公共卫生研究摘要 (2025-10-08)
共收录 61 篇研究文章
1. HPV vaccination willingness and behavior among nursing female students in China based on the protection motivation theory: A cross-sectional study.
期刊: Human vaccines & immunotherapeutics 发表日期: 2025-Dec 链接: PubMed
摘要
Female nursing students show high intention yet low uptake of HPV vaccination, which undermines cervical cancer prevention efforts. To examine the mechanisms influencing their vaccination behavior, this study developed and validated an intention-behavior transition model based on Protection Motivation Theory, thereby providing a theoretical foundation for designing targeted interventions and improving vaccination coverage. A total of 631 female nursing students from universities in Wuhan were selected by the convenience sampling method and were surveyed using a General Information Questionnaire, Protection Motivation Questionnaire, and HPV Vaccination Willingness and Behavior Questionnaire, and a structural equation model was constructed using AMOS 24.0 software. 69.3% of the 631 female nursing students had HPV vaccination intention, and 13.3% had vaccination behavior. The results of structural equation model fitting showed that threat appraisal significantly affected female nursing students’ willingness to receive HPV vaccination (β = 0.209, P < .002) and behavior (β = -0.198, P = .002). Coping appraisal significantly influenced their willingness to vaccinate (β = -0.085, P < .008) and behavior (β = -0.170, P < .001). Willingness to vaccinate significantly influenced vaccination behavior (β = 0.627, P < .001). The Protection Motivation Theory is applicable for explaining the decision-making mechanism regarding HPV vaccination among female nursing students, as both threat appraisal and coping appraisal collectively influence the intention-behavior transition process. This study provides theoretical support for formulating immunization promotion policies targeted at this population; however, future research should expand sample diversity to enhance the generalizability of the findings.
2. Factors Associated With More Medication Trials Before Surgical Evaluation and Postsurgical Outcomes in Pediatric Drug-Resistant Epilepsy.
期刊: Neurology 发表日期: 2025-Nov-11 链接: PubMed
摘要
Despite strong evidence supporting timely surgical evaluation, many children with drug-resistant epilepsy undergo multiple antiseizure medication (ASM) trials before surgery. Because guidelines recommend evaluation after failure of 2 appropriate ASMs, evaluation after failure of >2 ASMs serves as a clinically relevant benchmark. The aim of this study was to identify factors associated with initiation of surgical evaluation after failure of >2 ASMs and evaluate its association with seizure freedom. We performed a retrospective analysis using the Pediatric Epilepsy Research Consortium Surgery Database, including 24 US pediatric epilepsy centers. Children aged 18 years and younger who initiated epilepsy surgery evaluation between January 2018 and February 2023 were included. Timing of evaluation was defined by the number of ASM failures before first phase I evaluation (≤2 vs >2). Unadjusted analyses and multivariable logistic regression were used to identify predictors of later evaluation and assess its association with seizure freedom, adjusting for etiology, seizure type, MRI findings, and surgical procedure. Among 1,767 patients, 802 (45.4%) initiated surgical evaluation after failing ≤2 ASMs and 965 (54.6%) after failing >2 ASMs, with a median age at seizure onset of 5.96 and 4.00 years, respectively. Factors independently associated with later initiation of surgical evaluation included genetic etiology (odds ratio [OR] 1.83, 95% CI 1.28-2.60), generalized seizures (OR 2.64, 95% CI 1.58-4.40), daily seizures (OR 1.69, 95% CI 1.33-2.14), multiple seizure types (OR 1.59, 95% CI 1.39-1.82), normal MRI (OR 1.82, 95% CI 1.52-2.18), and abnormal neurologic examination (OR 2.44, 95% CI 2.01-2.96). Surgical intervention rates were similar (∼50%) between groups. Patients who initiated surgical evaluation after failure of ≤2 ASMs had significantly higher seizure freedom rates (60.8% vs 39.3%, p < 0.001). On multivariable analysis, failure of >2 ASMs before surgical evaluation was independently associated with lower odds of seizure freedom (OR 0.66, 95% CI 0.45-0.96, p = 0.028). Initiation of surgical evaluation after failure of more than 2 ASMs is associated with more complex epilepsy phenotypes and lower rates of seizure freedom. However, 80% of these patients still experienced a >50% reduction in seizures, highlighting the therapeutic benefits of timely epilepsy surgery-even when seizure freedom is unlikely-regardless of epilepsy subtype.
3. The prevalence of autoimmune hepatitis is rising: Estimates and trends from a large, multi-ethnic cohort in the United States.
期刊: Hepatology communications 发表日期: 2025-Nov-01 链接: PubMed
摘要
Large epidemiologic studies of autoimmune hepatitis (AIH) in the United States are limited. None have reported prevalence trends over time. This contemporary study examines AIH prevalence and demographic trends over 10 years in a community-based integrated healthcare system in Northern California. We further assessed whether prevalence trends differed by AIH ascertainment approach. This retrospective study used data from adults aged ≥18 years in Kaiser Permanente Northern California (2010-2019). AIH was identified by coded diagnosis and confirmed with diagnostic testing (laboratory and/or liver biopsy) and treatment response. Annual AIH prevalence was estimated and stratified by age, sex, and race/ethnicity. Among 1129 patients with confirmed AIH, 80% were female, 44% non-Hispanic White, 26% Hispanic, 16% Asian/Pacific Islander, and 9% Black. In all, 76% of patients on AIH treatment demonstrated treatment response at 6 months. AIH prevalence (per 100,000 adults) increased from 9.1 in 2010 to 18.8 in 2019 (p<0.0001). Prevalence among older adults (≥75 years) quadrupled from 10.1 to 43.7 per 100,000. Prevalence rose among all ethnicities and in 2019 was highest for Black (28.9) and Hispanic populations (25.2) per 100,000. AIH prevalence doubled over 10 years in a large healthcare system, with pronounced increases among older populations. Prevalence was highest among Black and Hispanic adults. Further studies should examine demographic differences in the clinical course of AIH, including response to therapy, adverse events, and outcomes.
4. Paired snRNA-seq and scRNA-seq analysis of MASLD patients to identify early-stage markers for disease progression.
期刊: Hepatology communications 发表日期: 2025-Nov-01 链接: PubMed
摘要
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease worldwide. Progression from simple metabolic dysfunction-associated steatotic liver (MASL) without necro-inflammation to metabolic dysfunction-associated steatohepatitis (MASH) triggers fibrosis, leading to liver-related morbidity and mortality. Early recognition of MASH is imperative to enable appropriate interventions aimed at preventing liver damage. Thus, this study aimed to elucidate molecular mechanisms driving MASLD progression and identify early-stage transcriptomic signatures by analyzing paired liver tissue and peripheral blood mononuclear cells (PBMCs). We collected 16 paired liver and PBMC samples from 8 histologically confirmed patients with MASLD. Liver tissue was obtained by needle biopsy for single-nucleus RNA sequencing, and PBMCs underwent single-cell and bulk RNA sequencing. PBMC-liver interactions were examined to identify cross-tissue signaling, and machine learning was applied to derive transcriptomic signatures predictive of fibrosis stage. Hepatocyte transcriptomic profiling revealed distinct MASH-associated alterations, including downregulated fatty acid metabolism, upregulated immune activation pathways, and changes in tissue remodeling. PBMC analysis identified shifts in immune populations, with increased aTregs and chronic CD4+ T cell activation. Liver-PBMC interaction analysis highlighted enhanced HSC-natural killer cell signaling in MASH, linking immune responses to fibrosis progression. Machine learning identified liver-derived and PBMC-derived transcriptomic signatures that robustly distinguished mild (F0-F2) from advanced (F3-F4) fibrosis (AUC=0.93), suggesting their potential for early diagnostic stratification. Significant molecular and immune alterations occur in disease progression of MASLD to MASH, reflecting both localized hepatic changes and systemic immune dysregulation. The identified transcriptomic signatures provide a promising tool for fibrosis prediction and monitoring, underscoring the need to target early disease mechanisms for improved diagnosis and therapeutic strategies.
5. Activity Loss and Retention Patterns Following Unilateral Peripheral Nerve Injury: Implications for Rehabilitation.
期刊: The American journal of occupational therapy : official publication of the American Occupational Therapy Association 发表日期: 2025-Nov-01 链接: PubMed
摘要
Peripheral nerve injury (PNI) in the upper extremity can significantly affect the ability of patients to participate in preferred activities, yet measuring this effect is challenging because of limited suitable tools. To understand the impact of PNI on activity participation on basis of the activities’ motor demands (fine motor, gross motor, and/or bimanual). We hypothesized that fine motor activities would show lower retention than gross motor or nonmotor activities, that hand dexterity would correlate with fine motor retention, and that unimanual activities would be retained more than bimanual activities. Cross-sectional observational study. Two upper extremity rehabilitation clinics. Forty-eight patients with unilateral PNI in the upper extremity. Primary outcome was participation retention rates in five activity dimensions, as assessed with the Activity Card Sort. Participants retained fewer gross motor activities than fine motor activities. Pain and health-related quality of life were the only patient factors significantly associated with participation. Hand dexterity did not correlate with fine motor retention, and unimanual activities showed higher retention than bimanual activities, regardless of the injured side. Patterns of activity loss after PNI cannot be fully explained by motor demands alone. Although addressing specific motor skills remains important, participation is shaped by a complex interplay of physical, personal, and contextual factors as well as compensation and difficulties with bimanual tasks, even in unilateral injuries. Rehabilitation should incorporate activity-based assessments that capture real-world challenges and support individualized intervention planning. Plain-Language Summary: Nerve injuries in the upper extremity can significantly affect the ability to engage in essential activities. This study aimed to enhance the assessment of activity participation for people with upper extremity nerve injuries. We found that focusing on specific motor skills, such as fine and gross motor skills, gives a better understanding of how nerve injuries affect engagement in important activities. Hand dexterity, as measured using standard tools, was not linked to the ability to retain fine motor activities. These findings suggest that, to tailor interventions to enhance overall recovery, rehabilitation should include an individualized assessment (in addition to standard scales) to identify the activities that depend on the patient’s specific motor skills impairments.
6. Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Occupational Performance: A Scoping Review.
期刊: The American journal of occupational therapy : official publication of the American Occupational Therapy Association 发表日期: 2025-Nov-01 链接: PubMed
摘要
Pediatric acute-onset neuropsychiatric syndrome (PANS) is a neuroimmune condition that significantly affects children’s occupational performance across multiple domains. However, occupational performance is often overlooked in current PANS clinical frameworks, despite its critical role in daily functioning and well-being. To synthesize evidence on the occupational performance challenges experienced by children with PANS, the tools used to assess these challenges, and occupational therapy interventions used with these children. MEDLINE, CINAHL, Cochrane Library, PsycINFO, SCOPUS, ERIC, and EMBASE were searched from their inception through May 17, 2024. Peer-reviewed studies addressing PANS and occupational performance were included, with data categorized using the Occupational Therapy Practice Framework, 4th Edition. Of 3,431 records, 40 studies met inclusion criteria. Occupational performance challenges centered on communication, nutrition, education, rest/sleep, social participation, and toileting, with limited data on bathing, dressing, personal hygiene, and play and leisure. Assessments emphasized client factors, rarely using occupation-based tools. Only 2 studies mentioned occupational therapy interventions. PANS has a pervasive impact on children’s occupational performance, highlighting the urgent need to prioritize it within clinical frameworks. Future research should focus on occupation-based intervention studies and assessments to enhance outcomes for children with PANS. Plain-Language Summary: Pediatric acute-onset neuropsychiatric syndrome (PANS) causes sudden, severe symptoms, such as obsessive-compulsive behaviors, eating difficulties, sensory and motor changes, and developmental regression, which significantly disrupt children’s ability to perform daily activities. This study included 40 research articles addressing what is known about the impact of PANS on children’s daily functioning and the role of occupational therapy in managing challenges. Results showed that most studies focused on communication, nutrition, education, sleep, social, and toileting challenges, but few addressed other daily tasks like bathing, dressing, personal hygiene, and play or leisure. Despite identified challenges, only two studies mentioned occupational therapy interventions, highlighting a major gap in the evidence. Assessments focused mainly on a child’s skills and challenges, rather than looking at how the child participates in everyday activities. The findings highlight the need to better understand the challenges children with PANS face in their everyday activities and to provide practical strategies to help them succeed. Positionality Statement: Newby is a pediatric occupational therapist and researcher with both professional and personal experience of PANS. Her clinical work with children diagnosed with PANS, along with personal experience supporting a family member with this condition, has deepened her interest in the episodic fluctuations in occupational performance that occur during periods of exacerbation and remission. Haracz is an occupational therapist, academic, and researcher with a focus on mental health and the intersection between physical and psychological well-being. Lane is an occupational therapist, academic, and researcher who specializes in the neuroscience of developmental conditions and how sensory processing differences affect children’s engagement in daily occupations. Tona is an occupational therapist and educational psychologist whose interest in neuroinflammatory disorders emerged following a family member’s diagnosis with PANS. Her research explores the characteristics of PANS, treatment access, caregiver burden, and the role of occupational therapy in improving participation in both PANS and long-COVID populations.
7. Occupational Therapy Intervention for Improvement of Activity and Participation in Home Rehabilitation for Community-Dwelling Older Adults: A Scoping Review.
期刊: The American journal of occupational therapy : official publication of the American Occupational Therapy Association 发表日期: 2025-Nov-01 链接: PubMed
摘要
The demand for effective home-based rehabilitation is increasing with the aging global population. Occupational therapy supports older adults in maintaining and improving activity and participation; however, standardized intervention approaches, consistent outcome measures, and goal-setting frameworks are still lacking. To systematically map current home-based occupational therapy interventions aimed at enhancing activity and participation among community-dwelling older adults and identify research gaps in intervention methods, evaluations, and designs. PubMed, Web of Science, Scopus, Ichushi Web, and J-Stage were searched without time restrictions. Additional relevant studies were identified manually. Studies involving community-dwelling adults age 65 yr or older were included. Data on intervention strategies, outcome measures, and research designs were extracted and categorized by using qualitative methods. Fifty-four studies were included. Interventions ranged from activities of daily living (ADLs) and instrumental ADLs (IADLs) training and environmental modifications to structured programs such as Community Aging in Place-Advancing Better Living for Elders (CAPABLE) and Reablement. However, outcome measures were highly diverse (126 unique tools), and 16 nonstandardized assessments were identified, mostly in case reports. Although many studies showed positive effects, the diversity of study designs and limited use of remote interventions hindered generalizability and long-term evidence building. Home-based occupational therapy can positively affect older adults’ activity, participation, and quality of life. However, standardized evaluation methods, integration of remote approaches, and culturally tailored intervention programs are needed to strengthen evidence and guide clinical practice. Plain-Language Summary: This review examined studies on home-based occupational therapy for older adults. Interventions often targeted activities of daily living, instrumental activities of daily living, and environmental adaptations. Most occupational therapy interventions showed benefits in everyday function and well-being. However, a lack of standardized tools and goal-setting methods, variation in study quality, and limited evidence on remote rehabilitation remain challenges.
8. Psychosocial Occupational Therapy Interventions for High-Risk Pregnancies: A Systematic Review.
期刊: The American journal of occupational therapy : official publication of the American Occupational Therapy Association 发表日期: 2025-Nov-01 链接: PubMed
摘要
High-risk pregnancies present significant psychological challenges for affected women, and psychosocial interventions may improve their mental health and quality of life. To evaluate the effectiveness of psychosocial occupational therapy interventions for managing anxiety, depression, stress, and quality of life among women with high-risk pregnancies. CINAHL, SocIndex, AMED, Embase via Ovid, MEDLINE in PubMed, Cochrane Library, OTseeker, and PsycINFO. This systematic review followed Cochrane Collaboration methodology and Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Studies included women with high-risk pregnancies (e.g., gestational diabetes, hypertensive disorders, preterm labor) and examined occupational therapy-related psychosocial interventions. Eligible studies reported outcomes for anxiety, depression, stress, or quality of life and were classified as Level 1b, 2b, or 3b evidence. Data were analyzed using narrative synthesis. Thirty-four studies met the inclusion criteria. Cognitive-based and counseling-based interventions showed moderate to strong effectiveness in reducing anxiety, depression, and stress. Emotion-based approaches had low to moderate effectiveness, and sensory-based interventions were largely ineffective. Integrated approaches, such as mindfulness-based cognitive therapy, showed mixed results. Findings support integrating psychosocial interventions into occupational therapy to enhance mental health and occupational engagement for women with high-risk pregnancies. Plain-Language Summary: This study reviewed 34 studies of psychosocial interventions for women with high-risk pregnancies. Cognitive and counseling-based strategies were most effective in reducing anxiety, depression, and stress. Sensory-based approaches had little impact. These findings reinforce the role of occupational therapists in supporting mental health and inform future practice and education.
9. Human deep sleep facilitates cerebrospinal fluid dynamics linked to spontaneous brain oscillations and neural events.
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
How sleep maintains our healthy brain function has remained one of the biggest mysteries in neuroscience, medical settings, and daily lives. While cerebrospinal fluid (CSF) during sleep has been implicated in metabolic waste reduction in animals, how CSF dynamics are driven in the healthy human brain during deep sleep remains elusive. A myriad of research has shown that crucial cognitive processing manifests in slow-wave and rapid-eye movement (REM) sleep, suggesting that a key to maintaining brain functions lies in deep sleep. By leveraging a simultaneous sparse-functional MRI and polysomnography method, we demonstrate that deep sleep-specific CSF dynamics are associated with spontaneous brain oscillations in healthy young human participants. Slow waves and sleep spindles during slow-wave sleep are tightly linked to short-cycle, frequent, and moderate CSF fluctuations. In contrast, slow waves during light sleep and arousals produce slow, infrequent, and steep CSF signal changes. Rapid eye movements and sawtooth waves during REM sleep are also linked to CSF signal changes. Furthermore, CSF signals are significantly faster in frequency during deep than light sleep. These brain oscillations during light and deep sleep recruit essentially different brain networks, with deep sleep involving memory and homeostatic circuits. Thus, human deep sleep has a unique way of facilitating CSF dynamics that are distinctive from arousal mechanisms.
10. Evaluation of Mobile Intermittent Fasting Applications in Chinese App Stores: Quality Evaluations and Content Analysis.
期刊: JMIR mHealth and uHealth 发表日期: 2025-Oct-07 链接: PubMed
摘要
Obesity and related disorders are rising globally, especially in China, where they are linked to chronic diseases like diabetes and cardiovascular issues. As intermittent fasting (IF) gains popularity for weight management, the use of IF apps has increased, yet their quality varies significantly. A systematic evaluation of these apps is essential to assess their effectiveness and reliability. This study aimed to conduct a comprehensive evaluation of IF apps available in the Chinese mobile app market. We concentrated on evaluating their features, quality, and overall user experience to help users avoid low-quality options and direct app developers to enhance their offers. A systematic search was performed across 5 major app stores in China, including the Apple App Store, Huawei AppGallery, Oppo Software Store, Vivo App Store, and Xiaomi Market. “Fasting”, “Intermittent Fasting”, “Time-Restricted Feeding”, “Time-Restricted Fasting”, “Time-Restricted Eating” and “Meal Skipping” were used as keywords to identify relevant apps, which were then screened based on inclusion and exclusion criteria. The evaluation was conducted using the user version of the Mobile Application Rating Scale (uMARS). The uMARS assessment examined 4 key subscales: engagement, functionality, aesthetics, and information. Each app was independently evaluated by 2 raters who underwent uniform training to ensure consistency in scoring. A total of 35 apps were assessed for the study. These apps mostly contain features such as fasting timer (100.0%), recording weight (97.14%), fasting reminder (85.71%), and recording water intake (85.71%). All of the apps have an obvious privacy protection. Most of the apps (79%) have tools for quantifying users’ health status. The results showed that the overall average uMARS score across the apps was 4.35 (SD 0.51). The subscale scores were as follows: engagement 4.42 (SD 0.47), functionality 4.65 (SD 0.31), aesthetics 4.19 (SD 0.64), and information 4.15 (SD 0.58). The functionality subscale had the highest mean score, while the aesthetic subscale showed the greatest range of scores, from 2.17 to 5.00. The overall uMARS score was significantly positively correlated with the subscale scores (r=0.786-0.953, P<.001). The user ratings in the app stores did not significantly correlate with the uMARS overall scores (r=-0.290, P=.091). Strong inter-rater reliability was confirmed by intraclass correlation coefficients (ICC=0.809-0.909 across subscales). All the apps reveal high overall quality but gaps in professional engagement and social features. Limited clinical input may undermine the evidence-based accuracy and long-term applicability of some apps. Developers are encouraged to collaborate with health care professionals to enhance content reliability and incorporate social features to boost user engagement, while ensuring robust privacy protections and reasonable use of artificial intelligence.
11. ChatGPT in Medical Education: Bibliometric and Visual Analysis.
期刊: JMIR medical education 发表日期: 2025-Oct-07 链接: PubMed
摘要
ChatGPT is a generative artificial intelligence-based chatbot developed by OpenAI. Since its release in the second half of 2022, it has been widely applied across various fields. In particular, the application of ChatGPT in medical education has become a significant trend. To gain a comprehensive understanding of the research developments and trends regarding ChatGPT in medical education, we conducted an extensive review and analysis of the current state of research in this field. This study used bibliometric and visualization analysis to explore the current state of research and development trends regarding ChatGPT in medical education. A bibliometric analysis of 407 articles on ChatGPT in medical education published between March 2023 and June 2025 was conducted using CiteSpace, VOSviewer, and Bibliometrix (RTool of RStudio). Visualization of countries, institutions, journals, authors, keywords, and references was also conducted. This bibliometric analysis included a total of 407 studies. Research in this field began in 2023, showing a notable surge in annual publications until June 2025. The United States, China, Türkiye, the United Kingdom, and Canada produced the most publications. Networks of collaboration also formed among institutions. The University of California system was a core research institution, with 3.4% (14/407) of the publications and 0.17 betweenness centrality. BMC Medical Education, Medical Teacher, and the Journal of Medical Internet Research were all among the top 10 journals in terms of both publication volume and citation frequency. The most prolific author was Yavuz Selim Kiyak, who has established a stable collaboration network with Isil Irem Budakoglu and Ozlem Coskun. Author collaboration in this field is usually limited, with most academic research conducted by independent teams and little communication between teams. The most frequent keywords were “AI,” “ChatGPT,” and “medical education.” Keyword analysis further revealed “educational assessment,” “exam,” and “clinical practice” as current research hot spots. The most cited paper was “Performance of ChatGPT on USMLE: Potential for AI-Assisted Medical Education Using Large Language Models,” and the paper with the strongest citation burst was “Are ChatGPT’s Knowledge and Interpretation Ability Comparable to Those of Medical Students in Korea for Taking a Parasitology Examination?: A Descriptive Study.” Both papers focus on evaluating ChatGPT’s performance in medical exams. This study reveals the significant potential of ChatGPT in medical education. As the technology improves, its applications will expand into more fields. To promote the diversification and effectiveness of ChatGPT in medical education, future research should strengthen interregional collaboration and enhance research quality. These findings provide valuable insights for researchers to identify research perspectives and guide future research directions.
12. Use of a Preliminary Artificial Intelligence-Based Laryngeal Cancer Screening Framework for Low-Resource Settings: Development and Validation Study.
期刊: JMIR formative research 发表日期: 2025-Oct-07 链接: PubMed
摘要
Early-stage diagnosis of laryngeal cancer significantly improves patient survival and quality of life. However, the scarcity of specialists in low-resource settings hinders the timely review of flexible nasopharyngoscopy (FNS) videos, which are essential for accurate triage of at-risk patients. We introduce a preliminary AI-based screening framework to address this challenge for the triaging of at-risk patients in low-resource settings. This formative research addresses multiple challenges common in high-dimensional FNS videos: (1) selecting clear, informative images; (2) deriving regions within frames that show an anatomical landmark of interest; and (3) classifying patients into referral grades based on the FNS video frames. The system includes an image quality model (IQM) to identify high-quality endoscopic images, which are then fed into a disease classification model (DCM) trained on efficient convolutional neural network (CNN) modules. To validate our approach, we curated a real-world dataset comprising 132 patients from an academic tertiary care center in the United States. Based on this dataset, we demonstrated that the IQM quality frame selection achieved an area under the receiver operating characteristic curve (AUROC) of 0.895 and an area under the precision-recall curve (AUPRC) of 0.878. When using all the image frames selected by the IQM, the DCM improved its performance by 38% considering the AUROC (from 0.60 to 0.83) and 8% considering the AUPRC (from 0.84 to 0.91). Through an ablation study, it was demonstrated that a minimum of 50 good-quality image frames was required to achieve the improvements. Additionally, an efficient CNN model can achieve 2.5-times-faster inference time than ResNet50. This study demonstrated the feasibility of an AI-based screening framework designed for low-resource settings, showing its capability to triage patients for higher-level care efficiently. This approach promises substantial benefits for health care accessibility and patient outcomes in regions with limited specialist care in outpatient settings. This research provides necessary evidence to continue the development of a fully validated screening system for low-resource settings.
13. Probing the Relationship Between Perioperative Complications in Patients With Valvular Heart Disease: Network Analysis Based on Bayesian Network.
期刊: JMIR formative research 发表日期: 2025-Oct-07 链接: PubMed
摘要
Heart valve surgery is associated with a high risk of perioperative complications. However, current approaches for predicting perioperative complications are all based on preoperative or intraoperative factors, without taking into account the fact that perioperative complications are multifactorial, dynamic, heterogeneous, and interdependent. We aimed to construct and quantify the association network among multiple perioperative complications to elucidate the possible evolution trajectories. This study used the data from China Cardiac Surgery Registry (CCSR), in which 37,285 patients were included in the analysis. A Bayesian network was used to analyze the associations among 12 complications. Score-based hill-climbing algorithms were used to build the structure and the association between them was quantified using conditional probabilities. We obtained the network of valve surgery complications. A total of 13 nodes represented complications or death, and 34 arcs with arrows represented the directly dependent relationship between them. We identified clusters of complications that were logically related and not related and quantified the associations. The correlation coefficient between complications increases with the severity of the complications, ranging from 0.01 to 0.41. Meanwhile, the probability of death when multiple complications occurred was calculated. Even mild complications, when progressing to multiple organ dysfunction syndrome, result in a mortality rate of over 90%. Our network facilitates the identification of associations among specific complications, which help to develop targeted measures to halt the cascade of complications in patients undergoing the valve surgery.
14. Childhood Maltreatment, Bullying, and Internet Addiction in Relation to Suicidal Ideation Among Adolescents: Cross-Sectional Mediation and Network Analysis.
期刊: Journal of medical Internet research 发表日期: 2025-Oct-07 链接: PubMed
摘要
Internet addiction (IA), childhood maltreatment (CM), and bullying are prevalent psychosocial stressors among adolescents and have each been associated with suicidal ideation (SI). However, existing research often treats these factors in isolation, overlooking their potential interrelationships and joint associations with SI. This study aimed to examine how CM, IA, and bullying are jointly related to SI at both the scale and symptom levels and identify key symptoms within the CM-IA-bullying-SI network that may serve as intervention targets to disrupt maladaptive associations across the network. A total of 6573 adolescents were recruited through cluster sampling. Mediation analyses were conducted to assess direct and indirect effects of CM on SI via IA and bullying. Network analysis was conducted to examine symptom-level associations among CM, IA, bullying, and SI and identify core and bridge symptoms within the network. Network comparison tests were conducted to assess differences in network structure by gender and history of nonsuicidal self-injury. Mediation analyses revealed that both IA and bullying partially mediated the association between CM and SI, with significant indirect effects via IA (c’=0.010, 95% CI 0.008-0.011; P<.001) and bullying (c’=0.004, 95% CI 0.002-0.005; P<.001). In the network, tolerance, time management, and compulsive internet use were identified as central symptoms, whereas SI, emotional abuse, and traditional bullying victimization served as bridge symptoms. Emotional abuse and cyberbullying victimization were most strongly linked to SI. Among individuals with a history of nonsuicidal self-injury, emotional abuse and emotional neglect showed stronger associations with SI. Sex subgroup analysis showed no significant difference in global strength (S=0.095; P=.69) but a significant difference in network structure (M=0.174; P=.01). This study revealed how CM, bullying, and IA are jointly related to SI among adolescents at both the scale and symptom levels. Key symptoms, including tolerance and time management, played central roles within the symptom network, with SI bridging multiple psychosocial domains. These findings underscore the need for multilevel, targeted interventions to disrupt maladaptive links and reduce suicide risk in adolescents.
15. The effect of a symptom management program developed based on story theory on vasomotor symptoms and sleep quality in postmenopausal women: a mixed methods study.
期刊: Menopause (New York, N.Y.) 发表日期: 2025-Oct-07 链接: PubMed
摘要
This study examined the effect of a symptom management program developed based on story theory on vasomotor symptoms and sleep quality in postmenopausal women. The research was conducted as a mixed methods study using an interventional design, one of the advanced mixed methods designs. The study population consisted of postmenopausal women who presented to 5 family health centers. A total of 76 women were enrolled, with 38 in the experimental group and 38 in the control group. The symptom management program developed based on story theory was applied individually to women in the experimental group. A personal information form, the Menopause Symptoms Assessment Scale, the Pittsburgh Sleep Quality Index, and a story theory-based semistructured interview form were employed as data collection tools. The independent 2-sample t test, Mann-Whitney U test, generalized linear model, Tukey test, and Robust ANOVA test were used for the analysis of quantitative data, while content analysis was applied to qualitative data. The Menopause Symptoms Assessment Scale total and subdimension scores and the total Pittsburgh Sleep Quality Index score were lower in the experimental group than in the control group at the end of the program. Six themes were identified in the study: thoughts about menopause, symptoms experienced during menopause, perception of femininity in menopause, the effect of menopause on daily life, coping with menopause, and expectations in menopause. The program reduced vasomotor symptoms and improved sleep quality among the postmenopausal women in the experimental group.
16. Clinical and Economic Outcomes Associated With Musculoskeletal Care in an Integrated Advanced Primary Care Model: Controlled Cohort Analysis.
期刊: Journal of medical Internet research 发表日期: 2025-Oct-07 链接: PubMed
摘要
Health care costs in the United States are skyrocketing, with commercial spending increasing 7.7% between 2022 and 2023. Musculoskeletal conditions affect more than one-third of US adults and account for over US $300 billion in total medical spending, more than any other chronic condition. Employers bear a disproportionate burden of these costs, both because they pay for the care of employees and their families with musculoskeletal conditions and because musculoskeletal pain is the second leading cause of workplace absenteeism, accounting for approximately 290 million lost workdays annually. Tele-physical therapy (TPT) solutions can be an effective alternative to in-person physical therapy (PT) and, especially when provided early in the course of care, have the potential to reduce employer-sponsored health care spending. We sought to evaluate the effects of a proactive musculoskeletal treatment approach-TPT integrated into advanced primary care-on patient access, changes in functional status, and employer cost. We performed a retrospective analysis of participants (>13 years old) seen by TPT integrated with primary care compared to a risk-adjusted, nationally matched cohort of patients receiving PT. The studied intervention had five key elements: (1) a multidisciplinary team, (2) a musculoskeletal toolkit for primary care physicians, (3) a peer-to-peer musculoskeletal expert opinion portal, (4) a shared technology platform, and (5) musculoskeletal educational rounds. We collected participants’ access to both primary care and PT and compared participants’ functional status at baseline and at the end of their course of PT to risk-adjusted Focus on Therapeutic Outcomes controls, providers’ assessments of participants’ progress with PT, participants’ satisfaction with their TPT, and costs of care. We evaluated 1563 participants whose average age was 42.8 (SD 10.4) years. Of these, 586 (37.5%) identified as female, 574 (36.7%) as White, 182 (11.6%) as Asian, and 19 (1.2%) as Black or African American. Their presenting complaints included shoulder pain (282/1563, 18%), knee pain (250/1563, 16%), and low back pain (187/1563, 11.96%). The mean time to TPT appointment was 7.6 (SD 5) days. On average, TPT patients required 5.4 (SD 2.7) visits to symptom resolution, compared to 6.5 (SD 5.5) visits for controls (a 17% reduction) and 10.3 (SD 1.55) predicted visits from risk-adjusted benchmarks, resulting in US $193 to US $1411 in savings per injury per patient. Recovery, defined as patients either meeting, mostly meeting, or on track to meet expectations, was achieved for 461/473 (97.5%) participants for whom it was assessed. Overall participant satisfaction was high, with a net promoter score for PTs of 97. TPT integrated with advanced primary care was associated with greater functional improvement in 17% fewer visits compared to usual care. This model holds considerable promise for addressing the escalating musculoskeletal costs of US commercially insured populations.
17. A Personalized and Smartphone-Based Serious Gaming App Targeting Cognitive Impairments in Alcohol Use Disorder: Double-Blinded, Randomized Controlled Efficacy Trial Among Outpatients.
期刊: JMIR mental health 发表日期: 2025-Oct-07 链接: PubMed
摘要
Alcohol use disorder (AUD) is associated with cognitive impairments that are known to affect the outcomes of conventional treatment. Digital cognitive training programs have been examined as a possible way of addressing these overlooked challenges. Existing findings regarding the efficacy of such training programs are divergent, and further studies are warranted to examine more engaging cognitive training programs using the latest technology. Smartphone-based training built upon the principles of serious gaming would not only increase the accessibility of the program, but it could also increase the motivation of the patients, potentially maximizing adherence to the training program. The aim of the present feasibility and efficacy study was to examine the feasibility and acceptability of the Brain+ Alco-Recover app (Brain+ A/S) with gamified elements among patients with AUD when delivered as an add-on to treatment-as-usual (TAU) and with minimal guidance from health care practitioners. In addition, the effects on cognitive and alcohol-related outcomes were examined. A total of 72 outpatients were randomized into either group A, experimental + TAU (n=36), or group B, sham + TAU (n=36), and they had to complete a 1-month training program in addition to primary treatment. Self-reported experience at the 6-month follow-up as well as actual game usage was used to determine the feasibility of the training program. Cognitive performance and alcohol consumption were assessed as well. The patients in both groups reported a high level of acceptability, and up to 83% of the patients in the experimental group met the minimum requirements for the usage of the app. The experimental group also demonstrated significant improvements in working memory (P<.001). Although no significant differences were found between the 2 groups regarding clinical outcomes, a greater reduction in alcohol consumption was evident at the 6-month follow-up in the experimental group. The acceptability and adherence to the minimum training requirements deems the gamified Brain+ app as a feasible tool for cognitive training when delivered as an add-on to TAU. Furthermore, the potential improvements in cognitive functions should be further replicated in a larger-scale trial to assess whether these could be used to improve the treatment of AUD in the future. RR2-10.3389/fpsyt.2021.727001.
18. The associations of early and surgical menopause with 10-year employment trajectories bracketing final menstruation or surgery.
期刊: Menopause (New York, N.Y.) 发表日期: 2025-Oct-07 链接: PubMed
摘要
This study examines the employment trajectories of women experiencing early and surgical menopause over a 10-year period bracketing their final menstruation or surgery, representing for most women the menopause transition. It also investigates the potential mediating role of hormone therapy in early postmenopause in these relationships. We used data from 1,386 women in the English Longitudinal Study of Aging (ELSA) who had undergone natural menopause, premenopausal bilateral oophorectomy or hysterectomy. We used sequence analysis of employment histories to define 3 different 10-year employment trajectories. We then carried out regression analysis to assess associations between timing and type of menopause on employment, followed by mediation analysis. Sensitivity analysis was conducted by excluding cases with hysterectomy with preserved ovaries. Women with early menopause, compared with those who undergo menopause at 45 or older, are less likely to have flexible working arrangements (part-time work or self-employment) compared with full-time work during this sensitive period (relative risk ratio [RRR], 0.70; 95% CI: 0.51-0.97). However, the likelihood of leaving the labor market compared with working full-time is similar in women with early and later menopause (RRR, 0.95; 95% CI: 0.62-1.41). Surgical menopause, compared with natural menopause, is associated with an increased risk of labor market exit (RRR, 1.45; 95% CI: 1.01-2.32), particularly for women aged 45 or older at the time of surgery (RRR, 1.50; 95% CI: 0.94-2.38). Hormone therapy use may help reduce the risk of labor market exit for women with both early (RRRNATURAL INDIRECT EFFECT [NIE], 0.79; 95% CIBIAS-CORRECTED [BC], 0.58-1.04) and surgical menopause (RRRNIE, 0.73; 95% CIBC, 0.53-1.01). Sensitivity analysis suggests that the potential reduction in labor market exit risk via hormone therapy for early menopausal women holds true only when women with hysterectomy with preserved ovaries are included. Our study highlights that early menopause and surgical menopause, including hysterectomy with preserved ovaries, impact women’s labor market trajectories and suggests that hormone therapy within the early years of the final menstruation may help women remain employed. We advocate for further research on the impact of the timing and type of menopause on women’s labor market circumstances and for workplace policies that consider their diverse experiences.
19. Helicobacter pylori Infection, Metabolomic Signature and Extra-gastric Cancer Risk: A Mediation and Mendelian Randomization Analysis.
期刊: Molecular carcinogenesis 发表日期: 2025-Oct-07 链接: PubMed
摘要
Emerging evidence suggests that Helicobacter pylori (H. pylori) infection may contribute to extra-gastric malignancies, but the mechanisms are unclear. Using untargeted metabolomics data from two prospective Chinese cohorts, we constructed an H. pylori associated metabolomic signature in 1800 baseline participants and evaluated cancer risks using conditional logistic regression in 1:1 matched case-control studies for lung cancer (n = 352 pairs), colorectal cancer (CRC; n = 190 pairs), esophageal cancer (n = 146 pairs), and hepatocellular carcinoma (n = 163 pairs), with confounder adjustment and sex stratification. Mediation analysis was performed to evaluate the mediating effects of the metabolomic signature and specific plasma metabolites on the observed associations. Mendelian randomization (MR) analysis was conducted to evaluate causal relationships. H. pylori infection was significantly associated with an increased risk of CRC (OR = 1.80, 95% CI: 1.13-2.85), especially driven by males (OR = 3.01, 95% CI: 1.44-6.31), but not with other cancers. Additionally, the H. pylori infection-related metabolomic signature consisting of 26 metabolites (OR per standard deviation [SD] increment = 1.52, 95% CI: 1.03-2.25) and plasma metabolite methionine sulfone (OR per SD increment = 1.73, 95% CI: 1.16-2.58) were positively associated with CRC risk in males. Mediation analysis indicated partial mediation by the metabolomic signature (12.08%, 95% CI: 0.26-46.88%) and methionine sulfone (16.79%, 95% CI: 0.11-74.76%). MR analysis further supported a potentially causal association between methionine sulfone and CRC (OR = 1.08, 95% CI: 1.02-1.15). Collectively, these results implicate sex-specific metabolomic alterations, particularly involving methionine sulfone, in mediating the relationship between H. pylori infection and CRC risk in males. These insights advance understanding of CRC pathogenesis and may inform targeted prevention strategies.
20. Opioids and Cardiovascular Health - The Past, Present and Future?
期刊: European journal of preventive cardiology 发表日期: 2025-Oct-07 链接: PubMed
摘要
21. Navigating sampling bias in discrete phylogeographic analysis: assessing the performance of an adjusted Bayes factor.
期刊: Molecular biology and evolution 发表日期: 2025-Oct-07 链接: PubMed
摘要
Bayesian phylogeographic inference is widely used in molecular epidemiological studies to reconstruct the dispersal history of pathogens. Discrete phylogeographic analysis treats geographic locations as discrete traits and infers lineage transition events among them, and is typically followed by a Bayes factor (BF) test to assess the statistical support. In the standard BF (BFstd) test, the relative abundance of the involved trait states is not considered, which can be problematic in the case of unbalanced sampling. Existing methods to correct sampling bias in discrete phylogeographic analyses using continuous-time Markov chain (CTMC) model, often require additional epidemiological information to balance the sampling effort among locations. As such data is not necessarily available, alternative approaches that rely solely on available genomic data are needed. In this perspective, we assess the performance of a modification of the BFstd, the adjusted Bayes factor (BFadj), which incorporates information on the relative abundance of samples by location when inferring support for transition events and root location inference without requiring additional data. Using a simulation framework, we assess the statistical performance of BFstd and BFadj under varying levels of sampling bias, estimating their type I and type II error rates. Our results show that BFadj complements the BFstd by reducing type I errors at the cost increasing type II errors for inferred transition events, while improving type I and type II errors in root location inference. Our findings provide guidelines for implementing the complementary BFadj to detect and mitigate sampling bias in discrete phylogeographic inference using CTMC modelling.
22. Highlights of ASCO 2025.
期刊: The oncologist 发表日期: 2025-Oct-07 链接: PubMed
摘要
23. Health conditions that impact fitness-to-practice in physicians: A scoping review.
期刊: International journal for quality in health care : journal of the International Society for Quality in Health Care 发表日期: 2025-Oct-07 链接: PubMed
摘要
It has been over 50 years since health conditions in physicians were first suggested to affect their fitness-to-practice, with consequent impacts on patient safety and patient care. Recent policy positions from physician regulatory bodies express a desire for clarity regarding the impact of these health conditions alongside their standardization in physician regulatory processes. Furthermore, these conditions have not been fully enumerated. Therefore, this scoping review intended to find all health conditions which were identified in the literature to impact physician fitness-to-practice. A specialist librarian developed and executed a systematic literature search in Ovid MEDLINE, Embase via Ovid, APA PsycINFO, and ProQuest Dissertations & Theses Global (to January 2024). The SPIDER framework was used for inclusion criteria and records were screened independently by two reviewers by title and abstract, then by full text. Any study addressing a health condition identified as able to affect fitness-to-practice in physicians and surgeons, physician assistants, or medical trainees was eligible. In 403 eligible records of 2542 screened, 4336 total mentions of 203 fitness-to-practice-related health conditions were identified. Conditions relating to mental health issues (32.0%) and drug/substance use (26.0%) comprised more than half of the condition reports. This was followed by neurological conditions (13.2%), medical conditions (12.8%), alcohol use (6.0%), addiction (3.0%), and aging (2.9%) as well as conditions affecting dexterity/fine motor skills/psychomotor performance (2.1%), vision (1.4%), and hearing (0.6%). This scoping review identified a wide variety of health conditions which could affect physician fitness-to-practice, with a potential impact on patient care and safety. These conditions have persisted in the literature, and we commend them to the attention of practicing physicians, researchers, regulators, and physician health programs.
24. Placing Public Health onto the Alzheimer's Disease and Related Dementias Public Policy Platform.
期刊: The Gerontologist 发表日期: 2025-Oct-07 链接: PubMed
摘要
In 2017, the United States Senate Special Committee on Aging added public health to the Alzheimer’s disease and related dementias (ADRD) policy platform by introducing the Building Our Largest Dementia Infrastructure for Alzheimer’s Act. Since then, 34 state health departments, seven local, two territorial and one tribal health organization have received a BOLD Program award from the CDC. With the support of the Alzheimer’s Association and university-based Centers of Excellence, their efforts have increased public awareness, expanded training of health care providers, linked public health programs and health care systems, and supported programs to reduce the risk for ADRD. In this forum, we draw on examples of federal and state policy making targeting persons living with dementia and demonstrate how iron triangles consisting of advocacy organizations, public servants and policy makers have been critical in building a public policy platform for more than 50 years. We then consider how public health leadership may rely on such iron triangles to expand their role, focusing on the critical role assumed by professional and academic organizations in educating and training those who may help respond to the public health crisis being presented by the booming number of older Americans with ADRD.
25. Sustaining Perioperative Patient Safety Improvement: The Relevance of Patient Safety Policies and Contextual Factors in European Healthcare Systems.
期刊: International journal for quality in health care : journal of the International Society for Quality in Health Care 发表日期: 2025-Oct-07 链接: PubMed
摘要
Perioperative patient safety aims to minimise risk and reduce adverse events throughout the surgical journey. Despite investments in national and international initiatives, sustaining these efforts remains a challenge. Contextual factors such as national policies and legal requirements play a key role in ensuring long-term success. This qualitative study examines the national patient safety policies and frameworks in five European countries and investigates contextual factors to understand how these policies may affect the implementation and sustainability of perioperative patient safety initiatives. Semi-structured interviews were conducted with decision-makers from Ministries of Health, regulatory or accreditation bodies, professional medical or scientific societies, managerial hospital staff, and academic patient safety experts from Spain, the Netherlands, Portugal, Estonia, and the Czech Republic. A desktop search for relevant policy and regulatory frameworks around perioperative patient safety informed the development of the semi-structured interview guide. Generated data were coded using an a priori framework adapted from the updated Consolidated Framework for Implementation Research (CFIR) and a framework for assessing health systems’quality improvement and patient safety initiatives. Using content analysis, codes were thematically analysed to delineate and compare the perioperative patient safety landscapes of the five countries. In total, 28 high-level decision-makers were interviewed. Based on the insight from interviewees, a patient safety policy profile was generated for each of the five countries, capturing the key features of their frameworks and strategies. While all countries have developed policies to improve patient safety, the scope and structure of these frameworks vary widely. Some countries have established centralized systems with detailed national action plans and robust oversight mechanisms, whereas others rely on more fragmented approaches with responsibilities distributed across various organizations. Common challenges identified include the inconsistent integration of patient safety education into medical curricula and cultural barriers, such as a fear of blame that affects reporting practices. Interviewees provided several propositions how project-based patient safety initiatives could be embedded in national contexts. These propositions differed considerably between countries. This study highlights the diverse and evolving nature of patient safety policy landscapes across five European countries. The varying scope, structure, and implementation of patient safety frameworks emphasize the need for context-specific approaches to promote the sustainability of perioperative patient safety initiatives. As the field continues to advance, it is important to tailor approaches that aim to sustain patient safety initiatives.
26. The Healthy Brain Initiative-Expanding Public Health Capacity to Address Dementia.
期刊: The Gerontologist 发表日期: 2025-Oct-07 链接: PubMed
摘要
In 2005, Congressional support led to the creation of the Healthy Brain Initiative (HBI) and the collaboration between the Alzheimer’s Association and the Centers for Disease Control and Prevention to prioritize brain health in public health practice. Over 20 years, the HBI has developed and implemented the HBI Road Map Series to increase the capacity of health departments to integrate dementia into health departments nationwide, aligning frameworks like the Essential Public Health Services and focusing on health equity across the life course. A growing number of HBI partners now work together to implement public health strategies that promote brain health, address dementia, and support people living with dementia and caregivers. Recognizing opportunities to influence the trajectory of public health action, the HBI prioritizes growing the availability and use of dementia-related public health data and equipping the public health workforce with the knowledge and confidence to make change. This article documents the history and evolution of the HBI, including a description of current efforts and the broader public health context to which it has contributed; efforts of the HBI and partners in national, state, local, territorial, and tribal public health agencies have led to transformative change.
27. Effective strategies for typhoid conjugate vaccine delivery: Health and economic insights from the 2015 Kampala outbreak.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Oct-07 链接: PubMed
摘要
Typhoid fever remains a major public health threat in low- and middle-income countries (LMICs), where inadequate access to clean water and sanitation drives recurrent outbreaks. With antimicrobial resistance on the rise, the urgency of deploying preventive strategies such as typhoid conjugate vaccines (TCVs) have grown. In this study, we developed a dynamic compartmental model calibrated to the 2015 typhoid outbreak in Kampala, Uganda, to assess the health and economic outcomes of various outbreak response immunization (ORI) strategies using TCVs. We aimed to identify optimal ORI strategies that minimize cases and typhoid-related deaths as well as the costs of implementation. Our model incorporated different phases of the outbreak, vaccine coverage levels (30%, 50%, 70%), timing (early, late, combined), and campaign duration. Cost-effectiveness was evaluated based on disability-adjusted life years (DALYs) and incremental cost-effectiveness ratios (ICERs), using World Health Organization (WHO) thresholds derived from Uganda’s 2015 gross national income per capita. Early, high-coverage vaccination (Scenario 1) was most impactful reducing the effective reproduction number (Rt) below 1 during the epidemic peak and averting over 7,000 cases including 180 deaths. The timing of vaccine deployment was the most critical determinant of effectiveness, followed by coverage level and campaign duration. Our findings highlight the importance of rapid, high-coverage TCV deployment at the early stages of an outbreak. Strengthening disease surveillance and improving vaccine logistics are essential for a timely response. This modeling framework offers actionable evidence to support policy development and optimize outbreak preparedness in typhoid-endemic regions.
28. Dynamic modelling of cell cycle arrest through integrated single-cell and mathematical modelling approaches.
期刊: PLoS computational biology 发表日期: 2025-Oct-07 链接: PubMed
摘要
Highly multiplexed imaging assays allow simultaneous quantification of multiple protein and phosphorylation markers, providing a static snapshots of cell types and states. Pseudo-time techniques can transform these static snapshots of unsynchronized cells into dynamic trajectories, enabling the study of dynamic processes such as development trajectories and the cell cycle. Such ordering also enables training of mathematical models on these data, but technical challenges have hitherto made it difficult to integrate multiple experimental conditions, limiting the predictive power and insights these models can generate. In this work, we propose data processing and model training approaches for integrating multiplexed, multi-condition immunofluorescence data with mathematical modelling. We devise training strategies for mathematical models that are applicable to datasets where cells exhibit oscillatory as well as arrested dynamics and use them to train a cell cycle model on a dataset of MCF-10A mammary epithelial exposed to cell-cycle arresting small molecules. We validate the model by investigating predicted growth factor sensitivities and responses to inhibitors of cells at different initial conditions. We anticipate that our framework will generalise to other highly multiplexed measurement techniques such as mass-cytometry, rendering larger bodies of data accessible to dynamic modelling and paving the way to deeper biological insights.
29. Clinical application of a custom-made simple subcutaneous negative pressure drainage device for the treatment of SSI after abdominal surgery. A randomized controlled trial.
期刊: International journal of surgery (London, England) 发表日期: 2025-Oct-07 链接: PubMed
摘要
The current gold standard for managing surgical site infections (SSIs) is the vacuum-assisted closure (VAC) technique, also known as vacuum sealing drainage (VSD). However, its high cost and technical complexity necessitate specialized health care personnel for proper application and monitoring, thereby limiting its widespread clinical adoption. Building on the theoretical framework and mechanistic principles of VSD systems, we developed a simplified subcutaneous negative pressure drainage device and conducted a preliminary evaluation of its clinical efficacy and potential for broader implementation. To evaluate the clinical efficacy of a novel, custom-designed simplified subcutaneous negative pressure drainage device for the treatment of SSIs following abdominal surgery. A total of 85 patients who were diagnosed with postoperative incisional infections following abdominal surgery between August 2022 and November 2024 were enrolled as study participants. These patients were randomly allocated using a computer-generated randomization sequence into either a standard care group or an intervention group. The standard care group received standard wound care, including conventional dressing changes, whereas the intervention group was treated with a custom-designed simplified subcutaneous negative pressure drainage device. The primary endpoint was wound healing status. The secondary endpoints included the wound healing time, frequency of dressing changes, cost of wound care, duration of antibiotic therapy, length of hospital stay, serum C-reactive protein (CRP) and interleukin-6 (IL-6) levels, and patient satisfaction scores. Compared with the standard care group, the intervention group demonstrated superior wound healing outcomes (P < 0.001). Furthermore, the intervention group demonstrated significantly shorter wound healing times, fewer dressing changes, lower wound care costs, a shorter duration of antibiotic use, and shorter hospital stays than did the standard care group (all P < 0.001). Posttreatment CRP and IL-6 levels were significantly lower in both groups (P < 0.001). Patient satisfaction scores were also significantly higher in the intervention group than in the standard care group (P < 0.001). The custom-designed, simple subcutaneous negative pressure drainage device effectively improves the healing of infected wounds after abdominal surgery. It shortens the duration of antibiotic therapy and hospital stay while reducing overall treatment costs. This device demonstrates satisfactory therapeutic efficacy and holds strong potential for widespread clinical application and promotion.
30. Benzodeazaoxaflavin Sirtuin Inhibitors Inhibit Schistosoma mansoni Sirt2 and Cause Phenotypic Changes and Lethality in Schistosomula and Adult Worm Stages.
期刊: ACS infectious diseases 发表日期: 2025-Oct-07 链接: PubMed
摘要
Schistosomiasis, a neglected tropical disease caused by trematodes of Schistosoma genus, urgently requires new treatments due to praziquantel’s limited efficacy against juvenile worms as well as the threat of drug resistance. In this study, we evaluated a series of benzodeazaoxaflavin (BDF4)-based compounds as inhibitors of the parasite’s epigenetic enzyme SmSirt2. Three compounds, 7-9 (MC2346, MC2141, and MC2345), showed activity against both Liberian and Puerto Rican strains of Schistosoma mansoni. The compounds reduced schistosomula and adult worm pair viability, pairing, and egg production, with low cytotoxicity in mammalian cells. These effects were linked to histone H3 hyperacetylation and cytochrome c-mediated apoptosis, confirming SmSirt2 as a functional target. These findings support the development of SmSirt2 inhibitors as novel antischistosomal agents with therapeutic potential for both curative and preventive applications. Further in vivo studies are warranted to assess their pharmacokinetic and safety profiles.
31. Precision Nutritional Genomics, Gut Microbiota and Artificial Intelligence in Chronic Kidney Disease.
期刊: Journal of the American Nutrition Association 发表日期: 2025-Oct-07 链接: PubMed
摘要
Chronic kidney disease (CKD) is a prevalent global health issue, and nutritional management of CKD is an integral component through all stages of the disease. However, response to dietary interventions varies, potentially due to genetic variations influencing metabolic pathways. This review highlights key gene-diet interactions relevant to CKD management, including risk factors and comorbidities such as hypertension, diabetes, and proteinuria. Variants in the ACE gene influence salt sensitivity and blood pressure responses, while TCF7L2 polymorphisms affect the relationship between dietary glycemic load and diabetes risk, impacting kidney complications. Protein intake, a key modifier of CKD, correlates with proteinuria risk, moderated by a PPM1K polymorphism. Dietary bioactives, such as caffeine, may also alter the progression rate of proteinuria and hypertension, with effects contingent upon CYP1A2 genotype. Additional markers of cardiovascular disease, CKD-associated bone-mineral disease, and CKD anemia are also discussed as well as role of the gut microbiome in nutrition modulation and vice versa. The review concludes with the potential of artificial intelligence as a clinical tool to refine precision nutrition, enabling clinicians to adopt targeted approaches, stratified by genetic-metabolic patient profiles that match best nutritional interventions for prevention and management of CKD. Vitamin D is used as a model nutrient to illustrate a simulated framework for precision nutrition, incorporating molecular mechanisms, genetic variation, epigenetic modifications, and translational tools applicable to both population health and clinical practice. Nutritional management is critical in CKD, but individual responses vary, partly due to genetic and metabolic differences.Gene–diet interactions influence key risk factors and comorbidities, including hypertension, diabetes, proteinuria, and cardiovascular complications.Specific nutrients and dietary bioactives (protein, caffeine, vitamin D) interact with genetic variation to affect CKD progression.The gut microbiome and molecular pathways (genetic, epigenetic) further shape nutrition’s role in CKD.Emerging tools such as artificial intelligence offer opportunities to implement precision nutrition approaches in clinical care.
32. Efficacy and safety of pyrotinib in patients with previously treated HER2-positive non-breast solid tumors: a phase 2, open-label basket trial.
期刊: The oncologist 发表日期: 2025-Oct-07 链接: PubMed
摘要
Amplification/overexpression of the human epidermal growth factor receptor 2 (HER2) gene drives cell proliferation, differentiation, and migration of breast cancer. However, HER2-targeted therapies are not standard treatment for HER2-positive non-breast solid tumors currently. This phase II open-label basket trial evaluated pyrotinib’s efficacy and safety in patients with non-breast solid tumors. Patients with previously treated HER2-positive advanced non-breast solid tumors were enrolled at Zhongshan Hospital, Fudan University. All participants received pyrotinib in 21-day cycles. Primary endpoint was objective response rate (ORR) at 6 weeks, assessed per RECIST version 1.1. Circulating tumor DNA (ctDNA) analysis was conducted to identify biomarkers of efficiacy. Fifty-three patients were enrolled and 51 evaluable for efficiacy analysis. The median follow-up was 32.2 months. ORR was 18.9% (95% CI: 10.2-31.7%) and disease control rate was 73.6% (95% CI: 60.1-84.2%). Median progression-free survival (mPFS) was 5.1 (95% CI: 4.2-8.1) months and median overall survival (mOS) was 17.2 (95% CI: 16.2-33.2) months. Patients with colorectal cancer had the highest ORR and the longest mOS (33.2 months, 95% CI: 14.9-51.5). Among patients with HER2 overexpression, those with immunohistochemistry 3+ had longer mPFS and mOS. Sixteen patients required dose reductions due to grade 3 adverse events (AEs); no ≥grade 4 AEs occurred. Analysis of ctDNA revealed that patients with progression disease (PD) had higher mutation frequency, more diverse mutational profiles, and higher copy number burden. Pyrotinib demonstrated a favorable safety profile and modest efficacy in patients with previously treated HER2-positive advanced non-breast solid tumors.
33. Retrospective Evaluation of Cryoprecipitate Transfusion in Dogs to Prevent or Treat Hemorrhage: 21 Cases (2009-2023).
期刊: Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) 发表日期: 2025-Oct-07 链接: PubMed
摘要
To report homologous cryoprecipitate transfusions in dogs with hemostatic disorders, hemorrhage, or risk of hemorrhage, and to report adverse reactions associated with these cryoprecipitate transfusions. Retrospective case series (July 2009 to July 2023). University teaching hospital. Twenty-one client-owned dogs with hemostatic disorders, hemorrhage, or risk of procedure-related hemorrhage. None. All dogs received homologous cryoprecipitate transfusion. Sixteen dogs had von Willebrand disease (one also had factor XI deficiency); three dogs had hemophilia A; and two dogs had normal concentration of von Willebrand factor and were not diagnosed with any hemostatic disorder. Sixteen dogs also received other blood products and/or hemostatic medications. Twenty-two cryoprecipitate transfusions were administered to 16 dogs before, during, or after surgery; 16 of those 22 transfusions were given to 14 dogs without evidence of hemorrhage but with history of bleeding disorder and/or previous hemorrhage with the aim of preventing hemorrhage. Eight transfusions were given to six dogs to control hemorrhage not associated with surgery. Sixteen dogs (18 transfusions) received cryoprecipitate prepared in-house. Five dogs (12 transfusions) received a commercial lyophilized cryoprecipitate. No dog developed any serious adverse reactions to cryoprecipitate transfusion. All dogs were discharged from the hospital (median, 2 days after cryoprecipitate transfusion [range, 1-25 days]). The benefits of cryoprecipitate transfusion could not be well documented because of the retrospective nature of this study and the concurrent administration of other blood products and/or hemostatic medications to 16 dogs. Homologous cryoprecipitate transfusion appeared to be safe when administered for prevention or treatment of hemorrhage in dogs, but additional studies to assess safety and efficacy are warranted.
34. Designing a multidimensional vulnerability index for supervising dengue cases from 2015 to 2020 in a low/middle-income country: A spatial principal component analysis.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Oct-07 链接: PubMed
摘要
Dengue is one of the most prevalent infectious diseases worldwide, affecting around 390 million people each year. Previous studies have reported that social, climatic, and government-related conditions can increase the frequency of dengue events in some territories. This study aimed to design a multidimensional vulnerability index encompassing social, climatic, and government-related factors associated with dengue and correlate this index with dengue incidence in Colombia between 2015 and 2020. Observational, ecological, longitudinal study conducted from 2015 to 2020. Based on administrative data from state sources such as the Ministry of Health, the National Administrative Department of Statistics (DANE), the National Planning Department (DNP), and other sources, a principal component analysis was performed to design the multidimensional vulnerability index. Data from 1099 municipalities over the six-year analysis period were included. The index comprised five main factors: climatic factors, basic service coverage, precipitation-related factors, municipal performance, and transparency in social development. The proposed index showed a mean vulnerability of 0.48 (median = 0.48; SD = 0.15; IQR: 0.36-0.59). Higher index values were found in the southwestern territories and the Amazon regions of Colombia, as well as some municipalities in the Caribbean region. These territories exhibited the highest levels of poverty, regional access to services, precipitation, and temperature. Spatial analyses confirmed this concordance. The nonlinear association between the MVI and dengue incidence suggests threshold effects, in which municipalities with MVI scores above 0.8 have higher levels of dengue morbidity. The proposed index showed a suitable correlation with dengue case frequency at a regional level and could be extended to other countries for the development of dengue outbreak prevention campaigns.
35. Effect of Industrial Hemp (Cannabis sativa) Supplementation on Rumination Behaviour, Plasma Antioxidant Enzymes and Stress Biomarkers in Angus Cattle.
期刊: Journal of animal physiology and animal nutrition 发表日期: 2025-Oct-07 链接: PubMed
摘要
Oxidative stress is known to affect the behaviour, performance and well-being of cattle. The objective of this study was to determine the effect of industrial hemp (IH) supplementation on rumination behaviour, stress biomarkers and antioxidant enzymes in Angus cattle. A total of 20 black Angus heifers were completely randomized into either control (CON) (receiving commercial concentrates) or IH (150 g of IH/kg of commercial concentrates) in a trial that lasted for 35 days with IH supplementation for 21 days and 14 days post-supplementation. Rumination behaviour (rumination time, ruminal pH, temperature and water intake) was recorded with smaXtec bolus, plasma antioxidants (total antioxidant activity [TAA], superoxide dismutase [SOD], glutathione peroxidase [Gpx], catalase [CAT], nitric oxide [NO], malondialdehyde [MDA]) and stress biomarkers (cortisol and heat shock proteins) were analyzed. Results showed that IH supplementation decreased water intake with an average consumption of 51.39 L/day in the IH group and 55.09 L/day in the CON. No significant (p = 0.67) difference was observed in the ruminal pH and rumination time (p = 0.58) of the animals. The TAA increased from 7.26 to 17.95 U/mL in the IH group during supplementation but decreased to 11.48 U/mL post-supplementation. GPx was significantly (p = 0.0023) higher in IH (46.47 mmol/L) than in CON (44.01 mmol/L) group. Similar results were observed with NO. MDA was significantly (p < 0.05) higher in the CON compared to the IH group. Cortisol was significantly (p = 0.03) lower in the IH group (97.54 ng/mL) than CON (122.23 ng/mL). No significant (p < 0.05) difference was observed for heat shock proteins 70 and 72. Conclusively, IH improved rumination behaviour in cattle by maintaining optimum rumen pH. Furthermore, IH increased the antioxidant status as well as the reduction of oxidative stress biomarkers, suggesting that IH supplementation could improve the health and welfare of Angus cattle.
36. Hormonal contraceptives and the risk of meningioma: a Swedish register-based case-control study.
期刊: Neuro-oncology 发表日期: 2025-Oct-07 链接: PubMed
摘要
Studies of hormonal contraceptives and the risk of meningioma has often relied on self-reported information, primarily focusing on oral contraceptives. Recently, an association between progestins and meningioma was suggested. We aimed to analyze the association between hormonal contraceptives and meningioma using data from Swedish national registries. We used the Swedish Cancer Register to identify women born 1955-1995, diagnosed with meningioma at age ≥20 years, between 2007 and 2015 (N=1055). Twenty controls per case were randomly selected from the Swedish population register, matched by birthyear and county of residence. We retrieved information regarding prescriptions of hormonal contraceptives from the National Prescribed Drugs Register. Adjusted conditional logistic regression models were used to evaluate the association between hormonal contraceptive use and meningioma occurrence. Women prescribed hormonal contraceptives ≥1 year before the index date had an odds ratio (OR) of meningioma of 1.76 (95% CI 1.53-2.03). For contraceptives containing medroxyprogesterone the OR was 5.49 (95% CI 4.51-6.67), while the association was weaker for other progesterone contraceptives (OR = 1.34, 95% CI 1.09-1.65). No association was found for intrauterine devices, vaginal rings, and subdermal implants. This large register-based case-control study show a strong association between injectable hormonal contraceptives containing medroxyprogesterone and meningioma risk. The results add to the growing body of evidence of an association between meningiomas and progestins in general and the strong, consistent associations suggest a causal role of injectable medroxyprogesterone in meningioma growth. Our results correspond to two additional cases of meningioma per 10 000 women exposed to medroxyprogesterone per year.
37. Early life oxidant pollutant exposure induces lung redox and RAAS dysregulation: Implications for innate immune responses.
期刊: American journal of physiology. Lung cellular and molecular physiology 发表日期: 2025-Oct-07 链接: PubMed
摘要
The potential for early life air pollutant exposure to result in later onset respiratory disease in children and adults is an emerging public health concern. Fetal-growth-restriction (FGR) and childhood res-piratory infections are associated with impaired lung function in adulthood, and later in life, death from COPD. We previously showed that early gestational exposure of rats to the oxidant air pollutant, ozone, resulted in asymmetrical FGR and lung developmental delays. Herein, we investigate effects of early ges-tational, peri-adolescent, and combined ozone exposure on offspring health, lung injury, antioxidant reserve, and innate immune responses. Results revealed similar ozone effects in all offspring irrespective of exposure timing in terms of minor weight loss, reduced body temperature (1.5-2.0˚C), and moderate lung injury. Lung injury was inversely correlated with lung antioxidant capacity. Progeny of ozone-exposed dams (i.e., FGR-prone offspring) showed greater variability in ventilatory responses (EF50, Penh) and increased Penh correlated with greater lung injury. FGR-prone offspring had more variable, often blunted immuno-inflammatory responses to subsequent ozone exposure. Enhanced expression for an-tioxidant (Nrf2-related or ARE) genes were observed in FGR-prone males, whereas decreased expression for hypoxia (Hif-related or HRE) and RAAS genes (Ace, Agtr1, Ace2) were observed in FGR-prone females, potentially suggesting that cross-talk between redox transcription factors, Hif/RAAS, NFκB, and Nrf2 led to differential responses. Collectively, these findings indicate that early life oxidant air pollutant exposure and resultant redox and RAAS dysregulation may impact both lung development and innate immune responses in a sex-dependent manner, effects that may increase vulnerability to respiratory infections.
38. Maternal Smoking and CC-16: Implications for Lung Development and COPD Across the Lifespan.
期刊: American journal of respiratory and critical care medicine 发表日期: 2025-Oct-07 链接: PubMed
摘要
Early-life lung function trajectories predict long-term respiratory health, including COPD risk. Club Cell protein 16 (CC16) is a key determinant of lung health, with low levels associated with impaired lung development, reduced lung function, and COPD. Cigarette smoking lowers CC16, but it is unknown whether maternal smoking leads to persistent CC16 deficiency from early life, thereby disrupting lung development and predisposing to COPD risk and progression Methods: CC16 expression was analyzed across 4 human cohorts, in plasma samples (COPDGene [n=1,062] and ECLIPSE [n=2,164]), nasal brushings (ALLIANCE [n=63]), and peripheral lung sections (LTRC [n=44]) from participants with and without a history of maternal smoking exposure. Lung histology and respiratory mechanics were assessed in WT and Cc16-/- mice with and without maternal smoking exposure. Recombinant human (rh)CC16 effects on lung maturation were assessed in embryonic murine lung explants. Maternal smoking was linked to reduced circulating and airway CC16 in COPD patients, controls, and a preclinical murine COPD model. In human adults, lower CC16 correlated with accelerated lung function decline and emphysema progression, while in children it was associated with obstructive physiology and early small airway impairment. In both mice and humans, maternal smoking-induced CC16 reduction was accompanied by greater epithelial injury (fibrosis, inflammation, apoptosis, oxidative stress). In murine explants, smoking impaired lung branching, whereas rhCC16 restored branching via α2-integrin binding Conclusions: Maternal smoking reduces CC16 levels, disrupting lung development in ways that predispose to lifelong impairment of lung function and worse COPD outcomes. Defining the mechanisms by which CC16 regulates lung maturation is essential for establishing reliable outcome measures and designing trials aimed at preventing early COPD. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).
39. Litigation following Traumatic Brain Injury-what are the challenges and what can we do?
期刊: International journal for quality in health care : journal of the International Society for Quality in Health Care 发表日期: 2025-Oct-07 链接: PubMed
摘要
40. Exploring the association between metacognition, personality traits and dispositional resilience among firefighters; A pilot study.
期刊: Work (Reading, Mass.) 发表日期: 2025-Oct-07 链接: PubMed
摘要
BackgroundFirefighters are the first responders who are actively involved in emergency mitigation and rescue. It is critical to explore and evaluate the mental health variables among the firefighters as they are dealing with extreme stressors and make critical decisions during emergencies.ObjectiveThis study was aimed at exploring the association between the cognitive resource named metacognition and personal resources such as personality traits and dispositional resilience among the firefighters.MethodsA total of 103 firefighters in India were participated in this pilot study. Data were collected from the participants in the month of March 2024 via standardized measures. Data were analysed using SPSS software. Descriptive statistics, Spearman’s correlation and regression analyses were used in the study.ResultsThe results revealed that metacognition positively predicts dispositional resilience (β = 0.429, t = 4.77, p < 0.001). Additionally, Metacognition was positively associated with the personality trait of conscientiousness (β = 0.346, t = 3.710, p < 0.001). More importantly, study revealed that the variables metacognition (β = .228) and conscientiousness (β = .350) collectively predicted the dispositional resilience (F (2, 100) = 14.95, p < .001, R2 = 0.23).ConclusionFindings of this study imply that a higher level of metacognitive awareness and skills, along with conscientiousness may help the firefighters to build greater resilience in the face of occupational challenges. These findings underscore the significance of enhancing metacognitive skills and personality traits through efficacious interventions within the firefighting community for ensuring professional well-being and resilience.
41. Does Working in Shifts Matter? A Comparative Study of Occupational Balance and Health Promoting Lifestyle Profile in Healthcare Workers.
期刊: Journal of occupational and environmental medicine 发表日期: 2025-Oct-07 链接: PubMed
摘要
Objective: This study aimed to examine the impact of shift work on occupational balance and health-promoting lifestyle profile among healthcare workers.Methods: The study included 248 healthcare professionals working in public hospitals. Participants were divided equally into shift and non-shift work groups. Data were collected using a demographic information form, the Occupational Balance Questionnaire (OBQ), and the Health-Promoting Lifestyle Profile II (HPLP II).Results: Non-shift workers reported higher OBQ scores and higher scores in the spiritual growth, stress management dimensions, and total score of the HPLP II scale compared to shift workers. Work schedule was a significant predictor of occupational balance. Demographic differences such as age, gender, marital status, work experience, and income-expenditure balance varied between groups.Conclusions: Shift work negatively affects occupational balance and certain dimensions of health-promoting lifestyle profile in healthcare workers.
42. Discovery of Thiazole-5-Carboxamide Derivatives Containing Diphenyl Ether Fragments as Potential Succinate Dehydrogenase Inhibitors.
期刊: Journal of agricultural and food chemistry 发表日期: 2025-Oct-07 链接: PubMed
摘要
Succinate dehydrogenase inhibitors (SDHIs) have become one of the fastest-growing categories in the fungicide market and are widely utilized for crop protection in agricultural production. Currently, guided by the imperative of cost reduction and efficiency enhancement, the replacement of biphenyl fragments in SDHIs with cost-effective diphenyl ether fragments has emerged as an innovative strategy for developing novel, highly efficient, and broad-spectrum fungicides. Based on the above structural features, 45 thiazole-5-carboxamide derivatives containing diphenyl ether fragments (potentially targeting fungal SDH) were designed and evaluated for their antifungal effects against Rhizoctonia solani, Sclerotinia sclerotiorum, Alternaria alternata, and Alternaria solani. Notably, the in vitro EC50 value of compound IIIe against R. solani was 0.009 mg/L, exhibiting significantly greater potency than thifluzamide (0.039 mg/L), boscalid (1.849 mg/L), fluxapyroxad (0.049 mg/L), and carboxin (0.146 mg/L), and proving comparable to that of the novel SDHIs fungicide flubeneteram (0.008 mg/L). Concurrently, compound IIIe demonstrated high efficacy in controlling rice sheath blight through detached leaf and pot experiments. Further investigations into fungal SDH inhibition, respiratory suppression, mitochondrial membrane potential detection, molecular docking, cell cytotoxicity, scanning electron microscopy, and transmission electron microscopy analysis confirmed the practical value of compound IIIe as a potential SDHI. The present results provide an indispensable complement for the structural optimization of antifungal leads to the targeting of SDH.
43. Effect of Aspirin Versus Low-Molecular-Weight Heparin for Thromboprophylaxis in High-Risk and Fracture Location Subpopulations: A Secondary Analysis of the PREVENT CLOT Trial.
期刊: Journal of orthopaedic trauma 发表日期: 2025-Oct-06 链接: PubMed
摘要
To compare the effectiveness and safety of aspirin versus low-molecular-weight heparin (LMWH) for thromboprophylaxis in 11 high-risk or fracture location subpopulations. Design: A post-hoc secondary analysis of the published PREVENT CLOT trial. 21 trauma centers. Adult patients with an operatively treated extremity fracture or any pelvic or acetabular fracture were enrolled from April 2017 through August 2021. Patients with only hand or foot fractures, presenting >48 hours after injury, or with a history of VTE within 6 months of injury were excluded. The 11 subpopulations included i) a head injury, ii) an abdominal injury, iii) a spinal injury, iv) a thoracic injury, v) multiply injured patients, vi) obesity, vii) previous VTE ≥ 6 months, viii) isolated upper extremity fracture, ix) isolated lower extremity fracture, x) isolated pelvic or acetabular fracture, and xi) geriatric femur fracture. The primary outcome was 90-day all-cause mortality. Secondary outcomes included non-fatal pulmonary embolism, proximal deep vein thrombosis (DVT), distal DVT, and bleeding events. Outcomes were assessed using Kaplan-Meier estimators and Cox proportional hazards models comparing 81 mg of aspirin versus 30 mg of LMWH twice daily. The threshold for statistical significance was a Bonferroni-corrected alpha of 0.001 to account for multiple comparisons. The largest subpopulations were isolated lower extremity fractures (n=6,289), obesity (n=4,234), and polytrauma with Injury Severity Score (ISS) >16 (n=1,596). No comparison of aspirin vs LMWH within the 11 subpopulations for the 5 outcomes reached the corrected threshold for statistical significance of P < 0.001. However, 5 comparisons of aspirin vs LMWH were less than the conventional P-value of 0.05. Specifically, the aspirin group demonstrated lower mortality in patients with a head injury (difference, -3.2%; 95% CI -6.1% to -0.3%; P = 0.03) or a spine injury (difference, -6.0%; 95% CI -11.7% to -0.3%; P = 0.04) than the LMWH group. The LMWH group demonstrated a lower rate of distal DVTs for patients with a head injury (difference, 4.4%; 95% CI, 0.8% to 8.1%; P = 0.03), thoracic injury (difference, 1.5%; 95% CI, 0.0% to 2.9%; P=0.034) or with ISS >16 (difference, 1.7%; 95% CI, 0.2% to 3.3; P = 0.03) than the aspirin group. Within 11 high-risk or fracture location-specific subpopulations, there were no statistically significant differences between aspirin or LMWH in the 90-day rates of all-cause mortality, non-fatal PE, proximal DVT, distal DVT, or bleeding complications at a threshold corrected for multiple comparisons (P < 0.001). Therapeutic Level I.
44. Behçet Disease Uveitis: Insights into Epigenetic and Environmental Factors, Retinal Imaging, and Treatment.
期刊: Ocular immunology and inflammation 发表日期: 2025-Oct 链接: PubMed
摘要
45. Comparison of Outcomes Between Modular Dual Mobility and Conventional Hip Implants in Primary, Elective Total Hip Arthroplasty.
期刊: Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews 发表日期: 2025-Oct-01 链接: PubMed
摘要
Modular dual mobility designs (MDM) are designed to reduce the risk of postoperative dislocations following primary total hip arthroplasty (THA). This study investigated both the usage and outcomes (ie, patient-reported outcomes and complications) associated with MDM hips compared with conventional implant designs. Patients who underwent a THA at a single, tertiary, orthopaedic specialty hospital between January 2019 and June 2022 were included. Primary outcomes of interest were compared between MDM and conventional hip designs and included complication rates, dislocation rates, clinical outcomes, and the hip disability and osteoarthritis outcome score for joint replacement (HOOS, JR). A total of 2869 patients (88% conventional THA) were included in this study. Modular dual mobility hip utilization increased 117% during the study period. Patients in the MDM group were often older females (P < 0.001) with concomitant lumbar pathology (P = 0.034). None of the MDM hips dislocated in the first 30 days post THA compared with 0.4% of the conventional hips. Despite markedly lower hip disability and osteoarthritis outcome score for joint replacement scores in the MDM group, the number of patients reaching the minimally clinically important difference was similar (P = 0.915). MDM patients experience lower rates of dislocation compared with those receiving conventional implants. Despite worse clinical outcomes and increased all-cause emergency department utilization in the MDM group, multivariate regression suggests that these outcomes were associated with the implant being used in an older, sicker population instead of the implant itself. The results suggest similar overall outcomes and a lower dislocation rate for patients who received an MDM hip.
46. The Fallacy of Person-Centred Care: Deconstructing the Discourse to Reimagine Practice.
期刊: Nursing philosophy : an international journal for healthcare professionals 发表日期: 2025-Oct 链接: PubMed
摘要
Person-centred care dominates today’s sociopolitical landscape, influencing the approach and conduct of healthcare institutions, organisations and practices. It seeks to elevate and transcend former biomedical models by centralising a person’s needs, preferences and values in the care process. Positioned as the ‘gold standard’ approach, person-centred care has become a central attribute in shaping professional identities and public discourse, influencing the ethos, attitudes and behaviours of healthcare professionals. Despite its dogmatic prominence in policy and professional discourse, there are entrenched bureaucratic structures, organisational barriers and conflicting agendas that impede professional efforts to uphold patient agency and autonomy; this has resulted in inconsistencies in its understanding and implementation. Furthermore, the framework itself fails to empower healthcare professionals to challenge practice when it is felt that person-centred principles are compromised, rendering it little more than a rhetorical device used to promote self-interest, enhance professional status and power. Given this fallacy, this critique contends that person-centred care is effectively ‘dead’; its demise regrettably orchestrated at the hands of those entrusted to deliver it. In line with a Derridean deconstructive approach, we also provocatively question whether the very concept was ever ‘alive’ to begin with and whose interest it ultimately served. While its demise may signal time for a paradigmatic shift, it also presents an opportunity to reimagine healthcare practice in a manner that aligns with a more authentic approach. Inspired by Nietzsche’s concept of the Übermensch (‘Over-man’), we propose a vision of the ‘Über-professional’, whose ‘Will to Power’ transcends institutional constraints and conventional practices. By embracing authenticity, the Über-professional model offers both opportunity and ‘permission’ for adoptees to recognise and resist practices when these conflict with the provision of care. It therefore empowers them to ensure that all voices are heard, preferences are respected and the interests of patients are fully represented in all care decisions.
47. Identification of five sleep-biopsychosocial profiles with specific neural signatures linking sleep variability with health, cognition, and lifestyle factors.
期刊: PLoS biology 发表日期: 2025-Oct 链接: PubMed
摘要
Sleep is essential for optimal functioning and health. Interconnected to multiple biological, psychological, and socio-environmental factors (i.e., biopsychosocial factors), the multidimensional nature of sleep is rarely capitalized on in research. Here, we deployed a data-driven approach to identify sleep-biopsychosocial profiles that linked self-reported sleep patterns to inter-individual variability in health, cognition, and lifestyle factors in 770 healthy young adults. We uncovered five profiles, including two profiles reflecting general psychopathology associated with either reports of general poor sleep or an absence of sleep complaints (i.e., sleep resilience), respectively. The three other profiles were driven by the use of sleep aids and social satisfaction, sleep duration, and cognitive performance, and sleep disturbance linked to cognition and mental health. Furthermore, identified sleep-biopsychosocial profiles displayed unique patterns of brain network organization. In particular, somatomotor network connectivity alterations were involved in the relationships between sleep and biopsychosocial factors. These profiles can potentially untangle the interplay between individuals’ variability in sleep, health, cognition, and lifestyle-equipping research and clinical settings to better support individual’s well-being.
48. Risk of major depression in partners of people with Alzheimer's disease: a national cohort study.
期刊: Age and ageing 发表日期: 2025-Aug-29 链接: PubMed
摘要
Alzheimer’s disease (AD) may cause significant psychosocial distress not only in the patient but also their partner. However, long-term risks of major depression in partners of AD patients are largely unknown. A national cohort study was conducted of all 145 289 partners of people diagnosed with all-cause dementia, including 57 113 partners of people diagnosed with AD, in Sweden during 1998-2017, and 1 300 561 population-based controls. Cox regression was used to compute hazard ratios (HRs) for subsequent risk of major depression identified from nationwide outpatient and inpatient diagnoses through 2018, adjusting for sociodemographic factors and prior mental disorders. The 10-year cumulative incidence of major depression was 5.4% in partners of people with AD, 5.6% in partners of people with all-cause dementia, and 3.9% in controls. The adjusted relative rate of major depression was increased ~1.5-fold in partners of people with AD (HR, 1.53; 95% CI, 1.35-1.72) or all-cause dementia (1.45; 1.34-1.57), compared with controls. These risks were elevated among both women (AD: HR, 1.41; 95% CI, 1.22-1.64; all-cause dementia: 1.36; 1.24-1.50) and men (AD: 1.81; 1.46-2.25; all-cause dementia: 1.73; 1.48-2.01). Risks remained significantly elevated ≥3 years later in both women (1.3- to 1.5-fold) and men (1.5-fold). Risks were generally highest in partners aged ≥85 years. In this large national cohort, partners of people diagnosed with AD or all-cause dementia had ~1.5-fold risks of major depression, which remained elevated several years later. Partners of people with dementia need psychosocial support and long-term follow-up for timely detection and treatment of depression.
49. Longitudinal idiographic assessment of adolescent-dog relationships and adaptive coping for youth with social anxiety: The Teen & Dog Study protocol.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The Teen & Dog Study is a longitudinal research project aimed at understanding the impact of youth-dog relationships on youth coping with social anxiety. The study will follow 514 United States adolescents (ages 13-17) with high social anxiety who live with dogs and their families, collecting longitudinal assessments of their physiological, emotional, and social well-being. With a focus on identifying the mechanisms by which youth-dog interactions may support adaptive coping, the study has three primary aims: (1) assess how the youth-dog relationship contributes to coping with social anxiety over time, factoring in individual, family, and peer influences; (2) investigate family-level processes that enhance youth-dog relationships and identify barriers to optimization; and (3) examine how dog interactions influence adolescents’ physiological responses, particularly in relation to anxiety. The study integrates quantitative and qualitative data, including surveys, interviews, ecological momentary activity, and continuous physiological monitoring, to assess strategies for optimizing youth-dog interactions in the context of social anxiety. This paper outlines the study protocol and presents characteristics of the study sample at baseline. Ultimately, the Teen & Dog Study seeks to inform interventions that harness the benefits of youth-dog relationships to improve mental health outcomes.
50. FIB-4: A screening tool for advanced liver fibrosis in a cohort of subjects participating in a primary care weight-loss program.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Systematic screening for liver fibrosis using FIB-4 score is recommended in primary care for patients with chronic liver disease risk factors. This study assesses the prevalence and characteristics of patients at risk for advanced fibrosis in a weight loss program. This multicenter retrospective cohort study includes obese and overweight subjects participating in a weight loss program across 110 French centers. 34 510 participants with baseline FIB-4 available were included, predominantly women (78.3%), median age of 54 years, 70% obese. Baseline FIB-4 values were <1.3, 1.3-2.67 or >2.67 in 80.9%, 18.1% and 1% of the participants, respectively. When moving from the lower risk category (<1.3) to the highest (>2.67), the rates of metabolic comorbidities such as diabetes rose (from 3.2% to 13.3%). After 5 (3-7) months, all anthropometric parameters improved. A follow-up FIB-4 value was available in 20.7% participants. Among high-risk, 43% changed classes, 4.6% moving to the lower risk-category.
51. Sources of successful participant engagement in a public health research study: A focus on a Latino community.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Latino populations remain vastly underrepresented in clinical and translational research. This study aims to characterize the most common sources of successful participant engagement within our sample. Between February 2022 and March 2023, research staff systematically recorded how participants learned about an ongoing study (which we term source of successful participant engagement) designed to co-create and implement a COVID-19 testing program in a U.S./Mexico border community. Demographic characteristics were correlated with each source of participant engagement at the univariate level using a chi-squared test and, if significant, were included in a multinomial logistic regression model to determine the association between participant characteristics and source of participant engagement. A total of 2836 individuals responded to questions regarding source of participant engagement; the most common responses were: Word of Mouth (32%), Clinic/Provider referral (32%), and Walk Up to the testing site (21%). Males were 35% less likely than female participants to report having heard of the study through their Clinic/Provider compared to Walk Up (p < .01). Participants <18 years of age were 2.78 times as likely compared to individuals >54 years of age to have learned about the study through Word of Mouth compared to Walk Up (p < .01). Compared to Walk Up, participants who lived outside San Ysidro were 2.36 times more likely to be recruited through their Clinic/Provider (p < .01) and 2.11 times more likely through Word of Mouth (p < .01), compared those in San Ysidro. Education and clinical symptoms were not significantly associated with engagement source. Advancing our understanding of sources of successful participant engagement in marginalized communities is necessary to increase equitable participation in clinical and translational research.
52. Effectiveness and theory-based evaluation of a personalised digital intervention (EviBody®) for healthy and sustained lifestyle behaviours and well-being among adults: Study protocol for a real-world quasi-experimental study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Digital interventions offering behaviour change support are warranted to prevent and treat non-communicable diseases, and have been evaluated rigorously in controlled settings. Effectivenss, factors influencing the uptake of scaled-up interventions-such as reach, received dose, usability and acceptability- and predictors and mediators of efficiency are rarely explored in research. The study described herein aims to evaluate the effectiveness of a personally tailored digital intervention (the app EviBody®), intended to support healthy and sustained lifestyle behaviours among the adult population, on well-being and behaviour change. Further aims are to explore context and uptake factors, predictors and mediators for behaviour change over 24 months. This is a real-world study, employing a quasi-experimental design and a process evaluation. EviBody® will be marketed and managed by its owner. A four-armed design will allow for comparison between three levels of intervention (basic, standard and premium) and a control group. Adults who sign up for the app will be invited to the research study including sharing app data and answering questionnaires at 0, 1, 3, 6, 12, 18, and 24 months. Study start is Autumn 2025. Controls (n = 200 to evaluate the primary endpoint well-being at 6 months) will be recruited through advertisements on social media and asked to answer the same questionnaires at 0 and 6 months provided by email. For predicting and mediating analyses the intention is to recruit 1500 app users. Well-being (measured with the WHO-5 Well-Being Index), goal achievement, physical activity, eating habits, mental health, mediators (motivation, self-efficacy, and perceived barriers), and demographics will be self-reported. Uptake will be collected using analytics and ratings of usability and acceptability, and described by demographics. Mixed models for repeated measures and structural equation modelling will be employed for data analysis. Besides evaluating the effectivenss of a digital intervention, this study also applies a theory-based evaluation to understand which mediators are effective, for whom they are effective, and the specific conditions under which they are most beneficial. ClinicalTrials.gov, ID: NCT05973383 on 8 July 2023.
53. Utilization of varenicline among Kansas Medicaid enrollees.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Smoking prevalence among Medicaid beneficiaries is twice that of privately insured adults, yet effective smoking cessation treatments remain underutilized. Understanding varenicline use, the most effective smoking cessation medication, can inform efforts to improve tobacco treatment for Medicaid enrollees. To describe varenicline utilization among Kansas Medicaid (KanCare) enrollees from 2014-2021, including changes related to the FDA’s December 2016 removal of the black box warning, and explore changes and demographic differences in its use. This retrospective cohort study analyzed pharmacy claims data for varenicline utilization from January 1, 2014, to December 31, 2021. Tobacco use was estimated from the KanCare External Quality Review survey. The sample included 78,295 new adult enrollees (age 18+) with at least 11 months of continuous coverage. The primary outcome was varenicline utilization, defined as any pharmacy claim for the medication. Secondary outcomes included time to first prescription, completion of the 12-week treatment, and demographic differences in use. With an estimated 30% smoking prevalence, only 12.7% of KanCare smokers received varenicline, and just 1.6% completed a full course of treatment. Among 78,295 new enrollees, 2,980 (3.8%) had one or more claims for varenicline, with the mean time from enrollment to first prescription being 1.5 years (SD 1.3). Utilization was higher among males (4.8%) than females (3.4%) and varied by race/ethnicity (Whites: 4.4%, Blacks: 2.7%, American Indians: 2.5%, Hispanics: 1.6%, p<0.0001). Among those who initiated treatment, only 13.5% (N=380) completed the recommended 12-week regimen. Despite the high smoking prevalence among KanCare beneficiaries, varenicline is underutilized, with significant demographic disparities. Men and non-Hispanic Whites were more likely to receive varenicline than women and other racial and ethnic groups, despite comparable or higher smoking rates among other subgroups. Medicaid programs must intensify efforts to provide equitable and effective tobacco treatment.
54. Health aspects and lifestyle of licensed manual therapists during the COVID-19 pandemic in Sweden: The CAMP cohort study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
This study assessed health and change in lifestyle factors in Swedish manual therapists during one year of the COVID-19 pandemic, and potential differences with regards to age, sex, and business constellation. Further, therapists’ strategies for health promotion during the pandemic were explored. In this cohort study, 816 clinically active manual therapists were followed with web-based surveys during a year of the COVID-19 pandemic in Sweden, measuring physical activity, sedentary time, COVID-19-related worries, maladaptive coping, alcohol and tobacco consumption. Health promotion and impact of the pandemic on physical and mental health were explored in free text questions. Generalized estimating equations were conducted to assess changes in sample averages over time, and qualitative content analysis was used to code and categorize free-text answers. There was a decrease in physical activity and sedentary time increased as well as subjective mental health impact by the pandemic over one year. Maladaptive coping decreased during follow-up, and alcohol and tobacco consumption decreased in younger participants, and women, respectively. Participants stated that the pandemic affected their physical and mental health and reported using health promoting activities primarily targeting physical activity, nutrition, and sleep. Swedish manual therapists maintained good lifestyle habits except for a small decrease in physical activity and slight increase in sedentary behavior and subjective mental health impact by the pandemic over time. There were small differences in terms of maladaptive coping, alcohol consumption, and tobacco consumption, however, these differences were not likely clinically relevant. The therapists seemed conscientious regarding health promotion measures during one year of the COVID-19 pandemic.
55. Dose-response and isotemporal substitution analysis of domain-specific physical activity and sedentary behavior with abdominal aortic calcification risk: A cross-sectional study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Abdominal aortic calcification (AAC) is an independent risk factor for cardiovascular disease. This study aims to examine the dose-response relationships between domain-specific moderate-to-vigorous physical activity (MVPA), sedentary behavior (SB), and AAC risk, and the effects of time reallocation among these behaviors, in individuals aged 40 years and older. This cross-sectional study used data from NHANES participants from the 2013-2014 cycle. MVPA and SB were self-reported, and AAC status was assessed using the Kauppila scoring system and DXA. Weighted logistic regression calculated odds ratio (OR) and 95% confidence interval (CI) for dose-response relationships, using restricted cubic splines (RCS). Furthermore, weighted logistic regression models within an isotemporal substitution analysis were employed to examine the effect on AAC risk of reallocating time among different MVPA domains and sedentary behavior. This study included 2,842 participants (median age 58 years, interquartile range [IQR] 48-68 years, 48.42% male), of whom 861 (30.30%) had AAC. Adherence to physical activity (PA) guidelines (≥150 minutes/week) for leisure-time MVPA was associated with a 33.7% reduction in AAC risk (OR = 0.643, 95% CI 0.488-0.848, P = 0.035). However, no significant effect of occupation and transportation-related MVPA on reducing AAC risk was found. RCS revealed dose-response relationships between total MVPA, leisure-time MVPA, and SB with AAC risk, indicating a U-shaped pattern for total MVPA, with the lowest risk at 1086 minutes/week (OR = 0.712, 95% CI 0.546-0.928, non-linear P = 0.023). Moreover, isotemporal substitution analysis showed that replacing 30 minutes/day of sedentary behavior (OR: 0.837, 95% CI: 0.747-0.927) or occupational MVPA (OR: 0.842, 95% CI: 0.692-0.992) with leisure-time MVPA was significantly associated with lower AAC risk. There is a positive linear dose-response association between sedentary behavior and AAC risk; conversely, leisure-time MVPA shows a negative linear dose-response association. Total MVPA presents a nonlinear dose-response association, with AAC risk being lowest when activity reaches 1086 minutes per week. Isotemporal substitution analysis further revealed that reallocating time from sedentary behavior or occupational MVPA to leisure-time MVPA is associated with a lower risk of AAC. These results suggest that increasing leisure-time MVPA and reducing sedentary behavior may help optimize AAC risk.
56. Occupational Hazards and Injuries in Total Joint Arthroplasty: Identification and Prevention.
期刊: Journal of surgical orthopaedic advances 发表日期: 2025 链接: PubMed
摘要
Joint replacements are demanding surgeries that take physical and mental tolls on arthroplasty surgeons. Occupational hazards of joint replacement surgery include musculoskeletal injuries, blood-borne diseases, radiation exposure, noxious chemical exposure, noise exposure, and emotional stress. This article is a review of the available literature surrounding occupational hazards that arthroplasty surgeons face and how they can be prevented. The goal is to address adult reconstruction occupational hazards in order to increase the longevity of arthroplasty surgeons. (Journal of Surgical Orthopaedic Advances 34(3):130-133, 2025).
57. Exploring health literacy pertaining to general wellbeing and chronic disease management among population registered within Primary Healthcare System: A Study protocol.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Evidence suggests that high level of health literacy among patients is associated with high levels of accessibility to healthcare, better understanding consent-to-treat forms, increased compliance to treatment (particularly in taking medication for longstanding chronic diseases), comprehending general healthcare and improved preventive care and early disease detection, proper use of home medical devices from patients and increased capability of accessing the various channels of health information when required. The proposed study aims to assess and capture preferences and perceptions regarding health literacy of population (registered within primary care clinics in state of Qatar) in context to their general wellbeing (physical and mental health) and management of chronic disease conditions. The study design will be mixed methods (include both quantitative and qualitative elements). The HLQ survey will be sent online (text messages) to the population registered with PHCC and to capture service users’ perceptions and preferences pertaining to health literacy channels. The qualitative method will be utilized to gain an in-depth understanding of the various health literacy channels, challenges and barriers pertaining to the implementation of the health literacy strategies from both the healthcare provider and service users’ perspective. The qualitative analysis will be interpreted utilizing the Socioecological Model (SEM). The REPORT statement will be followed during analysis and writing of the study. For the qualitative component we aim to report the results in accordance with ‘Consolidation criteria for reporting qualitative research (COREQ) and ‘Standards for reporting qualitative research ‘(SRQR) guidelines. The findings (quantitative and qualitative) will be triangulated to design an evidence-based health literacy framework which can be utilized for service design and re-design to deliver optimal patient centered primary health care services within the country & modelled in similar health care settings geographically. Evidence generated from the study can increase health literacy levels among service users by modification of health behavior through effective health education. Moreover, increased health literacy levels and improved self-care can lead to improved compliance with treatment leading to effective management of diseases, particularly long-term chronic diseases which are associated with multi-morbidity, polypharmacy and challenges associated side effects of prescribed medications.
58. Exploring regional air pollution transition dynamics: A multi-state markov model approach.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Air pollution, commonly measured by the Air Quality Index (AQI), is a significant global health risk, yet its transition dynamics remain poorly understood. This study aims to investigate the regional air pollution transition dynamics across different air quality states. We analyzed weekly average Air Quality Index (AQI) data from January to September 2024 for 19 countries across Asia, Africa, and Europe, collected from an open-access air quality monitoring platform. According to international standards, AQI was categorized into three states (Good, Unhealthy, Very Unhealthy). We applied a multi-state Markov model to assess weekly transitions between these states and estimate the average time spent in one state before transition. Findings indicate that in Asia and Africa, air quality tends to deteriorate more frequently than it improves, with low transition rates from “Very Unhealthy” to better states. Transitions from Unhealthy to Good were less frequent in Asia (HR: 0.09, 95% CI: 0.04, 0.19) and Africa (HR:0.25, 95% CI: 0.11, 0.55) compared to Europe, where air quality showed more stability and improvement. The Good and Unhealthy states in Asia had similar sojourn times of 6.80 (±1.77) and 6.64 (±1.38) weeks, while the Very Unhealthy state lasted 3.36 (±0.98) weeks. The Very Unhealthy state persisted for 0.95 (±0.48) weeks in Africa. Europe maintained the “Good” state longest at 7.68 (±1.98) weeks, with shorter durations for Unhealthy and Very Unhealthy states. The study highlights lengthy pollution incidents in Asia and Africa, while Europe demonstrates effective pollution control. These insights can guide policymakers in formulating strategies to mitigate pollution based on regional AQI transition trends.
59. Detection, transport, and retention of Toxoplasma gondii oocysts in saturated sandy porous media: Influence of electrolytes and natural organic matter in flow-through systems.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Understanding the transport and retention of Toxoplasma gondii oocysts through soils and into ground and surface water is essential for determining the risk this parasite poses to water resources and human health worldwide. We studied here how various naturally occurring groundwater solutions containing different types of organic compounds (fulvic and humic acids) and electrolytes (NaCl, MgCl2, CaCl2) at different concentrations can affect the transport and retention of oocysts in engineered-saturated silica sand columns subjected to continuous flow to simulate the movement of groundwater through an aquifer. Breakthrough curve results from the qPCR analysis were then compared to non-reactive tracer tests to determine parameters that govern the transport of oocysts in saturated porous media. Though breakthrough of oocysts was observed in all tested solutions, higher ionic strength and ion valency resulted in greater oocyst retention. When both organic matter and electrolyte solutions were added to the systems, the electrolyte solutions displayed a far greater influence on parasite retention when compared to the influence of the organic matter alone. Collectively, this study demonstrates the pivotal role of soil groundwater solution chemistry in both the transport and retention of this important zoonotic parasite.
60. Changes in free-roaming dog population demographics and health associated with a catch-neuter-vaccinate-release program in Jamshedpur, India.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
India’s large free-roaming dog populations contribute to significant human health, environmental, and social challenges. Population management strategies, such as catch-neuter-vaccinate-release (CNVR), aim to reduce dog numbers, improve their welfare, and reduce human-animal conflict. Humane Society International (HSI; now operating as Humane World for Animals), in partnership with the Animal Health Foundation, implemented a CNVR program in Jamshedpur, neutering and vaccinating over 20,000 dogs. This study evaluated the impact of this program on dog health, population structure and size. The study areas encompassed 10 sites within Jamshedpur, including both intervention sites where CNVR was directly applied and sites without direct intervention. Data was collected from May 2014 until December 2018, including bi-annual street surveys, as well as clinical data from the dogs captured and treated. We fit logistic regression, negative binomial, and binomial mixed effects models to assess changes in dog population characteristics, health, and reproductive conditions over time in relation to the CNVR intervention. We found that, over the period of this study, the probability of dogs entering the clinic with mange, transmissible venereal tumours, and pregnant significantly reduced. Street surveys showed an increase in sterilised dogs, with higher proportions observed in CNVR-treated sites, although the counts of dogs observed increased overall. The age-structure of free-roaming dogs remained stable over time. In CNVR-treated areas, the probability of observing lactating female dogs decreased, whereas it increased in untreated sites. This work contributes to the growing body of knowledge investigating the impact of dog population management interventions. Continued monitoring and evaluation of CNVR programs are required to identify optimal coverage required to reduce population size effectively.
61. Promoting mental well-being among secondary school students in Vietnam using the Y-MIND app: A protocol for a hybrid type 2, sequence pre-post, quasi-experimental study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
This study is registered at ClinicalTrials.gov (NCT06753344).