公共卫生研究摘要 (2025-10-05)
共收录 56 篇研究文章
1. The Effectiveness of Workplace Violence Prevention Education Training Programs on Healthcare Professionals' Confidence: A Systematic Review and Meta-Analysis.
期刊: International nursing review 发表日期: 2025-Dec 链接: PubMed
摘要
The purpose of the study is to examine the effectiveness of educational training programs on healthcare professionals’ confidence in dealing with workplace violence. Workplace violence is a global problem with serious consequences in healthcare. While training enhances knowledge, skills, and confidence, the critical factor for translating learning into practice, remains underexplored. A systematic review and meta-analysis. Data were retrieved from four databases searched through September 2024. Ten studies met the inclusion criteria, and two meta-analyses were conducted. With the control group design, a pooled analysis indicated a significant improvement in healthcare professionals’ confidence following workplace violence training. With a one-group pre- and post-design, a significant improvement was also found. Although subgroup analysis based on different confidence measurement tools was conducted, heterogeneity was not substantially reduced. Workplace violence training programs improve confidence, yet the evidence is constrained by heterogeneity and limited randomized trials. Confidence-building strategies such as simulation and repeated practice may be more effective than lectures, though standardized measures and program designs are needed to strengthen comparability and guide best practices. Workplace violence prevention training appears effective in enhancing healthcare professionals’ confidence. Future studies should establish optimal models, frequency, and validated instruments to ensure sustainable outcomes. According to the WHO Global Strategic Directions, workplace violence prevention training should be integrated into nursing education and practice. Simulation and team-based methods enhance confidence more effectively than lectures. Institutions must adopt standardized protocols, refreshers, and debriefings, while nursing leaders and professional bodies establish unified standards. Building confidence is central to care quality and system sustainability.
2. Challenges and Perspectives in Treating Individuals With Musculoskeletal Disorders and Comorbidity: A Systematic Literature Review With a Descriptive Thematic Synthesis.
期刊: Scandinavian journal of caring sciences 发表日期: 2025-Dec 链接: PubMed
摘要
The prevalence of comorbidity amongst individuals seeking care for musculoskeletal disorders is rising. This underscores the importance of understanding how health care professionals are managing individuals with musculoskeletal disorders and comorbidity. To analyse the existing literature focusing on healthcare professionals’ challenges and perspectives in managing individuals with musculoskeletal disorders and comorbidity. A comprehensive search was conducted across four databases: PubMed, CINAHL, Embase and Scopus, focusing on healthcare professionals’ experiences of treating individuals with musculoskeletal disorders and comorbidity. The review included studies of a qualitative nature that explored healthcare professionals’ experiences in the management of this patient population. The systematic search yielded 2645 articles, of which five studies were included. All included studies investigated physiotherapists as their target group, while one study also included occupational therapists. Most studies focused on individuals with osteoarthritis and comorbidity. Common challenges identified included a lack of knowledge and training in addressing comorbidities in healthcare professionals, particularly psychological conditions, diabetes and obesity, which was perceived as a barrier for making individualised treatment plans. This systematic literature review highlights the limited evidence on the experiences of healthcare professionals in treating individuals with musculoskeletal disorders and comorbidity. Findings underscore the need for further training to support clinicians in treating this patient population, and the need for further research exploring the perspectives of healthcare professionals, especially among others than physiotherapists.
3. The impact of an institutional sepsis guideline on selecting appropriate empirical treatment in patients with carbapenem-resistant gram-negative bacilli bacteremia.
期刊: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology 发表日期: 2025-Oct-04 链接: PubMed
摘要
We aimed to investigate the impact of our institutional sepsis protocol on the empirical treatment of carbapenem-resistant Gram-negative bacteria in a setting where infectious disease consultation (ID) is available 7 days / 24 h and broad-spectrum antibiotic use requires ID approval. A total of 612 patients (168 patients pre-guideline, 444 patients post-guideline) who received empirical antibiotics for suspicion of sepsis before documentation of antibacterial susceptibility were included. Demographic, clinical and microbiological data were collected from the hospital’s electronic medical record system, retrospectively. Compliance with institutional guidelines and the rate of appropriate antibiotic use prior to the availability of antibiograms were assessed. There was a statistically significant increase in the utilization rate of empirical antibacterial treatment based on pre-defined risk factors of multidrug resistance [OR (95% CI) 1.73 (1.21-2.48), p = 0.003]. Furthermore, appropriateness of the initial antibacterial treatment according to the antibiogram results increased significantly in the post-guideline period [OR (95% CI) = 3.25 (2.09-5.06), p < 0.001]. The rate of compliance with guideline recommendations (p = 0.004) and the rate of appropriate empirical antibiotic treatment (p < 0.001) by each year were significant when compared with the pre-guideline period. Also, practices that improve drug pharmacokinetics such as loading dose, prolonged infusion of meropenem and adjusting antibiotic doses according to renal function increased statistically after the release of guideline. An institutional sepsis protocol based on risk factors for multidrug resistance and local epidemiology increased the rate of appropriate empirical antibiotic treatment even in a setting where ID consultation is readily available.
4. Effectiveness of haptic feedback during local and remote robotic surgery: single-blind cadaveric study.
期刊: Journal of robotic surgery 发表日期: 2025-Oct-04 链接: PubMed
摘要
Robotic surgery has rapidly evolved, with telesurgery emerging as a promising extension. However, the lack of haptic feedback remains a key limitation, potentially compromising surgical safety. This study aimed to evaluate the impact of haptic feedback on surgical performance in both local and remote robotic settings using a cadaver model. Six gastrointestinal surgeons were assigned to local or remote groups and performed standardized bowel traction tasks using the Saroa™ surgical robot. Haptic feedback was tested at three levels: none (0), moderate (0.5), and full (1.0). Each participant completed the task three times under each condition. Task completion time, grip force, and forceps path length were measured. Grip force significantly decreased with increasing haptic feedback levels, particularly in the non-dominant (left) hand. No significant differences in task completion time or forceps path length were found across feedback levels or between local and remote settings, except for a longer right-hand path length in the remote group at feedback level 0.5. Haptic feedback reduced grip force in both local and remote robotic surgery, suggesting enhanced surgical safety. However, its effect on efficiency metrics was limited. These findings support the integration of haptic feedback in telesurgical systems, although further validation with complex procedures and more participants is warranted.
5. Regulation of pyruvate dehydrogenase complex: Dancing to different drums in cancer.
期刊: International journal of cancer 发表日期: 2025-Oct-04 链接: PubMed
摘要
Mechanisms governing the regulation of pyruvate dehydrogenase complex (PDC) are markedly modified in cancer cells compared to normal cells. PDC activity in normal cells is controlled by the reversible phosphorylation of three serine residues by dedicated kinases and phosphatases. Recent advances in metabolic reprogramming of glucose in cancer cells show that new and expanded mechanisms operate to regulate PDC. This comprehensive review presents several post-translational modifications of PDC proteins such as phosphorylation, acetylation, lactylation, methylation, and others (at least 12). Transcriptional regulation of PDC-specific kinase and phosphatase genes amplifies cancer-specific regulation of PDC. In some cancer cells, to enhance the mitochondrial oxidative metabolism to meet increased energy requirements, PDC is maintained in its active state by employing yet another novel mechanism involving AMPK-mediated phosphorylation of two different serine residues. Interestingly, impairment in PDC function as a major supplier of mitochondrial acetyl-CoA to the nuclear pool of acetyl-CoA is circumvented by the translocation of the PDC to the nucleus for histone acetylation. These cancer-specific PDC regulatory mechanisms represent an incredible advancement in our understanding of the reprogramming of cellular metabolism in cancer cells and could contribute to the development of new therapeutic strategies.
6. County-level mobility and sociopolitical context in the spread of COVID-19 during spring 2020.
期刊: Health care management science 发表日期: 2025-Oct-04 链接: PubMed
摘要
The implementation of social distancing policies is key to reduce the spread of the recent COVID-19 pandemic and future pandemics. However, their effectiveness ultimately depends on human behavior. For example, in the United States, compliance with social distancing policies widely varied in Spring 2020. What factors were associated with the observed variability in behavioral compliance with the policies? Utilizing detailed county-level data, we estimate the association between human mobility and the growth rate of COVID-19 cases across approximately 3,100 U.S. counties from January 1, 2020 to June 20, 2020. In addition, using data from U.S. presidential elections we measured how the association between mobility and COVID-19 growth rate varied as a function of county voting pattern. Our results generalize previous reports in finding a significant association between political leaning and the COVID-19 growth rate. These results highlight how it might be beneficial to consider political orientation when building models of the multivariate relationships between the spread of pandemics and public health policies intended to curb the expansion of the pandemic.
7. A descriptive investigation of the impact of statewide distribution policies and consumer vulnerabilities on COVID-19 vaccination in the united States.
期刊: Health care management science 发表日期: 2025-Oct-04 链接: PubMed
摘要
This research leverages data from various disparate sources to examine how state-level policy distribution decisions and local, county-level population vulnerability factors likely to hinder vaccination influenced COVID-19 vaccination efforts across the United States. Unlike other nations that coordinated their responses at a national level, this study uses U.S. states and counties as individual units of analysis. This approach allows for an assessment of which policies and population attributes were most impactful in driving vaccination and ensuring efficient and equitable distribution among citizens. By focusing on the diverse strategies employed by different states in terms of (1) defining the entity responsible for distribution policy, (2) determining the groups eligible for vaccination, and (3) the timing for communication of distribution plans for vaccination, this descriptive investigation sheds light on the effectiveness of state-level interventions and contributes to a deeper understanding of how to manage large-scale public health initiatives. By identifying successful strategies and potential pitfalls, the study provides a roadmap for responding to future pandemics, ensuring that vaccination efforts can be swiftly and fairly implemented to protect public health.
8. Association between legume consumption and risk of esophageal cancer among Chinese adults: a 17-year prospective cohort study.
期刊: Cancer causes & control : CCC 发表日期: 2025-Oct-04 链接: PubMed
摘要
Epidemiological studies have reported the influence of legume consumption on multiple cancers risk, but the association in esophageal cancer (EC) remains unclear. This study aimed to investigated the prospective associations between legume consumption and EC risk, especially among Chinese populations. We conducted a prospective cohort study with 15,184 participants aged 40 to 69 years from two high-risk areas of EC in China between 2005 and 2009, with follow-up until 2022. A validated questionnaire was used to collect the consumption frequency of major food groups at baseline and subsequent resurveys, including legume. The Cox proportional hazard regression was used to evaluate the multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of legume consumption and EC risk. To quantify the linear association of legume consumption and EC risk and to account for regression dilution bias, the mean usual consumption amount for each baseline group was estimated by combining the consumption level at both baseline and the second resurvey. The final study sample included 15,184 participants in the cohort (mean [SD] baseline age, 51.8 [7.5] years). During a follow-up of 219,365 person-years, a total of 176 new EC cases were identified. Legume consumption was inversely associated with EC risk, with a 63% reduction in risk for participants who consumed legume regularly compared with nonconsumption (HR: 0.37; 95% CI 0.16, 0.84; p for trend = 0.022). After correction for regression dilution bias, each 10 g/day increased legume consumption was associated with a HR of 0.35 (0.13, 0.96) for esophageal squamous cell carcinoma (ESCC) risk. The associations were consistent across most subgroups and sensitivity analyses. Higher frequency of legume consumption was associated with lower risk of EC among Chinese adults, particularly ESCC. Our findings suggest legume consumption may play an important role in preventing the development of EC.
9. A Scoping Review on Community-based Diabetes Screening Interventions: Paving the Pathway to Early Care and Prevention of Diabetes.
期刊: Current diabetes reports 发表日期: 2025-Oct-04 链接: PubMed
摘要
This review mapped evidence on community-based screening interventions for early detection of prediabetes and type 2 diabetes (T2D), and identified barriers and strategies for developing and implementing such interventions in community settings for diverse populations. Using the Arskey & O’Malley and Levac frameworks, we conducted a scoping review that identified 33 studies across 13 countries that developed and tested a community-based T2D screening intervention, utilizing risk assessment and Point-of-Care (POC) glucose testing. Screenings occurred in settings such as pharmacies (21%), faith-based centers (6%), and mobile vans (6%), with most studies from the United States (42%), Australia (16%), and Canada (9%). Post-screening, 89% of interventions offered referrals to primary care, while few connected participants to community programming. Barriers and strategies were mapped to the socioecological model to guide future development and implementation of early detection interventions in community settings. This review identified key factors for successful community-based T2D screening interventions, including adequate resources (i.e., funding and personnel), community engagement efforts, and accessible, feasible screening of T2D in community settings. POC testing proved valuable for early detection through immediate glucose results that would prompt potential interventions. However, challenges remain in ensuring long-term sustainability and feasibility of such approaches, as many interventions encountered high attrition rates due to challenges with referral pathways to health care and community programs, structural inequities, and lack of sustainable follow-up processes. Future research should focus on evaluating the cost-effectiveness and sustainable integration of these community-based T2D screening approaches into health systems for broader impact.
10. Molecular-based evidence for school transmission of enteroaggregative Escherichia coli among apparently healthy children attending nursery, infant, and primary schools in Madrid (Spain).
期刊: European journal of pediatrics 发表日期: 2025-Oct-04 链接: PubMed
摘要
Information on the epidemiology, transmission dynamics, and public health impact of enteroaggregative Escherichia coli (EAEC) infection in schoolchildren from high-income countries is scarce. This study investigated the occurrence of EAEC infections in apparently healthy children (0-12 years) attending nursery, infant, and primary schools in Spain. High-resolution whole-genome sequencing typing was used to detect and trace back unnoticed episodes of transmission within school settings. An overall EAEC prevalence of 5.1% was observed, with children in the 0-3 age group showing the highest prevalence (24.2%). Besides their gastrointestinal potential, 17% of EAEC isolates revealed an additional urinary/systemic pathogenic potential. Presumptive outbreaks of EAEC infection were identified in two different nursery schools involving the endemic subtypes O126:H27-ST200 (15 children) and O111:H21-ST40 (12 children). Most affected children shared caregivers and common areas including activity, eating, sleeping, and diapering/toileting rooms. Direct person-to-person transmission was highly suspected, although foodborne transmission could not be completely ruled out. Six independent micro-foci of EAEC infections were additionally identified in five different infant and primary schools also involving O126:H27-ST200 (two children) and O111:H21-ST40 (three children), as well as O3:H2-ST10 (three children), O44:H18-ST1380 (two children and two siblings), and ONT:H33-ST34 (four children). No clear information was available on the sources of infection and transmission routes in these settings. Apparently healthy Spanish schoolchildren may be carriers and potential spreaders of certain EAEC subtypes with gastrointestinal/extra-intestinal pathogenic potential. While transmission within school settings appears to be the most likely explanation for the EAEC genomic clusters identified, particularly among toddlers, extra-school infections through alternative pathways cannot be entirely ruled out. • EAEC is increasingly considered as an important agent of domestically acquired paediatric diarrhoea in high-income countries. • Endemic EAEC subtypes differ between low- and high-income countries. • Apparently healthy children in high-income countries may be carriers and potential spreaders of certain EAEC subtypes with gastrointestinal/extra-intestinal pathogenic potential. • Transmission of endemic EAEC subtypes can occur within school settings, particularly during early childhood, without precluding other transmission modes.
11. Impact of COVID-19 on the prevalence of multi-drug-resistant bacteria: a literature review and meta-analysis.
期刊: Antonie van Leeuwenhoek 发表日期: 2025-Oct-04 链接: PubMed
摘要
The COVID-19 pandemic affected the global healthcare delivery system, raising concerns about its influence on antimicrobial resistance (AMR). This systematic review and meta-analysis assessed the impact of the COVID-19 pandemic on the prevalence of MDR bacteria in different healthcare environments. A systematic search was carried out in PubMed-MEDLINE, Embase, Web of Science, BIOSIS, Scopus, and Google Scholar for articles published from December 2019 to January 2024. After screening 77 full-text studies, 28 studies were included in the analysis. The inclusion criteria included original human studies presenting MDR bacteria incidence before and during/after COVID-19 with reference to Carbapenem-resistant Acinetobacter baumannii, Carbapenem-resistant Enterobacteriaceae, Vancomycin Resistant Enterococci, Carbapenem-Resistant Pseudomonas aeruginosa, Methicillin-resistant Staphylococcus aureus, and Extended-Spectrum Beta-Lactamase-producing Enterobacteriaceae. The overall odds ratio (OR = 0.91, 95% CI: 0.70-1.17) indicates no significant change in the prevalence of multidrug-resistant (MDR) bacterial infection between the pre-COVID-19 and the COVID-19 period. There was no significant change in the prevalence of MRSA, ESBL, and VRE pre- and post-COVID. However, there was a significant reduction in the prevalence of CR-Ab, CRE, and CRPA pre- and during/after-COVID-19. MDR prevalence was significantly increased in Asia (18%) while it decreased slightly in North America (10.3%), showing variations in antibiotic use. The findings show that COVID-19 has different effects on the prevalence of MDR bacteria across geographical regions and healthcare facilities.
12. Effect of neoadjuvant chemotherapy on years of life lost in radical cystectomy-treated T2N0M0 bladder cancer patients.
期刊: World journal of urology 发表日期: 2025-Oct-04 链接: PubMed
摘要
Neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC) is standard of care for T2N0M0 urothelial carcinoma of urinary bladder (UCUB) patients. However, the effect of NAC on years of life lost (YLL) in RC-treated T2N0M0 patients has never been quantified. Within the Surveillance, Epidemiology, and End Results (SEER) database (2004-2021), T2N0M0 UCUB patients aged 40-75 years treated with RC, with or without NAC, were included. Relying on Social Security Administration (SSA) life tables, an age/sex-matched control (Monte Carlo simulation) was simulated for each patient. Kaplan-Meier method was used to calculate average YLL until the age of 75 years between SEER cases and SSA simulated controls. Overall, 1511 (27.8%) T2N0M0 UCUB patients treated with RC + NAC and 3932 (72.2%) with RC alone were identified. Compared to simulated population controls, RC + NAC vs. RC alone patients exhibited 1.3 vs. 2.3 YLL. In sensitivity analyses according to age at diagnosis, the most pronounced YLL values were recorded in youngest patients (40-55 years): RC + NAC: 2.2 YLL vs. RC alone: 6.1 YLL. Intermediate YLL values were recorded in intermediate age patients (56-65 years): RC + NAC: 1.9 YLL vs. RC alone: 3.2 YLL. Finally, the least pronounced YLL values were recorded in oldest patients (66-75 years): RC + NAC: 0.4 YLL vs. RC alone: 0.7 YLL. Invariably, RC alone was associated with higher YLL values than RC + NAC. When YLL represented the endpoint, RC + NAC patients exhibited more favorable outcomes than RC alone patients. In both RC + NAC and RC alone groups maximal YLL applied to youngest individuals and decreased in proportion to increasing age.
13. Streptococcus dysgalactiae as a cause of peripartum infections - a population-based cohort study with phylogenetic analysis of hospital clusters.
期刊: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology 发表日期: 2025-Oct-04 链接: PubMed
摘要
We aimed to investigate the incidence and clinical features of Streptococcus dysgalactiae peripartum infections (SDPI), and to investigate the distribution of emm-types in relation to disease severity and the genetic relatedness of isolates from hospital clusters. Patients with growth of S. dysgalactiae in a genital or wound culture, collected between January 2014 and September 2020 at departments for gynecology and obstetrics, were identified. For inclusion, patients had to be pregnant, or given birth, or undergone an abortion within 42 days prior to debut of symptoms. All isolates had previously been emm-typed. A cluster was defined as two or more patients with S. dysgalactiae of the same emm-type admitted to the same hospital within a 30-day period. The cluster isolates were subjected to whole genome sequencing (WGS). The final study cohort comprised 130 patients. The incidence of S. dysgalactiae postpartum infection was approximately 1 case/1000 births. The patients fulfilled criteria for endometritis (n = 94), postpartum fever (n = 15), wound infection (n = 8) or chorioamnionitis (n = 4). Most patients with endometritis (87%) had onset of symptoms > 48 h post-partum. The most common emm-type was stG62647 (n = 41). Thirteen hospital clusters were identified, of which only three had bacterial isolates that were closely genetically related (0-6 SNP). Our findings demonstrate that SDPI impact a relatively large number of patients. No patient was critically ill, but the morbidity appeared to be substantial. Hospital outbreaks of SDPI are rare, but when suspected, WGS should be employed to investigate relatedness between isolates.
14. "We Get Stuck in our Own Little Bubbles": How Community Mental Healthcare Professionals Acknowledge their Role in Interorganizational Collaboration.
期刊: Community mental health journal 发表日期: 2025-Oct-04 链接: PubMed
摘要
Interorganizational collaboration (i.e., organizations working together towards one goal) is one approach that can be used by community-based organizations to ensure marginalized individuals receive needed care. Though there has been some research on the mechanisms of collaboration from the perspective of leadership, less literature has focused on the perspective of staff working in community-based settings. The study aimed to explore staff perceptions of interorganizational collaboration within a North Carolina county and to gather their recommendations for strengthening such collaboration. Semi-structured interviews were conducted with twenty community-based staff that worked with behavioral health clients, were employed in varying roles and occupied different levels of the organization. Employing a generic qualitative methodology, data were analyzed using an inductive coding approach with the help of a research assistant. Thematic analysis was used across codes to generate seven themes. Community-based staff viewed collaboration as primarily driven by historic relationships and being facilitated by the possession of similar technological infrastructure. Staff reflected on the disconnect between interpersonal relationships and organizational relationships when it came to prioritizing client care. Solutions to improving collaboration as a way of strengthening a client’s access to care included organizations providing time and space to network, building out technological infrastructure for more organizations, and emphasizing the ability to provide holistic care through collaboration. Using staff-driven solutions to improving collaboration can encourage buy-in and can build sustainable relationships.
15. First serological evidence of equine coronavirus and severe acute respiratory syndrome coronavirus 2 in horses in North Africa.
期刊: Veterinary research communications 发表日期: 2025-Oct-04 链接: PubMed
摘要
Viral diseases cause significant economic losses within the equine population. Horses are susceptible to equine coronavirus (ECoV) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), although only ECoV has been associated to clinical disease. The aim of this study was to investigate, for the first time in Algeria, the seroprevalence of ECoV and SARS-CoV-2 antibodies and the prevalence of ECoV infection in horses. In 2022, a total of 299 serum samples was collected from horses aged 1 to 27 years. Serological analysis for the presence of ECoV and SARS-CoV-2 was performed using a validated in-house and a commercially available ELISA, respectively. In addition, fecal samples of these animals were tested for the presence of ECoV RNA by RT-qPCR. SARS-CoV-2-ELISA positive sera with high S/P ratios and negative samples close to the doubtful threshold were retested using a virus neutralization test (VNT). The seroprevalence of ECoV and SARS-CoV-2 in the tested horses was 63.5% (190/299) and 4.3% (13/299), respectively. Among CoVs-seropositive horses, six were seropositive for both ECoV and SARS-CoV-2, thus 6/10 sera were VNT positive, including two ELISA-negative samples for SARS-CoV-2. ECoV seroprevalence varied according to age, breed and sex. None of the fecal samples tested positive for ECoV. Antibodies against SARS-CoV-2 were confirmed by VNT in six samples (2%). One SARS-CoV-2-positive serum tested by ELISA and confirmed through VNT was cytotoxic for VERO cells. This study is the first to report the circulation of ECoV and SARS-CoV-2 in the Algerian horse population. Further studies are necessary to isolate and obtain molecular characterisation of ECoV and SARS-CoV-2 from horses in Algeria.
16. Does SUFU's best practice policy statement regarding antibiotic prophylaxis predict urinary tract infection after urodynamic study? : Evidence from a retrospective cohort.
期刊: World journal of urology 发表日期: 2025-Oct-04 链接: PubMed
摘要
To validate the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Best Practice Policy Statement (BPPS) risk factors (RFs) for predicting urinary-tract infection (UTI) after urodynamic study (UDS) and to identify possible RFs that could better guide antibiotic prophylaxis. A retrospective cohort study included all adults undergoing UDS at a single institution. Patients with asymptomatic bacteriuria received a 3-day antibiotic course, while those without bacteriuria received no prophylaxis. The primary endpoint was a culture-confirmed UTI within 7 days. Regression analysis was performed to check SUFU BPPS RFs as predictors for post-UDS UTI. Among 1666 patients (median age 68 years; 42% female), UTI occurred in 31 (1.9%). Abnormal GU anatomy was found as a predictor for post-UDS UTI (OR = 3.26, p = 0.033). Other examined RFs were not found to predict post-UDS UTI. More concise variables were identified as statistically significant predictors: hydronephrosis (OR = 4.98, p = 0.004), elevated post-void residual (PVR) (OR = 2.80, p = 0.011), and NLUTD due to neurologic disease (OR = 2.27, p = 0.042). In multivariate analysis, elevated PVR and NLUTD caused by neurologic disease remained independent predictors. The current SUFU BPPS criteria exhibit limited accuracy for predicting post-UDS UTI. Our study emphasizes hydronephrosis, NLUTD caused by neurologic disease, and elevated PVR as predictors of post-UDS UTI. Updating prophylactic guidelines to incorporate these findings could enhance patient safety and antimicrobial stewardship without compromising infection control.
17. Risk stratification of high-risk muscle invasive upper urinary tract urothelial carcinoma: multi-institutional study.
期刊: World journal of urology 发表日期: 2025-Oct-04 链接: PubMed
摘要
This study aimed to analyze a large multi-institutional UTUC database to identify prognostic factors in patients with organ-confined and non-organ-confined disease, and to further stratify pT2 patients using a nomogram to identify high-risk subgroups who may benefit from adjuvant therapy. The records of patients diagnosed with UCTC who underwent nephroureterectomy from 1988 to 2022 at 15 hospitals in Taiwan were retrospectively reviewed. The outcomes evaluated were overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), and bladder recurrence-free survival (BRFS) after nephroureterectomy. A total of 2635 patients were included: 1935 with organ-confined (pTis/pTa/pT1/pT2 stage) disease, and 700 with non-organ confined (pT3/pT4 stage) disease. Significant risk factors for poor survival in patients with organ-confined disease were age ≥ 70 years, ureter involvement, high pathological T stage (pT2), multiplicity, lymphovascular invasion, and eGFR ≤ 44 ml/min/1.73 m2. In patients with non-organ-confined disease, risk factors included male sex, age ≥ 70 years, ureter involvement, high pathological T stage (pT4), multiplicity, eGFR ≤ 44 ml/min/1.73 m2, tumor necrosis, variant UC cell type, and smoking. In patients with pT2 UTUC, those classified as high risk based on a nomogram-derived total score > 115 had significantly worse OS (P < 0.0001) and CSS (P = 0.025) compared to those with a score ≤ 115 (low risk). Patients with high-risk pT2 UTUC had significantly worse survival outcomes compared to those with low-risk pT2 UTUC. These findings suggest that further refinement of clinical trial designs is needed to better identify high-risk pT2 UTUC patients who may benefit from more aggressive treatment strategies, such as adjuvant therapy, while minimizing unnecessary systemic therapy in low-risk pT2 UTUC patients. Future studies should validate these findings and help establish the true value of systemic therapy for this patient population.
18. Enhancing patient accessibility of primary care: the redesign of Italian territorial medicine.
期刊: Health care management science 发表日期: 2025-Oct-04 链接: PubMed
摘要
Ensuring widespread accessibility of healthcare services is a crucial policy objective. Accordingly, the Italian National Recovery and Resilience Plan (NRRP) has prioritized territorial medicine, channeling post-pandemic investments toward the restructuring of primary care services. A notable change is the establishment of Community Healthcare Centers (CHCs). This paper investigates how CHCs contribute to the accessibility of healthcare in urban and rural areas. By leveraging a comprehensive dataset of general practitioners’ availability and estimating future demand-and-supply scenarios, we examine the impact of CHCs under two different capacity allocation strategies. Strategy 1-Capacity expansion-involves allocating additional service hours of general practitioners to CHCs in order to maximize accessibility. Strategy 2-Capacity redistribution-accounts for the persistent shortage of healthcare professionals faced by Italy in the recent years by reallocating a portion of general practitioners’ current services from their existing workplace locations to CHCs. Our results indicate that CHCs have the potential to maintain current accessibility levels and also enhance them in the years to come. Moreover, we demonstrate that simply redistributing the current capacity can improve future accessibility. Finally, we show that a mix of the capacity expansion and redistribution strategies (Strategy 3) can maximize accessibility in the future, limiting the need for new professional staff.
19. Curcumin: multifaceted biological actions and therapeutic implications-a narrative review.
期刊: Inflammopharmacology 发表日期: 2025-Oct-04 链接: PubMed
摘要
Curcumin, a bioactive polyphenol extracted from the rhizome of Curcuma longa, has garnered considerable attention for its wide-ranging pharmacological properties and potential therapeutic applications. This narrative review critically synthesizes current evidence on curcumin’s multifaceted biological actions, encompassing its antioxidant, anti-inflammatory, anti-cancer, and metabolic regulatory effects. Extensive preclinical and clinical studies have demonstrated that curcumin exerts beneficial effects by modulating key cellular signaling pathways and mitigating oxidative stress and inflammatory responses. Despite its promising profile, clinical translation has been hampered by issues related to low bioavailability and rapid metabolism. Recent advances in novel formulation strategies and combination therapies, however, have shown potential in overcoming these limitations. This review uniquely consolidates recent mechanistic insights with clinical translation challenges, identifying specific gaps in bioavailability research and proposing novel combination therapy approaches that distinguish it from existing curcumin reviews, ultimately facilitating evidence-based therapeutic development.
20. Health utility book: A systematic review and meta-analysis of health utilities in gastric cancer.
期刊: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 发表日期: 2025-Oct-04 链接: PubMed
摘要
The treatment landscape in gastric cancer has changed drastically over the last 15 years with surgical advancements and the introduction of new therapeutic agents and combinations. Despite the potential for improved survival, these new interventions can impact health-related quality of life (HRQoL). Our objective was to identify and synthesize health utility data for gastric cancer patients as part of the Health Utility Book (HUB) project. We searched MEDLINE, EMBASE, EconLit, and CINAHL from inception to March 2023 for original studies that reported health utility data for gastric cancer. Records were screened independently and in duplicate by two reviewers. Data on study design, patient characteristics, and health utilities were extracted using a standardized form. A random effects meta-analysis was conducted to synthesize health utilities by cancer stage. Heterogeneity was evaluated using the I2 statistic. 600 health utilities from 3,405 respondents were identified across 19 studies. All studies were published between 2018 and 2022 and most were conducted in Asia (n = 12, 63.2%). The EQ-5D was the most common method of preference elicitation (n = 17, 89.5%), and health utilities ranged from 0.298 (SD 0.088) to 0.920 (SD 0.130). Mean health utilities from random effects models were 0.82 (95% Confidence Interval [CI] 0.76-0.88), 0.76 (95% CI 0.68-0.85), and 0.67 (95% CI 0.46-0.87) for early stage, advanced stage, and metastatic gastric cancer, respectively. This systematic review provides a reference set of health utilities for gastric cancer, which can help understand HRQoL and facilitate the retrieval and selection of health utilities for economic evaluations.
21. Systematic analysis of cutting-edge technology for the wellbeing and safety of older persons.
期刊: Disability and rehabilitation. Assistive technology 发表日期: 2025-Oct-04 链接: PubMed
摘要
With global populations aging at an unprecedented pace, health and social care systems face mounting challenges in supporting older adults to live safely and independently. A wide range of assistive and digital technologies has emerged to enhance well-being, autonomy, and safety in later life. This systematic review explores the current landscape of such technologies, critically assessing their reported benefits, usability and implementation barriers. A structured search was conducted across six major databases for peer-reviewed studies published between January 2015 and May 2025. The review followed PRISMA 2020 guidelines, and methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT) (2018), augmented with technology-specific criteria. Of the 1838 records screened, 69 studies met the inclusion criteria. These studies evaluated interventions such as smart home systems, wearable health monitors, socially assistive robots and artificial intelligence (AI)-driven behaviour recognition tools. Reported outcomes included improved fall prevention, more rapid emergency response, increased engagement in daily activities and enhanced emotional well-being. Despite these promising results, many studies reported persistent challenges related to usability, affordability, data privacy and the mismatch between design and user needs. Only 17.4% of the studies included achieved high methodological quality. The findings highlight a need for more robust, user-centred research and the development of implementation models that account for the diversity of older adults’ needs. This review provides actionable insights for researchers, clinicians and developers aiming to design effective, equitable, and scalable technological interventions in rehabilitation and aging. Technology-enabled interventions: Smart home systems, wearable monitors and socially assistive robots demonstrate measurable benefits in supporting rehabilitation goals such as fall prevention, autonomy in daily activities and physical engagement in older adults.Personalisation is critical: Rehabilitation outcomes improve when technologies are tailored to individual cognitive, sensory and functional capacities, emphasising the need for adaptable, user-centred design in clinical and community settings.Bridging the usability gap: Many older adults encounter barriers due to poor usability and technology-related anxiety. Rehabilitation professionals should play a proactive role in facilitating technology adoption through hands-on training, gradual exposure and continuous support.Multidisciplinary integration: Effective rehabilitation strategies increasingly depend on collaboration between clinicians, engineers, caregivers and end-users to ensure that technological tools are functional, acceptable and aligned with therapeutic goals.Equity in access: Financial constraints and digital divides limit access to advanced rehabilitation technologies. Inclusive policy frameworks and reimbursement models are essential to ensure equitable access for all aging populations, particularly those in under-resourced settings.Evidence-based practice: The review highlights a pressing need for standardised outcome measures, longitudinal evaluations and real-world implementation research to guide technology integration in rehabilitation protocols.
22. Regional Differences in Characteristics, Service Utilization, and Outcome of Patients Receiving Physician-Led Home Visit Care in Japan: A Nationwide Study.
期刊: Geriatrics & gerontology international 发表日期: 2025-Oct-04 链接: PubMed
摘要
Physician-led home-visit care has become essential in the super-aged society of Japan. To develop region-specific service systems, understanding regional differences in patient profiles is essential. This study aimed to describe regional differences in patient characteristics, service utilization, and outcomes, and to assess the associations between regional healthcare resources and patient outcomes. This retrospective study used linked data from the National Database of Health Insurance Claims and Specific Health Checkups and the Japanese Long-term Care Database (April 2020-March 2021). Patients aged ≥ 65 years receiving regular physician-led home visits in October 2020 were included. Analyses were conducted by prefecture and region. Associations between regional healthcare resources and patient outcomes were assessed using Spearman’s correlation coefficients (ρ). Among 337 863 patients, regional variations were observed. Western Japan had a higher prevalence of cancer, heart disease, respiratory disease, and orthopedic disorders, whereas Tohoku showed the highest rates of high care-need levels and home nursing utilization. Hospitalization risk was highest in western Japan, whereas in-home deaths were more frequent in eastern Japan. Hospital bed density was positively correlated with hospitalization risk (ρ = 0.62) and negatively with 6-month mortality risk (ρ = -0.44). Utilization of enhanced home care support clinics/hospitals was moderately associated with higher in-home death risks (ρ = 0.49). Substantial regional differences exist in patient characteristics, service utilization, and outcomes among older adults receiving physician-led home-visit care. Healthcare resources were strongly associated with hospitalization and end-of-life care, highlighting the need for region-specific strategies to optimize healthcare delivery and resource allocation for the super-aged society of Japan.
23. Diagnostic imaging modalities to detect regional nodal involvement in oral squamous cell carcinoma: a systematic review and meta-analysis.
期刊: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico 发表日期: 2025-Oct-04 链接: PubMed
摘要
To determine the most effective diagnostic imaging modality including computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography-computed tomography (PET/CT), and ultrasound (US) for the identification of regional lymph node involvement in patients with oral squamous cell carcinoma (OSCC). A search was performed to identify qualified studies using PubMed, Scopus, and Web of Science electronic databases from January 2013 to December 2023. The outcome assessed was the diagnostic performance of different imaging techniques in the detection of cervical lymph node metastasis in OSCC, with lymph node yield in neck dissection specimens as the gold standard for validation. Summary estimates for diagnostic performance were sensitivity, specificity, and diagnostic odds ratio (DOR) with 95% confidence intervals (CIs). Differences in sensitivities, specificities, and DOR were tested using a bivariate random effects model. Twelve observational studies including PET/CT, MRI, and CT alone or combined in OSCC patients were included in the meta-analysis. Data from a single study based on US were insufficient to assess the value of this imaging modality. The pooled estimates of sensitivity were 0.87 for PET/CT, 0.70 for MRI, and 0.66 for CT. The corresponding pooled specificities were 0.79, 0.79, and 0.81, respectively. The DOR was 24.85 for PET/CT, 8.60 for MRI, and 8.59 for CT. PET/CT may be recommended in clinical practice for detecting cervical metastatic disease in OSCC patients as this technique showed the most favorable diagnostic performance as compared with MRI and CT.
24. Synthesis of molecularly imprinted polymer for highly selective adsorption of Sulfasalazine from contaminated wastewater.
期刊: Environmental geochemistry and health 发表日期: 2025-Oct-04 链接: PubMed
摘要
The molecularly imprinted polymer (MIP) was synthesized using the bulk polymerization technique and characterized by Scanning electron microscope (SEM), X-ray diffraction (XRD), Brunauer-Emmett-Teller/Barrett-Joyner-Halenda (BET/BJH), Thermogravimetric Analysis (TGA), and point of zero charge (pHPZC) analyses. The adsorption of sulfasalazine (SSZ) onto the MIP was systematically investigated under various conditions. The researchers investigated the effect of initial SSZ concentration, MIP mass, temperature, pH, and contact time. The highest removal efficiency was achieved at pH 7, MIP dosage of 0.8 g/L, and an initial SSZ concentration of 10 mg/L, with an equilibrium contact time of 75 min. The maximum adsorption capacities obtained from the Langmuir model were 217.1, 235.4, 254.3, and 284.5 mg/g at 20, 30, 40, and 50 °C, respectively, confirming a monolayer adsorption process. Kinetic analysis indicated that the adsorption followed the pseudo-second-order model (R2 > 0.995), while thermodynamic studies revealed that the process was spontaneous (ΔG° = -3.41 to -8.95 kJ/mol) and endothermic (ΔH° = 38.4 kJ/mol). The MIP maintained over 93% of its initial adsorption capacity after five regeneration cycles. Competitive adsorption tests further demonstrated a significantly higher affinity of the MIP for SSZ compared with ciprofloxacin and amoxicillin. These results suggest that the synthesized MIP is a highly efficient, selective, and reusable adsorbent for removing SSZ from aqueous environments.
25. Phagophores originate from endoplasmic reticulum membranes in vasopressin neurons in a mouse model of familial neurohypophysial diabetes insipidus.
期刊: Cell and tissue research 发表日期: 2025-Oct-04 链接: PubMed
摘要
Familial neurohypophysial diabetes insipidus (FNDI) is an autosomal dominant disorder caused by mutations in the arginine vasopressin (AVP) gene. In AVP neurons in a mouse model of FNDI, aggregates of mutant AVP precursors accumulate within a specific compartment of the endoplasmic reticulum (ER). However, as FNDI mice aged, or were exposed to repeated water deprivation, the ER lumen dilated and mutant aggregates dispersed throughout the ER. Meanwhile, autophagic isolation membranes, known as phagophores, emerged to envelop ER containing these aggregates, indicating induction of ER-phagy. Previous in vitro studies showed that phagophores originate from ER membranes, but the structural relationship between phagophores and the ER membrane in vivo remains unknown. In this study, we used serial block-face scanning electron microscopy to investigate the structural relationship between phagophores, ER membranes, and protein aggregates within dilated ER of AVP neurons from FNDI mice subjected to intermittent water deprivation for 4 weeks. Three-dimensional analysis revealed that phagophores enveloped aggregates located within the dilated ER. Serial imaging further demonstrated a physical connection between these phagophores and intact ER membranes. This study provides the first in vivo evidence of the structural continuity between phagophores and the ER membrane in AVP neurons in a mouse model of FNDI.
26. Molecular characterization of Rhipicephalus microplus and tick-borne pathogens in cattle in Nepal.
期刊: Veterinary research communications 发表日期: 2025-Oct-04 链接: PubMed
摘要
Ticks and tick-borne pathogens (TBPs) have a significant economic impact on livestock. In Nepal, only limited information is available for the molecular identification of ticks and TBPs. This study aims to address this major challenge by providing data on the diversity of TBPs in Nepalese cattle, along with molecular sequences to facilitate accurate identification. A total of 145 cattle blood samples were collected from Pokhara (n = 70) and Madi (n = 75). The cattle were also examined for tick infestations, and the detected ticks were subjected to morphological identification, followed by molecular characterization using the cytochrome c oxidase subunit I (COI) gene. The heat shock protein (groEL) and citrate synthase (gltA) genes were targeted for screening Anaplasmataceae. Piroplasmida infections were initially screened using nested polymerase chain reaction (PCR) targeting the 18S ribosomal RNA gene. Theileria orientalis and Anaplasma marginale were further characterized by the major surface protein 4 (MSP4) gene. Rhipicephalus microplus was the only tick species detected in the examined cattle. Overall, 29.7% (43/145) of the cattle examined were infected with at least one TBP, with 3.4% (5/145) being co-infected with more than one TBP. The detection rate of TBPs was 20% (n = 29) for A. marginale, 3.4% (n = 5) for Anaplasma bovis, 6.2% (n = 9) for T. orientalis, and 4.1% (n = 6) for Theileria annulata. The phylogenetic analysis showed that two genotypes of A. marginale and T. orientalis (types 5 and 7) were present in cattle. This study provides preliminary baseline data on the prevalence and genetic diversity of ticks and TBPs in cattle in Nepal.
27. Molecular Docking and Simulation of Bioactive Molecules from Antiepileptic Plant Extract Presenting Significant Result in in-vivo Study.
期刊: Cell biochemistry and biophysics 发表日期: 2025-Oct-04 链接: PubMed
摘要
28. Impact of pet ownership in early childhood at ages 1 and 4-5 years on mental health at ages 7-8: findings from the INMA project.
期刊: World journal of pediatrics : WJP 发表日期: 2025-Oct-04 链接: PubMed
摘要
We aimed to explore associations between the presence of pets at one and 4-5 years of age with internalizing and externalizing problems at 7-8 years. Participants comprised 1893 families from the INfancia y Medio Ambiente (INMA) project. Information was collected on the presence of (1) any pet, (2) dogs, (3) cats, (4) birds or (5) other animals. Pet ownership was categorized as never, always, only at age 1 and only at age 4-5. Internalizing and externalizing problems were measured at ages 7-8 years through the Strengths and Difficulties Questionnaire, a Likert questionnaire on children’s behavioural and emotional symptoms. Negative binomial regression models and Tukey’s multiple comparison tests were used to analyse data sets. Five sensitivity analyses were performed. Families that always owned a pet made up 24.4% of the sample. In addition, 11.5%, 4.5%, 3.8% and 17.6% of the families owned a dog, cat, bird or other animal, respectively. The median (P25-P75) for internalizing problems was 3 (1-5) and 5 (3-8) for externalizing problems. Owning a cat only at age 4-5 increased mental health problems: relative rate ratio (RRR) [95% confidence interval (CI)] 1.37 (1.05-1.79) for internalizing and 1.26 (1.02-1.56) for externalizing. Always having other animals was a protective factor for internalizing problems with an RRR of 0.80 (0.66-0.96). These associations remained after multiple comparison testing and sensitivity analyses. Owning a cat only at 4-5 years of age was linked to more internalizing and externalizing problems, whereas always having other animals was a protective factor against internalizing problems.
29. Genomic architecture of bipolar disorder in Japan: Insights from genomic structural equation modeling.
期刊: Psychiatry and clinical neurosciences 发表日期: 2025-Oct-04 链接: PubMed
摘要
30. Unraveling the interplay between RAS axes and NOX signaling in fibroblasts during cardiac fibrosis.
期刊: Molecular and cellular biochemistry 发表日期: 2025-Oct-04 链接: PubMed
摘要
Cardiac fibrosis results from cardiovascular diseases (CVDs) and is characterized by excessive extracellular matrix (ECM) accumulation, particularly collagen, leading to cardiac dysfunction. Despite the availability of treatments for CVDs, no targeted therapies are available to prevent disease progression to irreversible stages. Further research is needed to explore the pathways and signaling molecules involved in this progression. The renin-angiotensin system (RAS) plays a significant role, with pharmacological agents targeting its harmful axis, i.e., Angiotensin-converting enzyme (ACE)/Angiotensin II (Ang II)/Angiotensin 1 receptor (AT1R) axis, while an antagonistic axis, ACE2/Angiotensin 1-7 (Ang 1-7)/mitochondrial assembly receptor (MasR) axis offers cardioprotective effects. Reactive oxygen species (ROS) also contribute to CVDs, with NADPH oxidases (NOXes) being key inducers of ROS. NOX1, NOX2, NOX4, and NOX5 are upregulated in pathological conditions, exacerbating the disease. This review focuses on the mechanisms by which the ACE/Ang II/AT1R and ACE2/Ang 1-7/MasR axes regulate NOX activity, aiming to enhance our understanding of future targeted therapies.
31. Epstein-Barr virus infection and vitamin D deficiency are both "causal" for multiple sclerosis (MS) - could the common denominator be their effects on hepcidin levels?
期刊: Metabolic brain disease 发表日期: 2025-Oct-04 链接: PubMed
摘要
Multiple sclerosis (MS) is a neurological disorder characterized by damage to the myelin sheaths surrounding axons in the central nervous system, causing decreased axonal signal transmission and disability in people with MS. Epstein-Barr virus (EBV) infection and vitamin D deficiency have been put forward as causal factors for the development of MS, but their effects have not been conclusively linked to the disruption of myelin maintenance. Interestingly, both EBV infection and vitamin D deficiency increase the levels of hepcidin, an acute-phase peptide hormone that inhibits iron absorption. The current understanding of iron dysregulation in MS is that iron accumulates in deep gray matter brain structures which leads to disability progression. However, recent studies have revealed that the apparent iron influx may be an artefact of disease-related brain atrophy, and that iron is in contrast depleted in the deep gray matter in MS, which could cause iron deficiency in oligodendrocytes (the cells producing myelin), leading to their demise due to a mitochondrial energy deficit, with consequent demyelination. EBV infection, vitamin D deficiency and iron deficiency may converge as causal risk factors for MS. Dismantling the current understanding that iron excess underpins MS would improve testing and optimization of iron parameters and vitamin D as part of clinical management of MS. This review additionally explores the risk factors for lytic reactivation of EBV which is hypothesized to drive MS disease activity. Conversely, ensuring that EBV remains in a latent state by ameliorating these risk factors may prevent MS exacerbations and disease worsening.
32. Brivaracetam and Topiramate Co-Therapy Attenuates Seizure Progression, Neuroinflammation, and Hippocampal Pathology in Chronic Pentylenetetrazole-Kindled Mice.
期刊: Neurochemical research 发表日期: 2025-Oct-04 链接: PubMed
摘要
Rational polytherapy is increasingly gaining attention when monotherapy fails to control seizures. Accordingly, the current study investigated the effects of topiramate and brivaracetam, administered individually (10 mg/kg each) or combined, on seizure progression alongside electroencephalographic (EEG) changes and neuroinflammatory responses in Pentylenetetrazole (PTZ)-induced kindled mice. Eleven doses of PTZ (40 mg/kg) were administered on alternate days over three weeks. Monotherapy with topiramate and brivaracetam delayed the development of generalized tonic-clonic seizures during the first week. However, it did not prevent seizures later, resulting in 80% and 60% kindled mice with 25% and 16.16% mortality, respectively. Combination therapy demonstrated 100% protection against kindling progression, with no mortality. EEG recordings revealed progressively increasing epileptiform spikes in PTZ and monotherapy-treated groups throughout the kindling period. Conversely, the combination-treated group exhibited significantly consistent reduction in epileptiform spike activity across all EEG sessions, indicating a better anticonvulsant effect. Post-kindling brain analysis revealed elevated levels of neuroinflammatory markers in the monotherapy-treated groups, while these markers were absent in the combination-treated group. RT-PCR confirmed substantial downregulation of proinflammatory and excitatory markers, including BDNF, TrkB, and TNF-α, indicating suppression of neuroinflammation and excitotoxicity in combination-treated group. Histopathological examination showed neuronal damage in the hippocampal tissues of monotherapy-treated mice, whereas no neuronal degenerations were seen in the brains of combination-treated mice. The results indicate that dual therapy with topiramate and brivaracetam provides superior neuroprotection by modulating neuroinflammatory pathways, thereby preventing seizure development and ictogenesis. These findings support the potential clinical utility of rational polytherapy in drug-resistant epilepsy.
33. Optimizing the diagnosis of idiopathic granulomatous mastitis with shear wave elastography: insights from Young's modulus.
期刊: Journal of ultrasound 发表日期: 2025-Oct-04 链接: PubMed
摘要
Idiopathic granulomatous mastitis (IGM) is a granulomatous condition with non-specific manifestations and a challenging diagnosis. This study aims to describe the appearance of biopsy-proven IGM lesions utilizing shear wave elastography (SWE) Young’s modulus. We performed a retrospective search for pretreatment ultrasounds of IGM referred to two tertiary breast clinics over five years. Patients with at least one pre-treatment ultrasound and pathologically-proven IGM entered the study. Ultrasound and SWE were performed and interpreted by a breast imaging fellowship-trained radiologist. The data were analyzed using SPSS software. Among 201 pretreatment ultrasound, non-mass lesions (76%) and intercommunicating channels (52%) were the most common findings. All the patients had BIRADS of 4. The BIRADS of 4a was the most common (75%). Among 138 SWE, dark blue was the most common color in the center and periphery, with 80% and 76%, respectively. The mean stiffness (kPa) of the center was significantly higher than that of the peripheral parts in IGM lesions (P < 0.001). None of the IGM lesions were hard enough to prevent sound waves from effective propagation. Although IGM mostly presents in non-specific grayscale ultrasound patterns, SWE findings can provide more specificity to imaging findings and probably can help to reach an accurate diagnosis.
34. Tuberculosis outbreak in a German daycare center.
期刊: Infection 发表日期: 2025-Oct-04 链接: PubMed
摘要
Young children who are exposed to people with infectious tuberculosis (TB) have an increased risk of developing TB disease following infection. The risk of infection and disease progression can be minimized by prompt identification of TB-exposed individuals and initiation of prophylactic or preventive treatment. We report on a TB outbreak in a daycare center in Berlin, Germany following a delayed diagnosis of cavitary pulmonary TB in a childhood educator. We describe contact investigation, diagnostic, prophylactic, preventive and therapeutic measures in 62 TB-exposed children (median age 3.9 years), including 30 with prolonged TB exposure. The initial examination took place 5-16 days after the index patient was diagnosed with TB. Ten of the 30 children with intensive contact became infected, six (median age 2.7 years) developed pulmonary TB. Three of these children had a concurrent influenza infection, which may have contributed to disease progression. No child without prolonged exposure to the index patient developed disease. Early diagnosis of TB in adult patients, especially those with persistent cough, is crucial to prevent TB in vulnerable infants. Close collaboration between public health departments and specialized facilities is essential for the effective control of TB outbreaks.
35. Inflammation and immune biomarkers: new frontiers in understanding and managing diabetes complications.
期刊: Inflammopharmacology 发表日期: 2025-Oct-04 链接: PubMed
摘要
Chronic inflammation and immune dysregulation are central to the development and progression of diabetes complications, redefining existing paradigms of disease pathogenesis and management. Key pro-inflammatory cytokines, including tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-1 beta (IL-1β), contribute to tissue injury in the vasculature, kidneys, retina, and peripheral nerves by activating systemic and local inflammatory cascades. Emerging evidence highlights the utility of haematological inflammatory biomarkers such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) as accessible, cost-effective predictors of risk for both microvascular and macrovascular complications in diabetes. These markers reflect the ongoing immune activation linked to insulin resistance, beta-cell dysfunction, and oxidative stress. Integrating these biomarkers with genomic and proteomic data enhances precision medicine approaches for complication risk stratification and individualized therapy. Novel anti-inflammatory and immunomodulatory treatments, alongside lifestyle interventions, show promise in mitigating chronic inflammation’s effects, potentially reducing the burden of diabetic complications beyond conventional glycaemic control. This review critically appraises the molecular mechanisms of immune-mediated damage in diabetes, evaluates the prognostic and diagnostic value of emerging inflammatory biomarkers, and discusses therapeutic advances aimed at targeting inflammation. Challenges remain in optimizing biomarker validation and translating molecular insights into routine clinical practice. Ultimately, embedding inflammation-focused strategies into diabetes management promises to enhance preventive and therapeutic outcomes, alleviating the global impact of diabetes complications.
36. Kaempferol prevents Nrf2 from ubiquitin-mediated proteolysis to mitigate both NLRP3 inflammation and oxidative stress: implications for alleviating DSS-induced colitis in mice.
期刊: Inflammopharmacology 发表日期: 2025-Oct-04 链接: PubMed
摘要
Activation of the NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome and oxidative stress are key pathological hallmarks of inflammatory bowel disease (IBD) and represent novel targets for therapeutic intervention. The therapeutic potential of the naturally occurring flavonoid kaempferol (KAE) in IBD, along with its underlying molecular mechanisms, remains incompletely understood. We established dextran sulfate sodium (DSS)-induced colitis and lipopolysaccharide (LPS)-induced systemic inflammation mouse models. KAE was administered as an intervention. In vitro, peritoneal macrophages (PMs) were stimulated to activate the NLRP3 inflammasome. We comprehensively evaluated the effects of KAE on interleukin-1β (IL-1β) release, NLRP3 inflammasome assembly, and mitochondrial reactive oxygen species (mt-ROS) production. Additionally, we assessed its impact on the Keap1-Nrf2 pathway. Molecular docking and ubiquitin-dependent degradation assays were conducted to confirm Nrf2 as a direct target of KAE. KAE significantly attenuated colitis development, marked by reduced NLRP3 expression and enhanced Nrf2 activation. It inhibited both the priming and assembly phases of NLRP3 inflammasome activation. Notably, Nrf2 inhibition completely abolished KAE-mediated removal of mt-ROS and downstream suppression of NLRP3 inflammasome activation. Mechanistically, KAE prevented Nrf2 proteolysis by directly binding to Arg415 of Keap1. Our findings demonstrate that KAE acts as an mt-ROS scavenger to protect against inflammatory pyroptosis, offering novel mechanistic insights and a promising therapeutic strategy for colitis treatment.
37. Decision-making when a child with haematological malignancy relapses following haematopoietic stem cell transplantation: A meta-ethnographic review.
期刊: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 发表日期: 2025-Oct-04 链接: PubMed
摘要
Lived experience and decision-making processes for families, following relapse after haematopoietic stem cell transplant (HSCT) in children, are under-reported. This meta-ethnographic review aims to synthesize qualitative studies that investigate how families conceptualize and cope with difficult decision-making situations, which can include treatment following relapse or refractory disease, decision for HSCT, and clinical trial enrolment. Qualitative synthesis was conducted using meta-ethnography. The search was executed across seven bibliographic databases. Initial screening did not identify any eligible studies addressing decision-making following relapse after HSCT. Qualitative studies that reported on parental, child, and healthcare professionals’ decision-making in difficult situations were included. Potentially eligible studies, which included families of a child < 18 years of age, were retrieved in full for further review. Data abstraction and analysis involved considering and identifying constructs from included studies. Data were organized to show descriptions and patterns of content, which was then summarized to show key patterns in content and concepts. Of 4355 unique references identified, 23 were included from 67 retrieved in full. Synthesis led to the emergence of two concepts: (1) precision in adapting to family needs and (2) communication and information to help prevent decision regret. As treatment for relapse following HSCT becomes more complex, families will have greater choices with unclear outcomes for their child. Future research should focus on investigating their lived experience. Greater understanding of the experience when a child with haematological malignancy relapses following HSCT will assist in improving care for these families, both in the short-term and in the psychological well-being of those involved in making these difficult decisions.
38. The Lipase Enzyme Attached Micromotors for Degradation of Oils As Water Contaminant.
期刊: Applied biochemistry and biotechnology 发表日期: 2025-Oct-04 链接: PubMed
摘要
In this study, a research design was implemented to investigate the potential of PPy-COOH/Ni micromotors for the degradation of oils as water pollutants. The study’s objective was to determine the micromotors’ capacity for oil removal. For this purpose, PPy-COOH/Ni micromotors were prepared by template-directed electrodeposition method, and lipase enzyme (from Porcine Pancreas) was covalently bound to these micromotors. The micromotors were characterized by SEM, EDX, and FTIR techniques. From the SEM photographs, it was found that the synthesized micromotors were cylindrical, about 5 μm in diameter and 15 μm in size. In addition, from the FTIR spectra, the binding of lipase enzyme to the micromotors was shown by amide I, II, and III bonds at 1640 cm-1, 1540 cm-1, and 1240 cm-1. The present study has determined that the optimal pH level for lipase-attached micromotors is 8.0. Furthermore, the optimal temperature has been ascertained to be 45°C. In addition, the results of this study indicate that lipase-attached micromotors exhibit superior thermal and storage stability in comparison to free lipase. When the reusability of the immobilised lipase was examined, the immobilised lipase showed 73.5% activity even after five uses. The lipase-attached micromotors were tested on tributyrin triglyceride and were found to degrade 90% of the initial amount of tributyrin within 90 min. The findings obtained are consistent with existing literature on the subject, and these lipase-attached micromotors have the potential to be utilized in environmental applications, such as oil breakdown.
39. Pseudomonas spp. and antimicrobial resistance: unlocking new horizons with 1-hydroxyphenazine.
期刊: Folia microbiologica 发表日期: 2025-Oct-04 链接: PubMed
摘要
Antimicrobial resistance (AMR) is a mounting global health challenge projected to cause up to 10 million deaths annually by 2050. Despite advances in antibiotic discovery, the rapid emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) pathogens undermines modern medicine, threatening procedures such as surgery, chemotherapy, and organ transplantation. Conventional antibiotics face increasing limitations due to target-site mutations, efflux mechanisms, enzymatic degradation, and biofilm-associated tolerance, underscoring the urgent need for novel antimicrobial strategies. Phenazines, particularly 1-hydroxyphenazine (1-HP), represent promising alternatives owing to their redox activity, broad-spectrum antimicrobial properties, and ecological roles in microbial competition. Recent advances highlight the potential of 1-HP as both a virulence factor and a therapeutic scaffold, with applications spanning agriculture, biotechnology, and medicine. Synthetic biology, metabolic engineering, and nanocarrier-based delivery systems have enabled scalable production and reduced toxicity, while structural modifications such as halogenation have expanded therapeutic potential. This review consolidates historical, mechanistic, and translational insights into 1-HP, emphasizing its dual role as a pathogenic metabolite and a lead compound for future antimicrobial and anticancer development.
40. Hydrogeochemical conceptualization of granitic-urban area for sustainable water resource management: a case study of Daejeon, Korea.
期刊: Environmental geochemistry and health 发表日期: 2025-Oct-04 链接: PubMed
摘要
Groundwater is increasingly vital under growing demand and climate pressures, making its effective management essential for sustainable use. A thorough understanding of hydrogeochemical processes is therefore critical to secure water quality and guide resource development. This study develops a conceptual model of a granitic aquifer in Daejeon, Korea, representing a typical weathered-fractured system under mixed urban and green land-use conditions. An integrated approach was applied, combining conventional geochemical analysis, multivariate statistics, geochemical modeling, and strontium isotope tracing. The results highlight silicate weathering as the dominant control on groundwater chemistry, validated by 87Sr/86Sr ratios (~ 0.716). Mineral-water interactions explain nearly half of the observed variance, mainly through the weathering of silicate minerals to secondary clays, which promote ion exchange processes. Anthropogenic activities, particularly agriculture and land use, account for ~ 15% of the variation, indicating localized contamination risks in the lowland areas. The conceptual model, supported by natural tracers, demonstrates that groundwater evolves from a Ca-HCO3 type in recharge zones to mixed types, such as Ca(Na)-HCO3 and Ca-Cl, along downgradient flow paths. This hydrogeochemical evolution reflects the combined effects of progressive mineral weathering and superimposed anthropogenic influences.By capturing both natural processes and human impacts, this study advances the understanding of hydrogeochemical dynamics in granite-based aquifers. The proposed conceptual framework provides a basis for predicting groundwater evolution and emphasizes the urgent need for sustainable management of these vulnerable resources in rapidly urbanizing regions.
41. Genetic and Environmental Influences on the Development of Callous-Unemotional Behaviors in the Preschool Period.
期刊: Research on child and adolescent psychopathology 发表日期: 2025-Oct-04 链接: PubMed
摘要
Callous-Unemotional behaviors (CU) can be seen in early childhood and are associated with negative developmental outcomes. The present study examined the genetic and environmental influences on the development of CU in the preschool period from both rank-order stability/instability and absolute-level developmental trajectories perspectives. A community sample of 310 twin pairs (MZ = 123; DZ = 187; 51% female) was longitudinally assessed with the Child Behavior Checklist 11/2-5 reported by primary caregivers at ages 3, 4 and 5 years. Genetic and environmental contributions to rank-order stability/instability and absolute-level change in CU over time were assessed via biometric trivariate Cholesky and latent growth curve models, respectively. Age-to-age rank-order stability in CU was moderate and was mostly explained by genetic influences, whereas instability was due to genetic and nonshared environmental influences. Absolute-level change at the group level showed an overall pattern of decreasing CU across age, and individual differences in patterns of change were primarily due to nonshared environmental influences. Although rank-order change in CU was explained by genetic and nonshared environmental factors, within-individual changes in levels of CU were primarily influenced by nonshared environmental factors. These latter findings affirm that environmentally based intervention strategies in early childhood could affect CU trajectories.
42. A Trust-Aware Architecture for Personalized Digital Health: Integrating Blueprint Personas and Ontology-Based Reasoning.
期刊: Journal of medical systems 发表日期: 2025-Oct-04 链接: PubMed
摘要
This paper presents a trust-aware architecture for personalized digital health that combines user modeling, symbolic reasoning, and adaptive trust mechanisms. The proposed system uses Blueprint Personas to capture detailed patient profiles, including clinical, behavioral, and emotional traits. These profiles guide an intelligent agent that interacts with patients and healthcare professionals to provide context-sensitive support. Personalization is achieved through an ontology-based reasoning layer that interprets user needs and integrates real-time data from electronic health records, wearable devices, and environmental sources. To promote transparency and foster long-term user engagement, the system includes a formal trust modeling component based on a Reference Ontology of Trust (ROT), allowing the system to flexibly tailor communication strategies in response to user feedback and evolving trust levels. A simulated scenario involving a patient with chronic obstructive pulmonary disease demonstrates how the system delivers proactive and personalized healthcare interventions, such as medication reminders and air quality alerts. While the architecture is modular and designed for scalability, it has not yet been deployed in real-world clinical settings. Empirical validation and integration with clinical platforms remain part of future work. Nevertheless, this ongoing work contributes to the development of explainable and ethically aligned AI systems that enhance autonomy, accessibility, and trust in digital health environments through explainable reasoning.
43. Overexpressed miR-135b in the ovaries of PCOS promotes granulosa cell proliferation by inhibiting Hippo signaling pathway.
期刊: Journal of assisted reproduction and genetics 发表日期: 2025-Oct-04 链接: PubMed
摘要
Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder, characterized by ovarian structural abnormalities that lead to ovulatory dysfunction. The Hippo signaling pathway is crucial in regulating ovarian enlargement and cortical thickening, which are hallmarks of PCOS, although the regulatory mechanisms remain unclear. We assessed the expression of miR-135b and its target gene LATS2 (large tumor suppressor 2) in granulosa cells from both PCOS and normal ovaries using quantitative PCR. Dual-luciferase assays confirmed their direct interaction. The expression and localization of YAP (yes-associated protein), a key effector of the Hippo pathway, were examined through immunofluorescence in granulosa cells (GCs) from both groups. Additionally, the impact of miR-135b overexpression or inhibition on Hippo pathway genes was investigated in the KGN granulosa cell line, with changes in cell proliferation and apoptosis analyzed by cell proliferation assay and flow cytometry. MiR-135b was significantly upregulated (9.15-fold) in PCOS granulosa cells and targeted LATS2, a critical Hippo pathway regulator. Dual-luciferase assays confirmed the miR-135b binding site in the 3’-UTR of LATS2. Mechanistically, high miR-135b expression reduced LATS2 levels, impairing YAP phosphorylation, promoting nuclear translocation of unphosphorylated YAP, and driving excessive granulosa cell proliferation. Our findings suggest that miR-135b overexpression in PCOS ovaries contributes to abnormal granulosa cell proliferation by inhibiting the Hippo pathway. This study enhances our understanding of ovarian abnormalities in PCOS and identifies miR-135b as a potential biomarker and therapeutic target for the disorder.
44. Benefits, barriers, and accessibility in video games: a focus group study of college students with disabilities.
期刊: Disability and rehabilitation. Assistive technology 发表日期: 2025-Oct-04 链接: PubMed
摘要
This study explores the barriers, including psychological and emotional challenges, faced by college students with disabilities while engaging in video gaming. It also investigates the benefits of gaming, utilising Self-Determination Theory (SDT) to understand motivations and experiences. Furthermore, it provides insights into future development and accessibility measures to promote inclusive gaming environments. Guided by SDT, we designed the semi-structured interview guide and conducted a hybrid deductive-inductive reflexive thematic analysis that interpreted themes in terms of autonomy, competence, and relatedness. Three primary themes emerged: (a) Benefits, including social connection, stress relief, and skill development; (b) Barriers, such as physical, cognitive, and financial challenges, and limited accessibility in game design; and (c) Accessibility, emphasising customisable controls, adaptive features, and inclusive designs. Participants highlighted the positive role of gaming in fostering psychosocial well-being and managing symptoms of their disabilities. This study provides insights into the intersection of gaming and disability, advocating for inclusive game design to enhance autonomy, competence, and relatedness. Findings demonstrate the potential of accessible gaming to promote empowerment, social inclusion, and mental health. Aligned with the goals of rehabilitation and assistive technology, this research offers actionable recommendations for reducing barriers and fostering innovation in game development to support individuals with disabilities. Integrate holistic accessibility into rehabilitation tools: Incorporate customisable controls, adaptable interfaces, and flexible settings for cognitive, visual, and auditory needs to enhance usability and engagement in therapeutic contexts.Support autonomy and motivation through personalisation: Allow users to adjust difficulty levels, choose interaction methods, and tailor their experiences, promoting greater control, competence, and sustained participation in rehabilitation.Address both intrinsic and extrinsic barriers: Design interventions that consider emotional, cognitive, physical, and environmental challenges to improve accessibility and reduce dropout in therapy.Adopt inclusive design strategies from gaming: Use innovations, such as AI-driven adaptation, haptic feedback, and co-design with people with disabilities to create more effective and engaging rehabilitation technologies.
45. Understanding knowledge, perception, attitude and behaviour on sustainable healthcare waste management practices in selected National Health Service Trusts in the Northwest of England.
期刊: Waste management & research : the journal of the International Solid Wastes and Public Cleansing Association, ISWA 发表日期: 2025-Oct-04 链接: PubMed
摘要
Of the carbon emissions that the National Health Service (NHS) directly produces, waste and water currently make up about 21%, only second to building energy. This study evaluated current knowledge, perception, attitude and behaviour on sustainable healthcare waste management (SHCWM) practices within selected NHS Trusts in Northwest England post-COVID-19 as part of wider research to develop a resilient assessment tool for SHCWM implementation within NHS Trusts in the United Kingdom. The study utilised a questionnaire survey of hospital staff across three NHS Trusts. A total of 58 respondents from clinical and non-clinical roles were analysed. The results showed lack of periodic training, reflected in generally low levels of knowledge on health/environmental risks of healthcare waste management (HCWM), SHCWM practices and legislation on HCWM in the United Kingdom and deficiencies in segregation practice. Statistical tests showed significant differences in attitude among age groups and roles. Those under the age of 35 demonstrated more positive attitude towards SHCWM, whereas clinical support staff demonstrated more positive attitude towards SHCWM compared to doctors and nurses. While the findings demonstrate a lack of periodic training on SHCWM, there appears to be a generally positive perception and attitude towards SHCWM practices. Where SHCWM initiatives are introduced, the findings suggest that staff would be willing to engage and participate. This paper gives those leading sustainability efforts at NHS Trusts a snapshot of current sentiment towards SHCWM and elevates the need to develop minimum mandatory periodic training to improve staff knowledge and practice on SHCWM as part of efforts towards a net zero future.
46. The Pregnant Surgeon: Welcoming the Advanced Ergonomics of Robotic Surgery.
期刊: ANZ journal of surgery 发表日期: 2025-Oct-03 链接: PubMed
摘要
The detrimental effect of poor operative ergonomics in surgery cannot be underestimated. It’s associated with negative outcomes such as increased burn-out, fatigue, clinically relevant pain, and early retirement. Pregnancy creates additional challenges for female surgeons to prevent injury while adjusting to anthropometric changes that are difficult to accommodate for using open and laparoscopic surgical techniques. The robotic platform has been associated with improved ergonomic capabilities while maintaining dexterity and access. Robotic surgery will likely chaperone in a new era of possibility for female surgeons in particular of career longevity, reduced leave requirements, and improved comfort while operating pre- and post-partum.
47. Assessing spatial variability in observed infectious disease spread in a prospective time-space series.
期刊: International journal of health geographics 发表日期: 2025-Oct-03 链接: PubMed
摘要
Most of the growing prospective analytic methods in space-time disease surveillance and intended functions of disease surveillance systems focus on earlier detection of disease outbreaks, disease clusters, or increased incidence. The spread of the virus such as SARS-CoV-2 has not been spatially and temporally uniform in an outbreak. With the identification of an infectious disease outbreak, recognizing and evaluating anomalies (excess and decline) of disease incidence spread at the time of occurrence during the course of an outbreak is a logical next step. We propose and formulate a hypergeometric probability model that investigates anomalies of infectious disease incidence spread at the time of occurrence in the timeline for many geographically described populations (e.g., hospitals, towns, counties) in an ongoing daily monitoring process. It is structured to determine whether the incidence grows or declines more rapidly in a region on the single current day or the most recent few days compared to the occurrence of the incidence during the previous few days relative to elsewhere in the surveillance period. The new method uses a time-varying baseline risk model, accounting for regularly (e.g., daily) updated information on disease incidence at the time of occurrence, and evaluates the probability of the deviation of particular frequencies to be attributed to sampling fluctuations, accounting for the unequal variances of the rates due to different population bases in geographical units. We attempt to present and illustrate a new model to advance the investigation of anomalies of infectious disease incidence spread by analyzing subsamples of spatiotemporal disease surveillance data from Taiwan on dengue and COVID-19 incidence which are mosquito-borne and contagious infectious diseases, respectively. Efficient R packages for computation are available to implement the two approximate formulae of the hypergeometric probability model for large numbers of events.
48. Surgeon well-being: a systematic review of stressors, mental health, and resilience.
期刊: BMC surgery 发表日期: 2025-Oct-03 链接: PubMed
摘要
Surgeons work in high-pressure environments, predisposing them to psychological distress. High rates of burnout and workforce shortages highlight the critical importance of understanding and improving surgeon well-being to sustain healthcare delivery. The multifactorial challenges to surgeon well-being remain insufficiently addressed. This study systematically synthesizes evidence on occupational stressors, burnout, mental health challenges, and resilience strategies among surgeons, and identifies evidence-based interventions to enhance well-being and workforce sustainability. A systematic search of PubMed, Scopus, Web of Science, and Google Scholar (2000-2025) identified peer-reviewed studies on surgeon well-being, burnout, mental health, and resilience. Editorials and non-empirical studies were excluded. Sixty-six studies were included following application of inclusion/exclusion criteria and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework screening. A narrative synthesis identified thematic domains and intervention outcomes. Primary outcomes included the prevalence of burnout, anxiety, and depression among surgeons, sources of occupational stress, and descriptions of interventions promoting resilience or institutional wellness. The literature search identified 534 records through database searching, and an additional 22 records from other sources. After removing duplicates, 356 records remained. 253 records were excluded after initial screening. 103 full-text articles were assessed for eligibility, and 27 were excluded, leaving 76 studies for qualitative synthesis. Surgeons experience high levels of burnout (30-60%) and elevated risks of anxiety, depression, and attrition. Key stressors include long work hours, high patient responsibility, and insufficient institutional support. Individual-level strategies (e.g., mindfulness, physical activity, peer support) offer some benefit but are insufficient alone. Organizational interventions-such as flexible scheduling, resilience training, and embedded mental health services-show promise but are inconsistently implemented. Stigma and licensing concerns remain systemic barriers to seeking help. Surgeon well-being is crucial for both provider and patient outcomes. Addressing this requires coordinated efforts at the individual, institutional, and policy levels. Prioritizing surgeon well-being is essential for safeguarding the surgical workforce and ensuring quality patient care in modern healthcare systems.
49. Silent crisis on the frontlines: a systematic review of suicidal behaviors among disaster responders - epidemiology, risk pathways, and evidence-based interventions.
期刊: Scandinavian journal of trauma, resuscitation and emergency medicine 发表日期: 2025-Oct-03 链接: PubMed
摘要
First responders (including paramedics, firefighters, police, and dispatchers) experience significantly elevated suicide risk due to repeated trauma exposure, high rates of PTSD and depression, and systemic barriers to mental healthcare. This systematic review examines (1) suicide prevalence, (2) psychological and occupational risk factors, and (3) interventions across different emergency service roles and global contexts. This study rigorously adhered to the PRISMA guidelines in conducting a systematic and comprehensive analysis of 24 peer-reviewed studies (up to February 2025), meticulously sourced from PubMed, Scopus, Web of Science, and Embase. Only studies providing unique qualitative or quantitative insights into Suicidal Behaviors Among Disaster Responders were included. The extracted data was meticulously examined using advanced thematic analysis and robust descriptive statistics, ensuring a deep, evidence-based exploration of this critical issue. The systematic analysis of 24 studies revealed four critical categories shaping suicidal behaviors among disaster responders: (1) Epidemiology and Prevalence, highlighting elevated risks in firefighters and EMS personnel; (2) Psychological and Occupational Risk Factors, including PTSD, depression, and workplace burnout; (3) Systemic and Cultural Barriers, such as stigma and rural access gaps; and (4) Interventions and Solutions, demonstrating efficacy in trauma-focused therapies, peer support, and policy reforms like Houston’s zero-suicide program. Thematic synthesis underscored the interplay of individual vulnerabilities and structural failures, urging integrated, occupation-specific prevention strategies. Effective prevention requires integrated clinical interventions (trauma-focused therapies), organizational reforms (routine screenings), and cultural shifts (destigmatization).
50. Changes in accelerated aging and risk of cardiovascular disease and mortality: three cohort studies.
期刊: BMC medicine 发表日期: 2025-Oct-03 链接: PubMed
摘要
Accelerated aging is a dynamic process, yet few studies examined the association of changes in accelerated aging with cardiovascular disease (CVD) and mortality. This study aims to evaluate this association in three prospective cohorts from China and the UK. Data were drawn from the Kailuan cohort (n = 107,830), the Dongfeng-Tongji (DFTJ) cohort (n = 14,032), and the UK Biobank (n = 316,087). Accelerated aging was assessed by PhenoAge and Klemera-Doubal method (KDM) age, measured at baseline (Kailuan cohort: 2006-2009; DFTJ cohort: 2008-2010; UK Biobank: 2006-2010) and the first follow-up (Kailuan cohort: 2010-2013; DFTJ cohort: 2013; UK Biobank: 2012-2013). Changes in accelerated aging were classified as persistent accelerated aging, recovery from accelerated aging, delayed accelerated aging, and stable non-accelerated aging. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Meta-analysis was performed to summarize estimates across three cohorts. Median follow-up periods were 10.3-15.9 years across three cohorts. When defining accelerated aging by PhenoAge, baseline accelerated aging was significantly associated with increased risks of CVD (pooled HR: 1.41, 95% CI: 1.25, 1.60) and mortality (pooled HR: 1.47, 95% CI: 1.33, 1.63). Compared to participants with persistent accelerated aging, participants recovering from accelerated aging (pooled HR of CVD: 0.76, 95% CI: 0.72, 0.81; pooled HR of mortality: 0.84, 95% CI: 0.78, 0.89), delaying accelerated aging (pooled HR of CVD: 0.75, 95% CI: 0.70, 0.79; pooled HR of mortality: 0.77, 95% CI: 0.72, 0.83) or maintaining non-accelerated aging (pooled HR of CVD: 0.59, 95% CI: 0.48, 0.71; pooled HR of mortality: 0.58, 95% CI: 0.55, 0.62) exhibited decreased risks of both CVD and mortality. When defining accelerated aging by KDM age, the results remained consistent with those of PhenoAge. Accelerated aging is a significant risk factor for CVD and mortality. Recovering from or delaying accelerated aging, or maintaining non-accelerated aging, was associated with reduced risks of CVD and mortality.
51. Occupational status and outcomes in acute myocardial infarction: a prospective cohort study.
期刊: BMC public health 发表日期: 2025-Oct-03 链接: PubMed
摘要
52. Long-term results of conservative and surgical treatment of congenital x-linked retinoschisis: A retrospective multicentre international study.
期刊: Acta ophthalmologica 发表日期: 2025-Oct-03 链接: PubMed
摘要
To evaluate the demographic and clinical characteristics, treatment indications, long-term outcomes and prognostic factors in patients with congenital x-linked retinoschisis (CXLR) managed conservatively or surgically. This retrospective, international, multicentre study included data from retina specialists across 14 centres in 9 countries. Demographic information, best corrected visual acuity (BCVA), phenotype, optical coherence tomography (OCT) findings and disease management were analysed. Surgical indications, techniques and anatomical and visual outcomes were evaluated. A total of 635 eyes of 318 patients were included. Median age at presentation was 9 years (range: 0-81). Observation was preferred in 73.5% of eyes, laser photocoagulation (LPC) in 9.3% and vitreoretinal surgery in 18.1%. Surgical patients presented younger (7 vs. 10 years; p = 0.002) and with worse baseline BCVA (1.50 vs. 0.50 LogMAR; p < 0.0001). Disease symmetry was lower in surgical cases (24.4%) than in conservative and LPC groups (p < 0.0001). Vitreous veils, peripheral pigmentary changes and white spiculations were predictive of surgical need, particularly in eyes with rhegmatogenous retinal detachment (RRD) and vitreous haemorrhage (VH). OCT predictors of peripheral progression included absence of ganglion cell layer cysts and presence of outer plexiform layer cysts. Single-surgery anatomical success was 68.7%, increasing to 94.7% with additional procedures. Inner-wall retinectomy significantly improved outcomes in macula-threatening retinoschisis (p = 0.026). Visual acuity improved significantly after surgery in RRD and VH cases (p = 0.003). CXLR shows a broad clinical spectrum requiring individualized care. Fundus and OCT features effectively predicted progression and surgical need. Surgical management achieved high success, with inner-wall retinectomy beneficial in certain cases.
53. National Data on the Prevalence of Food Insecurity in Australia: Implications for Health Promotion.
期刊: Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals 发表日期: 2025-Oct 链接: PubMed
摘要
54. Co-Production, Co-Creation and Co-Design in Primary Health Care: A Scoping Review of Design, Implementation, Impact and Sustainability.
期刊: Health expectations : an international journal of public participation in health care and health policy 发表日期: 2025-Oct 链接: PubMed
摘要
The terms coproduction, co-creation and codesign (called the ‘Three-Cs’ in this article) are applied to activities that include stakeholders in the design and implementation of health services. This scoping review sought to understand how Three-Cs approaches have been designed and implemented sustainably in the primary health care context. Three databases (Medline, Embase and CINAHL) were searched for articles published between 2013 and 2024 using key words related to the Three-Cs and primary health care (Appendix A) and limited to articles available in English. Dual blind review against specific inclusion and exclusion criteria was carried out at both title/abstract and full text screening stages. The SPICE Framework was used to consider design, implementation, impact and sustainability. An assessment of quality and risk of bias was completed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist [1]. The Framework to Assess the Impact of Translational (FAIT) health research [2] was used to review and assess the impact of the design and implementation of Three-Cs approaches in each study. Thirty articles were included in this review with 33% (n = 10) providing a clear definition of their Three-Cs approach: 10% (n = 3) identified their approach as Coproduction, 20% (n = 6) as co-creation, and 70% (n = 21) as Codesign. Implementation contexts included clinical settings (10%, n = 3), for example prediabetes programs; community settings (50%, n = 15) such as care navigation support; and health systems settings (40%, n = 12) including health service development. Approaches were implemented across metropolitan (37%, n = 11), regional (43%, n = 13), and rural (17%, n = 5) settings. Three-Cs approaches in primary health care settings were most typically used for health promotion, and to support improved health equity and health access. Key outcomes included novel solutions to problems, improvements to health and health systems, and solutions that met consumer needs. While nine of the 30 studies undertook some form of evaluation, limited evidence on impact and sustainability was found (7%, n = 2), where only two studies assessed whether the change that was implemented using a Three-Cs approach was maintained in the longer term. Three-Cs approaches have been adopted across a variety of primary health care settings, yet evidence for impact and sustainability is currently limited. More research is needed to evaluate how the Three-Cs may best be implemented to support the long-term sustainability of programs designed by such approaches. Future work should focus on developing a primary health care specific framework or guidance for implementing and evaluating Three-Cs models, particularly in low-resource settings and in typically underrepresented populations. This study will extend to consider how the FAIT assessment process can help to support the development of much needed implementation guidance.
55. Impact of Virtual Reality-Based Serious Games on Cognitive-Motor Rehabilitation for Stroke Patients in Daily Activities: Protocol for a Randomized Trial.
期刊: Physiotherapy research international : the journal for researchers and clinicians in physical therapy 发表日期: 2025-Oct 链接: PubMed
摘要
Stroke is among the most prevalent medical conditions and often leads to persistent complications within the central nervous system. It results in both physical and cognitive impairments that can substantially affect individuals’ ability to perform activities of daily living (ADL). Conventional rehabilitation exercises are frequently lengthy, repetitive, and unengaging, which may reduce adherence and limit therapeutic outcomes. Therefore, there is a pressing need to explore innovative approaches that enhance motivation, increase the frequency and duration of exercises, and improve patient satisfaction. This protocol describes a randomized, two-blind controlled trial with blinded outcome assessment. The study will be conducted at a physiotherapy clinic in Tabriz and will compare standard rehabilitation with an intervention combining standard rehabilitation and a virtual reality (VR)-based serious game. A VR-based serious game is an innovative technology incorporating advanced user-computer interaction to deliver simulation and engagement through visual and auditory feedback. Due to the ongoing debate about the effectiveness of VR-based serious gaming interventions and the limited availability of high-quality clinical trials, further research is warranted. To date, no studies have examined the integration of VR with conventional treatments or compared it with standard physiotherapy practices. The aim of this study is to investigate the effect of a VR-based serious game on promoting cognitive-motor rehabilitation in stroke patients, with a focus on improving performance in daily life activities. This protocol outlines the methodology for a prospective randomized controlled trial designed to generate evidence supporting the use of VR technologies in stroke rehabilitation.
56. Evaluation of the Effectiveness of Conventional and Technology-based Oral Health Education Tools in the Improvement of Periodontal Health.
期刊: The journal of contemporary dental practice 发表日期: 2025-Jul-01 链接: PubMed
摘要
The current study aimed to evaluate the effectiveness of conventional and technology-based oral health education (OHE) tools in the improvement of periodontal health. A total of 400 patients who required scaling and root planing were selected by the simple random sampling technique. All participants were divided into four groups, i.e., 100 participants in each group based on the inclusion criteria, group I: Conventional group, group II: Receiving model demo-based OHE, group III: Receiving video-based OHE mode, and group IV: Receiving app-based reminders as the OHE mode. The gingival index (GI), Quigley-Hein Turesky modification index (QHTMI), and oral hygiene index score (OHI-s) were used to capture baseline data once the scaling was finished. On the 7th, 21st, 90th, and 180th days, all data were repeated. On comparison of mean plaque index score, in model demo group, the maximum reduction score found was 2.72 ± 0.14 on 90th day, in video-based OHE group was 1.72 ± 0.04 on 90th day, and in app-based reminder group was 2.16 ± 0.26 on 180th day. On comparison of mean GI score, in model demo group, the maximum reduction found was 1.96 ± 0.06 on 180th day, in video-based OHE group was 1.40 ± 0.08 on 90th day, and in app-based reminder group was 1.90 ± 0.06 on 90th day. On comparison of mean OHI-s, in model demo group, the maximum reduction found was 1.54 ± 0.44 on 180th day, in video-based OHE group was 0.98 ± 0.01 on 90th day, and in app-based reminder group was 1.08 ± 0.08 on 21st day. The significant association was found in video-based OHE and app-based reminder groups. The present study concluded that video-based and app-based OHE significantly improve overall periodontal health compared to model demo-based and conventional group. An essential oral health issue on a global scale is the increased incidence of periodontal disorders. Preventing periodontal diseases requires raising public awareness of the condition and influencing attitudes toward it. Nonetheless, one of the main preventative strategies is OHE. Oral health education programs with recognized technology, such as video-based, app-based, model-based, and traditional lecture-based methods, could be strategic in promotion of oral health behavior of the individuals. How to cite this article: Mishra D, Jalaluddin M, Singh DK, et al. Evaluation of the Effectiveness of Conventional and Technology-based Oral Health Education Tools in the Improvement of Periodontal Health. J Contemp Dent Pract 2025;26(7):688-692.