公共卫生研究摘要 (2025-11-27)
共收录 54 篇研究文章
1. Predictors of willingness to undergo back surgery: a survey of Australian privately insured adults with chronic back pain.
期刊: Australian health review : a publication of the Australian Hospital Association 发表日期: 2025-Dec-04 链接: PubMed
摘要
Spinal surgery rates in Australia continue to rise despite limited evidence for their effectiveness in managing uncomplicated chronic back pain. This study examined patient-level factors that influence willingness to undergo surgery, to informing future work promoting non-surgical care pathways. We conducted a cross-sectional online survey in March 2025 of 152 privately insured Australian adults with chronic low back pain. Participants reported pain characteristics, functional interference, prior imaging and pain-related beliefs (expectations of recovery, self-efficacy and catastrophising). Willingness to undergo spinal surgery within 5 years was assessed on a 5-point scale, and dichotomised into ‘willing’ (3-4) and ‘unwilling’ (0-1); respondents answering ‘unsure’ were excluded. Logistic regression examined predictors of willingness to consider surgery. Of 152 participants (mean age 59.3 years, 64% female), 24% expressed willingness to undergo surgery. Negative pain beliefs, higher pain intensity and younger age significantly predicted willingness, with the strongest effect seen for negative pain beliefs (OR 2.62, 95% CI 1.16-5.92, P = 0.02). Functional interference, imaging history and gender showed positive, but non-significant, associations. Negative pain beliefs predict willingness to undergo spinal surgery. This finding has important policy implications, suggesting that addressing belief-driven demand may help reduce the economic burden of surgery by directing patients towards guideline-based, high-value, non-surgical care.
2. Uncovering heterogeneous intercommunity disease transmission from neutral allele frequency time series.
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 COVID-19 pandemic has underscored the need for accurate epidemic forecasting to predict pathogen spread, evolution, and evaluate intervention strategies. Forecast reliability hinges on detailed knowledge of disease transmission across population segments, which may be inferred from contact surveys or mobility data. However, these indirect approaches make it difficult to estimate rare transmissions between socially or geographically distant communities. We show that the steep ramp-up of genome sequencing surveillance during the pandemic can be leveraged to directly identify transmission patterns between geographically defined communities. Our approach uses a hidden Markov model to infer the fraction of infections a community imports from others based on how rapidly allele frequencies in the focal community converge to those in the donor communities. Applying this method to SARS-CoV-2 sequencing data from England and the United States, we uncover networks of intercommunity transmission that reflect geographical relationships while exposing significant long-range interactions. The scaling of importation rate with distance is consistent across both countries, yet weaker than expected based on mobility data, highlighting limitations of indirect inference. We show that transmission patterns can change between waves of variants of concern and analyze how the inferred heterogeneity in intercommunity transmission impacts evolutionary forecasts. While applied here to geographically defined communities, our approach could be applied to those defined by other traits (e.g., age, socioeconomic status), provided time-series data can be stratified accordingly. Overall, our study highlights population genomic time series data as a crucial record of epidemiological interactions, which can be deciphered using tree-free inference methods.
3. Response to the Letter to the Editor: Recalibrating evidence: a cautionary note on the use of post hoc thresholds in IPD meta-analyses.
期刊: European thyroid journal 发表日期: 2025-Dec-01 链接: PubMed
摘要
4. Urban contact patterns shape respiratory syncytial virus epidemics with implications for vaccination.
期刊: Science advances 发表日期: 2025-Nov-28 链接: PubMed
摘要
Urban environments may alter the landscape of disease transmission with implications for control. Yet, it is unclear whether urban-rural differences exist in the dynamics of childhood respiratory diseases, given specific mixing patterns in younger age groups. Here, we leverage county-level data on respiratory syncytial virus (RSV) from the United States to reveal an urban-rural gradient in both the intensity and age structure of the RSV epidemic, where urban locations experience more prolonged epidemics with higher burden in infants (under 1 year of age). We develop a mechanistic epidemiological model to show that these differences can be explained by daycare utilization rates in children under 5. Using our model to consider control measures, we find that expanding seasonal immunization access in urban and rural areas may limit the risk of off season RSV epidemics.
5. Escalated heatwave mortality risk in sub-Saharan Africa under recent warming trend.
期刊: Science advances 发表日期: 2025-Nov-28 链接: PubMed
摘要
Evidence from high-income countries indicates populations are adapting to frequent heatwaves, but similar trends in resource-constrained regions remain unknown. We analyzed mortality data from 11 Health and Demographic Surveillance Systems across sub-Saharan Africa (2005 to 2015) to examine temporal changes in heat-related mortality risk. Contrary to global trends, our findings suggest that heat vulnerability is increasing across African populations. Nighttime heatwave mortality risk increased significantly between 2005 to 2010 and 2011 to 2015 [OR from 1.02 (95% CI: 0.87 to 1.13) to 1.18 (95% CI: 1.13 to 1.23)], while daytime heatwaves showed no significant impact. Compound heatwaves transformed from nonsignificant to significant risk factors [OR = 1.11 (95% CI: 1.03 to 1.22)]. Males showed increased risks across all heatwave types, females only for nighttime and compound heat. Children under 5 showed universal risk increases, while the elderly showed the highest increases for nighttime and compound heat. These findings suggest that physiological adaptation alone is insufficient to cope with increasingly frequent heatwaves without adequate socioeconomic resources. Heightened nighttime vulnerability underscores the need for context-specific adaptations reflecting Africa’s distinct conditions.
6. Societal restraint of behavior during the pre-vaccine pandemic saved working-age men but not women.
期刊: Science advances 发表日期: 2025-Nov-28 链接: PubMed
摘要
Risky behavior disproportionately contributes to death in the working-age (i.e., 15 to 64 years old) population. Men exhibit riskier behavior than do women. As a result, working-age men die more frequently than do working-age women. Despite these circumstances, surprisingly little research has attempted to estimate the gender-specific efficacy of societal restraint of risky behavior. This study provides such estimations by exploiting differences among the Nordic countries in the dose of forced restraint adopted to reduce mortality in the pre-vaccine COVID-19 pandemic. Results show that relatively great restraint reduced the likelihood of death among working-age men but not among working-age women. The findings suggest that debate over the wisdom of forced restraint of behavior as a strategy to reduce deaths should reflect the likely divergent effects of such interventions on working-age men and women.
7. Predicting and controlling infectious disease epidemics in cities.
期刊: Science advances 发表日期: 2025-Nov-28 链接: PubMed
摘要
Modeling across urban-rural gradients shows city size and structure shape RSV epidemics and can guide more effective immunization strategies.
8. Engasertib versus Placebo for Bleeding in Hereditary Hemorrhagic Telangiectasia.
期刊: The New England journal of medicine 发表日期: 2025-Nov-27 链接: PubMed
摘要
Hereditary hemorrhagic telangiectasia (HHT) can cause recurrent, severe epistaxis, as well as anemia and reduced quality of life. The disease remains without licensed therapies worldwide. In this proof-of-concept, multicenter, double-blind, placebo-controlled trial, we evaluated the safety and efficacy of oral engasertib, a new, allosteric, selective AKT inhibitor, in patients with HHT. Patients were randomly assigned in a 1:1:1 ratio to receive engasertib at a dose of 30 mg, engasertib at a dose of 40 mg, or placebo once daily for 12 weeks. The primary outcomes were the frequency and severity of adverse events. Key secondary outcomes included the frequency and duration of epistaxis. An open-label extension is ongoing. A total of 75 patients were assigned to 30-mg engasertib (24 patients), 40-mg engasertib (25 patients), or placebo (26 patients). Among the patients who received at least one dose of the trial regimen, the most common on-target adverse events associated with engasertib included mild-to-moderate rash (5 patients [21%] in the 30-mg engasertib group, 10 [42%] in the 40-mg engasertib group, and 2 [8%] in the placebo group) and mild-to-moderate hyperglycemia (3 patients [12%] in the 40-mg engasertib group and no patients in the other two groups), which were reversible. The incidence of serious adverse events in each of the two engasertib groups was similar to that in the placebo group. From baseline to week 12, the mean (±SD) decrease in epistaxis frequency was 26.5±26.5% with 30-mg engasertib, 27.8±35.1% with 40-mg engasertib, and 18.0±36.0% with placebo; the mean decrease in epistaxis duration was 29.9±53.2%, 41.4±41.0%, and 23.8±53.4%, respectively. The safety profile of engasertib was similar to that of placebo except for mild-to-moderate rash, which resolved in most patients who continued to receive the drug. Engasertib treatment was associated with decreases in epistaxis frequency and duration. (Funded by Vaderis Therapeutics; ClinicalTrials.gov number, NCT05406362.).
9. Daily Mosnodenvir as Dengue Prophylaxis in a Controlled Human Infection Model.
期刊: The New England journal of medicine 发表日期: 2025-Nov-27 链接: PubMed
摘要
Approximately half the worldwide population is at risk for dengue. No antiviral prophylaxis or treatment options are available. In a phase 2a, double-blind, randomized trial, we assigned healthy adults to receive oral mosnodenvir once daily as a low dose (40-mg loading dose followed by 10-mg maintenance dose), medium dose (200 mg followed by 50 mg), or high dose (600 mg followed by 200 mg) or matched placebo. Loading doses were given for 5 days and maintenance doses for 21 days. In a controlled human infection model, participants received subcutaneous inoculation of an underattenuated dengue virus serotype 3 (DENV-3) strain (rDEN3Δ30) on the day of the first maintenance dose (day 1). The primary efficacy end point was the DENV-3 RNA load, assessed as the log10 area under the concentration-time curve from day 1 (immediately before inoculation) through day 29 (AUCD1-29). The high-dose and placebo groups were compared in the primary end-point analysis. Safety, pharmacokinetic features, and virologic and serologic features were evaluated through day 85. The percentage of participants without signs of DENV-3 infection was 0% (0 of 6 participants) with the low dose of mosnodenvir, 17% (1 of 6) with the medium dose, and 60% (6 of 10) with the high dose, as compared with 0% (0 of 7) with placebo. High-dose mosnodenvir led to a significantly lower DENV-3 RNA load, assessed as the log10 AUCD1-29, than placebo (two-sided P<0.001 by tobit analysis of variance). In this small trial, mosnodenvir did not result in any serious adverse events. Plasma concentrations of mosnodenvir increased from day -5 to day 1 and were maintained through day 21. Among participants with available NS4B sequencing data, emerging amino acid variations in the NS4B region of the rDEN3Δ30 genome were detected in 14 of 14 mosnodenvir recipients and none of 7 placebo recipients. In a controlled human infection model, a high daily dose of oral mosnodenvir led to a significantly lower DENV-3 RNA load than placebo. Mosnodenvir did not result in any serious adverse events. (Funded by the National Institute of Allergy and Infectious Diseases and Johnson & Johnson; ClinicalTrials.gov number, NCT05048875.).
10. Frequency-Following Response in Infants With Congenital Syphilis.
期刊: Journal of speech, language, and hearing research : JSLHR 发表日期: 2025-Nov-26 链接: PubMed
摘要
This work aimed to study the frequency-following response (FFR) of infants with congenital syphilis under treatment. A cross-sectional study with 112 infants recruited at public maternities was conducted. A total of 90 infants were included in the sample and divided into two groups: 53 infants whose mothers and infants received perinatal syphilis treatment and 37 infants whose mothers and infants were free of syphilis (control group). Infant age ranged from 15 to 90 days (M = 39.9 ± 17.2 days). FFRs were recorded to a 170-ms consonant-vowel /da/ stimulus, presented at 80 dB nHL to the right ear. Data were analyzed in the time and frequency domains. The Shapiro-Wilk and Mann-Whitney U tests were applied with a significance level of p ≤ .05. No significant between-groups differences were observed in FFR spectral amplitude at the stimulus fundamental frequency or its harmonics, whether computed in the transient or steady portions of the stimulus. No significant differences were observed in prestimulus root-mean-square, neural lag, and the signal-to-noise ratio of the spectral amplitude. These findings suggest that infants with congenital syphilis, when appropriately treated at birth, demonstrate preserved auditory pathway function and sound processing, including temporal and spectral characteristics that are relevant for language acquisition.
11. Comparative analysis of oxidative stress resulting from heavy metal occupational exposure among green space workers.
期刊: International journal of occupational safety and ergonomics : JOSE 发表日期: 2025-Nov-26 链接: PubMed
摘要
Objectives. Occupational exposure to heavy metals has emerged as a significant public health threat. These metals can induce oxidative stress, a significant risk for green space workers due to frequent exposure to air pollutants in urban areas. Even with these high-risk levels, exposure to heavy metals among this group is understudied. The objective of this study is to investigate the impact of exposure to nickel (Ni), lead (Pb) and manganese (Mn) on oxidative stress among these workers. Methods. Air samples were taken from 88 male participants for Ni, Pb and Mn analysis using NIOSH-7300. Urine samples were taken for heavy metal and 8-hydroxy-2’-deoxyguanosine (8-OHDG) biomonitoring. Results. The exposed population of green space workers showed significantly elevated levels of airborne Ni and Pb (p ≤ 0.001) and urinary Mn and Ni (p ≤ 0.001) compared with a control group of office workers. The exposed population also had elevated urinary 8-OHDG levels, indicating increased oxidative stress. The strong correlation and regression analysis (R2 = 0.7964) confirm that metal exposure had a significant effect on oxidative stress. Conclusion. The study underscores the occupational risk of heavy metal exposure in outdoor settings, emphasizing the need for effective health and safety policies despite limitations such as sample size and city-specific focus.
12. Perspectives on App-Assisted Self-Testing Using Rapid Diagnostic Tests Among Community Members, Health Care Providers, and Public Health Leaders in Kenya, South Africa, and Zambia: Qualitative Study.
期刊: Journal of medical Internet research 发表日期: 2025-Nov-26 链接: PubMed
摘要
Self-testing using rapid diagnostic tests (RDTs), integrated with mobile phone-based apps, offers potential to improve health outcomes in low-resource settings, including sub-Saharan Africa. Despite its advantages, uptake remains limited because of concerns about accuracy, accessibility, and integration within existing health care systems. This study aimed to assess the acceptability of self-testing using RDTs for various health conditions, both independently and app-assisted, among community members, health care providers (HCPs), and community and public health leaders in Kenya, South Africa, and Zambia. From May 15 to August 24, 2023, we conducted an exploratory qualitative study across rural and urban areas in the 3 countries. We used key informant interviews with community leaders and public health leaders in the ministries or departments of health, in-depth interviews (IDIs) with HCPs, and IDIs and focus group discussions (FGDs) with community members. Using framework analysis, we categorized data guided by the Theoretical Framework of Acceptability to assess affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy toward self-testing using RDTs, with and without assistance from an app, across countries and participant types. The study involved 178 participants, including 24 key informants, 41 HCPs, and 113 community members who participated in 55 IDIs and 11 FGDs across the 3 countries. Self-testing, both standalone and app-assisted, was highly acceptable to community members, HCPs, and community and public health leaders in the 3 countries for its ability to empower individuals, enhance access to health care, and improve efficiencies in health care delivery. Self-testing was aligned with values of privacy, confidentiality, and autonomy and increased reach to underresourced areas. Participants valued its potential to save time, reduce opportunity costs, and facilitate early diagnosis and treatment, while easing burdens on the health care systems. Participants perceived the benefits of self-testing to outweigh possible risks, including human error, false readings, and emotional distress from unexpected results, especially if linked by an app to real-time guidance and improved health care coordination. Apps were praised for modernity, convenience, and ability to streamline processes for users and health care systems. Foreseeable challenges included resistance from less tech-savvy individuals, ethical concerns such as misuse of self-tests, technological barriers, data security, training needs, and insufficient digital and physical infrastructure for equitable implementation. Regular education, system support, integration, and community trust were identified as critical for success. Self-testing, both alone and app-assisted, was viewed as acceptable and relevant for increasing health care accessibility and efficiency in these low-resource settings. However, to optimize its benefits, efforts must address challenges related to test accuracy, infrastructure development, data privacy, and integration into existing health care systems. Policies should further emphasize education, support, user-friendly design, and minimal costs to ensure equitable access and effective implementation across diverse populations.
13. The Efficacy of Fan Use on Autophagy and the Cellular Stress Response During Prolonged Exposure to Extreme Heat in Older Adults: A Randomized Trial.
期刊: Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme 发表日期: 2025-Nov-26 链接: PubMed
摘要
Recent guidance has advocated the use of electric fans as a simple and sustainable cooling strategy to safeguard older adults during exposure to extreme heat. While we showed that fans have negligible impacts on core temperature during daylong (8-h) heat exposure (36°C, 45% [relative humidity]), their impact on cellular responses may contribute to the pathogenesis of heat-induced cellular vulnerability in older adults remains unknown. We assessed 18 participants (8 females, median age 72 [IQR, 67-76] years) exposed to 3 heat exposures (8-h, 36°C, 45% RH) with either no fan (control), or with fans generating air speeds of 2 m/s, or 4 m/s directed at the front of the body. Rectal temperature was measured continuously, while proteins associated with autophagy, the heat shock response, acute inflammation, and apoptotic signaling were measured before and after each exposure in peripheral blood mononuclear cells. We observed signs of autophagic dysfunction as indexed via elevations in p62 and pULK1/ULK1 from baseline in each condition, however responses were not different between conditions (p ≥ 0.077). Further, while fan use did not alleviate elevations in rectal temperature or prevent observations of autophagic dysfunction compared to control, fan use at 4 m/s elicited significant elevations in apoptotic protein cleaved-caspase-3 (mean difference: +0.69 relative quantity, p = 0.033), potentially attributed to elevated serum osmolality (+2.6 mOsm/L, p = 0.020). Therefore, fan use at high settings during heatwaves may be ineffective at alleviating autophagic dysfunction and can potentially incur greater cellular stress in older adults.
14. Comparison of Machine Learning Models for Colon Cancer Survival: Predictive Modeling Approach.
期刊: JMIR cancer 发表日期: 2025-Nov-26 链接: PubMed
摘要
Colon cancer is a leading cause of cancer-related deaths worldwide, with survival influenced by risk factors, treatment type, and patient characteristics. Traditional statistical models, such as Kaplan-Meier curves, have been widely used to estimate survival probabilities. However, these models often have difficulty handling complex interactions, covariates, and nonlinear relationships between risk factors. Recently, machine learning (ML) techniques have emerged as promising tools for improving survival prediction by handling large covariates and capturing complex patterns. This study compares several ML models to accurately estimate colon cancer survival by leveraging data from the Kentucky Cancer Registry. By identifying key risk factors, these analyses aim to improve risk stratification, treatment planning, and prognosis for overall colon cancer survival within subgroups. We conducted a retrospective analysis of colon cancer cases diagnosed between 2010 and 2022 (n=33,825), using Kentucky Cancer Registry data linked to mortality records, with approval from the University of Kentucky Institutional Review Board (#63067). We compared multiple predictive modeling techniques, including Cox proportional hazards, accelerated failure time models, Extreme Gradient Boosting, random survival forests, least absolute shrinkage and selection operator (LASSO), and elastic net regression, to estimate survival probabilities. The Kaplan-Meier method provided baseline survival estimates, and multivariate models, including ML approaches, evaluated contributions of key risk factors. Model performance was compared across evaluation metrics such as the Brier score, concordance index, out-of-bag error, and Continuous Ranked Probability Score. Missing data were handled via multiple imputation, and leave-one-out cross-validation was applied to reduce overfitting. The ML models identified key covariates influencing survival outcomes, such as age, treatment type, positive nodes, tumor stage, smoking, and comorbidities. In the overall model, patients who refused or received no treatment had a 3.24-fold higher risk of mortality compared to those who underwent surgery at primary and regional sites. Elevated mortality risk was also observed among smokers (24% higher than non-smokers) and Appalachian residents (7% higher than non-Appalachian residents). Our overall model achieved a concordance index of 0.8146, with strong discriminatory performance across subgroups, including early-age diagnosis (0.8175), late-age diagnosis (0.7841), Appalachia (0.8135), non-Appalachia (0.8126), White patients (0.8164), and Black patients (0.7881). The results highlight the strengths and limitations of each ML approach, with the random survival forest and LASSO models outperforming traditional methods such as the Cox model in prediction accuracy and model discrimination. Our study demonstrated the utility of ML in identifying risk factors associated with colon cancer survival, with positive lymph nodes, age at diagnosis, treatment received, clinical tumor size, tumor grade, smoking status, geographic region, and marital status emerging as dominant predictors across all statistical models. This comparative analysis offers valuable insights for clinical decision-making and prognosis, highlighting the potential of ML to identify risk factors specific to different subgroups, ultimately advancing personalized care for patients with colon cancer.
15. Characterization of H5N1 high pathogenicity avian influenza virus belonging to clade 2.3.4.4b isolated from Ezo red fox in Japan in a mouse model.
期刊: Microbiology spectrum 发表日期: 2025-Nov-26 链接: PubMed
摘要
H5N1 high pathogenicity avian influenza virus (HPAIV) has spread in wild birds and poultry worldwide. H5N1 HPAIV belonging to the currently predominant clade 2.3.4.4b has infected not only birds but also mammals (wild and domestic animals), with several human infections also being reported, raising concerns for public health. In 2022, a clade 2.3.4.4b H5N1 HPAIV strain, A/Ezo red fox/Hokkaido/1/2022 (H5N1; Fox/Hok/1/22), was isolated from an Ezo red fox (Vulpes vulpes schrencki) in Hokkaido, Japan; this was the first reported case of clade 2.3.4.4b H5N1 HPAIV isolation from a mammalian species in Japan. Several amino acid substitutions in the PB2 protein play an important role in the adaptation of avian influenza viruses to mammals, but Fox/Hok/1/22 PB2 does not have any of these well-known mammalian-adapting PB2 substitutions. Here, we investigated the biological properties of Fox/Hok/1/22 in a mouse model and found that this virus was highly virulent in mice and replicated well in multiple organs, including the lungs and brain. We then examined whether viruses isolated from these organs acquired known mammalian-adapting PB2 amino acid substitutions, such as PB2 E627K. Deep sequencing analysis of viral RNA from mouse brain and lungs revealed that virus with PB2-627E was predominant in three of four mice, whereas the PB2-627K substitution was predominant in one mouse. These results indicate that Fox/Hok/1/22 is highly virulent in mice despite lacking known PB2 substitutions involved in mammalian adaptation.IMPORTANCEThe H5N1 avian influenza virus has caused severe disease in birds worldwide and is now spreading to mammals, including humans. In 2022, this virus was detected for the first time in an Ezo red fox in Japan. To understand its potential impact on mammals, we studied this virus in mice and found that it caused severe illness, spreading to multiple organs, including the lungs and brain. Surprisingly, despite lacking genetic mutations typically associated with mammalian adaptation, the virus was highly virulent in mice. This finding suggests that the H5N1 virus may pose a greater threat to mammals, including humans, than previously thought. Given their continued spread among wild and domestic animals, our findings underscore the urgent need to monitor how recent H5N1 viruses behave in mammals.
16. Epidemiological and antigenic inferences from serological cross-reactivity among arboviruses.
期刊: Science translational medicine 发表日期: 2025-Nov-26 链接: PubMed
摘要
Multiplex immunoassays can facilitate the parallel measurement of antibody responses against multiple antigenically related pathogens, generating a wealth of high-dimensional data that depict complex antibody-antigen relationships. In this study, we developed a generalizable analytical framework to maximize inferences from multipathogen serological studies. We fit the model to measurements of immunoglobulin antibody binding against 10 arboviral pathogens from a cross-sectional study in northwest Bangladesh with 1453 participants. We used our framework to jointly infer the prevalence of each pathogen by location and age as well as between-pathogen antibody cross-reactivity. Reconstructing immunological profiles, we found evidence of endemic transmission of Japanese encephalitis virus and recent outbreaks of dengue and chikungunya viruses in this district. Our estimates of antibody cross-reactivity were highly correlated with phylogenetic distances inferred from genetic data [correlation coefficient (r) = 0.94], demonstrating how antigenic landscapes can be inferred from population-level serological studies. Furthermore, we showed how our framework could be used to identify the presence of antigenically related pathogens that were not directly tested for, representing a potential opportunity for the detection of emerging pathogens. The presented analytical framework offers a tool that can be applied to a growing number of multipathogen studies and will help support the integration of serological testing into disease surveillance platforms.
17. Exploring the Relationship Between Boil Water Advisories and Beverage Attitudes and Intake in Adults in Newfoundland and Labrador.
期刊: Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme 发表日期: 2025-Nov-26 链接: PubMed
摘要
Newfoundland and Labrador (NL) became the first Canadian province to implement a tax on sugar sweetened beverages (SSBs) in 2022 to reduce consumption and lower the rate obesity and diabetes. NL also launched a Rethink Your Drink campaign to promote water as the drink of choice. However, there may be barriers to choosing water such as the presence of boil water advisories and negative attitudes towards tap water. The objective of this study is to explore the factors influencing total water consumption in NL and assess the impact of attitudes towards tap water and boil water advisories as a predictor of total water and SSB intake. We conducted a cross-sectional online study with adults in NL before and after the implementation of the SSB tax. Attitudes towards tap water and perceptions about being under a boil water advisory impacted beverage consumption. Having negative attitudes towards tap water predicted lower total water consumption (-221mL/week, p = .002) as well as reported being under a boil water advisory (-213mL/week, p = .042), after accounting for sociodemographic variables. Having negative attitudes towards tap water was not a significant predictor of SSB intake after controlling for sociodemographic factors (p = .090). Positive health impacts of the NL SSB tax may not be fully realized if SSBs are not substituted for healthier beverage choices, such as water. Policy makers should be aware of the relationship between negative attitudes towards tap water, boil water advisories and beverage consumption when implementing initiatives to improve public health.
18. Emergency contraception in Chile: Analysis of public policy according to Walt and Gilson.
期刊: Medwave 发表日期: 2025-Nov-26 链接: PubMed
摘要
This study aims to analyze Chile’s policy governing access to the emergency contraceptive pill from the perspective of Walt and Gilson’s policy triangle. Its purpose is to generate evidence on relevant actors, implementation, activities, and decisions taken. Through a retrospective case study with a qualitative-analytical approach, supported by a literature review, official reports available online, and analysis of relevant documents, an empirical analysis was conducted using a qualitative-descriptive synthesis matrix based on the Policy Triangle. The analysis followed a historical structure organized into four time periods that characterized the political process surrounding the emergency contraceptive pill in Chile. The main results highlight the participation of numerous sociopolitical actors in formulating the public policy to secure access to the emergency contraceptive pill, within a context of persistent ideological tensions. These dynamics were expressed in arguments that at different moments strengthened or weakened the policy process. Although issues were progressively resolved and the policy remains a work in progress, the process contributed to strengthening the reproductive rights of Chilean women. In conclusion, Walt and Gilson’s policy triangle, as an interpretive tool, offers concrete opportunities to analyze public policy in health, confirming the importance of interaction among health authorities, politicians, academic groups, and civil society organizations in matters related to health in general and respect for the sexual and reproductive rights of women with the introduction of emergency contraception. Este estudio tiene por objetivo analizar la política de acceso a la píldora anticonceptiva de emergencia desarrollada en Chile, desde la perspectiva del triángulo de políticas de Walt y Gilson. Su propósito es generar evidencia sobre actores relevantes, implementación, actividades y decisiones tomadas. Por medio de un estudio de caso retrospectivo, con enfoque analítico cualitativo, apoyado con métodos de revisión de literatura, informes en línea de fuentes oficiales y análisis de documentos relevantes; se desarrolla un análisis empírico mediado por matriz de síntesis cualitativa-descriptiva basada en el triángulo de las políticas de Walt y Gilson. Para ello se siguió una estructura histórica relacionada con cuatro períodos de tiempo que caracterizaron el proceso político de la píldora anticonceptiva de emergencia en Chile. Como principales resultados destacan la participación de numerosos actores sociopolíticos en el proceso de formulación de la política pública para obtener la píldora anticonceptiva de emergencia, que dieron cuenta de un escenario de tensiones ideológicas permanentes. Esto fue demostrado en argumentos que fortalecen y debilitan el proceso político que, si bien logró resolverse con el tiempo, siendo hoy un trabajo en progreso, impactó en el fortalecimiento de los derechos reproductivos de las mujeres chilenas. Para concluir, el triángulo de políticas de Walt y Gilson como herramienta interpretativa brinda oportunidades concretas para analizar la política pública en salud, confirmando la importancia de la interacción de autoridades sanitarias, políticos, grupos académicos y organizaciones de la sociedad civil en temas relacionados con la salud en general y el respecto a los derechos sexuales y reproductivos de mujeres con introducción de la anticoncepción de emergencia.
19. The association between implant design, age, sex and the rate of major reoperation in patients undergoing primary total hip replacement: A retrospective study of UK National Joint Registry and Hospital Episodes Statistics data.
期刊: PLoS medicine 发表日期: 2025-Nov-26 链接: PubMed
摘要
Implant revision is an operation with exchange of implants, and is used as a standard outcome after total hip replacement (THR), but may not fully represent the patient experience after a THR. Major reoperation (hereafter referred to as ‘reoperation’) without revision of implants can also lead to increased patient morbidity and mortality, and most commonly occurs when the femur fractures around an implant (postoperative periprosthetic femoral fractures; POPFF) and is treated with fixation and the implant is left in place. Reliance on revision metrics that do not capture these reoperations has led to large-scale underreporting of reoperations in THR, and is likely to have affected implant performance estimates, which have guided national policy and implant selection. It is important to include these additional reoperations when estimating treatment success to guide innovation and clinical practice. We aimed to estimate the incidence of reoperation following primary THR. We performed a large national cohort study on a mandatory, prospective database, the National Joint Registry, linked to Hospital Episode Statistics. All linkable primary THRs using recently available implants, with highest safety ratings between 01/01/2010 and 31/12/2020, were included. Major reoperation was defined as the first revision for any cause or fixation of POPFF and was identified using a combination of procedural and diagnosis codes. We identified 372,967 THRs representing 2,127,464 prostheses years at risk with a median follow-up time of 5.39 years (range 0 to 12.1 years). A total of 8,043 reoperations were identified that had been surgically treated by revision for any cause or fixation of POPFF. The incidence of reoperation was 3.78% (95% confidence interval [CI 3.70%, 3.86%]) per 1,000 prostheses years in comparison to 3.00% (95% CI [2.93%, 3.07%]) per 1,000 prostheses years when using conventional revision only outcomes. Cumulative incidence of major reoperation at 10 years was 3.1% (95% CI [3.0%, 3.1%]). Cumulative reoperation estimates were stratified by age and sex. In men aged 68 years and older, collared cementless stems performed better than cemented stems and in women aged 75 years and older, the relationship was reversed. Residual differences in patient characteristics may affect the accuracy of the estimates. Treatment failure after THR has been underrepresented by revision-only estimates. Major reoperation rates in older men were lowest with cementless collared stems, and in older women, reoperation rates were lowest with cemented polished taper stems made of stainless steel. These results prompt a review of the current implant guidance for hip replacements in older patients. III (Retrospective cohort study).
20. Healthy Futures for Young Women With Obesity: A Mixed Methods Study.
期刊: American journal of health promotion : AJHP 发表日期: 2025-Nov-26 链接: PubMed
摘要
PurposeIn young women with obesity, we sought to explore their: (1) psychosocial health; (2) perceptions of their and engagement in current health behaviors; (2) motivation to change their health behaviors; and (3) desired characteristics of a health behavior intervention.ApproachConvergent-parallel mixed methods study.SettingFocus groups were conducted over zoom.Participants34 young women with obesity (M ± SD; age = 23.79 ± 4.22 years; BMI = 35.66 ± 5.56 kg/m2; 41.2% non-Hispanic White).MethodQuantitative data were collected via Qualtrics prior to focus groups. We conducted 8 semi-structured focus groups (2-7 participants per group; 32-93 minutes) to address the pre-specified objectives.ResultsParticipants reported poor psychosocial health, with 100% meeting the cut-point indicative of significant depressive symptoms and 79.4% for clinically meaningful anxiety. Participants expressed the interconnectedness of their physical and mental health and desire to improve consistency in their eating and physical activity behaviors. However, participants did not want to emphasize weight loss as the primary focus of a health behavior intervention. Preferences for the characteristics of a health behavior intervention were in support of a hybrid format, with in-person meetings focusing on active engagement (e.g., cooking classes).ConclusionsOur findings support shifting the focus from a weight-normative to a weight inclusive approach to health behavior interventions to meet the needs and preferences of young women with obesity.
21. Diet has minimal effect on Salmonella Typhimurium infection in the gut of a cockroach vector despite altering the microbiome.
期刊: Applied and environmental microbiology 发表日期: 2025-Nov-26 链接: PubMed
摘要
The German cockroach, Blattella germanica, can harbor and transmit enteric human pathogens, including Salmonella enterica serovar Typhimurium. German cockroaches are omnivores that subsist on highly varied diets in the field, in contrast to most arthropod vectors. Diet plays an important role in shaping the gut microenvironment across a range of animals, which can in turn affect numerous aspects of physiology, including the ability to resist infection. Yet, the impact of diet on the ability of cockroaches to maintain and transmit pathogens had not been investigated previously. Here, we tested the hypothesis that dietary differences among otherwise identical populations of B. germanica could lead to differences in vector competence for S. Typhimurium. Cockroaches were maintained on three defined formulated diets with distinct macronutrient profiles for 10 days. Food consumption was monitored during this period, and the gut microbiome was profiled by 16S rRNA amplicon sequencing. The cockroaches were then orally infected with S. Typhimurium, and pathogen loads in the gut and excreta were quantified. Cockroaches equally consumed formulated high-protein, high-fat, and high-carbohydrate diets in no-choice assays. Furthermore, as expected, some significant differences in microbiome composition and diversity were observed between groups of cockroaches maintained on different diets. However, despite the effects on the microbiome, no significant diet-dependent differences in the load of S. Typhimurium maintained in the gut or shed in the excreta were observed. Although the results provide evidence that the dietary macronutrient profile is not a major contributor to vector competence, the possibility that other natural diets could influence pathogen infection and transmission dynamics is not ruled out by this study. German cockroaches are one of the most common structural pests worldwide, while Salmonella enterica serovar Typhimurium is an emerging human pathogen accounting for a significant portion of the global burden of enteric disease. Understanding the factors that contribute to the ability of cockroaches to transmit pathogens is important for infection prevention, but these remain almost entirely unknown. Here, we provide new insight into the variables involved in the vector competence of cockroaches.
22. FMDV 3A cooperates with PDCD10 to promote FMDV replication by inhibiting VISA-mediated innate immunity.
期刊: Journal of virology 发表日期: 2025-Nov-26 链接: PubMed
摘要
RIG-I like receptors (RLRs) recognize RNA viruses and induce an innate immune response. Although many host factors strictly regulate the signal transduction of the RLR pathway, the mechanisms remain unclear. In the present study, we demonstrated that virus infection slightly increased the expression of programmed cell death protein 10 (PDCD10). PDCD10 overexpression inhibited interferon beta (IFN-β) promoter activation after Sendai virus (SeV) infection. Moreover, PDCD10 negatively regulated RNA virus-induced IFN-β secretion. These effects were reversed following PDCD10 gene knockout. PDCD10 also interacted with virus-induced signaling adaptor (VISA) and disrupted the formation of the VISA-IRF3 complex to inhibit IFN-β production. Additionally, PDCD10 promoted foot-and-mouth disease virus (FMDV) replication by inhibiting IFN-β production. FMDV is the causative pathogen of foot-and-mouth disease, one of the most destructive and contagious animal diseases in the world. The FMDV 3A protein plays important roles in viral replication, host tropism, and immune regulation. Our experimental results also showed that full-length 3A cooperated with PDCD10 to inhibit IFN-β production by promoting the binding of PDCD10 to VISA. Collectively, the study findings revealed that PDCD10, as a new negative regulator, cooperated with 3A to inhibit viral-induced IFN-β production. Foot-and-mouth disease virus (FMDV) is a pathogen that causes a highly contagious and destructive foot-and-mouth disease in animals with cloven hooves. Although the 3A protein of FMDV is involved in viral replication and host tropism, its function remains unclear. PDCD10 plays critical roles in normal cardiovascular development, cell proliferation, and normal structure and assembly of the Golgi complex. The present study showed that PDCD10 expression was slightly increased by virus infection, while PDCD10 promoted FMDV replication. Our results also demonstrated that PDCD10 inhibited Sendai virus-induced interferon beta (IFN-β) production through interaction with virus-induced signaling adaptor (VISA). PDCD10 also disrupted VISA-IRF3 complex formation to impair IFN-β production induced by RNA virus. The FMDV 3A protein bound with PDCD10 to synergistically promote FMDV replication. This study helped to reveal the potential mechanism of FMDV 3A protein and PDCD10 impact on viral replication.
23. Particulate Matter Increases Bone Morphogenetic Protein 2 in Lung Fibroblasts.
期刊: American journal of physiology. Lung cellular and molecular physiology 发表日期: 2025-Nov-26 链接: PubMed
摘要
Particulate matter less than 2.5 μm (PM2.5) contributes to many chronic respiratory disorders, but the mechanisms for this are not fully understood. The actions of PM2.5 on lung epithelial cells have been well studied, but their effect on lung fibroblasts has not been as extensively reported. Bone morphogenetic protein (BMP) 2, part of the transforming growth factor cytokine family, plays crucial roles in development, morphogenesis, and repair, and functions as a critical mediator in the pathogenesis of lung diseases such as pulmonary fibrosis and chronic obstructive lung disease. Here, we investigate the impact of PM2.5 on fibroblast BMP2 production and the role of BMP2 in mediating fibroblast-to-myofibroblast differentiation and matrix generation. Treatment of fibroblasts to PM2.5 resulted in a dose-dependent rise in BMP2 mRNA and protein secretion, which was specific to BMP2 and not observed with other BMP family members. In normal quiescent fibroblasts, BMP2 induced an increase in collagen and α-smooth muscle actin expression. Interestingly, BMP2 exerted an opposite effect in TGF-β1-differentiated myofibroblasts, whereby BMP2 downregulated collagen levels. These differential responses aligned with variations in p38 and ERK1/2 phosphorylation. Fibroblasts treated with high concentrations of PM2.5 demonstrated reduced collagen and α-smooth muscle actin expression, an effect reversed by BMP2 silencing or gremlin, a BMP2 antagonist. Overall, PM2.5 was observed to induce BMP2 production in fibroblasts and this was associated with suppression of fibroblast activation and matrix production by PM2.5. These findings highlight a potential mechanism whereby PM2.5 contributes to lung disease via impairment of fibroblast regenerative and repair capabilities.
24. Sex, Stress and the Heart: Long-term Cardiovascular Effects of Embryonic Metabolic Disruption.
期刊: American journal of physiology. Heart and circulatory physiology 发表日期: 2025-Nov-26 链接: PubMed
摘要
Adverse conditions within the embryonic environment can alter embryogenesis, programming systemic physiological changes that may manifest as disease states in adult life. The process of developmental programming represents an important factor underlying cardiometabolic diseases, many of which are leading causes of death globally. Importantly, there is evidence that males are less tolerant to certain environmental perturbations during embryogenesis, mirrored by sex differences in the incidence of certain cardiometabolic diseases. Understanding sex differences in programmed responses in mammalian models is complicated by maternal compensation and placental factors. Avian models offer a valuable comparable system in which such effects are not present. Here, we investigate the influence of developmental hypoxia and hypothermia in programming cardiovascular structure and function in the domestic chicken (Gallus gallus domesticus). In agreement to mammalian studies, adult males but not females show pathological mitochondrial morphology and respiratory capacity, ventricular hypertrophy and reduced body weight programmed by embryonic hypothermia and hypoxia. Notably, adult males but not females incubated under combined hypoxia and hypothermia display reduced left ventricle size, more spherical mitochondria and a reduction in mitochondrial complex IV activity in cardiomyocytes. Adult females incubated under hypothermic conditions show higher protein levels of mitochondrial complex V and do not display the same level of telomere shortening in comparison to males incubated under identical conditions. These data not only represent novel findings in birds but demonstrate the utility of the avian model for understanding sex differences in developmental stress responses, revealing common responses among endothermic amniotes.
25. Protein-Rich Soft Foods for the Elderly with Swallowing Difficulties: Advances in Formulation, Characteristics, and Digestibility.
期刊: Annual review of food science and technology 发表日期: 2025-Nov-26 链接: PubMed
摘要
Dietary requirements for older adults differ from those of younger individuals. A higher proportion of older adults experience swallowing difficulties and/or live in institutional care, further influencing the design of suitable food products. Furthermore, there is an increasing demand for protein-rich soft foods for the elderly. These foods should be nutritious, support safe swallowing, promote ease of digestion, and possess high sensory appeal. This review provides a comprehensive overview of protein functionality, gelation mechanisms, and structure-texture relationships in protein-rich soft-food products for older adults. Advances in gelation, cross-linking, and protein-hydrocolloid interactions are discussed in relation to their effects on food texture and digestibility. Standardized methods for characterizing soft foods, including rheology, stability, and sensory attributes, are also outlined. The review also highlights recent developments in in vitro digestion models that simulate elderly gastrointestinal conditions, with an emphasis on gastric-emptying rate and amino acid release kinetics. It also underscores the need for physiologically relevant in vitro and in vivo digestion studies to guide the development of protein-rich soft foods that effectively support nutrient delivery.
26. Mineralization and Transfer of Polymer-Derived Carbon from Biodegradable Mulch into the Soil Microbial Biomass and Organic Matter Pool.
期刊: Environmental science & technology 发表日期: 2025-Nov-26 链接: PubMed
摘要
The use of biodegradable mulch (BDM) instead of a conventional plastic mulch film has the potential to reduce the accumulation of legacy plastic in agroecosystems. The fate of BDM polymer carbon (C) in soil, however, remains poorly understood, especially the fraction of polymer-C that enters microbial catabolic (mineralization) versus anabolic (immobilization) pathways. We present a novel approach that allows tracking of polymer-C into CO2, macro- and microplastic residues, living microbial biomass, and soil organic matter (SOM) through the combination of CO2 emission, 13C- and 14C-phospholipid fatty acid (PLFA) analysis, and plastic polymer analysis. After exposing a clear BDM piece (2 cm × 2 cm) in an agricultural soil for up to 1 year, we found that 22 ± 9% (mean and standard deviation) of the polymer-C remained as macroplastic residues (>1 mm), 19 ± 3% was present in microplastic particles (<1 mm), 22 ± 1% was emitted as CO2, 0.9 ± 0.1% was present in living microbial biomass, and 37 ± 9% was present in microbial necromass or SOM. Similar values were observed for black BDM (21 ± 3%, 10 ± 2%, 21 ± 4%, 0.8 ± 0.0%, and 47 ± 6%, respectively). Our findings indicate that, within 1 year of soil incubation, a fraction of the macroscopic BDM pieces fragmented into microplastics, while a fraction of polymer-C was mineralized and emitted as CO2, and another substantial fraction transferred into SOM. Our research advances knowledge on reducing reliance on polyethylene-based plastics and offers practical implications for improving agroecosystem sustainability.
27. A personalized automated system designed to assign hazardous noise exposures to tasks among agricultural workers.
期刊: Journal of occupational and environmental hygiene 发表日期: 2025-Nov-26 链接: PubMed
摘要
Farming is a noisy occupation, resulting in a high prevalence of hearing loss among agricultural workers. The aim of this study was to improve the accuracy of an automatic algorithm designed to cluster individual sound events into tasks. This work is part of the HearSafe Study, which aimed to increase agricultural workers’ use of hearing protection devices by providing personalized information on hazardous noise to workers. Participants in the study interacted with the HearSafe System: a small sound level meter, a website, and an algorithm to associate noise with tasks. They wore the sound level meter that recorded loud (≥ 80 dBA) sound “events,” their location, and audio clips. They interacted with the website to view where and when participants were exposed to hazardous noises during the day. To simplify interpretation, an algorithm clustered individual sound events into tasks based on their proximity in time and location. The system’s effectiveness hinges on the accuracy of this clustering algorithm. In Phase I, the accuracy was determined using parameters for time between events (2, 5, and 10 min) and distances between tasks (5, 9, and 18 m). In Phase II, the algorithm was refined to account for pauses in work and riding on equipment. Researchers manually clustered events into tasks by listening to the audio clips. Algorithm accuracy was measured as the percentage of events matching the manual clustering. The automating accuracy was improved from 57% with the base algorithm to 87% with the most accurate algorithm (p = 0.02; 10 min between events, 9 m average distance between tasks, and added the condition to combining consecutive tasks that were within 9 m of each other). Increased accuracy in identifying noisy tasks will improve the efficacy of the HearSafe System to communicate when and where use of hearing protection devices are needed among agricultural workers.
28. Genetic identification of the selenate reductase in Enterobacter cloacae SLD1a-1.
期刊: Applied and environmental microbiology 发表日期: 2025-Nov-26 链接: PubMed
摘要
Bacterial selenate reduction is a key microbial process that affects the speciation and mobility of selenium in the environment. In this study, we identified the selenate reductase gene in the facultative anaerobe Enterobacter cloacae SLD1a-1. Genome sequencing revealed a membrane-bound, twin-arginine translocation (TAT) exported molybdoenzyme operon designated as srnABCD, under the regulation of the fumarate and nitrate reductase regulator (FNR) transcription factor. The srnA gene encodes a molybdenum-containing subunit; srnB and srnC encode iron-sulfur and membrane anchor subunits, respectively; and srnD encodes a TAT chaperone. Targeted mutagenesis of the srnA gene resulted in a mutant defective in selenate reduction. Complementation with the wild-type srnA sequence restored the abolished phenotype. Heterologous expression of srnA in an Escherichia coli ΔynfEF mutant conferred selenate reduction activity, demonstrating cross-species functionality. Protein structure modeling of the selenate reductase using Boltz-1 showed a funnel-shaped active site involved in selenate binding and reduction. These findings provide new molecular insights into the genetics and mechanism of bacterial selenate reduction. Selenium pollution poses risks to ecosystems and human health, largely due to the mobility and toxicity of selenate, a common form found in soil and water. Diverse bacterial species are able to convert soluble selenate into insoluble elemental selenium, but the genes and enzymes that underpin this process are not fully understood. In this study, we identified a gene in Enterobacter cloacae SLD1a-1 that enables the bacterium to catalyze selenate reduction. We showed that this gene produces a functional enzyme even when it is transferred into a different species, Escherichia coli. Protein structure modeling revealed features of the enzyme that help it recognize and reduce selenate. This information advances our understanding of how selenium is enzymatically cycled in the environment.
29. Machine learning for predicting burnout among healthcare workers: a systematic review and meta-analysis.
期刊: Contemporary nurse 发表日期: 2025-Nov-26 链接: PubMed
摘要
Burnout among healthcare workers (HCWs) is a major occupational health challenge, with detrimental consequences for both staff well-being and patient care. Machine learning (ML) offers potential for early detection and prevention, but evidence synthesis on its predictive performance and applicability is lacking. To systematically evaluate the performance, methodological quality, and clinical applicability of ML models for predicting burnout in HCWs. Systematic review and meta-analysis. Ten databases (PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, Scopus, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wanfang) were searched for studies published from inception to 13 February 2025. Eligible studies developed or validated ML models for HCW burnout prediction, using clinically validated tools (e.g. Maslach Burnout Inventory). Two reviewers independently extracted data and assessed study quality using the Prediction Model Risk of Bias Assessment Tool for Artificial Intelligence (PROBAST-AI). Pooled area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were calculated using a random-effects model. Subgroup analyses explored heterogeneity. Twenty-two studies met inclusion criteria. The pooled AUC was 0.72 (95% CI: 0.68-0.76), indicating moderate discrimination. Sensitivity was 0.63 (95% CI: 0.53-0.73) and specificity was 0.84 (95% CI: 0.75-0.90). Models performed better when using self-reported data, focusing on nurses, conducted in the Asia-Pacific region, or using MBI-based assessments (p < 0.0001). Key predictors clustered into five categories: demographic/occupational, psychological/behavioral, organizational/social, physiological/wearable, and activity/work patterns. All studies showed high or unclear risk of bias in at least one PROBAST-AI domain. ML models show promise for predicting burnout in HCWs but are limited by methodological weaknesses, heterogeneity, and lack of external validation. Advancing this field requires rigorous design, transparent reporting, multimodal data integration, and ethical safeguards to enable trustworthy clinical use.
30. Dysregulated inflammatory cytokines in MSM living with HIV who exhibited suboptimal immune reconstitution despite antiretroviral therapy (ART).
期刊: Cytokine 发表日期: 2025-Nov-25 链接: PubMed
摘要
The relationship between serum cytokine levels and immunologic non-response in people living with HIV (PLWH) receiving antiretroviral therapy (ART) remains inadequately characterized. This study aimed to comprehensively characterize the serum cytokine profiles of men who have sex with men (MSM) living with HIV who exhibited different immunologic responses to ART. We recruited MSM living with HIV and HIV-uninfected MSM (healthy controls, HC) in Guangzhou between June 1 to October 31, 2021. MSM living with HIV were classified as poor immunological responders (PIR, CD4+ T cell count <350 cells/μL) and good immunological responders (GIR, ≥ 350 cells/μL) after more than 24 months of ART. Blood samples were collected, and serum cytokines were quantified using Olink multiplex proximity extension assay (PEA). A total of 134 MSM were enrolled, including 44 HC, 52 GIR, and 38 PIR. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis revealed significant difference in the PI3K-AKT signaling pathways between GIR and PIR. Six candidate cytokine markers (PD-L1, FGF-19, CD244, CD8α, 4E-BP1, and CASP-8) were identified by least absolute shrinkage and selection operator (LASSO) regression for the construction of diagnostic models. The corresponding area under the curve (AUC) based on these six candidate markers was 0.844 (95 %CI: 0.647-1.000) in the support vector machine (SVM) model. Notably, PD-L1 and FGF-19 were identified as the top2 important cytokines for distinguishing between GIR and PIR based on LASSO regression, random forest (RF), and SVM analyses. Furthermore, PD-L1 and FGF-19 levels were negatively correlated with CD4+ T cell count (r = -0.34) and CD4+/CD8+ T cell ratio (r = -0.29), respectively. Distinct serum cytokine profiles were observed among PLWH with divergent immunologic responses, offering novel insights into the pathogenesis of immunologic non-response and identifying serum cytokines as promising therapeutic targets.
31. Integrated approach for sustainable management and control of Kyasanur forest disease in alignment with sustainable development goals.
期刊: Virology 发表日期: 2025-Nov-25 链接: PubMed
摘要
Kyasanur forest disease virus (KFDV) is a highly pathogenic tick-borne flavivirus that is endemic to India, primarily affecting rural communities in forested regions. The virus is transmitted through the bite of infected Haemaphysalis spinigera ticks, leading to a severe febrile illness characterized by symptoms that can range from mild to life-threatening. In approximately 20 % of cases, patients exhibit biphasic symptoms, which can progress to serious complications, including encephalitis and hemorrhagic manifestations. This review aims to provide a comprehensive analysis of the clinical presentation of Kyasanur forest disease (KFD), examining its geographical distribution and the risk factors associated with transmission. It highlights the complex interplay between environmental factors, tick ecology, and human behavior that contributes to the spread of the disease. Additionally, the review underscores the urgent need for further research focused on understanding the biphasic nature of KFD, which remains poorly characterized. It also calls for the development of cost-effective diagnostic tools as well as the creation of new vaccines to protect at-risk populations. Developing a rapid diagnostic kit for KFD, coupled with a mobile app for data collection and analysis, can streamline surveillance efforts, enabling real-time monitoring of outbreaks and facilitating timely public health responses in affected regions. Ultimately, a deeper understanding of KFD is crucial for enhancing disease management strategies and implementing effective prevention measures to reduce the incidence and impact of this significant public health threat. This is the first comprehensive study to establish the alignment of KFDV research with SDGs. The study aligns with multiple Sustainable Development Goals (SDGs), including SDG 3 (Good Health and Well-being), SDG 13 (Climate Action), SDG 15 (Life on Land), SDG 9 (Industry, Innovation and Infrastructure), and SDG 17 (Partnerships for the Goals), by addressing KFDV through improved diagnostics, vaccination, ecological understanding, technological innovation, and collaborative public health strategies.
32. COVID-19 as a catalyst? Uptake and drivers of seasonal influenza and pneumococcal vaccination among older adults in post-pandemic Shenzhen, China.
期刊: Vaccine 发表日期: 2025-Nov-25 链接: PubMed
摘要
Increasing vaccination coverage among older adults is a key post-pandemic public health priority. While seasonal influenza (SIV) and pneumococcal vaccines (PV) are widely available and subsidized in China, uptake remains low. This study explored post-pandemic willingness and determinants of SIV and PV uptake among older adults in Shenzhen. A cross-sectional survey of 1917 adults aged ≥60 years was conducted from January to May 2024. Descriptive statistics, chi-square tests, and multivariable logistic regression identified factors associated with willingness to receive future SIV and PV, and perceived pandemic influence, including sociodemographic characteristics, healthcare access, vaccination history, health beliefs, and policy awareness. Willingness to receive SIV and PV was high (77.4 % and 73.4 %), but actual uptake was much lower (55.1 % and 29.2 %). Over 70 % of respondents reported increased willingness due to the COVID-19 pandemic. For SIV, key predictors included previous uptake (adjusted odds ratio [aOR] = 3.92, 95 % confidence interval [CI]: 3.00-5.15), concern about influenza (aOR = 1.96, 95 % CI: 1.52-2.52), awareness of free vaccination policy (aOR = 1.90, 95 % CI: 1.47-2.47), awareness of life-course vaccination (aOR = 1.60, 95 % CI: 1.11-2.35), having a family doctor (aOR = 1.54, 95 % CI: 1.10-2.14), and frequent health check-ups (aOR = 1.33, 95 % CI: 1.03-1.71). For PV, predictors included concern about pneumonia (aOR = 3.83, 95 % CI: 3.00-4.90), prior uptake (aOR = 3.08, 95 % CI: 2.18-4.45), free policy awareness (aOR = 2.91, 95 % CI: 2.27-3.74), having a family doctor (aOR = 1.78, 95 % CI: 1.27-2.48), frequent check-ups (aOR = 1.62, 95 % CI: 1.26-2.07), awareness of life-course vaccination (aOR = 1.45, 95 % CI: 1.03-2.09), and higher household income (aOR = 1.43, 95 % CI: 1.06-1.95). Willingness-to-pay remained low; healthcare providers, community channels, and traditional media were the main information sources. While the pandemic increased vaccine willingness and uptake among older adults, an intention-behavior gap persists. Strengthening community-based services, life-course immunization promotion, policy communication, and expanded vaccine subsidies are crucial to sustaining uptake progress among this age group.
33. Striatin-3 is a human autoantigen but it is not associated with the S-phase G2 nuclear antigen (SG2NA) staining pattern.
期刊: Journal of autoimmunity 发表日期: 2025-Nov-25 链接: PubMed
摘要
Human autoantibodies have a long history of being valuable reagents to identify and characterize unique subcellular compartments, macromolecular complexes, and their individual components. One such discovery started as a unique cell-cycle related immunofluorescence pattern characterized as autoantibody targets localized in S and G2 phase nuclei of tissue culture cells, which became known as the “SG2NA” (SG2 nuclear antigen). These descriptions were followed by the identification of a calmodulin-binding protein family named ‘striatin’ that was later identified as three paralogs: Striatin/STRN1, Striatin-3/STRN3/SG2NA, and Striatin-4/STRN4/Zinedin. Many subsequent reports have used the designations SG2NA and striatin interchangeably. This report reviews the history of SG2NA and clarifies that striatin-3 is indeed a target autoantigen of some autoimmune sera, but commercially available striatin-3 antibodies or human sera that react with striatin-3 do not produce a SG2 phase nuclear staining pattern on HEp-2 cells. Hence, future reports should not use anti-SG2NA and anti-striatin interchangeably.
34. Cancer-Associated Thromboembolic Disease and the Evolution of Management.
期刊: Cardiology in review 发表日期: 2025-Nov-22 链接: PubMed
摘要
Venous thromboembolism remains a serious complication for patients with cancer, affecting survival and disrupting cancer-directed therapy. Cancer-associated thrombosis unfolds due to a combination of factors, including systemic inflammation and intrinsic patient and tumor characteristics. Tissue factor expression, cytokine release, and neutrophil traps increase prothrombotic risk. The burden is also higher in cases of immobility, surgery, the use of central venous catheters, chemotherapy, and immunotherapy, which increase the risk. Pancreatic, gastric, lung, and brain cancers have especially high rates of venous thromboembolism. The Khorana score is still often used to estimate risk, although newer tools using biomarkers and machine learning are showing promise in recent research. Direct oral anticoagulants seem to be the drug of choice for most patients. Gastrointestinal and genitourinary malignancies pose a bigger challenge given their higher risk for bleeding, requiring an individualized approach for these patients. Other situations requiring special attention are thrombocytopenia and patients with kidney and liver dysfunction. More research is needed on immunotherapy-associated thrombosis and biomarkers to contribute to a better understanding of pathophysiology, develop more effective diagnostic mechanisms, and improve prevention and quality of life.
35. Neutral red functionalized upconversion nanoparticles as ratiometric luminescence nanoprobes for high sensitively and precisely sensing megestrol acetate in bovine liver.
期刊: Spectrochimica acta. Part A, Molecular and biomolecular spectroscopy 发表日期: 2025-Nov-22 链接: PubMed
摘要
The residues of megestrol acetate (MA) in food and the environment had posed potential risks to ecological safety and human health. Here, we had developed a ratiometric luminescence nanoprobe using neutral red (NR)-functionalized upconversion nanoparticles (UCNPs) and luminescence resonance energy transfer (LRET) for highly sensitive MA detection. Through the host-guest reaction between NR and γ-Cyclodextrin (γ-CD), NR had been assembled into the γ-CD cavities on the surface of UCNPs@γ-CD, quenching the green upconversion emission at 540 nm while activating the characteristic luminescence of NR at 600 nm, which had enabled dual-signal ratiometric detection. The probe had achieved a detection limit of 0.81 μM (S/N = 3) and had performed well in milk, fetal bovine serum, and bovine liver samples. This study had provided a highly specific and environmentally friendly analytical method for the precisely screening of hormone residues in animal-derived foods.
36. Stachydrine Ameliorates Uterine Hypercontractility in Primary Dysmenorrhea by Targeting the COX-2/PGF2α Pathway.
期刊: Current issues in molecular biology 发表日期: 2025-Nov-19 链接: PubMed
摘要
Primary dysmenorrhea (PDM) is a typical gynecologic disease in which uterine contractions and inflammation cause pain. Stachydrine (Sta) possesses multiple pharmacological activities but its effect on PDM has not yet been clarified. In vitro uterine contraction and oxytocin (OT)-induced PDM mouse models were used to evaluate the effect of Sta. Sta (10-6.5 to 10-4 mol/L) dose-dependently inhibited spontaneous and OT-induced uterine contractions, with maximum inhibition rates of 47.1% and 40.4%, respectively. This effect was reversed by N-nitro-L-arginine (L-NAME) and indomethacin (Indo), suggesting the involvement of the nitric oxide and prostaglandin pathways. In vivo, Sta (20, 10, 5 mg/kg) significantly reduced writhing episodes, prolonged latency to the first response, and alleviated OT-induced uterine damage and inflammation. Additionally, Sta downregulated cyclooxygenase-2 (COX-2) expression in uterine tissue and decreased serum malondialdehyde (MDA) and prostaglandin F2α (PGF2α) levels. These findings suggest that Sta alleviates PDM by modulating the COX-2/PGF2α pathway, inhibiting uterine contractions, and reducing inflammation and oxidative stress, making it a promising therapeutic candidate for PDM.
37. Development and evaluation of a novel RT-qPCR assay for detection of Crimean Congo haemorrhagic fever virus using the Genedrive® point-of-care platform.
期刊: Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology 发表日期: 2025-Nov-17 链接: PubMed
摘要
Crimean-Congo haemorrhagic fever (CCHF) is a viral haemorrhagic fever classed by the World Health Organization as a priority disease due to the lack of countermeasures. A point-of-care (POC) diagnostic test for rapid detection of positive cases to expedite patient management is not currently available but urgently needed. We have developed an RT-qPCR assay to be used with the commercially available POC Genedrive® PCR platform enabling viral detection in serum with minimal sample preparation. The sensitivity and specificity of the novel assay in the Genedrive® was evaluated against the RealStar® CCHFV RT-qPCR Kit (Altona Diagnostics, Germany). The sensitivity and specificity in assay V1 (sample n = 150) were 94.4 % (95 % CI, 88.2-97.9) and 97.6 % (95 % CI, 87.1-99.9). For assay (n = 55) V2 sensitivity was 92.3 % (95 % CI, 74.9-99.5) and specificity was 100 % (95 % CI, 87.7-100). This study supports the feasibility of diagnosing CCHF using POC RT-qPCR platforms, having the potential to reduce turnaround times, leading to improved clinical management.
38. Long-term Senolytic Treatment Prevents Endothelial Dysfunction in Arterial Aging.
期刊: Aging and disease 发表日期: 2025-Nov-16 链接: PubMed
摘要
Endothelial senescence is a critical contributor of arterial dysfunction and age-related cardiovascular diseases. This study demonstrates that long-term senolytic treatment with dasatinib plus quercetin (D+Q; 5 mg/kg + 50 mg/kg biweekly for 8 months) in mice significantly attenuates vascular endothelial senescence. D+Q lowered senescence markers (p21 protein and SA-β-gal positivity) in aged mesenteric arteries and human umbilical vein endothelial cells (HUVECs), while maintaining endothelial integrity. Transcriptomic analysis indicated activation of the relaxin signaling pathway and upregulation of nitric oxide synthase isoforms. Mechanistically, D+Q reversed age-related eNOS uncoupling by promoting dimerization, increased nitric oxide bioavailability, and reduced mitochondrial dysfunction, evidenced by restored mitochondrial ultrastructure, decreased mitochondrial mass, and lowered reactive oxygen species (ROS) production. Consequently, D+Q restored endothelium-dependent vasodilation and enhanced blood flow in aged mesenteric arteries following acetylcholine stimulation. These findings demonstrate that clearance of senescent endothelial cells via senolytic therapy mitigates arterial aging by restoring mitochondrial homeostasis and eNOS function, highlighting its therapeutic potential for age-related vascular dysfunction.
39. A SAS macro for multilevel Cosinor analysis.
期刊: Computer methods and programs in biomedicine 发表日期: 2025-Nov-14 链接: PubMed
摘要
Cosinor analysis allows for the fitting of a cosine curve to describe cyclical variation in periodic data. The analysis provides an intuitive set of estimates that includes the MESOR (Midline Estimating Statistic of Rhythm), i.e., the mid-point of the fitted outcome, the amplitude, i.e., one-half the distance between the MESOR and the peak for normally distributed outcomes, and the acrophase, i.e. the time at which the outcome reaches its peak. Traditionally, most published cosinor analyses were generated though a two-stage approach in which a curve was fit to each individual’s data and differences in the estimated cosinor parameters were compared in downstream analyses. More recently multilevel cosinor modeling software has been developed which allows for the simultaneous modeling of data from multiple individuals. In addition to simplifying the model building process, the advantage of multilevel vs. two-stage cosinor analysis includes the option to fit more complex models and, likely, an improvement in fit for each individual’s data. However, to our knowledge, there are no SAS procedures or macros that assist users with this analytical approach. In this paper we introduce multilevel cosinor models and SAS macros we have developed to perform these analyses. In addition, we compare model fit between the multilevel and two-stage methods. The SAS macros presented in this paper allow users to select the best random variable specification for the unconditional cosinor model and add a dichotomous grouping variable to detect differences in parameters across groups. At each step of model building, parameter estimates, measures of model fit and graphical output help the user understand the model derived and its appropriateness for their data. Results of cross-validation analyses are presented that illustrate the superior fit of the multilevel over the single-level approach for the dataset utilized in the examples. Multilevel cosinor analysis extends the single subject cosinor model by allowing for more convenient model selection and may provide a better fit for each individual’s data. We are hopeful that this manuscript will introduce more researchers to this analytical technique and allow them to apply it in their own research.
40. The Relationship Between Forms of Childhood Maltreatment and Vascular Function Indices in Black Men and Women.
期刊: Biopsychosocial science and medicine 发表日期: 2025-Nov-10 链接: PubMed
摘要
Examine the association between types of childhood maltreatment and surrogate markers of vascular function, and to test whether sex modify these relationships. Childhood maltreatment and indices of vascular function were assessed in a cohort of healthy Black adults without known CVD (n=404). Maltreatment (physical, sexual, emotional, and general trauma) domains were assessed using the Early Trauma Inventory Short Form. A trauma severity index score was calculated by summing the indexes for each domain. Outcomes of central augmentation index (cAIx) corrected for a heart rate of 75 bpm, and carotid femoral pulse wave velocity were measured as indices of wave reflections and arterial stiffness, respectively, and central pulse pressure (CPP). Associations between each domain and outcomes were assessed using multivariate-adjusted (demographics, clinical, health behaviors, and depressive symptoms) and sex-stratified linear regression models. The cohort had a mean age of 53±10.3 years, and 61% were women. After adjustments, emotional abuse (2.68 [95%CI: -4.78, -0.58, P=0.013]) and physical abuse (-2.38[-4.26, -0.50, P=<0.001]) were associated with cAIx in the overall cohort. Significant sex interactions were identified for emotional (P=0.009) and physical abuse (P=0.001) with cAIx and for emotional abuse with CPP (P=0.021). Among women, physical abuse was associated with a higher cAIx (2.22 [95%CI: 0.70, 3.73, P=0.004]), and among men, a lower cAIx (-2.59 [95%CI: -4.98, -0.19, P=0.035]). Emotional abuse was also associated with higher CPP measures among women (1.31 [95%CI: 0.15, 2.46, P=0.027]) with no associations identified in men. Physical and emotional abuse was associated with higher cAIx and CPP in women, but not men, suggesting sex-specific effects of early trauma on vascular function.
41. The Molecular and Metabolic Landscape of Insulin Resistance in Aging-Related Cardiovascular Diseases.
期刊: Aging and disease 发表日期: 2025-Nov-09 链接: PubMed
摘要
Cardiovascular diseases (CVDs) have long been the leading cause of mortality among the elderly worldwide. Despite substantial progress, a complete understanding of the initiation and progression of CVDs remains elusive. Emerging evidence suggests that the risk of developing CVDs increases with aging and prolonged insulin resistance (IR). Insulin is a key metabolic hormone crucial for regulating glucose and lipid metabolism in various tissues. An impaired tissue response to insulin stimulation results in IR. With aging, pathological changes such as visceral obesity, chronic inflammation, and oxidative stress collectively exacerbate IR, leading to dyslipidemia, hyperglycemia, and hypertension. These conditions highlight IR as a critical factor linking aging to various CVDs, including atherosclerosis, heart failure, and hypertension. Thus, preventing IR is essential for preserving cardiac function. In this review, the pathological mechanisms of IR in elderly individuals are summarized, emphasizing their association with aging-related CVDs. Additionally, potential therapeutic targets associated with IR for treating CVDs are discussed, along with current limitations and future directions for cardiac recovery strategies.
42. Adherence, Switches, and Drug Spending After Angiotensin Receptor Blocker Recalls and Shortages.
期刊: JAMA health forum 发表日期: 2025-Nov-07 链接: PubMed
摘要
Angiotensin II receptor blockers (ARBs) are common treatments for hypertension, heart failure, and chronic kidney disease. From 2018 to 2019, hundreds of valsartan, losartan, and irbesartan products were recalled due to ingredient impurities. To estimate the impact of the 2018 to 2019 ARB shortages on medication adherence, switches to alternatives, and associated drug spending up to 18 months. This longitudinal cohort study with a difference-in-differences (DiD) analysis used pharmacy claims data from IQVIA’s all-payer Formulary Impact Analyzer dataset from July 2017 to January 2020, comprising prerecall users of valsartan, irbesartan, and losartan vs similar nonrecalled medications (other ARBs, angiotensin-converting enzyme inhibitors [ACEIs]). Analyses were conducted from November 2023 to October 2025. Use of the recalled drugs (valsartan, irbesartan, and losartan) at baseline vs comparison antihypertensives (nonrecalled ARBs, ACEIs). Mean proportion of days covered for ARBs and ACEIs, switches to alternatives, medication gaps of 30 or more days, and associated drug spending (insurer and patient out-of-pocket costs). For 13.8 million ARB users (median [IQR] age in 2018, 66 [56-74] years; 54.8% female) vs 23.4 million comparison drug users (median [IQR] age in 2018, 62 [54-72] years; 46.0% female), mean proportion of days covered changed by 0.55 percentage points (pp; 95% CI, 0.34-0.76 pp) within 18 months. Relative changes in gaps of 30 or more days, insurer drug spending, and patient out-of-pocket drug spending changed by less than 5% (relative changes of -2.5%, 0.6%, and 3.7%, respectively). ARB users experienced an increase in medication switches in the 90 days after the valsartan recall (DiD estimate: 8.46 pp; 95% CI, 8.30-8.63 pp; 229.0% relative increase). Smaller increases in switching occurred after the first irbesartan and first losartan recalls (DiD estimate: 1.20 pp; 95% CI, 1.12-1.27 pp; 32.4% relative increase). The proportion of individuals switching was greater among those with Medicare (DiD estimate: 9.49 pp; 95% CI, 9.28-9.72 pp; 256.8% relative increase) or third-party insurance (DiD estimate: 7.81 pp; 95% CI, 7.57-8.04 pp; 210.8% relative increase) vs Medicaid fee-for-service insurance (DiD estimate: 2.54 pp; 95% CI, 2.31-2.77 pp; 43.1% relative increase) or among customers paying with cash (DiD estimate: 3.42 pp; 95% CI, 3.22-3.61 pp; 87.1% relative increase). This cohort study shows that access to alternatives may have mitigated gaps in treatment during the 2018 to 2019 ARB recalls and drug shortages. Potential disparate impacts among certain subgroups highlight the need for policies to mitigate financial and other systematic access barriers to receiving health care during drug shortages.
43. Redefining the gender identity spectrum in longitudinal studies: adolescent response patterns after adopting the two-step measure of sex and gender.
期刊: Health promotion and chronic disease prevention in Canada : research, policy and practice 发表日期: 2025-Nov 链接: PubMed
摘要
Ongoing, large-scale longitudinal studies and surveillance systems are moving beyond historical single-item sex or gender measures to better capture gender identity. We examined patterns in adolescents’ responses over a two-year period (2020-2021 to 2021-2022 school years) after the COMPASS study adopted a two-step measure of gender identity. Descriptive analyses revealed that, over time, 3.5% and 5.5% of high school students (n = 11 618) selected a different response for sex and gender, respectively. Our findings show that by implementing an inclusive measure that recognizes sex and gender as distinct constructs can improve the identification of all gender identities without compromising data quality. Afin de mieux saisir l’identité de genre, les études longitudinales et les systèmes de surveillance à grande échelle évoluent pour aller au-delà des mesures traditionnelles du sexe ou du genre fondées sur une question unique. Nous avons analysé les profils des réponses d’adolescents sur deux ans (années scolaires 2020-2021 et 2021-2022) après l’adoption dans l’étude COMPASS d’une mesure de l’identité de genre en deux étapes. Les analyses descriptives ont révélé qu’au fil du temps, 3,5 % des élèves du secondaire (n = 11 618) ont choisi une réponse différente à la question sur le sexe et 5,5 % à celle sur le genre. Nos résultats montrent qu’en mettant en œuvre une mesure inclusive qui considère le sexe et le genre comme des concepts distincts, on peut améliorer la détermination des identités de genre sans compromettre la qualité des données. Historical single-item measures often do not differentiate between sex and gender and/or provide only binary response options (e.g. “male” and “female”). This study examined patterns in adolescents’ responses regarding their sex and gender after an ongoing longitudinal study adopted a two-step measure of gender identity. We found that over a two-year period, 3.5% of adolescents selected a different response for sex (e.g. “female” to “male”) and 5.5% selected a different response for gender (e.g. “female” to “boy”). Collecting more inclusive data on gender identity in population-based longitudinal studies can fill data gaps, identify gender-related health disparities and strengthen the health and well-being of all Canadians. Les mesures traditionnelles fondées sur une seule question ne font souvent aucune distinction entre le sexe et le genre ou fournissent seulement des options de réponse binaires (comme « garçon » et « fille »). Cette étude a permis d’analyser les profils des réponses d’adolescents aux questions sur leur sexe et leur genre après l’adoption, dans une étude longitudinale en cours, d’une mesure de l’identité de genre en deux étapes. Nous avons constaté que, entre ces 2 années, 3,5 % des adolescents ont choisi une réponse différente pour le sexe (par exemple, de « féminin » à « masculin ») et 5,5 % ont choisi une réponse différente pour le genre (par exemple, de « féminin » à « garçon/homme »). La collecte de données plus inclusives sur l’identité de genre dans des études longitudinales fondées sur la population permet de combler des lacunes dans les données, cerner les disparités en matière de santé liées au genre et renforcer la santé et le bien-être de l’ensemble des Canadiens.
44. Clinical utility of combined butyrylcholinesterase activity measurements in assessing acute malathion intoxication severity: A case series.
期刊: Human & experimental toxicology 发表日期: 2025 链接: PubMed
摘要
BackgroundAccurate and prompt assessment of malathion intoxication severity remains a significant clinical challenge, often hampered by reliance on single diagnostic markers. This exploratory case series investigated the combined utility of rapid butyrylcholinesterase (BChE) activity measurements and gas chromatography-tandem mass spectrometry (GC-MS/MS) for quantifying urinary malathion to enhance diagnostic precision.MethodsWe investigated three independent patients admitted with acute malathion intoxication. BChE activity was measured using both a point-of-care (POCT) device and a laboratory-based enzyme-multiplied immunoassay technique (EMIT). Urinary malathion was quantified using a validated GC-MS/MS method.ResultsMalathion exposure was confirmed in all patients via urinary analysis. Strong per-case positive correlations (r ranging from 0.905 to 0.996) were observed between the two BChE measurement methods, though Bland-Altman analysis revealed noteworthy discrepancies (mean bias of 10%, limits of agreement ranging from -20% to 40%). Critically, statistically significant inverse correlations (p < 0.05) were identified between urinary malathion concentrations and both BChE activity measurements, underscoring the dynamic relationship between exposure and enzymatic inhibition.ConclusionThese findings, derived from a small, exploratory case series, suggest the importance of an integrated diagnostic approach for malathion intoxication. This combined strategy may support improved assessment of severity and prognosis in individual cases, offering insights into the pesticide’s systemic impact and elimination kinetics, especially when exposure details are unclear. While rapid BChE tests are valuable for initial screening, their interpretation should occur within this multi-marker framework. The generalizability of these findings is limited by the small sample size, and no formal power calculation was performed.
45. Understanding the challenges of healthcare transition in the context of HIV-related stigma for young adults with perinatal HIV in Thailand.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The healthcare transition during adolescence and young adulthood has consistently been reported as a critical period for attrition and adverse health outcomes. The study assessed HIV-related stigma and transition experiences among young people living with perinatal HIV (YPHIV) in Thailand. We conducted a mixed-methods cross-sectional study at two research sites in Chiang Mai and Bangkok, Thailand from December 2023 to February 2024. We recruited YPHIV aged between 18-30 years who remained under care in pediatric HIV clinics (group A), those who had transitioned to adult care from those clinics (group B), and caregivers of group B participants (group C). We assessed HIV-related stigma using the validated 8-item Thai Internalized HIV-related Stigma Scale brief (Thai-IHSS brief) and transition-related experiences through in-depth interviews and focus group discussions. Thirty YPHIV (median age 23 years [IQR 22-26]) and ten caregivers were enrolled. The Thai IHSS brief score revealed a low level of internalized stigma in the study participants (median score 14; IQR 11-17). Anticipated negative thoughts and negative self-thoughts were common. HIV-related stigma experiences of YPHIV and caregivers were grouped into 3 themes: internalized, anticipated, and enacted stigma/discrimination. Transition experiences of YPHIV in both groups included hesitation to navigate care in adult clinics and feeling unprepared, perceived loss of support, and demotivation from being in care. Anticipated stigma and social problems were expressed by YPHIV and caregivers. In the focus groups, YPHIV indicated their need to learn about the transition beforehand, to be guided to the new clinic while staying connected to their original clinics, and to extend time in the pediatric clinic until they were more confident with transitioning care. In conclusion, we found many stigma issues started since childhood, plus collective experience while growing up. The internalized HIV-related stigma influenced the healthcare transition journey of YPHIV. Healthcare providers need additional guidance on how to manage transition in YPHIV, including individualized transition plans for those at increased risk of adverse outcomes, interventions to manage internalized stigma, and follow-up strategies after transition.
46. The struggle for medicine: A valid and reliable cross-sectional study on the impact of war on healthcare access and its consequences for displaced Sudanese citizens.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
Armed conflicts severely impact healthcare systems leading to medication shortages and restricted access to essential services. The ongoing war in Sudan has disrupted healthcare infrastructure affecting patients particularly those with chronic diseases. This study examines the accessibility of medications and the consequences of limited healthcare access during the conflict. A descriptive cross-sectional study was conducted among individuals affected by the Sudan war. Data were collected through an online questionnaire assessing medication accessibility, healthcare service availability, and socioeconomic factors. Statistical analysis was performed using SPSS to examine correlations between accessibility and health outcomes. Out of 300 participants, 56.7% reported poor medication accessibility while 43.3% had to relocate due to a lack of medical care. 65.7% experienced worsening health condition and 61.3% believed medication shortages contributed to increased mortality. Low-income and unemployed individuals faced the greatest challenges in accessing medications. The Sudan war has significantly disrupted healthcare access with severe consequences for medication availability and patient health. Urgent humanitarian interventions and policy measures are needed to restore medication supply chains and improve healthcare access for conflict-affected populations.
47. Urban-rural consumption differences among the elderly in developed regions: Evidence from Zhejiang, China.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
This study examines the consumption patterns of older adults and the urban-rural disparities in Zhejiang Province, a highly developed yet rapidly aging region of China. A total of 276 valid samples were obtained from Ningbo, Hangzhou, and Wenzhou through a mixed approach combining online snowball sampling with offline random sampling. A LASSO regression model was employed to assess the effect of residence while controlling for socioeconomic variables. The results indicate that urban older adults spend significantly more than their rural counterparts, with average monthly consumption reaching 3,980 RMB compared to 2,502 RMB. Urban residence was associated with an increase of 995 RMB in total expenditure, with higher spending observed on housing, food, daily necessities, leisure and education, and health rehabilitation. Although rural respondents expressed strong interest in leisure, education, and health services, their actual expenditures in these categories were much lower, revealing a gap between intentions and behavior. Offline consumption remains dominant, but online consumption is expanding slowly. Digital exclusion persists, particularly in rural areas, due to limited literacy, complex interfaces, and unstable internet access. These findings suggest that elderly consumption is influenced not only by income but also by structural inequalities, health constraints, and digital inclusion. Policy measures should therefore strengthen rural healthcare, expand cultural and recreational opportunities, and promote elder-friendly digital platforms. Programs such as healthcare vouchers and targeted subsidies could help narrow the gap between intention and capability. This study provides preliminary exploratory insights into inclusive policies that may foster the sustainable development of China’s silver economy.
48. Characteristics of individuals who received a complete, 2-dose mpox vaccine regimen as part of the public health response to the mpox epidemic in Ontario, Canada.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
In May 2022, an outbreak of mpox emerged in Canada. In June 2022, the province of Ontario began offering first doses of a 2-dose regimen of Modified Vaccinia Ankara-Bavaria Nordic (MVA-BN) to those at high risk of exposure. Second doses became available in September 2022. To help increase dose 2 access and uptake, we sought to understand how individuals who received 2 doses differed from those who received only 1 dose. We conducted a cross-sectional study using population-level data among individuals who received ≥1 dose of MVA-BN between June 6, 2022 and October 31, 2023 in Ontario. We used age-adjusted Poisson regression to examine the association between demographic, social, and economic characteristics; co-morbidities; and proxies for sexual exposure (e.g., bacterial sexually transmitted infection [STI] diagnoses) and proxies for healthcare engagement (e.g., syphilis testing, past receipt of other vaccines) with MVA-BN dose 2 receipt. Among 33,012 individuals with ≥1 MVA-BN dose, 38.2% (12,620) received 2 doses. Receipt of dose 2 versus only dose 1 was associated with region (e.g., higher in Ottawa compared with Toronto [prevalence ratio, PR = 1.08, 95% confidence interval, CI 1.06-1.09]); syphilis testing (≥4 tests PR = 1.12, 95%CI 1.11-1.14) or receiving a COVID-19, influenza, or other vaccine (PR = 1.12, 95%CI 1.11-1.14) in the year before dose 1; and syphilis testing (≥4 tests PR = 1.19, 95%CI 1.18-1.20) or bacterial STI diagnoses >3 months after dose 1 (≥4 diagnoses PR = 1.07, 95% CI 1.05-1.08). Refugees were less likely to get dose 2 versus Canadian-born individuals or long-term immigrants (PR = 0.93, 95%CI 0.91-0.95).Our findings suggest lower healthcare access and/or engagement may play a role in limiting dose 2 receipt in Ontario. Public messaging around availability and eligibility of second doses, tailored strategies for eligible refugees, increased access outside healthcare venues, and adopting promotion strategies from regions with high uptake, may help increase dose 2 coverage.
49. Association between shift work and insulin resistance in women: Implications for metabolic health.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Shift work has been associated with circadian rhythm disruption and related metabolic disturbances, with women potentially being more vulnerable due to physiological and hormonal characteristics. Research on the correlation between shift work and insulin resistance in women outside hospital nursing settings remains scarce. Therefore, this study investigated the relationship between shift work and insulin resistance in working-age women, using the triglyceride-glucose (TyG) index as a surrogate marker. Data from 3,780 female participants aged 19-64 years were collected from the 2019-2021 Korea National Health and Nutrition Examination Survey. Participants were classified as day or shift workers, and insulin resistance was categorized as high or low based on the TyG index. The association between work schedule and insulin resistance was evaluated after adjusting for potential confounders. Shift workers had 1.30 times higher odds of elevated insulin resistance than day workers. Stronger associations were observed among women aged 40-50 years, those in pink-collar occupations, and individuals with adverse lifestyle factors, including overweight status, physical inactivity, alcohol consumption, and smoking. These findings underscore the importance of tailored workplace health interventions and the adoption of personalized, circadian rhythm-aligned strategies to reduce metabolic risk among female shift workers, thereby supporting occupational health policy and preventive care.
50. Associations of calcium and magnesium intakes and their intake ratio with albuminuria in middle-aged and older adults.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Calcium and magnesium both work together and against each other by sharing homeostatic regulatory systems in the kidneys. Previous studies suggested that these minerals and their intake ratio were associated with chronic health conditions such as cardiovascular disease. Our objective was to investigate the association of calcium and magnesium intake and their intake ratio with albuminuria. This cross-sectional study analyzed data from a Japanese community-based cohort comprising 6,849 individuals aged ≥40 years (mean age 68.8 years, 51.3% women). Energy-adjusted dietary intake of calcium and magnesium and the calcium-to-magnesium intake ratio were derived from a validated food frequency questionnaire. The outcome was spot urinary albumin-to-creatinine ratio (ACR, mg/g). Linear and logistic regression analyses were performed with adjustments for potential confounders. The analytic population had 1.65 and 73.5 mL/min/1.73 m2 as median intake ratio and estimated glomerular filtration rate, respectively. In multivariable linear regression analysis, lower intakes of calcium and magnesium were associated with the log-transformed ACR but, after mutual adjustment, only calcium intake was independently associated with the ACR (regression coefficient -0.084; 95%CI, -0.149, -0.019). A lower intake ratio was associated with the log-transformed ACR (regression coefficient, -0.085; 95%CI, -0.150, -0.021). These associations were evident overall and in male participants. Although magnesium intake was associated with albuminuria only before accounting for calcium intake, calcium intake and calcium-to-magnesium intake ratio demonstrated robust associations. Our findings support that the importance of calcium intake and its balancing with magnesium might extend to kidney health, especially albuminuria.
51. [Mental Health and Return/Integration to Work: International Concertation on Solutions and Priority Actions].
期刊: Sante mentale au Quebec 发表日期: 2025 链接: PubMed
摘要
Introduction and Objective As part of the conference Crossed Perspectives on Mental Health and Return to Work, held in Montreal in 2021, a white paper was produced to highlight 10 solutions aimed at promoting mental health in the workplace and facilitating return to work (RTW). Examples include actions such as formalizing the RTW process with common guidelines for personalized follow-up, training managers on mental health prevention and employees support during their RTW, and generating evidence-based data to better understand and promote sustainable and healthy return to work after medical leave. Three years later, during a roundtable discussion at the inaugural conference of the International Community of Practice on Mental Health and Work (CoP-SMT in French), the objective was to revisit these solutions by engaging stakeholders involved in employee support and company representatives. Method During the round table, eight individuals holding executive positions in RTW services or management roles in public and private organizations from Belgium, France, and Quebec were invited to select one or two solutions from the white paper. They were asked to share which solutions they had implemented or wished to implement in their work contexts. Additionally, participants were encouraged to identify one or two priority actions they deemed essential for discussion at the next conference in 2027. A synthesis of their responses are presented as the outcome of this exercise. Results and Conclusions The results provide insight into current practices, challenges, and needs identified by the experts consulted, helping to outline research directions to support the implementation of practices/initiatives across different countries. These reflections also consider emerging responsibilities and evolving roles of various stakeholders involved. Notably, the concept of workplace mental health should extend beyond merely addressing psychosocial risk factors by incorporating protective factors as well.
52. [From stigma to exclusion of individuals with mental health conditions: Analyzing the perceptions and emotions of stakeholders engaged in the work return and reintegration processes].
期刊: Sante mentale au Quebec 发表日期: 2025 链接: PubMed
摘要
Objectives The stigma surrounding individuals with mental conditions persists, making their return to work or access to employment complex. These negative stereotypes are often internalized by the affected individuals, leading to self-stigmatization. Literature shows that the medical and entrepreneurial sectors harbor many prejudices and apprehensions towards these individuals. In contrast, the fields of rehabilitation and employment support, which frequently interact with these individuals and use recovery approaches, show less resistance. Although the stigma of these populations is relatively well-documented, few studies have differentiated the perceptions of actors responsible for implementing their return and reintegration into work. This study aims to identify and compare these actors’ tendencies to stigmatize individuals with mental conditions and their intentions of professional inclusion. Method As part of the international survey by the community of practice in mental health and work (CoP-SMT), data was collected through an online quantitative survey involving 586 actors in the return to work and reintegration processes. Four actor systems were identified: health, corporate, employment support, and individuals with mental disorders on sick leave or job seeking. The questionnaire included a two-factor stigma scale (perceived organizational burden and negative emotions) and a professional inclusion intention measure with three indicators (avoidance, paternalism, and collaboration). Factor analysis and internal consistency validated the psychometric qualities of these measures. Variance analyses with post-hoc comparisons allowed the comparison of responses from categories of 20 or more actors, reducing the sample to 473 participants. Results The results highlight a significant effect of the actor system on stigma and professional inclusion intention. They reveal that actors involved before employment (rehabilitation and employment support) are less prone to stigmatize and more open to including individuals returning or reintegrating into work than those within the company (hierarchy, colleagues, and occupational health professionals). They also show the persistence of self-stigmatization among individuals with mental health issues returning or reintegrating into work. Conclusion To better interpret the results, the experience of coexistence and inclusion in the ordinary work environment of individuals with mental health conditions is explored, considering the roles of various stakeholders. Knowledge, conceptual orientations around mental health, and collaborative multidisciplinary work are suggested as anti-stigma strategies. Based on these findings, research perspectives and recommendations are formulated.
53. [Preventing occupational reintegration and return to work: An example of multi-partner collaboration in an inter-company occupational health prevention service in France].
期刊: Sante mentale au Quebec 发表日期: 2025 链接: PubMed
摘要
Context In France, both Return to Work (RTW) and sustained employment following extended medical leave are critical concerns, due to the substantial risk of professional disengagement after returning to work. Professional disengagement, influenced by a combination of work-related and health-related factors, necessitates proactive awareness, prevention, and adapted support to maintain employment. The involvement of diverse stakeholders in this process complicates access to available resources, highlighting the need for effective coordination. The occupational health law of August 2, 2021, mandates that Inter-Company Occupational Health Services (SPST) establish Professional Disengagement Prevention (PDP) units. These units are tasked with coordinating RTW support actions among the relevant stakeholders. Objective This exploratory research examines the collaborative process for RTW within a PDP unit at a rural SPST. It analyzes the development of a multi-partner collaborative process with the Health Insurance (Assurance Maladie) and a service provider specializing in maintaining the employment of workers with disabilities. The research aims to describe the development of this multi-partner collaboration and to elucidate the roles of organizational factors and the professionals’ understandings of work disability in this process. Method A qualitative methodology was employed, involving the observation of meetings and a word association task with the stakeholders. This approach was used to identify both the facilitators and barriers to collaboration and to analyze the stakeholders’ perceptions. Results The analysis identified several facilitators, including effective communication, coordination, and complementarity, as well as barriers, such as operational methods, role ambiguity, and workload. While facilitators enhanced communication and coordination, barriers were associated with limited availability and discrepancies between planned and actual work, intensified by administrative and human resource constraints. The co-construction of a collaborative tool facilitated interactions, decision-making, and improved the efficiency of RTW. Results indicate that sustained collaboration requires role clarification and aligned expectations over time. Perceptions of Professional Disengagement showed both commonalities and differences among the actors, with “support” being central but other elements revealing inter-professional variability. Conclusion In conclusion, the study emphasizes the importance of allowing sufficient time for the development of a shared understanding of roles and perspectives among stakeholders. This is crucial for fostering a robust work collective and ensuring the long-term success of multi-partner collaborations. The collaborative creation of a shared tool was shown to be a significant facilitator in establishing effective collaboration, built on shared, rather than entirely common, understandings.
54. [A Legal and Collective Approach to Mental Health Disclosure at Work].
期刊: Sante mentale au Quebec 发表日期: 2025 链接: PubMed
摘要
Introduction The disclosure of mental health issues in the workplace highlights tensions between the need to adapt working conditions and the risk of stigmatization affecting the individuals concerned. This research examines the barriers and facilitators shaping this disclosure process within a collaborative framework involving the employee, colleagues, management, and health professionals, using an interdisciplinary approach that combines law and sociology. Method This study is part of an action-research initiative conducted in Belgium since 2018, aimed at developing a support system based on the Individual Placement and Support (IPS) methodology, intended for workers on long-term sick leave related to moderate to severe mental health conditions. It draws on three sets of data: a focus group conducted in 2023 on workplace accommodations for individuals living with mental health conditions, bringing together professionals from mutual insurance funds, employment support specialists, and experts by experience; a series of interviews conducted between 2023 and 2024 with employers and employees participating in the Belgian IPS program; and focus groups held in 2017 that explored the dynamics of professional reintegration, bringing together professionals involved in return-to-work processes, legal experts, and mental health practitioners to offer a more institutional perspective. Following a co-constructive approach with stakeholders, the research adopts a critical stance toward the tensions and limitations inherent in current legal, organizational, and practical frameworks. Thematic analysis of the data was combined with a review of Belgian, European, and international standards to shed light on common challenges across different occupational health systems. Results The disclosure of mental health issues in the workplace goes beyond an individual decision (“to disclose or not to disclose”) and is embedded in complex social dynamics. Stigma, rooted in everyday social interactions, affects not only the employees directly concerned but also the professionals supporting them. Moreover, the legal framework reveals an imbalance: the right to privacy is better established than the right to workplace accommodations, which may limit the responsibilities of employers and other actors. A strictly individualized approach to these issues tends to obscure the need for broader engagement among workplace stakeholders. The Belgian case highlights promising practices, particularly within the IPS program, where job coaches play a key role: they help clarify individual needs, support the implementation of concrete accommodations, and contribute to sharing the burden of disclosure among different actors. However, these efforts remain hindered by weak inter-institutional coordination and the lack of shared trust frameworks for the exchange of sensitive information. Discussion The findings call for a collective approach that goes beyond individual handling of disclosure and workplace accommodations. Shared professional confidentiality emerges as a key tool for balancing confidentiality and collaboration, particularly in supported employment. This approach could help build a climate of trust and enable more sustainable and collectively supported adaptations. Conclusion Stronger individual and collective acknowledgment of the right to adapt work conditions, combined with effective integration of shared professional confidentiality, could contribute to more inclusive work environments. Awareness efforts, training programs, and enhanced coordination between stakeholders are essential to consolidate the innovative approaches implemented, particularly within the IPS program.