公共卫生研究摘要 (2025-10-15)
共收录 60 篇研究文章
1. Humoral immune responses to the second dose of a COVID-19 mRNA vaccine in cancer patients undergoing treatment.
期刊: Human vaccines & immunotherapeutics 发表日期: 2025-Dec 链接: PubMed
摘要
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in 2020 led to the immediate development of vaccines to combat SARS-CoV-2 infections and coronavirus disease 2019 (COVID-19). First-generation (2020-2021) COVID-19 vaccines demonstrated high immunogenicity and efficacy, successfully reducing hospitalization, disease severity and COVID-19 related deaths. However, the initial clinical trials for these vaccines focused on overall healthy individuals, and generally excluded high risk populations, such as people with cancer. The SARS-CoV-2 VaccinE Response, Immunological eFfects and safetY in patients with Cancer (VERIFY-C) study formed a unique cohort in early 2021, to capture the initial immune response to BNT162b2 mRNA (Pfizer) vaccination in people with cancer, with or without ongoing/recent exposure to systemic cancer treatment. Fifty-three participants diagnosed with cancer were enrolled. Majority were non-Hispanic, Caucasian females. Patients under cancer treatment had significantly lower antibody responses than those without treatment at pre-second dose and 1-month post-second dose. The levels at 6-months post-second dose were similar between both groups. Patients under treatment had a significantly lower immune response 1-month post-second dose, with an increased immune response at 6-months post-second dose, suggesting a delayed immune response. Further investigations are needed to understand antibody functionality post-vaccination in these individuals.
2. Association Between Obesity and the Risk of Migraine: A Nationwide Cohort Study in South Korea.
期刊: Neurology 发表日期: 2025-Nov-11 链接: PubMed
摘要
Although obesity is recognized as a risk factor of migraine chronification, its longitudinal impact on migraine onset remains unclear. The aim of this study was to investigate the association between obesity and the risk of developing migraine in a longitudinal setting. We conducted a population-based prospective cohort study using data from the Korean National Health Insurance Service. Individuals aged 20-39 years who underwent health examinations between 2009 and 2012 were enrolled, excluding those with a history of migraine, missing data, or a migraine diagnosis within the first year. Participants were followed to the end of 2018. Body mass index (BMI) was categorized into 5 groups and waist circumference (WC) into 6 levels. Outcome was the first migraine claim (International Classification of Diseases, Tenth Revision code G43). We evaluated the associations of BMI and WC with the risk of migraine using multivariable Cox proportional hazard regression models. Interaction analyses were conducted based on demographic and lifestyle factors. Among 6,106,560 individuals included (mean age: 30.6 ± 4.98 years; 39% female), the risk of migraine increased with increasing BMI (adjusted hazard ratio [aHR] 1.001 [95% CI 0.991-1.010], 1.047 [95% CI 1.040-1.055], 1.087 [95% CI 1.079-1.094], and 1.121 [95% CI 1.106-1.136] for underweight, overweight, stage 1 obesity, and stage 2 obesity, respectively, compared with normal BMI) and WC (aHR 0.913 [95% CI 0.906-0.921], 0.969 [95% CI 0.960-0.978], 1.022 [95% CI 1.010-1.034], 1.048 [95% CI 1.032-1.065], and 1.048 [95% CI 1.030-1.067] for levels 1, 2, 4, 5, and 6, respectively, compared with level 3). This dose-dependent relationship remained significant for WC after adjusting for BMI, but not vice versa. A stronger association between abdominal obesity and migraine risk was observed in younger individuals (<30 years) (p for interaction = 0.0181), nonsmokers (p for interaction = 0.0341), and heavy drinkers (p for interaction = 0.0143). Obesity was associated with an increased risk of migraine in young adults in a dose-dependent manner, with WC demonstrating a more robust independent association than BMI. Owing to the limitations of claims data, our study needs cautious interpretation and further validation in studies with detailed clinical information.
3. Tackling the growing burden of pain in low/middle-income countries.
期刊: Pain 发表日期: 2025-Nov-01 链接: PubMed
摘要
The global pain disability burden is a significant problem, with inequities in access to effective care and treatment outcomes for people living in low/middle-income countries (LMICs), particularly in rural settings. Social determinants of health greatly influence health and pain outcomes, often more than treatment-related factors. Urgent actions are needed to tackle the growing burden of pain in LMICs. We provide practical guidance for researchers, policymakers, and healthcare providers and how each group may contribute to the solution. With unified responses at global, national, and local levels, we can tackle the growing burden of pain in LMICs and rural settings.
4. The transformative potential of digital therapeutics in pediatrics.
期刊: Pain 发表日期: 2025-Nov-01 链接: PubMed
摘要
Digital therapeutics (DTx) are applied healthcare technologies designed to prevent, manage, or treat health conditions. In pediatric pain, DTx can enhance access to evidence-based, effective pain assessment and management. This article explores technologies such as artificial intelligence (AI), extended reality (XR), mobile health (mHealth), and sensors (eg, smartwatches). Equitable DTx deployment can address geographic disparities by enabling on-demand pain care, necessitating an intelligent learning DTx-enabled health system. Ensuring safety will require comprehensive regulatory frameworks at national and international levels. Achieving this transformation requires robust regulatory frameworks, workforce training, and equitable codesign to ensure accessible, evidence-based care for all pediatric populations.
5. Leveraging technologies to upskill primary care providers in person-centred pain care.
期刊: Pain 发表日期: 2025-Nov-01 链接: PubMed
摘要
There is a critical need to upskill primary care providers to enable timely high-quality care for children, youth, and adults living with pain. Leveraging technologies has the potential to increase accessibility of pain education as part of continuing professional development. In this paper, we highlight 2 digitally enabled education strategies-Project Extension for Community Healthcare Outcomes (synchronous) and eLearning pain training (asynchronous). Emerging areas of interest for education and research are also highlighted including blended synchronous and asynchronous pain education; the use of artificial intelligence tools to create personalised and engaging eLearning experiences; and consumers as partners in the development, implementation, and evaluation of digitally enabled pain education.
6. Response to: Revisiting Opioid Risk Assessment.
期刊: Pain 发表日期: 2025-Nov-01 链接: PubMed
摘要
7. Reordering neuroimmune signaling to prevent and resolve chronic pain.
期刊: Pain 发表日期: 2025-Nov-01 链接: PubMed
摘要
Chronic pain is subserved by interactions between the immune and nervous systems. There has been an historical emphasis on the disordered pro-inflammatory mechanisms that maintain chronic pain. This narrative review will highlight the adaptive benefit of initial pro-inflammatory signaling for the long-term trajectory of pain, as well as pro-resolving mechanisms that can prevent pain from becoming chronic. Importantly, there is potential for these insights to be harnessed for safe, nonaddictive, disease-modifying treatment of pain.
8. ACSM Expert Consensus Statement: Considerations and Recommendations for Prescribing Exercise and Designing Physical Activity Programs for People with Disabilities.
期刊: Medicine and science in sports and exercise 发表日期: 2025-Nov-01 链接: PubMed
摘要
Participating in physical activity and meeting physical activity guidelines are far more challenging for persons with disabilities than for the general population. This American College of Sports Medicine expert consensus statement provides an evidence-based summary of (i) the impact of physiological factors, physical activity guidelines, and barriers on physical activity participation and prescription for individuals with disabilities; (ii) three consensus statements derived from research evidence; and (iii) five practical recommendations for prescribing and designing physical activity programs tailored to adults with disabilities, based on an integration of research evidence with expert consensus.
9. TSPO Expression and [18F]DPA-714 PET/CT Imaging as Pathogenetic and Diagnostic Biomarkers in Symptomatic Stages of Skeletal Muscle Fiber Degeneration in SOD1-G93A ALS Mice.
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
Emerging evidence highlights the involvement of skeletal muscle in the pathogenesis of amyotrophic lateral sclerosis (ALS), through mechanisms involving inflammation and mitochondrial dysfunction in skeletal muscle fibers. The 18 kDa translocator protein (TSPO) is primarily expressed on the outer mitochondrial membrane, is implicated in inflammation, and serves as both a biomarker and a therapeutic target for neuroinflammation. This study investigated whether PET imaging targeting the TSPO, immunohistochemistry, and confocal microscopy can characterize skeletal muscle inflammation and muscular fiber damage in SOD1-G93A ALS transgenic mice. High-resolution PET/CT imaging with [18F]DPA-714 was employed to assess TSPO expression in the triceps brachii of SOD1-G93A mice at mild (age range: 98-112 days; Clinical Score (CS) range:1-1.5) and moderate-severe (age range: 120-137 days; CS range: 2-4) symptomatic stages. To support PET data, TSPO was analyzed by immunohistochemistry and confocal microscopy in the triceps skeletal muscle obtained from mild and moderate-severe SOD1-G93A mice. Inflammatory and anti-inflammatory macrophage cells in skeletal muscle tissues were detected by immunofluorescence. PET/CT revealed a progressive, significant increase of [18F]DPA-714 uptake in SOD1-G93A triceps brachii in mild and moderate-severe stages. Immunohistochemistry and confocal microscopy confirmed increased TSPO expression in the degenerating muscle fibers and in infiltrating macrophage cells. In vivo studies of TSPO expression in ALS-affected skeletal muscles may provide valuable insights into muscle inflammation and mitochondrial involvement during disease progression. In addition, TSPO and PET/CT imaging with [18F]DPA-714 might represent a noninvasive and promising diagnostic biomarker for detecting early muscle pathology in ALS.
10. Fundamental features of social environments determine rate of social affiliation.
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
Humans start new friendships and social connections throughout their lives and such relationships foster mental and physical well-being. While friendship initiation may depend on alignment of subtle and complex personal variables, here we investigated whether it also depends on basic features of social environments. In a preregistered online study (n = 783) using a novel social-affiliation seeking paradigm, we found people were more likely to send friend requests as the density of friendship opportunities decreased and frequency of success increased. Further, we found task-related measures, like overall friend requests, were correlated with mental health dimensions like social thriving and anhedonia. Next, in an ultra-high-field fMRI study (n = 24), we found that both fundamental features of social environments–opportunity density and frequency of success–affected neural activity across a network of regions linked to foraging including dorsal raphe nucleus, substantia nigra, and anterior insula. Thus, humans consider the background statistics of an environment while making social decisions and these decisions are linked to activity in cortico-subcortical circuits mediating the influence of environmental statistics on other aspects of behavior. Moreover, individual differences in how environmental features influence social behavior are associated with variation in mental health dimensions, offering key insights into interindividual variability in social functioning.
11. The psychosocial web of oral health: exploring the links between sense of coherence, dental anxiety and quality of life in adolescents.
期刊: International journal of adolescent medicine and health 发表日期: 2025-Oct-16 链接: PubMed
摘要
The dynamic interplay between oral health-related quality of life (OHRQoL), sense of coherence (SOC), and dental anxiety has garnered increasing attention in recent years, highlighting the need for a comprehensive understanding of their interconnections. This review synthesizes current evidence from interdisciplinary research to explore how these constructs interact and influence one another. OHRQoL reflects the functional, psychological, and social impact of oral health, while SOC represents an individual’s capacity to perceive life as comprehensible, manageable, and meaningful. Dental anxiety, a prevalent barrier to oral healthcare, can significantly impair OHRQoL and is influenced by both subjective health perceptions and coping mechanisms. The literature indicates that a strong SOC may mitigate dental anxiety and buffer the negative effects of poor oral health on quality of life. Conversely, heightened dental anxiety can lead to avoidance behaviors, exacerbating oral health problems and diminishing OHRQoL. This review underscores the importance of a biopsychosocial approach in dental care, advocating for integrative strategies that enhance SOC and reduce anxiety to improve overall oral health outcomes and patient well-being. Gaps in the literature and directions for future research are also discussed, with emphasis on longitudinal studies and intervention-based approaches.
12. Physical Activity and BrainAGE: Exploring the Impact on Brain Health and Plasticity in Older Adults.
期刊: Human brain mapping 发表日期: 2025-Oct-15 链接: PubMed
摘要
With an aging global population, cognitive decline in older adults presents significant healthcare challenges. Emerging evidence suggests that physical activity can support cognitive health by promoting plasticity, functional reorganization, and structural adaptation of the brain. In the FIT4BRAIN study, we examined the effects of multi-component physical activity on cognitive and brain health. Here, we report the results on one of the secondary outcomes, namely changes in brain age (BrainAGE), which estimates the difference between chronological and predicted brain age based on structural MRI data, and changes in brain structure, assessed through voxel-based morphometry (VBM). Ninety-two healthy older adults were randomized into a multi-component physical activity group, performing aerobic, coordination, and balance exercises, or an active control group engaging in non-aerobic relaxation exercises and educational content (physical activity group (PAG): 36 participants; active control group (CON): 33 participants). Of these, 69 participants underwent MRI assessment and were included in the present analyses. BrainAGE analyses revealed a greater decrease in the physical activity group compared to the control group, indicating a beneficial effect of physical activity on brain aging. Subgroup analyses based on baseline cardiorespiratory fitness (CRF) further revealed that participants with lower CRF showed greater benefits, consistent with VBM findings of structural changes in the same subgroup. These results underscore BrainAGE as a sensitive biomarker for intervention outcomes and suggest that stratification by baseline fitness level may help identify differences in the benefits of physical activity on brain health.
13. Exploring Fit in a Mobile Health Intervention for Alcohol Use Disorder: Qualitative Study.
期刊: JMIR mHealth and uHealth 发表日期: 2025-Oct-14 链接: PubMed
摘要
Implementation frameworks such as the Exploration, Preparation, Implementation, Sustainment model emphasize the importance of the fit between an intervention and its context, which includes the needs of its target population, as well as the culture, resources, and capabilities of the implementing organization. Although lack of fit is a major barrier to implementation, fit has not often been a focus of implementation research. This paper uses fit as a lens to examine the implementation of Tula, a mobile health app aimed at reducing risky drinking days among individuals meeting the criteria for mild to moderate alcohol use disorder, in a 3-arm (app alone, app plus peer mentoring, and app plus health coaching) randomized controlled trial. We sought to better understand the trial results and to provide actionable guidance for future implementation of digital health interventions in health care organizations. Semistructured interviews with 18 trial participants and 7 Tula implementers were conducted. Trial participants were pulled equally from each arm of the trial and represented participants who demonstrated both high and low engagement with the app. Implementers consisted of a project manager, 4 peer mentors, and 2 health coaches. Interviews with participants focused on their motivations, opinions, and experiences of the intervention and their perception of their drinking behavior following the intervention, including how their use of the app worked to change that behavior. Interviews with implementers were centered on their roles, theories of change, perceptions of intervention, and areas for improvement. All interviews were analyzed using rapid qualitative analysis with deductive and inductive components. We identified areas of both fit and misfit. For example, there was a good fit between implementers’ theories of change and participants’ description of how change occurred. Fit was improved by the versatility of the app, which allowed participants to customize their experiences. Conversely, misfit was noted in the app’s inability to cultivate connection for many participants and a disjunction between the role of peer mentors in the intervention and their broader professional ethos. Focusing on fit provides a useful guide to enhance future iterations of the Tula app that lead to better sustainment of the intervention.
14. Bibliometric Insights Into the Infodemic: Global Research Trends and Policy Responses: Quantitative Research.
期刊: JMIR medical informatics 发表日期: 2025-Oct-14 链接: PubMed
摘要
Amidst the COVID-19 pandemic, the proliferation of misinformation on social media, termed the “infodemic,” has complicated global health responses. This study aims to identify research trends and information-making in the context of this challenge. This paper synthesizes key areas of scholarly investigation into the COVID-19 infodemic, both within China and internationally, to guide public health strategies and the management of public sentiment. By employing a bibliometric approach, using CiteSpace software, we conducted a visual analysis of the global literature, covering a total of 1437 publications from the Web of Science and the China National Knowledge Infrastructure core databases between 2016 and 2025, focusing on publication trends, citation frequencies, and keyword clusters. After analysis, the results reveal distinct focal points in the research priorities of Chinese and international scholars. International studies often focus on machine learning and public psychology, while Chinese research tends to address information control and safeguarding. Common ground is found in the interest in preventing the spread of misinformation. While literature on COVID-19 abounds, cross-national systematic reviews are limited. This paper fills this gap through a comparative bibliometric analysis, offering valuable insights for information management, media communication, and public administration, thus charting new directions for future research.
15. Self-Health Monitoring by Smart Devices and Ontology Technology for Older Adults With Uncontrolled Hypertension: Quasi-Experimental Study.
期刊: JMIR nursing 发表日期: 2025-Oct-14 链接: PubMed
摘要
Hypertension is a prevalent concern among older adults, often leading to complex cardiovascular complications when uncontrolled. Telenursing technology facilitates self-management, and the integration of domain-specific ontology allows real-time interpretation of behavioral and biometric data to provide personalized recommendations, enhancing patient engagement and self-care. This study aimed to examine the within-group and between-group effects of self-health monitoring using smart devices combined with ontology technology on hypertension-controlling behavior and mean arterial pressure among older adults with uncontrolled hypertension. The quasi-experimental design was conducted with 91 older adults in Bangkok, Thailand (46 experimental and 45 comparison participants). Participants in the experimental group used the “HT GeriCare@STOU” app on smartphones, linked to smartwatches for blood pressure monitoring, step count, and sleep pattern, with telenursing support via video calls. Data on hypertension-controlling behavior were collected using a validated questionnaire (Cronbach α=0.83; content validity index=0.98). Descriptive statistics and t tests were used to analyze within-group and between-group differences. Within-group analysis revealed that experimental participants showed improved hypertension-controlling behavior and reduced mean arterial pressure after the program. Between-group comparisons indicated that mean arterial pressure in the experimental group was significantly lower than in the comparison group (P<.05), although hypertension-controlling behavior did not differ significantly between groups. Older adult participants and nurses reported high satisfaction, noting that real-time feedback increased awareness of blood pressure and motivated independent health behavior adjustments. Self-health monitoring using smart devices integrated with ontology technology effectively improved physiological outcomes and supported self-management in older adults with uncontrolled hypertension. The ontology framework enabled personalized, real-time decision support, highlighting its novelty, and potential to enhance nursing practice. Future studies with larger samples and longer follow-up are recommended to further evaluate the intervention’s effectiveness and scalability.
16. The Relationship Between State Fiscal Capacity and Opioid Settlement Expenditures.
期刊: Substance use & misuse 发表日期: 2025-Oct-14 链接: PubMed
摘要
The distribution of funds from national opioid settlements provides a critical opportunity for states to address the ongoing overdose crisis in the US. However, it remains unclear whether these funds have been spent by states with significant fiscal needs, in addition to higher opioid-related needs. We used data from KFF Health News to examine per capita opioid settlement spending across states, categorizing them into tertiles. Fiscal need, defined as the ability of governments to fund programs and services, was assessed using US Census of Governments data, and overdose crisis need was measured using Centers for Disease Control and Prevention overdose mortality data. We identified states as “higher overdose need” and “higher fiscal need” and calculated the mean per capita settlement funds spent for each category. The mean settlement funds spent per capita were $3.45 (SD: 1.75) for tertile 1 (n = 16), $8.11 (SD: 2.04) for tertile 2 (n = 16), and $ 23.69 (SD: 28.12) for tertile 3 (n = 13). Tertile 3 had the highest overdose death rate (23.69, SD: 28.23), while tertile 2 had the highest fiscal need. States categorized as both higher fiscal and overdose need (n = 12) spent a mean of $21.48 (SD: 33.22) per capita, compared to $7.82 (SD: 4.59) in states with lower fiscal and overdose need (n = 21). States with higher fiscal and overdose needs spent the most settlement funds per capita in 2022-2023, suggesting effective targeting. Future research should examine whether the opioid settlement funds lead to reductions in overdose deaths, particularly in fiscally constrained areas.
17. The science of implementation and its application in primary healthcare.
期刊: Medwave 发表日期: 2025-Oct-14 链接: PubMed
摘要
18. A Social Media Campaign and Web-Based Survey About Prostate Cancer Genetics: Mixed Methods Study.
期刊: JMIR cancer 发表日期: 2025-Oct-14 链接: PubMed
摘要
Germline genetic variants are important for prostate cancer (PCa) management and hereditary cancer risk assessment, but testing is underused. Furthermore, patients are often unaware of the genetic connections to PCa. Social media is increasingly serving as a source of awareness for health information and a method to gather data from a large population. There were three objectives: to (1) create and test social media messages related to PCa genetics and genetic testing, (2) determine which social media message was most engaging, and (3) assess knowledge of and attitudes toward PCa genetic testing through an online survey using the most engaging social media message. A paid social media campaign was developed to disseminate targeted messages about PCa and genetics. We tested combinations of 8 images and 8 messages that were created or selected by the research team and reviewed by a study-specific advisory board. We targeted men and women older than 35 years living in the United States. The campaign was launched on Facebook for 6 days (June 3-8, 2023). We tracked the reach and impressions of each post. The survey, administered directly after someone viewed a post, assessed knowledge about PCa and cancer genetics as well as beliefs about cancer risk and genetic testing. Descriptive and multivariable analyses were used to analyze survey data. Most posts were viewed by women (13,675/16,224, 84.3% of impressions) and people over the age of 55 years (19,997/22,906, 87.3% of impressions). The 2 most engaging images were a group of men of different races and ethnicities (reach: 28,151 people; impressions: 33,727 views), followed by a Hispanic family (reach: 16,026 people; impressions: 20,113 views). The following message had the most engagement: ”Breast cancer and prostate cancer may be related because they can arise from the same gene mutation in a family” (reach: 58,980 people; impressions: 74,834 views). A total of 875 people (n=796, 91% male; mean age 43.42, SD 14.1 years; n=224, 25.6% Black or African American individuals; n=255, 29.1% Hispanic individuals) completed the survey. In total, 75.2% (658/875) strongly or somewhat agreed that genetics play a role in the development of PCa, and 84% (735/875) would want to know if they had a genetic predisposition to PCa. It is feasible to use social media platforms to test and disseminate messages that raise awareness about PCa genetics and the connection with other cancers (eg, breast cancer), as well as to deploy surveys that reach a wide audience.
19. Atypical Presentations at Risk for Diagnostic Errors in Internal Medicine: A Scoping Review.
期刊: Journal of general internal medicine 发表日期: 2025-Oct-14 链接: PubMed
摘要
Little is known about how atypical disease presentations lead to diagnostic errors. Better definitions of atypical presentations may improve our understanding. We aimed to describe how atypical presentations were defined in studies of diagnostic errors in internal medicine. We included papers that described the association between atypical presentations in adult patients and diagnostic errors in internal medicine, indexed from database inception to July 31, 2025. We excluded case reports and conference abstracts. The data were extracted through MEDLINE, Web of Science, CINAHL, Embase, Cochrane Library, Google Scholar, and MedRxiv searches. We included 56 papers in this review. Thirty studies included a definition of atypical presentation, but there was a considerable heterogeneity among the definitions. Using basic qualitative content analysis, we developed a new approach (Primary, Suggestive, Uncommon, and Chameleon features-the PSUC approach) to describe clinical presentations and identified four patterns at high risk of diagnostic errors. Pattern 1 lacks Primary disease features (i.e., features always written in textbooks) but has Suggestive features (i.e., stimulating consideration of specific disease); Pattern 2 lacks Primary features but Suggestive and Uncommon features (i.e., uncommon but known features in specific disease) are present. Pattern 3 lacks Primary and Suggestive features but has Uncommon features and Pattern 4 is similar to 3 but with Chameleon features (i.e., primary features for other diseases). Atypical presentations in studies of diagnostic errors in internal medicine currently have high heterogeneity. A new approach to classify atypical presentations may be useful and warrants investigation in future research. Open Science Framework www.osf.io/27d5m .
20. Genomic and Pathogenic Characterization of Vibrio alginolyticus CG-1 Isolated from Crassostrea gigas.
期刊: Current microbiology 发表日期: 2025-Oct-14 链接: PubMed
摘要
The Pacific oyster (Crassostrea gigas) is a species of significant economic importance in global aquaculture. Vibrio alginolyticus, a halophilic marine bacterium widely distributed in coastal environments, is recognized as an opportunistic pathogen in both humans and marine organisms. However, the genomic determinants of V. alginolyticus pathogenicity in oysters remain poorly understood. The strain CG-1 was isolated from diseased Pacific oysters collected during a mortality event in Tongyeong, South Korea. Here, we report the complete genome sequence of strain CG-1, which comprises two circular chromosomes measuring 3,535,696 bp (chromosome I) and 1,806,773 bp (chromosome II), with GC contents of 44.61% (chromosome I) and 44.66% (chromosome II). The genome contains 4,785 protein-coding sequences, 127 tRNA genes, 37 rRNA genes, and one tmRNA. Plasmids were not identified. Functional annotation assigned 96.21% of the coding sequences to clusters of orthologous groups (COG) categories primarily related to metabolism, transcription, and inorganic ion transport. The genome encodes multiple virulence-associated genes including components of the type III secretion system, extracellular enzymes, motility and chemotaxis regulators, outer membrane proteins, iron acquisition systems, and antibiotic resistance genes. A pathogenicity assay revealed that V. alginolyticus CG-1 induced dose-dependent mortality in Pacific oyster larvae, with an LD50 of 5.04 × 106 CFU/mL. The clinical symptoms were comparable to those caused by major pathogens such as V. coralliilyticus, although the overall mortality rates were comparatively lower. Overall, this study provides valuable insights into the genome-based mechanisms and pathogenicity of V. alginolyticus in oyster larvae, underscoring its role as an emerging marine pathogen with the potential to impact aquaculture health and sustainability.
21. Adenosine A2A receptor activation in the nucleus accumbens decreases motivation for wheel running in male mice.
期刊: Psychopharmacology 发表日期: 2025-Oct-14 链接: PubMed
摘要
Wheel running is a highly motivated behavior in rodents and is often used as a natural reinforcer. The adenosine A2A receptor is abundantly expressed in the nucleus accumbens (NAc) and plays a key role in the regulation of motivation and reward-related behaviors. However, its involvement in motivation for wheel running remains unclear. This study aimed to investigate how systemic and intra-NAc pharmacological manipulation of A2A receptors affects motivation for wheel running in mice. We examined the effects of systemic administration of the A2A receptor antagonist istradefylline and the A2A receptor agonist CGS21680 on voluntary wheel-running activity and general locomotor activity. We also assessed the effects of these drugs on operant conditioning tasks in which wheel-running served as a reward. Furthermore, we infused CGS21680 directly into the NAc to examine site-specific effects. Systemic istradefylline administration increased voluntary wheel-running activity and general locomotion. In contrast, CGS21680 decreased voluntary wheel-running without affecting locomotion. In the operant task, systemic CGS21680 significantly reduced the operant response, a measure of appetitive behavior, without altering running duration, which reflects consummatory behavior. Similarly, intra-NAc infusion of CGS21680 suppressed appetitive behavior. These findings demonstrate that, in male mice, A2A receptor activation selectively suppressed the appetitive component of wheel-running motivation, whereas A2A receptor blockade did not. Together, our results highlight the crucial role of NAc A2A receptors in regulating motivation for wheel running and suggest the potential therapeutic application of A2A receptor agonists for treating maladaptive behavioral over-engagement.
22. Effects of Intensity and Fatigue on the Kinetics and Kinematics of the Barbell Squat, Bench Press, and Deadlift in Experienced Lifters: A Systematic Review.
期刊: Sports medicine - open 发表日期: 2025-Oct-14 链接: PubMed
摘要
Powerlifting is a competitive strength sport focused on achieving the highest possible single-repetition load in three barbell lifts: the back squat, bench press, and deadlift, each testing maximal force output under standardized conditions. Increases in training intensity and the accumulation of fatigue can lead to measurable alterations in kinetic and kinematic variables, with potential implications for both performance and injury risk. Although trained lifters typically exhibit more stable movement patterns than novices, the biomechanical responses to intensity and fatigue remain complex and variable. This systematic review aimed to identify consistent, observable changes in kinetic and kinematic variables in experienced lifters during the back squat, bench press, and deadlift under conditions of increasing intensity and fatigue. A keyword search was performed on MEDLINE Complete, SPORTDiscus, and CINAHL Plus up to June 2024. Studies that examined the effects of load and fatigue on the kinetics and kinematics of the back squat, bench press, and deadlift in experienced lifters were included. The quality of studies was rated according to the Quality Assessment of Observational Cohort and Cross-sectional Studies scale. Results were summarized in tables and with a narrative synthesis. Twenty-two studies, with a total of 293 participants, met the inclusion criteria. Increased intensity was consistently associated with decreases in mean and peak barbell velocity and power, increased force production, longer concentric durations, and greater joint variability, especially in the acceleration and sticking regions. Fatigue led to similar reductions in velocity and power, although findings on force production were inconsistent across studies. Only two studies examined the deadlift, and reporting practices varied between studies. Increased intensity and fatigue produce predictable kinetic and kinematic changes in the back squat, bench press, and deadlift, particularly during the acceleration and sticking phases. Velocity consistently decreased with intensity and fatigue, while power and joint mechanics showed greater variability across individuals and studies. Coaches and clinicians should monitor these changes to inform programming and technical interventions. However, different lifters may adopt distinct mechanical strategies as intensity increases, especially near the sticking point. Future research should distinguish between- and within-individual variability in kinetic and kinematic expression and address underrepresented movements, particularly the deadlift. This systematic review was registered with PROSPERO (CRD42024550339).
23. Exogenous and endogenous antioxidants (ROS) in Physiology and Pathology of the Cardiovascular System.
期刊: Canadian journal of physiology and pharmacology 发表日期: 2025-Oct-14 链接: PubMed
摘要
Generation of reactive oxygen species (ROS) is a physiological product of cell activity that is mainly generated by the mitochondria as well as by transmembrane NADPH oxidases (NOX1-5) present at the plasma and nuclear envelope membranes. The level of basal intracellular ROS is regulated by endogenous antioxidants such as glutathione (GSH) and the endogenous and exogenous antioxidant taurine. These two antioxidants are present in all types of cells and more particularly in the heart and the vascular system. They regulate and control intracellular ROS levels in order to prevent this latter from inducing dysfunction of the cardiovascular system. There are also exogenous antioxidants that are present in many types of food, such as vitamin C, vitamin E, and resveratrol. These exogenous antioxidants are necessary to complement the effect of endogenous antioxidants. However, according to the literature, it is difficult to generalize about the beneficial effect of exogenous antioxidants in preventing cardiovascular disease. This does not necessarily seem to be the case for endogenous antioxidants. In this review, we will discuss the advantages and disadvantages of using exogenous and endogenous antioxidants, and suggest the potential application of one of them.
24. A Novel Approach Using Serious Game Data to Predict the WISC-V Processing Speed Index in Children With Attention-Deficit/Hyperactivity Disorder: Machine Learning Study.
期刊: JMIR serious games 发表日期: 2025-Oct-14 链接: PubMed
摘要
The processing speed index (PSI) of the Korean Wechsler Intelligence Scale for Children-Fifth Edition (K-WISC-V) is highly correlated with symptoms of attention-deficit/hyperactivity disorder (ADHD) and is an important indicator of cognitive function. However, restrictions on the frequency of testing prevent short-term PSI assessments. An accessible, objective technique for predicting PSI scores would enable better short-term monitoring and intervention for children with ADHD. To enable objective and accessible monitoring of cognitive function beyond traditional clinical assessments, this study aimed to develop a machine learning model that predicts the PSI scores of children with ADHD using behavioral data from serious games. Sixty-eight children (6-13 y of age) with ADHD were recruited, and after excluding incomplete data, 59 participants were included in the final analysis. The participants completed an initial PSI assessment using the K-WISC-V followed by 25 minutes of engagement with serious game content. Data from the game sessions were used to train machine learning models, and the models’ performance in predicting PSI scores was evaluated using the root mean squared error (RMSE), mean absolute error (MAE), and mean absolute percent error (MAPE), with K-fold cross-validation (k=4) applied to ensure robustness. Among the individual machine learning models, support vector regression (SVR) had the best performance, with the lowest RMSE of 11.288, MAE of 7.874, and MAPE of 7.375%. The best overall performance was achieved by the ensemble integrating AdaBoost, Elastic Net, and SVR, which recorded the lowest RMSE of 10.072, MAE of 6.798, and MAPE of 6.611%. The predictive accuracy of this ensemble model was highest for PSI scores near the mean value of 100, demonstrating its reliability for clinical applications. The developed PSI prediction model has the potential to serve as an objective and accessible tool for monitoring cognitive function in children with ADHD. As a complement to traditional assessments, this approach allows continuous tracking of symptom changes and can support more personalized treatment planning in both clinical and everyday settings, which may improve accessibility and adherence. However, the findings need to be validated in larger, more diverse populations, and the long-term feasibility of using serious games in clinical and educational settings must be further examined.
25. Combined Inhibition of FABP4/5 Ameliorates Pulmonary Hypertension by Reducing Pulmonary Vascular and Right Ventricular Fibrosis.
期刊: American journal of respiratory cell and molecular biology 发表日期: 2025-Oct-14 链接: PubMed
摘要
Lipid metabolism disorder is increasingly recognized as hallmarks of Pulmonary hypertension (PH). Fatty acid-binding proteins (FABPs), particularly FABP4 and FABP5, which regulate lipid transport and metabolism of fatty acid, are thought to contribute to the development of PH. However, it remains unclear whether FABP4 and FABP5 serve as therapeutic targets for the treatment of PH. In the present study, the levels of FABP4/5 were elevated in the plasma and lung tissues of IPAH patients, as well as in the lung tissues of the PH rat model compared with control. The circulating levels of FABP4 of IPAH patients were correlated with mean pulmonary arterial pressure (mPAP). To determine the preventive or therapeutic effect of FABP4 and FABP5 inhibition, FABP4 and FABP5 inhibitors alone or combination were administered at early (days 2 following monocrotaline (MCT) injection) and late (day 12 following MCT injection) stage of PH rat model, respectively. Combined treatment with FABP4/5 inhibitors in the early stage of the MCT-PH rat model effectively reduced right ventricular systolic pressure (RVSP) and improved right ventricular function, accompanied by reductions in pulmonary vascular and right ventricular fibrosis, as well as blood lipid levels, lipid peroxidation, and inflammation. Combined treatment with FABP4/5 inhibitors at the late stage of MCT-PH improved right ventricular function, suppressed pulmonary vascular and right ventricular fibrosis, and lowered blood lipid levels, but did not affect RVSP. In conclusion, our study indicates that combined inhibition of FABP4 and FABP5 can prevent the pathogenesis of PH, representing a potential therapeutic strategy for PH.
26. A novel aliphatic glycoside and a new lignan glycoside from Siraitia grosvenorii and their hepatoprotective activities.
期刊: Natural product research 发表日期: 2025-Oct-14 链接: PubMed
摘要
Five glycosides (1-5) containing one novel aliphatic glycoside Luohanguonoside G (1), one new lignan glycoside Luohanguonoside H (2) and three known ones (3-5) were isolated from the fresh fruit extract of Siraitia grosvenorii (S. grosvenorii). Structurally, according to various spectroscopic techniques analysis, the new compounds 1 and 2 were elucidated as a rare seven-carbon heptane glucose glycoside and a lignan glycoside, respectively. Among 1-5, the lignan glycosides 3 and 4 have been reported in other plants but separated from S. grosvenorii for the first time. Additionally, a cytotoxicity and a hepatoprotective activity experiment were performed on compounds 1-5 to evaluate their preventing ability for liver disease. The results indicate that compound 5 exhibited significant hepatoprotective activities in comparison with bicyclol and compound 1-4 exhibited moderate activity for liver protection compared to model control group. This research firstly assessed the hepatic protection competence of the isolates from S. grosvenorii in vitro, providing evidence for the further investigation on the preventing potential of liver diseases of this plant.
27. Clinical Pathways in Knee and Hip Arthroplasty: Narrative Review on Sustainability, Quality, and Resource Management.
期刊: JMIR perioperative medicine 发表日期: 2025-Oct-14 链接: PubMed
摘要
Increasing arthroplasty volumes are testing health care system capacity, budgets, and workforce resilience. Clinical pathways (CPWs) provide a practical, evidence-based structure that aligns perioperative actions from preparation through follow-up. In this review, we treat three aims as coprimary: quality (patient outcomes and adherence to best practice); resource management and efficiency at the episode level (eg, length of stay, perioperative flow, direct costs); and sustainability, defined as the ability to maintain high-quality services over time by optimizing financial, human, and environmental resources while safeguarding equitable access. This study aimed to describe the main CPW subtypes used in hip and knee arthroplasty and synthesize evidence on their effects on quality of care, resource management, and sustainability. We conducted a narrative review of studies indexed in PubMed and Cochrane (2013-2024) that evaluated CPWs in total hip and knee arthroplasty. Screening and selection were documented with a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-style flow diagram for transparency, and findings were synthesized thematically. Across CPW models, consistent signals of benefit were identified. Enhanced Recovery After Surgery (ERAS) pathways accelerate recovery and enable earlier discharge without increasing complications, often reducing opioid exposure and time to mobilization. Integrated Clinical Pathways improve standardization and multidisciplinary coordination across settings, reducing unwarranted variability and supporting safer transitions of care. Fast-track programs emphasize early mobilization and streamlined perioperative processes, improving patient flow and satisfaction while decreasing length of stay. Outpatient arthroplasty pathways allow same-day discharge in carefully selected, low-risk patients, reducing bed occupancy and freeing inpatient capacity. Virtual clinics support remote follow-up, patient education, and complication surveillance, decreasing unnecessary in-person visits and optimizing clinician time. Collectively, these pathways align quality improvement with sustainability by lowering bed-days, improving adherence to evidence-based practices, and enabling more efficient use of operating rooms, wards, and workforce. This review highlights the importance of CPWs in improving care delivery and patient outcomes in orthopedic surgery. Future efforts should refine CPWs, integrate digital tools and platforms, adopt standardized sustainability metrics, and stay flexible to evolving service demands.
28. Major Risk Factors in the Development of Propeller Flap Necrosis: A Prospective Monocentric Study of 144 Flaps.
期刊: Plastic and reconstructive surgery 发表日期: 2025-Oct-14 链接: PubMed
摘要
Propeller flaps have become increasingly popular with lower donor site morbidity, flexibility in flap design, and lower operating time. A disadvantage remains partial or total flap necrosis with reconstruction failure. We performed a monocentric prospective study that evaluated patients who underwent propeller flap, and we studied the relationship between flap necrosis and the patients’ preoperative biological markers (hemoglobin and hematocrit). We also looked into patients’ risk factors, and the risk for flap necrosis including smoking, radiation therapy, malignancy, harvesting time, direction and angle of rotation, and the preoperative rates of hemoglobin and hematocrit. This study analyzed 144 patients of different ages (range 8-85 years, mean age 45.03) on a 6-year follow-up period (November 2018-2024). Preoperative hemoglobin and hematocrit levels were noted, and post-operative flap monitoring was conducted. We observed 32 necrosis cases (22.2%) with 23 partial necrosis (16%), and nine total necrosis (6.25%). The hematocrit rate and the hemoglobin level do not have a significant effect on the risk of occurrence of necrosis. Patients were significantly older in the necrosis group (OR = 4.53; p-value = 0.02). The risk of necrosis also increased significantly with increasing arc of rotation (OR = 1.01 for each degree of increase; p-value = 0.002). Our study highlighted that the hematocrit rate and the hemoglobin level did not seem to significantly influence the risk of necrosis. Another factors could influence the risk of occurrence of necrosis such as the age of the patients and the angle of rotation. In literature, previous studies did not analyze the patient’s biological markers in relation to flap necrosis and complications. Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.
29. Unraveling the drivers of leptospirosis risk in Thailand using machine learning.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Oct-14 链接: PubMed
摘要
Leptospirosis poses a significant public health challenge in Thailand, driven by a complex mix of environmental and socioeconomic factors. This study develops an XGBoost machine learning model to predict leptospirosis outbreak risk at the provincial level in Thailand, integrating climatic, socioeconomic, and agricultural features. Using national surveillance data from 2007-2022, the model was trained to classify provinces as high or low risk based on the median incidence rate. The model’s predictive performance was validated for the years 2018-2022, spanning pre-COVID-19, COVID-19, and post-COVID-19 periods. SHapley Additive exPlanation (SHAP) analysis was employed to identify key predictive factors. The optimized XGBoost model achieved high predictive accuracy for the pre-pandemic (AUC = 0.937 with 95% CI: 0.878 - 0.976) and post-pandemic (AUC = 0.951 with 95% CI: 0.861 - 0.999) testing periods. SHAP analysis revealed rice production factors, household size, and specific climatic variables as the strongest predictors of leptospirosis risk. However, model performance declined during the COVID-19 pandemic (2020-2021), suggesting surveillance disruption and potential underreporting. This study demonstrates the utility of machine learning for predicting leptospirosis risk in Thailand and highlights the complex interplay of environmental and socioeconomic factors in driving outbreaks. The adaptable modeling framework provides a foundation for developing early warning systems and targeted interventions to reduce the burden of this neglected tropical disease.
30. Factors driving implementation success of mental health gap action programme (mhGAP) in Colombia: a cross-sectional study.
期刊: Discover mental health 发表日期: 2025-Oct-14 链接: PubMed
摘要
There are gaps in people’s access to mental health recovery. To this end, global programs have been outlined to strengthen primary health care and community settings. However, there are implementation challenges and a lack of monitoring. to determine key variables for the effective implementation of the mhGAP guides within the framework of primary health care (mhGAP-IG) and in connection with community actions (mhGAP community toolkit). A cross-sectional study was conducted with the participation of 447 individuals trained for the application of the mhGAP program. To assess facilitators, accessibility, adaptability, and acceptability of the program, as well as national and territorial capacity for training and supervision, the Implementation Drivers Scale was used. The scale is based on the Active Implementation Framework, and incorporates drivers for to ensure that evidence-based practices are faithfully implemented. These drivers include staff selection, training, supervision, intervention adaptation, and organizational support. Significant and relevant correlations for the maintenance of the program between monitoring and effectiveness. Exist significant differences between the groups with and without follow-up in all evaluated variables: Total IDS (U = 11569.000, p < 0.001), System (U = 13028.000, p < 0.001), Access (U = 15953.500, p < 0.001), Adaptation/Access (U = 15280.500, p < 0.001), and Training/Supervision (U = 12605.000, p < 0.001). Among the globally proposed strategies, the Mental Health Gap Action Programme (mhGAP) stands out. The importance of adequate and complete program implementation is emphasized, supported by a monitoring process that facilitates progressive appropriation and promotes intersectoral coordination processes to address barriers related to lack of resources and resistance to change.
31. JAK1 gain-of-function variant causes alopecia areata, atopic dermatitis, and autoimmune thyroid disease.
期刊: The Journal of allergy and clinical immunology 发表日期: 2025-Oct-14 链接: PubMed
摘要
32. Brain Age Is Longitudinally Associated With Sensorimotor Impairment and Mild Cognitive Impairment in Subacute Stroke.
期刊: Journal of the American Heart Association 发表日期: 2025-Oct-14 链接: PubMed
摘要
33. Disparities in Community-Based Rehabilitation Following Stroke: Findings From the COMPASS Trial.
期刊: Journal of the American Heart Association 发表日期: 2025-Oct-14 链接: PubMed
摘要
Our objective was to assess the extent of sociodemographic and geographic disparities in the use of community-based rehabilitation following stroke, an area that has been understudied. We conducted an observational, secondary analysis of data from the COMPASS (Comprehensive Post-Acute Stroke Services) trial, linking data of 6754 survivors of stroke to insurance claims. Our primary outcome was receipt of physical or occupational therapy in the home or outpatient setting within 30 days of hospital discharge. Secondary outcomes included therapy receipt within 90 days, time to first visit, number of visits, care in the home versus outpatient setting, and therapy type (physical therapy and occupational therapy versus 1 type). Our exposures were sex, race, rurality of patient residence, and socioeconomic status (Medicaid insurance). We used generalized estimating equations to examine associations between exposures and outcomes, controlling for therapy need. We found evidence of disparities in therapy receipt, setting, and type. Individuals on Medicaid (versus no Medicaid) were 8% (-0.08 [95% CI, -0.10 to -0.05]) less likely to receive therapy within 30 days, with the effect being slightly smaller for White patients (-0.05 [95% CI, -0.09 to -0.01]). Individuals living in rural versus metropolitan areas were 5% less likely (-0.05 [95% CI, -0.08 to -0.02]) to receive care within 30 days and 12% (-0.12 [95% CI, -0.22 to -0.03]) less likely to receive physical therapy and occupational therapy. Overall, we found minimal evidence of racial disparities. Our findings add to the limited evidence on disparities in community-based rehabilitation after stroke.
34. Selective silver recovery through single-pyrrolic nitrogen engineered carbon electrodes: A capacitive deionization breakthrough.
期刊: Water research 发表日期: 2025-Oct-13 链接: PubMed
摘要
Elucidating the role of single pyrrolic nitrogen in carbon materials for capacitive deionization (CDI) enables precise design of high-performance electrode materials. We synthesized single pyrrolic nitrogen-doped carbon material (SPNCM) using a defluorination-mediated pyrolysis strategy to investigate its role in capacitive Ag⁺ removal. In 2500 mg/L AgNO3 solution at 0.8 V, the SPNCM electrode achieved an exceptional Ag+ adsorption capacity of 1538.8 mg/g with 99.63 % removal efficiency. The electrode maintained outstanding Ag+ selectivity (ρMAg>15) in mixed heavy metal solutions, demonstrating feasibility for industrial wastewater extraction. After 25 adsorption-desorption cycles in mixed solutions, capacity retention reached 95.05 %. Multiscale simulations and experiments reveal that the pyrrolic-N five-membered ring acts as a dual ideal site for efficient Ag+ adsorption and rapid charge transfer due to its short bond length and high electron localization. This work provides atomic-level insights for optimizing nitrogen-doped carbon-based CDI materials.
35. Letter to the Editor: Misclassification of fibres in Ramage et al. (2025) and implications for microplastics research.
期刊: Chemosphere 发表日期: 2025-Oct-13 链接: PubMed
摘要
36. Polylactic acid microplastics and fish species intestinal inflammation risk: Associated with mitochondrial function mediated by Sesn2/Nrf2 pathway.
期刊: Environment international 发表日期: 2025-Oct-12 链接: PubMed
摘要
The polylactic acid (PLA), a kind of biodegradable plastic (BP), is widely used in various industries due to its environmental friendliness. Microplastics (MPs) derived from incomplete degradation of PLA presents significant ecological and health risks to aquatic organisms. However, the potential toxic mechanism of PLA MPs on intestines is still unclear. In the present study, rare minnows (Gobiocypris rarus) were exposed to 0 µg/L, 4.5 µg/L and 18 µg/L PLA MPs for 15 d. The results showed that PLA MPs exerted slight influence on intestinal growth in rare minnows, but caused intestinal damage as evidenced by intestinal villous epithelial cells eroded and necrotic, gap of edematous mucosal layer increased and fibrosis, and significantly increased inflammatory related genes expression. Moreover, the incidence and severity of intestinal damage escalated in a concentration-dependent manner, accompanied with the severe deterioration at distal intestines. Additionally, PLA MPs exposure caused intestinal mitochondrial dysfunction, as evidenced by significantly increased mitochondrial reactive oxygen species (ROS) and markedly decreased adenosine triphosphate (ATP) contents and mitochondrial respiratory enzymes activities (p < 0.05). The further studies found that PLA MPs exposure activated intestinal oxidative stress, as evidenced by significantly increased intestinal ROS and malondialdehyde (MDA), markedly decreased antioxidative stress enzyme activities and decreased antioxidative related genes expression. And then, the expression of pro-apoptotic related genes was significantly increased in PLA MPs exposure groups compared with the control levels, but decreased in the anti-apoptotic gene. Moreover, inhibited Sesn2/Nrf2 pathway may promote mitochondrial dysfunction by amplifying oxidant responses and apoptosis under PLA MPs exposure. Taken together, environmental PLA MPs aggravated intestinal damage through Sesn2/Nrf2 pathway-mediated mitochondrial dysfunction. These findings reveal a specific molecular pathway for PLA MPs to induce intestinal damage, which will contribute to assessing the ecological risks of BMPs to aquatic organisms.
37. Pre- versus post-COVID-19 pandemic comparison of kindergarten teacher-reported child development in multiple Canadian jurisdictions.
期刊: Social science & medicine (1982) 发表日期: 2025-Oct-11 链接: PubMed
摘要
Little is known so far about the impact of the COVID-19 pandemic on young children. We assessed the effect of the pandemic on pre-existing developmental trends in this population-level, repeated cross-sectional cohort design study of child development at school entry, measured with the kindergarten teacher-completed Early Development Instrument (EDI) in the 10 years prior to the onset of the COVID-19 pandemic and two years after. Individual EDI data for 913,739 children with individual EDI records were aggregated to 1398 neighbourhoods in 8 of Canada’s 13 provinces and territories and grouped into four time intervals (three pre-pandemic and one post-pandemic) including all jurisdictions. The COVID-19 pandemic was the main exposure, and overall vulnerability on the EDI (scoring below normative threshold in one or more of the 5 developmental domains) was the primary outcome. Demographic (e.g., age) and neighbourhood-level socioeconomic (SES) characteristics were investigated as potential modifiers- specifically, whether poverty and COVID-19 suggested a double jeopardy effect. Latent growth curve models with structured residuals were used to quantify whether post-COVID-19 vulnerability rates deviated from the pre-COVID-19 trajectory. Overall vulnerability rates were increasing by 0.39 % per year prior to the onset of the pandemic. On average, post-COVID-19 developmental vulnerability rates did not deviate from this pre-COVID-19 trajectory. Demographic variables predicted post-COVID-19 deviations, whereas neighbourhood SES did not. However, neighbourhood SES moderated the effects of some demographic variables. As society continues to grapple with the consequences of the COVID-19 pandemic impact, these results underscore the continuing need of monitoring child development and education trends.
38. Childhood SES gradients in adult functional limitations: Does state-level macro-economic context matter?
期刊: Social science & medicine (1982) 发表日期: 2025-Oct-11 链接: PubMed
摘要
Numerous studies document associations between childhood socioeconomic status (SES) and adult health, but less is understood about how macroeconomic context shapes these links. The current study examined whether income and income inequality measured at the state level moderated the association between parent education and functional limitations in a national sample of adults. Time-series economic data, derived from tax records (1917-2014), were merged with Midlife in the United States Study (MIDUS) data (N = 10,685; Mean age = 47.7, SD = 13.6; 51 % female) by state/year to assess economic conditions during four life stages: childhood (0-15), emerging adulthood (20-25), early adulthood (ages 30-35), and midlife (ages 40-45). Results showed that higher state mean income (at all four ages of exposure) was associated with fewer adult functional limitations. Childhood exposure to higher state-level income inequality (but not later periods) predicted more adult functional limitations. Childhood SES-adult health associations weakened with higher state income during childhood (B = 0.023, p = .018) and emerging adulthood (B = 0.036, p = .026), but not in later stages. Income inequality did not moderate SES-health links. Findings suggest that the impact of childhood SES on adult health varies by state economic context, particularly mean income, with effects dependent on exposure timing. Notably, childhood income inequality also independently predicted worse health outcomes, irrespective of state income. Future directions and policy implications are discussed.
39. The carceral state beyond bars: Pretrial surveillance as a structural determinant of health.
期刊: Social science & medicine (1982) 发表日期: 2025-Oct-10 链接: PubMed
摘要
The expanding reach of the carceral state has led to a rise in surveillance-based reforms marketed as humane alternatives to incarceration. Electronic monitoring (EM), an increasingly common condition of pretrial release, is often portrayed as a non-punitive solution to mass incarceration. Drawing on 40 in-depth interviews with individuals on pretrial EM in Cook County, Illinois-home to one of the largest and most restrictive EM programs in the U.S.-this paper critically examines the health harms that EM imposes on legally innocent people. We identify three mechanisms through which EM operates as a structural determinant of health: (1) persistent psychological distress caused by constant surveillance and legal uncertainty, (2) restricted access to medical care due to stringent movement controls, and (3) the use of emergency healthcare as a coercive and surveillance-laden last resort. Rather than shrinking the carceral state, EM spatially redistributes its harms and embeds carceral control within homes and bodies. We conclude by advancing abolitionist public health frameworks and outlining non-carceral alternatives that center dignity, autonomy, care, and community-based support.
40. The price of mobility: How migration shapes health outcomes in China.
期刊: Social science & medicine (1982) 发表日期: 2025-Oct-10 链接: PubMed
摘要
With the rapid pace of economic development, China has witnessed unprecedented population migration, which exerts a profound influence on migrants’ health outcomes. This study used data from the 2023 Yangtze River Delta Health and Life Satisfaction Survey to explore the effects and underlying mechanisms of internal migration on health outcomes. The findings revealed that migration significantly worsened the migrants’ health, and that the negative effects were more pronounced for interprovincial migration than for intraprovincial migration. Moreover, the study also found that greater social support could effectively buffer the negative health effects of migration, while the overall evaluation of the local healthcare services mediated this impact. These findings underscored the need for policymakers to reduce regional barriers, strengthen community cohesion, extend public services and social security to migrants, and promote their integration into residential communities through institutional reforms.
41. Diverse in vitro liver models reveal comprehensive biotransformation pathways of tetrabromobisphenol A.
期刊: Environment international 发表日期: 2025-Oct-09 链接: PubMed
摘要
Tetrabromobisphenol A is a widely used brominated flame retardant. Its biotransformation in human liver has raised significant environmental and health concerns. This study investigated and compared the metabolism of TBBPA in three in vitro liver models-human liver microsome (HLM), human hepatoblastoma (HepG2) cell, and human normal hepatocyte (MIHA) cell systems. At the end of exposure, 92.4%, 13.6%, and 98.4% of TBBPA was metabolized in HLM, HepG2 cell, and MIHA cell systems, respectively. According to the nontarget analysis, a total of 21 metabolites of TBBPA, including 7 for HLM, 9 for HepG2 cell, and 16 for MIHA, were found. A novel metabolite TBBPA mono-β-d-glucopyranoside mono-β-d-glucuronide was identified for the first time. The metabolism degrees and metabolite types differed significantly across the three in vitro models, which might be related to the different expression and activity of enzymes. By combining these three in vitro models, complex transformation pathways were confirmed, including glucuronidation, deglucuronidation, sulfation, methylation, glycosylation, debromination, coupling elimination reaction, and substitution, contributing to a better understanding of the environmental fate and health risk assessment of TBBPA in the human body.
42. The evolving role of occupational health and wellbeing: a personal view.
期刊: British journal of nursing (Mark Allen Publishing) 发表日期: 2025-Oct-09 链接: PubMed
摘要
43. The Tyrer-Cuzick risk model: Is it effective for all races?
期刊: Clinical imaging 发表日期: 2025-Oct-08 链接: PubMed
摘要
The IBIS/Tyrer-Cuzick [version 8 (TC8)] risk model is widely used to estimate breast cancer risk, and to inform the allocation of magnetic resonance imaging (MRI) screening for high-risk breast patients. No study to date has evaluated the latest TC model in diverse populations. To assess the predictive value of the TC8 Risk Model across diverse racial and ethnic groups in an urban American population. Retrospective data analysis from five sites within a single urban health care system from January 1, 2018-November 1, 2022. The sample included 73,435 patients; 639 had a history of breast cancer. Average TC risk scores were calculated by racial and ethnic groups for the overall sample, and then for those with a history of breast cancer. Analyses were conducted to evaluate relationships between TC8 risk scores, cancer rates, ethnicity and race. As expected, analyses revealed that TC8 scores were significantly associated with increased risk of cancer, with each percentage point increase in TC8 score the odds of cancer caseness increased by 2 %; (OR = 1.02, 95 % CI [1.01, 1.03]). Black/AA patients were less likely to be diagnosed with cancer than Whites; OR = 0.72, 95 % CI [0.59, 0.89]. Hispanic patients were less likely to be diagnosed with cancer than Non-Hispanic patients; OR = 0.49, 95 % CI [0.39, 0.61]. White patients had the highest TC8 scores, followed by Asian, Black/AA, and Other patients. Among cancer patients, White patients had higher TC8 scores than Black/AA patients (p < 0.02). Interestingly, we also found a stronger effect of TC8 scores on cancer caseness among Hispanic patients than Non-Hispanic patients [χ2(1) = 5.1, p < 0.024]. White patients had a greater odds of reaching the TC8 threshold of 20 than Black/AA (OR = 0.49, 95 % CI [0.46, 0.53]), Asian (OR = 0.62, 95 % CI [0.57, 0.68]), and Other (OR = 0.44, 95 % CI [0.41, 0.47]) patients. Similarly, Hispanic patients were significantly less likely to meet TC8 threshold scores than Non-Hispanic patients; χ2(1) = 390.6, p < 0.001, OR = 0.53, 95 % CI [0.50, 0.57]. A higher TC8 risk score is significantly associated with increased odds of cancer across demographic groups. White patients exhibited the highest TC8 scores, and White patients have the highest odds of reaching the TC8 threshold for qualifying for breast MRI, while the relationship between TC8 scores and caseness was highest for Hispanic patients.Among cancer patients, Black/AA patients continued to have lower TC8 scores, raising the question of whether the cut-off of TC8 = 20 is appropriate for all groups. TC8 scores guide decisions for MRI screening, but the predictive value of the TC8n score may differ based on ethnicity. Furthermore, due to potential score bias, Black and other minority patients may receive fewer breast MRIs than their White counterparts. Such potential bias could potentially contribute to racial disparities in breast cancer care including delayed diagnosis, or increased mortality and morbidity.
44. Adolescents and young adults' preferences for sexual and reproductive health services in Ethiopia: Evidence from three discrete choice experiments.
期刊: Social science & medicine (1982) 发表日期: 2025-Oct-07 链接: PubMed
摘要
Adolescents and young adults (AYAs) in Ethiopia face significant sexual and reproductive health (SRH) challenges, yet service utilisation remains low, partly because current services could better align with their preferences. This study assessed AYAs’ preferences for SRH services. We conducted three distinct but interrelated discrete choice experiments (DCEs) on contraceptive services, abortion care, and sexually transmitted infection (STI) services between February and April 2024 in Ethiopia. A D-efficient design with two blocks of 24 choice tasks was used. A mixed logit model was used to estimate attribute importance, willingness to pay (WTP), choice probabilities, and preference heterogeneity. Analyses were weighted to improve representativeness and comparability. A total of 984, 990, and 990 participants completed the contraceptive, abortion care, and STI DCEs, respectively. The majority of respondents were from urban areas. Privacy was the most important attribute for contraceptive and abortion care, while quality of care dominated in STI services. Privacy and quality of service were three times more valued than the attitude of the healthcare providers. Respondents from rural and regional areas prioritised privacy, whereas urban and metropolitan participants valued high-quality care. Under optimal conditions, predicted service uptake reached 95 %, compared to 10 % under unfavourable scenarios. The highest WTP (2923 Ethiopian birr/54 USD) was observed to avoid poor-quality STI services. Privacy and service quality emerged as the most important attributes influencing the uptake of SRH services among AYAs. However, there is preference heterogeneity among sociodemographic groups, underscoring the need for context-specific interventions.
45. Chapter 4.
期刊: Epidemiology (Cambridge, Mass.) 发表日期: 2025-Oct-07 链接: PubMed
摘要
46. Causal identification conditions for the effect of treatment in the treated: Illustration using the Northwest Germany Stroke Registry.
期刊: Epidemiology (Cambridge, Mass.) 发表日期: 2025-Oct-07 链接: PubMed
摘要
A set of conditions sufficient to identify the average treatment effect (ATE) in observational data includes no measurement error, causal consistency, and conditional mean exchangeability with positivity. The average treatment effect in the treated (ATT) is identified under a subset of these conditions, specifically relaxing the symmetry of conditional exchangeability with positivity. We reanalyzed data from the Northwest Germany Stroke Registry (2020-2021) to estimate the effect of t-PA on in-hospital mortality. We used inverse probability of treatment weighting (IPTW) for the ATE and standardized mortality ratio (SMR) weighting for the ATT. We also conducted 5,000 simulations of 6,000 patients, varying the prevalence of treatment indication. We generated homogeneous and heterogeneous treatment effects under two scenarios: (1) positivity holds for treated and untreated groups and (2) positivity only holds for the treated. Among 6,000 patients, 20% received t-PA, and 5% died. The IPTW risk ratio (ATE) was 1.70 (95% CI: 0.80, 3.64), while the SMR-weighted risk ratio (ATT) was 0.82 (95% CI: 0.59, 1.14). In simulations, ATT estimates of the risk ratio remained unbiased when we violated positivity for the untreated. However, ATE estimates showed increasing log-scale bias with increased non-positivity, ranging from 0.2 to 1.1 for homogeneous effects and 0.2 to 0.9 for heterogeneous effects. While ATE estimates suggested harm from t-PA, ATT estimates suggest a protective effect. Simulations show that when one-sided positivity violations exist, epidemiologists can leverage weaker identification conditions to consistently estimate the ATT, even when estimates of the ATE are biased.
47. If you want to know the end, look at the end.
期刊: Epidemiology (Cambridge, Mass.) 发表日期: 2025-Oct-07 链接: PubMed
摘要
48. How Do We Address Racial Disparities in Sports Cardiology?
期刊: Current sports medicine reports 发表日期: 2025-Oct-01 链接: PubMed
摘要
Black individuals in the United States experience a disproportionate burden of cardiovascular disease, driven by higher prevalence of traditional risk factors such as hypertension, diabetes, obesity, and hyperlipidemia, as well as the enduring impact of structural racism, socioeconomic inequality, and environmental injustice. These disparities contribute to elevated cardiovascular mortality and sudden cardiac death, including among competitive athletes. Additionally, Black athletes face a higher risk of cardiac arrest and are more likely to have preparticipation electrocardiograms misclassified as abnormal, which can lead to inappropriate disqualification from sport. Current diagnostic standards reinforce systemic bias and perpetuate the myth of biological racial determinism. Instead, a race-conscious approach - one that integrates the social determinants of health, develops inclusive diagnostic reference ranges, and ensures equitable access to preventive care - can reduce false positives, improve risk stratification, and foster more equitable clinical decision-making. Addressing these disparities requires comprehensive strategies, including upstream investment in equitable health systems and downstream implementation of culturally competent, evidence-based care tailored to athletes’ needs. By shifting the focus from race as a biological construct to race as a proxy for structural inequities, sports cardiology can advance toward a more just and prevention-focused model that improves cardiovascular outcomes for all athletes.
49. Commotio Cordis in Sports.
期刊: Current sports medicine reports 发表日期: 2025-Oct-01 链接: PubMed
摘要
On January 2, 2023, Damar Hamlin collapsed after a routine tackle during a nationally televised football game and was diagnosed with commotio cordis. This rare but dangerous condition occurs when a blunt chest impact disrupts the heart’s rhythm, leading to cardiac arrest. Hamlin’s survival, thanks to immediate CPR and defibrillation, highlights the risks athletes face from chest trauma and the importance of timely response. This paper reviews current literature on commotio cordis, emphasizing its under-recognition in sports. It explores prevention strategies, including enhanced protective gear, sports rule changes, and preparticipation screening. The review also stresses the need for educating athletes and coaches on the risks and proper emergency response protocols with commotio cordis. With these measures, the incidence of commotio cordis in sports can be significantly reduced.
50. A large-scale study across the avian clade identifies ecological drivers of neophobia.
期刊: PLoS biology 发表日期: 2025-Oct 链接: PubMed
摘要
Neophobia, or aversion to novelty, is important for adaptability and survival as it influences the ways in which animals navigate risk and interact with their environments. Across individuals, species and other taxonomic levels, neophobia is known to vary considerably, but our understanding of the wider ecological drivers of neophobia is hampered by a lack of comparative multispecies studies using standardized methods. Here, we utilized the ManyBirds Project, a Big Team Science large-scale collaborative open science framework, to pool efforts and resources of 129 collaborators at 77 institutions from 24 countries worldwide across six continents. We examined both difference scores (between novel object test and control conditions) and raw data of latency to touch familiar food in the presence (test) and absence (control) of a novel object among 1,439 subjects from 136 bird species across 25 taxonomic orders incorporating lab, field, and zoo sites. We first demonstrated that consistent differences in neophobia existed among individuals, among species, and among other taxonomic levels in our dataset, rejecting the null hypothesis that neophobia is highly plastic at all taxonomic levels with no evidence for evolutionary divergence. We then tested for effects of ecological factors on neophobia, including diet, sociality, habitat, and range, while accounting for phylogeny. We found that (i) species with more specialist diets were more neophobic than those with more generalist diets, providing support for the Neophobia Threshold Hypothesis; (ii) migratory species were also more neophobic than nonmigratory species, which supports the Dangerous Niche Hypothesis. Our study shows that the evolution of avian neophobia has been shaped by ecological drivers and demonstrates the potential of Big Team Science to advance our understanding of animal behavior.
51. Multi-method proof-of-concept evaluation for R2Play: a novel multi-domain return-to-play assessment tool for concussion.
期刊: PLOS digital health 发表日期: 2025-Oct 链接: PubMed
摘要
Return-to-play (RtoP) clearance after concussion typically involves single- and dual-task assessments that do not reflect the speed or complexity of sport. We developed R2Play, a dynamic multi-domain assessment tool for concussion. This study aimed to (1) demonstrate proof of concept for R2Play by evaluating alignment with design objectives (easy to use, fun, sport-like, clinically valuable, resource efficient, and flexible); and (2) document subsequent iterations to R2Play design. A multi-method evaluation was performed wherein clinicians were paired with youth to test R2Play together and complete separate semi-structured interviews. Quantitative metrics included the System Usability Scale (SUS), heart rate (HR), ratings of perceived exertion (RPE), assessment durations, and R2Play completion times, errors, and multi-task cost scores (changes in performance with the introduction of new challenges). Interviews explored perspectives on design objectives, analyzed using content analysis. Participants included five clinicians (n = 2 occupational therapy; n = 1 physiotherapy; n = 1 athletic therapy; n = 1 medicine) and 10 youth (ages 10-22 years). Assessments took 30-40 minutes despite minor technical challenges (e.g., unresponsive equipment). Clinician-rated usability was good-to-excellent (SUS = 81 ± 8.4; 95% CI: 73.6, 88.4) and youth reported that instructions were easy to follow. Moderate-to-high-intensity exertion was achieved (peak HR = 80 ± 11% age-predicted maximal; 95% CI: 77.4%, 88.5%). Multi-task cost scores reflected some aspects of hypothesized level demand loading. Clinicians described R2Play as potentially valuable to assess sport tolerance and enable rich observations of multi-domain skill integration. Tables were constructed to map study findings onto design iterations. This study supports proof-of-concept for R2Play, a new multi-domain concussion assessment tool, and identified areas for improvement, which has informed changes to the design of R2Play before broader evaluation among youth post-concussion.
52. Pesticide Exposure and Parkinson's Disease: A Qualitative Study of Experiences in Ireland.
期刊: Health expectations : an international journal of public participation in health care and health policy 发表日期: 2025-Oct 链接: PubMed
摘要
Parkinson’s disease (PD) is a common neurodegenerative disorder, affecting an estimated 10 million people globally, and its incidence rate is rising rapidly. PD most commonly develops sporadically, with only 5%-10% of cases linked to genetic causes. Environmental factors, including exposure to pesticides, have been associated with a higher risk of PD. Multiple studies have shown an increased incidence of PD in geographical regions which have high levels of pesticide use. However, there is little data on links between pesticide exposure and PD in Ireland, and the experiences of Irish people with PD in relation to pesticides remain underexplored. To conduct a qualitative study to explore the experiences and perceptions of individuals in Ireland regarding the potential links between occupational and environmental pesticide exposure and PD. This qualitative study investigated the experiences of individuals with PD and their families in Ireland, regarding pesticide exposure. Semi-structured interviews were conducted with 21 participants, including people with Parkinson’s (PwP) and their close relatives. Purposive sampling was used to recruit participants from farming and rural communities. The semi-structured interviews lasted 10-15 min, and data were transcribed and analysed using thematic analysis. The research adhered to ethical guidelines, including informed consent and confidentiality. Three main themes were identiifed from the analysis: ‘Occupation-Related Pesticide Exposure and PD Risk’, ‘Dangers of Pesticides, and Barriers to Personal Protective Equipment (PPE) Usage’, and ‘Family and Community Influence/Mixed Messaging about Pesticide Safety’. Participants frequently reported significant pesticide exposure due to occupational activities or living in agricultural areas. Many people highlighted inadequate use of PPE and described how exposure was often unregulated or unavoidable. Family and community contexts further compounded exposure risks. This study highlights the need for heightened awareness and education regarding risks associated with pesticide exposure. It reveals gaps in the application of protective measures and highlights a need for improved regulation of safety protocols. The design and conduct of this study were supported by people with Parkinson’s disease and their family members, as well as members of the public who have experience with pesticide use. In advance of the study, members of the Cork branch of Parkinson’s Ireland reviewed the research question, methodology and interview schedules, and provided feedback on these, which was incorporated into the study.
53. A randomized trial of two online platforms for dementia family caregivers: GamePlan4Care and Resources4Care.
期刊: Alzheimer’s & dementia : the journal of the Alzheimer’s Association 发表日期: 2025-Oct 链接: PubMed
摘要
Digital technologies can increase the accessibility of evidence-based caregiver programs. A 6-month, phase I, exploratory, randomized-controlled trial of two dementia caregiver support platforms, GamePlan4Care (GP4C) and Resources4Care (R4C), each enrolling 120 community-based family caregivers. Outcome measures included burden, positive aspects of caregiving, social support, and depression. Caregivers showed significant follow-up improvements in burden (GP4C: effect size [ES] = 0.50, p < 0.001; R4C: ES = 0.47, p < 0.001), positive aspects of caregiving (GP4C: ES = 0.26, p = 0.022; R4C: ES = 0.23, p = 0.030), social support (GP4C: ES = 0.21, p = 0.035), and distress (GP4C: ES = 0.30, p = 0.010). Caregivers engaged more in GP4C (GP4C: mean 5.5 h, SD = 0.61; R4C: mean 1.9 h, SD = 0.20) and set more goals for the safety domain (mean 8.9 goals, SD = 7.60). GP4C was not superior to R4C; however, both platforms demonstrated improved outcomes. Findings highlight a health system’s successful development and implementation of online dementia caregiver platforms. Improving digital technology for caregivers requires studies with larger populations and longitudinal outcomes. ClinicalTrials.gov Identifier: NCT04540198 HIGHLIGHTS: Online platforms can be useful in the goal of supporting family caregivers with educational and skills-training material to reduce the negative consequences of caregiving and to improve positive feelings of caregiving. Rules-based conditional logic was successfully integrated into a Web-based platform to tailor evidence-based strategies to an individual’s unique caregiving context and needs. Health systems are in an ideal position to adopt online technologies that provide education, skills training, and support for family caregivers of persons living with dementia.
54. SNMMI/EANM/ASNC/ACNM procedure standard/practice guideline for 18F-Flurpiridaz PET myocardial perfusion imaging and blood flow quantitation.
期刊: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology 发表日期: 2025-Sep-18 链接: PubMed
摘要
The Society of Nuclear Medicine and Molecular Imaging (SNMMI), founded in 1954 and headquartered in Reston, Virginia, USA, is a nonprofit scientific and professional organization that promotes the science, technology, and practical application of nuclear medicine and molecular imaging. SNMMI strives to be a leader in unifying, advancing, and optimizing molecular imaging with the ultimate goal of improving human health. With 13,000 members worldwide, SNMMI represents nuclear and molecular imaging professionals, all of whom are committed to the advancement of the field. The European Association of Nuclear Medicine (EANM) is a professional, nonprofit medical association that facilitates communication worldwide between individuals pursuing clinical and research excellence in nuclear medicine. The EANM was founded in 1985. The American College of Nuclear Medicine (ACNM) is a professional organization providing education, training, and advocacy for the most sought-after and trusted experts in nuclear medicine who deliver state-of-the-art and innovative care and service to patients and referring physicians. The ACNM’s mission is to foster the highest standards in nuclear medicine consultation and service to referring physicians, hospitals, and the public, and to advance the science of nuclear medicine through a program of continuing professional development emphasizing high standards of nuclear medicine practice. The American Society of Nuclear Cardiology (ASNC) is the international home for nuclear cardiology and the largest professional society devoted exclusively to the field. ASNC membership includes more than 5700 nuclear cardiology professionals from around the world. Founded in 1993, ASNC’s mission is to improve cardiovascular outcomes through image-guided patient management. ASNC’s official publication is the Journal of Nuclear Cardiology. The SNMMI/EANM/ACNM will periodically define new standards/guidelines for nuclear medicine practice to help advance the science of nuclear medicine and to improve the quality of service to patients. Existing standards/guidelines will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated. Each standard/guideline, representing a policy statement by the SNMMI/EANM/ACNM, has undergone a thorough consensus process in which it has been subjected to extensive review. The SNMMI, EANM, and ACNM recognize that the safe and effective use of diagnostic nuclear medicine imaging and therapy requires specific training, skills, and techniques, as described in each document. This document was jointly developed with ASNC. ASNC endorses this guideline, and it will be published alongside the Journal of Nuclear Medicine in the Journal of Nuclear Cardiology. The SNMMI, EANM, ASNC, and ACNM have written and approved these standards/guidelines to promote the use of high-quality nuclear medicine procedures. These standards/guidelines are intended to assist practitioners in providing appropriate care for patients. They are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal standard of care. For these reasons and those set forth below, the SNMMI, EANM, ASNC, andACNM caution against the use of these standards/guidelines in litigation in which the clinical decisions of a practitioner are called into question. The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by medical professionals considering the unique circumstances of each case. Thus, there is no implication that an approach differing from the standards/guidelines, standing alone, is below the standard of care. To the contrary, a conscientious practitioner may responsibly adopt a course of action different from that set forth in the standards/guidelines when, in the reasonable judgment of the practitioner, such a course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology subsequent to publication of the standards/guidelines. The practice of medicine involves not only the science but also the art of dealing with the prevention, diagnosis, alleviation, and treatment of disease. The variety and complexity of human conditions make it impossible to always reach the most appropriate diagnosis or to predict with certainty a particular response to treatment. Therefore, it should be recognized that adherence to these standards/guidelines will not ensure an accurate diagnosis or a successful outcome. All that should be expected is that the practitioner will follow a reasonable course of action based on current knowledge, available resources, and the needs of the patient to deliver effective and safe medical care. The sole purpose of these standards/guidelines is to assist practitioners in achieving this objective. Qualitycontrol andimprovement,safety,infectioncontrol, andpatienteducationconcerns See the SNMMI Guideline for General Imaging. Policies and procedures related to quality, patient education, infection control, and safety should be developed and implemented in accordance with good quality control practices. Quality control should also be done regularly to assure consistent, accurate physician interpretation of results. Equipment performance monitoring should be in accordance with a recognized accrediting organization. Documentation/reporting See the SNMMI Guideline for General Imaging for documentation/reporting requirements. Radiationsafety inimaging See the SNMMI Guideline for General Imaging. It is the position of SNMMI that patient exposure to ionizing radiation should be at the minimum level consistent with obtaining a diagnostic examination. Reduction in patient radiation exposure may be accomplished by administering less radiopharmaceutical when the technique or equipment used for imaging can support such an action. Each patient procedure is unique and the methodology to achieve minimum exposure while maintaining diagnostic accuracy needs to be viewed in this light. Radiopharmaceutical activity ranges outlined in this document should be considered as a guide. Dose-reduction techniques should be utilized when appropriate. The same principles should be applied when CT is used in a hybrid imaging procedure. CT acquisition protocols should be optimized to provide the information needed while minimizing patient radiation exposure. Minimizing radiation dose is especially important in children. Thebreastfeedingpatient See the Advisory Committee on the Medical Uses of Isotopes (ACMUI) guidelines.
55. Diversity of haemosporidian parasites in cranes: description of Haemoproteus balearicae and its phylogenetic position within the H. antigonis clade.
期刊: Parasite (Paris, France) 发表日期: 2025 链接: PubMed
摘要
Haemosporidian parasites from the genera Haemoproteus, Plasmodium, and Leucocytozoon are significant avian pathogens. This study aimed to identify and characterize these parasites in cranes (family Gruidae), using combined morphological and molecular methods. The results confirmed the presence of Haemoproteus balearicae, redescribed here from Balearica regulorum and associated with cytb lineage hBAREGI210. This lineage, previously assigned to Haemoproteus antigonis, is reassigned to H. balearicae, suggesting possible cryptic speciation within the H. antigonis complex. The findings broaden the known host range and geographic distribution of H. balearicae, detected in captive-born cranes in France and captive cranes housed in conservation facilities in South Africa. Phylogenetic analyses revealed three distinct Haemoproteus clades in Gruidae, corresponding to at least three species, including H. balearicae and lineages representing H. antigonis. These crane-specific parasites may require taxonomic revision as a separate subgenus or genus, pending further studies on their life cycles and vectors. Additionally, several novel cytb lineages of Plasmodium and Leucocytozoon were detected, many unassigned to morphospecies. Notably, the pCATUS05 lineage, a member of the Plasmodium lutzi group previously reported only in the Americas, was detected for the first time in South African cranes, along with Leucocytozoon aff. californicus (lCIAE02), a widespread lineage lacking morphological description. Together, these findings reveal underestimated genetic diversity of haemosporidian parasites in cranes and highlight the importance of combining morphological and molecular data to clarify parasite taxonomy and host associations. This study advances our understanding of avian parasite ecology and systematics, with implications for crane conservation and disease management. Diversité des parasites hémosporidiens chez les grues : description d’Haemoproteus balearicae et sa position phylogénétique au sein du clade H. antigonis. Les parasites hémosporidiens des genres Haemoproteus, Plasmodium et Leucocytozoon sont d’importants agents pathogènes aviaires. Cette étude visait à identifier et à caractériser ces parasites chez les grues (famille Gruidae), en utilisant des méthodes morphologiques et moléculaires combinées. Les résultats ont confirmé la présence d’Haemoproteus balearicae, redécrit ici chez Balearica regulorum et associé à la lignée cytb hBAREGI210. Cette lignée, précédemment attribuée à Haemoproteus antigonis, est réattribuée à H. balearicae, suggérant une possible spéciation cryptique au sein du complexe H. antigonis. Ces résultats élargissent la gamme d’hôtes et la répartition géographique connues de H. balearicae, détecté chez des grues nées en captivité en France et des grues captives hébergées dans des centres de conservation en Afrique du Sud. Les analyses phylogénétiques ont révélé trois clades distincts d’Haemoproteus chez les Gruidae, correspondant à au moins trois espèces, dont H. balearicae et des lignées représentant H. antigonis. Ces parasites spécifiques aux grues pourraient nécessiter une révision taxonomique en tant que sous-genre ou genre distinct, dans l’attente d’études complémentaires sur leurs cycles biologiques et leurs vecteurs. De plus, plusieurs nouvelles lignées cytb de Plasmodium et Leucocytozoon ont été détectées, dont beaucoup n’étaient pas attribuées à des morphoespèces. Notamment, la lignée pCATUS05, un membre du groupe Plasmodium lutzi précédemment signalé uniquement dans les Amériques, a été détectée pour la première fois chez des grues sud-africaines, ainsi que Leucocytozoon aff. californicus (lCIAE02), une lignée répandue manquant de description morphologique. Ensemble, ces résultats révèlent une sous-estimation de la diversité génétique des parasites hémosporidiens chez les grues et soulignent l’importance de combiner les données morphologiques et moléculaires pour clarifier la taxonomie des parasites et les associations avec les hôtes. Cette étude améliore notre compréhension de l’écologie et de la systématique des parasites aviaires, avec des implications pour la conservation des grues et la gestion des maladies.
56. What are the underlying factors for the severity of cyclic mastalgia?
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Cyclic Mastalgia (CM) is the most common breast complaint among reproductive-aged women and can affect their quality of life. The exact etiology is not completely understood, but several factors are suggested to be effective. This study aimed to assess the relationship of some possible related factors with CM. This cross-sectional study was conducted on 335 female students with severe cyclic Mastalgia. They were selected by multi-stage sampling method from dormitories of Shahid Beheshti University of Medical Sciences in Tehran-Iran. Data was collected using an online questionnaire including the Beck’s Depression Inventory, the Spielberger Anxiety Inventory, the Fisher Body-Image Questionnaire, the Cardiff Breast Pain Chart (NDBP), and a socio-demographic questionnaire. The data were analyzed by SPSS 29 and using Spearman, Mann-Whitney, Kruskal-Wallis, and multiple linear regression tests. The average age of the participants was 25.61 ± 5.92 years with a Cardiff score of 31.76 ± 4.33 (mean ± SD). The mean scores for body image, anxiety, and depression were 159.33 (±37.62), 43.35 (±10.32), and 10.80 (±9.79), respectively. Beck’s depression score had a significant positive correlation with the severity of CM (P = 0.035). A significant positive correlation was also found between smoking and the severity of CM (P = 0.035, r = 0.115). There were significant positive correlations between the severity of CM with the duration of the menstrual cycle (P < 0.001) and menstruation (P = 0.001). There were no significant relationships between the severity of CM with other variables. The multiple linear regression test demonstrated that depression (P = 0.014) and duration of the menstrual cycle (P = 0.001) are predictors of severity of CM. Depression and duration of menstrual cycle are potential predictors of the severity of CM. Promotion of Women’s menstrual and mental health as well as prevention of high-risk habits such as smoking should be considered for the severity of CM and improving the quality of life.
57. Sexual and reproductive health rights: A cross-sectional study of knowledge and practice among the married women of reproductive age residing in Besishahar Municipality, Nepal.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
Married women of reproductive age (MWRA) can experience violations of their sexual and reproductive health rights (SRHR). Adequate knowledge and understanding of SRRs are critical to their ability to protect themselves. This study assessed the knowledge and practice of SRHRs among the MWRA residing in Besishahar Municipality. A cross-sectional study was conducted among the 342 MWRA in Besishahar Municipality using a pre-tested structured questionnaire through face-to-face interview. The collected data were analyzed using SPSS IBM version 16. The logistic regression model was applied to examine the factors associated with the outcome variable using an adjusted odds ratio with a 95% CI, and a p-value <0.05 was considered statistically significant. Among the respondents, 47.7% had adequate knowledge on SRHR and 41.5% had good practice. Women married at age ≥ 18 years were 2.075 times more likely to have adequate knowledge of SRHR compared to women who had early marriages (<18 years) (aOR=2.075, 95% CI = 1.16-3.69) while women married at age ≥ 18 years were 1.82 times likely to had good practice than those married at age 18 years (aOR=1.82, 95% CI = 1.02-3.24). Respondents involved in formal sectors were 1.834 times more likely to have adequate knowledge of SRHR compared to informal sectors (aOR=1.834, 95% CI = 1.15-2.90) which was (aOR=1.518, 95% CI = 0.96-2.39) in case of good practice. The odds of having adequate knowledge was 2.51 among the respondents who were above the poverty line (aOR=2.511, 95%CI = 1.52-4.14). MWRA who had adequate knowledge of SRHR were 3.234 times more likely to have good practice of SRHR compared to women who had inadequate knowledge of SRHR (aOR=3.234, 95% CI = 1.85-6.56). A large proportion of married women of reproductive age did not have adequate knowledge about SRHR, and their practice was poor. So intervention focusing on the promotion of knowledge on SRHR is essential at the community level.
58. Psychological distress and wellbeing as mediators between anti-mattering (feelings of insignificance) and irritability among Lebanese adolescents: A cross-sectional study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
This study examined the mediating effect of psychological distress and wellbeing in the association between anti-mattering and irritability among a sample of Lebanese adolescents-a topic that remains largely underexplored in adolescent mental health research. A cross-sectional study was conducted during November 2023 and included 763 adolescents currently residing in Lebanon (mean age 16.08 ± 1.74 years, 37.6% males and 62.4% females) recruited from all Lebanese governorates using a snowball sampling technique. Data were collected via an online questionnaire and analyzed using the PROCESS Macro for mediation analysis. The findings indicated that both psychological distress (β = .39, BootSE = .04, 95% CI [.33,.46]) and wellbeing (β = .07, BootSE = .02, 95% CI [.03,.12]) partially mediated the relationship between anti-mattering and irritability. Adolescents with higher levels of anti-mattering reported greater distress and reduced wellbeing, both of which were associated with increased irritability. Our results highlight the psychological relevance of anti-mattering in adolescence and suggest that addressing feelings of insignificance may play a key role in managing emotional dysregulation. Mental health practitioners and educators should consider developing culturally sensitive interventions that target feelings of anti-mattering, enhance wellbeing, and reduce psychological distress. School-based programs promoting emotional support and social inclusion may prove especially beneficial. Future studies should investigate these associations longitudinally and across varied cultural contexts to better inform prevention and intervention strategies.
59. Trends in the disease burden of thyroid cancer among adolescents and young adults: A comparative study of China and global estimates (1990-2021).
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
This study aimed to assess temporal trends, epidemiological features, and sex differences in the thyroid cancer burden among adolescents and young adults, globally and in China, from 1990 to 2021, using the Global Burden of Disease 2021 data. We projected China’s future burden through 2041, to support precision prevention strategies. Data on the incidence, prevalence, mortality, and disability-adjusted life years of thyroid cancer in AYAs were extracted from the Global Burden of Disease 2021 database. Age-standardized rates and estimated annual percentage changes were calculated. Joinpoint regression was used to detect shifts in trends. An age-period-cohort model was used to quantify the effects of age, period, and birth cohort on the incidence. Decomposition analysis was used to evaluate the contributions of population growth, aging, and epidemiological changes. A Bayesian age-period-cohor model projected future trends for China. Furthermore, we conducted a stratified analysis by sex to investigate the heterogeneity in the evolution of disease burden between the Chinese and global populations. Between 1990 and 2021, China experienced a rapid increase in the incidence and prevalence of thyroid cancer among adolescents and young adults; the age-standardized incidence rate increased by 152.6%, far exceeding the global average. Mortality and disability-adjusted life years declined, forming a pattern of high incidence, low mortality, and moderate disability. This increase was primarily driven by epidemiological transitions. In terms of sex differences, Males exhibited a sharper increase in both incidence and disability-adjusted life years than females, indicating growing sex-based disparities. Notably, the burden in China began increasing earlier and more rapidly than global trends, particularly in males, whose incidence continued to increase even as global rates stabilized. Age-period-cohort model analysis further revealed that, among the adolescent and young adult population in China, the incidence of thyroid cancer increased significantly with advancing age, the incidence risk potentially increased after 2010, and more recent birth cohorts born after 1980 also exhibited an upward risk trend. However, despite these patterns, neither the period nor cohort effect reached statistical significance. Finally, Bayesian age-period-cohort projections suggested that the incidence and prevalence will continue to increase over the next 20 years, while mortality will remain stable, and disability-adjusted life years will decline slightly. Over the past three decades, the burden of thyroid cancer among adolescents and young adults in China has increased at a substantially accelerated rate compared to global trends, with a pronounced widening of the sex gap in disease burden. While Chinese female patients have continued to show improvements in prognosis and relative burden measures, male patients have experienced a marked rise in both incidence and disability-adjusted life years, accompanied by a consistent decline in prognostic outcomes. These findings underscore the need for sex-specific strategies: for males, prioritizing the identification and mitigation of modifiable risk factors to curb the rising burden and improve prognosis; for females, consolidating effective diagnostic and therapeutic practices while minimizing overdiagnosis. Gender-sensitive approaches, aligned with precision prevention, may help address the growing burden.
60. Impact of the COVID-19 pandemic on the routine immunization system in Bangladesh.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The COVID-19 pandemic has put immense pressure on countries’ health structures to maintain routine immunization and VPD surveillance programs, especially in LMICs such as Bangladesh. Understanding the effects of COVID-19 will allow countries like Bangladesh to become better prepared for future health emergencies, so this study explored the effects of COVID-19 on routine immunization and VPD surveillance programs in Bangladesh. With a sequential mixed-method approach, the quantitative data was collected from the DHIS2 for January 2019-December 2021. The qualitative data was collected from ten KIIs, which was conducted with the key stakeholders of EPI and VPD surveillance in Bangladesh. Findings suggest that there had been three drop-rebound periods in the routine immunization program in Bangladesh. The study identified that Bangladesh was able to catch up with the pre-pandemic level immunization within four to six months from the first drop, and the immunization drops became less severe with the progression of time. COVID-19-related movement restrictions, lack of workforce, fear and concern regarding COVID-19, prioritizing COVID-19 vaccination, lack of a comprehensive EPI structure in urban compared to rural areas, and lack of knowledge to conduct EPI and VPD activities amidst the pandemic situation were identified as the main reasons for these drops.