公共卫生研究摘要 (2025-10-07)
共收录 56 篇研究文章
1. Total cancer risk estimates from measured concentrations of volatile organic compounds in industrialized southeastern Louisiana.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Oct-14 链接: PubMed
摘要
Communities in southeastern Louisiana are subject to disproportionate environmental health burdens, including elevated risk for cancer, from emissions of industrial hazardous air pollutants (HAPs). However, there are few ambient measurements (or none) of various HAPs in the heavily industrialized corridor between Baton Rouge and New Orleans (BR-NO). We measured 17 carcinogenic volatile organic compounds using fast-response in situ instrumentation aboard a mobile laboratory. Using spatially resolved concentrations, we estimate cancer risk in 15 census tracts along an 81 km-long stretch of the BR-NO corridor. In 14 of 15 tracts, our estimates of total cancer risk were higher (range: 0.9 to 11.6[Formula: see text]; median: 5[Formula: see text]) than those from the U.S. Environmental Protection Agency’s (USEPA) 2020 Air Toxics Screening Assessment (AirToxScreen). Our maximum estimate for total tract-level cancer risk was 560-in-one million excess cancer cases, far exceeding the upper limit of USEPA’s acceptable risk range (100-in-one million). This discrepancy is largely explained by differences between measured vs. modeled ethylene oxide concentrations, though there are important contributions from a number of additional HAPs. Our risk estimates are dominated by ethylene oxide, which contributes between 39.5 and 92.2% of total cancer risk across all tracts; chloroprene (0.2 to 36.8%); and formaldehyde (4.1 to 14.6%). AirToxScreen also identifies these three compounds as primary drivers of risk in this location. Together, these three compounds account for between 63 and 96.9% of total cancer risk. There is substantial spatial variability in total cancer risk and the relative contribution of each HAP, both between and within tracts. These data substantiate claims that the region has high HAPs-related cancer risk and quantify which individual HAPs are of highest concern.
2. A time-gated PKA-CREB signaling circuit licenses IL-12 responsiveness and Th1 fate in CD4+ T cells.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Oct-14 链接: PubMed
摘要
Naïve CD4+ T cells differentiate into Th1 cells upon T-cell Receptor (TCR) stimulation in the presence of Interferon gamma (IFN-γ) and Interleukin 12 (IL-12). However, the intracellular signaling networks that temporally coordinate these inputs to reinforce Th1 lineage commitment remain incompletely defined. Here, we identify protein kinase A (PKA) as a time-gated regulator of IL-12 responsiveness and Th1 differentiation. Using a conditional knockout mouse model that deletes both catalytic PKA subunits in CD4+ T cells, we show that PKA is dispensable for early T cell activation but is essential for the late-phase induction of IL-12 receptor β2 (Il12rb2) and signal transducer and activator of transcription (STAT4). PKA-deficient CD4+ T cells fail to differentiate into Th1 cells in vitro and cannot induce Th1-mediated colitis in vivo. Instead, they adopt a Th2-skewed phenotype and drive eosinophilic lung inflammation and fibrosis. Mechanistically, prolonged TCR stimulation induces the expression of the peptide hormone Adrenomedullin and its receptor component Ramp3, which activate PKA and its downstream effector cAMP response element binding protein (CREB). Activated CREB drives Il12rb2 and Stat4 transcription, establishing a feedforward circuit that integrates signal duration with cytokine responsiveness. In the absence of PKA, this transcriptional program fails to initiate, leading to impaired IL-12 signaling and a loss of Th1 identity. These findings define a PKA-CREB signaling module that links sustained antigen stimulation to transcriptional and epigenetic commitment in CD4+ T cells, offering a mechanistic explanation for the temporal gating of Th1 differentiation and the prevention of Th2-driven tissue pathology.
3. Inequality in air pollution-attributable mortality by income level between and within countries.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Oct-14 链接: PubMed
摘要
Air pollution is a major global health threat, with exposure exhibiting substantial heterogeneity across and within regions. While disparities in air pollution exposure by income groups are well documented, how these inequalities translate into differential burdens of pollution-attributable premature mortality remains understudied. We utilize high-resolution estimates of secondary air pollutants, combined with income data, to investigate the relationship between global air pollution-attributable mortality and poverty across urban-rural contexts and air pollutants. We show that high-income countries face higher air pollution-attributable mortality owing to population aging, in contrast to the established exposure inequality pattern. While affluent populations within most countries also face higher mortality burdens, in several low-income countries, this pattern is reversed due to elevated exposures among impoverished rural populations. South Asia and Africa exhibit the highest levels of vulnerability to coincident mortality and poverty, where populations living in periurban transition zones bear disproportionate dual burdens. In many low-income countries, those living near wealthier urban centers also face elevated health burdens from air pollution: a “cost of opportunity” when air pollutant regulations are weak. Our findings emphasize the imperative for tailored policy interventions to mitigate amplified health risks in vulnerable communities.
4. Trends in and Predictors of Physician Attrition From Clinical Practice Across Specialties : A Nationwide, Longitudinal Analysis.
期刊: Annals of internal medicine 发表日期: 2025-Oct-07 链接: PubMed
摘要
The United States faces a predicted shortage of 36 500 physicians by 2036, with an increasing proportion of physicians leaving clinical practice or expressing an intent to do so. Evidence is limited about the extent to which stated intent to leave clinical practice translates to actual attrition from clinical practice and which factors are associated with this outcome. To characterize rates of physician attrition from clinical practice and to describe the factors associated with a differential likelihood of attrition. Nationwide, longitudinal study. All clinical settings. Physicians who provided care to Medicare patients between 2013 and 2022. Attrition from clinical practice. The sample consisted of 712 395 physicians (70.8% male, 90.8% in urban settings). Unadjusted rates of clinical practice attrition increased significantly from 3.5% in 2013 to 4.9% in 2019 (rate difference, 1.4 percentage points [95% CI, 1.3 to 1.4 percentage points]). Rates of attrition increased across the study period for both male and female physicians, in both rural and urban settings, across specialties, across geographic regions, and in all groups of physicians aged 35 years or older. In adjusted models, female physicians and those practicing in rural areas were more likely to leave clinical practice. Caring for Medicare beneficiaries with a greater average risk score, a greater average age, and a greater percentage of dual-eligible beneficiaries was also associated with attrition. Focus on services provided to Medicare fee-for-service beneficiaries. Rates of clinical practice attrition have increased since 2013. Specific physician and patient characteristics are associated with a greater risk for attrition. These findings have implications for workforce planning and the design of interventions to sustain the physician workforce. The Physicians Foundation.
5. School-Level Gaps in MMR Coverage as the Fuel for Measles Outbreaks.
期刊: Annals of internal medicine 发表日期: 2025-Oct-07 链接: PubMed
摘要
6. Annals On Call - High-Concentration Cannabinoids: Are They Safe?
期刊: Annals of internal medicine 发表日期: 2025-Oct-07 链接: PubMed
摘要
7. In adults with overweight or obesity and ≥5% weight loss, a patient-delivered intervention reduced weight regain at 18 mo.
期刊: Annals of internal medicine 发表日期: 2025-Oct-07 链接: PubMed
摘要
GIM/FP/GP: [Formula: see text] Public Health: [Formula: see text].
8. GRADE Guidance 42: Using Thresholds for Judgments on Health Benefits and Harms in Decision Making (GRADE Guidance 42).
期刊: Annals of internal medicine 发表日期: 2025-Oct-07 链接: PubMed
摘要
Users of GRADE (Grading of Recommendations Assessment, Development and Evaluation) make judgments about the size of intervention effects on desirable and undesirable people-important health outcomes or on benefits and harms. Benchmarking effect sizes by using decision thresholds (DTs) can help to facilitate these judgments and the process. This article provides GRADE guidance for use of DTs for judgments about the magnitude of desirable and undesirable health effects, such as in a health guideline or health technology assessment. Through iterative discussions and refinement in in-person and online meetings of a GRADE project group and through e-mail communication, the authors developed guidance for using DTs in Evidence-to-Decision (EtD) frameworks. The authors applied the approach and used these examples from guidelines and the results of a randomized methodological study to develop official GRADE guidance. Several alternatives for determining and using DTs are presented. In the first main approach, outcome-specific DTs for trivial, small, moderate, and large effects are determined through a calculation using empirically derived generic coefficients and the outcome’s utility value and are compared with the effect estimate obtained from an evidence synthesis. In the second main approach, outcome-specific DTs are also determined, but through direct surveying of decision makers to explicitly assign thresholds for the prioritized health outcomes. The article also describes how these approaches can be combined. The suggested approaches provide transparency for judgments in EtD frameworks that are based on findings from evidence syntheses.
9. Two-Week Atrial Fibrillation Burden and Incident Heart Failure Among Older Individuals in the ARIC Study.
期刊: Circulation 发表日期: 2025-Oct-07 链接: PubMed
摘要
10. Assessing a Community Health Worker-Facilitated, Digitally Delivered, Family-Centered Diabetes Management Program: Single-Arm Quasi-Experimental Study.
期刊: JMIR formative research 发表日期: 2025-Oct-06 链接: PubMed
摘要
The high prevalence of type 2 diabetes (T2D) and associated complications disproportionately affect low-income Latino populations, who also experience disparities in diabetes self-management (DSM), including poor medication adherence, physical activity, diet, and glycemic control. This study examined, through an academic-community partnership, the effectiveness of ¡Salud, Salud! (an evidence-based, family-centered diabetes self-management education and support [DSMES] program) on primary (glycemic control and quality of life) and secondary (social, psychological, and behavioral factors related to T2D management) outcomes among low-income Latino adults with T2D or prediabetes. In total, 81 adults (mean age 48.90 years, SD 12.57; n=57, 70.4%, female; n=66, 81.5%, Latino) with T2D or prediabetes were enrolled in a 12-week, single-arm quasi-experimental study conducted in two Central Texas Young Men’s Christian Association (YMCA) locations. ¡Salud, Salud! incorporated individual coaching by community health workers (CHWs), online family-centered DSMES training lessons, and a YMCA family membership. The delivery of ¡Salud, Salud! was supported and facilitated by digital technologies, including a dashboard to deliver intervention content and monitor participants’ engagement in intervention activities. Outcomes measured at baseline and 12 weeks (ie, postintervention) included hemoglobin A1c (HbA1c); quality of life; anthropometrics; self-reported physical activity and diet; mindfulness; perceived stress; and diabetes-related knowledge, self-efficacy, and support. Participant engagement in program activities was assessed via four index variables that underlay multiple dimensions of influences on ¡Salud, Salud! uptake: family engagement and support, participation in self-management education, program support and facilitation, and participation in self-monitoring. Paired t-tests and McNemar chi-square tests were used to examine the change in outcomes from baseline to 12 weeks. The number of program activities participants completed for each engagement index variable was converted to percentages to estimate the mean proportion of activities completed. In total, 48 (59.3%) participants completed the 12-week posttest. At the end of the program, participants demonstrated a marginally significant reduction in HbA1c (-0.30%, P≤.09) and a significant increase in participants reporting good-to-excellent health from baseline (n=19, 39.6%) to posttest (n=28, 58.3%; P≤.003). There were significant reductions in body weight (-1.30 kg, P=.02), body fat percentage (-1.26%, P=.01), perceived stress (-0.28, P=.02), added sugar intake (-2.15 teaspoons/day, P=.001), and time spent sedentary per week (-70.27 minutes, P=.003) from baseline to posttest. Mindfulness increased significantly (2.21, P=.01). Participant engagement in ¡Salud, Salud! varied, with participants exhibiting a high completion rate in program support and facilitation activities (88%) and a moderate-to-low completion rate in self-management training (66%), self-monitoring (56%), and family engagement and support (49%) activities. ¡Salud, Salud! shows promising preliminary effects on key diabetes-related outcomes. Future research should investigate how to enhance participant engagement and optimize uptake of evidence-based T2D self-management practices among low-income Latino adults with diabetes.
11. The Bidirectional Modification Effects Between Non-Optimum Temperatures and Fine Particulate Matter Pollution on Lower Respiratory Infections.
期刊: American journal of respiratory and critical care medicine 发表日期: 2025-Oct-06 链接: PubMed
摘要
12. Promoting Physical Activity and Preventing Falls Among Older Adults in a Nursing Home Setting: Protocol for Development and Implementation of the BeSt Age Mobile App.
期刊: JMIR research protocols 发表日期: 2025-Oct-06 链接: PubMed
摘要
Most nursing home residents do not meet physical activity guidelines. Many interventions to promote physical activity and prevent falls in nursing home residents have low adherence rates, lack a theoretical foundation, or require much time from staff for preparation or delivery. This study aims to describe the rationale, development, and implementation approach of the BeSt Age app through a cluster randomized controlled trial. We also provide baseline characteristics of the study sample and discuss possible implications for further app developments. We iteratively developed a novel, tablet-based mobile app (BeSt Age) that enables nursing home staff to deliver individualized physical exercise training to residents with or without motor or cognitive impairments. The app was designed and developed based on an intervention-mapping approach. A needs assessment was performed, followed by defining objectives, theory-based methods, program development, implementation, and evaluation. We took several steps to ensure that the app was based on a sound theoretical background and considered limitations identified in prior research. For implementation and evaluation purposes, we conducted a study among 229 older adults from 19 nursing homes (171 females, 58 males; mean age 85, SD 7 years). Results will be used to examine the effectiveness of the app with regard to different outcomes. Primary outcomes among participating nursing home residents are quality of life, fall risk evaluated through 2 performance-oriented balance tests, and fall incidence. Secondary outcomes include motor performance, cognition, activities of daily living, physical activity behavior, and fall efficacy. In this paper, we examined differences between intervention group (IG) and control group (CG) participants at baseline using the chi-square test, the Mann-Whitney U test, or the t test. The IG (n=137 from 11 nursing homes) received a 12-week intervention with the BeSt Age app in small, homogenous groups of 5-7 nursing home residents, with 2 exercise sessions per week, each lasting 25-30 minutes. The CG (n=92 from 8 nursing homes) received usual care. At baseline, the IG had a statistically significantly larger number of females, participants had a higher BMI, and more participants rated attending physical activity programs as important. There were no further statistically significant differences between the groups. Results with regard to the effectiveness of the BeSt Age app are expected to be published in spring 2026. If proven effective, the BeSt Age app may be a viable solution for physical activity promotion and fall prevention among older adults residing in nursing homes, thereby contributing to maintaining quality of life and overall well-being in this vulnerable population. The app can support nursing home staff in delivering exercise training to residents with minimal additional workload and without requiring specific resources.
13. Validity of Heart Rate Measurement Using Wearable Devices During Cardiopulmonary Exercise Testing in Patients With Cardiovascular Disease: Prospective Pilot Validation Study.
期刊: JMIR cardio 发表日期: 2025-Oct-06 链接: PubMed
摘要
Wearable devices offer a promising solution for remotely monitoring heart rate (HR) during home-based cardiac rehabilitation. However, evidence regarding their accuracy across varying exercise intensities and patient profiles remains limited, particularly in populations with cardiovascular disease (CVD) such as those with heart failure (HF). The objective of this study was to evaluate the accuracy of HR measurements obtained using the Fitbit Inspire 3 during cardiopulmonary exercise testing (CPX) in patients with CVD, including those with HF. In this single-center, prospective pilot study, we enrolled 30 patients with CVD undergoing CPX. HR was simultaneously recorded using electrocardiography and the Fitbit Inspire 3 at 1-minute intervals across various CPX phases: rest, exercise below and above the anaerobic threshold (AT), and recovery. The correlation between the two methods was assessed using the Pearson correlation coefficient. Measurement error was quantified by mean absolute error and mean absolute percentage error (MAPE), with a MAPE of ≤10% defined as the threshold for acceptable agreement. All data points were 630 points per minute. The Fitbit Inspire 3 device demonstrated a strong overall correlation with electrocardiography-derived HR (r=0.90; IQR 0.88-0.91) and an acceptable MAPE of 5.40% (SD 8.33%). The total error was 14.9% (94/630), with overestimation and underestimation of 37 (5.8%) points and 57 (9%) points, respectively. The rate of HR underestimation reached 19 (16%) points during exercise above the AT, compared to 1 (3%) point at rest. When stratified by HF stage (B vs C), underestimation was more pronounced in patients with HF (14/275, 5% points vs 40/355, 11.2% points). The Fitbit Inspire 3 provides acceptable validity for HR monitoring during CPX in patients with CVD. However, clinicians should interpret HR data with caution during high-intensity exercise, especially in patients with HF.
14. Designing Digital Mental Health Tools to Support the Needs of Black Adults in the United States: Qualitative Analysis.
期刊: JMIR formative research 发表日期: 2025-Oct-06 链接: PubMed
摘要
Depression and anxiety are associated with excess morbidity and mortality, constituting a major health care challenge. The prevalence of these conditions is increasing. In the United States, the health-related burden of depression and anxiety may disproportionately affect Black adults, who face unique stressors impacting their mental health and barriers to accessing treatment, including but not limited to systemic racism, discrimination, underdiagnosis of common mental health concerns (ie, depression, anxiety), limited access to culturally sensitive care, and mental health stigma within and outside Black communities. This study aimed to explore the mental health experiences of nontreatment-seeking Black adults, and how these experiences relate to their needs and preferences for the design of digital mental health (DMH) tools through user-centered design methods. This study included 25 nontreatment-seeking Black adults (aged 18-61 years) with experiences of depression or anxiety to share their perspectives on how DMH tools can meet their needs. Participants were recruited either through social media advertisements or depression and anxiety questionnaires. All participants engaged in an asynchronous online discussion group in which they discussed their past and current mental health experiences, distinct challenges faced by Black Americans, and perceptions of DMH tools, as well as how such tools can be tailored to meet their mental health needs. Participants also completed a technology probe in which they used an automated mental health self-management text messaging tool (Small Steps SMS; Audacious Software) for 18 days. They shared their perceptions of the tool and ideas for specific design improvements in the discussion group. A subset (n=6) completed follow-up interviews to elaborate on their online discussion group posts. All participants reported significant mental health concerns and difficulty managing related symptoms. A majority of participants (22/25, 88%) expressed that racism and mental health stigma severely impacted their mental health and limited opportunities to discuss their experiences within and outside Black communities. They were interested in the use of DMH tools for mental health self-management and nearly all participants (23/25, 92%) endorsed text messaging as a convenient way to introduce techniques for coping with symptoms of depression and anxiety; however, some participants strongly advocated for additional design features that they believed would improve the program, including the integration of content that centers the experiences of Black individuals, creating nonjudgmental spaces for discussing mental health experiences, and linking formal mental health treatment resources for those who want them. These findings suggest that our participants hold generally favorable views toward DMH tools, which can provide psychoeducation, self-management support tailored to the needs of Black adults, and a safe environment to address mental health concerns. Furthermore, it is critical to consider the role of racial discrimination and mental health stigma when designing inclusive and culturally sensitive DMH tools.
15. Effectiveness and Costs of Participant Recruitment Strategies to a Web-Based Population Cohort: Observational Study.
期刊: Journal of medical Internet research 发表日期: 2025-Oct-06 链接: PubMed
摘要
Recruitment to population-based health studies remains challenging, with difficulties meeting target participant numbers, biosample returns, and achieving a representative sample. Few studies provide evaluations of traditional and web-based recruitment methods particularly for studies with broad inclusion criteria and extended recruitment periods. Generation Scotland (GS) is a family-based cohort study that initiated a new wave of recruitment in 2022 using web-based data collection and remote saliva sampling (for genotyping). Here, we provide an overview of recruitment strategies used by GS over the first 18 months of new recruitment, highlighting which proved most effective and cost-efficient in order to inform future research. This study evaluated recruitment strategies using four main outcomes: (1) absolute recruitment numbers, (2) sociodemographic representativeness, (3) biosample return rate, and (4) cost per participant. Between May 2022 and December 2023, recruitment was undertaken via snowball recruitment (through friends and family of existing volunteers), invitations to those who participated in a previous survey (CovidLife: the GS COVID-19 impact survey), and Scotland-wide recruitment through social media (including sponsored Meta-advertisements), news media, and TV advertisement. The method of recruitment was self-reported in the baseline questionnaire. We present absolute recruitment numbers and sociodemographic characteristics by recruitment method and evaluate the saliva sample return rate by recruitment strategy using chi-square tests. The overall cost and cost per participant were calculated for each method. In total, 7889 new participants joined the cohort over this period. Recruitment sources by contribution were social media (n=2436, 30.9%), survey responder invitations (n=2049, 26.0%), TV advertising (n=367, 17.3%), snowball (n=891, 11.3%), news media (n=747, 9.5%), and other methods or unknown (n=399, 5.0%). More females signed up than males (5570/7889, 70.5% female). To date, 83.5% (6543/7836) of participants returned their postal saliva sample, which also varied by demographic factors (3485/3851, 90.5% older than 60 years vs 471/662, 71.1% aged 16-34 years). Average cost per participant across all recruitment strategies was £13.52 (US $16.82). Previous survey recontacting was the most cost-effective (£0.37 [US $0.46]), followed by social media (£14.78 [US $18.39]), while TV advertisement recruitment was the most expensive per recruit (£33.67 [US $41.89]). This study highlights both the challenges and the opportunities in large web-based cohort recruitment. Overall, social media advertising has been the most cost-effective and easily sustained strategy for recruitment over the reported recruitment period. We note that different strategies resulted in successful recruitment over varying timescales (eg, consistent sustained recruitment for social media and large spikes for news media and TV advertising), which may be informative for future studies with different requirements of recruitment periods. Limitations include self-reported methods of recruitment and difficulties in evaluating multilayered recruitment. Overall, these data demonstrate the potential cost requirements and effectiveness of different strategies that could be applied to future research studies.
16. Misinformation About Medical Cannabis in YouTube Videos: Systematic Review.
期刊: JMIR formative research 发表日期: 2025-Oct-06 链接: PubMed
摘要
YouTube has become a major source of health information, with 2.5 billion monthly users. Despite efforts taken to promote reliable sources, misinformation remains prevalent, particularly regarding medical cannabis. This study aims to evaluate the quality and reliability of medical cannabis information on YouTube and to examine the relationship between video popularity and content quality. A systematic review of YouTube videos on medical cannabis was conducted. Search terms were selected based on Google Trends, and 800 videos were retrieved on July 8, 2024. After applying exclusion criteria, 516 videos were analyzed. Videos were categorized by content creators: (1) nonmedical educational channels, (2) medical education channels, and (3) independent users. Two independent reviewers (SK and SE) assessed content quality using the DISCERN grade and the Health on the Net (HON) code. Statistical analysis included one-way ANOVA and Pearson correlation coefficient. Of the 516 videos analyzed, 48.5% (n=251) were from the United States, and 17.2% (n=89) from the United Kingdom. Only 12.2% (n=63) were produced by medical education channels, while 84.3% (n=435) were by independent users. The total views reached 119 million, with nonmedical educational channels having the highest median views with 274,957 (IQR 2161-546,887) and medical education channels having the lowest median views at 5721 (IQR 2263-20,792.50). The mean DISCERN and HON code scores for all videos were 34.63 (SD 9.49) and 3.93 (SD 1.20), respectively. Nonmedical educational creators had the highest DISCERN score (mean 47.78, SD 10.40) and independent users had the lowest score (mean 33.5, SD 8.50; P<.001). Similarly, nonmedical educational creators had the highest HON code score (mean 5.33, SD 1.22), while independent users had the lowest (mean 3.78, SD 1.10; P=.007). Weak positive correlations were found between video views and DISCERN scores (r=0.34, P<.001) and likes and DISCERN scores (r=0.30, P<.001). YouTube is a key source of information on medical cannabis, but the credibility of videos varies widely. Independent users attract the highest viewers but have reduced reliability according to the DISCERN and HON scores. Educational channels, despite increased reliability received the least engagement. The weak correlation between views and content quality emphasizes the need for content moderation to ensure that the most reliable and accurate information on health issues is widely disseminated. Future research should identify strategies to promote verified sources of information and limit misinformation.
17. Impact of social media health promotion on HIV/AIDS stigma reduction: the role of multi-language campaign and emotional empathy.
期刊: AIDS care 发表日期: 2025-Oct-06 链接: PubMed
摘要
HIV/AIDS stigma remains a global challenge, restricting healthcare access and reinforcing discrimination. This study examines how social media health promotion reduces HIV/AIDS stigma, focusing on the mediating role of multi-language campaigns and the moderating effect of emotional empathy. Using a cross-sectional survey of 659 social media users analyzed with PLS-SEM, the results show that social media health promotion significantly reduces stigma. Multi-language campaigns partially mediate this effect, highlighting the importance of linguistic inclusivity in health communication. Emotional empathy further moderates the relationship, with highly empathetic individuals more receptive to stigma-reduction messages across languages. Unlike prior studies emphasizing social media’s direct role in health awareness, this research reveals how language accessibility and emotional engagement strengthen digital health campaigns. The findings hold implications for health communicators, policymakers, and advocacy groups seeking inclusive and impactful strategies. Additionally, the study supports SDG 4: Quality Education by showing how social media fosters HIV/AIDS awareness, reduces stigma, and promotes inclusive education. Platforms such as Facebook and TikTok are key in enhancing digital literacy, reducing misinformation, and creating equitable, stigma-free learning opportunities.
18. Leadership Education in Physical Therapy: A Roadmap to Prioritize Interventions.
期刊: Journal, physical therapy education 发表日期: 2025-Oct-06 链接: PubMed
摘要
Leadership training is crucial for meeting the evolving demands in health care, but remains inconsistently integrated into physical therapist education programs. This study aims to identify impactful educational interventions from health care programs that would be relevant for developing leadership competencies in entry-level physical therapy programs. Although leadership development is well-researched in medicine and nursing, evidence-based interventions specific to physical therapy education remain underexplored. This gap hampers innovation in teaching and research, potentially compromising the profession’s capacity to sustain and expand its scope of practice. This consensus study involved 19 academic faculty members from 9 Canadian university physical therapy programs, all of which are aligned with global competency frameworks. A literature review using Medline, CINAHL, and ERIC identified studies evaluating leadership education interventions in university health sciences programs. Interventions were categorized by Tremblay-Wragg’s educational strategies and by impact levels based on Kirkpatrick’s model. A Delphi method was employed to reach consensus on the relevance of implementing these interventions in physical therapy education to foster health promotion, advocacy, and scope of practice expansion. Thirty articles were selected, identifying 27 interventions, primarily in medicine (n = 10) and nursing (n = 10). The two-round Delphi study reached consensus on 24 interventions, with the strongest agreement to include internships in community settings (100% agreement), community service projects (95% agreement), and advocacy projects (95% agreement). The most endorsed educational strategies were project-based learning (24%), teamwork (21%), experiential learning (14%), all socio-constructivist approaches. The selected interventions predominantly (63%) demonstrated impacts on attitudes, knowledge, or skills (Kirkpatrick level 2). This study offers an evidence-based roadmap of impactful leadership interventions that can be adapted to the practical realities of physical therapy programs. Prioritizing these interventions may enhance students’ leadership competencies and support future multisite trials and longitudinal outcome research.
19. Cytokine profiling of patients with immune checkpoint inhibitor-associated myocarditis: a pilot study.
期刊: Molecular biology reports 发表日期: 2025-Oct-06 链接: PubMed
摘要
Although immune checkpoint inhibitors (ICIs) have demonstrated high efficacy against malignant tumors, immune-related adverse cardiovascular events remain a significant concern. ICI-associated myocarditis is rare but potentially fatal. Therefore, identifying biomarkers is crucial for patient selection and management during ICI therapy. This pilot study aimed to explore cytokine profiles associated with the development of ICI myocarditis and evaluate their predictive value. This study included 16 patients treated with ICI (6 with myocarditis [myocarditis group] and 10 without myocarditis [control group]). Serum samples were collected before ICI initiation (baseline) and 2-3 weeks after the first cycle of ICI administration (before the second cycle). Semi-quantitative membrane-based cytokine array analysis was used to detect 80 human cytokines. Serum IL-1β and IL-2 levels significantly increased, and CCL4, CXCL5, angiogenin, EGF, and IL-10 significantly decreased in both groups after ICI initiation compared to baseline. In contrast, baseline cytokine levels differed between the groups: 43 cytokines, including G-CSF, IL-6, and CXCL13, were significantly elevated, and IL-10 was decreased in the myocarditis group compared to controls. After ICI treatment, serum levels of 23 cytokines, including CXCL13, IL-6, and leptin, were significantly higher in the myocarditis group than in controls. Cytokine profiles change dramatically at the onset of ICI-associated myocarditis. Baseline immune dysregulation and/or increased reactivity to ICI therapy may contribute to the development of myocarditis. However, further studies are required to confirm these findings.
20. Capsosiphon fulvescens glycopeptides restore synaptic plasticity and mitigate cognitive decline via calcineurin regulation in aged hippocampus.
期刊: European journal of nutrition 发表日期: 2025-Oct-06 链接: PubMed
摘要
Age-related cognitive decline and synaptic loss are associated with alterations in hippocampal synaptic protein phosphorylation and signaling pathways. Natural compounds from marine sources, such as Capsosiphon fulvescens glycopeptides (Cf-tPep), have shown potential neuroprotective properties. This study aimed to investigate the effects of trypsinized glycopeptides from C. fulvescens on synaptic protein phosphorylation and cognitive function in aging hippocampal neurons and rats. The research employed both in vitro and in vivo experimental models to evaluate the impact of Cf-tPep on aged hippocampal neurons and cognitive function in rats. Primary hippocampal neurons from rats were cultured for 49 days to model aging. Synaptic protein expression and phosphorylation were analyzed through Western blotting, immunoprecipitation, and double-immunofluorescence. In vivo, aged rats received Cf-tPep via hippocampal microinjection using osmotic pumps. Cognitive function was assessed using the Morris water maze test. Cf-tPep treatment restored phosphorylation levels of synaptic proteins, including PSD95 (S295) and GluN2B (Y1472), in aged neurons. This effect was mediated through inhibition of the calcineurin-STEP signaling pathway and activation of CaMKII-ERK1/2 signaling, enhancing synaptic plasticity and reducing neuronal senescence. In aged rats, Cf-tPep improved spatial learning and memory retention by modulating synaptic protein phosphorylation. Trypsinized glycopeptides from C. fulvescens show promise as a therapeutic agent for alleviating age-related cognitive decline through regulation of synaptic signaling pathways. These findings suggest their potential for promoting brain health in the elderly.
21. Risk of advanced adenoma detection in colorectal cancer screening programmes according to personal characteristics and screening history.
期刊: International journal of cancer 发表日期: 2025-Oct-06 链接: PubMed
摘要
The detection of advanced adenomas (AA) is an important benefit-relevant indicator in colorectal cancer screening programmes (CRCSP). The study hypothesis is that factors related to personal screening history and social characteristics may influence the risk of detecting AA. We performed a retrospective study of men and women aged between 50 and 69 who participated in the Valencia Region CRCSP between 2010 and 2018. Variables: sex, age, number of previous negative faecal occult blood tests (FOBT), and faecal Hb concentration in the previous FOBT (Prev-f-Hb). We analysed the risk of AA and the influence of factors related to screening history in the first screening attendance (First_A) (n = 594,242) and in the most recent screening attendance (Recent_A) (n = 388,558) for people who had participated on at least two occasions. Logistic multivariate models were used to estimate odds ratios (OR). The risk of AA in First_A was higher in men (OR = 2.59; 2.50-2.68) and in the 60-69 age group (OR = 1.62; 1.57-1.67). In Recent_A, the risk was higher in the population with a Prev-f-Hb of greater than 0 ng/mL, and this risk increased for 0.1-19.9 ng/mL, 20-39.9 ng/mL, 40-59.9 ng/mL, 60-79.9 ng/mL, and 80-99.9 ng/mL (women: OR = 1.70, OR = 3.78, OR = 7.05, OR = 9.98, OR = 14.1 and men: OR = 1.66, OR = 3.61, OR = 5.69, OR = 8.45, OR = 10.30, respectively). The risk was lower in the population with four or five previous negative FOBT (OR = 0.76, 0.68-0.85; OR = 0.53, 0.41-0.66). Demographic characteristics and screening history could be used to design risk-adapted screening strategies.
22. Metabolic stress and muscle mechanics: Acute response of isolated soleus and EDL muscles to prolonged fasting in mice with distinct muscle phenotypes.
期刊: Biology open 发表日期: 2025-Oct-06 链接: PubMed
摘要
Prolonged fasting impacts skeletal muscle by inducing atrophy, thereby limiting contractile capacity and altering tissue mechanical behavior. This study investigated the effects of 48 h of fasting (FAS) versus ad libitum food consumption (CON) on the mechanical properties of fast-twitch (extensor digitorum longus, EDL) and slow-twitch (soleus, SOL) muscles in three mouse strains with distinct muscle phenotypes: C57BL/6J (normal-sized), BEH+/+ (larger muscles), and BEH (myostatin-deficient with markedly larger muscles). Isolated SOL and EDL were subjected to 100 isometric-eccentric contraction cycles, and peak and specific force, rate of force development, fatigue, stiffness, and tangent modulus were assessed. Fasting significantly reduced muscle size and force production capacity (isometric and eccentric) across all strains (p<0.05). SOL muscles showed a greater decline in tetanic force (fatigue index: SOL 67% vs. EDL 33%, p<0.05), while BEH mice exhibited the steepest contractile impairment (p<0.05). Fasting also reduced stiffness and tangent modulus across all strains and muscle types (p<0.05). These findings demonstrate that fasting consistently impairs contractile and mechanical properties of skeletal muscle, with slow-twitch muscles and larger muscles phenotypes being particularly vulnerable. Muscle type and genetic background thus play key roles in determining the extent of functional decline under metabolic stress.
23. Aspiration prevention surgeries for adult patients with brainstem malignant gliomas: illustrative cases.
期刊: Journal of neurosurgery. Case lessons 发表日期: 2025-Oct-06 链接: PubMed
摘要
Adult patients with brainstem gliomas have a poor prognosis, with a median survival of approximately 1 year. Although patients often remain conscious until the end of life, lesions affecting the medulla oblongata can cause severe dysphagia and increase the risk of aspiration and suffocation. These symptoms significantly reduce quality of life (QOL) during advanced stages. While aspiration prevention surgery is often performed for severe dysphagia in other conditions, its efficacy in adult patients with brainstem gliomas remains unclear. This report presents 2 cases of adult patients with malignant brainstem gliomas who develoved progressive dysphagia. In case 1, glottic closure was performed as an aspiration prevention surgery; however, postoperative complications delayed the resumption of oral feeding, and the patient died due to tumor progression. In case 2, total laryngectomy was performed as an aspiration prevention surgery, which facilitated long-term oral intake and resulted in a good functional outcome, despite subsequent disease progression. Aspiration prevention surgery may benefit selected adult patients with malignant brainstem gliomas. However, potential complications must be carefully considered. Further studies with larger sample sizes are needed to assess the impact of this intervention on QOL and clinical outcomes. https://thejns.org/doi/10.3171/CASE25284.
24. Stachyose Attenuates Hepatic Cholesterol Deposition in Nonalcoholic Fatty Liver Mice via Gut Microbiota-Driven Bile Acid Profile Remodeling.
期刊: Journal of agricultural and food chemistry 发表日期: 2025-Oct-06 链接: PubMed
摘要
Nonalcoholic fatty liver disease (NAFLD), driven by liver lipid accumulation, presents a global health challenge. Bile acid metabolism critically regulates cholesterol homeostasis, but whether prebiotic stachyose can modulate it for NAFLD intervention is unknown. In NAFLD mice induced by a high-fat-high-sucrose diet, stachyose (200 mg/kg bw, 20 weeks) expanded the bile acid pool, elevating the primary bile acids (such as cholic acid and chenodeoxycholic acids) in both serum and liver while reducing secondary bile acid levels. Mechanistically, stachyose upregulated the expression of bile acid synthesis enzymes CYP7A1 and CYP27A1 by inactivating the farnesoid X receptor (FXR)-small heterodimer partner (SHP) pathway, attributed to reducing the high-affinity ligand taurodeoxycholic acid level. Concurrently, it suppressed gut bile salt hydrolase (BSH) and 7α-dehydroxylase (7α-DH) activities, along with Bacteroides abundance, thereby suppressing secondary bile acid biotransformation. In conclusion, these findings highlight stachyose’s ability to restore bile acid homeostasis in NAFLD, providing a novel theoretical basis for preventive and therapeutic strategies.
25. Comparing respiratory illness surveillance case definitions to detect Bordetella pertussis in children aged <5 years with respiratory illness in South Africa, 2017-2023.
期刊: The Journal of infectious diseases 发表日期: 2025-Oct-06 链接: PubMed
摘要
Pertussis is vaccine-preventable and surveillance can guide interventions. Assessing the performance of syndromic surveillance and the World Health Organization (WHO) pertussis case definitions can identify improvements to enhance detection and monitoring of Bordetella pertussis. We analysed respiratory illness sentinel surveillance data among children aged <5 years from January 2017 through December 2023. Participants were enrolled as outpatients with influenza-like illness (ILI), or hospitalised patients with severe respiratory illness (SRI) surveillance. Nasopharyngeal swabs were tested for B. pertussis using polymerase chain reaction (PCR). Sensitivity, specificity, and performance indicators of case definitions were evaluated against PCR results. Of 23,642 participants with PCR results, B. pertussis was detected in 0.7% (30/4,125; median age: 6.2 months; interquartile range [IQR]: 2.1-15.8) from ILI and 1.6% (314/19,517; median age: 1.7 months; IQR: 1.2-2.4) from SRI surveillance. Compared to the WHO pertussis case definition, a modified pertussis case definition (including apnoea, omitting cough duration) improved sensitivity (ILI: 30.0% vs. 43.3%; SRI: 55.7% vs. 60.2%), but reduced specificity (ILI: 90.5% vs. 75.8%; SRI: 88.3% vs. 80.9%). Negative predictive values were high for both definitions (>99%), while positive predictive values were low (<15%), reflecting low prevalence. Both WHO- and modified pertussis case definitions missed a large proportion of true pertussis cases (ILI: 70.0% vs. 56.7%; SRI: 44.3% vs. 39.8%). Both WHO and modified pertussis case definitions missed many laboratory-confirmed pertussis cases, underestimating disease burden. Revising the WHO pertussis case definition and integrating pertussis into syndromic surveillance could improve detection while leveraging existing resources.
26. A systematic review of the effectiveness of the health belief model-based nutrition education for dietary behavior change and chronic disease risk reduction.
期刊: Nutrition and health 发表日期: 2025-Oct-06 链接: PubMed
摘要
Background: The health belief model (HBM) provides a theoretical framework to understand and predict health-related behaviors. Numerous studies have shown that HBM-based nutrition education programs are effective in inducing the adoption of healthy dietary behaviors, which is an effective way to prevent diet-related chronic diseases. However, little is known about reviews of existing findings pertaining to the HBM and nutrition education, aiming to highlight the need for a validated HBM-based practical tool that can be adapted and used by program managers or related specialists when developing, implementing, and evaluating nutrition education programs. Aim: This study aims to review the application of the HBM in nutrition education and highlight the need for an HBM-based practical tool that can be consistently used in nutrition education programs. Methods: We searched articles published between 2014 and 2025, which were related to the HBM and nutrition education, using Google Scholar, PubMed, EBSCO, and Taylor & Francis databases. Twelve articles were selected for this review after applying the inclusion and exclusion criteria. Results: Across all the studies reviewed, HBM constructs were consistently shown to be significant predictors of positive dietary behavior changes (p < 0.05). All the articles reviewed indicated that the use of the HBM-based approach is an effective way to improve the effectiveness of nutrition education programs. Conclusion: The HBM can be used to assess and identify the HBM behavioral gaps of individuals, groups, or communities at the beginning of nutrition education programs, which can be subsequently addressed to induce the adoption of healthy dietary behaviors.
27. "From the moment I started standing again, I was worried about falls": Fear of Falling in ICU Survivors over 12 Months.
期刊: Annals of the American Thoracic Society 发表日期: 2025-Oct-06 链接: PubMed
摘要
Post Intensive Care Syndrome is a significant challenge for survivors of critical illness. However, little is understood about fear of falls - the concern for falls. This study sought to quantify the prevalence of fear of falls within the first year after hospital discharge and identify factors associated with high fear of falls. Mixed methods approach. Fear of falls was assessed using the Falls Efficacy Scale International short form questionnaire with participants dichotomised into low/moderate (7-12) and high fear of falls (13-28). Persistence was defined as high fear of falls across at least two assessment time points. Data were also collected on physical parameters, frailty, cognition, mood, quality of life and physical activity levels. Participants were assessed at hospital discharge, 3, 6, and 12 months. A high fear of falls was reported in 66 participants in the first 12 months with 41% reporting persistent high fear. High fear primarily commenced at hospital discharge (79%). Hospital discharge factors associated with reduced odds of experiencing high fear of falls in the first 12 months were: higher cognition, strength; physical function; balance; and health-related quality of life. Whereas increased odds of experiencing high fear were: older age, comorbidities; ICU-delirium; frailty; delayed quadriceps time to peak force and mental health impairments. The final multivariate model found that ICU survivors who had ICU delirium were more likely to have high fear of falls (OR 4.67; 95%CI: 1.18-18.48) whilst those with better balance were less likely to do so (OR 0.83, 95%CI 0.74-0.94). High fear of falls was not predictive of physical activity or function at 6 months however it was a significant predictor of depression. Qualitative data highlighted participant concern for further incapacitation through injury and loss of independence. Perceived causes were reduced strength, balance and fatigue. Participants described strategies they adopted to reduce their risk of falling including environmental scanning, gait aid use, and slow deliberate movement. Fear of falls is a significant and persistent challenge for ICU survivors. Modifiable discharge factors exist such as strength, physical function/balance, ICU-related delirium and mood which may be the target of future post hospital interventions.
28. Accelerated Photolysis of Pharmaceutical and Personal Care Products at the Air-Water Interface.
期刊: Environmental science & technology 发表日期: 2025-Oct-06 链接: PubMed
摘要
The widespread use and environmental release of pharmaceutical and personal care products (PPCPs) pose a global threat to ecosystems and human health. Photolysis plays a critical role in determining the transformation and fate of PPCPs in natural environments. While the photolysis of PPCPs in bulk aqueous systems has been well-documented, their photochemical behavior at environmental interfaces, such as the air-water interface, remains largely unexplored. Here, we demonstrate significantly altered photolysis kinetics and pathways of PPCPs in microdroplets compared to bulk water. The photolysis rates of multiple recalcitrant PPCPs in microdroplets were universally accelerated by an astonishing (3.0 ± 0.1) × 101- to (4.4 ± 0.6) × 104-fold relative to bulk water. This enhancement was primarily attributed to the accumulation of hydrophobic PPCP molecules at the air-water interface. Interfacial accumulation facilitates enhanced direct PPCP photolysis due to localized light amplification and promoted photon absorbance. Additionally, indirect photolysis of PPCPs was also intensified in microdroplets, driven by an increased production of interfacial hydroxyl radicals (•OH) and their subsequent reactions. Therefore, the photolysis products of PPCPs in microdroplets differed markedly from those in bulk water, with significantly higher levels of hydroxylated transformation products detected in microdroplets. These findings unveil a previously unrecognized yet rapid pathway for the photolysis of PPCPs at the air-water interface, offering novel insights into their natural attenuation and detoxification processes.
29. Association of urinary copper and gestational diabetes mellitus: role of epigenome-wide DNA methylation and proteomics.
期刊: The Journal of clinical endocrinology and metabolism 发表日期: 2025-Oct-06 链接: PubMed
摘要
The association between copper exposure and gestational diabetes mellitus (GDM) remains inconclusive. Our study aimed to investigate the prospective relationship between urinary copper and GDM and the mediating role of DNA methylation for this association. Nested case-control study based on the Tongjing-Huaxi-Shuangliu Birth Cohort. Urinary copper and genome-wide DNA methylations were measured in early pregnancy for 432 pregnant women, and 737 proteins were measured in a subset of 150 pregnant women. Urinary copper levels were positively associated with risk of GDM (adjusted odd ratio =1.48 for each one-unit increase in the log-transformed levels of copper, 95% confidence interval 1.15-1.91). 73 differential cytosine-phosphoguanine sites (CpGs) were identified to associate with copper. Of these CpGs, cg23773809 annotated to SNX10 mediated 24.7% and 22.4% of the copper-GDM and copper-1 h plasma glucose (1-h PG) association, respectively. cg04168577 annotated to PPFIBP2 and cg06105935 mediated 23.4% and 13.9% of the copper-1-h PG association, respectively. The protein, CD2AP was found to be a reliable predictor for GDM. The 73 differential CpGs mediated 64.1% of the copper-CD2AP association. Copper exposure may induce alterations in DNA methylation patterns, which can subsequently lead to changes in the expression of proteins associated with GDM and elevate the risk of developing GDM.
30. Comprehensive evaluation of a pea co-product for piglet nutrition: fibre content, protein digestion, and intestinal barrier function.
期刊: Journal of animal science 发表日期: 2025-Oct-06 链接: PubMed
摘要
In pig production, weaning is a critical period associated with digestive intestinal disorders, due to the diet and environmental changes. The incorporation of transitional diets with high fibre and protein content represents a promising nutritional strategy to support piglets during the weaning period. This study examined the in vitro protein digestion and physicochemical properties of a co-product of interest for piglet at weaning: pea cream. The main objectives were i) to characterise pea cream in detail, focusing on its dietary fibre content, ii) to investigate in vitro the hydrolysis of its proteins, and iii) to examine the effect of pea cream digesta on intestinal barrier function using intestinal porcine epithelial cell lines (IPEC-J2). The composition in polysaccharides and the degradation of the pea cell wall were evaluated using biochemical and biophysical methods. The pea proteins from the pea cream were digested using an in vitro model of digestion simulating the upper gastrointestinal tract of pigs (based on the INFOGEST protocol). The obtained digesta were detoxified and then applied to IPEC-J2 cells. The results showed that pea cream was rich in dietary fibres, mainly insoluble, and contained approximately 4.6% protein (on an as fed-basis - 76.9% moisture). The in vitro protein digestibility of pea cream was high, with a significant release of proteins into the aqueous phase of the digesta earlier on during the digestion process. Microscopy revealed that some proteins remained encapsulated within cell wall fragments even after 6 h of digestion. The exposure of IPEC-J2 cells to detoxified pea cream digesta did not compromise the intestinal barrier integrity, as assessed by the passage of labelled molecules (FD4 and lucifer yellow) and the analysis of tight junction proteins (ZO-1 and occludin). In conclusion, pea cream presents several characteristics that make it a promising candidate for improving piglet weaning. It is a potential source of easily hydrolysable proteins, and its dietary fibres appear to maintain intestinal barrier function in the small intestine. Providing piglets with a suitable feed during weaning is essential to maintaining their health and growth. Pea cream, a co-product of pea, because of its semi-liquid texture and protein content, could be a promising and innovative ingredient to give to the piglet at this critical stage of their development. In this study, the nutritional quality of pea cream was characterised, including its in vitro hydrolysis, and the impact of the digesta obtained on the intestinal barrier function was evaluated using the cell line IPEC-J2. Pea cream proteins were hydrolysed almost entirely in the gastric phase. The dietary fibres contained in pea digesta did not compromise the intestinal barrier function. Overall, these findings demonstrated that intestinal integrity was maintained when intestinal cells were exposed to the pea cream digesta. Pea cream could therefore be a source of easily digestible protein while preserving piglets’ digestive function.
31. Mondo: Integrating Disease Terminology Across Communities.
期刊: Genetics 发表日期: 2025-Oct-06 链接: PubMed
摘要
Precision medicine aims to enhance diagnosis, treatment, and prognosis by integrating multimodal data at the point of care. However, challenges arise due to the vast number of diseases, differing methods of classification, and conflicting terminological coding systems and practices used to represent molecular definitions of disease. This lack of interoperability artificially constrains the potential for diagnosis, clinical decision support, care outcome analysis, as well as data linkage across research domains to support the development or repurposing of therapeutics. There is a clear and pressing need for a unified system for managing disease entities - including identifiers, synonyms, and definitions. To address these issues, we created the Mondo disease ontology-a community-driven, open-source, unified disease classification system that harmonizes diverse terminologies into a consistent, computable framework. Mondo integrates key medical and biomedical terminologies, including Online Mendelian Inheritance in Man (OMIM), Orphanet, Medical Subject Headings (MeSH), National Cancer Institute Thesaurus (NCIt), and more, to provide a comprehensive and accurate representation of disease concepts with fully provenanced and attributed links back to the sources. Mondo can be used as the handle for curation of gene-disease associations utilized in diagnostic applications, research applications such as computational phenotyping, and in clinical coding systems in clinical decision support by pointing the clinician to the numerous knowledge resources linked to the Mondo identifier. Mondo’s community-centric approach, stewarded by the Monarch Initiative’s expertise in ontologies, ensures that the ontology remains adaptable to the evolving needs of biomedical research and clinical communities, as well as the knowledge providers.
32. Integrated sampling and in situ SERS detection of diquat and paraquat using silver nanostars-modified PTFE substrates.
期刊: Mikrochimica acta 发表日期: 2025-Oct-06 链接: PubMed
摘要
A surface-enhanced Raman spectroscopy (SERS) strategy for integrated sampling and in situ detection of diquat (DQ) and paraquat (PQ) in air and water is presented. By leveraging the unique characteristics of the SERS fingerprint alongside the exceptional adsorption capacity of porous polytetrafluoroethylene (PTFE) membranes, we synthesized a composite substrate consisting of porous PTFE and silver nanostars (AgNSts). Utilizing the AgNSts@PTFE filter, DQ and PQ can be sampled with an air sampler and detected in situ using a portable Raman spectrometer effectively, without pre-processing steps. Strong correlations were found between SERS intensity and logarithmic analyte concentration, with R2 values between 0.937 and 0.968. The detection limits for DQ and PQ were 0.74 ppb and 0.23 ppb, respectively, and are below the permissible concentrations. This study presents a novel, rapid method for detecting DQ and PQ in aerosols in non-laboratory settings, offering an alternative approach to conventional techniques.
33. The post-ABI effect-long-term impact of aging on participation after acquired brain injury.
期刊: Journal of neurology 发表日期: 2025-Oct-06 链接: PubMed
摘要
Patients with a history of acute Acquired Brain Injury (ABI), including traumatic brain injury and stroke, will encounter the consequences of aging and its concomitant cognitive decline, which might result in a decline of participation level. This study aimed to assess the long-term clinical profile and participation level course in a large cohort of aging ABI patients. Multi-center observational study (BRAIN-ReADAPT study), recruiting 550 patients aged 50-68 years, at least five years post-ABI. Current participation levels were compared to levels post-ABI to assess the participation level course. Cognitive complaints and psychological factors were measured by validated questionnaires. With group comparisons and regression analyses the influence of demographic and injury-related factors were examined. A decline in participation level was reported by 43% independent of age, sex, type and severity of ABI or injury chronicity. Patients experiencing this decline reported more cognitive complaints (especially mental slowness, memory, concentration difficulties) and experienced higher levels of fatigue and emotional distress, with lower resilience. No difference in current participation level was present between groups, although more restrictions and less satisfaction with participation were reported when a decline in participation was present. A substantial proportion of aging ABI patients experience a secondary decline in participation. This phenomenon is referred to as the post-ABI effect. This effect is not associated with demographic or injury-related characteristics, but resilience might be a mitigating factor. Greater awareness in clinical practice of this post-ABI effect is needed to identify potential targets for treatment to cope with this effect.
34. Dysmenorrhea among working women and its effect on their work productivity and activity impairment.
期刊: The Journal of the Egyptian Public Health Association 发表日期: 2025-Oct-06 链接: PubMed
摘要
Dysmenorrhea, or painful menstruation, is a common condition among women of reproductive age, significantly hindering their ability to work and participate in social, family, and sports activities. In Egypt, there is limited data on the frequency of dysmenorrhea among working women and its impact on their productivity. Therefore, this study aimed to investigate the prevalence of dysmenorrhea among working women, its determinants, and its effect on their work productivity and activity impairment. A cross-sectional study was conducted on 548 working women aged 20 to 45 years. Data were collected using an interview-based questionnaire that included sociodemographic, occupational, and clinical information, menstrual history, job stress assessment using the workplace stress scale, and work productivity evaluation with the work productivity and activity impairment questionnaire. The dysmenorrhea rate was 66.1%, with 64.7% of those affected reporting moderate to severe pain. Key independent predictors of dysmenorrhea include young age (≤ 32 years), working overtime or extra jobs, experiencing workplace stress, having an early menarche (< 12 years), and having a family history of dysmenorrhea. Dysmenorrheic working women reported an absenteeism rate of 39.5%, a presenteeism rate of 96.1%, an overall work impairment rate of 96.4%, and a daily activity impairment rate of 94.2%. All of these rates were significantly higher in dysmenorrheic working women compared to those without the condition. Notably, the significant differences between the two groups increased with the severity of menstrual pain. Dysmenorrhea is a prevalent issue among working women in Egypt, adversely affecting their performance at work and in daily activities. Therefore, providing workplace rest areas equipped with pain relief options, implementing flexible work schedules or menstrual leave, and encouraging dysmenorrheic working women to seek medical care for severe pain that impairs their work or daily activities are highly recommended.
35. Aralianudasides C-E: three undescribed triterpenoid saponins from the buds of Aralia elata and its airway inflammation inhibitory activity.
期刊: Natural product research 发表日期: 2025-Oct-06 链接: PubMed
摘要
Aralia elata (Araliaceae), widely distributed in Asia, is traditionally used for treating arthritis, cardiovascular diseases, tumours and asthma. Phytochemical analysis of its buds led to the isolation of three previously undescribed triterpenoid saponins-Aralianudasides C-E (1-3). Aralianudaside C (1) represents the first taraxastane-type saponin identified in Araliaceae, featuring a β-D-glucose moiety at C-3. Aralianudaside D (2) contains a rare D-xylose unit linked to C-6’ of C-3-O-glucose, while Aralianudaside E (3) possesses a unique trisaccharide chain with D-glucose attached to C-4’’ of C-3’-O-glucose. Furthermore, compounds 2 and 3 significantly reduced IL-6 expression in LPS-induced 16HBE airway epithelial cells with the suppression rate of 31.63% and 37.27% (the suppression rate of positive control Dex was 79.04%).
36. Meteorological conditions hardly influence measurement strategy and measured respirable dust and quartz concentrations in the industrial minerals sector.
期刊: Annals of work exposures and health 发表日期: 2025-Oct-06 链接: PubMed
摘要
Respirable dust and quartz are important occupational hazards, yet the effects of meteorological conditions on these concentrations remain poorly understood and predominantly theoretical. Using respirable dust and quartz data from the Industrial Minerals Association Europe Dust Monitoring Programme (IMA-DMP) and outdoor meteorological data from the ERA5-LAND hourly land data, we aimed first to determine whether meteorological conditions had an impact on the sampling strategy for these exposures and, second, to describe the association between outdoor meteorological conditions and respirable dust and quartz concentrations. We linked the exposure data for 153 sites across Europe and outdoor meteorological data by date and IMA site location. We used descriptive statistics to compare the meteorological conditions (temperature, precipitation, and wind speed) on measurement and non-measurement days. A linear mixed-effects model was used to investigate the relationship between meteorological variables and respirable dust and quartz concentrations. The model includes adjustments for period-specific time trends, minerals produced, job site, and job function. Meteorological conditions on measurement and non-measurement days were similar. We estimate a 2.3% and 5.9% increase in dust and quartz concentrations for every 10 °C increase in temperature. A 10-fold increase in precipitation is estimated to reduce dust and quartz concentrations by -2.6% and -3.1%, respectively. A 10-fold increase in wind speed is estimated to reduce quartz concentrations by -9.0%, and this association was not statistically significant for dust. Temperature had the strongest effect on personal concentrations, followed by wind speed. Associations were generally stronger for respirable quartz than respirable dust. Within the IMA-DMP, meteorological conditions did not affect the measurement strategy for dust and quartz and had a small effect on concentrations measured at 153 sites across Europe. Thus, non-random, biased sampling schemes would result in a slight (<10%) overestimation or underestimation of long-term respirable dust and quartz concentration depending on the meteorological conditions, justifying the collection of meteorological data during sampling.
37. Accuracy of the Surgical Risk Preoperative Assessment System (SURPAS) in a broad, elderly (age ≥ 65) patient population.
期刊: Surgery 发表日期: 2025-Oct-05 链接: PubMed
摘要
As more operations are performed on older adults, risk assessment for postoperative complications is important to inform patients and providers, especially because older patients have higher complication rates compared with younger patients. The Surgical Risk Preoperative Assessment System, a universal, parsimonious surgical risk calculator, has not yet been evaluated for accuracy in the older patient population. Data from the American College of Surgeons National Surgical Quality Improvement Program participant use file, 2009-2018, were used to develop the Surgical Risk Preoperative Assessment System models, and data from 2019 to 2020 were used to test the models in all, older, and younger patients. Multiple logistic regression was used with the Surgical Risk Preoperative Assessment System variables (operation Current Procedural Terminology code, American Society of Anesthesiologists class, functional health status, surgeon specialty, emergency status, inpatient or outpatient, and patient age) as independent variables and 12 common postoperative complications as dependent variables. C-indices, Brier scores, and Hosmer-Lemeshow calibration graphs were used for model evaluation. Developmental and testing data had sample sizes of 6,924,709 and 1,929,287, respectively. In the testing data, 37.7% of patients were older. The mean c-index across all outcomes for older patients was 0.800 vs 0.846 for younger patients. The c-index was good to fair (≥0.70) for 11 of the 12 assessed outcomes for the older group. The average Brier score was slightly higher (worse) for older versus younger patients (0.036 vs 0.019). Hosmer-Lemeshow graphs showed good calibration between older and younger patients. The performance of the Surgical Risk Preoperative Assessment System was slightly worse in older versus younger patients but was clinically acceptable.
38. Deep-learning-driven spectral image analysis for intelligent monitoring of multiple pesticides and antibiotics.
期刊: Talanta 发表日期: 2025-Oct-03 链接: PubMed
摘要
With the widespread use of pesticides and antibiotics in agriculture and healthcare, their associated environmental pollution and potential health hazards have emerged as a global concern. This study presents a novel deep learning-based spectral image analysis approach that is dedicated to the intelligent monitoring of multiple pesticides and antibiotics in agricultural water bodies. A total of 6100 samples containing glyphosate (GL), bentazone (BE), benzylpenicillin potassium (BP), and tetracycline hydrochloride (TH) at concentrations range of 3.8-550 μg/L were prepared. After the samples were mixed with selected composite chromogenic reagents, the specific absorbance characteristics of the stabilized reaction mixtures were measured using a custom-designed spectrometer. The preprocessed spectral data were used to train a fine-tuned ResNet-50 deep learning model. By establishing mappings between spectral features and reference concentrations, the model effectively predicted unknown pollutant concentrations. The results indicated that the proposed method enables rapid and simultaneous detection of GL, BE, BP and TH. Under laboratory conditions, the coefficient of determination exceeded 0.993, the reliable prediction rate was over 80 % in the concentration range of 10-550 μg/L. The limits of detection for GL, BE, BP, and TH were 0.23, 0.32, 0.38, and 0.28 μg/L, respectively. In addition, the frequency of abnormal predictions for natural water samples exhibited an increase over the concentration range of 3.8-10 μg/L, while the overall accuracy remained relatively high. Our research provides a new perspective on the rapid identification of pesticides and antibiotics. In the future, we hope this method can offer a timely, cost-effective and scalable solution for the early warning and real-time tracking of pollutants in water bodies.
39. Unclassified Versus Well-Defined Platelet Function Disorders: A Multicenter Comparison of Bleeding Patterns and Treatment.
期刊: Journal of pediatric hematology/oncology 发表日期: 2025-Oct-02 链接: PubMed
摘要
Platelet function disorders (PFDs) are caused by abnormalities in platelet receptors, granules, and signaling pathways. While severe conditions like Glanzmann Thrombasthenia (GT) and Bernard-Soulier Syndrome (BSS) have well-characterized bleeding phenotypes, other PFDs remain less defined. This study aimed to describe the bleeding phenotype in different PFDs at the time of diagnosis and during longitudinal follow-up and compare bleeding symptoms and health care utilization for bleed management. This retrospective multicenter study analyzed data from 129 patients diagnosed with PFDs at 3 Hemophilia Treatment Centers in the United States from 2015 to 2020. Data included demographics, bleeding symptoms, and treatment utilization. Statistical comparisons of bleeding symptoms, frequency, and treatment across PFDs were performed using the χ2 or the Fisher exact tests. Among 129 patients, 8 had GT, 2 had BSS, 40 had platelet storage pool disorder, 7 had platelet secretion defect, and 72 had PFD not otherwise specified (NOS). Epistaxis was the most common symptom at diagnosis, except in platelet secretion defects, where soft tissue bleeding predominated. Heavy menstrual bleeding affected 31.7% of females. Over a 5-year period, epistaxis remained frequent in GT and PFD NOS. GT had the highest treatment burden, with 86.2% of bleeds requiring treatment. Hospitalizations were significantly greater in GT and platelet secretion defects. Individuals with PFD NOS and platelet secretion defects can experience serious bleeding. Life-threatening bleeds occur in PFDs beyond GT and BSS, necessitating thorough evaluation, close follow-up, and careful perioperative planning. Unclassified platelet disorders require further evaluation along with genetic testing to prevent excessive blood loss.
40. Proteomic analysis related to the mechanism of high-altitude polycythemia in tibetans.
期刊: Biochemical and biophysical research communications 发表日期: 2025-Oct-01 链接: PubMed
摘要
High-altitude polycythemia (HAPC) is a prevalent chronic condition affecting high-altitude populations. It is characterized by excessive erythrocytosis and has a high prevalence rate, posing significant risks to both physical and mental health. Therefore, this study aims to elucidate the pathogenesis of HAPC and identify potential therapeutic targets, using a proteomics analysis to characterize changes in plasma protein profiles between Tibetan patients with HAPC and Tibetan controls from the Qinghai-Tibetan Plateau. Proteomics analysis revealed 58 up-regulated and 54 down-regulated in patients with HAPC, compared to those in normal controls. GO and Kyoto Encyclopedia of Genes and Genomes pathway analyses revealed that the dysregulated proteins were primarily involved in the NF-κB signal pathway. ELISA validation in the population sample demonstrated that NF-κB p50 was down-regulated. Furthermore, a rat HAPC model was established to assess the expression level of NF-κB p50 in the bone marrow and spleen. Both the bone marrow and spleen showed down-regulated NF-κB p50 expression. These findings indicate that down-regulated NF-κB p50 expression is associated with the pathogenesis and progression of HAPC, providing novel insights into its prevention and treatment.
41. Expanded Child Tax Credit Payments During Pregnancy Were Associated With Decreased Odds Of Adverse Birth Outcomes.
期刊: Health affairs (Project Hope) 发表日期: 2025-Oct 链接: PubMed
摘要
The 2021 expanded Child Tax Credit (ECTC) provided families with six monthly cash transfer payments disbursed between July and December 2021, with the goal of alleviating financial strain during the COVID-19 pandemic. These payments reduced child poverty and food insufficiency and may have had beneficial effects on child health. Using 2019-22 Pennsylvania birth certificate data, we examined the association between parental receipt of monthly ECTC payments during pregnancy and infant birth outcomes, exploiting quasi-random variation in ECTC payment amounts based on date of birth and number of siblings. For every $1,000 in ECTC payments received during pregnancy, we observed decreased odds of preterm birth, low birthweight, and very low birthweight among infants of Medicaid-insured pregnant people. Nondirected cash transfer programs such as the ECTC and other income support programs and policies targeting pregnancy may lead to improved birth outcomes.
42. Medicaid Expansion Boosted Specialty Treatment Episodes For Substance Use Disorder In Expansion States, 2010-22.
期刊: Health affairs (Project Hope) 发表日期: 2025-Oct 链接: PubMed
摘要
The Affordable Care Act (ACA) enabled states to expand Medicaid to low-income adults and required expansion programs to cover substance use disorder (SUD) treatment. Extending prior research, we analyzed more recent effects of ACA Medicaid expansions on specialty SUD treatment, using 2010-22 all-payer data on treatment episodes. This period coincides with the worsening national drug overdose epidemic, as well as changes to Medicaid policy through program redesign and under the COVID-19 public health emergency. Using difference-in-differences methods, we found that after expansion, episodes to specialty treatment increased by 28 percent in expansion states compared with nonexpansion states. Financial protection through Medicaid as a source of insurance and payment for services also increased significantly in expansion states compared with nonexpansion states. Medicaid expansion is an important program for increasing access to SUD care for a population with high levels of need.
43. Hospital- And Private Equity-Affiliated Specialty Physicians Negotiate Higher Prices Than Independent Physicians.
期刊: Health affairs (Project Hope) 发表日期: 2025-Oct 链接: PubMed
摘要
Hospital and private equity (PE) consolidation in health care is altering the physician practice landscape, with more than three-quarters of physicians employed by these corporate entities as of 2023. We examined practice affiliation patterns for specialist physicians and those patterns’ association with commercial prices for cardiology and gastroenterology services. We found that in 2023, the majority of specialists (approximately 72 percent of cardiologists and 57 percent of gastroenterologists) were employed by hospitals, whereas PE-affiliated specialists constituted a lower share and were concentrated in certain geographic regions. Hospital-affiliated specialists negotiated prices that were 16.3 percent higher for cardiology procedures and 20.7 percent higher for gastroenterology procedures compared with specialists in independent practices. PE-affiliated specialists negotiated prices that were 6.0 percent higher for cardiology and 10.0 percent higher for gastroenterology procedures. If hospital- and PE-affiliated specialists charged prices equivalent to those of independent practices, commercial health care spending would decrease by approximately $2.9 billion and $156 million, respectively. As corporate consolidation of physician practices continues to accelerate, greater antitrust enforcement and enhanced transparency in ownership structures and pricing will be essential tools for policy makers to use in containing health care costs while preserving patients’ access to high-quality specialty care.
44. Commercial Insurers Paid More For Procedures At Hospital Outpatient Departments Than At Ambulatory Surgical Centers.
期刊: Health affairs (Project Hope) 发表日期: 2025-Oct 链接: PubMed
摘要
Site neutrality in payment practices has become a salient issue in the US health care debate, as rising prices have brought increased pressure for policy action. Although Medicare has received disproportionate attention, these policies could also apply to commercial insurers, particularly to address payment differentials between hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs). Using 2024 Transparency in Coverage data provided by Clarify Health on commercial prices for three insurers (UnitedHealthcare, Cigna, and BlueCross BlueShield), we compared payments for thirteen common procedures across settings. Overall, in 2024, commercial prices were $1,489 (78 percent) higher in HOPDs than in ASCs, whereas Medicare prices were $633 (97 percent) higher. However, site payment differentials varied substantially across payers: Cigna had the lowest differentials between HOPDs and ASCs ($327), whereas United had the highest ($1,673). Cigna achieved this through provider selection, contracting with only 14 percent of HOPDs in applicable markets compared with an average of 76 percent for United and BlueCross BlueShield. If United and BlueCross BlueShield paid Cigna’s average HOPD rates for these procedures, together they would save approximately $1.4 billion a year. Our results suggest that payers can reduce site differentials through provider selection; they also imply that larger insurers with broader networks may continue to reimburse different sites differently in the absence of either government action or a shift in market dynamics.
45. Favorable Selection Among Dually Enrolled Beneficiaries In Private Medicare Plans.
期刊: Health affairs (Project Hope) 发表日期: 2025-Oct 链接: PubMed
摘要
Medicare-Medicaid dual enrollees accounted for roughly a third of those programs’ spending but less than 20 percent of enrollment in 2021. Policy makers have responded to dual enrollees’ high levels of spending by encouraging their enrollment in private Medicare plans. However, assessing plans’ impact on spending is complicated by favorable selection, in which healthier people prefer private plans to Medicare fee-for-service. We tested for selection into Medicare plans among dual enrollees, using linked Medicaid-Medicare claims data from the period 2017-22. We tracked people transitioning from Medicaid to dual enrollment and compared their pre-dual enrollment spending among Medicare plan choices. We found evidence of favorable selection. After adjustment for for beneficiary characteristics, a 1 percent increase in medical spending reduced beneficiaries’ probability of enrolling in private plans by 1 percentage point (2.3 percent). The effects were driven by the highest-spending beneficiaries, who were 11 percentage points (25 percent) less likely to enroll in private plans. Selection appeared to be stronger among unintegrated plans (which cover Medicare but not Medicaid benefits), although higher spending on long-term services and supports reduced enrollment in all plan types. These findings highlight the need for researchers to control for underlying health status when evaluating health or spending outcomes in private plans.
46. Private Equity-Owned Hospices Report Highest Profits, Lowest Patient Care Spending Compared With Other Ownership Models.
期刊: Health affairs (Project Hope) 发表日期: 2025-Oct 链接: PubMed
摘要
Private equity (PE) firms and publicly traded companies own a growing share of US hospices, but little is known about differences in financial outcomes among for-profit hospices. Using 2022 Medicare cost reports, we compared revenue and expense data across four hospice ownership models: PE-owned, publicly traded company-owned, other for-profit, and not-for-profit. Adjusted analyses revealed that compared with for-profit models, not-for-profit hospices spent substantially more on direct patient care, driven by differences in nursing salaries. Relative to publicly traded company-owned and other for-profit hospices, PE-owned agencies reported the highest profits and lowest spending on direct patient care and nonsalary administrative services. PE-owned hospices also reported significantly greater expenses and revenues related to nursing facility room and board compared with all other ownership models. Our findings suggest that PE-owned hospices may follow distinct operational strategies, emphasizing nursing facility-based care and administrative efficiency while limiting direct patient care investments. Reduced spending on patient care may undermine hospice quality and shift costs to other areas of the health care system. To promote Medicare savings and better align payment with care delivery costs, policy makers could consider modifying the per diem model of hospice payment to reduce reimbursement when beneficiaries are co-located in nursing facilities.
47. Re-emergence of chikungunya virus in China by 2025: What we know and what to do?
期刊: PLoS pathogens 发表日期: 2025-Oct 链接: PubMed
摘要
In July 2025, China witnessed its most significant chikungunya virus (CHIKV) outbreak since 2010. As of August 1, with over 6,000 cases reported in Foshan city, Guangdong Province. Although the clinical manifestations have been relatively mild, the rapid transmission within communities warrants our attention. In this context, we emphasize our current knowledge and the necessary actions to take. Specifically, we identify critical gaps in CHIKV control efforts and assess the effectiveness of current measures. These include vector management strategies, viral genomic surveillance, the deployment of newly approved vaccines, and the development of antiviral agents. Overall, to effectively control the epidemic of CHIKV, we require a comprehensive and multifaceted strategy for its prevention and management.
48. "It's all about the money." Australian women's perspectives about menopause and the commercial determinants of health.
期刊: Health promotion international 发表日期: 2025-Sep-03 链接: PubMed
摘要
With increased public attention on menopause, researchers have started to investigate the surge of commercial products and services which claim to provide solutions for menopausal symptoms. Few studies have explored the views of women about the commercial determinants of menopause. Using an online qualitative survey, this study sought insights from n = 509 Australian women aged 45-64 years about the factors that might influence the use of products and services for menopause, the risks associated with the increased promotion of commercial solutions for menopause, and the role of the pharmaceutical industry in sponsoring menopause-related women’s health events. Three themes were constructed using a reflexive approach to thematic analysis. First, women perceived that commercial actors sought to exploit women’s concerns to stimulate product demand through catastrophizing menopause, appearing to listen to experiences, and capitalizing on worries about ageing. Second, they stated that marketing, access, and perceived affordability of products and services intersected with lived experiences of menopause to amplify women’s vulnerability to commercial tactics. Third, there were mixed views about the roles of the pharmaceutical industry in sponsoring women’s health events. These ranged from significant scepticism about the motives of the pharmaceutical industry, to support for initiatives that helped increase information and awareness. This study highlights the risks associated with commercial practices related to menopause. It shows that women themselves are concerned about the exploitation of women’s health for profit. It emphasizes the need for increased critical focus on the role of commercial determinants in shaping women’s understandings and experiences of menopause.
49. Computational toxicology in drug discovery: applications of artificial intelligence in ADMET and toxicity prediction.
期刊: Briefings in bioinformatics 发表日期: 2025-Aug-31 链接: PubMed
摘要
Toxicity risk assessment plays a crucial role in determining the clinical success and market potential of drug candidates. Traditional animal-based testing is costly, time-consuming, and ethically controversial, which has led to the rapid development of computational toxicology. This review surveys over 20 ADMET prediction platforms, categorizing them into rule/statistical-based methods, machine learning (ML) methods, and graph-based methods. We also summarize major toxicological databases into four types: chemical toxicity, environmental toxicology, alternative toxicology, and biological toxin databases, highlighting their roles in model training and validation. Furthermore, we review recent advancements in ML and artificial intelligence (AI) applied to toxicity prediction, covering acute toxicity, organ-specific toxicities, and carcinogenicity. The field is transitioning from single-endpoint predictions to multi-endpoint joint modeling, incorporating multimodal features. We also explore the application of generative modeling techniques and interpretability frameworks to improve the accuracy and credibility of predictions. Additionally, we discuss the use of network toxicology in evaluating the safety of traditional Chinese medicines (TCMs) and the potential of large language models (LLMs) in literature mining, knowledge integration, and molecular toxicity prediction. Finally, we address current challenges, including data quality, model interpretability, and causal inference, and propose future directions such as multi-omics integration, interpretable AI models, and domain-specific LLMs, aiming to provide more efficient and precise technical support for preclinical toxicity assessments in drug development.
50. Performance and Outcome of Pioneering Kidney Transplantation in a Resource-Constrained Setting in Southeast Nigeria.
期刊: West African journal of medicine 发表日期: 2025-May-30 链接: PubMed
摘要
Kidney transplantation is the optimal treatment for improving survival and quality of life for patients with end-stage kidney disease. There was no kidney transplant surgery and acute transplant care services in Southeast Nigeria until 2017 when our institution commenced kidney transplant surgery and acute transplant care. This study aims to share our first eight year experience including graft and patient outcome. To obtain the transplant rate, short and long term complications and the graft and patient survival over an eight year period in a tertiary hospital in Southeast Nigeria. A retrospective review of the transplant register for patients referred to the kidney transplant unit over an eight year period from January 2017 to January 2025. Complete data for ninety-three patients were analyzed. Out of these, twelve were transplanted giving a transplantion rate of 13%. Financial constraint is the leading reason (40%) for failure to get a kidney transplant done. Hypertension, hyperkalemia, anemia and urinary tract infection were the leading acute complications encountered while cytomegalovirus infection, recurrence of native disease, chronic graft loss and death were the major long term complications. The three-month, one-year, three-year and five-year patient survival in our program were 100%, 90%, 80% and 80% respectively while the graft survival were 90%, 90%, 70% and 60% respectively. The transplant conversion rate is low and a review of atient selection criteria will improve access kidney transplant. Acute complications were treatable in most cases. The patient and graft outcomes appear similar with other centres in Nigeria. La transplantation rénale est le traitement optimal pour améliorer la survie et la qualité de vie des patients atteints d’insuffisance rénale terminale. Il n’existait aucun service de chirurgie de transplantation rénale ni de soins aigus post-transplantation dans le Sud-Est du Nigeria jusqu’en 2017, année où notre établissement a lancé ces services. Cette étude vise à partager notre expérience sur huit ans, incluant les résultats des greffes et des patients. Obtenir le taux de transplantation, les complications à court et à long terme, ainsi que la survie du greffon et du patient sur une période de huit ans dans un hôpital tertiaire du sud-est du Nigeria. Revue rétrospective du registre de transplantation pour les patients référés à l’unité de transplantation rénale sur une période de huit ans, de janvier 2017 à janvier 2025. Les données complètes de quatre-vingt-treize patients ont été analysées. Parmi eux, douze ont bénéficié d’une transplantation, soit un taux de 13 %. La contrainte financière est la principale raison (40 %) de l’échec à réaliser une transplantation. L’hypertension, l’hyperkaliémie, l’anémie et les infections urinaires étaient les principales complications aiguës rencontrées, tandis que l’infection à cytomégalovirus, la récidive de la maladie native, la perte chronique du greffon et le décès représentaient les complications à long terme majeures. Les taux de survie des patients à trois mois, un an, trois ans et cinq ans étaient respectivement de 100 %, 90 %, 80 % et 80 %, tandis que les taux de survie du greffon étaient de 90 %, 90 %, 70. Le taux de conversion en transplantation est faible, et une révision des critères de sélection des patients pourrait améliorer l’accès à la transplantation rénale. Les complications aiguës étaient généralement traitables. Les résultats des patients et des greffons semblent comparables à ceux d’autres centres au Nigeria. Transplantation rénale, Résultats, Complications, Sud-Est du Nigeria, Pionnier.
51. Predictors of Sleep Quality in Older Persons Attending the Outpatient Clinics in a Tertiary Hospital in Nigeria.
期刊: West African journal of medicine 发表日期: 2025-May-30 链接: PubMed
摘要
Good quality sleep is critical to human functioning as decline in sleep quality has been linked with health issues. One of the factors that has been identified with decline in sleep quality is increasing age, making older persons at risk of significant deleterious consequences on their physical, social, and mental spheres of well-being when they have poor sleep quality. This study aimed at determining the predictors of sleep quality among older persons aged 60 years and above attending the outpatient clinics of a tertiary hospital in Uyo, South-South Nigeria with a view to suggesting appropriate recommendations for health improvement of participants and clinical practice, where necessary. This was a cross-sectional study involving two hundred and fourteen (214) respondents. Those who met the inclusion criteria were interviewed with the aid of a semi- structured questionnaire containing items on socio-demographic characteristics, clinical data, and items from the Pittsburgh sleep quality index. Data was analysed using Epi info® version 3.5.1. Of the 214 respondents recruited, the prevalence of good sleep quality was 63.1% with a higher rate of poor sleep quality observed in males (57%). Factors affecting sleep quality after bivariate analysis in this study were age group (70-74 years), polygamous family type, significant stress, sleep problems, chronic medical illness, routine medication, high blood pressure, overweight and obesity. However, when multiple logistic regression was done on these factors, family type, sleep problems, and chronic medical illness were still statistically significant. More than one-third of the older persons had poor quality of sleep in this study, and the predictors of sleep quality were family type (polygamous), sleep problems, and chronic medical illness. Therefore, there is need for a careful routine assessment of sleep among older persons and this should include comprehensive sleep history as well as evaluation and treatment of various co-morbidities in order to improve sleep quality among them. Un sommeil de bonne qualité est essentiel au bon fonctionnement humain, car une diminution de la qualité du sommeil a été liée à des problèmes de santé. L’un des facteurs identifiés comme responsable de la baisse de la qualité du sommeil est l’âge croissant, rendant les personnes âgées susceptibles de conséquences délétères significatives sur leurs sphères physique, sociale et mentale de bien-être en cas de mauvaise qualité de sommeil. Cette étude visait à déterminer les prédicteurs de la qualité du sommeil chez les personnes âgées de 60 ans et plus fréquentant les cliniques externes d’un hôpital tertiaire à Uyo, au Nigeria méridional, dans le but de suggérer des recommandations appropriées pour l’amélioration de la santé des participants et des pratiques cliniques si nécessaire. Il s’agissait d’une étude transversale impliquant deux cent quatorze (214) répondants. Ceux qui ont rempli les critères d’inclusion ont été interrogés à l’aide d’un questionnaire semi-structuré contenant des éléments sur les caractéristiques socio-démographiques, les données cliniques et des éléments de l’indice de qualité du sommeil de Pittsburgh. Les données ont été analysées à l’aide de Epi info® version 3.5.1. Parmi les 214 répondants recrutés, la prévalence d’une bonne qualité de sommeil était de 63,1 % avec un taux plus élevé de mauvaise qualité de sommeil observé chez les hommes (57 %). Les facteurs significatifs affectant la qualité du sommeil après une analyse bivariée dans cette étude étaient le groupe d’âge (70-74 ans), le type de famille polygame, le stress significatif, les problèmes de sommeil, les maladies médicales chroniques, la prise de médicaments de routine, l’hypertension artérielle, le surpoids et l’obésité. Cependant, lorsque la régression logistique multiple a été effectuée sur ces facteurs, le type de famille, les problèmes de sommeil et les maladies médicales chroniques restaient statistiquement significatifs. Plus d’un tiers des personnes âgées dans cette étude ont une mauvaise qualité de sommeil, et les prédicteurs de la qualité du sommeil étaient le type de famille (polygame), les problèmes de sommeil et les maladies chroniques. Par conséquent, il est nécessaire d’effectuer une évaluation systématique des habitudes de sommeil chez les personnes âgées, qui devrait inclure un historique complet du sommeil ainsi qu’une évaluation et un traitement des diverses comorbidités afin d’améliorer la qualité du sommeil parmi elles. Prédicteurs de la qualité du sommeil, Personnes âgées, Nigéria.
52. Knowledge of medication dispensing among community pharmacists in Brazil: A national cross-sectional survey.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Brazilian community pharmacists’ knowledge of medication dispensing was assessed through a nationally representative cross-sectional survey conducted between October 2021 and May 2022. A total of 366 licensed pharmacists working in private community pharmacies-71.3% of whom were female, with an average age of 36.4 years (standard deviation 9.4)-completed a validated online questionnaire covering fundamental aspects of dispensing practice and reported on their undergraduate training and preferred information sources. The overall mean correct-response rate was 70.8%, with the Southeast and South regions scoring highest at 71.0% and 71.9%, respectively. Domains related to antimicrobial and over-the-counter medication dispensing exhibited the largest knowledge gaps across all regions. Graduates of public universities and pharmacists holding postgraduate qualifications demonstrated significantly greater proficiency, and higher knowledge scores correlated with more positive perceptions of the relevance of their training for patient counseling and community health promotion. Internet resources and medication package inserts were the most frequently consulted references for resolving dispensing questions, with 38% of respondents consulting them on a daily basis. These findings reveal a moderate overall level of dispensing competence, pinpoint critical areas for improvement, and underscore the influence of educational background on professional performance. Targeted continuing-education initiatives are therefore essential to reinforce pharmacists’ competencies, enhance the quality of services in community pharmacies, and ultimately improve patient care outcomes.
53. Environmental health management in local community isolation facilities during COVID-19 pandemic: A case study in Nakhon Si Thammarat, Thailand.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Community isolation facilities (CIFs) were adopted as a containment strategy in many countries during the COVID-19 pandemic, but information on environmental health management in CIFs is unknown. This retrospective research aimed to study the preparedness and implementation of CIFs from an environmental health perspective. The study was conducted in Nakhon Si Thammarat Province, Thailand. A total number of 114 staff working during the establishment and operation of 57 CIFs were enrolled. Two questionnaires were collected from the founding and operating staff from 27 May to 5 October 2022. One questionnaire, designed based on the guidelines for establishing of CIFs developed by the Department of Health, was used to examine the preparedness of the founding staff. Another questionnaire was developed to investigate the implementation by the operating staff. The data was presented as the levels of preparedness and implementation of CIFs and analyzed by descriptive statistics. Local government organizations played a major role in the establishment and cooperation with local public health offices in the operation of CIFs. Two-thirds of the founding and operating staff had no experience in environmental health. However, most of the CIFs showed preparedness for the establishment of CIFs and conducted environmental health implementation at a good level in all dimensions, except for infrastructure for wastewater treatment, disinfection, and system monitoring. The decentralized governance model in Thailand facilitated the operation of small CIFs to prevent COVID-19 transmission in local communities. However, qualified personnel and appropriate infrastructure were obstacles to full environmental health implementation. The guidelines by the Department of Health suggested as fundamental for environmental health management of CIFs in this study should be appropriately adopted based on the different contexts of each country to ensure preparedness for future infectious disease outbreaks.
54. Building health: Motivational factors to enhance systematic work environment management in the construction industry.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The aim of the study was to investigate whether and how the interventions have been beneficial in developing a well-functioning systematic OSH management. The aim was also to investigate whether and how the interventions have facilitated or impeded autonomous motivation to develop a well-functioning systematic OSH management. Data were collected through individual interviews with participants in the Health Construction intervention project and audio recordings from the concluding workshop for each batch. The data were analyzed using an inductive thematic analysis. The seven themes from the analysis yielded the following results. Participation in the project was highlighted as a key factor for development, as it offered opportunities to collaborate and share experiences and insights about the domain of the occupational environment with representatives from other companies. Establishing a development team within participating companies appears to have influenced the legitimacy of occupational safety and health, as well as the assigned safety priority. A process consultative approach by external consultants seems to have contributed to an enhanced ability to articulate thoughts, identify solutions, synthesize discussions, and work effectively within the development team. The results suggest that the assigned safety priority of the respective participating companies has increased. Additionally, there are indications that autonomous motivation to continue and deepen efforts to address safety and health issues in a structured way has increased within the participating companies. The results of this study indicate that the interventions implemented in the project have been beneficial in fostering the development of a well-functioning systematic occupational safety and health management. This may have been achieved by enhancing the autonomous motivation to prioritize and develop a healthy and safe work environment within the participating companies.
55. "I know what to say now" Students' evaluation and utilisation of Accidental Counsellor Training.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
In 2020 and 2021, 280 health profession students who were engaged in student leadership roles and peer mentoring were invited to undertake extracurricular training in accidental counselling to build skills in recognising and responding to a person in distress. The aim of this study was to evaluate the acceptability of the online training course, and to explore students’ confidence to use Accidental Counsellor tools to support peers in distress after completion of the training course. A retrospective cohort study including a post- intervention only design was used. A survey was administered approximately 12 months after 225 students completed an Accidental Counsellor training program. The survey instrument assessed reluctance or confidence to recognise and respond to someone having a mental health crisis, and acceptability of the training. Reliability coefficients were computed for scales, and descriptive analyses including frequencies and percentages were conducted using IBM SPSS Statistics (Version 27). Open-text responses underwent descriptive content analysis. Sixty-one students completed the online survey. Of these, 90% felt confident and 85% felt low reluctance to respond to peer mental health crises. Nearly all (85%) participants recognised at least one person in distress in the 12 months following the training. T-test confirmed no gender differences in mean confidence score (Men mean = 30.0, Std. dev. = 2.90; Women mean = 29.5, std. dev. = 4.80; t(63)=0.48, p = 0.633), however, there was a statistically significant difference between age groups as determined by one-way ANOVA (F(2,62)=7.43, p = 0.001). Listening non-judgmentally and referring the person to resources was the most common response to peer distress. The online format was described as offering accessibility and interaction benefits but lacked realism and engagement for some. With ever increasing rates of depression and other mental health conditions being reported among university students, there is increasing pressure to develop strategies to support mental health and wellbeing. This project is unique in evaluating an online delivery of Accidental Counsellor training. Since completing the training, most participants recognized at least one person in distress and reported confidence and skill to respond.
56. Artificial stone dust affects oxidative stress and epithelial barrier in CALU 3 cells.
期刊: Experimental lung research 发表日期: 2025 链接: PubMed
摘要
Aim: Artificial Stone Dust (ASD) exposure has been identified as a significant health risk for workers, leading to oxidative stress, inflammatory responses, and potential systemic autoimmune diseases due to its high crystalline silica content. The aim of this study is to identify the impact of ASD on the permeability of alveolar epithelial cells and the mechanisms underlying particle translocation across the alveolar membrane remain unexplored. Methods: The acute toxicological effects of ASD on human bronchial submucosal gland cells CALU-3 cells in vitro were investigated to assess its impact on epithelial barrier integrity, in comparison to crystalline silica particles (Min-U-Sil®5). Results: Exposure to ASD increased oxidative stress, evidenced by heightened Reactive Oxygen Species (ROS) levels and Heme Oxygenase-1 (HO-1) gene expression in CALU-3 cells, exceeding effects observed with Min-U-Sil®5. Notably, ASD exposure resulted in a significant decrease in Transepithelial Electrical Resistance (TEER), indicating compromised epithelial barrier integrity, especially at higher concentrations (3.7 mg,18.5 mg and 37 mg) after 24, 48 and 72 h. These findings were not paralleled by a decrease in cell viability, underscoring a specific effect on cellular barrier function rather than cytotoxicity. Conclusions: Our study reveals that ASD induces oxidative stress and disrupts epithelial barrier integrity in vitro, potentially contributing to systemic translocation of particles and subsequent health effects. These findings underscore the need for a rigorous protective measure for workers and highlight potential biomarkers of ASD-induced cellular damage.