公共卫生研究摘要 (2025-09-28)
共收录 59 篇研究文章
1. Silence, Awkwardness and Discomfort: Understanding How Health Interventions Fail-An Ethnographic Study of a Peer Support Intervention for People With Type 2 Diabetes in Denmark.
期刊: Sociology of health & illness 发表日期: 2025-Nov 链接: PubMed
摘要
Unsuccessful peer support interventions rarely receive detailed ethnographic attention. The article examines a peer support intervention part of a randomised controlled trial designed to provide people with type 2 diabetes socio-emotional support while adopting self-care technology. The trial concluded that the intervention yielded no benefits. This article insists on ‘failure’ as an analytical opening with potential for intervention research. Ethnographic fieldwork was conducted in Denmark between January 2020 and June 2022. The ethnographic material comprises intervention audio recordings and observations involving 15 participants, as well as follow-up interviews. Using the concept of ’lifeworld’ to understand participants’ perspectives and ‘the will to improve’ to interpret the intervention’s framework, we unpack the tensions and awkwardness that permeated meetings. Comprehending why the intervention’s activities failed to engage participants meaningfully, we highlight how it framed diabetes as a socio-emotional problem in need of fixing, thereby problematising living with the illness, contrasting participants’ shared endeavours to de-problematise the experience within the intervention. The intervention offered a version of their lives with values and priorities that did not resonate and was thereby unsuccessful in bringing the aimed-for outcomes. Challenging the will to improve, we propose the ‘lifeworlding’ of future health interventions, prioritising lived experiences in the very framing of interventions.
2. Psychometric Properties of a Turkish Version of the Assessment of Physiotherapy Practice Tool.
期刊: Physiotherapy research international : the journal for researchers and clinicians in physical therapy 发表日期: 2025-Oct 链接: PubMed
摘要
Assessment of physiotherapy undergraduate students in clinical placement is academically important and holds practical value. This study aimed to translate the Assessment of Physiotherapy Practice (APP) tool, which is widely used for this purpose, into Turkish and to verify the factor validity and examine the reliability of this version using a cross-sectional design on senior physiotherapy students. The APP and performance indicators were translated into Turkish in accordance with the recommended protocol. Exploratory and confirmatory factor analyses were conducted using scale data from 100 students. For reliability analyses, 10 clinical supervisors from a Turkish university assessed 63 students using the Turkish version of the Assessment of Physiotherapy Practice (APP-TR) tool. Supervisors performed the APP-TR assessment for each student at week 3 and at the end of the 6-week clinical placement, yielding a score for analysis. In both assessments, the scale demonstrated high levels of internal consistency (Cronbach’s α = 0.961 for the first assessment, 0.959 for final assessment). Two factors were identified by exploratory factor analysis explaining 65.84% of the total variance and a two-factor model was confirmed to fit by confirmatory factor analysis. Test-retest reliability was assessed by ICC and was high for all subheadings and total score. For all items, the close agreement was at least 98.41% and the exact agreement was at least 88.89% in the percentile analysis between the two assessments. The results of this study suggest that the APP-TR is a reliable and valid tool for evaluating final year physiotherapy students in a clinical placement in Turkey.
3. Procyanidin Alleviates Diabetic Retinopathy by Activating the Expression of Activating Transcription Factor 1 Expression to Upregulate Synoviolin 1 and Inhibit the High Mobility Group Box 1/Toll-Like Receptor 4 Pathway.
期刊: Chemical biology & drug design 发表日期: 2025-Oct 链接: PubMed
摘要
Diabetic retinopathy (DR) remains a major cause of vision loss among working-age individuals, significantly impairing quality of life in diabetic patients. While no definitive cure exists, Procyanidin (PRO), a polyphenolic compound, has shown potential in mitigating diabetes-related complications. However, its mechanism of action in DR remains poorly understood. To explore this, we established an in vitro high glucose (HG) model using human retinal microvascular endothelial cells (hRMECs) and an in vivo diabetic rat model. Cells were cultured in normal glucose (NG, 5 mM) or HG (30 mM) for 48 h, followed by PRO treatment. Techniques including qRT-PCR, Western blotting, flow cytometry, histological staining, Transwell, tube formation, chromatin immunoprecipitation (ChIP), and dual-luciferase assays were employed. PRO treatment conferred protection against DR; however, this effect was reversed upon knockdown of activating transcription factor 1 (ATF1). Mechanistically, ATF1 enhanced transcription of synoviolin 1 (SYVN1), promoting HMGB1 degradation via ubiquitination and suppressing the HMGB1/toll-like receptor 4 (TLR4) signaling pathway. Findings from the in vitro model were validated in vivo. In conclusion, PRO alleviates DR by regulating the ATF1/SYVN1/HMGB1 axis and inhibiting pro-inflammatory signaling. These results provide novel insights into the molecular mechanism of PRO’s protective role in DR and support its therapeutic potential.
4. The Impact of Late Adolescents' Social Network Strength on Mental Health.
期刊: Brain and behavior 发表日期: 2025-Oct 链接: PubMed
摘要
This study examined how social network strength (i.e., the intensity and frequency of interactions within one’s personal network, assessed using centrality measures such as degree, closeness, betweenness, and eigenvector centrality) affects mental health. The study was conducted with 108 first-year university students. Data were collected using a structured questionnaire, and NetMiner 4.0 was employed to analyze degree centrality, closeness centrality, betweenness centrality, and eigenvector centrality as indicators of social network centrality. Additionally, Quadratic Assignment Procedure (QAP) correlation analysis and QAP regression analysis were conducted to assess the relationship between social network strength and mental health. The study found that stronger social networks were linked to better mental health in late adolescence. Specifically, higher social network centrality was associated with lower levels of hopelessness and depression. QAP correlation analysis revealed that hopelessness had a significant negative correlation with in-closeness centrality (which reflects how easily one can be reached by others within the network) (r = -0.252, p < 0.05), while depression was negatively correlated with in-degree centrality (the number of direct incoming connections from peers) (r = -0.233, p < 0.05), in-closeness centrality (r = -0.256, p < 0.05), and eigenvector centrality (a measure of how well a person is connected to popular or influential members of the network) (r = -0.291, p < 0.01). QAP regression analysis further confirmed that weaker social ties, indicated by higher out-closeness centrality (how easily one can reach others, especially those at a distance), were associated with higher depressive symptoms (adj. R2 = 0.143, F = 2.423, p < 0.05). These results suggest that building stronger and more integrated social networks may help reduce psychological distress and support mental well-being in late adolescence. Stronger social networks in late adolescence are associated with better mental health, highlighting the importance of social connections. While correlational findings suggest general links between centrality and emotional well-being, the regression results underscore specific predictors with practical implications. In-degree, in-closeness, and eigenvector centrality were associated with reduced depressive symptoms, indicating that being well-integrated within a social network may offer protective benefits. In contrast, high out-closeness centrality predicted increased depression, suggesting that the effort required to maintain outward-reaching connections may impose psychological burdens. These findings suggest that targeted interventions should focus on strengthening inward social integration while addressing the stress related to maintaining extensive outward connections, providing direction for more effective youth mental health strategies.
5. Cross-Sectional and Longitudinal Immunoprofiling of Oligoarticular Juvenile Idiopathic Arthritis Reveals Different Patterns in Synovial Fluid and Plasma.
期刊: Scandinavian journal of immunology 发表日期: 2025-Oct 链接: PubMed
摘要
Oligoarticular juvenile idiopathic arthritis (oligoJIA) constitutes nearly 60% of all JIA cases. The immune mechanisms involved in the pathogenesis remain incompletely understood. Few proteomic studies have been performed using synovial fluid (SF) samples. We conducted an exploratory analysis of plasma and SF samples to define inflammatory profiles, assess plasma-SF correlation and examine longitudinal variations. Using proximity extension assay (PEA), we profiled 92 immune-related proteins in plasma and Sf from 14 oligoJIA patients (untreated or NSAID-treated) and plasma from 28 age and sex-matched healthy controls. Differentially expressed proteins were analysed using gene ontology (GO) and KEGG pathways via STRING. Plasma proteomic immune profiles from oligoJIA patients were highly overlapping with immune profiles of healthy donors. Six proteins were differentially expressed between the two groups. Overall, plasma and SF protein expressions correlated (r = 0.78), mainly driven by 13 proteins including CCL25, FGF21 and KITLG. However, the differentially expressed proteins in plasma did not correlate with those in SF. Longitudinal analysis of 20 SF and 10 plasma samples from one patient revealed immunosuppressive effects of methotrexate (MTX) with distinct kinetics in plasma and SF. Paired SF samples from five patients revealed that cell chemotaxis was a key feature in early disease, distinguishing it from the persistent phase. Immunoprofiling of SF from patients with oligoJIA identified more disease-relevant characteristics than analysis of plasma samples. Several proteins, but not all, correlated between plasma and SF. Early-phase enrichment of chemotaxis suggests that targeting chemokines may offer therapeutic potential for early disease remission.
6. Early in-hospital treatment of acute heart failure. Part 2 of the international expert opinion series on AHF management.
期刊: ESC heart failure 发表日期: 2025-Sep-27 链接: PubMed
摘要
Acute heart failure (AHF) remains a major global health challenge, contributing significantly to morbidity, mortality and healthcare resource utilization. It is one of the leading causes of hospitalization, with persistently high readmission rates underscoring the need for improved early management strategies. Despite its prevalence, clear and evidence-based guidance for the early evaluation and treatment of AHF is limited. Congestion is the primary reason for emergency admission, making rapid and effective decongestion a top priority, but diuretics are often underdosed in AHF patients. Medications proven to improve mortality are often not started. In this state-of-the-art review, we address this critical gap by outlining a practical, evidence-based framework for the early management of AHF. Key components include early identification of co-existing conditions, bedside haemodynamic profiling, a structured diagnostic approach incorporating both standard and individualized assessments, a stepwise pharmacologic diuretic strategy beginning with high-dose intravenous loop diuretics, and early in-hospital initiation of guideline-directed medical therapy.
7. Advancing Air Pollution Exposure Models with Open-Vocabulary Object Detection and Semantic Segmentation of Street-View Images.
期刊: Environmental science & technology 发表日期: 2025-Sep-27 链接: PubMed
摘要
Mobile monitoring campaigns combined with land use regression (LUR) models effectively capture fine-scale spatial variations in urban air pollution. However, traditional predictor variables often fail to capture the nuances of the built environment and undocumented emission sources. To address this, we developed a framework integrating customizable object-level and segmentation-level visual features from street-view images into stepwise regression and random-forest-based LUR models. Using 5.7 million mobile air pollution measurements (2019-2020) and 0.37 million street-view images (2008-2024), we mapped nitrogen dioxide (NO2), black carbon (BC), and ultrafine particles (UFP) across 46,664 road segments in Amsterdam, The Netherlands. Incorporating street-view images improved model performance, increasing R2 by 0.01-0.05 and reducing mean absolute errors by 0.7-10.3%. Sensitivity analyses indicated that key street-view-derived visual features remained stable across years and seasons. Using images from nearby years expanded training instances, thereby enhancing alignment with mobile measurements at fine granularity. Our open-vocabulary object detection module identified influential but previously unrecognized object predictors, such as chimneys, traffic lights, and shops. Combined with segmentation-derived features (e.g., walls, roads, grass), street-view images contributed 8-18% feature importance to model predictions. These findings highlight the potential of visual data in enhancing hyperlocal air pollution mapping and exposure assessment.
8. Framingham risk score associates with incident cancer and heart failure.
期刊: European journal of preventive cardiology 发表日期: 2025-Sep-27 链接: PubMed
摘要
The Framingham Risk Score (FRS), a tool primarily used for atherosclerotic cardiovascular disease (ASCVD) risk stratification, incorporates factors like age, obesity, and smoking. However, its role in predicting cancer and heart failure (HF) risk remains unclear, while emerging data suggest these two conditions coincide frequently. We conducted a post-hoc analysis using data from the PREVEND study and validated our findings in the UK Biobank. We examined the association between FRS tertiles at baseline and incident cancer or HF. Fine-Gray regression models were used to calculate subdistribution hazard ratios (sHRs), adjusting for estimated glomerular filtration rate and urinary albumin excretion with all-cause mortality as a competing risk. In PREVEND, we included 8123 participants (mean age 49±13 years, 50% female). Over follow-up periods of 17.46 years (IQR 17.15-17.80) years (cancer) and 23.39 years (IQR 13.78-23.81) years (HF), 1176 participants developed new-onset cancer, and 758 developed new-onset HF. In a multivariable analysis, participants in the highest FRS tertile compared to the lowest had a higher hazard for both cancer (sHR 2.32, p<0.001) and HF (sHR 10.08, p<0.001). Participants in the highest FRS tertile had the worst survival (log-rank p<0.001). We validated these findings in the UK Biobank (N=389942) wherein individuals in the highest FRS tertile also had a higher hazard for both cancer (sHR 2.05, p<0.001) and HF (sHR 5.99, p<0.001) compared to the lowest tertile. The FRS associates with new-onset cancer or HF, implicating a broader clinical application of the FRS beyond ASCVD-risk stratification in cardio-oncology. Heart disease and cancer are the two most common causes of death worldwide. They are usually treated as separate problems, but research shows they can be connected. For example, some cancer treatments can damage the heart, and people with heart problems may also have a higher risk of cancer. In this study, we looked at whether a simple heart health score -the Framingham Risk Score (FRS) -can also help predict who might get cancer or heart failure in the future. This score is usually used to estimate a person’s risk of heart disease over 10 years. We used health data from two large groups of people: one from the Netherlands (PREVEND) and one from the UK (UK Biobank), following them for up to 23 years. We found that people with a high FRS were more likely to develop both cancer and heart failure compared to those with a low score. This means the FRS could be useful not just for predicting heart problems, but also for spotting people at higher risk of serious illnesses like cancer. Doctors could then take early steps like lifestyle changes, better treatment of blood pressure or cholesterol, and more regular health checks to help prevent these diseases. Our study suggests that looking at heart and cancer risks together could lead to better care and prevention in the future.
9. Acute Gastroenteritis and Intussusception Surveillance Studies in Seven Indian States Following the Introduction of the Oral, Pentavalent, Rotavirus Vaccine.
期刊: Indian journal of pediatrics 发表日期: 2025-Sep-27 链接: PubMed
摘要
10. Factors Impacting Pneumococcal Vaccination Among Non-Hispanic Black Adults With Type 2 Diabetes: A Nationwide Cross-Sectional Study.
期刊: The science of diabetes self-management and care 发表日期: 2025-Sep-27 链接: PubMed
摘要
PurposeThe purpose of the study was to evaluate factors associated with pneumococcal vaccination among non-Hispanic Black adults with type 2 diabetes mellitus (T2DM).MethodsA cross-sectional, online survey was conducted in December 2023 using a Qualtrics research panel. Eligible participants were adults 19 years and older and non-Hispanic Blacks who self-reported a T2DM diagnosis. The survey comprised 55 items across 5 sections based on the health belief model. Descriptive and bivariate analyses and hierarchical binary logistic regression were used for data analysis.ResultsThere were 330 eligible participants. Two-thirds received at least 1 dose of the pneumococcal vaccine. Participants had a mean age of 51.4 ± 16.8 years; 63.9% were women. Higher perceived susceptibility and higher cues to action were significantly associated with pneumococcal vaccination. However, higher perceived susceptibility, higher severity, geographical location, and history of influenza vaccination emerged as significant predictors, and improved model predictive ability for pneumococcal vaccination was observed (Akaike information criterion = 384.1 vs 423.5) after controlling for sociodemographic and other factors (education level, income, geographical location, diabetes-related complications, treatment types, frequency of health visits, influenza vaccination history, pneumococcal disease history, general vaccine beliefs, perceived mistrust).ConclusionClinical, public health, and health policy programs should address these factors in planning educational campaigns and strategies to increase pneumococcal vaccination among non-Hispanic Black individuals with T2DM.
11. Self-Administered Home Sleep Testing Model in Screening of OSA in Healthcare Workers-Sohew Study: A National Multicenter Study in Vietnam.
期刊: Pulmonary therapy 发表日期: 2025-Sep-27 链接: PubMed
摘要
Sleep disorders, including snoring and obstructive sleep apnea (OSA), are significant health concerns. OSA affects an estimated 4 million (8.5%) individuals in Vietnam, with 2.3 million suffering from moderate-to-severe conditions. Despite the high prevalence, underdiagnosis and limited accessibility to sleep diagnostics remain challenges. This study aims to assess the feasibility and effectiveness of a guided, self-administered home sleep study using a level 3 diagnostic model. A cross-sectional multicenter survey conducted from September 2023 to March 2024 included healthcare professionals (HCPs) across Vietnam. Participants completed questionnaires (Epworth Sleepiness Scale, STOP-BANG), and high-risk individuals underwent respiratory polygraphy using ApneaLink Air devices. Standardized instructions and technical support were provided remotely by trained technicians. Out of 1721 participants, 21.9% were diagnosed with OSA, comprising mild (32.4%), moderate (19.6%), and severe cases (9.2%). Prevalent symptoms included insomnia (22.2%), daytime sleepiness (40.7%), and memory decline (49.4%). Technical issues were minimal, supporting the feasibility of this approach. A level 3 home sleep study model is effective for large-scale OSA screening. Integrating such approaches into public health initiatives can enhance early diagnosis and treatment access, reducing OSA-related health and economic burdens. Graphical abstract available for this article.
12. Pandemic vaccines and 'The Global Public Good': a call for distributive justice.
期刊: Medicine, health care, and philosophy 发表日期: 2025-Sep-27 链接: PubMed
摘要
Whether (1) vaccines produced in response to a pandemic should be considered “global public goods” and whether (2) Big Pharma companies should waive intellectual property rights for pandemic disease vaccines are important questions in global health ethics and public health policy. The extended argument advanced here (a) affirms such vaccines are global public goods and (b) supports those among low- and middle-income nations who, during the COVID-19 pandemic, proposed waiver of intellectual property rights. As a matter of distributive justice, we argue that (c) Big Pharma, national regulatory agencies, and international intergovernmental organizations such as the World Health Organisation and the World Trade Organisation have a moral responsibility to ensure developing countries have equitable access to pandemic vaccines. Hence, (d) there should be appropriate technology transfer for production and distribution of pandemic-responsive vaccines in these nations.
13. The Mental Health of Sporting Officials: A Systematic Review and Meta-analysis.
期刊: Sports medicine (Auckland, N.Z.) 发表日期: 2025-Sep-27 链接: PubMed
摘要
The mental health of participants in sport has attracted increasing focus within research, practice, and policy. While mental health in sports has received increased attention, the mental health of sporting officials-such as judges, referees, and umpires-remains significantly under-researched compared with athletes. To our knowledge, there are no systematic reviews and meta-analyses that have synthesised available prevalence data of mental health symptoms and disorders in sporting officials. In addition, while previous reviews have provided a broad overview of risk and protective factors in relation to overall mental health, links between identified factors and specific mental health and well-being outcomes have not been explored. Therefore, this study aimed to systematically review and analyse the prevalence rates of mental health symptoms and disorders (e.g., depression and anxiety) among sporting officials and identify specific risk and protective factors influencing sporting officials’ mental health and/or psychological well-being. Relevant studies were retrieved from SCOPUS, Web of Science, SPORTDiscus and PsycINFO up until July 2025. Prevalence rates of specific mental health outcomes (i.e. anxiety and depressive symptoms) were meta-analysed. A total of 26 studies were included. Meta-analyses comprising 2797 sporting officials showed that the pooled proportion of elevated anxiety symptoms was 19.1% (95% CI 13.4-27, I2 = 94.1%) and 20.6% (95% CI 12.4-32.3, I2 = 97.3%) for elevated symptoms of depression. Sport-environmental risk factors were identified in 70% of the studies (k = 19) (e.g., levels of professional experience, environment around matches, experiences of abuse), while 48% of studies (k = 13) examined personal risk factors (e.g., age, sex, injury). A total of 37% of studies (k = 10) examined sport-environmental protective factors (e.g., years of officiating experience, level of officiating, hours and frequency of officiating), while 33% of studies (k = 9) investigated personal protective factors (e.g., emotional intelligence, feelings of competence, age, sex). The results suggest that targeting change at various levels of the sport ecosystem may help foster and promote positive mental health outcomes among sporting officials. The findings of this review suggest that strategies tailored to officials could include age/level of experience-specific support interventions and creating organisational cultures that prioritise mental health outcomes.
14. Hospitalizations at Home in Israel, a Retrospective Observational Study.
期刊: Health care analysis : HCA : journal of health philosophy and policy 发表日期: 2025-Sep-27 链接: PubMed
摘要
Israel’s aging population and demographic growth have driven a surge in hospitalizations, prompting the Ministry of Health to expand community-based care. In 2019, a financial incentive was introduced, special payments to health maintenance organizations (HMOs) for Hospital at Home (HaH) services, implemented in 2020. This study examines changes in the volume and geographic distribution of HaH following this policy. We analyzed retrospective Ministry of Health data on all HaH admissions from 2017-2023, excluding COVID-19 cases. Data included length of stay, referral source (hospital vs. community), patient age, and residence. HMOs reported 70,203 HaH admissions during the study period, increasing from only 8 in 2017 to 33,141 in 2023. Growth was most rapid after the payment policy was introduced. The mean monthly HaH days rose sharply, reaching 2762 in 2023. Over time, the proportion of HaH admissions from central Israel increased, while peripheral areas saw a relative decline. Readmission rates to HaH were low-3% within 1 week, and 8%, 15%, and 23% within 1, 3, and 6 months, respectively. HaH could play a significant role in meeting Israel’s growing demand for inpatient care. To maximize its impact, policy efforts should address barriers to expansion, particularly in peripheral regions, and promote more equitable geographic access.
15. Neurosurgical journals' policies on artificial intelligence use in manuscript preparation and peer review.
期刊: Neurosurgical review 发表日期: 2025-Sep-27 链接: PubMed
摘要
As artificial intelligence (AI), particularly large language models (LLMs), continues to progress, its impact on academic publishing, both in manuscript drafting and peer review, has attracted considerable attention. In neurosurgery, where journals serve a crucial role in disseminating research, formal guidelines regarding AI remain relatively underexplored. Our study aims to investigate the current state of AI policies among prominent neurosurgical journals, focusing on their role in manuscript preparation and peer review. 38 neurosurgical journals were identified by searching the Johns Hopkins University of Medicine Welch Medical Library, combined with National Library of Medicine subject terms. Each journal’s author instructions, editorial policies, and peer-review guidelines were examined for explicit AI usage policies, focusing on manuscript preparation and peer review. Tasks such as writing assistance, data analysis, figure generation, and citation management were documented if identified. Any stated requirements, prohibitions, and disclosure practices for AI were recorded, as well as instances where no policy existed. Of the 38 journals surveyed, 31 (81.6%) had AI use guidelines, 9 (23.7%) based on individual journal-level explicit policies and 22 (57.9%) based on publisher-level guidelines. Majority of journals (n=30, 78.9%) provided guidelines for using AI in manuscript preparation, with most prohibiting its inclusion as an author. Most journals allow but mandate transparent disclosure of AI involvement in readability improvements, grammar correction, and style editing. Fewer journals (n = 13, 34.2%) specified AI policies for peer review, although those that did mention AI often prohibited its use for evaluating submissions due to confidentiality concerns. Although many neurosurgical journals now acknowledge AI’s role in manuscript preparation, guidelines for AI-driven peer review remain scarce. Given AI’s rapid advancement, establishing clear, comprehensive, and standardized AI policies will be critical for upholding transparency, quality, and efficiency in neurosurgical publishing.
16. Association of duration and timing of household dysfunction with aggression: A Taiwan birth cohort study.
期刊: European child & adolescent psychiatry 发表日期: 2025-Sep-27 链接: PubMed
摘要
While household dysfunction (HD) is associated with negative health outcomes, it remains unclear whether the duration or timing of exposure contribute to aggression. The underlying mechanisms in the HD-aggression relationship are also understudied. This study examined the effects of HD duration and timing on aggression while investigating potential mediating role of depressive symptoms. Sex differences were also explored. Data were obtained from 7,800 participants in the Taiwan Birth Cohort Study (52.32% male, 47.68% female) followed to ages 17 or 18 years. HD were coded at five life stages: infancy, early childhood, middle childhood, late childhood, and early adolescence. A structured life course modeling approach was used to assess whether the accumulation of HD (duration), or the timing of exposure, including exposure during sensitive periods and more recent periods, exhibited the strongest association with aggression at age 17 or 18. Causal mediation analysis was conducted to evaluate the role of depressive symptoms in the pathway from HD to aggression. Among males, both HD accumulation (β = 0.04, 95% CI: 0.004-0.07) and middle childhood HD (β = 0.04, 95% CI: 0.01-0.07) were associated with increased adolescent aggression at age 17/18. Depressive symptoms at age 12 mediated the effects of both cumulative HD and middle childhood HD on aggression at ages 17/18, accounting for an estimated 33% and 20% of the total effects, respectively. No significant association between HD and aggression was observed among females. Interventions should address HD early and sustain support throughout adolescence, while also targeting depressive symptoms, to effectively reduce aggression, particularly among males.
17. Critically ill patients are not just luggage: The experiences of health workers on the transportation of critically ill patients in hospitals in Tanzania.
期刊: Journal of health services research & policy 发表日期: 2025-Sep-27 链接: PubMed
摘要
BackgroundCritical illness is a life-threatening condition impacting millions of patients globally each year. Critically ill patients often need to be transported within the hospital during their care and the safety and efficiency of transportation are key for good health outcomes. There is a lack of knowledge about the processes and safety of intra-hospital patient transport in low-resourced health care settings.ObjectiveThis study aimed to understand health workers’ experiences of the process and the safety of intra-hospital transportation of critically ill patients in Tanzania.MethodsQualitative in-depth interviews were conducted with 15 health workers involved in the care and transportation of critically ill patients in five Tanzanian hospitals. Purposive sampling identified participants. Data were analysed using thematic analysis, guided by the Donabedian quality of care framework.ResultsThree themes of health workers’ experiences of patient transportation were identified, the first two related to structures and the third to processes: (i) the design and organisation of hospitals did not facilitate the initiation and conduct of quick, short and safe transport for critically ill patients; (ii) hospitals lacked resources for safe, effective transportation of critically ill patients; (iii) there were weaknesses in the preparation for, conduct of, and handover of information concerning the transportation of critically ill patients. Health workers in Tanzania faced substantial challenges in ensuring safe transportation due to hospital infrastructure limitations, resource shortages, and inadequate processes.ConclusionWe conclude that the transport of critically ill patients is overlooked in hospital services in Tanzania, despite the importance of safe intra-hospital transportation in preventing deaths. Feasible solutions to these challenges are necessary for reducing high mortality and morbidity among critically ill patients.
18. Senescence-associated gene signatures predict survival in lung cancer: a multi-cohort analysis.
期刊: GeroScience 发表日期: 2025-Sep-27 链接: PubMed
摘要
Lung cancer is a leading cause of cancer-related mortality worldwide and is predominantly diagnosed in older adults, underscoring the need to explore aging-related biological mechanisms that influence disease progression and prognosis. Cellular senescence, a hallmark of aging, plays a dual role in cancer by contributing to both tumor suppression and tumor promotion through its influence on tumor growth, modulation of the tumor microenvironment, the senescence-associated secretory phenotype (SASP), and response to therapy. In this study, we evaluated the prognostic significance of senescence-related gene expression in lung cancer using three independent gene signatures, including the SenMayo gene set and two additional curated lists. Transcriptomic and clinical data from publicly available datasets were analyzed using Cox regression, Kaplan-Meier survival analysis, and multivariate modeling. All three senescence signatures were significantly associated with overall survival, with the SenMayo signature showing the most robust and consistent prognostic power. Notably, higher expression of senescence-associated genes was associated with improved survival in the overall lung cancer cohort and in lung adenocarcinoma, while a more heterogeneous pattern emerged in squamous cell carcinoma. Although hazard ratios varied among the gene sets, their broadly concordant associations with clinical outcomes highlight the biological relevance and context dependence of senescence in lung cancer. These findings suggest that senescence-associated gene expression may serve as a valuable prognostic biomarker and offer mechanistic insights into tumor behavior. Our results contribute to the growing body of gero-oncology research and emphasize the need for tumor-specific exploration of aging-related processes in cancer.
19. How is the European Prevention Curriculum (EUPC) Implemented in Practice and What Lessons Have We Learnt so far? Introduction to the Special Issue.
期刊: Journal of prevention (2022) 发表日期: 2025-Sep-27 链接: PubMed
摘要
20. Measuring and monitoring child health and well-being - an integral part of the climate change agenda.
期刊: Health policy and planning 发表日期: 2025-Sep-27 链接: PubMed
摘要
21. Intravenous haloperidol or chlorpromazine-which is more effective to improve agitation and communication in agitated delirium at the end of life?
期刊: The oncologist 发表日期: 2025-Sep-27 链接: PubMed
摘要
Delirium frequently occurs in terminally ill patients with cancer. The purpose of this study was to determine whether intravenous haloperidol or chlorpromazine is more effective in improving agitation and communication in agitated delirium at the end of life.
All terminally ill patients with delirium treated in 39 specialized palliative care services were enrolled via the web. Delirium diagnosis and severity (Delirium Rating Scale-revised-98
22. Building Community-Academic Research Partnerships to End the HIV Epidemic in Arizona: Findings to Inform Next Steps.
期刊: Health promotion practice 发表日期: 2025-Sep-27 链接: PubMed
摘要
In 2022, Arizona saw an unprecedented 20% increase in new HIV infections and viral suppression rates of 61.8% among people with HIV. Existing local efforts to address HIV should be complemented with research to identify gaps and approaches to improve outcomes. Using CBPR as a guiding framework, we explored the potential for community-academic HIV research collaborations by hosting a Community-Academic HIV Research Partnership Series. Attendance across five workshop sessions totaled 123 attendees, with representation from nonprofit community-based organizations, clinic settings, city and state government, and the university. Meeting content was guided by the following broad ideas: (a) experiences and perceptions of research; (b) successful models of community-academic research partnerships; and (c) local HIV research needs. Thematic analysis of transcribed notes identified the following overall themes and selected parenthetical subthemes: Experiences and Perceptions of Research (Responsibilities of Research and Researchers, Benefits and Barriers of Research, and Required Knowledge for Researchers); Successful Community-Academic Research Partnerships (Mechanisms to Facilitate Successful Research Partnerships); and HIV Research Needs in Arizona. Communication, trust, transparency, cultural humility, mutual benefit, diversity and inclusivity, and genuine relationship-building were regarded by community attendees as priorities for community-academic partnerships. These findings have been instructive in cultivating relationships and laying the groundwork for a formal structure for community-academic HIV and equity research partnerships. Building on early HIV/AIDS activism that set the stage for advancements in clinical, social and behavioral research, we aim to expand local collaborative efforts that will maximize the expertise of communities and researchers to effectively end the HIV epidemic.
23. Loganin, an Iridoid Glycoside, Alleviates Paclitaxel-Induced Skeletal Muscle Toxicity by Enhancing Mitochondrial Function, Boosting Antioxidant Defenses, and Reducing Cellular Senescence.
期刊: The Kaohsiung journal of medical sciences 发表日期: 2025-Sep-27 链接: PubMed
摘要
Mitochondrial dysfunction and energy imbalance caused by chemotherapy are key contributors to skeletal muscle atrophy, which severely impacts the quality of life in cancer patients. Paclitaxel, a commonly used chemotherapeutic agent, is known to promote muscle wasting and cellular senescence, largely by impairing mitochondrial function. In this study, we investigated the protective role of loganin, a naturally occurring iridoid glycoside, in preventing paclitaxel-induced damage to skeletal muscle cells. Using C2C12 cells, we assessed whether loganin could counteract the harmful effects of paclitaxel. Our results demonstrated that loganin significantly improved cell viability and protected mitochondrial function, as reflected by better preservation of mitochondrial DNA content, membrane potential, and ATP production, while further enhancing mitochondrial biogenesis through upregulation of PGC-1α, TFAM, and NRF1. In parallel, loganin activated metabolic regulators SIRT1 and AMPK, while restoring PDK4 expression, suggesting improved energy regulation. Additionally, glycogen levels and myotube morphology were maintained, alongside sustained myosin heavy chain expression. Loganin effectively reduced both cellular and mitochondrial reactive oxygen species and increased antioxidant defenses, including superoxide dismutase activity and glutathione levels. Notably, it also suppressed paclitaxel-induced senescence and inflammation, as shown by decreased p21 expression, reduced NFκB phosphorylation, and lower levels of Cdkn1a and Il6 as well as reduced SA-β-gal staining. Overall, our findings demonstrate that loganin offers comprehensive protection against paclitaxel-induced skeletal muscle injury by preserving mitochondrial function, supporting metabolic homeostasis, reducing oxidative stress, and limiting senescence. These results highlight the potential of loganin as a preventive adjunctive agent to mitigate chemotherapy-related muscle toxicity.
24. Appropriateness of Antiplatelets and Anticoagulants Among Older Adults Experiencing Falls.
期刊: Journal of the American Geriatrics Society 发表日期: 2025-Sep-27 链接: PubMed
摘要
Antiplatelet and anticoagulant (collectively called antithrombotics) use remains ubiquitous in older adults due to well-established benefits in treating atherosclerotic and thromboembolic disease. It is unclear whether these benefits outweigh the risk of traumatic hemorrhage in older adults with elevated fall risk. Emergency department (ED) providers are well-positioned to identify opportunities to deprescribe likely inappropriate antithrombotics following an emergency visit for a fall. The objective was to determine the prevalence of likely inappropriate antithrombotic use among older adults on antithrombotics presenting to an ED with a fall. This was a secondary analysis of a prospective cohort study of older adults presenting to an ED with a fall enrolled from 2020 to 2021 in a pharmacist-led medication reconciliation program at a southeastern academic ED. We utilized the Medication Appropriateness Index (MAI) to assess antithrombotic appropriateness, categorized: appropriate (MAI = 0), potentially inappropriate (MAI = 1-2), and likely inappropriate (MAI ≥ 3). 171 out of 514 enrolled patients who presented with a fall to the ED were on an antithrombotic. Their mean age was 81.2 years (std dev 9.2) and 66.1% were female (113/171; 95% CI: 58.6%-72.8%). The median MAI score was 2 (IQR: 2-4). Potentially inappropriate or likely inappropriate use was observed in 82.5% (141/171; 95% CI: 76.0%-87.5%) of participants. Aspirin had the highest prevalence of likely inappropriate use at 60% (59/98; 95% CI: 50%-69%), while P2Y12 inhibitors, warfarin, and direct oral anticoagulants had prevalence of likely inappropriate use at 53% (8/15; 95% CI: 27%-78%), 30% (3/10; 95% CI: 8%-67%), and 29% (21/72; 95% CI: 20%-41%), respectively. There was a high prevalence of likely inappropriate antithrombotic use among older adults presenting to the ED with a fall. While aspirin had the highest rate of likely inappropriate use, all antithrombotics had 30% or greater rates of likely inappropriate use. An ED encounter presents a critical opportunity to evaluate the appropriateness of antithrombotic use in patients who have fallen.
25. Phytochemical Profile, Antioxidant Capacity, Acetylcholinesterase, and Butyrylcholinesterase Enzyme Inhibition Properties of Myosotis amoena Boiss.
期刊: Chemistry & biodiversity 发表日期: 2025-Sep-27 链接: PubMed
摘要
Myosotis amoena Boiss. (Turkish name: “Hoş boncukotu”) is a perennial herbaceous plant that produces blue flowers during the spring. Phytochemicals, which are secondary metabolites distributed across plants, fungi, microorganisms, and even animal tissues, play crucial roles in health through their antioxidant and bioactive properties. Their antioxidant capacity largely arises from hydroxyl groups and aromatic ring structures that stabilize free radicals via electron delocalization. Enzyme inhibition is a therapeutic strategy in several diseases, including Alzheimer’s disease (AD), where acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) inhibitors are employed to manage symptoms. This study investigated the phytochemical composition (via LC-MS/MS), total phenolic content, antioxidant capacity, and AChE/BChE inhibitory effects of the ethanol extract of M. amoena using four in vitro methods. The CUPRAC assay demonstrated that M. amoena (1.070) exhibited higher antioxidant activity than Trolox (0.894), although its activity in FRAP, ABTS, and Fe3+ reduction assays was lower compared to standard antioxidants. The extract contained 53.03 mg GAE/g extract of total phenolics, with rosmarinic acid being the predominant compound (15.27 mg/g). Furthermore, the extract strongly inhibited AChE and BChE, with IC50 values of 3.9 and 19.8 µg/mL, respectively. These findings highlight, for the first time, the significant bioactive potential of M. amoena as a natural source of antioxidants and cholinesterase inhibitors, supporting its prospective use in the prevention or management of neurodegenerative conditions.
26. Methodological considerations for advancing general paresis research.
期刊: Brain : a journal of neurology 发表日期: 2025-Sep-27 链接: PubMed
摘要
27. SafeWax: A Bio-Inspired Multifunctional Coating for Sustainable Crop Protection.
期刊: Small (Weinheim an der Bergstrasse, Germany) 发表日期: 2025-Sep-27 链接: PubMed
摘要
Modern agriculture faces numerous challenges, including the rise of fungal diseases and the effects of climate change. Traditional reliance on chemical pesticides poses environmental hazards, such as the emergence of resistant fungal strains. SafeWax, a biodegradable and multifunctional coating, provides a sustainable alternative by emulating natural plant wax cuticles. Its superhydrophobic surface prevents fungal adhesion and colonization, while also protecting crops from ultraviolet (UV) radiation and low humidity. Additionally, the self-cleaning properties of SafeWax coatings enhance water collection, promoting robust plant growth and productivity. Initial studies demonstrate the ability of SafeWax to reduce fungal infections and boost the resilience of crops like grapevines and tomatoes. This paper aims to introduce the SafeWax technology, explain its mechanisms, present preliminary results from lab and greenhouse trials, and discuss its potential to lower the demand for conventional pesticides in alignment with the European Green Deal, which targets a 50% reduction in pesticide use by 2030.
28. Grape Seed Proanthocyanins Extract Ameliorates the Neurotoxicity Induced by Fluoride Through mTOR/p70s6k Signaling Pathway in Vivo and in Vitro.
期刊: Cell biochemistry and biophysics 发表日期: 2025-Sep-27 链接: PubMed
摘要
29. Parabiosis, Assembloids, Organoids (PAO).
期刊: Advanced science (Weinheim, Baden-Wurttemberg, Germany) 发表日期: 2025-Sep-27 链接: PubMed
摘要
The research and treatment of major diseases challenge global public health, necessitating advanced disease models. Existing approaches have clear limitations: two-dimensional cell cultures lack multi-organ interactions, clinical trials are costly and ethically constrained, and animal models, focused on single organs, fail to replicate systemic regulation. Parabiosis, which connects two organisms via shared circulation, provides insights into systemic factors and multi-organ interactions but has limited applicability to humans. Furthermore, organoids are three-dimensional structures formed through stem cell self-organization that replicate the functions of individual tissues and advance personalized medicine; however, they cannot model inter-tissue interactions. Assembloids overcome these constraints by integrating diverse organoids, enabling sophisticated simulation of multi-organ dynamics. The integration of these parabiosis, assembloids, organoids (PAO) models with emerging technologies, such as artificial intelligence for precision analytics, CRISPR-based gene editing for disease mechanism elucidation, organ-on-a-chip platforms for dynamic environmental control, and soft robotics for replicating physiological biomechanics, promises to revolutionize disease modeling, regenerative medicine, and precision therapeutics. This review evaluates parabiosis, assembloids, and organoids, highlighting their development, current limitations, and transformative potential when combined with frontier biomedical engineering approaches to address complex human diseases.
30. Response to the letter of Tekiner and Kelestimur.
期刊: Journal of endocrinological investigation 发表日期: 2025-Sep-27 链接: PubMed
摘要
31. Scaffold-based breast conserving surgery in patients with non-malignant breast lesions: long-term follow-up of a first-in-human pilot study on the REGENERA™ biomimetic breast implant.
期刊: Breast cancer (Tokyo, Japan) 发表日期: 2025-Sep-27 链接: PubMed
摘要
Frequently, the breast surgeon must employ complex oncoplastic techniques (OBS) to guarantee optimal cosmetic results. The success of the REGENERA™ implant in combining the benefits of OBS with the simplicity of breast conserving surgery (BCS) has been previously reported in five patients with short follow-up. The goal of this study was to build on these promising data by reporting safety and efficacy results in a larger population with a longer follow-up. Fifteen females with non-malignant breast lesions who underwent lumpectomy and implantation of REGENERA™ device, followed-up for six months, were included in this interventional FIH study. Fourteen of these, were included in a long-term observational study (LTFU) and followed-up for 24 months. Safety (incidence of adverse events [AEs]) and performance (changes in breast appearance, interference with imaging) of the device, and investigator and patient satisfaction were evaluated. Data from these two studies are reported herein. (Registered on clinicaltrials.gov: NCT05533099 and NCT04131972). A total of 113 AEs were reported. Only 3 (2.6%) were considered possibly device-related. The great majority (91,2%) were mild/moderate and only in one case the device was explanted. The REGENERA™ implant demonstrated high levels of performance, with an aesthetic score of ‘Excellent’ in 85.7% of patients, no interference with imaging, and high levels of patients and investigator satisfaction. Data continue to be strongly supportive of the use of the REGENERA™ implant in BCS, further paving the way for an innovative surgical approach.
32. University Students' Digital Life Balance: Relationship With Occupational Balance, Social Skills, Nomophobia.
期刊: OTJR : occupation, participation and health 发表日期: 2025-Sep-27 链接: PubMed
摘要
Background: Digital life balance may be linked to occupational balance, social skills, and nomophobia (the fear of being without one’s phone). Objectives: his study explored the relationship between digital life balance, occupational balance, social skills, and nomophobia among university students. Methodology: A total of 284 students (80.3% female; mean age = 20.44 ± 3.20) participated in this cross-sectional study. Participants completed scales assessing digital life balance, occupational balance, social skills, and nomophobia. Results: Digital life balance was positively correlated with occupational balance (r=0.472) and social skills (r=0.243), and negatively with nomophobia (r=-0.242). Regression analysis showed that occupational balance (p<.001) and four nomophobia dimensions were significantly associated variables (p<.05). Conclusion: Digital life balance in university students is influenced by occupational patterns and phone-related anxiety. Occupational therapy interventions aiming to enhance daily role balance, interpersonal skills, and reduce maladaptive digital habits may help support healthier digital engagement. Digital Life Balance Is Associated With Occupational Balance, Social Skills, and Nomophobia in University StudentsNowadays, digital devices are widely used in all aspects of life, both by university students and the general population. While digital tools offer many advantages, spending excessive time on these tools or an imbalance in time allocated to other meaningful occupations can be negatively associated with well-being. Digital life balance refers to an individual’s ability to effectively integrate digital technology into their daily life in a way that supports, rather than disrupts, their routines, social relationships, and mental health. This study investigates how students’ digital life balance is related to occupational balance as a subjective sense of balance among meaningful activities, social interaction, and phone-related anxiety (nomophobia). The results showed that students with better digital life balance also reported more structured daily routines and stronger social skills. In contrast, students who experienced higher levels of nomophobia tended to have poorer digital life balance. Further regression analyses showed that specific dimensions of nomophobia — such as communication difficulties, feelings of disconnection, discomfort when without a phone, and problems accessing information — were significant negative predictors of digital life balance. These findings highlight the importance of understanding students’ daily routines, interpersonal competencies, and digital habits when considering their overall digital balance.
33. A Multicenter Observational Study for the Establishment of Novel Severity Criteria Including Endoscopic Evaluation for Intestinal Behçet's Disease.
期刊: Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 发表日期: 2025-Sep-27 链接: PubMed
摘要
This study aimed to establish a novel severity classification for intestinal Behçet’s disease (BD) (SCIBD) and validate its criteria across multiple institutions. Five parameters, including abdominal pain, tenderness, intestinal bleeding, serum C-reactive protein (CRP) level, and endoscopic findings, were identified to assess the severity of intestinal BD. Disease severity was categorized into remission and mild, moderate, or severe disease based on the criteria of each factor. This study also evaluated the correlation among the SCIBD scale, serum biomarkers, former disease activity for intestinal BD (DAIBD), and treatment decisions. A total of 146 patients with intestinal BD and simple ulcers were retrospectively enrolled from 14 institutions between April and November 2022. As SCIBD severity increased, CRP and DAIBD levels significantly increased, whereas serum albumin levels decreased in the whole population. Similar correlations have been observed even in patients with intestinal BD. Antitumor necrosis factor-alpha treatment was also significantly more common in severe cases (49.4%) than in moderate cases (20.8%; p = 0.001). However, the proportion of patients requiring corticosteroids was comparable between the moderate and severe disease groups (39.6% vs. 33.3%). In addition, no significant differences were observed in the frequency of corticosteroid treatment, anti-TNF-α treatment, or surgery among the four groups: quiescent, mild, moderate, and severe cases of DAIBD. SCIBD was changed after treatment with corticosteroids and TNF-α according to improving clinical, biological, and endoscopic findings. The severity assessment of intestinal BD using our novel criteria correlated with appropriate treatment decisions, prognosis prediction, and treatment responses.
34. Family Dynamics and Mental Health in Schizophrenia: Investigating the Impact of Cohesion and Adaptability.
期刊: The International journal of social psychiatry 发表日期: 2025-Sep-27 链接: PubMed
摘要
This study aimed to examine how family cohesion and adaptability are associated with mental health outcomes, including functionality, mood, stress, and well-being, in individuals with schizophrenia. A total of 225 individuals diagnosed with schizophrenia spectrum and other psychotic disorders were included in the analysis. Participants were assessed using the Family Adaptability and Cohesion Evaluation Scale (FACES-III), Positive and Negative Syndrome Scale (PANSS-6), Drug Attitude Inventory (DAI-10), Social and Occupational Functioning Assessment Scale (SOFAS), Health of the Nation Outcome Scales (HoNOS), Beck Depression Inventory (BDI-I), Perceived Stress Scale (PSS-10), Subjective Well-being under Neuroleptics Scale (SWN-20), Warwick-Edinburgh Mental Well-being Scale (WEMWBS), and Multidimensional Scale of Perceived Social Support (MSPSS). K-means clustering was performed to classify participants into distinct groups based on FACES-III scores. K-means clustering, based on FACES-III scores, classified participants into high cohesion and adaptability (HC-HA; N = 139) and low cohesion and adaptability (LC-LA; N = 86) groups. No significant differences were observed in symptom severity (PANSS-6), medication adherence (DAI-10), or functionality measured by SOFAS. However, overall psychosocial functioning (HoNOS) was better in the HC-HA group. The HC-HA group exhibited lower depressive symptoms (BDI-I) and stress levels (PSS-10), as well as higher subjective well-being (SWN-20) and mental well-being (WEMWBS) compared to the LC-LA group. Perceived social support (MSPSS) was significantly higher in the HC-HA group. Family cohesion and adaptability are associated with improved psychosocial outcomes in individuals with schizophrenia. These findings suggest that enhancing family dynamics may support recovery and well-being.
35. Association between wildfire smoke exposure and pediatric emergency department visits for headache.
期刊: Headache 发表日期: 2025-Sep-26 链接: PubMed
摘要
The purpose of this study was to determine whether short-term exposure to wildfire smoke is associated with emergency department visits for headache in children and adolescents. Wildfires are becoming increasingly common and are associated with numerous adverse health outcomes. However, we currently do not know how wildfire smoke exposure affects children and adolescents with primary headache disorders. Headache disorders in youth are a major contributor to frequently missed school days and youth with headache disorders have high medical care utilization and total healthcare costs. Therefore, understanding factors that may contribute to headache exacerbations and potential increases in healthcare utilization is of particular interest. This was a time-stratified case-crossover study linking daily health data from the California Department of Health Care Access and Information to daily ZIP code-level wildfire PM2.5 concentrations between 2006 and 2019. We included all visits for headache to emergency departments in California among youth 5-19 years old during the study period. The primary exposure was the ZIP code-level daily wildfire-specific PM2.5 concentration, modeled as a continuous and binary (wildfire-specific PM2.5 ≥15 μg/m3) variable. The primary outcome was an emergency department visit for headache. We identified relevant encounters according to the International Classification of Diseases, 9th/10th revision codes assigned in the first diagnostic position. To capture a potential delayed impact, we estimated odds ratios for the association for days 0 to 6 between the exposure and outcome. We identified 206,230 unique emergency department encounters for primary headache disorders. Most visits were in female patients (61.4%) 15-19 years old (58.5%) who identified as Hispanic (48.8%) and lived in a very low-opportunity (37.7%) or low-opportunity (21.6%) neighborhood. The adjusted odds of an emergency department visit incrementally decreased per unit increase in wildfire-specific PM2.5 concentrations from days 0 to 6 after wildfire smoke exposure (same-day adjusted odds ratio [aOR], 1.00; 95% confidence interval [CI], 0.998-1.001; day +6 aOR, 0.995; 95% CI, 0.993-0.997). Using a binary exposure, the adjusted odds of an emergency department visit incrementally decreased from days 0 to 6 after a wildfire smoke day (same day aOR, 0.99; 95% CI, 0.92-1.08; day +6 aOR, 0.84; 95% CI, 0.78-0.92). Children are less likely to seek care in the emergency department for primary headache in the days following exposure to wildfire smoke, suggesting that healthcare utilization changes during wildfires. Clinicians should ensure youth with headache disorders who experience worsening symptoms associated with air pollution are equipped with strategies to manage their headache disorder at home during days with wildfire smoke, including effective at-home acute headache medications.
36. Parents' experiences of caring for a child with an eating disorder: the impact of financial challenges.
期刊: Journal of eating disorders 发表日期: 2025-Sep-26 链接: PubMed
摘要
Research has highlighted significant challenges associated with caring for a child or adolescent with an eating disorder, and that the impacts on the family are both long-standing and widespread. Within the literature, parents have reported that all aspects of their lives were affected, including their occupational functioning and financial situation. This study explored parents’ experiences of the challenges associated with caring for a child with an eating disorder, focusing on the financial implications and the effect of these on the family and treatment. Using the exploratory descriptive qualitative approach, semi-structured interviews were completed with 12 parents recruited from a child and adolescent eating disorder service. Interview transcripts were analysed using reflexive thematic analysis. The overarching theme generated was Life is completely different living with the eating disorder. The analysis process yielded nine sub-themes, which were grouped into three main themes: (1) Financial costs, (2) Financial impact on us, and (3) Things that helped. Parents reported significant interrelated psychosocial and economic impacts, which were exacerbated by their child’s resistance to treatment, an unpredictable course of illness, and a lack of understanding about eating disorders at a societal level. The findings suggest financial pressures exacerbate the significant caregiver burden and, without adequate financial support, some families struggle to afford essential treatment costs, both of which can impede recovery. Thus, services must address the financial implications and each family’s unique situation throughout the assessment and treatment process. Services can mitigate burdens for parents by tailoring support to families’ needs, offering foodbank vouchers, providing information on benefits, and assisting with reclaiming parking and public transport costs. Further research is required to assess the extent of the financial burden and its impact on treatment, and to determine which individuals are most affected. Research has found that there are significant challenges faced by families caring for individuals with eating disorders, including financial challenges. This study interviewed parents who were caring for a child with an eating disorder to better understand the financial implications and the effect of these on the family and treatment process. The findings highlight that financial costs contribute to caregiver burden, and without support, some families may not be able to afford all components of treatment, which can negatively impact recovery. Practical and easy-to-implement strategies are provided, for both parents and services, to reduce the negative impact of financial challenges on families and ED recovery.
37. Exploring the nexus: physical activity, body image, and anxiety among university students.
期刊: BMC psychology 发表日期: 2025-Sep-26 链接: PubMed
摘要
This study aimed to investigate the relationship between physical activity, body image, and anxiety among undergraduate university students. A total of 450 university students (67 male, 383 female) voluntarily participated in this research. Physical activity levels were assessed using the International Physical Activity Questionnaire (IPAQ), anxiety levels with the Beck Anxiety Scale (BAI), and body image perception using the Body Image Scale (BIS). The study was conducted in Türkiye between November 15, 2021 and February 2022. Only 18.44% of the participants met the recommended level of physical activity, with 51.11% having moderate activity levels and 30.44% being entirely low activity levels. Anxiety was prevalent, as 85.1% of students reported moderate anxiety, and 14.9% reported high anxiety. Additionally, a negative relationship between physical activity and body image was observed, implying that increased physical activity correlated with more positive body image (r=-0.177, p = 0.00). As the physical activity score increased, the body image score decreased. Due to this negative relationship, an increase in the IPAQ score had a positive influence on the individual’s perception of their body image. Conversely, a significant, moderately positive relationship existed between anxiety and body image. Regression analysis demonstrated that perceived body image significantly influenced anxiety levels (p < 0.000), explaining 20.3% of the variance (p < 0.000). In this study, we found the alarmingly low physical activity levels among university students and highlight the role of physical activity in enhancing body image and potentially reducing depressive symptoms. Practical implications include the necessity for effective interventions within universities to promote physical activity, support students in maintaining adequate activity levels, and consequently, improve mental well-being. These findings stress the importance of addressing physical activity and mental health within university settings and suggest actionable strategies for enhancing the overall health of students.
38. Feasibility of automatic knee kinematic feature learning for discriminating between individuals with and without a history of an anterior cruciate ligament reconstruction.
期刊: Clinical biomechanics (Bristol, Avon) 发表日期: 2025-Sep-24 链接: PubMed
摘要
Knee osteoarthritis is a degenerative joint disease that often develops following an anterior cruciate ligament (ACL) injury, even following surgical reconstruction (ACLr). This research evaluated whether biomechanical biomarkers, derived from wearable sensors, could differentiate people with an ACLr, who are at risk of early knee osteoarthritis, from healthy controls. Twelve participants with an ACLr and 19 controls participated. Continuous three-dimensional (3D) knee kinematics were captured using inertial measurement unit (IMU) sensors during sequential daily living tasks comprising sit-to-stand, walking, obstacle crossing, squatting, and stand-to-sit. Using a least absolute shrinkage and selection operator regression model, 468 knee time-series features were extracted to classify individuals with an ACLr from controls. Cohen’s d effect sizes were calculated for features selected by the regression model to quantify between-group differences. The model achieved an accuracy of 80.7 %, with 92 % sensitivity and 74 % specificity. Seven features were retained from the model. The top two features with the greatest effect sizes when compared to controls were: a reduction in peak-to-peak knee axial rotation and maximum knee axial rotation angle (d = 1.35 and d = 1.31, respectively). The present study found that axial knee kinematics could serve as important biomarkers of an ACLr, potentially representing a modifiable feature for osteoarthritis treatment and prevention. These findings demonstrate the feasibility of early knee osteoarthritis detection using biomechanical biomarkers, providing preliminary evidence for the use of wearable sensors outside clinical settings and underscoring the possibilities for at-home monitoring.
39. On metrics for subpopulation detection in single-cell and spatial omics data.
期刊: Nucleic acids research 发表日期: 2025-Sep-23 链接: PubMed
摘要
Benchmarks are crucial to understanding the strengths and weaknesses of the growing number of tools for single-cell and spatial omics analysis. A key task is to distinguish subpopulations within complex tissues, where evaluation typically relies on external clustering validation metrics. Different metrics often lead to inconsistencies between rankings, highlighting the importance of understanding the behavior and biological implications of each metric. In this work, we provide a framework for systematically understanding and selecting validation metrics for single-cell data analysis, addressing tasks such as creating cell embeddings, constructing graphs, clustering, and spatial domain detection. Our discussion centers on the desirable properties of metrics, focusing on biological relevance and potential biases. Using this framework, we not only analyze existing metrics but also develop novel ones. Delving into domain detection in spatial omics data, we develop new external metrics tailored to spatially aware measurements. Additionally, a Bioconductor R package, poem, implements all the metrics discussed. While we focus on single-cell omics, much of the discussion is of broader relevance to other types of high-dimensional data.
40. Development of sustainable N,S carbon quantum dots turn-off fluorescence method for rivastigmine determination using box-behnken design in pharmaceutical and environmental applications.
期刊: Talanta 发表日期: 2025-Sep-23 链接: PubMed
摘要
Rivastigmine, a dual cholinesterase inhibitor used for dementia treatment, poses significant environmental concerns due to its persistence in aquatic systems and potential ecotoxicological effects on non-target organisms, necessitating sensitive analytical methods for environmental monitoring. Herein, a novel, sensitive, and environmentally sustainable spectrofluorimetric method was developed for rivastigmine determination using nitrogen and sulfur co-doped carbon quantum dots (N,S CQDs) as fluorescence probes. The N,S CQDs were synthesized via a rapid microwave-assisted carbonization method and subsequently characterized using different techniques to elucidate their morphological, structural, and optical properties. The fluorescence quenching mechanism was then systematically investigated through Stern-Volmer kinetic analysis at three temperatures (298-313 K) revealing inverse temperature dependence of quenching constants Ksv (5.57 × 105 to 3.86 × 105 M-1), thereby confirming static quenching through ground-state complex formation. Additionally, thermodynamic analysis revealed exothermic binding (ΔH = -21.06 kJ/mol) with spontaneous complex formation. Subsequently, critical analytical parameters including pH, N,S CQDs volume, and reaction time were systematically optimized using Box-Behnken experimental design. Notably, response surface methodology revealed significant factors such as pH and N,S CQDs volume as well as synergistic interactions between these factors, which yielded a predictive mathematical model (R2 = 0.9759) with optimized conditions: pH 6.0, N,S CQDs volume 0.9 mL, and reaction time 3 min. The method was validated according to the ICH guidelines demonstrating high analytical performance with linear range 0.05-1.5 μg/mL (r2 = 0.9996), low detection limit (0.0165 μg/mL), high accuracy (98.92 ± 1.207 %), and good precision (RSD <2 %). The method was then successfully applied to pharmaceutical formulations and environmental water samples with satisfactory recovery rates (95.43-103.26 %). Comprehensive greenness and blueness assessments using AGREE and BAGI tools revealed superior environmental performance (0.77) compared to conventional HPLC-UV methods (0.63) while maintaining acceptable practical applicability (77.5). The developed method offers a viable green alternative for rivastigmine determination in pharmaceutical and environmental analysis.
41. Evaluating human serum for trace levels of lipophilic organic chemicals: A novel GC-(Q)Orbitrap methodology.
期刊: Talanta 发表日期: 2025-Sep-22 链接: PubMed
摘要
The exposome encompasses all environmental exposures across the lifespan, with chemical pollutants representing a major component. A robust sample preparation and multiresidue analytical method based on GC-(Q)Orbitrap technology was developed and validated for comprehensive characterization of the human chemical exposome in serum. The method demonstrated high accuracy and satisfactory performance at validation levels of 2 and 10 ng mL-1, enabling the simultaneous quantification and confirmation of 198 GC-amenable compounds from diverse physicochemical properties (e.g., OPEs, PCBs, PAHs, and alkyl-PAHs). The validated methodology was applied to 24 serum samples from pregnant women participating in the INSULIN cohort (Hospital Joan XXIII, Tarragona, Spain), detecting ten chemicals (three PAHs, six alkyl-PAHs, and one synthetic antioxidant) at concentrations between 1 and 4 ng mL-1. Furthermore, nontarget screening tentatively identified 64 additional compounds from various chemical families, highlighting the potential of GC-(Q)Orbitrap for broad-spectrum non-target analysis and holistic exposome characterization. This approach overcomes LC-based analytical limitations by enabling detection of low-to-medium polarity and semi-volatile compounds, demonstrating its value for expanding chemical coverage in human biomonitoring. Overall, this validated methodology provides a powerful tool for exposome-wide association studies (ExWAS) and public health assessments by enabling more comprehensive evaluation of human chemical exposures.
42. Integrating metagenomics, lipidomics and proteomics to explore the effect and mechanism of ginsenoside Rb1 on atherosclerosis co-depression disease.
期刊: Phytomedicine : international journal of phytotherapy and phytopharmacology 发表日期: 2025-Sep-22 链接: PubMed
摘要
The comorbidity of atherosclerosis (AS) and depression presents a significant clinical challenge. Its pathogenesis entails complex abnormalities in inflammatory responses, lipid metabolism, and gut microbiota homeostasis. Ginsenoside Rb1 (GRb1)-a bioactive compound derived from the dried roots of Panax ginseng (Araliaceae)-demonstrates anti-inflammatory, antioxidant, lipid-lowering, and neuroprotective properties. However, GRb1’s therapeutic potential and underlying mechanisms in AS co-depression remain inadequately characterized. This study aims to elucidate the mechanism of GRb1 in AS co-depression disease, identify potential therapeutic targets, and thereby develop novel therapeutic strategies for this condition. An AS co-depression comorbidity model was established using ApoE⁻/⁻ mice fed a high-fat diet and subjected to chronic restraint stress. To evaluate GRb1’s therapeutic efficacy, we assessed serum lipid profiles, performed aortic Oil Red O staining, and conducted behavioral tests for depressive-like phenotypes. Furthermore, we employed an integrated multi-omics approach-combining metagenomics, targeted lipid metabolomics, and proteomics-to identify key alterations in gut microbiota, lipid metabolites, and proteins, with subsequent correlation analysis. Key differential proteins and associated pathways identified through multi-omics were validated using both in vivo (AS co-depression mouse model) and in vitro (HT22 cells) experiments. Finally, GRb1’s effects on ferroptosis and specific signaling pathways (CD44/Gls2, ACSL4/LPCAT3/ALOX15, SLC7A11/GPX4) were examined via Western blotting, immunofluorescence, and transmission electron microscopy in both mouse tissues and HT22 cells. Proteobacteria, Helicobacter, and Helicobacter_typhlonius represent significant intestinal microbiota components. Their primary differential lipids include phosphatidylethanolamine (PE), phosphatidylcholine (PC), and lysophosphatidylcholine (LPC), while key differential proteins encompass CD44, Gls2, and Snrpf. Notably, a strong correlation exists among Helicobacter_typhlonius, PE, and CD44. GRb1 modulates PE metabolic dysregulation by reducing the relative abundance of Helicobacter_typhlonius, thereby inhibiting lipid peroxidation and ameliorating oxidative stress. Furthermore, GRb1 suppresses the CD44/Gls2 axis, ACSL4/LPCAT3/ALOX15 pathway, and activates the SLC7A11/GPX4-mediated ferroptosis pathway, thereby exerting its anti-AS co-depression effects through these multi-target mechanisms. GRb1 regulates the intestinal microbiota, abnormal lipid metabolism, modulates protein function, inhibits lipid peroxidation, improves oxidative stress, inhibits ferroptosis, regulates the CD44/Gls2, ACSL4/LPCAT3/ALOX15, SLC7A11/ GPX4 signaling pathways, and prevents the progression of AS co-depression disease.
43. Acetylshikonin regulates the gut microbiota and inhibits the horizontal transmission of colistin-resistant plasmids.
期刊: Phytomedicine : international journal of phytotherapy and phytopharmacology 发表日期: 2025-Sep-22 链接: PubMed
摘要
The gut microbiota serves as a major reservoir for antibiotic resistance genes (ARGs), driving the spread of antimicrobial resistance (AMR) via horizontal gene transfer (HGT). Acetylshikonin (ASK), a naphthoquinone derived from the medicinal plant Lithospermum erythrorhizon, was proved to inhibit plasmid conjugation in vitro and in vivo. However, its impact on gut microbiota composition and precise HGT inhibition process within complex gut microbiota community remains unexplored. This study aims to clarify the precise inhibition effect of ASK on the transfer process of colistin-resistant plasmid in gut microbiota and its mechanisms. High-throughput cell sorting and 16S rRNA gene amplicon sequencing were employed to assess the precise gut microbiota species that ASK inhibited the resistant plasmid transfer to. The plasmid stability and re-transferability of transconjugants was evaluated by passaging culture and in vitro conjugative assay. The biochemical impact of ASK on donor cell and gut microbiota were tested by fluorescence assay and ELISA. ASK changed the gut microbiota composition by enriching probiotics and reducing Gram-positive bacteria. In addition, ASK effectively inhibited the conjugative transfer of colistin-resistant plasmids to Proteobacteria (Escherichia and Ligilactobacillus) within the gut community. Furthermore, ASK weakened the stability and re-transferability of transconjugants, thereby limiting ARG further dissemination in gut. Moreover, ASK inhibited the electronic transport chain (ETC) and suppressed the ATP supply for both donor cells and the gut microbiota. Thus the plasmid conjugation processing in gut microbiota was inhibited by ASK. This study demonstrated that ASK restructured gut microbiota and disarmed plasmid-mediated resistance spreading, offering a dual-targeted strategy against antimicrobial resistance.
44. Molecular insights into the transport and toxicity of 6-PPD: Interactions with human serum albumin and alpha-glucosidase.
期刊: Biophysical chemistry 发表日期: 2025-Sep-22 链接: PubMed
摘要
The rubber antioxidant, N-(1,3-dimethylbutyl)-N’-phenyl-p-phenylenediamine (6-PPD), as an emerging pollutant, is receiving more and more attention recently. This study investigated the intermolecular interactions of 6-PPD with two key biological macromolecules, human serum albumin (HSA) and alpha-glucosidase (AG), to understand the transport and toxic effects of 6-PPD. Using multiple spectroscopic methods and molecular docking technology, the results demonstrated that 6-PPD could bind to both HSA and AG, thereby inducing fluorescence quenching and conformational changes in both proteins. The binding constants were determined to be (5.93 ± 0.20) × 105 and (3.17 ± 0.15) × 104 L mol-1 respectively for HSA-6-PPD and AG-6-PPD systems at 298 K, revealing strong binding affinities. Molecular docking identified specific binding sites and non-covalent interactions of the two systems. MD and Energy decomposition analysis revealed the dynamics conformational changes of the complexes and identified van der Waals and electrostatic interactions as primary binding drivers for both systems, while polar solvation energy impeded complex formation. TYR161, ILE142, and TYR138 dominated HSA-6-PPD stabilization, whereas AG-6-PPD was driven by hydrophobic interactions with TRP1369 and VAL1373, with ARG1377 incurring substantial desolvation penalties. Synchronous fluorescence and circular dichroism spectroscopy indicated that 6-PPD binding did not disrupt the microenvironment of Tyr and Trp residues in HSA and AG, while induced structural alterations in HSA and AG that could affect their physiological function. In-vitro tests showed that 6-PPD inhibited AG activity in a dose-dependent manner, with an IC50 of 8.22 ± 0.44 μmol L-1. ADMET and PASS online tools was used to predict physicochemical properties and multiorgan toxicity. This work provided insights into the transport and molecular toxicity of 6-PPD, highlighting the adverse biological effects associated with this common rubber additive.
45. A novel efficient pretreatment device integrated with chitosan aerogel and hydrogel composite membrane for detection of norovirus in seafood.
期刊: Talanta 发表日期: 2025-Sep-19 链接: PubMed
摘要
Norovirus (NoV) GII.4 is a major causative agent of foodborne illness, with its contamination of shellfish and other marine products posing a significant public health risk. Therefore, there is an urgent need to develop efficient on-site detection methods. However, current sample pretreatment technologies are often associated with limitations such as bulky instrumentation, high operational costs, and time-consuming procedures, which hinder the widespread adoption and practical application of on-site detection solutions. This study presents an innovative “two-step series” micro-pretreatment device (TSMPD) that utilizes membrane material pore size regulation. The primary materials employed are chitosan aerogel and nanofiber hydrogel composite membranes. The technical core of this approach involves the initial rapid interception and efficient separation of complex food sample matrices through a large-pore, high-adsorption aerogel layer, which effectively removes matrix interference. Subsequently, a nanofiber hydrogel composite membrane featuring a small-pore dense structure is utilized to achieve efficient enrichment and recovery of target virus particles. In line with the aforementioned enrichment principle, oysters were selected as representative food samples in this study, successfully facilitating the efficient enrichment and concentration of NoV GII.4 within oyster samples. Notably, virus enrichment was accomplished within 80 min, achieving a recovery rate of 25.35 %. Meanwhile, in conjunction with the RPA-CRISPR/Cas12a fluorescence detection system, a rapid and sensitive quantitative detection method for NoV GII.4 in food has been developed. The results indicate that the integrated technical solution of “enrichment - detection” established in this study can facilitate on-site rapid screening of norovirus-contaminated positive samples within 2h, achieving a detection limit of 97 copies/μL. Furthermore, this method demonstrates excellent specificity and stability. When compared to the gold standard for nucleic acid testing, the findings revealed a high degree of consistency (p>0.05), notably reducing the total duration of the entire testing process by half. This method offers several advantages including ease of operation, reduced time consumption, and low cost, thereby providing reliable technical support for on-site rapid screening of NoV GII.4 in food products.
46. Financial incentives and COVID-19 vaccinations: Evidence from a conditional cash transfer program.
期刊: Journal of health economics 发表日期: 2025-Sep-19 链接: PubMed
摘要
This paper investigates the effects of a nationwide conditional cash transfer program aimed at increasing COVID-19 vaccine uptake in Slovakia. Due to relatively low vaccination rates and the overcrowding of hospitals during the COVID-19 pandemic, the Slovak government decided to offer €200 or €300 cash transfers to individuals aged 60 or older, conditional on taking any of the available vaccines at the time. The eligibility requirements resulted in a discontinuity in treatment assignment at the age threshold. Our results suggest that the program significantly increased vaccination rates in the population. However, overall costs related to the intervention do not appear to outweigh the benefits.
47. Polluted air, healthier diets: Household food consumption patterns in response to air quality in China.
期刊: Journal of health economics 发表日期: 2025-Sep-16 链接: PubMed
摘要
This study examines how air pollution affects household food consumption using high-frequency data from over 30,000 households in 25 Chinese cities (2014-2019). Employing an instrumental variable approach based on wind direction, we find that a one-standard-deviation increase in PM2.5 raises weekly expenditure on healthy foods, such as fruits, vegetables, and dairy, by 9.3 yuan, or 11 % of the within-household standard deviation. Spending on less healthy foods remains unaffected, suggesting targeted adjustments toward nutrient-dense foods. These changes improve nutrient intake but are immediate and transitory, with no evidence of lasting dietary shifts. The effects are stronger for higher-income households and those with elderly members, reflecting health concerns and financial flexibility, while lower-income households show constrained responses. Air pollution also reduces dining out expenditures, indicating a substitution toward home-prepared meals. These findings highlight air pollution’s welfare costs, socioeconomic disparities, and the need for equitable public health policies.
48. [Female reproductive function -after radioiodine therapy for differentiated thyroid carcinoma].
期刊: Problemy endokrinologii 发表日期: 2025-Sep-14 链接: PubMed
摘要
Combined treatment of differentiated thyroid cancer (DTC) may have an impact on the reproductive health of patients, in particular on the ovarian reserve (OR) of childbearing-age women. However, knowledge in this area is still insufficient to create general recommendations and an algorithm for managing this cohort of patients based on their current reproductive status and desire to realize their reproductive potential. To assess ovarian function and OR using anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) in dynamics in the early follicular phase in women of reproductive age receiving combined treatment for DTC. In a single-center prospective non-comparative study, the clinical and morphological, anamnestic and laboratory parameters of patients receiving combined treatment for DTC were analyzed. The levels of AMH, FSH, LH and E2 were determined in dynamics - after surgical treatment but no later than one month before radioiodine therapy (RAIT), as well as 3 and 6 months after RAIT on the background of suppressive therapy. A total of 39 women aged 18 to 40 years with a median age of 32 years [27; 37] undergoing combined treatment for DTC were enrolled in the study. The frequency of transient menstrual cycle disturbances after surgery was 18%, and after RAIT - 38%. According to the post-operative DTC status the majority of patients belonged to ATA intermediate-risk group (69%). In addition, 72% of patients received thyroid hormone withdrawal for a period of 4 weeks as a preparation for RAIT. The average activity of 131I was 3720 MBq [3050; 3838]. The levels of FSH and LH did not differ significantly before and after RAIT (R=NS). The level of E2 decreased significantly 3 months after RAIT (P<0.010), further increasing in 6 months to almost the initial values (P=NS). The level of AMH decreased significantly 3 and 6 months after RAIT compared with baseline values (P<0.001). The median AMH before the treatment was 4.10 ng/ml [2.34; 5.82], the nadir of AMH was observed after 3 months - 2.09 ng/ml [1.05; 3.05], and after 6 months AMH increased to 2.31 ng/ml [1.42; 3.37]. In 29% of patients, the AMH level decreased below the reference after 3 months. The predictor of AMH level below 1.2 ng/ml (reflecting reduced OR) 3 months after RAIT was the patient’s age before RAIT. Using the Juden index, a cut-off point of 31 years was determined. The level of AMH decreases significantly after RAIT for DTC, which indicates the effect of the therapy on OR, while age at the time of RAIT is the main predictor of AMH level below 1.2 ng/ml after 3 months.
49. [Restoration of ejaculate quality following androgen replacement and combined therapy for hypogonadism].
期刊: Problemy endokrinologii 发表日期: 2025-Sep-14 链接: PubMed
摘要
To optimize androgen replacement therapy for male hypogonadism to improve reproductive prospects. To compare the effectiveness of restoring the quality of ejaculate in men receiving androgen replacement therapy (AZT) and patients receiving course combination therapy with testosterone and chorionic gonadotropin (AZT/HG). In observational prospective study was included 53 men observed at The National Medical Research Center for Endocrinology and AZT (n=19) or AZT/HG (n=34) more than 5 years, followed by stimulating gonadotropin therapy. The qualitative parameters of ejaculate were evaluated in all patients. The basic level of statistical significance was p<0,05. The patient groups were comparable in age, BMI, duration of therapy used, type of testosterone preparation, as well as the etiology of hypogonadism. Sperm concentration in the AZT group there was a statistically significant negative dynamics, while in the ART/HG group, there were no statistically significant differences in the dynamics of sperm concentration. Statistically significant differences in the value of sperm concentration change were revealed. In both groups was observed statistically significant negative dynamics for sperm motility and morphology. There were no statistically significant differences in the value of changes motility and sperm morphology in both studied groups. Course combination therapy with testosterone and chorionic gonadotropin is characterized by better results for sperm concentration restoration compared with androgenic replacement therapy. For the restoration of sperm motility and morphology both methods do not show satisfactory results.
50. [Iodine status of the population in the WHO European Region (an abridged translation of selected sections of the WHO European report)].
期刊: Problemy endokrinologii 发表日期: 2025-Sep-14 链接: PubMed
摘要
This review is an abridged translation of selected chapters of the report “Prevention and control of iodine deficiency in the WHO European Region: adapting to changes in diet and lifestyle”, published by the WHO Regional Office for Europe and the Iodine Global Network (IGN) in 2024. Iodine deficiency, especially mild iodine deficiency, remains a widespread problem in the WHO European Region. Since the last WHO report on iodine deficiency in the Region 15 years ago, much new data on iodine status has become available, especially for vulnerable populations. This review presents data on the iodine status of the population in 53 WHO European Member States (and Kosovo), the adverse effects of mild iodine deficiency and the effectiveness of salt iodization in preventing iodine deficiency. Mainly due to progress in salt iodization, the number of countries with iodine deficiency has decreased from 23 in 2003 to 2 in 2023. Mandatory salt iodization ensures adequate iodine intake in all population groups, with the exception of a few countries where these programs are poorly implemented. The positive cost-benefit ratio for preventing mild iodine deficiency in the European Region is plausible given the high prevalence of thyroid disease and the low cost of salt fortification programs.
51. Tricuspid Regurgitation and Pulmonary Haemodynamics After Pulmonary Endarterectomy.
期刊: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery 发表日期: 2025-Sep-02 链接: PubMed
摘要
To assess tricuspid regurgitation evolution after pulmonary endarterectomy and to identify predictive factors for residual postoperative tricuspid regurgitation. Perioperative and 6-month follow-up echocardiography and right heart catheterization data were retrospectively retrieved from all chronic thromboembolic pulmonary hypertension patients who underwent pulmonary endarterectomy between January 2009 and December 2023 in University Hospitals Leuven, Leuven and St. Antonius Hospital, Nieuwegein. Patients with vs without decreased tricuspid regurgitation and with vs without moderate/severe residual postoperative tricuspid regurgitation were compared. Moderate/severe preoperative tricuspid regurgitation was present in 150/162 (93%) patients. It decreased with at least 1 degree 6 months postoperatively in 70/150 (47%) patients. In these patients, reductions in mean pulmonary artery pressure (-23 [-26; -21] vs -13 [-16; -11] mm Hg, P < .001), pulmonary vascular resistance (-6.73 [-7.61; -5.85] vs -3.28 [-4.05; -2.52] Wood units, P < .001), and N-terminal pro brain natriuretic peptide (ratio post-/preoperative measurement: 0.227 [0.168; 0.307] vs 0.968 [0.741; 1.265], P < .001) were larger than in patients without this decrease. Moderate/severe residual tricuspid regurgitation was seen in 26/162 (16%) patients. Postoperative mean pulmonary artery pressure (34 [30; 37] vs 24 [22; 25] mm Hg, P < .001) and pulmonary vascular resistance (5.54 [4.77; 6.31] vs 2.99 [2.65; 3.33] Wood units, P < .001) were higher in these patients vs those without moderate/severe residual tricuspid regurgitation. Arterial hypertension, older age, atrial fibrillation, shorter 6-min walking distance, and higher tricuspid regurgitation degree were potential preoperative risk factors for residual tricuspid regurgitation. In our study population, tricuspid regurgitation improvement after pulmonary endarterectomy was associated with improved pulmonary haemodynamics. Concomitant tricuspid valve annuloplasty might be considered in patients with atrial fibrillation and a dilated tricuspid valve annulus, but in the absence of risk factors for persistent pulmonary hypertension.
52. Impact of the CALLY Index in Predicting Overall Survival and Disease-Free Survival in Patients Undergoing Radical Cystectomy for Muscle-Invasive Bladder Cancer.
期刊: Nigerian journal of clinical practice 发表日期: 2025-Sep-01 链接: PubMed
摘要
Muscle-invasive bladder cancer (MIBC) is associated with poor survival outcomes despite radical cystectomy (RC), creating a clinical need for simple and reliable prognostic biomarkers. The CALLY index, a composite biomarker derived from serum C-reactive protein (CRP), albumin, and lymphocyte counts, reflects systemic inflammation, nutritional status, and immune function. Its prognostic utility in MIBC has not been fully elucidated. To evaluate the prognostic value of the CALLY index in predicting overall survival (OS) and disease-free survival (DFS) in patients undergoing RC for non-metastatic MIBC. In this retrospective cohort study, 134 patients who underwent RC for non-metastatic MIBC between February 2014 and January 2024 were included. Patients who received neoadjuvant chemotherapy, had secondary malignancies, or active infections were excluded. The CALLY index was calculated as follows: (Albumin [g/dL] × Lymphocyte count [10⁹/L])/CRP [mg/dL] ×10⁴. Kaplan-Meier and receiver operating characteristic curve analyses were used to evaluate survival outcomes and the predictive performance of the index. Patients with a CALLY index of ≥1.33 had significantly longer OS (median 62 vs. 29 months, p < 0.001), and a cut-off of ≥1.11 was predictive of improved DFS (p = 0.004). The index demonstrated moderate discriminative ability (AUC: 0.682 for OS; 0.647 for DFS). CRP and albumin were independent prognostic factors, whereas lymphocyte count was not. The CALLY index may serve as a valuable prognostic tool in patients with non-metastatic MIBC undergoing RC. Its incorporation into clinical risk stratification models could enhance individualized treatment planning. Prospective studies are warranted to validate these findings.
53. Correlation between Chronic Urinary Retention, Retained Urine Volume, and Renal Function in Men with Urinary Retention from Bladder Outlet Obstruction in Southeast Nigeria.
期刊: Nigerian journal of clinical practice 发表日期: 2025-Sep-01 链接: PubMed
摘要
Urinary retention (UR) can lead to both anatomical and functional derangement in the urinary system. Chronic kidney disease occurs when there is renal damage. This study aims to determine the relationship between chronic UR (CUR), retained urine volume, and renal function among men with chronic and acute-on-chronic UR. The study was a hospital-based prospective study of Nigerian men presenting with chronic or acute-on-chronic UR. Diagnosis of UR was made based on history and physical examination. The estimated glomerular filtration rate (eGFR) was calculated using the serum creatinine level. Retained urine volume was measured after an aseptic urethral catheterization. Spearman’s rank correlation test was used for correlation analysis between CUR, retained urine volume, and renal function. A P value of < 0.05 was accepted as statistically significant. Fifty-six men met the inclusion criteria. Most of the patients were in the age range of 80-89 years. A total of 20 (35.7%) had acute-on-chronic UR, while 36 (64.3%) had CUR. The mean retained urine volume was 1500 ± 748.0 mL and 1100 ± 515.0 mL for the chronic and acute-on-chronic UR groups, respectively. Obstructive nephropathy occurred in 88.6% of the participants with CUR. There was a significant negative relationship between the eGFR and the volume of retained urine (r = -0.397, P = 0.002). A high prevalence of obstructive nephropathy was observed among men with chronic and acute-on-chronic UR in this study.
54. Comparative Analysis of Physical Performance and Quality of Life in Adolescents with Down Syndrome and their Typically Developing Peers.
期刊: Nigerian journal of clinical practice 发表日期: 2025-Sep-01 链接: PubMed
摘要
Down syndrome (DS) also causes serious physiological impairments, musculoskeletal problems, and functional limitations. Especially during and after adolescence, a decrease in aerobic capacity, a tendency toward a sedentary lifestyle, low quality of life, low participation, and an increase in various health risks are observed. To examine the anthropometric characteristics, physical performance levels, and quality of life of adolescents with DS and identify their need to better prepare them for healthier adulthood. Thirty adolescents with DS and 28 typically developing (TD) peers participated in this study. Anthropometric measurements, lower extremity strength, and physical performance levels were assessed using the 30 secSit-to-Stand Test, timed up-and-go Test, Six-Minute Walking Test, Beighton hypermobility test, and physiological cost index. The Physical Activity Questionnaire for Adolescents (PAQ-A) and the Pediatric Quality of Life Questionnaire-Adolescent Form (PedsQL-A) were administered. Differences between groups were tested using an independent samples t-test. Pearson’s correlation coefficient was calculated to examine the relationships between variables. The level of significance was set at P < 0.05. The study found that 83.33% of adolescents with DS were classified as obese or overweight. Adolescents with DS showed significantly lower lower extremity strength and physical performance levels but higher flexibility. The quality of life, except for emotional functionality, was higher in the TD group across all areas. Body mass index (BMI) in adolescents with DS was positively correlated with the PedsQL-A score and negatively correlated with the PAQ-A. Targeted interventions are needed to improve physical performance and overall health outcomes of adolescents with DS.
55. Impact of pre-existing frailty on all-cause mortality in stroke survivors: a systematic review and dose-response meta-analysis.
期刊: Age and ageing 发表日期: 2025-Aug-29 链接: PubMed
摘要
The association between pre-existing frailty and increased mortality in stroke survivors remains unclear, with prior studies reporting inconsistent findings. This meta-analysis aimed to evaluate the impact of pre-stroke frailty on all-cause mortality in this population. We systematically searched PubMed, Embase, Web of Science, Cochrane Library, CINAHL, PsycINFO, CNKI, Wanfang, VIP, and SinoMed databases up to November 12, 2024. Study selection and data extraction were independently performed by two investigators. Studies using validated frailty assessment tools and reporting adjusted hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were included. Sixteen studies involving 55,897 patients met the inclusion criteria. The prevalence of frailty among stroke survivors ranged from 11.2% to 75.3%. Meta-analysis showed that pre-stroke frailty was significantly associated with increased all-cause mortality (pooled HR = 2.19, 95% CI: 1.44-3.34; pooled OR for continuous frailty scores = 1.26, 95% CI: 1.14-1.38). Dose-response analysis revealed a linear relationship, with each one-point increase in frailty score associated with a 6.4% higher risk of death (HR = 1.064, 95% CI: 1.031-1.098). Subgroup analyses indicated that the association was particularly strong in acute ischemic stroke populations (OR = 3.43, 95% CI: 1.81-6.51). The type of frailty assessment tool and study sample size were identified as potential sources of heterogeneity. Pre-stroke frailty independently predicts all-cause mortality in stroke survivors. Even mild increases in frailty burden are associated with worse outcomes, highlighting the clinical importance of incorporating frailty assessment into prognostic evaluation.
56. Vascular ageing and cognitive function: blood pressure mediation in the association between arterial stiffness and cognitive decline in Chinese adults.
期刊: Age and ageing 发表日期: 2025-Aug-29 链接: PubMed
摘要
Arterial stiffness has emerged as a potential risk factor for cognitive decline, yet underlying mechanisms remain incompletely understood. We investigated the longitudinal association between arterial stiffness and cognitive function in Chinese adults, examining blood pressure components as potential mediators. Data from 3485 participants (aged 45-90) in the China Health and Retirement Longitudinal Study (2011-2018) were analysed. Arterial stiffness was assessed using estimated pulse wave velocity (ePWV). Multivariate regression models examined associations between baseline ePWV and cognitive outcomes. Mediation analyses quantified blood pressure mediation effects. Baseline cognitive scores demonstrated significant inverse relationships across ePWV tertiles: 13.67 ± 2.62, 13.40 ± 2.68 and 12.93 ± 2.79 (P < 0.001), persisting at 7-year follow-up. Each unit increase in ePWV was associated with cognitive decline in fully adjusted models (β = -0.14, 95% CI: -0.23 to -0.05, P = 0.003). Whilst unadjusted analysis suggested blood pressure mediation (systolic: 63.4%, diastolic: 47.0%), these effects became non-significant after demographic adjustment. Restricted cubic spline analysis revealed optimal ePWV thresholds below 8.0 m/s, with U-shaped blood pressure interactions showing maximum cognitive vulnerability at intermediate ranges (systolic: 110-140 mmHg, diastolic: 70-90 mmHg). ePWV independently predicts long-term cognitive decline in Chinese adults through mechanisms beyond blood pressure elevation alone. The U-shaped interactions between ePWV and blood pressure reveal maximum cognitive vulnerability at intermediate blood pressure ranges (110-140/70-90 mmHg), suggesting that cognitive risk assessment should integrate ePWV measures alongside blood pressure control, with optimal targets potentially individualised based on arterial compliance status.
57. The association between dual sensory impairment and dementia: a meta-analysis and systematic review of the literature.
期刊: Age and ageing 发表日期: 2025-Aug-29 链接: PubMed
摘要
Recent evidence suggests an association between dual sensory impairment (DSI)-that is, both visual and hearing impairments-and dementia. The aim of this systematic review was to synthesise the literature evaluating the dementia risk of adults >18 years with DSI compared to those without sensory impairment and/or those with a single sensory impairment (SSI). PubMed, Web of Science and PsycINFO were systematically searched in February 2024 and August 2024 for studies that considered the association between DSI and dementia, and compared individuals with DSI to those with either no sensory impairment or a SSI. A meta-analysis was conducted on studies reporting hazard ratios. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and was registered on the Prospective Register of Systematic Reviews (PROSPERO). A total of 22 papers were included in the narrative review, and 13 were included in the meta-analysis. Overall, findings from the narrative synthesis highlighted a consistent link between dementia prevalence and incidence with DSI. The meta-analysis revealed that individuals with DSI are at an ~50% greater risk of developing dementia compared to those without sensory impairments. Moreover, we identified DSI as a potentially greater risk factor for dementia than isolated hearing and visual impairment, with the risk for dementia in the DSI group exceeding the combined risk of the individual sensory impairments. This review highlights that there is substantial evidence linking DSI to an increased risk of dementia, emphasising the importance of considering the interplay between multiple senses in dementia research. Future research should focus on exploring whether interventions targeting DSI could also improve cognitive outcomes.
58. Remote assessment of physical function in older people: feasibility, safety and agreement with in-person administration.
期刊: Age and ageing 发表日期: 2025-Aug-29 链接: PubMed
摘要
Physical function is a key health indicator in older people. Interchangeable remote and in-person assessments could improve monitoring flexibility. To evaluate feasibility, safety and agreement between remote home and in-person laboratory physical function assessments in community-living older people. Thirty-seven people aged 60+ completed remote and in-person assessments of the five-times Sit-to-Stand (5STS), Timed Up-and-Go (TUG), standing balance test, 4 m Walk and Short Physical Performance Battery (SPPB) in counter-balanced order, two days apart. Feasibility was assessed as technological and environmental barriers, safety as adverse events, and agreement using intraclass correlation coefficients (ICCs) and smallest detectable differences (SDD), and based on kappa using clinical cutpoints (κ). All participants completed the remote assessments without adverse events; 8% experienced minor connectivity issues. In-person performance was better for 5STS, TUG, 4 m Walk and standing balance; SPPB scores were comparable. Agreement was good for 5STS, TUG and standing balance (ICCs: 0.89 [95% confidence interval: 0.79-0.94], 0.85 [0.54-0.94], 0.77 [0.59-0.88], respectively)) and moderate for 4 m Walk and SPPB (ICCs: 0.64 [0.19-0.84] and 0.68 [0.46-0.82], respectively). SDD values for 5STS, TUG and SPPB fell within clinically acceptable ranges; categorical agreement was substantial (κ: 0.65, 0.77 and 0.65, respectively). Remote 5STS and TUG assessments showed good agreement, supporting their use with existing cut-points. Differences between settings in standing balance and walking speed (affecting SPPB) suggest caution in interpretation. Telehealth offers a feasible, safe option for monitoring physical function, though protocol refinements are needed for walking speed and standing balance.
59. New Legal Measures Restricting Gender-Affirming Care: Implications for Research Ethics.
期刊: Ethics & human research 发表日期: 2025 链接: PubMed
摘要
Increasingly, new legal measures are restricting the use of gender-affirming care, raising challenges not only for the medical care of transgender/gender-nonbinary individuals, but also for medical research and research ethics. These restrictions may discourage researchers from conducting various types of research with transgender/gender-nonbinary individuals, such as asking about sexual behavior and gender identity or related issues in studies of adolescents and young adults more broadly. Researchers and institutions may also face professional risks in pursuing such research. Thus, restrictions on the use of gender-affirming care have important implications for researchers, institutional review boards (IRBs), institutional officials, policy-makers, and others. Restrictions could have an impact on the design, implementation, and management of research studies, potentially requiring consent form modifications, reconsent of participants, and asking participants about possible resulting physical/legal/social problems. Researchers and IRBs need to carefully assess these shifting legal restrictions. Input from legal experts may be needed concerning the interpretation, implementation, and enforcement of local and federal legal measures for initial and continuing IRB review of research protocols and the assessment of any changes to relevant legal measures. Researchers, IRBs, and others thus need to recognize, address, and develop “best practices” regarding these new restrictions.