c level ≥6.5%. A survey collected demographic and healthcare access data.Results61.1% (95% CI: 53.0%-68.6%) of participants screened positive for hypertension, significantly higher than county (31.1%), state (32.3%), and national (32.7%) rates (P < .001). The prevalence of diabetes was 14.1% (95% CI: 8.7%-21.1%), slightly higher than Bexar County (10.2%) and national (8.4%) rates, though not statistically significant. Gender and the number of children in the household were significantly associated with hypertension and diabetes, respectively.ConclusionLaundromats can effectively serve as sites for health screening and interventions for hypertension and diabetes, offering a unique opportunity to reach underserved populations and address health disparities.
2. Intersections of sexual orientation, gender identity, and race/ethnicity and odds of reporting depression and anxiety symptomology in the Household Pulse Survey.
期刊: Journal of mental health (Abingdon, England) 发表日期: 2025-Sep-13 链接: PubMed
摘要
We examined odds of anxiety and depression symptomology among sexual and gender minority (SGM) individuals compared to straight and cisgender individuals, stratified by race. Data represented 918,892 households in the Household Pulse Survey from July 2021-October 2022. The Patient Health Questionnaire-2 measured depression symptoms (Scores >3 = depression symptoms). The Generalized Anxiety Disorder Scale-2 measured anxiety symptoms (Scores >3 = anxiety symptoms). Sexual orientation was categorical: “Gay/Lesbian,” “Straight,” “Bisexual,” “Something Else,” or “Don’t know.” Gender identity had 3 levels: “Cisgender Male,” “Cisgender Female,” or “Transgender/other gender identity.” Logistic regression estimated odds ratios(OR) and 95% confidence intervals(CI) for depression and anxiety among sexual minority individuals compared to straight individuals and transgender individuals compared to cisgender males. Intersection of sexual orientation/gender identity was also examined. Models (adjusted for sociodemographic factors) were stratified by race/ethnicity. Transgender individuals showed doubled odds of depression (OR:2.30 95%CI:1.98,2.67) and anxiety (OR:2.41 95%CI:2.23,2.61) versus cisgender individuals. Bisexual individuals had nearly tripled odds versus straight individuals. Transgender bisexual individuals showed highest odds versus cisgender males (depression OR:6.22 95%CI:5.06,7.64; anxiety OR:7.11 95%CI:6.13,8.24). Non-Hispanic White individuals typically showed highest symptomology. SGM individuals showed increased anxiety and depression symptomology, with unexpected racial disparities warranting further intersectionality research.
3. Reply to: Letter to the Editor: Short- and Long-Term Effect of Multidomain Lifestyle Intervention on Frailty.
期刊: Journal of the American Geriatrics Society 发表日期: 2025-Sep-13 链接: PubMed
摘要
4. Cystatin C and creatinine eGFR reference intervals in healthy adults from Cameroon.
期刊: Scandinavian journal of clinical and laboratory investigation 发表日期: 2025-Sep-13 链接: PubMed
摘要
Several equations are available for estimation of glomerular filtration rates (eGFRs) from serum cystatin C and creatinine, but data on reference intervals from healthy subjects are scarce. Employing nine well-known equations, we calculated eGFRs for healthy Cameroonians, 194 men and 187 women 18-71 years of age. Reference intervals were calculated using conventional techniques. For subjects < 50 years of age the eGFR reference intervals were with CAPA (men; women) 70.1-127.1; 79.9-172.2, with CKD-EPIcys 2012 75.1-131.2; 81.3-135.5, with LM rev 65.4-106.5; 61.4-110.3, with CKD-EPIcrea 2021 74.1-127.2; 67.0-129.8, with mean (LM rev, CAPA) 72.2-110.6; 72.8-136.9, with CKD-EPIcrea, cys 2021 81.1-126.6; 77.0-135.7, with EKFCcys 85.5-116.3; 83.3-124.8, with EKFCcrea 69.4-114.2; 62.8-114.3, and with EKFCcrea, cys 82.5-114.0: 77.1-116.4 mL/min/1.73 m2, respectively. Median eGFRcys was significantly higher than eGFRcrea irrespective of equations used. The eGFRcys difference between healthy men and women aged < 50 years may be explained by lower production rates of cystatin C in women. The higher eGFRcys reference intervals compared to that of eGFRcrea may be caused by increased tubular secretion of creatinine or increased production of cystatin C in the cohorts used for establishing the equations relative the case in healthy subjects. This suggests that the eGFR equations need to be further assessed regarding accuracy to adequately correspond to true GFR.
5. Algorithms to Identify Major Congenital Malformations in Routinely Collected Healthcare Data: A Systematic Review.
期刊: Drug safety 发表日期: 2025-Sep-13 链接: PubMed
摘要
Major congenital malformations (MCMs) are a primary outcome of interest in pregnancy safety studies. This study aimed to identify and summarize algorithms used to identify MCMs in routinely collected healthcare data sources in the USA, Canada, and Europe by conducting a systematic literature review. We developed a search strategy to identify studies containing algorithms for MCMs from January 1, 2010, to April 11, 2025. Search terms included those related to MCMs as an outcome, routinely collected healthcare data, epidemiologic designs likely to incorporate algorithms, and pregnant individuals and/or infants. Study review and data extraction was conducted in duplicate using a standardized data collection form. Among the initially identified 2242 studies, 974 were selected for full-text review. Of these, 70.3% were excluded, leaving 289 studies. Over half (58.1%) of the included studies were from Europe, predominantly from Nordic countries using national register data (N = 135; 80.4%). Studies using claims (18.0%) or hospital discharge data (16.3%) were also common. Although there was heterogeneity in the timing of MCM assessment, 55.7% of studies collected MCMs through the infant’s first year of life. Overall, algorithms varied across data source type and geography in the codes specified, rules, utilization of maternal versus infant records, and coding system. There were 27 (9.3%) validation studies, 70.4% of which were based on claims and/or electronic health record data only. Most had positive predictive values >70%, though this varied according to MCM type or anatomical site. We provide the first comprehensive systematic literature review of algorithms used to identify MCMs in routinely collected healthcare data, aiding researchers in their ability to generate reliable evidence in pregnancy safety pharmacoepidemiology.
6. Diagnostic Performances of a Rapid Screening Tool for Detection of Psychiatric Symptomatology in an Urban Community Setting of People Who Use Drugs in France.
期刊: Journal of dual diagnosis 发表日期: 2025-Sep-13 链接: PubMed
摘要
Objective: We aimed to evaluate the diagnostic accuracy a rapid 9-item peer-administered questionnaire, the Quick Screening Tool (QST), to detect urgent mental health symptoms in an urban community setting in France of People who use drugs (PWUD). Methods: Participants were recruited through Respondant-Driven Sampling. We used modules from the Mini International Neuropsychiatric Interview as the reference standard (current major depressive episode, suicidal risk, or current psychotic disorder). We calculated the area under the curve as well as sensitivity and specificity. Results: Thirty-four percent of the 175 participants were assessed as in need of urgent mental care. The prevalence for depressive episode, suicidal risk and current psychotic syndrome was 11%, 19%, and 8%, respectively. The QST had an area under the curve for the detection of urgent psychiatric symptoms of 0.82. With a cutoff of 3, it had a sensitivity of 83.3% and a specificity of 64.4%. Conclusions: The performance of the QST in screening for urgent mental health symptoms was satisfactory. This questionnaire could be more broadly used in hard-to-reach PWUD populations in community-based interventions.
7. Ecological associations between gastric acid suppressant use and gastrointestinal cancer incidence: a three-decade global study.
期刊: Irish journal of medical science 发表日期: 2025-Sep-13 链接: PubMed
摘要
Gastric acid suppressants, including proton pump inhibitors (PPIs) and histamine H2-receptor antagonists, are widely used globally. Their long-term safety remains a concern, particularly regarding gastrointestinal cancer risks. To assess population-level associations between gastric acid suppressant use and the incidence of major gastrointestinal cancers, adjusting for potential confounders. This ecological panel study analyzed country-year data from 24 nations (1990-2020). Consumption of acid suppressants (ATC A02B, DDD/1000/day) was obtained from OECD Health Statistics. Age-standardized cancer incidence rates (colorectal, liver, pancreatic, esophageal) were sourced from the GBD 2019 dataset. Multivariable linear mixed-effects models were adjusted for dietary risks, BMI, tobacco, alcohol, antibiotics, NSAIDs, and GDP per capita. Higher acid suppressant use was significantly associated with increased liver cancer (β = 0.0086; 95% CI 0.0019 to 0.0154; p = 0.0136) and pancreatic cancer (β = 0.0148; 95% CI 0.0068 to 0.0227; p = 0.0004) incidence. No significant associations were found for colorectal or esophageal cancers. Model fit was strongest for liver and pancreatic outcomes. While causal inference cannot be drawn from ecological data, the findings suggest a population-level association between gastric acid suppressant consumption and increased liver and pancreatic cancer incidence. These results support the need for cautious prescribing and further research using individual-level data.
8. Diagnostic accuracy of next-generation sequencing (NGS) for identifying actionable mutations in advanced non-small cell lung cancer: Systematic Review and Meta-Analysis.
期刊: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico 发表日期: 2025-Sep-13 链接: PubMed
摘要
To evaluate the diagnostic accuracy and clinical performance of next-generation sequencing (NGS) compared to conventional techniques for detecting actionable mutations using tissue or liquid biopsy samples in patients with advanced non-small cell lung cancer. A systematic review and meta-analysis of diagnostic test studies (PROSPERO: CRD42023450465) were conducted. We included studies with sufficient comparative data, using a t test to analyze turnaround time differences and hypothesis testing for valid result proportions (p < 0.05). The meta-analysis, performed in Stata 17®, pooled sensitivities and specificities by mutation and evaluation technique. The QUADAS-2 tool assessed study quality. A total of 56 studies involving 7143 patients were analyzed. No significant differences were found in valid result percentages between standard tests and NGS in tissue (85.57% vs. 85.78%; p = 0.99) and liquid biopsy (81.50% vs. 91.72%; p = 0.277). Liquid biopsy had a significantly shorter turnaround time (8.18 vs. 19.75 days; p < 0.001). NGS demonstrated high accuracy in tissue for EGFR (sensitivity: 93%, specificity: 97%) and ALK rearrangements (sensitivity: 99%, specificity: 98%). In liquid biopsy, NGS was effective for EGFR, BRAF V600E, KRAS G12C, and HER2 (sensitivity: 80%, specificity: 99%) but had limited sensitivity for ALK, ROS1, RET, and NTRK rearrangements. NGS enables comprehensive mutation analysis, particularly for point mutations. Further validation is required to improve the detection of gene rearrangements.
9. Exploring Ciliary Mechanisms in the Causation of Hydrocephalus in Humans-Similarities and Differences from Animal Models.
期刊: Journal of molecular neuroscience : MN 发表日期: 2025-Sep-13 链接: PubMed
摘要
Hydrocephalus is a condition defined by excessive cerebrospinal fluid (CSF) relative to the brain volume. Congenital and infantile forms of hydrocephalus are both genetically and physiologically heterogenous. Among the candidate genes implicated in hydrocephalus, many are associated with cilia, a subcellular structure involved in CSF circulation and neurodevelopment. First, we provide an overview of 129 genes associated with human hydrocephalus and currently reported in the literature, categorized according to their possible involvement in ciliary structure, ciliary function, or cilia-mediated processes/signalling pathways. Intriguingly, there are large differences in the prevalence and manifestations of cilia-related hydrocephalus in humans as compared to rodents. Second, we address these differences by revisiting human and animal studies to outline potential cilia-related mechanisms and molecular signalling pathways contributing to hydrocephalus. We propose that our rapidly expanding understanding of cilia’s role in CSF circulation and brain development will support a more precise characterization of hydrocephalus subtypes, ultimately guiding the development of more personalized treatment strategies.
10. Comparative analysis of surgical and endovascular aneurysm repair in subarachnoid hemorrhage: a single-center study with 1,171 patients.
期刊: Acta neurochirurgica 发表日期: 2025-Sep-13 链接: PubMed
摘要
To compare surgical and endovascular therapy (EVT) approaches to aneurysm repair in all aneurysmal subarachnoid hemorrhage (aSAH) patients treated within our institution over a 12-year period from 2011 to 2022. The study comprised a retrospective analysis of prospectively collected data extracted from a hospital quality registry that we established in 2011, containing comprehensive information about all patients treated for aSAH. We included SAH patients within the institution’s catchment area who underwent surgical or endovascular aneurysm repair. Exclusion criteria involved patients from external regions, those treated at other institutions, no aneurysm repair performed, or instances undergoing a combination of surgery and EVT. Pretreatment data encompassed the clinical condition at admission, comorbidity, radiological details, aneurysm characteristics, and duration between the bleed and aneurysm repair. Mortality was primary outcome measure; secondary outcome included modified Rankin Score after approximately six months. The study encompassed 1,171 patients (65% women and 35% men) undergoing aneurysm repair from 2011 to 2022. Admission data revealed 31.1% in Hunt-Hess grade 4-5. Surgical repair was performed in 573 (48.9%) patients, and EVT in 598 (51.1%) patients. Pretreatment information was comparable for both groups. Kaplan-Meier survival curves demonstrated lower mortality in the surgical than the EVT group (P = 0.023; Log-rank test) over the 12-year period. The 1-year, 5-year, and 10-year mortality rates were 12.4%, 19.5%, and 27.7% for the surgery group, and 18.7%, 25.2%, and 31.7% for the EVT group, respectively. Modified Rankin Score was worse for EVT. There was lower mortality in surgical than EVT groups in patients treated for anterior communicating artery (ACOM, n = 420) and posterior communicating artery (PCOM, n = 177) aneurysms. Shorter time to aneurysm repair and more extensive cerebrospinal fluid (CSF) drainage characterized the surgery group. Mortality was lower in surgical patients. Plausible explanations are the maintenance of surgical skills and prompt reduction of intracranial pressure.
11. The efficacy and safety of disitamab vedotin combined with immune checkpoint inhibitors in metastatic upper tract urothelial carcinoma: a multicenter real-world study.
期刊: Cancer immunology, immunotherapy : CII 发表日期: 2025-Sep-13 链接: PubMed
摘要
Disitamab vedotin (DV, RC48-ADC) has shown promising efficacy and manageable safety as monotherapy or combined with immune checkpoint inhibitors (ICIs) in metastatic urothelial carcinoma (mUC) patients progressing after systemic chemotherapy. This study evaluates the efficacy and safety of RC48-ADC plus ICIs in metastatic upper tract urothelial carcinoma (mUTUC) in a real-world setting. This retrospective, multicenter study included 198 mUTUC patients treated with RC48-ADC plus ICI at 23 clinical centers between June 2021 and December 2023. Data were analyzed from July to September 2024. objective response rate (ORR). Secondary endpoints: progression-free survival (PFS), overall survival (OS), duration of response (DoR), time to objective response, and treatment-related adverse events (TRAEs). Among the patients, 122 (61.6%) received combination therapy as first-line treatment, while 76 (38.4%) as second-line or beyond. ORR was 58.6% (95% CI: 51.4-65.5), with a median PFS of 13.0 months; median OS was not reached. Subgroup analyses showed consistent ORR across all subgroups. Adverse events (AEs) occurred in 79.8% of patients, with grade 3-4 AEs in 19.7%. Common AEs included neuropathy (40.4%), fatigue (26.8%), alopecia (25.3%), and rash (21.7%). The main limitations of this study include its retrospective design and the population of the study only include patients from China, leading to potential selection bias. RC48-ADC combined with ICIs demonstrated robust antitumor activity and a favorable safety profile in real-world mUTUC, particularly in selected patient groups. Further studies are needed to explore its potential in this high-risk population.
12. The relative importance of key life domains for people with disability: findings from a cross-sectional survey of NDIS participants in Australia.
期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2025-Sep-13 链接: PubMed
摘要
This study investigates the relative importance for people with disability of key life domains and whether this differs between young people (15-24) and adults (25 and over). A cross-sectional survey was conducted from 20 October to 31 December 2022 with National Disability Insurance Scheme (NDIS) participants asked to rank eight domains: Choice & control, Daily living, Relationships, Home, Health & wellbeing, Lifelong learning, Work, Social, Community and Civic participation. Based on a random utility framework, the data were analysed based on a ranked-ordered logit model to estimate preference shares for the order of preferences across domains. Analyses were conducted separately for the young and adult cohorts. Sensitivity analyses were conducted by relaxing the equal importance of NDIS domains in the ranking exercise based on related life domain importance rating information, which was also collected in the survey. Our sample consisted of 1140 NDIS participants. While the majority ranked the domains as equally important, answers from the rating module suggested otherwise. Adjustments for these differences lead to similar results with both age cohorts ranking Health & Wellbeing, Home and Daily living as the most important domains. These were followed by Relationships, Choice & control, Social, Community & Civic participation, Lifelong learning, and Work for younger people. For older people the importance order between the Choice & control and Relationships was switched. Our results revealed similarity between what younger and older people perceive as important and despite often receiving a fair share of policy attention, work was seen, on average, as the least important life domain. Understanding what matters in the lives of people with disabilities is crucial for tailoring policy decisions to their needs. This study surveyed people with disability who are part of the National Disability Insurance Scheme, an Australian scheme which provides personalised funding for services and support based on individual needs. Participants were tasked to rank eight life domains and our study shows that Health & Wellbeing, Home, and Daily Living were considered the most important areas for both the young (15–25 years old) and adult (25 years old and over) cohorts. Although Work is often a policy focus, this domain was ranked the least important by both cohorts.
13. Understanding health-related quality of life in Chinese infertility patients: a qualitative study.
期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2025-Sep-13 链接: PubMed
摘要
Infertility is a global issue that significantly impacts health-related quality of life (HRQoL), HRQoL has become increasingly relevant in health policies, patient-centered care, and shared clinical decision-making. Socio-contextual factors influence reproductive populations’ attitudes towards childbearing, ultimately shaping their HRQoL. The objective of this study was to gain a deeper understanding of fertility issues from the perspectives of infertility patients and fertility professionals, and to develop a comprehensive conceptual framework for understanding infertility patients’ HRQoL. Participants were recruited from a national multicenter interview survey, including four reproductive centers in the east (Jinan), west (Chongqing), south (Guangzhou), and north (Shenyang) of China. This qualitative study was conducted using semi-structured face-to-face interviews with 93 participants. Furthermore, considering that fertility is a relatively private topic, the infertility patients’ electronic diaries recorded on an online community (Zhihu) were used as supplementary material. A grounded theory approach was used to analyze the data. In total, 77 infertility patients and 10 fertility professionals were included. A total of 2580 initial concepts were identified, and 71 initial categories were derived from the initial concepts. By summarizing and sorting out the initial categories, 18 sub-categories were identified, including symptoms, physical functioning, role-physical, negative emotions, and reproductive stress, etc. Four principal categories were identified: (i) physical health, (ii) mental health, (iii) social health, and (iv) subjective wellbeing. Finally, we derived a disease-specific HRQoL conceptual framework for infertility patients based on the revised Wilson and Cleary HRQoL model. This study provides a culturally sensitive HRQoL framework for infertility patients in Eastern contexts, addressing gender-specific experiences, and establishing a foundation for tailored interventions that support patient-centered infertility care. Furthermore, these findings will support the development of a novel, disease-specific HRQoL instrument for male and female infertility patients.
14. Emotion-centered problem solving therapy for generalized anxiety disorder: a single-arm pilot study with middle-aged and older adults.
期刊: Aging & mental health 发表日期: 2025-Sep-13 链接: PubMed
摘要
Older adults may be particularly vulnerable to the negative effect of distress on cognition, thus explaining cognitive behavioral therapy’s (CBT’s) diminished efficacy for generalized anxiety disorder (GAD) in later life. Emotion-centered Problem Solving Therapy (EC-PST) may address this and other barriers to skill acquisition. This single-arm pilot aimed to determine the feasibility of 6-session EC-PST to achieve clinically significant improvements in anxiety and/or worry symptoms in adults aged 55+ with GAD. Secondary analyses also examined reductions in depressive symptoms and assessed participant satisfaction with treatment components. Sixteen adults aged 58 to 83 years old with current GAD were enrolled. Fourteen participants completed treatment. Twelve participants (85.7%) had a clinically significant pre- to post-treatment reduction in anxiety and/or worry symptoms. Additionally, nine (64.2%) had a clinically significant reduction in depressive symptoms. Qualitative feedback indicated a high level of satisfaction based on themes of reduced avoidance, increased confidence in managing anxiety, and feeling more in control of life problems. Findings support feasibility and acceptability of EC-PST for GAD in middle-aged and older adults that is worthy of follow up in a randomized controlled trial given the limited options for evidence-based therapy in later life anxiety.
15. A cross-national cost-effectiveness analysis of brivaracetam focusing on psychiatric and behavioral adverse effects.
期刊: Epilepsia open 发表日期: 2025-Sep-13 链接: PubMed
摘要
Levetiracetam (LEV) has been widely used as an antiseizure medication (ASM), but is associated with psychiatric and behavioral adverse effects (PBAEs). Brivaracetam (BRV) has demonstrated better psychiatric tolerability, albeit at a higher cost. This study aimed to evaluate the cost-effectiveness of initiating BRV versus LEV therapy with a subsequent switch to BRV in the event of PBAEs across the US, Australia, and Japan. We developed a decision tree model with a 10-year time horizon comparing two strategies across the US, Australia, and Japan: initial BRV therapy versus initial LEV therapy with a switch to BRV upon the occurrence of PBAEs. We utilized clinical trial data and regional cost estimates to conduct base-case and probabilistic sensitivity analyses. The results of the base-case analyses indicated that initial BRV therapy was cost-effective only in Australia. The results of the sensitivity analyses revealed that the probability of initial BRV being cost-effective was 0% in the US, 49.6% in Japan, and 99.99% in Australia. In Japan, when the risk of LEV-induced PBAEs was assumed to be 24%, the probability that initial BRV therapy would be cost-effective rose to 70%, supporting the potential utility of an initial BRV strategy in high-risk populations. By contrast, in the US, the risk of PBAEs needed to exceed 76% to achieve a comparable cost-effectiveness probability. While the initial BRV strategy consistently demonstrated cost-effectiveness in Australia, it failed to do so in Japan and the US. However, Japan presents a unique opportunity where BRV can be used cost-effectively when combined with pre-assessments of LEV-induced risk for PBAEs. BRV causes fewer PBAEs than LEV, but costs more, creating a clinical dilemma. A cost-effectiveness analysis comparing BRV versus LEV as initial monotherapy with a focus on PBAEs was conducted across the US, Australia, and Japan. The results indicated that compared with LEV, BRV is cost-effective in Australia, but not in the US. In Japan, BRV is cost-effective as initial treatment only for patients at high risk for LEV-induced PBAEs.
16. Metal(oid)s in Vegetables: Human Health Risks Though Vegetable Consumption.
期刊: Biological trace element research 发表日期: 2025-Sep-13 链接: PubMed
摘要
Contamination of vegetables with metals may pose many health problems for consumers. Hence, it is crucial to determine metal levels in frequently consumed vegetables. This study investigates levels of ten metal(oid)s in various vegetable samples from Gonabad’s market and assesses the potential health risks associated with consuming metal-contaminated vegetables. In this regard, 11 vegetable species were examined for the presence of arsenic (As), cadmium (Cd), cobalt (Co), chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), nickel (Ni), lead (Pb) and zinc (Zn) using an ICP-MS analyzer. Levels of As, Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb and Zn were in the ranges of 0.02-0.5 (mean 0.18), 0.03-0.5 (mean 0.17), 0.5-10.50 (mean 1.52), 0.45-1.90 (mean 1.09), 5.25-13.58 (mean 8.90), 55.69-411.83 (mean 174.46), 0.04-0.5 (mean 0.26), 0.19-4.51 (mean 1.56), 0.18-2.47 (mean 1.17) and 12.60-31.01 (mean 20.99), respectively. Levels of some of the selected metals (Co, Cr, Cu, Fe, Mn and Zn), except four metals including As, Cd, Ni and Pb, which exceeded the FAO/WHO limits, were within the FAO/WHO limits in the vegetables. In Gonabad, the sequence of HQ associated with metal(oid)s in vegetables exhibited the following pattern: children > teenagers > adults. However, HI values for children through consumption of eggplant and parsley were above 1, respectively, indicating that children may be facing health hazards due to the consumption of these two vegetables. However, no non-cancer risk was estimated for teenagers and adults. TCR values showed high cancer risk from the consumption of some vegetables for the three age groups, with higher TCR for adults. Therefore, routine monitoring of metal levels in vegetables, as well as associated health hazards, is suggested to prevent the accumulation of these metal(oid)s in the human food chain and to prevent potential health hazards in the future.
17. Conceptual framework for caregivers' quality of life and well-being supporting children with special health and medical needs in East Asia: asystematic review and narrative synthesis.
期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2025-Sep-13 链接: PubMed
摘要
There is a growing need to understand how cultural, relational, and contextual factors shape the quality of life (QOL) and well-being of caregivers of children with special health and medical needs in East Asia. Currently, no culturally grounded conceptual framework exists, and the unique demands of caring for developmentally dependent children present distinct challenges. This study aimed to identify key factors influencing caregiver QOL and well-being in this context. We conducted a systematic review of qualitative studies examining QOL among caregivers of children with chronic or life-threatening conditions in East Asia. The databases searched included MEDLINE, Cochrane, EMBASE, PsycINFO, CINAHL, and Ichushi (to June 2024). Studies were included if they addressed informal caregiving for children and focused on QOL or well-being in East Asian countries. Existing reviews were used to identify relevant studies, with an additional search conducted for Japan. We applied a framework synthesis approach guided by the EQ-HWB conceptual model. Risk of bias was assessed using the CASP Qualitative Studies Checklist. Fourteen studies met the inclusion criteria. Ten core themes emerged, including emotions, activity, role, social and family relationships, functioning, financial strain, and parenting. Role, family ties, and parenting were especially prominent in East Asian contexts. Caregivers’ experiences were deeply influenced by cultural factors such as collectivism, traditional norms, and stigma. These findings underscore the importance of culturally sensitive frameworks to assess caregiver QOL and to inform policies and interventions in East Asian health and social systems. In pediatric medical research, the impact on informal caregivers has been pointed out as important. This study provides important insights for the development of an assessment scale for caregivers of children with medical problems. The main objective of this study is to summarize the existing knowledge on the components of quality of life (QOL) and well-being of caregivers of children with medical problems. It is important to reflect the cultural background of Asia. Analysis identified 10 major themes: (1) feelings and emotions; (2) activity; (3) self-identity; (4) role; (5) autonomy; (6) social relationships; (7) family relationships; (8) functioning; (9) financial strain; and (10) parenting. This study revealed that the importance of parent-child relationships and connections with family and society, which are unique to Asia, is reflected in the important components of QOL and well-being.
18. Chemogenetic activation of the medial prefrontal cortex alleviates the impaired extinction of fear memory through the increase in the binding of EGR1 and TET1 in an animal model of PTSD.
期刊: Psychopharmacology 发表日期: 2025-Sep-13 链接: PubMed
摘要
Impaired extinction of fear memory (EFM) is one of the principal symptoms of posttraumatic stress disorder (PTSD). We recently reported that chemogenetic activation (CA) of the infralimbic cortex (ILC) during extinction training did not reduce fear instantly but rather facilitated later extinction retrieval in a single prolonged stress (SPS) rats, an animal model of PTSD. We examined the mechanism by which CA alleviates the impaired EFM in SPS rats. We measured protein levels of Early Growth Response 1 (EGR1) and ten-eleven translocation methylcytosine dioxygenase 1 (TET1) by western blotting, levels of binding of these two proteins by co-immunoprecipitation and western blotting, and levels of 5-hydroxymethylcytosine (5hmC), an indicator of DNA demethylation, by ELISA. Bobcat339 was used as a selective TET inhibitor, and EFM was evaluated using extinction training and extinction testing following contextual fear conditioning. CA of the ILC increased the binding of EGR1 and TET1 and increased the 5hmc level in the prefrontal cortex. Administration of Bobcat339 inhibited the 5hmc increase and the alleviation of impaired EFM by the CA of the ILC in SPS rats. The extinction training was indispensable for the increased binding of EGR1 and TET1 and the alleviation of impaired EFM in response to the CA of the ILC. Our results suggest that CA alleviates the impaired EFM via the increase in EGR1-TET1 binding in SPS rats. Pharmacotherapy promoting DNA demethylation through the activation of the TET1 cascade may be pivotal in the treatment of PTSD.
19. Culinary Medicine Program Using Herbs and Spices to Increase Vegetable Consumption Among Adults with Hypertension: A Randomized Controlled Feasibility Study.
期刊: American journal of health promotion : AJHP 发表日期: 2025-Sep-13 链接: PubMed
摘要
PurposeUnhealthy diets contribute to hypertension. Culinary medicine (CM) combines cooking skills with medical science to improve eating behavior. This study assessed the feasibility of an electronic CM education program emphasizing herbs/spices to improve diet and health among adults with hypertension.Design/SubjectsSeventeen individuals with hypertension completed a 6-week, randomized, controlled, feasibility study, assigned to an eCulinary medicine (e-group) or control (c-group).Intervention/MeasuresThe e-group received CM and nutrition education videos focusing on herbs/spices to enhance vegetable consumption. Dietary intake, weight, and blood pressure were measured at baseline, every two weeks for six weeks, and one-month follow-up.Analysis/ResultsAt one month, the e-group showed significantly lower sodium (P = .008), caloric (P = .02), and fat intake (P = .005) compared to the c-group. Within the e-group, fiber intake (P = .01) and diastolic blood pressure (P = .003) improved significantly between baseline and one-month follow-up.ConclusionThis study suggests that a 6-week virtual CM program emphasizing herbs/spices was feasible and led to modest improvements in dietary behaviors and health outcomes in adults with hypertension.
20. Partnering with Black Funeral Home Directors to Reduce Mortality and Gun Violence.
期刊: Social work in public health 发表日期: 2025-Sep-13 链接: PubMed
摘要
For generations, Black Funeral Home Directors BFHDs have operated within the Black community, accumulating extensive knowledge of multiple family generations impacted by firearm-related deaths and possessing decades of neighborhood-level insights. BFHDs can be key allies in developing and implementing premature death and violence prevention efforts. The increasing incidence of chronic disease, suicide, and homicide related to gun violence among Black Americans, particularly in low-income neighborhoods, represents a significant public health threat and social justice issue. The Epidemiological Criminology framework is proposed to understand factors affecting chronic disease risks, premature deaths, and criminal justice responses, allowing for the promotion of social work practice that supports trauma-informed responses, self-care, and healing. This article explores the potential for collaboration between BFHDs and social workers to address the complex issues of gun violence and premature death in Black communities, leveraging the unique position and cultural competence of BFHDs to complement existing efforts targeting high-risk groups.
21. A Case Control Study to Assess Frequency, Risk Factors, and Genetic Diversity of Entamoeba gingivalis.
期刊: Oral diseases 发表日期: 2025-Sep-13 链接: PubMed
摘要
22. Conservation Arks: Genomic Erosion and Inbreeding in an Abundant Island Population of Koalas.
期刊: Molecular ecology 发表日期: 2025-Sep-13 链接: PubMed
摘要
The persistence of many threatened species depends on isolated habitat patches such as conservation parks, fenced reserves, and islands. While these ‘conservation arks’ provide refuge from many contemporary threats, they can also pose risks of genetic diversity loss and inbreeding depression, further exacerbating extinction risk. A pertinent example is the Kangaroo Island koala population in South Australia that originated from a few translocated founding individuals in the 1920s but now sustains a large population with a low prevalence of infectious disease. We investigated the extent and consequences of founder effects on genomic diversity, inbreeding, and adaptive potential in Kangaroo Island koalas by comparing them with mainland Australian populations using high-coverage whole genomes. Our findings support sharp, recent declines in effective population sizes (Ne) in both mainland and Kangaroo Island populations. However, Kangaroo Island koalas had much lower individual and population-level diversity. Together with longer and more numerous runs of homozygosity and an increased proportion of homozygous genetic load, these results support the hypothesis that a severe bottleneck has contributed to inbreeding and maladaptation in Kangaroo Island koalas. While Kangaroo Island has the potential to conserve a viable population of koalas, we recommend genetic rescue to restore diversity and mitigate inbreeding depression in this isolated population. Our results emphasise the need for longitudinal genomic monitoring and genetic management to maintain long-term viability and resilience in potential conservation arks. Understanding the demographic history of such populations will help inform future conservation aimed at preventing genetic erosion and preserving biodiversity.
23. 1H, 15N, and 13C resonance assignment of human heat shock protein 10.
期刊: Biomolecular NMR assignments 发表日期: 2025-Sep-13 链接: PubMed
摘要
The human chaperonin system, Hsp60/Hsp10, is essential for maintaining protein homeostasis and is found mainly in mitochondria. Hsp60 forms a bowl-shaped structure that provides an enclosed environment for protein folding, while its co-chaperone, Hsp10, acts as a cap to seal the barrel. This coordinated process is crucial for the proper folding of many unfolded or misfolded proteins, making the Hsp60/Hsp10 complex an indispensable chaperone system. Changes in their expression levels have been linked to diseases such as neurodegenerative disorders and cancer. Although Hsp60 has gained increasing attention, its co-chaperone Hsp10 remains relatively underexplored and has often been assumed to play a passive role. However, emerging studies challenge this view, suggesting that Hsp10 alone may exert regulatory functions within the chaperonin cycle. Here, we present the near-complete NMR backbone assignment of the 102-residue human Hsp10, laying the groundwork for future investigations into its structure, interactions, and roles in facilitating protein folding and preventing aggregation.
24. Aluminum Induced Higher Neurotoxicity than Nano-Alumina During Early Development in Zebrafish, Exacerbated by Trem2 Knockdown.
期刊: Biological trace element research 发表日期: 2025-Sep-13 链接: PubMed
摘要
Early exposure to toxic substances is a known risk factor for neurotoxicity. The present study is aimed at exploring the neurotoxicity of nano-alumina (AlNPs) and aluminum chloride (AlCl3) in zebrafish at 144 h post-fertilization (hpf) and at investigating the role of the type II triggering receptor expressed on myeloid cells (trem2) among them. Zebrafish embryos within the four-cell stage were exposed to control, negative control, trem2 knockdown, AlCl3, AlCl3 + trem2 knockdown, AlNPs, and AlNPs + trem2 knockdown until 144 hpf. 500 pL of lentivirus containing trem2 inhibitor at 5 × 108 TU/mL was microinjected into the yolk sacs to achieve trem2 knockdown. AlCl3 and AlNPs were applied at 50 mg/L. Neurobehavior, AChE and SOD levels, and the expression of trem2 and neurodevelopmental genes were measured. AlNPs significantly increased the average speed while decreasing the absolute angle compared to AlCl3. Upon trem2 knockdown, time spent in the outer zone, distance travelled, and accelerated speed were further reduced in both AlCl3 and AlNPs groups. The trem2 loss also exacerbated the suppression of AChE and SOD levels, trem2, α1-tubulin, and mbp gene levels in the AlCl3 and AlNPs groups. In conclusion, AlCl3 induced higher neurotoxicity than AlNPs, and these effects were intensified by trem2 knockdown. Studying larvae allows us to capture neurodevelopmental disturbances during critical stages of brain formation, offering a more comprehensive assessment of the risks and therapeutic potential of targeting trem2 in Al- and AlNPs-induced neurotoxicity.
25. Modification of biochar by iron containing adsorption centers as a method to enhance the remediation of perfluorooctanoic (PFOA) and (PFOS) acids from water and soil: a density functional theory study.
期刊: Journal of molecular modeling 发表日期: 2025-Sep-13 链接: PubMed
摘要
Perfluoroalkyl and polyfluoroalkyl substances (PFAS), with over 15,000 types listed in the US EPA’s CompTox database, are found in everyday items like textiles, packaging, firefighting foams, and medical devices. Their widespread use has led to concerning health effects-including cancers, elevated cholesterol, and fertility issues-with detectable levels present in 98% of Americans. While perfluorooctanoic (PFOA) and perfluorooctanesulphonic (PFOS) are among the most studied, their environmental behavior and ecological interactions remain poorly understood. Advances in computer-based methods, including chemoinformatics and quantum modeling, now aid in predicting properties and simulating PFAS dynamics. Biochar (BC), produced via biomass pyrolysis under limited oxygen, is known for its porosity and adsorption capabilities. Magnetic biochar (MBC), enhanced with iron-based compounds, adds the benefit of magnetic separation, making it ideal for water decontamination. This paper explores the use of MBC to remove PFOA and PFOS from the environment, leveraging computational tools to investigate molecular interactions and adsorption properties. A doubled crystallographic unit of hematite (Fe₂₄O₃₆) was constructed and fully optimized using density functional theory (DFT) with the M06-2X functional. Geometry optimization used the 6-31G(d,p) basis set, while single-point energies were calculated with 6-311 + + G(d,p). Antiferromagnetic conditions were ensured by setting the total spin to zero (Sz = 0), and triplet instability analysis was performed to evaluate ferromagnetic potential. To simulate bulk water effects on adsorption, the CPCM solvation model (ε = 78.3) was applied. Harmonic frequency analysis confirmed structural minima, and Gibbs free energies were calculated using Gaussian 16. PFOA and PFOS, with highly negative pKa values (~ -0.1 and <). Quadratic SCF convergence (scf = qc) addressed numerical challenges, and interaction energies were corrected for basis set superposition error using the counterpoise method. Calculated IR spectra and molecular visualizations were generated with Chemcraft, without applying scaling factors.
26. In vitro inhalation bioaccessibility for PM10-bound neonicotinoids: method development, effects of hydrophobicity, and its implication in health risk assessment.
期刊: Environmental geochemistry and health 发表日期: 2025-Sep-13 链接: PubMed
摘要
The concentrations of neonicotinoids in atmospheric inhalable particles (PM10) and their inhalation bioaccessibility were examined in a coastal urban city in Eastern China. Seven neonicotinoids were analyzed using a QuEChERS (quick, easy, cheap, effective, rugged, safe) extraction method in conjunction with a triple quadrupole mass spectrometer (HPLC-MS/MS) for PM10 samples. Additionally, a dispersive liquid-liquid microextraction technique combined with HPLC-MS/MS detection was employed, offering a simple, rapid, sensitive, accurate, and cost-effective methodology for quantifying neonicotinoids in two simulated lung fluids: Gamble’s Solution (GMB) and Artificial Lysosomal Fluid (ALF). The accuracy of the bioaccessibility study was evaluated using mass balance approaches with a PM10 filter. Factors such as the solid-liquid ratio, extraction time, and oscillation rate were found to influence inhalation bioaccessibility. All samples contained neonicotinoids, with overall concentrations ranging from 23.3 to 140 pg/m3. The inhalation bioaccessibility of neonicotinoids under healthy conditions (GMB: 24.0-90.0%) was lower compared to that under inflammatory conditions (ALF: 33.7-91.1%). The bioaccessibility of organic components exhibited a negative correlation with both their hydrophobicity and molecular weight. The average bioaccessible concentrations of imidacloprid-equivalent total neonicotinoids (IMIeq), determined using the relative potency factor method, was 114 ± 71.9 pg/m3 for GMB and 123 ± 71.6 pg/m3 for ALF. A health risk assessment of target PM10-associated neonicotinoids via inhalation was conducted, taking into account bioaccessibility concentrations through the application of hazard quotient and IMIeq methodologies. The results indicated an absence of carcinogenic risk for both children and adults in the area during the sampling period.
27. Disposable paper-based electrochemical sensor for hydroquinone detection in environmental samples using a MXene-CNT hybrid composite.
期刊: Mikrochimica acta 发表日期: 2025-Sep-13 链接: PubMed
摘要
This study investigates the electrochemical performance of MXene/multi-walled carbon nanotubes (MWCNT) composite-based sensor and its comparison with MWCNT for the sensitive detection of hydroquinone (HQ) in undiluted water samples. The sensor employs custom-made screen-printed carbon electrodes modified with Ti3C2Tx/MWCNT, allowing for rapid fabrication and integration of the working, reference, and counter electrodes into a compact, portable device. The multilayer MXene provides a large specific surface area, while MWCNT enhances electrical conductivity, enabling clear electrochemical signals even in complex sample matrices. The MWCNT/SPCE and Ti3C2Tx/MWCNT/SPCE sensors demonstrated excellent sensitivity, achieving low detection limits of 0.055 µM and 0.261 µM, with wide Linear ranges of 3-600 µM and 6-900 µM, respectively. The sensor demonstrates strong selectivity for HQ with minimal interference from coexisting species and requires little to no sample preparation, offering a feasible approach for real-time environmental monitoring.
28. Developmental neurotoxicity of organophosphate flame retardants (OPFRs): risks to human health and ecosystems.
期刊: Archives of toxicology 发表日期: 2025-Sep-13 链接: PubMed
摘要
Organophosphate flame retardants (OPFRs), widely used as primary alternatives to banned brominated flame retardants, have been extensively applied across various industries worldwide. In recent years, OPFRs have increasingly emerged as significant environmental pollutants and have been shown to possess potential developmental neurotoxicity. This review systematically synthesizes current research on their environmental distribution, bioaccumulation, and neurodevelopmental effects. Studies indicate OPFRs are widely detected in air, water, soil, and organisms, demonstrating high environmental persistence and mobility. Humans are exposed through inhalation, ingestion, and dermal absorption, with infants and young children at higher risk due to frequent hand-to-mouth behavior and prolonged indoor exposure. Epidemiological studies suggest that prenatal exposure to OPFRs may be associated with low birth weight, behavioral abnormalities, and cognitive deficits, with evidence of sex-specific susceptibility. Experimental studies using model organisms, such as zebrafish and rodents, have further elucidated the potential mechanisms underlying OPFR-induced developmental neurotoxicity. Chemicals such as TDCPP, TPhP, and TCEP have been found to disrupt neural cell proliferation and differentiation, dysregulate gene expression, induce neuroinflammation, increase oxidative stress, and impair endocrine homeostasis. Despite significant progress in understanding the toxicity of OPFRs, critical scientific challenges remain unresolved. For example, the long-term effects of low-dose OPFR exposure on the nervous system are not yet fully understood. Furthermore, there is a lack of systematic analysis regarding the combined effects of multiple pollutants. Therefore, a deeper understanding of the toxicological mechanisms of OPFRs is essential to provide a stronger scientific foundation for the formulation of evidence-based environmental and public health policies.
29. Interplay between (poly)phenols, gut microbiota, and biological rhythms: outlook for a new paradigm in brain health.
期刊: Critical reviews in food science and nutrition 发表日期: 2025-Sep-13 链接: PubMed
摘要
Dietary (poly)phenols, bioactive compounds abundantly found in plant-based foods, undergo extensive metabolism by the host and its gut microbiota, producing metabolites that influence systemic and brain health. Despite their low bioavailability, (poly)phenols have been consistently associated with neuroprotective benefits, such as reducing neuroinflammation and enhancing gut-brain communication. Additionally, circadian rhythms can influence (poly)phenol bioactivity, while these compounds, in turn, modulate biological rhythms. The gut microbiota’s diurnal oscillations affect (poly)phenol metabolism and modulate (poly)phenols’ effects by producing bioactive metabolites, adding complexity to their health impact. Understanding these mechanisms can aid in designing functional foods and precision nutrition strategies to enhance neuroprotection. However, critical questions remain unanswered. This review explores the interplay between (poly)phenols, circadian rhythms, and gut microbiota, highlighting their collective role in brain health. The influence of individual gut microbiota profiles, polyphenol-related metabotypes, and circadian synchrony on (poly)phenol metabolism and neuroprotection is not fully understood. Likewise, the timing of (poly)phenol consumption and its interaction with rhythmic microbial processes require further exploration. Addressing these gaps could lead to targeted dietary interventions. Future research should prioritize human trials and multi-omics approaches to unravel these complex relationships, advancing precision health strategies that foster cognitive resilience and reduce neurodegenerative disease risk.
30. Chinese Guideline for the Rehabilitation Treatment of Osteoporosis (2024 Edition).
期刊: Journal of evidence-based medicine 发表日期: 2025-Sep-13 链接: PubMed
摘要
Osteoporosis (OP) is one of the most serious health problems, causing a huge economic burden to patients, families, and society. OP rehabilitation treatment plays an important role in pain-relieving, reducing the risk of fracture, improving the ability of daily activities, and promoting the healing of OP fractures, and has been increasingly valued and recommended by domestic and foreign guidelines. This guideline was updated based on the Chinese Expert Consensus on Rehabilitation Intervention for Primary OP 2019 editions and was initiated by the Chinese Society of Physical Medicine and rehabilitation and the West China Hospital of Sichuan University. This guideline development was guided by domestic and international guideline development methods and principles and selected through clinical issue screening and deconstruction and two rounds of Delphi questionnaire consultation. The International Classification of Functioning, Disability and Health (ICF) was used as the theoretical framework, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used based on the best available evidence. The guideline was developed based on the best available evidence, used the GRADE method to grade the quality of evidence and recommendations, and reported according to the Reporting Items for Practice Guidelines in Healthcare. Taking into account patients’ preferences and values and the needs of Chinese clinical practice, it puts forward 22 recommendations covering seven aspects (rehabilitation assessment, therapeutic modalities, occupational therapy, assistive devices, cognitive behavior and psychological therapy, traditional Chinese medicine therapy, and health education) to systematically standardize OP rehabilitation.
31. Impulsivity in cerebellar ataxia: an online, multidimensional assessment.
期刊: Journal of neural transmission (Vienna, Austria : 1996) 发表日期: 2025-Sep-13 链接: PubMed
摘要
While considered a motor control structure, the cerebellum contributes to non-motor functions, including impulsivity. However, whether it contributes to impulsivity in a domain-specific manner remains unknown. Studies on cerebellar ataxia (CA), a common model for cerebellar dysfunction, typically have small sample sizes, limiting robustness. In a multicenter cross-sectional study, we investigated the cerebellum’s role in various forms of impulsivity by comparing large cohorts of CA to age- and education-matched neurotypical healthy (NH) controls. Additionally, to examine the ability to identify individuals with CA using impulsivity features alone, we developed supervised machine learning (ML) models. In experiment 1 (CA = 140, NH = 136), impulsivity was assessed using the BIS-11 questionnaire. In experiment 2 (CA = 110, NH = 107), performance-based impulsivity was assessed using the MCQ-27, evaluating delay discounting in monetary decision-making. Two ML models-Logistic Regression and Random Forest-were utilized to classify disorder status (CA/NH). The CA group showed higher BIS-11 scores (p = 0.001), indicating higher impulsivity, driven by motor (p < 0.001) and attention (p = 0.002) impulsivity. However, the CA group exhibited lower non-planning impulsivity (p = 0.014). In the MCQ-27, the CA group showed lower k-values (p < 0.005), indicating reduced impulsivity in monetary decisions. Both ML models demonstrated strong classification performance (AUC ≥ 0.85) in independent datasets. This study highlights the cerebellum’s selective role in impulsivity. We found higher motor and attentional impulsivity in CA alongside lower non-planning and decision-making impulsivity. This suggests a unique impulsivity profile in CA that may indicate a compensatory mechanism for future events. ML models demonstrated high classification performance, suggesting impulsivity is a core non-motor feature of CA.
32. Trends in first-line monotherapy and combination therapy for hypertension in UK primary care.
期刊: British journal of clinical pharmacology 发表日期: 2025-Sep-13 链接: PubMed
摘要
Debate remains about the optimal initial treatment strategy for hypertension. Most guidelines recommend first-line combination therapy for most patients. However, the UK’s National Institute for Health and Care Excellence recommends first-line monotherapy for all patients. It is unknown if first-line combination therapy use is increasing despite this recommendation. This study aims to assess trends in prescriptions for first-line antihypertensive monotherapy and combination therapy in UK primary care. Using the Clinical Practice Research Datalink, we formed a cohort of all patients newly diagnosed with hypertension between 2011 and 2019. We calculated annual proportions of patients newly prescribed first-line monotherapy and combination therapy within 3 months of diagnosis. We used Kaplan-Meier methods to estimate the median treatment persistence, and the probability of persistence at 6 months and 1 year for mono- and combination therapy. Among 535 234 patients with hypertension, 1.7% received first-line combination therapy, while 85.6% received monotherapy. Rates of initiation varied by age and hypertension stage. Median treatment persistence was 298 (95% confidence interval [CI] 276-318) days on first-line combination therapy, compared to 398 (95% CI 394-403) days on monotherapy. At 6 months, 58.2% (95% CI 57.2%-59.3%) of combination therapy and 62.2% (95% CI 62.1%-62.4%) of monotherapy initiators remained on first-line treatment; at 1 year the numbers fell to 46.4% (95% CI 45.4%-47.6%) and 51.2% (95% CI 51.1%-51.4%), respectively. First-line antihypertensive combination therapy remains exceedingly rare in the UK in accordance with National Institute for Health and Care Excellence guidelines, but in contrast to other international recommendations. Treatment persistence was lower on first-line combination therapy than monotherapy.
33. Health Concerns of Women in Agriculture in the Midwestern United States.
期刊: Journal of agromedicine 发表日期: 2025-Sep-13 链接: PubMed
摘要
In 2022, the USDA Agricultural Census recognized that over one-third of agricultural producers in the United States were female. However, information on the health and safety needs of women working in agriculture is lacking. To help guide the direction of further research to understand the needs of women in agriculture, a brief survey was administered at a conference for agricultural women in the Midwest US. The goal was to understand the priority concerns and whether the concerns differed by age group or by occupational role. The survey was conducted in person with women attending a Women in Ag Conference in 2024. Participants were asked their age in six categories, whether they were directly involved in agriculture, and how concerned they were about nine health and safety topics using a 5-point Likert scale. Occupational role was determined by classifying the self-reported job description into five categories, academic/professional, academic/professional and agricultural operator, crop producer, livestock producer, and crop and livestock producer (n = 111). Descriptive statistics were calculated to describe the age distribution, occupational roles, and differences in concerns. Correspondence analysis was used to analyze and visualize frequency tables. Chi-square and Fisher’s Exact tests, and logistic regression were used to explore differences. Injuries and respiratory exposures significantly differed between women who were both academic/professionals and agricultural operators and those who were only academic/professional. Academics were similar to crop producers, livestock producers were different from all others, and those who were both crop and livestock producers fell between the two. Fewer differences were seen among the age groups. Younger women were most concerned about reproductive health and older women more concerned about mental health and musculoskeletal disorders. Concerns differed by occupational role and less by age group. Although injuries were of concern for women working in an academic/professional role, they were not a major concern when women also worked a farm or ranch. It is unclear why this might be and further studies need to be conducted to ascertain if these differences can be replicated.
34. Adherence to Mediterranean Diet During Pregnancy, Breastfeeding, and Development of Food Allergy in the Offspring: Results From the MEDALLION Cohort Study.
期刊: Allergy 发表日期: 2025-Sep-13 链接: PubMed
摘要
Prevention is a key strategy for reducing the burden of food allergies (FA). The maternal diet during pregnancy and breastfeeding is increasingly recognized as a factor contributing to FA risk. We analyzed data from a sub-cohort of the MEDALLION study to evaluate the association between maternal adherence to the Mediterranean Diet (MedDiet) and the development of FA in offsprings. Maternal dietary intake during pregnancy and lactation was assessed using a validated scale, i.e., the MedDiet Score, along with individual food group consumption. Multiple logistic regression models were performed. A total of 430 mother-offspring dyads were included in the analysis. Higher maternal adherence to the MedDiet was associated with reduced odds of FA in offspring during both pregnancy (adjusted OR 0.94, 95% CI 0.89-1.00) and lactation (adjusted OR 0.94, 95% CI 0.88-1.00). Increased weekly consumption of fruits and full-fat dairy products during pregnancy, and vegetables during breastfeeding, was associated with reduced likelihood of FA in the offspring. Conversely, higher intake of poultry and red meat (> 3 servings/week) during both periods, and fish consumption during pregnancy (> 1 serving/week), were associated with increased odds of FA. This study points out that the MedDiet and, especially, some specific components, such as fruits, vegetables, and full-fat dairy products, may contribute to lowering the risk of FA in infants, whereas a higher intake of poultry, red meat, and fish may increase it. These findings support the potential of maternal nutrition to reduce childhood FA.
35. The Prevalence of Symptomatic Dermographism: Results of the International UCARE PREVALENCE-D Study.
期刊: Allergy 发表日期: 2025-Sep-13 链接: PubMed
摘要
The prevalence of symptomatic dermographism (SD) in the general population remains unclear. This study aimed to internationally estimate the prevalence of SD and two other dermographic subtypes-physiological red dermographism and simple urticarial dermographism-among adults worldwide. The PREVALENCE-D (Prevalence Estimation of Dermographism) study was the largest international, cross-sectional, internet-based investigation conducted by the Urticaria Centers of Reference and Excellence of the Global Allergy and Asthma Excellence Network from 2021 to 2024. A world expert-designed questionnaire was completed by participants from 28 centers across 19 countries to diagnose SD. Participants were recruited into three age groups (18-24, 25-60, and > 60 years), with ≥ 1000 individuals per group per country. We calculated sex- and age-adjusted prevalence estimates internationally and by country, with 95% confidence intervals. Among 59,543 participants worldwide, those with SD had an adjusted point prevalence of 3.20% (95% confidence interval [CI] 2.68%-3.73%) and a lifetime prevalence of 5.94% (95% CI 5.32%-6.56%). The 25-60 years group presented the highest prevalence. Females had higher rates than males, with statistically significant differences across all age groups for both point and lifetime prevalence. Physiological red dermographism had an adjusted point prevalence of 10.02% (95% CI 9.48%-10.55%) and a lifetime prevalence of 33.47% (95% CI 32.01%-34.94%). Simple urticarial dermographism showed an adjusted point prevalence of 1.21% (95% CI 1.08%-1.35%) and a lifetime prevalence of 5.39% (95% CI 4.99%-5.79%). These findings provide comprehensive international estimates of dermographism, particularly SD, and emphasize the need for appropriate healthcare resource allocation and disease recognition.
36. What pushes males to marry underage girls? Demand-side insights of child marriage from northern Bangladesh.
期刊: Public health 发表日期: 2025-Sep-12 链接: PubMed
摘要
This study aims to assess the factors that drive males to marry underage girls (i.e., girls below the legal age of marriage), with a specific focus on how individual, household, and contextual characteristics of males relate to the prevalence of child marriage in geographically isolated areas, particularly the riverine islands (chars) of Bangladesh. This study employs a cross-sectional design, which is appropriate for capturing data at a single point in time. In this case, data were collected between March and April 2024. With a sample of 5415 individuals, the study applied multilevel mixed-effects Poisson regression to identify factors associated with male preferences for child marriage of girls. Results are reported as incidence rate ratios (IRRs). Younger males had a 29 % higher likelihood of marrying underage girls (IRR = 1.29, 95 % confidence interval [CI] = 1.26, 1.33). Self-employed men were 12 % more likely to engage in child marriage (IRR = 1.14, 95 % CI = 0.99, 1.30). Socioeconomic status influenced risk, with moderately poor (IRR = 1.08, 95 % CI = 1.02, 1.14) and non-poor (IRR = 1.04, 95 % CI = 1.00, 1.08) households showing slightly elevated likelihoods of engaging in child marriage compared to extremely poor households. While the main effect of education alone was not statistically significant (IRR = 0.99, 95 % CI = 0.96, 1.02), among moderately poor households, each additional year of schooling was associated with a reduction in the risk of marrying underage girls (IRR = 0.98, 95 % CI = 0.97, 1.00). This indicates that education may act as a protective factor, especially in certain socioeconomic contexts, by reducing the influence of poverty or informal employment on child marriage decisions. Overall, this study reinforces the notion that, beyond economic status, education plays a critical role in reducing the tendency of men to marry underage girls. Therefore, interventions should focus on promoting male education, engaging younger and self-employed men in awareness programs, and integrating child marriage prevention strategies with broader infrastructure development efforts.
37. Effectiveness and acceptability of interventions to improve readability of patient healthcare materials: A narrative systematic review.
期刊: Public health 发表日期: 2025-Sep-12 链接: PubMed
摘要
Reading age is a key component of Health literacy (HL) yet many written healthcare materials in the UK exceed recommended reading levels, making them less accessible to much of the population. Creating barriers to understanding contributes to health inequalities. Simplifying the way information is written and terminology used could be a useful and low-cost approach to support HL, yet effectiveness of such interventions remains unclear. This study aims to systematically review evidence evaluating the effectiveness and acceptability of healthcare material readability interventions in high income countries. Narrative systematic review. Searches of CENTRAL, Embase, MEDLINE, CINAHL, ERIC, APA Psych Articles, and Psychology and Behavioral Science, databases from 2014 to 2024 were conducted. Articles title/abstract and full text were double screened. Eligible studies examined tailored or improved written healthcare materials across clinical specialities. Data extraction included study characteristics, and interventions’, impact on patient acceptability, comprehension and health outcomes. The Mixed Methods Appraisal Tool (MMAT) was used for critical appraisal. Thirty studies were included, predominantly from the USA. The majority evaluated interventions using simplified language, structured formatting, or visual enhancements. Findings indicated that simplified content was associated with greater patient understanding and preference. However, evidence on behavioural adherence and direct health outcomes was mixed, with few studies demonstrating statistically significant improvements. Quality of included studies was generally low, with methodological and reporting limitations. Readability interventions can enhance patient comprehension and acceptability, yet their long-term impact on health outcomes remains uncertain. Future research should assess sustained effects and explore routine implementation in healthcare settings to inform best practices.
38. Implementation of Teen Dating Violence Laws and Policies in High Schools: Staff and Student Perceptions.
期刊: The Journal of adolescent health : official publication of the Society for Adolescent Medicine 发表日期: 2025-Sep-12 链接: PubMed
摘要
Many US states and school districts have enacted laws and policies to address teen dating violence (TDV) in schools. There is mixed evidence around their effectiveness, underscoring the need to examine whether and how schools are implementing TDV laws and policies. This study explored barriers to and facilitators of implementing TDV policies and programs in high schools. We conducted semistructured interviews with school staff (n = 14) and students (n = 22) in four states with long-standing TDV laws that require districts to develop written TDV policies and provide educational programs (New Jersey, Texas, Rhode Island, and Massachusetts). Interview topics included knowledge and awareness of TDV and response to TDV through policies and programs. Interviews were recorded, transcribed, and analyzed using codebook thematic analysis in Dedoose. Barriers and facilitators were organized by relevant domains of the Consolidated Framework for Implementation Research. Implementation barriers and facilitators were identified in the outer setting, inner setting, and individuals domains. Barriers included community pushback and norms, lack of training and resources for TDV, and limited awareness of laws and policies. Facilitators included state-level mandates to address TDV, clear policies and procedures, additional staff training, and willingness to recognize TDV as an issue. Our findings highlight the multilevel determinants of how schools address TDV through policies and programs and the substantial unmet need that remains. While written laws and policies are promising systems-level strategies to reduce TDV, further resources and attention devoted to implementation are critical to ensure TDV is addressed effectively within schools.
39. FAP promotes progression of oral leukoplakia via activation of PI3K/AKT pathway by interacting with ITGB1.
期刊: Translational oncology 发表日期: 2025-Sep-12 链接: PubMed
摘要
This study aims to elucidate the molecular mechanisms by which fibroblast activation protein (FAP) contributes to the malignant progression of oral leukoplakia (OLK). FAP expression was assessed via immunohistochemistry in human OLK and oral squamous cell carcinoma (OSCC) tissues across varying grades of dysplasia (mild, moderate, and severe). DOK and SCC15 cell lines were transfected to modulate FAP expression, followed by functional assays including colony formation, cell viability, transwell migration, and wound healing. Western blot analysis was performed to evaluate the expression of proteins involved in the integrin β1 (ITGB1) /PI3K/AKT pathway. In vivo, FAP-knockdown reagents were administered to OLK lesions in a murine model. Hematoxylin and eosin (HE) staining was used to assess the incidence of dysplasia and OSCC, while immunohistochemistry (IHC) was employed to examine FAP and p-AKT expression. FAP and p-AKT expression levels were positively correlated with the severity of dysplasia in OLK. Mechanistic investigations revealed that FAP enhances malignant behaviors such as proliferation and migration through activation of the ITGB1/PI3K/AKT signaling pathway. Importantly, suppression of FAP significantly reduced the incidence of both oral epithelial dysplasia and OSCC in the mouse model. FAP facilitates the progression of OLK via the ITGB1/PI3K/AKT signaling axis, and its suppression attenuates malignant transformation. This study highlights the critical involvement of FAP in the malignant transformation of OLK, offering new theoretical foundations for early diagnosis and targeted intervention. The expression level of FAP is positively correlated with the degree of OLK dysplasia, indicating its potential utility as a biomarker for evaluating malignant transformation risk. Moreover, therapeutic approaches targeting FAP or the ITGB1/PI3K/AKT signaling pathway may delay or prevent the progression of OLK to OSCC, presenting promising avenues for the development of precision medicine strategies in clinical practice.
40. Global matrisome changes in obese lung are linked to fibroblastic stroma and premature aging.
期刊: Cell reports 发表日期: 2025-Sep-12 链接: PubMed
摘要
Obesity is linked to an increased risk of various lung disorders, yet its role in disease progression remains poorly understood. We have utilized multiomics approaches together with functional assays to explore the effect of obesity on the lung. Obesity induced matrisome remodeling and structural alterations in the elastic fiber network, exhibiting solubility shifts that overlapped with those seen in the aging lung. In addition, protease inhibitor levels were reduced in lung tissue and bronchoalveolar lavage fluid, suggesting a more damage-prone environment. At the cellular level, fibroblastic stromal cells (FSCs) selectively accumulated lipids, adopted myofibroblast-like phenotypes, and exhibited transcriptional hallmarks of premature aging. Functional assays confirmed that lipid-enriched fibroblasts displayed enhanced contractility, implicating them in the altered mechanical compliance of the obese lung. Overall, obesity led to complex alterations in the lung that ultimately affect FSCs and suggest that overnutrition may act as a contributor to premature aging, thereby compromising lung heath.
41. Reply.
期刊: The Journal of allergy and clinical immunology 发表日期: 2025-Sep-12 链接: PubMed
摘要
42. Dual-channel ratiometric sensing of hypochlorous acid based on organic cage with red and green fluorescence.
期刊: Spectrochimica acta. Part A, Molecular and biomolecular spectroscopy 发表日期: 2025-Sep-09 链接: PubMed
摘要
The high-performance detection of hypochlorous acid (HClO) is crucial for life and environmental health, but still challenging for the single fluorescence signal and single sensing channel of probes. Organic cage with strong adsorption ability and cage structure-related fluorescence property, is a type of potential fluorescent probe. However, the single signal and short emission of organic cage hinders its sensing performance. The design of dual emitting organic cage with long wavelength for dual-channel ratiometric sensing of HClO is of great significance. Herein, we reported an organic cage (ROX) as a probe for accurate quantification of HClO. The prepared ROX exhibited capsule topology-facilitated red/green dual emission around 660/502 nm. The cage-like structure was disrupted by the rapid specific redox interaction between imine bond in ROX and HClO. As a result, the fluorescence at 660 nm quenched in conjunction with the enhancement at 502 nm in PBS (pH 4). Besides, the fluorescence increased at 582 nm with constant emission at 480 nm in DMSO/PBS (pH 7) (V/V, 9/1). The ratio signal in PBS and DMSO/PBS respectively gave the linearity range of 1-30 and 20-45 μM, the limit of detection (3 s) of 14 and 49 nM, and the relative standard deviation of 1.04 % and 0.54 % for 10 replicate determinations. Based on the mutual validation of dual ratio, the dual-channel ratiometric sensing possesses good accuracy, sensitivity, selectivity, and precision. Moreover, ROX can be applied to HClO monitoring in actual water and disinfectant samples with the recoveries of spiked HClO ranged from 95.0 % to 104.2 %. The proposed sensing method highlights the great potential of organic cage in fluorescence sensing.
43. The association of individual food security status with women's political participation, labor-force participation, and reproductive health: A cross-sectional analysis of gendered structural inequality in the League of Arab States.
期刊: Social science & medicine (1982) 发表日期: 2025-Sep-06 链接: PubMed
摘要
This article applies a conceptual framework based on multilevel theories of gender inequality to examine individual-level food insecurity (FI) outcomes in the League of Arab States (LAS). We conceptualize FI as an embodied waypoint on a discriminatory cycle incorporating material and cultural practices that function at macro-, situational-, and individual-levels. Using data drawn from the Gallup World Poll representing a sample of non-institutionalized, aged 15 and above respondents, FAO’s Food Insecurity Experience Scale, the UNDP’s Gender Inequality Index, and the Varieties of Democracy (V-Dem) Project, we provide cross-sectional evaluations of the associations between gender-related variables and individual-level measures of the experience of FI for both women and men for the LAS, and for states stratified by Human Development Index. National measures of gender inequality were significantly associated with FS status for both men and women, including women’s reproductive health (adolescent births and maternal mortality), parliamentary representation, and labor force participation. Regression models run separately for each measure had explanatory power, and addition of each level substantially improved Pseudo R2s. This suggests national-level policies on FS should address national-level gender inequalities and broaden women’s substantive representation in governance, promising further value in exploring FI as an embodied health disparity among women and men, through the multilevel framework of gendered structural inequality.
44. Impact of donor-recipient size mismatch on post-transplant outcomes in kidney transplant recipients: A systematic review.
期刊: Transplantation reviews (Orlando, Fla.) 发表日期: 2025-Sep-05 链接: PubMed
摘要
Donor-recipient size mismatch builds on the nephron dosing concept, but studies suggest unclear associations with kidney allograft outcomes. We systematically searched, critically appraised, and summarized associations between donor-recipient size mismatch and primary outcome of death-censored graft failure, secondary outcomes of kidney function, all-cause graft failure, and mortality. The study protocol was registered a priori on PROSPERO (ID CRD42023455394). We searched MEDLINE, Embase, and Cochrane Databases from 1946 to 2025 for studies evaluating adult kidney transplant recipients. We excluded non-English or unavailable full texts, and studies with donors <16 years old. Risk of bias was assessed using Risk of Bias in Non-randomized Studies - of Exposure tool. Studies were narratively synthesized; marked heterogeneity precluded quantitative meta-analysis. From 1521 citations, 56 studies were included. Sample sizes ranged from 23 to 238,895 donor-recipient pairs (median 214, IQR [95, 807]), with follow-up from 1 week to >20 years. Studies varied in size mismatch definitions, exposure subgrouping, outcomes, patient populations, and follow-up period. Overall, 32 % demonstrated worse kidney allograft outcomes with unfavorable size mismatch, 9 % showed no association, and 59 % reported mixed findings. All studies had high or very high risk of bias. Available studies do not provide strong evidence to support or reject the idea of nephron underdosing, however existing reports were generally of poor quality, with high or very high risk of bias. Due to data heterogeneity, quantitative meta-analysis was not performed. Well-designed studies with clear exposure definitions, standardized outcome assessments, appropriate confounder control, adequate follow-up, and robust statistical analyses remain a priority.
45. Theory of planned behavior constructs as mediators of relations between personality traits, trust, and COVID-19 preventive behavior adherence.
期刊: Social science & medicine (1982) 发表日期: 2025-Sep-02 链接: PubMed
摘要
Dispositional constructs (personality traits, generalized beliefs) are associated with health behaviors, but few studies test potential underlying mechanisms. The current study tested an integrated theoretical model specifying indirect effects of personality traits (conscientiousness, extraversion) and socio-political beliefs (trust in political leaders and health authorities) on initial participation, and subsequent trajectories, in COVID-19 preventive behaviors (handwashing, physical distancing, limiting social contact, mask wearing) mediated by social cognition constructs (attitudes, subjective norms, perceived behavioral control) and intentions. Belgian residents (N = 1762) completed measures of dispositional and social cognition constructs and intentions for COVID-19 preventive behaviors on an initial occasion and self-reported their engagement in the behaviors on four follow-up occasions from April to July 2021. Model predictions were tested using latent growth curve modeling. Indirect positive effects of conscientiousness and trust in politicians and health authorities, and indirect negative effects of extraversion, on health behavior intentions and initial behavior participation as mediated through social cognition (with minor exceptions). These accounted for non-trivial variance in each outcome. Contrary to predictions, model constructs did not account for variance in behavioral trajectories. The current analysis lends support for the model across behaviors, adding to an evidence base of potentially malleable determinants of COVID-19 preventive actions and a candidate mechanism. How to sustain adherence to COVID-19 preventive actions remains an open question in need of further research. Replication studies in other national contexts and other public health crises are warranted.
46. Post-COVID-19 Vaccination (or Long Vax) Syndrome: Putative Manifestation, Pathophysiology, and Therapeutic Options.
期刊: Reviews in medical virology 发表日期: 2025-Sep 链接: PubMed
摘要
With the global rollout of COVID-19 vaccines, vaccine safety remains a priority. Emerging concerns have raised the potential risk of a long COVID-like syndrome following vaccination, informally called long Vax and provisionally termed post-COVID-19 vaccination syndrome (PCVS). Our narrative review describes the putative manifestation, pathophysiology, and therapeutic approaches of PCVS based on the available evidence, mostly from case reports/series and observational studies. Our review noted that PCVS typically manifests within days to weeks post-vaccination, with symptoms lasting months to years. PCVS may present as recognized diagnoses such as postural orthostatic tachycardia syndrome (POTS), small-fibre neuropathy (SFN), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), or as long-term sequelae of myocarditis, vaccine-induced thrombotic thrombocytopaenia (VITT), or immune thrombocytopaenia purpura (ITP). Symptomatically, PCVS overlaps with long COVID, such as fatigue and brain fog, but PCVS may involve more frequent paraesthesia and less dyspnoea. We also review pathophysiological hypotheses of PCVS, focussing on the vaccine-derived spike protein and related immune responses. Finally, we discuss potential therapies used to treat patients with PCVS or related conditions, primarily documented in case reports/series, which could guide future clinical research. Overall, PCVS remains a poorly understood condition that requires more research to elucidate its prevalence, prognosis, risk factors, and treatments.
47. Understanding the Engagement Process of Prostate Cancer Patients in Physical Activity: A Qualitative Study Comparing Profiles of "Inactive Patients" With "Active Patients".
期刊: Psycho-oncology 发表日期: 2025-Sep 链接: PubMed
摘要
Despite the recognised benefits of physical activity in tertiary prevention, 60%-70% of patients with prostate cancer are insufficiently active. Therefore, it is important to understand the process of engagement in physical activity to develop an intervention that enables prostate cancer patients, treated in France, to engage in regular physical activity. This study was unique in that it compared active and inactive profiles using the concepts of ‘disease trajectory’ and ‘career’, borrowed from sociological interactionist theory. We interviewed 39 male participants who had been diagnosed with prostate cancer at least 1 year previously and were no longer receiving treatment other than hormone therapy. Participants’ engagement in PA after a prostate cancer diagnosis was shaped by emotional, social, and structural factors. Two main thematic axes emerged: (1) how participants made sense of PA within their illness trajectory, and (2) how past experiences and representations of sport influenced their motivation and perceived ability to engage in PA. While active participants integrated PA into a narrative of self-management and control, inactive participants valued it primarily for social support and needed more tailored, supportive approaches. These findings suggest that PA promotion and interventions should consider individuals’ lived experiences, prior representations of PA. Personalizing support, particularly through PA promotion by healthcare professionals or peer-based strategies, may promote and sustainable PA engagement, ultimately improving quality of life and long-term health outcomes.
48. Comparison of Intramuscular and Intranasal Midazolam in Great Horned Owls (Bubo virginianus).
期刊: Journal of avian medicine and surgery 发表日期: 2025-Sep 链接: PubMed
摘要
There are few studies evaluating safe and effective sedatives for wild birds. Most sedatives are injectable drugs that are commonly administered intramuscularly (IM) or subcutaneously (SC); however, needle injuries occasionally occur from the bird struggling during the injection. Previous research in parrots and other bird species explored the effects of intranasal (IN) midazolam compared with IM administration; however, this delivery method has not been well studied in wild birds, such as raptors. To our knowledge, there is only 1 study that has been published evaluating midazolam IN in a raptor. In the present study, we compared midazolam sedation via IM and IN administration in great horned owls (Bubo virginianus; GHOW). Six GHOWs were randomly assigned to receive midazolam at 2 mg/kg IN or IM using a crossover study design. For each treatment type, sedation score, heart rate, respiratory rate, and muscle tone were recorded. Linear mixed models were used to interpret and compare the data. Results for both IN and IM treatments showed no significant difference in onset of sedation, overall muscle tone in the wings, legs, and jaw, heart rate, or respiratory rate over time. These data indicate that IN midazolam sedation at the same dose used IM is a viable option for sedation of GHOWs. Further research is needed for other species of raptors.
49. Post-pandemic planning for maternity care for local, regional, and national maternity systems across the four nations: a mixed-methods study.
期刊: Health and social care delivery research 发表日期: 2025-Sep 链接: PubMed
摘要
During the COVID-19 pandemic, significant reconfigurations were made to maternity care, to deliver this essential service while minimising the risk of infection for pregnant/post partum women and their infants, initially considered to be more vulnerable. This mixed-methods study had three work packages. Work package 1 used quantitative methods to analyse pregnancy outcomes over time, considering service reconfiguration and inequalities, using routinely collected maternity and offspring data from three diverse South London trusts. Work package 2 involved in-depth interviews with a diverse sample of pregnant/post partum women, partners, healthcare professionals and policy-makers, and used thematic framework analysis. Systematic reviews were undertaken of women’s experiences of receiving maternity care during the pandemic, and healthcare professionals’ experiences of providing that care. Questionnaires (October-December 2021 and August-September 2022) were administered nationally via the King’s College London COVID Symptom Study Biobank, to evaluate vaccine uptake among women who were planning pregnancy, pregnant or post partum. Work package 3 engaged stakeholders within maternity systems through regional Listening Events and a national Policy Lab. Among women of reproductive age (8 December 2020-15 February 2021), older age, white ethnicity and a lack of social deprivation were associated with higher vaccine uptake, although ethnicity exerted the strongest effect (Office for National Statistics data). Across pre-pandemic, pandemic with and pandemic without lockdowns, pregnancy outcomes, over time, largely followed pre-pandemic trends (record linkage, South London). However, virtual antenatal care in the second and third trimesters was associated with an excess of adverse pregnancy outcomes (and increased costs). Our systematic reviews of experiences of receiving (by women) or delivering (by healthcare professionals) maternity care during the pandemic identified the need for personalised care adapted to service users and communities, including those who are marginalised, and including provision of information; and co-design and coproduction of services with service users and staff, to reflect their collective lived experiences. This has the potential to improve workplace well-being for maternity care staff and facilitate inclusive and equitable care for service users. Interviews about COVID-19 vaccination in pregnancy identified a legacy of mistrust, lack of information, and confusing guidance that contributed to vaccine hesitancy for pregnant women during the pandemic. In our national survey, women of reproductive age (including pregnant/post partum women) reported being promptly vaccinated, but with angst and despite having received misinformation and discouragement from some healthcare professionals. Our programme’s findings, published literature and Listening Event discussions led us to focus our Policy Lab on how coproduction can be used in local health systems to substantially improve maternity care over the next 2 years. Participants identified barriers to success, set out their vision for what could be achieved and suggested possible actions to progress improvement at a local level. In our analysis of data for women of reproductive age (from the Office for National Statistics), we lacked data on other potential determinants of vaccination (such as previous COVID-19 or comorbidities). For analysis of pregnancy outcomes (work package 1), limitations include that our study population was only from South London, however diverse, and we did not adjust fully for multiple analyses; however, we consider that our results reflect a coherent pattern of the main processes operating. For our trajectories of virtual antenatal care analysis, a limitation is that those women assigned to the same trajectory are assumed to follow the same pattern of virtual antenatal care. Also, we defined virtual antenatal care as an appointment that was missing blood pressure, dipstick proteinuria and fetal heart rate (after 16 weeks’), without mention of self-monitoring of these parameters at home; however, if blood pressure had been recorded in the observations as part of ‘at-home’ monitoring during the COVID-19 pandemic, we will have underestimated the prevalence of virtual antenatal care. For our national survey, our participants were not diverse, reflecting the general demographic of ZOE (ZOE Limited, London, UK) app users, limiting generalisability of our findings. For our systematic reviews, we included only English-language papers, but our focus was on studies of the United Kingdom population which are highly likely to be published in English; regardless, no studies for this review were excluded based on language. Maternity care is currently in crisis in the United Kingdom. Adopting a maternity system through partnership between those receiving and delivering maternity care could provide solutions necessary to ‘build back better’, for now and for future health system shocks. Our findings suggest that maternity care provision, although altered substantially, largely preserved pregnancy outcomes, although experiences of care receipt and delivery were poorer. Costs may have been lower because less care was sought, although virtual (vs. face-to-face) care was more expensive. There is evidence to suggest that the current context of maternity care is of a demoralised and depleted workforce. Implementing a coproduction learning health system could offer needed solutions to improve maternity care delivery, experiences of care and workplace culture, building resilience to withstand future health system shocks. This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR134293. During the pandemic, many pregnant and postpartum women received virtual care and monitored their health at home. They faced a dilemma about COVID-19 vaccination due to limited information on its efficacy and safety; this decision was especially crucial for minority ethnic women, who had higher risks of severe illness from COVID-19. We aimed to find out how pregnant women and babies have been affected by maternity care changes due to COVID-19. We wanted to learn and ‘build back fairer’. Questions included: Were any changes useful, unwelcome, damaging or more costly? How were different groups affected? Can we learn to reduce inequalities in maternity care? Our project comprised three work packages: Work package 1: used maternity and mental health records from South London, comparing care (such as for gestational diabetes) and outcomes over time (such as caesarean birth), among different groups of women. With few exceptions, patterns of outcomes over time remained similar to how they were changing (or not) before the pandemic. However, virtual antenatal care was associated with more poor outcomes and higher costs (for minority ethnic group women). Work package 2: involved reviewing the literature, and conducting interviews and a national survey. First, our review of other studies of the experiences by women of receiving maternity care, or by healthcare professionals of providing that care during the pandemic, identified the need for personalised care. This means care that is tailored to the needs of service users and their communities, especially those who are often overlooked. This includes giving people clear information and working together with both patients and staff to design services that reflect their real-life experiences. By doing this, we may improve the well-being of maternity care staff and ensure that care is fair and inclusive for everyone. Second, our interviews – with women, partners and healthcare providers and leaders – identified a legacy of mistrust, lack of information and confusing guidance that contributed to vaccine hesitancy for pregnant women during the pandemic. Third, in our national survey, women of reproductive age (including pregnant/postpartum women) reported being promptly vaccinated, but with angst and despite having received misinformation and discouragement from some healthcare professionals. Work package 3: involved holding ‘Listening Events’ (discussions) and a national Policy Lab, collaborative workshop at which stakeholders work together to develop clear solutions that can be put into action. Our programme’s findings, published literature and Listening Event discussions led us to focus our Policy Lab on how coproduction between care users and care providers can be used in local health systems to improve maternity care. Throughout, we worked with our patient and public involvement and engagement advisory group. Our findings show that while pregnancy outcomes were largely unchanged, experiences of care suffered, and virtual care was more expensive. Maternity care is currently in crisis in the United Kingdom. Adopting a maternity system through partnership between those receiving and delivering maternity care could provide solutions necessary to ‘build back better’, for now and for future health system shocks.
50. Openness about sexuality predicts deferral policy noncompliance among recent MSM (men who have sex with men) blood donors: An exploratory analysis.
期刊: Transfusion 发表日期: 2025-Sep 链接: PubMed
摘要
Blood service providers use deferral policies to reduce the risk of transfusion-transmitted infections, but policy effectiveness depends on donors’ honesty in disclosing risk behaviors. Identifying specific social factors within men who have sex with men (MSM) may provide insight into noncompliance with sexual behavioral deferral criteria. We identified a sample of 136 recent blood donors from a large behavioral surveillance survey of MSM in New Zealand. Univariate analyses were used to identify factors associated with self-reported noncompliance before a two-step hierarchical regression assessed whether MSM-related social factors added to the prediction of noncompliance, compared to only considering background characteristics. Incorporating the MSM-related social factors significantly enhanced the model fit, explaining 23.2% additional variance in noncompliance (Nagelkerke R2 = 0.331, p = .002). Only MSM who were more open about their sexuality had increased odds of noncompliance (Odds ratio 5.25, 95% Confidence Interval 1.78-15.48, p = .003). Full-time employment remained a predictor of lower noncompliance in the final model (OR 0.19, 95% CI 0.05-0.69, p = .012). This exploratory evidence suggests that blood service providers should consider the broader social context, particularly openness about sexuality, in understanding noncompliance with time-based sexual behavior donor deferral criteria. This “outness” in MSM donors likely reflects confidence in making disclosure decisions based on their perceived HIV risk, challenging the notion that noncompliance necessarily arises from discomfort or lack of knowledge about policies. Future research should explore the gap between perceived risk and policy understanding to better address MSM donors’ complex decision-making processes.
51. Characterization of a population with pregnancy potential and anti-K alloimmunization in the United States.
期刊: Transfusion 发表日期: 2025-Sep 链接: PubMed
摘要
Maternal alloantibody formation against fetal blood cell antigens can lead to hemolytic disease of the fetus and newborn (HDFN), and anti-K alloimmunization has the potential to result in severe HDFN. Despite the benefits of prophylactic K-matched red blood cell transfusions demonstrated in other high-income countries, the United States lacks such a national policy for patients with pregnancy potential (PWPP). This study aims to characterize a population of PWPP impacted by anti-K alloimmunization in a large US academic medical system. Retrospective review was undertaken to identify all cases of anti-K alloimmunization among PWPP between August 1, 2021, and July 31, 2024, in the University of California, San Francisco (UCSF) network. Demographic, clinical, and transfusion data were collected from electronic medical records and the blood bank information system and reviewed by an interdisciplinary physician team. Over the 3-year study period, 150 anti-K results were reported for 69 unique PWPPs. The median age was 38 years (range: 11-50). Most PWPPs were not chronically transfused (32/39; 82% with ≤6 lifetime RBC units) and lacked identifiable alloimmunization-associated comorbidities (45/69; 65%). Thirty-seven (63%) of the PWPPs had red blood cell transfusions administered only at facilities outside of the UCSF network. Five of fifteen (33%) pregnancies following incident anti-K alloantibody identification resulted in healthy live births. Our results support reconsideration of a national policy of prophylactic K-matching or K-negative transfusion for people with pregnancy potential as a way to prevent further alloimmunization and improve clinical care in this population.
52. BCOR-Mutated Conventional and Dedifferentiated Chondrosarcoma: A Clinicopathologic Study.
期刊: Genes, chromosomes & cancer 发表日期: 2025-Sep 链接: PubMed
摘要
Conventional and dedifferentiated chondrosarcoma encompass a group of malignant neoplasms that produce cartilaginous matrix and arise within or on the surface of bone. Conventional chondrosarcomas are graded on a three-tiered scale, whereas dedifferentiated chondrosarcoma is typically not graded but is considered a high-grade sarcoma and represents the most aggressive subtype with a poor prognosis. IDH1 (isocitrate dehydrogenase-1) and IDH2 (isocitrate dehydrogenase-2) are the most commonly mutated genes in conventional and dedifferentiated chondrosarcoma, followed in frequency by COL2A1 and TP53. IDH1/2 driver mutations are also commonly found in enchondroma, considered a benign precursor lesion of chondrosarcoma, and other malignancies such as gliomas, cholangiocarcinoma, and acute myeloid leukemia. In acute myeloid leukemia, the presence of concurrent BCOR (BCL-6 corepressor) loss-of-function mutations has been linked to disease relapse and resistance to treatment with IDH inhibitors. After identifying an index case of conventional chondrosarcoma with unusually aggressive clinical evolution, we investigated the clinicopathological features of 12 cases of BCOR-mutated conventional and dedifferentiated chondrosarcomas against a control group of 15 BCOR-wildtype (WT) cases to determine whether BCOR-mutated tumors had patterns of biological progression different from tumors with intact BCOR. All identified BCOR alterations led to loss-of-function by either missense or nonsense mutations. The prevalence of BCOR mutations occurred in 5% of conventional and dedifferentiated chondrosarcoma, and these were associated with larger tumor size (p = 0.024), metastasis at the time of diagnosis (p ≤ 0.001) and higher T category (3-4 vs. 1-2) (p = 0.009). Although larger studies are necessary to clarify the full impact of BCOR mutations on patients with conventional and dedifferentiated chondrosarcoma, our data indicate that BCOR genetic aberrations are associated with adverse clinical features.
53. Impact of the Anti-Homosexuality Act on HIV service delivery in Uganda: Evidence from community-led monitoring.
期刊: Journal of the International AIDS Society 发表日期: 2025-Sep 链接: PubMed
摘要
In 2023, the Ugandan government enacted the Anti-Homosexuality Act (AHA), which included expanded and intensified criminal penalties for consensual same-sex relations. While arrests, harassment and violence have been reported, evidence of the AHA’s impact on HIV healthcare delivery is limited. Community-led monitoring (CLM) is an accountability mechanism that uses community-gathered evidence to advocate for improved healthcare quality and is well-positioned to describe changes in access and quality of care. Data from the CLM programme in Uganda were used to identify changes in healthcare delivery and use related to the AHA. As part of the CLM programme, routine survey data were collected from clients and managers in 320 public health facilities and 50 drop-in centres (DICs) from 2022 to 2024. Survey data were analysed using a difference-in-differences logistic model to measure changes in indicator measures before and after the AHA was signed into law. Seven semi-structured individual interviews were conducted with DIC facility managers, deductively coded and thematically analysed. In public health facilities and DICs, the proportion of respondents identified as men who have sex with men (MSM) declined significantly after AHA. In facilities, all categories of key populations (KPs) reported high levels of discrimination. After the AHA, MSM reported significant reductions in key HIV-related services compared to other populations, including lower rates of pre-exposure prophylaxis (PrEP) counselling, lower participation in support groups and having fewer friendly staff interactions. In DICs, all types of clients were less likely to be referred to health facilities, receive PrEP and find the DIC easy to access after the AHA was signed. DIC managers described experiencing harassment, violence and staffing challenges due to AHA, which they responded to by leveraging partnerships with local and global allies, providing virtual services, and seeking registration as full-service clinics. Data from the Uganda CLM programme provide an early view of the impact of the AHA on service delivery in public health facilities and DICs. While DICs and health facilities developed strategies to build resiliency and adapt, the AHA created significant barriers to care. These findings provide empirical warnings of the barriers experienced by KPs when accessing healthcare services in a criminalized context.
54. The Impact of a Personal Cancer Diagnosis on the Psychological Health of Adolescent/Young Adult Cancer Survivors: A Mixed Methods Study.
期刊: Psycho-oncology 发表日期: 2025-Sep 链接: PubMed
摘要
Adolescent/young adult cancer survivors (AYACS), describing people diagnosed with cancer between 15 and 39 years old across the cancer continuum, suffer from poor psychological health. Poor psychological health is associated with difficulty achieving professional goals, financial stress, and poorer health. The objective of this study was to use a mixed methods approach to understand AYACS’ perspectives on how a personal cancer diagnosis impacts psychological health. In this convergent mixed methods study, data from 35 AYACS participants were collected consisting of Patient Reported Outcomes Measurement Information System Anxiety and Depression measures, a sociodemographic survey, and semi-structured interviews. Mixed methods integration revealed the following for AYACS across the cancer continuum: (1) A need for proactive and longitudinal addressal of psychological health; (2) Promotion of social connectedness as a means of coping with illness; (3) A need for innovative and age-appropriate coping strategies; and (4) Promotion of resilience to help improve psychological health. This study provides direction for intervention development to improve psychological health.
55. Occurrence and Antimicrobial Resistance Profiles of Staphylococcus spp. Strains Isolated From Healthy Stray Dogs.
期刊: Veterinary medicine and science 发表日期: 2025-Sep 链接: PubMed
摘要
The potential role of stray dogs as reservoirs and disseminators of zoonotic antimicrobial-resistant pathogens to humans has long been underestimated. This study aimed to assess the occurrence of antimicrobial-resistant Staphylococcus spp. strains in the ear and nasal swabs collected from stray dogs housed at the Veterinary Hospital of Local Health Authority ASL Napoli 1 Centro. Out of 306 skin samples analysed, 256 bacterial strains were isolated using selective and differential media and identified through MALDI-TOF MS technology. The antimicrobial resistance profiles of the isolated strains were determined using the Kirby-Bauer disc diffusion method on Mueller-Hinton agar, testing susceptibility to 19 antimicrobials across 10 classes. Staphylococcus spp. was isolated in 46% of cases (119/256), with Staphylococcus pseudintermedius being the most prevalent species (50%; 59/119), followed by Staphylococcus simulans (17%; 20/119) and Staphylococcus aureus (14%; 17/119). The evaluation of the antimicrobial resistance profiles revealed a great circulation of methicillin-resistant strains in the stray dog population, as highlighted by the high levels of resistance recorded for penicillin (83.2%; 99/119), cefoxitin (72.3%; 86/119) and oxacillin (62.2%; 74/119). Notably, 85% (101/119) of the isolates were classified as multidrug-resistant, being resistant to three or more antimicrobial classes. These findings suggest that stray dogs may serve as important reservoirs of multidrug-resistant staphylococci, highlighting the need for ongoing surveillance and monitoring of antimicrobial resistance in these animals, especially in the context of the One Health approach that links human, animal and environmental health.
56. Bidirectional associations of problematic social media use and problematic gaming with mental health difficulties and strengths in adolescents: Sex and social support as potential moderators.
期刊: Journal of research on adolescence : the official journal of the Society for Research on Adolescence 发表日期: 2025-Sep 链接: PubMed
摘要
The evidence on the direction of associations between mental health and problematic social media use (PSMU) and problematic gaming (PG) in adolescents remains inconclusive. Therefore, this study investigated a comprehensive model of temporal associations between mental health difficulties and strengths, and PSMU/PG, while accounting for sex and perceived social support as potential moderators. Mental health domains were measured with the Strengths and Difficulties Questionnaire, PSMU was measured with the Social Media Disorder Scale, and PG with the Internet Gaming Disorder Scale, assessed at two time points (2019, 2021). The analysis sample consisted of 645 Dutch adolescents (63% boys; Mage = 15.8, SD = 0.3, at Time 1) from the Amsterdam Born Children and their Development cohort. Cross-lagged panel analysis did not indicate general bidirectional associations, but the multigroup analysis revealed separate temporal associations by sex and social support. In girls, emotional problems preceded PSMU and PG. In boys, PG preceded emotional problems and hyperactivity/inattention preceded PSMU. Adolescents with more perceived social support did not show a relationship between emotional problems and subsequent PG. We suggest that emotional problems may be a potential risk factor for PSMU/PG in girls, while they may be considered a negative consequence of PG in boys. Additionally, hyperactivity/inattention may be a risk factor for PSMU in boys, and social support may be a general protective factor for PG. These findings highlight the importance of understanding individual differences in the relationships between PSMU/PG and mental health symptoms.
57. Calciprotein Particles and the Mineral Buffering System of Blood: Preventing the Toxicity of Mineral Stress.
期刊: Journal of the American Society of Nephrology : JASN 发表日期: 2025-Aug-20 链接: PubMed
摘要
58. Beyond smoking: A geospatial investigation of factors associated with lung and bronchus cancer risk in Pennsylvania.
期刊: Social science & medicine (1982) 发表日期: 2025-Aug-14 链接: PubMed
摘要
While smoking is the leading cause of lung and bronchus cancer (LBC), additional exposures have been implicated and may explain the rise in LBC among never-smokers. To better understand the spatial distribution of LBC incidence and associated risk factors, this study aims to identify geographic areas with significantly elevated incidence rates in Pennsylvania and investigate the potential underlying risk factors. Using cancer registry data aggregated to the census tract level, spatial scan statistics were applied to detect areas of higher-than-expected LBC incidence across the state. Associations were then tested between census tract inclusion in a high-incidence area and eight area-level risk factors, including behavioral (e.g., smoking prevalence), environmental (e.g., PM2.5), built environment (e.g., traffic density, housing age), and socioeconomic (e.g., poverty, race) and occupational (e.g., construction work) characteristics. Twenty-two geographic areas of higher-than-expected LBC incidence were identified. Smoking rates, PM2.5, traffic density, old homes, and population density were found to be positively associated with inclusion in one of these areas. All high LBC areas had higher rates of smoking than the remainder of Pennsylvania, 20 were also high on PM2.5, traffic, or both; 19 had elevated rates of old housing. By evaluating multiple factors simultaneously, this study provides a more nuanced understanding of how exposures interact to shape geographic variation in LBC incidence. This multifactorial, spatially explicit approach also assesses whether area-based environmental and socioeconomic risks contribute to LBC burden independently of smoking rates, thus informing targeted prevention strategies and future research.
59. Coxsackievirus B3 Inhibited Colorectal Cancer by Upregulating miR-214-3P and Promoting Ferroptosis.
期刊: Cancer control : journal of the Moffitt Cancer Center 发表日期: 2025 链接: PubMed
摘要
IntroductionColorectal cancer (CRC) is the third most common cancer worldwide and a significant public health threat with far-reaching societal implications. The currently available CRC therapeutic strategies have limitations, thus requiring the development of new strategies. Coxsackievirus B3 (CVB3) exhibits strong oncolytic activity in CRC, although its mechanism of action remains unclear. This study aimed to investigate whether the induction of ferroptosis is a promising treatment strategy for CRC and whether CVB3 could activate ferroptosis during infection.MethodsIn vitro and in vivo experiments were conducted to evaluate whether CVB3 infection activates the ferroptosis pathway by upregulating miR-214-3p to suppress glutathione peroxidase 4 (GPX4) expression. Dual-luciferase assays and rescue experiments were performed to confirm this regulatory mechanism. Clinical CRC tissues and colon cancer xenograft models were used to demonstrate the mediating role of the miR-214-3p/GPX4 axis in the interaction between viral replication and ferroptosis.ResultsCVB3 demonstrated oncolytic virus properties by selectively lysing tumor cells. The in vitro and in vivo experiments confirmed that CVB3 activates the ferroptosis pathway by upregulating miR-214-3p to suppress GPX4 expression, thereby promoting viral replication and tumor regression. Antagonizing miR-214-3p reversed this process.ConclusionmiR-214-3p expression was upregulated during CVB3 infection of CRC tissues and cells, activating the ferroptosis pathway and promoting tumor cell death.