公共卫生研究摘要 (2025-11-25)
共收录 57 篇研究文章
1. Global & Community Health: What Did the COVID-19 Pandemic Teach Us About Neurologic Surveillance Approaches, and How Should We Be Better Prepared?
期刊: Neurology 发表日期: 2025-Dec-23 链接: PubMed
摘要
It is well recognized that many pandemic viruses are associated with neurologic complications, most recently with COVID-19. After the outbreak of the COVID-19 pandemic, neurologic surveillance platforms were implemented to characterize the complications of COVID-19. Surveillance platforms are invaluable in providing timely data, informing clinical practice, and directing future research. Lessons learned from recent neurologic surveillance networks include the importance of global and cross-specialty collaboration. It is critical for future surveillance systems to consider these aspects, as it will also serve to improve representation of low and middle-income countries (LMICs) and communities. Trainees played a critical role in the success of neurologic surveillance networks; as frontline health care workers, they were able to provide timely data collection, and their fresh insights are important for future pandemic surveillance system development. In this article, we review the methods of recent neurologic surveillance networks and discuss their strengths and limitations. We explore the outlook for pandemic surveillance platforms and the crucial role global collaboration plays in ensuring that LMICs are represented. We review the role of trainees in pandemic surveillance networks and discuss how it is vital to encourage their continued involvement to ensure that, as future health care leaders, they are prepared to manage future pandemics effectively.
2. Elevated risk of infectious diseases in adulthood after prenatal or early postnatal exposure to the Great Chinese Famine.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Dec-02 链接: PubMed
摘要
Although prenatal exposure to famine is known to increase the risk of various noncommunicable conditions, its effects on infectious diseases remain poorly understood. We examined the effect of prenatal exposure to the Great Chinese Famine on risks for 11 notifiable infectious diseases in two consecutive generations through the analysis of >4.4 million surveillance records in Sichuan Province, China. Using an approach combining cohort models with counterfactual effect imputation, we estimated the ratio of observed to expected incidence rates (incidence rate ratio, IRR) in the absence of famine among both the directly affected birth cohort (F1) and their possible offspring (F2). We further examined whether there was a dose-response relationship between famine severity and infectious disease outcomes using meta-regression at the prefecture level. We found that the risk of acquiring any of the 11 infectious diseases studied increased significantly among both the F1 (IRR: 1.13, 95% CI: 1.04 to 1.21) and the F2 cohort (IRR: 1.08, 95% CI: 1.00 to 1.15). IRRs for the F1 generation were higher in prefectures that experienced more severe famine, with one interquartile range increase in famine severity associated with a 3.95% (95% CI: 1.87 to 6.05%) increase in F1 IRR. Positive associations of varying magnitudes were estimated between increased risks in the F1 cohort and famine intensity for most individual diseases. Prenatal exposure to famine may have long-term and potential intergenerational impacts on the risk of a broad range of infectious diseases. Ensuring adequate prenatal nutrition may be crucial in reducing the burden of infectious diseases across generations.
3. Neuroplastin-55 is a receptor of Manf and protects against diet-induced obesity by promoting adipose browning.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Dec-02 链接: PubMed
摘要
The browning of white adipose tissue (WAT) enhances thermogenesis and holds great potential in obesity treatment. Membrane receptors have been proven as essential factors during WAT browning. In this study, we found that transmembrane receptor neuroplastin-55 (Np55) was markedly upregulated in the adipose tissue of both obese individuals and mice. Fat-specific Np55 knockout (Np55FKO) sensitized mice to high-fat diet-induced obesity and metabolic disorders, which was attributed to impaired energy expenditure and WAT browning. We identified that mesencephalic astrocyte-derived neurotrophic factor (Manf) acts as a ligand for Np55 with high binding affinity. Mechanistically, Np55 forms a complex with tumor necrosis factor receptor associated factor-2 (TRAF2) and apoptosis signal-regulating kinase 1 (ASK1) to activate p38 mitogen-activated protein kinase (MAPK) signaling pathway and conduct WAT browning after Manf stimulation. Additionally, we identified a single-nucleotide polymorphism (rs2470738600) in Manf compromised the binding affinity to Np55 and thermogenic capacity. Finally, we showed that Np55 is indispensable for Manf-induced thermogenesis and weight loss in obese mice. Our results underscore the pivotal role of Np55 as a receptor of Manf in maintaining metabolic homeostasis, highlighting its potential as a therapeutic target for obesity and related disorders.
4. The impacts of European arrival on Australian dingoes.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Dec-02 链接: PubMed
摘要
The European colonial expansion had dramatic consequences on both Indigenous Peoples and local fauna. In Australia, the degree to which the arrival of Europeans and their dogs impacted the ecology and ancestry of dingoes is contentious. To test for gene flow with European dogs, we sequenced genomes of 18 ancient Australian dingoes from the Nullarbor Plain, two early 20th-century New Guinean dingoes, a mid-19th-century kangaroo hound, and 33 contemporary dingoes from across Australia. To quantify dietary shifts after the arrival of the First Fleet (AD1788), we generated stable isotopic (δ13C, δ15N) data for 55 directly dated ancient Australian dingoes spanning the last ~2,300 y. We show that the diet of Nullarbor Plain dingoes shifted soon after European arrival, possibly due to shifts in prey abundance. Our genomic analyses demonstrated that pre-European dingoes were more inbred than most contemporary dog breeds, possibly as a result of population bottlenecks. We also showed that many dingoes, particularly those from Southeast Australia, experienced admixture with European dogs. Although we detected European ancestry dating to the early 18th-century, the majority of gene flow events coincided with the initiation of landscape-scale population control in the 1960s. Furthermore, some European dog alleles may have provided adaptive benefits to dingoes and alleviated inbreeding depression. Despite the existence of gene flow with European dogs, dingoes have maintained their distinctiveness. This suggests that management strategies should prioritize maintenance of substantial population sizes across Australia to both facilitate effective purifying and positive selection on introgressed alleles, and mitigate inbreeding.
5. Mating system of free-ranging domestic dogs and its consequences for dog evolution.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Dec-02 链接: PubMed
摘要
The polygamous mating system of free-ranging domestic dogs (FRDs) contrasts with the social monogamy typical of gray wolves and all other wild canids. The transition to polygamy in dogs could have been initiated by a shift from apex predator to human commensal during the early domestication stages. Here, we test this hypothesis by investigating the characteristics of the FRD mating system that could have been important for domestication. This inference is based on genome-wide Single Nucleotide Polymorphism (SNP) data from three geographically distinct populations, including behavioral data for one of them. The reconstructed genealogies form a wide network of kinship relationships resulting from the frequent occurrence of maternal and paternal half-siblings, reflecting male and female polygamy. Reproductive success is positively correlated with the strength of social interactions and the number of connections with opposite-sex individuals, implying a preference toward familiar mates and the importance of social relationships in determining mating patterns. This is supported by a nonrandom distribution of reproductive partners and a reproductive skew in males and females. Multiple paternity within litters points to female polygamy within a single estrus, and sexual size dimorphism implies sexual selection favoring larger males. Physiological changes resulting from polygamy, including increased male fertility and reduced breeding seasonality, could have facilitated the natural spread of novel adaptive traits and limited the introgression from wolves. The change in reproductive patterns, typically considered a consequence of selective breeding, could instead have occurred naturally in response to the dietary niche change, triggering further changes that facilitated the domestication process.
6. Construction of a deep learning model and identification of BSG, PPARD, and SLC16A8 expression as potential indicators in the context of strategies for precision therapy to acute myeloid leukemia.
期刊: Hematology (Amsterdam, Netherlands) 发表日期: 2025-Dec 链接: PubMed
摘要
Acute myeloid leukemia (AML) exhibits significant heterogeneity and aggressiveness. This study aimed to investigate T cell heterogeneity in the AML tumor microenvironment using single-cell RNA sequencing (scRNA-seq) and identify potential biomarkers for prognosis and precision therapy. scRNA-seq data from AML patient samples were analyzed to identify T cell subsets. A prognostic risk model was constructed using random forest and LASSO regression analyses based on key genes derived from a specific T cell cluster (Cluster 4). The model’s predictive performance was validated using external datasets. Analysis revealed significant functional heterogeneity among T cell subsets. Cluster 4 T cells showed distinct gene set activities related to immune regulation. Three genes - BSG, PPARD, and SLC16A8 - were identified as independent prognostic factors. The risk model effectively stratified patients into high-risk and low-risk groups, with the high-risk group demonstrating significantly poorer survival outcomes. The model showed robust predictive accuracy, with areas under the ROC curve of 0.78, 0.86, and 0.86 for 1-, 3-, and 5-year survival, respectively. This study highlights the functional diversity of T cells in AML and identifies BSG, PPARD, and SLC16A8 as promising biomarkers for prognostic stratification. The developed risk model provides a valuable tool for guiding personalized treatment strategies in AML.
7. Primary healthcare providers' knowledge, attitudes, and practices regarding cancer screening recommendation and referral in Georgia, 2023.
期刊: The European journal of general practice 发表日期: 2025-Dec 链接: PubMed
摘要
Cancer screening uptake in Georgia is only 13%. We aimed to assess cancer screening recommendations and referral practices among primary health care providers (PHC) and factors associated with these practices. We conducted a cross-sectional survey of 2,958 doctors and nurses in PHC in November 2023, using descriptive, bivariate, and multivariate analyses to assess the association between provider characteristics, system-level factors, and practices in recommending and referring for cancer screening. Respondents were predominantly female (95%), mean age of 57.5 years, family doctors (56%), with >20 years’ work experience (60%) and rural practice (67%). Almost all (98%) reported actively recommending and referring patients for cancer screening; however, 64.7% did so for only 1-5 patients per week, while 12% reported none. Predictors of higher recommendation and referral rates (≥6 patients per week) included being a family doctor (AOR 1.36; 95% CI: 1.11-1.67; p = 0.003), working in the capital city - Tbilisi (AOR 1.36; 95% CI: 1.14-1.95; p = 0.003), receiving comprehensive cancer screening training (AOR 1.49; 95% CI: 1.04-1.68; p = 0.024), reporting adequate infrastructure (AOR 1.39; 95% CI: 1.07-1.81; p = 0.015), reporting proper public promotion (AOR 1.41; 95% CI: 1.12-1.78; p = 0.003), and perceiving screening as part of their role (AOR 1.87; 95% CI: 1.52-2.30; p < 0.001). Despite strong belief in cancer screening, recommendation and referral rates remain low, underscoring the urgent need for policy reforms to enhance education, raise awareness, and improve infrastructure for effective cancer screening initiatives.
8. Effect of Nonmedical Cannabis Legalization and Exposure to Retail Stores on Cannabis Harms : A Quasi-experimental Study.
期刊: Annals of internal medicine 发表日期: 2025-Nov-25 链接: PubMed
摘要
In 2018, Canada became the second country to legalize nonmedical cannabis and the first to allow a commercial retail market. Limiting the density of stores selling other legal substances is associated with reductions in use and harms; however, similar associations for cannabis are not well established. To examine the association between exposure to cannabis retail stores and cannabis-related harms. Population-based natural experiment examining cannabis-attributable emergency department (ED) visits between 2017 and 2022. Ontario, Canada. 10 574 neighborhoods containing 6 140 595 persons aged 15 to 105 years. The opening of all cannabis stores in Ontario was tracked to identify neighborhoods that became exposed (cannabis store within 1000 m) over time. Absolute and relative changes in rates of cannabis-attributable ED visits were compared in neighborhoods after they became exposed with matched neighborhoods that remained unexposed. Cannabis-attributable ED visits were increasing over time before retail store openings. In neighborhoods that became exposed to a cannabis store, the rate of cannabis-attributable ED visits remained constant after stores opened. In contrast, in matched unexposed neighborhoods, the rate of ED visits decreased. Collectively, neighborhoods that were exposed to retail stores had a monthly increase of 1.30 cannabis-attributable ED visits per 100 000 persons (95% CI, 0.51 to 2.09; P < 0.001) compared with unexposed neighborhoods, which was equivalent to a 12% (CI, 6% to 19%) relative increase in the monthly rate of visits. Findings may be influenced by unmeasured confounding between exposed and unexposed neighborhoods. Findings suggest that prohibiting stores in certain areas, limiting store density, or placing restrictions on the overall number of stores may offer public health benefits in countries pursuing legalization. Canadian Institutes of Health Research.
9. Diving Deeper: Understanding What Is Effective About Advance Care Planning.
期刊: Annals of internal medicine 发表日期: 2025-Nov-25 链接: PubMed
摘要
10. Principles of Managed Care: A Position Paper From the American College of Physicians.
期刊: Annals of internal medicine 发表日期: 2025-Nov-25 链接: PubMed
摘要
Most U.S. health plans use managed care strategies, including health care use management and clinician networks. Most Medicare, Medicaid, and commercial insurance enrollees are covered by managed care plans. Managed care is ostensibly used to steer patients toward high-quality clinicians and facilities and contain costs; however, prior authorization, narrow clinician networks, and other managed care strategies often restrict access to necessary care, causing frustration among patients and physicians. In this position paper, the American College of Physicians offers policy recommendations to protect patients from onerous managed care processes, reduce administrative burdens associated with managed care, and ensure that patients can promptly access high-value, medically necessary care.
11. Rapid decline of SARS-CoV-2-specific salivary IgA antibody levels in people with hybrid immunity-data from the STOPCoV study.
期刊: ImmunoHorizons 发表日期: 2025-Nov-24 链接: PubMed
摘要
Hybrid immune individuals who experience an infection after a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine series show evidence of salivary anti-spike and anti-receptor binding domain (RBD) IgA antibodies with broad specificity against different variants. It is unclear how long these antibodies persist and whether they offer protection against new SARS-CoV-2 infections. We compared salivary IgA levels to full-length spike protein and its RBD of the ancestral Wuhan SARS-CoV-2 virus and the Omicron BA.1 variant in a subset of persons participating in a longitudinal study of binding antibody responses to vaccination. We assessed the decay rate of the salivary IgA antibodies in those with hybrid immunity. In our heavily vaccinated population, low levels of salivary IgA to RBD and spike was variably detected in vaccine-only immunity to both Wuhan and Omicron BA.1, but antibody levels were an order of magnitude higher in those with hybrid immunity. In hybrid immune individuals, anti-spike/RBD salivary IgA rapidly decayed over a 4-month observation period. In a multivariate analysis, salivary IgA antibody to Omicron BA.1 was not associated with protection from a new SARS-CoV-2 infection over the subsequent 10 months during the Omicron XBB.1.5, EG.5, and JN waves of infection. In contrast, receipt of a new vaccine dose was significantly associated with protection.
12. Individuals with latent tuberculosis infection display pulmonary airway enrichment and recall recruitment of CD4+ TRM with protective functional phenotypes.
期刊: ImmunoHorizons 发表日期: 2025-Nov-24 链接: PubMed
摘要
Tuberculosis (TB) remains a worldwide public health threat, in part because of the limited efficacy of current BCG vaccination. Respiratory infection with Mycobacterium tuberculosis (Mtb) is most often followed by the development of protective immunity that contains the pathogen, resulting in latent tuberculosis infection (LTBI). We previously introduced bronchoscopic challenge of LTBI individuals using instillation of purified protein derivative (PPD) of Mtb to model specific induced local recall responses in the human lung. Here, we examined phenotypic and functional aspects of human airway CD4+ T cell populations in LTBI that correlate with protection from Mtb in animal infection models. Baseline bronchoalveolar lavage (BAL) was enriched for CD4+ T cells expressing the KLRG-/CD69+ tissue resident-memory (TRM) phenotype. Both Th1 (CCR6-CCR4-CXCR3+) and Th1* (CCR6+CCR4-CXCR3+) CD4+ T cell subsets demonstrated polyfunctional IFN-γ+TNF-α+ cytokine responses in response to in vitro PPD stimulation. Bronchoscopic PPD challenge, although leading to less robust cellular recruitment than observed previously, preserved the predominance of KLRG1-CD69+ TRM and also of CD4+ T cells that displayed IFN-γ+TNF-α+ dual cytokine production in response to PPD. CD4+ T cells of both control and PPD challenged human lung segments displayed increased expression of the protective CD153 molecule; CD153 expression also correlated with increased cytokine polyfunctionality, particularly of polyfunctional IFN-γ+IL-2+TNF-α+ and IFN-γ+TNF-α+ dual-positive cells. These results support the utility of BAL studies in LTBI to model human correlates of protection from Mtb with potential applicability to the design and initial evaluation of novel approaches to TB vaccination.
13. CD4 and CD8 T-cell response is dominated by IL-10-secreting cells in children with uncomplicated Plasmodium falciparum malaria.
期刊: ImmunoHorizons 发表日期: 2025-Nov-24 链接: PubMed
摘要
Plasmodium falciparum malaria and Epstein-Barr virus (EBV) coinfections have been associated with an increased risk of developing the EBV-associated cancer endemic Burkitt lymphoma (eBL). In children living in malaria-endemic areas, repeated episodes of malaria may alter the immune system’s ability to suppress EBV, creating a permissive environment for eBL pathogenesis. However, the malaria-driven mechanisms involved remain undefined, including whether malaria-induced immune alterations are EBV-specific or systemic. To identify whether acute clinical P. falciparum malaria affects EBV T-cell immunity, we characterized T-cell activation status and cytokine secretion profiles using flow cytometry. We compared profiles in 10 Kenyan children with acute clinical P. falciparum malaria at baseline and matched 4-week recovery, and 10 healthy community controls following antigenic stimulation with EBV- and cytomegalovirus-specific peptides. The percentage frequency of activation-induced marker cells was comparable within the study cohort across the different stimulations. Furthermore, we observed a shift in cytokine secretion in children with acute malaria during active disease and at 4 weeks postrecovery, favoring IL-10 for both T-cell subsets. Our findings suggest that clinical malaria did not result in the impairment of T-cell activation, but rather induced shifts in cytokine secretion in favor of IL-10. We further demonstrate that malaria-induced T-cell immune alterations are not EBV-specific but rather affect overall immune suppression.
14. Polymorphisms in FCN genes and their influence on systemic lupus erythematosus susceptibility: a report from Western India.
期刊: ImmunoHorizons 发表日期: 2025-Nov-24 链接: PubMed
摘要
Ficolins, encoded by FCN genes, are key pattern recognition molecules of the lectin complement pathway involved in immune complex clearance, a process often impaired in systemic lupus erythematosus (SLE). Genetic polymorphisms in FCN genes may influence disease susceptibility. However, their functional significance in SLE remains unclear. The present study aimed to investigate the association of selected FCN gene single-nucleotide polymorphisms (SNPs) with SLE, lupus nephritis (LN), and serum ficolin levels in a Western Indian cohort. Seven SNPs in FCN1 (rs2989727, rs1071583), FCN2 (rs7851696, rs17549193, rs7865453, rs17514136), and FCN3 (rs3813800) were genotyped in 200 SLE patients and 200 healthy controls using polymerase chain reaction (PCR) sequence-specific primer and PCR restriction fragment length polymorphism. Serum ficolin-1, -2, and -3 levels were measured using ELISA. Statistical analysis included χ2 test, Kruskal-Wallis test, and logistic regression to assess associations and calculate odds ratios with 95% confidence intervals. The analysis identified significant associations of FCN2 rs7851696, rs7865453, and rs17514136, as well as FCN3 rs3813800, with SLE susceptibility. Among LN patients, FCN1 rs2989727 and rs1071583, FCN2 rs17514136, and FCN3 rs3813800 showed significant associations. FCN3 rs3813800 was significantly associated with ficolin-3 levels, while FCN2 rs7865453 was associated with complement component 1q-circulation immune complex levels. These findings provide novel insight into associations of FCN gene polymorphisms with SLE and LN susceptibility, with genotype-phenotype correlations suggesting their biological relevance. Future longitudinal and mechanistic studies are warranted to validate these associations and explore their therapeutic potential.
15. Male infertility and risk of cardiometabolic conditions: a population-based cohort study.
期刊: Human reproduction (Oxford, England) 发表日期: 2025-Nov-24 链接: PubMed
摘要
Is male infertility independently associated with an increased risk of incident hypertension, ischemic and non-ischemic heart disease, diabetes, and/or cerebrovascular disease? Fathers diagnosed with male infertility have a modestly increased risk of heart disease, diabetes, and hypertension compared with fertile fathers, after controlling for measured confounders; however, some important confounders remain inadequately measured. Cohort studies suggest that infertile men have an increased risk of incident cardiometabolic diseases, including diabetes, hypertension, heart disease, and cerebrovascular disease, although findings are mixed. The reasons for this association are unclear, but cardiometabolic conditions and male infertility share a wide range of shared etiological factors including age, chronic conditions such as obesity and obstructive sleep apnea, cancers and their treatments, environmental exposures such as pollution and pesticides, lifestyle factors such as smoking and cardiorespiratory fitness, autoimmune conditions such as lupus and Hashimoto’s thyroiditis, as well as congenital conditions such as cystic fibrosis and muscular dystrophy. Our population-based cohort study included 445 909 men whose partner conceived a child between January 2009 and September 2016 in New South Wales (NSW), Australia. We excluded men with a diagnosis of infertility prior to 2009, men who were under the age of 14 at the time of the child’s conception, and men diagnosed with cardiometabolic conditions in the 6.5 years prior to their index date. The index date was the later of the date of the child’s conception or the date of the vasectomy for fertile men or the date of diagnosis of infertility for infertile men, i.e. the time when the exposure status was determined. From the index date, we followed participants for 5 years up until the latest available date of September 2021. The study was conducted in NSW, Australia. We determined infertility status by a diagnosis of male infertility in the Australian and New Zealand Assisted Reproduction Database, hospital records, or a record of fertility-related procedures. We assessed the following outcomes: incident hypertension, ischemic and non-ischemic heart disease, all heart disease, diabetes, and cerebrovascular disease. We calculated age-standardized prevalence rates at baseline. We mapped potential confounding pathways using directed acyclic graphs and controlled for measured confounders using inverse probability of treatment weighting and g-computation. We estimated adjusted marginal risk ratios (aRR) and adjusted marginal risk differences (aRD) using robust Poisson regression. The number of events and 5-year crude incidence rate for the outcomes were: hypertension (events: 17 433, fertile: 41.09 per 1000 population, infertile: 70.03 per 1000 population), all heart disease (events: 15 549, fertile: 36.44 per 1000 population, infertile: 59.88 per 1000 population), ischemic heart disease (events: 12 628 fertile: 29.24 per 1000 population, infertile: 47.1 per 1000 population), non-ischemic heart disease (events: 5183, fertile: 11.69 per 1000 population, infertile: 20.24 per 1000 population), cerebrovascular disease (events: 512, fertile: 1.14 per 1000 population, infertile: 1.78 per 1000 population) and diabetes (events: 7064, fertile: 16.05 per 1000 population, infertile: 27.59 per 1000 population). Compared with fertile men, men diagnosed with infertility demonstrated increased risk of incident disease for: hypertension aRR = 1.20 (95% CI 1.11-1.31, P < 0.001), aRD = 1.1% (95% CI: 0.6%-1.6%, P < 0.001); all heart disease aRR = 1.20 (95% CI 1.09-1.31, P < 0.001), aRD =0.9% (95% CI: 0.4%-1.4%, P < 0.001); non-ischemic heart disease aRR = 1.26 (95% CI 1.08-1.48, P = 0.004), aRD = 0.4% (95% CI: 0.1%-0.7%, P = 0.009); ischemic heart disease aRR = 1.13 (95% CI 1.02-1.25, P = 0.020), aRD = 0.4% (95% CI: 0.1%-0.7%, P = 0.028); and diabetes aRR = 1.28 (95% CI 1.12-1.46, P < 0.001), aRD 0.6% (0.2%-0.9%, P = 0.001). There was no significant difference in the incidence of cerebrovascular disease, aRR = 1.0 (95% CI 0.56-1.80, P = 0.996), aRD = 0.0% (95% CI: -0.1% to 0.1%, P = 0.996). These results remained consistent in sensitivity analyses, including an expanded exposure definition of infertility, a 10-year follow-up period, changing the outcomes of people who died in follow-up, and using an alternative index date. The cohort includes men who fathered a child, so men who did not seek to, or were unable to, have a child, and men with poor access to the reproductive healthcare may not be included. This may generate selection effects, biasing the estimates toward the null. We were unable to adequately control for several confounders, including important lifestyle factors like smoking, diet, cardiorespiratory fitness, and alcohol intake, due to data limitations, which may bias estimates away from the null. It appears plausible that a combination of unmeasured and inadequately measured confounders may attenuate the observed estimates. These findings suggest that male infertility may serve as an early indicator for a slightly heightened cardiometabolic risk, specifically relating to hypertension, diabetes, and various forms of heart disease. Our study is the largest on this topic, with extensive control for confounders. Our findings align with published research, indicating that men diagnosed with infertility have a slightly higher risk of incident diabetes, hypertension, and heart disease. From a public health perspective, fertility treatment may be an opportunity for earlier detection and intervention to help prevent the onset of cardiometabolic conditions in men diagnosed with infertility, particularly given that men generally have low rates of contact with the health system. The PhD candidacy of J.M. is supported by Medical Research Future Fund (MRFF) Emerging Priorities and Consumer Driven Research initiative: EPCD000007, 2020. M.K.O’B. and G.M.C. declare receiving payment to their institution by the same MRFF grant. G.M.C. reports receiving funding from an Australian MRFF grant paid to UNSW to support this work, and J.M. reports receiving PhD funding from the same MRFF grant. C.V. declares an unpaid role on Human Reproduction’s Editorial Board, and paid employment at the University of New South Wales (UNSW) until January 2023. The National Perinatal Epidemiology and Statistics Unit (NPESU), which belongs to UNSW, is custodian of the Australian and New Zealand Assisted Reproduction Database (ANZARD). Data from ANZARD were used in this study. G.M.C. also declares paid employment from UNSW. The remaining authors have nothing to declare. N/A.
16. Associations Between Hearing Loss and Depressive Symptom Trajectories in Middle-Aged and Older People in China: Retrospective Analysis.
期刊: JMIR aging 发表日期: 2025-Nov-24 链接: PubMed
摘要
Hearing loss and depression are important health issues among the middle-aged and older population. This study aimed to investigate the associations between hearing loss and depressive symptom trajectories in the Chinese middle-aged and older adult population. The survey data of 2011, 2013, 2015, and 2018 waves collected in the China Health and Retirement Longitudinal Study were used for analysis. The latent growth mixture modeling approach was used to explore the trajectories of depressive symptoms. Hearing loss was identified through self-reporting, and depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression scale. The associations between hearing loss and depressive symptom trajectories were examined using logistic regression models. A total of 4768 participants without depressive symptoms at baseline were included for analysis. Among them, 4 depressive symptom trajectories, including “stable low symptoms” (n=3656, 76.68%), “slowly progressing symptoms” (n=503, 10.55%), “relieved symptoms after progression” (n=467, 9.79%), and “rapidly progressing symptoms” (n=142, 2.98%) were identified. Hearing loss was found to be significantly associated with the trajectory of “rapidly progressing symptoms.” The trajectories of depressive symptoms in middle-aged and older people have 4 types with distinct patterns. Hearing loss is associated with the progression of depressive symptoms, and its impact is more significant for males, affecting not only symptom severity but also progression speed. These findings indicate that the mental health status of middle-aged and older people with hearing loss requires careful consideration, and timely interventions should be provided.
17. Barriers to Wellness Among General Surgery Residents During the COVID-19 Pandemic: Qualitative Analysis of Survey Responses.
期刊: JMIR perioperative medicine 发表日期: 2025-Nov-24 链接: PubMed
摘要
Health care provider burnout worsened during the COVID-19 pandemic. This qualitative study described general surgery residents’ perceptions of burnout and the impact of the COVID-19 pandemic and their attitudes toward wellness initiatives. General surgery residents at a large training program in Canada completed a 21-item survey focused on self-reported burnout, mental health, perceptions of wellness resources, and the effects of the COVID-19 pandemic. Free-text responses were extracted for qualitative thematic content analysis. A coding framework was established, and emergent themes were identified. A total of 62% (51/82) of the residents completed the survey. Most respondents were senior residents (21/51, 41%) and identified as male (32/51, 63%). In total, 65% (33/51) of the residents met the criteria for burnout. Three themes were identified: (1) the culture of general surgery does not promote wellness, (2) the COVID-19 pandemic worsened existing access to vacation days and rest, and (3) wellness education in general surgery is ineffective and onerous to complete. General surgery residents emphasized the rigid lifestyle and culture of the specialty. Residents said that the idea of wellness was poorly executed. COVID-19 protocols increased the acceptance of taking sick days, but this was offset by staff shortages during the pandemic. Finally, residents emphasized the inefficacy of wellness education. They felt that they did not lack knowledge on reaching wellness but simply lacked the adequate time and resources to improve their well-being. There are persistent concerns within the culture of general surgery that were further impacted by workload and stress during the pandemic. These results may inform future programmatic efforts to decrease resident burnout.
18. Predictors of Successful Neoadjuvant Chemotherapy and Interval Cytoreductive Surgery in Management of Ovarian Cancer.
期刊: JCO oncology practice 发表日期: 2025-Nov-24 链接: PubMed
摘要
In patients with ovarian cancer undergoing neoadjuvant chemotherapy (NACT) with the goal of achieving complete interval cytoreductive surgery (ICS), tools are needed to accurately assess NACT efficacy and predict the feasibility of complete ICS after 3-4 cycles. The GINECO group (France) and Gemelli Hospital (Italy) analyzed two independent data sets to evaluate the predictive values of three tools available in routine. Data from CHIVA randomized phase II trial (ClinicalTrials.gov identifier: NCT01583322) and Policlinico Gemelli real-world registry (ID5936-ProtN45) were used to construct the French (N = 185) and Italian data sets (N = 357). Logistic regression models were used to identify the significant predictors-among modeled CA-125 Elimination Rate Constant K (KELIM); radiologic response; and BRCA/homologous recombination deficiency (HRD) status-of the following key indicators of successful ICS after NACT: (1) a low peritoneal carcinomatosis burden (Peritoneal Carcinomatosis Index [PCI]/Predictive Index Value [PIV]); (2) a complete CC0-R0 ICS); and (3) a pathologic Chemotherapy Response Score of 3 (CRS3). In both French and Italian data sets, a favorable KELIM score ≥1.0 was reproducibly a predictor of higher probability of low PCI/PIV (odds ratios [OR], 2.92-4.19); CC0-R0 ICS (OR, 3.66-4.24); and pathologic CRS3 (OR, 2.36-21.44). An objective radiologic response was inconsistently associated with a lower PCI/PIV (OR, 1.78-3.69) and a CC0-R0 ICS (OR, 1.78-5.20). The BRCA/HRD status was not predictive of NACT efficacy. The proportion of patients achieving a CRS3 response was similar regardless of BRCA/HRD status. In two data sets, the tumor chemosensitivity assessed by the KELIM (online calculator)29 was a consistent significant predictor of three critical outcomes associated with successful ICS after NACT. The radiologic response was inconsistently associated with lower disease bulk. The BRCA/HRD status was not predictive of NACT efficacy. These outcomes may inform decisions and future chemosensitizing innovative strategies.
19. Use of an Integrated Knowledge Translation Approach to Develop an Electronic Patient-Reported Outcome System for Cancer Rehabilitation: Tutorial.
期刊: JMIR cancer 发表日期: 2025-Nov-24 链接: PubMed
摘要
Electronic prospective surveillance models (ePSMs) have the potential to improve the management of cancer-related impairments by systematically screening patients using electronic patient-reported outcomes during and after treatment, and linking them to tailored self-management resources and rehabilitation programs. However, their successful implementation into routine care requires careful consideration of patient and provider needs and must align with clinical workflows, which may vary across settings and require adaptation to the local context. The aim of this paper is to describe the development of REACH, a web-based ePSM designed to remotely screen for physical cancer-related impairments and direct patients to rehabilitation resources based on need. The development of REACH followed an integrated knowledge translation (iKT) approach, engaging key knowledge users including patients, clinicians, administrators, and information technology specialists. The development process involved collaboration across 5 working groups. The system content and logic group selected the impairments to be screened, measures used, frequency of screening, and resources recommended based on results of a survey with oncology providers and researchers, patient feedback, a literature review, and an environmental scan. The machine learning group explored predictive modeling approaches to optimize the assessment frequency using retrospective patient data. The implementation group identified features from existing systems that could be built to promote assessment completion and integration into clinical workflows through a scoping review, interviews with clinic staff, and focus groups with patients. The design group conducted co-design workshops and usability testing with patients to iteratively refine the interface and develop a prototype. Finally, the software development group converted the prototype to a web-based application and conducted privacy and security assessments and quality assurance. The integration of key knowledge users through an iKT approach played a critical role in determining the design and functionality of REACH. REACH allows patients to remotely complete assessments tailored to their cancer type and treatment status on any electronic device. The system generates automated advice based on the assessment responses, including links to educational resources for self-management, suggestions for community programs to register for, and recommendations to contact their oncology team for further assessment and possible referral to rehabilitation services. These recommended resources are stored in the patient’s personalized library, organized by type and severity of cancer-related impairments reported, and are updated following each new electronic patient-reported outcomes assessment completed. Additional key system features include a patient-driven and structured process for managing high impairment scores, usability enhancements to improve navigation, and safeguards to ensure data security. The development of REACH demonstrates how an iKT approach can be used to design an ePSM that is user-friendly, clinically relevant, and aligned with implementation considerations. The system has been implemented at 4 Canadian cancer centers, and its implementation is being evaluated to inform future refinements.
20. Elevated Depression Symptoms, Elevated Anxiety Symptoms, and Frequent Loneliness Among US Adults With Children in Their Household: A Cross-Sectional Analysis of National Survey Data.
期刊: American journal of health promotion : AJHP 发表日期: 2025-Nov-24 链接: PubMed
摘要
PurposeTo examine demographic, socioeconomic, and family characteristics associated with elevated depression and anxiety symptoms and frequent loneliness among US adults with children.DesignCross-sectional survey.SettingUS Census Household Pulse Survey (July-September 2024).SubjectsUS adults with 1 or more children (0-17 years) in their household (N = 31 063, representing approximately 87 million US adults with children).MeasuresParticipants completed the Patient Health Questionnaire for Depression and Anxiety (PHQ-4); scores of 3+ out of 6 indicated elevated depression and anxiety symptoms, respectively. Participants reported how often they feel lonely. Frequent loneliness was indicated by responses of “always” or “usually” (versus “sometimes”, “rarely”, or “never”). Participants reported several demographic, socioeconomic, and family characteristics.AnalysisWe used unadjusted logistic regression models to compare the proportion of US adults with children experiencing elevated depression symptoms, elevated anxiety symptoms, or frequent loneliness by demographic, socioeconomic, and family characteristics. Analyses were weighted to represent US adults living with children.ResultsAmong US adults with children, 14.2% (SE: 0.4%) reported elevated depression symptoms, 19.2% (SE: 0.5%) reported elevated anxiety symptoms, and 13.5% (SE: 0.4%) reported usually or always feeling lonely; prevalences differed by several demographic, socioeconomic, and family characteristics.ConclusionsCollecting nationally-representative data about families is critical to inform efforts to support the mental and physical health of US parents and other adults who care for children.
21. Unveiling Environmental and Economic Drivers of Pollution-Related Mortality in Sub-Saharan Africa: Evidence from Panel QARDL and LightGBM Analyses.
期刊: Integrated environmental assessment and management 发表日期: 2025-Nov-24 链接: PubMed
摘要
This study investigates the environmental and economic factors driving pollution-related mortality in 37 Sub-Saharan African countries from 1990 to 2022. The analysis combines two complementary approaches. The first is a Panel Panel Quantile Autoregressive Distributed Lag (QARDL) model, which captures both short- and long-run relationships across different levels of the mortality distribution. The second is a Light Gradient Boosting Machine (LightGBM) model, a machine-learning method that detects nonlinear patterns and reveals interactions that may be missed by traditional statistical models. Together, these methods integrate structured econometric inference with flexible pattern recognition, offering a clearer and more reliable picture of how environmental and economic forces jointly shape mortality outcomes. The LightGBM partial dependence plots further confirm the Panel QARDL results, showing consistent directional effects across all variables. Fine particulate matter and consumer price index display the strongest nonlinear responses, while methane, health expenditures and Gross Domestic Product exhibit moderate but coherent patterns that reinforce the robustness of the findings. The results show that higher levels of fine particulate matter are consistently linked to increased mortality across all quantiles. Economic growth reduces mortality at higher quantiles of the distribution, where health burdens are most severe, indicating that stronger economies are better able to mitigate pollution-related deaths. Inflation exhibits a positive relationship with mortality, particularly at higher quantiles, indicating that rising prices can limit access to essential health services and increase vulnerability. Health spending, in contrast, reduces mortality, though its impact varies by both time horizon and income level. Overall, the findings highlight the importance of cleaner air, stable prices and stronger healthcare systems for reducing pollution-related mortality in Sub-Saharan Africa. The study provides policy-relevant insights for promoting health resilience under economic and environmental stress.
22. Impact of Hydrocodone Rescheduling on Pharmaceutical Pain Management in End-of-Life Lung Cancer Patients.
期刊: Journal of palliative care 发表日期: 2025-Nov-24 链接: PubMed
摘要
ObjectiveLung cancer is the leading cause of cancer mortality in the USA, and terminal patients endure severe pain. In October 2014, hydrocodone was rescheduled from Schedule III to Schedule II to curb misuse, yet its specific impact on end-of-life lung cancer pain management remains unclear. The objective of this study is to evaluate the impact of hydrocodone rescheduling on pharmaceutical pain management among end-of-life lung cancer patients in the USA.MethodsWe conducted a retrospective study using SEER-Medicare data including 24,804 patients aged ≥66 with stage IV lung cancer who died between 2011 and 2019. We examined hydrocodone, opioid, NSAID, and antidepressant use in the last three months of life and used multivariable logistic and OLS regression to assess the effects of hydrocodone rescheduling and time trends, adjusting for demographic and clinical factors.ResultsHydrocodone was used by 47.5% of patients and any opioids by 75.4%. Although the hydrocodone rescheduling showed a nonsignificant immediate reduction in use (AOR = 0.92, p = .0795) and dosages (estimate = -1.78 MME, p = .358), significant declining trends were observed over time for hydrocodone (AOR = 0.92 per 12 months, p < .001; -1.15 MME per 12 months, p = .003) and overall opioids (AOR = 0.94 per 12 months, p < .001; -2.44 MME per 12 months, p = .002). NSAIDs and antidepressants use remained stable.ConclusionOur study is the first to examine hydrocodone rescheduling’s impact on pain management in end-of-life lung cancer care. While no immediate significant changes were observed, the overall decline in opioid use over time reflects broader clinical and regulatory shifts, highlighting the need for balanced, multimodal pain management strategies.
23. Evaluating Causal and Noncausal Text Messages to Promote Physical Activity in Adults: Randomized Pilot Study.
期刊: JMIR formative research 发表日期: 2025-Nov-24 链接: PubMed
摘要
Physical inactivity increases the risk of chronic disease and reduces life expectancy, yet adherence to physical activity (PA) guidelines remains low. SMS text messages are promising for promoting PA, but it is not clear what type of messaging is most effective. Messages with causal information, which explain why a recommendation is being made, may be more persuasive than messages containing only recommendations. This study aims to compare the effectiveness of causal versus noncausal SMS text messages for promoting PA in US adults. In this pilot study, we randomized US adults (n=28 in the analytic sample) aged 18-64 years to receive causal or noncausal SMS text messages roughly every other day for 2 weeks, following a 1-week baseline. PA was measured using Empatica wristbands during intervention and baseline periods, and the International Physical Activity Questionnaire - Short Form (IPAQ-SF) at baseline, postintervention, and 4 weeks later. The primary outcome was the change in mean metabolic equivalent of tasks (METs) per minute from baseline to intervention. The secondary outcomes were (1) PA differences on intervention and nonintervention days (mean METs/min), (2) changes in self-reported METs per week between surveyed periods, and (3) participant satisfaction. We used a linear mixed model to analyze our primary outcome, the Mann-Whitney U test and the chi-square test of independence to analyze quantitative secondary outcomes, and qualitative coding to analyze survey data. The causal message group had a greater increase in mean METs per minute from baseline to intervention compared to the noncausal group with a moderate effect size (P=.01; Cohen d=0.54). In the causal group, PA was significantly higher on SMS text message days (mean 2.46, SD 0.12 METs/min) compared to nonmessage days (mean 2.25, SD 0.15 METs/min; P=.02), while there was no difference in the noncausal group (P=.54). No significant between-group difference was found in self-reported PA or satisfaction. Causal information that links suggested PA to health outcomes can increase the effectiveness of SMS text messages promoting PA, indicating the value of incorporating causal information into intervention design. Our results provide further basis for just-in-time interventions, as activity was higher on message days. Further work is needed to better personalize message content and timing to maintain participant engagement.
24. Possible contribution of the STAT3 signaling pathway to disseminated intravascular coagulation (DIC) in mice with cecal ligation and puncture-induced sepsis.
期刊: Naunyn-Schmiedeberg’s archives of pharmacology 发表日期: 2025-Nov-24 链接: PubMed
摘要
Disseminated intravascular coagulation (DIC) is a serious disorder characterized by the systemic activation of blood coagulation and is a frequent complication in sepsis. Once septic patients develop DIC, it leads to a poor outcome. Appropriate DIC prevention strategies will be helpful for the management of sepsis. In this study, we attempted to identify coagulation disorder in mice with cecal ligation and puncture (CLP)-induced sepsis, a clinically relevant animal model of sepsis, and to provide pharmacological approaches for preventing the occurrence of DIC in sepsis. In CLP-induced septic mice, the blood platelet count was significantly declined, prothrombin time was significantly prolonged, the coagulation blood markers D-dimer and thrombin-antithrombin complex were significantly elevated, microvascular fibrin deposition and thrombus formation were detected in liver and kidney tissues, and thrombin levels in liver tissues were prominently up-regulated in comparison with sham-operated controls, implying that coagulation was developed in this animal model of sepsis. These changes were almost entirely abrogated when the signal transducers and activators of transcription 3 (STAT3) pathway was inhibited by transfection of STAT3 decoy oligodeoxynucleotides (ODNs) or pharmacological intervention with stattic. CLP-induced septic mice exhibited significant increases in tissue expression of plasminogen activator inhibitor (PAI-1) and tissue factor (TF), both of which play a crucial role in thrombogenesis. STAT3 ODN transfection strikingly suppressed overproduction of PAI-1 and TF after CLP. Nuclear factor-κB inhibition also reduced the PAI-1 and TF up-regulation but was without effect on prolonged prothrombin time in CLP mice. Our results suggest that inhibition of the STAT3 signaling pathway provides a potential benefit for preventing the development of DIC in sepsis.
25. Cross-Cultural Adaptation and Content Validity of the 2019 CDC Worksite Health ScoreCard for Use in Brazil.
期刊: American journal of health promotion : AJHP 发表日期: 2025-Nov-24 链接: PubMed
摘要
PurposeTo develop a cross-cultural adaptation and analyze evidence of content validity of the 2019 CDC Worksite Health ScoreCard (WHSC) for use in Brazil.DesignPsychometric study conducted according to international guidelines for cross-cultural adaptation and evidences of validity.SettingBrazil, November to December 2023.SampleFive independent bilingual reviewers evaluated linguistic equivalence; 18 experts in occupational health or psychometrics assessed content validity (response rate 52.9%); 10 occupational health and safety professionals participated in cognitive testing with gender parity.MeasuresSemantic, idiomatic, conceptual, and experiential equivalences; clarity, practical and theoretical relevance, and dimensionality of items.AnalysisContent Validity Ratio (CVR) was applied, with critical values ranging from 0.44 to 0.50; qualitative thematic analysis was performed on cognitive testing.ResultsInitial evaluations identified items with CVR <0.99 due to clarity issues, which were revised. In content validity assessment, CVR values ranged from 0.80 to 1.00 across all items, confirming acceptable agreement among experts. Cognitive testing confirmed comprehension and cultural adequacy, with participants suggesting inclusion of diversity-related items in future versions.ConclusionsThe Brazilian Portuguese version of the WHSC demonstrated strong linguistic quality and evidence of content validity with adequate clarity and cultural relevance for electronic administration. Limitations include reliance on a convenience sample of experts and the need for further evaluation of additional psychometric properties, such as internal structure and reliability.
26. Cannabis and Tobacco Product Use Classes and Psychosocial Correlates among US Young Adults.
期刊: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 发表日期: 2025-Nov-24 链接: PubMed
摘要
This study examined US young adults’ cannabis-tobacco use classes. Latent class analysis used 2023 data among young adults (ages 18-34, purposively recruited via Facebook to represent ~50% past-month cannabis use), specifically the 2267 reporting past-month cannabis and/or tobacco use. Indicators included: cannabis, cigarette, and e-cigarette use (0 days, infrequent [1-10], frequent [11-30]) and any cigar, hookah, smokeless tobacco, and nicotine pouch use. Multivariable regressions examined sociodemographics, adverse childhood events (ACEs), mental health, and personality characteristics in relation to class. Five classes were identified: (#1) “primarily cannabis” (36.6%): all used cannabis (74.0% infrequent), <14% tobacco products; (#2) “frequent cannabis-cigarette” (34.2%): 86.7% cannabis (82.9% frequent), 65.9% cigarettes (51.6% frequent), 59.4% e-cigarettes (33.6% frequent), <37% other tobacco; (#3) “product-dabbling” (16.0%): 79.8% cannabis, 71.8% cigarettes, 66.7% e-cigarettes (largely infrequently used each), <40% other tobacco; (#4) “frequent poly-product” (7.7%): 93.9% cannabis, 90.9% cigarettes, 98.2% e-cigarettes (~half frequently used each), >84% other tobacco; and (#5) “primarily e-cigarette” (5.5%): all used e-cigarettes (51.0% frequent), <9% other tobacco. Correlates of class #4 membership were: being Black (vs. White) and more mental health symptoms vs. other classes; being Hispanic vs. #2 and #5; being heterosexual (vs. other) vs. classes #1-#3; being older and male and higher extraversion vs. #1 and #5; in non-legalized states vs. #1; more ACEs vs. #1, #3, and #5; and higher neuroticism and less openness vs. #1-#2. The frequent poly-product class represented characteristics (e.g., race/ethnicity, sexual minority, mental health) implicated in substance use related disparities, underscoring the need for targeted intervention.
27. Mortise-tenon inspired silk fibroin-tannic acid/platelet-rich fibrin composite hydrogel enhances bone regeneration.
期刊: Journal of materials chemistry. B 发表日期: 2025-Nov-24 链接: PubMed
摘要
The primary challenge in bone tissue engineering is that single materials cannot simultaneously satisfy both biological function and physical support requirements. Conventional approaches fail due to uncontrolled degradation kinetics, poor growth factor retention, and unstable material interfaces that compromise therapeutic efficacy under dynamic physiological conditions. Inspired by ancient Chinese mortise-tenon joinery, this study proposes a “mortise-tenon structural integration” strategy, designing a composite system of silk fibroin-tannic acid (ST) hydrogel and injectable platelet-rich fibrin (iPRF). In this system, the ST hydrogel serves as a “mortise” structure providing excellent wet adhesion, self-healing ability, and controllable degradation characteristics, while iPRF acts as the “tenon” component carrying specific bioactive factors. This precise structural complementarity addresses the inherent limitations of single materials: iPRF, despite being rich in growth factors, has rapid degradation and insufficient mechanical properties; ST hydrogel provides excellent structural support but lacks bone inductive activity. The composite system demonstrates outstanding injectability, adhesiveness, and sustained growth factor release capability, significantly promoting the osteogenic differentiation of MC3T3 cells and upregulating osteogenesis-related gene expression. In vivo experiments confirmed that the composite hydrogel significantly enhanced bone repair in rat cranial and rabbit mandibular defect models by optimizing the immune microenvironment. This design based on structural complementarity and functional synergy provides an innovative solution for complex bone defect repair.
28. The preclinical discovery and development of romosozumab for the treatment of people with severe osteoporosis who are at high risk of fracture.
期刊: Expert opinion on drug discovery 发表日期: 2025-Nov-24 链接: PubMed
摘要
. The discovery of romosozumab, a monoclonal antibody to sclerostin and treatment option for severe osteoporosis, resulted from convergent genetic research of persons with rare hyperostotic bone diseases and the discovery of the Wnt signaling pathway, a vital pathway in bone metabolism. The authors provide an overview of the discovery of the SOST gene in humans and of Wnt signaling in animals, leading to the identification of sclerostin, a major regulator of bone formation and resorption. The authors further provide an overview of the studies that led to the development of romosozumab, a unique dual action monoclonal antibody that increases bone formation while decreasing bone resorption. In postmenopausal women, the administration of romosozumab over one year decreased the risk of vertebral and clinical fractures versus placebo and versus alendronate. Furthermore, sequential treatment, switching romosozumab over to denosumab, reduced the risk of vertebral fractures compared to switching the placebo to denosumab. Meanwhile, switching romosozumab to alendronate reduced the risk of vertebral, clinical, nonvertebral and hip fractures compared to continuous alendronate. An imbalance in cardiovascular events was found when using romosozumab in comparison to alendronate but not versus placebo. Romosozumab was eventually approved by EMA and FDA in 2019 for the treatment of patients with very high risk of fractures while considering their cardiovascular risk and is available and reimbursed in many countries.
29. The human cost of US foreign aid cuts: implications for HIV service delivery, research and innovation in South Africa.
期刊: AIDS care 发表日期: 2025-Nov-24 链接: PubMed
摘要
In early 2025, the abrupt suspension of U.S. foreign aid to South Africa - including funding from United States President’s Emergency Plan for AIDS Relief (PEPFAR), the United States Agency for International Development (USAID), the Centers for Disease Control and Prevention (CDC), and the National Institutes of Health (NIH) - has triggered a multidimensional crisis in the country’s HIV response. This paper synthesises emerging evidence on the human and systemic costs of these cuts, highlighting disruptions in HIV service delivery, research continuity, and health workforce stability in South Africa. As of March 2025, over 8,000 healthcare workers have been displaced, leading to service gaps in testing, treatment, and outreach to key populations. The cessation of many NIH sub-awards has halted clinical trials and weakened South Africa’s global leadership in HIV research. Modelling studies project up to 500,000 excess HIV-related deaths and millions of new HIV infections if services are not restored. The paper calls for urgent, multisectoral action - including domestic funding reform, mental health integration, and research continuity - to prevent the reversal of two decades of progress and to build a more resilient, self-sustaining HIV response in South Africa.
30. Field-effect transistor based sensors for heavy metal ion detection in water systems.
期刊: Nanoscale 发表日期: 2025-Nov-24 链接: PubMed
摘要
Real-time monitoring of heavy metal ions (HMIs) in water systems is regarded as a critical task in environmental analysis, given the acute and chronic threats these ions pose to public health. As an emerging platform, field-effect transistor (FET) based sensors are recognized for their combination of high sensitivity, real-time response, miniaturization, and cost-effectiveness. This review systematically examines recent advances in FET-based HMI sensors, with emphasis placed on working mechanisms, channel materials, surface functionalization, and integration with artificial intelligence (AI) and the Internet of Things (IoT). The working mechanisms of FET-based HMI sensors are categorized for the first time into three distinct types, based on the mode of ion FET interaction. Subsequently, the development of channel materials is reviewed, with performance characteristics and emerging trends highlighted, while current challenges in surface functionalization are also addressed. Selectivity issues are further explored, with efforts focused on AI/IoT-assisted sensor arrays discussed as a promising solution. Finally, future challenges and potential strategies are outlined to advance FET-based HMI sensors from fundamental research toward practical application.
31. The illusion of safety indicators in the mining industry.
期刊: International journal of occupational safety and ergonomics : JOSE 发表日期: 2025-Nov-24 链接: PubMed
摘要
Objectives. This study evaluates the effectiveness of safety indicators in the mining sector, questioning their ability to accurately represent the risks of severe and catastrophic accidents. Indicators such as the frequency rate, severity rate and Bird’s pyramid suggest a correlation between events of varying severity, creating the perception of a safe environment when their metrics are low. However, disasters such as the explosions at the BP Texas refinery and the Deepwater Horizon platform occurred despite seemingly ideal safety indicators. Despite the relevance of this topic, there are few systematic investigations into the effectiveness of these indicators, particularly in the mining industry. Methods. To bridge this gap, the study analyzed public and private data from four companies in the sector, using a mixed-methods approach to examine the relationship between frequent, less severe events and rare, more severe incidents. Results. No significant correlation between these events was indicated, contradicting Bird’s pyramid logic. Furthermore, the analyzed safety data exhibit biases that compromise their reliability. Conclusion. This study suggests replacing traditional indicators with new management metrics and incorporating activity analysis to enhance accident prevention and minimize catastrophic risks.
32. Exploring key determinants shaping occupational safety perceptions among occupational health and safety students.
期刊: International journal of occupational safety and ergonomics : JOSE 发表日期: 2025-Nov-24 链接: PubMed
摘要
Objectives. This study aimed to evaluate occupational safety perception and its influencing factors among students in the Department of Occupational Health and Safety at Sinop University, with a particular focus on the impact of socio-demographic variables and participation in occupational health and safety (OHS)-related training. Methods. A cross-sectional study was conducted with 154 OHS students in the 2022-2023 autumn term. Data from 128 students (83.1%) were collected using an informed consent form, a descriptive questionnaire and the occupational safety scale (OSS). The OSS is a 32-item Likert scale with a reliability of 0.75. Data analysis used SPSS version 25, including descriptive statistics, t tests, analysis of variance and Pearson correlation. Results. Participants had a mean age of 21.72 ± 1.33 years, 50.8% were male and 43% were second-year students. Most (73.4%) reported middle-income levels, and 66.4% had not received personal protective equipment (PPE) training. No significant correlation was found between socio-demographic factors and OHS perception scores (p > 0.05). However, students who received PPE training or participated in OHS activities had significantly higher perception scores (p = 0.018 and p = 0.002). Conclusion. OHS-related training, particularly in PPE and OHS activities, significantly improves safety perception. Expanding such training in educational settings can enhance future professionals’ safety awareness.
33. Impact of noise on school bus drivers' visual reaction time: An experimental approach with road safety implications Noise and Reaction Time.
期刊: Work (Reading, Mass.) 发表日期: 2025-Nov-24 链接: PubMed
摘要
BackgroundFast reaction time is essential for safe and effective driving.ObjectiveThe objective of this research was to ascertain the visual reaction time of school bus drivers and the effect of additional noise on this time.Methods28 volunteer professional school bus drivers were included in the study. Each participant was in both the experimental and control groups. Vehicle simulation was used to determine the reaction time of the participants. The participants’ throttle response time was measured in the presence and absence of an 85 dBA (A-weighted decibels) supplemental noise. The Wilcoxon rank-order sign test and linear mixed-effects regression models were used for the statistical analysis.ResultsThe reaction time of the participants without additional noise was calculated to be 0.10 ± 0.02 (0.06-0.15 s). It was found that the noise statistically increased the reaction time of the participants.ConclusionsThe additional noise in the vehicle has been shown to have a detrimental effect on the reaction time of school bus drivers, thereby impacting their cognitive functions. The findings emphasise the practical significance of noise control strategies in both occupational and transportation contexts, with the objective of enhancing safety and cognitive efficiency.
34. Evaluating occupational stress in manufacturing workers using a dot probe task game board: A pilot study.
期刊: Work (Reading, Mass.) 发表日期: 2025-Nov-24 链接: PubMed
摘要
BackgroundOccupational stress in manufacturing negatively impacts worker health and productivity. Effective tools for assessing stress levels in this high-risk industry can support interventions aimed at improving worker well-being.ObjectiveThis pilot study aims to develop and validate a dot probe task game board to measure occupational stress, integrating the Perceived Stress Scale (PSS-10), the Technology Acceptance Model (TAM), and EEG brainwave analysis.MethodsThe dot probe task measured reaction times to stress-related stimuli, with EEG recordings (focused on the AF8 electrode) taken before and after the task. A RidgeCV regression model assessed predictive factors, emphasizing stress levels measured by the PSS-10.ResultsSignificant reaction time differences validated the task’s sensitivity to stress-related cognitive impairment. The RidgeCV model achieved high predictive accuracy (R² = 0.945), identifying the PSS-10 as a primary predictor of stress. EEG data provided insights into stress-induced neurobiological changes in cognitive function.ConclusionThe study supports the integration of the dot probe task in occupational health assessments, highlighting its potential to improve well-being and inform targeted interventions in manufacturing and other high-risk sectors.
35. Interprofessional collaboration competency development in healthcare students during clinical placements in the time of COVID-19: a mixed methods systematic review.
期刊: Journal of interprofessional care 发表日期: 2025-Nov-24 链接: PubMed
摘要
The COVID-19 pandemic triggered unprecedented challenges to the clinical education of healthcare students. Although alternative clinical placements were developed and introduced, it is unclear whether students successfully acquired interprofessional competencies required to be collaborative practice-ready healthcare workers. We examined interprofessional collaboration competency acquisition from adapted and alternative clinical placements that were made available to pre-qualification healthcare students during the COVID-19 pandemic. Information searches from online databases and supplementary sources identified 20 articles that met criteria. Student perceptions indicate that these alternative placements supported the learning of interprofessional collaboration competencies. Outcomes mapped against the updated Canadian Interprofessional Health Collaborative Competency Framework indicate that the most frequently reported interprofessional collaboration competency was team communication and the least reported were collaborative leadership and team differences/disagreements processing. Although gains in interprofessional collaboration competencies were reported across the studies, their methodological shortcomings make it difficult to determine whether alternative placements (e.g. online and telephone-based) were better or comparable to traditional placements (i.e. with face-to-face interactions), for interprofessional collaboration competency development. These findings suggest the need for further research assessing the effectiveness and sustainability of alternative placement models. A greater understanding of clinical placement alternatives could inform educational practices in future pandemics or other unprecedented events.
36. Obstructive Sleep Apnea, Positive Airway Pressure, and Implications of Early Treatment in Parkinson Disease.
期刊: JAMA neurology 发表日期: 2025-Nov-24 链接: PubMed
摘要
Obstructive sleep apnea (OSA) is associated with many health conditions, including dementia and early mortality. Prior epidemiological studies linking OSA with Parkinson disease (PD) are conflicting, and no studies have examined the influence of continuous positive airway pressure (CPAP), the criterion standard treatment for OSA, on PD risk. To examine the association between OSA with incident Parkinson disease among US veterans and risk modification by CPAP. This electronic health record (EHR)-based cohort study was conducted among US veterans from January 1, 1999, to December 30, 2022, with mean (SD) follow-up of 4.9 (1.8) years. Veterans with PD at the time of exposure or incomplete records were excluded. Data analysis was completed from September 2024 to September 2025. OSA was defined by its appropriate administrative code; CPAP usage was extracted from a semistructured medical interview field in the EHR. The primary outcome, cumulative incidence of PD, was calculated adjusting for competing risk of death after balancing for age, race, sex, and smoking status. A total of 13 737 081 US veterans were screened, and 11 310 411 veterans (1 109 543 female veterans [9.8%]) with mean (SD) age of 60.5 (14.7) years were included in analyses. Of included veterans, 1 552 505 (13.7%) had OSA. Veterans with OSA demonstrated 1.61 additional cases of PD (point estimate; 95% CI, 1.13-2.09) at 6 years from diagnosis per 1000 people compared to those without OSA. Results were confirmed when adjusting for body mass index, vascular comorbidities, psychiatric conditions, and relevant medications and were of greater magnitude in female veterans. Case numbers were significantly reduced when treated with CPAP early in the disease course. In this EHR-based cohort study, OSA appeared to be an independent risk factor for the later development of PD and could be modified by early treatment with CPAP. Effective screening measures and protocols for consistent adherence to CPAP may have large impacts on brain health.
37. Traditional Mediterranean physical activity: integration of active lifestyle behaviors and exercise with social interactions as part of daily life.
期刊: The Journal of sports medicine and physical fitness 发表日期: 2025-Nov-24 链接: PubMed
摘要
The Mediterranean lifestyle has attracted significant research attention in recent years. This lifestyle is supported by several key pillars, including dietary habits, social and spiritual engagement, and physical activity. Although much of the research has focused on the health benefits of the Mediterranean diet, physical activity has received comparatively less emphasis. Nevertheless, physical activity remains a vital component of the Mediterranean lifestyle, deeply embedded in cultural traditions and daily routines. This paper examines the defining features, movement patterns, and cultural foundations of physical activity within the traditional Mediterranean lifestyle. By drawing on historical sources, anthropological studies, and contemporary research, we characterize Traditional Mediterranean Physical Activity (TMPA) as a set of habitual, non-structured movement patterns integrated into daily life. These activities include farming, fishing, manual labor, dancing, and walking for transportation, all reflecting a functionally active lifestyle shaped by environmental and occupational demands. The study also explores how TMPA has evolved and its potential alignment with modern physical activity paradigms. The key components of TMPA include functional movements, outdoor engagement, and communal participation, reflecting a culturally embedded approach to physical activity in Mediterranean societies. This study provides a foundation for understanding TMPA as a distinct movement model shaped by tradition and sustainability and offers insights into how these activity patterns have persisted or adapted in contemporary settings.
38. Does tattoo exposure increase the risk of cutaneous melanoma? A population-based case-control study.
期刊: European journal of epidemiology 发表日期: 2025-Nov-24 链接: PubMed
摘要
The incidence of cutaneous melanoma (CM) has risen sharply over the past 30 years, coinciding with the rapidly growing tattoo trend. In Sweden, 20% of the population is tattooed. Repeated reports of the presence of carcinogenic chemicals, such as polyaromatic hydrocarbons, aromatic amines and heavy metals in tattoo ink justifies the investigation of CM risk in relation to tattooing. We aimed to investigate the potential association between tattoo exposure and CM. We identified 2880 individuals who were diagnosed with CM at age 20-60 years, in the Swedish National Cancer Register. For each case, we sampled three random age- and sex-matched controls from the Swedish Total Population Register. Exposure data and data on potential confounders were collected through a questionnaire in 2021. We estimated the relative risk of CM in tattooed compared with nontattooed individuals using multivariable logistic regression, rendering incidence rate ratios (IRR). Of the participants, 22% of the cases (354/1598) had a tattoo before the index date, vs. 20% of the controls (815/4097). We observed an adjusted relative risk of CM in tattooed compared to nontattooed individuals of 1.29 (95% confidence interval [CI]: 1.07-1.56). The results suggested that tattoos may be a risk factor for CM, but further studies are needed to establish causality.
39. Implementing generative pretrained transformer models for text recognition tasks in safety data sheets.
期刊: Annals of work exposures and health 发表日期: 2025-Nov-24 链接: PubMed
摘要
Workplaces handling chemicals require an up-to-date and comprehensive assessment of the potential risks for their workforce. Online safety data sheets (SDSs) inventories provide adequate information to perform risk assessments. However, current practices that manually import information from SDSs into the online inventories are time-consuming, leading to delayed or inadequate risk assessments. This study presents a pipeline using large language models (LLMs) to automate the extraction and management of data from SDSs to online chemical inventories. The pipeline achieved an average accuracy of 0.83 in (close to precisely) extracting multiple variables of interest, such as company name, product name, and hazard statements, in comparison to manually extracting these variables. Overall, this pipeline illustrates the ability of LLM tools to automate SDS inventory management and thereby support the possibility to perform up-to-date risk assessments and evaluation tasks on the work floor, ultimately contributing to occupational safety.
40. Improving cognitive and functional outcomes in rural older adults living with dementia through paper-and-pencil training.
期刊: Geriatric nursing (New York, N.Y.) 发表日期: 2025-Nov-23 链接: PubMed
摘要
Dementia is a significant global public health concern. Accessible interventions are essential for supporting cognitive function and independent living, particularly in underserved rural areas. This study aimed to examine the effectiveness of paper-and-pencil cognitive training in improving cognitive function and instrumental activities of daily living (ADL) among older adults with dementia in rural communities. A cluster randomized trial was conducted with one 50-minute session and a weekly home assignment over a 12-week period. Findings demonstrated large effect sizes for changes in overall cognition and Stroop color-word interference test accuracy, with 43.5 % to 84.6 % of participants in the intervention group showing reliable improvement compared to 8.3 % to 22.2 % in the control group. A significant group-by-time interaction was observed for instrumental ADL, with moderate effect size. These results highlight the potential for accessible, low-tech, non-pharmacological cognitive interventions to support older adults living with dementia in resource-limited rural settings.
41. Replication of an evidence-based epilepsy self-management program in Georgia (USA): The HOBSCOTCH trial.
期刊: Epilepsy & behavior : E&B 发表日期: 2025-Nov-23 链接: PubMed
摘要
The efficacy of Managing Epilepsy Well Network (MEWN) self-management programs is well-established. The purpose of this study was to replicate the HOBSCOTCH program to evaluate program implementation and assess effectiveness on patient cognition, quality of life and self-management behaviors. Participants from clinical and community settings were recruited and randomized to intervention vs waitlist control. Program outcomes assessing quality of life, cognition, treatment adherence, depressive symptoms, and self-management behavior were measured at baseline and 3 months. Program staff provided survey data guided by the RE-AIM model regarding program delivery and acceptability, appropriateness, and feasibility. Data were analyzed using descriptive statistics, linear regression, and qualitative methods. This predominantly female (69 %) and White (64 %) sample (N = 61) with active epilepsy (66 % had a seizure in the past year) also had a higher portion of Black (32 %) participants. Analyses yielded significant differences in cognition, quality of life and self-management behaviors between the two groups at follow-up. Staff indicated the packaged intervention, remote delivery, trained coaches and investment of leaders/clinical staff as intervention benefits. Implementation barriers included difficulty contacting participants and mental health concerns. Program appropriateness and feasibility ratings were high; 98 % reported that they very much or moderately enjoyed working with their coach and would recommend the program to others. HOBSCOTCH was effective in increasing cognition and quality of life in people with epilepsy in this replication study. A novel finding highlighted changes in the frequency of participants’ self-management behaviors. These findings have implications for healthcare systems incorporating evidence-based self-management programs for their patients.
42. Health risk and benefit assessment methods for antibiotic resistance bacteria/genes in the environment: A critical review.
期刊: Journal of environmental management 发表日期: 2025-Nov-23 链接: PubMed
摘要
Antibiotics are widely used across various sectors, leading to significant environmental residues. These residues exert continuous selective pressure, which facilitates the proliferation and dissemination of antibiotic resistance genes (ARGs) and antibiotic resistant bacteria (ARB) in the environment. The spread of ARGs and ARB undermines the clinical efficacy of antibiotics and poses substantial risks to public health. Recognized as emerging environmental contaminants, ARGs and ARB have garnered increasing global concern. While existing research has extensively investigated their sources, species, environmental distribution, fate, and removal mechanisms, studies evaluating their health risks and benefits remain limited, hindering the development of a comprehensive knowledge system. This review discussed the crucial considerations for establishing a comprehensive health risk and benefit assessment system for ARGs and ARB. It also systematically examined the existing relative grading and quantitative health assessment frameworks, as well as benefit assessment frameworks based on the economic burden of antibiotic resistance. Additionally, the limitations of these frameworks in practical applications were discussed, along with future challenges and opportunities for improving the assessment systems. These insights aim to inform the management of environmental antibiotic resistance and provide scientific references for policymaking related to environmental health and public health security.
43. A survival analysis of T1 stage breast cancer and nomogram development: based on the SEER database.
期刊: Clinics (Sao Paulo, Brazil) 发表日期: 2025-Nov-23 链接: PubMed
摘要
Breast Cancer (BC) is a widespread non-cutaneous malignancy. T1 stage of small tumors are generally considered to have a favorable prognosis, but controversy persists regarding their treatment and prognosis. The cohort included clinicopathological characteristics of BC patients along with treatment information from T1 in the Surveillance, Epidemiology and End Results program (SEER) database from 2010‒2015. Construct a nomogram based on the variables identified by the multifactorial analysis results. A total of 164,906 female patient records were obtained for enrolment. Patients in the training set of T1 had a 3-, 5- and 10-years of OS for 95.2 %, 90.9 % and 84.4 % as well as a 3-, 5- and 10-years of BCSS for 98.4 %, 97.0 % and 95.4 %. Multivariate analysis found age, race, grade, T-stage, N-stage, chemotherapy, radiation, surgery, Estrogen Receptor (ER) status, Progesterone Receptor (PR) status and Human Epidermal growth factor Receptor-2 (HER2) status to be associated with OS. And age, grade, T-stage, N-stage, chemotherapy, radiation, surgery, diagnosis to treatment, ER-status, PR-status, and HER2-status are associated with BCSS. Independent prognostic risk factors incorporated into the construction of a nomogram. The AUC values for 3-, 5- and 10-years of OS and BCSS were greater than 0.7. The ROC, calibration and DCA curves verified that the nomogram had better predictability and benefits. The outcomes demonstrated a disparity in prognosis between groups T1a, T1b, and T1c. The constructed nomogram is able to predict OS and BCSS for 3-, 5- and 10-year periods reasonably well.
44. Management of alien bird impacts does not reflect their severity.
期刊: Journal of environmental management 发表日期: 2025-Nov-23 链接: PubMed
摘要
Biological invasions can harm biodiversity - indeed, they are a principal cause of native species extinctions (Bellard et al. 2016. Alien species as a driver of recent extinctions. Biol. Lett. 12:20150623). Biological invasions occur worldwide - whilst some of their impacts are managed, others are not. Identifying drivers of management actions may reveal why some impacts remain unmanaged, informing strategies to improve management consistency. We identified factors that influence actions to protect native animals from the biodiversity impacts of alien birds. We reviewed literature to identify impacts, categorising them as unmanaged or managed (irrespective of management success). For each impact, we collected data on variables hypothesised to influence management, including characteristics of affected native species (e.g., endemism) and alien species (e.g., years resident as an alien); characteristics of impacts (e.g., their severity - how harmful they are to native species, as measured using a published framework); and characteristics of the environment (e.g., human population density). We used binomial mixed effects models to identify associations between variables and management. Intuitively, actions to manage alien bird impacts tend to focus on the protection of endemic species. However, they do not focus on the most severe impacts, nor the most threatened native species. Indeed, feasibility influences actions, whereby long-established alien bird populations with damaging biodiversity impacts remain unmanaged, most likely because these long-established populations tend to be large and widespread and hence are considered too difficult or costly to manage. Timely interventions are crucial to prevent the damaging biodiversity impacts of biological invasions from becoming unmanageable.
45. Biodegradation and decolorization of Congo red dye by metal-dependent hydrolase (MdeH) in Buttiauxella sp. S19-1.
期刊: Journal of hazardous materials 发表日期: 2025-Nov-21 链接: PubMed
摘要
As one of the azo dyes, Congo red (CR) is widely used in the garment industry, posing significant environmental and health risks. In this study, Buttiauxella sp. S19-1 was selected for the efficient decolorization of CR. The optimal decolorization conditions were determined to be the anaerobic culture at 100 mg/L, with pH 5.0, and 27 °C for 30 h, achieving a decolorization efficiency of 89.6 %. Prokaryotic transcriptome analysis revealed a significantly up-regulated gene encoding a metal-dependent hydrolase in Buttiauxella sp. (BuMdeH) during biodegradation of CR, with zinc ions identified as the essential metal ion. The S19-1 mutant lacking the BuMdeH gene (S-∆M) showed a 1.42-fold decrease in decolorization efficiency compared to S19-1. In contrast, the Escherichia coli (E. coli) expressing BuMdeH (E-M) exhibited a 2.8-fold increase compared to E. coli. The recombinant BuMdeH protein (rBuMdeH) was purified, displaying a specific activity (with Zn2 +) of 1.10 ± 0.02 μmol/min·mg. Gas chromatography-mass spectrometry (GC-MS) analysis identified [1,1’-biphenyl]-4-amine and 1-naphthylamine as the metabolites of CR, which significantly decreased the toxicity following degradation by rBuMdeH. The results implied that MdeH played a pivotal role in the catalytic degradation of CR by strain S19-1 through a novel pathway, which proposed a sustainable bioremediation strategy for CR-contaminated wastewater.
46. Development and application of DAISY framework for benchmarking AI generated vs human-written abstracts in dental research.
期刊: International journal of medical informatics 发表日期: 2025-Nov-20 链接: PubMed
摘要
Despite the increasing use of AI tools like ChatGPT, Claude, and Gemini in scientific writing, concerns remain about their ability to generate accurate, high-quality, and consistent abstracts for research publications. The reliability of AI-generated abstracts in dental research is questionable when compared to human-written counterparts. This study aimed to develop a framework for evaluating AI-generated abstracts and compare the performance of ChatGPT, Claude, and Gemini against human-written abstracts in dental research. The DAISY framework was developed to evaluate AI-generated abstracts across five domains: Data accuracy (D), Abstract quality (A), Integrity and consistency (I), Syntax and fluency (S), and Yield of human likelihood (Y). Reliability of the framework was assessed using Cohens Kappa (κ = 0.85) and Pearsons’s correlation coefficient (0.92) for inter- and intra- expert reliability and was found to be satisfactory. This study adopted a comparative observational study design. Eight research articles belonging to structured (n = 4) and unstructured (n = 4) categories were selected from reputable journals. Researchers trained in scientific writing wrote abstracts for these articles, while AI-generated abstracts were obtained using specific prompts. Ten dental experts evaluated the abstracts using this framework. Statistical analysis was performed using ANOVA and Tukey’s post-hoc test. Human-written abstracts consistently outperformed AI-generated ones across all DAISY framework domains. Among AI tools, ChatGPT scored highest in all DAISY framework domains, followed by Gemini and Claude. Human-written abstracts achieved the highest human likelihood score (90.25 ± 4.68), while AI-generated abstracts scored below 50%, with Gemini scoring least (3.25 ± 1.75). The differences between the groups were statistically significant (P ≤ 0.05). The DAISY framework proved reliable for evaluating AI-generated abstracts. While ChatGPT performed better than other AI tools, none matched the quality of human-written abstracts. This indicates that AI tools, though valuable, remain limited in producing credible scientific writing in dental research.
47. Perovskite-COF hybrid enables sequence-programmed, anti-correlated ECL/SERS readout of NF-κB p50.
期刊: Biosensors & bioelectronics 发表日期: 2025-Nov-20 链接: PubMed
摘要
Physical medicine and rehabilitation (PM&R) needs mechanism-anchored biomarkers that change early enough to guide exercise dosing and physiotherapy. Here we position NF-κB p50 as a PM&R biomarker-read out not by bulk abundance but by DNA-binding activity that reflects the inflammation-to-repair transition. We develop a dual-mode ratiometric sensor in which the same p50-κB recognition event yields opposite signals-electrochemiluminescence (ECL) increase and SERS decrease-combined as R=IECL/ISERS to self-normalize interface and matrix variability. The platform shows ultrasensitive detection (attomolar-level), wide working range, high specificity versus related nuclear proteins, and strong robustness across batches and complex matrices (cell lysate, spiked plasma) with ≤100 μL sample. By providing a pathway-activity readout, p50 complements routine clinical markers (e.g., CRP, IL-6, NT-proBNP) and links molecular response to functional recovery. We outline PM&R use cases-musculoskeletal repair, osteoarthritis rehabilitation, and neurorehabilitation-where serial R trajectories can inform progression/overload decisions and personalize therapy. This work frames p50 detection as a practical, translational biomarker for PM&R/physiotherapy, and offers a robust sensing architecture readily extendable to other rehabilitation-relevant transcriptional pathways.
48. Wide-field Retinal and Choroidal Thickness in Healthy Chinese Children: Normative Ranges and Influencing Factors.
期刊: Retina (Philadelphia, Pa.) 发表日期: 2025-Nov-18 链接: PubMed
摘要
To characterize the normative distribution of wide-field retinal and choroidal thickness in a large cohort of Chinese children aged 7-19 years and to evaluate the associations with age, sex, intraocular pressure(IOP) and refractive status. This cross-sectional study included 2032 healthy Chinese students (1487 Primary school students and 545 middle school students). Primary school students underwent comprehensive ocular examinations including IOP, axial length (AL), refractive status, corneal curvature, and wide-field Optical coherence tomography (OCT); middle school students received basic exams and OCT. Correlation analyses assessed relationships between retinal/choroidal thickness and ocular parameters. Longer AL was associated with higher IOP, lower vertical corneal curvature (K2) and greater myopia. Older age correlated with greater myopia, longer AL, and reduced K2. Males had longer AL; females had higher K2. The mean subfoveal retinal thickness was 267.69±20.80µm, progressively decreasing toward the temporal periphery, up to 15mm from the fovea. In contrast, the mean subfoveal choroidal thickness was 304.11±65.61µm, with the thinnest region located nasally, near the optic nerve. Choroidal thickness decreased with age, AL, myopia severity, and lower K2. Retinal and choroidal thickness showed opposite spatial trends. Wide-field retinal and choroidal thickness exhibited distinct distribution patterns associated with age, myopia, and multiple ocular parameters in children, providing normative data to facilitate early detection, monitoring, and research of ocular development and pediatric eye diseases.
49. Huang-Jin-Shuang-Shen Decoction delays gastric tumorigenesis by suppressing stemness via SCD-mediated fatty acid metabolism modulation.
期刊: Phytomedicine : international journal of phytotherapy and phytopharmacology 发表日期: 2025-Nov-14 链接: PubMed
摘要
The Correa cascade posits that gastric cancer (GC) originates from chronic atrophic gastritis. However, the role of fatty acid (FA)-mediated stemness in gastric tumorigenesis remains unclear. Huang-Jin-Shuang-Shen granules (HJSS), a traditional Chinese medicinal formula, may delay gastric tumorigenesis. However, the underlying mechanisms have not been characterized. We investigated the role of stearoyl-CoA desaturase (SCD)-mediated stemness in gastric tumorigenesis and determined whether HJSS granules inhibit stemness by regulating SCD-dependent Wnt signaling to block malignant progression. We established a rat model of GC induction. Tissues were collected at the intestinal metaplasia (IM), dysplasia, and carcinoma stages to analyze FA metabolism enzyme profiles. In vitro experiments have identified downstream regulatory mechanisms of SCD. The efficacy of HJSS was evaluated based on the histopathological changes, gastric mucosa, gut microbiota, and fecal metabolites. SCD overexpression was used to validate the HJSS targeting of the SCD-Wnt stemness axis. SCD demonstrated stepwise upregulation during gastric tumorigenesis. SCD inhibition suppressed cancer stemness and Wnt signaling in vitro, and this effect was reversed by the catalytic product, oleic acid (OA). HJSS ameliorates gastric mucosal pathology, gastric mucosa phenotype, gut microbiota dysbiosis, and metabolic disturbances in rats. HJSS attenuated malignant stemness by targeting SCD-Wnt/β-catenin signaling. SCD overexpression partially counteracted the effects of HJSS. SCD promotes gastric tumorigenesis by activating Wnt-driven stemness. HJSS inhibits cancer stemness by suppressing the activation of SCD-mediated aberrant Wnt/β-catenin, positioning it as a promising candidate for delaying gastric malignant progression.
50. New Horizons in Transfusion Medicine.
期刊: Transfusion medicine reviews 发表日期: 2025-Nov-05 链接: PubMed
摘要
51. Not All That Glows Is Cancer: Ga-68 FAPI PET/CT Uptake in Eosinophilic Esophagitis.
期刊: Clinical nuclear medicine 发表日期: 2025-Oct-16 链接: PubMed
摘要
A 70-year-old man with dysphagia since 2 months, underwent endoscopy, showing distal esophageal edema and furrows. Biopsy was negative for malignancy. F-18 FDG PET/CT showed low-grade distal esophageal uptake with mild smooth wall-thickening on CT scan. Ga-68 FAPI PET/CT was further performed to substantiate diagnosis and delineate repeat biopsy site, which exhibited intense, diffuse esophageal uptake, mimicking malignancy. However, repeat biopsy confirmed eosinophilic esophagitis, conjugated with peripheral eosinophilia (13.6%) and elevated absolute eosinophil count (801 cells/μL). This case, therefore, highlights a false-positive Ga-68 FAPI PET/CT finding in inflammatory esophageal diseases and underscores the need for multimodal correlation to prevent misdiagnosis.
52. The SnaFab versus the Razi antivenom for treatment of snakebite envenomation: A randomized, double-blind (investigator and victims), active controlled, non-inferiority clinical trial.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
Snakebite envenomation is a significant public health issue in Iran, and it is crucial to have effective and easily accessible antivenom treatments. This study aimed to evaluate the non-inferiority of the SnaFab and the Razi antivenoms for treating snakebite envenomation. The study was a randomized, double-blind, multicenter, active-controlled, non-inferiority trial involving 98 snakebite victims. The patients received either the SnaFab or the Razi antivenoms, with the primary endpoint being the recovery rate within 48 hours after antivenom infusion. The secondary endpoints included adverse events over a 14-day monitoring period and total antivenom consumption. The non-inferiority margin (NIM) was set at 20 percent. The study was commenced on April 17th, 2020, and concluded on May 15th, 2021. The recovery rate was 100 percent in the SnaFab group, which was non-inferior to the Razi antivenom group (98%). The mean number of antivenom units administered was 8.95 ± 4.40 units in the SnaFab group, compared to 9.04 ± 4.49 units in the Razi group (P value: 0.92). Adverse events were reported by 10.2% of individuals in the SnaFab group and 20.4% in the Razi group (p value = 0.27). Muscle weakness was the most commonly reported adverse event in the Razi group (8%), while vertigo was most frequent in the SnaFab group (4%). Moreover, there were no reports of anaphylactic shock or serum sickness. In summary, this study found that SnaFab antivenom is non-inferior to Razi antivenom for treating snakebite envenomation in Iran. Overall, the incidence of adverse events was comparable between groups, with no statistically significant differences observed.
53. Harm reduction services and interventions for People Who Use Drugs (PWUD) in Latin America and the Caribbean (LAC) between 2013-2024: A scoping review protocol.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
In Latin America and the Caribbean (LAC) the response to substance use has primarily been abstinence-based, acute-care-oriented treatments. While harm reduction services (HRS) and interventions have expanded in LAC over the last decade, the research evidence on such programs has been sparse and disjointed. This scoping review will map peer-reviewed literature on HRS and interventions in LAC, and synthesize gaps and opportunities for policy, practice, and research. Studies conducted in LAC. The HRS that will be included in the search are opioid agonist therapy, syringe services programs, drug consumption facilities, safer consumption kits, managed alcohol programs, and drug-checking services. The scoping review will consider peer-reviewed original research, including qualitative, quantitative, and mixed-methods designs. We will exclude studies addressing harms associated with nicotine or tobacco use. We included original research written in English, Spanish, Portuguese, or French published between January 2013 and December 2024. We will conduct literature searches in English (PubMed, Scopus, Web of Science), Spanish, Portuguese (SciELO and BIREME), and French (BIREME). Two reviewers will independently screen the literature. Extraction of characteristics of the studies using a template in Covidence. Data on the HRS and interventions studied and implemented in LAC will be summarized and presented in tables, graphs, and a narrative summary. We will use a narrative synthesis approach to summarize implications for policy, research, and practice identified in the literature. The review was registered in Open Science Framework (https://osf.io/qya7c/). The proposed scoping review will provide valuable information regarding the current state of HRS and interventions for PWUD in LAC. This in return can help guide future research for evaluating services that are already being implemented or unveil services needed in the region. To our knowledge, this is the first scoping review to map HRS in LAC using a systematic approach. Furthermore, among the strengths of this review are: the broad number of services, countries, and time, as well as the consultation with experts and knowledge users.
54. "I just needed somebody to talk to": The role of the Veterans Crisis Line in social connection for women veterans.
期刊: The American journal of orthopsychiatry 发表日期: 2025 链接: PubMed
摘要
The U.S. Surgeon General in 2023 declared an “epidemic of loneliness and social isolation” in the United States, conditions that impact health risks, including suicidal ideation. U.S. women military veterans may face particular challenges to social connection due to relatively small numbers of women veterans within civilian communities as well as gender-specific military experiences that can increase isolation and disrupt social relationships. There is growing concern about suicide risk among this population. As part of the U.S. Department of Veterans Affairs suicide prevention efforts, the Veterans Crisis Line (VCL) provides free, 24-hr human support during acute crises and connection to other resources. Through analysis of qualitative interviews with 26 women veterans who had contacted the VCL in the prior year, we identified that women veterans sought human connection through the VCL in times of acute mental distress when other opportunities were limited due to the following: (a) lack of people within their social networks, (b) people in their social networks not being available in times of need, (c) not wanting to burden people in their networks, or (d) experiencing those in their social networks as not supportive or understanding. Our findings speak to the value of the VCL for supporting women veterans’ needs for the structural, functional, and quality elements of social support and connection, with opportunities to mitigate the impacts of social isolation and loneliness for this population. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
55. Neighborhood level factors and use of cigarettes, cannabis and e-cigarettes: A population-based study among Canadian adults.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Despite public health efforts, use of legal substances such as cigarettes, cannabis and e-cigarettes are common in Canada. Most policies focus on individual level factors, which do not account for possible influences of the environments to which people belong (i.e., neighborhoods). This study aimed to identify neighborhood-level risk factors for use of cigarettes, cannabis and e-cigarettes in the Canadian Partnership for Tomorrow’s Health cohort. Participants completed questionnaires on demographics and health behaviors including recent (30-day) use of cigarettes, cannabis and e-cigarettes. Geospatial neighborhood-level measures: deprivation, gentrification, household security, labor force participation, immigration and visible minority proportion were linked via postal codes. Regression models were built to understand associations between substance use and neighborhood factors. Neighborhood material deprivation, social deprivation, and household insecurity were positively associated with odds of using cigarettes, cannabis, and e-cigarettes. Odds of using these substances was higher for participants living in gentrified neighborhoods. Lower odds of cigarette, cannabis, and e-cigarette use were found for participants living in neighborhoods with a high proportion of recent immigrants and/or visible minorities. Evidence from this study suggests interventions aimed at reducing or preventing substance use should be multidimensional, encompassing strategies directed at both individuals and neighborhoods.
56. Trends and disparities in antenatal care utilization: A multilevel analysis of four-plus and eight-plus ANC visits among urban women in Ethiopia.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Antenatal care(ANC) is the gateway of the continuum of reproductive health care, offering a framework for complication prevention, screening, diagnosis, and health promotion. This study examined trends, disparities and associated factors of ANC utilization (ANC4+ and ANC8+) among urban women in Ethiopia between 2000 and 2019. We analyzed five rounds of Ethiopian Demographic and Health Surveys (2000-2019) data, disaggregated by wealth, education, and region using Stata version 16.1. Multilevel logistic regression model was used to identify factors associated with four-plus and eight-plus ANC utilization. Adjusted odds ratios (AORs) with 95% confidence intervals were reported, with statistical significance set at p < 0.05. ANC4 + utilization increased from 43.1% in 2000 to 58.7% in 2019. while, ANC8 + utilization declined from 11.4% to 3.6%. Among the urban non-poor, ANC4 + rose from 60.5% to 81.8% compared to 37.8% to 48.7% among the urban poor. Regional disparities were pronounced: Addis Ababa showed the highest ANC4 + use (72% to 82%), but a decline in ANC8+ (38% to 10%). Somali region had the lowest ANC4+ (9% to 24%) utilization, though it increased from 9% in 2000 to 24% in 2019 and Gambella had the lowest ANC8 + utilization. Wealth disparities were strong, with non-poor women more likely to utilize ANC4+ (AOR= 2.43; 95% CI: 2.12-2.78) and ANC8+ (AOR= 3.02; 95% CI: 2.49-3.65) than poor women. Education also significantly associated: women with secondary or higher education had greater odds of ANC4+ (AOR= 3.02; 95% CI: 2.54-3.59) and ANC8+ (AOR= 2.13; 95% CI: 1.63-2.78). Women aged 30-34 years had higher odds of utilizing ANC4+ (AOR= 2.89; 95% CI: 2.10-3.98) and ANC8+ (AOR= 2.22; 95% CI: 1.37-3.59). Weekly media exposure was positively associated with ANC4+ (AOR= 1.53; 95% CI: 1.28-1.83). Significant disparities in ANC (ANC4+ and ANC8+) utilization persist across wealth, education and regions in urban Ethiopia. Wealth status was the strongest predictor, with non-poor women steadily advantaged. Maternal education, age, media exposure, and marital status also showed positive associations, while regional disparities persisted, with Addis Ababa outperforming other urban areas. Improving ANC uptake requires targeted interventions for urban poor women, alongside media-based awareness and educational initiatives.
57. Spiritual care in the outpatient environment for chronically ill older African American patients: Protocol for a pilot feasibility study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Spirituality is vital to holistic patient care and should be proactively addressed by healthcare providers as unmet spiritual needs are a major source of suffering for patients living with chronic illnesses. However, spiritual concerns are seldom referenced by clinicians during disease-related treatment discussions, particularly for minority and under-resourced patients. This paper outlines a protocol for administering and evaluating a culturally-responsive spiritual care intervention conducted with chronically ill African Americans receiving care at a community safety net health service. A total of 60 African American patients who have chronic conditions and are aged 50 or older will be recruited for this study and randomly assigned to either the intervention (spiritual care program delivered by a board-certified chaplain) or the control group. All participants will complete a baseline interview that encompasses demographic information, religiosity, spiritual well-being, quality of life, and perception of care. Follow-up surveys will be conducted 12 weeks post-baseline, and participants assigned to the intervention group will also undergo a semi-structured acceptability and feasibility interview. Effect size measures and bivariate tests will be used to compare pre- and post-test outcomes while the interviews will be analyzed using constant comparative and thematic analysis. Study findings will assess the feasibility and effectiveness of a culturally-responsive spiritual care intervention for under-resourced African American patients with chronic illnesses. Furthermore, the provision of spiritual care may help patients clarify their healthcare values and decision making priorities.