公共卫生研究摘要 (2025-10-13)
共收录 58 篇研究文章
1. Five-Year Follow-Up of Patients With Relapsed and Refractory Classic Hodgkin Lymphoma Treated With Low-Dose Nivolumab (40 mg): A Matched Cohort Study With Standard-Dose Therapy.
期刊: Hematological oncology 发表日期: 2025-Nov 链接: PubMed
摘要
The use of low-dose PD-1 inhibitors may offer a promising treatment strategy for patients with refractory Hodgkin lymphoma. This approach has the potential to mitigate the financial toxicity commonly associated with immune checkpoint inhibitors while also reducing the likelihood of severe adverse events. The aim of this study was to further investigate the efficacy and safety of nivolumab (nivo) at a 40 mg dose (LD group) within NCT03343665 clinical trial framework and to compare these results to the standard-dose therapy (SD group) using a propensity score matching approach. This study included 62 patients in each group. Median follow up was 63 (11-87) and 73 months (20-107) in the LD and SD group, respectively. The overall response rate and complete response was 68% and 39% versus. 70% and 39%, respectively. Five-year PFS was 26.8% (95% CI 17.8-40.7) and 22.1% (95% CI 12-40.6), p = 0.77, and 5-year OS 95.7% (95% CI: 90-100) and 93.3% (95% CI: 87-99), p = 0.33. The PFS was not statistically different regarding the prior treatment and key clinical factors. In the LD group the median dose of nivo was 0.58 mg/kg (0.35-0.91). There was no statistically significant difference based on dose per body weight in terms of survival. No differences were observed in the incidence of any AEs (69% vs. 77%) and 3-4 AEs (6% vs. 13%). Nivolumab therapy at a dose of 40 mg demonstrates comparable efficacy and safety to the standard dose of 3 mg/kg in patients with r/r cHL.
2. Approach to premenopausal osteoporosis.
期刊: Current opinion in endocrinology, diabetes, and obesity 发表日期: 2025-Oct-13 链接: PubMed
摘要
Premenopausal osteoporosis, characterized by low bone mass and fractures, is rare but poses long-term skeletal risks. Unlike postmenopausal osteoporosis, it often stems from inadequate peak bone mass accrual or secondary causes such as systemic diseases, medications, or lifestyle factors. This review explores contemporary approaches to defining, diagnosing, and treating low bone mass and osteoporosis in premenopausal women. Prevalence varies according to ethnicity and is further influenced by the diagnostic criteria, with higher risks in Caucasian and Asian women. Key determinants of peak bone mass achieved by the late 20 s include genetics (60-80% of variability), nutrition (calcium, vitamin D, and protein), lifestyle (exercise, smoking, and alcohol), and occupational exposures (e.g., heavy metals and sedentary work). Pregnancy and lactation-associated osteoporosis also cause transient bone loss, particularly in high-risk individuals. Bone mineral density by dual-energy X-ray absorptiometry is the gold standard for diagnosis despite of certain limitations. Additionally, emerging technologies like radiofrequency echographic multi spectrometry show promise. Management focuses on optimizing bone health through adequate nutrition, weight-bearing exercises, and addressing secondary causes, when present like rheumatoid arthritis, long-term glucocorticoid use, hypogonadism, etc. Pharmacological options such as bisphosphonates and teriparatide can be considered in high-risk cases, but evidence on their safety and efficacy in premenopausal women is limited, and concerns about teratogenicity remain. Early identification and intervention are critical to reduce fracture risk, emphasizing the need for better diagnostic tools and individualized treatment strategies.
3. Characteristics of Medicare Advantage (MA) Plans and Quality-of-Life and Health Outcomes of Medicare Beneficiaries: Evidence from Medicare Health Outcomes Survey.
期刊: Journal of aging & social policy 发表日期: 2025-Oct-12 链接: PubMed
摘要
Enrollment in Medicare Advantage (MA) plans surpassed fee-for-service (FFS) Medicare beneficiaries in 2024. Still, little is known about how effectively these private plans impact Medicare beneficiaries’ health and quality of life outcomes. The current study aimed to examine the associations of MA plans’ characteristics with beneficiaries’ health-related quality of life (EQ-5D) physical and mental health summary scores (PCS, MCS) using the Medicare Health Outcomes Survey (2015-2017). The study used two cross-sectional samples (2016 and 2018) and one repeated sample with baseline (2015) and follow-up (2017) data. I used propensity score matching analysis (PSM) and the instrumental variable approach to address the selection of MA plans. Findings suggest that PPO (Preferred Provider Organization) enrollment was significantly associated with higher EQ-5D, PCS, and MCS scores than HMO (Health Maintenance Organization) plans. Results from linear models with individual and time-fixed effects suggest that beneficiaries enrolled in PPO plans experienced an improvement in all three outcomes from baseline to follow-up compared to HMO plans. Other significant plan-level characteristics were plan enrollment, ownership status, and duration. Assessing health and quality-of-life outcomes is important for a better understanding how MA plans directly impact population health, the core of the value-based care model. Characteristics of the Medicare Advantage plans are associated with beneficiaries’ health and quality of life outcomes.Importance of evaluating health and quality-of-life outcomes for MA insurers for making community health investment decisions.
4. Laparoscopic Repair of Diaphragmatic Pericardial Hernia Following Blunt Trauma: A Case Report.
期刊: The American journal of case reports 发表日期: 2025-Oct-12 链接: PubMed
摘要
BACKGROUND Diaphragmatic pericardial hernias (DPH) are a rare and potentially life-threatening variant of diaphragmatic rupture, most often arising after high-velocity blunt thoracoabdominal trauma. Clinical presentations range from acute cardiorespiratory compromise to delayed, insidious symptoms such as chest pain, upper-abdominal discomfort, nausea, or vomiting. Because standard radiographic studies may fail to detect small or atypically located defects, misdiagnosis is common and carries a risk of organ strangulation, obstruction, or cardiorespiratory compromise. Prompt recognition and definitive surgical management are therefore essential to optimize outcomes. CASE REPORT A 63-year-old man with end-stage renal disease secondary to diabetic nephropathy presented with a 2-day history of intermittent epigastric pain, nausea, and non-bilious vomiting. His only antecedent trauma was a motor vehicle collision 8 months earlier, which was managed conservatively. Contrast-enhanced computed tomography revealed a 5-cm defect in the central tendon of the diaphragm, with herniation of transverse colon and omental fat into the pericardial cavity. The patient underwent successful laparoscopic reduction of herniated contents and tension-free bridging repair using both biologic and composite synthetic mesh. The postoperative course was unremarkable. At 1-month follow-up, the patient remained asymptomatic. CONCLUSIONS This case underscores the importance of maintaining a high index of suspicion for DPH in patients with prior blunt trauma who present with unexplained thoracoabdominal symptoms, even months after injury. Laparoscopic mesh repair can achieve durable, tension-free closure with low morbidity, and should be considered the preferred approach when expertise and patient factors permit. A multidisciplinary care pathway is critical for optimizing perioperative management in high-risk populations.
5. [Influence of early clinical experience on the development of professional identity of medical students].
期刊: Orvosi hetilap 发表日期: 2025-Oct-12 链接: PubMed
摘要
Bevezetés: Az orvosképzés végső célja, hogy az új orvosgenerációk nemcsak tárgyi tudás tekintetében, hanem érzelmi, intellektuális és gyakorlati szempontok alapján is alkalmasak legyenek a betegek biztonságos gyógyítására. A munkahelyi tanulás hatékonyan segítheti ennek a folyamatnak a megvalósulását. Célkitűzés: Vizsgálatunk célja az volt, hogy feltárjuk a klinikai környezetben, valódi betegen végzett tanulás összetevőit preklinikai éveikben járó orvostanhallgatóknál. Módszer: 2019 és 2024 között keresztmetszeti vizsgálatot végeztünk a Semmelweis Egyetemen preklinikai tanulmányaikat végző (első-, másodéves) orvostanhallgatókkal, akik kiscsoportos formában, háziorvosi praxisokban, 48 oktató orvossal vettek részt egy szemeszteren keresztül klinikai gyakorlaton, amelynek célja az oktató háziorvos által kiválasztott betegek anamnézisfelvételének tanulása volt. A Manchester Clinical Placement Index szabad szöveges válaszainak használatával mértük a tanulási környezet hatását. Elemzésünkhöz kvalitatív módszerként latens konstruktumelemzést végeztünk. Eredmények: Összesen 883 hallgatói választ elemeztünk. Az elemzés három fő témát eredményezett, a mentor által teremtett befogadó, egyenrangú, kollegiális tér lehetővé tette a hallgatók aktív részvételét. A feladatok végrehajtásának megfigyelése és a személyre szabott, előremutató visszajelzés a tanulási folyamat kulcspontjai voltak. A gyermekkorból felnőttkorba, illetve laikusból professzionális szerepbe lépés, valamint a klinikusi és az oktatói szerep közötti különbségek elmosódása voltak a legmeghatározóbb feszültségforrások. Megbeszélés: A korai klinikai tapasztalat elősegítette, hogy a hallgatók hivatástudata erősödjék azáltal, hogy az elméletben tanultakat klinikai kontextusban, személyes jelentéstartalommal gazdagítva tanulmányozhatták. Az oktató hivatástudata és humánuma olyan példaképpel szolgált, amely hozzájárul az orvosi pálya iránti elköteleződéshez, és megalapozza a humánus, személyközpontú gyógyítást. Következtetés: A tapasztalt klinikus oktató által vezetett munkahelyi tanulás a hallgatók aktív szerepvállalásán és példaképeken keresztül segíti a professzionális identitás fejlődését, miközben lehetővé teszi, hogy a hallgatók elméleti tanulmányaikat klinikai kontextusba helyezzék. Orv Hetil. 2025; 166(41): 1611–1621.
6. [The development and focus group analysis of a decision-support checklist to start special palliative care].
期刊: Orvosi hetilap 发表日期: 2025-Oct-12 链接: PubMed
摘要
Bevezetés: A palliatív szakellátás korai, az aktív onkológiai kezeléssel párhuzamos bevezetésének egyre több előnyét igazolják a kutatások. Számos tanulmány bizonyította a túlélés növekedését, a beteg és a hozzátartozók jobb életminőségét, az egészségügyi személyzet pszichés kimerültségének csökkenését. A betegek ritkábban kerülnek kórházba, és kevesebb időt töltenek aktív ágyakon. Az előrehaladott állapotú daganatos betegek kezelése nem teljes az integrált, személyre szabott, támogató szolgáltatások nélkül, ugyanakkor még továbbra sincs olyan, nemzetközileg is elfogadott kritériumrendszer, amely alapján könnyen meghatározható lenne, hogy pontosan mikor és melyik betegnek van szüksége speciális palliatív ellátásra. Célkitűzés: Célunk a mindennapi betegellátásban is könnyen használható, a betegirányítást támogató szempontrendszer létrehozása volt, amely segít annak meghatározásában, hogy javasolt-e a beteget a speciális palliatív ellátórendszerbe referálni. Módszer: A szakirodalom áttekintése után létrehoztunk egy 1 + 8 kérdésből álló döntéstámogató pontozási rendszert, majd három fókuszcsoport tartalomelemzésével vizsgáltuk meg háziorvosok, onkológusok és palliatív orvosok részvételével. Eredmények: Az előrehaladott állapotú daganatos betegek ellátásában leginkább érintett három szakma képviselői mind hasznosnak találták a döntéstámogató pontrendszert, és a mindennapi betegellátásban való felhasználását javasolták. A családorvosok indikátorként, az onkológusok pedig az onkoteam döntéselőkészítő anyagaként alkalmaznák. Az adatlap kérdéseit a szakértők javaslatai szerint módosítottuk, és a végleges változatot a jelen cikkben mutatjuk be. Következtetés: A kutatás megerősítette, hogy egy egységes pontrendszer segíthet a betegek igényeinek felmérésében, és rendezheti a szakmák közötti együttműködést, könnyíti a betegutakat, automatikus alkalmazása sokban javíthatja a betegek megfelelő ellátáshoz való hozzájutását. A bevezetése előtt ugyanakkor mindenképp szükség van a palliatív szakellátók számának növelésére, hogy a várhatóan jelentősen megnövekvő betegszám ne terhelje túl a meglévő rendszert. Orv Hetil. 2025; 166(41): 1603–1610.
7. Thrombolysis-to-recanalization time and clinical outcomes in large-vessel occlusion patients with successful recanalization.
期刊: Journal of neurology 发表日期: 2025-Oct-12 链接: PubMed
摘要
The benefit of intravenous thrombolysis (IVT) before endovascular treatment (EVT) in patients with anterior circulation large-vessel occlusion (LVO) remains unclear. This study aimed to determine whether thrombolysis-to-recanalization time (TRT) can affect the benefit of IVT. From the DETECT2-China registry cohort, patients with anterior circulation LVO who achieved complete reperfusion after IVT and bridging EVT were included. Based on TRT corresponding to the minimum adjusted odds ratio (aOR) associated with favorable functional outcome on the restricted cubic spline (RCS), patients were divided into two groups: TRT ≤ 170 min and TRT > 170 min. The primary efficacy outcome was a favorable functional outcome, defined as mRS 0 to 2 at 90 days. Clinical outcomes were compared in the original cohort and in a cohort matched using inverse probability of treatment weighting (IPTW). A total of 167 eligible patients were included in the final analysis, comprising 82 in the TRT ≤ 170 min group and 85 in the TRT > 170 min group. In the original cohort, TRT ≤ 170 min group had a higher rate of favorable functional outcome (70.7% vs. 50.6%, aOR = 2.919, 95% CI 1.204-7.416, P = 0.020), excellent functional outcome (59.8% vs. 40%, aOR = 2.856, 95% CI 1.225-6.912, P = 0.017). Similar results were found in the IPTW-matched cohort. Furthermore, The restricted cubic spline analysis revealed a linear association between TRT and favorable functional outcome at 90 days (P for linearity = 0.019). In patients with acute anterior circulation LVO stroke who received IVT-bridging EVT and achieved complete reperfusion post-procedural angiography, there may be a time-dependent benefit of IVT associated with TRT. Shorter TRT may be associated with better clinical outcomes.
8. Elucidation of the Nature of Pelargonium Vein Banding Virus Sequences Present in Pelargonium × hortorum.
期刊: Phytopathology 发表日期: 2025-Oct-12 链接: PubMed
摘要
The family Caulimoviridae are plant-infecting pararetroviruses that replicate by reverse transcription and encapsidate a circular dsDNA genome. They can occur as episomal (encapsidated and replicative forms), and endogenous forms integrated into the host genome. Some endogenous sequences can give rise to episomal forms. In this study, we report and characterize a new badnavirus infecting Pelargonium × hortorum. We propose the name Pelargonium vein banding virus (PVBV). The episomal genome is 7,586 bp in length. Endogenous PVBV (ePVBV) DNA was identified in healthy plants and characterized. Southern blotting and PCR suggest that in many cultivars the ePVBV consists of a tandem array of the complete PVBV genome. The ePVBV tandem array was not detected in ‘Maverick White’. The major parents of Pelargonium × hortorum hybrids are P. zonale and P. inquinans. P. zonale contained ePVBV but P. inquinans did not. The sequence of ePVBV recovered from the cultivar ‘BullsEye Salmon’ was >99% identical to the episomal sequence. Agroinoculation experiments demonstrated that ePVBV is infectious. Bacilliform-shaped virions with a modal particle length of 144 nm and 33 nm in diameter were recovered from leaves of agroinfected ‘Maverick White’ exhibiting mosaic symptoms and chlorosis surrounding the veins. P. zonale and Pelargonium × hortorum varieties with full ePVBV genomes were not infected. Interestingly, P. inquinans, which does not contain ePVBV was also not infected.
9. Prevalence and Antimicrobial Resistance of Klebsiella pneumoniae Isolated from Subclinical Mastitis in Selected Pure Dairy Cattle Breeds in Pakistan.
期刊: Current microbiology 发表日期: 2025-Oct-12 链接: PubMed
摘要
Bovine mastitis caused by Klebsiella pneumoniae poses significant economic and health challenges in dairy production, particularly in its subclinical form. In this study, milk samples (n = 305) from different cattle breeds of Red Sindhi, Sahiwal, Cholistani, and Holstein Friesian were collected from six dairy farms in Pakistan. The prevalence of subclinical mastitis ranged from 42.3% in Red Sindhi to 77.0% in Sahiwal breeds, with an overall prevalence of 56.39%. The prevalence of K. pneumoniae was 11.8% (36/305), varying significantly among breeds: Cholistani (26.2%), Red Sindhi (17.3%), Holstein Friesian (5.0%), and Sahiwal (0%). Farm-specific prevalence ranged from 0% to 26.2%, underscoring the influence of local management practices. All tested microorganisms remained sensitive to cefotaxime, meropenem, and ciprofloxacin but revealed 100% resistance to ampicillin and 80.5% and 69.4% resistance to amoxicillin and streptomycin, respectively. Molecular analysis detected the blaTEM in 91.6% of isolates. These findings highlight significant breed and farm-level differences in subclinical mastitis and resistance patterns. The predominance of blaTEM and full susceptibility to third-generation cephalosporins suggest that local K. pneumoniae isolates may differ from global trends. Strengthened farm management and prudent antimicrobial use are essential to limit infections and safeguard both animal and public health.
10. Individualized Perioperative Blood Pressure Management in Patients Undergoing Major Abdominal Surgery: The IMPROVE-multi Randomized Clinical Trial.
期刊: JAMA 发表日期: 2025-Oct-12 链接: PubMed
摘要
Intraoperative hypotension is associated with organ injury. However, it remains unknown if targeted blood pressure management during surgery can improve clinical outcomes. To evaluate whether individualized vs routine perioperative blood pressure management during major abdominal surgery improves clinical outcomes in patients considered at high risk of postoperative complications. This randomized single-blind clinical trial enrolled patients 45 years or older undergoing elective major abdominal surgery with general anesthesia expected to last 90 minutes or longer who had at least 1 additional high-risk criterion between February 26, 2023, and April 25, 2024, at 15 German university hospitals. The date of last follow-up was July 25, 2024. Patients were randomized in a 1:1 ratio to individualized perioperative blood pressure management (with mean arterial pressure [MAP] targets based on preoperative mean nighttime MAP assessed using automated blood pressure monitoring) or routine blood pressure management with a MAP target of 65 mm Hg or higher. The primary outcome was the incidence of a composite outcome of acute kidney injury, acute myocardial injury, nonfatal cardiac arrest, or death within the first 7 postoperative days. There were 22 secondary outcomes, including infectious complications within the first 7 postoperative days and a composite outcome of need for kidney replacement therapy, myocardial infarction, nonfatal cardiac arrest, or death within 90 days after surgery. Of the 1272 patients enrolled, 1142 were randomized (571 patients to each group), and 1134 were included in the primary analysis (median age, 66 years [IQR, 59-73 years]; 34.1% female). The primary outcome occurred in 190 of 567 patients (33.5%) assigned to individualized blood pressure management and 173 of 567 patients (30.5%) assigned to routine blood pressure management (relative risk, 1.10 [95% CI, 0.93-1.30]; P = .31). None of the 22 secondary outcomes were significantly different, including infectious complications within the first 7 postoperative days (90/567 [15.9%] vs 97/567 [17.1%]; P = .63) and a composite outcome of need for kidney replacement therapy, myocardial infarction, nonfatal cardiac arrest, or death within 90 days after surgery (32/566 [5.7%] vs 20/567 [3.5%]; P = .12). Among patients at high risk of postoperative complications undergoing major abdominal surgery, individualized perioperative blood pressure management with MAP targets based on preoperative mean nighttime MAP did not decrease the composite outcome of acute kidney injury, acute myocardial injury, nonfatal cardiac arrest, or death within the first 7 postoperative days compared with routine blood pressure management with a MAP target of 65 mm Hg or higher. ClinicalTrials.gov Identifier: NCT05416944.
11. [The management of febrile conditions in childhood: what's new in the health professional guideline 2025?].
期刊: Orvosi hetilap 发表日期: 2025-Oct-12 链接: PubMed
摘要
Bevezetés: A gyermekkori lázas állapotok ellátásáról 2011-ben, majd 2025-ben jelent meg egészségügyi szakmai irányelv. A közleményben a két irányelv ajánlásait hasonlítjuk össze az elmúlt másfél évtized kibővült evidenciáinak fényében. Módszer: Irodalmi összehasonlítást hajtottunk végre. A két irányelv ajánlásait szisztematikusan, egyenként vetjük össze, kiemelve a tartalmi és formai változásokat és különbségeket. Eredmények és következtetés: Az összehasonlítás alátámasztja az irányelv fejlesztőinek szándékát egyrészt a betegek biztonságos ellátásának fokozására – elsősorban a súlyos betegséget jelző tünetek és állapotok felismerése és a kellő betegutak, a szakszerű ellátás biztosítása érdekében –, másrészt a laikusok egészségtudatosságának fokozására a helytelen vagy indokolatlan gyógyszerelés és az orvosi konzultációk számának csökkentése céljából. Javaslatokat teszünk az irányelv széles körű terjesztésére és hatékony átültetésére a klinikai mindennapokban. Orv Hetil. 2025; 166(41): 1622–1627.
12. Development of a diagnostic model of insulin-related lipohypertrophy for patients with diabetes mellitus.
期刊: Journal of diabetes investigation 发表日期: 2025-Oct-12 链接: PubMed
摘要
To develop a diagnostic model of insulin-related lipohypertrophy for patients with diabetes mellitus. A cross-sectional study was performed. Between December 2021 and November 2022, a total of 395 diabetic patients treated with insulin were enrolled from a tertiary hospital in Tianjin, China. Demographic and clinical factors were collected, and patients were assessed for lipohypertrophy by ultrasound scanning. The rate of lipohypertrophy was investigated, and a nomogram was developed based on a logistic regression model. SPSS 26.0 and R Studio 2022.12.0+353 3.6.3 were used to analyze the data. 89.6% (354/395) patients were identified with lipohypertrophy. In this study, 693 lipohypertrophy sites in lipohypertrophy patients and 91.5% (634/693) lipohypertrophy were distributed at the abdomen. Self-injection, duration of insulin injection, and incorrect rotation were selected as predictors to develop a lipohypertrophy diagnosed diagnostic nomogram model of lipohypertrophy in diabetic patients treated with insulin. The accuracy, calibration, and clinical applicability of the model are good; thus, it fits well. A nomogram including three easily available factors (self-injection, duration of insulin injection, and incorrect rotation) was developed, and it can be used in diabetes management among diabetes patients treated with insulin.
13. Rolipram prevents detrusor underactivity related to pelvic nerve injury in rats by promoting regeneration of nerve axons.
期刊: World journal of urology 发表日期: 2025-Oct-12 链接: PubMed
摘要
Evaluation of the effects of rolipram, a phosphodiesterase 4 (PDE4) inhibitor, on detrusor underactivity in a rat model of pelvic nerve crush (PNC) injury. Female Sprague-Dawley rats (12 weeks old) were divided into sham, PNC, PNC with saline (PNC/Vehicle) and PNC with oral rolipram (1.0 mg/kg/day) treatment (PNC/Rolipram) groups. Cystometrograms, organ bath studies and histological examinations were performed 10 days later. Micturition interval, bladder capacity and residual volume were significantly increased, and voiding efficiency was significantly decreased in the PNC and PNC/Vehicle groups as compared with the sham group (P < 0.01 each). In organ bath studies, the responses of muscle strips to electrical field stimulation, which activates nerves, were significantly weaker in the PNC and PNC/Vehicle groups than the sham group. Significant improvements in cystometric parameters and muscle strip contractility were seen in the PNC/Rolipram group as compared with the PNC and PNC/Vehicle groups. Immunohistochemical staining demonstrated a significantly increased density of GAP-43-positive nerves, a marker of nerve regeneration, in the detrusor layer of PNC (P = 0.01) and PNC/Vehicle (P = 0.01) groups compared with the sham group. Moreover, the PNC/Rolipram group showed a further significant increase in GAP-43 expression compared with both the PNC group (P = 0.04) and the PNC/Vehicle group (P = 0.04). Chronic rolipram treatment might prevent detrusor underactivity by promoting regeneration of nerve axons in a rat PNC model.
14. Clinical characteristics and risk factors for the bidirectional association between immune thrombocytopenia and Sjögren's syndrome.
期刊: Clinical rheumatology 发表日期: 2025-Oct-12 链接: PubMed
摘要
This study investigated the clinical characteristics and risk factors for bidirectional association between immune thrombocytopenia and Sjögren’s disease (ITP/SjD). Patients with ITP/SjD in the First People’s Hospital of Yunnan Province from July 2024 to December 2024 were retrospectively analyzed and compared to those of sex- and age-matched ITP or SjD controls. Logistic regression analysis was used to identify risk factors. A total of 110 consecutive patients with ITP/SjD were enrolled. One hundred and five (95.45%) patients were female. The mean age at onset of ITP/SjD, ITP preceding SjD, SjD preceding ITP, and simultaneous ITP/SjD was 50.34 ± 16.46 years, 53.37 ± 12.38 years, 44.78 ± 18.50 years, and 57.73 ± 13.80 years, respectively. Compared to SjD controls, ITP/SjD patients were less likely to have dry mouth (p < 0.001) and more likely to have epistaxis (p = 0.012). Compared to ITP controls, the ITP/SjD patients presented with fewer petechiae, purpura, and ecchymosis, gingival bleeding, and epistaxis (p < 0.001). Fewer patients with ITP/SjD received corticosteroids (p = 0.010) and immunosuppressants (p = 0.002) than ITP controls. For SjD progressing to ITP/SjD, multivariate logistic analysis indicated that dry mouth (OR = 4.828), dry eyes (OR = 5.204), and anti-ENA (OR = 4.621) were independent risk factors. For ITP progressing to ITP/SjD, multivariate analysis confirmed only platelet counts (p = 0.041) as an independent predictor. Our findings highlight the roles of platelet counts, dry mouth, dry eyes, and anti-ENA in the development of this bidirectional association disease. Key Points • There are few documents on the pathogenesis and risk factors of SjD/ITP at home and abroad, and most of them are case reports. • This study aims to investigate the clinical characteristics and risk factors of SjD/ITP, so as to improve the cognition of SjD/ITP, reduce the risk of bleeding and death in SjD patients to the greatest extent, and improve the prognosis of patients. • Based on the comparative results of ITP/SjD with ITP or SjD controls, risk factors for ITP developing SjD and SjD developing ITP were further identified. Patients with SjD preceding ITP, ITP preceding SjD, and simultaneous ITP and SjD were analyzed and compared. • We found the roles of platelet count, dry mouth, dry eye, and anti ENA in the development of this bidirectional association disease, providing guidance for clinical doctors in diagnosing the condition and predicting outcomes.
15. Spontaneous Pleural, Pericardial, and Intracranial Hemorrhages in a Patient with End-Stage Kidney Disease Receiving Apixaban: A Case Report.
期刊: The American journal of case reports 发表日期: 2025-Oct-12 链接: PubMed
摘要
BACKGROUND Apixaban, the direct oral anticoagulant (DOAC) with the lowest renal clearance (~27%), is often preferred for stroke prevention in non-valvular atrial fibrillation (NVAF) among patients with kidney impairment. According to U.S. prescribing information, a dose of 5 mg twice daily is permitted in patients with severe kidney disease, unless they are aged ≥80 years or weigh ≤60 kg. However, in severe chronic kidney disease (CKD) or end-stage kidney disease (ESKD), even limited renal excretion can result in elevated drug levels and bleeding. Apixaban-related bleeding most commonly occurs in the gastrointestinal tract, but rare events such as pleural or pericardial effusions can also develop and may precede intracranial hemorrhage. CASE REPORT We describe a 73-year-old man with NVAF and stage 3b CKD who presented with progressive dyspnea and chest pain. Renal function had declined significantly from baseline. Imaging revealed large bilateral hemorrhagic pleural effusions and a concurrent pericardial effusion; both improved following apixaban discontinuation and therapeutic thoracentesis. During hospitalization, he was diagnosed with ESKD (CKD G5D), defined by a glomerular filtration rate <15 mL/min/1.73 m² and the initiation of dialysis. Despite this, apixaban was restarted in a nursing facility, after which he developed an intracranial hemorrhage. His condition deteriorated despite aggressive management, and he subsequently died. CONCLUSIONS This report emphasizes vigilant monitoring for rare but serious hemorrhagic complications of apixaban. Such bleeding may involve uncommon sites like the pleura, pericardium, or intracranial space, especially in patients with severe kidney disease, despite guideline-based dosing.
16. Soil health indicators are compromised differently by municipal solid waste leachate under various climate conditions.
期刊: Environmental geochemistry and health 发表日期: 2025-Oct-12 链接: PubMed
摘要
In many developing countries, landfilling is widely used as an efficient method for disposing of municipal solid waste. Literature review reveals that knowledge regarding the effects of climatic factors such as temperature and precipitation on different landfill sites is still insufficient and fragmented, especially in forest ecosystems. Therefore, this study sought to examine how waste accumulation affects soil health under different climatic conditions in the north of Iran. Soil samples were collected from four distinct sites that show a decline in precipitation alongside a rise in air temperature: Chalous, Noor, Shirgah, and Behshahr. Soil sampling across the 4 sites was performed in 2 environmental conditions (forest landfill and forest stand as a control), 4 seasons (spring, summer, fall, and winter), 3 soil depths (0-10 cm, 10-20 cm, and 20-30 cm), with 20 sampling replications taken at distances ranging from 200 to 300 m from each other. Soil sampling was done exactly at the waste dump site and after discarding the waste. Our results indicated that landfills led to a decline in litter chemical properties. In addition, landfills reduced soil porosity, aggregate stability, and soil fertility (nearly 1-2 times more in Chalous forest stand with higher precipitation and lower temperatures). Notably, the concentrations of heavy metals, such as cadmium, lead, and zinc significantly increased in landfill areas compared to the forest stand. Additionally, populations of fungi, bacteria, collembola, nematodes, acarina, protozoa have also decreased in all landfill sites. Furthermore, microbial parameters such as respiration, microbial biomass of C, N, and P, have declined following the climate pattern from Chalous to Behshahr in all the landfill sites, which were 1.5-2 times higher in Chalous forest stand with higher precipitation and lower temperatures than the other sites. Our findings highlight that unengineered landfilling had negative effects on soil health indicators at all sites studied, however, the region with the driest climate and least fertile soil suffered the most severe impacts. As a recommendation, municipalities can create targeted approaches, including waste recycling programs, that aim to mitigate risks and negative impacts while improving the overall benefits of landfills from a life-cycle perspective, addressing the needs of different stakeholders.
17. Sustainable and effective degradation of high concentration of aniline by acetylguanidine activated persulfate.
期刊: Environmental geochemistry and health 发表日期: 2025-Oct-12 链接: PubMed
摘要
Advanced oxidation processes (AOPs) utilizing sodium persulfate (PDS) have garnered significant attention in recent years. In this study, acetylguanidine (ACG) was discovered to effectively activate PDS for organic contaminants degradation. The system achieved a degradation rate of 98.5% for aniline in wastewater within 50 min and 95.0% for aniline in soil within 3 h. The reaction system showed remarkable resilience, with only a minimal impact from common inorganic ions and organic compounds. The ACG/PDS system displayed robust and efficient performance across a broad pH range of 7.5-12.5. ACG-activated PDS system also demonstrated significantly superior performance in soil remediation compared to humic acid and WQ-8476. EPR and scavenging experiments revealed that ·OH were the dominant active species in the ACG/PDS system. Degradation pathways were proposed based on the degradation products identified through GC-MS analysis. This research provides valuable insights into the practical application of ACG/PDS system for industrial wastewater treatment and soil remediation.
18. Impact of glucometabolic status on type 4a myocardial infarction in patients with non-ST-segment elevation myocardial infarction: the role of stress hyperglycemia ratio.
期刊: Cardiovascular diabetology 发表日期: 2025-Oct-11 链接: PubMed
摘要
Type 4a myocardial infarction (MI) is a relevant complication in non-ST-segment elevation myocardial infarction (NSTEMI) patients undergoing percutaneous coronary intervention (PCI). While glucometabolic status has been linked to type 4a MI in chronic coronary syndromes, data in the acute setting are lacking. This study aimed to assess the association of glucometabolic parameters-admission blood glucose (ABG), glycated hemoglobin (HbA1c) and stress hyperglycemia ratio (SHR)-with type 4a MI in NSTEMI patients undergoing PCI and evaluate their independent predictive role. Consecutive NSTEMI patients undergoing PCI from the AMIPE multicenter prospective registry (NCT03883711) with stable or falling pre-procedural cardiac troponin levels were analyzed. The optimal glucometabolic predictor of type 4a MI among ABG, HbA1c and SHR was identified using receiver operating characteristic analysis. The best cut-off for each parameter was derived using Youden’s index. Regression analysis and Kaplan-Meier curves were performed to identify independent predictors of type 4a MI and their prognostic implications. The study population included 1005 patients (mean age 70.3 ± 12.5 years, 25.5% females), with 45.9% having diabetes mellitus. SHR showed a significantly higher accuracy (AUC 0.69, 95% CI 0.65-0.73) in predicting type 4a MI compared with ABG and HbA1c (p < 0.001), with an optimal cut-off of 1.14, consistent across diabetic and non-diabetic patients. SHR > 1.14 was independently associated with type 4a MI (aOR = 2.73; 95% CI 1.70-4.42; p < 0.001), unlike ABG and HbA1c, and was also linked to an increased risk of long-term major adverse cardiovascular events (p < 0.001). SHR emerged as a strong predictor of type 4a MI in NSTEMI patients undergoing PCI, outperforming other glucometabolic markers.
19. Association between cholesterol, high-density lipoprotein, and glucose index and risks of cardiovascular and all-cause mortality in patients with calcific aortic valve stenosis: the ARISTOTLE cohort study.
期刊: Cardiovascular diabetology 发表日期: 2025-Oct-11 链接: PubMed
摘要
Cholesterol, high-density lipoprotein, and glucose (CHG) index, an alternative marker of insulin resistance (IR), play a significant role in predicting cardiovascular diseases. However, its prognostic value in patients with calcific aortic valve stenosis (CAVS) remains unclear. This study included 1175 patients diagnosed with calcific aortic valve stenosis via echocardiography from the First Affiliated Hospital of Sun Yat-sen University. Participants were grouped based on the cut-off value of the CHG index. The association between the CHG index and cardiovascular mortality and all-cause mortality in patients with calcific aortic valve stenosis was evaluated using Cox proportional hazards regression and restricted cubic model spline. Among the 1175 patients (mean age 68.91 ± 11.68 years, 56.6% male), the median follow-up time was 3.23 [1.15, 6.07] years. In the fully adjusted model, each 1-unit increase in the CHG index was linked to a 53% higher risk of cardiovascular mortality and a 43% higher risk of all-cause mortality. Moreover, compared to the low CHG index group, the high CHG index group had a 1.44-fold higher risk of cardiovascular mortality and a 1.43-fold higher risk of all-cause mortality. The restricted cubic spline model indicated a linear relationship between the CHG index and the risks of cardiovascular mortality (p for nonlinearity = 0.529) and all-cause mortality (p for nonlinearity = 0.436). Higher levels of insulin resistance, as assessed by the CHG index, are associated with increased risks of cardiovascular and all-cause mortality in patients with calcific aortic valve stenosis. RISk facTOr assessmenT and prognosis modeL construction (ARISTOTLE) study (Registry: ClinicalTrials.gov, TRN: NCT06069232, Registration date: 1 October 2023).
20. Trends and patterns of global health risk factors (2015-2019): a composite index approach across 100 countries stratified by human development index groups.
期刊: Journal of health, population, and nutrition 发表日期: 2025-Oct-11 链接: PubMed
摘要
Global health risk factors contribute significantly to mortality and morbidity worldwide, with diverse impacts across socio-economic groups. This study developed a composite index for health risk factors and subdomains, including nutrition, environmental risks, and non-communicable diseases, across 100 countries stratified by human development index (HDI) from 2015 to 2019. The index tracks disparities, trends, and associations with human development, aiding in resource allocation and informed policy-making for reducing health risks and improving global health outcomes. A panel dataset comprising 100 countries, categorized into four HDI groups, was analyzed for the period 2015 to 2019. Health indicators were selected to construct a Health Risk Factors Index based on the World Health Organization’s Global Reference List 2018. The development of the composite index and its sub-domains followed the United Nations Development Programme’s methodology for data normalization, utilized Principal Component Analysis to determine weights, and employed the inverse normalized Euclidean distance formula for aggregation. Spearman’s rank correlation was used to examine the relationships between the composite Health Risk Factors Index, its sub-indices, and the HDI. The study revealed that very high HDI countries excelled in the Health Risk Factors Index and sub-indices for nutrition and environmental risks, indicating lower health risks. While low and medium HDI groups performed better in the non-communicable diseases index. Singapore achieved the highest health risk factors index scores in 2015 and 2019. A strong positive correlation was observed between HDI with composite and sub-indices of health risk factors and a negative correlation with sub-index of noncommunicable disease during 2015-2019. The study highlights significant disparities in health risk factors across HDI groups, underscoring the need for tailored interventions. In general, very high and high HDI countries require focused efforts on noncommunicable disease-related health risk factors, while low and medium HDI countries should prioritize nutrition and environmental risks. Composite indices like the health risk factor index facilitate benchmarking and policy development, promoting accountability and targeted strategies for global health improvement.
21. Investing in health care AI: Decision-making traps.
期刊: Healthcare (Amsterdam, Netherlands) 发表日期: 2025-Oct-11 链接: PubMed
摘要
22. Hospital readmission disparity measure for evaluating hospital performance and penalties.
期刊: Archives of public health = Archives belges de sante publique 发表日期: 2025-Oct-11 链接: PubMed
摘要
The excess readmission ratio (ERR) is currently used to determine penalties for hospitals with excessive readmission rates. To determine whether the effectiveness of alternative measures, such as the Risk-Standardized Readmission Rate (RSRR), or Excess Days in Acute Care (EDAC), or differences between paired measures, would provide comparable or superior assessments. A retrospective national study on readmission measures. This study analyzed national readmission data from 3,047 hospitals for the fiscal year (FY) 2022. We measured the agreements and disparity scores in hospital performance assessments, as well as the changes in penalty status between the paired readmission measures. The ERR and RSRR measures showed a significantly high degree of agreement, ranging from 83.5 to 93.8% across the six applicable conditions/procedures. In contrast, marked differences emerged when comparing EDAC with ERR or RSRR, showing varying levels of disparities. If the EDAC measure were adopted, between 15.9 and 25.2% of hospitals would experience a change in their penalty status. Specifically, using EDAC would reduce financial penalties for 11.4-16.6% of small community hospitals and safety-net hospitals for at least one of the targeted conditions. These findings suggest that integrating disparity scores into the current ERR-based measurement system could have significant implications for promoting equity and informing policy decisions. By doing so, the evaluation of individual providers and hospital care quality could become more comprehensive, insightful, accurate, and equitable.
23. Clinical, radiological, and laboratory assessment of pulmonary eosinophilia syndrome: a case control study in Saudi Arabia.
期刊: BMC pulmonary medicine 发表日期: 2025-Oct-11 链接: PubMed
摘要
Pulmonary eosinophilic syndromes (PES) are a heterogeneous group of respiratory disorders characterized by eosinophilic infiltration of lung tissues and/or elevated eosinophil counts in peripheral blood. Accurate diagnosis and understanding of PES are crucial for effective management, especially in underrepresented regions such as Saudi Arabia. To evaluate the clinical, radiological, and biomarker profiles of PES in a Saudi Arabian cohort and to identify factors associated with disease presentation and severity. This retrospective case-control study included 95 patients diagnosed with PES at Mouwasat Hospital, Jubail, Eastern Province, Saudi Arabia, from January 2023 to January 2024. Clinical data, laboratory findings (including eosinophil counts, IgE, and FeNO levels), pulmonary function tests, and radiological imaging were analyzed. Statistical analysis was performed using SPSS, with descriptive and inferential methods to assess associations. The cohort had a mean age of 40.5 ± 12.9 years, with a majority being male (65.3%) and Saudi nationals (87%). Elevated eosinophil counts and FeNO levels were significantly associated with PES (p < 0.05). Patients exhibited characteristic radiological patterns such as ground-glass opacities and consolidations. Pulmonary function tests showed reduced FEV₁ and small airway impairment in cases versus controls (p = 0.027). The study observed strong correlations between eosinophilia, airway obstruction, and higher BMI. Smoking was associated with increased symptom severity. The study underscores the distinct clinical, radiological, and biomarker features of PES in the included population. Integrating multi-modal assessments can improve diagnostic accuracy. These findings emphasize the importance of standardized pathways for PES diagnosis, especially in regions with potential underdiagnosis, and highlight the need for increased awareness among healthcare professionals.
24. Living with mental health issues: citizen science project on self-management strategies.
期刊: Npj mental health research 发表日期: 2025-Oct-11 链接: PubMed
摘要
People living with mental health issues use a range of self-management strategies. Most strategy recommendations have been developed by clinicians and researchers, so they may not reflect the full range of approaches used in practice. A citizen mental health science methodology can address this bias in strategy identification. We co-created a list of 77 pre-defined self-management strategies, and 1116 public contributors (n = 468 mental health service users, n = 497 lived experience not using services, n = 151 no lived experience) living in the United Kingdom completed an online survey identifying their use of each strategy, and identifying extra strategies. A wide range of pre-defined strategies were used by contributors, with differences in usage patterns identified between the three groups. 401 distinct extra strategies were identified. The active use of avoidance as a self-management strategy was more common than anticipated, including avoiding alcohol, social media, thinking about problems, other people, and mental health services.
25. Early immune responses to systemic inflammation in the postnatal mouse brain initiated by migrating macrophages and leptomeningeal fibroblasts.
期刊: Journal of neuroinflammation 发表日期: 2025-Oct-11 链接: PubMed
摘要
26. Pink powerhouses: insights into the multifaceted role of Methylobacterium in climate-resilient farming.
期刊: Folia microbiologica 发表日期: 2025-Oct-11 链接: PubMed
摘要
The plant microbiomes consist of a myriad of microorganisms that inhabit and interact with plant tissues and play pivotal roles in improving crop productivity and sustainability. These microbiomes constitute bacteria, fungi, archaea and viruses that have coevolved and supported plants inhabiting the Earth for millions of years. Among these, bacterial members play major functional roles in fostering plant growth and are regarded as plant growth-promoting bacteria (PGPB). One of the major bacterial genera of the plant microbiome that colonizes the entire plant system is the genus Methylobacterium. The genus Methylobacterium is categorized as a member of the class Alphaproteobacteria and is distinguished by its pink pigmentation, which is a result of the synthesis of carotenoids, mainly xanthophiles. Members of the Methylobacterium genus are commonly known as pink-pigmented facultative methylotrophs, which are ubiquitous in nature and have gained significant importance in crop production in various agricultural ecosystems because of their versatile ability to promote plant growth and enhance stress tolerance. They have the unique ability to utilize single-carbon compounds that are released during plant cell metabolism, improve plant growth, siderophore and phytohormone (auxin and cytokinin) production, and nitrogen fixation; phosphorous and zinc solubilization and induced systemic resistance against phytopathogens; protective biofilm formation; and the production of 1-aminocyclopropane-1-carboxylate deaminase to increase stress tolerance and carotenoid production for UV stress tolerance. Owing to its use as a biostimulant, biofertilizer and biocontrol agent, Methylobacterium has potential applications in agriculture for increasing soil health, crop productivity and environmental sustainability. This review provides broad perspectives on the multifaceted role and sustainable application of Methylobacterium in climate-smart agriculture.
27. Healthcare workers' knowledge, attitudes, and practices towards cardiovascular disease prevention: a multi-national cross-sectional study.
期刊: Postgraduate medical journal 发表日期: 2025-Oct-11 链接: PubMed
摘要
We sought to understand healthcare workers’ (HCW) cardiovascular disease (CVD) prevention knowledge, attitudes, and practices to help inform future healthcare policies and optimize preventive cardiology care. Data was collected via an anonymous, online questionnaire which consisted of pre-validated CVD prevention and smoking cessation scales adapted from the Preventive Medicine Attitudes and Activities Questionnaire. Six hundred sixty-eight HCWs (60.5% doctors, 27.8% nurses, 11.7% medical students) from 25 nations responded to the survey. Overall, 74.9% of HCWs routinely assessed patients’ cardiovascular risk profiles in clinical practice. About 65.7% of HCWs counselled patients who were asymptomatic for CVD on tangible lifestyle changes to improve their cardiovascular risk profiles, while 68.2% of HCWs did so when patients were overweight. Of note, only 51.3% of HCWs implemented comprehensive smoking cessation interventions for their patients. Practising HCWs demonstrated higher levels of CVD prevention promotion than medical students in all aspects, except for self-reported importance of CVD risk factor counselling (Tukey honestly significant difference diff: 0.31, P-value: .051). Among practising HCWs, there were no significant differences in their CVD prevention practices across varying lengths of clinical practice. HCWs from higher income nations tended to fare worse than their lower income counterparts. A large multi-national survey reveals significant gaps in the promotion of CVD prevention by HCWs. Significant differences between medical students and practising HCWs’ CVD prevention behaviours, highlight the role of education for the promotion of long-term positive CVD prevention practices. Further efforts should target the medical education of early-career HCWs, especially in higher income nations. Key message What is already known on this topic: The importance of lifestyle modification for the primordial prevention (risk factor prevention) and primary prevention (risk factor management) of cardiovascular disease (CVD) is indisputable. Studies have shown that physicians and other healthcare workers (HCWs) may be best placed to encourage tangible lifestyle changes and enact meaningful modification in patients’ cardiovascular health-related behaviours. What this study adds: However, in practice, the role of HCWs in monitoring and encouraging patients’ health behaviours is complicated by the challenges of real-life clinical practice, such as time constraints or lack of manpower. Hence, this large multi-national survey sought to understand HCWs’ CVD prevention knowledge, attitudes, and practices to help inform future healthcare policies and optimize preventive cardiology care. How this study might affect research, practice, or policy: This study reveals significant gaps in the promotion of CVD prevention by HCWs, highlighting key differences in CVD prevention practices based on profession, level of training, subspecialty, and national income status. Nurses, cardiology subspecialists, and HCWs from lower middle-income nations were found to be more proficient in promoting CVD prevention compared to their counterparts. Further efforts should target the medical education of undergraduate HCWs, especially in higher income nations, as established clinical practices learned during clinical education typically persist and are resistant to change over time.
28. Protocol for monitoring the stability of transcription factor EB using global protein stability assay.
期刊: STAR protocols 发表日期: 2025-Oct-11 链接: PubMed
摘要
Transcription factor EB (TFEB), the master regulator of autophagy-lysosomal networks, undergoes multiple regulatory mechanisms to maintain proteostasis. Here, we present a protocol for quantifying TFEB stability following loss of function of its regulator (YEATS domain-containing protein 2 [YEATS2] knockdown), utilizing a dual-fluorescent reporter system based on flow cytometry. We describe strategies for vector construction, cell transfection, and fluorescence detection. We then detail procedures for analytical workflows. This protocol is designed to enhance sensitivity and reduce processing duration. For complete details on the use and execution of this protocol, please refer to Wang et al.1.
29. Accuracy of SAM-TB Platform as a Diagnostic Assay for Detection of Mycobacterium tuberculosis Drug Resistance Versus TB-Proflier, PhyResSE, and Mykrobe: A Head-to-Head Comparison.
期刊: Current microbiology 发表日期: 2025-Oct-11 链接: PubMed
摘要
Accurate detection of drug-resistant Mycobacterium tuberculosis (MTB) is essential for tuberculosis control, particularly with increasing multidrug-resistant strains. Whole-genome sequencing (WGS), as a supplement to phenotypic drug susceptibility testing (DST), holds great potential for resistance detection, but comparative analyses of multiple WGS tools remain limited. This study assessed four WGS-based tools-SAM-TB, TB-Profiler, Mykrobe predictor, and PhyResSE-for predicting resistance to four first-line drugs (isoniazid, rifampicin, ethambutol, and streptomycin) using 113 clinical MTB isolates from Ganzhou, China, with phenotypic DST as reference. All tools showed similar sensitivity (85.04-88.19%) and high specificity (95.69-96.31%). Several known resistance-associated mutations were identified, along with seven novel mutations absent from the WHO catalogue and thirteen of uncertain clinical significance. Discrepancies between WGS and DST occurred across all drugs, potentially due to disputed mutations, outdated databases, or limitations of phenotypic methods. These results highlight the complementary roles of WGS and phenotypic DST in drug resistance surveillance and emphasize the need for continuously updated mutation databases, including the WHO catalogue, and standardized interpretation criteria to enhance the clinical utility of WGS.
30. Abnormal activation of platelets and inflammation in smoking-induced rheumatoid arthritis is alleviated by 3,3'-diindolylmethane.
期刊: Genes and immunity 发表日期: 2025-Oct-11 链接: PubMed
摘要
Rheumatoid arthritis (RA) is generally recognized as a complex disease initiated by environmental factors in the context of genetic susceptibility, among which smoking is one of the independent risk factors for RA. Smoking exposure would promote RA inflammation amplification probably because of platelet abnormal activation. This study aims to discover the preventive bioactivities of 3,3’-diindolylmethane (DIM) against RA with smoke exposure and explore the mechanisms by targeting platelet. The findings demonstrate that DIM can ameliorate smoking induced inflammation amplification in CIA mice through diverse of pathology analysis. Notably, the platelet abnormal activation was observed in CIA mice with smoke exposure and it was indeed inhibited by DIM treatment. Additionally, in vitro cigarette smoke extract (CSE) promoted platelet abnormal activation and aggregation characterizing by up-regulation of CD62p expression, Ca2+ mobilization, ROS release and down-regulation of mitochondrial membrane potential (ΔΨm), while DIM could suppress these processes. We verified DIM could mitigate RA inflammation amplification induced by smoking and smoke exposure via inhibiting MAPK/NF-κB and PI3K/Akt/mTOR pathways phosphorylation during platelets abnormal activation. Our research provided a scientific basis for the rational use of DIM and other phytochemicals in the prevention and treatment of RA with smoking and smoke exposure from the perspective of nutrition.
31. Integrating GPS-based exposure assessment and intracardiac device monitoring to link air pollution and atrial fibrillation.
期刊: Environmental science and pollution research international 发表日期: 2025-Oct-11 链接: PubMed
摘要
Air pollution is a significant risk factor for atrial fibrillation (AF), a condition marked by sudden and transient episodes. Accurately capturing these short-term associations requires precise exposure assessment. However, conventional methods utilizing residential addresses alone do not account for personal mobility and rapid fluctuations in pollutant levels, leading to exposure misclassification. To improve exposure precision, we developed a novel method that integrates GPS-tracked mobility data with intracardiac device monitoring to examine short-term associations between ambient air pollutants and atrial fibrillation (AF) episodes. We applied a time-stratified case-crossover design combined with distributed lag nonlinear models (DLNMs) to evaluate associations between short-term exposure to air pollutants, including particulate matter ≤ 2.5 µm and ≤ 10 µm in diameter (PM2.5 and PM10), nitrogen dioxide (NO2), ozone (O3), and sulfur dioxide (SO2), and AF episodes. AF episodes were ascertained through intracardiac devices (pacemakers and defibrillators) equipped for continuous recording arrhythmic events. Exposure estimates derived from GPS-based mobility data were compared to those based on participants’ residential addresses. An increase by interquartile range of exposure within 1 day before event showed higher odds ratios (ORs) for AF with GPS-based estimates, particularly for PM2.5 (OR: 1.26, 95% CI: 0.81, 1.96) and NO2 (OR: 1.22, 95% CI: 0.94, 1.57), compared to residential methods (PM2.5 OR: 1.07, 95% CI: 0.53, 2.14; NO2 OR: 1.01, 95% CI: 0.65, 1.55). Participants younger than 70 years old demonstrated stronger associations using GPS-based methods. Similarly, higher effect estimates were observed among current smokers, while differences between exposure models were less pronounced in non-smokers. GPS-enhanced, real-time pollutant exposure demonstrates feasibility and may improve accuracy by capturing dynamic exposure patterns. The results suggest potential advantages of GPS-based approach in identifying vulnerable populations, but larger studies are needed to confirm is superiority in environmental health research.
32. Paternal SARS-CoV-2 infection impacts sperm small noncoding RNAs and increases anxiety in offspring in a sex-dependent manner.
期刊: Nature communications 发表日期: 2025-Oct-11 链接: PubMed
摘要
Given that the SARS-CoV-2 virus, and the COVID-19 pandemic, constitutes a major environmental challenge faced by billions of people worldwide, we investigated whether paternal pre-conceptual SARS-CoV-2 infection has impacts on sperm RNA content, and intergenerational (F1) and transgenerational (F2) effects on offspring phenotypes. Using an established mouse-adapted SARS-CoV-2 (P21) preclinical model, we infected adult male mice with the virus, or performed a mock control infection, and bred them with naïve female mice four weeks later, when males were no longer infectious. Here we show that offspring of infected sires display increased anxiety-like behaviors. Additionally, the F1 offspring have significant transcriptomic changes in their hippocampus. Various sperm small noncoding RNAs, including PIWI-interacting RNAs, transfer-derived RNAs and microRNAs, are differentially altered by prior paternal SARS-CoV-2 infection. Microinjection of RNA from the sperm of SARS-CoV-2 infected males into fertilized oocytes leads to a phenotype resembling that of the naturally born F1 offspring, supporting the interpretation that sperm RNAs are contributing to the outcomes of our paternal SARS-CoV-2 model. Therefore, this study provides evidence that paternal SARS-CoV-2 infection impacts sperm and affects offspring phenotypes. These findings have public-health implications and inform further research in males affected by COVID-19, and their offspring.
33. Activating NRF2E79Q mutation alters the differentiation of human non-small cell lung cancer.
期刊: Cancer gene therapy 发表日期: 2025-Oct-11 链接: PubMed
摘要
The NRF2 signaling pathway promotes tumor initiation, progression and resistance to chemotherapy, radiation therapy and immune checkpoint inhibitors. The mechanisms underlying the biology of NRF2-active tumors are varied and include altered cellular metabolism, a reductive shift in redox state, and immunosuppression. Here we determined the molecular and phenotypic impact of NRF2 activation on two human non-small cell lung cancer (NSCLC) cell models. Inducible expression of NRF2E79Q, a common activating NRF2 mutation, in H358 lung adenocarcinoma (LUAD) cells altered cellular morphology and increased xenograft tumor growth in mice but not in 2D cell culture. In contrast, NRF2E79Q expression in H596 lung adeno-squamous cell carcinoma altered cellular morphology, increased neuroendocrine marker gene expression, but did not impact tumor growth in 2D or in xenografts. Gene expression profiling revealed shared and unique NRF2 transcriptional programs between these models, some of which were shared in primary lung tumors. Collectively, our findings reveal context-dependent effects of NRF2 activation on the growth and differentiation state of two human NSCLC models, supporting a role for NRF2 activation in altering the differentiation of human NSCLC during tumor progression.
34. Mistrust Limits Possibilities for Patient-Provider Discussions Regarding Cannabis Use During Pregnancy.
期刊: Women’s health issues : official publication of the Jacobs Institute of Women’s Health 发表日期: 2025-Oct-10 链接: PubMed
摘要
Recent changes in cannabis policy and use among pregnant people have prompted recommendations that health care providers discuss cannabis use with pregnant patients. We explored pregnant people’s perceptions of their interactions with health care providers regarding cannabis use during pregnancy. We conducted in-depth interviews with 34 individuals who were either pregnant or had been pregnant within the past 2 years and who used cannabis before or during their pregnancy. The interviews explored people’s experiences with and perspectives on communication with health care providers about cannabis use during pregnancy. Most participants reported an absence of provider-initiated inquiries about cannabis use and few disclosed their cannabis use to a provider. Participants expressed distrust in providers as sources of accurate cannabis information, as they understood providers as grouping cannabis with alcohol and other drugs, which they saw as conflicting with their perception of a lack of conclusive scientific evidence about health effects of cannabis use during pregnancy. They worried about providers judging and reporting them to child welfare if providers learned about their cannabis use. Participants described using cannabis for medical reasons, but only rarely recalled experiencing providers talking with them about risks and benefits of cannabis versus other treatments. Although many pregnant people use cannabis as a medicine to manage pregnancy symptoms or health conditions, they perceive providers as viewing and treating cannabis as a harmful recreational drug. This disconnect, along with their fears of provider judgment and of providers reporting them to child welfare, appears to be limiting effective, person-focused discussions regarding risks and benefits of different approaches to treating the symptoms and health conditions for which pregnant people use cannabis.
35. Association of chemsex and risk of chlamydia, gonorrhoea, and syphilis infections: a systematic review and meta-analysis.
期刊: Public health 发表日期: 2025-Oct-10 链接: PubMed
摘要
Chemsex, the use of psychoactive substances to enhance sexual experiences, is increasingly recognized as a public health concern, particularly among men who have sex with men (MSM). This behavior is associated with risky sexual practices, including condomless sex, multiple partners, and prolonged sexual sessions, which may elevate the risk of sexually transmitted infections (STIs) such as chlamydia, gonorrhea, and syphilis. This systematic review and meta-analysis aim to quantify the association between chemsex and these bacterial STIs. Systematic review and meta-analysis. A systematic search of PubMed, Embase, and Web of Science was conducted to identify studies reporting associations between chemsex and chlamydia, gonorrhea, or syphilis until November 10, 2024. Eligible studies included observational designs with chemsex participants and STI outcomes. Random-effects meta-analyses were performed to estimate pooled odds ratios (ORs) with 95 % confidence intervals (CIs). Statistical analysis was performed by using R software version 4.4. A total of 13 studies were included across multiple countries. The meta-analysis revealed a significant association between chemsex and syphilis (pooled OR: 1.741, 95 % CI: 1.337-2.267), gonorrhea (pooled OR: 1.784, 95 % CI: 1.428-2.228), and chlamydia (pooled OR: 1.429, 95 % CI: 1.195-1.710). Two studies reporting hazard ratios for gonorrhea (pooled HR: 1.699, 95 % CI: 1.361-2.121) and chlamydia (pooled HR: 1.202, 95 % CI: 0.972-1.487) showed consistent findings. Heterogeneity across studies was minimal for most outcomes (I2 = 0 %), and prediction intervals supported stable effect sizes. This study confirms that chemsex is significantly associated with an increased risk of bacterial STIs, particularly syphilis and gonorrhea. The findings highlight the urgent need for interventions addressing chemsex behaviors, including harm reduction strategies, STI prevention programs, and culturally competent healthcare services. Future research should focus on standardizing definitions of chemsex, expanding investigations to low- and middle-income countries, and addressing publication bias to ensure global relevance and reliability of evidence.
36. Trends in blunt smoking among adults in the United States, 2015-2022.
期刊: Addictive behaviors 发表日期: 2025-Oct-10 链接: PubMed
摘要
We quantify and compare population-level trends in blunt smoking across demographics as well as behavioral and regulatory factors among adults in the US from 2015 to 2022. We analyzed eight (8) years of data from the National Survey of Drug Use and Health (NSDUH). Participants were n = 326,087 adults; a subsample of n = 22,294 current blunt smokers was used to examine daily blunt smoking. We modeled linear trends in lifetime (ever), current (past 30-day), and daily (30/30 days) blunt smoking by: sex, race/ethnicity, age category, income, Major Depressive Episodes, alcohol use, and state-level cannabis regulatory policy. From 2015 to 2022, lifetime blunt smoking increased ∼21.7 % (p < 0.001), current blunt smoking increased ∼34.4 % (p < 0.001), and daily blunt smoking among current users increased ∼24.5 % (p < 0.001). Lifetime blunt smoking increased significantly more among non-Hispanic White (23.7 %) and Hispanic (30.2 %) relative to non-Hispanic Black (8.6 %) adults; similar increases were observed among those older than 18-25 years. Current blunt smoking increased significantly greater among females (63.6 %) relative to males (19.0 %) and among those who did not use alcohol (92.3 %) relative to those who did use alcohol (23.4 %). Daily blunt smoking increased significantly greater among non-Hispanic White (80.4 %) relative to non-Hispanic Black (3.7 %) adults. Blunt smoking increased substantially from 2015 to 2022. The greatest increases in blunt smoking were observed among females, older adults, and those who did not use alcohol; groups with historically lower rates of blunt smoking. Future study is needed to understand patterns of blunt initiation, escalation, and use disorder.
37. Movement and brain health in perimenopausal and early postmenopausal females: A scoping review.
期刊: Maturitas 发表日期: 2025-Oct-10 链接: PubMed
摘要
The menopause transition is associated with dramatic fluctuations and eventual decline in levels of ovarian hormones, leading to loss of neuroprotection, marking this as an important intervention period for brain health promotion in females. Physical activity and exercise can improve brain health in older, postmenopausal females. Whether movement (physical activity and exercise) can protect brain health in perimenopausal and early postmenopausal females is not clear. The objective of this scoping review was to map the literature examining the relationship between movement and brain health in perimenopausal and early postmenopausal females, with a focus on identifying key methodological approaches and gaps in the knowledge. This scoping review considered studies of any design that included a movement component with a primary focus on perimenopausal females and secondary focus on early postmenopausal females, with a brain health outcome. This scoping review followed JBI recommendations and methodology and the PRISMA-ScR reporting guidelines. The following databases were searched: Medline All (OVID), Embase (OVID), APA PsycInfo (OVID), Scopus (Elsevier), CINAHL (Ebsco), and SportDiscus (Ebsco). Details about participant population, study methods, and key findings were extracted. Of the 30,927 identified records, 19 studies were included in the synthesis, with 3 studies conducted with only perimenopausal females, 8 studies with only early postmenopausal females, and 8 studies with a mixed cohort. Aerobic training was the most common form of movement (n = 7) and executive function was the most common brain health outcome measured (n = 12). Benefits of movement on brain health were seen in 13 studies (68.4%). In this scoping review, we cover the limited research published to date that explores movement and brain health in perimenopausal and early postmenopausal females. While current research provides promising support for the effectiveness of exercise and physical activity to promote brain health during this period of the lifespan, more high-quality studies in perimenopause are needed with standardized reproductive staging and comprehensive brain health and menopausal symptom measures to establish the effectiveness of exercise during this critical neuro-aging period. doi: 10.17605/OSF.IO/F52JR.
38. The role of cord blood lipidomics in the associations of prenatal exposure to bisphenol A and its analogs with infant growth: A birth cohort study.
期刊: Ecotoxicology and environmental safety 发表日期: 2025-Oct-10 链接: PubMed
摘要
Prenatal bisphenols (BPs) exposure may affect infant growth, but the underlying mechanisms remain unclear. Based on Shanghai-Minhang Birth Cohort Study, we examined associations of prenatal BPs exposure with cord blood lipidomics and further explored whether lipid profile alterations mediate the associations between BPs and infant growth. We measured 6 BPs in late-pregnancy maternal urine and infant anthropometry at birth, 6, and 12 months. Cord blood lipid metabolites were measured through lipidomics, including fatty acyls (FA), sterol lipids (SL), and glycerophospholipids (GP). Principal components (PCAs) of FA, SL, and GP metabolites were extracted as FA1-3, SL1, and GP1-3, respectively. Multiple linear regression models showed that BPA, BPF, BPS, and BPAF were associated with decreased concentrations of FA, SL, and several GP metabolites (mainly representing GP1), but increased other GP metabolites (mainly representing GP2), while TCBPA showed opposite patterns. Mediation analysis showed that metabolites in arachidonic acid and phosphatidylinositol metabolism pathways mediated the associations between BPA, BPF, BPS and increased infants’ skinfold thickness, with proportions ranging from 18.15 % to 32.47 %. Our findings provide novel evidence that prenatal BPs exposure may disrupt fetal lipid metabolism and highlight the role of arachidonic acid and phosphatidylinositol metabolism in effects of BPs exposure on infant growth.
39. Real-world characterization of clinical management and achievement of the recommended risk-based low-density lipoprotein cholesterol and blood pressure goals in patients with arterial hypertension and dyslipidemia. The SNAPSHOT study.
期刊: Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis 发表日期: 2025-Oct-10 链接: PubMed
摘要
Arterial hypertension and dyslipidemia are two of the most relevant modifiable cardiovascular risk factors (CVRFs), and they often coexist. No recent studies specifically evaluating the achievement of LDL-C and blood pressure (BP) targets in hypertensive patients with dyslipidemia are available in Spain. The SNAPSHOT study was a multicenter, cross-sectional observational study conducted in cardiology and internal medicine (IM) departments/clinics and primary care (PC) centers in Spain. The study enrolled consecutive adult patients (≥18 years of age) diagnosed with both hypertension and dyslipidemia. The primary endpoint was the percentage of patients achieving both the LDL-C goals recommended by the 2021 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines and the BP targets established in the 2018 ESC/European Society of Hypertension (ESH) guidelines. Cardiovascular (CV) risk (very high, high, low-to-moderate) was centrally assessed according to the updated Systematic Coronary Risk Evaluation (SCORE2) and SCORE2-Older Person (OP) algorithms recommended in the 2021 ESC guidelines. Between December 2021 and April 2022, a total of 443 evaluable patients were enrolled (males: 54%; ≥65 years of age: 66.1%; obesity: 37.4%; diabetes mellitus: 37.3%; coronary artery disease [CAD]: 25.7%). Out of the 388 patients in whom CV risk could be assessed, 34.3% and 56.4% were considered as having high and very high risk, respectively. Overall, 24% of the patients had achieved their risk-based LDL-C goals (21.8% of the patients at high-CV risk and 25.1% of those at very high risk), and 30.3% of the patients had reached the recommended BP targets (27.1% of the patients at high risk and 36.1% of those at very high risk). A total of 8.8% of the patients had achieved both the LDL-C and BP targets. Overall, 51.4% of the patients with concurrent diabetes had achieved glycemic control (HbA1c <7%), while only 9.4% of the diabetic patients had reached simultaneous control of LDL-C, BP and HbA1C targets (7.8% of the patients at high risk and 10.4% of those at very high risk). The attainment of LDL-C and BP goals is still suboptimal in patients with dyslipidemia and hypertension in the real-world setting in Spain, with approximately 75% of the patients at very high risk of cardiovascular disease failing to reach their risk-based LDL-C and BP targets. Additionally, the rate corresponding to simultaneous control of LDL-C, BP and HbA1c is likewise very low. The present study thus highlights the current challenge of controlling multiple CVRFs that significantly contribute to atherosclerotic cardiovascular disease events and mortality and emphasizes the need for more effective management of CVRFs in the real-world setting.
40. Corrigendum to "From lipids to glucose: Investigating the role of dyslipidemia in the risk of insulin resistance" [J. Steroid Biochem. Mol. Biol. 250 (2025) 106744].
期刊: The Journal of steroid biochemistry and molecular biology 发表日期: 2025-Oct-10 链接: PubMed
摘要
41. Investigating polychlorinated naphthalenes (PCNs) in Asia Pacific regions: A review of sources, occurrences and health impacts.
期刊: The Science of the total environment 发表日期: 2025-Oct-10 链接: PubMed
摘要
Polychlorinated naphthalenes (PCNs) are a class of persistent organic pollutants (POPs) that can exhibit high environmental persistence, bioaccumulation properties and significant toxicological effects. Historically, PCNs have been used as insulators and fire retardants in various electrical and industrial applications due to their stability and compatibility. Despite the implementation of global regulatory initiatives such as the ‘phase-out policy’ and Stockholm Convention on POPs, their legacy contamination and ongoing emissions continue to pose environmental and public health risks, especially in Asia. This review investigated current knowledge on the sources, occurrences and health impacts of PCNs in rapidly developing and densely populated urban Asian regions. Our findings indicate that metallurgy industries are the major source of PCNs, contributing over 97 % of total emissions, followed by thermal processes, historical usage and emerging concerns of electronic waste recycling activities. Lower chlorinated PCN congeners (mono to tetra) levels were found to vary significantly from fg to ng levels in environmental distribution, contributing to the extensive contamination of air, soil, water, sediments and biota samples in proximity to industrial areas. Occupational exposure was associated with increased cancer risks (CR), while elevated non-CR were observed in vulnerable populations such as infants and children. Ingestion was the primary exposure route, occurring through consumption of PCNs contaminated food. PCNs exposure showed potential health risks including carcinogenicity, neurotoxicity, endocrine disruption and reproductive disorders. This review highlights the need for further research on emerging potential sources, longitudinal environmental monitoring and epidemiological studies to evaluate health impacts of PCN exposures in Asian regions.
42. Public Health Investigations in Outpatient Healthcare Settings Nationwide, August 2019 - July 2023.
期刊: American journal of infection control 发表日期: 2025-Oct-09 链接: PubMed
摘要
Outbreaks and other adverse patient safety events can occur in any healthcare setting and warrant investigation to minimize harm; however, national-level data for outpatient setting investigations are limited. We reviewed data reported by health departments to characterize these investigations. Health department investigations of novel or targeted multidrug-resistant organisms (nMDRO investigations) or clusters of healthcare-associated infections caused by non-nMDROs and infection control breaches with or without reported infections (HAI investigations) conducted from August 1, 2019, to July 31, 2023, were reported to CDC and reviewed to describe investigations involving outpatient settings only. SARS-CoV-2 investigations were excluded. Among 4,182 reported investigations, 330 (8%) involved ≥ 1 outpatient settings. Of these, 230 (70%) involved outpatient settings only, including 38 dental (17%), 21 ambulatory surgery (9%), and 21 urology (9%) investigations. Of the 230, 148 (64%) were HAI investigations, and 82 (36%) were nMDRO investigations. Infection control breaches were reported in 100 of 148 (68%) HAI investigations, including in 78 (53%) without reported infections. Of the 100, device reprocessing (56, 56%) and injection safety and medication preparation (29, 29%) breaches were most common. Infection risks were identified across a variety of outpatient settings, highlighting the role of health departments in addressing urgent outpatient safety issues.
43. GSTA1 conferred tolerance to osimertinib and provided strategies to overcome drug-tolerant persister in EGFR-mutant lung adenocarcinoma.
期刊: Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer 发表日期: 2025-Oct-09 链接: PubMed
摘要
The generation of drug-tolerant persister (DTP) cancer cells remains a major challenge for lung adenocarcinoma (LUAD) patients treated with EGFR-tyrosine kinase inhibitors (TKIs), as these cells eventually lead to drug resistance and disease progression. However, the mechanisms underlying DTP formation are poorly understood, limiting treatment options when DTP state or resistance emerges following TKI therapy. In this study, utilizing samples from LUAD patients receiving front-line osimertinib therapy, including baseline, DTP, and stable resistance states, we dissected the cellular and transcriptomic features of TKI-induced DTP cells. These cells exhibited an active drug-metabolizing phenotype, characterized by significantly increased expression of Glutathione S-Transferase Alpha 1 (GSTA1), which was regulated by Radial Spoke Head Component 1 (RSPH1). Mechanistically, we demonstrated that elevated GSTA1 expression in cancer cells promoted osimertinib degradation. Furthermore, RSPH1+ DTP cells interacted with macrophages via Protein S (PROS1)-AXL signaling to establish an immunosuppressive tumor microenvironment (TME), thereby contributing to persister formation. We investigated the RSPH1-CALML4-GSTA1 regulatory axis and found that PROS1 expression was also governed by this axis, suggesting that GSTA1 acted as an upstream regulator of the PROS1-AXL signaling pathway. We evaluated the feasibility of combination therapy using osimertinib and the GSTA1 inhibitor curzerene in both osimertinib-induced DTP and acquired resistance mouse models. Notably, this strategy demonstrated superior efficacy and safety compared to chemotherapy or AXL inhibitor combination in both settings. Collectively, our study elucidated novel mechanisms contributing to the TKI-induced DTP state and provided a promising combination strategy to overcome drug tolerance and resistance in osimertinib-treated LUAD patients.
44. Genome-wide association study and HLA genotyping for beryllium disease susceptibility in a European descent population.
期刊: Gene 发表日期: 2025-Oct-09 链接: PubMed
摘要
Workplace exposure to beryllium can result in beryllium sensitization (BeS), a cell-mediated immune response that can progress to chronic beryllium disease (CBD), a granulomatous lung disease. DPB1-E69 is highly associated with CBD and BeS, although DRB1-E71 may also be a risk factor in the absence of DPB1-E69. This study 1) identified novel genetic variants associated with CBD/BeS using a genome-wide association study (GWAS) approach and 2) clarified the role of DRB1-E71 in conjunction with DPB1-E69. We performed GWAS and HLA analysis on 1,626 subjects with BeS, CBD and beryllium exposure without disease. We found that rs1042140, the first base of the codon that encodes E69, was associated with CBD and BeS. We also found two single nucleotide polymorphisms (SNPs), rs56011217 and rs72636334, near SRIP1 on chromosome 4 associated with CBD and BeS independent of rs1042140. HLA alleles DRB104:04 (non E71) and DQB106:04 were significantly associated with CBD and BeS independent of rs1042140. We found both DPB1-E69 and DRB1-E71 carriers have a higher risk of CBD or BeS both independently and jointly, with DPB1-E69 status having higher impact than DRB1-E71 status. DRB1-E71 also increases the risk in subjects without DPB1-E69. Our study also implies that beyond HLA, SRIP1 should be investigated in chronic beryllium disease pathogenesis.
45. Laboratory-Acquired Infections in the MENA Region: A Systematic Review of Reported Cases and Biosafety Gaps.
期刊: The Journal of hospital infection 发表日期: 2025-Oct-09 链接: PubMed
摘要
Laboratory-acquired infections (LAIs) are a significant occupational health hazard to laboratory workers. Laboratory personnel can become infected by various pathogens handled as part of their work, including bacteria, fungi, viruses, and parasites. Despite their importance, data on LAI in the Middle East and North Africa (MENA) regions are limited. The aim of this study was to systematically review the reported LAIs in the MENA region to identify gaps in biosafety practices and identify the most common infectious agents contributing to them. The PubMed, Scopus, LAI, and Belgian Biosafety Server (BBS) databases were searched from conception to October 2024 for any reports and cases of LAIs in the MENA region, following PRISMA guidelines. Using a systematic strategy, inclusion criteria were relevant studies reporting cases involving MENA laboratory workers. Non-laboratory cases or studies with insufficient data were excluded. Quality was assessed using a specific quality assessment tool for case reports and case series. Reported cases were analyzed by infection type, risk factors, and laboratory practices. Of 2,062 studies, 12 articles (24 cases) from Egypt, Saudi Arabia, Turkey, and UAE were considered eligible for inclusion. Twenty-four LAI cases were reported in the MENA region between 1968 and 2016. Brucella melitensis was the most frequently reported pathogen, reported in 66.7% of cases, highlighting a specific occupational risk in microbiology laboratories in the region. The review also identified gaps in data reporting, variability in laboratory biosafety practices, and a tendency towards underreporting. This review highlights the occupational health risks posed by LAIs in the MENA region, with Brucella spp. identified as the predominant pathogens in reported cases, and it also identifies gaps in biosafety practices. Limitations include underreporting and English-only searches. No funding was received.
46. Post-Hospitalization Telerehabilitation is Acceptable and Feasible for Veterans With Dementia: A Secondary Qualitative Study.
期刊: Journal of the American Medical Directors Association 发表日期: 2025-Oct-08 链接: PubMed
摘要
The objective of this secondary analysis of qualitative data was to examine the acceptability and feasibility of telerehabilitation as a post-acute service delivery model for veterans with dementia. We conducted a secondary analysis of qualitative, semistructured interview data from veterans who have a dementia diagnosis and were hospitalized, their care partners, and Department of Veterans Affairs rehabilitation clinicians. We conducted a directed content analysis guided by the Practical, Robust Implementation and Sustainability Model (PRISM) using a rapid qualitative, deductive team-based approach. Our analysis of qualitative data from 11 veterans with dementia, 13 care partners, and 23 rehabilitation clinicians (physical therapists N = 11, occupational therapists N = 12), suggested that perceived telehealth acceptability and feasibility in post-acute care for veterans with dementia were interdependent factors. We identified that acceptability would likely be influenced by subthemes of (1) rehabilitation at the intersection of technology, cognitive impairment, and preferences; (2) telerehabilitation as a supplement to in-person care; and (3) telerehabilitation as a veteran-centered benefit. We also identified that feasibility of telerehabilitation could be supported by (1) veteran and clinician physical space, (2) usable technology with tailored support, (3) telerehabilitation-specific education, and (4) clinical resources and operations. Telerehabilitation may be an acceptable model for veteran-centric, post-acute care for persons with dementia, particularly if veterans, care partners, and clinicians have support for feasibility. Future research is needed to examine post-acute telerehabilitation implementation, service delivery timing, and influence on patient-centered outcomes.
47. The role of aging biomarkers and reproductive hormones in the association between microcystin-LR exposure and semen quality.
期刊: Journal of hazardous materials 发表日期: 2025-Oct-08 链接: PubMed
摘要
Toxicological evidence suggests that microcystin-LR (MC-LR) may impair male reproductive function, but epidemiological data remain limited. We conducted a cross-sectional study in Henan Province to investigate the effects of MC-LR exposure on semen quality and the potential mediating roles of aging biomarkers, including sperm mitochondrial DNA copy number (mtDNAcn) and telomere length (TL), as well as reproductive hormones. Urinary MC-LR concentrations were measured using a newly developed ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method. Generalized linear models were used to evaluate associations, and mediation analysis was conducted to quantify indirect effects. Furthermore, the role of oxidative stress in MC-LR-induced alterations of mtDNAcn and TL was examined in vitro using GC-1 cells. MC-LR exposure was associated with adverse changes in semen quality, reproductive hormones, and aging biomarkers. Mediation analysis revealed that follicle-stimulating hormone, sperm mtDNAcn, and sperm TL mediated the effects of MC-LR on the decline in semen quality (mediation proportion 8 %-55 %). Moreover, certain doses of MC-LR increased ROS, mtDNAcn, and TL in GC-1 cells, which were partially reversed by the antioxidant N-Acetyl-L-cysteine. These findings provide new evidence linking environmental MC-LR exposure to impaired male reproductive health, possibly attributable to accelerated aging processes mediated by oxidative stress.
48. Obesity and hypertension new insights in management.
期刊: Current opinion in cardiology 发表日期: 2025-Oct-06 链接: PubMed
摘要
Obesity-associated hypertension is a pressing and ever-growing public health concern. The prevalence of obesity has increased four-fold over the four preceding decades, with concomitantly rising rates of hypertension not far behind. Importantly, the interplay between these conditions exacerbates cardiovascular disease (CVD) risk, and optimal management strategies remain an evolving challenge. This review synthesizes recent advancements in understanding obesity-associated hypertension pathophysiology and explores emerging therapeutic options, highlighting their relevance in shaping future clinical practice. Emerging research into understanding obesity-associated hypertension has identified mechanisms, including dysregulated hormonal signaling, increased sympathetic activity, and enhanced inflammation as the key processes underlying obesity-associated hypertension development. With respect to management, new dietary interventions are poised to overtake traditional strategies as the ideal approach to achieving sustained weight loss for obesity-associated hypertension patients. Additionally, while conventional antihypertensive medications highlight the mainstay of standard pharmacotherapy, recent studies highlight the efficacy of diabetic agents and other novel therapies, which have the potential to further shape obesity-associated hypertension management guidelines. As an emphasis on precision medicine underscores contemporary research into obesity-associated hypertension management, targeted treatment strategies are emerging as promising alternatives for reducing CVD burden and improving patient outcomes. Ultimately, further research is necessary to continue to refine treatment guidelines and explore the full potential of evolving interventions.
49. A systematic review of Photovoice studies on health-promoting behaviors among individuals with disabilities: Insights from the socio-ecological model.
期刊: Disability and health journal 发表日期: 2025-Oct-06 链接: PubMed
摘要
Photovoice enables participants to document their lived realities through photography, fostering self-expression and deeper reflection. Leveraging these strengths, this study aimed to systematically review Photovoice research involving people with disabilities to explore the lived experiences with health-promoting behaviors. A systematic literature review was conducted in July 2024 using multiple electronic databases, including PubMed, EMBASE, CINAHL, Cochrane, and Medline. The search process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Quality appraisal was performed using the Critical Appraisal Skills Program. Identified facilitators and barriers to health-promoting behaviors among individuals with disabilities were mapped onto the Socio-Ecological Model to provide a structured analysis. Ten studies met the inclusion criteria for this review. At individual level, nine facilitators and seven barriers were identified. The interpersonal level revealed three facilitators and two barriers, while the institutional level included two facilitators and one barrier. At the community level, four facilitators and four barriers were found. No relevant factors were identified at the policy level. This study expands the existing literature on participatory research by systematically reviewing Photovoice studies that examine health-promoting behaviors among people with disabilities. By offering a comprehensive analysis of facilitators and barriers, this review enhances the understanding of lived experiences and informs future interventions aimed at fostering inclusive and supportive environments for health promotion.
50. Changes in the levels and predictors of per- and poly-fluoroalkyl substances in maternal plasma, relative to timelines of EPA PFOA Stewardship.
期刊: Environment international 发表日期: 2025-Oct-04 链接: PubMed
摘要
Declines of several common-studied PFAS noted in the U.S. likely reflect policies that successfully reduced long-chained PFAS production and emission such as the EPA PFOA Stewardship Program. Policy impacts on under-studied PFAS and on predictors of PFAS exposure remain unknown. To assess changes in population-levels and exposure predictors of 10 PFAS in the Boston Birth Cohort (BBC) by Stewardship timelines. In 1,288 BBC mothers who delivered 1999-2016, the current study focused on 10 PFAS in plasma samples collected 24-72 h postpartum. We estimated PFAS percent differences (%Δ), stratified by the Stewardship timelines. We evaluated predictors related to sources, vulnerability, blood-loss, and diet during pregnancy. The majority of participants were Black (65 %); 8 PFAS were commonly detected (>85 %). PFOS, PFOA, PFHxS, PFHpS, and Me-PFOSA-AcOH decreased by up to 88 % during PFOA reduction-period (2006-2009) or elimination-period (2010-2016) compared to pre-policy (1999-2005), regardless of race/ethnicity; PFNA, PFUnA, PFDeA, PFDoA, and GenX increased by up to 104 % among non-White mothers. PFAS were up to 148 % higher in mothers who frequently consumed shellfish or fish or vegetables, worked, owned pet(s), or had wall-to-wall carpet, with stronger associations post-policy for shellfish, fish, and working. PFAS were up to 36 % lower in mothers who had cesarean-section, took vitamin supplements, or lived overseas during pregnancy, with weaker associations post-policy for delivery type and country of residence. Chemical policies can be effective at reducing PFAS exposures at the population-level, although the beneficial effects may not be equal across population-subgroups and could increase unregulated chemical exposures. Fish and vegetable consumption and occupational status were consistently associated with higher levels, while patterns of other predictors changed over time.
51. Chemiluminescence immunoassay based on anti-MRGPRX2&HRP@ZIF-8 and its application in the clinical detection of chronic spontaneous urticaria.
期刊: Talanta 发表日期: 2025-Oct-03 链接: PubMed
摘要
The immunoassay methods, stand as the gold standard in biomedicine, are widely used in diagnostics. However, they often encounter inherent limitations in practical applications, such as the poor stability of enzymes and antibodies, and the laborious process of preparing enzyme-antibody conjugates through covalent bonding. Mas-related G-protein-coupled receptor X2 (MRGPRX2) has been identified as a blood-based diagnostic biomarker for chronic spontaneous urticaria (CSU). In this study, a bifunctional enzyme-labeled antibody (anti-MRGPRX2&HRP@ZIF-8) was successfully constructed by integrating horseradish peroxidase (HRP) into ZIF-8 during its synthesis, followed by adsorption of anti-MRGPRX2 onto the surface of HRP@ZIF-8. The resulting anti-MRGPRX2&HRP@ZIF-8 complex not only preserved its antigen-capturing capability but also exhibited improved stability. The established chemiluminescence immunoassay (CLIA) method based on anti-MRGPRX2&HRP@ZIF-8 demonstrated enhanced stability and achieved a lower detection limit (1.035 ng/mL) compared to conventional enzyme-linked immunosorbent assay (ELISA) method. Furthermore, MRGPRX2 was successfully detected in serum samples by the established method, demonstrating its suitability for the diagnosis of CSU in real clinical samples. Consequently, this study presented a promising approach for simplifying the preparation of enzyme-antibody conjugates and highlighted the potential of metal-organic framework (MOF)-based composites in biomedical applications.
52. Pregnancy psychological distress: A concept analysis.
期刊: Midwifery 发表日期: 2025-Oct-02 链接: PubMed
摘要
Pregnancy psychological distress is a critical determinant of maternal and infant health outcomes, however, there is a lack of clarity regarding its definition and conceptual meaning. This concept analysis aimed to explore the concept of pregnancy psychological distress and establish an operational definition for application in practice, research and policy. The Walker and Avant’s concept analysis was used to explore the concept of pregnancy psychological distress. A systematic literature search was conducted across five English (CINAHL, PubMed, Web of Science, Scopus, and Embase) and three Chinese (CNKI, WanFang, and VIP) literature databases from their date of inception to 1 October 2024. All selected papers were analysed for definitions of pregnancy psychological distress, as well as for its defining attributes, antecedents and consequences. Twenty-five papers were included. The defining attributes of pregnancy psychological distress include subjective emotionality, broad-spectrum affective variability and non-psychiatric aetiology. Antecedents include demographic and medical history factors, as well as social and psychological factors. Consequences include adverse maternal-neonatal outcomes, negative attitudes, avoidance behaviours and relational dysfunction. This study provides a conceptual clarification of pregnancy psychological distress by distinguishing it from broader prenatal conditions. This elucidated concept establishes the necessary foundation for informing the development of targeted midwifery-led assessments and care, thereby bridging the gap between theory and clinical practice.
53. Prevalence of Enduring Power of Attorney and Advance Health Directive documents among culturally and linguistically diverse patients receiving community palliative care: a study in Queensland's most culturally diverse health service.
期刊: Internal medicine journal 发表日期: 2025-Oct 链接: PubMed
摘要
This study examined the prevalence of Enduring Power of Attorney (EPOA) and Advance Health Directive (AHD) among culturally and linguistically diverse (CALD) and non-CALD patients referred to community palliative care. Of 576 eligible patients, 20% were from CALD backgrounds. No significant difference in EPOA prevalence existed between CALD (12%-19%) and the general population (23%) (P = 0.20). AHD prevalence was significantly lower in CALD (3%-4%) compared to the general population (13%) (P = 0.017). Minimal increases in document completion were observed in both groups over 6 months.
54. A clinician's guide to the diagnosis and management of kidney cysts.
期刊: Internal medicine journal 发表日期: 2025-Oct 链接: PubMed
摘要
Kidney cysts are frequently encountered as incidental findings on imaging studies and are typically benign in nature. However, certain cysts exhibit characteristics that may predispose them to malignant transformation. The Bosniak classification, based on contrast-enhanced computed tomography or magnetic resonance imaging, offers a systematic approach to stratifying kidney cysts by their radiological features and estimating the associated risk of malignancy. This classification further informs clinical decision-making regarding surveillance, intervention or referral. This review provides a comprehensive examination of the pathophysiology, epidemiology, diagnostic evaluation and referral pathways for kidney cysts, with an emphasis on the practical application of the Bosniak classification in clinical practice.
55. Mapping the dissemination of scientific literature during the COVID-19 pandemic.
期刊: Internal medicine journal 发表日期: 2025-Oct 链接: PubMed
摘要
The use of social media continues to introduce novel means for the communication of scientific knowledge. We assessed the change in social media use between pandemics regarding total shares, rates of dissemination and rates of global uptake of articles communicating the spread of diseases between epicentres. We found a substantial temporal increase in the use of social media for this purpose, as well as large global discrepancies in circulation, highlighting the role social media has in the communication of scientific knowledge globally and the importance of journals adopting social media policies.
56. Investigating the burden of cerebral palsy in low- and middle-income countries: Implications and priorities for pediatric neurology.
期刊: Seminars in pediatric neurology 发表日期: 2025-Oct 链接: PubMed
摘要
Cerebral Palsy (CP) is the most common pediatric physical disability worldwide presenting as a non-progressive motor dysfunction due to insults to the developing brain. While CP has a higher prevalence and burden in low- and middle-income countries, the most extensive research towards care and management of the patients with CP has been conducted in high-income countries. There is a disparate impact on CP from resource limited countries due to insufficient healthcare resources, barriers to healthcare access, inadequate public health awareness, and lack of accurate data. In this article we examine the state of CP in low- and middle-income countries. We explore the multitude of environmental, socioeconomic, and infrastructural factors that contribute to the clinical profile of CP in these regions. Finally, we high light the primary areas of burden that need to be addressed in low- and middle-income countries: inadequate healthcare infrastructure and resources, lack of registries, social stigma with the and limited public health education, and strain on primary caregivers.
57. Associations between chrononutrition variables and carotid atherosclerosis in adults.
期刊: Nutrition, metabolism, and cardiovascular diseases : NMCD 发表日期: 2025-Sep-15 链接: PubMed
摘要
The associations between chrononutrition variables (time of first meal, time of last meal or eating window) and carotid atherosclerosis (CAS) remain unclear. This study aimed to estimate the associations between chrononutrition variables and CAS. A total of 671 participants (231 participants with CAS and 440 participants without CAS) were included in the study. Chrononutrition variables were collected through face-to-face interview. CAS was assessed via ultrasound by an experienced sonographer. Logistic regression models were used to analyze the associations between chrononutrition variables and CAS. Restricted cubic spline analyses were used to examine the dose-response relationship between eating window and CAS. Stratified analyses were conducted to analyze the association between eating window and CAS. Multivariate logistic regression analysis revealed that a longer eating window was significantly associated with a higher risk of CAS, but no significant associations were observed between time of first meal or last meal and CAS. After multivariable adjustment, compared with participants in the lowest quartile, the ORs (95 % CIs) for participants in the highest quartile were 2.15 (1.10, 4.20) for eating window, 0.99 (0.27, 1.58) for time of first meal, and 1.15 (0.60, 2.21) for time of last meal. Restricted cubic spline analysis revealed a linear association between eating window and CAS (P for overall = 0.038, P for nonlinearity = 0.459). Consistent associations between eating window and CAS were observed in subgroup analyses. Our findings suggest that a longer eating window may be detrimental to CAS.
58. Health-related quality of life in esophageal cancer: a state-of-the-art review of patient-reported outcomes and an evidence and gap map.
期刊: Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus 发表日期: 2025-Sep-01 链接: PubMed
摘要
Esophageal cancer represents a substantial global health challenge, marked by poor prognosis, even after curative treatment. Health-related quality of life is crucial for evaluating the treatment efficacy and long-term outcomes in patients with esophageal cancer. This state-of-the-art review and evidence gap map sought to identify existing research on the impact of interventions on health-related quality of life in adults with esophageal cancer, providing a comprehensive overview of various health-related quality of life aspects following diagnosis and treatment. This review entailed a systematic literature search, data extraction, and analysis, with the findings visualized in an evidence and gap map. The review synthesized key insights from the literature, focusing on clinical context, treatment, health-related quality of life outcomes, and interventions to enhance health-related quality of life. The evidence and gap map revealed that most studies concentrated on surgical interventions, chemotherapy/chemoradiotherapy, supportive care, and lifestyle interventions, primarily evaluating the overall quality of life, symptom burden, and emotional and psychological health. Several areas remain unexplored, including cognitive and existential well-being, social functioning, and the impact of specific interventions such as immunotherapy. This review underscores the need for high-quality longitudinal studies assessing long-term health-related quality of life, the inclusion of health-related quality of life as a primary or key secondary endpoint in future trials, and improved methodological quality of systematic reviews. Addressing these gaps will contribute to a more patient-centered, evidence-based approach to esophageal cancer care.