公共卫生研究摘要 (2025-09-15)
共收录 58 篇研究文章
1. Obituary Étienne-Émile Baulieu (1927-2025).
期刊: The Journal of steroid biochemistry and molecular biology 发表日期: 2025-Nov 链接: PubMed
摘要
2. A pragmatic randomized controlled pilot trial of brief meaning-centered psychotherapy in home care.
期刊: Cancer 发表日期: 2025-Sep-15 链接: PubMed
摘要
Individuals with advanced cancer receiving home health care experience elevated psychosocial and existential distress, yet few interventions address these concerns. This pilot randomized controlled trial examined the feasibility, acceptability, and preliminary efficacy of brief, nurse-delivered, meaning-centered psychotherapy in patients with advanced cancer compared with treatment as usual (TAU). Distressed patients (aged 18 years and older) were randomized 1:1 to receive either a three-session Meaning-Centered Psychotherapy for Hospitals, Hospice, and Home (MCP-H; n = 33) or TAU (n = 32). Feasibility was based on recruitment, retention, data completion, fidelity, and intervention engagement. Acceptability was based on patients’ and nurses’ ratings of MCP-H satisfaction. Preliminary efficacy was determined by changes in scores from baseline (T1) to 6 weeks (T2) and 10 weeks (T3) in meaning, and secondary outcomes were assessed using between-group analysis. Seventy-one patients enrolled. Feasibility was demonstrated by satisfactory recruitment (75% approach-to-consent rate; 92% enroll-to-randomize rate), retention (74% and 75% at T2 and T3, respectively), intervention engagement (94% completed 100% of the sessions), and treatment adherence (87% mean rating). Participants endorsed the intervention’s acceptability (96% satisfied or very satisfied). MCP-H participants experienced improvements in meaning using the Cohen’s d (d = 0.59 at T2; d = 0.39 at T3) and most other secondary psychosocial outcomes at 6 and 10 weeks compared with TAU participants. MCP-H is feasible and acceptable among patients with advanced cancer in home care. This intervention demonstrated promising evidence of clinical efficacy. A larger, fully powered randomized controlled trial is needed to test the efficacy of the intervention for patients, nurses, and health system outcomes against an active control group.
3. Clenbuterol induces lean mass and muscle protein accretion, but attenuates cardiorespiratory fitness and desensitizes muscle β2-adrenergic signalling.
期刊: The Journal of physiology 发表日期: 2025-Sep-14 链接: PubMed
摘要
The β2-adrenergic agonist clenbuterol is widely abused because of its purported fat-burning actions, muscle accretion properties and performance enhancing effects, and yet it remains unexplored in randomized controlled trials. In the present study, we subjected 11 healthy men (aged 18-40 years) to two 2 week cycles of oral clenbuterol (80 µg day-1) or placebo, separated by a 3 week washout. During each cycle, we assessed body composition, cardiorespiratory fitness, sprint power output, cardiac left ventricular mass and intravascular blood volume. We obtained vastus lateralis muscle biopsies and analysed them for protein content, 3-hydroxyacyl CoA dehydrogenase (HAD) activity, oxidative phosphorylation complex (OXPHOS) abundance, platelet endothelial cell adhesion molecule (PECAM-1) abundance and β2-adrenergic signalling. Compared to placebo, clenbuterol induced a 0.91 kg lean mass gain (95% confidence interval = 0.02-1.81, P < 0.05) but had no effect on fat mass. Clenbuterol reduced maximal oxygen uptake by 7% (P < 0.001) and exercise capacity by 4% (P < 0.001) but had no effects on sprint power output, left ventricular mass, intravascular blood volume or haemoglobin mass. Clenbuterol increased muscle protein content (P < 0.05) and PECAM-1 abundance (P < 0.05) but repressed HAD activity (P < 0.01) and OXPHOS complex V abundance (P < 0.05). Clenbuterol markedly activated muscle protein kinase A (P < 0.001) and phosphorylated ribosomal protein S6 (Ser235/236) but this effect declined during the 2 week cycle. Although a 2 week clenbuterol cycle effectively induces lean mass gain and muscle protein accretion, it negatively affects cardiorespiratory fitness, represses muscle oxidative capacity, and induces tolerance in β2-adrenergic signalling and ribosomal protein S6 phosphorylation. The adverse effects of clenbuterol along with its muscle anabolic actions justify its prohibition in elite sports. KEY POINTS: Clenbuterol, a potent β2-adrenergic agonist, has purported fat-burning and muscle accretion properties. However, its purported effects, along with its potential adverse effects on cardiorespiratory fitness, remain unexplored in humans. A short 2 week clenbuterol cycle induces lean mass gain and muscle protein accretion in healthy young men. Clenbuterol induces β2-adrenergic signalling and phosphorylates RpS6Ser235/236 in skeletal muscle, but this signalling response is attenuated with repeated exposure. Clenbuterol negatively affects cardiorespiratory fitness and represses muscle oxidative capacity. Clenbuterol does not affect left ventricular mass, intravascular blood volume or haemoglobin mass.
4. Efficacy of Acceptance and Commitment Therapy for Suicide and Self-harm: A Systematic Review and Meta-analysis.
期刊: Psychotherapy and psychosomatics 发表日期: 2025-Sep-14 链接: PubMed
摘要
Self-injurious thoughts and behaviors (SITBs) are major public health issues worldwide. In recent years, there has been a growing body of research investigating the application of acceptance and commitment therapy (ACT) for SITBs. This study systematically reviews and meta-analyzes the effectiveness of ACT in reducing SITBs. We systematically searched six databases and examined the reference lists of relevant studies. Studies that explored the effectiveness of ACT versus control conditions for reducing SITBs were included. Effect sizes were calculated using Hedges’ g with the random effect model. Subgroup analyses and meta-regression were also performed. A total of 48 studies (N = 4,719) were included in this review. The results indicated that ACT outperformed control conditions in alleviating suicide ideation (g = -0.64), suicide attempt (g = -0.66), self-harm (g = -1.53), non-suicidal self-injury (g = -0.59), and overall SITBs (g = -0.99) at post-treatment. Also, ACT was effective in reducing suicide ideation (g = -2.15), non-suicidal self-injury (g = -1.18), and overall SITBs (g = -1.52) at follow-up. Moderator analyses revealed that ACT was more successful in mitigating suicide ideation when delivered in a group format or in Eastern countries. Similarly, studies conducted in Eastern countries, or those employing direct interventions, reported greater efficacy in addressing overall SITBs. This review highlights the effectiveness of ACT in reducing SITBs and suggests that it may serve as a promising alternative strategy to standard treatment for SITBs. More high-quality and large-scale randomized controlled trials are required to substantiate our findings.
5. INTEGRATIVE SYSTEMATIC REVIEW ON PHARMACOLOGICAL, PSYCHOTHERAPEUTIC AND NEUROSTIMULATORY TREATMENT OPTIONS IN TREATMENT-RESISTANT ANXIETY DISORDERS.
期刊: Psychotherapy and psychosomatics 发表日期: 2025-Sep-14 链接: PubMed
摘要
Treatment resistance in anxiety disorders (TR-AD) constitutes a major clinical challenge conferring a considerable burden regarding quality of life and societal health costs. This systematic review provides an overview of pharmacological, psychotherapeutic and neurostimulatory treatment options in adults with treatment-resistant generalized anxiety disorder (TR-GAD), panic disorder (TR-PD) / agoraphobia and social anxiety disorder (TR-SAD). A total of 26 randomised controlled trials (RCTs) and 36 open label studies were identified, with, however, mostly small sample sizes and several methodological limitations. According to RCTs, selective serotonin reuptake inhibitors (SSRI) or clomipramine are effective in TR-PD after failure to respond to cognitive behavioral therapy (CBT). In pharmacological TR-SAD, switching from one SSRI to another or to venlafaxine was found helpful in open label trials. RCTs further suggest augmentation with quetiapine, risperidone, olanzapine or pregabalin in TR-GAD, pindolol in TR-PD and clonazepam in TR-SAD. Open label studies in TR-AD provide preliminary evidence for ketamine or augmentation with nefazodone, reboxetine, buspirone, aripiprazole, olanzapine, quetiapine, risperidone, ziprasidone, divalproex sodium, levetiracetam, zonisamide, flumazenil, pregabalin, cannabidiol and acamprosate. For pharmacological TR, CBT was effective in several RCTs. Following non-response to CBT, first evidence suggests effectiveness of Acceptance and Commitment Therapy and Mindfulness-Based Cognitive Therapy. Only inconclusive support was identified for repetitive transcranial magnetic stimulation (rTMS) in TR-AD. In summary, this integrative review may provide an evidence base for expert recommendations, inform clinical guidelines, and inspire further research into innovative, personalized treatment of TR-AD increasing response rates and lowering the considerable individual and public health burden of anxiety disorders.
6. Patient-controlled analgesia with droperidol and H1 antihistamine for prevention of postoperative nausea and vomiting after laparoscopic gynecological surgery: a retrospective cohort study.
期刊: Journal of anesthesia 发表日期: 2025-Sep-14 链接: PubMed
摘要
This study investigated the incidence and risk factors for postoperative nausea and vomiting (PONV) in patients receiving intravenous patient-controlled analgesia (IVPCA) with fentanyl, droperidol, and H1 antihistamine (PCA-DH) after laparoscopic gynecological surgery. Previous studies showed differing PONV incidence and risk factors between IVPCA containing droperidol (PCA-D) and that containing H1 antihistamine (PCA-H). This study aims to assess whether the combination alters incidence or risk profiles. We retrospectively analyzed patients who underwent laparoscopic gynecological surgery under general anesthesia and received PCA-DH. Multivariate logistic regression was used to evaluate associations between PONV and patient characteristics, anesthetic factors, and prophylactic antiemetic use. Among 3832 patients, the incidence of nausea, vomiting, and rescue antiemetic use was 14.6%, 4.0%, and 5.5%, respectively-lower than previously reported rates in PCA-D (36.6%, 17.6%, 17.7%) and PCA-H (26.5%, 8.7%, 11.0%). Additionally, the risk factors for PONV in PCA-DH differed from those identified in PCA-D and PCA-H studies. IVPCA with both droperidol and H1 antihistamine was associated with a reduced incidence of PONV. The findings suggest that this combination may effectively mitigate opioid-related PONV risk, and that risk factors may vary by IVPCA composition.
7. Evaluating the predictive potential of Th1 (IFN-γ+CD4+)/CD4+ in rapidly progressive amyotrophic lateral sclerosis.
期刊: Journal of neurology 发表日期: 2025-Sep-14 链接: PubMed
摘要
Th1 (IFN-γ+CD4+)/CD4+ cells exacerbate the release of pro-inflammatory cytokines, contributing to neuronal death. It is proposed that the peripheral immune system plays a pivotal role in the pathophysiology of amyotrophic lateral sclerosis (ALS). This study aims to develop an interpretable machine learning model based on blood Th1/CD4+ cells to predict rapidly progressive ALS. We enrolled 564 patients with sporadic ALS who met the eligibility inclusion criteria for further analysis. Immune cells and cytokines were quantified using flow cytometric cell counting and a flow cytometry-based fluorescent bead capture assay. Multivariate Cox proportional hazards models and restricted cubic spline analyses were applied to estimate the correlation between Th1/CD4+ cells and rapidly progressive ALS. The important variables identified through LASSO regression analysis were incorporated into the development of the machine learning model. The multivariate Cox proportional hazards model revealed that, compared to the low Th1/CD4+ group (Th1/CD4+ < 16.21), the high Th1/CD4+ group (Th1/CD4+ ≥ 16.21) was positively associated with the rate of ALS progression (HR: 1.90, 95% CI: 1.34-2.70). Th1/CD4+ is also associated with the decline in forced vital capacity (r = 0.11, P = 0.01). The machine learning model was built using Th1/CD4+ in combination with the other 4 features. Xgboost performed best in the validation cohort, achieving an AUC of 0.804 and a G mean of 0.756. Th1/CD4+ (with an optimal cutoff value of 16.21) was established as an independent risk factor for rapid progression in ALS. The machine learning model incorporating Th1/CD4+ demonstrated strong predictive performance. The prospective cohort study is registered with the Chinese Clinical Trial Registry (ID: ChiCTR2400079885) ( http://www.chictr.org.cn/ ).
8. Enhanced biodegradation of fluorinated pharmaceutical by Aspergillus flavus and Cunninghamella elegans biofilms: kinetics and mechanisms.
期刊: Biodegradation 发表日期: 2025-Sep-14 链接: PubMed
摘要
The increasing occurrence of pharmaceutical compounds in aquatic environments poses significant ecological and public health challenges due to the persistence and bioaccumulation potential. While Aspergillus flavus and Cunninghamella elegans have demonstrated efficacy in removing heavy metals and dyes, their potential for pharmaceutical bioremediation remains unexplored. This study investigated these fungi capacity to degrade three persistent fluorinated pharmaceutical-atorvastatin (ATO), ciprofloxacin (CIP), and fluoxetine (FLX), through an innovative biofilm-based approach. Using polyurethane foam (PUF) as a carrier in two different configurations (fixed foam (PUF-F) and moving foam (PUF-M)), the performance of both fungal species was evaluated. C. elegans biofilms on PUF-F demonstrated high removal efficiencies of 97.3% for ATO and 97.7% for CIP, while A. flavus achieved 92.4% FLX reduction in the same system. Notably, the biofilm-based systems consistently outperformed carrier-free cultures, confirming the advantage of immobilized fungal growth. Kinetic analysis indicated pseudo-first-order degradation with remarkably short half-lives (1.0-1.7 days), surpassing reported values for white-rot fungi. Although adsorption contributed minimally (< 10%) to overall removal, species-specific biofilm characteristics emerged as key factors: C. elegans exhibited superior surface hydrophobicity (0.76) and stress resistance, whereas A. flavus developed denser extracellular matrices. These findings highlight the potential of tailored fungal biofilm systems for efficient removal of recalcitrant pharmaceutical, presenting a promising biological solution for wastewater treatment applications. The study provides critical insights into species-specific degradation mechanisms and operational parameters that could guide the development of scalable fungal bioremediation technologies.
9. Pantinin-Derived Peptides against Veterinary Herpesviruses: Activity and Structural Characterization.
期刊: ChemMedChem 发表日期: 2025-Sep-14 链接: PubMed
摘要
Animal viral infections represent a growing public health concern, as animals serve as reservoirs for pathogens, threatening food safety, biodiversity, and human health. In response, novel antiviral strategies are urgently needed. This study investigates the antiviral activity and structural properties of two antimicrobial peptides, pantinin-1 and pantinin-2, both derived from the venom of the scorpion Pandinus imperator, against caprine herpesvirus 1 (CpHV-1) and bovine herpesvirus 1 (BoHV-1). The results obtained from the plaque reduction assay and the quantitative real-time polymerase chain reaction (PCR) indicate that synthetic pantinin-mimetic peptides exhibited potent antiviral effects at concentrations ranging from 6-25 µM, impairing viral infectivity through direct virucidal action and inhibition of the viral entry and fusion with host cell. To characterize their structural behavior, nuclear magnetic resonance spectroscopy is performed in aqueous and membrane-mimetic environments (trifluoroethanol (TFE)/H2O). In aqueous solution, both peptides predominantly adopted random coil conformations, with pantinin-2 showing greater secondary structure propensity. In TFE/H2O, both peptides transitioned to α-helical structures, which are often associated with membrane interaction and antiviral activity. These findings demonstrate that pantinin-1 and pantinin-2 possess promising antiviral properties, supporting their potential development as therapeutic agents against herpesviruses and other animal viral infections.
10. [Defining the concept and potential roles of patient organizations in Hungary].
期刊: Orvosi hetilap 发表日期: 2025-Sep-14 链接: PubMed
摘要
Magyarországon sokféle betegszervezet működik, melyek küldetésükben, szervezettségükben, ellátott feladatukban jelentősen eltérnek. Számos olyan betegszervezeti funkció van, amelynek sikeres ellátásához, illetve egyesek – különösen a döntéshozatalban való részvételi, valamint a betegképviseleti feladatok – gyakorlásához szükség van a betegszervezetek kereteinek pontosabb meghatározására. A betegszervezetek részvételi és képviseleti feladatainak sikeres ellátásához szükséges a szervezeti keretek meghatározása, a fogalom tartalmának rögzítése. Célunk egy megalapozott definíció megalkotása és a betegszervezetek lehetséges feladatainak összegyűjtése. A munkacsoport a definíció meghatározásához a témában megjelent célzott irodalomkutatás keretében áttekintett tudományos publikációkat vette alapul, kiegészítve térségünk tagországainak jogszabályi példáival. A szerzők konszenzusos alapon fogalmazták meg a betegszervezetek általuk javasolt definícióját, valamint a témához illeszkedő betegszervezeti feladatokat. A szerzők által javasolt definíció szerint a betegszervezet olyan önsegítő, önkéntes alapon szerveződő, független és nonprofit bejegyzett egyesület vagy alapítvány (amennyiben irányítótestületének tagjait választják), amelynek fő tevékenysége a betegek segítése, jogainak és érdekeinek védelme, valamint hozzátartozóik és a hozzájuk hasonló személyek életkörülményeinek javítása önkéntesek és más, a társadalmi felelősségvállalásban elhivatott személyek segítségének igénybevételével. További feltétel, hogy tagsága és vezetősége – alapítvány esetében az irányítótestülete – többségében személyükben érintett betegekből és/vagy azok hozzátartozóiból álljon, akiknek döntő befolyást kell gyakorolniuk a szervezet gazdálkodására, működésére, és többségben kell lenniük a legfelsőbb és az irányítótestületben. Tudomásunk szerint ez az első olyan hazai kutatás, amely tudományos igénnyel és módszerekkel kívánja megalkotni a betegszervezetek magyarországi definícióját. Az azonosított fogalmi keretrendszer illeszkedik a vizsgált országokban megalkotott definíciókhoz. A jelen kutatás keretében megalkotott definíció és meghatározott feladatok mentén lehetőség nyílik arra, hogy a betegszervezetek transzparensen működő, valós felhatalmazással bíró érdemi érdekképviseleti szervként jelenjenek meg egyes egészségügyi döntéshozatali folyamatok során. Orv Hetil. 2025; 166(37): 1443–1455.
11. The SWI/SNF chromatin remodeling complex subunit BAF53B as an immunohistochemical marker for neuroendocrine neoplasms.
期刊: Human cell 发表日期: 2025-Sep-14 链接: PubMed
摘要
The Switch/Sucrose Nonfermentable (SWI/SNF) complexes are chromatin remodeling factors that consist of multiple protein subunits. Each subunit plays a distinct role in gene regulation and is aberrantly expressed in tumors, such as neuroendocrine neoplasms (NENs). BRG1-associated factor 53B (BAF53B), which is also known as ACTL6B, is a neuron-specific subunit that acts as a regulator during neurogenesis. Because the BAF53B expression pattern in tumors is unknown, the present study investigated the expression in cell lines and tissues. Publicly available transcriptome data indicated that BAF53B mRNA was highly expressed in NEN-derived cell lines. We performed immunohistochemical staining on tissue microarrays of different types of NENs with neuroendocrine (NE) marker expression (n = 117) (small cell lung carcinoma (SCLC)lung carcinoid (LC), gastroenteropancreatic-NEN (GEP-NEN), esophageal neuroendocrine carcinoma (ENEC), medullary thyroid carcinoma (MTC), neuroblastoma (NB), and pheochromocytoma (PHEO)) and non-NENs (n = 178). While few positive cells were observed in many cases of non-NENs (e.g., lung adenocarcinoma), positive expression was found in cases of NENs (SCLC (14/19, 73.7%), LC (12/16, 75.0%), GEP-NEN (4/9, 44.4%), ENEC (1/2, 50.0%), MTC (24/27, 88.9%), NB (18/20, 90.0%), and PHEO (16/24, 66.7%)). In NCI-H889 cells, BAF53B knockdown did not affect the cellular viability, and its effect on NE marker expression was only marginal. However, a gene expression microarray analysis suggested that BAF53B-regulated genes were associated with the development and progression of NENs. Our analysis revealed that BAF53B was an immunohistochemical marker for specific NENs, indicating its potentially important role in the pathogenesis.
12. Determinants of severe COVID-19 in vaccinated adults: a study from southern Brazil (2021-2023).
期刊: Pathogens and global health 发表日期: 2025-Sep-14 链接: PubMed
摘要
Despite the effectiveness of vaccination in preventing severe COVID-19, some individuals remain at risk. The study goal was to determine risk factors for COVID-19 requiring hospital admission. A case-control study was conducted in Porto Alegre, Brazil. Vaccinated adults with confirmed SARS-CoV-2 infection from February 2021 to March 2023 were eligible. Hospitalized patients (cases) and outpatients with non-severe infections (control group) were time-matched in a 1:1 ratio. Moreover, we followed hospitalized patients (cases) to evaluate factors related to 30-day mortality and/or ventilation support. We included 364 patients: 182 cases and 182 controls. Age > 60 years (odds ratio [OR] 3.98 [95% confidence interval{CI} 2.23-7.19]), male sex (OR 3.07 [95%CI 1.78-5.40]), diabetes mellitus (OR 4.61 [95% CI 2.08-11.08]), cardiovascular disease (OR 4.07 [95%CI 1.73-10.64]), lung disease (OR 3.06 [95%CI 1.39-6.94]), obesity (OR 3.39 [95%CI 1.29-9.73]), and previous infection (OR 0.19 [95%CI 0.06-0.51]) were independently related to COVID-19 hospital admission. In the arm of hospitalized patients, the number of vaccine doses (OR 0.53 [95%CI 0.39-0.73]) was a protective factor against 30-day mortality and/or ventilation support, whereas obesity (OR1.62 [95%CI 1.19-2.20]) was a risk factor. Health policies should consider focusing on these risk populations for targeted interventions, such as additional boosters, early treatment and prophylaxis.
13. The effects of e-cigarette use on asthma severity in adult BALB/c mice.
期刊: Experimental physiology 发表日期: 2025-Sep-14 链接: PubMed
摘要
Electronic cigarettes (e-cigarettes) are often perceived to be a less harmful alternative to tobacco cigarettes. Potentially due to this perception, they are used by people with pre-existing respiratory conditions, such as asthma, who otherwise would not smoke. Despite this, there are few studies exploring the health effects of e-cigarette use on pre-existing asthma. In this study, a house dust mite-induced allergic-airways disease phenotype was generated in adult BALB/c mice over 7 weeks. For the last 2 weeks of this period, mice were also exposed to either medical air, or tobacco smoke or e-cigarette aerosol (with or without nicotine) for 2 h/day. Twenty-four hours later, respiratory parameters including lung volume/function and responsiveness to methacholine were assessed. Biological samples were taken for analysis of pulmonary cellular inflammation and mediator levels, serum IgE and lung/airway structure. There were complex effects of exposure on respiratory outcomes. For example, tobacco smoke-exposed mice of both sexes were the most responsive to methacholine but had suppressed total cellular and eosinophilic inflammation. Female e-cigarette aerosol-exposed mice had impaired parenchymal mechanics at functional residual capacity compared with tobacco smoke-exposed mice, irrespective of nicotine. Interferon γ levels were suppressed in both e-cigarette-exposed groups. There was no effect of any exposure on IgE or lung structural parameters. E-cigarette aerosol exposure exacerbated aspects of an allergic airways disease phenotype in mice. This suggests that asthmatics should exercise increased caution if thinking of using e-cigarettes.
14. Work Practices and Respirable Crystalline Silica Exposures in Stone Countertop Fabrication Shops.
期刊: American journal of industrial medicine 发表日期: 2025-Sep-14 链接: PubMed
摘要
Reports of silicosis among US workers who fabricate and install stone countertops are increasing. Our aim was to better characterize work processes, stone type, occupational health practices, and exposures to respirable crystalline silica (RCS) in this industry. A survey was administered to stone countertop fabrication shops to assess shop characteristics, controls, and operations. Shops were asked to share past RCS air monitoring reports. We examined associations between RCS concentrations and stone type, similar exposure groups (SEG), and engineering controls in multivariate models, and RCS exposures by shop. Of 257 shops surveyed, 98% reported processing both natural and engineered stone (ES), utilizing semi-automated equipment and small hand tools, and a variety of control methods. Only 42% of shops that required the use of a respirator reported conducting respirator fit testing, and only 19.5% performed medical surveillance. A total of 47% of shops reported RCS air sampling, with 38% submitting 292 RCS air samples used for this analysis. Overall, the RCS geometric mean (GM) was 14.1 μg/m3, with 75.7% of RCS samples below the US Occupational Safety and Health Administration (OSHA) action limit (AL). However, RCS levels were highly variable (range 2.8-5100.0 μg/m3), with 9.2% of RCS samples exceeding the OSHA permissible exposure limit (PEL), and 43.5% shops 1 or more samples above the OSHA AL. Use of small hand tools with no controls produced the highest RCS exposures, and dry work had significantly higher RCS exposures than any control method. The findings underscore the extensive use of ES and the opportunity for overexposure to RCS in this industry. They highlight the need to eliminate dry processing methods, enhance respiratory protection, and perform repeated RCS sampling to monitor the effectiveness of controls. Additionally, more widespread medical surveillance is urgently needed to assess the extent of silicosis in this industry.
15. Acceptance of chikungunya vaccination: a rapid survey in Reunion island during an epidemic.
期刊: Vaccine 发表日期: 2025-Sep-13 链接: PubMed
摘要
During the 2025 chikungunya outbreak in Réunion Island, two vaccines-IXCHIQ (live-attenuated) and VIMKUNYA (virus-like particle)-received European Union authorization; a local campaign began in April 2025 and was temporarily adjusted for older adults after safety concerns. We assessed vaccine acceptability at the outbreak onset among residents, focusing on people with comorbidities. In January 2025, a cross-sectional web survey yielded 918 complete responses (mean age 44.5 years; 13.1 % prior chikungunya; 53.4 % healthcare workers). Acceptability was highest in the hypothetical full-reimbursement scenario (60.5 %) and was lower among women and those with prior chikungunya; healthcare workers were more likely to accept vaccination. In the hypothetical clinical-trial and self-financed scenarios, acceptability declined to 35.5 % and 20.1 %, respectively, with the same pattern of predictors. Comorbidities showed no significant association. Financing and implementation context, together with gender differences, were key drivers of uptake at the beginning of 2025 outbreak.
16. Exploring Facilitators and Barriers for Personalized Dietary Incentives Among Online Shoppers at Cardiovascular Risk and Key Informants to Inform an Automated Shopping Platform.
期刊: Journal of nutrition education and behavior 发表日期: 2025-Sep-13 链接: PubMed
摘要
To identify preferences, facilitators, and barriers to healthy eating and using a personalized diet application (Smart Cart 2.0) for online grocery shopping. Convergent, parallel multimethods study among shoppers (aged > 18 years, grocery shopped online with obesity [body mass index, 30 kg/m2] or hypertension, n=20) and public health professional key informants (n = 11). Online surveys (shoppers only) and in-depth interviews using mock-up application images queried preferences, facilitators, and barriers. We synthesized quantitative and qualitative data for thematic analysis. The most common barriers (25%) were money and time, while health motivated most food purchases (55%). Four themes emerged from interviews: (1) consuming healthy foods was hard, (2) healthy meal planning would be easier with a one-stop shopping tool, (3) the application addressed shoppers’ needs, and (4) some additions could promote application sustainability. Smart Cart 2.0 addressed healthy eating barriers. Integrating feedback will enhance application design for future evaluation.
17. Barriers and enablers to childhood immunization in high zero-dose burden communities in Kano and Lagos states, Nigeria.
期刊: Vaccine 发表日期: 2025-Sep-13 链接: PubMed
摘要
Reducing the number of zero-dose children in Nigeria requires a context-specific understanding of the factors driving under-immunization at individual and community levels. This study identifies barriers and enablers to immunization uptake among caregivers of children under two in high-burden zero-dose communities in Kano and Lagos States, Nigeria. We followed a qualitative methods approach, conducting 40 focus group discussions (FGDs) among caregivers in the urban communities of Ungogo and Alimosho in Kano and Lagos states, respectively, peri-urban communities of Gezawa in Kano state and rural communities of Ikorodu in Lagos state. Vignettes, gender analysis, and concept-testing of interventions were integrated into the FGD guides to minimize social desirability and explore gendered factors. FGDs were pretested, translated into local languages, audio-recorded, transcribed, and back-translated into English. Thematic analysis was performed using NVivo software. We identified high recognition of the importance of childhood immunization among our study communities, despite inadequate immunization uptake. The main barriers to immunization uptake found in this study were gender-skewed decision-making in childhood vaccination between caregivers, prevalent misconceptions about immunization, prioritization of unmet socio-economic needs over immunization, and past negative experiences with immunization and health services. Enablers included effective community mobilization, involvement of religious and traditional leaders, positive attitudes of well-trained health workers, reliable fixed and outreach immunization services, and material incentives for caregivers. Caregivers preferred community-based strategies, especially those engaging community and religious leaders. While similar barriers and enablers are inherent in global vaccine rejection, two-way community engagement for collective action, vaccination awareness campaigns, and engagement of cultural and traditional leaders, including fathers, offer promising strategies for improving immunization uptake in Nigeria.
18. Impact of nirsevimab immunoprophylaxis on respiratory syncytial virus-related outcomes in hospital and primary care after two consecutive seasons: a population-based retrospective cohort study in infants in their second year of life in Catalonia, Spain.
期刊: European journal of pediatrics 发表日期: 2025-Sep-13 链接: PubMed
摘要
To analyse the effect of nirsevimab immunoprophylaxis on RSV-associated outcomes after two consecutive epidemic seasons in infants born and Living in Catalonia, Spain. We conducted a population-based retrospective cohort study including all infants born in Catalonia between April 2023 and March 2024. We established two cohorts (immunised with nirsevimab and non-immunised). We estimated adjusted cumulative incidences (CInc) curves for RSV-associated hospital admissions, paediatric intensive care unit (PICU) admissions, emergency department (ED) visits for bronchiolitis, and RSV infections and bronchiolitis registered in primary care from October 2023 to mid-February 2025 using inverse probability-weighted Kaplan-Meier methods. Marginal risk differences and risk ratios (RR) with 95% confidence intervals (95%CI) were calculated at the end of the first RSV season (January 15, 2024), beginning of the second season (October 1, 2024), and end of the second season (February 16, 2025). As a secondary analysis, we estimated adjusted hazard ratios (aHR) during the second RSV season (October 2024 to mid-February 2025) using Cox proportional hazard models. Among 51,154 infants, 45,971 (89.9%) were immunised with nirsevimab just before or during their first RSV season. After two RSV seasons, the CInc of severe outcomes remained substantially lower in the immunised group. By the end of the study period, the CInc of hospital admissions was 9.57 per 1,000 infants (95%CI: 7.92-11.20) in the immunised group and 35.56 per 1,000 (95%CI: 25.69-47.58) in the control group (RR: 0.27, 95%CI: 0.20-0.40); and for PICU admissions, 1.90 vs. 9.08 per 1,000 (RR: 0.21, 95%CI: 0.11-0.48). Primary care infection rates were also lower in the immunised group (13.78 vs. 16.96 per 1,000), although the difference was not statistically significant (RR: 0.81, 95%CI: 0.57-1.29). No statistically significant differences were observed in aHR across any outcomes during the second season. After two consecutive epidemic seasons, nirsevimab immunization provides protection against severe RSV-associated outcomes, with a significant reduction observed during the first season without increasing the risk of severe disease during the second. • Nirsevimab, a long-acting monoclonal antibody, was approved in 2023 to prevent severe respiratory syncytial virus (RSV) infections in the first seasonal exposure to the virus. • It has demonstrated high effectiveness in real-world studies in preventing RSV-associated hospital admissions in infants during their first season. • Our study provides evidence that nirsevimab reduces severe RSV-associated outcomes during the first season without increasing the risk of more severe disease in the second season. • After two years we still found lower rates of hospital and PICU admissions in the nirsevimab group, despite a slightly increased RSV infection rate among immunised infants during the second season, but with reduced severity.
19. Trends in US Adolescent Use of Vaping and Flavored Solutions for Marijuana Consumption, 2021-2024.
期刊: The Journal of adolescent health : official publication of the Society for Adolescent Medicine 发表日期: 2025-Sep-13 链接: PubMed
摘要
To document recent, national trends in vaping and use of flavored vaping solutions among US adolescents who use marijuana. Data come from Monitoring the Future, which conducted annual, cross-sectional, nationally-representative surveys from 2021 to 2024 of eighth, 10th, and 12th grade students. Among adolescents who used marijuana in the past 12 months, the percentage who vaped it increased over the study period from 48% to 57% in eighth grade (p < .05), 60%-66% in 10th grade (p = .07), and 58%-67% in 12th grade (p < .01). The percentage of adolescents who used a flavored solution when vaping marijuana switched from a minority to a majority over the study period, from 47% to 63% (p < .01) in eighth grade, 41%-53% (p < .01) in 10th grade, and 36%-50% (p < .01) in 12th grade. The percentage of all adolescents who vaped a flavored marijuana solution in the past 12 months over the study period increased from 2% to 4% (p < .01) in eighth grade, 5%-6% in 10th grade (p = .25), and 7%-9% in 12th grade (p < .01). The percentage of US adolescents who vaped flavored marijuana solutions increased from 2021 to 2024, one of very few drug outcomes that increased since the pandemic onset. With this increase, adolescents who used flavors to vape marijuana shifted from a minority to a majority and vaping became more common among adolescents who used marijuana. These results point to flavored marijuana vaping solutions as an increasingly important target for research and policy on adolescent marijuana use.
20. Impact of the location of the initial admitting intensive care unit on the delivery of extracorporeal membrane oxygenation in Australia and New Zealand.
期刊: Anaesthesia and intensive care 发表日期: 2025-Sep-13 链接: PubMed
摘要
Extracorporeal membrane oxygenation (ECMO) is a method of life support provided in a limited number of (typically centralised) intensive care units (ICUs) which may lead to inequity in the delivery of ECMO. We conducted a retrospective cohort study of all ICU admissions in Australia and New Zealand reported to the Australian and New Zealand Intensive Care Society Adult Patient Database between 2018 and 2022. We performed descriptive and propensity-matched analyses to determine how healthcare jurisdiction, remoteness, and initial admitting hospital type (based on ECMO capability) affected the chance of receiving ECMO. There were 703,529 patients at 199 hospitals who met inclusion criteria, of whom 1654 (0.2%) received ECMO. After propensity matching, patients had a reduced odds of receiving ECMO if admitted in the Australian Capital Territory (odds ratio (OR) 0.54, 95% confidence interval (CI) 0.34 to 0.86), New Zealand (OR 0.42, 95% CI 0.26 to 0.67), Northern Territory (OR 0.29, 95% CI 0.1 to 0.86), Queensland (OR 0.53, 95% CI 0.45 to 0.63) or Western Australia (OR 0.46, 95% CI 0.35 to 0.62) compared with New South Wales. Patients from Outer Regional areas were less likely to receive ECMO than those residing in a Major City (OR 0.77, 95% CI 0.63 to 0.94). Initial admission in a non-ECMO centre was associated with reduced odds of receiving ECMO (OR 0.60, 95% CI 0.52 to 0.69), whilst initial admission in a Major ECMO centre was associated with increased odds of receiving ECMO (OR 2.03, 95% CI 1.78 to 2.31), compared with Minor ECMO centres. Our study suggests there is inequity in the delivery of ECMO in Australia and New Zealand, which should inform policy and planning for ECMO provision throughout the region.
21. Correction: Navigating the crossroads of health and wealth: socioeconomic inequality in flu vaccination uptake among the elderly in Iran.
期刊: BMC geriatrics 发表日期: 2025-Sep-13 链接: PubMed
摘要
22. Upper Body Rotation for Obstacle Avoidance in Individuals With Stroke With Different Degrees of Upper Extremity Paralysis.
期刊: Motor control 发表日期: 2025-Sep-13 链接: PubMed
摘要
Individuals with stroke have difficulty adapting their walking to their environment; the upper extremity on the paretic side is particularly prone to colliding with surfaces when walking through openings. We aim to investigate how individuals with stroke with different levels of upper extremity motor paralysis rotate each part of their upper body for safe obstacle avoidance. Participants included eight, 17, and 19 individuals in the moderate (MDR), mild (MLD), and control groups, respectively. Participants were asked to walk through door-like openings of four different widths without colliding with them. Each participant performed the task by entering either from the paretic side or the nonparetic side. To examine the effects of the group, entering direction, and opening width on rotation angles we conducted a statistical analysis using a Generalized Linear Mixed Model. For the head angle, the main effect of group was significant (p = .011). Post hoc multiple comparisons showed that the angle was significantly larger in the MDR than that in the MLD and control groups (both p < .001). Shoulder and hip rotation angles did not differ significantly between groups. Although some interaction effects between the group and opening width were observed, no consistent interaction patterns were found across body segments. The results were interpreted in terms of motor difficulty and visual attention. Therefore, individuals with stroke who had moderate upper extremity paralysis may have rotated their heads at higher angles due to difficulty with movement adjustments and increased visual attention demands.
23. 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.
24. Impact of preoperative body mass index on postoperative outcomes in infective endocarditis: a multicenter analysis of 4801 consecutive patients.
期刊: International journal of obesity (2005) 发表日期: 2025-Sep-13 链接: PubMed
摘要
The impact of body weight disorders on outcomes of patients undergoing cardiac surgery for infective endocarditis (IE) have been poorly studied. Obesity or malnutrition may significantly influence the course and prognosis of endocarditis, driven by distinct comorbidities and microbiological profiles. Hence, we investigated the impact of preoperative body mass index (BMI) on postoperative outcomes in a large multicentric cohort of surgically treated IE patients. Data from the Clinical Multicenter Project for Analysis of Infective Endocarditis in Germany (CAMPAIGN) registry (n = 4917) was used for retrospective analysis. The patients were divided into four groups for comparison according to their BMI: (1) underweight (≤18.5 kg/m2), (2) normal-weight (18.6-24.9 kg/m2), (3) overweight (25.0-29.9 kg/m2), (4) obesity (≥30.0 kg/m2). Patients with incomplete data on body weight or height were excluded (n = 116). The primary outcomes were 30-day and 1-year mortality. The final study cohort comprised 4801 patients, including 133 underweight patients (2.8%), 1884 normal-weight patients (39.2%), 1797 patients with overweight (37.4%), and 987 patients with obesity (20.6%). The mean age in the entire cohort was 65.0 [54.0-73.0] years. Patients with obesity had more comorbidities, including hypertension (63.0%; p < 0.001), diabetes mellitus (45.7%, p < 0.001), coronary artery disease (29.5%; p < 0.001), previous cardiac surgery (32.2%, p < 0.012) and dialysis-dependent chronic kidney disease (11.6%, p < 0.001). Patients with obesity had the highest prevalence of staphylococcal endocarditis (33.4%; p < 0.001), while underweight patients had more streptococcal infection (22.0%; p < 0.001). Patients with obesity had the worst 30-day and 1-year mortality rates after surgery for IE (14.1% and 19.6%, p < 0.001 and p < 0.001 respectively). IE patients with obesity present with comorbidities, higher 30-day mortality and lower 1-year survival rates, possibly linked to more frequent staphylococcal infections and comorbidities. This emphasises the need for early risk stratification, enhanced infection prevention and improved perioperative care in patients with obesity.
25. Corrigendum to: A Clinical Tool to Relate Youth Risk Factors to Adult Cardiovascular Events and Type 2 Diabetes: The i3C Consortium J. Pediatr. 2025 Jan;276:114277.
期刊: The Journal of pediatrics 发表日期: 2025-Sep-12 链接: PubMed
摘要
26. AHA's new PREVENT 10-year cardiovascular risk and all-cause, CVD, and non-CVD mortality among US adults: The NHANES 2003-2019.
期刊: Hipertension y riesgo vascular 发表日期: 2025-Sep-12 链接: PubMed
摘要
The relationship between the American Heart Association’s (AHA) new Predicting Risk of cardiovascular disease EVENTs (PREVENT) risk and long-term disease progression, like mortality, is unresolved. We investigated the associations of PREVENT cardiovascular disease (CVD) risk with all-cause, CVD, and non-CVD mortality among adults in the US. This cohort study used data from 30,544 adults from 2003-2018 survey cycles of the National Health and Nutrition Examination Survey and linked to the mortality data until 2019. All-cause mortality, further stratified into CVD and non-CVD mortality, were defined by the leading cause of death using the International Classification of Diseases codes. Employing PREVENT’s base model and component variables, we estimated 10-year total CVD risk stratified into low (<5%), borderline (5-7.4%), intermediate (7.5-19.9%), and high (≥20%). Multivariable Cox proportional hazards regression (hazard ratio [HR] and 95% confidence interval [CI]) analyses were used. Participants’ mean±SD age was 50.3±13.1 years, with a balanced sex distribution. Compared to individuals with low CVD risk, those with borderline and intermediate risks had a greater risk of all-cause mortality (HR [95% CI], 1.08 [1.03-1.13] and 1.12 [1.08-1.16], respectively). Those with borderline, intermediate, and high risks had a greater risk of CVD mortality (HR [95% CI], 1.11 [1.06-1.16], 1.21 [1.18-1.25], and 1.40 [1.33-1.47], respectively), compared to low-risk individuals. Similar trends were observed for non-CVD mortality. With significant racial/ethnic group-interactions, the associations were evident in Mexican Americans. Higher PREVENT 10-year CVD risk is associated with higher risk of all-cause, CVD, and non-CVD mortality, and the associations differ by race/ethnicity.
27. Interventions to address inequities in infant mortality and morbidity in the NICU and beyond: A focus on the mother-infant dyad.
期刊: Seminars in perinatology 发表日期: 2025-Sep-12 链接: PubMed
摘要
In 2022, United States infant mortality increased for the first time in over 20 years, driven largely by deaths due to maternal complications and preterm birth, and highlighted significant racial/ethnic and socioeconomic inequities in both infant mortality and morbidities. This underscores the relationship between maternal and infant health outcomes. This article presents a framework for understanding the mother-infant dyad using an adaptation of the socio-ecological model and focuses on patient and family factors, provider and healthcare system factors, community factors, and policy and societal factors that perpetuate inequities in infant outcomes. The neonatal intensive care unit (NICU) is a driver of inequities, but also provides critical, yet underutilized, opportunities for intervention. Strategies to promote physical, emotional, social, and financial well-being of mothers and infants include NICU-based lactation and mental health support, culturally responsive care, screening for social determinants of health, and engagement of families in care and quality improvement. Beyond the NICU, broader structural and policy changes are essential, including equitable access to risk-appropriate care, paid family leave, comprehensive health insurance, and investments in community partnerships. Addressing these drivers of inequity through coordinated healthcare, policy, and community action can better support the mother-infant dyad and improve the well-being of all families.
28. Use of prothrombin complex concentrates in liver transplantation: a systematic review and meta-analysis.
期刊: British journal of anaesthesia 发表日期: 2025-Sep-12 链接: PubMed
摘要
Liver transplantation (LT) can be a high transfusion procedure. Frozen plasma (FP) is widely used despite mixed efficacy and safety data. Several centres perform LT with no or low volume of FP by using prothrombin complex concentrate (PCC). This systematic review and meta-analysis characterises the existing efficacy and safety data of PCC use in LT. This review was registered (PROSPERO CRD#42024561866). MEDLINE, Embase, Cochrane, and ClinicalTrials.gov were searched from inception to 30 May 2024. Studies in adults undergoing LT where PCC exposure was reported in relation to clinical outcomes were included. Random effects models were used to obtain pooled effect estimates. All studies were retrospective, with seven reporting the number of patients receiving PCC [392/1901 (21%)], and one grouping patients receiving different factor concentrates together [576/939 (61%)]. Patients receiving PCC had worse preoperative coagulopathy, model for end-stage liver disease scores, and comorbidities. Patients exposed to PCC had a comparable mean number of red blood cell (RBC), plasma, or platelet units transfused. Use of viscoelastic testing-based algorithms incorporating PCC compared with usual care was associated with reduced odds of RBC exposure (odds ratio [OR]: 0.53, 95% confidence interval [CI]: 0.32-0.86, I2=0%) and FP exposure (OR: 0.35, 95% CI: 0.13-0.92, I2=50%), but not platelets. Safety outcomes were driven by one large study using PCC as rescue therapy. Although there are no randomised trials comparing use of PCC vs FP in LT, their efficacy and safety appear comparable. Higher-quality studies are needed to assess PCC use for coagulopathic bleeding in LT.
29. The major role of the REL2/NF-κB pathway in the regulation of midgut bacterial homeostasis in the malaria vector Anopheles gambiae.
期刊: Cell reports 发表日期: 2025-Sep-12 链接: PubMed
摘要
Multicellular organisms harbor diverse microbial communities that play essential roles in host physiology. While often beneficial, these interactions require tight regulation to prevent dysbiosis and disease. This study examines the tissue-specific immune responses of mosquitoes to blood feeding and Plasmodium falciparum infection in Anopheles females. We demonstrate that REL2 regulates the expression of antimicrobial peptide genes and shapes midgut bacterial composition post-blood meal. Loss of REL2 leads to midgut dysbiosis, characterized by the overgrowth of Serratia spp., and mosquito lethality after blood feeding. Interestingly, Serratia-induced dysbiosis also reduces P. falciparum prevalence in surviving mosquitoes. Our findings highlight the critical role of the immune system in maintaining midgut bacterial homeostasis and uncover complex interactions between mosquito immunity, gut microbiota, and malaria parasites.
30. Characterization of humoral and cellular immunity induced by mRNA vaccines expressing norovirus VP1 proteins in mice and nonhuman primates.
期刊: Molecular therapy : the journal of the American Society of Gene Therapy 发表日期: 2025-Sep-12 链接: PubMed
摘要
Noroviruses are a leading cause of acute gastroenteritis across all age groups, associated with ∼18% of diarrheal disease globally. Infections span a broad clinical spectrum, ranging from asymptomatic and self-limiting illnesses to hospitalizations and deaths. No preventative vaccines or targeted therapies are currently available. In this study, we designed vaccine candidates containing mRNAs encoding norovirus VP1 proteins of genotypes GI.1, GII.2, GII.3, GII.4, and GII.6, and evaluated their immunogenicity in mice and nonhuman primates (NHPs). In mice, all five mRNAs, dosed separately or together, elicited serum IgG antibodies that bound to norovirus virus-like particles (VLPs), serum antibodies that blocked the binding of VLPs to histo-blood group antigens (HBGA), and norovirus-specific T cell responses. In NHPs, a pentavalent vaccine candidate induced strong humoral and cellular immune responses against each genotype included in the vaccine. Furthermore, compared to VLPs, mRNAs induced similar levels of humoral and cellular responses and comparable levels of durability, as measured by serum antibody titers. Our results indicate that a multivalent mRNA vaccine candidate encoding norovirus VP1 proteins is immunogenic in preclinical models and is a promising candidate to be evaluated in clinical trials.
31. New nicotine products and vascular risk.
期刊: Hipertension y riesgo vascular 发表日期: 2025-Sep-12 链接: PubMed
摘要
Tobacco use is the leading cause of preventable diseases, disability, and death in Spain, causing 56,124 deaths annually, one-third of which are due to cardiovascular disease. The aim of this study is to review the relationship between the use of novel products and vascular risk and other health risks, as well as their impact on cessation and harm modification. Searches were conducted in PubMed, Tripadatabase.com, Truth Tobacco, Industry Documents, and Tobacco Tactics. There is some evidence that the harm of these products is less than the individual harm by cigarettes at vascular, cardiorespiratory, and metabolic levels. There is no evidence that replacing cigarettes with novel nicotine products reduces overall harm because: (a) they promote dual smoking in most users; (b) they increase vulnerability to relapse; (c) they delay or prevent cessation of nicotine addiction; and (d) they facilitate the transition to tobacco use in minors.
32. Magnitude and determinants of underreporting needlestick injuries among healthcare workers in a tertiary care hospital.
期刊: Infection, disease & health 发表日期: 2025-Sep-12 链接: PubMed
摘要
Needlestick injuries (NSIs) among healthcare workers (HCWs) represent a major occupational risk. While the underreporting of NSI is well-acknowledged, there are limited data on its magnitude. The objective was to estimate the incidence of NSIs and the degree of underreporting among HCWs and their influencing factors. A cross-sectional study was carried out at a large tertiary care hospital. The study targeted clinical HCWs who were directly involved in patient care in different departments/units. Non-clinical HCWs and students/trainees were excluded. Data were collected using a structured online questionnaire that includes HCWs characteristics and injury information. A total of 529 HCWs were included. The mean age of HCWs was 35.0 ± 8.6 years. Most HCWs were females (76.6 %), nurses (69.8 %), and non-Saudi (61.9 %). A total of 158 (29.8 %) HCWs had at least one NSI event sometime during healthcare service, including 28 (5.3 %) during the last year. NSIs were highest in dental clinics (44.4 %), followed by surgical wards (38.8 %), ICUs (34.1 %), emergency unit (21.4 %), and non-surgical wards (18.2 %, p = 0.007). Out of those who had NSIs, 18.4 % did not report their event. Non-reporting was highest among physician and other HCWs (38.5 % each), followed by dentists (27.3 %), and lastly nurses (10.2 %). Additionally, non-reporting NSIs was significantly higher among Saudi HCWs and those who were unaware about protocol and methods of NSIs reporting. The findings show a considerable underreporting of NSIs, especially among non-nursing professions. There is an urgent need to implement strategies that promote reporting practices, including awareness campaigns and efficient reporting systems.
33. Frontline mental resilience: Lessons learned from the pandemic experience.
期刊: Australasian emergency care 发表日期: 2025-Sep-12 链接: PubMed
摘要
The COVID-19 pandemic affected frontline Healthcare Workers (HCWs) immensely, subjecting them to extreme psychological distress. The current study assesses the burnout, anxiety, depression, PTSD, and resilience levels among HCWs and analyses the efficacy of institutional mental health interventions. A cross-sectional longitudinal study design that combined quantitative surveys and qualitative interviews was employed. There were 500 HCWs from public hospitals, private hospitals, primary healthcare centres, and emergency response teams who took part. Validated measures included the Maslach Burnout Inventory (MBI), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), PTSD Checklist (PCL-5), and Connor-Davidson Resilience Scale (CD-RISC). Descriptive statistics, chi-square tests, t-tests, and logistic regression were used in data analysis. Psychological distress was common, with 42.5 % burnout, 35.2 % anxiety, 29.8 % depression, and 21.4 % PTSD. Long hours (OR = 1.85, p < 0.001), high patient volume (OR = 1.67, p < 0.001), and absence of PPE (OR = 1.52, p = 0.002) were major contributors, and robust workplace support (OR = 0.75, p = 0.037) was protective. Qualitative interviews revealed key themes, including persistent sleep disturbances, Mental Health Support, Emotional and Social consequences, Impact on relationships and fear of infecting family members. HCWs experienced extreme psychological distress throughout the pandemic, which requires additional mental health policies, organizational support, and greater access to digital interventions.
34. Association between driving status and visiting places among older adults in a suburban area in Japan: Findings from a cross-sectional survey.
期刊: Geriatric nursing (New York, N.Y.) 发表日期: 2025-Sep-12 链接: PubMed
摘要
Driving is an important mobility resource for increased outings and social activities among older adults; however, little is known about the impact of driving restrictions on visiting places. This study examined whether visiting places differ according to driving status and whether the association is modified by alternative transportation use. We included a total of 432 community-dwelling individuals aged ≥65 years (mean age, 74.8 years; 52.8 % women) with functional independence from a suburban area through a mailed self-administered questionnaire. Multivariable regression analysis revealed that not driving was associated with fewer visiting places, especially for consumer, administration, and self-care places, and social, cultural, and spiritual places. Public transportation availability (trains and buses) moderated the association between not driving and visiting places. The findings suggest that driving restrictions have the potential to reduce visiting places among older adults, particularly life-related, social, and cultural places.
35. Public Health in the Age of TikTok: A Content Analysis of Measles Narratives.
期刊: International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 发表日期: 2025-Sep-11 链接: PubMed
摘要
This cross-sectional study aimed to analyze TikTok content related to measles. TikTok videos tagged #measles were sampled by selecting the first 100 results. Using a structured codebook, videos were classified by source, tone, vaccination stance, content focus, target audience, and Vitamin A mention. Engagement metrics were analyzed using t-tests or Wilcoxon rank-sum tests for binary predictors and two-way ANOVA for source-tone interactions. Analyses were conducted in Excel and RStudio. The 100 TikTok videos tagged with #measles in this sample garnered over 30 million views, with experts producing 44% of them. Expert-created videos received significantly more views, likes, favorites, and comments than non-expert ones, and tone was linked to differences in saves, with an expertise-tone interaction affecting comments. Most coded content features, such as conspiracy theories, policy mentions, side effects, or Vitamin A, appeared in fewer than 5% of videos and showed no significant relationship to engagement. Two-way ANOVAs confirmed that comments were the only metric significantly influenced by the interplay between expertise and tone, with no other meaningful interactions observed. These results highlight the importance of credible messengers and carefully chosen tone to maximize audience engagement with measles-related content on TikTok. Future research is needed to determine whether such engagement translates into changes in vaccine attitudes or behaviors.
36. Does home COVID-19 testing bias COVID-19 vaccine effectiveness estimates?
期刊: American journal of preventive medicine 发表日期: 2025-Sep-11 链接: PubMed
摘要
COVID-19 home testing became widely available in early 2021. Care seeking for acute respiratory illness (ARI), and COVID-19 vaccine effectiveness (VE) estimates may be affected by home testing. In a test-negative case-control study, between January-May 2022, U.S. Flu VE Network outpatients were asked about their home COVID-19 testing before seeking care for ARI and were laboratory tested for SARS-CoV-2. Associations among home testing, care seeking and COVID-19 VE were assessed using multivariable logistic regression. Among 2,614 enrollees, home COVID-19 testing was significantly associated with current (≤6 months) COVID-19 vaccination (adjusted odds ratio (aOR=1.70; 95%CI=1.19-2.42); cough (aOR=1.69; 1.22-2.34) and having a college degree or higher (aOR=1.67; 1.37-2.03) and negatively associated with a prior positive COVID-19 test. COVID-19 illness was associated with cough (aOR=3.07; 2.04-4.61), contact with a COVID-19 case (aOR=2.41; 1.93-3.0), home testing (aOR=1.87; 1.53-2.29) and negatively associated with a prior positive COVID-19 test. In unadjusted modeling with only the association between current vaccination and COVID-19 infection, the OR was 0.77 (95% CI=0.66, 0.92); adjusting for patient race/ethnicity, age, days from onset to enrollment, prior COVID-19 illness and study site, the aOR was 0.65 (0.55, 0.78); estimated VE=35% (95%CI=22%-45%). Adding home testing to this adjusted model, VE was 37% (95%CI=13%-46%). Among patients who home tested, VE was 31% (13%-46%) versus 43% (24%-57%) among patients who did not. Patients reporting home testing for COVID-19 before seeking outpatient care for ARI differed from patients not using home tests, which could affect estimates of COVID-19 VE in some populations.
37. Association between Ambient Air Pollution and Renal Function Indicators: A Comprehensive Systematic Review and Meta-analysis.
期刊: Environmental research 发表日期: 2025-Sep-11 链接: PubMed
摘要
Ambient air pollution is an emerging environmental risk factor for chronic kidney disease (CKD). Recognizing that changes in renal function indicators are critical markers for diagnosing and grading CKD and other kidney diseases, this meta-analysis aims to assess the associations of ambient air pollution with key renal function indicators. A comprehensive search up to September 27, 2024, was conducted across four databases (i.e., PubMed, Web of Science, Scopus, and Embase). Eligible studies were required to report the associations of ambient particulate matter (PM1, PM2.5, PM10), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide (SO2), carbon monoxide (CO) with key renal function indicators (including eGFR, estimated glomerular filtration rate; SCr, serum creatinine; BUN, blood urea nitrogen; UA, uric acid; CysC, cystatin C) and to provide quantitative estimates of these associations. The primary meta-analyses were conducted involving 32 studies with adults (n = 3,022,895) as participants. Long-term PM2.5, PM10, and NO2 exposures were linked to decreased eGFR, with pooled percent changes of -0.90% (95%CI: -1.71%, -0.08%), -1.05% (95%CI: -1.67%, -0.42%), and -0.43% (95%CI: -0.78%, -0.08%) every 10 μg/m3 increase in these air pollutants, respectively. Meanwhile, long-term PM2.5 exposure (per 10 μg/m3) was also linked to elevated SCr (0.87%, 95%CI: 0.83%, 0.92%) and UA (1.07%, 95%CI: 0.31%, 1.84%). Furthermore, short-term PM2.5 exposure (per 10 μg/m3) was linked to lower eGFR (-0.57%, 95%CI: -1.03%, -0.10%) and higher BUN (2.17%, 95%CI: 1.08%, 3.28%). Our study highlights the potential detrimental impacts of ambient air pollution on kidney function.
38. Challenges and Opportunities of Read-Across for the Tumor Promotion Effects of Microcystins.
期刊: Regulatory toxicology and pharmacology : RTP 发表日期: 2025-Sep-11 链接: PubMed
摘要
The microcystins (MCs) are a family of cyclic oligopeptides toxins expressed in at least 30 cyanobacterial species and are liable to pose significant hazard to human health due to hepatotoxicity. Microcystin-leucine arginine (MC-LR) is the most extensively studied and toxic congener and classified as possibly carcinogenic to humans based on tumor promotion activity in the liver. Given the substantial toxicity data gaps for the MCs, read-across was assessed to evaluate the tumor promotion effects of a series of data-poor MC congeners based on in vivo information for MC-LR as the source molecule. Lines of evidence from in silico estimates of structural similarity, physico-chemical properties, hepatotoxicity, genotoxic and carcinogenicity were compiled to support the filling of data gaps. Uncertainties were evaluated according to scenario 4 of the European Chemicals Agency’s (ECHA’s) Read-Across Assessment Framework (RAAF). The read-across process followed a harmonized framework previously proposed to apply the common principles together with new approach methodology (NAM) information. Lines of evidence showed consistency across the MC congeners and the uncertainties were found to be acceptable for data gap filling. Read-across strategies, with known caveats and restrictions, were shown to be applicable for large, complex molecules such as the MCs.
39. In Vitro Evaluation of Ibrexafungerp Against Clinical and Environmental Isolates of Cryptococcus neoformans and Cryptococcus gattii.
期刊: Journal of global antimicrobial resistance 发表日期: 2025-Sep-11 链接: PubMed
摘要
40. Temporal dynamics of pathogen removal and faecal source tracking in a Norwegian nature-based solution/system treating urban waters.
期刊: Environmental research 发表日期: 2025-Sep-11 链接: PubMed
摘要
Nature-based solutions (NBS) have been broadly adopted to strengthen water and wastewater sanitation by effectively removing microbial pollutants and limiting significant health risks to aquatic environments and humans. However, temporal variations of pathogen removal efficiencies in NBS and the specific link with faecal pollutants remain understudied. In this study, a Norwegian urban NBS operating as a nature-based treatment system (NBTS) for water purification was monitored on pathogen removal capacities and faecal source tracking through a 1-year study. Applying coupled molecular analyses, i.e., pathogen molecular detection and genetic microbial source tracking, enabled the systemic assessment of this NBTS’s remediation performance while unveiling the intrinsic link between pathogen prevalence and the faecal pollution sources. Notably, the system exhibited stronger pathogen attenuation activity on Enterococcus faecalis, Salmonella enterica serovar Typhimurium, Clostridium perfringens, and Legionella pneumophila (linked closely to human origin in the studied NBTS) than Shigella species and Giardia lamblia sourced mainly from animals. Moreover, the studied system displayed temporal dynamics of its functioning. As such, more fluctuations often occurred in cold months than in the warm period and under varying impacts of measured environmental conditions (i.e., water temperature, pH, electrical conductivity, dissolved oxygen, total dissolved solids, salinity, and oxidation reduction potential). Collectively, the findings of this study consolidate the functional potential of NBS in combating the microbial pollution that results specifically from waterborne enteric pathogens in a tight link with faecal contamination. The disclosed performance seasonality also calls for extra consideration for better-informed system management and remediation enhancement. Last but not least, the holistic study outcomes underscored the explicit value of applying complementary molecular approaches to achieve deeper insights into the functional status of a target NBS over time.
41. QSAR Model for Pesticide Toxicity in Bioluminescent Vibrio qinghaiensis sp.-Q67.
期刊: Environmental research 发表日期: 2025-Sep-11 链接: PubMed
摘要
Quantitative structure-activity relationship (QSAR) is a computational approach that correlates chemical structural features with biological activity, enabling toxicity prediction without prior knowledge of nonspecific toxicological modes of action. Despite its potential, the application of QSAR models to predict pesticide toxicity in Vibrio qinghaiensis sp.-Q67 (Q67), a photobacterium, remains underexplored. In this study, we developed QSAR models to assess the toxicity of 11 pesticides detected in the dietary pesticide residue exposure of the Chinese population toward Q67. Molecular descriptors were computed using DRAGON 6.0, followed by principal component analysis and descriptor screening via a variable selection method incorporating leave-one-out (LOO) cross-validation (VIPLS). A robust seven-descriptor QSAR model was established and internally and externally validated using 41 toxicity datasets by Y randomization and cross-validation, respectively. The model demonstrated stable predictive performance for the acute toxicity of the 11 pesticides on Q67. Based on the similarity calculation between the predicted compounds and the training set compounds (K nearest neighbor method), the toxicity predictions generated by our QSAR model are within the defined domain of application. Additionally, we summarized the toxicity of these pesticides using pEC50 as the toxicity index, revealing a toxicity range of 2.88-6.66 μg/L. The toxic effects exhibited either time-dependent or time-independent patterns. By comparing the QSAR descriptors across different organisms, including Q67 bacteria, it was revealed that pesticide toxicity to aquatic organisms is fundamentally linked to the electronic polarization and van der Waals forces of the pesticides.
42. Hispolon reduces mitochondrial dysfunction and improves fibrosis of diabetes nephropathy by activating AMPK signal and inhibiting mPTP opening.
期刊: Cellular signalling 发表日期: 2025-Sep-11 链接: PubMed
摘要
Diabetic nephropathy progression is linked to the AMPK/SIRT1/PGC-1α signaling pathway. Hispolon’s potential in improving mitochondrial function and treating diabetic nephropathy via this pathway was unclear. This study used db/db mice and high glucose-induced SV40 MES 13 cells to explore Hispolon’s renoprotective mechanisms. In vivo, db/db mice showed glomerular damage, collagen deposition, glycoprotein accumulation, and elevated serum creatinine and urea nitrogen. Hispolon intervention improved these features and parameters. It reduced renal MDA levels, enhanced SOD activity, suppressed pro-inflammatory mediators, and downregulated fibrosis markers. Western blot analysis showed Hispolon restored p-AMPK, SIRT1, and PGC-1α protein levels. In vitro, Hispolon enhanced cell viability, inhibited apoptosis, and reversed high glucose-induced oxidative stress and inflammation in SV40 MES 13 cells. It improved mitochondrial energy metabolism by restoring mitochondrial membrane potential, increasing ATP production, and inhibiting abnormal mPTP opening. Mechanistic studies confirmed that the AMPK/SIRT1/PGC-1α signaling cascade is key for Hispolon’s regulation of mPTP dynamics. In conclusion, Hispolon slows diabetic nephropathy progression by activating the AMPK/SIRT1/PGC-1α pathway, inhibiting mPTP opening, and improving mitochondrial dysfunction.
43. Climate change and mental health: announcing a new Lancet Psychiatry Commission.
期刊: The lancet. Psychiatry 发表日期: 2025-Sep-10 链接: PubMed
摘要
44. Unexpected arsenic compound in routine determination of arsenic species in urine.
期刊: Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS) 发表日期: 2025-Sep-10 链接: PubMed
摘要
A validated method of anion exchange liquid chromatography coupled to inductively coupled plasma mass spectrometry (LC-ICP-MS) was applied to determine arsenic species in human urine, particularly for occupational and environmental health investigations. In addition to the chromatographic peaks of arsenobetaine (As-B), dimethylarsinate (DMA), methylarsonate (MA), As(III) and As(V), which occur regularly, we have observed an additional As peak overlapping with that of As(V) in several routine analyses. Further investigations identified this unknown As compound as p-arsanilic acid, which had contaminated the urine samples due to application of a test strip for rapid determination of certain clinical parameters before shipment of the samples to the laboratory. It is essential that urine samples for trace element analysis do not come into contact with test strips, an important prerequisite that is not always considered in subsequent occupational biomonitoring.
45. Reliability and minimal detectable change for inertial measurement units - Derived stability, symmetry, and smoothness indexes of gait in people with multiple sclerosis.
期刊: Gait & posture 发表日期: 2025-Sep-09 链接: PubMed
摘要
people with multiple sclerosis (PwMS) experience loss of gait stability, smoothness, and symmetry, which affects quality of life and requires accurate evaluation for effective rehabilitation. Inertial measurement units (IMUs) offer a promising approach to monitor gait quality by quantifying indices reflecting stability, symmetry, and smoothness whose minimal detectable changes (MDCs) are not defined in people with MS (PwMS). to assess the within-day test-retest reliability and MDCs of IMUs - derived gait stability, symmetry, and smoothness metrics in PwMS during the 10 m walking test (10MWT). 58 PwMS wore five IMUs and performed the10MWT twice with a 10 min rest between each trial. Log dimensionless jerk (LDLJ) and improved Harmonic Ratio (iHR) were calculated for each gait trial based on the signals from the pelvis - mounted IMU, normalized Root Mean Square (nRMS) were calculated also from the head and sternum-mounted IMUs. Intraclass correlation coefficient (ICC) were calculated between the results of the two 10MWT to assess test -retest reliability, and minimal detectable change scores were calculated. Reliability of the investigated parameters ranged from moderate to excellent values, with ICC ranging from 0.64 to 0.98. MDC values ranged from 0.09 to 0.53 for the nRMS, from 7.54 to 11.36 for the iHR and from 0.15 to 0.20 for the LDLJ. This study showed moderate to excellent reliability for the investigated indexes when calculated based on 10MWT, with the LDLJ showing the highest reliability, thus providing a reliable smoothness metric in pwMS. Also, nRMS showed good reliability, but caution is warranted with iHR due to its lower reliability and higher MDCs.
46. Advances in aptasensors engineered with carbon nanomaterials for food safety monitoring.
期刊: Advances in colloid and interface science 发表日期: 2025-Sep-08 链接: PubMed
摘要
Today, the smart sensing platforms concept has been programmable with multiplexed desired target emitters with the emergence of ultra-sensitive diagnosis on nanochip, lab-on-a-chips, and three-dimensional printed devices supporting decision-making with artificial-intelligence. Since carbon nanomaterials such as carbon nanotubes, carbon dots, carbon nanofibers, graphene, and carbon nitride etc., have unique properties such as high selectivity, specificity, and sensitivity, biocompatibility and sustainability, low or non-toxicity, ideal recognition and binding affinity, user-friendliness, variety, ease of preparation or use, and easy tunability, scalability, and modification compared to other nanomaterials, aptasensors decorated with carbon nanomaterials are being considered to monitor and audit food safety and quality control, environmental, bio/nanotechnology, and medicine to detect various targets like biomarkers, heavy metals, antibiotics, pesticides, allergens, and other contaminants. This review paper comprehensively and specifically investigates the characteristics, synthesis, and immobilization of aptasensors based on carbon nanomaterials. The use and integrity of carbon nanomaterials-functionalized aptasensors on portable and electronic devices (microfluidic chip/smartphone) for the tracking and analysis of different hazardous materials, targets, and biomarkers are also covered in this paper. Finally, it addresses how carbon nanomaterials -functionalized aptasensors may be used to monitor and identify targets in the environment and food chain. Therefore, commercialization and industrialization of carbon nanomaterials -functionalized aptasensors as “Lab-on-chip” systems facilitate the tracking and monitoring of hazardous materials/contaminants and various targets in the food chain and environment for consumers and beneficiaries using portable smart electronic tools. Nevertheless, to overcome possible limitations in the construction and introduction of multifunctional carbon nanomaterials -functionalized aptasensors with the capability to use in complex matrices as rapid, portable, and user-friendly, as well as disposable, online/offline and integrated sensors to detect and monitor hazardous material/targets is necessary, which has been highlighted in this study.
47. 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.
48. The Treatment Profile of Migraine in India: A Glimpse of the Real World Scenario.
期刊: Neurology India 发表日期: 2025-Sep-01 链接: PubMed
摘要
Migraine is a highly prevalent, disabling disease of the brain. Despite the availability of migraine-specific medications, it is undertreated across the world. This study reports the real-world scenario regarding the treatment patterns of migraine in India. We conducted a cross-sectional study of 400 persons with migraines, fulfilling the ICHD-3 criteria. The demographic details, history of headache, disability, and treatment details, including pathways to care, were collected. The majority (77.3%) of those with migraine were females, unemployed (64%), and reported a mean age of 37.2 ± 11.5 years. The median duration of migraine was 24 months. The most common diagnosis was episodic migraine (57.3%), and the remaining cases were chronic migraine. Only 11 (<3%) among the 400 patients disclosed visiting a Complementary and Alternative Medicine (CAM) practitioner. The majority of the patients (72.5%) routinely used balms and oils for acute pain relief. The most common abortive medications were naproxen, frequently in combination with domperidone, and/or paracetamol. Among the patients with a high frequency of episodic migraines, only 25% were on adequate prophylaxis. This study describes the pattern of acute and preventive treatment of migraine in a large sample of patients with migraine attending a tertiary care center. After identifying the gaps and comparison them with international literature, we suggest that awareness programs targeting pharmacists, as well as the education and empowerment of healthcare professionals at the grassroots level, may be required to tackle the challenges posed in the management of migraine.
49. Postoperative delirium after short-acting spinal anesthesia and general anesthesia after shared decision-making.
期刊: The Journal of international medical research 发表日期: 2025-Sep 链接: PubMed
摘要
ObjectivePrevious studies have shown that the postoperative delirium rate does not differ between anesthetic techniques in randomized controlled trials. Subjective concerns such as anxiety and pain are often not adequately addressed in randomized controlled trials and reported to be associated with postoperative delirium. Shared decision-making is reported to have an impact on anxiety and pain. Therefore, the aim of this study was to evaluate the effect of shared decision-making while making a choice between spinal and general anesthesia on postoperative delirium incidence.MethodsThis prospective, observational, two-armed cohort study included 192 patients who underwent lower extremity, lower abdominal, pelvic, or perineal short-time surgery that lasted <90 min. The three-talk shared decision-making model was used to make the choice for the type of anesthesia. Depending on the shared decision-making process, either spinal anesthesia with short-acting local anesthetics (prilocaine hydrochloride or chloroprocaine hydrochloride) or general anesthesia was performed according to a standardized protocol including intraoperative electroencephalogram monitoring. Patients’ anxiety and pain levels were measured before and after the surgery using validated scales.ResultsBased on their shared decision-making choice of anesthesia, 97 patients were allocated to the spinal anesthesia group and 95 to the general anesthesia group. Postoperative delirium occurred less frequently after spinal anesthesia (2.1%) than after general anesthesia (16.8%; p < 0.001). No postoperative delirium was observed in patients who received only spinal anesthesia, as chosen using the shared decision-making model (spinal anesthesia: 0%, general anesthesia 16.8%; p < 0.001). Anxiety and pain levels did not differ between the two groups.ConclusionsThe incidence of postoperative delirium was lower in patients who were administered spinal anesthesia than in those who were administered general anesthesia after using a shared decision-making approach. Integrating patients’ perspectives and treatment preferences might change postoperative outcomes and should be taken into consideration in future trials.Trial registration: clinicaltrials.gov: NCT03715244https://clinicaltrials.gov/study/NCT03715244?intr=NCT03715244&rank=1.
50. Urbanisation Facilitates Intrapopulation Dietary Niche Diversity in a Generalist Carnivore.
期刊: Ecology letters 发表日期: 2025-Sep 链接: PubMed
摘要
The niche variation hypothesis predicts that members of generalist species are specialists, and that the degree of individual specialisation correlates positively with resource diversity. Urban landscapes are highly heterogeneous in resource distribution; therefore, we predicted urbanisation would be associated with narrower individual dietary niches and greater differentiation among individuals of generalist species. We used stable isotope analysis to compare diets of urban and nonurban coyote (Canis latrans) populations in San Francisco and Marin County, California, USA. Urban coyotes had dietary niches nearly three times narrower than nonurban coyotes and greater among-individual variation in isotope values. Within-individual differences explained 18% of total δ13C variation in urban coyotes compared to 58% in nonurban coyotes, and 34% versus 44% of δ15N variation, indicating stronger individual specialisation in the urban population. Our findings suggest urbanisation facilitates intrapopulation dietary niche diversity by spatially structuring foraging, highlighting the role of human activity in promoting ecological diversification.
51. 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.
52. 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.
53. Nutritional Heterogeneity of Dietary Proteins: Mechanisms of Gut Microbiota-Mediated Metabolic Regulation and Health Implications.
期刊: Comprehensive reviews in food science and food safety 发表日期: 2025-Sep 链接: PubMed
摘要
Dietary proteins play an essential role in human health, modulating metabolic processes and disease risk through intricate interactions with the gut microbiota. This review focuses on the nutritional heterogeneity of animal- and plant-derived dietary proteins, systematically examining their differential effects on the gut microbiota and host metabolic health, along with the underlying mechanisms. Evidence suggests that, despite limitations such as restricted amino acid profiles and lower digestibility, plant-derived proteins generally enhance the diversity and functionality of beneficial gut microbiota, thereby promoting metabolic health. In contrast, the effects of animal-derived proteins are more complex, with health outcomes varying depending on factors such as protein source, processing methods, and intake levels, leading to diverse physiological responses. A key finding is that the enrichment or suppression of gut microbiota and their metabolic products serves as a critical mediator of the health effects associated with dietary proteins. This review underscores the significance of understanding these differences for optimizing gut health and preventing metabolic diseases through dietary interventions. Looking forward, further research is warranted to elucidate the specific mechanisms involved and to explore personalized nutrition strategies, advancing the development of precision health approaches.
54. Vascular endothelial cell-targeted mRNA delivery via synthetic lipid nanoparticles for venous thrombosis prevention.
期刊: Journal of controlled release : official journal of the Controlled Release Society 发表日期: 2025-Aug-30 链接: PubMed
摘要
Venous thromboembolism significantly contributes to the global disease burden. Anticoagulant and antiplatelet therapies are currently the treatment strategies. However, challenges remain due to hemorrhagic complications and the inability to resolve established thrombi. There is an urgent need for a new generation of antithrombotic agents. Given the fibrin specificity and rapid thrombus dissolution capacity of recombinant tissue plasminogen activator (TPA) protein, along with the significant advantages of mRNA therapeutics in protein replacement, we aim to develop an antithrombotic strategy through the targeted delivery of TPA mRNA to vascular endothelial cells using synthetic lipid nanoparticles (LNPs). A series of amino ionizable lipids were synthesized to create an LNP library, from which the LNP selectively targeting vascular endothelial cells (vtLNP) was selected by a DNA barcode labeling high-throughput screening method. The antithrombotic efficacy and safety of vtLNP loaded with TPA mRNA (vtLNP@TPA) were evaluated in a deep vein thrombosis (DVT) mouse model and normal ICR mice, respectively. The results revealed that vtLNP@TPA significantly prevented the occurrence and development of venous thrombosis. This study provides relevant experimental evidence for a novel antithrombotic therapy strategy for venous thrombosis using mRNA therapeutics.
55. Reference Values for Fat-Soluble Vitamins in Human Milk: The Mothers, Infants and Lactation Quality (MILQ) Study.
期刊: Advances in nutrition (Bethesda, Md.) 发表日期: 2025-Aug-26 链接: PubMed
摘要
This fourth article in the series presenting reference values for nutrients in human milk describes the values for the fat-soluble vitamins A, E, and D. The Mothers, Infants and Lactation Quality (MILQ) and Early-MILQ studies collected human milk samples at multiple times during the first 8.5 mo of lactation, from 1242 well-nourished women in Bangladesh, Brazil, Denmark, and The Gambia. Vitamins A and E were measured using high-performance liquid chromatography, whereas vitamin D was measured by liquid chromatography-tandem mass spectrometry. Milk fat-soluble vitamin concentrations from the MILQ study were compared with those used by the Institute of Medicine (IOM) for setting recommendations for nutrient requirements of infants and with other selected data sets. MILQ median concentration was on par with the value used by the IOM for retinol activity equivalents except in early lactation, when they were higher. For α-tocopherol, MILQ median concentration was 76% of the IOM value. The estimate of 0.89 mg/L γ-tocopherol is novel, given that the IOM does not define a concentration in human milk. Although it is known that human milk does not meet infant requirements for vitamin D, results of the MILQ study suggest that actual median concentrations are 60%-80% of those estimated by the IOM. Total daily median intakes from 1 to 6 mo were 97%, 75%, and 6% of IOM adequate intakes for vitamin A, α-tocopherol, and vitamin D, respectively. The MILQ fat-soluble vitamin estimated percentile curves are provided to enable comparison and interpretation of data from other studies.
56. Future Applications of Human Milk Reference Values for Nutrients: A Global Resource for Maternal and Child Nutrition Research.
期刊: Advances in nutrition (Bethesda, Md.) 发表日期: 2025-Aug-26 链接: PubMed
摘要
The World Health Organization recommends exclusive breastfeeding for the first 6 mo of life as human milk is considered to be the optimal form of nutrition to support infant health and development. Human milk provides many nutrient and non-nutrient bioactive compounds to young infants, including micronutrients. In contexts where diets are nutritionally poor, the concentration of micronutrients in human milk is lower, impacting infant’s supply. However, understanding when lower values indicate the need for interventions and then evaluating the impact of interventions on maternal nutritional status and milk nutrient concentrations has been challenged by the absence of reliable reference values (RVs) for nutrient concentrations in human milk. The multicenter Mothers, Infants, and Lactation Quality (MILQ) and Early-MILQ studies were developed to establish evidence-based RVs for human milk nutrients. This paper presents and discusses the potential utility of these RVs as an international reference for global maternal and child health research.
57. Clinical Outcomes and Patterns of Care Among Patients With Newly Diagnosed Classical Hodgkin Lymphoma in a Safety-Net Health System.
期刊: Clinical lymphoma, myeloma & leukemia 发表日期: 2025-Aug-14 链接: PubMed
摘要
There is limited data on outcomes and patterns of care for patients with classical Hodgkin lymphoma (cHL) who are uninsured or have adverse social determinants of health. We conducted a retrospective cohort study of patients with newly diagnosed cHL treated in a large safety-net hospital system between January 2011 and December 2021. Of the 231 patients aged ≥18 years diagnosed with cHL at Harris Health, Houston, TX, the median age was 39 years, 82% were uninsured, and 87% lived in a neighborhood with an Area Deprivation Index below the national median. Most (73%) had stage III/IV disease; 19% had a history of HIV. The median diagnosis-to-treatment interval was 24 days. The median follow-up interval was 72.3 months. Among 217 evaluable patients, 67% achieved a complete response, and 7% had a partial response. Twenty-two (61%) of 36 eligible patients underwent hematopoietic stem cell transplantation. At 5 years, event-free and overall survival (OS) rates were 62.7% and 79.6%, respectively. Factors associated with OS in multivariable analysis included age (hazard ratio [HR] 1.34 per 10-year increase, P = .007), Eastern Cooperative Oncology Group performance status (HR 2.35 for 2-4 vs. 0-1, P = .026), serum creatinine (HR 2.94 per mg/dL increase, P = .006), and serum albumin (HR 0.59 per g/dL increase, P = .014). In this health system with financial assistance and access to cell therapies, uninsurance was not associated with inferior outcomes. Small survival differences may be due to a greater proportion of patients with advanced-stage, higher-risk, and HIV-associated disease.
58. Interaction of Framingham risk score and sarcopenia in cardiovascular events and all-cause mortality among patients with hypertension: a prospective study based on the standard treatment of the SPRINT group.
期刊: Nutrition, metabolism, and cardiovascular diseases : NMCD 发表日期: 2025-Aug-09 链接: PubMed
摘要
The Framingham Risk Score (FRS) is an important risk assessment tool for cardiovascular health and can predict the risk of cardiovascular disease (CVD) in hypertensive patients. Sarcopenia is associated with increased CVD events and all-cause mortality. However, the interactive effects between them remain unclear. This study aimed to identify the interactive effects of FRS and sarcopenia on CVD events and all-cause mortality in hypertensive patients. Data on 4683 participants of the standard treatment arm were extracted from the Systolic Blood Pressure Intervention Trial (SPRINT). The serum creatinine/cystatin C ratio (CCR) was used to measure skeletal muscle mass. After excluding participants with missing data, a total of 4239 participants were included in the final analysis. During a median follow-up of 3.21 and 3.26 years, 296 and 188 participants experienced CVD events and all-cause mortality, respectively. A multivariable Cox proportional hazards model revealed that both FRS and CCR were independently associated with CVD events and all-cause mortality, with a significant interaction observed for all-cause mortality (HR = 1.899, 95 % CI: 1.011-3.570). Compared to those at low risk for both CVD and sarcopenia group, individuals at high risk for both CVD and sarcopenia group had a higher all-cause mortality (HR = 2.102, 95 % CI: 1.288-3.430). The interactive effects of FRS and CCR on all-cause mortality were observed among patients with hypertension, indicating the importance of incorporating both muscle loss and cardiovascular health into strategies to reduce all-cause mortality rate.