公共卫生研究摘要 (2025-10-14)
共收录 63 篇研究文章
1. Multi-Omics Dissection of TIMP1 in Monocytes/Macrophages Reveals Pathogenic Mechanisms and Therapeutic Opportunities in Ankylosing Spondylitis.
期刊: FASEB journal : official publication of the Federation of American Societies for Experimental Biology 发表日期: 2025-Oct-31 链接: PubMed
摘要
The pathogenesis of ankylosing spondylitis (AS) remains unclear, and its treatment poses significant challenges. This study aims to elucidate the underlying mechanisms of AS and explore potential therapeutic targets. We conducted a comprehensive multi-omics analysis, integrating proteomics, miRNA profiling, and single-cell sequencing data. Various analytical methods were employed to investigate the expression, cellular origin, and regulatory mechanisms of the target protein, as well as to explore potential therapeutic strategies. Finally, we established a chronic inflammation model and performed qPCR analysis on the paraspinal ligament muscle. TIMP1, a gene associated with AS, was found to be downregulated in AS. Single-cell sequencing revealed that this reduction was primarily observed in the monocyte/macrophage lineage, especially in CD14+ monocytes. The downregulation of TIMP1 was linked to the overexpression of hsa-miR-8059, hsa-miR-3692-5p, hsa-miR-4481, and decreased STAT1 expression. TIMP1 appears to exert its effects on AS pathogenesis indirectly through RHOA. Therapeutic exploration identified several compounds, including Isotretinoin, Oxaliplatin, Simvastatin, and active components from traditional Chinese medicines (TCM) such as Tripterygii Radix, Niudali, and Cinnamaldehyde, which stably bind to TIMP1. qPCR results showed that TIMP1, STAT1, and RHOA were all significantly downregulated in the paraspinal ligament muscle of the chronic inflammation model. This multi-omics study highlights the role of reduced TIMP1 expression in CD14+ monocytes due to elevated miRNAs and decreased STAT1, contributing to AS pathogenesis via RHOA. The study also identifies several drugs and active compounds with potential therapeutic effects on TIMP1, offering new directions for AS research and treatment.
2. Precise gene editing of pathogenic Lamin A mutations corrects cardiac disease.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Oct-28 链接: PubMed
摘要
Mutations in the Lamin A (LMNA) gene, which encodes the Lamin A and C proteins, cause severe human diseases collectively known as laminopathies. These conditions are often devastating and lack effective therapies. In this study, we developed precise base editing (BE) strategies targeting the human LMNA gene variants L35P and R249Q, which cause congenital muscular dystrophy (CMD) and dilated cardiomyopathy with conduction defects (DCM-CD), respectively. Induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) carrying the R249Q mutation displayed nuclear aberrations, DNA damage, and abnormal Ca2+ transients. Similarly, L35P iPSC-CMs exhibited abnormal contraction, DNA damage, and reduced Lamin A/C protein expression. We also generated “humanized” mouse models carrying these pathogenic human mutations. R249Q homozygous mice exhibited cardiac conduction abnormalities, cardiac arrhythmias, and premature death. Mice with the homozygous L35P mutation displayed severe muscle-wasting and reduced lifespan, while heterozygous L35P mice displayed DCM. We developed an adenine base editing (ABE) approach for correcting the R249Q mutation and a cytosine base editing (CBE) strategy for the L35P variant. Precise correction of these mutations in iPSC-CMs successfully rescued all of the in vitro abnormalities. Furthermore, delivery of the BE components using adeno-associated virus prevented the pathological phenotypes and extended longevity of mice carrying the LMNA L35P and the R249Q mutations. These results demonstrate the efficacy of ABE and CBE in correcting pathogenic LMNA mutations that cause cardiac disease, highlighting BE as a promising therapeutic approach for human laminopathies.
3. Sperm and offspring production in a nonobstructive azoospermia mouse model via testicular mRNA delivery using lipid nanoparticles.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Oct-21 链接: PubMed
摘要
Microsurgical testicular sperm extraction (microTESE) with intracytoplasmic sperm injection (ICSI) represents the current standard treatment for nonobstructive azoospermia (NOA). However, cures remain unavailable for NOA patients lacking retrievable haploid cells. mRNA supplementation could be a potential treatment for genetic defects leading to impaired spermatogenesis. Lipid nanoparticles (LNPs) have emerged as mRNA delivery vehicles with minimal risk of genome integration; however, their ability to selectively deliver mRNA to specific cell types remains limited. To overcome this, microRNA (miRNA) target sequences were incorporated into mRNA constructs to restrict expression specifically to germ cells. Using pyruvate dehydrogenase E1 subunit alpha 2 (PDHA2) knockout mice as an NOA model with meiotic arrest, we demonstrate that LNP-mediated delivery of Pdha2 mRNA enables the resumption and completion of meiosis, restores sperm production, and facilitates the generation of healthy fertile offspring via ICSI. Whole-genome sequencing of the offspring confirmed the absence of large-scale genomic abnormalities. Our results provide proof of concept for a safe and effective chemically synthesized LNP-based mRNA therapy with miRNA-regulated germ cell specificity, offering a promising therapeutic approach to treating male infertility caused by spermatogenesis arrest.
4. Synthetic bottlebrush block copolymer prevents disease onset in Duchenne muscular dystrophy.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Oct-21 链接: PubMed
摘要
Duchenne muscular dystrophy (DMD) is a fatal genetic disease of progressive muscle deterioration with no cure. DMD treatment requires a body-wide approach to target all diseased striated muscles: limb, respiratory, and heart. To address this, we focus studies on blocking the onset of muscle membrane instability, the primary defect in DMD, as a promising yet unmet druggable target. Here, data show the remarkable potency of a synthetic poly(ethylene oxide)/poly(propylene oxide) side chain-based bottlebrush block copolymer, ~150,000 times more potent than linear polymers, to rapidly restore contractile function to DMD skeletal muscle fibers in vitro. Strikingly, upon bottlebrush polymer delivery to DMD animals, results show highly efficacious prevention of the onset of skeletal and diaphragm muscle damage and the blocking of stress-induced cardiac injury and death in vivo. These data suggest bottlebrush polymers as a potent stand-alone muscle membrane-stabilizing therapeutic for DMD. Given DMD’s early childhood onset, together with newborn screening for DMD, bottlebrush macromolecules could be envisioned as an early therapy to preserve and protect viable muscle and potentially for other acquired or inherited diseases involving membrane damage.
5. Sex differences in healthy brain aging are unlikely to explain higher Alzheimer's disease prevalence in women.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Oct-21 链接: PubMed
摘要
As Alzheimer’s disease (AD) is diagnosed more frequently in women, understanding the role of sex has become a key priority in AD research. However, despite aging being the primary risk factor for AD, it remains unclear whether men and women differ in the extent of brain decline with age. Using 12,638 longitudinal brain MRIs from 4,726 participants aged 17 to 95 y across 14 cohorts, we examined sex differences in structural brain changes over time, controlling for differences in head size. Men showed greater cortical thickness (CT) decline in the cuneus, lingual, parahippocampal, and pericalcarine regions; surface area decline in the fusiform and postcentral regions; and in older adults, greater subcortical decline in the caudate, nucleus accumbens, putamen, and pallidum. In contrast, women only showed greater surface area decline in the banks of the superior temporal sulcus and greater ventricular expansion in older adults. These results suggest that sex differences in age-related brain decline are unlikely to contribute to the higher AD diagnosis prevalence in women, necessitating research into alternative explanations.
6. Estimating the number of hospital beds for the care of sick and small newborns: an evidence-based systematic approach.
期刊: Journal of global health 发表日期: 2025-Oct-14 链接: PubMed
摘要
Current recommendations for neonatal bed requirements are largely assumption-based rather than data-driven. We aimed to estimate the number of beds per 1000 live births needed for the care of small and sick newborns. We first extracted data from studies published between 2018 and May 2023. Then, due to considerable heterogeneity in the data, we performed a meta-analysis using a random effects model to estimate the number of neonatal admissions and the length of stay. We divided the total patient days (admission rate multiplied by the length of stay) by 365 to estimate the annual number of beds per 1000 live births. We include 54 included studies, of which 46 provided data on the incidence of neonatal admissions and 20 on length of stay. The pooled analysis indicated that the number of neonates requiring admission ranged from 126 to 143 per 1000 live births. Admission rates were higher in the African region (160.5; 95% confidence interval (CI) = 122.2-198.7), in low-income countries (175.3; 95% CI = 102.8 to 247.8), in tertiary care settings (147.5; 95% CI = 115.9-179.1), and in settings with a high neonatal mortality rate (149.4; 95% CI = 90.5-218.2). The pooled length of stay was estimated to be 6.4 days (95% CI = 5.7-7.1). The overall estimated number of beds needed for the care of small and sick newborns was 2.4 (95% CI = 2.0-2.8) per 1000 live births, with regional variations. This method estimates the required neonatal care beds using admission rates and hospital stay data, aiding healthcare planning. Refinements and local adaptations are needed for effective policy decisions. PROSPERO: CRD42023417847.
7. Strategies for Enhancing a School-Based Suicide Prevention Training: Student Perspectives.
期刊: Issues in mental health nursing 发表日期: 2025-Oct-13 链接: PubMed
摘要
Suicide remains a leading cause of death among adolescents in the United States, and instances of death by suicide continue to increase in this population. To mitigate this public health crisis, effective and accessible suicide prevention programming is critical; however, suicide prevention programming is often developed and implemented without input from the adolescents engaged in the training. This study developed themes that emerged from student feedback as to how a school-based suicide prevention training, delivered to adolescents by either their peers or school personnel, could be improved. Data was collected from 2,480 adolescents who completed pre-training and post-training surveys between March 2022 and June 2023. Thematic analysis was used to explore participant responses to an open-ended question included in the post-training survey, which asked whether students had suggestions for improving the training. Four themes were generated: empowerment, self-care, increased sensitivity and discretion, and enhanced interactive learning and engagement. These themes highlight the need to incorporate a flexible, trauma-informed approach into school-based suicide prevention training. Given their role and expertise, nurses are well-suited to implement these strategies. Student perspectives should consistently be sought and integrated into curricula as communities strive to decrease death by suicide among adolescents.
8. Public Health, Xenozoonosis, and the Right to Withdraw from Long Term Xenotransplant Biosurveillance.
期刊: The New bioethics : a multidisciplinary journal of biotechnology and the body 发表日期: 2025-Oct-13 链接: PubMed
摘要
Is it ethically defensible to remove xenotransplant recipients’ right to withdraw from long term biosurveillance on grounds of theoretically possible but potentially excessive third-party risk? Some think so arguing that to protect public health from potential infectious diseases originating in the xenograft, xenotransplant recipients should not be allowed to withdraw from long term biosurveillance. We present a dilemma for this view: if xenotransplant research poses such significant risk to public health as to warrant the requirement that xenotransplant recipients voluntarily waive their right to withdraw, then the research warrants long term quarantine. If the risk is not so great as to require long term quarantine, however, then individuals should not have to forfeit this right in order to participate in xenotransplant research. Either way, xenotransplant recipients should not be required to waive their right to withdraw from long term biosurveillance.
9. Healthcare renunciation among Italian older adults during the COVID-19 pandemic: insights from the PASSI d'Argento surveillance system.
期刊: European journal of public health 发表日期: 2025-Oct-13 链接: PubMed
摘要
During the COVID-19 pandemic, a noticeable decrease in medical care utilization occurred which may contribute to increased morbidity and mortality rates associated with treatable conditions. In Italy, severely impacted by the pandemic, a comprehensive data source on healthcare renunciation is essential for policy formulation and intervention strategies. This study used data from the PASSI d’Argento (PdA) surveillance system to investigate healthcare renunciation among people aged ≥65 years in Italy from August 2020 to December 2021 and to estimate the health and sociodemographic profiles associated with barrier-renunciation (due to service disruption) and refusal-renunciation (because of fear of contagion). A total of 4364 out of 10 827 individuals needing healthcare reported foregoing at least one medical visit or diagnostic test, with the major reasons being fear of COVID-19 contagion (33%) and service disruptions (29%). Sociodemographic inequalities existed: regression analysis revealed significant associations between healthcare renunciation and being female [adjusted prevalence ratio (aPR) 1.17, 95% CI: 1.08-1.26], reporting economic difficulties (aPR 1.15, 95% CI: 1.02-1.28), having two or more chronic conditions (aPR 1.18, 95% CI: 1.04-1.34), and having at least one sensory problem (aPR 1.13, 95% CI: 1.06-1.22). Compared to 2020, healthcare renunciation decreased in 2021. The relevant healthcare renunciation among elderly in Italy during the pandemic highlights widening health gaps and barriers to care access. Long-term monitoring tools are crucial to mitigate the pandemic’s impact on public health, especially for vulnerable populations.
10. Tailoring Fiscal Food Policies to Diverse Contexts: A Shared Priority.
期刊: Nutrition reviews 发表日期: 2025-Oct-13 链接: PubMed
摘要
11. Perspectives of Carers on the Physical Health of Young People with Early Psychosis.
期刊: Issues in mental health nursing 发表日期: 2025-Oct-13 链接: PubMed
摘要
The beginning of poor physical health trajectory for young people with early psychosis is found to occur prior to the onset of psychosis. Promotion of physical health requires sustainable positive health behaviour change. This study is aimed at exploring the views of carers on the physical health of young people with early psychosis, the physical health care young people receive and carers’ perspectives on important elements in promoting sustainable positive lifestyle changes. The outcome of this study will help inform the development of a co-designed lifestyle intervention for young people with early psychosis. Semi-structured interviews were conducted with 12 carers using an exploratory descriptive approach. Three main themes were identified using thematic analysis: (i) Physical health - what makes them worry and seek help; (ii) Disconnected physical health care; (iii) Key to sustainability - “Nothing succeeds like success”. Carers are at the forefront of physical health promotion for young people. The findings of this study emphasised that a lifestyle intervention designed for young people should be tailored to the needs and preferences of not only young people but also their carers, with incorporation of elements of health literacy, psychosocial wellbeing and self-determination in the drive for sustainable positive health behaviour change.
12. Immunology of atherosclerosis as an inflammatory disease: rethinking the dynamic immunoinflammatory activity beneath stability.
期刊: Expert review of clinical immunology 发表日期: 2025-Oct-13 链接: PubMed
摘要
Atherosclerosis is a chronic inflammatory disease characterized by the accumulation of lipids, immune cells, and fibrous components within the arterial wall. While traditionally considered a lipid-driven process, growing evidence suggests that immune mechanisms play a central role in all stages of atherogenesis. This review summarizes the most relevant evidence supporting the immunoinflammatory basis of plaque development, progression, and destabilization. Both innate and adaptive immune responses contribute to endothelial dysfunction, immune cell recruitment, cytokine production, and the activation of inflammasome pathways, which amplify vascular inflammation. Crucially, the interplay between inflammation and thrombosis, termed thromboinflammation, plays a pivotal role in plaque instability and clinical events. We critically examine the limitations of the classic dichotomy between stable and unstable plaques, proposing instead a tripartite classification: active, dormant, and inactive plaques, analogous to the states of volcanic activity. Even clinically ‘stable’ plaques may exhibit silent yet ongoing immunometabolic and thromboinflammatory activity, contributing to residual cardiovascular risk. Advanced imaging, molecular diagnostics, and inflammation-sensitive biomarkers (e.g. high-sensitivity C-reactive protein, IL-6) can help detect subclinical plaque activity. Finally, the concept of ‘thromboinflammaging’ emphasizes the impact of age-related immune dysregulation on vascular pathology. This evolving paradigm supports immunomodulation as a cornerstone in precision cardiovascular medicine.
13. Food Insecurity Interventions to Improve Blood Pressure: The Healthy Food First Factorial Randomized Clinical Trial.
期刊: JAMA internal medicine 发表日期: 2025-Oct-13 链接: PubMed
摘要
Food insecurity is associated with worse blood pressure control, but the optimal design for a food insecurity intervention to improve blood pressure is unknown. To inform food insecurity intervention design by comparing different intervention elements: type of food resources provided, whether to offer lifestyle counseling, and intervention duration. A 2 × 2 × 2 factorial comparative effectiveness randomized clinical trial was carried out including adults with hypertension and systolic blood pressure (SBP) of 130 mm Hg or higher, who spoke English or Spanish, and reported food insecurity in 2 clinical networks across 364 clinical sites in North Carolina. Food resources included healthy food subsidy redeemable at grocery stores vs biweekly healthy food box home delivery. The lifestyle intervention included either no intervention or offering telephone-based lifestyle counseling. The intervention duration included 6 months vs 12 months. The primary outcome was SBP. Secondary outcomes were diastolic blood pressure (DBP) and food security. The primary time point was 6 months from randomization. Twelve and 18 months were secondary time points. Overall, 458 individuals were randomized. The mean (SD) age was 49.7 (10.7) years and 345 (75.3%) were female individuals. Fewer than 11 participants identified as American Indian/Alaska Native; 11 (2.4%) identified as Asian, 237 (51.7%) identified as Black, 20 (4.4%) identified with multiple races, fewer than 11 participants identified as Native Hawaiian/Pacific Islander, 165 (36.0%) identified as White, and 22 (4.8%) did not report a racial identity. Twenty two participants (4.8%) identified as Hispanic ethnicity. Mean (SD) preintervention SBP and DBP were 138.2 (11.9) and 87.4 (9.1) mm Hg, respectively. The food subsidy, compared with the food box, led to moderately lower SBP at the 6-month primary time point (132.8 vs 135.3 mm Hg; difference -2.5 mm Hg; 95% CI -4.1 to -0.9; P = .003). DBP was also lower at 6 months (80.5 vs 82.1 mm Hg; difference -1.5 mm Hg; 95% CI, -2.5 to -0.6). The food subsidy group also had lower SBP and DBP at 18 months (SBP difference, -2.1 mm Hg; 95% CI, -4.2 to -0.05; DBP difference, -1.6 mm Hg; 95% CI -2.8 to -0.3). SBP and DBP differences at 12 months were in favor of the food subsidy, but not significantly different. Offering lifestyle counseling did not produce significantly lower SBP or DBP than not offering counseling at any time point. The 12-month duration did not produce significantly lower SBP or DBP than 6-month duration at any time point. 6-, 12-, and 18-month food security scores decreased from baseline in all groups, and did not differ significantly between groups. In this randomized comparative effectiveness trial, a food subsidy produced a moderate reduction in SBP and DBP compared with a delivered food box. Offering lifestyle counseling and a longer benefit duration did not produce better blood pressure outcomes. Food insecurity declined from baseline in all groups, but did not differ between groups. ClinicalTrials.gov Identifier: NCT05048836.
14. The Application of Reverse Transcription Loop-mediated Isothermal Amplification to Detect Cell-Free Seminal mRNA.
期刊: Molecular biotechnology 发表日期: 2025-Oct-13 链接: PubMed
摘要
Cell-free seminal mRNA (cfs-mRNA) has been utilized in the diagnosis of diseases affecting the male reproductive system. However, the existing detection methods are time-consuming and labor-intensive. Loop-mediated isothermal amplification (LAMP) is a nucleic acid amplification method with high efficiency and accuracy; however, it has not been applied to cell-free RNA in human body fluids. Herein, we designed gene-specific primers for TGM4 and DDX4 and established a reverse transcription-LAMP (RT-LAMP) system for detecting their cfs-mRNA. The sensitivity of this system was investigated using RNA standards. The optimal conditions were 65 ℃ for 30 to 45 min for TGM4 and 65 ℃ for 45 to 60 min for DDX4. When incubated at 65 ℃ for 45 min, the limit of detection (LOD) for DDX4 mRNA was 124 copies, which increased to 37 copies when the reaction time was extended to 90 min. We also validated the RT-LAMP reaction using semen plasma samples from 20 azoospermic patients and identified 3 DDX4 cfs-mRNA negative patients among 72 azoospermic patients in total. In conclusion, this study establishes a novel RT-LAMP method for rapid and sensitive detection of TGM4 and DDX4 cfs-mRNA in seminal plasma. RT-LAMP is a rapid, sensitive and specific method for cfs-mRNA detection, which has the potential to be used in the diagnosis of male reproductive system diseases, RNA detection in other body fluids, and commercial promotion. The validated technique offers significant potential for efficient diagnosis of male reproductive disorders and broader RNA detection applications.
15. Trends in chlamydia prescribing practices after changes to national treatment guidelines in the United States, 2016-2023.
期刊: Sexually transmitted diseases 发表日期: 2025-Oct-13 链接: PubMed
摘要
In 2021 the US Centers for Disease Control and Prevention revised Chlamydia trachomatis (CT) treatment guidelines to recommend only doxycycline as first line-therapy, instead of recommending either azithromycin or doxycycline. The extent to which this recommended change has been translated into practice is unknown. We used 2016-2023 MarketScan data (national convenience sample of insurance claims from individuals with employer-sponsored insurance and Medicaid beneficiaries from 8-12 states) to identify encounters of CT diagnoses for individuals aged 15-60 years old who were treated with doxycycline or azithromycin within 14 days after diagnosis. We examined trends in doxycycline treatment before and after the 2021 change to the treatment guidelines. We compared receipt of doxycycline in 2022 by characteristics and facility/provider type. We included 154,200 encounters. Between 2016-2020, the percentage prescribed doxycycline remained stable at 17%. In 2021 and 2022, the percentage prescribed doxycycline increased to 37.6% and 57.1%, respectively. In 2022, women were significantly less likely to receive doxycycline compared to men (commercial: 55.3% vs. 76.5%; Medicaid: 48.2% vs. 71.5%), and people under age 25 were significantly less likely to receive doxycycline compared to those >25 (commercial: 61.0% vs. 67.4%; Medicaid: 50.8% vs. 57.4%). People treated in an emergency department were significantly more likely to receive doxycycline compared to other clinicians/facility types. There has been rapid uptake of the new CT treatment guidelines; however, those at risk of acquiring CT (women and those aged <25 years) are the least likely to receive recommended treatment.
16. Aging with HIV: multimorbidity and polypharmacy burden.
期刊: AIDS care 发表日期: 2025-Oct-13 链接: PubMed
摘要
Aging people living with HIV (PLWH) are at higher risk of multimorbidity and polypharmacy, complicating care. To assess the prevalence and risk factors of multimorbidity and polypharmacy in elderly PLWH on antiretroviral therapy (ART). In this cross-sectional study, PLWH aged ≥50 were compared with age- and sex-matched people without HIV. Logistic regression was used to identify predictors of polypharmacy. Multimorbidity (≥2 chronic conditions) was seen in 29% of PLWH and 22% of controls. Osteoporosis (9.5% vs. 2.3%) and psychiatric disorders (9.5% vs. 2.8%) were significantly more common in PLWH (p < 0.001). Polypharmacy (≥5 non-ART medications) was more frequent in PLWH (20.4% vs. 11.8%, p = 0.014). In multivariable analysis, being in the PLWH group (aOR 2.41), increasing age (aOR per 1-year 1.05), and having no formal education (aOR 4.59) were independent predictors of polypharmacy. Potential drug-drug interactions were present in 19.4% of PLWH and were present in those with polypharmacy (33% vs. 16%, p < 0.001). Older PLWH experience greater multimorbidity and polypharmacy than people without HIV. Tailored strategies - such as medication review, drug interaction monitoring, and preventive care - are essential to optimize outcomes in this growing and vulnerable population.
17. Uptake of Artificial Sweeteners in Wheat (Triticum aestivum L.): Subcellular Distribution and Nontarget Identification of New Metabolites.
期刊: Journal of agricultural and food chemistry 发表日期: 2025-Oct-13 链接: PubMed
摘要
Artificial sweeteners (ASs), which serve as vital alternatives to sucrose, have been detected in agricultural soils and crops. However, knowledge gaps persist regarding their bioaccumulation in plants, which is vital for assessing ecosystem risks. This study examined saccharin (SAC) and acesulfame (ACE) absorption, translocation, and biotransformation in plants via hydroponic experiments. Inhibition studies revealed that root uptake is an active, energy-dependent process involving aquaporins and anion channels. Their hydrophilicity enabled upward movement to above-ground tissues through transpiration and storage in water-soluble cellular components. High-resolution mass spectrometry detected 11 metabolites, proposing potential degradation pathways and identifying, for the first time in plants, phase II metabolites undergoing methylation and glucuronide conjugation. Ecotoxicity predictions indicated that hydroxylated and methylated metabolites were more toxic. This study is the first to explore the mechanisms of AS accumulation and biotransformation in plants, providing deeper insights into their in-plant behavior.
18. Impact of meteorological parameters and air pollutants on weed pollen-induced allergic rhinitis symptoms in Dalian, China.
期刊: International archives of allergy and immunology 发表日期: 2025-Oct-13 链接: PubMed
摘要
In recent years, coastal cities like Dalian have experienced a notable rise in pollen-induced allergic rhinitis (PiAR). This trend highlights the urgent need to investigate how climatic changes and air pollution exacerbate this growing public health challenge. This study examines the combined effects of meteorological variables, air pollutants, and airborne pollen on weed PiAR symptoms in Dalian, a coastal city located in the warm temperate zone of China. Daily pollen concentrations were monitored from August to October 2023, concurrently with meteorological data and air quality indices. Clinical data, including symptoms and fractional exhaled nitric oxide (FENO) levels, were collected from 61 PiAR patients to evaluate the impact of environmental factors on allergy severity and airway inflammation. Among meteorological variables, temperature exhibited a positive influence on the concentrations of total pollen, specifically that of Artemisia, Humulus, and Chenopodium pollen, while air pressure showed an inverse relationship. Regarding air pollutants, O3 concentration was positively associated with Artemisia pollen levels, whereas CO and NO2 were negatively associated. Statistical analysis demonstrated a strong positive correlation between daily weed pollen concentrations and the Combined Symptom and Medication Score (CSMS) (r = 0.81, p < 0.0001), as well as between weekly average pollen concentrations and the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score (r = 0.95, p < 0.0001). Pollen exposure showed a significant immediate effect on CSMS at lag 0 (EE = 0.205, 95% CI: 0.076-0.334), while air pressure exhibited significant lagged and cumulative effects during lag days 0-5 (EE = 0.815, 95% CI: 0.337-1.293). Notably, the interaction between temperature and air pressure was also statistically significant (p < 0.001). Additionally, FENO levels in PiAR patients significantly rose during the peak weed pollen season (p < 0.001), indicating elevated airway inflammation. This study highlights the complex interplay between meteorological factors, air pollutants, and pollen in exacerbating allergic symptoms. The findings underscore the need for integrated environmental and clinical management strategies to mitigate the burden of PiAR in urban settings.
19. Interface-Adaptive Dual-Color Hydrogel with Self-Repairing Function and High Adhesion as Flexible Wearable Sensor for Minimally-Invasive Monitoring Pesticide Residue in Living Crop.
期刊: Advanced science (Weinheim, Baden-Wurttemberg, Germany) 发表日期: 2025-Oct-13 链接: PubMed
摘要
Harnessing dandy mechanical property, hydrogels facilitate the construction of wearable fluorescence sensors for minimally-invasive monitoring pesticide residue in living crops, while the interface self-adaptability and detection accuracy remain hugely challenging. Herein, blue-emission aggregation-induced emission nanoparticles (b-TPE NPs) and red-emission Mn-doped ZnS quantum dots (r-Mn@ZnS QDs) are encapsulated inside agarose, borax, and polyvinyl alcohol-co-constituted hydrogel to construct dual-color TPE@Mn@ZnS@AG@PVA as wearable crop sensor. Owing to specific recognition of r-Mn@ZnS QDs by thiophannate-methyl (TM), the customized TPE@Mn@ZnS@AG@PVA shows a gradual color evolution from reddish purple to blue with high resistance to environmental and experimental interferences via quenching r-Mn@ZnS QDs’ fluorescence by target-induced aggregation and photo-induced electron transfer while acting negligible disturbance in blue fluorescence of b-TPE NPs, consequently achieving TM dual-color assay with limit of detection at 0.045 µg mL-1. Additionally, TPE@Mn@ZnS@AG@PVA fascinates smart interface self-adaptability, high adhesion, and outstanding self-repairing function, and then is pasted onto the interfaces of crops to deliver on the sense pesticide residue data in minimally-invasive manner, leading to the monitor of dynamic TM degradation. This study offers an in-depth penetration into dual-color wearable sensor with distinctive features for minimally-invasive monitoring pesticide residue in living crops, advancing the development of wearable crop sensors and precision agriculture.
20. Disinfection Byproducts Confirmed over 50 Years: Systematic Curation, Modes of Toxic Action, and Toxicogenomics.
期刊: Environmental science & technology 发表日期: 2025-Oct-13 链接: PubMed
摘要
Research on water disinfection byproducts (DBPs) over the past 50 years has unveiled more than 700 DBPs, many of which pose unrecognized risks to human health. Despite significant progress, systematic integration of the chemical curation of the confirmed DBPs with emerging toxicological paradigms is missing. This review systematically curates 716 confirmed DBPs reported from 1974 to 2024, offering a comprehensive resource to support risk identification and prioritization. We introduce a multiple classification framework based on molecular scaffolds, functional groups, and halogenation patterns, enabling researchers to map structural diversity to toxicological profiles. The modes of action applied in DBP research outlined here include nonspecific baseline toxicity, receptor- or enzyme-specific interactions, and reactive mechanisms such as oxidative stress and genotoxicity. Furthermore, we provide a system-level toxicogenomic view of DBP-induced toxicity, which has progressed from static single- and multiomics approaches to emerging time-resolved omics. These approaches reveal DBP-induced perturbations: the genome defines susceptibility, the transcriptome reflects expression levels, the proteome indicates functional execution, and the metabolome captures phenotypic outcomes. This review underscores critical knowledge gaps while charting future directions for DBP risk assessment and regulation and supports global efforts toward clean and safe drinking water.
21. Moving Beyond Awareness: Advancing Evidence for Social Marketing in Cholangiocarcinoma Prevention.
期刊: Journal of cancer education : the official journal of the American Association for Cancer Education 发表日期: 2025-Oct-13 链接: PubMed
摘要
22. Indoor air pollutants of PM2.5, carbon monoxide, nicotine and carcinogens in waterpipe bars.
期刊: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 发表日期: 2025-Oct-13 链接: PubMed
摘要
Waterpipe smoking has become popular in East Asia and other regions. However, few studies have investigated the indoor air quality, including the presence of carcinogens, in waterpipe bars (WBs). This study aimed to compare indoor air quality between WBs and non-WBs in Hong Kong, focusing on differences observed during weekdays and weekends. Air samples from 8 WBs and 6 non-WBs were collected to investigate levels of fine particulate matter (PM2.5), carbon monoxide (CO), nicotine, volatile organic compounds (VOCs), and polycyclic aromatic hydrocarbons (PAHs) in the ambient air of these bars. Samples were collected for two hours in each bar during both a weekday and a weekend evening. Data were analysed using descriptive statistics, the Wilcoxon rank-sum test, and Wilcoxon signed-rank test. The median PM2.5 levels in WBs was 332.1μg/m3 on weekdays and 1001μg/m3 on weekends. Similarly, CO levels in WBs were 22.5ppm on weekdays 27.9ppm on weekends. The comparison showed that PM2.5 (P=0.0019) and CO (P=0.0019) levels in WBs were significantly higher than those in non-WBs on weekdays. Airborne nicotine levels were 3.2μg/m3 on weekdays and 16.1μg/m3 on weekends. Most VOCs and PAHs levels were higher during weekends, with Benzo[a]pyrene at 15.3ng/m3 (weekday) and 22.5ng/m3 (weekend), and Formaldehyde at 57μg/m3 (weekday) and 66.5μg/m3 (weekend) - Group 1 carcinogens. This study revealed alarmingly high levels of airborne PM2.5, CO, nicotine, and carcinogens such as Benzo[a]pyrene and Formaldehyde in WBs in Hong Kong, especially on weekends. This study provides the first evidence of air quality in waterpipe establishments in Asia, demonstrating extremely poor air quality that pose significant health risks to both patrons and staff. These results can serve as evidence for the strict enforcement of tobacco control policies, such as total waterpipe bans. It is also crucial to assess compliance with occupational safety regulations in WBs and to ensure employees exposed to high levels of harmful substances such as PM2.5, carbon monoxide, nicotine, and carcinogens are offered education and health screenings and education. These measures are vital to ensuring the safety and health of workers.
23. Association of whole grain intake with cognitive function among middle-aged and older adults in China.
期刊: Food & function 发表日期: 2025-Oct-13 链接: PubMed
摘要
Background: Whole grains, rich in dietary fiber, vitamins, minerals, and phytochemicals, are beneficial to human health. However, evidence regarding the relationship between whole grain intake and cognitive function remains limited. Objective: This cross-sectional study aimed to investigate the association between whole grain intake and global cognition, specific cognitive domains, and the risk of mild cognitive impairment (MCI) among middle-aged and older adults in China. Methods: This study included 5020 participants with a mean age of 63.76 years from the Chinese Square Dance Cohort. Dietary intake was assessed using a 64-item semi-quantitative food frequency questionnaire (FFQ), and daily whole grain intake was calculated. Global cognition was evaluated through a composite z-score based on the Auditory Verbal Learning Test (AVLT), Digit Symbol Substitution Test (DSST), Verbal Fluency Test (VFT), and Trail Making Test B (TMT-B). MCI was diagnosed according to Petersen’s criteria. The relationship between whole grain intake and cognitive scores was analyzed using multiple linear regression, with results expressed as β coefficients and 95% confidence intervals (CIs). The association between whole grain intake and MCI was assessed using logistic regression models, with results expressed as odds ratios (ORs) and 95% CIs. Results: In this study, a total of 622 participants were diagnosed with MCI. After adjusting for covariates, compared to the lowest quartile of whole grain intake, the highest quartile was associated with higher composite z-scores (βQ4 = 0.13, 95% CI: 0.09, 0.18), AVLT scores (βQ4 = 0.16, 95% CI: 0.10, 0.23), VFT scores (βQ4 = 0.18, 95% CI: 0.11, 0.26), and DSST scores (βQ4 = 0.07, 95% CI: 0.01, 0.12), as well as lower TMT-B completion time (βQ4 = -0.12, 95% CI: -0.20, -0.05). In addition, each 25 g d-1 increment in whole grain intake was associated with 18% lower odds of MCI (OR = 0.82, 95% CI: 0.74, 0.91; P for trend < 0.001). Conclusions: Higher whole grain intake was associated with better cognitive function and lower risk of MCI among middle-aged and older adults in China, suggesting potential benefits for cognitive health. Future longitudinal and interventional studies are needed to confirm this association and establish causality.
24. Longitudinal Outcomes for a 10-week Interdisciplinary Pain Rehabilitation Program.
期刊: The Clinical journal of pain 发表日期: 2025-Oct-13 链接: PubMed
摘要
Chronic pain is an important public health problem. Interdisciplinary pain rehabilitation programs (IPRPs) demonstrate immediate and long-term improvements in pain, functioning, and overall quality of life for individuals with chronic pain. However, data on treatment durability for different program models and patient populations are limited. The purpose of this study was to examine long-term outcomes of a 10-week IPRP. 398 adults with chronic pain were treated at a rehabilitation hospital between February 2019 and May 2021 in an intensive 10-week outpatient interdisciplinary pain rehabilitation program consisting of physical therapy, occupational therapy, pain psychology, and medical management. Participants completed measures of pain ratings, pain interference, depressed mood, anxiety, physical functioning and pain catastrophizing at intake, discharge, and 3-, 6-, 9-, and 12-months posttreatment. A total of 34.7% of participants returned post program surveys at 3 months, 26.9% at 6 months, 17.6% at 9 months, and 15.6% at 12 months. Participants were primarily female (79.1%), White/Caucasian (79.4%) and married (51.5%) with an average age of 49.30±15.29 years. The results demonstrated statistically and clinically significant improvement across all outcome measures comparing intake to discharge. While there was some deterioration of treatment gains over time, all measures remained improved at all time points compared to intake. A 10-week IPRP model can improve pain and functioning in a population of participants with heterogenous chronic pain conditions in a community setting, providing durable improvements over time. These results add to the body of literature supporting IPRPs as an effective intervention for chronic pain.
25. Tick-borne encephalitis: Burden of disease and impact of vaccination, Austria (2000-2024).
期刊: Vaccine 发表日期: 2025-Oct-12 链接: PubMed
摘要
Tick-borne encephalitis (TBE) incidence has increased across Europe in the past decade, even in Austria which has the highest vaccination coverage in Europe. This study investigated the field effectiveness of TBE vaccination using nationwide hospital-based surveillance data (2000-2024), and examined age-specific differences in vaccine effectiveness and disease severity. We conducted a retrospective analysis of laboratory-confirmed TBE cases in Austria using nationwide hospital-based surveillance from 2000 to 2024. Annual TBE incidence rates were calculated for populations with regular, irregular, and no TBE vaccination. Vaccine effectiveness was estimated based on relative differences in incidence between vaccinated and non-vaccinated groups. Additionally, the number of cases prevented by vaccination from 2000 to 2024 was estimated, including TBE hospitalizations, severe cases, and deaths. Among 2260 hospitalized TBE cases, 274 (12 %) occurred in children (1-15 years), 1066 (47 %) in adults (16-59 years), and 920 (41 %) in older adults (≥ 60 years). Severe disease was documented in 1051 (47 %) patients, and 26 (1.2 %) patients died. TBE vaccination provided excellent protection (99 % with regular and > 90 % with irregular vaccination schedules) and prevented more than 10,000 hospitalizations, 4000 severe cases, and 80 deaths between 2000 and 2024. Our data, however, revealed that vaccine uptake and schedule adherence declined over time, coinciding with increasing case numbers in unvaccinated and irregularly vaccinated populations, which resulted in a significant rise in TBE incidence (p < 0.0001). TBE vaccination substantially reduced disease incidence across all age groups. Sustaining high vaccination coverage and compliance with vaccine recommendations is needed to prevent TBE and reduce healthcare burden.
26. Drivers of herpes zoster vaccine hesitancy in adults aged 50 and above: A machine learning approach.
期刊: Vaccine 发表日期: 2025-Oct-12 链接: PubMed
摘要
Herpes zoster (HZ) poses a growing public health challenge among adults aged 50 and above, with vaccine hesitancy being a major barrier to improving immunization rates. Understanding the factors driving HZ vaccine hesitancy is essential for developing strategies to enhance vaccination uptake in this population. This study aims to identify and analyze the key determinants of HZ vaccine hesitancy using machine learning models, providing insights to guide targeted educational strategies and interventions. A cross-sectional study was conducted from April to August 2024, collecting data from individuals aged 50 and older at four community health service centers in Shanghai. Data collection included demographic information, HZ disease and vaccine knowledge, the 5C scale, and the vaccine health literacy. We employed LASSO regression for variable selection, followed by analysis of key variables using four machine learning algorithms: logistic regression, random forest, support vector machine, and eXtreme Gradient Boosting (XGBoost). Model performance was evaluated using AUC and calibration plots. Shapley Additive Explanations (SHAP) were used to interpret and identify key predictors. A total of 1152 participants (mean age 66.1 ± 8.8 years; 49.7 % male) were included, with 73.95 % reporting hesitancy toward the HZ vaccine. Ten out of 21 features were selected for modeling. XGBoost model showed the best performance with an AUC of 0.960 (95 % CI: 0.937-0.983). SHAP analysis identified confidence, vaccine literacy, complacency, disease knowledge, and calculation as the primary predictors. The SHAP-XGBoost model showed strong predictive performance for herpes zoster vaccine hesitancy, with vaccine literacy and the 5C psychological antecedents identified as key predictors. This tool can inform targeted health interventions, and future work may integrate community databases for large-scale identification and tailored group strategies.
27. 6-aminonicotinamide, a G6PD inhibitor, mitigates CAPS1 reduction mediated HCC metastasis via ERK and GSK3β signals.
期刊: Neoplasia (New York, N.Y.) 发表日期: 2025-Oct-11 链接: PubMed
摘要
Redirecting glucose into the pentose phosphate pathway (PPP) is a strategy used by cancer cells to facilitate accelerated proliferation and dissemination. Glucose-6-phosphate dehydrogenase (G6PD) is a rate-limiting enzyme of PPP. However, the regulation of G6PD in hepatocellular carcinoma (HCC) has not been well understood. Here we found that G6PD activity was induced in HCC tissues. G6PD inhibition, by its inhibitor 6-aminonicotinamide (6-AN) or siRNA, attenuated HCC metastasis. CAPS1 (calcium-dependent activator protein for secretion 1) was identified as a novel regulator of G6PD. CAPS1 C2 domain directly interacted with the N-terminus of G6PD. This interaction disrupted G6PD dimer formation and inhibited G6PD activity. In HCC, CAPS1 down-regulation, primarily due to miR-30d-5p elevation, accumulated metabolic products in PPP. Loss of CAPS1 elevated ROS level, an event that induced epithelial-mesenchymal transition (EMT) process and HCC metastasis via ERK and GSK3β signals. Importantly, these effects could be reversed in vitro and in vivo by G6PD inhibitors, 6-AN, or siRNA. Our studies revealed CAPS1 as a novel regulator of G6PD and suggested that G6PD inhibition, such as 6-AN, represented a strategy for HCC therapy in patients with low CAPS1 expression.
28. Determinants of parental readiness for childhood vaccination: experiences, information, sociodemographics and adherence.
期刊: Vaccine 发表日期: 2025-Oct-11 链接: PubMed
摘要
High childhood vaccination coverage is critical for safeguarding public health. Sustaining high coverage requires effective infrastructure and delivery systems, as well as attention to individual decision-making, which is shaped by social, psychological and contextual factors. To optimize uptake, vaccination programmes must account for these influences and their interactions. To advance understanding on parental childhood vaccination readiness and to inform strategies for maintaining high uptake, we conducted a survey in August 2023 among 2077 parents in Norway whose children (aged 0-5 or 8-16 years) were age-eligible for the national Childhood Immunization Programme (CIP). We examined factors associated with childhood vaccination readiness among parents using the validated 7C model, which assesses seven psychological antecedents of vaccination and provides an overall readiness score. Overall parental childhood vaccination readiness was high. However, lower readiness was significantly associated with negative experiences with vaccination services, not being sufficiently informed about vaccines at the health clinic, finding vaccination less accessible, and sociodemographic factors. Moreover, reliance on official public health information sources (e.g., child health clinics, government websites) for vaccination decision-making was positively associated with readiness, while reliance on social media, YouTube, or religious institutions corresponded with lower readiness. Overall readiness was also associated with vaccination behaviors: parents who had previously declined or postponed childhood vaccinations had substantially lower vaccination readiness scores. These findings show that experiential, informational and sociodemographic factors are associated with parents’ childhood vaccination readiness. Efforts to improve communication and trust, including in parent-provider encounters, may be crucial to maintaining high and equitable coverage in childhood vaccination programmes.
29. Long-term effectiveness of live zoster vaccine against herpes zoster and related complications: a nationwide emulated target trial in South Korea.
期刊: Vaccine 发表日期: 2025-Oct-11 链接: PubMed
摘要
The live attenuated zoster vaccine is used to prevent herpes zoster in older individuals, but evidence on its durability remains limited, particularly across diverse populations and healthcare systems. We therefore assessed the long-term vaccine effectiveness of live attenuated zoster vaccine against herpes zoster and its complications in a nationally representative cohort of older individuals in South Korea. We emulated target trial from a large-scale, population-based nationwide cohort of individuals aged ≥50 years in South Korea (n = 2,519,582), integrating health insurance data (Korea Health Insurance Review and Assessment Service), national health screening (Korean National Health Insurance Service), and live attenuated zoster vaccination data (Korea Disease Control and Prevention Agency). Exposure was defined as receiving the live attenuated zoster vaccine between January 1, 2012, and December 31, 2021, with a follow-up period through January 31, 2024. Outcomes included incident herpes zoster, postherpetic neuralgia, herpes zoster encephalitis, and hospital admission for herpes zoster. The effectiveness and durability were estimated using adjusted hazard ratios (aHRs) with 95 % confidence intervals (CIs) from Cox proportional hazard models and restricted mean survival time (RMST) up to 10 years in an overlap-weighted cohort. Among 910,602 individuals (mean age, 61.48 [SD, 2.53] years; 47.30 % males) after overlap weighting, vaccination was associated with significantly lower risks of herpes zoster (aHR, 0.48 [95 % CI 0.48-0.49]; RMST differences, 151.1 days), postherpetic neuralgia (0.47 [0.46-0.48]; 86.0 days), herpes zoster encephalitis (0.40 [0.25-0.63]; 0.20 days), and hospital admission for herpes zoster (0.33 [0.31-0.35]; 14.1 days). Although effectiveness declined, protection remained significant for up to 8 years. Similar waning patterns were observed for postherpetic neuralgia and hospital admissions. Greater effectiveness was observed in males, individuals aged <60 years, and those who consumed alcohol less than once per week. Live attenuated zoster vaccination was associated with substantially reduced risks of herpes zoster and its complications in South Korea. Despite waning, protection persisted for 8 years, supporting the continued role of live attenuated zoster vaccine, particularly where recombinant vaccines are limited.
30. Engineering sulfoxide synthases for efficient microbial production of ergothioneine: Mechanisms, strategies, and perspectives.
期刊: Food chemistry 发表日期: 2025-Oct-08 链接: PubMed
摘要
Ergothioneine (ERG), a natural antioxidant with significant physiological functions and commercial value, is increasingly produced via microbial synthesis. Sulfoxide synthases play a pivotal role in this process by catalyzing the CS bond formation between cysteine and histidine derivatives-A rate-limiting step determining ERG yield and economic viability. This review comprehensively summarizes recent advances in the molecular mechanisms, structural features, and substrate selectivity of these enzymes, with a focus on engineering strategies (e.g., enhancing expression, improving activity, and mining novel variants) to boost catalytic efficiency and increase ERG yield. Furthermore, future research directions for sulfoxide synthases and related engineering strategies in promoting ERG biosynthesis are discussed. The insights and engineering approaches presented here extend beyond ERG production, offering a generalizable framework for understanding sulfur biocatalysis and developing high-value sulfur-containing compounds, thus providing broad theoretical and industrial implications for synthetic biology and metabolic engineering.
31. From Concept to Practice: The Development of ClinFIT for Musculoskeletal Disorders.
期刊: American journal of physical medicine & rehabilitation 发表日期: 2025-Oct-07 链接: PubMed
摘要
This study aimed to develop ClinFIT-MSK, an International Classification of Functioning, Disability and Health (ICF)-based clinical tool for the assessment and reporting of the functioning and rehabilitation potential of patients with a musculoskeletal condition. This multistep, mixed-methods tool development process encompassed developing an initial shortlist of ICF categories (comprising the aggregation of the ICF Core Sets for musculoskeletal conditions and a literature search), identifying the ClinFIT-MSK items feasible for clinical use via a two-round Delphi survey, developing a simple description for each item and deciding on the rating scale through development working group consultations. These consultations were also instrumental at each step of tool development. Based on a shortlist of 33 categories, the Delphi survey generated 17 items (7 body function and 10 activity and participation categories) which can be rated with a 0-4 scale (0 = no problem to 4 = complete problem) accompanied with rating specifications or with a 0-10 numeric rating scale without specification. ClinFIT-MSK can be used by rehabilitation professionals to support individualized care and track functional outcomes. It can also be employed in research and public health. Psychometric testing and cross-cultural validation will be pursued to ensure ClinFIT-MSK’s scientific robustness and applicability across diverse settings.
32. Factors Associated With Time to Surgery of Geriatric Hip Fractures: An Analysis of the American College of Surgeons' Trauma Quality-Improvement Program Database.
期刊: The Journal of the American Academy of Orthopaedic Surgeons 发表日期: 2025-Oct-02 链接: PubMed
摘要
Increased time to surgery (TTS) for geriatric patients with hip fractures is independently associated with increased risk of perioperative morbidity and mortality. Facility and patient-level variables associated with time to surgery have not been fully described. In this study, we aimed to determine the facility and patient factors associated with TTS for patients ≥65 years with hip fractures to inform strategies for reducing TTS. Using the American College of Surgeons (ACS) Trauma Quality Improvement Program database, we identified 65,512 patients ≥65 years who underwent hip fracture surgery during 2017 to 2018 at ACS-verified level I-III trauma centers. Facility and patient factors, including trauma center level, teaching hospital status, hospital size, age, sex, race, comorbidities, and injury severity score were recorded. The primary outcome was time to surgery, defined as the time from emergency department or hospital arrival to surgery (in hours). Of 65,512 eligible patients, 37,782 (57.7%) and 58,732 (89.7%) received surgery within 24 and 48 hours of arrival, respectively. In the multivariable analysis, male sex and Black race were associated with a 5% (95% CI: 4 to 7%) and 14% (95% CI: 8 to 20%) increase in TTS, respectively. Anticoagulant therapy (+25% [95% CI: 22 to 28%]), bleeding disorder (+19% [95% CI: 12 to 26%]), and congestive heart failure (+16% [95% CI: 13 to 19%]) were also associated with increased TTS. An increase in TTS of 12 hours was independently associated with 14% (95% CI: 12 to 16%), 15% (95% CI: 13 to 16%), and 8% (95% CI: 2 to 15%) increase in the odds of experiencing any hospital complication, a general medical complication, and return to the OR. Patient, but not facility, factors were associated with increased TTS for geriatric patients with hip fractures. Further research is needed to describe the general and context-specific determinants (eg, inefficient transfer processes, OR staffing) of TTS for hip fractures.
33. Barriers to the Development of Health Literacy in Iran's Health System: A Qualitative Study.
期刊: Health literacy research and practice 发表日期: 2025-Oct 链接: PubMed
摘要
Despite the significance of health literacy, studies show the inadequacy of health literacy in the health system of Iran. Inadequate health literacy is considered a warning for service providers. It needs to be integrated into educational programs that are administered within health and medical centers. Therefore, the present study was conducted to explore the barriers to health literacy in Iran’s health system. The present qualitative study was conducted in 2023 using a conventional content analysis. To this aim, 18 participants were selected among urban health center staff, 21 from rural health centers, 10 health volunteers, and 8 trainees (people participating in training classes) for interviews and group discussions. After the first interview, continuous data analysis began and continued to saturation level. The data were collected through semi-structured interviews and focus group discussions and were simultaneously analysed using a conventional qualitative analysis. Two main categories of internal and external barriers were detected. The data analysis led to the extraction of four main subcategories: (1) personal barriers (trainee’s inadequate competence, lack of physical or mental health, low motivation and commitment of health staff, beliefs, contextual barriers); (2) interpersonal barriers (health care providers’ misunderstanding of correct training, malcommunication or miscommunication in training sessions, the trainer’s limited skill, underestimated role of education in behavior change); (3) organizational barriers (high workload of health care staff, inadequate human resources, poor management and distrust in the health system, low organizational motivation); and (4) social barriers (uninterest in learning about health issues, issues related to the internet and cyberspace, lack of interpectoral cooperation). Considering the multidimensional nature of barriers to health literacy, it is recommended to make and implement a comprehensive plan to integrate efforts by health authorities and institutions, mass media, experts, decision-makers, policymakers, and service providers to remove barriers. Health literacy is defined as a wide range of knowledge and skills in accessing, appraising, understanding, and applying health information. Health literacy is a major means of improving the state of health in society.
34. Effects of Different Isometric Exercise Modalities on Microvascular and Metabolic Function.
期刊: Microcirculation (New York, N.Y. : 1994) 发表日期: 2025-Oct 链接: PubMed
摘要
This study compared near-infrared spectroscopy (NIRS)-derived microvascular function, muscle oxygenation (SmO2) dynamics, and fatigability during sustained isometric forearm flexion under two conditions: a rating of perceived exertion (RPE) level of 3 (RPE-Clamp) versus a constant torque (CT) matched to the torque produced during the first second of RPE-Clamp. Thirteen healthy males (22.2 ± 4.7 year) completed both tasks on separate days. SmO2 was measured during exercise, maximal voluntary isometric contractions (MVIC) were performed before and after exercise, and time to task failure (TTF) was recorded. Vascular occlusion tests (VOT) were used to assess microvascular function pre- and post-exercise. CT induced significantly greater performance fatigability than RPE-Clamp (p < 0.001), despite similar TTF (p = 0.171). SmO2 significantly decreased during early (p = 0.001) and final (p = 0.028) phases of CT, while increasing during mid (p < 0.001) phases in RPE-Clamp. Post-VOT indicated a significantly reduced desaturation rate (slope 1; p < 0.001), a greater extent of tissue hypoxia (minimum SmO2; p = 0.003), and increased microvascular reactivity (slope 2; p = 0.021) than pre-VOT, with greater peak re-saturation (MaxSmO2; p = 0.010) observed in CT than RPE-Clamp. Despite greater fatigability and desaturation in CT, both exercise modalities may enhance microvascular reactivity. Prolonged isometric exercise and subsequent hypoxic stress may contribute to a reduced desaturation rate post-exercise.
35. Climatic, socioeconomic, and migratory factors on the epidemiological dynamics of cutaneous leishmaniasis in Colombia, 2007-2021.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Oct 链接: PubMed
摘要
The World Health Organization considers cutaneous leishmaniasis (CL) to be one of the most important neglected tropical diseases (NTDs). The application of geostatistical models, in conjunction with sociodemographic and environmental factors, enables the understanding of disease epidemiology and facilitates the implementation of targeted measures and effective case management. This research aimed to evaluate the association between climatic, sociodemographic, and socioeconomic factors with the monthly CL incidence rate at the municipality level in Colombia from 2007 to 2021. An ecological study was conducted, including laboratory-confirmed notifications of CL reported in municipalities located below 1,700 meters above sea level through the National Public Health Surveillance System. Climate data were sourced from NASA, and sociodemographic and socioeconomic variables were obtained from the National Planning Department. Hierarchical spatio-temporal regression models within a Bayesian framework were used to analyze the monthly CL. A total of 121,828 cases of CL were analyzed, with an annual median of 7,605 cases. Standardized incidence rates (SIR) ranged from 0 to 16,072 per 100,000 population (median: 105.7; IQR: 46.7-419). Eight of the 11 studied factors were associated with the monthly cases of CL: rainfall, urban dimension, and Venezuelan migration were associated with a decrease in CL cases, while qualitative housing deficit, internal migration, the multidimensional poverty index, the index of unmet basic needs, and forest coverage were associated with an increase in CL cases. CL incidence in Colombia fluctuated during the study period, with high spatial heterogeneity linked to climatic, sociodemographic. and socioeconomic factors. These findings highlight the necessity for customized territorial approaches to the prevention and control of CL, emphasizing the importance of considering municipal characteristics and aligning strategies with the Colombian Strategic Plan for CL.
36. The Role of the Glass Ceiling Syndrome in Female Healthcare Workers and Its Association With Telogen Effluvium.
期刊: Journal of cosmetic dermatology 发表日期: 2025-Oct 链接: PubMed
摘要
Telogen effluvium (TE) type hair loss is the most common cause of diffuse and non-scarring alopecia in women and may develop on the basis of many etiological causes. Glass ceiling syndrome, which is a popular research topic especially in recent years, is one of the syndromes that define the invisible barriers that women face in their careers and can cause long-term stress during periods of exposure. Women working in the health sector are frequently exposed to the glass ceiling, and this situation has negative effects on skin health. The aim of the study is to investigate the relationship between glass ceiling syndrome-induced stress and telogen effluvium, which has not been examined before. In addition, another aim of the study is to determine the effect of socio-demographic variables such as age, gender, and education level on stress symptoms telogen effluvium. This study was conducted on 108 female participants working in University Hospitals. Questionnaires were used to determine how the participants experienced the glass ceiling syndrome, their professional and marital status, and their level of education. In addition, an examination including a pull test and trichoscopy for telogen effluvium disease was performed by specialized doctors. 56 (51.85%) of 108 female health workers were diagnosed with telogen effluvium. It was determined that 73 (67.59%) of them had glass ceiling experience. Of the 108 female health workers, 36 were doctors, 44 were nurses, and 28 were other health workers. Regarding their education levels, 36 of them have a master’s degree, 18 have a bachelor’s degree, 34 have an associate’s degree, and 20 have a high school degree. As for marital status, 71 of them were married, 24 of them were single, and 13 of them were divorced. A significant statistical relationship was found between telogen effluvium and glass ceiling syndrome and education and occupational status. At the same time, a significant statistical relationship was found between glass ceiling experience and education and occupational status. Glass ceiling syndrome is statistically significantly associated with telogen effluvium in female health workers, and it is emphasized that this situation should not be neglected as a source of intense stress during treatment. In addition, professional and marital status and education levels are also seen to feed this intense stress source.
37. Reply to 'Letter to the Editor: "Asbestosis Requiring Lung Transplantation in a Retired Hairdresser: An Occupational Exposure to Comb Through"'.
期刊: Respirology case reports 发表日期: 2025-Oct 链接: PubMed
摘要
38. Financial distress among individuals with epilepsy: Insights from a nationwide survey analysis.
期刊: Seizure 发表日期: 2025-Sep-20 链接: PubMed
摘要
We aimed to assess the prevalence of financial distress, defined as the negative effects of the economic burden of medical care on patients’ quality of life, in persons with epilepsy compared to those without epilepsy in a nationally representative sample of U.S. adults. We also aimed to identify associated factors of financial distress in persons with active epilepsy. We pooled cross-sectional data from the 2021 and 2022 National Health Interview Survey. We divided individuals with epilepsy into active (medication use or seizure in the past year) and inactive cohorts. We analyzed measures of financial distress using survey responses from individuals who had self-reported epilepsy. Multivariable logistic regression was conducted to investigate the association between epilepsy status and financial distress, and to identify factors associated with financial distress measures among persons with epilepsy. In a multivariable logistic regression analysis, epilepsy status was not significantly associated with financial distress (OR=1.03, 95% CI: 0.87-1.22, p = 0.76). However, several factors were significantly associated with higher odds of financial distress among those with active epilepsy, including female sex (OR=1.38, 95% CI: 1.32-1.44), Hispanic ethnicity (OR=1.72, 95% CI 1.61-1.85), having a high school degree or less (OR=1.34, 95% CI: 1.26-1.41), one or more annual hospitalizations (OR=1.33, 95% CI: 1.27-1.40), and multiple comorbidities (OR=1.76, 95% CI: 1.60-1.93). A substantial proportion of individuals with active epilepsy experience financial distress, underscoring the need for system-level policies to expand access and patient-level strategies to improve financial navigation and promote affordable therapies.
39. Impact of Tourniquet Type on Outcomes in ORIF of Pediatric Distal Radius Fractures.
期刊: Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina 发表日期: 2025-Aug-25 链接: PubMed
摘要
The objective of this study was to assess the benefits of utilizing a silicone ring tourniquet in relation to traditional pneumatic cuff tourniquets and scenarios without any tourniquet intervention. The tested hypothesis was that the clinical results could be increased after use of the silicone ring tourniquet. The study was monocentric and retrospective evaluation of collected data. Inclusion criterion was open reduction and internal fixation of a displaced distal radius fracture in pediatric population (6-12 years). The pneumatic tourniquet (PT) group involved 18 patients, the no tourniquet (NT) 19 patients and the silicon ring (SR) group 19 patients. All patients were followed for 6 months. Primary criterion was the VAS score at 1 day and 7 days postop. Secondary criteria were delay of discharge, time of surgery and occurrence of complications. The VAS score in the first and seven day postop was respectively 3.8 ±1 and 2.0 ± 0.5 for the PT group, 3.5 ± 0.5 and 1.8 ± 0.2 for the NT group and 3.2 ± 0.8 and 1.8 ± 0.4 for the SR group without statistically significant differences (p>0.1). There was a non-significant higher rate of complication PT group, especially for skin complications and a higher time of surgery in the NT group. The proposed hypothesis was not validated, as there were no notable changes observed in the clinical outcomes. Additionally, the analysis of complications revealed no evidence of bias. However, the reduced incidence of skin complications may indicate a beneficial effect associated with the silicone ring tourniquet.
40. Untargeted Urinary Metabolomic Profile of Isolated Chest Trauma Patients.
期刊: Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina 发表日期: 2025-Aug-25 链接: PubMed
摘要
Untargeted Urinary Metabolomic Profile of Isolated Chest Trauma Patients. ABSTRACT: Aim To explore the untargeted urinary metabolomic biomarkers in isolated chest injury patients. Methods It was a prospective study for 1 year period including the patients of isolated chest trauma as per inclusion criteria. Day 0, 3, and 7 urine samples from patients and day 0 sample from age matched healthy relatives were collected. Samples were prepared and gas chromatography mass spectrometry analysis was done using Agilent Technologies. Multivariate analyses were done using the ‘Biomarker Analysis’ module of the MetaboAnalyst 6.0 to identify potential biomarkers associated with chest injuries. To identify the promising biomarkers with high sensitivity and specificity, exploratory multivariate (receiver operating characteristic) ROC curve analysis was used. Results A total of 31 patients and 31 healthy controls were enrolled. A total of 101 metabolites were annotated. Based on ROC analyses, the top 15 potential markers (azelaic acid, glycerol, anthranilic acid, 2-palmitoylglycerol, 2-hydroxyhippuric acid, 4-hydroxybenzeneacetic acid, arachidic acid, 3-hydroxyhippuric acid, adenine, sucrose, butanedioic acid, 4-hydroxyphenyllactic acid, butanoic acid, 4-hydroxybenzoic acid and 2-hydroxybenzeneacetic acid) were identified. Selected frequencies of >0.6% led to the selection of 9 biomarkers. It was found 66.5% predictive accuracy of the most accurate 50-feature panel of model with the AUC of 0.708 with 95% confidence interval. Conclusion Nine metabolites (azelaic acid, glycerol, anthranilic acid, 2-palmitoylglycerol, 2-hydroxyhippuric acid, 4-hydroxybenzeneacetic acid, arachidic acid, 3-hydroxyhippuric acid and adenine) based on their selected frequencies of more than 0.6% can be considered as biomarkers in isolated chest trauma patients.
41. Association of Botulinum toxin treatment due to aesthetic corrections in the face with the level of happiness, anxiety and depression.
期刊: Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina 发表日期: 2025-Aug-25 链接: PubMed
摘要
Aim Any aesthetic procedure in the head and/or in the face might have an impact on psychological status of the treated participants. Aim of this study was to investigate whether Botulinum toxin treatment for aesthetic purpose in the face influences on the level of happiness, depression and anxiety. Methods This prospective cohort observational study included 30 participants, who were treated by botulinum toxin (Botox) due to aesthetic corrections. The treatment included laugh lines, frown lines and horizontal forehead lines. Preprocedural, three and six months after the treatment the participants were assessed by The Oxford Happiness Questionnaire (OHQ), The Beck Depression Inventory (BDI) and The Beck Anxiety Inventory (BAI) to determine the level of happiness, anxiety and depression was used. Results Three months after the treatment by Botox the level of happiness was significantly increased (5.26±0.43 vs 4.3±0.34; p<0.0001). The levels of depression (7.6±6.0 vs 14.2±8.3; p<0.0001) and anxiety (8.8±6.3 vs 16.4±8.8; p<0.0001) were significantly decreased compared with preprocedural level. Significant increased level of happiness and decreased levels of depression and anxiety remained six months after the treatment, but attenuated. A dose of applied botulinum toxin was negatively correlated with the level of depression (r = -0.394; p=0.0421) and anxiety (r = -0.387; p=0.0302). Conclusion Botulinum toxin treatment for aesthetic purpose in the face positively influences psychological status of the treated individual in the short-therm.
42. Correlation Between Brain-Derived Neurotrophic Factor and Cognitive Function in Older Adults.
期刊: Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina 发表日期: 2025-Aug-25 链接: PubMed
摘要
Aim Brain Derived Neurotrophic Factor (BDNF) plays a crucial role in supporting neuronal survival, promoting neurogenesis, and enhancing synaptic plasticity, all of which are vital for cognitive health. Aim of this study was to investigate the relationship between BDNF levels and cognitive impairment in the elderly population. Methods This was a cross-sectional study involving older adults at a social service care. Cognitive function was assessed using the Montreal Cognitive Assessment-Indonesian Version (MoCA-INA). BDNF levels were measured in peripheral blood samples using the Enzyme-Linked Immunosorbent Assay. Results Of the 88 participants (50 females 38 males) with a median age of 69.5 years, 71 (80.7%) had cognitive impairment. The median MoCA-INA score was 15.0. The most affected cognitive domain was abstraction, absolute number of patients 87 patients (98.9%). The mean BDNF level was 1.55 (±0.62) ng/mL with 50 (56.8%) patients having normal level. A weak positive correlation was found between BDNF level and performance in the visuospatial-executive (r= 0.232; p=0.029) and abstraction domains (r= 0.249; p=0.019). BDNF levels were significantly lower in those with cognitive impairment compared to those with normal cognitive function (p=0.029). Conclusion A correlation between BDNF levels and cognitive function, particularly in the visuospatial-executive and abstraction domains, highlighting the potential role of BDNF in cognitive decline in aging.  .
43. Quality of life among adults with hearing loss in Cantonal Hospital of Zenica: A cross-sectional study.
期刊: Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina 发表日期: 2025-Aug-25 链接: PubMed
摘要
Aim To assess Qualitiy of life (QoL) in adults by comparing two groups, the one with diagnosed hearing loss (HL) and the other without hearing complaints. Methods This cross-sectional study included 110 consecutive voluntary adult patients divided in two groups: patients with hearing loss and control group. All participants , after examination , answered to a questionnaires on sociodemographic, clinical data and the World health Organization Quality of Life- Short version (WHOQOL-BREF). Results: Among 110 adults participants, 59 were with hearing loss (hearing loss group – HLG) and 19 in hearing loss with hearing aid group (HLHAG) and 51 in control group. Consistently higher score in the domains of physical health (p=0.036) and psychological health (p=0.024) in control group was found; other domains did not reach statistical significance Significant differences between the HLHAG and control group in physical health (mean difference = -11.3; p=0.036) and psychological health (mean difference = -11.3; p=0.029) was confirmed. Conculsion Hearing loss could decrease QoL. Therefore, it is very important to recognize hearing impairment in a timely manner and to take a serious approach to treatment.
44. Acquired demyelinating diseases of the central nervous system in children: A single center experience.
期刊: Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina 发表日期: 2025-Aug-25 链接: PubMed
摘要
Acquired demyelinating diseases (ADD) of central nervous system encompasses a wide spectrum of neurological symptoms depending on the location and the severity of demyelination. The aim of this study is to present the frequency and the clinical, immunological, and radiological characteristics of ADD in pediatric patients at the Pediatric Clinic, Clinical Center University of Sarajevo. This is a retrospective observational study, conducted between 2017-2024, that included patients under 18 years with ADD. The diagnosis is established through clinical evaluation, characteristic MRI findings, immunological markers, and the exclusion of alternative conditions that mimic ADD, following the IPMSSG (International Pediatric Multiple Sclerosis Study Group ) 2010 criteria. We classified the patients into two groups based on the disease course: monophasic, multiphasic group which is further subdivided into multiple sclerosis (MS) and non-MS multiphasic group. Forty-one patients with ADD were included in the study. Seventeen patients (17/41, 41.46%) remained monophasic, whereas twenty-four patients (24/41, 58.54%) exhibited a multiphasic course. Within the multiphasic group 22/24 patients (91.67%) were diagnosed with multiple sclerosis (MS), and 2/24 (8.33%) had a non-MS multiphasic disease course. In this study, we presented the frequency and the clinical, immunological, and radiological characteristics of acquired demyelinating diseases in pediatric patients. Recognizing these distinct clinical patterns is crucial for enhancing early diagnostic accuracy and optimizing management strategies in this patient population. Ultimately, our study supports the need for a prospective, multicentric investigation to further consolidate data and refine our understanding of ADD epidemiology in our region.
45. Clinical and Nutritional Assessment of Iron Deficiency Anemia in Children Under Two Years of Age.
期刊: Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina 发表日期: 2025-Aug-25 链接: PubMed
摘要
Aim To determine the frequency of iron deficiency anemia IDA, its causes, feeding behaviors, and preventive measures among children under the age of two. Methods This cross-sectional study included 110 children presenting with IDA and compared them with 100 children with normochromic normocytic anemia as the comparison group. Results Pallor was observed in all patients. Other symptoms included lethargy (83%), anorexia (65%), splenomegaly (27%), delayed milestones (25%), and heart murmurs (30%). The majority of affected children were aged 9–12 months and had weights below the 5th percentile. A strong correlation was found between feeding type and IDA, with highest prevalence in children not receiving milk-based diets. Hemoglobin and serum iron levels were significantly reduced in IDA patients. Conclusion The study’s findings suggest that factors like starting foods early or not getting enough iron from diet or formula milk can increase the risk of iron deficiency anemia (IDA) in children between 9 to 12 months old. This research highlights the role of nutritional strategies like appropriate weaning methods and iron supplementation, in averting IDAs and related health issues.
46. Clinical characteristics of hospitalized children with bronchiolitis before and after the COVID-19 pandemic: a single-center study.
期刊: Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina 发表日期: 2025-Aug-25 链接: PubMed
摘要
AimAcute respiratory infections caused by viral pathogens are the most common reason for hospitalization of children. Annually, 150 million infants worldwide are diagnosed with bronchiolitis, and 2-3% of them are hospitalized. This study aimed to compare bronchiolitis severity before and after the COVID-19 pandemic. MethodsThis retrospective study was conducted at the Department of Pulmonology, Paediatric Clinic, Clinical Centre University of Tuzla, covering the period from November 1st, 2018, to April th 30, 2019 (pre-COVID period) and November 1st, 2023, to April 30th, 2024 (post-COVID period). A total 129 children under the age of 2 years were involved. Results No significant differences in the age, body mass, comorbidities, duration of hospitalization, use of oxygen therapy, and mechanical ventilation was found. There was a significant reduction in antibiotic in the post-COVID group (p=0.0173), and a significant increase in the use of aminophylline and inhalation therapy drugs in the post-COVID group. There was a significantly higher number of isolated respiratory syncytial virus (RSV) cases in the post-COVID group, 32 (42.7%). prevalence of fully vaccinated children was significantly higher in the pre-COVID period compared to the post-COVID period, 34 (74.4%?) and 29 (45.3%), respectively. Conclusion This study reveals a significant increase in the severity of bronchiolitis and an increase in RSV cases after the COVID-19 pandemic. Keywords: anti-bacterial agents,coinfection, oxygen inhalation therapy,respiratory syncytial virus infections, vaccination.
47. Fluoropyrimidine adjuvant chemotherapy leads to long-term impact on coronary arteries, blood cell profile and iron in colorectal cancer survivors.
期刊: Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina 发表日期: 2025-Aug-25 链接: PubMed
摘要
Aim To assess whether colorectal carcinoma (CRC) survivors 5 years post-fluoropyrimidine (5-fluorouracil and capecitabine) chemotherapy (ChemT) have increased presence of subclinical coronary artery disease (CAD), lower iron and altered blood cell composition. Methods This prospective, 2 year, single-center study used invasive coronary angiography to detect the presence of CAD among ChemT (N=45) and control group patients (age, gender-matched, cancer-naïve (N=45). Full blood count and iron levels were compared between two groups. Results Coronary angiography in 90 patients (mean age 65±7 years; 60% male) identified significantly higher presence of CAD in CRC ChemT patient group compared to control: 80% vs. 55 % (p=0.013). CRC ChemT patients had lower red blood cell count (4.45± 0.56 vs. 4.68± 0.50 x109/L; p=0.044), platelet count (214.18±50.99 vs. 251.00 ±156.40 x109/L; p=0.002) and white blood cell count (5.50 ±1.62 vs. 7.67±1.72 x109/L; p=0.000). Mean corpuscular hemoglobin concentration was higher in CRC ChemT patients (342.11 g/L ±15.74 vs. 336.42 g/L ±10.29: p=0.046), and iron deficiency was more prevalent (ChemT20.40 µmol/L ±3.891vs. control 23.37 µmol/L ±4.10: p=0.001). Conclusion Our study shows that among CRC survivors who underwent 5-FU and capecitabine therapy there is a significantly higher prevalence of CAD accompanied by long-term impairment in blood erythropoiesis. Keywords: coronary artery disease, coronary angiography, erythropoiesis.
48. Clinicopathological Characteristics of Young-Onset Breast Cancer Patients Stratified by Molecular Subtypes at H. Adam Malik Hospital.
期刊: Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina 发表日期: 2025-Aug-25 链接: PubMed
摘要
Aim To examine and evaluate the clinicopathological characteristics of young-onset breast cancer across molecular subtypes in patients from Southeast Asia, with a specific focus on those treated at H. Adam Malik Hospital, Indonesia. Methods A descriptive observational study with a cross-sectional design was conducted on medical records of breast cancer patients aged <40 years treated at H. Adam Malik Hospital from January 2017 to December 2022. Data included demographic, clinical, histopathological, and immunohistochemical findings. Statistical analyses were performed descriptively. Results Among the 104 patients analyzed, 71 (69.2%) had T4 tumors, and 49 (47.1%) had NST-type tumors. Most cases lacked ER (72, 69.2%) and PR (71, 68.3%) expression. A total of 41 patients had poorly differentiated tumors, with the majority at stage IV. The HER-2 positive subtype was most common (39, 37.5%), followed by Luminal B (31, 29.8%) and TNBC (22, 21.2%). Conclusion Young-onset breast cancer at H. Adam Malik Hospital predominantly features advanced stages, aggressive histopathological grades, and a high prevalence of HER2-positive and Luminal B subtypes. These findings highlight the importance of early detection and personalized treatment approaches.
49. Prevalence of cervical cytology abnormalities and its correlation with human papillomavirus infection: a single- institution five-year experience.
期刊: Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina 发表日期: 2025-Aug-25 链接: PubMed
摘要
Aim to investigate the prevalence of cervical cytology abnormalities over five years and to correlate it with patient’s age and presence/absence of HPV infection. Methods Pap findings of 614 women with documented cervical abnormalities and Pap findings of HPV-positive women (regardless of whether the Pap test showed an intraepithelial abnormality) were included in this study. Results The majority of women included in the study (36.5%) were aged 30-39 years. The most common abnormalities included atypical squamous cells-ASC (47.4%) and low-grade intraepithelial lesions (LSIL)-15.1%. Out of 614 women, 270 (43.9%) were positive for HPV. HR HPV positivity was found in 256 (41.7%). The proportion of HPV infection positivity decreases with age, especially in the two oldest age groups (women older than 60), p=0.03. The analysis showed a higher ratio of Pap smear abnormalities in groups of patients older than 40 years of age (p=0.02). The youngest age group (patients younger than 20 years of age) showed no other lesions than ASC, while women younger than 40 had no SCC on Pap smear. (p<0.01). Out of 256 HR HPV- positive women 42.2% (n=108) showed Pap abnormalities. HR HPV-positive women more commonly had HSIL lesions, but without statistical significance (p>0.05). Conclusion The results obtained contribute to the knowledge about HPV prevalence and the incidence of squamous cell abnormalities and confirm the necessity for further implementation of HPV vaccination and organized cervical cancer screening program on national level. Keywords: cervical dysplasia, Pap smear, screening.
50. Prognostic significance of CD163 expression in colorectal cancer stroma: a retrospective cohort study.
期刊: Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina 发表日期: 2025-Aug-25 链接: PubMed
摘要
Colorectal cancer (CRC) ranks among the leading causes of cancer-related mortality worldwide, with significant incidence and mortality rates recorded in Kazakhstan. CRC poses a substantial healthcare burden, prompting investigations into novel prognostic markers. This study investigates the prognostic significance of CD163 expression in patients with colorectal cancer. This retrospective cohort study was conducted in Aktobe, Kazakhstan, utilizing tissue microarrays from 175 patients diagnosed with Tumor, Node, Metastasis (TNM) stage I–IV colon adenocarcinoma. CD163 expression was assessed through immunohistochemistry. Kaplan-Meier survival analysis was employed to estimate 5-year overall survival, defined as the interval from diagnosis to death or last follow-up. Cox proportional hazards models were used to evaluate the relationship between CD163 expression levels and survival outcomes. High CD163 expression was linked to advanced disease stage of colorectal cancer (p < 0.001), lymphovascular invasion (p < 0.001), perineural invasion (p < 0.001), and Collagen I>30%, A type (p<0.001). CD163 infiltration was a negative prognostic factor for colorectal cancer patients, with higher risks of death in the high CD163 expression group compared to the low CD163 group (HR=5.769, 95% CI 3.194 – 10.42, p<0.001). The findings highlight CD163 as a potential prognostic biomarker in CRC, warranting further investigation into its mechanistic role and therapeutic implications.
51. Association of triglyceride glucose index as insulin resistance measure and waist to hip ratio in apparently healthy students of University of Sarajevo.
期刊: Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina 发表日期: 2025-Aug-25 链接: PubMed
摘要
This study aimed to reveal the prevalence of the insulin resistance (IR) identified by triglyceride glucose index (TyG index) among students of University of Sarajevo. The impact of visceral fat level and waist to hip ratio measures on TyG value in students has been investigated. Study included 160 apparently healthy students, both genders, aged from 19-27 years. Two groups were formed: Group1, TyG <4,49 and Group 2, TyG³4,49. A short interview, questionnaire, anthropometric measures, visceral fat level (VFL), blood pressure and biochemical parameters were applied. The statistical level of significance was P<0,05. Forty-five students (28, 1%) were insulin resistant. There was a significant difference in TyG value (P<0,001), [group 1- 4,19 (3,93-4,34 vs. group 2 - 4,59 (4,55-4,74)]. Fasting blood glucose (FBG) and lipid parameters-total cholesterol, triglycerides and very low-density lipoprotein cholesterol (TC, TG and VLDL-C) were significantly higher in group TyG ³4,49 compared to TyG <4,49 group, with exception of HDL-C of LDL-C (P>0.05). Stepwise linear regression analysis showed significant impact of waist to hip ratio on TyG value (P=0,001). The prevalence of IR measured by TyG in university students was 28,1%. The impact of waist to hip ratio on value of TyG index points on possible application of both parameters in visceral obesity and insulin resistance assessment in apparently healthy individuals.
52. The Relationship between Neutrophil-Lymphocyte Ratio and Ocular Manifestations in Children with Human Immunodeficiency Virus.
期刊: Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina 发表日期: 2025-Aug-25 链接: PubMed
摘要
Children with Human Immunodeficiency Virus (HIV) face elevated risks of systemic and ocular complications, potentially leading to blindness, particularly in developing countries where cases are rising. Aim To investigate the association between neutrophil-lymphocyte ratio (NLR) and ocular manifestations in children with Human Immunodeficiency Virus (HIV) infection. Methods This cross-sectional study involved 75 HIV-positive children aged 5–18 years at Yayasan Peduli Anak, Medan, Indonesia, from October to December 2023. Data were collected via interviews, comprehensive eye examinations (visual acuity, slit-lamp biomicroscopy, Schirmer test, indirect ophthalmoscopy), and recent NLR from medical records. Systemic cytomegalovirus (CMV) infection was assessed via CMV PCR. Sample size was calculated for correlation analysis (α=0.05, power=0.80, effect size=0.5). Results Of 75 participants (56% male, median age 11.64 years), 88% had normal immune status. Mean antiretroviral therapy (ARV) duration was 9.56 years. Common ocular complaints included blurry vision (24%), red/itchy eyes (16%), and watery eyes (4%); no dry eye was reported. Anterior segment findings included conjunctivitis (6%), blepharitis (8%), and corneal scarring (4%); posterior segment findings included tigroid fundus/nasalization (4%) and retinal detachment (2%). Mean NLR was 1.76 in those with ocular manifestations (p=0.024). CMV PCR positivity was significantly associated with blurry vision (OR=6.63; p=0.015), red eyes (OR=4.75; p=0.049), corneal scarring (OR=16.00; p=0.044), and nasalization (OR=16.00; p=0.044). Conclusion Elevated NLR was associated with ocular manifestations in pediatric HIV, particularly CMV-related complications. Regular eye screenings and ARV adherence are critical for early detection and prevention of vision-threatening conditions. Keywords: antiretroviral therapy, Cytomegalovirus, eye diseases, inflammation, pediatrics .
53. Knowledge + Innovation = Power: A protocol for implementing Aboriginal data sovereignty in an Aboriginal Medical Service for service delivery reform.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Comprehensive Primary Health Care (CPHC) is an interconnected, holistic, and strengths-based health and wellbeing approach fundamental to Aboriginal Community Controlled Health Organisations (ACCHOs) in Australia. However, policy and funding trends increasingly threaten the capacity of ACCHOs to deliver CPHC by imposing burdensome administrative and accountability requirements. A central constraint is the marginalisation of culturally informed data measures and tools that could enable improved development, implementation, evaluation and reporting of CHPC services and programs. To mitigate this, ACCHOs must be enabled to take charge of collecting and using meaningful data to increase self-determination and drive impactful policy and service delivery. Central to this approach is the capacity, skills, and infrastructure to collect and use culturally informed data and tools that align with community needs and organisational imperatives. This project will undertake an Aboriginal participatory action research (APAR) mixed methods developmental evaluation approach to Aboriginal Data Sovereignty (ADS) initiatives. The project will be conducted both centrally and across the regional sites of the South West Aboriginal Medical Service (SWAMS), an ACCHO in regional Western Australia. Activities to initiate the APAR process include the development and training of a Community Research Panel to lead/facilitate APAR projects. A series of regional workshops will be held to build data literacy (including regional population health data) and identify innovative culturally-informed health and wellbeing data measures and tools for selected health priorities. Project team Aboriginal academic researchers and Aboriginal researchers at SWAMS will ensure the inclusion of Aboriginal research methods (Aboriginal ways of knowing, being and doing). Data collection will include both quantitative and qualitative data which will be analysed to identify the enabling processes and community and organisational outcomes as they align to the principles of ADS. The protocol herein describes the first phase of a two-phase project, where the second phase will implement the new and/or adapted data measures and tools established in phase one of the project. This project will build capacity towards evidence-based decision making by ACCHOs and support self-determination by enabling local, real-time evaluation of the integrated models of care that ACCHOs deliver.
54. Prevalence and causes of blindness and vision impairment in Western Uganda: Findings from a rapid assessment of avoidable blindness (RAAB) survey.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
To determine the prevalence and causes of blindness and vision impairment (VI) among adults aged ≥50 years in Western Uganda. A population-based cross-sectional survey was conducted in Western Uganda (July-August 2023) using RAAB7. Adults aged ≥50 years who had resided in the study districts for at least six months in the past year were eligible. Participants were identified through door-to-door household visits using a two-stage cluster sampling approach. Primary outcomes include prevalence of blindness and VI and its causes. Secondary outcomes include cataract surgical coverage (CSC), effective CSC (eCSC), refractive error coverage (REC), and effective REC (eREC). A total of 3,125 participants were examined (54.1% female). The adjusted prevalence of blindness (presenting visual acuity (PVA) <3/60) was 0.9% (95% CI: 0.5-1.3%). Severe, moderate, and mild VI were found in 0.9% (95% CI: 0.4-1.3%), 4.5% (95% CI: 3.3-5.8%), and 3.8% (95% CI: 3.0-4.6%), respectively. Untreated cataract was the leading cause of bilateral blindness (49.4%). The CSC and eCSC at the < 6/12 threshold were 19.7% and 7.3%, respectively. Only 19.4% of 108 operated eyes achieved good outcomes (PVA ≥ 6/12). The main barriers to cataract surgery included lack of awareness (32.8%), cost (23.9%), and perceived lack of need (20.9%). The adjusted prevalence of uncorrected refractive error as a cause of moderate VI was 1.6% (95% CI: 1.1-2.0%), and mild VI was 2.8% (95% CI: 2.2-3.5%). REC was 1.0%, while eREC was 0.6% (95% CI: 0.0-1.4%). Blindness and vision impairment remain major public health issues in Western Uganda, primarily due to untreated cataract and uncorrected refractive error. Poor post-operative outcomes highlight the urgent need to improve surgical quality. These findings may guide targeted interventions and policy to strengthen eye care services.
55. Intersectional disparities in mental healthcare utilization by sex and race/ethnicity among US adults: An NHANES study.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
Mental healthcare utilization in the US remains low, with persistent disparities observed across population groups. However, little is known about how sex and race/ethnicity jointly shape access to care. Intersectionality theory highlights the need to examine these dimensions together, as their combined influence may produce unique disadvantages not captured in single-axis analyses. This study utilized data from the 2009-2018 cycles of the National Health and Nutrition Examination Survey (NHANES). The relative differences (prevalence ratios) of mental healthcare utilization across intersecting sex and racial/ethnic groups were estimated using design-based log-binomial models. The absolute measure (prevalence differences) across these intersectional groups were obtained using linear probability regression models. Stratified analyses were conducted to examine how socioeconomic and need-related factors modified disparities. Overall, 9.1% of adults reported accessing mental health services in the preceding year. Marked disparities were observed across the intersectional groups. Hispanic males had the lowest utilization rates compared to Non-Hispanic (NH) White males, with an adjusted prevalence ratio (aPR) of 0.59 [95% CI: 0.47-0.73]. Among females, all minority racial/ethnic groups reported lower utilization compared with NH White females with aPRs ranging from 0.73 to 0.81. Within racial/ethnic groups, women generally accessed care more than men, though the magnitude of sex differences varied. Stratified analyses showed that disparities were magnified among those without insurance and attenuated at higher income levels. These results show that sex and race/ethnicity jointly shape patterns of mental healthcare utilization in the United States, producing compounded disadvantages for specific groups such as Hispanic men. Stratified analyses suggest that socio-economic status may modify these disparities, pointing to the role played by systemic inequities. These findings underscore the importance of intersectional approaches in population mental health research and policy. Future research should consider additional intersecting identities including sexual orientation and disability.
56. Insights Into School-Based Physical Activity Implementation Strategies During the COVID-19 Pandemic: A Thematic Analysis.
期刊: Child: care, health and development 发表日期: 2025 链接: PubMed
摘要
In the United States, most school-aged children do not meet recommended physical activity (PA) guidelines that promote health. Prior to the COVID-19 pandemic, schools were well-situated to provide children with structured PA opportunities through physical education, organized sports, recess and active transportation to school. However, the COVID-19 pandemic limited schools’ abilities to provide these opportunities, likely due to the global adoption of recommended COVID-19 guidelines (e.g., social distancing guidelines, remote and hybrid learning, shared equipment limitations). Preliminary evidence suggests that children’s PA levels decreased during the COVID-19 pandemic, but few studies have explored how schools responded to these challenges in real time. This study explored how schools provided students with PA opportunities amid COVID-19 pandemic restrictions during the 2020-2021 school year. We conducted a secondary data analysis using an interpretive qualitative approach through a partnership with a childhood obesity prevention initiative providing infrastructure to schools to promote healthy behaviours. Participants representing 247 schools in Maine and Carroll County, New Hampshire, USA responded to a 34-question digital survey, including a subset of three open-ended questions, which were analysed through inductive thematic analysis. The 247 participants were predominantly nurses and teachers. Most schools were public schools with fewer than 400 students enrolled, nearly half of the participants represented elementary schools and more than half of the student body was eligible for free/reduced lunch in 35% of schools. Themes included: (1) PA strategies in disruptive learning environments; (2) barriers to PA participation; and (3) silver linings: physical activity and crisis resilience. These findings provide insight into how schools created PA opportunities for students amid COVID-19 pandemic restrictions. Emergency preparedness plans may incorporate flexible PA programming and further develop infrastructure that supports opportunities for PA.
57. One Health Disparities and Blastocystis infection among smallholder farmers in northeastern Madagascar.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
Blastocystis is a globally transmitted gastrointestinal protozoa that commonly infects people living in low- and middle-income countries. Transmission is thought to occur via consumption of contaminated water or food and through contact with infected animals, although the specific factors that influence infection in low-resource, rural settings remain unclear. We applied a One Health Disparities framework that considers the interconnectedness of human, nonhuman animal, and environmental health to investigate disparities in Blastocystis spp. infection in rural northeastern Madagascar. We focused on a suite of predictors including wealth, animal contact, hand hygiene, and demographic factors. Overall, 76.5% of 783 participants were infected with at least one of three subtypes of Blastocystis, and 19% of people were co-infected with two or more subtypes (ST1, 2, and 3). We found that men had lower risk of infection than women, while individuals who reported washing their hands without soap had higher odds of infection across all subtypes. Within a single subtype, soap-use remained significant for both ST1 and ST2, while for ST3, the effect of gender remained significant. Wealth and animal interactions had no significant associations with infection. Our study sheds light on gender disparities and the importance of hand hygiene in explaining variation in Blastocystis infection in rural Madagascar, while failing to support hypotheses based on socioeconomic status and exposure to domesticated animal reservoirs of disease. The findings also underscore the importance of gastrointestinal infections in vulnerable rural populations in Madagascar and highlight ways to address health equity and environmental justice in rural, low-resource settings.
58. Healthcare waste management practices and associated factors among healthcare workers in Sub-Saharan Africa: A systematic review and meta-analysis.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Inadequate management of healthcare waste present significant health hazards to healthcare workers, patients, waste handlers, and the whole communities, especially in developing countries. Although various primary studies have been conducted in different countries across the continent, there has been no comprehensive research examining healthcare waste management practices in Sub-Saharan Africa. This review aimed to assess healthcare waste management practices and associated factors among healthcare workers in Sub-Saharan Africa. This systematic review and meta-analysis were performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA 20) guidelines. PubMed, Science-Direct, Google Scholar, Hinari, and Google databases were used to find essential literature. The extracted data were analyzed using statistical software, STATA version 14. Publication bias was assessed using the Egger test and funnel plot, whereas heterogeneity was assessed using the I2 statistic. This review include 29 studies comprising 7588 participants. The pooled estimate of good healthcare waste management practices among participants was 49.74% (95% CI: 43.73-55.76) (I2 = 96.8%, P < 0.000). Sex, knowledge, training on healthcare waste management, use of working manuals/guidelines, and working hours were factors significantly associated with healthcare waste management practices among healthcare workers., Studies done in South Africa reported the highest good healthcare waste management practices with a value of 54.34% (95% CI: 48.05, 60.63), I2 = 0.00%, P < 0.00. The pooled estimate of good healthcare waste management practices before the occurrences of COVID-19 pandemic was 50.49% (95% CI: 40.7, 60.25), (I2 = 97.9%, P < 0.000). Public health facilities also reported having lower waste management practices with a value of 46.86% (95%CI: 39.33, 54.38%), I2 = 96.8%, P < 0.000. This review showed that only half of the healthcare workers practiced good healthcare waste management practices. Sex of the healthcare workers, training status, use of working manuals/guidelines, knowledge towards healthcare waste management, and their daily working hours were factors significantly associated with healthcare waste management practices among healthcare workers. Hence, respective healthcare authorities should develop and implement different healthcare waste management strategies, including ongoing in-service training, provision of healthcare waste management manuals, and conducting regular monitoring to enhance healthcare workers’ knowledge and practices towards healthcare waste management practices.
59. Machine learning framework for forecasting air pollution: Evaluating seasonal and climatic influences in Istanbul, Turkey.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Air pollution, driven by seasonal and meteorological variations, poses a significant threat to public health and urban sustainability. Despite numerous forecasting approaches, the influence of seasonal patterns on air pollutant levels remains underexplored. This study presents a computational framework utilizing the Nonlinear Autoregressive network with Exogenous inputs (NARX) model to predict concentrations of key pollutants SO₂, PM₁₀, NO, NOX, and O₃ in Esenyurt, one of the most industrialized districts in Istanbul, Turkey. Through systematic feature selection techniques, the study determines the most influential seasonal factors for each pollutant, reducing model complexity while improving predictive accuracy. The developed framework exhibits substantial improvements in predictive performance, with the optimal models achieving high determination coefficients (up to R² = 0.965 for O₃) and low error metrics across training and validation datasets. Particularly, the inclusion of seasonal variables considerably improved prediction accuracy for NO, NO₂, and PM₁₀, while SO₂ predictions performed best when utilizing comprehensive seasonal indicators. These results demonstrate that seasonal dynamics play a crucial role in governing pollutant behavior and highlight the importance of incorporating such variables in forecasting models. This research contributes significantly to the field by advancing methodological approaches in air quality prediction while providing an adaptable model for policymakers and environmental agencies to implement in proactive pollution management strategies. Through examination of seasonal dependencies in air pollutant patterns, the study delivers a practical tool for urban planning and public health applications in rapidly expanding metropolitan regions.
60. Reliability of blood inflammatory markers at constant real-life workloads over time: Study protocol.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Work-related musculoskeletal disorders (WMSDs) are prevalent in occupations characterised by high repetition and high force demands. Both factors not only evoke inflammatory and degenerative processes in affected musculoskeletal tissue, but also systemic responses identified by biomarkers in blood serum. Clarifying methodological aspects of biomarkers may provide insights into their predictive role in the pathway of developing WMSDs. This study will primarily assess reliability of systemic inflammatory biomarkers (CRP, TNF-α, IL-6, IL-1β) and immune cell reactivity by repeated measures in workers with constant workloads over time. This observational cross-sectional study will include two groups of workers: exposed group including workers exposed to higher upper-extremity physical workloads, especially affecting the elbow/forearm/hand-area; unexposed group, including office workers exposed to lower upper-extremity physical workloads. Recruited persons are screened against eligibility criteria followed by a medical anamnesis and blood analysis. Enrolled participants undergo nine repeated measurements once every two weeks, taking blood among others. Blood analyses will determine values of systemic inflammatory biomarkers and reactivity of immune cells. The absolute test-retest reliability of biomarkers and immune cell reactivity over time is assessed by the intra-class correlation coefficient applying two-way mixed-effects models. The relative test-retest reliability is assessed by the standard error of measurement. Knowledge of and models currently describing the pathological role of systemic inflammatory biomarkers are based on highly-controlled laboratory rat experiments. This study has the strength of assessing a human population under real-life conditions. The major challenge is in participant recruitment given the intensive and complex study design. The results of this study could provide fundamentals for initiating a cohort study and be used for developing work-related stress-recovery concepts for occupations with different physical demands to identify workers who may be at risk for developing WMSDs. German Clinical Trials Register (DRKS00031872, 25 May 2023).
61. Unraveling the "black box" of school tobacco policy implementation: A mixed-methods study at Danish vocational schools informed by Normalization Process Theory.
期刊: Implementation research and practice 发表日期: 2025 链接: PubMed
摘要
Smoke-free policies are often poorly implemented in schools. The Smoke-Free Vocational Schools intervention aimed to support the routine implementation of a comprehensive school tobacco policy at Danish vocational schools and took place across seven schools. This study aimed to assess and understand the mechanisms-that is, reasoning and behavior change-that shaped if and how policy implementation outcomes occurred. We applied a convergent mixed-methods design informed by Normalization Process Theory (NPT). The quantitative strand employed a repeated cross-sectional design, assessing implementation mechanisms-Coherence, Cognitive Participation, Collective Action, Reflexive Monitoring-and implementation outcomes at two time points: 5+ months post-policy (T1) and 14+ months post-policy (T2). Additional mechanisms-Change Commitment and Change Efficacy-were surveyed among subsamples who completed questionnaires pre-policy (T0) and at the follow-ups (i.e., T0-T1 and T0-T2). The qualitative strand involved interviews and focus groups with 40 participants to explore the mechanisms and their connections to intervention activities. Integration of qualitative and quantitative findings was achieved through joint displays. Quantitative analyses included responses from N = 419 participants at T1, N = 452 at T2, N = 209 at T0-T1, and N = 182 at T0-T2. All implementation mechanisms were significantly and consistently associated with the total implementation outcomes score. Coherence encompassed the perceived meaningfulness of the policy, for example, believing the policy was a school responsibility. Cognitive Participation was related to policy legitimacy, for example, enforcement legitimacy beliefs. Collective Action involved practical implementation efforts, for example, enforcement and communication strategies. Reflexive Monitoring encompassed perceived policy impacts, for example, reduced smoking visibility. Change Commitment and Change Efficacy were found to be closely interrelated with the other mechanisms. Moreover, qualitative analysis revealed plausible connections between intervention activities and mechanisms. This study identified critical mechanisms for implementing school tobacco policies and demonstrated how specific intervention activities can activate these mechanisms, offering guidance for future research and practice development. From Rules to Reality: How Schools Embed Smoke-Free Policies in Daily Routines Many schools have rules against smoking, but these rules are not always effective in protecting students from being exposed to smoking. In many cases, smoking is banned only on school grounds, which means that students may still gather just outside the school gates to smoke. This makes smoking visible and normal in young people’s daily lives. A more comprehensive approach is called smoke-free school hours. With this type of policy, smoking is not allowed at all during the school day—whether students and staff are on or off school grounds. Experts believe that such a time-based rule is more effective. To support schools in implementing this stronger policy, the Smoke-Free Vocational Schools intervention was created. Our study explored how this policy was put into practice at seven vocational schools in Denmark. We looked at the factors—called “mechanisms”—that help schools succeed in making the policy part of everyday life. We gathered information from school staff through surveys, interviews, and group discussions. Staff members described how their understanding and practices changed as the new rules were introduced. Key factors included: (a) seeing the policy as meaningful and important, (b) feeling that schools have a responsibility to address smoking, (c) recognizing that the policy was legitimate and fair, (d) developing practical ways to enforce and communicate the rules, and (e) noticing positive impacts, such as less visible smoking on and around school grounds. Over time, schools became better at embedding the smoke-free school hours policy into their daily routines. The findings shed light on the “black box” of policy implementation—how rules move from paper into practice. These insights can guide other schools and policy makers who wish to create healthier, smoke-free environments for young people.
62. Assessment and prediction of copper release amount from copper oxide facepieces.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
Disposable facepieces, as important personal protective equipment, provide respiratory protection for workers. However, Cu containing facepieces may cause Cu release, posing a potential danger to human health. In this study, aging experiments were conducted on 36 groups of facepieces, simulating the use of facepieces under high temperature, radiation environment and work rate to assess the exposure levels of workers to Cu amount. Meanwhile, a machine learning model was developed based on the Cu release amount to predict the exposure level. The research found that after simulating the aging of facepieces, the Cu release ranged from 7.25µg to 23.65µg, and the release trend showed an increasing trend under the simulated harsh conditions. The exposure levels in different scenarios were evaluated based on the release amount. Among them, 27 groups were evaluated as level III and 9 groups were evaluated as level II. Furthermore, the prediction results of Support Vector Machine (SVM), Backpropagation Neural Network (BPNN), and Random Forest (RF), test and training sets were evaluated using coefficient of determination (R2), root mean square error (RMSE) and mean absolute error (MAE). Among them, the SVM algorithm performed the best, further improving its predictive ability by using data augmentation methods and Particle Swarm Optimization (R2 of 0.9045, RMSE of 0.0762, and MAE of 0.0525). The relative errors between the predicted values and the true values of all samples were mostly less than 5%. The research method in this study can effectively assess the Cu exposure level of workers and provide a scientific basis for occupational health monitoring.
63. Characterizing potential subtypes and influencing factors of burnout in emergency department nurses by latent profile analysis.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
This study aims to explore the heterogeneity of burnout among emergency department nurses, identify the factors influencing burnout in different subtypes of emergency nurses, and provide targeted strategies and measures to reduce burnout in emergency department nurses. A cross-sectional survey was conducted from December 26, 2023, to January 18, 2024, involving 1,555 emergency nurses from 30 tertiary hospitals in China. The survey was distributed via an online questionnaire platform, which included general demographic information and the Maslach Burnout Inventory (MBI). The collected data were analyzed using latent profile analysis, Kruskal-Wallis H test, and multiple logistic regression. A total of 1,555 questionnaires were sent out in this survey, and finally 1,540 were included for data analysis. The average burnout score among emergency nurses was (4.77 ± 6.16). Occupational burnout could be categorized into three subtypes: low burnout-low professional efficacy (C1), low burnout-high professional efficacy (C2), and high burnout-low professional efficacy (C3). The proportions of these subtypes were 41%, 32.3%, and 26.7%, respectively. Significant differences in the latent categories of burnout were observed for age (χ2 = 31.749, P < 0.001), education level (χ2 = 6.778, P = 0.034), professional title (χ2 = 21.928, P < 0.001), years of work (χ2 = 29.269, P < 0.001), weekly working hours (χ2 = 52.493, P < 0.001), number of night shifts (χ2 = 34.685, P < 0.001), and monthly income (χ2 = 18.994, P < 0.001). Occupational burnout is prevalent among emergency nurses, with significant heterogeneity in burnout types. Burnout is associated with age, education level, professional title, number of night shifts, weekly working hours, and monthly income. The heterogeneity of burnout subtypes and their influencing factors provides a basis for future personalized interventions.