公共卫生研究摘要 (2025-09-27)
共收录 62 篇研究文章
1. Unlocking Multiple Sclerosis Genetics: From Susceptibility to Severity.
期刊: Neurology 发表日期: 2025-Oct-21 链接: PubMed
摘要
Multiple sclerosis (MS) is a clinically diverse and unpredictable CNS disorder. The considerable heterogeneity in disease course between people with MS is believed to reflect the varying magnitude and extent of the pathologic processes present at different stages of the disease. Genetic factors are known to contribute to the risk of developing MS and are emerging as predictors of clinical outcomes. They may also offer insights into the biological processes influencing disability. In this review, we evaluate the role of genetic factors in MS from disease susceptibility to disease severity. We consider how understanding of the genetic contribution to the risk of developing MS has evolved to recognize over 230 genetic variants that implicate peripheral immune cells at disease onset. Although MS-risk genes have shown little association with disease severity outcomes, we re-evaluate associations of the main MS-risk allele, HLA-DRB1*1501, with disease activity using observations from long-term longitudinal cohorts. We summarize progress identifying genetic variants associated with clinical phenotypes, including the discovery of the first genetic variant associated with age-related MS severity, rs10191329, and its pathologic associations. We assess the challenges faced by replication studies, including low statistical power, methodologic variations in disability outcomes, and the potential impact from differences in treatment and disease temporality. Reconciling these findings, in contrast to MS-risk genes, MS severity variants appear enriched in CNS tissues, suggesting at least in part distinct genetic architectures for MS risk and severity. Despite advances in our understanding of MS genetics, there remain significant gaps in our knowledge that reflect the elaborate genetic architecture underlying disease progression. Potential gains are to be made from exploring rare variants and ancestrally diverse populations, while the causality of variants may be interrogated through analyses of gene sets and recognized biological pathways. However, further work is required to improve phenotyping of disease severity beyond physical disability measures and to disentangle complex genetic interactions, which may vary with environmental factors and time. Resolving these challenges is crucial if genetic analyses are going to be able to power clinically useable predictive models and inform mechanistic targets for novel treatments in progressive MS.
2. Versatile Xenopus tropicalis model with targeted integration of human BRAFV600E.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Sep-30 链接: PubMed
摘要
Targeting exogenous gene integrations in animals often exhibits low efficiency, limiting the development of gene knock-in models. Theoretically, by screening founder generation individuals based on the cell phenotypes resulting from gene knock-ins and leveraging the high fecundity of animals, heritable descendants with targeted knock-ins can be efficiently generated. Therefore, we utilized the high fecundity of Xenopus tropicalis and easily observable pigment phenotypes to construct a BRAFV600E-targeted mitf locus knock-in model. Results indicated that this approach enabled efficient generation of BRAFV600E knock-in X. tropicalis and produced a versatile frog model. The BRAFV600E knock-in induced the transdifferentiation of RPE cells into retinal cells, resulting in a symmetric retinal structure in the eyes of these frogs. The transformation of RPE cells ultimately leads to these frogs becoming eyeless frogs, which serve as a tool for retinal regeneration research. Additionally, in eyeless frogs the BRAFV600E knock-in led to the abnormal proliferation of both melanocytes and xanthophores into melanocytic and xanthocytic nevi respectively. Consequently, eyeless frogs provide a model for studying abnormal pigment cell proliferation, offering a platform for investigating pigment cell nevus formation. Furthermore, the cdkn2b-knockout eyeless frogs serve as a valuable xanthophoroma model for tumor biology research. Overall, the BRAFV600E-targeted knock-in X. tropicalis not only represents a strategy for constructing gene knock-in animal models but also serves as a versatile tool for research in retinal regeneration and tumor biology.
3. Prevalence and risk factors of anemia among adolescent females in Beni-Suef governorate, Upper Egypt.
期刊: International journal of adolescent medicine and health 发表日期: 2025-Sep-29 链接: PubMed
摘要
To estimate anemia prevalence and risk factors among adolescent females in Beni-Suef Governorate. A population-based cross-sectional mixed quantitative and qualitative survey was conducted among 1000 adolescent females in the seven Beni-Suef governorate, Upper Egypt districts from November 2023 to March 2024. A structured questionnaire including socio-demographic and menstrual history was used. Focus group discussions (FGD) were conducted to assess their awareness. Hemoglobin testing was performed on the participants, and the diseased ones were treated. Anemia is highly prevalent among adolescent females in the Beni-Suef governorate (35.8 %). Residence (Adjusted OR=0.652, 95 % CI:0.439-0.970), and daily number of pads (Adjusted OR=1.208, 95 % CI:1.006-1.451) were found to be statistically significant risk factors for anemia in adolescent females. Anemia is highly prevalent among adolescent females. Early assessment and management of anemia is highly recommended. Nutritional interventions such as food fortification, supplementation, and nutrition education should be provided. Micronutrient supplementation programs should be implemented in all basic schools, and extensive nutrition awareness initiatives should be implemented for adolescent females and caregivers.
4. The use of telehealth in pediatric neurosurgery for rural patients of Appalachia.
期刊: Journal of neurosurgery. Pediatrics 发表日期: 2025-Sep-26 链接: PubMed
摘要
The authors’ objective was to assess the impact of telehealth on pediatric neurosurgical care access for underserved and rural populations in West Virginia. The authors explored how telehealth utilization varied over time, the socioeconomic benefits it provided to families, and its effect on visit completion rates compared with in-person appointments. Clinic visits from January 1, 2017, to May 31, 2023, at the sole pediatric neurosurgery clinic in West Virginia were retrospectively reviewed. The data included three types of outpatient visits: in-person, telemedicine satellite clinic, and MyChart video appointments. Initial statistical analysis focused on visit completion rates, distance traveled, and time and cost savings for families. Additional geospatial analysis used heat density mapping to recognize regional utilization patterns, and community-level socioeconomic variables were analyzed for correlation with visit type utilization. Telehealth usage (telemedicine and MyChart) increased significantly during and after the COVID-19 pandemic. MyChart visits demonstrated the highest completion rates postpandemic. Telehealth visits saved families substantial travel time and cost, especially for those living more than 100 miles from the clinic. Geospatial analysis revealed that telemedicine usage was clustered in specific Appalachian regions, and in-person visits were more common among patients from economically distressed communities. Correlation analysis showed that higher poverty and unemployment rates were associated with in-person visit reliance, while telehealth adoption was lower in these populations. Telehealth significantly enhances access to pediatric neurosurgical care for rural and economically disadvantaged families, reducing travel-related burdens and increasing visit adherence. However, economically distressed communities in Appalachia are less likely to use telehealth, possibly due to digital access issues or skepticism about remote care. Addressing these barriers is crucial to ensure equitable healthcare access. Further research should investigate structural and personal obstacles to telehealth uptake to improve service delivery for at-risk populations, ultimately fostering more inclusive and accessible healthcare options in remote areas.
5. The role of government in protecting the public during a public health emergency.
期刊: Healthcare management forum 发表日期: 2025-Sep-26 链接: PubMed
摘要
Protecting the public is a key role of all levels of government in Canada. This role takes many forms. During a public health emergency, preparation, timely and evidence-based decisions, considering the unique needs of vulnerable populations, and balancing between action taken to protect the public while being cognizant of the impact of such actions on the longer-term well-being of the public, particularly equity-deserving groups, is critical. This article reflects on some of our historical failures in public health to protect the public in Canada, the lessons learned, how these impacted our experience during COVID-19, and how the related framework for optimizing our work can protect the public in future events.
6. Validation of an Infarction Code Care Checklist and Determination of its Relationship With Other Patient Safety Indicators: Protocol for a Prospective Study.
期刊: JMIR research protocols 发表日期: 2025-Sep-26 链接: PubMed
摘要
In the care of time-dependent illnesses, facilitating care and systematizing actions with a checklist provides security to health professionals and reduces errors, thereby increasing patient safety. However, despite the widespread use of checklists in other clinical contexts, no studies have yet validated a checklist specifically for infarction code care. The objective of this study is to validate the checklist and determine its relationship with the rest of the patient safety indicators in the primary care teams of the Catalan Health Institute of Central Catalonia. This is a prospective study for the validation of a checklist for infarction code care. In this study, 2 clinical scenarios of varying difficulty are defined, and the correct answers are established in each case according to the gold standard guidelines. During the first 3 months of the ongoing year, we held an annual training meeting where infarction code referents from various primary care teams gathered to review the new guidelines and outline the training strategy for the next year. These referents conducted annual training sessions for their respective teams before Easter, during which they explained the new guidelines. On the same day as the training, the 2 clinical scenarios were completed using the online version of the checklist for the first time for all participants. The checklist was sent in digital format to all health professionals who responded the first time, and then a reminder was sent to respond a second time at 30, 45, and 90 days to obtain the maximum number of second responses, as the checklist should be completed twice to assess internal reliability and temporal robustness. The number of hits was compared with respect to the gold standard for both the first and the second response. The results obtained from the responses and accuracies, when compared with the gold standards, were evaluated against other available patient safety indicators in the region. Between January 2023 and May 2023, we obtained 615 responses to the online version of the checklist. We conducted analyses to assess both internal consistency and temporal robustness of the responses and have also structured the framework for comparing these results with other patient safety indicators available in the region. Data analysis is currently underway, and we expect to publish the results in early 2026. If the checklist demonstrates strong internal consistency and temporal robustness and shows a meaningful relationship with patient safety indicators, it could be implemented across primary care centers using the infarction code. This would support safer, more standardized care in time-sensitive clinical situations. IDIAP Jordi Gol 4R22/343; https://idiapjgol.org/grup-recerca/prosaaru/projectes/. DERR1-10.2196/66584.
7. Endoscopic Ultrasound-guided Esophagojejunal Anastomosis for Delayed Reconstruction: A Case Series on the Novel Technique and our Experience.
期刊: Journal of gastrointestinal and liver diseases : JGLD 发表日期: 2025-Sep-26 链接: PubMed
摘要
Esophagojejunal (EJ) anastomoses are integral to gastrointestinal reconstructive surgeries following procedures such as gastrectomy, particularly in cases of cancer or Roux-en-Y reconstruction. However, the traditional surgical EJ anastomosis approach can pose challenges with notable risks such as anastomotic leakage, stricture, or fistula formation. Endoscopic interventions have been employed for managing these adverse outcomes through stent placement, but a primarily endoscopic EJ anastomosis technique has not yet been described. This retrospective case series details five patients who underwent delayed endoscopic EJ anastomosis, with each patient under differing circumstances of instability necessitating this emergent alternative to standard surgical reconstruction. This approach involved the placement of a lumen-apposing metal stent between the esophagus and jejunum. Successful endoscopic EJ anastomosis was achieved in all cases, with hospital stays ranging from 6-13 days. Adverse events included stent migration, dysphagia, and stricture. Subsequent management strategies for these adverse events included stent removal and exchange, balloon dilation, triamcinolone injection, and appropriate follow-up. Follow-up evaluations revealed successful outcomes with no mortalities or anastomotic leaks. Primarily endoscopic EJ anastomosis for delayed reconstruction emerges as an advanced, minimally invasive alternative in complex patients deemed unsuitable for conventional surgical reconstruction secondary to instability or critical conditions. Within the literature, this is the first human case series description of an endoscopic EJ anastomosis with stent placement between the esophagus and jejunum. This novel technique offers the potential in improving patient outcomes which warrants further investigation to optimize these endoscopic techniques and assess its long-term efficacy across a larger patient cohort.
8. Vonoprazan-containing Dual and Triple Therapies are Non-inferior to Bismuth-quadruple Therapy for Helicobacter pylori Eradication: A Single-center, Prospective, Open-label, Real-World Study.
期刊: Journal of gastrointestinal and liver diseases : JGLD 发表日期: 2025-Sep-26 链接: PubMed
摘要
Vonoprazan (Vo) and amoxicillin (Amx) dual therapy has shown promising results for Helicobacter pylori (H. pylori) eradication. However, its efficacy needs to be verified in an area with a high prevalence of both H. pylori and gastric cancer. It is also unknown if the modified Vo-Amx plus bismuth (Bis) regimen might increase the eradication rate. We aimed to investigate the efficacy and safety of Vo-Amx and Vo-Amx-Bis regimens, compared to bismuth-containing quadruple therapy (BQT) for H. pylori eradication, as well as factors that affect the curing rate. A total of 342 treatment-naïve H. pylori-infected patients were screened and 255 were enrolled and randomized into Vo-Amx, Vo-Amx-Bis, and BQT groups for treatment. H. pylori infection status was determined by 13C-urea breath test. The eradication rate and incidence of adverse events were assessed, and factors that might affect the curing rate were also analyzed. In per-protocol (PP) analysis, H. pylori eradication rates in Vo-Amx, Vo-Amx-Bis, and BQT groups were 95.1%, 92.7%, and 90.4%, respectively (p>0.05). In intention-to-treat (ITT) analysis, eradication rates in Vo-Amx, Vo-Amx-Bis, and BQT groups were 91.8%, 89.4%, and 88.2%, respectively (p>0.05). The eradication efficacy of Vo-Amx and Vo-Amx-Bis groups was non-inferior to that of BQT group, and the incidence of side effects (including nausea, vomiting, anorexia, abdominal pain, diarrhea, palpitation, dizziness, and debilitation) was lower than that of BQT group (6.1% and 4.9%, vs 45.8%, respectively, p<0.001). Successful eradication was associated with lower body surface area (BSA) in BQT group (p<0.05), but not in Vo-Amx and Vo-Amx-Bis groups. Gender, cigarette smoking, alcohol drinking, side effects, education level, body mass index, infection status of family members, and the frequency of dining out did not affect the curing rate in all three groups (p> 0.05). Efficacy of the two Vo-containing regimens was comparable and non-inferior to the BQT in this region, and could serve as the first-line regimen for H. pylori eradication, and reduced use of one antibiotic per each patient treatment in real-world clinical application.
9. Clínica Universidad de Navarra-Body Adiposity Estimator Index as A Predictor of Metabolic Dysfunction-associated Steatotic Liver Disease: A Large-scale Cross-sectional Analysis.
期刊: Journal of gastrointestinal and liver diseases : JGLD 发表日期: 2025-Sep-26 链接: PubMed
摘要
Metabolic dysfunction-associated steatotic liver disease (MASLD) affects 32.4% of the global population and is a major cause of chronic liver disease and cardiometabolic complications. Early detection is challenging due to limitations of conventional obesity indices like body mass index (BMI) and waist circumference (WC), which do not account for age- and sex-specific adiposity variations. The Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) index, integrating BMI, age, and gender, may offer a better measure of body fat percentage, but its utility in MASLD prediction is unexplored. We aimed to evaluate the predictive value of the CUN-BAE index for MASLD and to compare it with conventional obesity indices. 1,003 participants from Guang’anmen Hospital were recruited (2023-2024). MASLD diagnosis was based on established criteria, and participants underwent clinical and laboratory assessments. Logistic regression models were used to determine the association between the CUN-BAE index and MASLD, with predictive performance assessed using area under the receiver operating characteristic curve (AUROC). Among 949 participants, 555 (58.5%) had MASLD. The CUN-BAE index showed a significant positive association with MASLD risk (Model 3: OR=1.16, 95%CI: 1.12-1.20, p<0.001). Its AUROC (0.677) surpassed BMI (0.612) and WC (0.598), especially in women (AUROC=0.809 vs. BMI=0.721, WC=0.698) compared to men (AUROC=0.664 vs. BMI=0.603, WC=0.591). A dose-response relationship was observed, with increased CUN-BAE levels correlating with higher MASLD risk beyond a threshold of 29.097. The CUN-BAE index is a robust predictor of MASLD, outperforming BMI and WC, particularly in women. It captures age- and gender-specific adiposity variations, enhancing its utility as a non-invasive screening tool. Future research should focus on longitudinal validation and integrating additional metabolic parameters.
10. Clinical validation of a rapid, markerless, headset-contained augmented reality stereotactic neuronavigation system.
期刊: Journal of neurosurgery 发表日期: 2025-Sep-26 链接: PubMed
摘要
Digital enhancement and visualization technologies, such as augmented reality (AR), are increasingly used in surgery. Rapid and accurate patient registration with minimal device confinements enables AR systems to increase efficiency, safety, and effectiveness, especially in urgent/emergency and/or bedside scenarios. The aim of this study was to quantitatively compare an AR headset-based neuronavigation system with a standard-of-care reference array-based neurosurgical stereotactic navigation system in a real-world setting. This clinical validation trial included adult patients undergoing cranial neurosurgery with stereotactic navigation at a single center from February 2024 to July 2024. Preoperative CT and MR images were acquired and used for construction of a 3D hologram model that included surface-based target fiducial markers for comparison. Preoperative images were stereotactically registered to the patient’s head using standard techniques. The registration coordinates for the fiducial markers (control) and registration time were recorded. The AR system was then deployed to create a separate stereotactic registration to the same preoperative images. A second set of registration coordinates for the fiducial markers (experimental) were acquired using the AR system, and the time for this process was also recorded. The Wilcoxon signed-rank test was used to assess differences in registration time, and a linear mixed-effects model (LMM) was used to conduct equivalence testing of coordinates between the control and experimental data. Twenty patients (mean age ± SD 50.05 ± 14.38 years) were included in the trial. The mean baseline validation error of the control system was 0.73 ± 0.29 mm (range 0-1.0 mm). Using the control system as ground truth, the mean registration accuracy of the AR system was 2.16 ± 0.12 mm. LMM equivalence testing, conducted with margins of 3 mm and 2.5 mm, demonstrated statistical equivalence between the ground truth and AR system coordinates (p < 0.001 and p < 0.003, respectively). The time required for patient model registration using the AR system was a mean of 45.98 ± 15.00 seconds, which was significantly shorter compared with the control system (228.86 ± 100.06 seconds, p < 0.001). The AR navigation system provided statistically similar registration accuracy and significantly faster patient model registration compared with the standard-of-care stereotactic neuronavigation system. AR navigation was accurate, fast, and had a minimal footprint, offering new opportunities to incorporate stereotaxis in low-resource, bedside, and urgent/emergency settings.
11. Small Bowel Neuroendocrine Neoplasms: A Single Tertiary Center Real World Experience.
期刊: Journal of gastrointestinal and liver diseases : JGLD 发表日期: 2025-Sep-26 链接: PubMed
摘要
Small bowel neuroendocrine neoplasms (SB-NENs) are a rare type of tumor that is clinically challenging and is often diagnosed in advanced stages. This retrospective study aimed to characterize the clinical presentation, diagnostic workup, and therapeutic strategies, as well as to evaluate the prognosis of patients managed in a tertiary care center in Bucharest, Romania, over five years. We conducted an observational, retrospective cohort study on 42 cases of SB-NEN evaluated at our center between January 1, 2020, and March 31, 2025. Data regarding clinicopathological characteristics, treatments, and disease evolution were summarized. Overall survival was estimated at 1, 3, and 5 years. Computed tomography was the most frequently used imaging method for diagnosis (52.4%). Surgery was the most adopted method for obtaining the pathological specimen, used in 70.7% of cases. The majority of tumors were well-differentiated (85.6%). The overall survival distribution showed a median survival time of 94 months. The cumulative proportion of patients surviving at 1 year was 97.6%, at 3 years was 89.3% and at 5 years was 75.7%. There was a significant difference in overall survival stratified by tumor grading (p=0.006), indicating that this was a significant prognostic factor; the metastatic status and large tumors showed a trend toward statistical significance, but they did not meet the conventional threshold (p=0.068 and 0.103, respectively). SB-NEN showed favorable outcomes, with surgery improving survival even in some metastatic cases. Lower tumor grade was associated with a better prognosis, while somatostatin analogues (SSA) therapy showed no survival benefit. Patients with large tumors and metastatic disease also showed a trend towards reduced survival.
12. The relationship of sleep problems between eight-year-old South African children and their mothers.
期刊: Journal of global health 发表日期: 2025-Sep-26 链接: PubMed
摘要
Sleep problems are common among children and mothers. However, little is understood about sleep behaviours in low- and middle-income countries. Here we examine sleep behaviours and predictors among black, low-income, South African mothers and their eight-year-old children over time. We administered standardised measures of sleep behaviours at eight years post-birth to a population cohort of mothers and children in 24 neighbourhoods of Cape Town, South Africa, in 2009-10. We assessed mothers and children six times over eight years with 84% retention since pregnancy. While 71% remained in Cape Town, about 29% of households moved to the profoundly rural Eastern Cape of South Africa. Mothers completed the Pittsburgh Sleep Quality Index and rated their children on the Children’s Sleep Habits Questionnaire. Among mothers, 29.5% reported sleep difficulties based on their global sleep score, with a mean sleep quality score of 3.72 (standard deviation (SD) = 2.6). Children’s sleep scores were 64.4 (SD = 4.0), with subscale scores on sleep difficulties higher than documented in high-income countries (HICS). There was a relatively low inverse relationship between the quality of maternal and child sleep (r = -0.201; 95% confidence interval (CI) = -0.264, -0.136), which resulted in an R2 value of 0.041 in the simple linear regression model. Problematic maternal sleep was associated with living in the rural Eastern Cape (P = 0.034), experiencing intimate partner violence (P = 0.052), and a higher score on the Edinburgh Postnatal Depression Scale (P < 0.001), but not alcohol use. Children’s sleep difficulties decreased by 0.191 points (95% CI = -0.229, -0.152) with a one-unit increase in aggressive behaviour and, similarly, cognitive scores decreased by 0.035 points (95% CI = -0.063, -0.006). Household resources, such as formal vs. informal housing, income, and having water on the premises, were unrelated to sleep difficulties. Counter to hypotheses, a small, inverse relationship existed between mothers’ and children’s sleep behaviours. Alcohol use, HIV status, and socioeconomic markers were unrelated to sleep, but intimate partner violence and depressive symptoms affect sleep negatively, similar to HICS.
13. Evaluating Characteristics and Quality of Mental Health Apps Available in App Stores for Indian Users: Systematic App Search and Review.
期刊: JMIR mHealth and uHealth 发表日期: 2025-Sep-26 链接: PubMed
摘要
The mental health app sector in India is expanding rapidly, driven by increasing smartphone usage, growing internet penetration, the popularity of digital initiatives, and heightened recognition of mental health challenges in public discourse. This growth is also influenced by both supply- and demand-side barriers to seeking professional help and the rise of mental health tech startups. While digital mental health solutions provide scalable ways to address unmet needs, concerns persist regarding app quality, privacy, and safety due to rapid market expansion, regulatory challenges, and limited empirical research. We conducted a comprehensive and systematic review of smartphone-based mental health apps accessible to Indian users through app stores. This study aims to describe apps in terms of characteristics such as the nature of their functions, involvement of mental health professionals in development, reference to an empirical basis, and inclusion of nudges to seek professional help, as well as to evaluate app quality. This systematic review of mental health apps was conducted using the TECH (Target user, Evaluation focus, Connectedness, and Health domain) approach, along with the PASSR (Protocol for App Store Systematic Reviews) checklist. Fifteen search terms covering mental health conditions and therapies were applied to both Google Play and Apple App Store. Identified apps were screened according to predefined inclusion and exclusion criteria and subsequently downloaded for detailed review. Data were extracted based on prespecified parameters. Additionally, app quality was evaluated using the Mobile Application Rating Scale (MARS). The initial search identified 5827 apps, of which 350 were reviewed in detail after removing duplicates and applying eligibility criteria. Common search terms such as “depression” and “anxiety” yielded nearly a quarter of relevant apps (128/495, 25.9% to 133/497, 26.8%); 62 (17.7%) of the 350 reviewed apps originated from Asia, and 131 (37.4%) focused on a single mental health condition. Multifunction apps (eg, those combining assessment and intervention) constituted the largest category (230/350, 65.7%). Privacy concerns were notable; for example, 54 (15.4%) apps did not mention a data-sharing policy. Most apps were developed by commercial organizations, and 228 (65.1%) did not report involvement of mental health professionals, while 45 (12.9%) mentioned it only cursorily. Only 38 (10.9%) apps referenced empirical research, and more than half did not indicate an empirical basis for their content. Pointers to seek professional help were present in 139 (39.7%) apps, mostly in the form of disclaimers, whereas nudges or motivational prompts to seek help appeared in slightly less than a quarter. Only 105 (30%) apps attempted to dispel mental health myths. Functionality and aesthetics ratings on the MARS were relatively high, but 50 (14.3%) apps scored 3 or lower on the information subscale. This study is among the first systematic evaluations of mental health apps accessible to Indian users on Google Play and Apple App Store. The findings provide insights to guide future research, app development, and policy making in the digital mental health space. International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) INPLASY2024100035; https://inplasy.com/inplasy-2024-10-0035/. RR2-10.2196/71071.
14. Racial Differences in Trauma Outcomes After a Mindfulness App Intervention in Frontline Nurses: A Secondary Data Analysis.
期刊: Issues in mental health nursing 发表日期: 2025-Sep-26 链接: PubMed
摘要
Empirical understanding of the effects of mindfulness-based interventions for post-traumatic stress disorder (PTSD) across different racial groups remains limited. This secondary analysis of a randomised controlled trial examined racial differences in trauma-related outcomes among U.S. frontline nurses traumatised by the COVID-19 pandemic. Participants (N = 56) were randomly assigned to either the MABSA intervention (Mindfulness and Acceptance-Based Smartphone App), a mindfulness app grounded in Acceptance and Commitment Therapy, or a wait-list control group. Outcomes included PTSD symptoms, experiential avoidance, rumination, mindfulness, and resilience. The intervention significantly reduced PTSD symptoms, experiential avoidance, and rumination for both Black and White participants compared to controls. A significant interaction effect was found for experiential avoidance, with Black participants showing greater improvement than their White counterparts. Across groups and time points, Black participants also consistently reported higher levels of rumination and mindfulness. These findings suggest that there may be differences in how individuals from different racial groups respond to mindfulness-based interventions, highlighting the importance of developing culturally informed PTSD treatments.
15. Reframing the Overdose Crisis: Stigma, Industry Influence, and the Politics of Abuse-Deterrent Opioids.
期刊: International journal of social determinants of health and health services 发表日期: 2025-Sep-26 链接: PubMed
摘要
Between 2013 and 2017, Canadian federal policymakers grappled with mandating abuse-deterrent formulations (ADFs) for oxycodone products as a response to the overdose crisis. Marketed as a safeguard against misuse and diversion, ADFs promised a technological fix to opioid-related harms, yet their population-level effectiveness remained contested. This study systematically analyzes federal parliamentary debates and committee hearings, identifying key arguments in framings to support or oppose ADF mandates. Proponents framed the crisis through the lens of individual misuse, positioning ADFs as pharmaceutical safeguards that protected “legitimate” patients while curbing illicit opioid use. Opponents challenged ADFs’ effectiveness, highlighted Purdue Pharma’s role in the crisis, and warned of unintended consequences, including shifts to more dangerous illicit markets. These discursive struggles reinforced a bifurcation between “legitimate” and “illegitimate” opioid use, shaping perceptions of responsibility, medical necessity, and the scope of appropriate intervention. Divergent framings reflected deeper ideological fissures over the etiology of the overdose crisis and who should be considered a justifiable opioid patient. By demonstrating how ADF debates entrenched a dichotomy between acceptable and unacceptable opioid use, this study advances theories of problem framing to demonstrate how policy debates actively shape regulatory paradigms and the boundaries of acceptable government intervention.
16. Epidemiology of cerebral palsy in Malawi.
期刊: Developmental medicine and child neurology 发表日期: 2025-Sep-26 链接: PubMed
摘要
17. Developing Recommendations to Improve Crisis Line Supports for Public Safety Personnel in Canada: Protocol for a Multimethod National Study.
期刊: JMIR research protocols 发表日期: 2025-Sep-26 链接: PubMed
摘要
Public Safety Personnel (PSP) in Canada experience disproportionately high rates of mental distress and suicidal thoughts and behaviors. PSP mental health is a critical public health issue with far-reaching implications for both individual well-being and the effectiveness of emergency response systems. Crisis lines are an evidence-based public health intervention; however, knowledge gaps remain regarding PSP crisis line use, barriers to accessing services, and the appropriateness of crisis line service models for meeting PSP mental health needs. This study aims to address these knowledge gaps using a participatory approach to better understand the crisis line needs and preferences of PSP communities. We also aim to apply our learnings and co-design actionable recommendations for crisis line service improvements and to support PSP who may wish to contact a crisis line. This Canada-wide study uses multiple methods across three iterative phases. Phase 1 involves community engagement with PSP to better understand their crisis needs and existing supports. Instrumental to our engagement ethic is the formation of a co-researcher group, composed of PSP with lived experience, who will guide the research process. We will review deidentified crisis line interactions to identify patterns in service use and call outcomes to identify possible points of intervention to enhance service efficacy. We will launch a national web-based anonymous survey to understand the crisis line needs, barriers, and preferences of PSP. Phase 2 focuses on deepening our understanding of PSP experiences with crisis lines through in-depth interviews with those who have accessed or thought about accessing crisis lines and those without crisis line experience who wish to share their views. We will conduct focus groups with crisis sector staff to learn about desired training and resources for improving service delivery to PSP. Phase 3 focuses on developing and conducting co-design workshops to generate evidence-based recommendations with PSP, crisis line responders, researchers, and clinicians. Collaborating across sectors will allow us to codevelop feasible strategies for improving crisis line services to better meet the needs of PSP in crisis who may be inclined to access crisis lines for support. As of December 2024, the crisis line dataset has been identified and study recruitment for the national survey was completed. Data collection for all other research activities is expected to conclude by May 2025. We anticipate that study findings will be available by the end of 2025. By identifying barriers to crisis line use and codeveloping solutions, this research will inform policy, service design, and training to enhance services. Ensuring PSP can access crisis line supports that are equitable, evidence-based, and integrated within mental health care systems is crucial to fostering a resilient public safety workforce and emergency response capacities at a societal level. DERR1-10.2196/75285.
18. When Limited Clinical Time With Patients Meets Unlimited Online Information.
期刊: JMIR cancer 发表日期: 2025-Sep-26 链接: PubMed
摘要
As patients with cancer increasingly seek guidance from online sources, the patient-clinician relationship is at risk of being displaced by fragmented, often unreliable information. One of the primary drivers of this trend is the insufficient time available for in-depth, relational consultation with health care providers (HCPs). We argue that the current clinical routine, constrained by documentation and administrative demands, fails to allow adequate time for supporting the informational, emotional, and relational needs of patients navigating complex decisions. This shortfall undermines HCPs’ ability to engage patients in shared decision-making and weakens the foundation of trust between patient and HCP. For some patients, this can result in selecting less-effective treatments or turning away from evidence-based care toward unproven online alternatives. While policy reforms to reduce administrative burdens and free up time for patient education and counseling are essential, they are slow to materialize, making immediate, actionable steps at the clinician level more urgent. We propose a set of practical, evidence-informed strategies that clinicians can adopt today to help meet patients’ informational and emotional needs, strengthen patient-HCP relationships, and ensure that patients’ health care decisions fit their preferences and are supported by scientific evidence.
19. Health Care Content and Engagement in Chronic Illness Instagram Posts: Content Analysis.
期刊: JMIR formative research 发表日期: 2025-Sep-26 链接: PubMed
摘要
Instagram and other social media platforms provide a unique environment for people with chronic illnesses to share experiences, but posts with higher engagement may also shape behavior. The hashtag #ChronicIllness appears in over 5 million posts, reflecting the large digital community where users seek validation, connection, and support. Frameworks such as social cognitive theory, self-presentation theory, and illness identity theory suggest that highly engaging content can shift social norms and drive behavior change via observational learning. Despite the strong theoretical basis for this behavioral impact, little is known about what chronic illness-related content is the most engaging. The aim of this study is to identify the content of Instagram posts related to chronic illness and determine if health care content is associated with higher engagement. This study is a mixed methods content analysis of 279 publicly available Instagram posts tagged with #chronicillness, #chronicallyill, or #spoonie. Posts were selected via convenience sampling and included if they featured original, nonvideo content. Photos, hashtags, and captions were coded for themes including location, medical equipment, health care experience, and illness identity. Quantitative metrics, such as likes, comments, and overperforming scores (a normalized metric of engagement), were extracted using CrowdTangle. Multivariate analyses assessed if health care content (posts featuring health care experiences or photos in a medical setting or with medical equipment) was associated with a higher odds of overperforming. Posts had a median of 25 (IQR 0-14,936) likes, 3 (IQR 0-525) comments, and 20 (IQR 1-31) hashtags. A total of 222 (80%) posts were created by women, and 110 (40%) were overperforming. Photo analysis (260 posts with 406 photos) showed 27 (10%) in health care settings, and 49 (19%) included medical equipment, with 10 (4%) featuring invasive devices (eg, intravenous lines and feeding tubes), which were strongly associated with higher engagement. Hashtag analysis revealed that 243 (87%) posts referenced a medical condition, most commonly chronic pain (n=101, 36%), fibromyalgia (n=56, 20%), and Ehlers-Danlos syndrome (n=38, 14%), while 57 (20%) included medical interventions. Captions reflected 4 main themes: medical experience, illness journey, connection, and nonillness experiences. In multivariate regression analysis, longer captions (odds ratio [OR] 2.44, 95% CI 1.05-5.67), health care content (OR 1.85, 95% CI 1.00-3.42), and invasive medical equipment (OR 6.19, 95% CI 1.16-32.99) were independently associated with overperforming. Posts featuring health care content and invasive medical equipment were associated with significantly more engagement, suggesting that medicalized portrayals of illness may be amplified on Instagram. This visibility may offer support but also risks reinforcing illness-centered identities and overmedicalization through the influence of observational learning and identity formation. Medical professionals must be aware of these trends and promote balanced, evidence-based content. Future research should explore how social media shapes health behaviors, identity, and utilization to mitigate potential harms while preserving support.
20. Open science and transparency are our strongest tools in the fight against fraudulent publishing activities.
期刊: PLoS medicine 发表日期: 2025-Sep-26 链接: PubMed
摘要
Systematic fraud threatens the integrity of science, with paper and review mills distorting the evidence base in medicine and global health. Data transparency-once seen mainly as a driver of discovery-must now be recognized as a frontline defense against misconduct. Only through open data and coordinated action can we safeguard trust in research and its impact on health.
21. Comparative safety and effectiveness of apixaban and rivaroxaban for treatment of cancer-associated venous thromboembolism: A retrospective cohort study.
期刊: PLoS medicine 发表日期: 2025-Sep-26 链接: PubMed
摘要
While apixaban has demonstrated advantages over alternative direct oral anticoagulants (DOACs) in some settings, its comparative safety and effectiveness in cancer-associated venous thromboembolism (VTE) remain uncertain. Current guidelines recommend DOACs as first-line treatment for cancer-associated VTE, though they do not recommend any specific DOAC over another. This study aimed to quantify the risk of recurrent VTE, major bleeding, and clinically relevant non-major bleeding among individuals with cancer-associated VTE treated with apixaban versus rivaroxaban. In this retrospective cohort study, we used data from Medicare fee-for-service (2016-2020) and MarketScan (2016-2022), two U.S. administrative claims databases covering publicly and commercially insured individuals. We included individuals aged ≥65 years (Medicare) or 18-64 years (MarketScan) with active cancer, defined as a cancer diagnosis within 6 months before an index VTE event, who newly initiated apixaban or rivaroxaban within 30 days of that event. The outcomes were (1) hospitalization for recurrent VTE; (2) hospitalization for major bleeding; and (3) hospitalization or outpatient visit for clinically relevant non-major bleeding events. Eligible individuals were followed for outcomes at 6 months (consistent with guideline recommendations) and during the entire follow-up period. We used inverse probability of treatment weighting to adjust for baseline differences, including demographics, comorbidities (e.g., prior bleed), VTE risk factors, cancer type and treatments, and medication use, and applied inverse probability of censoring weighting to account for differential loss to follow-up. We analyzed outcomes using adjusted Cox proportional hazards models, pooling estimates using an inverse variance-weighted fixed-effects model. The final cohort included 6,329 apixaban and 4,260 rivaroxaban users across both databases. At 6 months, apixaban was associated with similar risks of recurrent VTE (hazard ratio [HR] 0.66, 95% confidence interval [CI] [0.40,1.11]; p-value = 0.11) and major bleeding (HR 0.95, 95% CI [0.73,1.23]; p = 0.70), and a lower risk of clinically relevant non-major bleeding (HR 0.84, 95% CI [0.74,0.96]; p = 0.009) compared to rivaroxaban. The same pattern persisted during the extended follow‑up. The main limitation is the observational design, which may leave residual confounding despite adjustments using inverse probability weighting. In cancer-associated VTE, apixaban was associated with similar risks of recurrent VTE and major bleeding, and a lower risk of clinically relevant non-major bleeding compared with rivaroxaban. These findings suggest apixaban may be a favorable option for anticoagulation in cancer-associated VTE when minimizing bleeding risk is a priority.
22. Digitally Mediated Occupational Therapy to Increase Physical Activity in Urban and Rural Breast Cancer Survivors: Protocol for a Single-Arm Feasibility Trial.
期刊: JMIR research protocols 发表日期: 2025-Sep-26 链接: PubMed
摘要
The 5-year survival rate for breast cancer (BC) has increased in recent years. However, functional limitations associated with BC treatment (eg, loss of strength, fatigue, and lymphedema) often have far-reaching effects on survivors’ physical and mental health. Aerobic physical activity (PA) and muscle-strengthening exercise (MSE) can reduce functional limitations, and occupational therapy (OT) can support these health-promoting behaviors after treatment. Yet, barriers to access among BC survivors (eg, time burden and distance to the OT clinic) limit participation in OT programing. This is particularly true in Oklahoma, where 33% of residents live in rural counties. Digital technologies (eg, telehealth) can help urban and rural BC survivors circumvent these barriers. We are investigating the feasibility of a novel OT program among urban and rural BC survivors that features (1) 8 once-weekly telehealth OT sessions targeting constructs grounded in Self-Determination Theory (SDT), and (2) self-regulatory strategies known to support aerobic PA and MSE in BC survivors including self-monitoring via a wearable PA tracker, goal setting, and the provision of timely feedback. This is a single-arm feasibility trial. We are recruiting 38 BC survivors using community-based recruitment approaches and via referral from collaborating oncologists. Participants include individuals who have undergone primary treatment and/or breast-conserving surgery or mastectomy for BC in the last 24 months and who do not meet recommended PA levels at the time of enrollment. We will assess self-reported program acceptability and feasibility via recruitment rates, study retention, and protocol adherence. We will also evaluate program safety by tracking BC-related lymphedema events, musculoskeletal injuries, and other adverse events. Finally, we will assess changes in aerobic PA, MSE, and health-related quality of life during the program period using accelerometry and self-report measurement tools. We received funding in March 2024 and institutional review board approval in September 2024. We began recruiting in November 2024. We anticipate completing data collection in early 2026. We hypothesize that the SDT-grounded OT program will be acceptable, feasible, and safe. We also expect pre- to post-program improvements in (1) SDT-informed determinants of PA, (2) levels of aerobic PA and MSE engagement, and (3) health-related quality of life. The novel OT program under investigation is designed to decrease barriers to engaging in aerobic PA and MSE among people who have undergone various BC treatments. It is centered on facilitating a successful transition from active treatment to the posttreatment period and combines OT with the benefits of telehealth delivery and health behavior change theory. This program is amenable to wide-scale dissemination and, if shown to be acceptable and feasible, will represent a promising approach to supportive cancer care. ClinicalTrials.gov NCT06671730; https://clinicaltrials.gov/study/NCT06671730. DERR1-10.2196/73554.
23. GITR/GITRL interaction promotes the expansion of T helper 9 and T helper 17 in psoriatic arthritis.
期刊: Clinical and experimental rheumatology 发表日期: 2025-Sep-26 链接: PubMed
摘要
Psoriatic arthritis (PsA) is a chronic inflammatory disease characterised by the involvement of multiple targets. Accumulating evidence suggests the key role played by T helper (Th)9 and Th17 cells in PsA. Recently, the ability to activate GITR in promoting differentiation and proliferation of Th17 and Th9 cells has been investigated in several inflammatory conditions. We aimed to evaluate the effects of GITR/GITRL interaction in the immune responses underlying the disease, including the main PsA target sites. Twenty-one PsA patients with active disease, naive to disease-modifying anti-rheumatic drugs, were enrolled. Peripheral blood mononuclear cells and synovial fluid (SF) mononuclear cells were collected to assess GITR and GITRL expression by flow cytometry. An in vitro functional assay with recombinant GITR agonist was performed to detect the effect on T cell subsets. Synovial and ileal biopsies were obtained to evaluate GITR and GITRL expression by immunofluorescence. Healthy subjects and osteoarthritis patients were enrolled as controls. We reported an increased in vitro expression of GITR among CD4+ T cells and its cognate ligand GITRL on antigen-presenting cells in PsA peripheral blood. In vitro, the addition of the GITR agonist resulted in increased expansion of Th9 and Th17 cells. Increased expression of GITR and GITRL was found even in PsA SF, synovium and ileum. Our results suggest a novel role of GITR/GITRL in promoting the expansion of Th9 and Th17 in PsA-inflamed tissues.
24. The IMPACT Survey: The Humanistic Impact of Caring for an Individual with Osteogenesis Imperfecta.
期刊: Advances in therapy 发表日期: 2025-Sep-26 链接: PubMed
摘要
The IMPACT Survey (“IMPACT”) investigated the humanistic, clinical, and economic impact of osteogenesis imperfecta (OI) on affected individuals, caregivers, and the broader community. Prior publications reported the methodology, initial findings, and economic and humanistic impacts on adults with OI. Here, data is presented on the humanistic impact of OI on caregivers to explore how caring for an individual with OI impacts their quality of life (QoL), and any drivers of impact. We hypothesise that caring for an individual with OI will impact the QoL of caregivers. IMPACT, fielded July through September 2021 in eight languages, targeted adults and adolescents with OI, close relatives, and caregivers with or without OI. The survey covered demographics, socioeconomic factors, clinical characteristics, treatment patterns, QoL, and health economics. The impact of caring for an individual with OI was measured across QoL and worry domains. We performed descriptive analyses of the QoL of caregivers without OI and exploratory regression analyses to identify independent associations between caregiver and care recipient characteristics (“predictors”), and their QoL impact on caregivers. Of 528 caregivers without OI with one care recipient, across 10 areas and three domains (career and finances, social and relationships, and mental and physical well-being), 58-83% reported that caring for an individual with OI negatively impacted their QoL; 80% and 83% reported impacted mental health and time for leisure activities, respectively. Predictors of QoL impact included caregiver age, care recipient OI severity, age, and clinical signs, symptoms and events (SSEs). Additionally, 36-96% worried about their care recipients’ future lives, medication access, and transition to adult care. Our results suggest that caring for individuals with OI might have considerable impacts on QoL and worries. The level of impact may be predicted by caregiver age and care recipient OI severity, age, and clinical SSEs. The IMPACT Survey looked at how osteogenesis imperfecta, a rare bone condition also known as brittle bone disease, affects people living with the condition and their caregivers. This report presents data on how caring for someone with osteogenesis imperfecta affects caregivers’ quality of life. The Survey was done in 2021 and was open to caregivers (both with and without osteogenesis imperfecta), as well as people with osteogenesis imperfecta. It asked about health, daily life, treatments, emotional well-being, and caregiving costs. It included 528 caregivers who do not have osteogenesis imperfecta and who care for one person with the condition. Most caregivers (between 58% and 83%) said that caring for someone with osteogenesis imperfecta negatively affected their lives. They reported effects on their mental health, free time, work, social life, and finances. Many also said that they were very worried, especially about the future of their care recipients. For example, they were concerned about accessing medication and moving from child to adult healthcare. Some factors, like the caregiver’s age and the care recipient’s osteogenesis imperfecta severity, were linked to how much the caregiver’s life was affected. This study shows that caring for someone with osteogenesis imperfecta can have a big impact on the caregiver’s life—especially their mental health and personal time.
25. Estimation of organ and effective doses for rotational cerebral angiography using the National Cancer Institute Dosimetry System for Radiography and Fluoroscopy (NCIRF).
期刊: Radiological physics and technology 发表日期: 2025-Sep-26 链接: PubMed
摘要
Rotational cerebral angiography requires accurate dosimetry. The National Cancer Institute Dosimetry System for Radiography and Fluoroscopy (NCIRF), a Monte Carlo-based dosimetry software, can evaluate the organ dose (OD) and effective dose (ED) with higher accuracy than the conventional Monte Carlo software (PCXMC). We estimated the OD and ED for three-dimensional digital subtraction angiography (3D-DSA) and cone beam computed tomography (CBCT) using the NCIRF, reflecting dose variations during rotational cerebral angiography. The 3D-DSA and CBCT simulation parameters were obtained by rotational imaging of a physical head phantom using the Artis Q biplane system. The air kerma area product for each projection was determined based on the ratio of the tube current-time product for each projection; the NCIRF was used with male and female voxel-type reference computational phantoms. To validate the simulation results, the lens dose of the phantom was measured using radiophotoluminescence glass dosimeters and compared to the simulated lens dose. The highest ODs were delivered to the brain: 8.8 mGy (males) and 11.6 mGy (females) in 3D-DSA and 50.0 mGy (males) and 59.4 mGy (females) in CBCT. The EDs were 0.27 mSv (males) and 0.35 mSv (females) in 3D-DSA and 1.49 mSv (males) and 1.83 mSv (females) in CBCT. Lens doses differed within 8.0% between measurements and simulations, with 45.9-65.5% overestimation in simulations that did not account for dose variability. Simulations that considered dose variability using the NCIRF more accurately estimated OD and ED in rotational cerebral angiography.
26. Ultra-low-field MRI: a David versus Goliath challenge in modern imaging.
期刊: La Radiologia medica 发表日期: 2025-Sep-26 链接: PubMed
摘要
Ultra-low-field magnetic resonance imaging (ULF-MRI), operating below 0.2 Tesla, is gaining renewed interest as a re-emerging diagnostic modality in a field dominated by high- and ultra-high-field systems. Recent advances in magnet design, RF coils, pulse sequences, and AI-based reconstruction have significantly enhanced image quality, mitigating traditional limitations such as low signal- and contrast-to-noise ratio and reduced spatial resolution. ULF-MRI offers distinct advantages: reduced susceptibility artifacts, safer imaging in patients with metallic implants, low power consumption, and true portability for point-of-care use. This narrative review synthesizes the physical foundations, technological advances, and emerging clinical applications of ULF-MRI. A focused literature search across PubMed, Scopus, IEEE Xplore, and Google Scholar was conducted up to August 11, 2025, using combined keywords targeting hardware, software, and clinical domains. Inclusion emphasized scientific rigor and thematic relevance. A comparative analysis with other imaging modalities highlights the specific niche ULF-MRI occupies within the broader diagnostic landscape. Future directions and challenges for clinical translation are explored. In a world increasingly polarized between the push for ultra-high-field excellence and the need for accessible imaging, ULF-MRI embodies a modern “David versus Goliath” theme, offering a sustainable, democratizing force capable of expanding MRI access to anyone, anywhere.
27. Distance learning on breastfeeding for residents in pediatrics.
期刊: European journal of pediatrics 发表日期: 2025-Sep-26 链接: PubMed
摘要
Breastfeeding is essential for maternal and neonatal health, yet its promotion and support are often insufficiently addressed in medical and pediatric residency curricula. This study evaluated the acceptance and perceived effectiveness of a distance learning course on breastfeeding (DLC-Bf) developed by the Italian Societies of Pediatrics and Neonatology. A cross-sectional, observational study was conducted between August and November 2024. All pediatric residents enrolled in Italian pediatric schools (n = 1281) were invited to participate in an 11.5-h asynchronous distance learning course. The course included pre-recorded lectures, reading materials, and clinical case discussions. A 33-question anonymous online questionnaire was administered to evaluate participants’ perceptions of the course’s quality, content, format, and usefulness. Descriptive statistics were used for data analysis. Of the 1281 residents invited, 74.2% accessed the course and 40.4% completed at least 90% of it. Among those who completed the DLC-Bf, perceived clarity, clinical relevance, and usefulness were high, particularly for modules on the management of common breastfeeding issues; however, only 23% completed the full course and 13.2% of all invitees responded to the survey, limiting inference due to potential selection and nonresponse bias. Almost two out of three residents noted discrepancies between the course contents and current practices in training hospitals, mainly referred to the management of the most common breastfeeding problems. The DLC-Bf was well received, highlighting the need for structured breastfeeding education during pediatric training. It may require improvements in order to increase the participation rate of residents, although this might depend mainly on the specific priority given to breastfeeding. Future research should assess the course’s impact on residents’ knowledge, attitudes, and skills in breastfeeding support. What is Known: • Breastfeeding is fundamental for maternal and neonatal health, even if training in medical and pediatric residency programs is often inconsistent. • Pediatricians play a key role in supporting breastfeeding, but curricula lack standardized, evidence‑based breastfeeding education. What is New: • We developed an online distance learning course on breastfeeding for pediatric residents with high reported satisfaction but low full completion • Practice-content discrepancies were observed, indicating the need for more interactive, clinically focused modules.
28. Where do adults see alcohol marketing? Insight from a cross-sectional survey in the United Kingdom.
期刊: Journal of public health (Oxford, England) 发表日期: 2025-Sep-26 链接: PubMed
摘要
There is limited insight about the reach of alcohol marketing among adults in the United Kingdom (UK). We therefore examined awareness across a range of marketing activities and sources and how this differed by degree of alcohol use. An online cross-sectional survey with a nonprobability adult sample (18+) in the UK (n = 6021). Participants self-reported past-month awareness of alcohol marketing and special price deals from companies/brands, off-trade shops (e.g. supermarkets), online retailers, and on-trade venues (e.g. pubs/bars). Alcohol use was assessed using the AUDIT-C (coded: nondrinkers, lower-risk drinkers, higher-risk drinkers, not stated). For alcohol companies/brands, 65.9% had seen advertising (e.g. on TV) and 79.5% had seen wider marketing (e.g. sponsorship). For off-trade shops, 86.8% had seen marketing (e.g. product displays) and 76.6% had seen special price deals (e.g. multi-buy discounts). For online retailers, 30.8% had seen marketing (e.g. leaflets/flyers) and 52.4% had seen special price offers. For on-trade venues, 69.0% had seen marketing (e.g. posters/leaflets/flyers) and 52.1% had seen special price offers. The odds of reporting awareness were generally lower among nondrinkers and higher among higher-risk drinkers (vs. lower-risk). Adults see alcohol marketing through various activities and sources, with awareness generally increasing with degree of alcohol use.
29. Does segmental alignment matter? A novel understanding of segmental compensation and reciprocal change following single-level lumbar reconstruction.
期刊: Journal of neurosurgery. Spine 发表日期: 2025-Sep-26 链接: PubMed
摘要
Global and regional spinal compensatory alignment changes are well documented, but segmental compensation/reciprocation remain poorly understood. The purpose of this study was to provide a detailed analysis of adjacent segment behavior after single-level reconstruction. Inclusion criteria were adult patients who underwent L5-S1 anterior lumbar interbody fusion for nonnormative preoperative segmental lordosis (SL), demonstrated a ≥ 5° SL increase by intradiscal angle (IDA) or motion segment angle (MSA), and had normal preoperative lumbar lordosis (LL; pelvic incidence [PI]-LL < 10°). IDA; MSA; anterior disc height (ADH) and posterior disc height (PDH) at the index, adjacent, and supra-adjacent levels; and LL, PI, and L1 pelvic angle, were measured preoperatively and at 1 month and 1 year postoperatively. A total of 100 patients met the inclusion criteria. The fusion levels increased IDA and MSA at 1 month (IDA: 11.12°, p < 0.001; MSA: 9.26°, p < 0.001) and 1 year (IDA: 11.45°, p < 0.001; MSA: 9.13°, p < 0.001). There was a reciprocal decrease in L4-5 SL at 1 month for MSA and IDA (-3.58° and -2.01°, p < 0.001) and 1 year (-3.03° and -1.91°, p < 0.001). PDH increased at 1 month (1.16 mm, p < 0.001) and 1 year (0.92 mm, p = 0.002). The L3-4 level showed postoperative reciprocal decrease in MSA and IDA at 1 month (-1.30°, p < 0.001; -0.99°, p < 0.001) and IDA reciprocation was maintained at 1 year (-1.01°, p < 0.001). ADH and PDH showed commensurate increases at 1 month (0.80 mm, p = 0.015; 0.91 mm, p < 0.001) and 1 year (0.83 mm, p = 0.049; 0.79 mm, p = 0.006). LL increased at 1 month (5.541°, p < 0.001) and 1 year (7.069°, p < 0.001). Changes in IDA and MSA at the index level showed a significant positive correlation with changes in LL at 1 month (p = 0.001, p = 0.002) and 1 year (p = 0.009, p = 0.010). At the 1-year follow-up, the reciprocal decrease in IDA at the adjacent level can be estimated using the equation -0.195(∆1-year IDA at the index level) + 0.332, while the reciprocal decrease in MSA at the adjacent level can be calculated as -0.440(∆1-year IDA at the index level) + 2.023. The postoperative reciprocation of the adjacent levels implies a preoperative segmental compensatory mechanism. Normative restoration of the surgical level lordosis may therefore have a preventative impact on the otherwise negative consequences of ongoing compensation mechanisms at the adjacent segmental levels in the lumbar spine. This could relate to the risk of adjacent segment disease and deserves further long-term analysis.
30. The Combination of Fluocinolone Acetonide and Ketocaine Hydrochloride in the Conservative Management of Symptomatic Hemorrhoidal Disease: An Overview of Preclinical and Clinical Data.
期刊: Journal of gastrointestinal and liver diseases : JGLD 发表日期: 2025-Sep-26 链接: PubMed
摘要
Hemorrhoidal disease (HD) is a prevalent anorectal disorder that affects up to 36% of the general population. It is characterized by symptomatic enlargement and displacement of anal cushions, frequently associated with pain, bleeding, and reduced quality of life. The pathophysiology of HD includes vascular congestion, venous stasis, and vascular dilatation, promoted by increased nitric oxide activity. Inflammatory responses are considered crucial in HD, with NF-κB playing a major role. Treatment strategies for HD vary from conservative approaches to office-based and surgical interventions. Conservative therapies, such as topical agents and flavonoid-based systemic treatments, serve as the mainstay of low-grade HD management, while invasive procedures are reserved for refractory cases. Topical formulations containing fluocinolone acetonide (FLA) and ketocaine hydrochloride (KH) combine anti-inflammatory and anesthetic effects, providing rapid and sustained relief from pain, itching, and inflammation. FLA exerts potent anti-inflammatory effects by inhibiting NF-κB and induces vasoconstrictive activity by reducing nitric oxide levels, while KH provides localized analgesia by blocking sodium channels. Collectively, these agents mitigate vascular congestion, inflammation, and HD symptoms. Clinical evidence supports the efficacy of this combination in alleviating acute symptoms, reducing recurrence, and improving patient outcomes. The FLA/KH formulation provides targeted local action with minimal systemic absorption and predominantly mild and transient adverse events. Treatment with FLA/KH is an effective and well-tolerated option for managing acute HD. Furthermore, its combination with flavonoid-based supplements, which improve venous tone and reduce capillary permeability, may aid in preventing recurrence. This combined approach leverages the rapid symptom relief provided by topical agents and the long-term benefits of systemic therapies, promoting comprehensive HD management and reducing the risk of recurrence.
31. An oral glucose tolerance test in pregnancy can serve as a valuable predictor for future diabetes.
期刊: The Journal of clinical endocrinology and metabolism 发表日期: 2025-Sep-26 链接: PubMed
摘要
Adherence to screening following a pregnancy with gestational diabetes mellitus (GDM) remains low. To assess the risk of future type 2 diabetes (T2D) based on the number and type of abnormal results of a 100-gram oral glucose tolerance test (OGTT) performed during pregnancy. This retrospective study used data from a major Israeli healthcare provider. Women aged 20 to 50 years without a prior diagnosis of T2D who had a complete 100-gram OGTT during their last pregnancy between January 2000 and December 2022 were included. The primary outcome was the development of T2D by September 2024. Risk was assessed using Cox proportional hazards models based on the number and type of abnormal OGTT values. The study included 107,889 women (age 34.1±5.2 years; BMI 27.6±5.3 kg/m²). Median follow-up was 6.7 years (IQR 3.3-12.4), totaling 900,000 person-years. T2D developed in 4,500 women (0.5%). When compared to women with all OGTT values normal, the risk of T2D rose with each additional abnormal value: hazard ratio (HR) 3.45 (95% CI: 3.15-3.77) for one abnormal value, 4.03 (3.69-4.41) for two, 7.15 (6.49-7.88) for three, and 10.60 (9.28-12.20) for four. Abnormal fasting glucose was associated with a higher risk (HR 5.28; 95% CI: 4.83-5.76) than abnormal non-fasting values (HR 3.03; 95% CI: 2.78-3.29). A previous diagnosis of GDM was significantly associated with future T2D risk, even in patients with no current abnormal OGTT values. The number and type of abnormal OGTT results strongly predict future T2D. These findings can inform targeted postpartum interventions and predictive tools for early prevention in high-risk women.
32. Simultaneous Quantification of Azole Antimycotics in Quantitative Dried Blood Spots: A Step Toward Home Sampling for Therapeutic Drug Monitoring.
期刊: Therapeutic drug monitoring 发表日期: 2025-Sep-26 链接: PubMed
摘要
Home sampling for therapeutic drug monitoring (TDM) shows promise as a valuable tool, particularly for stable patients with limited access to health care. Quantitative dried blood spot (qDBS) technology has emerged as a promising solution. This study aimed to develop a method for simultaneous quantification of fluconazole, voriconazole, isavuconazole, posaconazole, itraconazole, and hydroxyitraconazole and to investigate key technical issues such as transport stability and the conversion formulas between different matrices. The extraction protocol was optimized using spiked qDBS samples with a series of methanol/water and acetonitrile/water mixtures. Stability tests were performed at 2-8°C and 45°C to mimic environmental conditions of regular mail delivery. Linear regression for converting voriconazole concentrations from qDBS to plasma samples was established using 101 routine TDM samples. The optimal extraction solvent was acetonitrile/water (70/30). The method validation demonstrated excellent linearity (R2 > 0.99), accuracy (recovery of 92.1%-104.2%), and precision (intraday and interday variability <3.3% and 5.7%, respectively). Stability tests confirmed that all azole drugs remained stable, even at 45°C for 7 days. Conversion formula indicated that qDBS sample concentration was equivalent to that in plasma, as supported by Bland-Altman analysis, which revealed a mean bias of -8.49% and 95% limits of agreement ranging from -20.11% to +3.13%. This study established a sensitive, accurate, precise, and robust quantification method in qDBS samples containing only 10 μL of whole blood. Stability tests showed that samples could be safely mailed, offering a cheaper alternative to cold chain logistics. A conversion formula using routine TDM samples was developed, providing a straightforward and cost-effective approach for establishing a conversion formula that is potentially applicable to other TDM analytes. This study represents an in vitro analytical validation, and future clinical research is needed to translate the analytical method from bench to bedside.
33. Advice to people with Parkinson's in my clinic: How to manage running-induced dystonia.
期刊: Journal of Parkinson’s disease 发表日期: 2025-Sep-26 链接: PubMed
摘要
Exercise is an essential part of the treatment of Parkinson’s disease. However, certain symptoms can make exercise difficult. In this viewpoint, we describe an under recognized symptom called running-induced dystonia (RID), which can prevent people with Parkinson’s from exercising in their preferred way. We summarize the existing literature and use three case studies to outline potential mechanisms, aggravating and relieving factors and both pharmacological and non-pharmacological therapies to get rid of RID. Exercise is an important treatment for Parkinson’s disease to help manage symptoms. Dystonia is a symptom of Parkinson’s disease that can make exercise difficult. People with dystonia experience muscles spasms or contractions that lead to twisting or jerky movements of the body. In some people with Parkinson’s disease, dystonia can occur in the foot when running, making this kind of exercise difficult. This paper summarizes what is known about running and foot dystonia. It describes three people with Parkinson’s experiences with foot dystonia when running, and provides suggestions for management, including both medicines and rehabilitation strategies.
34. Targeted serum metabolomic profiling and machine learning approach in Alzheimer's disease using the Alzheimer's disease diagnostics clinical study (ADDIA) cohort.
期刊: Journal of Alzheimer’s disease : JAD 发表日期: 2025-Sep-26 链接: PubMed
摘要
BackgroundMetabolic biomarkers can potentially be used for early diagnosis, prognostic risk stratification and/or early treatment and prevention of individuals at risk to develop Alzheimer’s disease (AD).ObjectiveOur goal was to evaluate changes in metabolite concentration levels associated with AD to identify biomarkers that could support early and accurate diagnosis and therapeutic interventions by using targeted mass spectrometry and machine learning approaches.MethodsSerum samples collected from a total of 107 individuals, including 55 individuals diagnosed with AD and 52 healthy controls (HC) enrolled previously to ADDIA cohort were analyzed using the biocrates AbsoluteIDQ® p400 HR kit metabolite and lipid panel. Several machine learning models including Least Absolute Shrinkage and Selection Operator (LASSO), Partial Least Squares (PLS), Random Forest, and XGBoost were trained to classify AD and HC. Repeated cross-validation was used to ensure performance evaluation.ResultsThe LASSO and PLS models showed the strongest classification performance on the test set, achieving area under the ROC curve (AUC) values of 0.84 and 0.90, respectively. A refined model based on only the top 5 metabolites maintained strong performance, and the inclusion of Apolipoprotein E (APOE) genotype information notably improved classification accuracy, particularly by reducing false negatives in AD cases.ConclusionsThese results highlight important metabolic signatures that could help to reduce misdiagnosis and support the development of metabolomic panels to detect AD. The combination of multiple serum metabolic biomarkers and APOE genotyping can significantly improve classification accuracy and potentially assist in making non-invasive, cost-effective diagnostic approach.
35. Human precursor T follicular regulatory cells are primed for differentiation into mature Tfr and disrupted during severe infections.
期刊: Science advances 发表日期: 2025-Sep-26 链接: PubMed
摘要
T follicular regulatory cells (Tfr) play a pivotal role in maintaining immune self-tolerance and prevention of autoantibody induction. However, the stages of Tfr formation have still not been clarified. Here, we found that 30 to 50% of circulating Tfr in human blood have a naïve-like phenotype (preTfr, CD45RA+CD45RO-Foxp3+CXCR5+). PreTfr are expandable in vitro while retaining suppressive capacity. They are transcriptionally similar to naïve Tregs (nTregs) ex vivo, but after stimulation, they gain increased expression of Tfr-related suppressive molecules such as IL-1RA, suggesting that they are primed for full differentiation into mature Tfr. Further, we demonstrate that preTfr but not nTreg are significantly reduced in the blood of patients with COVID-19 and patients with sepsis and that this loss is correlated with increased anti-interferon-γ antibodies and activated atypical B cells. Together, these data suggest that Tfr are disrupted at the earliest stage of their formation during severe disease and may be an important therapeutic target in future vaccine developments.
36. Development of SARS-CoV-2 as a viral vector: A novel intranasal bivalent vaccine for SARS-CoV-2 and RSV.
期刊: Science advances 发表日期: 2025-Sep-26 链接: PubMed
摘要
Negative-sense RNA viruses have been widely used as viral vectors for vaccine delivery. However, little is known about coronaviruses as vectors for delivering vaccines. Here, we have developed safe SARS-CoV-2 Omicron JN.1-based live attenuated vaccine candidates by combining a mutation (D130A) in the viral nsp16 protein, deletion of the furin cleavage site (dFCS) in the spike protein, deletion of accessory proteins, and/or modification of the transcription regulatory sequences (mTRS). Subsequently, using rJN.1, rJN.1-D130A-dFCS, and rJN.1-mTRS-D130A-dFCS as the backbones, we generated three recombinant viruses expressing a nonfunctional, soluble, and stabilized prefusion F protein of human respiratory syncytial virus (RSVF). Among them, rJN.1-D130A-dFCS-RSVF virus was sufficiently attenuated and highly immunogenic, providing complete protection against challenge with both JN.1 and RSV in hamsters. However, rJN.1-mTRS-D130A-dFCS-RSVF was poorly immunogenic. Collectively, we demonstrate that attenuated SARS-CoV-2 is an effective viral vector for delivering RSV vaccine, warranting further development as a novel intranasal bivalent vaccine for SARS-CoV-2 and RSV.
37. USP13 stabilizes NLRP3 to facilitate inflammasome activation by preventing TRIM31-mediated NLRP3 ubiquitination and degradation.
期刊: Science advances 发表日期: 2025-Sep-26 链接: PubMed
摘要
NOD-, LRR-, and pyrin domain-containing protein 3 (NLRP3) has a fundamental role in host defense and is involved in diverse inflammatory diseases. NLRP3 protein expression is tightly controlled by the ubiquitin system. In particular, NLRP3 protein degradation has been extensively studied. In contrast, the mechanisms to stabilize NLRP3 protein are much less known. Here, we demonstrated the critical role of ubiquitin-specific protease 13 (USP13) in regulating NLRP3 protein stability and inflammasome activation independently of its deubiquitinating enzyme activity. USP13 competes with E3 ubiquitin ligase TRIM31 to interact with NLRP3 and prevents TRIM31-mediated NLRP3 ubiquitination at K192 and K496 sites, thereby inhibiting proteasomal degradation of NLRP3. USP13 deficiency reduces NLRP3 protein expression in both human and mouse macrophages, which consequently inhibits NLRP3 inflammasome assembly and activation. Accordingly, deficiency of USP13 attenuates monosodium urate crystal-induced mouse peritonitis. Overall, our findings reveal a previously unrecognized regulatory mechanism of NLRP3 stability by USP13 and provide a potential therapeutic target for NLRP3-driven diseases.
38. Pancreatic Enzyme Replacement Therapy: Not Only in Chronic Pancreatitis.
期刊: Journal of gastrointestinal and liver diseases : JGLD 发表日期: 2025-Sep-26 链接: PubMed
摘要
The therapeutic application of Pancrelipase spans several key gastroenterological conditions, ranging from chronic pancreatitis to genetic disorders such as cystic fibrosis. Consequently, pancreatic enzyme replacement therapy (PERT) is applicable in a variety of clinical settings, managing pancreatic insufficiency. Beyond chronic pancreatitis, PERT has also shown effectiveness in addressing malabsorption associated with pancreatic surgery, gastrointestinal malignancies, and various dysmetabolic conditions. This review aims to provide a comprehensive overview of the therapeutic applications of PERT and its clinical role in managing both surgical and non-surgical conditions, beyond chronic pancreatitis. PERT has proven crucial in improving patient outcomes, addressing gastrointestinal symptoms, and supporting long-term health in patients with pancreatic insufficiency. While more research, particularly from randomized controlled trials, is required to optimize dosing strategies and establish standardized PERT protocols, clinicians should consider tailoring PERT to individual patient needs based on the available evidence across various clinical scenarios.
39. Human Cases of Carbapenemase-Producing Escherichia coli Linked to Spread Between Animals and the Environment in a Veterinary Facility -Massachusetts, USA, 2023.
期刊: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 发表日期: 2025-Sep-26 链接: PubMed
摘要
Carbapenemase-producing Enterobacterales (CPE), traditionally thought to cause hospital-acquired infection in humans, are now emerging as agents of both community-acquired infections in humans as well as hospital-acquired infections in pets. It is currently unknown what impact this spread amongst animals may have on human health. The Massachusetts State Public Health Laboratory investigated links between three genetically-related human cases of blaNDM-5-harboring E. coli. Simultaneously, a separate, collaborative investigation into blaNDM-5-harboring E. coli animal infections at a Massachusetts veterinary hospital was conducted including animal and environmental screening. Whole genome sequencing (WGS) was performed on human, animal and veterinary hospital environmental isolates. Once a genetic link was established between animal and human isolates, follow-up interviews including questions related to pet exposure were performed with affected humans. WGS demonstrated that human, animal and veterinary environmental isolates clustered within 0-10 single nucleotide polymorphisms. Although initial case interviews failed to identify any epidemiologic linkages between the humans, follow-up questioning revealed that all three human cases had pets treated at the same veterinary hospital prior to their diagnosis. This report suggests the potential for transmission of blaNDM-5-harboring E. coli between animals and people. There is an urgent need to invest resources and develop a One Health approach to support veterinary facilities in recognizing and preventing transmission of CPE to limit spread within communities. Physicians, veterinarians, and public health professionals conducting outbreak investigations should be aware of this potential route of CPE spread.
40. Fluorene, phenanthrene, and pyrene degradation by a bacterial consortium enriched from rice field sediments.
期刊: Journal of environmental science and health. Part A, Toxic/hazardous substances & environmental engineering 发表日期: 2025-Sep-26 链接: PubMed
摘要
Polycyclic aromatic hydrocarbons (PAHs) pose a significant environmental challenge due to their toxicity that are harmful to living organisms, and commonly found in various ecosystems. Degradation using natural indigenous bacteria is the most cost-effective solution to remove PAHs in the environment. This study examines Sdt-1, an isolated bacterial consortium from agricultural soil in Wakabayashi-ward, Sendai, Japan, capable of degrading PAHs. Sdt-1 was incubated to a solution containing fluorene, phenanthrene, and pyrene in Bushnell Hass Medium (BHM) with 100 mg/L concentration of each compound. Fluorene degraded at the fastest rate, then phenanthrene, while pyrene was the slowest due to its higher molecular weight. Cloning of the 16S rRNA gene showed that Sdt-1 consists primarily of 48% Castellaniella, 16% Mycobacterium, 14% Desulfonatronum, 10% Azospirillum, and 2% each of several other genera. The dynamics of the Sdt-1 was tracked over the 15-d incubation periods through the PCR-DGGE analysis, showing Mycobacterium as the dominant PAH degrader. Correlation between bacterial activity and PAH-degrading genes (nidA and gram-positive PAH-RDH) demonstrates that specific microbes are in charge of various degradation phases. This study enhanced our understanding of the mechanics, characteristics, and the potential role for bioremediation applications of aerobic PAH-degrading bacteria from paddy soil in agricultural land.
41. Adaptation and content validity of a battery of questionnaires for identifying occupational conditions among Chilean artisanal and small-scale miners.
期刊: Medwave 发表日期: 2025-Sep-26 链接: PubMed
摘要
Small-scale and artisanal mining are historical activities in Chile that are deeply rooted in the region and economically significant. However, their workers face high levels of exposure to occupational hazards in informal conditions, with no adapted tools for occupational health surveillance. The available instruments are designed for formal companies and do not consider the operational context of artisanal miners. To adapt and validate the content of a battery of questionnaires designed to identify working conditions affecting artisanal and small-scale mining workers in Chile. An instrumental study was conducted in four phases: document review of national and international protocols; participatory risk identification with union leaders; development of thematic questionnaires; content validation through the judgment of 25 experts in occupational health, mining, psychometrics, and statistics. One hundred and fifty-five items were evaluated according to criteria of clarity, relevance, sufficiency, and coherence, using Aiken’s V coefficient (threshold ≥ 0.80). 87% of the items met the threshold in all four criteria. Aiken’s scores ranged from 0.77 to 0.98. The diesel exposure module obtained the highest scores, while the working conditions module showed less clarity (0.77), justifying the modification or elimination of 41% of its items. A new questionnaire on exposure to chemical agents was created by integrating modules. As a result of the adjustment process, the final battery consisted of six thematic questionnaires. This is the first questionnaire set with favorable content validity to assess working conditions in Chilean artisanal mining, a sector with high labor informality. It represents an initial validation step. Further studies should evaluate reliability, construct validity, and field applicability. La pequeña minería y minería artesanal son actividades históricas en Chile, con fuerte arraigo territorial y relevancia económica. Sin embargo, sus trabajadores enfrentan altos niveles de exposición a riesgos laborales en condiciones de informalidad, sin contar con herramientas adaptadas para su vigilancia en salud ocupacional. Los instrumentos disponibles están diseñados para empresas formales y no consideran el contexto operativo de dichos trabajadores. Adaptar y validar el contenido de una batería de cuestionarios diseñada para identificar condiciones laborales que afectan a trabajadores de la minería artesanal y de pequeña escala en Chile. Estudio instrumental desarrollado en cuatro fases: revisión documental de protocolos nacionales e internacionales; identificación participativa de riesgos con dirigentes sindicales; elaboración de cuestionarios temáticos; y validación de contenido mediante juicio de 25 expertos en salud ocupacional, minería, psicometría y estadística. Se evaluaron 155 ítems bajo criterios de claridad, relevancia, suficiencia y coherencia, usando el coeficiente V de Aiken (umbral igual o mayor a 0,80). El 87% de los ítems alcanzó el umbral en los cuatro criterios. Los valores de Aiken oscilaron entre 0,77 y 0,98. El módulo de exposición a diésel obtuvo los puntajes más altos, mientras que el de condiciones laborales mostró menor claridad (0,77), justificando la modificación o eliminación del 41% de sus ítems. Se creó un nuevo cuestionario sobre exposición a agentes químicos mediante la integración de módulos. Como resultado del proceso de ajuste, la batería final quedó conformada por seis cuestionarios temáticos. Esta es la primera batería de cuestionarios con validez de contenido favorable para evaluar condiciones laborales en la minería artesanal chilena, marcada por alta informalidad. Este trabajo, representa un primer paso en su validación. Se requieren estudios posteriores que analicen confiabilidad, validez de constructo y aplicabilidad en terreno.
42. Cross-cultural adaptation, validity, and reliability of the Turkish version of the trapeziometacarpal arthrosis symptoms and disability questionnaire.
期刊: Journal of back and musculoskeletal rehabilitation 发表日期: 2025-Sep-26 链接: PubMed
摘要
BackgroundThe Trapeziometacarpal Arthrosis Symptoms and Disability questionnaire (TASD) is widely used to assess symptoms and disability associated with trapeziometacarpal (TMC) arthrosis.ObjectiveTo adapt the TASD into Turkish (TASD-TR) and evaluate its reliability and validity.MethodsForty-one patients with TMC arthrosis were included in the study. Thumb function was assessed using the TASD-TR and the Thumb Disability Examination (TDX). Pain intensity was rated using the Visual Analogue Scale (VAS). Power grip strength (PGS) and pinch strength (PS) were measured using the Jamar Hydraulic Hand Dynamometer and Jamar Pinch Gauge, respectively.ResultsThe TASD-TR demonstrated good test-retest reliability and internal consistency (Cronbach’s alpha = 0.786-0.859; Intraclass Correlation Coefficient (ICC) = 0.844). TASD-TR Total score showed a high correlation with TDX Total score (r = 0.706) but weak correlations with PGS (r = -0.342), PS (r = -0.290), and VAS (r = 0.373) scores. The TASD-TR Disability subscale was highly correlated with both TDX Total (r = 0.882) and TDX-ADL (r = 0.877) scores, and the TASD-TR Symptoms subscale was moderately correlated with TDX Pain score (r = 0.508).ConclusionThe TASD-TR is a reliable and valid tool for assessing thumb symptoms and function in Turkish-speaking patients with TMC arthrosis.
43. A systematic review of the health effects of Acacia, Eucalyptus, and Pinus wood dust: Implications for South African occupational exposure limits.
期刊: Journal of occupational and environmental hygiene 发表日期: 2025-Sep-26 链接: PubMed
摘要
South Africa’s commercially planted timber is mainly from the non-native genera Acacia (acacia), Eucalyptus (eucalyptus), and Pinus (pine). These trees are popular because they are fast-growing, stress-tolerant, and commercially profitable. During timber processing, woodworkers can be exposed to wood dust through inhalation or dermal contact. Occupational exposure limits (OELs) have been developed to help protect workers against adverse health effects from overexposure to wood dust. In South Africa, the Regulations for Hazardous Chemical Agents of 2021 (RHCA 2021) list an inhalable OEL-maximum limit (ML) for wood dust from oak, beech, birch, mahogany, teak, and walnut (2 mg/m3), and OEL-restricted limit (RL) for all other species (5 mg/m3), but do not refer to acacia, eucalyptus, or pine. Due to their popularity as commercial plantation timber, these tree types may pose occupational health risks to South African woodworkers. This systematic review investigates the health effects associated with occupational exposure to acacia, eucalyptus, and pine wood dust and discusses the implications for South African OELs. A systematic literature search was conducted using EBSCO Academic Search Complete, PubMed Central, ScienceDirect, Scopus, and Web of Science. Overall, 67 articles were included in the study. The prevalence of skin and respiratory sensitization in exposed workers was <10%. Adverse dermal effects included non-allergic skin sensitivity, allergic contact dermatitis, palpable erythema, and pigmentation loss. Respiratory effects included allergic alveolitis, vocal cord dysfunction, airway inflammatory reactions, higher prevalence of respiratory symptoms, and occupational asthma. Carcinogenicity was not reported. Exposure concentrations exceeded current South African (5 mg/m3, all species) and international inhalable wood dust OELs. Based on case reports, epidemiological and toxicological data, exposure studies, and current regulations, the authors propose an inhalable 8-hr time-weighted average-OEL-ML of 2 mg/m3 with dermal and respiratory sensitization notations for acacia, eucalyptus, and pine wood dust. To date, only P. radiata has been investigated as an occupational health hazard. To create representative OELs for occupational wood dust exposure, occupational epidemiological and toxicological studies for other common timbers should be undertaken.
44. Physician-Reported Treatment Patterns in Moderate to Severe Chronic Hand Eczema: the RWEAL Multinational Medical Chart Review.
期刊: Dermatology and therapy 发表日期: 2025-Sep-26 链接: PubMed
摘要
Evidence for moderate to severe chronic hand eczema (CHE) treatments in clinical practice is limited. The objective was to investigate treatment patterns in patients with moderate to severe CHE, and in those with an inadequate response to topical corticosteroids (TCS) or in whom TCS were contraindicated. This was a multinational retrospective physician chart review. Physicians who routinely diagnosed and treated CHE were recruited in Canada, France, Germany, Italy, Spain, and the UK and provided data on adult patients with moderate to severe CHE treated with TCS over the past 12 months or for whom TCS were contraindicated. A total of 292 physicians provided data on 1939 patients. Worst severity of CHE in the 12-month study period was judged by the physician to be moderate in 56.8% and severe in 43.2% of patients. Overall, 6.7% of patients received topical calcineurin inhibitors, 3.9% phototherapy, 6.8% alitretinoin, 11.1% traditional orals (acitretin, azathioprine, oral corticosteroids, cyclosporine, methotrexate), 8.0% biologics, and 1.7% oral Janus kinase (JAK) inhibitors. An inadequate response or contraindication to TCS was reported in 39.9% of patients (27.4% progressed to phototherapy/systemics; 12.1% with adverse events or an inadequate response to high/ultra-high potency TCS, and 0.4% contraindicated). Among these patients, the highest line of treatment during the 12-month period was biologics in 29.2%, alitretinoin in 22.3%, oral JAK inhibitors in 5.1%, traditional orals in 33.3%, and phototherapy in 9.6% of patients. There were no significant differences in phototherapy/systemic treatments between patients with moderate and severe disease in this subgroup. Despite being a first-line treatment, 40% of patients with CHE were inadequately treated with or contraindicated to TCS. Over one-quarter of patients progressed to phototherapy or systemic therapy. These results suggest a lack of effective and well-tolerated topical treatment options in CHE. Graphical Abstract available for this article.
45. Letter to the Editor Regarding "Evaluation of VTE, MACE, and Serious Infections Among Patients with RA Treated with Baricitinib Compared to TNFi: A Multi-Database Study of Patients in Routine Care Using Disease Registries and Claims Databases".
期刊: Rheumatology and therapy 发表日期: 2025-Sep-26 链接: PubMed
摘要
46. Coping strategies and interventions to prevent and alleviate work-related burnout in midwives: A rapid scoping review of quantitative and qualitative research.
期刊: Women and birth : journal of the Australian College of Midwives 发表日期: 2025-Sep-25 链接: PubMed
摘要
Work-related burnout in healthcare is a public health crisis. It is particularly prevalent in midwives, due to high workloads, staff shortages, and the emotional demands of providing care for birthing women. Burnout affects midwives’ wellbeing and ability to provide high-quality care, exacerbating workforce challenges. Coping strategies and interventions to prevent and alleviate work-related burnout in midwives have been described in the literature. Identify and describe the evidence on coping strategies and interventions to prevent and alleviate work-related burnout in midwives. A rapid scoping review was conducted with systematic searches in four electronic databases. Three reviewers screened and extracted the data on reported coping strategies and interventions, which were collated and presented in a narrative format. 7379 articles were identified, and twenty-one articles were included. Five overarching types of coping strategies to prevent and alleviate burnout in midwives were present in the included studies: Support and understanding from colleagues; Structured support from the workplace; Support from friends and family; Ability to reflect and learn professionally and personally from events; Awareness of self-care techniques for use in practice and after events. Maternity services must prioritise workforce wellbeing by increasing the focus on preventing and alleviating burnout to support the retention of midwives and ensure the safe, effective care of women. Future research could focus on exploring how practical support for midwives, such as supervision and debriefing could be implemented effectively, and identify realistic, sustainable ways to integrate psychology-informed approaches into midwifery practice.
47. From individual interventions to structural change: Why public health leadership is needed to engage men and boys in violence prevention.
期刊: Public health 发表日期: 2025-Sep-25 链接: PubMed
摘要
To review practice in Wales for engaging men and boys in violence prevention and examine how public health can support effective and coordinated efforts as part of a whole system approach. A mixed-methods study combining a national mapping survey and qualitative focus group research. A mapping survey (n = 36) was conducted to identify programmes across Wales aimed at engaging men and boys in violence prevention. In addition, a focus group was held with leads from eight ‘Test and Learn’ pilot projects. Data were analysed thematically to identify key enablers, barriers, and features of promising practice. Programmes varied in focus, target age group, geographical reach, and tier of prevention. Practitioners highlighted the effectiveness of trauma-informed, strengths-based, and culturally relevant approaches. Staff empathy, relationships and coproduction were identified as critical success factors. However, the review also found limited evidence of strategic coordination, evaluation, or long-term investment in this area. Engaging men and boys in violence prevention is vital to addressing the gendered dynamics of perpetration and maximising opportunities for prevention. This research reveals a developing landscape of interventions that, while showing promising elements of trauma-informed, strengths-based practice, remains fragmented and inconsistent in its strategic coordination and evaluation. Realising the full potential of this approach will require public health leadership to move beyond individual behaviour change towards a whole-system approach that addresses the structural drivers of gendered violence.
48. Experiences of mothers in the context of a staffing intervention in select newborn units in Kenyan public hospitals.
期刊: International journal of nursing studies 发表日期: 2025-Sep-18 链接: PubMed
摘要
Maternal involvement, effective communication and adequate support are widely recognised as promoting respectful care and better maternal experience of small and sick neonate care. Nurses play a critical role in neonatal care, but staffing shortages and workplace stress significantly impact their ability to provide quality care. Few studies have examined the implications of staffing interventions for maternal care experiences in newborn units. In this ethnographic study, we explored mothers’ experiences following a staffing intervention (addition of 3 nurses and 3 ward assistants) across four newborn units in Kenyan County referral hospitals. Data were collected through nonparticipant observations and interviews with mothers. Across the four hospitals, we interviewed 46 mothers and conducted over 1000 observation hours over three phases of data collection. We examined mothers’ experiences of care and any changes with the staffing intervention in relation to communication, involvement in care, nurse-mother relationships and support. Mothers in newborn units face intense emotional, physical and practical challenges with limited guidance and support to cope with the demands of neonatal caregiving. We did not observe significant changes in communication, nurse-mother relationships, or the support offered to mothers due to the additional nurses. However, the addition of ward assistants was valued by mothers, who appreciated their role in orientation, maintaining ward cleanliness, and cleaning feeding cups. Following the staffing intervention, mothers continued to report challenges with adequacy of information, disrespectful communication, and limited support with tasks. Peer-to-peer support between mothers was evident across all sites and study phases. Contextual factors and norms of care greatly influenced nursing practices. Enhancing mothers’ experiences in neonatal units will require integrated approaches that acknowledge their critical role in newborn care. Mothers need structured psychosocial and practical support, strengthened communication with healthcare providers, and broader structural interventions that significantly increase staff numbers and shift care norms.
49. Gamma spectroscopic investigation of construction materials from Rajasthan, India: Assessment of radioactivity and radiological hazards.
期刊: Applied radiation and isotopes : including data, instrumentation and methods for use in agriculture, industry and medicine 发表日期: 2025-Sep-18 链接: PubMed
摘要
This study focused on assessing the radioactivity of 226Ra, 232Th, and 40K, along with their radiological health impacts in cement, marble slurry, and lime (CaO) samples used as construction materials collected from Rajasthan, India. The activity concentrations of 226Ra, and 232Th, with averages of 49.4 and 63.0 Bq kg-1, respectively, were higher than the world average. Consequently, the radium equivalent (Raeq) in cement samples was 154.5 Bq kg-1, exceeding the world average of 129.6 Bq kg-1 but remaining below the safety guideline of 370 Bq kg-1. In contrast, the levels of 226Ra, 232Th, 40K, and Raeq in marble slurry and CaO were well below the world average. Notably, there is no existing literature on the radioactivity of CaO, a primary construction material in India, making this the first study to report on its radiological implications. The various parameters such as hazard indices (Hex, Hin), level indices (Iα, Iγ), and activity utilization index (I) have been studied in all sample types for health risk assessment and found to be within permissible limits. Cement samples were found to have higher average ELCR resulting from AEDE which is derived from AGDR values in both indoor and outdoor environments compared to marble slurry and CaO samples. Hence, the average ELCR values resulting from AEDE which were derived from AGDR in both indoor and outdoor environments follow the trend: (ELCR)Cement > (ELCR)Slurry > (ELCR)Lime.
50. Characteristics of hub regions in the superficial white matter.
期刊: Cerebral cortex (New York, N.Y. : 1991) 发表日期: 2025-Sep-15 链接: PubMed
摘要
The superficial white matter (SWM) comprises short-range fibers that connect adjacent cortical regions; however, its structural connectivity remains poorly understood. In a previous dissection study, we identified anatomical “crossings” where superficial white matter fibers converge from multiple directions. Building on this, the present study investigated superficial white matter characteristics associated with these crossings using diffusion-weighted imaging data from 10 individuals in the Human Connectome Project. A total of 605 regions of interest (ROIs) were placed at presumed crossing locations in the dominant hemisphere. Superficial white matter fibers were categorized by tract length (short, medium, and long), and streamline distribution was analyzed. Short- and medium-length fibers showed predominantly intragyral connections, while long fibers exhibited more diverse intragyral connectivity. Graph theoretical analysis identified high-efficiency regions of interest, putative hub regions, which were mapped onto cytoarchitectonic structures from the Economo-Koskinas atlas and compared with myelin concentration. High-efficiency regions for short- and middle-length fibers were mainly in primary motor and sensory areas, particularly visual regions, corresponding to high myelin concentration and cytoarchitectonic areas 1 and 5. In contrast, high-efficiency regions for long fibers were distributed in the association cortex (area 3). These findings provide new insights into the structural organization of superficial white matter and its relationship to cortical architecture.
51. Racial and Ethnic Disparities in Occupational Health.
期刊: JAMA health forum 发表日期: 2025-Sep-05 链接: PubMed
摘要
Occupational health disparities affect the safety and well-being of workers across different racial and ethnic groups. Understanding these disparities is crucial for developing targeted interventions, but evidence on occupational injury rates by race and ethnicity has been scarce due to data limitations. To determine the incidence of lost-time workplace injuries among major racial and ethnic groups in California and to assess the contributions of occupational concentration and within-occupation disparities to these differences. A cross-sectional study analyzing 15 years (2005-2019) of California workers’ compensation data was carried out. The study examined injury rates across 4 racial and ethnic groups: Asian/Pacific Islander (non-Hispanic), Black (non-Hispanic), Hispanic, and White (non-Hispanic). California residents employed in the private sector or state and local government, encompassing diverse industries and occupations, between 2005 and 2019 were included. Analysis was conducted between May 2024 and May 2025. The study analyzed existing workers’ compensation data without specific interventions. The primary outcome was the incidence of lost-time workplace injuries, with comparisons made between racial and ethnic groups. The analysis focused on the role of occupational concentration and within-occupation disparities in explaining injury rates. The analysis included 2.6 million lost-time injuries among California workers (mean [SD] age, 42 [11]; 63% male). The overall injury rate was 1.32 lost-time injuries per 100 full-time equivalent workers (FTE). Lost-time injury rates were higher for Black (1.74 cases per 100 FTE) and Hispanic workers (1.90 cases per 100 FTE) than for White workers (1.00 cases per 100 FTE), whereas rates were lower for Asian/Pacific Islander workers (0.63 cases per 100 FTE). Black and Hispanic workers experienced injury rates that were 74% and 90% higher, respectively, compared with White workers, whereas Asian/Pacific Islander workers had injury rates that were 37% lower. Occupational concentration accounted for 53% of the disparity between Black and White workers and 71% of the disparity between Hispanic and White workers. Notably, 56% of the excess risk of injuries for Black women was attributed to within-occupation disparities. Disparities in workplace safety are a significant contributor to racial and ethnic health disparities. Addressing both occupational concentration and within-occupation disparities is essential for improving workplace safety and reducing health inequities among workers.
52. Exploring the knowledge, attitudes, and practices of livestock veterinarians on antibiotic prescription and use: insights from focus group discussions.
期刊: Animal : an international journal of animal bioscience 发表日期: 2025-Sep-04 链接: PubMed
摘要
Antimicrobial resistance (AMR) is a global threat impacting humans, animals, and ecosystems. Effective antibiotic stewardship in livestock veterinary practices is essential to combat resistance development and dissemination. This study aimed to explore Portuguese veterinarians’ knowledge, perceptions, attitudes, and practices regarding antibiotic prescription and use in livestock, namely bovine, swine, equine, and small ruminants. A qualitative methodology, focus groups (FGs), was conducted by videoconference, between July and December 2024. The FG guide was based on a comprehensive review of relevant literature. Sessions were audio-recorded, transcribed, and analysed using thematic analysis with webQDA software. Results: In total, 19 veterinarians participated in six FG. Three main themes were identified: (i) Antibiotic prescription, use, and management, (ii) Animal welfare management, and (iii) Fostering antibiotic stewardship. Veterinarians recognised the importance of prudent antibiotic use, but faced obstacles, such as farmer non-compliance, insufficient knowledge and/or economic constraints, and limited laboratory resources. National initiatives have increased awareness and surveillance efforts; however, implementation barriers remain, especially given regional farming differences. Findings suggest that addressing AMR requires medium- and long-term, tailored strategies involving policy reforms, enhanced veterinarian and farmer education, improved diagnostic capacity, and effective communication among stakeholders. Emphasising a One Health approach and considering regional contexts are vital to promoting responsible antibiotic use, advancing antibiotic stewardship, and reducing resistance.
53. Incorporating Continuous Mammographic Density Into the BOADICEA Breast Cancer Risk Prediction Model.
期刊: JCO precision oncology 发表日期: 2025-Sep 链接: PubMed
摘要
Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA v7) predicts future breast cancer (BC) risk using data on cancer family history (FH), genetic markers, questionnaire-based risk factors, and mammographic density (MD) measured using the four-category Breast Imaging Reporting and Data System (BIRADS) classification. However, BIRADS requires manual reading, which is impractical on a large scale and may cause information loss. We extended BOADICEA to incorporate continuous MD measurements, calculated using the automated Volpara and STRATUS tools. We used data from the Karolinska Mammography Project for Risk Prediction of Breast Cancer cohort (60,276 participants; 1,167 incident BC). Associations between MD measurements and BC risk were estimated in a randomly selected training subset (two thirds of the data set). Percent MD residuals were calculated after regressing on age at mammography and BMI. Hazard ratios (HRs) were estimated using a Cox proportional hazards model, adjusting for FH and BOADICEA risk factors, and were incorporated into BOADICEA. The remaining one third of the cohort was used to assess the performance of the extended BOADICEA (v7.2) in predicting 5-year risks. The BC HRs per standard deviation of residual STRATUS density were estimated to be 1.48 (95% CI, 1.33 to 1.64) and 1.41 (95% CI, 1.27 to 1.56) for pre- and postmenopausal women, respectively. The corresponding estimates for Volpara density were 1.27 (95% CI, 1.15 to 1.40) and 1.38 (95% CI, 1.25 to 1.54). The extended BOADICEA showed improved discrimination in the testing data set over using BIRADS, with a 1%-4% increase in AUC across different combinations of risk factors. On the basis of 5-year BC risk with MD as the sole input, approximately 11% of the women were reclassified into lower risk categories and 18% into higher risk categories using the extended model. Incorporating continuous MD measurements into BOADICEA enhances BC risk stratification and facilitates the use of automated MD measures for risk prediction.
54. Comparative efficacy of nonpharmacological interventions for preventing postoperative delirium in hospitalized older adults: a systematic review and network meta-analysis.
期刊: Age and ageing 发表日期: 2025-Aug-29 链接: PubMed
摘要
Postoperative delirium (POD) is the most common surgical complication. Although numerous studies have demonstrated the effectiveness of multicomponent interventions in preventing delirium among medical patients, the most effective nonpharmacological strategies for reducing the incidence of POD remains unclear. This study aimed to compare the effects of component-based and treatment-based nonpharmacological interventions on POD prevention in hospitalized older adults. A network meta-analysis was conducted using three databases from inception to February 1, 2024. Only randomized controlled trials evaluating nonpharmacological interventions versus usual care or other interventions for POD prevention in surgical older adults were included. A random-effects network meta-analysis assessed the comparative effectiveness of interventions. Nineteen studies involving 4340 hospitalized older adults were included. Component-based analysis showed that multicomponent interventions were the most effective for reducing POD compared to usual care (odds ratio [OR] = 0.48, 95% confidence interval [CI] = 0.35-0.66). Treatment-based analysis identified that multicomponent interventions comprising six elements-physical activity, reorientation, clinical adjustment, sensory stimulation, environmental control and relaxation promotion-most effectively reduced POD incidence (OR = 0.11, 95% CI = 0.04-0.33). This network meta-analysis, drawing on both direct and indirect evidence, suggests that multicomponent nonpharmacological interventions are the most effective strategies for reducing POD incidence in hospitalized older adults. Specifically, interventions incorporating physical activity, reorientation, clinical adjustment, sensory stimulation, environmental control and relaxation promotion significantly lowered the risk of POD. These findings support the adoption of comprehensive multicomponent interventions as a first-line approach for POD prevention in surgical older adult populations.
55. Stochastic modeling of intra- and inter-hospital transmission in Middle East respiratory syndrome outbreak.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Middle East Respiratory Syndrome (MERS) is an endemic disease that presents a significant global health challenge characterized by a high risk of transmission within healthcare settings. Understanding both intra- and inter-hospital spread of MERS is crucial for effective disease control and prevention. This study utilized stochastic modeling simulations to capture inherent randomness and unpredictability in disease transmission. This approach provides a comprehensive understanding of potential future MERS outbreaks under various scenarios in Korea. Our simulation results revealed a broad distribution of case number, with a mean of 70 and a prediction interval of [0, 315]. Additionally, we assessed the risks associated with delayed outbreak detection and investigated the preventive impact of mask mandates within hospitals. Our findings emphasize the critical role of early detection and the implementation of preventive measures in curbing the spread of infectious diseases. Specifically, even under the worst-case scenario of late detection, if mask mandates achieve a reduction effect exceeding 55%, the peak number of isolated cases would remain below 50. The findings derived from this study offer valuable guidance for policy decisions and healthcare practices, ultimately contributing to the mitigation of future outbreaks. Our research underscores the critical role of mathematical modeling in comprehending and predicting disease dynamics, thereby enhancing ongoing efforts to prepare for and respond to MERS or other comparable infectious diseases.
56. Evaluating the cost-effectiveness of COVID-19 mRNA primary-series vaccination in Qatar: An integrated epidemiological and economic analysis.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Qatar implemented a mass primary-series vaccination campaign to mitigate the impact of the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to retrospectively evaluate the cost-effectiveness of this program both before and after onset of the omicron wave. An economic evaluation was conducted from the public healthcare system perspective between January 5, 2021, and September 18, 2023. Cost-effectiveness was determined using an epidemiological retrospective cohort study and health economic modeling that compared the cohort of individuals who received two vaccine doses with the unvaccinated cohort with respect to incidence of infection, incidence of severe COVID-19 forms, quality-adjusted life years (QALYs), and medical costs. During the pre-omicron phase, primary-series vaccination incurred an additional cost of $104,422,358, led to a gain of 724.7 QALYs, and savings of $54,790,858 in direct medical costs. The incremental cost-effectiveness ratio (ICER) was $68,485 per QALY gained. The number needed to vaccinate was 35.4 individuals (95% CI: 24.4-49.9) to prevent one infection and 718.0 individuals (95% CI: 469.4-984.0) to prevent one severe COVID-19 outcome. The cost per infection averted was $3,180 (95% CI: $2,189-$4,484) and per severe COVID-19 outcome averted was $64,468 (95% CI: $42,146-$88,354). Vaccination of individuals ≥50 years of age, those more clinically vulnerable to severe COVID-19, and those with multiple coexisting conditions was substantially more cost-effective. Cost-effectiveness of primary-series vaccination was substantially reduced during the omicron phase, but vaccination remained cost-effective. Sensitivity analyses confirmed the findings. Primary-series vaccination was cost-effective with an ICER below the 1 GDP per capita threshold during the pre-omicron phase and within the 1-3 GDP per capita thresholds during the omicron phase. Targeted vaccination strategies for those most vulnerable to COVID-19 were the most cost-effective and remained essential, even in situations of moderate vaccine effectiveness or reduced infection severity.
57. Neuronal Activity in Rat Hippocampus During Light-Intensity Treadmill Running.
期刊: Advances in neurobiology 发表日期: 2025 链接: PubMed
摘要
In the early 2000s, it became evident that exercise enhances brain function, particularly in the hippocampus, attracting considerable attention. However, at that time, most studies relied on the voluntary wheel running model for experiments, it was unclear whether exercise conditions affected the impact of exercise on the hippocampus. Therefore, aiming to obtain translational insights applicable to humans, we focused on exercise intensity and started with the research investigating whether light-intensity exercise activates hippocampal neural activity in rats. We established an original running model in rats comprising laser Doppler flowmetry for monitoring hippocampal cerebral blood flow (Hip-CBF) and microdialysis for drug treatment. We found that Hip-CBF increased with light-intensity treadmill running, which was elicited by hippocampal neuronal activation and subsequent N-methyl-D-aspartate/nitric oxide (NMDA/NO) signaling. In this chapter, we first retrospectively summarize what we knew and what we did not know during that time, and the impact of our findings that light-intensity exercise can evoke neuronal activity in the rat hippocampus on our subsequent research.
58. Factors associated with wasting among pediatric cancer patients aged 2-17 years at Uganda cancer institute: A cross-sectional study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Wasting is a major concern among pediatric cancer patients and significantly affects treatment outcomes and quality of life. However, limited data exist on the prevalence of wasting and its associated factors in low-income contexts. This study determined the prevalence of wasting and its associated factors among pediatric cancer patients aged 2–17 years at the Uganda Cancer Institute. An institutionally based, cross-sectional study was conducted among 270 systematically randomly selected caregiver‒child pairs. Univariate, bivariate, and multivariable analyses were conducted using STATA version 14. Variables with p-value < 0.05 were considered statistically significant. Among 270 pediatric cancer patients aged 2-17 years, 27.4% (n = 74) were wasted. Children aged 5 years and older had a 20% higher prevalence of wasting (aPR = 1.2; p = 0.002). Cancers near the gastrointestinal tract were associated with a 10% greater prevalence of wasting (aPR = 1.1; p = 0.028). Wasting was lower by 20% among children whose caregivers had tertiary education (aPR = 0.8; p = 0.002), whereas treatment effects increased wasting prevalence by 10% (aPR = 1.1; p = 0.013). Wasting is a prevalent form of malnutrition among pediatric cancer patients requiring the integration of nutritional services to address the nutritional needs of children, especially those aged greater than 5 years, those with cancers along the gastro-intestinal tract and those experiencing treatment effects. Additionally, health and nutrition education programs tailored to the caregiver’s level of education are needed.
59. Predatory behavior, nesting habits, and impacts on honey bees (Apis mellifera) of an invasive hornet (Vespa tropica) on the island of Guam.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Hornets (genus Vespa) are a conspicuous taxon of large eusocial wasps that are predators of other insects. Increasingly, hornets are gaining notoriety as damaging invaders after repeated introductions into novel habitats. Most hornets are highly effective predators, so they have the potential to greatly impact local entomofauna, including economically important pollinators. In 2016, Vespa tropica, a hornet with a broad natural range throughout subtropical and tropical Asia, was detected on Guam, although few details have been published since the initial alert. We provide the first comprehensive update on the status and impact of V. tropica hornets on Guam based on nine years of beekeeper and public reports, as well as field collections of nests, hornets, and videos of hunting behavior in managed apiaries. We show that the population of non-native V. tropica is established and thriving on Guam. Nests were found in a diversity of sites: below and above ground, sheltered and exposed, and in urban and greenspaces. V. tropica was a year-round predator in apiaries, with up to 12% of colony losses per year attributed to hornet attacks. Notably, hornets often attacked single honey bee (Apis mellifera) colonies in groups, similar to the hunting strategy of their close relatives, the giant hornets Vespa mandarinia and Vespa soror. Hornets killed defending workers, eventually weakening colonies and entering hives to consume bee brood. Bees mounted defenses that included alarm piping, bee ‘carpets’, and attempts to ball hornets. Hornets were active all year, but were significantly more active during the wet season (July‒December). Preliminary analysis of color forms suggested that the source of V. tropica on Guam is likely continental southeast Asia, although genetic analyses are required. Our study reveals that Guam is facing a fierce invader in V. tropica, which is placing strong predatory pressure on pre-established honey bees.
60. Determinants of sustainable solid waste management in Jimma City, Southwest Ethiopia.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Exponential urban growth has led to a significant increase in solid waste production, making solid waste one of the most significant issues faced by urban spaces in developing countries. This rising volume of solid waste has led to pressing public health and environmental concerns, such as water, soil, and air pollution, increased greenhouse gas emissions, and the spread of diseases. Thus, this study aimed to evaluate the sustainable solid waste management practices and challenges in Jimma City, southwestern Ethiopia. A community-based cross-sectional study design was employed in this study. Quantitative data and solid waste samples were collected between 01/01/2024 and 01/03/2024 via stratified random sampling from 820 participants in Jimma City, Southwest Ethiopia. The data was analyzed using STATA 18, and a p-value <0.05 was used to determine the level of statistical significance. This study revealed a solid waste generation rate of 0.66 Kg/capita/day and the majority of households (84.63%) do not segregate their solid waste at a point of generation; only 38.66% of Households had access to door-to-door solid waste collection services even though about 81.71% of households are willing to pay for solid waste collection services and 69.76% of Households dump waste along rivers or roadsides. Household income, geographic location, level of education, and attitude are the major determinants of sustainable solid waste management, with Average Marginal Effects of (0.0411, 0.1098, 0.0621, 0.0495), respectively. There is a higher rate of solid waste generation and a lack of integrated solid waste management services like door-to-door collection, temporary public solid waste collection containers, and disposal systems. This study indicated that about 2/3 of total solid waste generation is attributed to organic waste, and limited waste-to-resource recovery practices are observed. Thus, systematic provisions of integrated solid waste management services, implementation of solid waste reduction, and waste-to-resource recovery strategies focusing on composting are recommended.
61. Layers of exposure risk management measures for the prevention and control of infections of healthcare workers treating COVID-19 patients.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
COVID-19 has changed the way hospitals manage infections and how healthcare workers (HCWs) carry out their activities. The pandemic has taught us how safety, hygiene and work schedules should be implemented. After the pandemic, a substantial body of research has examined the managerial capacities of health systems, national prevention programmes, and crisis-response strategies. The aim of this study is to determine the most critical risk management measures in the context of COVID-19 pandemic, with a focus both prevention and post-factum control measures. We conducted a study using a questionnaire previously validated by the World Health Organization, adapted to identify the key organisational measures for preventing and controlling infections during interactions with patients infected with COVID-19 virus. The setting for the study was the “Sf. Ioan cel Nou” County Emergency Hospital, Suceava, Romania. A total of 312 responses were collected between 10.10.2020 and 19.03.2021. The study complied with two ethical protocols, data were analysed using 21.0 version of the Statistical Package for the Social Sciences software. Statistical analysis identified four constructs grouping the measures - technical, organisational, human resources, and others, all aimed at preventing the spread of SARS-CoV-2 within and beyond the hospital. In our vision, these four main resulted constructs could be conceptualised similarly to a security system, which aims protects an “asset” from a threat by applying several layers that gradually reduce risk to near zero. Specifically, the first layer involves managing exposure risk by separating contaminated from uncontaminated areas; the second comprises general preventive measures for healthcare workers operating in contaminated areas; the third layer addresses staff attendance and workplace organisation, and the fourth focuses on risks perceived and manifested at the individual level. Exposure risk assessment and management follow a logic similar to that of a security system designed to protect an “asset” from a threat. In our case, the health of the HCWs was at risk due to their interactions with COVID-19 patients at “Sf. Ioan cel Nou” County Emergency Hospital, Suceava, Romania. Hypothesis testing indicated that all implemented measures contributed significantly to pandemic management, although a functional exposure risk management system requires effective risk reduction across all 4 layers. Given the validity of the second hypothesis - that preventive measures were generally applied at the hospital - we can conclude that HCWs and managers may primarily focus on this type of preventive measure, mainly addressing the second layer alone. This imbalance risks diverting managerial attention and resources toward the second layer at the expense of the other three.
62. Exploring the Role of Indigenous Determinants of Health in the Resilience of Native Nations during COVID-19.
期刊: American Indian and Alaska native mental health research (Online) 发表日期: 2025 链接: PubMed
摘要
American Indians and Alaska Natives (AI/ANs) were disproportionately affected by the COVID-19 pandemic, experiencing excess hospitalization, mortality, and economic losses compared to the non- Hispanic Whites. This study sought to document the Indigenous determinants of health (IDOH) in AI/AN communities that shaped mental wellbeing for four groups: educators, traditional knowledge holders/practitioners, first responders, and substance abuse recovery community, during the pandemic. This work was a collaboration with and had research approval from three Native nations in Arizona. In-depth interviews were conducted from May to November 2021; 92 participants were interviewed. The most prevalent IDOH and associated themes included strategies to cope with emotional and social stressors and the impact on physical and mental health, relationships, kinship, cultural continuity, and self-determination. The groups experienced differences in mental wellbeing aligned with their occupation. For example, first responders experienced disruption and social dissonance in the workplace due to varying political views, and traditional knowledge holders/ practitioners experienced a revitalization of cultural strategies to maintain health. Although the differences between occupational groups are striking, the similarities that did exist were grounded in Indigenous identity and worldview that emphasize relationships and connection to the natural environment.