公共卫生研究摘要 (2025-09-25)
共收录 63 篇研究文章
1. Collaboration, coordination, and cooperation in occupational health and safety management: perspectives of managers, human resource practitioners, and occupational health and safety representatives.
期刊: International journal of qualitative studies on health and well-being 发表日期: 2025-Dec-31 链接: PubMed
摘要
To increase knowledge about organizations’ OHSM, a specific focus should be placed on how managers, HR practitioners, and OHS representatives conduct OHSM. A content analysis was carried out based on semi-structured interviews with 18 managers, 6 HR practitioners, and 5 OHS representatives in different industries and occupations. All three roles had several OHS assignments. Managers initiate, lead, and check activities; HR practitioners develop routines and guidelines (strategic approach), while OHS representatives often initiate regular safety rounds and inspections (practical approach). The organizational conditions for fulfilling their assignments varied among the three roles. In general, managers and HR practitioners had more favourable conditions, while OHS representatives were dependent on others. Collaboration took place mostly between roles involved in strategic OHSM, i.e., top management and HR practitioners, while cooperation took place between roles involved in operational OHSM, i.e., (first-line) managers and OHS representatives. Regulation-based coordination occurred in a top-down manner through HR practitioners, while reactive coordination occurred in a bottom-up manner through OHS representatives. For more effective and successful OHSM, more developed interprofessional collaboration is needed between all involved roles. Such collaboration needs to be promoted through improved organizational conditions, regardless of role or organizational level.
2. Artificial Intelligence and Occupational Therapy: From Emerging Occupation to Educational, Practice, and Policy Imperative.
期刊: The American journal of occupational therapy : official publication of the American Occupational Therapy Association 发表日期: 2025-Nov-01 链接: PubMed
摘要
Artificial intelligence (AI) is now increasingly integrated into health care, education, and daily life. It now shapes how people learn, work, communicate, and manage health. For occupational therapy, which centers on enabling meaningful participation across contexts, this technological transformation presents critical challenges and opportunities. Despite AI’s growing presence, the profession lacks cohesive standards or strategies to address its impact on education, clinical reasoning, or client-centered practice. AI is a practice-relevant and educationally urgent phenomenon that demands structured engagement and leadership within the profession to ensure its ethical, inclusive integration. Occupational therapy practitioners must be prepared to support students, practitioners, and clients in navigating these technologies. Without clear competencies and shared frameworks, the profession risks marginalization and missed opportunities to uphold occupational justice. Action is needed in three domains: (1) occupational therapy education, where AI literacy and ethical use must be taught and modeled; (2) clinical practice, where AI tools require critical evaluation and adaptation; and (3) client engagement, where AI use must be recognized and supported as an evolving occupation. Accreditation, continuing education, and public policy must align to support this shift.
3. Rising Cognitive Disability as a Public Health Concern Among US Adults: Trends From the Behavioral Risk Factor Surveillance System, 2013-2023.
期刊: Neurology 发表日期: 2025-Oct-21 链接: PubMed
摘要
Cognitive disability-defined by the Behavioral Risk Factor Surveillance System (BRFSS) as serious difficulty concentrating, remembering, or making decisions because of a physical, mental, or emotional condition-has become the most commonly reported disability among US adults. This broad definition reflects a heterogeneous range of underlying causes and highlights the growing public health significance of cognitive disability in the population. Previous studies have identified disparities by race, age, and socioeconomic status, but few have examined how these patterns have evolved over the past decade. This study analyzes national trends in self-reported cognitive disability from 2013 to 2023 using BRFSS data, with a focus on differences across age groups, racial and ethnic populations, and key social determinants of health. We conducted a retrospective analysis using data from the Centers for Disease Control and Prevention’s Disability and Health Data System, which integrates nationally representative responses from US adults (aged ≥18 years) in the BRFSS from 2013 to 2023, excluding 2020 and participants who self-reported depression, to better identify nonpsychiatric cognitive impairment. The primary outcome was self-reported cognitive disability, defined as “serious difficulty concentrating, remembering, or making decisions.” Survey-weighted logistic regression was used to model prevalence trends and examine associations with demographic and socioeconomic factors. From 2013 to 2023, a total of 4,507,061 responses were included in the analysis. Apart from analyses focusing on strata of age, all estimates of cognitive disability were age-adjusted. Most respondents were aged 18-39 years (36.8%), identified as non-Hispanic White (60.9%), and had completed at least a high school education (87.3%). The age-adjusted self-reported cognitive disability prevalence in the United States rose from 5.3% (95% CI 5.1%-5.4%) in 2013 to 7.4% (95% CI 7.2%-7.6%) in 2023, with statistically significant increases beginning in 2016. The prevalence of cognitive disability among younger adults aged 18-39 years nearly doubled, increasing from 5.1% (95% CI 4.8%-5.3%) to 9.7% (95% CI 9.2%-10.2%), making this age group the primary driver of the overall rise in cognitive disability in the United States. The disproportionate growth in cognitive disability among younger adults seems to be the primary driver of the overall national trend. These findings warrant further investigation, given their potential long-term implications for population health, workforce productivity, and health care systems.
4. The Power of Touch: Skin-to-Skin Care and Preterm Brain Connectivity.
期刊: Neurology 发表日期: 2025-Oct-21 链接: PubMed
摘要
5. Prefrontal cortex cytosolic and synaptosome proteome reveal molecular signatures of resilience to chronic social isolation stress in rats.
期刊: Reviews in the neurosciences 发表日期: 2025-Sep-26 链接: PubMed
摘要
Chronic social isolation stress (CSIS) is a well-established preclinical model for studying stress-induced neurobiological changes and their effects on behavior and brain function in depression. The prefrontal cortex (PFC), a brain region essential for emotional regulation, cognitive control, and social interactions, is particularly susceptible to stress. While CSIS exposure triggers molecular and behavioral changes characteristic of depression-like behavior, a subset of animals displays a resilient phenotype, maintaining normal neurobiological and behavioral function despite experiencing adverse conditions. Understanding the molecular differences between resilient and susceptible phenotypes is crucial for identifying biomarkers and developing novel therapeutic targets for depression. Mass spectrometry-based proteomics, combined with bioinformatics approaches, provides a powerful tool for exploring these complex cellular processes. This review focuses on proteomic changes in cytosolic and synaptosome-enriched fractions of the PFC in adult male rats following CSIS exposure, with particular emphasis on differences between resilient and susceptible animals. We summarize findings of differential protein expression across multiple biological systems, including energy metabolism, cytoskeletal organization, cellular stress defense mechanisms, neurotransmitter regulation, and synaptic function. Additionally, we present protein predictors of resilience to CSIS identified through machine learning-based analyses, highlighting potential pathways for preventing and mitigating depression-like outcomes following CSIS.
6. Association of unexplained recurrent implantation failure with obstetric and neonatal outcomes: cohort study of 37 888 singleton live births.
期刊: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology 发表日期: 2025-Sep-24 链接: PubMed
摘要
To investigate the risk of adverse obstetric and neonatal outcomes in patients with unexplained recurrent implantation failure (uRIF) who had a singleton live birth. This multicenter retrospective cohort study reviewed 49 372 embryo-transfer cycles leading to a singleton live birth at three fertility centers in China between January 2014 and July 2021. Patients were categorized into the uRIF group if they had a history of at least three failed transfers of unknown cause with at least four good-quality embryos, while the control group comprised women who had experienced fewer than three failed implantation cycles. Obstetric and neonatal outcomes were collected via telephone interviews using a standardized questionnaire. Propensity score matching (PSM) and multivariate logistic regression analysis were used to control for potential confounders. After exclusions, 1244 patients with a history of uRIF and 36 644 controls were included in the study. All baseline characteristics were balanced following PSM, with 1243 patients retained in each group. Compared with the control group, the uRIF group exhibited significantly higher odds of placenta previa (2.7% vs 1.4%; adjusted odds ratio (aOR), 2.01 (95% CI, 1.01-4.00)), placental abruption (0.3% vs 0%; aOR, 6.51 (95% CI, 1.57-26.91)), Cesarean delivery (76.6% vs 71.8%; aOR, 1.27 (95% CI, 1.06-1.53)) and preterm birth (10.1% vs 7.3%; aOR, 1.44 (95% CI, 1.08-1.91)). The results remained consistent on sensitivity analysis using prematched data with multivariate adjustment. A history of uRIF was associated with increased risks for placenta previa, placental abruption, Cesarean delivery and preterm birth. While statistically significant, the absolute differences in the rates of these complications were modest and the clinical relevance of our findings should be interpreted with caution. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.
7. Incidence, risk factors, management and outcomes of high neuraxial block in obstetric anaesthetic practice: a prospective national observational study using the UK Obstetric Surveillance System.
期刊: Anaesthesia 发表日期: 2025-Sep-24 链接: PubMed
摘要
High neuraxial block has been identified as a leading cause of maternal cardiac arrest in the UK. There is a need to investigate the potential risk factors and causes of high neuraxial block in obstetrics to reduce its occurrence. We investigated the incidence, risk factors, management and outcomes of high neuraxial block presenting in maternity care in the UK using the UK Obstetric Surveillance System. High neuraxial block was defined as spinal and/or epidural anaesthesia/analgesia that required ventilatory support and/or cardiopulmonary resuscitation. There were 89 reports of high neuraxial block reported between 2017 and 2019. The estimated overall incidence was 14.7/100,000 (95%CI 11.8-18.0) neuraxial blocks, with the incidence of high neuraxial block of 19.6/100,000 (95%CI 14.9-25.3) after spinal anaesthesia and 7.0/100,000 (95%CI 4.6-10.1) after epidural analgesia or anaesthesia. The most common anaesthetic intervention that preceded a high neuraxial block was a single-shot spinal following labour epidural analgesia (43/89 of all cases), of which 37% (16/43) occurred after an unsuccessful epidural top-up to convert epidural analgesia to anaesthesia. Inadvertent dural puncture occurred in 15/89 cases. There were six cases of cardiac arrest. There were no maternal or neonatal deaths. Seven patients were reported to have been psychologically distressed and/or had awareness during tracheal intubation because of the high neuraxial block and its management. Whilst high neuraxial block is rare in UK obstetric practice and generally managed well, directed attention to key aspects of clinical practice may ameliorate the risk. These include strategies to minimise acute supine hypotension with induction of spinal anaesthesia; prudent intrathecal local anaesthetic dosing; and careful case selection for converting epidural analgesia to anaesthesia for caesarean birth. In the UK, a problem called high neuraxial block can sometimes happen when women are given an epidural or spinal block for pain relief during childbirth. It can be very serious and even stop the heart. Doctors want to find out what causes this so they can stop it from happening. Researchers looked at how often high neuraxial blocks happen, what might cause them, how they are treated and what happens afterwards. They used a system in the UK that collects information about serious problems during pregnancy. In this study, high neuraxial block means the medicine used in the epidural or spinal block caused breathing or heart problems that needed emergency help. From 2017 to 2019, there were 89 cases of high neuraxial block. This means it only happens about 15 times for every 100,000 spinal or epidural blocks. It was more common after spinal blocks than epidurals. In many cases, a spinal injection was given after an epidural had already been used, especially if the epidural didn’t work well. Six women had their hearts stop, but all survived. No mothers or babies died. However, seven women said they were very upset and remembered scary parts of the treatment, like having a breathing tube put in. Even though this problem is rare and usually treated well, doctors want do more to stop it from happening. They can do things like: help prevent blood pressure from dropping when giving a spinal block; be careful with how much medicine they give into the spinal block; and think carefully about who should switch from an epidural to a spinal for a caesarean section.
8. Comparing the Effectiveness of Multimodal Learning Using Computer-Based and Immersive Virtual Reality Simulation-Based Interprofessional Education With Co-Debriefing, Medical Movies, and Massive Online Open Courses for Mitigating Stress and Long-Term Burnout in Medical Training: Quasi-Experimental Study.
期刊: JMIR medical education 发表日期: 2025-Sep-24 链接: PubMed
摘要
Burnout among emergency room health care workers (HCWs) has reached critical levels, affecting up to 43% of HCWs and 35% of emergency medicine personnel during the COVID-19 pandemic. Nurses were most affected, followed by physicians, leading to absenteeism, reduced care quality, and turnover rates as high as 78% in some settings such as Thailand. Beyond workforce instability, burnout compromises patient safety. Each 1-unit increase in emotional exhaustion has been linked to a 2.63-fold rise in reports of poor care quality, 30% increase in patient falls, 47% increase in medication errors, and 32% increase in health care-associated infections. Burnout is also associated with lower job satisfaction, worsening mental health, and increased intent to leave the profession. These findings underscore the urgent need for effective strategies to reduce stress and burnout in emergency care. This study aimed to evaluate the effectiveness and effect size of a multimodal learning approach-Emergency Room Virtual Simulation Interprofessional Education (ER-VIPE)-that integrates medical movies, massive online open courses (MOOCs), and computer- or virtual reality (VR)-based simulations with co-debriefing for reducing burnout and stress among future health care professionals compared with approaches lacking co-debriefing or using only movies and MOOCs. A single-blind, quasi-experimental study was conducted at a university hospital from August 2022 to September 2023 using a 3-group treatment design. Group A (control) participated in a 3D computer-based, simulation-based interprofessional education (SIMBIE) without debriefing. Group B received the ER-VIPE intervention. Group C received the same as Group B, but the computer-based SIMBIE was replaced with 3D VR-SIMBIE. SIMBIE activities simulated a COVID-19 pneumonia crisis. Outcomes included the Dundee Stress State Questionnaire (DSSQ) and the Copenhagen Burnout Inventory, with trait anxiety as a behavioral control. Stress and burnout were measured at baseline, pre-intervention, postintervention, and 1-month follow-up. Generalized estimating equations were used to analyze group differences, with statistical significance set at P<.05. We randomized 87 undergraduate students from various health programs into the 3 groups (n=29 each). Participants’ mean age was 22 years, with 71% (62/87) as women. After the 1-month post-SIMBIE follow-up, adjusted analyses revealed positive trends in DSSQ-engagement across all groups, with Group B showing a significant increase compared with Group A (mean difference=3.93; P=.001). DSSQ-worry and DSSQ-distress scores decreased nonsignificantly across all groups. Burnout scores also improved across groups, with Group B having a significantly lower score than Group A (mean difference=-2.02; P=.02). No significant burnout differences were found between Group C and Groups A or B. A multimodal learning approach combining medical movies, MOOCs, and 3D computer-based SIMBIE with co-debriefing effectively improved engagement, reduced stress, and lowered burnout among future health care professionals. This scalable educational framework may help enhance well-being and resilience in high-pressure clinical environments.
9. Relationship Between Activity Tracker Metrics and the Physical Activity Index and Their Association With Cardiometabolic Phenotypes, Subclinical Atherosclerosis, and Cardiac Remodeling: Cross-Sectional Study.
期刊: JMIR mHealth and uHealth 发表日期: 2025-Sep-24 链接: PubMed
摘要
Consumer wearable technology quantifies physical activity; however, the association between these metrics and cardiometabolic health requires further elucidation. This study identified latent factors derived from Fitbit heart rate metrics and their relationship with cross-sectional cardiovascular phenotypes. This cross-sectional analysis included 457 participants from the SingHEART study, a multiethnic, population-based study of Asian individuals aged 21 to 69 years recruited in Singapore. Participants wore the Fitbit Charge HR for 7 days, and data on physical activity metrics, self-reported physical activity index (PAI), blood tests, coronary artery calcium scores, and cardiac magnetic resonance imaging were collected. Exploratory factor analysis identified latent factors from Fitbit metrics, and multivariate regression analysis assessed associations with blood and cardiovascular imaging phenotypes. Higher levels of self-reported PAI were significantly associated with a higher number of calories burned (P=.008), number of steps and floors climbed, distance, number of activity calories, and number of very active minutes (P<.001). However, there was no association between PAI and other Fitbit metrics. Using exploratory factor analysis, we identified three latent factors measured by Fitbit metrics: (1) elevated metabolic equivalents of task (METs; calories burned per day, minutes per day spent fairly active in 3-6 METs and very active in ≥6 METs, and activity calories), (2) total activity (steps per day, distance in kilometers per day, and number of floors per day), and (3) others, all with a Cronbach α of >0.7. Higher total activity was associated with increased high-density lipoprotein levels (β=0.06; P<.001), decreased triglyceride levels (β=-0.10; P=.006), and lower BMI (β=-0.63; P<.001) after adjustment for age, gender, systolic blood pressure, total cholesterol, and family history of heart disease. The interaction between total activity and elevated METs was associated with lower fasting glucose (β=-0.07; P=.004). Elevated METs were associated with higher log(coronary artery calcium+1) and higher BMI (P<.001). Total activity was significantly associated with higher indexed biventricular systolic (P=.01 for left and P=.006 for right) and diastolic volumes (P<.001) and higher indexed left ventricular mass (P=.005). We identified 3 groups of wearable metrics with distinct characteristics. While total activity had a significant relationship with self-reported PAI, most metrics of elevated METs did not. Total activity had a consistent and favorable association with lipid and glucose profiles and a dose-dependent association with cardiac remodeling. Elevated METs alone did not appear to have a significant association with favorable cardiovascular profiles. This study suggests that the total activity metrics are robust and dependable when interpreting an individual’s activity levels, with construct validity according to self-reported PAI and a positive association with lipid and glucose profiles, and demonstrate dose-dependent associations with cardiac remodeling after adjustment for demographics and risk factors. Findings related to elevated METs may be due to the Hawthorne effect and require further studies.
10. Permethrin-Treated Baby Wraps for the Prevention of Malaria.
期刊: The New England journal of medicine 发表日期: 2025-Sep-24 链接: PubMed
摘要
Malaria remains a major cause of childhood death in sub-Saharan Africa. We leveraged the traditional practice of mothers carrying children on their backs in cloth wraps to assess whether treating the wraps with an insect repellent might provide a layer of protection against malaria. In a double-blind, randomized, placebo-controlled trial conducted in Uganda, we enrolled adult women with a child who was 6 to 18 months of age. The mother-child pairs were randomly assigned in a 1:1 ratio to use permethrin-treated wraps (intervention group) or sham-treated wraps (control group). The wraps underwent retreatment every 4 weeks. All the participants received a new, pyrethroid-only long-lasting insecticide-treated bed net. The participants visited the trial clinics every 2 weeks for 24 weeks and made unscheduled visits in the case of febrile illness in the children. The primary outcome was clinical malaria in the children, as defined by fever and a positive malaria rapid diagnostic test. From June 2022 through April 2024, a total of 419 mother-child pairs were screened, and 400 underwent randomization; 200 pairs were assigned to the intervention group and 200 to the control group. Clinic attendance was high (5194 of 5200 planned visits [99.9%] were attended), and no participants were lost to follow-up. The incidence rate of clinical malaria was 0.73 cases per 100 person-weeks (95% confidence interval [CI], 0.51 to 1.02) in the intervention group and 2.14 cases per 100 person-weeks (95% CI, 1.73 to 2.62) in the control group (incidence rate ratio, 0.34; 95% CI, 0.23 to 0.51; P<0.001). Rash was reported more often in the intervention group than in the control group (8.5% vs. 6.0% of participants). Among mother-child pairs who had access to bed nets, maternal use of permethrin-treated baby wraps significantly reduced the incidence of clinical malaria in the children. (Funded by the Doris Duke Foundation and others; ClinicalTrials.gov number, NCT05391230.).
11. Social Transfers for Exclusive Breastfeeding in Brazil: Protocol for a Randomized Controlled Trial.
期刊: JMIR research protocols 发表日期: 2025-Sep-24 链接: PubMed
摘要
According to the World Health Organization’s infant and young child feeding guidelines, infants should be exclusively breastfed for the first 6 months of life. Despite public health campaigns to increase exclusive breastfeeding (EBF) rates, socioeconomic inequities persist among low-income breastfeeding mothers, especially in countries with large wealth and health gaps, such as Brazil. Social transfer programs are initiatives that provide financial support to individuals or households to improve their well-being and reduce financial burdens. These may be conditional, requiring recipients to meet specific criteria to receive the transfer, or unconditional, in which recipients receive the transfer without prerequisites. Evidence suggests that conditional and unconditional social transfers may help increase EBF rates while addressing the economic challenges breastfeeding mothers face. A randomized controlled trial (RCT) conducted in Vientiane, Lao People’s Democratic Republic, found that a social transfer program significantly improved both EBF rates at 6 months and EBF duration. Building on this study, we aim to evaluate the impact of this intervention in a different socioeconomic and cultural context. This protocol aims to implement an RCT to assess whether conditional and unconditional social transfers improve EBF rates at 6 months postpartum for mothers in low-income communities in São Paulo, Brazil. A prospective RCT will be conducted among 400 mothers who gave birth in the last 72 hours and plan to exclusively breastfeed. Participants will be recruited in São Paulo at the University Hospital of São Paulo and Amparo Maternal. Participants will be randomly assigned to one of the following groups: (1) control group-no social transfer; (2) intervention group 1-an unconditional social transfer at 6 months postpartum; and (3) intervention group 2-a social transfer at 6 months postpartum, conditional upon mothers’ EBF. All groups will receive educational materials supporting EBF. The study will have visits at birth, 1 month, 6 months, 1 year, and 2 years and will include a questionnaire and biological collections of breast milk samples, infant fecal samples, and blood samples (finger pricks) from both the mother and infant. The main study outcomes are the prevalence of EBF at 6 months and the duration of EBF across the 3 groups, where we hypothesize higher rates of EBF among mothers in the conditional group. Recruitment began on March 6, 2024. As of September 2025, we enrolled 204 participants. Our goal is to recruit 400 mother-infant dyads by October 2025, with study visits expected to be completed by October 2027. We hypothesize that the Social Transfers for Exclusive Breastfeeding in Brazil (STEBB) intervention will positively impact breastfeeding mothers in São Paulo. If successful, the program may inform national policy to enhance Brazil’s existing social transfer program for new mothers. ClinicalTrials.gov NCT06157697; https://clinicaltrials.gov/study/NCT06157697. DERR1-10.2196/75796.
12. Patient Participation in AI for Health Curriculum.
期刊: Journal of participatory medicine 发表日期: 2025-Sep-24 链接: PubMed
摘要
The adoption of artificial intelligence (AI) in health care has outpaced education of the clinical workforce on responsible use of AI in patient care. Although many policy statements advocate safe, ethical, and trustworthy AI, guidance on the use of health AI has rarely included patient perspectives. This gap leaves out a valuable source of information and guidance about what responsible AI means to patients. In this viewpoint coauthored by patients, students, and faculty, we discuss a novel approach to integrating patient perspectives in undergraduate premedical education in the United States that aims to foster an inclusive and patient-centered future of AI in health care.
13. Proliferation of Prior Authorization in Traditional Medicare - None the WISeR?
期刊: The New England journal of medicine 发表日期: 2025-Sep-24 链接: PubMed
摘要
14. Reply to: Comment on Human Epidermal Growth Factor Receptor 2-Low Metastatic Breast Cancer Treatment Costs and Cost-Effectiveness.
期刊: Journal of clinical oncology : official journal of the American Society of Clinical Oncology 发表日期: 2025-Sep-24 链接: PubMed
摘要
15. Benchmarking the Current Landscape: Insights From an Association of American Cancer Institutes Survey on Academic Cancer Service Lines.
期刊: JCO oncology practice 发表日期: 2025-Sep-24 链接: PubMed
摘要
A cancer service line (CSL) in academic medical centers provides a patient-centered approach aimed at enhancing the patient experience and clinical outcomes, managing financial operations, increasing access to clinical research, and reducing health disparities. In 2023, the Association of American Cancer Institutes (AACI) Physician Clinical Leadership Initiative (PCLI) Steering Committee conducted a survey to evaluate the current state of CSLs with respect to governance, leadership, organizational, and financial structure and function. The survey was electronically sent to cancer center directors and administrative directors at 107 of AACI’s 108-member cancer centers, achieving a response rate of 70%. Survey participation was voluntary, and no compensation was provided. Fifty-eight (77%) of the 75 survey respondents (which included 40 National Cancer Institute-designated cancer centers) had a defined CSL with only 35 (60%) using a formal charter. All CSL leadership teams included physician leaders, and 44 (76%) centers included their cancer center director within this leadership. More than 28 key services were identified as parts of the CSL structures. Most respondents reported that strategic planning (88%), quality and safety (83%), and regional alignment (78%) were key responsibilities. Twenty-six (45%) centers reported a policy defining a funds flow from the health system to the cancer center. Performance assessment for the CSLs included metrics related to growth and finance, access and services, quality and outcomes, and academics. These results demonstrate the diverse nature of CSLs across academic medical systems within the United States. Furthermore, given the complexity faced by academic cancer centers in establishing and expanding their CSLs, AACI remains committed to working closely with its members to identify best practices focused on innovative and value-based cancer care.
16. Intimate Partner Violence and Paramedicine: An Updated Scoping Review of Perspectives and Practices.
期刊: Prehospital emergency care 发表日期: 2025-Sep-24 链接: PubMed
摘要
Intimate partner violence (IPV) is increasingly being recognized as a clinical circumstance to which emergency medical services (EMS) clinicians attend; it refers to the use of physical, sexual, psychological, and coercive violence by a current or former intimate partner to exert power and control. The intersection of paramedicine and IPV remains largely unclear. Our objective is to provide a comprehensive synthesis of the available evidence at the intersection of paramedicine and IPV. This review followed a published protocol (Open Science Framework), and PRISMA-ScR guidelines. Co-developed with two trained librarians, a search strategy was used to locate potential articles in MEDLINE and CINAHL, including a gray literature search. Included articles examined perceptions and/or practice of EMS clinicians and students in the context of IPV. Titles and abstracts were screened by two reviewers, followed by full text reviews when eligible; a third reviewer resolved any disagreement(s). Data were extracted using a purpose-built template and the findings were summarized and synthesized. Of the 517 articles, 34 met inclusion criteria. The literature was varied and heterogenous, preventing mass, detailed synthesis. Generally, EMS clinicians were motivated to assist IPV survivors but perceived their education as insufficient to provide high-quality care, reporting low rates of training/education with corresponding low self-efficacy. Considerations for the specific and unique environment of paramedicine were lacking. Standardized patients and/or simulations were beneficial for pre-practice students acquiring history gathering and interview skills. Jurisdictional variations in legislation, policy, and standards, as well as overlapping agency/department regulations introduced practice variance. The validity and utility of EMS clinician-collected surveillance data were unclear. While EMS clinicians were recognized as a poorly understood, under-utilized, and under-equipped resource for IPV survivors, current literature is insufficient to comprehensively guide practice. Heterogeneity and limited quantity contribute to this challenge. Future research should leverage newly developed and validated measures to identify gaps responsive to educational and/or policy interventions and explore novel technologies to improve the quality of EMS clinician-collected IPV data. Equipping EMS clinicians with the tools to provide high-quality IPV care will benefit IPV survivors, EMS clinicians, and health care more broadly.
17. Preliminary evaluation of a cognitive rehabilitation intervention for post-COVID-19 cognitive impairment: A pilot randomized controlled trial.
期刊: Neuropsychological rehabilitation 发表日期: 2025-Sep-24 链接: PubMed
摘要
Despite the profound impact of “brain fog” and/or cognitive impairment in relatively young people with Long COVID, no interventions with demonstrated efficacy are currently available. We conducted a pilot randomized controlled trial investigating the preliminary outcomes of a cognitive rehabilitation (CR) intervention adapted for persons with post-COVID cognitive impairment. Participants were ≥18 years of age, English-speaking, had history of SARS-CoV-2, and had cognitive impairment on objective measures. Eligible participants were randomized to a 12-week CR intervention or a time - and attention-matched control arm. Objective and subjective cognitive functioning was assessed at pre - and within 2-weeks post-intervention, utilizing validated neuropsychological measures across multiple domains. We compared pre vs. post intervention changes in cognitive scores in intervention vs. control groups. The mean change in the intervention group compared to the controls in measures of processing speed, learning, memory, language, and of executive function did not reach the threshold for futility. In comparison to controls, the intervention group self-reported significant improvements in cognitive functioning. We found that an adapted CR intervention for Long COVID may improve post-COVID cognitive impairment in comparison to a time - and attention-matched control group and should be evaluated in a larger trial. Trial registration: ClinicalTrials.gov identifier: NCT05498493. Registered on 08/10/2022.
18. Online reinforcement learning of state representation in recurrent network supported by the power of random feedback and biological constraints.
期刊: eLife 发表日期: 2025-Sep-24 链接: PubMed
摘要
Representation of external and internal states in the brain plays a critical role in enabling suitable behavior. Recent studies suggest that state representation and state value can be simultaneously learned through Temporal-Difference-Reinforcement-Learning (TDRL) and Backpropagation-Through-Time (BPTT) in recurrent neural networks (RNNs) and their readout. However, neural implementation of such learning remains unclear as BPTT requires offline update using transported downstream weights, which is suggested to be biologically implausible. We demonstrate that simple online training of RNNs using TD reward prediction error and random feedback, without additional memory or eligibility trace, can still learn the structure of tasks with cue-reward delay and timing variability. This is because TD learning itself is a solution for temporal credit assignment, and feedback alignment, a mechanism originally proposed for supervised learning, enables gradient approximation without weight transport. Furthermore, we show that biologically constraining downstream weights and random feedback to be non-negative not only preserves learning but may even enhance it because the non-negative constraint ensures loose alignment-allowing the downstream and feedback weights to roughly align from the beginning. These results provide insights into the neural mechanisms underlying the learning of state representation and value, highlighting the potential of random feedback and biological constraints.
19. Medicare Part D Coverage and Costs for Glucagon-Like Peptide-1 Receptor Agonists.
期刊: JAMA 发表日期: 2025-Sep-24 链接: PubMed
摘要
This cross-sectional study examines Medicare Part D coverage and out-of-pocket costs for glucagon-like peptide-1 receptor agonists following implementation of the Inflation Reduction Act.
20. Functional characterization of two protein C variants causing type I deficiency via cellular degradation or retention.
期刊: International journal of hematology 发表日期: 2025-Sep-24 链接: PubMed
摘要
Hereditary protein C (PC) deficiency is a thrombotic disorder caused by variants in the PC gene (PROC). In this study, we identified a novel variant, p.Leu173Pro (L173P), and a previously reported variant, p.Val241Leu (V241L), in two unrelated Japanese families with venous thrombosis. We investigated the mechanisms by which these variants lead to type I PC deficiency. PC expression vectors were constructed and transiently expressed in human embryonic kidney 293 cells. Cell lysates and culture supernatants were subsequently analyzed by Western blotting, and intracellular trafficking was evaluated. Both PC-L173P and PC-V241L variants exhibited significantly reduced extracellular secretion compared to the wild-type PC. Furthermore, PC-L173P underwent proteasome-mediated intracellular degradation, whereas PC-V241L appeared to accumulate within the endoplasmic reticulum. This study elucidates the mechanism by which type I PC deficiency arises from distinct secretion defects: intracellular degradation and retention. Although both PROC variants result in type I PC deficiency, their differing intracellular fates are likely attributable to the mutation site and the physicochemical properties of the substituted amino acids. These findings underscore the heterogeneity of secretion defects in type I PC deficiency and provide novel insights into its molecular pathophysiology.
21. Clinical and discharge outcomes in an acute palliative care unit located in a comprehensive cancer center.
期刊: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 发表日期: 2025-Sep-24 链接: PubMed
摘要
The aim of this study was, other than assessing clinical outcomes after a comprehensive palliative care treatment in APCU, to report the activity and functioning of APCU in influencing subsequent care trajectory and settings of patients with advanced cancer. A consecutive sample of patients with cancer who were admitted to an acute palliative care unit (APCU) was prospectively assessed. All patients underwent comprehensive palliative care treatment. At admission (T0), patients’ demographics, reasons for admission, referral, and recent anticancer treatments were recorded, along with whether they were on/off treatment or uncertain. Subsequent referrals to next care settings and the pathway of oncologic treatment were reconsidered. Symptom intensity was measured by Edmonton Symptom Assessment Scale (ESAS). Five-hundred and twenty patients were surveyed. Clinical deterioration was the most frequent indication for APCU admission. Most admissions were planned (60.8%). At discharge, a significant decrease in the number of “on therapy” patients was reported, and concomitantly, the number of “off-therapy” patients increased (p < 0.0005) in comparison with data recorded at admission. A significant number of patients was assigned to a palliative care setting, including home palliative care or hospice at the time of discharge (p < 0.0005). All ESAS items that significantly improved during admission were significant. Being “off therapy” was independently associated with a lower Karnofsky (p = 0.002), higher global ESAS at discharge (p = 0.032), and discharge to a palliative setting (hospice or home palliative care) (p < 0.0005). Data from the present study has shown that APCU results in a crossroad for patients with advanced cancer, allowing selection for transition of care.
22. Degradation of 2,4-D by plant growth-promoting Cupriavidus sp. DSPFs: role in mitigating herbicide toxicity in soil and enhancing crop production.
期刊: Microbiology spectrum 发表日期: 2025-Sep-24 链接: PubMed
摘要
Repeated application of herbicides like 2,4-dichlorophenoxyacetic acid (2,4-D) in agriculture poses a significant environmental threat and health risk to non-target biota. Cupriavidus sp. strain DSPFs, isolated from Indian agricultural soil, utilizes 2,4-D and various other aromatics as the sole source of carbon and energy. It efficiently degrades high concentrations of 2,4-D (up to 0.3% wt/vol, i.e., 3,000 ppm) within 24 h with a maximum degradation rate of 105 mg L-1 h-1. Based on enzyme activity, whole-cell oxygen uptake, high-performance liquid chromatography (HPLC), and liquid chromatography-mass spectroscopy (LC-MS/MS) analyses, the strain was proposed to metabolize 2,4-D via 2,4-dichlorophenol (2,4-DCP) and 3,5-dichlorocatechol ortho ring-cleavage pathway. The key enzyme, 2,4-DCP monooxygenase (24DCPM), was purified to homogeneity and found to be homotetrameric with a native molecular mass of ~255 kDa with ~3.9 mol of FAD per mol of native protein. The enzyme exhibited high catalytic efficiency (Kcat/Km) of 4.5 and 6.6 µM-1 s-1 with NADH and NADPH, respectively. Strain also displayed various plant growth-promoting traits like production of indoleacetic acid, ammonia, siderophores and mineral solubilization. Priming of Vigna radiata (mung bean) seeds with strain enhanced (30-47%) growth of seedlings in non-contaminated soil microcosms, indicating plant growth-promoting potential of the strain. Seed priming with strain significantly reduced 2,4-D toxicity to mung bean seedlings, suggesting the phytoprotective abilities of the strain. Bio-augmentation of 2,4-D-contaminated soil with strain DSPFs could remove >95% of 2,4-D (100 ppm) in 4 days with a degradation rate of 91 mg kg-1 day-1. Cupriavidus sp. DSPFs is a promising candidate for the eco-friendly clean-up of agricultural fields and enhancing crop productivity. An agricultural soil isolate, Cupriavidus sp. strain DSPFs, is capable of degrading 2,4-dichlorophenoxyacetic acid (2,4-D), a widely used herbicide having deleterious effects on non-target crop plants and other biota. Strain DSPFs efficiently degrade relatively high concentrations of 2,4-D in minimal growth medium as well as in contaminated soil. This efficient degradation by strain can be attributed to the enhanced catalytic efficiency (low Km and high Vmax) of key enzyme 2,4-dichlorophenol-6-monooxygenase (2,4-DCPM). Strain DSPFs mitigate the toxicity caused by 2,4-D to crops and also promote plant growth. This tri-functional (bioremediator-phytoprotecting-plant growth promoting) bacterium has significant potential in the eco-friendly remediation of 2,4-D in agricultural fields to prevent groundwater contamination, reduce phytotoxicity of herbicides, and enhance crop productivity.
23. Synergistic Promotion of Triple-Negative Breast Cancer Tumorigenesis and Metastasis by Oral Polystyrene Nanoplastics Exposure via Alloprevotella-Derived Glutamate and Platelet Activation.
期刊: Advanced science (Weinheim, Baden-Wurttemberg, Germany) 发表日期: 2025-Sep-24 链接: PubMed
摘要
Nanoplastics (NPs) are emerging environmental pollutants with potential health risks, yet their role in cancer progression remains poorly understood. Here, this is demonstrated that oral exposure to 100 nm polystyrene nanoplastics (PS-NPs) accelerates tumor initiation and metastasis in a murine triple-negative breast cancer (TNBC) model, without affecting primary tumor growth. PS-NPs do not directly alter TNBC cell behavior in vitro but induced gut microbiota dysbiosis, characterized by Alloprevotella enrichment and elevated systemic glutamate levels, both identified as key mediators of PS-NPs-driven tumor promotion. Moreover, PS-NPs enhanced platelet activation, evidenced by increased aggregation, microthrombus formation at metastatic sites, and upregulation of CD36 and Serpine1. Collectively, these findings uncover a synergistic mechanism whereby oral PS-NPs promote TNBC progression via a gut microbiota-derived metabolite-platelet axis, establishing an unrecognized link between environmental nanoplastic exposure and cancer progression, and highlighting potential therapeutic targets for intervention.
24. Establishing a Practical Approach to Sewer Monitoring for Antimicrobial Resistance Genes and Organisms at Healthcare Facilities.
期刊: The Journal of infectious diseases 发表日期: 2025-Sep-24 链接: PubMed
摘要
Surveillance of wastewater from healthcare facilities has the potential to identify the emergence of multidrug-resistance (MDR) genes of public health importance. Specifically, wastewater surveillance (WWS) can provide sentinel surveillance of novel MDR genes or organisms in healthcare facilities, helping to direct targeted prevention efforts and monitor longitudinal effects. Several knowledge gaps need to be addressed before WWS can be used routinely for MDR surveillance, including determining optimal approaches to sampling, processing, and testing wastewater. To this end, we evaluated multiple methods for wastewater collection (passive, composite, and grab), concentration (nanoparticles, filtration, and centrifugation), and PCR quantification (real-time quantitative PCR vs. digital PCR) for Candida auris and 5 carbapenemase genes (blaKPC, blaNDM, blaVIM, blaIMP, and blaOXA-48-like) twice weekly for 6 months at a long-term acute care hospital in Chicago, IL. We also tested the effects of different transport and sample storage conditions on PCR quantification. All genes were detected in facility wastewater, with blaKPC being the most consistently abundant. Experiments were done in triplicate with gene copy, variance, and number of detections between triplicates used to determine method efficacy. We found that passive samples processed immediately by centrifugation followed by bead-beating and dPCR provided the most reliable results for detecting MDR genes and C. auris. We also present the tradeoffs of different approaches and use culture and metagenomics to elucidate clinical relevance. This study establishes a practical approach for WWS as a potential tool for public health monitoring of MDR burden in healthcare facilities.
25. Vagotomy improves brown adipose tissue morphology and reduces steatosis in obese mice.
期刊: Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme 发表日期: 2025-Sep-24 链接: PubMed
摘要
The abolishment of vagal abdominal afferents and efferents inputs through vagotomy has been shown to prevent obesity. However, it is unknown whether such a strategy, performed after obesity installation, may treat, or ameliorate obesity and its comorbidities. Here, we aimed to verify the effects of subdiaphragmatic vagotomy on obesity and metabolic dysfunction-associated steatotic liver disease (MASLD) in obese mice that continued to be fed an obesogenic diet after the operation. Obesity was induced in male C57Bl/6 mice by ingestion of a high-fat diet (HFD). Afterward, obese (OB) mice were randomly submitted to Sham (OB-Sham group) or subdiaphragmatic vagotomy (OB-Vag group) and continued to be fed a HFD for 8 weeks. Vagotomy led to reductions in body weight (BW), without modifying food intake in OB-Vag mice. While these rodents showed no modifications in subcutaneous fat accumulation, they exhibited higher abdominal adiposity. In contrast, the weight of the interscapular brown adipose tissue (BAT) was lower in OB-Vag mice, with brown adipocytes in its parenchyma showing reduced size and fewer lipid vacuoles, resembling the high-thermogenic adipocyte type. This effect was partially explained by increased gene expressions of Prdm16, Pgc-1α and Dio2, key factors maintaining BAT identity and function. Furthermore, subdiaphragmatic vagotomy enhanced glucose tolerance, insulin sensitivity, improved serum, and hepatic lipids levels and ameliorated MASLD in OB-Vag mice. Vagotomy performed after obesity induction improved BAT function and insulin sensitivity, which may partly contribute to alleviating MASLD in OB mice that continued to consume an obesogenic diet.
26. Exertional Heat Illness Recovery and Recurrence.
期刊: Military medicine 发表日期: 2025-Sep-24 链接: PubMed
摘要
Exertional heat illness (EHI) is a threat to force health and readiness. EHI recovery can entail lengthy periods of lost duty time as providers ensure that patients have completely recovered and that the risk for recurrent EHI is low. Although EHI recurrence is a common concern, there is little research to inform or predict EHI recurrence. Here we describe characteristics associated with EHI duty restrictions and use them to predict EHI recurrence and prognosis. We studied a retrospective cohort of 1,742 US Army soldiers who received EHI duty restrictions because of a recent EHI diagnosis between July 2014 and April 2017. We used EHI complications, medical history, and demographics to predict EHI recurrence. The study protocol was approved by the Naval Medical Center Portsmouth Institutional Review Board. 4.4% of soldiers had recurrent EHI. Among soldiers receiving an EHI profile, a history of another prior EHI was rare (5.6%) but was strongly associated with recurrent EHI (HRadj: 7.37, 95% CI: 4.24-12.81). These associations were consistent across heat exhaustion (HE), heat injury (HI), and heat stroke (HS) cases. Shorter profile durations were associated with reduced risk for recurrence, but this association was mostly attributable to milder EHI events. Based on total duty restriction days, HI represented a greater disease burden than HS or HE. Recurrent EHI was more common among soldiers who had been on an HI (4.6%) or HS (6.1%) profile than an HE profile (3.7%), although these differences were not statistically significant. Clinical complications (e.g., kidney injury, rhabdomyolysis, respiratory/cardiovascular distress, inpatient/ICU admission) were not associated with EHI recurrence. Among soldiers on EHI duty restrictions, prior EHI is rare but strongly associated with risk for yet another EHI. The clinical characteristics (e.g., profile duration, complications) of a prior EHI were not associated with risk for recurrent EHI. Further research should characterize the role of EHI severity in return to duty and validate HI as a diagnostic category.
27. Interpretable Machine Learning Model for Pulmonary Hypertension Risk Prediction: Retrospective Cohort Study.
期刊: JMIR medical informatics 发表日期: 2025-Sep-24 链接: PubMed
摘要
Pulmonary hypertension (PH) is a progressive disorder characterized by elevated pulmonary artery pressure and increased pulmonary vascular resistance, ultimately leading to right heart failure. Early detection is critical for improving patient outcomes. The diagnosis of PH primarily relies on right heart catheterization, but its invasive nature significantly limits its clinical use. Echocardiography, as the most common noninvasive screening and diagnostic tool for PH, provides valuable patient information. This study aims to identify key PH predictors from echocardiographic parameters, laboratory tests, and demographic data using machine learning, ultimately constructing a predictive model to support early noninvasive diagnosis of PH. This study compiled comprehensive datasets comprising echocardiography measurements, clinical laboratory data, and fundamental demographic information from patients with PH and matched controls. The final analytical cohort consisted of 895 participants with 85 evaluated variables. Recursive feature elimination was used to select the most relevant echocardiographic variables, which were subsequently integrated into a composite ultrasound index using machine learning techniques, XGBoost (Extreme Gradient Boosting). LASSO (least absolute shrinkage and selection operator) regression was applied to select the potential predictive variable from laboratory tests. Then, the ultrasound index variables and selected laboratory tests were combined to construct a logistic regression model for the predictive diagnosis of PH. The model’s performance was rigorously evaluated using receiver operating characteristic curves, calibration plots, and decision curve analysis to ensure its clinical relevance and accuracy. Both internal and external validation were used to assess the performance of the constructed model. A total of 16 echocardiographic parameters (right atrium diameter, pulmonary artery diameter, left atrium diameter, tricuspid valve reflux degree, right ventricular diameter, E/E’ [ratio of mitral valve early diastolic inflow velocity (E) to mitral annulus early diastolic velocity (E’)], interventricular septal thickness, left ventricular diameter, ascending aortic diameter, left ventricular ejection fraction, left ventricular outflow tract velocity, mitral valve reflux degree, pulmonary valve outflow velocity, mitral valve inflow velocity, aortic valve reflux degree, and left ventricular posterior wall thickness) combined with 2 laboratory biomarkers (prothrombin time activity and cystatin C) were identified as optimal predictors, forming a high-performance PH prediction model. The diagnostic model demonstrated high predictive accuracy, with an area under the receiver operating characteristic curve of 0.997 in the internal validation and 0.974 in the external validation. Both calibration plots and decision curve analysis validated the model’s predictive accuracy and clinical applicability, with optimal performance observed at higher risk stratification cutoffs. This model enhances early PH diagnosis through a noninvasive approach and demonstrates strong predictive accuracy. It facilitates early intervention and personalized treatment, with potential applications in broader cardiovascular disease management.
28. Afucosylation of anti-dengue IgG is associated with enhanced susceptibility to dengue virus infection postvaccination.
期刊: Science translational medicine 发表日期: 2025-Sep-24 链接: PubMed
摘要
Dengue viruses (DENVs) cause 390 million infections annually, although only ~25% of these infections are symptomatic. Whereas antibody features linked to severe DENV disease are well studied, factors influencing infection susceptibility remain less clear. Here, we examined immunoglobulin G (IgG) characteristics before and after DENV vaccination (Dengvaxia) in individuals with a history of prior DENV exposure, comparing those who developed postvaccination infections to those who remained infection free. Elevated anti-DENV afucosylation, present before or after vaccination, was associated with increased likelihood of infection after vaccination. These data were further supported by mechanistic studies, which revealed that nonneutralizing, afucosylated, post-Dengvaxia IgG enhanced DENV replication in mice. This enhancement was dependent on CD16, the receptor for the afucosylated IgG Fc domain. Together, these findings support a model in which the presence of afucosylated IgG promotes virus replication, increasing the likelihood of productive infection upon DENV exposure. Moreover, these results highlight that IgG1 fucosylation is a predictor of risk for breakthrough DENV infection despite vaccination and support the importance of investigating strategies to regulate Fc fucosylation during vaccination.
29. Environmental Factors That Regulate Mosquito Physiology and Behavior.
期刊: Annual review of entomology 发表日期: 2025-Sep-24 链接: PubMed
摘要
Mosquitoes remain the greatest threat to global human health because they transmit pathogens to humans and other animals when females imbibe a blood meal. Disease transmission is restricted temporally and spatially because not all seasons or habitats support mosquito growth, development, host seeking, and reproduction. Temperate mosquitoes respond to photoperiod by entering states of arrested development to survive harsh winter conditions. Additionally, temperature profoundly influences mosquito development, host seeking, and reproductive processes, as well as pathogen replication. Recent research is uncovering how humidity affects mosquito host-seeking and oviposition behavior. Researchers are also gaining an understanding of how light pollution and high temperatures in cities impact mosquito physiology and behavior. Future studies characterizing the interactions among multiple environmental factors will allow researchers to better predict how mosquitoes are responding to increasing urbanization and climate change, to develop novel control measures, and to better direct interventions to limit disease transmission.
30. Gender Matters: How Girls and Boys Express Multisystemic Resilience in the Context of Maternal Syndemics.
期刊: Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53 发表日期: 2025-Sep-24 链接: PubMed
摘要
Substance use, violence, and HIV/AIDS (i.e. SAVA) are three adversities known to cluster and contribute to other poor health outcomes among marginalized communities due to structural factors including racism and poverty. Most research on SAVA has focused on negative outcomes (e.g. psychopathology) among those directly affected. To address important gaps in the literature, the current study explored how child gender moderates the associations between maternal SAVA severity and child individual, relational, community, and cultural resilience. Participants included 263 children (Mage = 12.11, SD = 2.77; 59% girls; 82% Black) and their maternal caregivers. SAVA severity was examined as a continuous latent variable and resilience levels were calculated via confirmatory factor analysis based on manifest variables. After adjusting for covariates, linear regression analyses indicated that, among girls but not boys, lower maternal SAVA severity was associated with higher individual (β = -0.22, p = .04, d = 0.01) and community (β = -0.27, p = .02, d = 0.02) level resilience. Further, across all children, lower maternal SAVA severity was associated with higher cultural resilience (β = -0.24, p < .001, d = 0.04). The association between maternal SAVA and relational resilience was not statistically significant. Maternal SAVA impacts child resilience, but this effect is not uniform, as findings illustrated differential effects of SAVA by child gender and resilience level. This work emphasizes the critical need to assess and understand unique drivers of child resilience in order to intervene effectively on co-occurring adversities.
31. Loneliness in schizophrenia: Just loneliness.
期刊: Annals of the New York Academy of Sciences 发表日期: 2025-Sep-24 链接: PubMed
摘要
Loneliness is reported by the majority of people with schizophrenia (∼80%), yet the cognitive and neural mechanisms underlying loneliness in this population are incompletely understood. Similar to the general population, loneliness in schizophrenia is associated with cognitive biases toward mistrusting others, as well as structural barriers to social activity. In addition, some evidence suggests that predisposing genetic and environmental factors, as well as some of the neural changes and the poor cardiometabolic health linked with the illness, are associated with loneliness in schizophrenia. However, much evidence supports a transdiagnostic model of the causes and consequences of loneliness, with similar factors playing a role in loneliness in schizophrenia and the general population. Currently there are no validated treatments targeting loneliness associated with schizophrenia, although interventions focusing on cognitive bias modification, positive psychology, mindfulness, or interpersonal synchrony have shown promise. Taken together, the current state of the field suggests that future research on schizophrenia should include measurements of social isolation and loneliness. Overall, there is a need for novel intervention approaches that can interrupt the cycle of mutually reinforcing neurocognitive biases and environmental conditions linked with loneliness in schizophrenia and other populations.
32. Health hazards associated with radon present in soil of Nizampur, Khyber Pakhtunkhwa, Pakistan.
期刊: Isotopes in environmental and health studies 发表日期: 2025-Sep-24 链接: PubMed
摘要
Over 50% of the annual dosage is caused by inhaling radon, thoron, and their decay products. Additionally, indoor concentrations of radon and thoron’s decay agents are primarily responsible for the inhalation doses linked to these gases. This study aimed to measure the activity of radon in soil of Nizampur, and associated cancer risk using an RAD7 detector. The range and average values of radon in soil were found to be 994-14,700 Bq m-3 and 6184 Bq m-3, respectively. Radon exhalation rate ranged from 220 to 3442 Bq m-2 h-1 with an average value of 1447 Bq m-2 h-1. The statistical analysis of radon in the soil shows that due to possible localized sources or measurement inconsistency, ambient radon data often exhibits mild skewness or kurtosis, which is shown by minor deviations at the extremes (tails). Based on the values of radon exhalation rate which were found higher than the world permissible value of 57.60 Bq m-2 h-1, it is concluded that the soil of the study area may pose health hazards if it is used for construction or other purposes.
33. USP5 inhibition enables potential therapy for t(8;21) AML through ubiquitin-mediated AML1-ETO degradation in patient-derived xenografts.
期刊: Science translational medicine 发表日期: 2025-Sep-24 链接: PubMed
摘要
The AML1-ETO (AE) fusion protein is a key target for treating t(8;21) acute myeloid leukemia (AML). In this investigation, we identified ubiquitin-specific protease 5 (USP5) as the deubiquitinating enzyme of AE. USP5 knockdown decreased AML cell growth and induced differentiation both in vitro and in vivo. In addition, we developed a high-throughput screening (HTS) method and identified a potent, selective USP5 inhibitor, WCY-8-67. This lead compound was identified as a selective USP5 inhibitor by targeting the ubiquitin-associated domain 2 (UBA2) region. It also induced aggregation and precipitation of the target protein, which led to USP5 dysfunction. WCY-8-67 exhibited excellent in vivo bioavailability and tolerability, and it effectively inhibited the growth of AML cells in animal models. In addition, in a patient-derived xenograft (PDX) model, this compound, when combined with 5-azacytidine (5-Aza), improved therapeutic effects. This study presents promising targeted therapeutic possibilities for the treatment of t(8;21) AML that require further study.
34. Concurrent use of hormonal long-acting reversible contraception by women of reproductive age dispensed teratogenic medications, Australia, 2013-2021.
期刊: The Medical journal of Australia 发表日期: 2025-Sep-24 链接: PubMed
摘要
35. Evidence for the lack of an increase in DNA damage in occupational healthcare workers exposed to ionizing radiation: An indication of radiation safety.
期刊: Journal of occupational and environmental hygiene 发表日期: 2025-Sep-24 链接: PubMed
摘要
Understanding the health concerns linked to long-term low-dose ionizing radiation exposure is essential to creating safety protocols and protective gear for healthcare workers. Despite reports on the biological effects of low-dose chronic or protracted exposure to ionizing radiation, its association with long-term health effects remains unclear. To examine this, the authors obtained and tested peripheral blood samples from control participants (Healthcare workers not involved in radiation-based work (n = 21) and healthcare professionals (n = 25) receiving low-dose radiation over time as part of their occupation. Change in case with alignment to control, for early and delayed DNA damage was measured using the formation of gamma H2AX (γ-H2AX), micronucleus (MN), and Ferrodoxin reductase (FDXR) expression changes. These biomarkers were compared to cumulative registered doses, as determined by the individuals’ personal dosimetry records using thermoluminescent dosimeters (TLDs). The mean γ-H2AX foci frequency estimated in blood lymphocytes among the control group was 0.05 ± 0.01, and in healthcare workers was 0.04 ± 0.01 (p > 0.05). The mean of MN aberration frequency ± standard error (SE) in control was 0.001 ± 0.001 and in healthcare workers was 0.005 ± 0.002 (p < 0.0001). Similarly, FDXR expression in healthcare workers increased by 7% when compared to the control group. The cumulative registered dose in the healthcare workers’ monitoring device varied between 0 and 21 mSv with an average of 3.65 mSv. A weak correlation was observed between the registered TLD dose and biomarker- γ-H2AX (R2=0.0123), MN (R2= 0.0011), and FDXR expression (R2= 0.0006). The study results suggest a lack of dose-dependent increase in DNA damage as evaluated by γ-H2AX, MN formation, and FDXR expression change among healthcare workers exposed to chronic low-dose radiation. Moreover, the observed range of these biomarkers was not significantly different from the baseline data established from apparently healthy non-radiation workers of the same population. Assay sensitivity and healthcare worker adherence to safety procedures to decrease exposures are two probable factors for the lack of correlation between the registered dose and that of DNA damage.
36. Survival trends and cure rates of hematological neoplasms in the Spanish pediatric population.
期刊: European journal of epidemiology 发表日期: 2025-Sep-24 链接: PubMed
摘要
Hematological neoplasms (HN) were the first cause of death in children aged 5-9 years in Spain. The aim of this registry-based study is to provide a detailed overview of the survival of HN in the Spanish pediatric population. All pediatric HN cases included were classified according to the International Classification for Childhood Cancer. Flexible parametric models were used to estimate survival probabilities and long-term survival projections. Survival trends were evaluated with the annual average change in survival (AAC_S). Latent cure models were used to estimate cure fractions (CF). A total of 4706 cases of HN were diagnosed in Spain during 2000-2016, for which 2850 (60.6%) were boys. Leukemias and lymphoid leukemias (LL) were the most common type and subtype of HN in children. An overall 5- year survival of 84.3% [95% confidence intervals (CI): 83.3, 85.3] was observed for HNs. Children aged < 1 year with acute myeloid leukemia (AML) or myelodysplastic syndrome had the worst prognosis. An improvement over time was observed for all HN with an AAC_S of 0.71% [95% CI 0.50, 0.91], of which AML and Burkitt lymphomas displayed the greatest improvements. HNs revealed CF of 83.8% [95% CI 82.4, 85.3], with the highest CF being nearly 100% in Hodgkin lymphomas. Larger population coverage with updated data have aligned the Spanish results to those observed in other European countries. Continuous refinements in treatments, patient care and better diagnostic methods have revealed the highest survival improvements for HN subtypes with bad prognosis in children.
37. WITHDRAWAL - Administrative Duplicate Publication: Restructuring of the Québec Health Network and its Effects on the Profession of Home Health Aides and Their Occupational Health and Safety.
期刊: New solutions : a journal of environmental and occupational health policy : NS 发表日期: 2025-Sep-24 链接: PubMed
摘要
38. Effectiveness of work ability interventions on productivity - A systematic review.
期刊: Journal of occupational health 发表日期: 2025-Sep-24 链接: PubMed
摘要
This systematic review aimed to synthesize the effectiveness of work ability interventions on productivity outcomes. This systematic review was registered in PROSPERO (CRD42024541404) and conducted in accordance with PRISMA guidelines. In December 2024, a systematic search from 2000- onward was conducted using databases including EBSCO, ProQuest, Scopus, Web of Science, and PubMed. Two reviewers independently screened articles, assessed quality using risk of bias tools, extracted data, with a third reviewer resolving any disagreements. The eligibility criteria were defined using population, intervention, comparison, outcomes, and study design (PICOS) elements. Of the 55 articles that underwent quality assessment, 26 were excluded due to high risk of bias. Among the remaining 29 articles, 24 were RCTs, of which five conducted economic evaluation and five were NRCTs collectively conducting 33 interventions. The results of the original studies showed that five work ability interventions had a statistically significant effect on productivity. Four interventions effectively reduced absenteeism, while one intervention increased the risk of absenteeism. One intervention indicated that the cost of absenteeism was reduced, and another showed that the intervention was more effective and less costly than usual occupational care. The analysis of work ability interventions showed that 28 interventions did not have an effect on productivity and only five interventions affected productivity. This systematic review highlights the limited evidence regarding evidence-based work ability interventions that affect productivity. Despite the importance of the topic, it remains understudied, and there is insufficient evidence to support decision-makers aiming to enhance productivity.
39. Quantitative analysis of vial surface and cross-contamination of widely used antineoplastic drugs in Türkiye: A critical assessment for manufacturing and occupational safety.
期刊: Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners 发表日期: 2025-Sep-24 链接: PubMed
摘要
IntroductionThe global rise in cancer incidence has led to an increased demand for antineoplastic agents, intensifying occupational risks associated with drug handling.MethodsThis study aimed to quantitatively assess both surface contamination and cross-contamination on the vials of six frequently used cytotoxic drugs in Türkiye, 5-fluorouracil (5-FU), doxorubicin, etoposide, gemcitabine, ifosfamide, and cyclophosphamide, using a standardized wipe sampling method followed by LC-MS/MS analysis. This study quantitatively assess both surface contamination on 65 vials of six frequently used cytotoxic drugs and cross-contamination on an extended set of 75 vials (including oxaliplatin), using a standardized wipe sampling method followed by LC-MS/MS analysis.ResultsOut of 65 vials, 63.08% were contaminated with the active pharmaceutical ingredient (API), while 49.33% of 75 vials exhibited cross-contamination with other APIs. Notably, contamination was present in 100% of 5-FU and gemcitabine samples, with the highest recorded level reaching 2276.920 ng/cm2 (133199.848 ng/vial).ConclusionsWe explicitly state that this is the first study in Türkiye to assess both surface and cross-contamination on cytotoxic drug vials at a national level. These findings underscore significant disparities in manufacturing hygiene practices and highlight an urgent need for regulatory oversight to mitigate healthcare worker exposure risks. The study advocates mandatory contamination reporting, stricter decontamination protocols, and enhanced batch control measures in drug production facilities.
40. Exploring the potential toxic mechanisms of bisphenol F exposure in acute myeloid leukemia: Insights from network toxicology, molecular docking and experimental validation.
期刊: International immunopharmacology 发表日期: 2025-Sep-23 链接: PubMed
摘要
Bisphenol F (BPF), a major alternative to bisphenol A (BPA), is now widely used worldwide, posing significant risks to human health and the environment. Acute myeloid leukemia (AML) is a highly aggressive hematologic malignancy with a poor prognosis. This investigation aims to systematically evaluate the potential hematotoxic of BPF in AML through an integrated computational biology approach combining network toxicology, molecular docking simulations and experimental validation. The study is designed to identify critical molecular targets and elucidate the mechanistic basis of BPF-mediated toxicity in AML. Using network toxicology and molecular docking techniques, we identified potential BPF targets through the SwissTargetPrediction, PharmMapper, and SEA databases. A total of 162 targets associated with BPF and AML were identified, with 25 key targets-including EGFR, ALB, BCL2, HSP90AA1, and ESR1-screened using STRING and Cytoscape tools. GO and KEGG enrichment analysis showed that “Pathways in cancer”, “PI3K-Akt signaling pathway”, “reactive oxygen species”, “EGFR tyrosine kinase inhibitor resistance” and “Th17 cell differentiation” were mainly involved in potential toxicity of BPF in AML. Molecular docking with the CB-Dock online tool confirmed the stable interaction between BPF and key targets. Experimental validation supported these predictions: BPF exposure induced proliferation promotion in AML cell lines (HL-60/KG-1/MV4-11), along with rapid activation of EGFR/PI3K/AKT phosphorylation and BCL2 upregulation. In conclusion, this study provides a foundation for understanding the molecular mechanisms of potential toxicity of BPF in AML, provides valuable insights for risk assessment and public health policy, and emphasizes the need for stricter regulation and intervention of BPF exposure.
41. Recent advances and clinical potential of hyaluronic acid methacrylate (HAMA)/ceramic composites in oral and dental regenerative therapies: A comprehensive review.
期刊: Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie 发表日期: 2025-Sep-23 链接: PubMed
摘要
Hyaluronic acid methacrylate (HAMA) has emerged as a promising biomaterial for oral and dental applications due to its inherent biocompatibility, controllable biodegradability, and tunable mechanical properties. The incorporation of ceramic components (e.g., hydroxyapatite, tricalcium phosphate, bioactive glass) into HAMA-based composites synergistically enhances their mechanical robustness, bioactivity, and osteogenic capacity, thereby expanding their utility in dental tissue engineering, periodontal regeneration, and implant surface functionalization. This review provides a comprehensive analysis of recent advancements in the design, fabrication, and application of HAMA/ceramic composites. Our analysis of the literature reveals that these composites demonstrate significant promise: they enhance compressive modulus, support high cell viability in 3D-bioprinted constructs, and achieve sustained release of antimicrobials and ions to concurrently combat infection and promote osteogenesis. Key findings indicate their efficacy in guided bone regeneration, periodontal defect repair, where they reduce inflammatory markers and inhibit periodontal pathogens, and as bioactive implant coatings that improve osseointegration. Despite these advancements, significant challenges persist in scalability, long-term structural stability, and clinical translation. By integrating insights from materials science, cellular biology, and clinical dentistry, this review concludes that HAMA/ceramic composites represent a paradigm-shifting platform for next-generation dental therapies. Their unique combination of properties positions them to overcome the limitations of conventional biomaterials, though future efforts must focus on standardizing fabrication protocols and validating their efficacy in controlled human trials.
42. Visnagin mitigates acute kidney injury caused by lipopolysaccharide administration by inhibiting the NF-κB and pyroptosis pathways.
期刊: Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie 发表日期: 2025-Sep-23 链接: PubMed
摘要
Sepsis-associated acute kidney injury (AKI) is a life-threatening complication marked by inflammation-driven renal dysfunction. Although advances have been made in supportive care, pharmacologic therapies targeting the underlying molecular mechanisms of sepsis-associated AKI are lacking. Visnagin, a furanochromone derivative with anti-inflammatory properties, has yet to be explored in treatment for sepsis-associated AKI. This study used a network pharmacology approach to identify visnagin targets associated with AKI. We conducted gene enrichment and protein-protein interaction analyses and performed molecular docking to predict binding affinities between visnagin and key inflammatory proteins. An in vivo murine model of LPS-induced AKI was established to evaluate the protection of visnagin. Renal function was assessed through serum creatinine and blood urea nitrogen levels. Additionally, histological injury, inflammatory cytokine expression, and molecular pathways were analysed. Bioinformatics analyses identified MAPK1, MAPK14, NFKB1, and CASP1 as hub genes potentially targeted by visnagin. Molecular docking confirmed strong binding affinities between visnagin and these proteins that exceeded the binding affinity of dexamethasone in key inflammatory targets. In vivo, visnagin substantially reduced LPS-induced renal dysfunction and histopathological damage in a dose-dependent manner. Visnagin suppressed the phosphorylation of p38 MAPK and extracellular signal-related kinase, decreased NF-κB activation, and inhibited the generation of proinflammatory cytokines. Moreover, visnagin attenuated pyroptosis by inhibiting the NLRP3/apoptosis-associated-speck-like-protein-containing-a-caspase-recruitment-domain/caspase-1/Gasdermin-D axis. Visnagin mitigates LPS-induced AKI by targeting multiple signalling pathways, particularly NF-κB-mediated inflammation and NLRP3 inflammasome-mediated pyroptosis. These findings suggest that visnagin is a promising multitarget candidate for treating sepsis-associated AKI.
43. Recent developments in bioconjugation: From strategies to design and clinical applications.
期刊: Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie 发表日期: 2025-Sep-23 链接: PubMed
摘要
Bioconjugation is defined as the covalent attachment of biomolecules, such as proteins, carbohydrates, nucleic acids, or lipids, to another biomolecule or functional entity such as synthetic polymers, fluorescent probes, drugs, dyes, and targeting ligands. Bioconjugation plays a key role in modern biotechnology and medicine, enabling precise control over molecular recognition, stability, and biodistribution. This review provides a comprehensive and integrative perspective on bioconjugation, encompassing both traditional and emerging strategies while critically comparing their efficiency, stability, and clinical applicability. It evaluates the strengths and limitations of various approaches, from classical amide and thiol couplings to advanced bioorthogonal click chemistry. Furthermore, the review highlights innovative directions in optimizing bioconjugation, including linker design, enhanced stability profiles, stimuli-responsive release mechanisms, and predictive release kinetics. The work integrates recent advances into a framework that addresses key challenges, such as site-specificity, immunogenicity, and scalability and offers a practical guide for next-generation diagnostics and therapeutics.
44. Purpose in life and mortality among breast cancer survivors.
期刊: Health psychology : official journal of the Division of Health Psychology, American Psychological Association 发表日期: 2025-Sep-22 链接: PubMed
摘要
Purpose in life (PIL), referring to an individual’s sense of direction and meaning, may enhance well-being among cancer survivors. However, its relationship with survival remains unclear. This study investigates the association between PIL and mortality among breast cancer survivors and explores potential underlying pathways. We analyzed 3,692 breast cancer survivors from the Women’s Health Initiative, a cohort of postmenopausal women aged 50-79 recruited between 1993 and 1998. PIL was assessed in 2012 using a modified seven-item measure from Ryff and Keyes’ Psychological Well-Being scale. Breast cancer cases and causes of death were confirmed through medical record review and death certificates. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), with mediation analysis exploring underlying pathways. Over 9.1 years of follow-up, 1,627 women (44.1%) died. Women in the highest PIL quartile had a 33% lower mortality risk than those in the lowest quartile (HR = 0.67, 95% CI = [0.58, 0.78], p for trend < .0001). Stronger associations were observed among women under 70 (HR = 0.34, 95% CI = [0.19, 0.63]) and those diagnosed within the past year (HR = 0.28, 95% CI = [0.13, 0.58]). Physical activity, low perceived stress, and social engagement mediated 14.2%, 18.3%, and 13.7% of the association, respectively, collectively explaining 51% of the association. Higher PIL is associated with improved survival in breast cancer survivors, with physical activity, stress reduction, and social engagement as key pathways. Goal-oriented interventions promoting PIL may improve survivorship outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
45. AuNSs@Ag Nanoprobe-based dual-mode sensor for rapid and sensitive detection of dimethoate.
期刊: Spectrochimica acta. Part A, Molecular and biomolecular spectroscopy 发表日期: 2025-Sep-20 链接: PubMed
摘要
Dimethoate (DMT), an organophosphate pesticide, is extensively employed in agriculture for pest management, however its persistent residues raise critical concerns regarding human health and environmental safety, necessitating the development of reliable quantification methods for residual monitoring. The sensor utilizes silver-coated gold nanostructures (AuNSs@Ag), which possess bimetallic properties and intrinsic peroxidase-like activity, to catalyze the H2O2-mediated oxidation of 3,3’,5,5’-tetramethylbenzidine (TMB). This reaction results in the formation of a blue oxidation product (ox-TMB), producing a distinct colorimetric signal. Simultaneously, this reaction generates a characteristic SERS fingerprint spectrum of ox-TMB. However, upon the introduction of DMT, competitive adsorption occurs between DMT and TMB for the active sites on the surface of AuNSs@Ag, resulting in a reduction of the reactive sites on AuNSs@Ag and a decrease in its peroxidase-like activity. Consequently, the formation of ox-TMB is reduced, leading to a diminished transition from the colorless to the blue state, as well as a weakened SERS signal. Therefore, this dual-mode probe enables specific and highly sensitive detection of DMT. The limit of detection (LOD) for DMT was determined to be 6.76 μg/L using the colorimetric method and 1.19 μg/L using the SERS method. In real sample applications, such as in apples and celery, the recovery rates ranged from 88.33 % to 116.67 %, with relative standard deviations (RSD) below 5 %. This dual-mode sensor offers a simple, rapid, and cost-effective approach for on-site detection of DMT, presenting significant potential for applications in food safety monitoring and environmental protection.
46. A materialized intelligent sensing platform driven by ultra-sensitive fluorescent probe: Smart phone-assisted portable detection of SO2 and its derivatives.
期刊: Spectrochimica acta. Part A, Molecular and biomolecular spectroscopy 发表日期: 2025-Sep-20 链接: PubMed
摘要
Sulfur dioxide (SO2) has long been recognized as an environmental pollutant, and excessive intake of SO2 and its derivatives (HSO3-/SO32-) is harmful to human health. In this paper, we report a specific recognition of HSO3- fluorescent probe RQB-RP, which exhibits color-enhancing and strong fluorescence activation, good water solubility, fast response (4 s), high fluorescence quantum efficiency (Ф = 21.87 %) and high sensitivity (detection limit = 120.66 nM), and has a strong potential for application. Furthermore, the probe RQB-RP was materialized and combined with a smartphone sensing platform to achieve on-site visual quantitative detection of HSO3- without the need for large-scale instrumentation. The RQB-RP also has the ability to accurately detect HSO3- levels in food and Chinese medicine samples to assess compliance and safety. Furthermore, RQB-RP’s excellent biocompatibility has been successfully used for the in situ detection of endogenous and exogenous HSO3- in mitochondria of MCF-7 cells.
47. The socioeconomic, health, and family situation of parents of patients with substance use diagnosis: A descriptive registry study.
期刊: Drug and alcohol dependence 发表日期: 2025-Sep-18 链接: PubMed
摘要
The characteristics of parents of patients with substance use diagnoses (PPSUD) have received limited attention in public health. Previous studies, mainly based on convenience samples, report challenges in health, work, and family life. Using register data, this study provides a broad descriptive overview of their characteristics. Based on patient records from 2008 to 2018, we identified 111,075 PPSUD residing in Norway in 2018. A subgroup excluding parents with substance use diagnoses themselves (PPSUDExcl; n = 98,507) was matched by age and gender to parents without substance use diagnoses from the general population (Comparison; n = 98,507). We compared proportions and means. Parents of patients with substance use diagnosis were more often divorced (PPSUDExcl: 28.7 %; Comparison: 17.9 %; p-values <.001 for this and subsequent comparisons), less likely to work full-time (57.9 % vs. 68.5 %), and more likely to receive disability pension (23.4 % vs. 13.7 %) and have sickness absence (27.7 % vs. 20.8 %). General practitioner consultations were more common among PPSUDExcl (82.5 %) than Comparison (80.7 %), especially for mental health (15.4 % vs. 10.7 %) and musculoskeletal issues (35.8 % vs. 33.0 %), but physiotherapy use was lower (16.6 % vs. 18.5 %). Hospital admission rates were higher for PPSUDExcl (15.1 %) than Comparison (12.9 %). Parents of patients with substance use diagnosis face more challenges than other parents across life domains, including weaker labour market attachment, greater dependence on benefits, more mental health-related consultations, and higher overall healthcare use. Large discrepancies in disability pension and sickness absence, but modest in overall healthcare utilisation, suggest potential underutilisation of healthcare services.
48. Association of substance use with stroke in heart failure by community socioeconomic distress.
期刊: Drug and alcohol dependence 发表日期: 2025-Sep-18 链接: PubMed
摘要
Substance use is common among individuals with heart failure (HF) and is linked to cardiotoxic effects and adverse outcomes. Given the increased vulnerability of HF patients to ischemic stroke, understanding how substance use and community distress contribute to this risk is vital for optimizing clinical prevention strategies. This study examined whether substance use increases stroke risk among HF patients and whether this association differs by community distress level. We conducted a multicenter study using data from HF patients treated at WVU Medicine and Charleston Area Medical Center (CAMC) in West Virginia between 2017 and 2023. Multivariable logistic regression assessed the association between substance use and ischemic stroke, stratified by community distress level and adjusted for demographics and comorbidities. Among 33,663 individuals with HF in the WVU Medicine cohort, 2651 (7.88 %) experienced a stroke. Among 8050 in the CAMC cohort, 900 (11.18 %) experienced a stroke. Overall, among both cohorts, patients with substance use disorder diagnoses had greater odds of stroke. WVU (aOR, 1.36; 95 % CI, 1.14-1.63) and CAMC (aOR, 3.50; 95 % CI, 2.85-4.55). In distressed communities, the association was stronger: WVU (aOR, 1.68; 95 % CI, 1.34-2.09) and CAMC (aOR, 3.70; 95 % CI, 3.03-4.52). In non-distressed communities, only the CAMC cohort showed a significant association (aOR, 1.80; 95 % CI, 1.63-2.09). Substance use is linked to higher stroke risk among HF patients, especially in socioeconomically distressed communities. Addressing both clinical and structural factors is essential for effective stroke prevention in this population.
49. Multiparametric MRI and clinical factors for predicting early recurrence of breast cancer after modified radical mastectomy.
期刊: Clinical imaging 发表日期: 2025-Sep-18 链接: PubMed
摘要
To determine whether preoperative multiparametric MRI features and clinicopathological factors can predict early recurrence in breast cancer patients following modified radical mastectomy (MRM). This retrospective study included 132 patients who underwent MRM at two hospitals from January 2012 to December 2022. Patients were classified into early recurrence (disease-free survival ≤3 years, n = 86) or late recurrence (>3 years, n = 46). We collected preoperative MRI features (tumor size, morphology, enhancement patterns, apparent diffusion coefficient (ADC) values, early enhancement rate, time-signal intensity curves) and clinical/pathological factors (age, menstruation status, neoadjuvant chemotherapy, T/N/TNM stage, tumor grade, axillary nodal involvement, vascular/nerve/nipple/skin invasion, ER, PR, HER-2, Ki-67, molecular subtype, and adjuvant therapies). Univariate and multivariate analyses (binary logistic and Cox regression) identified independent predictors of early recurrence and their impact on disease-free survival. Predictive accuracy was assessed by ROC curves. Significant factors associated with early recurrence (P < 0.05) included tumor size, ADC value, early enhancement rate, axillary lymph node metastasis, T and TNM stage, vascular invasion, ER, PR, HER-2, molecular subtype, and endocrine therapy. Multivariate analysis identified early enhancement rate, lower ADC value, and larger tumor diameter as independent predictors (AUC = 0.899). These MRI factors, together with lack of endocrine therapy, also independently influenced disease-free survival. Preoperative multiparametric MRI features, especially early enhancement rate and tumor size, combined with endocrine therapy status, can predict early recurrence, enhancing prognosis for patients undergoing MRM.
50. Runners with osteoarthritis sustain more injuries than healthy runners: An observational cohort study.
期刊: Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine 发表日期: 2025-Sep-16 链接: PubMed
摘要
Examine whether runners with specific diseases, including osteoarthritis, osteoporosis, rheumatoid arthritis, diabetes, multiple sclerosis (MS), cancer, or multiple diseases, sustain more running-related injuries (RRI) compared with healthy runners in the Garmin-RUNSAFE Running Health Study. 18-month cohort study. Participants were runners ≥18 years, proficient in English, and using a Garmin watch. Exposure included having one of the following diseases: osteoarthritis, osteoporosis, rheumatoid arthritis, diabetes type 1 or 2, multiple sclerosis (MS), cancer, or multiple diseases. Outcome was sustaining an RRI and was reported through weekly questionnaires. Appropriate censoring methods were applied for discontinued participation. Time-to-event analysis assessed after 1000 km running. Of 7038 included runners, 6207 had no disease and 831 had at least one of the specified diseases. After 1000 km, 64.4 % of runners with a disease and 56.7 % of healthy runners sustained an RRI, yielding a cumulative incidence risk difference (cIRD) of 8.0 % (95 %CI: 4.0-12.0 %). Among separate diseases, a significant risk difference was observed between the osteoarthritis group and the healthy group, with a cIRD of 14.7 % (95 %CI: 9.0-20.4 %). A significantly higher incidence of running-related injuries was observed among adult runners reporting a disease. Runners with osteoarthritis is a particularly vulnerable sub-group.
51. Alcohol interventions for persons with HIV: Meta-analysis of randomized controlled trials using phosphatidylethanol and self-report.
期刊: Drug and alcohol dependence 发表日期: 2025-Sep-12 链接: PubMed
摘要
Interventions are needed to reduce alcohol use for people living with HIV (PWH), but prior randomized controlled trials (RCT) evaluated efficacy by self-reported alcohol use, potentially hampering validity. We aimed to determine alcohol intervention efficacy using the alcohol biomarker, phosphatidylethanol (PEth), combined with self-report, and compare results to each analysed alone. We conducted a systematic review of alcohol intervention RCTs to April 2023, followed by an individual participant data meta-analysis (IPD-MA) using two-step random effects modeling. Our primary outcome was unhealthy alcohol use defined as PEth/self-report (binary), i.e., PEth≥ 50ng/mL or Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) ≥ 3 (women) and ≥ 4 (men). We also evaluated PEth and self-report alone. We screened 280 studies, found 20 eligible, and obtained IPD for 16 (N = 3559, median age=41, 72.8 % male). Participants receiving an alcohol intervention had significantly lower odds of follow-up unhealthy alcohol use by PEth/self-report (OR=0.69, 95 % CI: 0.55-0.86; Cohen’s d=0.21; I2=29.4 %, 95 % CI: 0.0 %-62.8 %). Risk-of-bias assessment indicated low or moderate risk. The certainty of evidence was moderate. Findings for PEth alone (OR=0.81, 95 % CI: 0.69-0.97; Cohen’s d=0.12; I2=5.7 %, 95 % CI: 0.0 %-49.5 %) and self-report alone (OR=0.67, 95 % CI: 0.50-0.89; Cohen’s d=0.22; I2=68.7 %, 95 % CI: 6.6 %-84.5 %) outcomes were similar, but heterogeneity was greater for self-report alone. Findings were robust to higher PEth/self-report cutoffs and continuous measures. Results confirm prior findings of significant efficacy of alcohol interventions for PWH. Effect sizes were small across measurements, while heterogeneity was high when using self-report alone. Combined PEth/self-report is a useful primary outcome for alcohol intervention studies.
52. Incidence and risk factors for portal vein complications after pediatric liver transplantation: A retrospective cohort analysis from the PORTAL registry.
期刊: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society 发表日期: 2025-Sep-10 链接: PubMed
摘要
Portal vein complications (PVCs) are recognized but infrequent complications following pediatric liver transplantation (pLT), particularly in young patients with biliary atresia (BA). However, the exact incidence of PVCs remains unclear. This study aimed to determine the overall incidence of PVCs after pLT and to explore variations within specific subgroups defined by indication for pLT, age at pLT, donor type, transplant era, and center volume. Differences between portal vein stenosis (PVS) and portal vein occlusion (PVO) were also examined. The Portal Vein Obstruction Revascularization Therapy After Liver Transplantation (PORTAL) registry, a multicenter, retrospective, observational database, collected data on PVCs from 21 pLT centers. Analysis of 6,035 pLT procedures performed over a 19-year period identified 385 cases of PVCs, yielding an overall incidence of 6.3%. PVS and PVO most commonly occurred within the first year post-pLT, with PVO peaking in the first week and PVS cases distributed more evenly throughout the year. The incidence was highest following pLT for BA performed before the age of one year (13.0%). PVC rates increased over time, rising from 4.3% during 2001-2006 to 6.9% during 2016-2020. The highest rates of PVS and the lowest rates of PVO were observed in high-volume centers. These findings clarify the incidence of PVCs among pLT recipients and provide critical insights to improve prevention, early detection, and management strategies for these complications.
53. Size of the Financial Incentives in Medicare's Skilled Nursing Facility Value-Based Purchasing Program.
期刊: JAMA network open 发表日期: 2025-Sep-02 链接: PubMed
摘要
The Skilled Nursing Facility Value-Based Purchasing (SNF VBP) program is the largest test to date of the use of financial incentives to incentivize reductions in hospital readmissions from SNFs. Initial evaluations suggest the program was not successful, and a key question is to what extent the size and distribution of the financial incentives may have played a role. To measure the scale and scope of the SNF VBP financial incentives in the first 3 years of the program in which incentives were assessed (2019-2021). This is a retrospective cohort study of eligible stays, associated Medicare reimbursement amounts, financial incentive percentage assessed by SNF VBP, and proportion of financial incentive to SNF net operating revenue for each participating SNF in each year of the program. All SNFs certified by the Centers for Medicare & Medicaid Services are required to participate in the VBP program. Participants included fee-for-service Medicare beneficiaries discharged from hospital to SNF for postacute care using the same inclusion and exclusion criteria as the SNF VBP program. Data were analyzed from March 2022 to December 2024. Financial penalties (up to 2% of all Medicare fee-for-service reimbursement for that year) or bonuses (up to 3% of all Medicare fee-for-service reimbursement for that year) for performance on risk-adjusted 30-day readmission rates. The primary outcomes were the annual amount of Medicare revenue subject to financial incentive and the financial incentive percentage for SNFs in the program, calculated by multiplying the total annual fee-for-service revenue for each SNF by the incentive multiplier published in the public SNF VBP data files. The analytic sample included 5 392 281 qualifying SNF stays in 14 189 SNFs. In the first 3 years of the program, the median (IQR) reimbursement adjustment across SNFs was -$10 336 (-$27 373 to $0), or 0.15% of the median SNF net operating income. Financial incentives varied greatly from year to year for individual SNFs: only 22.3% of SNFs (3167 SNFs) remained in the same quartile in all 3 years, and a substantial minority of those that changed quartiles moved more than 1 quartile from year to year (38.3% [2890 SNFs] from 2019 to 2020, and 44.3% [3101 SNFs] from 2020 to 2021). This cohort study of the SNF VBP program found that financial incentives were small, with large year-to-year variability for individual SNFs. This may have limited the program’s ability to induce meaningful investments to reduce hospital readmission.
54. Therapeutic Advances in Neurofibromatosis Type 1: A Focus on Selumetinib.
期刊: Skin therapy letter 发表日期: 2025-Sep 链接: PubMed
摘要
Neurofibromatosis type 1 (NF1) is a genetic condition inherited in an autosomal dominant pattern, but with 50% of cases caused by de novo mutations. Neurofibromin, the gene product in NF1, regulates the RAS/MAPK pathway, and mutation can lead to cell proliferation and the development of tumours. NF1 often presents in childhood with cafe-au-lait macules, skinfold freckling, nervous system tumours, and phenotypically variable findings. Plexiform neurofibromas (PN), a type of peripheral nerve sheath tumour seen in NF1, are typically histologically benign. However, PN can cause significant physical disfigurement, pain, and decreased quality of life, and have historically been difficult to treat. Selumetinib, a MEK inhibitor inhibiting the RAS/MAPK pathway, was Health Canada approved in 2022 for the treatment of symptomatic, inoperable PN in individuals with NF1 aged 2 years and older. Phase 1 and 2 trials have demonstrated reduced tumour size, decreased disfigurement and pain, and increased quality of life.
55. Clinical and Pathologic Landscapes of Delta-Like Ligand 3 and Seizure-Related Homolog Protein 6 Expression in Neuroendocrine Carcinomas.
期刊: JCO precision oncology 发表日期: 2025-Sep 链接: PubMed
摘要
Delta-like ligand 3 (DLL3) and seizure-related homolog protein 6 (SEZ6) are appealing drug targets in neuroendocrine carcinomas (NECs) given their preferential expression on the tumor cell surface compared with normal cells. We aimed to describe the landscape of these proteins across NECs from eight different primary sites. We used immunohistochemistry to assess 124 NEC tumor samples from any primary site for DLL3 and 53 for SEZ6 and defined positivity as ≥1% staining. DLL3 and SEZ6 were commonly expressed in our cohort (97 of 124, 78% and 43 of 53, 81% positivity rates, respectively) and frequently coexpressed when both tested (35 of 53, 66%). NECs of the breast, prostate, and GI system had the highest rates of DLL3 positivity (2 of 2, 100%; 15 of 16, 94%; and 14 of 17, 82%, respectively); all primary sites except lung exhibited 100% positivity rates for SEZ6. DLL3 expression and SEZ6 expression were seen in transformed NECs (12 of 17, 71% and 3 of 4, 75%, respectively) and in brain metastases (5 of 7, 71% and 1 of 2, 50%, respectively). Expression of both proteins tended to remain stable among 10 patients with serial biopsies. DLL3 expression did not affect progression-free survival (PFS) on first-line platinum/etoposide with or without immunotherapy among patients with metastatic lung NEC (median PFS 5.3 v 5.7 months in DLL3+ v DLL3-, P = .9) but was associated with longer overall survival (median 12.5 v 2.6 months, P = .03). We describe the landscape of DLL3 and SEZ6 coexpression across NECs, establishing a broad-based cohort of patients who might derive benefit from therapeutics in development targeting these cell surface determinants.
56. Histologic Subvariants of Retroperitoneal Well-Differentiated Liposarcoma Show Evidence of Clinical and Genomic Progression Toward Dedifferentiated Liposarcoma.
期刊: JCO precision oncology 发表日期: 2025-Sep 链接: PubMed
摘要
Several histologic subvariants of retroperitoneal well-differentiated liposarcoma (WDLS) have been described, but their associations with clinical outcomes, underlying genomic differences, and transformation to dedifferentiated liposarcoma (DDLS) are not well-defined. We identified 276 patients with primary retroperitoneal WDLS and 353 patients with primary retroperitoneal DDLS who underwent resection between July 1982 and July 2021 at our institution. WDLS histology was reviewed by a sarcoma pathologist and divided into three subvariants: lipoma-like, sclerosing/myxoid, or incipient/early dedifferentiated WDLS. We also performed an exploratory genomic analysis on a subset of 140 patients with available next-generation targeted sequencing data generated using the MSK-IMPACT platform. Compared with the lipoma-like subvariant, the sclerosing/myxoid (hazard ratio [HR], 3.2) and incipient/early dedifferentiated subvariants (HR, 5.3) and DDLS (HR, 9.6) were independently associated with higher incidence of disease-specific death after controlling for other prognostic factors such as tumor size and resection margins. Both the sclerosing/myxoid (HR, 2.9) and incipient/early dedifferentiated (HR, 5.4) subvariants were also associated with a higher incidence of subsequent dedifferentiation compared with the lipoma-like subvariant. On genomic exploratory analysis, compared with the lipoma-like samples, the sclerosing/myxoid and incipient/early dedifferentiated samples had significantly higher copy number log ratios (CNLRs) of MDM2 and CDK4, with the incipient/early dedifferentiated samples having similar CNLRs of MDM2 and CDK4 to DDLS samples. WDLS subvariants exhibit both a morphological and genomic progression along the WDLS to DDLS disease spectrum. Distinguishing between them is clinically meaningful for accurate patient counseling and enrollment and stratification in future clinical trials.
57. Ending publication bias: A values-based approach to surface null and negative results.
期刊: PLoS biology 发表日期: 2025-Sep 链接: PubMed
摘要
Sharing knowledge is a basic tenet of the scientific community, yet publication bias arising from the reluctance or inability to publish negative or null results remains a long-standing and deep-seated problem, albeit one that varies in severity between disciplines and study types. Recognizing that previous endeavors to address the issue have been fragmentary and largely unsuccessful, this Consensus View proposes concrete and concerted measures that major stakeholders can take to create and incentivize new pathways for publishing negative results. Funders, research institutions, publishers, learned societies, and the research community all have a role in making this an achievable norm that will buttress public trust in science.
58. Carbon footprint of the Chinese healthcare service: An environmentally extended input-output analysis.
期刊: PLoS medicine 发表日期: 2025-Sep 链接: PubMed
摘要
With the healthcare sector contributing nearly 5% of total global greenhouse gas (GHG) emissions globally, a precise assessment of their carbon footprint is crucial for achieving carbon neutrality targets. This study aims to comprehensively assess the carbon footprint of Chinese healthcare service providers, to identify their driving activities and sources across different time periods, and to provide a solid foundation for the development of effective emission reduction policies in healthcare service in China. The data on overall national health expenditures for 2012 and 2018, as well as expenditures by different levels of hospitals, various hospital departments, and specific diseases, were sourced from China’s Health Statistics Yearbooks and national input-output tables (IOTs). Environmentally extended input-output analysis (EEIOA) and structural path analysis (SPA) were utilized to assess the carbon footprint of healthcare services in China in 2012 and 2018. Overall, the total carbon footprint of Chinese healthcare service providers increased by 51 MtCO2e (15%) in 2018 compared to that in 2012, accounting for about 3.7% of the total domestic GHG emissions. In 2018, public hospitals made the largest contribution to the carbon footprint within the national health expenditure categories, with their carbon emissions increasing by 29 MtCO2e (19%). Among medical institutions, procurement was the largest contributor to the carbon footprint, with emissions increasing by 46 MtCO2e (25%). Within hospital departments, the internal medicine department had the highest carbon footprint, reaching 47.66 MtCO2e (26%) in 2018. When classified by hospital grades, tertiary hospitals contributed the most, emitting 126.50 MtCO2e (70%). When classified by disease category, circulatory system diseases had the largest carbon footprint of 12.68 MtCO2e (19%), while malignant neoplasms were the primary contributor among subcategory diseases, emitting 5.52 MtCO2e (8%). The main limitation of this study lies in the fact that national IOTs are updated approximately every 5 years, and data for methane (CH₄) and nitrous oxide (N₂O) have not been updated since 2018. As a result, the analysis could only be performed for the years 2012 and 2018. These findings highlighted the substantial GHG emission contributions in China from public hospitals, especially tertiary hospitals, procurement activities, Internal Medicine Departments, and specific diseases in the carbon footprint. The findings provided robust scientific evidence for formulating strategies to reduce carbon emissions within the healthcare service in China and will also have implications for other countries.
59. Epidemiology of fatal and non-fatal unintentional childhood drowning in Malaysia-analyses of hospital-based registry data from 2000 to 2022.
期刊: Journal of tropical pediatrics 发表日期: 2025-Aug-08 链接: PubMed
摘要
Childhood drowning is a major cause of morbidity and mortality with significant economic and social implications, especially in low- and middle-income countries. Despite this, there is a lack of good-quality epidemiological data on childhood drowning. We report the epidemiology of fatal and non-fatal unintentional childhood drowning in Malaysia between the years 2000 and 2022. Data about childhood drowning were obtained from a hospital-based registry gathered by the National Health Informatics Centre, the Ministry of Health, Malaysia. Child population data were downloaded from the Malaysian Census. Overall incidence rates (IRs), case fatality rates (CFRs), and IR and CFR by age, sex, race, and region were calculated. Binary logistic regression was used to determine the factors associated with fatality. Between the years 2000 and 2022, a total of 4247 cases of drowning were reported. IR was significantly higher among children aged 0-9, boys, Bumiputera, and the East Coast and Borneo regions. Overall CFR was 3.7%. Age, year of hospitalization, and Bumiputera were associated with CFR. The site of drowning was unspecified in 84% of cases, while for those recorded, natural water sources and swimming pools accounted for most sites. While the annual incidence of drowning has remained nearly constant throughout the years, the fatality rate has increased between 2010 and 2022. Our report provides leads for further research data requirements to understand childhood drowning epidemiology better and improve preventive measures. Drowning is a neglected public health problem in developing countries. Both data on incidents of drowning and deaths are usually not collected by the authorities. Systematically collecting and analyzing the data about childhood drowning will help health authorities identify the characteristics of the children who drown and the rate of death among them. By studying the data about children who were hospitalized during 2000–22, we identified children who are 0–9 years old, boys, of Bumiputera race, and those who are from the East Coast and Borneo regions had a higher rate of drowning. About 4% of children who were hospitalized died. The yearly rate of drowning hospitalization was nearly constant, but the proportion of those who died slightly increased. Hospital data would not provide those minor cases not hospitalized and those who died at the drowning site. Accurate data on all incidents of childhood drowning, including site and circumstance, is needed to make preventive measures.
60. Troponin I is an independent marker of cardiovascular mortality risk in chronic kidney disease patients.
期刊: Jornal brasileiro de nefrologia 发表日期: 2025 链接: PubMed
摘要
Cardiovascular disease (CVD) is the main cause of death among chronic kidney disease (CKD) patients. However, the cardiovascular (CV) prognostic evaluation in CKD is not established. Despite previous reports establishing troponin as a CV mortality prognosticator in CKD, there is no consensus on its applicability. Moreover, studies on high-sensitivity troponin I (hsTnI) in this context are scarce. We evaluated the association between hsTnI and CV and overall mortality among CKD patients to identify higher CV-risk patients. 145 patients with CKD stages 3 to 5 underwent measurements of hsTnI, inflammatory, calcium-phosphorus metabolism, vascular calcification, and echocardiographic parameters. The association of hsTnI with CV and overall mortality after follow-up was established using Kaplan-Meier curves. The cutoff value of hsTnI for predicting CV and overall mortality was defined using ROC curve analysis. Multivariate analysis for CV and overall mortality was done using Cox regression models. HsTnI cutoff value for overall and CV mortality was 0.057 ng/mL. Patients with higher hsTnI had higher CV and overall mortality. In multivariate analysis, hsTnI was a marker of increased CV mortality (hazard ratio 12.8 (95% CI 1.56-105.08), p = 0.018), independent of age, sex, previous CVD, diabetes and dialysis, echocardiographic findings, and osteo-protegerin (OPG). HsTnI is independently associated with CV mortality in CKD patients, suggesting that it may be a potential CV risk stratification marker.
61. Design and implementation of a Targeted HealthcaRe InnoVation & Entrepreneurship (THRIVE) fellowship program.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The Targeted HealthcaRe InnoVation & Entrepreneurship (THRIVE) Fellowship was created to bridge the gap between healthcare professionals, who often lack experience in technology development and entrepreneurship, and engineers or technology experts, who may not fully understand clinical needs. This eight-month extracurricular program introduces medical and graduate students to the process of health technology innovation. Fellows form multidisciplinary teams to identify and address an unmet clinical need, following Biodesign principles. The program consists of three phases: (1) introduction to healthcare innovation and foundational skills; (2) team formation, mentor selection, and customer discovery; and (3) solution prototyping, pitching, and business plan development. A retrospective analysis of the 2022-2023 cohort evaluated participant demographics, subjective outcomes (Likert-scale surveys on skill acquisition and program satisfaction), and objective metrics (e.g., milestones completed, funds raised, technology disclosures). Descriptive statistics and paired t-tests for pre-post comparisons were used in the analysis. Of the 56 applicants, 29 were accepted, and 20 completed the program. Fellows rated overall satisfaction at 4.45/5, with 85% planning to incorporate healthcare innovation into their future careers. On average, teams met 10.4 of 12 milestones, raised $10,250 in additional funds (in addition to the $5,000 fellowship grant), and filed multiple technology disclosures. Fellows reported significant gains in key innovation skills (p = 1.3E-5) and spent an average of 7.4 hours per week on their projects. The THRIVE Fellowship fosters interdisciplinary collaboration, practical skill development, and a heightened commitment to healthcare innovation. Early successes include strong participant satisfaction, measurable skill acquisition, and substantial external funding. Future program refinements will focus on expanded mentor engagement, enhanced skill-building resources, and long-term tracking of career outcomes. This model may serve as a scalable approach to training future clinicians and researchers in healthcare technology innovation.
62. Development of a proposed solutions box for improving nutritional behaviors of female school students: Protocol of a mixed-method study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Adolescent girls in Iran face significant challenges related to poor nutritional behaviors, such as inadequate fruit and vegetable consumption, high intake of processed foods, and irregular meal patterns. These behaviors contribute to long-term health risks, including obesity and micronutrient deficiencies. ‘The aim of this study is to develop an evidence-based, context-specific ‘solution box’ to improve the nutritional behaviors of female school students in Khuzestan province. A mixed-method study using a sequential exploratory design (Creswell model). This research will be conducted in three distinct stages. Stage 1: Qualitative Phase -Part A: A qualitative study using directed content analysis based on Social Cognitive Theory will be conducted. This phase will involve focus groups and interviews with female students, parents, and stakeholders to identify barriers to healthy eating and propose context-specific solutions. Part B: The perceived solutions will be extracted and categorized based on their relevance and feasibility. Stage 2: Quantitative Phase - Part A: Extracted solutions will be prioritized using the nominal group technique. Part B: Prioritized solutions will be ranked using a pairwise comparison scoring method. Stage 3: Solutions Optimization - Part A: A matrix of solutions will be developed based on theoretical frameworks. Part B: An action plan for implementing the solutions will be created. Part C: The solutions will be visualized on a digital platform for accessibility and usability. Not applicable for the protocol study.
63. Water meter reading recognition method based on character attention mechanism.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
With the rapid advancement of computer vision technology, traditional manual methods of reading meters are increasingly being replaced by automated water meter reading technologies based on image recognition. This technology can precisely locate and recognize the readings on captured images of water meter dials, laying a solid technical foundation for the implementation of remote automatic meter reading systems. However, in practical applications, the recognition of water meter readings still faces challenges due to interference from factors such as shooting angles and changes in environmental lighting. To address these challenges, this paper proposes an innovative method based on deep learning. Firstly, the ResNet-based Feature Pyramid Network (FPN) is used to detect the reading area of the water meter to ensure the accuracy of the detection. For the problem of digit character detection, the character detection attention mechanism is introduced to improve the performance of digit detection and reduce the interference of background noise while ensuring high accuracy. For numerical character recognition, the improved LeNet-5 network can better identify water meter readings in natural scenes. Additionally, the integration of a global average pooling layer within the network effectively alleviates the issue of overfitting. To verify the effectiveness of our method, we conducted experiments on the CCF real-world water meter reading automatic identification dataset. The experimental results show that by scaling the water meter reading area and introducing the character attention mechanism to assist in numerical character detection, the recognition accuracy of individual digits improved by 8.8% and 5.5%, respectively, and the overall recognition accuracy of the final water meter reading also increased by 7.0% and 2.2%. These significant improvements demonstrate the superiority and effectiveness of our method in practical applications.