公共卫生研究摘要 (2025-10-16)
共收录 56 篇研究文章
1. Formation of a complex between TMEM217 and the sodium-proton exchanger SLC9C1 is crucial for mouse sperm motility and male fertility.
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
Sperm motility is essential for male fertility and is tightly controlled by signaling events in the flagellum. Slc9c1 encodes a sperm-specific Na+/H+ exchanger (sNHE/SLC9C1) that localizes to the flagellum and is indispensable for sperm motility and male fertility. SLC9C1 is unique among Na+/H+ exchangers in that it possesses a voltage-sensing domain (VSD), the physiological function of which remains poorly understood in mammals. Here, by analyzing coevolving genes with Slc9c1, we identified Tmem217, which encodes a transmembrane protein that is localized in the sperm flagellum. Knockout (KO) of Tmem217 in mice resulted in sperm motility defects and male infertility, phenocopying Slc9c1 KO mice. Coimmunoprecipitation and structural prediction analyses indicated that TMEM217 binds to SLC9C1 via its VSD. Further analyses indicated that the amounts of SLC9C1 and its associated protein, soluble adenylyl cyclase (sAC), were lost in mature Tmem217 KO spermatozoa, leading to disrupted 3’,5’-cyclic monophosphate (cAMP) signaling pathways. Remarkably, cAMP analogs restored the impaired motility and fertilizing ability of Tmem217 KO spermatozoa in vitro, validating the essential role of TMEM217 in regulating cAMP production. Our findings indicate that the association of TMEM217 with SLC9C1 via its VSD is critical for the proper organization and function of the SLC9C1-sAC-cAMP axis in mature spermatozoa.
2. Mass Administration of Azithromycin to Infants in Mali to Reduce Mortality.
期刊: The New England journal of medicine 发表日期: 2025-Oct-16 链接: PubMed
摘要
Mass administration of azithromycin to children 1 to 59 months of age has been shown to reduce mortality among infants and children in this age group in some areas of sub-Saharan Africa. The largest effects have appeared to be among infants younger than 12 months of age, within 3 months after treatment; this observation motivated the design of the current trial. In this trial, we randomly assigned villages in Mali, West Africa, in a 3:4:2 ratio to receive distributions of placebo, azithromycin two times a year, or azithromycin four times a year. Infants 1 to 11 months of age received, in doses of 20 mg per kilogram of body weight, placebo every 3 months (control group); azithromycin at two quarterly visits from January through June and placebo at two quarterly visits from July through December (twice-yearly azithromycin group); or azithromycin every 3 months (quarterly azithromycin group). The primary outcome was death within 3 months after eligibility had been confirmed, analyzed in the intention-to-treat population. From December 2020 through December 2022, a total of 1151 villages were enrolled in the trial; 386 villages were randomly assigned to the control group, 511 to the twice-yearly azithromycin group, and 254 to the quarterly azithromycin group. Among all the villages, 149,090 infants received at least one dose of placebo or azithromycin, with a total of 82,600 person-years of follow-up; 968 deaths were recorded. Mortality was 11.9 deaths per 1000 person-years at risk in the control group, 11.8 deaths per 1000 person-years in the twice-yearly azithromycin group (incidence rate ratio, 1.00; 95% confidence interval [CI], 0.83 to 1.19), and 11.3 deaths per 1000 person-years in the quarterly azithromycin group (incidence rate ratio, 0.93; 95% CI, 0.75 to 1.15). Adverse events were rare, and the percentages of infants with adverse events were similar in the three groups. Mortality among untreated children 12 to 59 months of age was similar across groups. Mass administration of azithromycin in Mali, limited to infants 1 to 11 months of age, did not result in lower infant or child mortality than placebo, regardless of whether azithromycin was delivered twice yearly or quarterly. (Funded by the Gates Foundation; LAKANA ClinicalTrials.gov number, NCT04424511.).
3. Long-Term Safety and Efficacy of Gene Therapy for Adenosine Deaminase Deficiency.
期刊: The New England journal of medicine 发表日期: 2025-Oct-16 链接: PubMed
摘要
Severe combined immunodeficiency (SCID) due to adenosine deaminase (ADA) deficiency (ADA-SCID) is a life-threatening inborn error of immunity for which lentiviral gene therapy has been investigated in clinical trials. Between 2012 and 2019, we treated patients who had ADA-SCID with busulfan nonmyeloablative conditioning followed by transplantation with autologous CD34+ hematopoietic stem cells transduced ex vivo with a lentiviral vector encoding human ADA. The primary efficacy end points were overall survival and event-free survival (defined as survival free from rescue allogeneic hematopoietic stem-cell transplantation, reinitiation of enzyme-replacement therapy, and additional gene therapy). Secondary end points included no receipt of immunoglobulin-replacement therapy, the presence of protective titers to tetanus or pneumococcal vaccines, and sustained discontinuation of fungal or viral prophylaxis. We now report the long-term results from this cohort representing 474 patient-years of follow-up, with a median follow-up of 7.5 years. We treated 62 patients with ADA-SCID in the United States (33 patients) and the United Kingdom (29 patients). Overall survival was 100%, and event-free survival was 95% (59 of 62 patients). All 59 patients who had successful gene-marked engraftment at 6 months have continued not to receive enzyme-replacement therapy and have had stable gene marking, ADA enzyme activity, metabolic detoxification, and immune reconstitution through the last follow-up; 58 of these patients (98%) discontinued IgG replacement therapy and have evidence of a robust response to vaccinations. None of the patients had a leukoproliferative event or clonal expansion. These long-term findings in a large patient cohort show the sustained clinical efficacy and safety of autologous CD34+ hematopoietic stem-cell lentiviral gene therapy for ADA-SCID, indicating that it is a curative treatment. (Funded by the National Heart, Lung, and Blood Institute and others; ClinicalTrials.gov number, NCT04049084.).
4. Exploring Feature Preferences for a Treatment-Accompanying App in Patients Undergoing Radiation Therapy: Cross-Sectional Study.
期刊: JMIR cancer 发表日期: 2025-Oct-15 链接: PubMed
摘要
Mobile health (mHealth) apps are playing an increasingly important role in health care, including in radiotherapy. However, adherence remains low. One way to increase adherence is to tailor app features to the patients’ preferences. This study aimed to explore the importance of patient preferences regarding the features of a therapy-supporting app in radiotherapy. In addition, we examined factors associated with the perceived importance of these features. A cross-sectional questionnaire study was conducted with patients undergoing radiotherapy between summer 2021 and winter 2022. The subjective importance of 18 features of a treatment-accompanying app was explored using a 5-point Likert scale from 1=not so important to 5=extremely important. Descriptive analyses were used to show the rated importance of app functions. Associations with possible predictors were examined using multiple hierarchical regressions, with age (interval-scaled), gender (dichotomous), previous experience with mHealth apps (dichotomous), education (3-level nominal), and supportive care needs (interval-scaled) as predictors. A total of 84 radiotherapy patients participated. The average age was 62 (SD 12.5) years. The feature with the highest importance was security against hacking (46/77, 60% extremely important). Explained variances in the regression analyses ranged between R2=0.25 (The app should give me tips on suitable sporting activities that are possible with my illness) and R2=-.07 (The app should provide me with information about suitable self-help offers). Previous mHealth usage predicted the importance of 6 features, such as managing appointments (β=.275; P<.05). Decreasing age was related to 6 features, for example, showing test results and laboratory values (β=-.358; P<.05). Other predictors were an increasing age and greater supportive care needs. Patients undergoing radiotherapy rated app features as having varying levels of importance. The findings may help to tailor mHealth apps in radiotherapy, potentially improving adherence to app usage.
5. Gastric neuroendocrine neoplasms: updated epidemiology and externally validated prognostic nomogram.
期刊: International journal of surgery (London, England) 发表日期: 2025-Oct-15 链接: PubMed
摘要
Gastric neuroendocrine neoplasms (G-NENs) are rare but increasingly diagnosed tumors with marked heterogeneity in prognosis. Existing prognostic tools, such as the AJCC staging system, lack integration of key clinical variables and are based on outdated datasets. Updated real-world data and individualized risk models are needed to improve prognostic accuracy and guide treatment decisions. A retrospective analysis of 1641 G-NENs patients from the SEER database (2004-2018) was conducted. Independent prognostic factors were identified through univariate and multivariate Cox regression and used to construct a nomogram. The model was validated in an internal SEER cohort (n = 493) and an external cohort from a Chinese cancer center (n = 108). Predictive performance was evaluated using the concordance index (C-index), area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis (DCA). The incidence of G-NENs rose from 0.435 to 7.033 per 1,000,000 persons over the past 46 years. Multivariate analysis identified age, sex, tumor size, grade, T stage, N stage, M stage, and surgery as independent prognostic factors. The nomogram outperformed the AJCC system, with C-index values of 0.86 (training), 0.86 (internal validation), and 0.72 (external validation). Risk stratification effectively differentiated low- and high-risk patients, and chemotherapy significantly improved survival in the high-risk group. The incidence of G-NENs has increased 16-fold in the past 46 years. The nomogram provides more precise survival predictions than the AJCC staging system and can effectively guide clinical decisions.
6. Exploring the Use of Digital Technology to Support Health Behavior Change in Young People Under the Care of Complications of Excess Weight (CCEW) Clinics: Qualitative Patient-Centered Design Study.
期刊: JMIR formative research 发表日期: 2025-Oct-15 链接: PubMed
摘要
Specialist multidisciplinary clinics have been established to provide care for the burgeoning number of young people presenting with comorbidities related to severe obesity in childhood. Digital technology, an integral component of most young people’s lives, may enable clinics to offer accessible, ongoing support between appointments to the patients, thereby increasing the likelihood of successful health behavior change. However, while short-term engagement with technology-based behavior change interventions is good, engagement tends to decrease over time, limiting their overall impact. Little is known about the views of young people living with obesity on the role of digital technology as an adjunct to current traditional care pathways. This study aims to explore the views of adolescent patients and their families on whether digital technology should be used by obesity services to support health behavior change. Participants included patients aged between 10 and 16 years from an obesity clinic, along with their adult family members. Four focus groups and co-design workshops, facilitated by a cross-disciplinary team of clinicians, academics, and technology innovators, explored young people’s health priorities, identified the barriers to and facilitators of health behavior change, and co-designed ways in which technology could be used to support them in overcoming these barriers to achieving their health goals. Data were analyzed using inductive content analysis, with findings integrated with key co-design workshop outputs. In total, 37 individuals participated, including 19 (51%) adolescents (n=11, 58% female) and 18 (49%) family members. The young participants, on average, were aged 13.4 (SD 1.68; range 10-16) years; the mean BMI was 36.6 (SD 0.3; range 34-47) kg/m2. The mean socioeconomic decile was 4.3 (SD 2; range 1-8). Participants did not mention weight as an important aspect of their health. Instead, mental health, sleep, and peer support were identified as the domains where patients felt they would most benefit from additional support. Addressing these aspects of health was viewed as foundational to all other aspects of health, with poor mental health, sleep, and social support reducing young people’s ability to engage in the process of health behavior change. Participants reported that technology could help provide this support as an adjunct to in-person support. Participants expressed a preference for technologies able to individually tailor content to the young person’s needs, including relatable peer-produced content. The need for support for both the young people and their family members was highlighted, along with the need to integrate in-person strategies to maintain engagement with any technological offering. There is clear potential for digital technology to support the holistic health priorities of young people receiving specialist care for the comorbidities of excess weight. This study’s findings will serve as a foundation for developing innovative approaches to the use of technology to support this high-need population.
7. Development of Age- and Sex-Specific Metabolomics-Based Biological Ageing Clocks for 10-Year Mortality Prediction.
期刊: Advanced science (Weinheim, Baden-Wurttemberg, Germany) 发表日期: 2025-Oct-15 链接: PubMed
摘要
Metabolite concentrations vary by age and sex, yet age- and sex-specific metabolomic risk scores and biological ageing clocks for mortality prediction remain undeveloped. Nuclear magnetic resonance (NMR)-based metabolomic profiling is conducted in 209144 UK Biobank participants (12347 deaths) and 6820 from the German ESTHER study (804 deaths). Mortality risk scores are derived using least absolute shrinkage and selection operator (LASSO)-regularized Cox regression, and metabolomics-based mortality risk clocks (MetaboMR clocks) are constructed using elastic net regression in sex- and age-stratified subgroups (50-59 and 60-69 years). Models are trained in 70% of UK Biobank and validated internally (30%) and externally in ESTHER. 68 metabolites are significantly associated with 10-year all-cause mortality in both cohorts. 20, 18, 12, and 13 metabolites improved 10-year mortality prediction in younger and older men, younger and older women. Metabolite-augmented models improved c-statistics by 0.036-0.084 across subgroups. In the external validation set, each year of age acceleration is associated with an 8% and 9% higher 10-year mortality risk for MetaboMR clock1 and clock2. Sex- and age-specific metabolomic risk scores significantly enhance 10-year mortality prediction beyond traditional models. The MetaboMR clocks may serve as measures of biological ageing and support personalized risk stratification in clinical settings.
8. Investigating the nitric oxide pathway stimulated by rosuvastatin on the pathological effects of renal ischemia-reperfusion in rats.
期刊: The Journal of pharmacy and pharmacology 发表日期: 2025-Oct-15 链接: PubMed
摘要
Renal ischemia-reperfusion (RIR) induces inflammation, oxidative stress, and impaired renal function, partly through reduced nitric oxide (NO) availability. Rosuvastatin enhances NO production and has reported organ-protective effects. This study examined whether rosuvastatin confers renoprotection in RIR through NO-dependent mechanisms. Five groups of rats (n = 6) were used: control, RIR, RIR + rosuvastatin, RIR + rosuvastatin + L-NAME (NG-Nitro-L-arginine methyl ester), and RIR + rosuvastatin + L-arginine. Drugs were administered once daily from 3 days before ischemia until 24 h after reperfusion. Twenty-four-hour urine, blood, and kidney tissues were collected for analysis. Statistical tests were performed with Prism software. Rosuvastatin significantly reduced serum urea and creatinine levels versus RIR alone. Glomerular filtration rate increased, though proteinuria remained unchanged. Inflammatory cytokines and oxidative stress decreased markedly, while tissue NO levels rose in the rosuvastatin group. L-NAME co-treatment diminished these effects, whereas L-arginine enhanced them, indicating NO involvement. Rosuvastatin ameliorated renal injury in RIR, likely through activation of NO signaling. These findings suggest a potential therapeutic role for rosuvastatin in ischemic renal injury.
9. Building the Workforce's Capacity to Support the Digital Transformation of Public Health: Environmental Scan of Training Programs for Digital Technologies in Public Health.
期刊: JMIR public health and surveillance 发表日期: 2025-Oct-15 链接: PubMed
摘要
The digital transformation of society and public health has created an urgent need for new competencies to address evolving and contemporary public health challenges. While some public health institutions and schools worldwide have begun responding through various training programs and approaches, many have yet to do so. A clearer understanding of the current training landscape can inform more coordinated efforts to update curricula and strengthen digital competency within the public health workforce. This study aimed to map and describe existing digital public health (DPH) training programs, identifying common curricula content, disciplinary involvement, and training approaches. It also aimed to identify gaps and opportunities for curricular adaptation. This environmental scan was conducted in 2 stages, drawing on guidance from studies by Rowel et al and Wilburn et al. First, we performed a systematic search of DPH training programs, followed by interviews with selected program directors to explore their program design and implementation. The scan emphasized a transdisciplinary lens, consistent with the evolving nature of DPH. Between March and May 2023, we searched Google and public health association directories to identify degree programs and courses (as part of degree awarding programs) focused on building capacity for using digital technologies in public health. We then conducted semi-structured interviews with 4 directors of identified programs exploring program characteristics and the inter- or transdisciplinary partnerships essential to their design. Search data were summarized using narrative synthesis, while content analysis was applied to the interview data. Overall, 58 DPH training programs were identified, categorized into 3 groups: public health data science (29/58, 50%), public health informatics (16/58, 28%), and a mix of programs exploring digital competencies (13/58, 22%) related to project management and addressing the digital determinants of health. Interviews revealed that motivation for developing interdisciplinary DPH programs stemmed from the need to meet evolving job market demands and respond to calls for curricular renewal among professional bodies. Effective design and delivery were supported by academic-industry partnerships, which aimed to cultivate professionals with depth in public health and breadth in digital competencies. These programs drew on diverse disciplinary perspectives from academia, the public sector, and private industry. However, sustaining such partnerships was challenged by the need to negotiate shared priorities, reconcile differing viewpoints, and secure ongoing funding. This global scan of DPH training programs found a strong focus on data-centric competencies, with less emphasis on digital skills for health promotion, leadership, and addressing digital determinants of health. Bridging these gaps requires a stepwise approach: integrating digital competencies into existing curricula, offering stand-alone programs for specialized skills, and strengthening partnerships to navigate funding and administrative barriers while promoting equity-driven, interdisciplinary collaboration.
10. Pan-immune-inflammation value and systemic immune-inflammation index predict the clinical efficacy of biological agents in Crohn's disease.
期刊: Postgraduate medical journal 发表日期: 2025-Oct-15 链接: PubMed
摘要
It remains unclear whether pan-immune-inflammation value (PIV) and systemic immune-inflammation index (SII) can predict treatment outcomes in Crohn’s disease (CD) patients receiving infliximab. This study explored the role of PIV and SII in predicting treatment response and prognosis in CD patients receiving biologics. Clinical data of 160 patients with CD were retrospectively collected from Anqing First People’s Hospital in China. Patients were classified into effective and ineffective groups based on therapeutic response. Additionally, 60 healthy controls were enrolled. Serum levels of PIV and SII were measured in all participants. The effectiveness of infliximab was evaluated based on Crohn’s Disease Activity Index. Clinical remission was defined as a Crohn’s Disease Activity Index score <150, while a reduction of ≥70 points from baseline indicated clinical response. The effective group included 125 patients (mean age, 34.5 ± 10.2 years; 68 men [54.4%]), and the ineffective group included 35 patients (mean age, 36.1 ± 9.8 years; 18 men [51.4%]). The healthy control group covered 60 individuals (mean age, 33.8 ± 11.1 years; 32 men [53.3%]). Patients in the high SII group demonstrated a markedly elevated hazard ratio (HR = 20.786, P < .001). A higher PIV was associated with better prognosis (HR = 0.386, 95% confidence interval: 0.228-1.655, P = .011). Conversely, a higher SII was associated with worse prognosis (HR = 20.786, 95% confidence interval: 9.412-45.902, P < .001). Both PIV and the SII are useful in predicting efficacy of CD patients treated with biologics. Compared with SII, PIV is a better choice. Key messages What is already known on this topic: Infliximab is the most efficacious and widely used biologic for inducing remission in moderate-to-severe Crohn’s disease. SII and PIV have been validated as prognostic indicators in many diseases. What this study adds: Higher PIV and SII both have positive effects on predicting the prognosis of patients with Crohn’s disease. Compared with the SII, the PIV holds greater significance in predicting the clinical outcomes for patients with Crohn’s disease. How this study might affect research, practice or policy: PIV and SII may aid in risk stratification and individualized treatment planning in Crohn’s disease.
11. The population-level impact of COVID-19 on maternal healthcare utilization: evidence from the 2022 Kenya Demographic and Health Survey.
期刊: International health 发表日期: 2025-Oct-15 链接: PubMed
摘要
Despite growing research attention on the impact of coronavirus disease 2019 (COVID-19) on maternal healthcare in low- and middle-income countries, substantial knowledge gaps remain about its population-level impact. This article uses population-based data to examine the extent of COVID-19 impact on maternal healthcare, population subgroups disproportionately impacted and subnational variations in such impact in Kenya. This was a secondary analysis of the 2022 Kenya Demographic and Health Survey data. It involved assessing differences in maternal healthcare between the pre-pandemic (before March 2020), COVID-19 onset (March-December 2020) and COVID-19 era/recovery (2021-2022) periods. Three-level logistic regression models were estimated to examine the role of multilevel predictors and subnational variations in COVID-19 impact on maternal healthcare. COVID-19 significantly impacted both routine and lifesaving/emergency maternal healthcare in Kenya. Compared with births pre-pandemic, births during COVID-19 onset and era/recovery had 14% and 26%, respectively, lower likelihood of adequate antenatal care (four or more visits, starting first trimester). Births during COVID-19 onset had a 33% higher likelihood of occurring at home and 31% lower likelihood of being through C-section than pre-pandemic. Certain population subgroups were disproportionately affected, with significant subnational variations in impact. The findings underscore a need for targeted policy/program strategies to mitigate adverse consequences of public health emergencies among disproportionately impacted population subgroups.
12. From CEPNs to Training Hubs: a decade of population-level workforce education and their strategic role in delivering the NHS 10-Year Plan.
期刊: Education for primary care : an official publication of the Association of Course Organisers, National Association of GP Tutors, World Organisation of Family Doctors 发表日期: 2025-Oct-15 链接: PubMed
摘要
Since 2013, CEPNs-and, from 2018, Training Hubs-have provided locally led, multi-professional mechanisms for workforce education in primary and community care, aiming to match training supply and skill mix to population health needs. To synthesise the development, evolution, and impact of CEPNs/THs and assess their strategic alignment with the NHS 10-Year Health Plan (July 2025). Evidence from local evaluations and national guidance indicates CEPNs/THs expanded placement capacity, supported interprofessional learning, integrated new roles into primary care, and improved links between education providers and employers-albeit against a backdrop of regional variability and short-termism in funding. The 10-Year Plan’s ‘three shifts’ (community-first, digital enablement, prevention) map directly to Training Hub functions, but require stronger place-based embedding, stable investment, and outcomes-focused evaluation. With explicit policy backing, multi-year funding, and standardised impact measures, Training Hubs can function as the operational bridge between national strategy and local delivery for the decade ahead.
13. Tale of Two Cities: The Adalimumab Biosimilars Experience for Uveitis and Ocular Inflammatory Diseases at Two Texas Academic Centers.
期刊: Ocular immunology and inflammation 发表日期: 2025-Oct-15 链接: PubMed
摘要
To assess appeal outcomes and factors influencing those outcomes in insurance-mandated non-medical switching (NMS) from adalimumab (Humira®) to biosimilars in patients with uveitis and ocular inflammatory diseases. This retrospective observational study reviewed the electronic medical records of patients receiving Humira® for non-infectious uveitis and ocular inflammatory diseases prior to pharmacy benefit manager (PBM) formulary changes effective April 1, 2024, at the University of Texas Southwestern Medical Center (UTSW) and University of Texas Health Austin (UTHA). Data collected included PBM assignment, treatment duration, remission status, incidence of NMS mandates, appeal outcomes, and final treatment status. Appeals at UTSW cited Texas Senate Bill 680, which allows exemptions from new step-therapy protocols. Logistic regression assessed associations between patient characteristics, PBM, and NMS outcomes. Of the 75 patients, 30 (40%) received NMS mandates. CVS Caremark patients were more likely to receive mandates for NMS (86.4% vs 20.8%; p < 0.01) and had a lower appeal success rate (14.3% vs 90.9%; p < 0.01) compared to non-CVS Caremark patients. Ultimately, 18 (24%) patients (94% CVS Caremark patients, p < 0.01) were forcibly switched. Median appeal time was 11 days (range 1-35), and processing biosimilar transitions added considerable administrative burden, even in the absence of appeals. PBM-driven formulary changes disrupted treatment continuity for patients with non-infectious ocular inflammation. Enforcement of NMS mandates varied by PBM and often disregarded clinical stability and physician input, underscoring the urgent need for policy reform and uveitis-specific biosimilar outcome data.
14. A Remotely Delivered Weight Management Service to Support Existing Obesity Services in the UK National Health Service: Preliminary Findings From an Early-Stage Service Evaluation.
期刊: JMIR formative research 发表日期: 2025-Oct-15 链接: PubMed
摘要
Specialist weight management services (SWMSs) in the UK National Health Service (NHS) face long waiting lists and limited resources. Remotely delivered SWMSs may support existing NHS services to increase access to treatment for patients living with obesity; however, evidence of remotely delivered services working to support NHS SWMSs in practice remains limited. This study aims to explore the potential effectiveness, feasibility, and acceptability of Second Nature’s remotely delivered SWMS for adults living with obesity referred from existing NHS SWMSs. Preliminary findings from the first phase (Preparing for weight loss) of a 3-phase remotely delivered SWMS are presented. A total of 39 adults (age range 23-74 years, mean age 45.6, SD 12.1; 74% female) completed a 16-week intervention, following referral from NHS SWMS leads. Eligible participants were assessed by a multidisciplinary team and allocated to one of three interventions: (1) a psychologically informed app-based intervention, (2) a Dialectical Behavioral Therapy (DBT)-based skills training group intervention, and (3) one-to-one psychological support. The primary outcomes were weight change (kg) and percentage weight change following completion of the intervention. Secondary outcomes included psychological distress, emotional eating, health-related quality of life, physical activity, emotion regulation, intervention feasibility, and acceptability. At 16 weeks, the mean weight change was -2.2 kg (SD 5.16), or -1.6% of body weight. Participants in the app-based intervention lost the most weight (-2.8kg), and participants in the one-to-one psychological support intervention lost the least weight (-1.3kg). Psychological distress was reduced to below the clinical threshold (mean score 0.95, SD 0.62). Emotional eating behaviors and difficulties in emotion regulation also decreased (mean change scores -3.2, SD 6.4 and mean -11.6, SD 13.9, respectively). Health-related quality of life saw improvements in self-care, usual activities, and anxiety and depression, while participants’ challenges with mobility, and pain and discomfort remained unaffected. Subjective ratings of health status improved by 17.4%. There were no significant changes in physical activity levels, with most participants remaining “Inactive” or “Moderately inactive.” Engagement with intervention sessions was high (93.7%) and the attrition rate was 27.4%. Participants rated their satisfaction with the intervention at 9/10 and highlighted key benefits, including improved mental well-being, healthier habits, and supportive coach relationships. Suggested improvements included greater scheduling flexibility, enhanced app functionality, and more accessible physical activity support. This preliminary service evaluation suggests that a remotely delivered SWMS has the potential to be effective, feasible, and acceptable for NHS-referred patients in the United Kingdom. Changes observed across several key measures point to clinically significant benefits, reinforcing the potential of this approach. A full evaluation of all 3 phases of this service with a larger sample size is required to support these early findings.
15. A cross-sectional analysis of baseline diet quality among participants enrolled in delicious eating for life in the southern homes weight loss randomized trial.
期刊: Nutrition and health 发表日期: 2025-Oct-15 链接: PubMed
摘要
Background: A healthful dietary pattern, which typically includes regular and generous consumption of healthful fats and carbohydrates, reduces the risk for obesity-related morbidity and mortality. To assess the potential for improving diet quality in the context of a weight loss intervention, it is important to assess baseline measures of diet quality. Aim: To describe the baseline diet quality among participants in a behavioral weight-loss clinical trial. Methods: Participants were referred to this study by primary care clinicians. The Harvard Food Frequency Questionnaire was used to assess dietary intake, and items from this instrument were used to calculate the Alternative Health Eating Index (AHEI)-2010, Dietary Approaches to Stop Hypertension (DASH), and Alternate Mediterranean Diet index scores. Reflection spectroscopy was used to objectively assess skin carotenoids. Results: Among 360 participants, the mean age was 54.7 (SD 12.0) years, 44.1% were male, 36.7% self-identified as Black, 32.5% had type 2 diabetes mellitus, and the median body mass index was 35.1 kg/m2 (Q1-Q3 32.4-40.2). Median energy intake from fat was 37.2%, including 12.1% from saturated fat, while total carbohydrate intake was 44.8% with total fiber intake 17.0 g/day (Q1-Q3 12.3-23.4). In multivariable models, younger age and Black race were significantly associated with lower AHEI-2010 and DASH scores, representing lower diet quality. Conclusions: Study participants’ dietary intakes were high in saturated fat and low in dietary fiber, underscoring the need for weight loss interventions to focus on diet quality as well as energy restriction.
16. Area-Specific State of Suicide Deaths Among Foreign Nationals Living in Japan: A National Vital Statistics Study 2013-2022.
期刊: Journal of immigrant and minority health 发表日期: 2025-Oct-15 链接: PubMed
摘要
This study compared the state of suicide deaths among foreign nationals across government ordinance-designated cities in Japan between 2013 and 2022 using vital statistics data containing information on all suicide deaths. We analyzed data on suicide deaths, defined as deaths due to “intentional self-harm” (codes X60-X84) in accordance with the International Statistical Classification of Diseases and Related Health Problems 10th Revision, among foreign nationals and Japanese citizens aged ≥ 10 years who lived in a designated city between 2013 and 2022. Standardized mortality ratios (SMRs) and 95% confidence intervals (CIs) were calculated for each city, with the total population of Japanese citizens as the standard population. Suicide mortality differed across designated cities. The number of deaths and mortality rate from suicide were particularly high among Korean residents, especially those living in Osaka where the presence of a significant Korean population is largely rooted in historical circumstances. Osaka also had a significantly higher relative suicide mortality for female foreign nationals compared with other designated cities (SMR 1.6, 95% CI 1.4-2.0). To achieve an inclusive society that guarantees well-being for all of its population, area-specific trends in suicide deaths among foreign nationals living in Japan, especially Korean and elderly residents in a specific urban area, should be recognized and considered in developing suicide prevention policies and measures for foreign nationals.
17. Insights From Testicular Cancer Deaths in the U.S. Military: Case Reports.
期刊: Military medicine 发表日期: 2025-Oct-15 链接: PubMed
摘要
Testicular cancer is the most common cause of cancer in the U.S. male active duty population. Advancements in surgical and chemotherapy approaches have led to a 95% 5-year survival rate across all stages. The United States Preventive Services Task Force recommends against non-symptomatic clinical screening or patient self-examination citing the high survival rate and overall low civilian incidence. We present 2 case reports of active duty individuals who died from complications of testicular cancer. Case 1 was found deceased. At autopsy, a pelvic mass was found disrupting the aorta along with hemoperitoneum. The mass was subsequently identified as a metastatic mixed germ cell tumor. Case 2 presented with orchalgia and a testicular mass, but did not attend to his ordered ultrasound before deployment. He returned to the United States with a >10 cm testis, widespread metastatic disease, and a serum beta-human chorionic gonadotropin (hCG) over 250,000. A non-seminomatous germ cell tumor was presumed, and an orchiectomy was delayed to initiate chemotherapy. He died shortly after therapy was initiated from a pulmonary hemorrhage. In this article, we discuss how unique features of the military population may impact testicular cancer care with evidence from these 2 cases along with suggestions where impactful change can be made.
18. Applying the Human-Centered Innovation Biodesign Framework to the Development and Piloting of a Program to Mitigate Risk for Cognitive Decline Among Historically Underrepresented Individuals: Case Study.
期刊: JMIR formative research 发表日期: 2025-Oct-15 链接: PubMed
摘要
Physical inactivity is a modifiable risk factor for dementia. Past physical activity interventions often overlook the voices of the end user in the design process, particularly minoritized groups living with dementia or memory challenges. To develop physical activity interventions, we use the principles of human-centered design. We applied human-centered design using the innovation biodesign framework to develop a physical activity intervention, Nurturing Aging Through Uplifting Activities in a Restorative Environment (NATURE) program for minoritized individuals as a use case. The innovation biodesign framework has three domains: (1) problem space, (2) invention, and (3) solution space. Each domain includes several activities. The problem space involves a needs assessment, needs screening, evidence-based literature review, review of existing models of programs, and iterative feedback from partners, leading to an invention. The solution space encompasses the implementation and validation of the invention and outcomes. We applied this framework in 3 steps: (1) identifying the problem: we used data points from multiple sources to identify needs and mapped them onto the problem space. These sources included reviews of the literature to identify existing interventions, findings from other nature programs to surmise gaps, and focus groups to iteratively identify unmet needs. (2) Designing the invention: we developed NATURE with Hispanic or Latino people with memory challenges and identified their preferred outcomes. (3) Mapping the pilot study. We added the study protocol and planned outcomes to the solution space. In step 1, three evidence-based programs guided the development of NATURE to address physical inactivity and related risks of decreased well-being and dementia. We received 50 referrals for focus group participants, 22 were eligible and completed consent, and 21 (n=6 Hispanic or Latino people with memory challenges and care partners, n=8 outdoor professionals, and n=7 health care providers) participants completed the focus groups. We received feedback from participants on local nature activities, program frequency, duration, and delivery mode, a referral pathway, and outcomes using 5 focus groups and 2 interviews. In step 2, the 12-week NATURE program was developed to promote an active lifestyle and well-being, using nature activities that a person enjoys. NATURE accounts for a person’s preferences, needs, and daily situation and includes 4-6 sessions with 2 phone check-ins. Preferred outcomes were well-being, sleep, and social connections. In step 3, we mapped the plan to pilot NATURE using activity tracker technology to measure sleep, heart rate, and activity (well-being), and validated questionnaires. The framework provided a systematic approach for mapping the development of NATURE to address the needs of Hispanic or Latino people with memory challenges, using human-centered design principles. Application of the framework can be a helpful tool to map the development of other interventions for minoritized populations. ClinicalTrials.gov NCT06403345; https://clinicaltrials.gov/study/NCT06403345.
19. Incidence and Burden of Cardiovascular Disease Attributable to Extreme Heat in China.
期刊: European journal of preventive cardiology 发表日期: 2025-Oct-15 链接: PubMed
摘要
The increasing frequency of heat events driven by climate change poses a serious challenge to cardiovascular health. This study aimed to investigate the relationship between high temperature and acute cardiovascular disease (CVD) incidence in China, and to quantify the heat-related burden of CVD. 856,357 incident acute CVD cases were used from CVD surveillance in China in 2023. A distributed lag non-linear model was applied to evaluate the dose-response relationship between temperature and CVD incidence, as well as the best linear unbiased prediction of the minimum incidence temperature (MIT). The heat-related burden was quantified using attributable fraction and attributable number for two temperature ranges: all heat and extreme heat. Higher temperatures were associated with an increased risk of acute CVD incidence. Extreme heat exposure resulted in a cumulative relative risk (RR) of 1.17 (95% confidence interval[CI] 1.05-1.30), with the highest cumulative risk observed on the fourth day following exposure. All heat exposure accounted for 3.19% of CVD cases, while extreme heat contributed to 0.08%. The burden was particularly pronounced among individuals aged≥65 years (RR = 1.20, 95% CI 1.05-1.37), rural populations (RR = 1.18, 95% CI 1.01-1.37), and those living in temperate monsoon and temperate continental climates (RR = 1.25, 95% CI 1.05-1.49). MIT varied geographically, ranging from 16.0 ℃ in northern regions to 26.2 ℃ in southern regions, with the highest MITs concentrated in tropical areas. These findings emphasize the urgent need for region-specific public health strategies that integrate climate change adaptation and CVD prevention to mitigate the growing health risks associated with rising temperatures. This study examined the relationship between high temperatures and acute cardiovascular disease (CVD) incidence in China and quantified the heat-related burden. Higher temperatures increased the risk of acute CVD, with extreme heat exposure leading to a 17% higher risk, peaking on the fourth day after exposure.The heat-related burden was more pronounced among older adults (≥65 years), rural populations, and residents of the northern region, highlighting the need for targeted public health strategies.
20. Examination of audiologic findings and noise sensitivity in motorcycle couriers.
期刊: Archives of environmental & occupational health 发表日期: 2025-Oct-15 链接: PubMed
摘要
This study evaluated peripheral hearing and noise sensitivity among motorcycle couriers in Istanbul. Participants comprised 31 couriers (29 males, 2 females; age: 28.51 ± 6.23) and 30 controls (27 males, 3 females; age: 27.03 ± 4.20). Assessment included Weinstein’s Noise Sensitivity Scale, tympanometry, pure tone audiometry, and otoacoustic emissions. Couriers demonstrated significantly elevated hearing thresholds in the right ear at 500 Hz (p = 0.017), 1,000 Hz (p < 0.001), 2,000 Hz (p = 0.004), 4,000 Hz (p = 0.001), 6,000 Hz (p = 0.002), and 8,000 Hz (p < 0.001), and in the left ear at 4,000 Hz (p = 0.010) and 8,000 Hz (p = 0.039). Noise sensitivity scores were significantly higher (p = 0.031). Motorcycle couriers represent an occupational group vulnerable to hearing loss and heightened noise sensitivity. Protective measures should encompass environmental noise mitigation, speed limit regulation, and helmet redesign incorporating ear protection to promote hearing conservation and improve overall well-being.
21. Natural selection preserves trans-specific chloroplast diversity in a Mediterranean evergreen oak.
期刊: Journal of evolutionary biology 发表日期: 2025-Oct-15 链接: PubMed
摘要
Cork oak (Quercus suber) is an ecologically and economically important Western Mediterranean tree species in severe risk of decline due to aggravated tree mortality and lack of natural regeneration. In Q. suber, two distinct chloroplast lineages, one of them of trans-specific origin, occur in sympatry in the western half its species distribution. We hypothesize that selection may drive the maintenance of the two lineages, and investigate this hypothesis by sequencing chloroplast genomes of 259 Q. suber samples across 24 locations. Protein-coding chloroplast genes were scanned for selection signal using different codon-based methods. Selection signal was found at different sites and genes, and polymorphism in selected sites was shown to segregate between the two chloroplast lineages. We postulate that trans-specific chloroplast diversity in Q. suber is preserved by balancing selection, rather than resulting exclusively from ongoing introgression. These results correspond to an unusual case of balancing selection on whole plastid genomes in a long-lived woody plant species, and have implications on conservation and management practices for Q. suber, which may benefit from taking into account genetic variation in plastid genomes as a possible source of increased adaptive potential for the species.
22. Carbon fiber laminated epoxy resin causing chronic occupational dermatosis: presentation with erythroderma and dyschromia - a case report.
期刊: Journal of occupational health 发表日期: 2025-Oct-15 链接: PubMed
摘要
Epoxy resins are a common cause of occupational allergic contact dermatitis. Carbon fiber-laminated epoxy resin (CFLER) is a newer material with enhanced mechanical properties, but its health effects remain underreported. A 46-year-old male worker developed erythroderma involving >90% of his body surface and dyschromia after chronic exposure to CFLER in a confined workspace. Skin biopsy demonstrated features of chronic dermatitis, and immunohistochemistry revealed uneven melanocyte distribution. Laboratory studies showed elevated immunoglobulin E levels without internal organ dysfunction. Chest radiography indicated prominent bronchovascular markings without clinical symptoms. Intervention with topical clobetasol and avoidance of CFLER led to gradual resolution of erythroderma and improvement of dyschromia. Unlike previous reports focusing on acute epoxy resin dermatitis, this case highlights chronic skin changes and pigmentary alterations. Chronic exposure to CFLER can lead to melanocyte dysfunction, resulting in hyperpigmentation and hypopigmentation. Prompt identification and management are crucial to prevent severe complications such as high-output cardiac failure. This case emphasizes the importance of protective measures against CFLER exposure to prevent severe occupational dermatological conditions, including erythroderma and dyschromia.
23. Effects of Robotic Mirroring Training and Mirror Therapy with Robot on Unilateral Neglect, Depression, and Activities of Daily Living Among Patients with Subacute Stroke.
期刊: NeuroRehabilitation 发表日期: 2025-Oct-15 链接: PubMed
摘要
BackgroundInterventions for unilateral neglect have involved various approaches, notably the integration of robotics into clinical practice.ObjectiveThis study examined the effects of Robotic Mirroring Training (RMTr) and Mirror Therapy with Robot (MTh-R) on unilateral neglect, activities of daily living (ADL), and depression, and compared the effectiveness of the two interventions.MethodsThis study was a randomized controlled trial. Twenty-four patients with subacute stroke were randomly assigned to either the RMTr group (n = 12) or the MTh-R group (n = 12). Both groups received 30-min sessions, three times per week for five weeks, using the same robotic glove (SY-HRE12, SYREBO): the mirroring function for the RMTr group and pre-programmed passive movements for the MTh-R group. Unilateral neglect was assessed using the Behavioral Inattention Test-Conventional (BIT-C) and the Korean Catherine Bergego Scale (K-CBS). ADLs were measured with the Korean version of the Modified Barthel Index (K-MBI), and depression was assessed using the Korean Short Form Geriatric Depression Scale (SGDS-K). Pre- and post-intervention scores and between-group differences were analyzed.ResultsBoth groups showed significant improvements in BIT-C and K-CBS scores (p < 0.01). The RMTr group demonstrated statistically significant improvements in K-MBI (p < 0.01) and SGDS-K (p < 0.01), while the MTh-R group showed significant improvements in K-MBI (p < 0.05) and SGDS-K (p < 0.01). These results indicate reduced unilateral neglect, enhanced ADL performance, and decreased depression in both groups. Significant between-group differences were observed in BIT-C (p < 0.01), K-CBS, and SGDS-K (p < 0.05), confirming the greater overall effectiveness of the interventions.ConclusionsWhile both interventions were effective, RMTr demonstrated greater efficacy in reducing unilateral neglect and depression.
24. Pressed for Time: Physiological Indicators of Care Aides' Mental Workload in Response to Simulated Pressures in Long-Term Care Homes.
期刊: The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmieres 发表日期: 2025-Oct-15 链接: PubMed
摘要
BackgroundMental workload is an important indicator of an individual’s interaction with task demands. Care aides in long-term care (LTC) settings frequently report excessive demands imposed on their daily work due to challenging resident behaviours and organizational expectations. Understanding mental workload in these contexts is key to predicting staff strain and guiding support strategies.MethodsTwenty-eight care aides from six LTC homes in New Brunswick, Canada, participated in a simulated care scenario involving common challenges encountered when completing resident care. Two physiological markers of mental workload, namely heart rate variability (HRV) and pupil dilation, were continuously measured across five experimental stages, each designed to elicit different cognitive and emotional demands. Hierarchical mixed-effects models assessed the impact of demographic variables and experimental stages on mental workload.ResultsMental workload increased significantly, as indicated by decreased HRV and increased pupil diameter, when the care aide was required navigate impossible requests made by the resident. Contrary to expectations, resistance to care, verbal aggression, direct time pressure, and intervention by a supervisor did not significantly influence physiological correlates of mental workload.ConclusionThese findings suggest that creative problem-solving, such as responding to impossible resident demands, may be more mentally taxing than expected stressors like aggression or time pressure. To manage mental workload, staff should be prepared and supported to adapt creatively under pressure. Further efforts should be made to understand the relationship between increased mental workload and cumulative stress in care aides.
25. Machine Learning, Generalization, and Transfer Learning for Predicting the Exceedance of Fecal Indicator Bacteria Thresholds at Beaches.
期刊: Environmental science & technology 发表日期: 2025-Oct-15 链接: PubMed
摘要
Beach water testing for fecal indicator bacteria (FIB) is a key element of public health protection for beachgoers. Because the process can be expensive and time-consuming, many beaches are infrequently monitored, putting the health of the public at risk. Machine learning (ML) models using large sets of FIB, weather, and other types of environmental data have been applied to predict FIB levels at beaches. If ML models developed using data from frequently monitored beaches in one location could be effectively applied to another location (referred to as “generalization”), public health protections could be easily extended to those infrequently monitored beaches. We found that source to target generalization augmented by transfer learning (TL) can predict FIB threshold exceedance with a specificity of 0.70 to 0.81 and sensitivity ranging from 0.28 to 0.76, depending on the beaches and TL methods. This degree of specificity and the high end of the sensitivity range are comparable to the performance of regression and ML models developed by using data from a given beach and applied to that same beach. With the addition of TL, we observed statistically significant improvements in model performance over source to target generalization, with increases of 28.3% in WF1 scores and 5.4% in AUC. Future research into optimizing the selection of data-rich source beaches for developing models that can be applied to a given target beach may further improve transfer learning.
26. In utero electronic cigarette exposure may have mind blowing impacts on the offspring.
期刊: The Journal of physiology 发表日期: 2025-Oct-15 链接: PubMed
摘要
27. The comet assay as a tool in human biomonitoring exposure to pesticides-A systematic review and meta-analysis.
期刊: Mutation research. Reviews in mutation research 发表日期: 2025-Oct-14 链接: PubMed
摘要
Exposure to pesticides, most usually in occupational settings, is associated with different adverse health effects. In this systematic review and meta-analysis, we have assessed the effects of pesticide exposure on the level of DNA strand breaks in human peripheral blood cells, measured by the comet assay, in human biomonitoring studies. The literature search led to 80 studies included in the review. Of these, 66 studies met the criteria to be used in the meta-analysis. Using standardized mean difference and 95 % confidence interval (CI), the meta-analyses show an increased level of DNA strand breaks in subjects exposed to pesticides (2.02, 95 % CI: 1.69, 2.35). Results originate mainly from studies on workers, with only a few studies on environmental pesticide exposure. Subgroup analysis indicates that all studies combined from middle-income countries have a higher effect size (2.22, CI: 1.84, 2.59, n = 55) than studies from high-income countries (1.09, CI: 0.41, 1.76, n = 11). This difference between middle- and high-income countries may be mostly due to legislative, economic, and socio-cultural aspects. It has to be pointed out that only 9 % of the studies were classified as having an overall low risk of bias, while 12 % of studies used exposure biomarkers. In conclusion, this systematic review and meta-analysis shows that exposure to pesticides is associated with increased levels of DNA strand breaks in human peripheral blood cells.
28. Mental health service utilization in publicly insured survivors of childhood cancer: a claims-based analysis.
期刊: JNCI cancer spectrum 发表日期: 2025-Oct-14 链接: PubMed
摘要
Childhood cancer survivors face long-term psychological challenges, including depression, trauma/stress, and anxiety. However, objective assessments of mental health service utilization among child and young adult (YA) survivors of childhood cancer remain limited. We examined mental health care utilization among publicly-insured childhood cancer survivors and disparities by sociodemographic and neighborhood-level factors. Using multistate public insurance claims data, we identified 5,946 survivors (diagnosed ≤21 years) who completed cancer therapy; initiated treatment episode(s) for depression, trauma/stress, or anxiety post-cancer-therapy; and maintained continuous coverage. Logistic regressions examined factors associated with having any mental health visit and ≥4 visits within 12 weeks of treatment episode initiation in children (ages 3-17) and YAs (ages 18-39). Among 4,052 child treatment episodes, 54.6% were in females, 41.5% non-Hispanic White, and 27.4% Hispanic; demographics were similar across 3,871 YA episodes. Utilization was highest among survivors aged 3-11 (any visit: 73.4%; ≥4 visits: 39.8%), followed by those aged 12-17 (67.8%; 33.2%), 18-26 (51.9%; 20.2%), and 27-39 (43.3%; 16.4%). Hispanic children were less likely than non-Hispanic White peers to have ≥4 mental health visits (marginal effect=-8.73 percentage points; 95% CI=-12.78, -4.68), as were children in most (vs. least) deprived neighborhoods (marginal effect=-8.80 percentage points; 95% CI=-14.07, -3.53). Similar disparities were observed for any mental health visit. Mental health service utilization was low among publicly-insured childhood cancer survivors following mental health diagnosis, with notable disparities by age, ethnicity, and geographic location, underscoring the need for interventions to improve psychological support in this underserved population.
29. Association of organophosphate flame retardant metabolite concentrations in follicular fluid with in vitro fertilization outcomes among infertile women.
期刊: Ecotoxicology and environmental safety 发表日期: 2025-Oct-14 链接: PubMed
摘要
Organophosphorus flame retardants (OPFRs) are widely used endocrine-disrupting chemicals; however, the influence of OPFRs in follicular fluid (FF) on early in vitro fertilization (IVF) outcomes remains unexplored. This study investigated the associations between OPFR metabolite (mOPFR) concentrations in FF and early IVF outcomes among 155 infertile women. Multivariate linear regression revealed negative associations between the concentrations of total mOPFRs in FF with the number of oocytes retrieved (β = -0.63, 95 % CI: -1.01 to -0.25, p = 0.001), between bis(1,3-dichloro-2-propyl) phosphate (BDCIPP) with the number of oocytes retrieved (β = -0.84, 95 % CI: -1.47 to -0.21, p = 0.009), and between bis(2-chloroethyl) phosphate (DBP) with the rate of high-quality day-3 embryos (β = -6.01, 95 % CI: -11.54 to -0.48, p = 0.033). The Bayesian kernel machine regression (BKMR) model identified BDCIPP as the dominant risk factor (posterior inclusion probability = 0.97) among five mOPFRs, corroborating the result of weighted quantile sum (WQS) models. Our findings revealed that BDCIPP in FF is a critical risk factor for the reduced number of oocytes retrieved, emphasizing that further research should focus on BDCIPP when exploring the effects of OPFR exposure on pregnancy outcomes. This study indicated that targeted policies and safe reproductive health strategies are warranted.
30. COVID-19 Vaccine Effectiveness in Patients with Hematologic Malignancies: a Nationwide Cohort Study.
期刊: The Journal of infectious diseases 发表日期: 2025-Oct-14 链接: PubMed
摘要
In patients with hematologic malignancies, COVID-19 vaccine effectiveness is unknown and determinants of severe COVID-19 lack granularity. To identify determinants of SARS-CoV-2 infection outcome we conducted a population-based, nationwide cohort study, including all adult Dutch residents who tested positive for SARS-CoV-2 between June 1, 2020, and March 31, 2022. Individuals were classified as having a (history of) hematologic malignancy, solid malignancy, or no malignancies. Primary outcome was severe COVID-19, defined as COVID-19-related hospitalization or death following first SARS-CoV-2 infection. Among 4 649 341 included individuals, those with hematologic malignancies were at highest risk of severe COVID-19. Vaccine effectiveness against severe COVID-19 in patients with hematologic malignancies was up to 74% (95% confidence interval, 60 to 83%), depending on the SARS-CoV-2 variant period, the number of received vaccinations, and the time interval since vaccination. Risk of severe COVID-19 was highest for patients with recently diagnosed hematologic malignancies and declined over time, except for patients with chronic hematologic malignancies. Risk of severe COVID-19 tended to be higher in patients on tumor-specific treatment such as CD38 and CD20 antibodies, proteasome inhibitors, and protein kinase inhibitors. COVID-19 vaccination lowered the risk of severe COVID-19 in SARS-CoV-2-infected patients with hematologic malignancies, although these patients remained at elevated risk compared to others. Determinants of severe COVID-19 included type of malignancy, time interval between malignancy diagnosis and SARS-CoV-2 infection, and treatment. These data can guide healthcare professionals in designing additional prevention and therapeutic strategies against respiratory virus infections for patients with hematologic malignancies.
31. The association between environmental toxin exposure and frailty: A full exposure group approach using NHANES 2013-2016.
期刊: Ecotoxicology and environmental safety 发表日期: 2025-Oct-14 链接: PubMed
摘要
Evidence indicates that exposure to environmental chemicals may be related to frailty; however, most existing research has focused on single-exposure scenarios. This study aims to systematically evaluate the relationships between multiple environmental toxin exposures and frailty using a comprehensive exposure group approach and to investigate potential mechanisms mediated by systemic inflammation. Data from 2354 participants in the 2013-2016 National Health and Nutrition Examination Survey (NHANES) were analyzed. Environmental toxins were categorized into 10 groups, encompassing 61 substances. Frailty was assessed using a 36-item Frailty Index (FI). We applied an exposure‑wide association study (ExWAS; to screen for individual toxin-frailty associations) and deletion/substitution/addition (DSA; to identify key exposures in multi‑exposure contexts) models, and used Bayesian kernel machine regression (BKMR; to evaluate joint relationships and potential interactions among selected exposures). The role of systemic inflammation was evaluated through mediation analysis. Of the 2354 adults analyzed, 657 (27.9 %) were classified as frailty. ExWAS and DSA models identified total nicotine equivalent-2, tungsten, cobalt, tin, and N-acetyl-S-(2-carboxyethyl)-L-cysteine as significant exposures associated with frailty. BKMR analysis revealed a positive correlation between key exposures and frailty. Mediation analysis indicated that systemic inflammation mediated 2.5-14.6 % of these associations. To our knowledge, this is the first comprehensive study to report associations between three categories of five environmental toxins and frailty in U.S. adults, with inflammation potentially serving as a partial mediator. These findings are critical for identifying hazardous environmental chemicals and developing targeted strategies to promote healthy aging.
32. A Survey Study of Concerns and Attitudes Towards Doxycycline Post-Exposure Prophylaxis (DoxyPEP) Among Bathhouse-Affiliated Individuals in the U.S. and Canada.
期刊: Sexually transmitted diseases 发表日期: 2025-Oct-13 链接: PubMed
摘要
This study assesses doxycycline post-exposure prophylaxis (doxyPEP) awareness, perceptions, and concerns among bathhouse-affiliated individuals. Antimicrobial resistance, adverse effects, and accessibility were primary concerns. Partnerships with bathhouses present opportunities to address these barriers through targeted education, enhancing acceptance and promoting doxyPEP’s effectiveness in preventing sexually transmitted bacterial infections.
33. Detection and in silico evaluation of undeclared venlafaxine and clomethiazole in a counterfeit herbal product marketed for alcohol withdrawal syndrome.
期刊: Journal of pharmaceutical and biomedical analysis 发表日期: 2025-Oct-11 链接: PubMed
摘要
Herbal products, increasingly popular for various health conditions, pose significant public health concerns due to their frequent adulteration with undeclared pharmaceutical ingredients. Such adulteration is alarming, as these readily accessible products can lead to severe health consequences, including direct poisoning or adverse drug interactions. In this study, we investigated a counterfeit herbal product, marketed for alcohol withdrawal syndrome, following a consumer complaint. Gas chromatography-mass spectrometry (GC-MS) analysis revealed the presence of two prescription-only drugs, clomethiazole and venlafaxine. The analytical method for both compounds was validated to ensure accurate quantification. Within a 530.14 mg capsule, a staggering amount of approximately 252 mg of venlafaxine and 70 mg of clomethiazole were detected. To further evaluate the potential health risks, molecular docking and ADME (Absorption, Distribution, Metabolism, Excretion) prediction studies were conducted with serotonergic targets (SERT and 5-HT2A), GABAA receptors, and key metabolic enzymes (CYP3A4, CYP2D6, CYP2E1). This study is the first to assess the potential risks posed by the co-existence of clomethiazole and venlafaxine in a counterfeit herbal product, utilizing both chemical analysis and silico methods. Our findings unequivocally demonstrate that adulterated products carry serious risks of poisoning, drug interactions, and accidents. The potential for serious adverse events is further amplified when these adulterated products are consumed by individuals in professions requiring high levels of motor coordination, such as drivers, who unknowingly ingest substances like clomethiazole and venlafaxine that impair motor functions. This underscores the urgent need for stricter regulatory oversight and enhanced forensic scrutiny of herbal products.
34. DIA proteomic analysis revealed the molecular characteristics of aluminum-induced hippocampal injury in rats.
期刊: Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS) 发表日期: 2025-Oct-11 链接: PubMed
摘要
Aluminum is widely used in production and daily life due to its excellent properties. However, aluminum can damage neurons and cause cognitive impairment. Therefore, studying the neurotoxic mechanism of aluminum is of great significance. This study established a subchronic aluminum exposure model in Sprague Dawley rats and systematically investigated the neurotoxic effects and molecular mechanisms of aluminum. The experimental animals were randomly divided into a control group (0.9 % saline) and an aluminum exposure group ﹛20 μmol/kg maltol aluminum [Al(mal)3]﹜. Both groups were given intraperitoneal injections every other day for 90 days. After the administration, the rats received a series of behavioral tests. Subsequently, the rat hippocampus was subjected to data independent acquisition proteomic sequencing. Through Morris water maze and electron microscopy analysis of hippocampal tissue, it was confirmed that rats exposed to aluminum exhibited significant learning and memory impairments, accompanied by hippocampal neuron damage. The bioinformatics results showed that 188 differentially expressed proteins were screened out. And aluminum exposure mainly damages mitochondrial function (such as oxidative phosphorylation and ATP synthesis). It is worth noting that pathway enrichment analysis suggests a common pathogenic mechanism between aluminum induced neurotoxicity and Alzheimer’s disease. This study confirms that subchronic aluminum exposure leads to cognitive decline by mediating a large amount of protein expression dysregulation. The core mechanism is to impair mitochondrial energy metabolism and synaptic plasticity.
35. Genetic diversity of Mycoplasma bovis isolated from bovine respiratory disease and bovine mastitis in Chile.
期刊: Veterinary microbiology 发表日期: 2025-Oct-11 链接: PubMed
摘要
Mycoplasma bovis, a major bacterial pathogen for cattle, is responsible for diseases such as pneumonia, mastitis, otitis, and arthritis, leading to substantial economic losses and animal welfare concerns. Despite its wide global distribution, there is limited information in South America. M. bovis has been reported as a mastitis agent in Chile, but its genetic diversity is poorly understood. Therefore, this study aimed to determine the genetic diversity of M. bovis isolates from Chilean dairy cattle (from bovine respiratory disease and mastitis cases) in the last two decades and evaluate their genetic relatedness with strains isolated in different countries using a whole genome sequencing approach. The M. bovis population in Chile was found to be highly homogeneous, with MLST and phylogenomic analysis identifying ST60 as the dominant clone, representing most of the isolates (97.8 %), while just one isolate was typed as ST12 (2.2 %). Phylogenomic analysis revealed close genetic relatedness among most Chilean isolates, showing a close genetic relationship with North American strains, forming a tight clade with Canadian ST60 strains, while the single Chilean ST12 isolate clustered with North American, Israeli, and European strains and clustered with the type strain (PG45) of this species. Moreover, the pangenome analysis confirms that M. bovis has an open pangenome, with a large range of accessory genes that remain largely unexplored and may hold key insights into its genome plasticity, thereby opening future research. The findings of this study provide the first insights into the Chilean population structure of M. bovis, contributing to the global epidemiology of this pathogen with a focus on South America. These results also open future research focused on the comprehensive characterization of this dominant clone, inspiring the scientific community to further exploration into the genetic diversity of M. bovis in Chile.
36. The association between atherogenic index of plasma and risk of preeclampsia: a prospective cohort study.
期刊: Atherosclerosis 发表日期: 2025-Oct-10 链接: PubMed
摘要
The atherogenic index of plasma (AIP) has been linked to hypertension in general populations. However, the existing evidence concerning its association with preeclampsia risk remains limited. This study aimed to assess the relationship between first-trimester AIP level and preeclampsia risk. 6028 singleton pregnant women from a birth cohort, all under 14 weeks of gestation and without a history of hypertension, were included. AIP was calculated as log10 (triglycerides/high-density lipoprotein cholesterol). Generalized linear models and restricted cubic spline regression were utilized to estimate the associations between AIP and preeclampsia risk. A random forest model was employed to determine the relative importance of parameters for predicting preeclampsia risk. 235 (3.90%) incident preeclampsia cases were confirmed. A linear relationship was found between AIP and preeclampsia risk, and each 1-standard deviation increase in AIP was associated with a 21% higher risk of preeclampsia (RR: 1.21, 95% CI: 1.06-1.38). A significant interaction was identified between AIP and uric acid (UA) level (P for interaction = 0.009). Elevated AIP was linked to an increased preeclampsia risk (RR: 1.32, 95% CI: 1.13-1.54) when UA level exceeded 198 μmol/L, and the highest combined level indicated the greatest risk. Moreover, AIP was identified as the strongest predictor among all variables in the prediction model. Elevated first-trimester AIP was associated with an increased preeclampsia risk, particularly at the higher UA level. These findings highlight the clinical significance of pro-atherogenic dyslipidemia as both a risk marker and a potential target for early screening in preeclampsia prevention strategies.
37. Trends in Private Equity Acquisition of US Physical Therapy Clinics, 2010 to 2024.
期刊: The Journal of the American Academy of Orthopaedic Surgeons 发表日期: 2025-Oct-10 链接: PubMed
摘要
Private equity (PE) investments have expanded rapidly in procedural specialties such as orthopaedics. Physical therapy (PT) has become a newer target for PE investment because of reliable reimbursement, scalable operations, and recent policy reforms enhancing access. This study examines national trends in PE acquisitions of PT clinics, their geographic distribution, and PE exit trajectories. This cross-sectional study analyzed PE acquisitions of PT practices in the United States between January 1, 2010, and December 31, 2024. Acquisition data were drawn from PitchBook and supplemented through public verification. State and nationwide PT practice counts were estimated using the 2024 Medicare Care Compare database. PE acquistions in physical therapy expanded rapidly, from four deals in 2010 to 175 deals in 2023. By 2024, these acquisitions accounted for 2,591 PE-affiliated physical therpay clinics in the US, with 91.1% of the deals comprising of add-on acquisitions. PE penetration varied widely geographically, with Rhode Island (69.8%), Massachusetts (61.2%), and Tennessee (52.8%) having the highest proportions. Ten platform companies operated 59.3% of PE-affiliated PT locations in the United States, with notable regional concentration. The majority (63%) of acquisitions remained with the original PE firm, while 33.3% were sold to another PE firm with the average holding period being 3.3 years. PE investment in PT is marked by rapid growth, regional consolidation, and short-term investment cycles. Recent federal and state policy changes-including direct access laws and expanded referral authority-may have further facilitated PE entry into PT practices and contributed to the sector’s investment appeal. Additional research is needed to evaluate the effect of PE ownership on care quality, access, and workforce stability.
38. A Qualitative Study of Older Adults' Perspectives on Assistive Technology: Yes but No Thanks!
期刊: JMIR human factors 发表日期: 2025-Oct-10 链接: PubMed
摘要
The aging population presents challenges for healthcare systems. Assistive technologies (ATs) like telemonitoring, fall detection, and self-monitoring devices offer potential solutions to support older adults and their care. However, successful implementation relies on their acceptance, which remains poorly understood, particularly among non-users. This study explores older adults’ perceptions of ATs, including perceived benefits, adoption barriers, and factors influencing willingness to use these technologies. A qualitative study was conducted with 31 participants (aged 65+) with varying levels of health and care needs. Data were collected through six focus groups and six in-depth interviews, then analyzed thematically using NVivo software. Seven themes emerged: 1) Limited familiarity, with greater recognition of fall detection and self-monitoring devices compared to telemonitoring; 2) Perceived benefits, include safety, independence, and chronic disease management; 3) Key concerns include usability, cost, reliability, privacy, and psychological impacts; 4) Suggested improvements comprise user-friendly designs and training programs; 5) Contextual influences identified with independent older adults perceiving greater utility; 6) Strategies for ATs’ promotion proposed such as media campaigns, government subsidies, and healthcare endorsements; and 7) Overall willingness to adopt ATs, driven by perceived need, social and healthcare influence, and ease of use. While ATs offer clear benefits, adoption remains limited due to usability, cost, and psychological concerns. Improving accessibility, training, and integration into traditional healthcare services delivery may facilitate acceptance and use. Future research should focus on inclusive designs and policy interventions to maximize ATs’ potential in aging populations.
39. Two residue mutations in VP1 of FMDV serotype A cause significant antigenic variation via reorientation of G-H loop revealed by lineage-specific neutralizing antibodies from the natural hosts.
期刊: Veterinary microbiology 发表日期: 2025-Oct-10 链接: PubMed
摘要
Foot-and-mouth disease virus (FMDV) serotype A exhibits extensive genetic and antigenic diversity, complicating vaccine strain selection. Here, we identified two distinct panels of host-derived neutralizing antibodies (nAbs) specific to the SEA97 lineage. The majority of nAbs (10/11) targeted antigenic site 2, while one bovine-derived antibody recognized residue 138 in the VP1 G-H loop. Compared with the ancestral A/AF72 strain of the A22 lineage, the T138A substitution and 140 N deletion on VP1 significantly enhanced the cross-neutralizing activity of SEA97 lineage-specific antibodies against the VP1 G-H loop and antigenic site 2, extending their coverage to the mutated A/AF72 strain. Neutralization assays with porcine immune sera further demonstrated that these mutations are key contributors to antigenic divergence between the A22 and SEA97 lineages. Structural simulations indicated that the T138A substitution and 140 N deletion in VP1 shifted the G-H loop conformation of A/AF72 strain toward that of SEA97 lineages, implicating them as molecular determinants of lineage-specific antigenicity. These findings suggest that substitution or deletion of upstream polar residues of the RGD motif reshaped G-H loop orientation, thereby contributing to antigenic variation in Asia topotype of FMDV serotype A.
40. Improving cancer survivorship care: lessons learned from an implementation process in a clinical setting.
期刊: European journal of oncology nursing : the official journal of European Oncology Nursing Society 发表日期: 2025-Oct-09 链接: PubMed
摘要
This project aimed to improve survivorship care in oncology by identifying existing needs, raising awareness, developing and implementing practical tools in clinical settings. This paper presents key reflections and lessons learned throughout the process. A participatory approach involving healthcare providers was chosen to ensure relevance and applicability. Researchers adopted a coaching leadership style to support collaboration. Main data collection methods included feedback cycles and interviews with healthcare professionals. Several interventions were developed and implemented, including a survivorship care passport, a holistic needs assessment, a patient booklet, training for professionals, a website and a survivorship care consultation. The extent to which these tools were adopted varied across teams, often influenced by practical barriers such as time constraints and logistical challenges. Their success largely depended on their practical use in clinical settings. While barriers remained at project’s end, some tools showed strong potential for sustained use. A key factor in this was fostering ownership among healthcare providers through consistent engagement and a balance between structure and autonomy. This highlights the importance of a coaching leadership style in improving survivorship care.
41. Associations between ideal cardiovascular health metrics and lipoprotein subclasses and atherogenic indices: A cross-sectional study of middle-to older-aged adults.
期刊: Atherosclerosis 发表日期: 2025-Oct-09 链接: PubMed
摘要
The American Heart Association ideal cardiovascular health (CVH) score aims, through positive health promotion, to improve cardiovascular health. Lipoprotein particles and atherogenic indices can provide better cardiovascular disease risk prediction than traditional lipid measures. Yet, ideal CVH score associations with intermediate disease markers remains under-researched. This study addressed this gap by investigating CVH score relationships with lipoprotein particle subclass concentrations and atherogenic risk indices. This was a cross-sectional study of 1216 middle-to older-aged men and women randomly selected from a large primary care centre. Individual participant CVH metrics (smoking, BMI, physical activity, diet, blood pressure, blood glucose and cholesterol) were derived from validated questionnaires, clinical assessment and biochemistry tests. Lipoprotein particle subclass concentrations and size were determined using nuclear magnetic resonance spectroscopy. Atherogenic risk indices were derived from lipid/lipoprotein measures. Linear regression analyses examined CVH score associations with lipoprotein biomarkers and atherogenic indices. In fully adjusted models, higher scores were associated with smaller VLDL and larger LDL and HDL particle size, less large and medium VLDL, total LDL and small LDL particles, more large HDL particles, and lower lipoprotein-related insulin resistance and atherogenic risk index scores. In models which examined these variable associations across CVH score quintiles, significant dose-response relationships were observed (p trend <0.001 for all). Higher CVH scores were associated with more favourable lipoprotein subclass concentrations and atherogenic risk profiles, highlighting the score’s potential usefulness as a tool for assessing atherogenic risk and the importance of improving overall cardiovascular health.
42. Quantification of active and total adalimumab using affinity purification coupled with tryptic digestion-based liquid chromatography-tandem mass spectrometry analysis.
期刊: Journal of pharmaceutical and biomedical analysis 发表日期: 2025-Oct-09 链接: PubMed
摘要
Therapeutic drug monitoring is commonly employed to investigate the loss of response to adalimumab. However, existing methodologies focus exclusively on measuring active adalimumab, neglecting the presence of inactive forms, which may result in incomplete or misleading clinical evaluations. To address this limitation, a liquid chromatography-tandem mass spectrometry method incorporating affinity purification was developed for the simultaneous quantification of both active and total adalimumab concentrations in serum samples. A signature peptide, APYTFGQGTK, was selected from in silico-generated peptides derived from the Fab region based on its selectivity and sensitivity. An isotope-labeled analog, [13C9, 15 N]-APYTF*GQGTK, was used as the internal standard. Sample pretreatment steps, including acidic dissociation, competitive binding using biotinylated tumor necrosis factor alpha (TNFα), and affinity capture, were optimized to achieve maximal recovery of both active and total adalimumab. The method was validated in accordance with the U.S. Food and Drug Administration guidelines, demonstrating excellent recovery (89.4-111.4 %), precision (coefficient of variation < 9.7 %), and linearity (r² > 0.998) across a concentration range of 1-32 μg/mL. Clinical sample analysis revealed a strong correlation (r = 0.929) with the latex-enhanced turbidimetric immunoassay; however, a systematic bias of 14.1 % was observed. The ratio of active to total adalimumab concentrations varied between 53.5 % and 115.8 %. These results of clinical samples have generated significant interest, warranting further investigation into the quantitative methods and the concentration ratios, both of which may have clinical significance in guiding drug response. The results also emphasize the importance of conducting quantifications within the same analytical system to ensure data comparability. Moreover, the proposed methodology provides a robust and adaptable framework that can be extended to the quantification of other therapeutic monoclonal antibody drugs.
43. Mastitis in goats: A comprehensive systematic review and meta-analysis of prevalence and the pathogens.
期刊: Preventive veterinary medicine 发表日期: 2025-Oct-08 链接: PubMed
摘要
Mastitis poses a significant challenge in the dairy industry, carrying economic, legal, public health, and animal welfare implications. The disease is primarily caused by pathogens and exacerbated by environmental, management, and host-related factors. However, comprehensive evidence synthesis remains limited compared to other livestock. Therefore, this review aims to bridge this gap by updating the prevalence and associated pathogens of mastitis in goats. We conducted systematic searches following PRISMA guidelines and, through established eligibility criteria, retrieved records were filtered and screened. Quantitative data obtained from qualified studies were analyzed using a random effects model. The overall estimated prevalence of mastitis was 30.6 % (95 % CI: 28.1-34.3 %; I² = 97. 9 %). The prevalences of clinical mastitis and subclinical mastitis were estimated at 7.5 % (95 % CI: 5.4-10.2 %) and 31.6 % (29.34-33.3 %). Subgroup prevalence was 26.1 % at the udder half level and 36.1 % at the bulk tank level. Single summary pooled prevalence at the goat level was highest in Australia (35 %) and lowest in North America (11.6 %). A decreasing trend was observed for udder half-level and overall mastitis prevalence, while goat-level mastitis showed an increasing trend. Major identified pathogens associated with goat mastitis were Staphylococcus, Streptococcus, E. coli, Klebsiella, Corynebacterium, and Pseudomonas. Staphylococcus species account about 30 % of mastitis, with non-Staphylococcus aureus species at 20 % and Staphylococcus aureus at 11 %. This review highlights goat mastitis as a significant challenge in the increasing demand of the dairy goat industry. Addressing and mitigating risk factors for goat mastitis with a view to reducing the prevalence is vital for dairy goat productivity.
44. Negative life events, suicidal ideation and self-harm among nurses with depressive symptoms: A latent class analysis.
期刊: International journal of nursing studies 发表日期: 2025-Oct-01 链接: PubMed
摘要
Suicidal ideation and self-harm among nurses with depressive symptoms are public health concerns, given their elevated prevalence and potentially severe outcomes. Prior studies predominantly examined negative life events either as isolated variables within broader exploratory analyses or as a single continuous measure, without assessing distinct patterns. This study aimed to identify distinct patterns of negative life events among Chinese nurses with depressive symptoms and examine their associations with suicidal ideation and self-harm. This cross-sectional study analyzed data from 73,371 nurses with depressive symptoms from the Nurses’ Mental Health Study in China. Latent class analysis identified patterns of ten negative life events experienced in the past year. Two binomial logistic regression models were used to examine associations between negative life event patterns and suicidal ideation (n = 64,569) and self-harm (n = 68,038), adjusting for demographic, work-related, health-related, and childhood experience covariates. Sensitivity analyses included stratified logistic regressions by levels of depressive symptom severity and multinomial logistic regressions that treated “prefer not to answer” responses as a separate category, to assess the robustness of associations and potential underreporting bias. Four distinct negative life event patterns emerged: Low-Stress Life Events (59.7 %), Health and Family Crisis (12.4 %), Economic and Relationship Struggles (23.1 %), and Widespread Life Crises (4.7 %). Compared to the Low-Stress group, nurses in the Economic and Relationship Struggles group had statistically significantly higher odds of suicidal ideation (AOR = 1.25, 95 % CI: 1.14 to 1.37) and self-harm (AOR = 1.20, 95 % CI: 1.04 to 1.39). The Widespread Life Crises group showed even stronger associations with suicidal ideation (AOR = 1.68, 95 % CI: 1.46 to 1.92) and self-harm (AOR = 1.86, 95 % CI: 1.54 to 2.24). The Health and Family Crisis group showed no statistically significant associations with either outcome. Sensitivity analyses supported the main findings, with consistent associations observed across depression severity subgroups. The multinomial logistic regression also showed elevated risk ratios for suicidal ideation and self-harm among respondents in the Widespread Life Crises group, including those who selected “prefer not to answer.” This study identified distinct patterns of negative life events among nurses with depressive symptoms and demonstrated that economic and relationship challenges, especially when occurring across multiple life domains, are significantly associated with the risk of suicidal ideation and self-harm. Targeted interventions addressing specific life stressor patterns may help reduce suicidality in this high-risk population.
45. Maternity Care Simulation in Rural Texas to Improve Clinician Knowledge and Skills.
期刊: MCN. The American journal of maternal child nursing 发表日期: 链接: PubMed
摘要
Maternal mortality rates in the United States are alarmingly high, especially in rural areas with limited access to care. Clinicians in rural hospitals are challenged to maintain their obstetric knowledge and skills due to low patient volumes and limited educational opportunities. The purpose of this project was to improve maternity care in rural Texas by providing tailored obstetric education and simulations to enhance emergency response and team collaboration. A team of five nurses provided simulation-based perinatal education to clinicians in 10 rural facilities and maternity deserts, including county emergency services. Tailored simulations conducted in situ addressed various obstetric emergencies and were designed to match each facility’s staffing ratios. Post-simulation surveys were sent to evaluate participants’ understanding, recognition, communication, and collaboration. Surveys from 48 participants, including nurses, technicians, and other health care professionals, indicated significant improvements in understanding, recognition, communication, and preparedness for obstetrical emergencies after simulation training. Qualitative feedback underscored the project’s success, highlighting the increased confidence, knowledge, and multidisciplinary collaboration among the participants. The simulation education effectively addressed facility-specific needs, enhancing overall effectiveness and engagement, despite challenges with participant attendance and group sizes. Perinatal outreach has improved rural health care teams’ confidence, preparedness, and competence in managing obstetric emergencies through specialized education and hands-on simulations. To ensure continued success, it is crucial to continually reassess and adapt educational programs to meet the evolving needs of rural health care facilities, thereby enhancing patient care and outcomes.
46. Importance of De Novo Gene Evolution to Emerging Viral Threats: The ORF10 Strain-Restricted Orphan Gene of SARS-CoV-2 Promotes Pathogenesis.
期刊: Molecular biology and evolution 发表日期: 2025-Oct-01 链接: PubMed
摘要
Orphan genes, which encode species-specific proteins, are common but are rarely investigated. The SARS-CoV-2 orphan gene, ORF10, has been understudied; in vitro work suggests it may modulate innate immunity. Whether ORF10 influences COVID-19 outcomes in humans remained unknown. Here, analyzing millions of SARS-CoV-2 genomes, we find ORF10 sequences are identical to ancestral Wuhan-Hu-1 haplotype. In all variants of concern, <5% of genomes carry any ORF10 mutation. Despite limited statistical power due to the sparsity of mutated sequences, four ORF10 mutations were associated with less severe clinical outcomes in COVID-19 patients: three affect protein structure, one alters RNA structural dynamics. No mutations were linked to increased severity. ORF10 transcript levels in humans and human models are conditionally discordant from other SARS-CoV-2 genes. ORF10 expression in A549 and 293T cells significantly perturbs oxidative phosphorylation gene expression, disrupts immune gene networks, and shifts expression of 14 novel human transcripts. ORF10 is present in multiple Betacoronavirus pandemicum strains, but absent from SARS-CoV-1-like strains. We propose that this strain-restricted orphan gene contributes to severe COVID-19 in humans, with implications for future therapeutic strategies. These findings underscore the importance of studying recently evolved, potentially overlooked, viral orphan genes as a standard approach in pandemic preparedness.
47. Novel scoring system to predict futile liver transplantation by multiterm outcomes to optimize recipient selection: retrospective cohort study.
期刊: BJS open 发表日期: 2025-Sep-08 链接: PubMed
摘要
Improvements in medical standards have allowed critically ill patients to benefit from liver transplantation, but defining futility arbitrarily according to one single-stage outcome could deprive patients of the potential benefits of transplantation. This study aimed to redefine futile liver transplantation by multiterm outcomes and develop a novel scoring system to predict futile liver transplantation. This retrospective study in China enrolled patients who had liver transplantation from 3 centres between January 2015 and April 2021. Independent risk factors were identified by logistic regression analysis and used to establish risk prediction models. Kaplan-Meier survival curves were calculated to explore the association between futile score and overall survival. Of 1408 patients undergoing liver transplantation, patients at persistent high risk for mortality in the short term (3 months), mid term (1 year), and long term (3 years) were defined as the truly futile liver transplantation group. Higher donor and recipient age, hepatorenal syndrome, intensive care unit stay, need for mechanical ventilator, ABO blood group incompatibility, prolonged cold ischaemia time, increased alanine aminotransferase levels, and decreased albumin levels were independent risk factors for futility, and were used to construct a futile scoring system. The scoring system had good predictive capability, with an area under the receiver operating characteristic curve of 0.921, better than that of a previously established scoring system. Survival analysis showed that the group with a high futile risk had decreased survival. This study has redefined futile liver transplantation and established a novel futile scoring system. This can be used to optimize the allocation of medical resources, especially with regard to recipient selection for liver transplantation, and increase survival prediction for selected patients.
48. Why is Jenna a Teen Mother? Conceptions and Misconceptions.
期刊: MCN. The American journal of maternal child nursing 发表日期: 链接: PubMed
摘要
Young mothers are depicted in the literature as inept parents whose poor decisions and risky behavior lead to early and unprotected sex, a poorly timed birth, and adverse outcomes. This risky conception of teen mothering emerged in the 1970s as social scientists, policy makers, and advocacy groups embraced theories and assumptions of deviance that blame young mothers for jeopardizing their future and their child’s well-being. This individualistic framing of young mothering is increasingly debunked by innovative well-designed studies over the last 3 decades. A hypothetical teenage couple is presented to highlight the limitations of the risky conception and to argue for its replacement. The Reproductive Justice movement challenges the individualistic framework by highlighting the socioeconomic conditions that contribute to teen births and health and social disparities among marginalized women and their children. Policies that rectify these conditions are required.
49. Review of All Solid Tumor Drug Approvals From 2019 to 2024 by US Food and Drug Administration, European Medicines Agency, and Brazilian Health Regulatory Agency.
期刊: JCO global oncology 发表日期: 2025-Oct 链接: PubMed
摘要
Regulatory agencies play a pivotal role in evaluating clinical evidence for oncology drug approvals. This study aimed to compare approved indications across the US Food and Drug Administration (FDA), European Medicines Agency (EMA), and Brazilian Health Regulatory Agency (ANVISA), with a focus on the robustness of the supporting evidence and consistency between labeling and clinical trial data. A systematic review identified all new drugs and indications for solid tumors approved by the FDA from January 1, 2019, to December 31, 2024. Each approval was cross-referenced with corresponding decisions by EMA and ANVISA. For each indication, the pivotal trial’s design, primary end point, study population, and the concordance between the approved label and the clinical evidence were identified. During the 6-year period, 199 new indications for solid tumors were approved by the FDA; 138 (69.3%) were also approved by EMA and 124 (62.3%) by ANVISA. Discrepancies between approved labels and the primary end point population occurred in 10.0% of FDA, 18.8% of EMA, and 12.9% of ANVISA approvals, most often due to label restrictions to subgroups, indicating a more conservative approach by EMA and ANVISA. Labeling differences were noted in 19 of 139 FDA-EMA and 10 of 124 FDA-ANVISA shared approvals. A total of 190 pivotal trials supported these approvals, including three phase I, 59 phase II, and 128 phase III studies. The most frequent end points were overall response rate and progression-free survival, including in phase III trials and regular approvals, rather than overall survival or quality of life. Notable differences in timelines, regulatory mechanisms, and evidentiary thresholds across agencies result in divergent labeling. These variations have clinical and policy implications for oncology drug access and adoption worldwide.
50. Reporting of Accelerometry in Health Research: A Scoping Review of Current Guidance.
期刊: Scandinavian journal of medicine & science in sports 发表日期: 2025-Oct 链接: PubMed
摘要
The use of accelerometers in health research is ubiquitous, but reporting of methods for translating raw acceleration data into movement behavior estimates remains inconsistent. This scoping review aims to identify and summarize existing reporting guidance for accelerometer-based assessment of physical activity, sedentary behavior, and sleep in health research. We systematically searched seven bibliographic databases up to May 2024 for literature containing guidance on reporting of accelerometry results in health research. We assessed the methodological rigor of reporting guidance development using the AGREE II tool and EQUATOR Network’s best-practice recommendations. A thematic synthesis categorized reporting guidance across four themes: (1) data collection, (2) data management and initial processing, (3) deriving movement behaviors from acceleration data, and (4) summary metrics. Searches retrieved 7739 records, from which 47 publications were included. Most applied evidence synthesis methods (76%), whilst others used consensus workshops or empirical research to generate reporting recommendations. Only 17% described stakeholder involvement, with limited descriptions of their role. We identified 380 items of reporting guidance, which were synthesized into 124 unique items. Reporting guidance was consistent for data collection, data management and initial processing, and variable derivation, but less so regarding which specific metrics to report. Existing reporting guidance for accelerometry in health research is extensive and wide in scope, but varies in methodological rigor and stakeholder involvement. A consolidated and systematically developed framework is needed to enhance the reproducibility and comparability of future accelerometer-based research, incorporating stakeholder engagement, consensus-driven methodology, and piloting to maximize uptake. PROSPERO Registration: CRD42021272228.
51. Addressing student substance use in Canadian schools: an exploration of administrators' perspectives.
期刊: Health promotion international 发表日期: 2025-Sep-03 链接: PubMed
摘要
To support the development of evidence-informed guidance for Canadian Kindergarten through Grade 12 (K-12) school administrators, this study examined their perceptions of the scope of student substance use and the challenges they face in responding within school settings. An online, cross-sectional survey collected data from 204 Canadian school administrators, capturing their experiences and perspectives on student substance use, including the types of challenges encountered, time spent addressing them, perceived capacity to respond, and differences across school levels (elementary, middle, and secondary). Responses from elementary/middle and secondary school administrators were compared in the analysis. Approximately 90% of administrators reported frequent student substance use challenges. The most common challenges were vaping (63.7%) and substance use on school property (41.7%). Secondary school administrators reported significantly more challenges and were more likely to spend in excess of 5 hours weekly addressing substance use. Most administrators reported a willingness to change practices (64.7%), but fewer felt equipped or effective in their current approaches. Student substance use poses a significant challenge for Canadian schools, particularly at the secondary level, increasing administrator workload. Administrators report feeling underprepared and insufficiently supported, despite a willingness to act. Findings highlight an urgent need for developmentally informed, evidence-aligned strategies and resources to support school-based responses to substance use and overall school health promotion.
52. Reducing classroom sedentary behaviour: a scoping review of interventions and student involvement.
期刊: Health promotion international 发表日期: 2025-Sep-03 链接: PubMed
摘要
Sedentary behaviour is increasingly common and is becoming a challenge to maintain the young population healthy. This scoping review aims to identify the existing literature on strategies for altering the classroom design to reduce sedentary behaviour in classroom settings during lessons and the impact of interventions. Three electronic databases (ERIC, PsycInfo, and Scopus) were searched for relevant literature. A total of 40 eligible articles from different countries published between January 2003 and April 2024 were included in the review, which was carried out to identify interventions to prevent sedentary behaviour by redesigning the classroom. The methodology was conducted by the framework presented by Arksey and O’Malley and is reported following the PRISMA-ScR guidelines. The findings reveal various approaches to preventing sedentary behaviour through active desks (e.g. standing desks, sit-to-stand desks, bicycling desks, and stability balls). Most studies focused on stand-biased desks, targeting students (9-12 years old) and were primarily from the USA. Since standing was voluntary, only minor bouts of standing and movement were typically achieved. Only a few studies included partial co-design elements. The thematic analysis identifies the impact of the different interventions. Five themes were found: impact on physical activity, classroom behaviour, cognitive performance, physical and/or mental well-being and challenges. The findings suggest that standing at standing desks while studying does not pose significant physical or mental challenges for students, although some physical fatigue was observed after prolonged standing up. However, a key gap was the absence of co-design in the intervention process. Trial registration: The scoping review protocol was not pre-registered.
53. Zoonosis: a comprehensive database of zoonotic pathogens.
期刊: Database : the journal of biological databases and curation 发表日期: 2025-Jan-18 链接: PubMed
摘要
Emerging infectious diseases pose a significant threat to global public health and economic security, with zoonoses accounting for a substantial proportion. Livestock such as cattle and sheep are critical reservoirs for zoonotic pathogens and play a key role in transmitting these pathogens to humans and other animals, including dogs and wildlife, due to their close interaction with diverse populations. In this study, we introduce Zoonosis (http://zoonosis.cn/zoonosis/), a comprehensive database that integrates data on pathogens, including Brucella, Mycobacterium tuberculosis, and Bacillus anthracis. Currently, Zoonosis integrates over 4500 samples from more than 60 countries, with a total data volume of 1.8TB, providing a global perspective on zoonotic disease distribution. Equipped with user-friendly visualization and analysis tools, Zoonosis enables rapid biological data interpretation, aiding disease diagnosis and prevention. This resource supports virology, zoology, and epidemiology experts in monitoring cross-species transmissions and mitigating future zoonotic outbreaks. Database URL: http://zoonosis.cn/zoonosis/.
54. Postural assessment of children with congenital Zika syndrome and caregivers in the home environment: a cross-sectional pilot study.
期刊: Sao Paulo medical journal = Revista paulista de medicina 发表日期: 2025 链接: PubMed
摘要
Children with congenital Zika syndrome (CZS) present severe motor impairment that hinders their caregivers’ positioning during activities of daily living (ADLs). To assess the posture of children with CZS and their caregivers during ADLs in the home environment. A cross-sectional pilot study conducted in Campina Grande (PB), Brazil. Nine children with CZS (mean age = 36.77 ± 2.94 months) and their caregivers (n = 9, mean age = 27 years) were assessed. Data were collected at the support home of a center for children with microcephaly in Northeast of Brazil. For postural assessment, children and their caregivers were filmed while performing ADLs in the living room and kitchen of the support home. During the environmental interaction, all children predominantly maintained a sitting position, exhibiting neck and trunk asymmetry; 77.8% (n = 7) showed inadequate postures with elevated arms and shoulders, and none maintained the ankles in a neutral position with supported feet. During feeding, 88.9% (n = 8) of children were positioned on the lap of caregivers, 88.9% (n = 8) exhibited neck and trunk asymmetry, 66.7% (n = 6) displayed inadequate upper-limb posture, and none maintained their ankles in a neutral position. During this activity, 66.7% (n = 6) of caregivers presented with trunk and neck asymmetry, 66.7% (n = 6) did not provide support for the upper limbs, and 55.6% (n = 5) did not maintain their knees flexed at 90o. Children with CZS and their caregivers present with inadequate postures during ADLs in the home environment, which may represent health risks.
55. Factors associated with adherence to post-exposure prophylaxis among dental professionals in Brazil.
期刊: Brazilian oral research 发表日期: 2025 链接: PubMed
摘要
This study analyzed the influence of sociodemographic, occupational, and accident-related factors on adherence to post-exposure prophylaxis (PEP) among dental professionals. A cross-sectional study was conducted using secondary data from the Brazilian Notifiable Diseases Information System, covering incidents of biological material exposure from 2018 to 2023 across all federal units. PEP adherence was the outcome analyzed, and related factors included sociodemographic, occupational, and accident characteristics. Descriptive, bivariate, and multivariate logistic regression analyses were performed (α = 5%). A total of 15,650 notifications involving dental professionals were analyzed, representing 3.91% of all cases of occupational exposure, with a PEP adherence rate of 91.0%. The exposed professionals had a mean age of 32.5 years (SD = 10.4), were predominantly women (76.6%), of White race/ethnicity (65.4%), and had higher education (79.7%). The mean work experience was 3.6 years (SD = 6.8). In the adjusted model, adherence was associated with lower educational attainment (OR = 0.71; 95%CI: 0.58-0.88), younger age (OR = 0.99; 95%CI: 0.98-0.99), and longer work experience (OR = 1.02; 95%CI: 1.01-1.03). Percutaneous exposure (OR = 1.39; 95%CI: 1.16-1.67), contact with blood (OR = 1.47; 95%CI: 1.18-1.82), and dental procedure-related accidents (OR = 1.35; 95%CI: 1.07-1.70) increased the likelihood of adherence. Hepatitis B vaccination (OR = 1.96; 95%CI: 1.62-2.36) was associated with increased adherence to PEP. Adherence to PEP was influenced by multiple factors, highlighting the need for effective strategies to improve adherence and occupational safety among these professionals.
56. Return-to-work for people living with long COVID: A scoping review of interventions and recommendations.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Long COVID is characterized by the presence of new onset or persistent symptoms 3 months after a suspected or confirmed history of SARS-CoV-2 infection. It is a complex and multi-faceted condition that affects people in different ways. Long COVID affects individuals’ labour market participation. While some cannot work, others may return to work (RTW) in a limited capacity. Determining what rehabilitation or related strategies are safe and effective for facilitating RTW is necessary. To synthesize evidence on RTW interventions for people living with Long COVID and to identify ‘promising’ interventions for enhancing work ability and RTW. We followed Arksey & O’Malley’s methodology and the PRISMA extension for scoping reviews. Five electronic bibliographic databases and grey literature were searched. The literature search included various study designs, such as randomized controlled trials (RCT), quasi-experimental designs, and observational studies as well as clinical practice guidelines (CPGs). Two reviewers conducted screening and data extraction, with disagreements resolved through consensus. Intervention studies were categorized as promising (statistically significant RTW outcomes or ≥ 50% RTW), somewhat promising (20% to < 50% RTW), not promising (non-statistically significant RTW outcomes or < 20% RTW), or uncertain (did not specify proportion of RTW). Twelve CPGs and nineteen intervention studies were identified. Of the intervention studies, 5 were cohort studies, 3 quasi-experimental studies, 4 observational, 2 interventional, 3 RCTs, and 2 case reports. Promising interventions included multimodal and interdisciplinary work-focused rehabilitation, multidisciplinary inpatient and outpatient rehabilitation, psychoeducation, pacing, and breathing strategies, shifting focus from symptom monitoring to optimizing functional outcomes, enhanced external counterpulsation inflatable pressure to improve blood flow, and constraint-induced cognitive therapy. Many uncertainties remain regarding which RTW interventions are effective or the optimal characteristics of these interventions.