公共卫生研究摘要 (2025-09-30)
共收录 61 篇研究文章
1. TNAP-induced CD47 membrane expression enhances TGF-β1 conversion in liver fibrosis.
期刊: Hepatology communications 发表日期: 2025-Oct-01 链接: PubMed
摘要
Tissue-nonspecific alkaline phosphatase (TNAP) expression increases after liver injury, but its role in liver fibrosis remains unclear. This study investigated the effect of TNAP on liver fibrosis and its mechanism in regulating TGF-β1 signaling. Human liver samples and a CCl4-induced liver fibrosis mouse model with adv-TNAP and a TNAP inhibitor (tetramisole, Tetra) were used to study the function of TNAP in liver fibrosis. Primary HSCs were used to study the mechanism of TNAP in regulating the TGF-β1 signal. Elevated TNAP expression was observed in human and murine fibrotic liver tissues, correlating with increased fibrotic markers. In vivo experiments using TNAP overexpression and inhibition in a CCl4-induced liver fibrosis mouse model demonstrated that TNAP exacerbated, while its inhibition alleviated, liver fibrosis. In vitro studies revealed that TNAP regulated TGF-β1 conversion and HSCs activation through the TGF-β1/SMAD pathway. TNAP facilitated TGF-β1 conversion by promoting the interaction between CD47 and thrombospondin-1 (TSP1). Membrane expression of CD47 modulated by TNAP might contribute to the binding effect of CD47 and TSP1. TNAP plays a critical regulatory role in TGF-β1-mediated liver fibrosis, probably by promoting the binding of CD47/TSP1. Targeting TNAP-mediated pathways may offer new therapeutic strategies for liver fibrosis.
2. U.S. Vietnamese Parents' Perceptions of Different Approaches for Confirming Adolescent HPV Vaccination Records in Research Studies.
期刊: Health expectations : an international journal of public participation in health care and health policy 发表日期: 2025-Oct 链接: PubMed
摘要
The United States (U.S.) Vietnamese communities face a high burden of HPV-related cancer rates; they also have low HPV vaccination coverage. HPV vaccination is a safe, effective tool to prevent HPV-related cancers, particularly when administered during adolescence. Understanding Vietnamese parents’ perspectives on the acceptability of different HPV vaccination status verification methods can improve the implementation of community-based research interventions to improve HPV vaccine coverage in this population. We assessed their perceptions of three HPV vaccination status confirmation methods: medical records, vaccination card photographs, and self-reported surveys. We conducted interviews with Vietnamese parents of adolescents ages 9-18, healthcare providers, and community leaders (n = 34). We used an inductive thematic analysis approach with four qualitative coders. Preferences for confirming vaccination status were split almost equally among each method. Key drivers of these preferences included privacy concerns, autonomy, efforts required from parents, digital literacy, and data accuracy. These findings suggest offering multiple confirmation options to accommodate diverse preferences and enhance the effectiveness of HPV vaccination promotion strategies in this population. Community involvement was integral to the design, implementation of this project, and writing of the manuscript. The study team partnered with a community organization that works closely with the U.S. Vietnamese population and Vietnamese healthcare providers. The group met regularly to discuss participant recruitment strategies and study instruments. Lived experiences from parents of adolescents, community leaders, and healthcare providers were included in the production of this manuscript to guide the interpretation of preferences for vaccination confirmation methods.
3. Albumin prevents kidney injury but is underutilized in a cohort of patients undergoing large-volume paracentesis.
期刊: Hepatology communications 发表日期: 2025-Oct-01 链接: PubMed
摘要
Cirrhosis and cirrhosis-related deaths have risen in the United States in recent years. Ascites is a common complication, often requiring large-volume paracentesis (LVP). The American Association for the Study of Liver Diseases (AASLD) recommends the administration of albumin in conjunction with LVP to prevent further complications of cirrhosis. Emerging research in cirrhosis care reveals significant variations in outcomes among different demographics. Therefore, we assessed the use of guideline-adherent albumin and outcomes in U.S. patients undergoing LVPs, particularly at the intersection of race, ethnicity, socioeconomic disparities, and cirrhosis. This retrospective study utilized Cerner Real World Data to identify adults with cirrhosis and ascites undergoing LVP between January 2016 and June 2022. We assessed albumin utilization patterns across racial and ethnic groups and payor types, and their overall impact on acute kidney injury (AKI)-related hospitalization using an adjusted generalized linear model (aGLM). We identified 736 patients: 301 in the LVP + albumin group and 435 in the LVP-only group. Despite clinical recommendations, only 41% undergoing LVPs received albumin. White patients and commercially insured patients received albumin at higher rates (p=0.042 and p=0.009, respectively). The overall rate of AKI-related admissions within the 30-day post-procedure period was 26%. However, patients who received albumin during LVP had a 36% lower risk of short-term AKI-related hospitalization (OR: 0.64; p=0.03). These findings indicate a potential for broader albumin utilization in U.S. patients with refractory ascites undergoing repeated LVPs to reduce AKI-related admissions.
4. Plasma proteome correlations with liver stiffness in pediatric cholestasis implicate epithelial to mesenchymal transition.
期刊: Hepatology communications 发表日期: 2025-Oct-01 链接: PubMed
摘要
Pediatric cholestatic liver diseases can be characterized by rapidly progressive fibrosis. A multicenter cross-sectional analysis of vibration-controlled elastography in biliary atresia (BA), alpha-1 antitrypsin deficiency (A1AT), and Alagille syndrome (ALGS) was leveraged to interrogate the plasma proteome relative to liver stiffness measurements (LSM). Slow off-rate modified aptamer scanning profiling of >7000 proteins in plasma from 187 children with BA (n=93), A1AT (n=31), ALGS (n=46), and healthy pediatric controls (n=17) was performed, and correlations with LSM were undertaken. There was an abundance of LSM correlated proteins (BA n=2720, A1AT n=694, ALGS n=5968). Interestingly, a distinct plasma proteome was found in ALGS relative to BA and A1AT. Weighted Correlation Network Analysis identified groups of proteins with strong LSM correlation (eg, in a BA module of interest, Pearson correlation coefficient 0.79, p=5´0-21). Machine learning developed models predicting LSM as a continuous variable (median R2=0.62 for BA). For BA, time to transplant could be predicted equally well by the proteome or clinical parameters (elastic net models achieved a C-index using proteome 0.91, clinical parameters 0.91, proteome and clinical parameters 0.90). Single-cell transcriptomics predicted the potential hepatic cell of origin for the most informative proteins, which included macrophage, mesenchymal, mesothelial, and endothelial cells. The epithelial-to-mesenchymal transition pathway was enriched in LSM correlated proteins in all 3 diseases. The plasma proteome is highly correlated in a disease-specific fashion with LSM in BA, A1AT, and ALGS. These correlations provide unique opportunities to identify biomarkers and focus attention on epithelial-to-mesenchymal transition in pediatric cholestasis.
5. Dementia prevalence in the Wisconsin Longitudinal Study.
期刊: Alzheimer’s & dementia : the journal of the Alzheimer’s Association 发表日期: 2025-Oct 链接: PubMed
摘要
While there is growing appreciation of the importance of sociobiological determinants of dementia, few lifespan cohorts offer well-characterized dementia outcomes to explore these aims. We sought to identify dementia prevalence in the Wisconsin Longitudinal Study (WLS), one of the most comprehensive lifespan cohort studies in the United States. Highlights We found dementia prevalence in the WLS to be 8.9% when this large population-based cohort was sampled at a mean age of 81. Of the identified dementia cases, 79% were clinically determined to be due to a presumed underlying etiology of AD. The targeted multiphased assessment approach used to classify dementia in WLS will be iteratively repeated over time to capture new dementia incidence, complemented by parallel efforts to link WLS with Medicare claims data to identify additional dementia cases among non-respondents or those not selected into the ILIAD sampling frame. Ongoing data collection efforts include in-home blood collection efforts to characterize plasma levels of AD biomarkers in the WLS cohort. When resultant dementia classifications are combined with the robust prospectively collected life course data covering a wide array of socioeconomic, educational, occupational, social, behavioral, and physical health variables, the WLS dataset offers an unparalleled opportunity to investigate the sociobiological determinants of late-life dementia. Using a targeted multiphased assessment approach, participants were first screened for dementia risk using a phone-based cognitive assessment. Those scoring below cut-off underwent additional cognitive/medical assessment to determine a consensus-based cognitive diagnosis and suspected underlying etiology. Cognitive status was determined for 5414 participants, with a dementia prevalence of 8.9% when assessed at a mean age of 81 years. The WLS offers prospectively collected data covering nearly every facet of participant’s lives from high school to late life. When combined with newly defined dementia outcomes, the WLS dataset offers a valuable resource to explore full life course determinants of dementia.
6. Prospective associations between diabetes and depressive symptoms across European regions: a secondary analysis of ELSA, TILDA, and SHARE datasets.
期刊: European journal of public health 发表日期: 2025-Sep-29 链接: PubMed
摘要
This article investigates predictive associations between diabetes and depressive symptoms across Ireland, the United Kingdom, and four European regions. The data were obtained by merging datasets from three large prospective cohort studies-the English Longitudinal Study on Ageing, The Irish Longitudinal study on Ageing, and the Survey on Health, Ageing and Retirement in Europe. We first applied a survival analysis design to two samples of 43 061 and 35 993 participants, investigating elevated depressive symptoms as a risk factor for diabetes, and diabetes as a risk factor for elevated depressive symptoms, respectively. We next applied a multilevel modeling approach to examine depressive symptoms before, during, and after diabetes onset across 101 799 participants. We found a bidirectional association between diabetes and depressive symptoms; however, the strength of these associations did not significantly differ between the regions (P > .01). The results also showed that individuals with newly diagnosed diabetes consistently reported higher depressive symptoms than those without diabetes, even before diagnosis. However, we observed no country-specific differences in the gradual changes in depressive symptoms regardless of participants’ diabetes status. Diabetes at baseline was associated with higher risk of developing depression; and vice versa. These associations were not moderated by geographical location. Therefore, the risks of diabetes and depressive symptoms comorbidity seem to be equal across all observed geographic regions.
7. A Scoping Review of RCT Studies on Community Health Worker Effectiveness.
期刊: Population health management 发表日期: 2025-Sep-29 链接: PubMed
摘要
Community health workers (CHW) play a unique role as trusted frontline public health workers who connect underserved populations with health and social services. In addition, CHWs have local insights on underserved patients and families, which can help to reduce information gaps and enhance the capacity of health care systems to understand health-related social needs. However, prior reviews have included studies of varying quality, which makes it difficult to assess rigorous evidence from randomized control trial (RCT) studies. Also, many CHW intervention studies do not clearly specify in which organizational setting a CHW is employed. This scoping review of US studies published in the peer-reviewed literature from 2000 to 2023 focuses on RCT studies of CHW interventions by type of organization. A total of 39 studies met all inclusion criteria. Most RCT studies were conducted in health care systems and among safety-net providers, including community health centers. However, only a handful of rigorous RCT studies of CHW interventions were conducted in public health agencies or payer settings (managed care organizations). Overall, most RCT studies of CHW interventions found consistent evidence of improved outcomes. Health care organizations can enhance their efforts to address resource gaps by hiring CHWs or partnering with organizations that employ CHWs. Finally, future RCT studies on CHWs employed by health plans (payers) or public health agencies are needed to bolster the growing body of rigorous evidence that CHWs are highly effective in improving patient outcomes across multiple organizational settings.
8. Public health challenges to inclusive workplaces for people with mental disorders in a post-COVID scenario.
期刊: Journal of occupational and environmental medicine 发表日期: 2025-Sep-29 链接: PubMed
摘要
9. Efficacy and Safety of a Digital Tapering Intervention for Patients Prescribed Opioids After Surgery: Protocol for a Prospective Exploratory Cohort Study.
期刊: JMIR research protocols 发表日期: 2025-Sep-29 链接: PubMed
摘要
More than 300 million surgical procedures are performed worldwide each year, and opioids remain a primary approach for managing acute postoperative pain. Studies have demonstrated that a significant number of patients do not discontinue opioid treatment and continue to use opioids for months or even years after surgery. Tapering and management of prescription opioids is a well-known practice and is a part of the current clinical guidelines on safe prescribing. Every patient should receive thorough monitoring, education, and a tapering plan when prescribed opioids or receiving refills after a prolonged treatment. There are challenges associated with tapering, including close follow-up, patient education, clinician time, and withdrawal safety. The evolution of smartphone app use for follow-up has shown promising results in some fields of medicine, and patients are increasingly interested in this approach. The objective of this study is to investigate the efficacy and safety of Prescriby services, comprising clinician management augmented with digital support, as a tapering intervention in patients after knee or hip replacement surgery. Efficacy will be measured in tapers successfully completed, doses successfully lowered during tapering, number of active users, satisfaction with the intervention, and patients successfully remaining off opioid medication at 6 and 12 months after the intervention. Participant safety will be monitored by assessing adverse effects during tapering using the numeric pain rating scale to assess the severity of pain. Participants are recruited via referrals from orthopedic clinics and orthopedic departments in the hospital after surgery during the 6-month study period to the Prescriby clinic, where they will receive a personalized tapering treatment and follow-up with a clinical pharmacist. Despite the existence of numerous clinical guidelines on tapering off dependence-inducing medications, there is limited knowledge of the outcomes of such tapering. This study received funding in February 2024. Data collection for secondary outcomes started in November 2024 and ended in July 2025. Data collection for primary outcomes will start in June 2026 and finish in July 2026. As of manuscript submission in August 2025, 75 patients had been recruited into the study. Analysis of secondary data started in August 2025, and results will be published in the fourth quarter of 2025. Analysis of primary data will start in July 2026, and results will be published in the fourth quarter of 2026. We anticipate that persistent opioid use in standard treatment could be somewhere in the range of 10% to 15%. We hypothesize that the intervention group will have a lower rate of persistent opioid use. With regard to the secondary outcomes, we estimate that more than 85% of the participants in intervention group will be able to taper completely off their opioid medication and anticipate a high degree of satisfaction with the intervention. DERR1-10.2196/72317.
10. Menopause Impact on Multiple Sclerosis Disability Progression.
期刊: JAMA neurology 发表日期: 2025-Sep-29 链接: PubMed
摘要
Most women with multiple sclerosis (MS) will experience menopause while living with MS. Despite this, the impact of menopause on MS disease trajectory remains unclear. To assess whether menopause modifies the risk of disability progression for women with relapse-onset MS. This retrospective cohort study used prospective clinical data that were collected within the MSBase Registry. Data were extracted from MSBase on July 1, 2023. These data were analyzed from January 2023 through February 2025. Female participants were recruited from 8 Australian neuroimmunology specialist centers (1 private practice and 7 tertiary referral centers) from 2018 through 2021. Participants included 1468 women aged 18 years or older who completed dedicated retrospective women’s health surveys. Of these, 987 women with relapse-onset MS, 3 or more Expanded Disability Status Scale (EDSS) measurements recorded, and reported menopausal status were included in the primary analysis. The secondary analysis included 209 women with 1 or more EDSS measurements recorded in the MSBase database predate and postdate of menopause onset. Crude and adjusted Cox proportional hazards models were used to assess the impact of menopause, modeled as a time-varying covariate, on progressive disability milestones. Analyses were adjusted for age at MS onset, baseline disease duration, baseline EDSS score, baseline relapse, and exposure to high-efficacy disease-modifying therapy modeled as a time-varying covariate. In the primary analysis, the main outcome was time to 6-month confirmed disability progression (CDP). The secondary outcome was time to secondary progressive MS (SPMS). The secondary inflection point analysis examined longitudinal changes in EDSS in women who were followed up with throughout their menopausal transition. Primary analysis included 583 premenopausal and 404 postmenopausal women with MS. The median age at menopause was 48.5 years. Following multivariable adjustment, menopause was not associated with an increased risk of CDP or SPMS (hazard ratio, 0.95; 95% CI, 0.70-1.29; P = .70 and hazard ratio, 1.00; 95% CI, 0.60-1.67; P = 1.00), respectively. In the secondary analysis, menopause did not represent an inflection point in EDSS worsening following multivariable adjustment. While reproductive aging may be additive to the effects of somatic aging, these results do not support menopause as the leading factor for disability progression in older women with MS.
11. The Rise in Early-Onset Cancer in the US Population-More Apparent Than Real.
期刊: JAMA internal medicine 发表日期: 2025-Sep-29 链接: PubMed
摘要
Rising rates of early-onset cancer have generated substantial media coverage and public concern. In response, early-onset cancer has become a federal research priority, and clinical guidelines have shifted to recommend earlier screening for some cancers. Yet, it remains unclear whether rising rates represent a true increase in cancer occurrence or that these may instead be explained by increased diagnostic scrutiny. In aggregate, the 8 cancers with the fastest-rising incidence (>1% per year) in US adults younger than 50 years (thyroid, anus, kidney, small intestine, colorectum, endometrium, pancreas, and myeloma) have doubled in incidence since 1992, while the aggregate mortality for these cancers has remained flat. Colorectal and endometrial cancer showed a slight rise in mortality; for the others, stable or declining mortality alongside rising diagnoses suggests that greater detection (rather than more disease) accounts for the trend. In some cancers, such as thyroid and kidney cancer, overdiagnosis is well documented. For others, incidental detection or earlier diagnosis may explain the trends. While not among the fastest growing (0.6% per year), breast cancer remains the most common early-onset cancer, and despite rising diagnoses in women younger than 50 years, mortality has decreased by approximately half. The rise in early-onset cancer incidence does not consistently signal a rise in the occurrence of clinically meaningful cancer. While some of the increase in early-onset cancer is likely clinically meaningful, it appears small and limited to a few cancer sites. Much of the increase appears to reflect increased diagnostic scrutiny and overdiagnosis. Interpreting rising incidence as an epidemic of disease may lead to unnecessary screening and treatment while also diverting attention from other more pressing health threats in young adults.
12. Benefiting Us All-Population-Level Impact of the HPV Vaccine.
期刊: JAMA pediatrics 发表日期: 2025-Sep-29 链接: PubMed
摘要
13. Extending Trauma-Informed Care.
期刊: JAMA 发表日期: 2025-Sep-29 链接: PubMed
摘要
14. Functional Variant Discovery Identifies a Novel Genetic Link Between SPRY2, Wood Smoke, and Asthma.
期刊: American journal of respiratory cell and molecular biology 发表日期: 2025-Sep-29 链接: PubMed
摘要
As a consequence of climate change and land use policies, there has been a historic rise in wildfire smoke across the United States and the world. While the deleterious effects of wildfire smoke and associated air pollution on asthma outcomes are established epidemiologically, genetic risks and molecular mechanisms of how wildfire smoke affects asthma are unknown. This knowledge gap hinders the identification of high-risk individuals and the creation of targeted therapies or recommendations to protect these individuals. We identified 52 genetic risk variants that colocalized with genomic responses to wood smoke particles (WSP), a model of wildfire particulate matter, and associated with asthma in the Genetic Epidemiology Research on Aging (GERA) cohort. We used additional filters to prioritize variants for direct testing of allele-dependent transcriptional regulatory function in plasmid reporters. We found that the rs3861144 variant (Odds Ratioasthma = 1.036) changes SPRY2 responses to WSP in airway epithelial cells, which are involved in Interleukin-8 secretion, Extracellular Signal-related Kinase (ERK) activation, and mechanical scratch repair in cell culture. These findings provide insights into the molecular pathways through which WSP may influence asthma risk and propose genetic candidates that warrant further study for their potential as clinical tools for asthma.
15. Population-Level Effectiveness and Herd Protection 17 Years After HPV Vaccine Introduction.
期刊: JAMA pediatrics 发表日期: 2025-Sep-29 链接: PubMed
摘要
Human papillomavirus (HPV) vaccine clinical trials demonstrate high vaccine efficacy, but postlicensure population-level effectiveness data are needed to inform vaccination and cancer-prevention recommendations and policies. Little is known about effectiveness in adolescent girls and young adult women at high risk for HPV-related cancers or after 9-valent HPV vaccine (9vHPV) introduction. To examine effectiveness and herd protection over the first 17 years after HPV vaccine introduction in adolescent girls and young women at increased risk for HPV infection and related cancers. This cross-sectional study analyzed data from 6 surveillance studies from 2006 to 2023. A consecutive sample of sexually experienced adolescent girls and young women aged 13 to 26 years was recruited from clinical settings. Participants were stratified by HPV vaccination status; those who received at least 1 vaccine dose were defined as vaccinated. Effectiveness and herd protection were assessed by comparing proportions of vaccinated and unvaccinated participants positive for at least 1 type in the 2-valent vaccine (2vHPV), 4-valent vaccine (4vHPV), and 9vHPV in each of 6 studies. The prevalence of vaccine-type HPV was compared in vaccinated participants from surveillance studies 2 through 6 vs participants recruited in surveillance study 1, all of whom were unvaccinated. Inverse probability of treatment weighting with propensity score was used to balance between-wave differences in participant characteristics. Of 2335 participants (mean [SD] age, 18.9 [2.7] years; 1526 African American [65.4%], 13 Asian [0.6%], 6 Native American [0.3%], 582 White [24.9%], and 151 multiracial [6.5%]; 173 Hispanic [7.4%]), 1195 participants (51.2%) reported a sexually transmitted infection history and 1843 participants (78.9%) reported 2 or more male sex partners. Vaccination rates increased from 0 of 371 participants to 330 of 402 participants (82.1%) from 2006 to 2023. Among vaccinated participants, positivity decreased from 93 of 371 participants (27.7%) to 1 of 330 participants (0.4%) for 2vHPV (relative difference, 98.4%), 118 participants (35.4%) to 3 participants (2.1%) for 4vHPV (relative difference, 94.2%), and 163 participants (48.6%) to 21 participants (11.8%) for 9vHPV (relative difference, 75.7%). Among unvaccinated participants, positivity decreased from 93 of 371 participants (25.8%) to 3 of 72 participants (7.3%) for 2vHPV (relative difference, 71.6%), 118 participants (25.3%) to 4 participants (6.1%) for 4vHPV (relative difference, 75.8%), and 163 participants (42.7%) to 13 participants (31.1%) for 9vHPV (relative difference, 27.2%). For positivity rates, counts are raw numbers and percentages are propensity score adjusted. Adjusted logistic regression demonstrated significant reductions in the odds of at least 1 HPV type in the 2vHPV and 4vHPV among all (adjusted odds ratio [aOR], 0.03; 95% CI, 0.01 to 0.07 and aOR, 0.06; 95% CI, 0.03 to 0.10, respectively), vaccinated (aOR, 0.01; 95% CI, <0.01 to 0.05 and aOR, 0.04; 95% CI, 0.02 to 0.08, respectively), and unvaccinated (aOR, 0.23; 95% CI, 0.08 to 0.63 and aOR, 0.19; 95% CI, 0.07 to 0.52, respectively) participants and in the 9vHPV among all (aOR, 0.22; 95% CI 0.16 to 0.31) and vaccinated (aOR, 0.14; 95% CI 0.09 to 0.21) participants. In this study, population-level effectiveness and herd protection were robust 17 years after HPV vaccine introduction, even in sexually experienced adolescent girls and young women at relatively high risk for HPV who may not have received the full vaccination series.
16. What RSV Is and Why Immunization Matters.
期刊: JAMA pediatrics 发表日期: 2025-Sep-29 链接: PubMed
摘要
This JAMA Pediatrics Patient Page describes respiratory syncytial virus (RSV) in children and how to prevent its spread.
17. Modeling the Health Impact of Discontinuing COVID-19 Vaccination During Pregnancy in the US.
期刊: JAMA pediatrics 发表日期: 2025-Sep-29 链接: PubMed
摘要
This decision analytical model study estimates the number of avertable COVID-19 hospitalizations in US infants younger than 6 months and pregnant persons with vaccinations during pregnancy.
18. Adverse Pregnancy Outcomes and Cognitive Change in Older Women.
期刊: Journal of women’s health (2002) 发表日期: 2025-Sep-29 链接: PubMed
摘要
Introduction: Whether the history of adverse pregnancy outcomes (APOs) contributes to cognitive decline in women is unclear. Methods: Among parous female Adult Changes in Thought (ACT) participants (aged ≥ 65 years without dementia at enrollment), we abstracted APO history for those born 1940 or later and enrolled between 2005 and 2020 (n = 444). Generalized estimating equations estimated the association between APO history and cognition score, measured using the Cognitive Abilities Screening Instrument assessment using item response theory (CASI-IRT), and cognitive decline. Results: Among all participants, 13% had a history of APO. In adjusted models, women with an APO history had 0.23-point lower CASI-IRT score at any age (95% confidence interval: -0.54, 0.07); this small difference was not statistically significant. We found no evidence of an association between APO history and 4-year cognitive change. Conclusion: Among women in the ACT study born in 1940 or later, we found no evidence of a significant association between history of APO and lower cognition or cognitive decline in older adulthood.
19. Epidemiology of Injury in Elite and Amateur Soccer Referees: A Systematic Review and Meta-analysis.
期刊: Sports medicine (Auckland, N.Z.) 发表日期: 2025-Sep-29 链接: PubMed
摘要
The epidemiology of injury in soccer has traditionally focused on soccer players, rather than match officials. Although injury data on referees exist, no comprehensive review has summarized injury profiles in this population. To conduct a systematic review and meta-analysis of injury epidemiology in elite and amateur soccer referees, focusing on injury rates, types, locations, severity, and causes. PubMed (Medline), Web of Science, Scopus, CINAHL, and SPORTDiscus, covering their entire history up to 19 April 2025 were searched. This review included prospective and retrospective studies reporting injury incidence or prevalence among football match officials, with a study period of at least one season. Studies needed to specify injury definitions and include data on injury location, type, mechanism, or severity. Both male and female officials were eligible. Systematic reviews, commentaries, and letters were excluded. Study quality and risk of bias were evaluated using the STROBE-SIIS, in addition to the Newcastle-Ottawa Scale and funnel plots. Injury incidence rates were estimated using a random effects Poisson regression, accounting for heterogeneity and moderators. Heterogeneity was assessed with the I2 statistic. A total of 17 studies were included, encompassing 3621 referees. The most frequent injuries were strains and sprains in the knee and ankle. The overall injury incidence was 2.19 injuries per 1000 h of exposure (95% CI 1.30-3.69). On-field referees experienced an incidence rate of 1.46 injuries per 1000 h of exposure (95% CI 0.76-2.81), while assistant referees had a lower rate of 0.84 per 1 h of exposure (95% CI 0.36-1.97). During matches, the injury incidence was 2.24 per 1000 h of exposure (95% CI 1.38-3.64), compared with 0.67 injuries per 1000 h of exposure during training sessions (95% CI 0.36-1.24). However, despite sensitivity analysis, there were still high levels of heterogeneity across included studies. Findings noted higher injury incidence during matches compared with training, and on-field referees compared with assistants. The variation in injury profiles highlights the importance of implementing targeted preventive strategies tailored to the unique demands of refereeing. However, there is still a lack of research in this population, especially in female referees. CRD42024497970.
20. Variation in US Commercial Health Plan Coverage Restrictions for Cell and Gene Therapies.
期刊: JAMA 发表日期: 2025-Sep-29 链接: PubMed
摘要
This Viewpoint examines variations in US commercial health plan coverage restrictions for cell and gene therapies.
21. Genetics services in Latin America: a descriptive study of availability and utilization of genetics in healthcare.
期刊: Journal of community genetics 发表日期: 2025-Sep-29 链接: PubMed
摘要
22. Adverse health outcomes associated with drinking highly saline water: a systematic review.
期刊: European journal of epidemiology 发表日期: 2025-Sep-29 链接: PubMed
摘要
In climate change-affected coastal areas, sea level rise, storm surges, droughts and altered rainfalls are significantly increasing salinity levels in drinking water sources. This is a major public health problem that affects many millions of people. We systematically reviewed and assessed the strength and quality of the evidence on the relationship between drinking water with high sodium levels (> 200 mgNa/l) and adverse cardiovascular, renal, and pregnancy-related health outcomes, following the PRISMA guidelines, the ROBINS-E Cochrane tool and the Navigation Guide. From five bibliographic databases, we identified 22 relevant studies, some of which assessed more than one health domain. The evidence was of moderate quality and strength. 14 analyses from eight studies at low risk of bias and four studies at moderate risk of bias, linked drinking high-salinity water to adverse health outcomes including hypertension and cardiovascular disease, impaired renal function, gestational hypertension and preeclampsia, and higher infant mortality. Eight studies were inconclusive. Three analyses, of which two at low risk of bias, associated drinking high-salinity water to improved health outcomes. Overall, our findings suggest that salinisation of drinking water sources is likely to increase adverse cardiovascular, renal, and pregnancy-related health outcomes. This conclusion highlights the importance of effective and timely adaptation at scale, and calls for a revision of the WHO guidelines for the intake of salt from water. The latest WHO guidelines (2022) do not set any health-based standard for sodium levels in drinking water, a problem that affects millions of people and will worsen with climate change.
23. Eastern healthy dietary patterns in relation to all-cause mortality.
期刊: European journal of nutrition 发表日期: 2025-Sep-29 链接: PubMed
摘要
Existing studies have mainly focused on healthy dietary patterns proposed based on Western populations, whereas the Eastern healthy dietary patterns (EHDP) recommended by the Chinese Dietary Guidelines have been rarely studied. This study aimed to investigate the association of the EHDP with all-cause mortality among Chinese adults. This study used cohort data from the China Health and Nutrition Survey (CHNS, with seven waves collected from 1997 to 2015). 10,436 participants aged over 18 years were included in our analysis. Adherence to the EHDP was evaluated in terms of the Dietary Diversity Score (DDS) and the Chinese Healthy Eating Index (CHEI). Time-varying Cox regression models were adopted to investigate the association between the EHDP and mortality. A higher DDS was associated with reduced mortality risk. Compared with the lowest tertile, participants with the highest tertile of DDS had a 38% decreased risk of all-cause mortality (HR: 0.62, 95% CI 0.46, 0.84). Increasing CHEI was also associated with a lower risk of mortality. Each ten-unit increase in CHEI was associated with a reduction of the mortality risk by 18% (HR: 0.82, 95% CI 0.75, 0.89). We further examined the combined associations between DDS, CHEI, and mortality. Dividing the participants into four groups based on the median values of DDS and CHEI, the group with both DDS and CHEI above the median had a lower risk of mortality than the group with lower DDS and CHEI. Adherence to the EHDP was associated with a reduced risk of mortality among Chinese adults.
24. Role of the gastroenterologist in the comprehensive management of people living with obesity. SEPD Position Paper.
期刊: Revista espanola de enfermedades digestivas 发表日期: 2025-Sep-29 链接: PubMed
摘要
Obesity represents the most prevalent chronic metabolic disease and one of the greatest healthcare and social challenges of our time. Its close association with multiple digestive disorders-including metabolic dysfunction-associated steatotic liver disease (MASLD), various digestive cancers, inflammatory bowel disease, and gastroesophageal reflux disease-positions the gastroenterologist as a key actor in its detection, stratification, and comprehensive management. The SEPD position statement underscores the need to move beyond a complication-centered approach and to establish the gastroenterology consultation as a privileged entry point for the care of individuals living with obesity. SEPD advocates for a digestive-centered framework that integrates prevention, advanced diagnostics, pharmacological therapies, endoscopy, and surgery within a continuum of care led by gastroenterologists. Distinctively, the position statement incorporates metabolic endoscopy as a minimally invasive and cost-effective alternative, serving as a bridge between pharmacological treatment and surgery-an area in which Spanish gastroenterologists have developed recognized expertise and international leadership. It also promotes a stigma-free approach, calling for respectful and equitable language as part of the society’s explicit ethical commitment. Furthermore, SEPD emphasizes the importance of real-world registries focused on digestive outcomes, fostering collaborative research and the generation of evidence applicable to both clinical practice and health policy. Taken together, this document reaffirms SEPD’s clinical, scientific, and social commitment in the fight against obesity, advancing an innovative, person-centered, interdisciplinary, and humanistic approach aimed at transforming healthcare delivery and decisively contributing to the improvement of digestive and overall population health.
25. Association between rivaroxaban and the prognosis of patients with acute myocardial infarction and new-onset atrial fibrillation.
期刊: Postgraduate medical journal 发表日期: 2025-Sep-29 链接: PubMed
摘要
New-onset atrial fibrillation (AF) in the setting of acute myocardial infarction (AMI) is associated with higher risks of stroke and mortality. However, current guidelines lack specific antithrombotic recommendations for this population. This study aimed to explore the association between rivaroxaban and the prognosis of patients with AMI and new-onset AF. This retrospective cohort study included patients with AMI and new-onset AF receiving dual antiplatelet therapy between August 2016 and June 2023 in Tianjin, China. New-onset AF (transient or nontransient) was defined as the first diagnosis of AF following AMI. The primary outcome was stroke. 2477 patients were identified, including 141 rivaroxaban users and 2336 patients without oral anticoagulants (OAC). Over a median follow-up of 922 days, rivaroxaban users had a 5.7% lower risk of stroke than non-OAC users, although this was not statistically significant (19.9% vs. 25.6%; P = .152). Despite the suggestion of a protective trend, multivariable Cox regression showed that rivaroxaban use was not associated with a lower risk of stroke (hazard ratio, 0.77; 95% confidence interval, 0.52-1.13, P = .187). After propensity score matching, 155 transient (rivaroxaban: 42; non-OAC: 113) and 295 nontransient AF patients (rivaroxaban: 85; non-OAC: 210) were included. No significant association was observed between rivaroxaban and stroke, ischemic stroke, hemorrhagic stroke, all-cause mortality, cardiovascular mortality, bleeding, or major bleeding. No significant association was observed between rivaroxaban and clinical outcomes in patients with AMI and new-onset AF. Given the small sample size and limited statistical power, the findings are exploratory and require further validation. Key messages What is already known on this topic: Evidence from previous studies indicates that acute myocardial infarction (AMI) patients with new-onset atrial fibrillation (AF) are associated with higher risks of ischemic stroke and mortality. However, the association between rivaroxaban and the prognosis of patients with AMI and new-onset AF remains uncertain. What this study adds: Among patients with AMI and new-onset AF receiving dual antiplatelet therapy, no significant differences were observed between rivaroxaban users and non-oral anticoagulant users in terms of the risks of stroke, ischemic stroke, hemorrhagic stroke, all-cause mortality, cardiovascular mortality, bleeding, or major bleeding. However, these results should be interpreted with caution due to the small sample size and limited statistical power of the study. How this study might affect research, practice or policy: Future prospective large-scale studies and randomized controlled trials are needed to further examine the role of rivaroxaban and other types of oral anticoagulants in patients with AMI and new-onset AF.
26. Pneumoconiosis and the subsequent risk of dementia: a retrospective cohort study.
期刊: Postgraduate medical journal 发表日期: 2025-Sep-29 链接: PubMed
摘要
Pneumoconiosis has been recognized as a risk factor for systemic diseases; however, its association with dementia remains unclear. This study aims to investigate the association of pneumoconiosis with the subsequent risk of dementia. This retrospective cohort study used data from Taiwan’s National Health Insurance database. The pneumoconiosis cohort included 17 871 patients diagnosed with pneumoconiosis from 2009 to 2020. A comparison cohort of 71 484 individuals without pneumoconiosis was matched in a 1:4 ratio in terms of age, sex, and diagnostic date. All study participants were followed up until the end of 2020 to evaluate dementia incidence. The incidence of dementia in the pneumoconiosis cohort was 17.6 per 1000 person-years, which was significantly higher than the 12.3 per 1000 person-years in the control group. Age-stratified analysis revealed that patients aged 65-74 years (aHR = 1.26, 95% CI = 1.15-1.38) and ≥75 years (aHR = 1.49, 95% CI = 1.38-1.60) demonstrated a significantly increased risk. Sex-specific analysis revealed that both men (aHR = 1.39, 95% CI = 1.31-1.48) and women (aHR = 1.30, 95% CI = 1.11-1.51) exhibited a significantly increased risk. Further, the frequency of emergency department visits among patients with pneumoconiosis was positively associated with dementia risk. Utilizing a large-scale medical database, this study reveals that patients with pneumoconiosis demonstrated a significantly increased risk of developing dementia. Early cognitive function screening is recommended for this population to reduce disability and improve long-term outcomes. Key messages What is already known on this topic: Pneumoconiosis has considerable comorbidities, particularly pulmonary and cardiovascular diseases. However, the association between pneumoconiosis and dementia is largely unknown. What this study adds: The nationwide, population-based, retrospective cohort study revealed that patients with pneumoconiosis had a significantly higher risk of dementia than those without pneumoconiosis. How this study might affect research, practice, or policy: Greater emphasis on early cognitive function screening in this population may help to reduce disability rates and enhance long-term outcomes.
27. Caffeine in Preterm Infants and its Effect on Neonatal Sleep: A Systematic Review.
期刊: Journal of clinical pharmacology 发表日期: 2025-Sep-29 链接: PubMed
摘要
The development of good-quality sleep is very important in early life. Sleep promotion programs aim to increase preterm infants’ sleep quality because preterm infants in the neonatal intensive care unit (NICU) have poor sleep. Interestingly, the majority of preterm infants are treated with caffeine, a nervous system stimulant. The primary objective of this systematic review was therefore to appraise the current evidence concerning potentially sleep-disruptive effects of caffeine in preterm infants within the first month of life. We performed a search (PROSPERO protocol CRD42022273596) according to PRISMA guidelines in PubMed, Embase, Scopus, and PsycInfo (as well as CENTRAL). We looked for studies involving preterm infants (<37 weeks of gestational age) treated with caffeine in the NICU, with sleep measures acquired within the first month of life. Eight studies met the eligibility criteria. Underlying effect sizes for main outcomes are represented using albatross plots. Among studies reporting on wakefulness (N = 213), 83.33% detected significant disruptions (P < .05). Among studies reporting on sensorimotor functioning (N = 80), 100% detected significant reductions (P < .05). Moreover, significant reductions (P < .05) in sleep states were detected. Available evidence suggests that caffeine exposure in preterm infants may produce alterations in sleep-wake and sensorimotor functioning, and related processes during the first month of life. The overall evidence is mixed, with some studies reporting no effect of caffeine exposure on neonatal sleep. Additional research is needed to understand how caffeine alters the quality of neonatal sleep in preterm infants and whether the effects may differ among infant subgroups. There is a continued need to investigate and support sleep quality in preterm infants during their NICU stay.
28. The Effect of an Educational Intervention Based on the Theory of Planned Behavior on Preventing Drug Relapse Among Men with Substance Use Disorder.
期刊: Substance use & misuse 发表日期: 2025-Sep-29 链接: PubMed
摘要
Drug abuse has severe physical and psychological consequences, contributing to family and social instability. Given the challenges of substance use disorders, prevention is crucial. This study aimed to evaluate the effect of an educational intervention based on the Theory of Planned Behavior (TPB) on preventing drug relapse among those with substance use disorder in treatment centers in Shiraz. This experimental study included 200 drug-dependent individuals undergoing methadone and buprenorphine treatment. Participants were selected through convenience sampling and randomly assigned to intervention and control groups. Data were collected using a validated researcher-made questionnaire based on TPB and the Billings & Moos Coping Strategies Questionnaire. The intervention consisted of 14 training sessions (50-55 min each), using lectures, discussions, visual aids, and videos. Before the intervention, the groups had no significant differences in knowledge, attitude, subjective norms, perceived behavioral control, or coping strategies. Six months after the intervention, the intervention group showed significant improvements in these areas compared to the control group. The relapse rate was significantly lower in the intervention group. The TPB-based intervention effectively improved awareness, attitude, perceived behavioral control, and coping strategies, reducing relapse rates. Implementing such educational programs in treatment centers can enhance long-term recovery outcomes.
29. Mobiliser l'action en faveur de la promotion de la santé dans le paysage géopolitique actuel.
期刊: Global health promotion 发表日期: 2025-Sep-29 链接: PubMed
摘要
30. The Impact of Nurse Staffing and Education on 30-Day Mortality Among Patients Hospitalized for Acute Kidney Injury.
期刊: Research in nursing & health 发表日期: 2025-Sep-29 链接: PubMed
摘要
Acute kidney injury (AKI) affects approximately 20% of hospitalized patients and is associated with higher mortality, extended hospital stay, and increased costs. While various strategies have been proposed to improve AKI management, the impact of nursing resources on AKI outcomes has not been explored. We sought to examine the association between nursing resources and 30-day mortality among patients hospitalized with AKI. Using a cross-sectional study design, we linked data from the CMS Medicare Provider Analysis and Review file, American Hospital Association Annual Survey, and RN4CAST-NY/IL survey of registered nurses. We identified 24,368 Medicare beneficiaries aged 18-99 years with a primary diagnosis of AKI hospitalized in 155 hospitals in New York and Illinois in 2021. The primary outcome was 30-day mortality. Key independent variables included nurse staffing (patient-to-nurse ratio) and nurse education (proportion of nurses holding a bachelor’s degree or higher). Covariates were patient demographics, comorbidities, and hospital characteristics. The 30-day mortality rate was 10.5%. In adjusted logistic regression models, each additional patient per RN increased the odds of 30-day mortality by 7% (OR = 1.07, 95% CI [1.01-1.13], p < 0.05). For each 10-point increase in the proportion of nurses with a bachelor’s degree or higher, the odds of 30-day mortality decreased by 9% (OR = 0.91, 95% CI [0.88-0.95], p < 0.001). Better nurse staffing and higher proportions of nurses with a bachelor’s degree or higher are associated with lower 30-day mortality among patients hospitalized with AKI. These findings underscore the significance of nursing in AKI outcomes and suggest that hospitals should prioritize investing in nursing resources to enhance AKI outcomes.
31. Master's Degree Nurses: A Mixed-Methods Study on Supply, Demand, and Utilisation.
期刊: Journal of advanced nursing 发表日期: 2025-Sep-29 链接: PubMed
摘要
To assess the supply, demand, and utilisation of master’s degree nurses in China’s top-tier hospitals and identify recruitment and retention challenges. A convergent parallel mixed-methods design. From January and September 2022, eight top-tier hospitals in mainland China were selected using convenience sampling. The proportion of master’s degree nurses, turnover rates, and recruitment outcomes were investigated and analysed using descriptive statistics. Concurrently, seven nursing administrators from these eight hospitals were interviewed using semi-structured interviews, and transcribed data were thematically analysed through inductive content analysis. Among the eight hospitals surveyed, the average proportion of master’s degree nurses was 3.58% (range: 0.58%-9.43%). The average ratio of planned to actual recruitment was 3.28, with four hospitals showing near parity (approximately 1:1) and three institutions failing to recruit any master’s degree nurses. The annual turnover rate of master’s degree nurses was 1.18%. Three themes emerged from the qualitative analysis: (1) shortages coexisting with oversupply; (2) nursing leaders’ retention efforts versus limited institutional policy support; and (3) prioritisation of research and management over advanced clinical roles. In China, even among top-tier hospitals, the proportion of master’s degree nurses remains relatively low. There is an overall shortage of these nurses, juxtaposed with localised oversupply in specific institutions. Promotion to nursing supervisor or administrative roles is the only developmental pathway, while structured career progression pathways for advanced nursing practice remain conspicuously absent. The study highlights the need to develop targeted policies that support the career advancement of master’s degree nurses, particularly by expanding career options in Advanced Practice Nurses (APNs) rather than limiting roles to nursing management or education. This shift would better leverage their clinical expertise and strengthen healthcare systems through specialised practice and innovation. What problem did the study address?: This study maps the supply-demand dynamics of master’s degree nurses in leading hospitals and identifies retention, utilisation, and motivation policies and strategies from the perspective of nursing administrators. What were the main findings?: The proportion of master’s degree nurses is low in China’s top hospitals. There is both an oversupply and a shortage of master’s degree nurses. Neither the government nor hospitals have policies in place to encourage the clinical involvement of master’s degree nurses, and their career progression is limited to managerial roles. Where and on whom will the research have an impact?: Nursing administrators and other health policy makers in China and comparable global health systems will be affected. It will also influence nursing associations, nursing educators, and general nurses. This study adhered to the Mixed Methods Article Reporting Standards. No contributions from patients or the public were involved in this study.
32. Longitudinal assessment of disease burden in juvenile systemic lupus erythematosus: A multicenter study of activity and damage scores.
期刊: Lupus 发表日期: 2025-Sep-29 链接: PubMed
摘要
IntroductionJuvenile Systemic Lupus Erythematosus (jSLE) is a rare pediatric rheumatic disease characterized by systemic inflammation that can lead to organ damage. Compared to adults, it often has a more severe course in children. Both disease activity and treatments may result in temporary or permanent damage.ObjectivesTo evaluate risk factors associated with damage occurrence in patients with jSLE.MethodsThis multicenter, retrospective study included patients with jSLE followed for at least 12 months. Low-dose corticosteroid therapy was defined as prednisolone 0.01-0.03 mg/kg/day (max 7.5 mg/day). The annual cumulative steroid dose was calculated by dividing the total steroid intake by 365.25 times the number of follow-up years. Collected data included SLEDAI and SDI scores at initial and final visits, laboratory parameters, and flare characteristics.ResultsA total of 158 patients (86.7% female) from 17 centers were included. Median age at diagnosis was 13.8 years, with a median follow-up of 35 months. Organ damage was present in 14 patients at diagnosis and in 23 at final visit. Damage types included proteinuria, cognitive dysfunction (each 3.2%), and others such as cataracts, erosive arthritis, avascular necrosis, optic atrophy, and vertebral collapse. Patients with damage had significantly higher SLEDAI scores at both time points, delayed transition to low-dose steroids, and a lower rate of achieving Lupus Low Disease Activity State (LLDAS) (p = .006).ConclusionPersistent disease activity and delayed control are major contributors to organ damage in jSLE. Early and sustained disease suppression is critical to prevent long-term complications.
33. Using the PREVENT Equations to Guide Aspirin Use for Primary Prevention of Cardiovascular Disease.
期刊: JAMA internal medicine 发表日期: 2025-Sep-29 链接: PubMed
摘要
This cross-sectional study examines eligibility for aspirin for the primary prevention of cardiovascular disease based on the pooled cohort equations and the Predicting Risk of Cardiovascular Disease EVENTs equations.
34. Impact of Wasting on the Severity of Rotavirus and Non-rotavirus Diarrhea in Children Aged Under 5 Years Hospitalized with Acute Gastroenteritis in Kerala, India.
期刊: Indian journal of pediatrics 发表日期: 2025-Sep-29 链接: PubMed
摘要
This analysis assessed the relationship between wasting and severity of rotavirus and non-rotavirus diarrhea among children hospitalized with acute gastroenteritis in Kerala. Children aged under 5 y admitted to sentinel hospitals in North, Central, and South Kerala with acute gastroenteritis between November 2020 and December 2023 were prospectively enrolled. Sociodemographic, anthropometric, and clinical data were collected using a case report form, and stool samples were tested for rotavirus using an enzyme-linked immunosorbent assay. Anthropometry was performed according to World Health Organization guidelines. Of the 1,142 children aged under 5 y admitted to the sentinel hospitals with acute gastroenteritis during the study period, 666 were enrolled in the study. Of the 643 children with stool samples tested for rotavirus, 115 (17.7%) were positive for rotavirus. Compared with children with wasting, children without wasting were (significantly more likely to have received ≥ 1 dose of rotavirus vaccine (69.5% vs. 60.2%; p = 0.022). In a subgroup analysis of children with wasting, compared with rotavirus-negative children, rotavirus-positive children were significantly more likely to develop severe to very severe disease (odds ratio: 5.31, 95% confidence interval: 2.28-12.34; p = 0.001). In children with wasting, rotavirus diarrhea was more severe than non-rotavirus diarrhea. Strategies to prevent and treat diarrhea should target children with wasting, who are at greater risk of severe disease. Maintaining high rotavirus vaccination coverage and measures to reduce the incidence of wasting are necessary to reduce incidence of severe diarrhea.
35. Deciphering key chemotherapeutic drug targets within tyrosine metabolism for breast cancer and advancing a wide-ranging diagnostic strategy.
期刊: Discover oncology 发表日期: 2025-Sep-29 链接: PubMed
摘要
The impact of tyrosine metabolism on the early diagnosis and treatment of breast cancer remains unclear. This underlines importance of exploring its mechanisms. This study conducted an integrated analysis of breast cancer transcriptome data from the TCGA and GEO databases, utilizing differential expression analysis, enrichment analysis, immune infiltration analysis, single-cell RNA sequencing analysis, hdWGCNA analysis, and molecular docking to investigate the role of tyrosine metabolism in breast cancer and its relationship with chemotherapy response. The co-expression prognosis model of tyrosine metabolism developed in this study demonstrated superior performance in the prognostic assessment of breast cancer, achieving an AUC value of 0.735, surpassing traditional clinical indicators. The identified two key genes(MAOA, MAOB) and their interaction network showed significant value in the diagnosis and prognosis of breast cancer. Moreover, the early diagnosis model “Extra Trees (BO)” developed using machine learning algorithms exhibited excellent stability and generalization capability. These findings not only highlight the critical role of tyrosine metabolism in regulating the tumor immune microenvironment but also mark Monoamine oxidase A (MAOA) and Monoamine oxidase B (MAOB) as important potential biomarkers linking immunotherapy and chemotherapy. This research provides an effective model for the prognostic assessment and early diagnosis of breast cancer, opening new avenues for research into the precision treatment of breast cancer and the management of chemotherapy side effects.
36. SMPD2 affects the prognosis of cancer patients by mediating lipid metabolism and the immune microenvironment.
期刊: Discover oncology 发表日期: 2025-Sep-29 链接: PubMed
摘要
The gene Sphingomyelin phosphodiesterase 2 (SMPD2), a member of the SMPD family, plays crucial roles in cell cycle progression and cell proliferation. However, the pathogenic implications of SMPD2 across various cancers remain poorly understood. Its potential involvement in lipid metabolism and immune-related processes within the tumor microenvironment has not been systematically characterized. To address these gaps, we conducted a comprehensive pan-cancer analysis of SMPD2. Using a range of computational tools, we investigated its role in tumor immune infiltration, immune evasion, tumor progression, therapy response, and prognosis across various cancer types. Our findings suggest that SMPD2 is widely expressed across cancers in The Cancer Genome Atlas (TCGA) and its expression levels are associated with tumor stages and clinical outcomes. Additionally, SMPD2 was found to be involved in tumor immune evasion across different cancer types. The methylation status of SMPD2 was inversely correlated with its mRNA expression levels, which were associated with dysfunctional T cell phenotypes and worse prognoses in diverse cancer cohorts. Furthermore, SMPD2 expression was linked to heterogeneous therapeutic outcomes across multiple cancer types, including variable responses to immune checkpoint blockade. Interestingly, SMPD2 demonstrated superior predictive capacity for treatment response and overall survival in immune checkpoint blockade sub-cohorts compared to three of the seven established biomarkers. While functional experiments are warranted, our results provide a data-driven, pan-cancer landscape of SMPD2 expression and its potential relevance to immune modulation and clinical outcomes Overall, SMPD2 may serve as a candidate biomarker for cancer prognosis and therapeutic response, and a potential target for future mechanistic studies.
37. Antifungal potential of hydrothermal liquefaction wastewater in plant protection.
期刊: World journal of microbiology & biotechnology 发表日期: 2025-Sep-29 链接: PubMed
摘要
This study investigates the antifungal potential of hydrothermal liquefaction (HTL) wastewater against Verticillium dahliae and its effects on the growth of pepper plants (Capsicum annuum L.). The HTL process generates wastewater containing various antimicrobial compounds, which can offer a sustainable alternative for plant protection. In this research, the biological control agent Trichoderma virens and HTL wastewater were applied both individually and in combination to assess their impact on plant growth and pathogen suppression. The results demonstrated that specific HTL wastewater treatments significantly enhanced root and shoot growth, biomass, and chlorophyll content in pepper plants. Plant growth observed in pathogen-free conditions may be related to the stimulation of plant physiology by biologically active components contained in wastewater, indicating a biostimulatory effect. Notably, the 4th wastewater mixture (wm) exhibited the highest efficacy, promoting plant development and mitigating the negative effects of V. dahliae. The combination of T. virens and wastewater also showed synergistic effects, reducing disease severity by up to 64% and improving plant biomass and structural parameters. Statistical analysis revealed significant differences among treatments, highlighting the potential of HTL wastewater as a natural and sustainable strategy for managing soil-borne pathogens. These findings suggest that integrating HTL wastewater with biocontrol agents could offer a promising approach to sustainable agriculture.
38. Leveraging MobileNetV2 and deep learning innovation for high accuracy Plasmodium Vivax detection in blood smears.
期刊: Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society 发表日期: 2025-Sep-29 链接: PubMed
摘要
Malaria remains a significant public health challenge in regions where it is endemic. Pregnant women and young children are particularly vulnerable to the disease. Effective and timely diagnostic methods are crucial for reducing severe health outcomes. These methods help prevent deaths and lessen the widespread clinical and epidemiological burden on at-risk populations. However, traditional methods involved in the process of malaria parasite detections such as microscopic examination of blood smear by medical trained technicians is known to be time consuming, purely subjective and highly prone to errors. Therefore, Artificial Intelligence (AI) based OD (Object Detection) model like YOLO are preferred for overcoming these issues faced by traditional approaches as YOLO is known to be more rapid and precise by predicting bounding boxes and class probabilities than other models. However, existing YOLO model face challenges such as higher localization error, struggle with small objects and better accuracy of the model. Therefore, proposed research work focuses on employing YOLOv3 model with modified MobileNetv2 in backbone structure for classifying Plasmodium vivax (P. vivax) cells with the aim of improving the performance and speed of the model for detecting objects as MobileNetv2 is known for its faster processing and reduced resource consumption. However, accuracy is still measured as one of the key downsides for detecting and classifying the classes of thin blood smear, therefore modified MobileNetv2 is used, where proposed TCL (Transformed Convolution Layer) is employed at bottleneck layer, where weights are calculated based on different classes of image features thereby making the process more effective for classifying the infected and uninfected malaria cells of thin blood smear images effective. Besides, the performance of the proposed model is evaluated by implementing different metrics where the findings obtained are accuracy value of 1.00, precision value of 0.98, recall of 0.98, F1 score of 0.97 and mean average precision (mAP) value of 0.90. The major contribution of the study focuses on providing a better diagnostic approach for medical professionals in order to obtain improved results.
39. MALAT1/miR-181b axis mediates the anti-bacterial and anti-inflammatory effects of Galla chinensis in the progression of dental caries : Short title: mechanism of Galla chinensis in dental caries.
期刊: Clinical oral investigations 发表日期: 2025-Sep-29 链接: PubMed
摘要
Dental caries is a common oral disease that seriously affects the oral health and quality of life of patients. The aim of this study is to investigate the anti-bacterial and anti-inflammatory effects of Galla chinensis (GC) in dental caries, and explore the underlying mechanisms based on non-coding RNAs. Mouse and cell models were established by bacterial infection method and LPS induction. The growth of Streptococcus mutans (S. mutans) was detected by growth curves and acid production experiments. ELISA was used to evaluated inflammatory responses, and the effect of GC on the viability of human dental pulp stem cells (HDPSCs) was analyzed by CCK-8 assay. The regulation of MALAT1 and miR-181b expression by GC was detected by qRT-PCR, and the role of the MALAT1/miR-181b axis in the function of GC was examined using rescue experiments by assessing cell and bacterial viability, inflammation and S. mutans infection. GC significantly inhibited the growth and acid production of S. mutans, the levels of inflammatory factors and MALAT1 levels, and promoted miR-181b expression in both cell and animal models. Additionally, the proliferation of disease cell model was elevated by GC. miR-181b as a target of MALAT1, was inhibited by MALAT1 in cell model, and the MALAT1/miR-181b axis was found to mediate the regulatory effects of GC on S. mutans growth, infection-induced inflammatory, HDPSC viability and inflammation. GC inhibits S. mutans growth and inflammatory responses in cells and animal models through the MALAT1/miR-181b axis. This study highlights the potential clinical value of targeting the MALAT1/miR-181b axis with GC, which may offer a novel therapeutic strategy for the prevention and treatment of dental caries in clinical practice.
40. Association between fish consumption and mortality risk from overall cardiovascular disease and its subtypes: a 20-year prospective cohort analysis by sex.
期刊: European journal of nutrition 发表日期: 2025-Sep-29 链接: PubMed
摘要
To investigate the association between fish consumption and mortality risk related to cardiovascular disease (CVD) and its subtypes among Korean adults by sex. A total of 110,134 adults were selected from the Ansan-Ansung and Health Examinees cohorts in the Korean Genome and Epidemiology Study. Fish consumption was assessed using a food frequency questionnaire and categorized into four groups: < 2, 2-4, 4-7, and ≥ 7 servings/week. CVD mortality was determined from 2001 to 2021 death records provided by Statistics Korea. Cox proportional hazards regression was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality across fish consumption. Restricted cubic spline regressions were conducted to examine nonlinear dose-response relationships between weekly fish consumption and CVD mortality. Among women, higher fish consumption was associated with a lower risk of CVD mortality (≥ 7 servings/week vs. < 2 servings/week: HR 0.76, 95% CI 0.54-1.07, P trend = 0.029). By CVD subtypes, higher fish consumption showed a significant inverse association with the risk of cerebrovascular disease mortality in women. Among men, fish consumption was not significantly associated with mortality risk related to CVD or its subtypes. A significant nonlinear inverse association with overall CVD mortality was observed in women and women with older ages and higher intake of fruits and vegetables showed a stronger association with overall CVD mortality compared to their counterparts. We found that higher fish consumption is associated with a reduced risk of CVD mortality in Korean women. Sex-specific dietary strategies may be necessary for the effective prevention and management of CVD.
41. Rotating gold microwire electrode for the voltammetric detection of mercury and arsenic in shellfish.
期刊: Analytical methods : advancing methods and applications 发表日期: 2025-Sep-29 链接: PubMed
摘要
Monitoring mercury (Hg) and arsenic (As) in bivalve shellfish is crucial for ensuring food safety and protecting human health, given the bioaccumulation potential of these toxic contaminants. This study introduces a novel, low-cost, and highly sensitive electrochemical method for the determination of Hg and As in bivalve molluscs, leveraging a unique assembly that incorporates a gold micro-electrode. The electrode’s design is characterised by its increased surface area resulting from the spherical geometry, enhancing sensitivity for trace metal detection. Further refinement is achieved through the integration of a conductive coupler, facilitating the electrode’s rotation to augment analyte mass transport to the electrode surface, thereby improving the detection limits and overall analysis efficiency. The simplicity of the sensor assembly combined with its capacity for on-site and in situ application, sets a new benchmark for practicality in environmental monitoring tools. After pretreatment and conditioning of the substrate its ability to detect trace levels of As and Hg in certified reference materials and in real shellfish samples after microwave digestion was investigated. The repeatability, linearity, accuracy, and detection limit of the procedure were evaluated. For mercury and arsenic, a short 90 second deposition time resulted in detection limits of 0.3 μg L-1 and 0.21 μg L-1 and a linearity of 0.5 to 100 μg L-1 and 1.0 to 100 μg L-1, respectively. Close agreement with stated values for a certified reference material verified the accuracy and reliability of the analysis.
42. Permeation of metallic gunshot residues in a commercial gun cleaning solvent through a disposable nitrile glove.
期刊: Forensic science, medicine, and pathology 发表日期: 2025-Sep-29 链接: PubMed
摘要
Gunshot residue (GSR) accumulates in firearms and must be removed mechanically and with gun cleaning solvent (GCS). There are no peer review journal publications on what gloves might be resistant to GSR being cleaned with a GCS. The aim was to fill the data gap. Methods. A Kimtech Science Blue disposable nitrile glove was challenged in triplicate by dissolved GSR of diameters less than 125 micrometers in a popular GCS with permeates collected in n-decane at 35 °C in a ASTM F739-20 glass permeation cell with no collection side recirculation. Samples from the collection and challenger sides and permeated glove pieces were analyzed for metals by solvent evaporation, concentrated acid digestion and then inductively coupled plasma-mass spectrometry. Results. Lead, copper and barium GSR compounds permeated between 240 min and 480 min, also being detected within the permeated glove material. The GSR concentrations in mg/g were lead 86.8 ± 0.2, copper 96.4 ± 0.2, and barium 0.622 ± 0.012. Conclusion. A practical and inexpensive method to resist the toxic elements in GSR in a popular GCS for at least 4 hours was to wear a disposable Kimtech Science Blue nitrile glove of average thickness 143-148 µm. More gloves, GCS and GSR should be tested.
43. Prioritizing soil heavy metal control based on source-specific probabilistic ecological-health risk assessment in industrial development areas of Shouguang, a typical agricultural city in China.
期刊: Environmental geochemistry and health 发表日期: 2025-Sep-29 链接: PubMed
摘要
Heavy metal (HM) contamination caused by industrial expansion may have a major effect on the environmental quality and human health in agriculture-dominated towns and cities. Identifying priority control factors for HMs in soil is essential for risk reduction. In this study, Positive Matrix Factorization (PMF), Monte Carlo simulation (MCS), and risk assessment models were integrated to identify priority control sources and target HMs in the industrial growth zones of a typical agricultural city. The PMF model ascertained five sources of HMs: coal combustion and smelting activities, welding and plating sources, transportation emissions, agricultural sources, and general industry sources. Overall, the study region exhibited mild to moderate ecological risk, primarily driven by coal combustion, smelting activities, and general industry, which should be prioritized for control. Hg (mean Ei = 47.05) and Cd (mean Ei = 42.28) were identified as target elements, contributing 40.6% and 36.5% to the NCRI, respectively. The non-carcinogenic risk posed by HMs was negligible, but the carcinogenic risk was significant, with mean TCR values for adults and children of 9.64E-06 and 2.93E-05, respectively. With Cr as the target element, welding and plating sources were recognized as priority control sources for health hazards in FTSG, contributing 40.06% and 40.78% to adults and children, respectively. Overall, this research offers a theoretical basis for carrying out the evaluation and management of the risk of soil HMs in towns with agriculture-led industrial development.
44. Polyoxazoline functionalized magnetic spinel iron oxide nanoparticles for efficient removal of pharmaceuticals and heavy metal ions from water.
期刊: Nanoscale 发表日期: 2025-Sep-29 链接: PubMed
摘要
This study introduces a novel class of multifunctional hybrid materials for advanced water remediation, based on Fe3O4 superparamagnetic nanoparticles functionalised with tailored polyoxazoline coatings (PiPOx and PAmOx). These materials uniquely combine the high selective adsorption capacity of the polymer coating - engineered to target both organic pollutants and heavy metal ions - with the inherent magnetic responsiveness of the Fe3O4 core, enabling efficient contaminant removal and facile particle recovery under an external magnetic field. Detailed adsorption experiments reveal striking differences in performances between the two hybrid nanoparticles. Fe3O4@PAmOx exhibits exceptional efficacy in removing organic pollutants from aqueous solutions, achieving recovery rates exceeding 80% ± 2 for a range of tested contaminants. Conversely, Fe3O4@PiPOx demonstrates a pronounced affinity for heavy metal ions, particularly Pb2+, with a recovery rate surpassing 25% ± 2. This selective adsorption behavior indicates that Fe3O4@PAmOx is optimally suited for the remediation of organic pollutants, whereas Fe3O4@PiPOx proves more effective in addressing heavy metal contamination. The synergistic combination of Fe3O4@PiPOx and Fe3O4@PAmOx offers a versatile and highly efficient solution for wastewater treatment capitalizing on their dual capabilities to selectively adsorb pharmaceutical residues and heavy metal ions, while preserving their magnetic properties following surface functionalization. This approach underscores the significant potential of these hybrid systems in practical water purification applications, facilitating the effective targeting of both organic and inorganic contaminants and providing a viable path towards sustainable water management.
45. Physical and Occupational Therapy Utilization After Infant Abdominal Surgery.
期刊: Physical & occupational therapy in pediatrics 发表日期: 2025-Sep-29 链接: PubMed
摘要
Postoperative mobilization in neonates is a critical component of the enhanced recovery pathway. We aimed to explore physical therapy (PT) and occupational therapy (OT) utilization in neonatal intensive care unit (NICU) patients and hypothesized that neonates with major abdominal surgery will experience increased barriers to receiving therapies compared to nonoperative neonates. We retrospectively analyzed neonates admitted to our institution from January 2020 to December 2021. We compared therapy type/timing and clinical outcomes between operative and nonoperative neonates. We assessed 210 neonates (92 operative, 118 nonoperative). Operative neonates had lower median [Q1, Q3] gestational age (GA) at birth and birthweight. Operative neonates experienced significantly greater median [Q1, Q3] time from admission to first PT/OT session. Time from index operation to first therapy session was 25 days for PT and 22 days for OT. Number of active and missed PT/OT sessions were not significantly different between groups after accounting for length of stay (LOS). Operative neonates more frequently missed PT/OT sessions due to out-of-unit procedures or imaging. Our data highlight a need for mitigation of barriers to mobilization among operative neonates, particularly in the first few weeks after surgery. Prospective studies are needed to explore the impact of earlier postoperative therapy among operative neonates.
46. Neonatal Therapy Interventions Supporting Oral Feeding Skills in Preterm Infants: A Systematic Review.
期刊: Physical & occupational therapy in pediatrics 发表日期: 2025-Sep-29 链接: PubMed
摘要
To synthesize the existing literature on neonatal therapy interventions and evaluate their impact on oral feeding outcomes among preterm infants in the neonatal intensive care unit. A systematic literature search was conducted in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and Physiotherapy Evidence Database (PEDro) databases for studies published from 2014 to 2023. Included studies were clinical trials evaluating neonatal therapy interventions delivered by neonatal therapists or caregivers trained by therapists, focusing on oral feeding outcomes for infants born at <37 week gestation. Primary outcomes were time to full oral feeding (FOF) and feeding quality. Secondary outcomes were weight gain and length of stay (LOS). Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Fourteen studies were included, identifying three categories of neonatal therapy interventions: oral motor stimulation, swallowing exercises, and sensory-based interventions. Most interventions began between 27 and 33 week postmenstrual age. Interventions generally resulted in improved oral feeding outcomes, notably faster achievement of FOF and improved feeding quality. Results for LOS and weight gain varied. Multidomain interventions demonstrated superior outcomes compared to single-domain approaches. Neonatal therapy interventions can start early and improve oral feeding outcomes in preterm infants, particularly when using multi-domain approaches.
47. Reply to: "Beyond Prevalence: The Importance of Multifactorial Assessment in Cancer Risk Among Myotonic Dystrophy Patients".
期刊: Muscle & nerve 发表日期: 2025-Sep-29 链接: PubMed
摘要
48. Breastfeeding infants with CHD: an evidence summary and recommendations from the Cardiac Newborn Neuroprotective Network, a special interest group of the Cardiac Neurodevelopmental Outcome Collaborative.
期刊: Cardiology in the young 发表日期: 2025-Sep-29 链接: PubMed
摘要
Human milk and direct breastfeeding provide the optimal, biologically normative nutrition for hospitalised infants, with well-established benefits for immune, gut, cardiac, brain, and maternal health. Despite these benefits, human milk and breastfeeding rates for infants with CHD in high-resource countries are typically low, and there are no formal guidelines to drive CHD breastfeeding practice. Our aim is to (1) summarise the evidence on breastfeeding for infants with CHD, (2) discuss key barriers to and facilitators of breastfeeding in this population, (3) identify critical research and practice gaps to improve breastfeeding care in CHD, and (4) provide recommendations for clinical practice and future research.Primary breastfeeding barriers for infants with CHD include (1) concern for dysphagia/aspiration, (2) concerns related to weight gain, (3) clinical instability/sickness, (4) developmental considerations, (5) general breastfeeding challenges, and (6) workflow and implementation issues, with racism and health disparities also contributing. The evidence to support these barriers is limited and often conflicting. Breastfeeding facilitators for preterm infants are well described, but facilitators may require modification for infants with CHD. Most lactation interventions have not been tested in CHD populations. Current evidence does not support automatic withholding of breastfeeding from infants with CHD; rather, the benefits of breastfeeding likely outweigh many potential concerns. There is a critical need for research and quality improvement to identify interventions that equitably and effectively support breastfeeding for infants with CHD and to evaluate the effect of breastfeeding on short- and long-term physical, psychological, and developmental outcomes for infants and families.
49. Small Intestinal Dilation Is Associated With Severe Abdominal Symptoms of Food-Protein-Induced Enterocolitis Syndrome in Adults.
期刊: Allergy 发表日期: 2025-Sep-29 链接: PubMed
摘要
Food-Protein-Induced Enterocolitis Syndrome (FPIES) is a non-IgE-mediated food allergy that causes gastrointestinal symptoms, though its anatomical origin and pathogenesis remain unclear. Abdominal distention is common in adult FPIES, but symptoms vary among patients. This study aimed to establish objective criteria for assessing abdominal distention and to clarify the pathophysiology and anatomical origin of FPIES. This study targeted 26 adult FPIES patients. Abdominal distention was broken down into eight factors, and an evaluation algorithm was developed based on items with high positivity rates. Clinical characteristics, blood, and imaging analyses were performed before and after OFC (oral food challenge) to investigate the pathophysiology. Among 14 adult FPIES patients who underwent OFC, seven showed positive results. The latency period was 1.5 h, with the most frequent symptoms being abdominal distention (100%), abdominal pain, and nausea (71.4%). All patients received treatment with intravenous extracellular fluid infusion and ondansetron, which resulted in reduced symptom duration. In an evaluation of blood test data, there were no specific serological markers of FPIES, except in the severe case. Image analysis with computed tomography revealed significant dilation and edema of the small intestine during the FPIES event, suggesting that dilation of the small intestine is associated with adult FPIES. These results are expected to aid in the early and appropriate diagnosis of FPIES based on medical interviews, blood test data, and imaging findings when adult patients present to medical institutions with severe acute gastroenteritis symptoms.
50. Uncovering the Tumorigenic Blueprint of PFOS and PFOA Through Multi-Organ Transcriptomic Analysis of Biomarkers, Mechanisms, and Therapeutic Targets.
期刊: Current issues in molecular biology 发表日期: 2025-Sep-15 链接: PubMed
摘要
Per- and polyfluoroalkyl substances (PFASs), called forever chemicals, persist in the environment and bioaccumulate, posing significant health risks. While epidemiological studies have linked exposure to specific PFAS types, perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS), to an increased incidence of various cancers, specific tumorigenesis mechanisms are unknown. Here, we investigated the potential molecular markers and signatures of perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA) tumorigenesis. We performed a comprehensive transcriptomic analysis across multiple species and tissue types (N = 529) using PFOS and PFOA-exposed RNA-Seq samples. Conserved signatures demonstrate significant disruptions in seven key carcinogenic characteristics including metabolic reprogramming, epigenetic modifications, immune suppression, oxidative stress, and genomic instability. Tumorigenic markers such as SERPINE1, FN1, PLIN2, ALDOA, TRIB3, and TSC22D3 and their associated pathways may act independently or synergistically to promote a pro-tumorigenic environment. Additionally, PPARα, LARP1, ACOX1, MYC, and MYCN were identified as key upstream regulators supporting disruptions in lipid metabolism, oxidative stress, and uncontrolled cell proliferation. In liver samples, low concentrations of PFOS and PFOA were sufficient to exhibit tumorigenic signatures associated with tumorigenesis initiation and development. Inferred mechanisms of ccRCC initiation and development were linked to lipid metabolism dysregulation and immunosuppressive signaling. In prostate and testicular xenograft tumor models, carcinogenic mechanisms for tumor progression and promotion were hypothesized. Receptor-mediated signaling and protein synthesis was disrupted in prostate cancer and epigenetic alterations and ECM remodeling observed in testicular cancer. We also explored potential therapeutic rescue strategies, including chemopreventive agents for early intervention. All our findings provide hypotheses for PFOS/PFOA-induced tumorigenesis; however, experimental studies are required to establish translational relevance. All the R codes developed in this study are publicly available.
51. The inclusion and impact of digital determinants of health in digital nutrition interventions for adolescents: a systematic review.
期刊: Health promotion international 发表日期: 2025-Sep-03 链接: PubMed
摘要
Digital determinants of health (DDoH) is an emerging concept that captures domains relating to both digital health adoption and health equity. Digital transformations are reshaping many aspects of healthcare and health promotion, including how adolescent nutrition interventions are developed, delivered and utilized. As digital health interventions expand in popularity, it is crucial that they do not widen existing health disparities. This systematic review aimed to evaluate whether the DDoH are addressed in the development or delivery of digital nutrition interventions for adolescents, and whether this impacts access or use of these interventions to influence nutrition outcomes. Ten major electronic databases were searched and dual screened, capturing randomized controlled trials published from 2005 that aimed to improve nutrition outcomes through digital health interventions among adolescents 10-19 years. Primary outcome was objective or self-report change in nutrition intake or behaviours. DDoH assessment criteria were developed against nine pre-established dimensions. Study and intervention characteristics including information aligning with DDoH assessment criteria were extracted, and data synthesized in narrative format. Twenty articles representing 19 unique studies (13 246 participants) were identified, with 84% of studies conducted in high-income countries. All studies delivered interventions through mobile phone or computers and addressed at least one DDoH criteria. Affordability (100%) and usability (42%) were the most common DDoH criteria addressed. No studies successfully addressed all DDoH criteria. Therefore, we were unable to assess impact of addressing DDoH on adolescent nutrition outcomes. Overall, DDoH were inadequately addressed or reported in the development of digital nutrition interventions targeting adolescents.
52. The practice of public health coordination in Sweden: roles, responsibilities, and realities.
期刊: Health promotion international 发表日期: 2025-Sep-03 链接: PubMed
摘要
In response to increasingly complex and cross-sectoral public health challenges, coordination has emerged as a key strategy for aligning efforts across fragmented systems. However, despite its widespread endorsement, coordination remains conceptually ambiguous and difficult to operationalise in practice. This qualitative study explores how public health coordination is enacted at the local level in Sweden, where municipalities employ public health coordinators to promote population health and reduce inequalities. Semi-structured interviews with 21 public health coordinators across diverse Swedish municipalities were conducted and through an inductive thematic analysis four key themes were developed: driving targeted efforts and holding processes together; connecting activities to policy goals through purposeful planning; creating conditions for collaboration by engaging relevant stakeholders; and building a knowledge support function through acquiring and sharing new knowledge. The findings reveal that coordination is a dynamic and adaptive function requiring strategic thinking, relational skills, and contextual sensitivity. Effective coordination depends not only on individual competencies, such as communicative, diplomatic, and administrative abilities but also on structural conditions, including political mandates, formalised goals, and sufficient time and resources. Coordinators often operate without formal authority, relying on trust and leadership support to navigate complex and shifting responsibilities. The study concludes that coordination is essential for enabling collaboration, sustaining public health efforts, and aligning activities with policy goals. It highlights the need for clearer role definitions, supportive frameworks, and further research into how coordination contributes to long-term public health outcomes across different domains and local contexts.
53. Naturalistic Tobacco Retail Exposure and Smoking Outcomes in Adults Who Smoke Cigarettes Daily.
期刊: JAMA network open 发表日期: 2025-Sep-02 链接: PubMed
摘要
The tobacco industry spends more than $8 billion annually in the US on marketing at the point of sale. Exposure to tobacco retail has been associated with smoking outcomes, but substantially less is known about how objectively logged everyday tobacco retail exposure is associated with smoking outcomes. To assess preregistered hypotheses that individuals would report (1) greater craving and (2) more cigarettes smoked on days when their exposure to tobacco retail is higher than usual. This multimodal, within-person cohort study combined objectively logged geolocation tracking, public tobacco retail location records, and ecological momentary assessment data. Eligible participants recruited from the GeoSmoking Study were aged 21 to 65 years, smoked at least 5 cigarettes per day over the previous 6 months, owned a smartphone, and were a resident of Pennsylvania, New Jersey, or Delaware. Data were collected from May 25, 2022, to June 10, 2024. Exposure to tobacco retail stores was assessed using mobility data matched with locations of tobacco retailers across Pennsylvania, New Jersey, and Delaware. Daily mean craving and daily number of cigarettes smoked were computed using ecological momentary assessment. A total of 273 participants were included in the final analyses (mean [SD] age, 42.5 [10.7] years; 151 women [55.3%]). Multilevel models revealed support for both preregistered hypotheses. On days when individuals had more tobacco retail exposure than their own average, they reported significantly higher levels of craving (b = 0.04; 95% CI, 0.01-0.07; t3457 = 2.72; P = .01) and smoking significantly more cigarettes (b = 0.01; 95% CI, 0.0002-0.01; t3469 = 2.05; P = .04). In this cohort study of individuals who smoke cigarettes daily, exposure to tobacco retail in their everyday lives was associated with increases in craving and smoking. These findings highlight the importance of retail exposure and smoking outcomes, information that is critical for developing effective tobacco control interventions and lays the foundation for broader health research on environmental factors that shape health behaviors.
54. Multimodal Intervention and Child Passenger Safety Guideline Adherence in Young Children: A Sequential, Multiple-Assignment, Randomized Clinical Trial.
期刊: JAMA network open 发表日期: 2025-Sep-02 链接: PubMed
摘要
Suboptimal child passenger safety behaviors are common despite the availability of effective child restraint systems (CRS), with national guidelines promoting-and state laws requiring-their use. To compare 6-month guideline adherence following the Tiny Cargo, Big Deal, Abróchame Bien, Cuídame Bien (TCBD/ABCB) intervention vs enhanced usual care (EUC); assess 12-month maintenance effect; and evaluate sequential, multiple-assignment, randomized trial (SMART) phase 2 outcomes by intervention intensity. This randomized clinical trial using a SMART study design was conducted at 1 pediatric emergency department (ED), 1 community ED, and 2 urgent care centers in metropolitan Chicago, Illinois, from February 2020 to August 2022. Eligible caregivers spoke English or Spanish, lived in Illinois, owned a smartphone, traveled weekly with their child (aged 6 months to younger than 11 years), and reported suboptimal child passenger safety behaviors. Of 5416 caregivers who were screened, 1517 were potentially eligible. Data analysis occurred from October 2024 to March 2025. Phase 1 included basic TCBD/ABCB (remote motivational interviewing [MI] plus tailored mobile health [mHealth]) vs EUC (text message photograph requests, follow-up activity reminders, and corrective feedback only for predefined critical errors). In phase 2, participants exposed to TCBD/ABCB but who were nonadherent at 6 months received high-intensity (second remote MI session plus extra text messages) or low-intensity (mHealth alone) interventions. The primary outcome was guideline adherence, a dichotomous measure of all 3 criteria: (1) appropriate CRS, (2) back seat location, and (3) never unrestrained. Outcomes were assessed at 6 and 12 months using logistic regression with prevalence differences, adjusted for randomization strata, caregiver gender, race, and ethnicity. In phase 1, there were 474 participants (mean [SD] caregiver age, 36.1 [6.2] years; 443 mothers [93.5%]; 52 [11.0%] preferred Spanish]) of whom 342 were randomized to basic TCBD/ABCB and 132 to EUC. Among participants with 6-month follow-up data, 131 of 278 caregivers receiving TCBD/ABCB (47.1%; 95% CI, 41.3% to 53.0%) vs 38 of 118 receiving EUC (32.2%; 95% CI, 23.8% to 40.6%) were guideline adherent (absolute change in treatment response, 13.1%; 95% CI, 3.6% to 22.6%; P = .007) with 12-month maintenance effects (adjusted prevalence difference, 39.2%; 95% CI, 26.5% to 51.9%; P < .001). In phase 2, 185 participants who received TCBD/ABCB and were not guideline adherent were rerandomized to high-intensity (87 participants) or low-intensity (84 participants) intervention. High-intensity TCBD/ABCB had no effect compared with low-intensity TCBD/ABCB (adjusted prevalence difference, -3.9%; 95% CI -17.9% to 10.1%; P = .59). In this randomized clinical trial of caregivers, TCBD/ABCB was associated with improved adherence to child passenger safety guidelines with lasting effects among those caregivers who were adherent at 6 months. These findings suggest that this remote precision prevention intervention against a leading cause of death may be adaptable to other settings. ClinicalTrials.gov Identifier: NCT04238247.
55. In-Flight Medical Events on Commercial Airline Flights.
期刊: JAMA network open 发表日期: 2025-Sep-02 链接: PubMed
摘要
In-flight medical events are an inevitable challenge in commercial aviation. Managing these events is complicated by constrained medical resources and delayed access to definitive care. To characterize the epidemiology of in-flight medical events and identify factors associated with aircraft diversion, hospital transport, and in-flight mortality. This cohort study included 77 790 in-flight medical events reported to a global ground-based medical support center from January 1, 2022, through December 31, 2023. All passengers experiencing an in-flight medical event across 84 participating airlines during the study period were included. Data were collected from consultations initiated by flight crew via radio or satellite communication with a dedicated ground-based physician. No demographic or clinical exclusions were applied. Medical conditions occurring during commercial flights that prompted contact with the ground-based support center. Data included clinical presentation, in-flight management, passenger demographics, involvement of volunteer medical professionals, and disposition. Primary outcome was aircraft diversion, and secondary outcomes were hospital transport and in-flight mortality. Descriptive statistics, univariate analyses, and multivariable analyses were used to identify clinical and operational variables associated with these outcomes. Among 77 790 in-flight medical events, the overall incidence was 39 events per 1 million enplanements, with 1 event per 212 flights, or 17 events per billion revenue passenger kilometers. The median (IQR) age of affected passengers (42 316 females [54.4%]) was 43 (27-61) years. Aircraft diversion occurred in 1.7% of cases, most frequently due to neurologic (41%) and cardiovascular (27%) conditions. Suspected stroke (adjusted OR [AOR], 20.35; 95% CI, 12.98-31.91) and acute cardiac emergencies (AOR, 8.16; 95% CI, 6.38-10.42) were the factors associated with the highest odds of diversion. The involvement of a physician volunteer was also associated with increased odds of diversion (AOR, 7.86; 95% CI, 4.49-13.78). In this cohort study of 77 790 in-flight medical events, these events occur more frequently than previously reported. Serious neurologic conditions, cardiac events, and physician volunteer involvement are each associated with higher odds of diversion. These findings contribute to the understanding of in-flight medical event frequency and outcomes and may inform policy, flight crew training, and diversion protocols.
56. SGLT2 Inhibitors and External Genital Infection in Male Patients With Type 2 Diabetes.
期刊: JAMA network open 发表日期: 2025-Sep-02 链接: PubMed
摘要
New medications for type 2 diabetes (T2D) control, such as sodium-glucose cotransporter-2 inhibitors (SGLT2Is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs), have emerged. However, the US Food and Drug Administration has warned about potential risks of Fournier gangrene, a severe genital infection associated with SGLT2I use. To determine comparative risks of male external genital infections (MEGIs) in adult male patients with T2D treated with SGLT2Is. A population-based cohort study analyzing Taiwan’s National Health Insurance Research Database was conducted to evaluate the MEGI risk in adult male patients with T2D newly treated with SGLT2Is between January 1, 2009, and December 31, 2020. Patients newly treated with GLP-1RAs were chosen during the same period for the active-comparator group, and propensity scores with inverse probability of treatment weighting were applied to balance the baseline characteristics between the 2 treatment groups. Data analyses were conducted between February 2023 and April 2025. Treatment with SGLT2Is or GLP-1RAs. The primary outcome was the incidence of MEGI, identified using International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis codes. To examine the result consistency, subgroup analyses based on age (older or younger than 60 years), diabetes severity (insulin use or not), and kidney function were conducted. The study included 239 757 patients; 224 360 initiated SGLT2Is (mean [SD] age, 58.4 [12.3] years) and 15 397 initiated GLP-1RAs (mean [SD] age, 58.1 [13.6] years). Compared with the GLP-1RA group, the SGLT2I group had a significantly increased risk of MEGI (hazard ratio [HR], 1.65; 95% CI, 1.59-1.71). The subgroup analyses indicated an increased risk of MEGI in the SGLT2I group among patients younger than 60 years (HR, 2.04; 95% CI, 1.58-2.65), those with an estimated glomerular filtration rate of 60 mL/min/1.73 m2 (HR, 1.69; 95% CI, 1.34-2.15), and those with hemoglobin A1c below 7% (HR, 3.22; 95% CI, 1.71-6.03). These findings suggest that SGLT2Is are associated with a higher risk of MEGI in adult male patients with T2D, compared with GLP-1RAs. Clinicians should be cautious when prescribing SGLT2Is in male patients with T2D.
57. Smoking Behavior and Environmental Cues-The Importance of Time and Place.
期刊: JAMA network open 发表日期: 2025-Sep-02 链接: PubMed
摘要
58. The Potential of Resveratrol as an Anticancer Agent: Updated Overview of Mechanisms, Applications, and Perspectives.
期刊: Archiv der Pharmazie 发表日期: 2025-Sep 链接: PubMed
摘要
The natural polyphenol resveratrol, found in several plants, has garnered significant interest due to its beneficial effects on health and for its potential anticancer properties. Studies have demonstrated that it can alter various signaling pathways linked to cancer development and that it inhibits tumor development and spread by exerting several antiproliferative, proapoptotic, anti-inflammatory, and antiangiogenic mechanisms. Its role in regulating oxidative stress and epigenetic modifications further enhances its therapeutic potential. Nevertheless, despite promising preclinical results, clinical translation is to some extent limited by bioavailability, metabolism, and dosage. This updated review explores the mechanisms, also from a structural point of view, behind the anticancer properties of resveratrol, focusing on its impact on crucial signaling networks in different cancer models. Additionally, it overviews the current limitations of resveratrol-based treatments and suggests potential improvements through innovative delivery methods, drug combination approaches, and development of new derivatives. This review was conceived as an update with respect to contributions already present in the literature, thus particular attention has been dedicated to the contribution reported in the literature within the last 5 years and to these studies reporting in vivo data.
59. Stakeholder Perspectives on Enhancing Eye Health Behaviors Among Thai Older Persons: An Application of the PRECEDE Model.
期刊: Journal of primary care & community health 发表日期: 2025 链接: PubMed
摘要
Eye health is an increasing concern among older populations dwelling in the community. Promoting positive eye health behaviors is essential not only for maintaining vision but also for preventing avoidable blindness. Understanding the factors that influence these behaviors is crucial for developing effective and sustainable interventions. This descriptive qualitative study explored key stakeholders’ perspectives on improving eye health behaviors among older persons in a Thai community, using the PRECEDE model as a framework. The findings offer insights into contextual factors that can guide the development of culturally appropriate and sustainable interventions. This descriptive qualitative study was conducted using focus group discussions with 8 key stakeholders involved in primary eye care services. Participants were purposively selected to provide diverse perspectives on eye health behaviors including primary eye care services among older persons in the community. Data from the focus groups were audio-recorded, transcribed verbatim, and analyzed using thematic analysis to identify key factors influencing eye health practices. The reliability of the research instrument, based on the constructs of the PRECEDE model, was tested by calculating the Index of Item-Objective Congruence (IOC). To ensure trustworthiness, credibility was enhanced through prolonged engagement and member checking. Transferability was supported by clear descriptions of the context and participants. Dependability was addressed by maintaining an audit trail, and confirmability was ensured through reflexive journaling and peer discussions to reduce bias. Analysis of the focus group discussions, guided by the PRECEDE model to identify administrative and policy factors and align interventions, revealed 4 key themes influencing eye health behaviors among older persons. These themes emerged from 4 main categories, which were derived from 10 main categories, 17 subcategories, and 26 corresponding codes: current policy, problems and obstacles, suggestions and needs, and resource management. The first theme emphasized primary eye care efforts, including vision screening for cataracts and glaucoma by ophthalmologists in cooperation with private hospitals. Cataract surgeries are funded by the National Health Security Office and state welfare, alongside a program providing prescription glasses to those aged 60 years and over. The second theme addressed financial barriers for older persons, who frequently pay for eye health beyond government support. Participants noted policy gaps and emphasized the need for careful planning and timely funding. Human resource issues, such as staff burnout and limited training of village health volunteers, were also identified as factors affecting service quality and screening accuracy. The third theme involved stakeholder engagement, where participants noted unclear roles limiting collaboration and emphasized the need for stronger social support. Despite these challenges, they highlighted the value of community engagement and proposed solutions such as eye health education for older persons, training village health volunteers in prevention and vision screening, and strengthening intersectoral collaboration. Finally, effective resource management was highlighted as essential to support the eye health promotion program, encompassing infrastructure, equipment, materials, and financial oversight. This study offers valuable insights into the factors influencing eye health behaviors among older persons in a Thai community, based on perspectives from key stakeholders. Guided by the PRECEDE model, it highlights the importance of health education, training, funding, service accessibility, and community collaboration. The findings underscore the need for community-based interventions that address both behavioral and environmental determinants. These insights can support the development of sustainable strategies to promote eye health and prevent avoidable blindness among community-dwelling older people. Future research should directly involve older persons and caregivers to enhance the depth and applicability of findings.
60. Analysis of the use of rosemary for cortisol levels and sleep quality among nursing professionals.
期刊: Revista da Escola de Enfermagem da U S P 发表日期: 2025 链接: PubMed
摘要
To analyze the effectiveness of 1 g of dry rosemary extract on sleep quality and hair cortisol concentration in emergency nursing professionals. Intervention, quasi-experimental, before-and-after study, carried out between September and November 2022 with nursing professionals from a hospital emergency room and an Emergency Room in Rio Grande do Sul. A sociodemographic/occupational questionnaire, Pittsburgh Sleep Quality Index, and hair samples were used. The intervention involved taking 500 mg capsules of dry rosemary extract twice a day for 56 days. Descriptive and analytical analysis, with association and correlation tests (p < 0.05) were used. Thirty-five workers participated. Poor sleep quality and high levels of hair cortisol concentration predominated. The intervention significantly improved sleep (p = 0.039), without reducing cortisol levels. The rosemary intervention improved sleep quality, but was not sufficient to reduce hair cortisol concentrations, with other strategies that contribute to the worker’s health being required.
61. Disease burden and attributable risk factors for chronic obstructive pulmonary disease in China, Japan, and South Korea: trends for 1990 to 2021 period and predictions for 2031.
期刊: Frontiers in medicine 发表日期: 2025 链接: PubMed
摘要
Chronic obstructive pulmonary disease (COPD) is a key public health concern in East Asia. China, Japan, and South Korea represent important regions in East Asia, and the three countries have various similarities in terms of culture, economic development models, and population structure. Therefore, understanding the COPD burden in these three countries is crucial for the prevention and management of COPD in East Asian. Age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), age-standardized disability-adjusted life rate (ASDR), age-period-cohort (APC) analysis, and Bayesian age-period-cohort (BAPC) analysis data of COPD in China, Japan, and South Korea were collected and determined using the GBD (Global Burden of Disease) 2021 database. China had the highest COPD burden between 1990 and 2021, followed by South Korea, and Japan. The dominant risk factor related to mortality rates and DALYs was environmental/occupational risks in China, whereas behavioral risks in Japan and South Korea were more significant. BAPC predictions indicated that the ASIR, ASPR, and ASDR for COPD in China, Japan, and South Korea would exhibit a downward trend between 2021 and 2031. However, the trend of the age-standardized mortality rate (ASMR) would vary among the three countries. Under the influence of environmental conditions, the aging population, economic development trends, and the construction of medical security systems, China, Japan, and South Korea share commonalities as well as differences in terms of COPD burden. China’s actions concerning environmental protection have been effective, although reducing smoking rates and alleviating the pollution caused by industrialization are crucial for further reducing the COPD burden in China. Owing to Japan’s environmental protection policies, low smoking rates, and comprehensive social security measures, the COPD burden in Japan is relatively low compared to that in China and South Korea. Owing to the impact of environmental pollution, imperfections in the medical security system, and the influence of South Korea’s handling of related issues after the economic rise of the nation, the COPD burden in South Korea has undergone significant fluctuations.