公共卫生研究摘要 (2025-10-01)
共收录 57 篇研究文章
1. Effect of Onset-to-Admission Time and Care Bundle Achievement on Functional Outcomes in Patients With ICH: A Population-Based Study.
期刊: Neurology 发表日期: 2025-Oct-21 链接: PubMed
摘要
Intracerebral hemorrhage (ICH) remains a leading cause of morbidity and mortality, with limited effective treatments. Early implementation of a care bundle protocol (CBP) within 6 hours of symptom onset has been shown to improve functional outcomes, although its effect beyond this time frame remains unclear. We assessed the impact of onset-to-admission (OTA) time and CBP achievement on functional outcome and mortality in patients with acute spontaneous ICH. We conducted a population-based study of a prospective cohort of consecutive patients diagnosed with acute spontaneous ICH between 2020 and 2022 in Catalonia, Spain. Inclusion criteria were patients aged 18 years or older, OTA time <24 hours, and a baseline modified Rankin Scale (mRS) score ≤3. CBP achievement was defined as attaining control in the first 24 hours of blood pressure (<140/90 mm Hg), glycemia (<150 mg/dL), body temperature (<37.5°C), and blood oxygen saturation (>92%) and, if required, anticoagulation reversal. The primary outcome was the proportion of patients with a favorable functional outcome, defined as mRS score ≤3 at 3-month follow-up. The effects of OTA time and CBP achievement on outcomes were evaluated using multivariable logistic regression. Potential interaction between OTA time and CBP achievement was assessed using the likelihood ratio test. A total of 1,821 patients were included (mean age 70.3 ± 14.1 years, 37.7% women). CBP was achieved in 27.7% of patients. Shorter OTA time was independently associated with poorer functional outcome (adjusted odds ratio [aOR]x1h 1.04, 95% CI 1.02-1.06). CBP achievement was associated with a higher probability of favorable outcome at 3 months (aOR 1.66, 95% CI 1.29-2.15). An interaction between OTA time and CBP achievement was observed (p = 0.016), indicating greater CBP benefits for earlier admission. This interaction was evident up to 13.8 hours after symptom onset, with the CBP benefit concentrated in the first 8 hours. Our findings highlight the importance of timely CBP application to improve functional outcome in patients with ICH, even beyond the first 6 hours after symptom onset. While earlier intervention remains ideal, our results support expanding CBP implementation and promoting “Code ICH” initiatives to enhance patient outcomes in stroke care systems. Multicentre Registry of Patients With Spontaneous Acute Intracerebral Hemorrhage in Catalonia (HIC-CAT). ClinicalTrials.gov ID: NCT03956485. Registration submission: May 2019. First patient enrolled March 2020. This study provides Class III evidence that in patients with acute ICH, achievement of a standardized CBP is associated with better functional outcomes at 3 months.
2. Duration of Current Statin Use and Amyotrophic Lateral Sclerosis Risk: A Norwegian Population-Based Cohort Study.
期刊: Neurology 发表日期: 2025-Oct-21 链接: PubMed
摘要
Although hypercholesterolemia may contribute to long-term amyotrophic lateral sclerosis (ALS) risk, it can also seem as a secondary effect during the early, prediagnostic phase of the disease. We aimed to investigate the relationship between short-term and long-term use of statins and subsequent ALS risk. We designed a cohort study where information on cardiovascular risk factors among Norwegian participants in large population-based health surveys was linked to nationwide administrative data on subsequent statin use and ALS diagnosis. Duration of statin use was calculated based on cumulative defined daily doses and analyzed as time-varying exposure with 3 levels: 0-1 year (short-term), 1-5 years, and 5-17 years (long-term). In Cox regression models adjusted for sex, age, health survey participation, triglyceride and cholesterol levels, body mass index, smoking, diabetes, and hypertension, we calculated hazard ratios (HRs) for ALS according to time-varying statin exposure. In a negative control analysis, we examined whether exposure to renin-angiotensin system (RAS)-acting agents was associated with ALS risk. A total of 425,564 participants (54% women), aged 40-65 years in January 2005, were followed for a mean period of 16 years (SD 2.3) during which 493 ALS cases (44% women) were identified. Compared with no current statin use, the HR for ALS was 3.56 (95% CI 2.58-4.90) for those with 0-1 year, 0.85 (95% CI 0.59-1.23) for those with 1-5 years, and 0.67 (95% CI 0.45-1.00) for those with 5-17 years of current use. The associations between both short-term and long-term statin use and ALS risk were most evident in men, with HRs for ALS of 4.03 (95% CI 2.72-5.95) and 0.47 (95% CI 0.26-0.86), respectively. There was no clear association between either short-term or long-term use of RAS-acting agents and ALS risk. The strong association between short-term current statin use and increased ALS risk is consistent with reverse causality, where statin initiation in the prediagnostic phase may occur when lipid levels rise and individuals seek medical attention due to emerging ALS symptoms. Long-term statin use was associated with reduced risk of ALS in men.
3. Cardiovascular Risk Trajectories and Risk of Developing Stroke and Dementia: A Community-Based Cohort Study in Taiwan.
期刊: Neurology 发表日期: 2025-Oct-21 链接: PubMed
摘要
Stroke and dementia share common cardiovascular risk factors, but few studies have evaluated long-term changes in cardiovascular disease (CVD) risk scores, which may better capture cumulative vascular burden. We aimed to investigate whether the longitudinal trajectory of CVD risk was associated with the risk of developing stroke and dementia. This prospective cohort study included residents aged 35 years and older from a community in northern Taiwan. We included participants without a history of stroke or dementia and assessed CVD risk at baseline (visit 1) and 3 follow-up visits (visits 2-4) from 1990 to 2000 using the Framingham general CVD risk function. CVD risk trajectories were modeled as linear changes over time using a pattern-mixture approach to account for attrition. Incident stroke and dementia were ascertained through linkage to National Health Insurance claims data starting in 2000. In the primary analysis, Cox proportional hazard models were used to estimate adjusted hazard ratios (HRs) for associations of CVD risk trajectory groups with risk of stroke and dementia. In the secondary analysis, we assessed the associations between baseline CVD risk and these outcomes. Among 2,335 participants (mean age 52.3 ± 11.2 years; 56.6% women), CVD risk trajectories over 10 years were classified as accelerated increase (29.2%), moderate increase (30.9%), or stable (39.9%). Over a median 21-year follow-up, an accelerated CVD risk trajectory, compared with the stable group, was associated with an increased risk of developing all stroke (HR 1.81, 95% CI 1.40-2.34), ischemic stroke (HR 1.84, 95% CI 1.37-2.48), hemorrhagic stroke (HR 2.38, 95% CI 1.49-3.80), and vascular dementia (HR 2.07, 95% CI 1.03-4.16). The secondary analysis revealed a positive association between baseline CVD risk and risk of developing stroke, but association with vascular dementia was weaker (baseline CVD risk ≥20% vs <10%: for stroke, HR 2.32, 95% CI 1.61-3.33; for vascular dementia, HR 1.84, 95% CI 0.74-4.56). No association was observed with all-cause or nonvascular dementia. Participants with an accelerated CVD risk had an elevated risk of developing stroke and vascular dementia. Our findings suggested that longitudinal trajectories of CVD risk may affect the risk of vascular dementia beyond individual baseline risks.
4. The impact of air pollution on petcare utilization.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Oct-07 链接: PubMed
摘要
Air pollution is one of the leading causes of morbidity and premature mortality globally. A large literature documents the adverse impacts of ambient air pollution on human health. In contrast, there is a lack of comparable research studying the effects of air pollution on animal health. We fill this gap, utilizing 5 y of data on over seven million visits to veterinary practices across the United Kingdom. Leveraging within-city variation in daily monitor-measured air pollution levels, we find that increases in fine particulate matter (i.e., PM2.5) are associated with significant increases in the number of vet visits for both cats and dogs. In aggregate, these estimates suggest that reducing ambient PM2.5 levels to a maximum of 5 mg per cubic meter as recommended by the World Health Organization would result in a 0.7 to 2.5% reduction in vet visits.
5. Mitochondrial ROS triggers mitophagy through activating the DNA damage response signaling pathway.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Oct-07 链接: PubMed
摘要
The homeostatic link between the production of mitochondrial ROS (mtROS) and mitophagy plays a significant role in how cells respond to various physiological and pathological conditions. However, it remains unclear how cells translate oxidative stress signals into adaptive mitophagy responses. Here, we show that mtROS act as signaling molecules that activate the ataxia-telangiectasia mutated (ATM)-cell cycle checkpoint kinase 2 (CHK2), a DNA damage response (DDR) pathway. When activated, CHK2 regulates three critical steps in mitophagy. First, CHK2 phosphorylates mitochondrial membrane protein ATAD3A at Ser371, which inhibits the transport of PINK1 to the inner mitochondrial membrane and leads to the accumulation of PINK1 and the commencement of mitophagy. Second, activated CHK2 targets the autophagy adaptor OPTN at Ser177 and Ser473, thereby enhancing the targeting of ubiquitinated mitochondria to autophagosomes. Finally, CHK2 phosphorylates Beclin 1 at Ser90 and Ser93, hence promoting the formation of autophagosomal membranes. Consistent with these effects, Chk2-/- mice show impaired mitophagic induction and impaired recovery in a ROS-dependent model of renal ischemia-reperfusion. Our study reveals a mtROS-triggered adaptive pathway that coordinates mitophagic induction, in order to protect cells and tissues exposed to pathophysiological stress-induced damage.
6. Understanding the Outcomes of Extracorporeal Membrane Oxygen Support in Patients With Sickle Cell Trait.
期刊: Critical care explorations 发表日期: 2025-Oct-01 链接: PubMed
摘要
The impact of common hemoglobinopathies, such as sickle cell trait (SCT), on outcomes in adults requiring extracorporeal membrane oxygenation (ECMO) remains understudied. Extracorporeal Life Support Organization registry data was analyzed to assess outcomes of adults with SCT or sickle cell disease (SCD) who underwent venoarterial or venovenous ECMO. Among 215 patients identified, 49 had SCT and 166 had SCD. The prevalence of SCT appeared grossly underestimated. Age-adjusted survival rates for SCT patients were favorable compared with those with SCD for venoarterial (43.5% vs. 19.5%; p = 0.04) and venovenous (73.3% vs. 44.8%; p = 0.11) ECMO. Bleeding and thrombotic event rates and renal complications in SCT patients were comparable to those with SCD and similar to reported rates in general adult ECMO populations. While our findings suggest that ECMO may be safely used in patients with SCT, further investigation is essential to determine the clinical impact of sickle cell and other hemoglobinopathies on ECMO therapy.
7. A Commentary on Nurse-Driven Approaches to Opioid Settlement Fund Utilization at the Intersection of Infectious Disease in the United States.
期刊: The Journal of the Association of Nurses in AIDS Care : JANAC 发表日期: 2025-Oct-01 链接: PubMed
摘要
This commentary seeks to inform registered nurses how to participate in opioid abatement decision making. Legal structures of opioid abatement spending are presented, as well as spending limitations citing federal and state law. Areas of advocacy at the intersection of infectious disease (ID), substance use disorder (SUD), and nursing, including harm reduction, scope of practice policies, and billing laws are discussed. Examples of nurse-led ID prevention and SUD treatment programs are offered. Overall, nurses with ID and SUD expertise can influence opioid abatement spending and nurse-related health policy.
8. Fibre-Enriched High-Carbohydrate (FEHC) Diet Modulates Inflammation Without Affecting Bone Health in Older Women With Obesity: A Randomised Clinical Trial.
期刊: Diabetes/metabolism research and reviews 发表日期: 2025-Oct 链接: PubMed
摘要
In older adults, obesity is associated with frailty, conditions worsened by age related decline in bone mineral density (BMD) and muscle mass. To evaluate whether a 3-month Fibre-Enriched High Carbohydrate (FEHC) diet preserves bone health, reduces inflammation and modulates Wnt signalling in older adults with obesity. In this clinical trial, 86 women aged 65-85 years with obesity (BMI ≥ 30 kg/m2) undergoing hip arthroplasty were assigned to a free control diet (FCD) or a FEHC diet (FEHC) group for 3 months before surgery. Clinical, systemic, and molecular assessments were performed, including gene expression analyses in bone and muscle tissues. A significant reduction in waist circumference was observed over time in the FEHC group (p = 0.037), whereas no changes were detected in body weight, BMD or bone microarchitecture. Compared to FCD, the FEHC group showed reduced circulating IL-6 (p = 0.03), IL-8 (p = 0.022) and TNFα (p = 0.04) levels, along with lower IL-6 gene expression in muscle (p = 0.035). A strong trend of increased IGF-1 gene expression in muscle tissue of the FEHC group was also observed (p = 0.058). Gene expression analyses revealed a significant increase in WNT5a expression in muscle (p = 0.049), and an upward trend in WNT10b expression in bone (p = 0.055) while serum levels of DKK-1 were significantly higher in the FEHC group compared to FCD (p < 0.0001). The FEHC diet reduces systemic and local inflammation, without affecting skeletal health in older adults with obesity.
9. Exploring Patient and Caregiver Perceptions of the Facilitators and Barriers to Patient Engagement in Research: Participatory Qualitative Study.
期刊: Journal of participatory medicine 发表日期: 2025-Sep-30 链接: PubMed
摘要
Patient engagement in research is the meaningful and active involvement of patient and caregiver partners (ie, patients and their family or friends) in research priority-setting, conduct, and governance. With the proper support, patient and caregiver partners can inform every stage of the research cycle, but common barriers often prevent their full engagement. This participatory qualitative study aimed to answer the question: What are the facilitators and barriers to patient engagement experienced by patient and caregiver partners in a Canadian research context? Participants were N=13 patient and caregiver partners (median age 62 y, IQR 58-69 y; 11/13, 85% women; 13/13, 100% White) from 4 provinces who completed 60-90-minute semistructured videoconferencing interviews. The interviews were transcribed verbatim. A researcher and a patient partner reviewed the transcripts and curated a dataset of 90 participant quotations representing facilitators and barriers to patient engagement. This dataset was co-analyzed using participatory theme elicitation alongside 7 patient and caregiver partners with diverse identities who were not among the participants we interviewed and, therefore, contributed novel perspectives. We generated four themes depicting factors that facilitate meaningful patient engagement alongside barriers that arise when these factors are not in place: (1) Co-defining roles and expectations; (2) demonstrating the value and impact of engagement; (3) psychological safety; and (4) community outreach, training, and education. We then discuss how barriers to enacting these 4 factors can be mitigated and provide a practical checklist of considerations for both researchers and patient and caregiver partners for engaging together throughout the research cycle. Research teams conducting patient and caregiver engagement activities should draw from our findings to mitigate barriers and facilitate meaningful engagement experiences.
10. Bedtime App-Guided Mindfulness Meditation in Patients With Insomnia: Mixed Methods Feasibility and Acceptability Pilot Study.
期刊: JMIR formative research 发表日期: 2025-Sep-30 链接: PubMed
摘要
While mindfulness meditation (MM) apps have gained popularity as a tool for promoting sleep, research focusing on bedtime mindfulness practice and app usage is limited. As the first step toward understanding the efficacy and mechanisms of such bedtime practice and to inform future investigations, the goal of this pilot study was to explore the feasibility of app-guided bedtime MM practice with both in-lab and at-home physiological and self-report sleep remote assessments. We conducted a single-arm, prospective mixed methods pilot study that included both standard in-lab sleep studies and remote at-home assessments of individuals with insomnia disorder with self-reported difficulty falling asleep. Participants practiced MM guided by a commercially available smartphone app at bedtime for 4 weeks. Pre-post assessments included a battery of sleep-related and psychological health questionnaires, objective physiological sleep measures (polysomnography and actigraphy), and daily sleep logs. We also conducted qualitative exit interviews to further assess feasibility and acceptability. Transcripts were analyzed for dominant themes using inductive and deductive qualitative methods. We recruited 13 participants with chronic insomnia (symptoms ≥3 nights weekly for ≥3 months) to complete the study protocol within 8 months (retention rate 77%). We were able to collect analyzable physiological and psychometric data with overall completion rates of more than 90%. The study was deemed feasible, meeting a priori benchmarks including recruitment, retention, completion, and adherence. The 10 participants retained in the program had excellent engagement (95% completion of in-lab studies, 100% completion of questionnaires, and 91% compliance with use of the app). Our preliminary analysis of subjective measures indicated improvement in sleep quality, insomnia severity, and presleep arousal, including Pittsburgh Sleep Quality Index change of -3.7 (95% CI -6.7 to -0.7), Insomnia Severity Index change of -4.5 (95% CI -7.7 to -1.4), Pre-Sleep Arousal Scale change of -7.7 (95% CI -13.1 to -2.3), and trend toward improvement in the Ford Insomnia Response to Stress Test indicated by a change of -2.5 (95% CI -5.9 to 0.9). From qualitative data, we identified domains that inform the feasibility and acceptability of the study, including (1) barriers to sleep prior to the study, (2) benefits and skills imparted by mindfulness, and (3) feedback on app use. Benefits and skills imparted by mindfulness included decreased catastrophizing, acceptance and nonreactivity, body awareness and relaxation, self-kindness, awareness of sleep hygiene and bedtime routine, earlier defusing of stress, increased focus and presence, and calm throughout the day. Bedtime app-guided MM as an intervention in patients with insomnia and the hybrid study design with in-lab and at-home assessments are feasible and acceptable. This study informs the design of future clinical and mechanistic research examining app-guided MM to impact insomnia severity and presleep arousal.
11. Analysis of a Medically Certified, Wrist-Worn Sensor for the Assessment of Heart Rate and Energy Expenditure During Daily Activities in Patients With Chronic Heart Failure or Coronary Artery Disease and Recreational Athletes: Validation Study.
期刊: JMIR cardio 发表日期: 2025-Sep-30 链接: PubMed
摘要
Exercise capacity and lifestyle have proven to be important prognostic factors for cardiovascular patients. Both can be ameliorated through different preventive interventions. Cardiac rehabilitation and remote patient monitoring have been proven to reduce cardiac events and cardiovascular mortality. One of the most important goals of cardiac rehabilitation and remote patient monitoring is improving physical fitness and monitoring of cardiovascular parameters, which could predict cardiac deterioration. In order to monitor cardiac patients successfully, reliable and nonobtrusive devices to assess physical activity and cardiovascular parameters need to be available. This validation study aims to determine the accuracy of the Philips Health Band (PHB), a noninvasive, wrist-worn, medically certified device, for the assessment of heart rate (HR) and energy expenditure (EE) in patients with chronic cardiovascular diseases and recreational athletes (RAs). The assessment of HR and EE by the PHB was compared with indirect calorimetry (Oxycon Mobile [OM; CareFusion GmbH]) during an activity protocol consisting of daily activities. Three groups were assessed: patients with heart failure with reduced ejection fraction (HFrEF), patients with stable coronary artery disease (CAD) with preserved left ventricular ejection fraction, and RAs. A total of 57 patients were included: 19 with CAD, 19 with HFrEF, and 19 RAs. HR assessment in the HFrEF and CAD groups was significantly underestimated over the entire protocol by the PHB as compared to the OM, with poor and fair reliability, respectively. No significant difference in HR was found between the PHB and OM over the entire protocol for the RA group, with good reliability (HFrEF: mean difference 3.0; P<.001; intraclass correlation coefficient [ICC] 0.36; CAD: mean difference 2.7; P<.001; ICC 0.55; RA: mean difference 0.8; ICC 0.60). Assessment of EE showed an underestimation over the entire protocol for the RA and CAD group, with poor and fair reliability, respectively. The HFrEF group showed no significant difference in EE assessment over the entire protocol, with poor reliability (HFrEF: mean difference 0.09; ICC 0.32; CAD: mean difference 0.29; P<.001; ICC 0.46; RA: mean difference 0.79; P<.001; ICC 0.26). The responsiveness to detect within-patient changes in activity intensity of the PHB was moderate for the HFrEF and CAD groups and acceptable for the RA group. HR and EE assessment of a medically certified noninvasive sensor using a photoplethysmogram and accelerometer showed poor accuracy and moderate responsiveness during an activity protocol reflecting daily living activities in patients with stable CAD and chronic HFrEF. Accuracy of HR in RAs was good and the responsiveness for both HR and EE was acceptable. This research confirms previous research and stresses the need for better patient-specific algorithms in noninvasive sensors, taking cardiovascular pathology and medication usage into account, for assessing HR and EE prior to their implemention in patient care.
12. The Validation and Accuracy of Wearable Heart Rate Trackers in Children With Heart Disease: Prospective Cohort Study.
期刊: JMIR formative research 发表日期: 2025-Sep-30 链接: PubMed
摘要
Wearables are increasingly used in pediatric cardiology for heart rate (HR) monitoring due to advantages over traditional HR monitoring, such as prolonged monitoring time, increased patient comfort, and ease of use. However, their validation in this population is limited. The objective of this paper was to assess HR accuracy and validity from 2 wearables, the Corsano CardioWatch bracelet and the Hexoskin smart shirt, in children attending the pediatric cardiology outpatient clinic, exploring factors that influence accuracy, the Hexoskin shirt’s arrhythmia detection efficacy, and patient satisfaction. Children with an indication for 24-hour Holter monitoring were equipped with a 24-hour Holter electrocardiogram (ECG; gold standard), together with both wearables. HR accuracy was defined as the percentage of HRs within 10% of Holter values, and agreement was assessed using Bland-Altman analysis. Subgroup analyses were conducted based on BMI, age, and time of wearing, among other factors. The association between accelerometry (expressed in gravitational units, g) and HR accuracy was analyzed to assess the impact of bodily movement on measurement accuracy. A blinded pediatric cardiologist analyzed Hexoskin shirt data for rhythm classification. Patient satisfaction was measured using a 5-point Likert scale questionnaire. A total of 31 participants (mean age 13.2, SD 3.6 y; n=14, 45% female) and 36 participants (mean age 13.3, SD 3.9 y) were included for the CardioWatch and Hexoskin measurements, respectively. Mean accuracy was 84.8% (SD 8.7%) for the CardioWatch and 87.4% (SD 11%) for the Hexoskin shirt. Hexoskin shirt accuracy was notably higher in the first 12 hours (94.9%, SD 7.4%) compared to the latter 12 (80%, SD 16.7%; P<.001). Higher accuracy was observed at lower HRs (low vs high HR: CardioWatch: 90.9%, SD 9.3% vs 79%, SD 10.6%; P<.001 and Hexoskin shirt: 90.6%, SD 14% vs 84.5, SD 11.8%; P<.001). Both wearables demonstrated good agreement in their HR measurement with Holter readings (CardioWatch bias: -1.4 beats per minute [BPM]; 95% limits of agreement [LoA] -18.8 to 16.0. Hexoskin shirt bias: -1.1 BPM; 95% LoA -19.5 to 17.4). HR measurement accuracy declined during more intense bodily movements. Correct classification of the Hexoskin’s shirt rhythm recordings was achieved in 86% (31/36) of cases. Patient satisfaction scores were significantly higher for both the CardioWatch (median 3.8, range 3.5-4.3; P<.001) and Hexoskin shirt (median 3.7, range 3.0-4.0; P<.001) compared to the Holter (median 2.6, range 2.1-3.2). The Corsano CardioWatch and Hexoskin shirt demonstrate good accuracy in pediatric HR monitoring and provide higher patient comfort than conventional monitoring. Both wearables show good agreement in relation to the gold standard device. However, measurement accuracy declines with increasing bodily movement and higher heart rates. More research is needed to explore the underlying causes for these inaccuracies and how to counteract them. The Hexoskin shirt also shows potential in arrhythmia detection. While further development is warranted, these wearables show promise in enhancing diagnostics, therapeutic monitoring, and patient safety in pediatric cardiology.
13. Comparative Analysis of Outcomes of Influenza and COVID-19 Admissions Among Children With Asthma: A Nationwide Retrospective Cohort Study Using the US National Readmissions Database.
期刊: JMIR medical informatics 发表日期: 2025-Sep-30 链接: PubMed
摘要
Asthma is a common chronic respiratory disease with increasing prevalence among children over the past few decades. It can cause significant respiratory symptoms and acute exacerbations, often requiring emergency care or hospitalization. Moreover, exposure to respiratory viral infections, such as COVID-19 and influenza, can trigger severe complications in children with asthma. Despite these concerns, few studies have directly compared the in-hospital outcomes of children with asthma experiencing these infections. This study aimed to compare the in-hospital outcomes of these infections in children with asthma from a population-based perspective. We conducted a population-based retrospective cohort study using data from the 2020 US Nationwide Readmissions Database. Children aged 1 to 19 years with asthma who were admitted for COVID-19 or influenza were eligible for inclusion. Outcomes evaluated included in-hospital mortality, major complications, and 90-day readmission rate. Survey-weighted logistic regression models were used to compare clinical outcomes between the two infection groups, adjusting for demographic and clinical characteristics. A total of 1472 hospitalized children with asthma were included, of whom 405 (27.5%) were admitted for COVID-19 and 1067 (72.5%) for influenza. After adjustment, the multivariate analysis revealed that children admitted for COVID-19 had a significantly higher risk of sepsis or shock (adjusted odds ratio [aOR] 4.30, 95% CI 1.79-10.32) but a lower risk of bacterial or fungal pneumonia (aOR 0.37, 95% CI 0.23-0.61) compared with those admitted for influenza. Stratified analyses by age revealed that among children aged 1 to 5 years, the risk of 90-day readmission was significantly higher for those with COVID-19 than for those with influenza (aOR 3.02, 95% CI 1.09-8.35). No significant difference in in-hospital mortality was detected between the two infection groups in either the multivariable model or any of the age-stratified analyses. US children with asthma hospitalized for COVID-19 had higher risks of sepsis or shock compared to those admitted for influenza. In contrast, children admitted for influenza had a higher risk for bacterial or fungal pneumonia. After stratifying by age, children aged 1 to 5 years with COVID-19 had a significantly higher risk of 90-day readmission than those with influenza. Our findings suggest that different clinical approaches may be needed for children with asthma, depending on infection etiology and patient age.
14. Professional Support Through a Tailor-Made Mobile App to Reduce Stress and Depressive Symptoms Among Family Caregivers of People With Dementia: Mixed Methods Pilot Study.
期刊: JMIR formative research 发表日期: 2025-Sep-30 链接: PubMed
摘要
Providing informal care to people with dementia living at home can be challenging and may cause caregiver stress and depression. Interventions delivered through mobile apps provide innovative solutions for community-based social care professionals to address the increasing support needs of family caregivers (FCs) of people with dementia. This study aimed to examine, among FCs of people with dementia living at home, (1) the potential association between professional support provided through a mobile app and caregiver stress and depressive symptoms, (2) types of support provided through chat interactions between FCs and social care professionals, and (3) how support provided through a mobile app relates to changes in caregiver stress and depressive symptoms. A mixed methods pilot study integrated quantitative pre- and postintervention data with qualitative logged chat data. FCs of people with dementia living at home (n=35) were recruited to test a tailor-made mobile app over 8 weeks. The primary and secondary outcome measures were caregiver stress and depressive symptoms, respectively. Descriptive statistics were used to summarize sociodemographic factors; inferential statistics were used to analyze mean differences in outcomes pre- and postintervention. FCs were divided into 3 groups based on changes in caregiver stress scores between pre- and postintervention. Generalized linear model analyses determined the association between participation in the intervention and caregiver stress and depressive symptoms, adjusting for age, gender, and relationship to the person with dementia. Logged chat data were analyzed using summative content analysis to identify types of support provided and received. Changes in caregiver stress were integrated with chat data to determine patterns in types of support received. The mean age of FCs was 69.4 (SD 11.9) years, with most being women (28/35, 80%), partners (24/35, 68.6%), and living with the person with dementia (26/35, 74%). The mean score of caregiver stress was marginally higher postintervention (24.1, SD 9.3) than preintervention (23.9, SD 9.2), whereas the mean score of depressive symptoms decreased from pre- (6.5, SD 5.1) to postintervention (6.2, SD 5.2). These differences were not statistically significant. Regression analyses showed that participation in the intervention was not statistically significantly associated with caregiver stress (β=0.171, α=.05; P=.86) or depressive symptoms (β=-0.293, α=.05; P=.75) after adjusting for age, gender, and relationship to the person with dementia. However, mixed methods analysis at the subgroup level suggested that frequent tailored support by social care professionals delivered through a mobile app may reduce caregiver stress among FCs of people with dementia living at home. The study highlights the importance of providing frequent and individualized support to meet the needs of FCs of people with dementia. Findings from this study may help community-based social care providers plan and organize digital support content provided to FCs of people with dementia living at home.
15. Culturally Tailored Diabetes Self-Management Education and Support Programs in Black African and Caribbean Adults With Type 2 Diabetes (HEAL-D): Protocol for a Multicenter, Pragmatic Randomized Controlled Trial.
期刊: JMIR research protocols 发表日期: 2025-Sep-30 链接: PubMed
摘要
People of Black African and Black Caribbean ethnicity experience higher rates and poorer outcomes of type 2 diabetes (T2D) than people of White European ethnicity; these inequalities are compounded by poor healthcare access. Cultural tailoring of diabetes self-management education and support (DSMES) programs has the potential to improve healthcare engagement and clinical outcomes for ethnic minority groups. Healthy Eating & Active Lifestyles for Diabetes (HEAL-D) is a co-designed, culturally tailored group-based DSMES program for adults of Black African and Black Caribbean ethnicity. This trial aims to evaluate the clinical and cost effectiveness of the HEAL-D intervention, compared to standard DSMES programs, in Black African and Black Caribbean adults living with T2D. A 24-month, multicenter, pragmatic, open-label, 2-arm, parallel-group, individually randomized group treatment trial will be conducted, with primary end point (glycated hemoglobin [HbA1c]) assessment at 12 months. Black African and Black Caribbean adults with T2D (n=300), recruited from 3 to 5 centers in the United Kingdom (including London, West Midlands, and Greater Manchester), will be randomized in a 1:1 ratio to HEAL-D (intervention) or a standard DSMES program (control). HbA1c, blood lipids, anthropometric outcomes, blood pressure, physical activity, and patient-reported outcome measures relating to psychological well-being and self-management support, lifestyle behaviors, and health economics will be collected at baseline and follow-up visits (6, 12, and 24 months). Cost-effectiveness will be assessed through a cost-utility analysis conducted from a health and social care perspective. A mixed methods process evaluation will provide a formative evaluation of delivery, intervention fidelity, and implementation of HEAL-D, and an embedded study within a project will assess the impact of multiple long-term conditions on uptake of, and engagement with HEAL-D, and the impact of HEAL-D on multiple long-term conditions. The trial received Research Authority and Research Ethics Council approval on April 22, 2024. Funding began in August 2023. Site “green light” was received on August 15, 2024, for London; November 29, 2024, for Manchester; and January 31, 2025, for the West Midlands. Recruitment commenced in August 2024 and is due to run for 11 months. As of March 26, 2025, a total of 76 participants have consented. Last patient, last visit is expected in June 2027; primary data analysis is expected to begin in July 2027. Final results are anticipated to be available in September 2027, and publication is expected by the end of 2027. The HEAL-D trial will address whether a culturally tailored DSMES program, provided in-person or via videoconferencing, is clinically and cost-effective compared to standard DSMES at improving diabetes management in Black African and Black Caribbean adults. If effective, this would provide an evidence-based model of equitable DSMES services and improve the implementation of healthcare programs for ethnic minority groups. ISRCTN 1434448; https://www.isrctn.com/ISRCTN14344948. DERR1-10.2196/71861.
16. Severity Classification of Anxiety and Depression Using Generalized Anxiety Disorder Scale and Patient Health Questionnaire: National Cross-Sectional Study Applying Classification and Regression Tree Models.
期刊: JMIR public health and surveillance 发表日期: 2025-Sep-30 链接: PubMed
摘要
Scalable and accurate screening tools are critical for public mental health strategies, especially in low- and middle-income countries (LMICs). While the Generalized Anxiety Disorder Scale (GAD-7) and Patient Health Questionnaire (PHQ-9) are widely used, their full application in large-scale programs can pose feasibility challenges. By contrast, shorter versions like GAD-2 and PHQ-2 reduce burdens but fail to capture symptom diversity. This study aimed to optimize screening for anxiety and depression severity using classification and regression tree (CART) models, identifying concise and high-performing decision rules based on the GAD-7 and PHQ-9 items, and to test their reproducibility in 5 independent datasets. A cross-sectional, nonprobabilistic study was conducted with 20,585 Brazilian adults from all 27 states and more than 3,000 cities, collected using digital outreach. Anxiety and depression symptoms were assessed using the GAD-7 and PHQ-9. CART models were trained and tested on bootstrapped samples (70% training, 30% testing), totaling 45,000 trees per scale. Each model used combinations of scale items and sociodemographic predictors. Robustness was evaluated via 10-fold cross-validation and evaluation across 3 hyperparameter configurations (minsplit and minbucket=500, 1000, 2000). Performance metrics included accuracy, sensitivity, specificity, precision, F1-score, and area under the curve (AUC). The CART models produced concise, high-performing decision rules-using only 2 items for the GAD-7 and 3 for the PHQ-9. No sociodemographic variable appeared in the final classification paths. For GAD-7, the models achieved an accuracy of 86.1% for minimal or mild severity and 85.1% for severe cases, with both categories showing AUC values above 0.900. By contrast, the moderate severity class had lower performance, with accuracy around 51% and an AUC of 0.728. For PHQ-9, the models achieved 81.7% accuracy for minimal or mild cases and 78.8% for severe cases, with AUCs again exceeding 0.900 for the extreme classes; the moderate or moderately severe class showed 66.9% accuracy and an AUC of 0.776. The most frequently repeated rules included the following: “GAD2<2 and GAD4<2” for identifying minimal or mild anxiety and “GAD2≥2 and GAD4=3” for severe anxiety; for depression, “PHQ2<2and PHQ4<2” for minimal or mild cases and “PHQ2≥2 and PHQ8≥2” for severe cases. These rule-based models demonstrated stable performance across thousands of bootstrapped replications and showed reproducibility in 5 independent datasets through external validation. CART models enabled simplified, symptom-specific pathways for stratifying anxiety and depression severity with high precision and minimal item burden. These rule-based shortcuts offer an efficient alternative to fixed short forms (eg, GAD-2, PHQ-2) by preserving symptom diversity and severity discrimination. The findings support and lay the groundwork for adaptive, cost-effective screening and intervention models, especially in resource-limited settings and LMICs.
17. How Engagement Changes Over Time in a Digital Eating Disorder App: Observational Study.
期刊: JMIR mHealth and uHealth 发表日期: 2025-Sep-30 链接: PubMed
摘要
Engagement with digital mental health interventions is often measured as a summary-level variable and remains underresearched despite its importance for meaningful symptom change. This study deepens understanding of engagement in a digital eating disorder intervention, recovery record, by measuring engagement with unique components of the app, on 2 different devices (phone and watch), and at a summary level. This study described and modeled how individuals engaged with the app across a variety of measures of engagement and identified baseline predictors of engagement. Participants with current binge-eating behavior were recruited as part of the Binge Eating Genetics Initiative study to use a digital eating disorder intervention for 4 weeks. Demographic and severity of illness variables were captured in the baseline survey at enrollment, and engagement data were captured through both an iPhone and Apple Watch version of the intervention. Engagement was characterized by log type (urge, behavior, mood, or meal), device type (logs on phone or watch), and overall usage (total logs) and averaged each week for 4 weeks. Descriptives were tabulated for demographic and engagement variables, and multilevel growth models were conducted for each measure of engagement with baseline characteristics and time as predictors. Participants (N=893) self-reported as primarily White (743/871, 85%), non-Hispanic (801/893, 90%), females (772/893, 87%) with a mean age of 29.6 (SD 7.4) years and mean current BMI of 32.5 (SD 9.8) kg/m2 and used the app for a mean of 24 days. Most logs were captured on phones (217,143/225,927; 96%), and mood logs were the most used app component (174,818/282,136; 62% of logs). All measures of engagement declined over time, as illustrated by the visualizations, but each measure of engagement illustrated unique participant trajectories over time. Time was a significant negative predictor in every multilevel model. Sex and ethnicity were also significant predictors across several measures of engagement, with female and Hispanic participants demonstrating greater engagement than male and non-Hispanic counterparts. Other baseline characteristics (age, current BMI, and binge episodes in the past 28 days) were significant predictors of 1 measure of engagement each. This study highlighted that engagement is far more complex and nuanced than is typically described in research, and that specific components and mode of delivery may have unique engagement profiles and predictors. Future work would benefit from developing early engagement models informed by baseline characteristics to predict intervention outcomes, thereby tailoring digital eating disorder interventions at the individual level.
18. Postoperative atrial fibrillation and stroke after non-cardiac surgery: a systematic review and meta-analysis.
期刊: European heart journal. Cardiovascular pharmacotherapy 发表日期: 2025-Sep-30 链接: PubMed
摘要
Postoperative atrial fibrillation (POAF) is common after non-cardiac surgery. Because often transient, there are uncertainties on the associated risk of stroke, possibly driving the need for long-term anticoagulation. We performed a systematic PubMed search until January 16th, 2025, related to the incidence of stroke in patients with POAF after non-cardiac surgery. We included papers reporting outcomes, excluding studies only dealing with epidemiology, mechanisms, management and treatment. We excluded studies reporting on POAF after cardiac surgery. Risk of bias was assessed for each study, and the certainty of evidence was evaluated using the GRADE methodology. We retrieved and included 40 studies (including review papers) for the systematic review. These were then further selected to create a final list of 19 studies included in the meta-analysis. The reported incidence of stroke after POAF was found to be widely variable, ranging between 0.4% and 16.7% at 1 year. Stroke incidence also varies widely according to the type of surgery and patient characteristics. With only three exceptions, all studies, however, reported a risk of stroke higher in the POAF group than in the no-POAF group, with a mean Odds Ratio (OR) of 3.02. POAF on average triples the risk of stroke, with variations related to patient characteristics and type of surgery. Patients after non-cardiac surgery should be monitored at least during hospitalization to detect POAF. Future studies are necessary to evaluate optimal duration and modalities of monitoring, as well as to assess the relevance of symptomatic vs asymptomatic AF episodes.
19. Assessment of a Digital Platform for Routine Outcome Monitoring in Psychotherapy: Usability Study and Thematic Analysis.
期刊: JMIR medical informatics 发表日期: 2025-Sep-30 链接: PubMed
摘要
The integration of digital tools into psychotherapy has gained increasing attention, particularly for practices such as routine outcome monitoring (ROM), which involves the regular collection of patient-reported data to inform treatment decisions. However, despite the potential benefits, the adoption of digital platforms remains limited, partly due to usability concerns and workflow misalignment. This study aimed to assess the usability of a digital platform, Mindy, designed to support psychotherapists in implementing ROM and to explore broader challenges associated with the integration of digital tools into psychotherapeutic practice. This study adopted a qualitative, 2-stage approach. Sixteen psychotherapists participated in semistructured interviews, which included task-based usability testing and reflective discussions. Participants interacted with Mindy by performing typical clinical tasks, such as creating patient profiles, managing session data, and sending questionnaires. The first stage of analysis used a deductive thematic approach focused on predefined platform functionalities. The second stage followed an inductive methodology to identify broader themes related to the integration of digital tools in psychotherapy. The usability assessment identified strengths in the platform’s appointment scheduling, questionnaire delivery, and dashboard functionalities, which were perceived as intuitive and supportive of ROM practices. However, limitations were reported in areas such as documentation flexibility, interoperability with other systems, and control over information sharing with patients. Broader thematic analysis revealed three main challenges: (1) the tension between standardized documentation and the need for narrative and implicit information; (2) difficulties in embedding digital platforms into existing therapeutic workflows, especially for clinicians less familiar with technology; and (3) concerns about confidentiality and the potential for misinterpretation when sharing therapeutic notes with patients. These findings underscore the importance of considering both technical and contextual dimensions when developing and implementing digital platforms in mental health care. Tailoring digital tools to the needs and practices of psychotherapists may improve adoption and ultimately enhance the quality of care.
20. Comparing the Clinical Work of Advanced Practice Professionals Working Within and Outside of Accountable Care Organizations.
期刊: Medical care 发表日期: 2025-Sep-30 链接: PubMed
摘要
Health care delivery organizations increasingly employ advanced practice professionals (APPs) and participate in alternative payment models such as accountable care organizations (ACOs). Given the former’s incentive to constrain spending, APPs’ practice patterns may vary in ACO-participating versus non-ACO practices. To compare outpatient care provided by APPs and physicians through ACO participation. We used multivariate linear regression to compare measures of workload allocation and billing across ACO-participating and non-ACO practices in 2022, controlling for practice size and market. A total of 91,149 practices, 12,072 in a Medicare Shared Savings Program ACO in 2022. We used 100% fee-for-service Medicare claims to identify ACO-participating and non-ACO practices. For every practice, we calculated the share of outpatient encounters provided by APPs rather than physicians and the share of APP-provided encounters billed indirectly to Medicare. We also calculated the share of annual wellness visits, chronic condition care management services, transitional care management services, and postoperative visits provided by APPs. APPs provided a smaller share of outpatient encounters at ACO-participating versus non-ACO practices, but were more likely to bill indirectly. Among most categories of routine services (eg, annual wellness visits and chronic condition management), APPs provided a smaller share of services at ACO-participating versus non-ACO practices. In the largest quartile of practices, APP practice patterns were more similar across ACO-participation status, and indirect billing was less likely within ACOs. Findings provide little evidence that ACOs deploy their APP workforce in a more cost-conscious manner than non-ACOs.
21. Variants in CALD1, ESRP1, and RBFOX1 are associated with orofacial cleft risk.
期刊: PLoS genetics 发表日期: 2025-Sep-30 链接: PubMed
摘要
Nonsyndromic orofacial clefts (OFCs) are common, heritable birth defects caused by both genetic and environmental risk factors. Despite the identification of many genetic loci harboring OFC-risk variants, there are many unknown genetic determinants of OFC. Furthermore, while the process of embryonic facial development is well characterized, the molecular mechanisms that underly it are not. This represents a major hurdle in understanding how disruptions in these biological processes result in OFC. Thus, we sought to identify novel OFC-risk loci through a genome-wide multi-ancestry study of five nested OFC phenotypes (isolated cleft lip [CLO], isolated cleft palate [CPO], cleft lip and palate [CLP], cleft lip with/without cleft palate [CL/P], and any cleft [ANY]) representing distinct cleft subtypes to identify subtype-specific signals and grouped types to maximize power to detect shared genetic effects. We performed genome-wide meta-analyses of these five OFC phenotypes from three cohorts totaling >14,000 individuals using METAL. In addition to replicating 13 known OFC-risk loci, we observed novel association in three regions: the 1p36.32 locus (lead variant rs584402, an intergenic variant, pCLO = 3.14e-8), the 7q33 locus (lead variant rs17168118, an intronic variant in CALD1, pCLP = 9.17e-9), and the 16p13.3 locus (lead variant rs77075754, an intronic variant in RBFOX1, pCL/P = 1.53e-9, pANY = 1.93e-9). We also observed a novel association within the known risk locus 8q22.1 that was independent of the previously reported signal (lead variant rs4735314, an intronic variant in ESRP1, pCLP = 1.07e-9, pCL/P = 3.88e-8). Next, we performed multi-tissue TWAS with s-MulTiXcan and identified four overlapping genes with significant genetically predicted transcription associated with OFC risk. These genes also overlapped the genome-wide significant association signals from the meta-analysis, including CALD1 and ESRP1 and known OFC-risk genes TANC2 and NTN1. Each of the newly reported loci has potential regulatory effects, including evidence of craniofacial enhancer activity, that offer new clues as to the molecule mechanisms underlying embryonic facial development.
22. A Stage of Change Theory-Based, Stage-Matched Intervention for Healthy Dietary Intake Among Office Workers in a Low- to Middle-Income Country: Protocol for a Cluster Randomized Trial.
期刊: JMIR research protocols 发表日期: 2025-Sep-30 链接: PubMed
摘要
An unhealthy diet is a well-established risk factor for the development of noncommunicable diseases, and office workers are at a higher risk of noncommunicable diseases due to their sedentary work style. Stage of change (SOC) theory-based and stage-matched interventions effectively influence dietary and behavior changes. The effectiveness of such interventions in the context of low- and middle-income countries is yet to be assessed. This protocol describes a cluster randomized trial planned to evaluate the effectiveness of an intervention for changing dietary behavior among government office workers in the Galle district in Sri Lanka. A cluster randomized trial was conducted in 20 clusters divided into intervention and control arms. A cluster was an office with 30 clerical-type workers who were sedentary at work. A stage-matched intervention based on behavior change processes was implemented in the intervention clusters for 3 months. Participants were provided with an intervention matched to their SOC at baseline. Precontemplators and contemplators received awareness-raising and emotional arousal interventions. Others received goal setting and self-monitoring interventions. The SOC and dietary intake were assessed at baseline and the postintervention stage through a staging algorithm, and 24-hour dietary recall was supplemented with a picture guide and computer software. Adherence to the intervention was assessed monthly. We hypothesized that participants would achieve a progressive change in the SOC and healthy dietary intake in the intervention clusters compared to the control clusters. By December 2024, the planned intervention was completed. Data analysis on the effectiveness of the intervention is to be completed and published in 2025. This protocol reports a stage-matched intervention based on SOC theory, enriching the current knowledge base with new evidence from office workers in a low- to middle-income country. Sri Lanka Clinical Trials Registry SLCTR/2020/025; https://slctr.lk/trials/slctr-2020-025. DERR1-10.2196/70293.
23. APOE ε4 Allele and Methylation Patterns Linked to Cardiovascular Outcomes in Women With Breast Cancer.
期刊: Biological research for nursing 发表日期: 2025-Sep-30 链接: PubMed
摘要
DNA methylation affects gene expression. While the Apolipoprotein E (APOE) genotype impacts cardiovascular risk, APOE methylation impact remains unknown, particularly in women with breast cancer (BC). This study explored associations of APOE methylation with hypertension history and cardiovascular fitness (CVF) and whether APOE genotype and methylation moderate exercise effects over 6 months. This study leveraged data from a 6-month exercise randomized clinical trial in postmenopausal women with BC. Using peripheral blood, methylation M-values (Illumina Infinium Methylation EPIC Beadchip) and 13 CpG sites within and 2kb 5’ and 3’ to APOE were abstracted post data quality checks. Outcome variables: self-reported hypertension and CVF (peak oxygen consumed per kilogram per minute [VO2max/kg/min] and peak metabolic equivalents [METs] through graded exercise testing). Participants completed 150 min/week of aerobic exercise or usual care for 6 months. Logistic and linear regression examined associations between CpG M-values and hypertension, VO2max/kg/min and METs. Baseline M-value and APOE genotype were interaction terms for longitudinal analyses. This study included 102 women (Mean = 62 yrs). APOEε4 carriers had increased methylation of cg06750524 (p = 0.04) and cg19514613 (p = 0.03), but lower methylation of cg21879725 (p = 0.04). Increased cg06750524 methylation was associated with higher hypertension odds (p = 0.022, OR = 2.813) and lower VO2max/kg/min and METs (p = 0.005). Increased cg05501958 methylation (M = 4.539, SD = 0.17) was associated with lower hypertension odds (p = 0.02, OR = 0.035) and higher VO2max/kg/min and METs (p = 0.022). Neither APOE ε4 nor baseline methylation moderated exercise effects. APOE methylation, differentially by ε4 carriage, may impact cardiovascular outcomes and serve as a biomarker of risk in women with BC.
24. Mental health promotion by local governments: a consensus study on community mental health workers.
期刊: Discover mental health 发表日期: 2025-Sep-30 链接: PubMed
摘要
Mental illness is a leading cause of disability worldwide and requires responses that extend strictly clinical care. Community health workers are increasingly recognized for their potential, yet no clear guidelines exist regarding their roles and training in mental health. This study aimed to establish expert consensus on a framework for implementing a Community Mental Health Worker Program within local governments, focusing on training requirements, strategic priorities, service delivery approaches and potential forms of funding. A three-round Delphi study was conducted with thirty experts. Participants rated fifty-seven items, ranked two sets of options, and answered three open-ended questions. Consensus was defined as 70% agreement (rated as “strongly agree” or “agree”) or disagreement (rated as “strongly disagree” or “disagree”) on a five-point Likert scale. Fifty-one items reached consensus. The ranking questions achieved moderate to strong agreement by round three. The open-ended responses generated 226 segments, grouped into twenty categories. Experts agreed that community mental health workers play a vital role in community-based mental health promotion, working collaboratively and intersectionally with various stakeholders. However, appropriate training is lacking and is considered crucial for ensuring their public recognition. Providing adequate funding is considered the primary incentive for implementing such programs. This study made it possible to gather consensus on the critical role of community mental health workers and the urgent need for structured training programs at the local level. It also identified key elements and strategic strategic approaches essential for implementing a successful Community Mental Health Worker Program.
25. The effect of dioxin exposure on diabetes and potential dietary modification in the Korean population.
期刊: Endocrine 发表日期: 2025-Sep-30 链接: PubMed
摘要
26. Modulation of the rhizosphere microbiome structure and optimization of beneficial functions in winter wheat induced by Bacillus subtilis: a metagenomic and phenotypic study.
期刊: FEMS microbiology ecology 发表日期: 2025-Sep-30 链接: PubMed
摘要
The rhizosphere microbiome critically determines plant health and productivity. This study investigated the impact of Bacillus subtilis H38 on the taxonomic and functional profiles of the winter wheat (Triticum aestivum L.) rhizosphere microbiome under typical chernozem conditions using 16S rRNA gene sequencing and shotgun metagenomics, complemented by plant phenotypic evaluation and targeted metabolite analysis. Inoculation with B. subtilis H38 significantly restructured the rhizosphere bacterial community, increasing alpha-diversity (Shannon index from 5.8 to 6.7) and showing distinct clustering in beta-diversity analysis. The relative abundance of putative plant-beneficial genera, including Bacillus, Pseudomonas, Azotobacter, and Streptomyces, was significantly elevated. Shotgun metagenomic analysis revealed enrichment of functional genes associated with nitrogen fixation, phosphorus mobilization, phytohormone biosynthesis, siderophore production, and synthesis of antimicrobial compounds. Targeted metabolomic analysis confirmed elevated levels of indole-3-acetic acid (IAA) and key siderophores. Concurrently, treated wheat plants exhibited an 18.0% increase in above-ground biomass and a 25.0% increase in root length under field conditions. These findings underscore the potential of B. subtilis to beneficially reshape the rhizosphere microbiome and its metagenome, leading to enhanced plant growth, and highlight its utility as a potent biofertilizer for improving wheat productivity. This research reinforces the potential of harnessing beneficial plant-microbe interactions to enhance agricultural productivity while minimizing dependence on synthetic agrochemicals.
27. Pathways to promotion: Leveraging your network for academic success.
期刊: Journal of hospital medicine 发表日期: 2025-Sep-30 链接: PubMed
摘要
28. Is Clinical Outcome Pathogen Related? Characteristics and Outcomes of ICU Patients with Severe Acute Respiratory Infections: Focusing on Respiratory Syncytial Virus, Human Metapneumovirus, Influenza Virus, and Parainfluenza Virus.
期刊: Journal of intensive care medicine 发表日期: 2025-Sep-30 链接: PubMed
摘要
IntroductionViral severe acute respiratory infections (SARI) are a major cause of intensive care unit (ICU) admission, with a significant burden and mortality. Comparative clinical data of patients admitted to the ICU with virus infections other than SARS-CoV-2 or influenza virus (IV) infection are limited. Therefore, this study investigates patient characteristics, clinical outcomes, and ventilation parameters of ICU patients admitted with SARI caused by Respiratory syncytial virus (RSV), Human metapneumovirus (HMPV), IV, or Parainfluenza virus (PIV).MethodsA retrospective cohort study was conducted of patients with SARI admitted to the ICU of the Spaarne Gasthuis, a Dutch secondary teaching hospital, between 2017 and 2023.Results277 patients were included, with RSV (n = 51), HMPV (n = 40), IV (n = 142), and PIV (n = 44) infections respectively. Pre-existing hematological malignancies were more common in RSV patients. No significant differences were found in length of hospital stay or ventilation parameters across the respective virus groups. Median duration of ICU stay was four days (IQR 2-7). Bacterial co-infections, pulmonary infiltrates and a higher ROX-index were more common in patients with noninvasive ventilation (NIV) failure. Hospital mortality rates were not different between the groups; RSV (25.5%), HMPV (15%), IV (24.6%), and PIV (20.5%).ConclusionThis study analyzed ICU patients with SARI caused by HMPV, RSV, IV, or PIV, revealing four key findings: high ICU, hospital and 1 year mortality rates with no differences and similar mechanical ventilation parameters between the groups, risk factors for NIV failure linked to prolonged ventilation, and co-morbidities associated with severe disease.
29. MitoQ reduces senescence burden in Doxorubicin-treated endothelial cells by reducing mitochondrial ROS and DNA damage.
期刊: American journal of physiology. Heart and circulatory physiology 发表日期: 2025-Sep-30 链接: PubMed
摘要
Cardiovascular toxicity is one of the adverse consequences of chemotherapy, limiting its therapeutic application. Chemotherapeutics, such as doxorubicin (DOXO), induce endothelial dysfunction via genotoxic effects, and reactive oxygen species (ROS) and mitochondrial ROS (mtROS) generation. These mechanisms increase DNA damage and cellular senescence, a persistent cell cycle arrest promoting inflammation, which elevates future cardiovascular disease risk. The adverse impact of DOXO on endothelial function can be mitigated by the mitochondria-targeted antioxidant, MitoQ; however, its precise protective mechanism in endothelial cells (ECs) remains unclear. The present study hypothesizes that co-treating ECs with MitoQ and DOXO attenuates DOXO-induced mtROS, thereby reducing DNA damage, senescence, and inflammation. Mitochondrial superoxide levels, mitochondrial mass, DNA damage, and cellular senescence were assessed in human umbilical vein ECs (HUVECs) 48 hours after DOXO and/or MitoQ treatment. DOXO treatment increased mtROS production and reduced mitochondrial mass compared to the vehicle group. Co-treatment with MitoQ decreased mtROS production and preserved mitochondrial mass compared to DOXO alone. MitoQ Co-treatment prevented senescence induction in DOXO-treated HUVECs, evidenced by preventing increased mRNA expression for senescence markers and senescence-associated beta-galactosidase (SA-ꞵgal) activity, alongside higher cell proliferation (BrdU incorporation). Additionally, MitoQ co-treatment reduced DNA damage and telomere dysfunction (DNA damage signaling at telomeres) compared to DOXO alone. Collectively, these data suggest mtROS drives cellular senescence in ECs through increased DNA damage and telomere dysfunction. These findings provide insight into mechanisms underlying DOXO-induced endothelial dysfunction and support mitochondrial-targeted antioxidant treatment as a potential therapeutic to mitigate chemotherapy-induced cardiovascular toxicity.
30. Effects of thyroid-stimulating hormone and sensitivity to thyroid hormones on the risk of hyperuricemia in euthyroid adults.
期刊: Archives of endocrinology and metabolism 发表日期: 2025-Sep-30 链接: PubMed
摘要
The current study was conducted to investigate whether thyroid-stimulating hormone (TSH) and thyroid hormone sensitivity are associated with hyperuricemia probability in euthyroid population. The observational analysis was based on a Chinese community-based cohort (n = 1,972). The prospective associations of TSH levels, TSH index (TSHI), thyrotrophic thyroxine resistance index (TT4RI), thyroid feedback quantile-based index (TFQI) and free triiodothyronine to free thyroxine (FT3/FT4) ratio with the risk of hyperuricemia were examined. Two-sample Mendelian randomization (MR) analysis was then used to test the causal effects of TSH on serum uric acid (SUA) levels and gout. Among 1,972 participants with normal thyroid function, 244 new hyperuricemia cases were identified during follow-up. The results suggested that the higher levels of TSH (HR = 1.87, 95% CI: 1.28-2.73, p-value < 0.01), TSHI (HR = 2.02, 95% CI: 1.38-2.95, p-value < 0.01), TFQI (HR = 1.92, 95% CI: 1.33-2.76, p-value < 0.01) and TT4RI (HR = 1.93, 95% CI: 1.34-2.80, p-value < 0.01) were significantly associated with hyperuricemia incidence. The MR results further indicated causal effects of TSH on SUA levels (inverse variance weighting [IVW] β = 0.037, 95% CI: 0.017-0.057) and gout (IVW OR = 1.0018, 95% CI: 1.0004-1.0032). The higher levels of TSH, TSHI, TFQI and TT4RI are significantly associated with the risk of hyperuricemia in euthyroid population. The MR analysis supports the causal effects of TSH on SUA levels and gout.
31. Knowledge, attitudes, and practices on anthrax in selected game management areas in Zambia.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Sep-30 链接: PubMed
摘要
In this study, we investigated anthrax, a zoonotic disease, at the human-wildlife-livestock interface in Zambia, focusing on Simalaha Conservancy, Blue Lagoon, and Lochinvar National Parks. These areas represent key points where illegal wildlife trade and anthrax risk coexist. Although anthrax remains endemic in Zambia, there is limited data on community knowledge, attitudes, and practices (KAPs) related to anthrax transmission and the role of wildlife trade value chains in its spread and maintenance. Therefore, we examined how these community KAPs influence anthrax transmission through the illegal game meat trade. We conducted a cross-sectional study involving 1,187 participants and analyzed data using descriptive statistics and logistic regression. Our findings revealed significant variations between knowledge of anthrax and behavior. While more than 80% of respondents demonstrated positive attitudes and safe practices, their knowledge of anthrax remained limited. Specifically, 72.5% of participants had low awareness of the disease, yet 82.1% acknowledged its severity, and 59.4% recognized vaccination as a control measure. Despite these positive attitudes, misconceptions about anthrax transmission and treatment were widespread. Some community members relied on spiritual or herbal remedies rather than seeking medical intervention. We also identified several risky behaviors that contribute to anthrax transmission. Notably, 14.9% of respondents admitted to consuming meat from animals that had died suddenly, while 46.3% reported handling potentially infected carcasses or animal products without taking safety precautions. We found strong correlations between knowledge, attitudes, practices, and education levels. Our results showed that prior exposure to anthrax information was the strongest predictor of knowledge (β > 1). Our findings highlight the urgent need for targeted public health interventions, improved veterinary services, and stricter enforcement of wildlife trade regulations to reduce the risk of anthrax transmission in these communities.
32. Factors affecting occupational stress: Identification, classification and determination of importance.
期刊: Work (Reading, Mass.) 发表日期: 2025-Sep-30 链接: PubMed
摘要
Backgroundoccupational stress is one of the problems that exists in almost all jobs and positions. In the related studies, researchers have considered various and numerous factors to be involved in causing occupational stress.ObjectiveThe purpose of this study is to identify, categorize and determine the importance of factors related to occupational stress.MethodA variety of databases were searched and reviewed from 2000 to 2022. In the first stage, 8702 articles were found. One-hundred articles were kept for review after careful screening and factors associated with occupational stress were identified. Fuzzy Dematel method was used for the relationship between identified factors and AHP fuzzy method was used for pairwise comparison of factors. The obtained network was modeled using Bayesian network to determine the importance of factors.ResultsFinally, 89 factors that causing stress in the workforce were identified and extracted. The factors were divided into 7 main categories: individual, occupational, organizational, work environmental, political and cultural, economic, and social. Among all the factors influencing occupational stress, job-related factors have the greatest impact, accounting for 23.1%, while cultural and political factors have the least influence at 6.2%. In a Bayesian network, if all factors are at a very weak level, occupational stress will be severe, with a proportion of 66.5%.ConclusionUsing the findings of this research, it is possible to prioritize the factors affecting the occurrence of occupational stress and try to eliminate or reduce them.
33. Triple-Synergistic Mitochondria-Targeted NIR Fluorescent Probe for Mitochondrial Hydrogen Sulfide: Precision Monitoring and Image-Guided Resection of Metastatic Breast Cancer.
期刊: Analytical chemistry 发表日期: 2025-Sep-30 链接: PubMed
摘要
Metastatic breast cancer (MBC) is the primary cause of breast cancer-related mortality, where mitochondrial H2S (Mito-H2S) serves as a key metastatic mediator. However, further understanding of Mito-H2S metabolism during metastasis remains limited, largely due to a lack of specific imaging probes. Additionally, the inherently low signal-to-noise (S/N) ratio of most fluorescent probes presents significant challenges for tumor localization and surgical resection. To address these, we developed an activatable near-infrared fluorescent probe (SCy-H2S) featuring triple-synergistic mitochondrial targeting: positive ζ-potential driven electrostatic interactions, high-affinity binding to membrane protein, and selective activation by Mito-H2S. Upon interaction with Mito-H2S, the probe exhibits a pronounced fluorescence turn-on, achieving a high S/N ratio for real-time tracking of Mito-H2S dynamics. Moreover, by exploiting the role of Mito-H2S, we elucidate the mechanistic relationship between Mito-H2S and mitochondrial ATP production during cancer progression. The probe successfully visualizes Mito-H2S upregulation during metformin-induced liver injury and breast cancer metastasis, enabling the accurate delineation of tumor margins for fluorescence-guided resection of liver metastases.
34. L-RNA Aptamer-Based Tools for G-Quadruplex Structure: Identification, Characterization, and Application.
期刊: Accounts of chemical research 发表日期: 2025-Sep-30 链接: PubMed
摘要
ConspectusAptamers are single-stranded DNA or RNA oligonucleotides that bind specifically and strongly to their target molecules. However, the inherent instability of natural DNA and RNA aptamers in biological environments limits their applications. To overcome this limitation, we focused on the development and application of L-RNA aptamers composed of unnatural L-RNA nucleotides. The mirror stereochemistry of L-RNA confers enhanced stability against nuclease degradation, making it an ideal candidate for molecular targeting and biological applications. In addition, L-RNA’s inability to hybridize with D-DNA/RNA through Watson-Crick base pairing enables the selection of aptamers based on structure recognition. Our group focuses on targeting functional G-quadruplex (G4) structures that play critical roles in various cellular processes, including DNA replication, transcription, and translation, and are implicated in diseases such as cancers, neurological disorders, and viral pathogenesis.This Account highlights our group’s recent efforts in developing novel and robust L-RNA aptamer selection platforms and tools for targeting functionally important G4 structures in different biological systems. Pioneering the L-RNA aptamer selection method for G4 structures, we have further established additional selection platforms enhancing SELEX (Systematic Evolution of Ligands by EXponential enrichment) efficiency, as well as binding affinity and specificity for G4 targets. Following lead aptamer identification and characterization using various biophysical and biochemical tools, our group has explored a number of innovative post-SELEX modification strategies to further improve the L-RNA aptamer’s functionality. Such include the development of circular L-RNA aptamers, L-RNA aptamer-antisense oligo (ASO) conjugates, L-RNA aptamer-fluorogenic RNA aptamer conjugates, and L-RNA aptamer-peptide conjugates for various in vitro, in-cell, and in vivo applications. From our studies, we have reported that these L-RNA aptamers can effectively regulate G4-mediated cellular processes by inhibiting G4-protein interactions and/or modulating transcription and translation and ultimately influencing gene expression and beyond.Together, these works have advanced the accessibility, efficiency, and robustness of L-RNA aptamer technology, offering significant potential for the diagnosis and therapeutics of various diseases, particularly those related to G4 dysregulation. Our ongoing research seeks to further refine L-RNA aptamer selection, structure characterization, post-SELEX modification strategies, and their applications in biological and therapeutic contexts.
35. Cerebral pressure-flow relationship directional sensitivity in healthy lowlanders and natives at high altitude.
期刊: American journal of physiology. Regulatory, integrative and comparative physiology 发表日期: 2025-Sep-30 链接: PubMed
摘要
Whether cerebral pressure-flow relationship directional sensitivity, which represents the attenuated changes in cerebral blood velocity in response to transient increases, compared with decreases, in mean arterial pressure (MAP), is altered in lowlanders at high altitude or differs between lowlanders and Sherpa (a well-adapted highlander population of the Nepalese Khumbu region) is unknown. Both MAP and middle cerebral artery mean blood velocity (MCAv) were recorded continuously during 5-min repeated squat-stands (RSS) at 0.05 Hz and 0.10 Hz at sea level (n=10), initial exposure to high-altitude (n=8), after 2 weeks of partial acclimatization to high-altitude (n=9), and in Sherpa (n=16). For each transition, we calculated absolute and relative MCAv and MAP changes with respect to the transition time intervals of both variables indexing time adjusted ratios when MAP increases (ΔMCAvT/ΔMAPTINCREASE and %MCAvT/%MAPTINCREASE) and decreases (ΔMCAvT/ΔMAPTDECREASE and %MCAvT/%MAPTDECREASE). Regardless of altitude conditions, %MCAvT/%MAPTINCREASE was lower than %MCAvT/%MAPTDECREASE [0.05 Hz RSS: (p=0.0.007); 0.10 Hz RSS (p=0.003)] in lowlanders. Partially acclimatized lowlanders and Sherpa had lower %MCAvT/%MAPTINCREASE than %MCAvT/%MAPTDECREASE at 0.05Hz (p=0.007), but comparable metrics at 0.10Hz RSS (p=0.971). These findings indicate acute exposure and partial acclimatization to high altitude do not alter the cerebral pressure-flow relationship directional sensitivity compared to sea level measures in lowlanders . In addition, the hysteresis-like pattern in Sherpa is not different when compared with partially acclimatized lowlanders.
36. Vertical Profile Corrections Explain Satellite-Inventory Ammonia Discrepancies and Reveal Concentrated Agricultural Sources in China.
期刊: Environmental science & technology 发表日期: 2025-Sep-30 链接: PubMed
摘要
Persistent discrepancies exist between bottom-up inventories and satellite-based ammonia (NH3) emission estimates, with satellites typically reporting values one-third higher. These discrepancies prevent accurate targeting of NH3 control policies for reducing air pollution and ecosystem nitrogen deposition. Here, we demonstrate that systematic biases in satellite vertical profile assumptions substantially explain these long-standing discrepancies. By replacing default vertical profile in satellite retrievals with spatially and temporally resolved atmospheric profiles, we reduced satellite-model discrepancies from 71 to 18%. Our hybrid inversion analysis across China reveals that baseline satellite retrievals overestimated growing season emissions by up to 44% due to systematic overestimation of near-surface NH3 concentrations, while our corrected estimates show close agreement with bottom-up inventories (7.9% difference). Critically, our analysis reveals that China’s NH3 emissions are more spatially concentrated than what the a priori inventory indicates, with the top 10% of high-emitting areas contributing 54-56% of national emissions. This concentration reflects agricultural intensification patterns inadequately captured by bottom-up inventories. Independent validation confirms improved accuracy with 1-27% error reductions across all months. These findings provide essential insights for targeted emission control policies in the most concentrated agricultural regions while resolving methodological uncertainties that have long complicated NH3 management strategies.
37. Promoting financial empowerment after brain injury: Findings from focus groups.
期刊: Clinical rehabilitation 发表日期: 2025-Sep-30 链接: PubMed
摘要
ObjectiveTo cocreate and synthesize financial empowerment ideas for people living with acquired brain injury from multiple perspectives.DesignWe completed a qualitative descriptive study using focus-group methods. Content analysis was guided by deductive categorization across overlapping idea areas of educational products, human-interaction services, and advocacy approaches, followed by inductive idea subcategorization.SettingWe held seven focus groups, five online and two in-person. Participants were recruited via community organization advertisements and convenience sampling. Four researchers analyzed transcripts using a triangulation approach.ParticipantsTwenty-five adults (ages 18+) participated in seven different focus groups: 15 individuals living with acquired brain injury (five groups); 2 close others (one group); and 8 project advisory members (one group). Demographics varied across age, education, and time since injury; most were women.ResultsWe generated 20 idea subcategories for financial empowerment after brain injury. Participants discussed ideas related to advocacy and service ideas more than products, but noted the salience of varied option availability to meet different needs across individuals. Participants living with brain injury identified seven unique ideas compared to the close other group and project advisory group.ConclusionsFinancial empowerment to address economic factors of financial capability and financial well-being after brain injury is important to brain injury rehabilitation, health, and well-being. Including lived experience voices provided unique ideas for addressing financial empowerment. Providing a spectrum of options and addressing contextualization factors could enhance the financial well-being of adults living with brain injury, which can contribute to brain injury recovery and improve community participation.
38. Residential fungal β-(1,3)-D-glucan exposure is associated with decreased pulmonary function in fibrotic pulmonary sarcoidosis.
期刊: Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG 发表日期: 2025-Sep-30 链接: PubMed
摘要
Sarcoidosis is a multi-system disease frequently affecting the lungs. It is thought to be mediated by gene-environment interaction; for example, epidemiological data show organic aerosol exposure increases risk of pulmonary sarcoidosis. The aim of this study was to assess whether exposure to bioaerosol associates with worse lung disease in patients with pulmonary sarcoidosis. Using an observational, cohort study design, we measured residential exposure to fungal and bacterial cell wall material, β-(1,3)-D-glucan (BDG) and endotoxin, respectively, in healthy control subjects and those with pulmonary sarcoidosis. In the case cohort, we compared bioaerosol concentrations to pulmonary disease severity, assessed by pulmonary function testing, qualitative chest computed tomography (CT), and serum biomarkers. Log-transformed bioaerosol concentrations were compared to lung function and significance and correlation determined by Pearson correlation. Homes of subjects with sarcoidosis had higher BDG and endotoxin concentrations than control subjects. Patients with significant pulmonary fibrosis had greater disease severity (Wasfi severity score, visual analogue scale) and reduced pulmonary function compared to those without fibrosis (all P<0.01). Residential fungal BDG correlated with declining FVC, only in patients with fibrosis on CT imaging (P=0.02). Survey data revealed higher BDG concentrations were found in homes of cat-owners, and the number of houseplants owned correlated with declines in FVC and FEV1 (P=0.05 and 0.02, respectively). In patients without fibrosis, eight inflammatory markers correlated with BDG (6CKine/CCL21, IL-9, IL-17F, IL-21, IL-28A, I-309, MIP-1β, TARC), while in those with pulmonary fibrosis, BDG correlated with two inflammatory markers (Eotaxin-3, M-CSF), suggesting immune anergy to inhaled antigens in patients with fibrosis. In patients with pulmonary fibrosis, disease severity was correlated with residential exposure to fungal cell wall material, but not gram-negative bacterial cell wall material. These patients may experience immune anergy to inhaled antigens.
39. Association Between exposure to VOCs mixture and impaired renal function in Korean adults.
期刊: American journal of epidemiology 发表日期: 2025-Sep-30 链接: PubMed
摘要
Evidence suggests that volatile organic compounds (VOCs) is linked to negative health outcomes. This study investigated the association of exposure to VOC mixtures with renal function parameters. Our study included a nationwide sample of Korean adults (n = 1758). The following nine urinary VOC metabolites were measured: SPMA, BMA, 3,4-MHA, 2-MHA, MA, 3-HPMA, BPMA, DHBMA, and PGA. Estimated glomerular filtration rate (eGFR) was calculated based on the serum creatinine levels. Urine albumin-to-creatinine ratio (ACR) was calculated. For mixture analysis, the Quantile g-computation (qgcomp) method and Bayesian kernel machine regression (BKMR) were conducted. Results from the qgcomp method indicated that a quartile increase in the levels of VOC metabolites was linked to a 1.33-point (95% CI: -2.46,-0.20) decrease in the eGFR and a 14.67% (95% CI: 4.25, 26.15) increase in the ACR. BKMR analyses also indicated that the overall increase in urinary VOC metabolite concentrations was related to a reduce in eGFR and an increase in ACR in a dose-dependent manner. Among the individual urinary VOC metabolites, SPMA and MA contributed the most to the decreased eGFR, whereas DHBMA was the primary contributor to the increased ACR. Policy efforts are needed to reduce environmental VOC exposure.
40. Associations between Social Determinants of Health and Post-Hospitalization Rehabilitation among Critically Ill Older Adults.
期刊: Annals of the American Thoracic Society 发表日期: 2025-Sep-30 链接: PubMed
摘要
Older adults who survive hospitalization with a stay in the intensive care unit (ICU) often develop new or worsened disability; those with social vulnerabilities suffer a greater burden of disability. It is unknown whether social determinants of health (SDOH) are associated with disparities in delivery of post-hospitalization rehabilitation. To evaluate whether SDOH are associated with disparities in delivery of post-discharge rehabilitation services to older adults in skilled nursing facilities (SNFs), in home health, and in outpatient rehabilitation facilities in the 100 days after an ICU hospitalization. In this observational cohort study, we used data from the National Health and Aging Trends Study (NHATS) with links to Medicare inpatient claims (2011-19), the Minimum Data Set for SNFs, the Outcomes and Assessment Information Set for home health, and outpatient claims files. We identified older adults with an ICU hospitalization who survived to discharge. The main outcome was rehabilitation delivery in the first 100 days after discharge ascertained as minutes of physical and/or occupational therapy (PT/OT) in SNFs and receipt of any PT/OT in home health and outpatient settings. We constructed multivariable regression models to evaluate the association between SDOH (socioeconomic disadvantage, race and ethnicity, education, and limited English proficiency), and rehabilitation delivery, adjusting for demographics, hospitalization, and post-hospitalization characteristics. We identified 295 ICU hospitalizations with SNF stays, 205 with home health assessments, and 784 where patients were alive for ≥7 days after discharge, thereby eligible for outpatient rehabilitation. Socioeconomic disadvantage, non-White race or Hispanic ethnicity, and lower level of education were associated with reduced delivery of in-home rehabilitation [adjusted odds ratio (95% CI):0.43 (0.23, 0.81); 0.39 (0.16, 0.93); and 0.42 (0.18, 0.99)]. Although the sample sizes in their respective cohorts were small, SDOH were not associated with rehabilitation delivery in either SNFs or outpatient settings. We found socioeconomic disadvantage, minoritized race and ethnicity, and lower education were associated with reduced delivery of rehabilitation at home among older ICU survivors. Given its important role in promoting functional recovery, our findings warrant interventions to mitigate inequities in rehabilitation delivery at home following hospital discharge.
41. Visual disorder and sensory integration in 3- to 6-year-old children with cerebral visual impairment and cerebral palsy.
期刊: PM & R : the journal of injury, function, and rehabilitation 发表日期: 2025-Sep-30 链接: PubMed
摘要
Sensory and behavioral difficulties are frequently observed in children with cerebral palsy (CP), and these challenges may intensify when cerebral visual impairment (CVI) co-occurs. However, the extent and nature of these combined effects remain underexplored. The aim of this study is to compare sensory processing skills and behavior of children with CP and CVI, CP without CVI, and typically development (TD) and to examine the relationship between sensory processing skills and behavior in children in these groups. Prospective, cross-sectional study with control group. Special education and rehabilitation center. A total of 120 children aged 3-6 years, consisting of three groups, were included in the study: 40 children with CP and CVI, 40 children with CP without CVI, and 40 children with TD. The Sensory Profile (SP) was used to assess sensory skills and the Child Behavior Rating Scale (CBRS) was used to assess behavior. There were significant differences in all pairwise comparisons between the three groups and between SP subdomains and CBRS scores (p < .05). Children with CP and CVI had the lowest median scores (SP: 7-78.5; CBRS: 26), followed by those with CP without CVI (SP: 9-95; CBRS: 33), whereas TD children had the highest scores (SP: 12-129; CBRS: 49). These findings suggest a trend toward worsening sensory and behavioral outcomes in the presence of CVI in addition to CP and in CP alone. Furthermore, moderate to strong positive correlations were observed between SP and CBRS scores in all groups (rho = 0.468-0.872; p < .001), suggesting that behavioral problems increase with decreased sensory processing skills. This study reveals that children with CP have more problems in sensory processing and behavioral functioning compared to their peers with TD and that these problems are exacerbated in the presence of CVI accompanying CP. In addition, the significant relationship observed between the decrease in sensory processing skills and the increase in behavioral problems emphasizes the importance of evaluating these two areas together and adopting a holistic approach in intervention planning.
42. Phytosphingosine alleviates DSS-induced colitis by regulating the gut microbiota and inflammatory responses.
期刊: International immunopharmacology 发表日期: 2025-Sep-29 链接: PubMed
摘要
Inflammatory bowel disease is becoming increasingly prevalent and represents a major concern in global public health. However, conventional therapies often come with various adverse effects. Phytosphingosine (PS), a key metabolite in sphingolipid metabolism, is widely found in plants and fungi and possesses notable anti-inflammatory properties. In this study, we aimed to evaluate the protective effects of PS against dextran sulfate sodium (DSS)-induced experimental colitis in mice and elucidate its underlying mechanisms. Our results showed that oral administration of PS significantly alleviated DSS-induced colonic injury and reduced levels of proinflammatory cytokines such as TNF-α and IL-1β. Additionally, PS improved intestinal barrier function disrupted by DSS, as indicated by increased expression of mucin-2 and tight junction proteins. Furthermore, PS suppressed the activation of the NF-κB signaling pathway, oxidative stress and enhanced PPARγ expression. We also observed that PS mitigated DSS-induced gut dysbiosis in mice, characterized by an increase in Bacteroidota and a decrease in Proteobacteria. To explore the role of the gut microbiota in PS-mediated protection against colitis, fecal microbiota transplantation (FMT) was conducted in DSS-treated mice. Recipients of FMT from PS-treated donors exhibited reduced inflammatory responses and improved intestinal integrity, accompanied by a higher abundance of Bacteroidota in the gut. Additionally, PS treatment modified the profile of short-chain fatty acids in the mice, with a notable increase in the levels of butyrate and propionate. Overall, our findings demonstrate that PS attenuates DSS-induced colitis in mice through modulation of the gut microbiota, providing a potential strategy for IBD intervention via microbiota regulation.
43. Adherence to the Japanese Diet is Associated with Lower Risk of Geriatric Depression: A Prospective-Cohort Study Based on the New Integrated Suburban Seniority Investigation (NISSIN) Project.
期刊: The journal of nutrition, health & aging 发表日期: 2025-Sep-29 链接: PubMed
摘要
Geriatric depression is an increasingly important public health issue in an aging society. However, while Japan boasts one of the world’s highest and healthiest life expectancies at birth, there was no prospective cohort study dedicated to the specific association between the Japanese diet and geriatric depression. Thus, we aimed to examine this relationship and assess whether such association extends beyond better physical health secondary to higher diet quality. Our study utilized the New Integrated Suburban Seniority Investigation (NISSIN) Project, which is an age-specific prospective cohort study that recruited residents of Nisshin City, Japan who were about to reach 65 years of age between 1996 and 2005. We measured the adherence to the Japanese diet of 1620 elderly Japanese individuals (827 male and 793 female) with a modified version of the Japanese Diet Index (JDI) and assessed the development of geriatric depression with the Geriatric Depression Scale 15 items questionnaire when they reached 70 years of age. A total of 135 individuals developed geriatric depression at 70 years of age. After adjusting for major confounding factors, those within the highest group of adherence to the Japanese diet had significantly reduced risk of developing geriatric depression (adjusted odds ratio [aOR] = 0.525, 95% confidence interval [CI]: 0.286 - 0.962) when compared to those with the lowest adherence, and each point received on the JDI was also associated with reduced risk of geriatric depression (aOR = 0.900, 95% CI: 0.816-0.992). Dietary item-wise analyses showed that fish and shellfish (p = 0.024), green-yellow vegetable (p = 0.003), and soybean-derived products (p = 0.001) were significantly associated with lower risk of geriatric depression. Adherence to the Japanese diet, especially those rich in green-yellow vegetables, soybean-derived products, and fish and shellfish, may be protective against geriatric depression.
44. Distal Radial Access vs Transradial Access in Patients With ST-Segment Elevation Myocardial Infarction: The DRAMI Trial.
期刊: JACC. Advances 发表日期: 2025-Sep-29 链接: PubMed
摘要
Distal radial access (DRA) has emerged as an alternative to transradial access (TRA) in coronary procedures. However, evidence supporting its use in ST-segment elevation myocardial infarction (STEMI) remains limited. The purpose of this study was to assess whether DRA is noninferior to TRA in patients undergoing primary percutaneous coronary intervention (PCI) for STEMI. This multicenter, open-label, randomized controlled trial was conducted at 3 centers in South Korea. Patients undergoing primary PCI for STEMI were randomly assigned to either the DRA or TRA group. The primary endpoint was the puncture success rate. A noninferiority testing with a prespecified margin of 5.65% was performed in the intention-to-treat, per-protocol, and as-treated populations (NCT03611725). From August 2018 to February 2023, 354 patients were randomized to DRA (n = 176) or TRA (n = 178). The primary endpoint, puncture success rate was 94.3% in DRA and 96.1% in TRA (difference -1.75%; 95% CI -6.20% to 2.71%) in the intention-to-treat analysis. The per-protocol analysis also failed to demonstrate noninferiority (difference -1.72%; 95% CI -5.99% to 2.54%). DRA demonstrated noninferiority to TRA in the as-treated population (difference -1.17%; 95% CI -5.56% to 3.22%). The rates of successful coronary angiography and PCI, access-site crossover, and bleeding complications were comparable between groups. One radial artery occlusion occurred in TRA group at 1-month follow-up. In STEMI patients, DRA failed to demonstrate noninferiority to TRA in terms of puncture success. However, both access routes showed comparable procedural efficacy and safety. Further validation with a larger, adequately powered study is required to confirm these findings.
45. Zn2 + alleviates ischemia/reperfusion injury in H9c2 cells by modulating mitochondrial biogenesis and dynamics via MCU.
期刊: Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS) 发表日期: 2025-Sep-26 链接: PubMed
摘要
Zinc is an essential nutrient implicated in cardiovascular health. This study investigates whether Zn2+ protects H9c2 cells by regulating mitochondrial biogenesis, dynamics, and calcium homeostasis via the mitochondrial calcium uniporter (MCU). The I/R model were established using simulated ischemia and reoxygenation as previous reported, and cells were then treated with MCU siRNA. Biochemical kits, inductively coupled plasma mass spectrometry (ICP-MS), RT-qPCR, and transmission electron microscopy were used to assess the effects of Zn2+ on cell viability, cytotoxicity, Zn2+ and ATP content, NAD⁺/NADH ratio, mtDNA copy number, and mitochondrial morphological changes following myocardial I/R. Confocal microscopy and fluorescence microscopy were used to observe the fluorescence changes of Zn2+, mitochondrial membrane potential, protein expression, and mitochondrial Ca2+. The effects of Zn2+ on protein expression levels were evaluated using molecular docking and Western blot analysis. Compared to the Control group, the I/R group exhibited decreased cell viability, and increased cytotoxicity. Intracellular and mitochondrial Zn2+ levels were reduced, accompanied by mitochondrial dysfunction and an increase in mitochondrial Ca2+ content. The expression levels of mitochondrial biosynthesis proteins SIRT1, PGC-1α, NRF1, and TFAM, mitochondrial fusion proteins OPA1, MFN1, and MFN2, as well as MCUb gene and protein expression were downregulated. Conversely, the expression of mitochondrial fission proteins DRP1 and FIS1, along with MCU, MICU1, and MICU2 proteins, was upregulated. Exogenous Zn2+ treatment reversed these alterations. MCU silencing by siRNA further enhanced the protection effects of Zn2+. I/R induced damage in H9c2 cells and mitochondrial dysfunction. Zn2+ protected H9c2 cells against I/R injury by regulating mitochondrial biogenesis, mitochondrial dynamics, and Ca2+ homeostasis via the MCU, with this protective effect potentially associated with the entire MCU complex.
46. Preparation of magnetic xylanase cross-linked aggregates (m-CLXAs) for the hydrolysis of arabinoxylan by mechano-enzymology.
期刊: Enzyme and microbial technology 发表日期: 2025-Sep-23 链接: PubMed
摘要
The development of a biocatalyst consisting of immobilised xylanases as cross-linked enzyme aggregates (CLEAs) on magnetic nanoparticles (MNPs) as support was undertaken. MNPs were prepared by a coprecipitation reaction of Fe3 + and Fe2+, followed by surface modification with (3-aminopropyl)-trimethoxysilane using a polycondensation reaction. Magnetic CLEAs were prepared via glutaraldehyde cross-linking after precipitation with acetone, and the physicochemical characterisation of the immobilised enzyme was performed at all stages using several techniques (FTIR, PXRD, TGA, and DLS). A one-factor-at-a-time approach (OFAT) was used to investigate the impact of temperature, time, enzyme: MNP ratio, precipitant, and cross-linking agent to determine their effect on the enzyme’s recovered activity. The results demonstrated that all parameters impacted the immobilisation differently, with the optimised conditions determined as 4°C, 12 h, 10 mg/g, 60 % (v/v) acetone, and 200 mM glutaraldehyde, respectively. The immobilisation did not affect the pH and temperature optima of the enzyme, which were 6.0 and 50-70°C, respectively, for both the free and immobilised enzymes. In contrast, the immobilised enzyme could be reused more than ten times to hydrolyse wheat arabinoxylan, without losing 50 % of its initial activity. Values for Vmax and Km only decreased slightly compared to those obtained for the free enzyme. The thermal inactivation parameters showed that the immobilisation procedure did not adversely affect the enzyme’s catalytic properties after immobilisation. Finally, we assessed the immobilised enzyme for its ability to catalyse reactions under mechanochemical conditions (grinding and ageing) and found that the free and immobilised enzymes were active during solvent-free and liquid-assisted grinding (LAG).
47. Impact of lead (Pb)-induced neurotoxicity on protein synthesis and cellular stress responses in LUHMES cells.
期刊: Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS) 发表日期: 2025-Sep-20 链接: PubMed
摘要
Exposure to lead (Pb) poses significant risks to human brain development. This study investigates the molecular mechanisms underlying Pb acetate-induced neurotoxicity in LUHMES cells, which represent a human fetal-derived dopaminergic neuronal precursor model particularly suited for studies of neurotoxicity and Parkinson’s disease. Morphological analyses revealed that Pb acetate exposure at concentrations exceeding 10 µM induced cytotoxicity and disrupted neurite outgrowth. Distinct gene expression changes associated with Pb exposure were determined through RNA-sequencing. Principal component analysis highlighted significant alterations in gene expression at higher Pb concentrations (10 µM) compared with lower Pb concentrations (1 µM) and controls. Notably, Pb acetate exposure impaired ribosomal function, Spliceosome and protein processing in the endoplasmic reticulum (ER) pathways. Furthermore, these three pathways related that Pb acetate exposure resulted in the upregulation of genes related to ER-associated degradation and apoptosis, whereas the ubiquitin ligase complex was disrupted, suggesting compromised protein homeostasis. These findings underscore the potential of ribosomal processes and ER stress pathways as biomarkers of Pb acetate exposure. This study provides advanced mechanistic insights into the toxicological effects of lead (Pb) as a heavy metal, with a specific emphasis on its influence on cellular processes related to proteostasis and stress response pathways. Our findings further highlight the importance of LUHMES cells as a human-derived neuronal model for elucidating neurodevelopmental toxicity and identifying molecular biomarkers of Pb exposure, particularly those associated with dysregulation in ribosomal function and endoplasmic reticulum (ER) stress signaling.
48. 'Here the Refrigerator is Empty': Food Insecurity among Puerto Rican Elders.
期刊: Puerto Rico health sciences journal 发表日期: 2025-Sep-18 链接: PubMed
摘要
The authors documented, described, and explained the food insecurity experiences of Puerto Rican elders, particularly how they perceive and give meaning to this phenomenon. The food insecurity experiences of 50 Puerto Rican elders (≥65 years) were collected using a mixed-methods approach. Qualitative data were collected through in-depth interviews, and quantitative data were obtained from a 22-item questionnaire. The data were integrated with a convergent design. 92% of the participants were food insecure. Puerto Rican elders’ food insecurity experiences have four components (quantity, quality, social, and psychological) and a common pattern of fourteen manifestations. Food insecurity in Puerto Rican elders has causes that go beyond the economic access to food. Addressing food insecurity should be a priority of integrated national food and nutrition policies to reduce the nutritional health inequities among this population. This study presents the first in-depth examination of food insecurity among Puerto Rican elders residing in Puerto Rico, focusing on their cultural interpretations of the phenomenon.
49. European Glaucoma Society - Terminology and guidelines for glaucoma, 6th Edition.
期刊: The British journal of ophthalmology 发表日期: 2025-Sep-08 链接: PubMed
摘要
ForewordWe practice medicine in times of exponentially increasing medical knowledge. In 1950, it was estimated that the doubling time was 50 years; by 1980, it was 7 years and by 2010, 3.5 years. In 2020, it was projected to be just 73 days! To continue to practice evidence-based medicine and to provide the best possible care for our patients, clinicians need to adapt their strategies to keep their knowledge up to date. There will always be a role for critical appraisal of individual studies in the field of a clinician’s practice, but with such an increase in the volume of published research, it becomes impossible to appraise all relevant material. For this reason, sources of distilled knowledge, such as the EGS Guidelines, become essential references for best practice medicine.Rigorous methods for evidence synthesis, such as the systematic reviews overseen by Cochrane, provide a comprehensive summary of the current state of knowledge for important clinical questions. However, for many clinical uncertainties, there is little or no high-quality evidence, let alone an evidence synthesis. Where evidence is lacking, practice guidance needs to be built from expert opinion and consensus, while acknowledging the limitations of such an approach. Expert opinion, derived from sound medical knowledge and years of practice experience, also has an important role in understanding the relevance of lines of evidence and the nuances of implementing them in practice. Thus, the expert commentary around the evidence base given in these Guidelines is essential for proper implementation of published evidence. Importantly, the EGS Guidelines also include ‘Choosing wisely’ elements indicating actions which should be avoided due to insufficient evidence and/or unsubstantiated belief.Guidelines need regular updating to take account of new knowledge and aspects of clinical care that have not been given sufficient emphasis in the past. This 6th Edition of the EGS Guidelines includes an updated ‘evidence based’ section with new clinical questions and evidence-based answers. The section ‘What matters to patients’ has also been updated, recognising that, because Guidelines are typically written by clinicians for clinicians, there have been gaps in understanding the patient perspective. The updated section now has direct input from the Expert by Experience patient advisors in the EGS Patient Involvement Project and includes eight Tips for Doctors in their communication with patients.The Guidelines team, led by Drs Pazos, Traverso and Viswanathan, is to be congratulated for the 6th Edition of the Guidelines, updating and enhancing the previous edition, while maintaining the highly success format which gives a framework for glaucoma care, based on evidence synthesis and consensus expert opinion, and presented as a ‘How to’ manual for patient diagnosis and management.David (Ted) Garway-HeathGlaucoma UK Professor of Ophthalmology, UCL[Formula: see text]IntroductionThe European Glaucoma Society Guidelines are at the heart of our educational mission serving not only our members, but all involved in glaucoma care. Previous editions have been among the most widely accessed documents in the field, helping navigate the growing complexity of glaucoma research and clinical practice.This sixth edition reaffirms our commitment to evidence-based, patient-centred care. It builds on the solid foundations of past editions while embracing key innovations that reflect new scientific insights, emerging technologies, and evolving priorities in glaucoma care.For the first time, we collaborated closely with patient representatives through the Experts by Experience (EbE) group. Their contributions helped shape clinical questions and emphasized the importance of empathy, communication, and psychological support in managing glaucoma.The Guidelines maintain a dual purpose: to answer clinically relevant questions through a rigorous evidence-based approach, and to offer comprehensive, practical knowledge for daily use. We have updated existing recommendations and added new topics, including artificial intelligence, cost-effectiveness, adherence strategies, and paediatric glaucoma. A new “Choosing Wisely” section provides clear guidance to avoid low-value interventions. We extend our heartfelt thanks to all contributors and collaborators. This includes the many colleagues who authored and reviewed chapters with great care and expertise, the patient representatives who generously shared their lived experiences, and the team at the University of Genoa, who worked tirelessly to refine content and layout, ensuring clarity and consistency throughout.A very special word of thanks goes to the Editors Marta Pazos, Carlo Traverso, and Ananth Viswanathan, whose relentless dedication, critical oversight, and countless hours of work were instrumental in shaping the high quality and coherence of this edition. Their leadership and perseverance have been extraordinary. Together, these collective efforts have made this edition a cornerstone of our vision: to foster innovation, strengthen education, enhance communication, and promote best practices in glaucoma care across Europe and beyond.Ingeborg Stalmans and Luis Abegao Pinto[Formula: see text]www.eugs.org EditorsMarta PazosCarlo E. TraversoAnanth ViswanathanEvidence-Based Working Group Methodological oversightAugusto Azuara-Blanco Manuele MichelessiLeaders of evidence reviewAugusto Azuara-Blanco Manuele Michelessi (EGS)Marta Pazos (EGS)Riaz Qureshi (US Cochrane Eyes and Vision Group)Evidence reviewAugusto Azuara-Blanco João Barbosa Breda Carlo Alberto CutoloGerhard GarhöferManuele MichelessiMarta PazosVerena ProkoshAndrew TathamEvidence consensus panelLuís Abegão PintoAugusto Azuara-BlancoGauti JóhannessonMarta PazosNorbert PfeifferIngeborg StalmansAndrew TathamCarlo E. TraversoAnanth ViswanathanEvidence patient’s feedback panelStelios GeorgoulasMarta PazosAndrew TathamThe Guidelines Task ForceLuís Abegão PintoEleftherios AnastasopoulosFlorent AptelAugusto Azuara-Blanco (advisor)João Barbosa BredaLuca BagnascoChiara BonzanoRupert BourneCarlo Alberto CutoloTheodoros FilippopoulosPanayiota FountiGerhard GarhöferGus GazzardDimitrios GiannoulisMichele IesterAndreas KatsanosAnthony KhawajaMiriam KolkoAntoine LabbéSophie LemmensManuele MichelessiAna MiguelFrancesco OddoneMarta Pazos (chair)Verena ProkoschAlessandro RabioloAlexander K SchusterCédric SchweitzerRiccardo ScottoAndrew TathamMarc Toeteberg-HarmsFotis TopouzisCarlo E. Traverso (chair)Ananth Viswanathan (chair)The Guidelines Writers, Authors and ContributorsLuís Abegão PintoIke AhmedZeynep AktasAugusto Azuara-BlancoAlessandro BagnisJoão Barbosa BredaChiara BonzanoRupert BournePaola CassotanaMaria Francesca CordeiroCarlo Alberto CutoloBarbara CvenkelPanayiota FountiJulian García-FeijooGerhard GarhöferTed Garway-HeathDaniele GaudenziGus GazzardStelios GeorgoulasFrancisco GoñiFranz GrehnAnders HejilEsther HoffmanMichele IesterGauti JóhannessonAnthony KhawajaAnthony KingMiriam KolkoEvgenia KonstantakopoulouYves LachkarSanna LeinonenSophie LemmensKarl MerciecaManuele MichelessiFrancesco OddoneMarta PazosDorothea PetersNorbert PfeifferVerena ProkoschLuca RossettiJohn SalmonLeopold SchmettererCédric SchweitzerRiccardo ScottoIngeborg StalmansGordana Sunaric-MégevandIan TapplyAndrew TathamJohn ThygessenFotis TopouzisCarlo E. TraversoNeeru VallabhAnanth ViswanathanThe Guidelines Internal ReviewersLuís Abegão PintoElefterios AnastasopoulosFlorent AptelJoão Barbosa BredaHenny BeckersChiara BonzanoRupert Bourne (ccordinator)Alain BronCarlo A. CutoloBarbara CvenkelTheodoros FilippopoulosPanayiota FountiGerhard GarhöferDimitrios GiannoulisFranz GrehnIngrida JanulevicieneStylianos KandarakisAndreas KatsanosAnthony KhawajaAnthony KingJames KirwanMiriam KolkoAntoine LabbéSanna LeinonenSophie LemmensKeith MartinJose Maria Martinez de la CasaFrances Meier-GibbonsStefano MigliorAna MiguelGiovanni MontesanoMarta PazosSergei PetrovVerena ProkoschAlessandro RabioloCédric SchweitzerAlexander K SchusterIngeborg StalmansMarc Toeteberg-HarmsFotis TopouzisCarlo E. TraversoAnja TuulonenAnanth ViswanathanZoya VeselovskayaIlgaz YalvaçMia Zoric GeberThe Experts by Experience Group (patients’ panel)Kate BackhausCarol BronzeAsle HaaukasMona KriegDeborah LoiDora RoloSarah TaylerTeam of Clinica Oculistica - University of Genova, Policlinico Ospedale San martino IRCCS - for medical editing and graphicsLuca BagnascoAlessandro BagnisChiara BonzanoPaola Cassottana (EGS Fellow)Carlo CattiCarlo Alberto CutoloDaniele Gaudenzi (EGS Fellow)Michele IesterMaria MusolinoRiccardo ScottoCarlo E. TraversoExternal Reviews from Glaucoma Societies AGSAPGSWGALAGSPAGS[Formula: see text]The EGS Executive CommitteeIngeborg Stalmans (President)Luís Abegão Pinto (Vice President)Norbert Pfeiffer (Treasurer)Fotis Topouzis (Past President)Gauti Jóhannesson (Secretary)Marta Pazos (Adjunct Secretary)Panayiota FountiSanna LeinonenLuca RosettiThe Board of The EGS FoundationCarlo E. TraversoFotis TopuzisJohn ThygesenFranz GrehnAnders HeijlAll contributors have provided the appropriate COI visible in detail at www.eugs.org/pages/guidesurgical/[Formula: see text]Glossary 5-FU 5-fluorouracilAAC Acute angle closureACG Angle closure glaucomaAGIS Advanced glaucoma intervention studyAH Aqueous humourAI Artificial intelligenceALT Argon laser trabeculoplastyANA-LIS Singapore asymptomatic narrow angles laser iridotomy studyAS-OCT Anterior Segment OCTBAC Benzalkalonium chlorideCCT Central corneal thicknessCDR Cup to disc ratioCGRN Childhood glaucoma research networkCIGTS Collaborative initial glaucoma treatment studyCNTGS Collaborative normal tension glaucoma studyDCT Dynamic contour tonometryEAGLE Effectiveness of early lens extraction for the treatment of primary angle closure glaucomaEbE Expert by experienceEGPS European glaucoma prevention studyEGS European glaucoma societyEMA The European Medicines AgencyEMGT Early manifest glaucoma trialFC Fixed combinationFc Flow chartFDT Frequency doubling technologyFL Fixation lossesFN False negativesFP False positiveGAT Goldmann applanation tonometryGC Ganglion cellGDD Glaucoma long tube draining deviceGHT Glaucoma hemifield testGITS Glaucoma intensive treatment studyGRADE Grading of recommendations, assessment, development and evaluationsHRT Heidelberg retina tomographyICE Irido-corneal endothelial syndromeIOL Intraocular lensIOP Intraocular pressureIPL IridoplastyITC Iridotrabecular contactIV IntravenousLiGHT Laser in glaucoma and ocular hypertension trialLoGTS Low-tension glaucoma treatment studyLPI Laser peripheral iridotomyLV Loss varianceMD Mean defect or mean deviationMIBS Minimally Invasive Bleb-forming ShuntsMIGS Minimally invasive glaucoma surgeryMMC Mitomycin CNCT Non-contact tonometryNd:YAG Neodymium-doped yttrium aluminum garnetNTG Normal tension glaucomaOAG Open angle glaucomaOCT Optical coherence tomographyOHT Ocular hypertensionOHTS The ocular hypertension treatment studyONH Optic nerve headORA Ocular response analyserOSD Ocular surface disease PAC Primary angle closurePACG Primary angle closure glaucomaPACS Primary angle closure suspectPAS Peripheral anterior synechiaePCG Primary congenital glaucomaPDS Pigment dispersion syndromePGA Prostaglandin analoguePOAG Primary open angle glaucomaPG Pigmentary glaucomaPRS Polygenic risk scorePSD Pattern standard deviationPTVT Primary tube versus trabeculectomy studyPXF Pseudoexfoliation syndromePXFG Pseudoexfoliation glaucomaRCT Randomised controlled trialRNFL Retinal nerve fiber layerRoP Rate of progressionSAP Standard automated perimetrySITA Swedish interactive threshold algorithmSLT Selective laser trabeculoplastySWAP Short-wavelength automated perimetryTAGS Treatment of advanced glaucoma studyTLPI Thermal laser peripheral iridoplastyTM Trabecular meshworkTVT Tube versus trabeculectomy studyUBM Ultrasound biomicroscopyUGH Uveitis-glaucoma-hyphaema syndromeUKGTS United Kingdom glaucoma treatment studyVEGF Vascular endothelial growth factorVF Visual fieldVFI Visual field indexZAP Zhongshan angle closure prevention trial.
50. Characteristics of healthy sinonasal microbiome - single-centre study in the Czech Republic.
期刊: Journal of applied biomedicine 发表日期: 2025-Sep 链接: PubMed
摘要
The human nasal cavity and paranasal sinuses host a complex and dynamic microbiome which has a crucial role in mucosal immunity. A comprehensive profile of the healthy sinonasal microbiome remains limited. The purpose of our study was to characterize the healthy sinonasal microbiome in adults using 16S rRNA long-read sequencing to enable species-level resolution, and to assess its associations with demographical and clinical factors such as smoking, allergy history, and olfactory function. We performed a prospective, single-centre study analysing middle meatus samples from 27 healthy individuals undergoing septoplasty in the age range from 21 to 57 years, excluding those with antibiotic and corticosteroid use and those with signs of acute or chronic rhinosinusitis. A high interindividual variability in the composition of healthy sinonasal microbiome was observed. At the phylum level, it was dominated by Firmicutes (48.96%), Actinobacteria (34.83%), and Proteobacteria (13.85%), while Firmicutes and Actinobacteria were consistently present in all samples. At the genus level, Staphylococcus spp. (32.32%), Cutibacterium (28.04%), and Corynebacterium (4.66%) were most abundant. We observed trend level correlations between phyla and some clinical factors (e.g., smoking and olfactory dysfunction) and selected phyla. However, none remained significant after false discovery rate (FDR) correction across taxa. The study proposes Staphylococcus spp., Corynebacterium spp., and Cutibacterium spp. to be a core taxa in the healthy sinonasal microbiome. Amid the interindividual diversity in our cohort, there was evidence of a stable core microbiome potentially influenced by environmental and host factors. Our findings suggest a baseline reference for distinguishing a dysbiosis in upper respiratory disease.
51. Prevalence, incidence and associated factors of pneumonia among severely malnourished children hospitalized in Mulago National Referral Hospital, Uganda.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Pneumonia is still a burden in children hospitalized with severe acute malnutrition (SAM). However, there is limited published information on the magnitude and characteristics of those who present with or develop pneumonia during hospitalization. We determined the prevalence and incidence of pneumonia, and associated factors among children aged 6-59 months hospitalized with SAM. This study employed 2 study designs; cross sectional for prevalence of pneumonia and single arm retrospective cohort design for incidence of pneumonia. We used secondary data collected as part of the ProbiSAM trial that assessed the effect of Probiotics on diarrhea in children with severe acute malnutrition conducted at Mwanamugimu Nutrition Unit Mulago Hospital. Children aged 6-59 months hospitalized with SAM were assessed for prevalence and incidence of pneumonia. Prevalence of pneumonia was the proportion of pneumonia cases at the time of enrolment or within the first 48 hours of admission. 2)Incidence of pneumonia was the proportion who developed clinical signs of pneumonia for the first time during hospitalization among those who did not have pneumonia at enrolment or within 48 hours after admission. 400 children were included in the study and of these, 58% were males. Most (87%) of the children were aged 24 months and below. The prevalence of pneumonia was 28% (95% CI: 24-33). In multivariable analysis, factors associated with prevalence of pneumonia include: female sex (Adjusted PR: 1.72, 95% CI: 1.20-2.45), stunting (Adjusted PR: 1.60, 95% CI: 1.12-2.30) and presumptive TB (Adjusted PR: 1.95, 95% CI: 1.34-2.82). Incident pneumonia was estimated at 356 (95% CI: 305-416) per 1000 hospital admissions of children with SAM. In multivariable analysis, children at risk of pneumonia were: young age 6 to 12 months (Adjusted RR: 1.89, 95% CI: 1.10-3.29), stunting (Adjusted RR: 1.59, 95% CI: 1.15-2.20), HIV infection (Adjusted RR: 1.59, 95% CI: 1.08-2.33), presumptive TB (Adjusted RR: 1.73, 95% CI: 1.23-2.43), used a nasogastric tube for feeding (RR: 1.38, 95% CI: 1.00-1.89) and prolonged hospitalization of 15 days or more (Adjusted RR: 2.16, 95% CI: 1.39-3.35). This study identified that prevalence of pneumonia among children hospitalized with SAM is still high and similar to previous studies done in different settings in Uganda. In addition, this study showed that the risk of incident pneumonia among children hospitalized with SAM is high. These findings point out the need to develop guidelines to monitor, detect and treat incident pneumonia among children hospitalized with SAM. Stunting as factor associated with both prevalence and incidence of pneumonia underscores the importance of further research to evaluate how stunting relates to pneumonia.
52. "You can't see what you've never had to live"-Cultivating imagination and solution spaces in global health and development.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
53. Navigating the dementia caregiving journey: A scoping review protocol of interventions and their responsiveness to caregivers' evolving needs across the illness trajectory.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Family caregivers of persons with dementia (PWD) provide critical and often sustained support across the dementia trajectory. Despite growing recognition of their evolving needs, many interventions remain episodic and not tailored to different caregiving phases. Frameworks like the Timing It Right (TIR) and the Caregiver-Identified Phases of Alzheimer’s Disease (CIP-AD) offer structured approaches to understanding how caregiver needs change over time. However, little is known about whether current interventions align with these phase-specific needs. This scoping review aims to (1) explore the extent to which existing dementia caregiving interventions address different stages of the caregiving journey or dementia progression; (2) summarize and characterize these interventions using the Template for Intervention Description and Replication (TIDieR) checklist; and (3) identify characteristics of the populations targeted by these interventions. Following JBI methodology and the PRISMA-ScR checklist, we will conduct a scoping review of randomized controlled trials, non-randomized controlled trials, and quasi-experimental studies focused on interventions for unpaid family caregivers of community-dwelling PWD. Studies will be included if they address at least one phase of the dementia trajectory and are delivered in community-based settings. A comprehensive search of six databases from 1995 to 2025 will be developed and peer-reviewed using the PRESS framework. Data will be extracted using a standardized form and analyzed thematically. This review will map how dementia caregiving interventions address the evolving needs of caregivers over time and inform future development and implementation of phase-responsive support strategies. The findings will guide research, policy, and practice in creating caregiver-centered interventions that reflect the realities of caregiving across the dementia continuum.
54. Digital nursing and midwifery leadership: Protocol for a multi-method exploration of policy implementation and impact on practice in the WHO European Region.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Digital health is redefining nursing and midwifery practice, fuelled by national and international priorities for health improvement and workforce planning. Developing digitally enabled healthcare systems can help enable universal health coverage and improve safety outcomes while offering solutions to workforce shortages. However, research suggests that nursing/midwifery leaders are often absent from the strategic planning, design, and implementation of digitally enabled healthcare service models and the associated technological systems that directly impact practice. This paper presents the protocol for a sequential, multi-method exploration of digital health policy implementation and its impact on practice. This investigation from the perspective of national nursing/midwifery leaders, will increase understanding of the impact these professions have on national decision-making, which will be used to inform digital healthcare policy implementation and development across Europe and beyond. A purposive sample of national nursing/midwifery leaders across the WHO European region will be recruited. In Phase 1, individuals will be invited via email to participate in an anonymous online survey, with findings used to inform the topic guide for online focus groups in Phase 2. Descriptive statistical analysis of the survey dataset will be used to understand the range of countries, roles, contexts, participant experiences, and perceptions on which the findings are based. Where possible, analysis will be undertaken, e.g., by country, and participant role to identify any patterns, gaps, and key areas for further exploration during Phase 2. Survey respondents will be offered the opportunity to participate in an online focus group. Free text questions from the survey and data from focus groups will be transcribed verbatim and analysed using a reflexive thematic approach. The study outlined within this paper will generate empirical data on to what extent and how national nursing/midwifery leaders influence the progress of digital healthcare, based on their experiences implementing key European policy. In gaining a better understanding of this policy implementation, and the role played by nursing and midwifery leaders, the factors that facilitate or hinder this process can be identified and better managed, to maximise the benefits of digital healthcare for population outcomes moving forward. Ethical approval for this study was granted on 10.12.25 by Anglia Ruskin University [ID ETH2425-0725].
55. Adverse childhood experiences and adult dental care utilization in the United States: Variation by race and ethnicity.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Adverse childhood experiences (ACEs) are associated with negative health outcomes, including poorer oral health. While research has shown that ACEs are associated with lower dental care utilization, most studies focus on childhood and adolescence, with limited attention to their long-term impact in adulthood or differences across racial and ethnic groups.. This study examines the relationship between ACE exposure and past-year dental care use in adulthood and assesses racial/ethnic differences in this association. Using data from the 2020 Behavioral Risk Factor Surveillance System (BRFSS), we analyzed a sample of 88,728 adults from 21 states and the District of Columbia. The primary outcome was any past-year dental care use. ACEs were summed into a composite score. Multivariable logistic regression models assessed the relationship between ACEs and past-year dental care use, with multiplicative interaction terms used to examine racial/ethnic differences in the observed association. Overall, 63.2% of adults reported any past-year dental care use. Higher ACE exposure was associated with lower odds of dental care use (adjusted odds ratio [aOR] = 0.95, 95% CI: 0.93-0.97, p < .001). The negative association between ACEs and dental care use was strongest for non-Hispanic White respondents, whereas the relationship between ACEs and dental care was attenuated for non-Hispanic Black and Hispanic respondents. These findings expand knowledge on the association of ACEs with dental care use in adulthood and how this relationship may vary across the population.
56. Sleep quality, emotional moods, and cognitive outcomes among people living with HIV: An ecological momentary assessment study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Although studies have explored the relationship between sleep quality, mood, and cognitive outcomes among people living with HIV (PLWH), few use ecological momentary assessment (EMA) techniques to evaluate within-person associations between sleep quality and emotional/cognitive outcomes among PLWH at the day level. This study investigated the association between previous night’s sleep quality and momentary psychological outcomes in participants’ natural setting. Study participants were PLWH in South Carolina who were at least 18 years old, diagnosed with HIV for at least 2 years, and able to operate a cellphone. Participants were sampled using posters posted in AIDS Service organizations, and snowball sampling. Data collection occurred between March and November 2023. During a 10-day EMA period, participants received 6 brief surveys throughout the day. Surveys were delivered within a 14-hour time window at semi-random times, with at least 1.5 hours between surveys. Five multilevel models were implemented with mindfulness, positive affect, negative affect, perceived cognition, and self-control as the outcome variables, and previous night’s sleep quality as the input variable. A total of 962 responses were gathered from 22 participants, with an average of 43.73 responses per person. Experiencing higher than usual levels of sleep quality the night prior had a significant positive association with higher levels of momentary mindfulness (β = 0.08, p < 0.001), positive affect (β = 0.1, p < 0.05), and self-control (β = 0.06, p < 0.05) when controlling for other covariates. Experiencing higher than usual levels of sleep quality the night prior exhibited trends towards a significant positive association with perceived cognition (β = 0.04, p < .1). Within-person sleep quality was not associated with momentary negative affect. Among PLWH, future interventions targeting health behaviors sensitive to poor mood and cognition (e.g., ARV adherence) should incorporate intervention activities that ensure good sleep quality among participants. Additional studies are needed with larger sample sizes to assess the generalizability of study results.
57. Well-being, physical activity and health promotion among officers and ratings on board cargo ships: A cross-sectional study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Health and well-being of seafarers working on merchant vessels is an essential area of research, given the significant physical and psychological demands placed on these workers. The present study focuses on assessing the current health status and well-being, identifying personal needs and requirements for health promotion among officers and ratings on board. A total of 583 seafarers from a German shipping company were surveyed by using a questionnaire including the standardized WHO-5-Well-being Index, PHQ-9, GPAQ and questions about the need for health measures as well as physical activity. The survey was distributed to 616 seafarers on 33 merchant ships with a response rate of 94.6%. Officers reported lower well-being compared to ratings (60.1% vs. 70.0%, p = 0.001). Regarding depressive symptoms no significant differences between the rank groups were found. Furthermore, ratings stated a significantly higher total physical activity than officers (10,437 vs. 8,035 MET-min/week, p = 0.005), while officers were significantly more sedentary compared to ratings (3.5 vs. 2.4 hours/day, p = 0.001). Seafarers also reported a high interest in sports on board (>56%) and health promotion (>60%), with a preference for digital formats and monetary incentives for participation in health programs. The impaired well-being of seafarers compared to shore-based reference groups underscores the need for targeted, digital interventions to improve the health and well-being of seafarers. The findings highlight significant differences in well-being, physical activity, and interest in health promotion between officers and ratings. Future research should apply longitudinal designs to better understand the causal relationships between occupational and socio-demographic factors with health outcomes among seafarers.