公共卫生研究摘要 (2025-11-28)
共收录 57 篇研究文章
1. Associations Between the Diverse Aspects of Psychological Frailty and Health-Related Outcomes in Community-Dwelling Older Adults: A Cross-Sectional Study.
期刊: Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society 发表日期: 2026-Jan 链接: PubMed
摘要
Psychological frailty (PsF), encompassing cognitive and emotional vulnerabilities, remains understudied despite its potential impact on health outcomes in older adults. This cross-sectional study aimed to explore the characteristics of diverse aspects of PsF, including cognitive frailty (CF), lower cognitive function, and affective frailty (AF), and to examine their associations with health-related outcomes in community-dwelling older adults. Data were analysed from 420 community-dwelling older adults participating in the Tarumizu Study in Japan, excluding those exhibiting physical or social frailty. Participants were categorised into Robust, Lower cognitive function, CF, AF, and Multi-domain PsF groups. AF was assessed using five items from the Geriatric Depression Scale, focusing on emotional vulnerability. Health outcomes included self-rated health, subjective memory complaints (SMC), and functional ability of daily living. Associations were analysed using adjusted multiple regression models controlling for covariates. PsF was present in 39.5% of the cohort (lower cognitive function: 18.1%, CF: 7.6%, AF: 11.0%, Multi-domain PsF: 2.9%). In the adjusted models, only AF showed a significant positive association with SMC (adjusted risk ratio = 1.62, 95% CI: 1.06-2.42, p = 0.023). No significant associations were found between any PsF domain and subjective health or daily functional ability in the adjusted models. AF, characterised by emotional vulnerability, was uniquely associated with SMC, suggesting emotional factors may play a more central role than cognitive decline in shaping perceptions of memory problems. These findings highlight the heterogeneous nature of PsF and underscore the need for nuanced assessments to inform targeted prevention and intervention strategies.
2. Three Years Later: Healthiness of Food in New Zealand Primary School Canteens Following Implementation of the Healthy Food and Drink Guidance.
期刊: Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals 发表日期: 2026-Jan 链接: PubMed
摘要
One-third of children in New Zealand (NZ) are overweight or obese, with suboptimal dietary patterns. The NZ government implemented the Healthy Active Learning (HAL) initiative and the ‘Healthy Food and Drink Guidance for Schools’ (2020) to improve school food environments. This study aimed to evaluate the impact of these guidelines over 3 years. A convenience sample of 89 primary schools (4.6% of NZ primary schools) provided menus at baseline (2020/2021) and follow-up (2023/2024). Food items were categorised according to the guidance using a traffic-light criteria (green, amber, red). ‘Green’ menu items increased from 15.5% to 21.2%. ‘Amber’ items decreased from 44.4% to 33.8% (p = 0.005). ‘Red’ items showed minimal change (35.4% to 37.5%). There were reductions in the presence of sugar-sweetened beverages (40% to 31%) and ultra-processed savoury snacks (42% to 33%). Schools in affluent areas reduced ‘amber’ foods, while schools in high deprivation areas saw minimal change in ‘green’ foods (8.6% to 7.2%) and ‘red’ foods (32.4% to 29%). The guidance implementation led to modest improvements in the healthiness of school menus, particularly reducing ‘amber’ foods and ultra-processed snacks. The limited increase in healthy ‘green’ foods and the persistent presence of unhealthy ‘red’ foods highlight the need for further intervention. SO WHAT?: This study emphasises the importance of sustained efforts to improve the nutritional quality of school food, particularly in communities facing socioeconomic challenges. National consistency, monitoring, and feedback are needed to support policy implementation and ensure children have equitable access to healthy food at school.
3. Efficacy of Almonertinib Versus Osimertinib as the First-Line Treatment for Non-Small Cell Lung Cancer With EGFR L858R Mutation and Prognostic Analysis: A Retrospective Comparative Cohort Study.
期刊: Cancer medicine 发表日期: 2025-Dec 链接: PubMed
摘要
Epidermal growth factor receptor (EGFR)-specific tyrosine kinase inhibitors show less efficacy against the EGFR L858R mutation than EGFR 19del, but no current head-to-head clinical trials have been performed comparing the efficacy of almonertinib and osimertinib. Therefore, our study compared the efficacy of these drugs against the EGFR L858R mutation. A total of 200 patients with non-small cell lung cancer harboring the EGFR L858R mutation were enrolled. Among these patients, 121 received 80 mg of osimertinib, while the other 79 received 110 mg of almonertinib once daily. The primary end point was progression-free survival (PFS). The secondary end points were continued response rate and safety. The median PFS was 18.5 months (95% confidence interval [CI] 16.1-22.5) for osimertinib and 19.4 months (95% CI 13.8-NA) for almonertinib, with a hazard ratio (HR) of 0.92 (95% CI 0.62-1.73), p = 0.69. Forest plots of subgroup analyses showed no significant difference in the median PFS between the almonertinib and osimertinib groups across the subgroups. Osimertinib and almonertinib demonstrated good efficacy in the treatment of patients with brain metastases. The median PFS was 18.6 months (95% CI 15.6-22.8) for patients with brain metastases and 17.1 months (95% CI 14.1-28.6) for those without brain metastases, p = 0.89. Patients with programmed cell death ligand 1 (PD-L1) expression between 1% and 49% and PD-L1 expression < 1% showed no significant differences for their median PFS. The continued response rates between almonertinib and osimertinib were comparable. The differences between almonertinib and osimertinib were minimal. Both almonertinib and osimertinib demonstrated good efficacy in patients with brain metastases, and PD-L1 expression was not associated with the prognosis of EGFR L858R mutant NSCLC. Finally, no significant difference between osimertinib and almonertinib for the treatment of patients with EGFR L858R mutations was observed. Both options remain viable for these patients.
4. Identifying Patterns of Late Effects With Latent Class Analysis Among Adolescent and Young Adult Thyroid Cancer Survivors in California and Utah.
期刊: Cancer medicine 发表日期: 2025-Dec 链接: PubMed
摘要
Thyroid cancer is one of the most common cancers in adolescents and young adults (AYA, 15 to 39 years), with an excellent 5-year survival of 98%. However, treatments for thyroid cancer such as radioactive iodine and thyroid hormone suppression may increase the risk for multiple late effects (LEs). We investigated the incidence of severe LE that clustered in AYA thyroid cancer survivors in a large population-based cohort. California and Utah Cancer Registry records identified AYAs diagnosed with first thyroid cancer during 2006-2018 linked to statewide hospitalization, ambulatory surgery, and emergency department data. Cohort entry began 2 years from diagnosis. Severe LE included cardiovascular, respiratory, renal, and liver diseases, diabetes, and second cancers. Cumulative incidence of each LE, accounting for the competing risk of death, was calculated. Latent class analysis (LCA) identified clustering of LE over the study period. The number of LE classes was identified by selecting models with the lowest likelihood-ratio G2 statistic, Akaike’s Information Criterion, and Bayesian Information Criterion. Probabilities of each LE are presented in each class. Of 14,268 survivors, median follow-up time was 7 years. The LCA model identified 3 classes: 88% with low LEs, 9% experiencing moderate LEs with elevated probability of diabetes, liver, and respiratory conditions, and the remaining 3% experiencing the highest probability of all LEs, including cardiovascular disease. Non-Hispanic (nH)-Black and Hispanic survivors, those on public insurance, residing in lower socioeconomic status neighborhoods, or diagnosed with distant stage disease experience greater odds of being in the moderate and cardiovascular classes. While most survivors of AYA thyroid cancer have a low incidence of LEs, a small proportion have a high probability of multiple morbidities. Multidisciplinary survivorship care should include identifying and supporting thyroid cancer survivors at higher risk for developing multiple LEs through early screening.
5. Rotator Cuff Imaging Abnormalities in Asymptomatic Shoulders: A Systematic Review.
期刊: The Journal of orthopaedic and sports physical therapy 发表日期: 2025-Dec 链接: PubMed
摘要
OBJECTIVE: To estimate the prevalence of rotator cuff (RC) imaging abnormalities (tendinopathy, partial-thickness tear, full-thickness tear, or calcification) on radiograph, ultrasound, computed tomography, or magnetic resonance imaging (MRI) in asymptomatic adult shoulders. STUDY DESIGN: Systematic review. LITERATURE SEARCH: Ovid MEDLINE, Embase, CINAHL, and Web of Science (searched September 1, 2024), with forward and backward citation searches. STUDY SELECTION CRITERIA: We included studies reporting the prevalence of RC abnormalities on imaging of asymptomatic shoulders. DATA SYNTHESIS: Due to heterogeneity, data were synthesized without meta-analysis. Risk of bias was assessed using a tool for prevalence studies. Certainty of evidence was determined using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: After screening 3801 records and 188 studies in full text, we included 53 studies (29 ultrasound, 24 MRI) across population-based, miscellaneous, and athlete populations. The certainty of evidence was low to very low. For full-thickness tears, prevalence on ultrasound was 11% to 17% in 2 population-based samples (1631 shoulders), 0% to 35% across 14 studies of miscellaneous populations (3390 shoulders), and 0% to 22% across 4 studies of athlete populations (346 shoulders). On MRI, the prevalence was 20% in 1 population-based study (20 shoulders), 0% to 14% across 10 studies of miscellaneous populations (490 shoulders), and 0% to 11% across 12 studies of athlete populations (326 shoulders). For tendinopathy and/or partial-thickness tears, the prevalence on ultrasound was 34% in 1 population-based sample (539 shoulders), 0% to 47% across 11 studies of miscellaneous populations (1971 shoulders), and 7% to 70% across 4 studies of athlete populations (346 shoulders). On MRI, the prevalence was 65% in 1 population-based sample (20 shoulders), 0% to 100% across 10 studies of miscellaneous populations (490 shoulders), and 6% to 96% across 13 studies of athlete populations (426 shoulders). CONCLUSION: Across studies with low- to very low-certainty of evidence, the prevalence of RC imaging abnormalities in asymptomatic shoulders ranged from 0% to 100%. J Orthop Sports Phys Ther 2025;55(12):1-16. Epub 5 November 2025. doi:10.2519/jospt.2025.13611.
6. Bearing the Burdens of Medical Uncertainty.
期刊: Journal of evaluation in clinical practice 发表日期: 2025-Dec 链接: PubMed
摘要
Uncertainty comes in many kinds, is ubiquitous in all parts of clinical work, and is burdensome to physicians, patients, proxies and policy makers. Moreover, it leads to a range of adverse responses such as excessive testing and interventions, overdiagnosis and overtreatment. While the technical aspects of uncertainty are widely accounted for, the burdens of uncertainty need closer scrutiny. The aim of this article is to investigate the complex burden of uncertainty for clinicians: as health professionals, carers for patients, and human beings facing the unknown. A conceptual analysis is applied introducing a case to illustrate the diverse aspects of uncertainty reviewed in the literature. We identify six types of burdens of uncertainty: cognitive, emotional, behavioural, social, moral and existential and show how they play out for clinicians in clinical care for their patients, as health professionals, as caregivers and human beings. Moreover, we suggest specific strategies for bearing these various types of burdens of uncertainty in all roles. Bearing the burdens of uncertainty is crucial for professional integrity, well-being, and communication with patients, but also for improving the quality, safety, efficiency and sustainability of healthcare.
7. "Both the Training and the Coffee Afterwards Mattered a Lot"-Factors of Importance in a Complex Intervention After Acute Hospitalization: Perspectives of Older Adults With Frailty.
期刊: Journal of evaluation in clinical practice 发表日期: 2025-Dec 链接: PubMed
摘要
Older adults with frailty often face functional decline and limitations in doing everyday activities after being discharged from acute hospital admission affecting their health and quality of life. However, engaging them in training interventions can be challenging. The aim of this study was to evaluate a combined training, nutrition, and social intervention from the perspective of newly discharged older adults with frailty participating in the intervention. Semi-structured interviews were conducted with 14 participants of whom 10 were interviewed twice. Data were analyzed using a theory-based evaluation approach using a CIMO (Context-Intervention-Mechanism-Outcome) framework, followed by subsequent analysis of key elements. The study found that a skilled and person-centered physiotherapist was crucial to making strength training feasible for participants, resulting in adherence and effort in training, although continuation after the intervention was challenged by different aspects such as geography and social factors. Including goal setting and test results could potentially be relevant motivational tools, but goal setting was not implemented well, according to the experiences of the participants. The social part of the intervention was important for encouraging participation and the well-being of participants, as groups were cohesive, and participants were accepting of each other. Participants did not recall the nutritional intervention very well, and it seemingly only had a small impact. The physiotherapist’s approach was essential for ensuring compliance and motivation for strength training for the older adults with frailty. Furthermore, fostering social cohesion within training groups could be important for promoting compliance and participant well-being. Factors influencing the continuation of training should be considered to ensure its long-term sustainability. Further research is warranted on incorporating nutritional guidance to enhance the impact of interventions for newly discharged older adults with frailty.
8. Placental malaria: a systematic review and meta-analysis of global burden, risk factors, and maternal and foetal outcomes.
期刊: Journal of global health 发表日期: 2025-Nov-28 链接: PubMed
摘要
Pregnant women in malaria-endemic countries are at risk of placental malaria (PM), which can lead to adverse outcomes for both mothers and children. Histology of placental tissue is the gold standard for diagnosing PM, as it can detect current and past infections. Prior reviews focussed on malaria in pregnancy generally; in this systematic review, we specifically examine PM due to Plasmodium falciparum, its associated risk factors, and its impact on maternal and foetal outcomes. We included studies performed since 2013, reflecting important updates in WHO policy recommendations for PM control efforts and resistance to sufadoxine-primethamine resistance over the past decade. After extracting relevant data, we calculated the pooled prevalence, odds ratios (ORs), and risk ratios. We assessed the quality of the included studies using the Newcastle-Ottawa scale. The review included 50 studies, 45 of which were from sub-Saharan Africa (SSA), with 15 (33%) of them using histological diagnosis. Global PM prevalence was 17% (95% confidence interval (CI) = 12-21), rising to 23% (95% CI = 1-4) in histology-based studies. Prevalence was higher in SSA (19%; 95% CI = 14-24) than in other regions (4%; 95% CI = 1-9), with West Africa showing the highest rates. One study including only HIV-positive women reported a PM prevalence of 45% (95% CI = 38-52) compared to 17% (95% CI = 10-25) in HIV-negative women. One study on stillbirth showed an OR of 3.81 (95% CI = 1.22-11.94) and primigravidae had pooled ORs of 1.61 (95% CI = 0.91-2.84) compared to multigravidae. The ORs and CIs for congenital malaria, malaria in infancy, preterm birth, and low birth weight were wide, indicating imprecision. Our meta-analysis reveals a high PM burden in high- malaria transmission areas, especially among primigravidae and HIV-positive women. We note that PM remains high in SSA, with regional variation, with one in four pregnant women diagnosed by histological examination of the placenta, reflecting both current and past PM exposure. Reliance on non-histological methods may lead to underestimation of true PM prevalence. Due to wide confidence intervals and limited data, we could draw no conclusions on the impact of PM on maternal and foetal outcomes. Residual high heterogeneity reflects real-world diversity across populations, strengthening the generalisability of our findings.
9. Insights from a Discrete Generalized Beta Distribution analysis of heart rate and blood pressure variability: An integrated approach to study end- stage renal disease.
期刊: Biomedical physics & engineering express 发表日期: 2025-Nov-27 链接: PubMed
摘要
The study of inter-beat intervals (IBI) and systolic blood pressure (SBP) fluctuations is of public health importance. Here we obtain insights about their underlying dynamics by means of an innovative study of the distribution of their rank-ordered registers, provided by fits to the Discrete Generalized Beta Distribution (DGBD), for healthy subjects and patients with end-stage renal disease (ESRD), under an active standing maneuver. SBP and IBI non-invasive time series were recorded during supine position followed by active standing for nine ESRD patients and eighteen age-matched healthy subjects. Once the data were rank ordered, the three parameter DGBD function was fitted through the Levenberg-Marquardt non-linear algorithm. Taking into consideration the statistical interpretations of the parameters, the quantitative exploration of their dependence with regard to the cases examined and changes in body position provided new insights: i) Evidence for the presence of regulatory mechanisms that preserve the tail symmetry of the IBI distributions in healthy subjects, which are not evident in ESRD patients; ii) The identification of a more pronounced weight of low-magnitude fluctuations at active standing in the SBP time series, manifested as a broader statistical dispersion of blood pressure values; iii) A quantitative determination of a more undermined SBP regulation in ESRD. Overall, a better understanding of the statistical behavior of IBI and SBP time series is achieved by means of the DGBD function. Through the variation of its parameters, the DGBD approach has the potential to become a marker for assessing or even predicting the impairment of cardiovascular control mechanisms.
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10. Punicalagin Ameliorates Diabetic Cognitive Dysfunction by Inhibiting Neuroinflammation via the CX3CL1/CX3CR1 Axis.
期刊: Phytotherapy research : PTR 发表日期: 2025-Nov-27 链接: PubMed
摘要
Diabetic cognitive dysfunction is a major complication of type 2 diabetes mellitus, with no effective therapy available. Punicalagin, a polyphenol compound, has demonstrated neuroprotective effects. This study aimed to explore the mechanism by which punicalagin ameliorates diabetic cognitive dysfunction, focusing on the inhibition of neuroinflammation. The type 2 diabetes mellitus model was established in vivo using a high-fat diet combined with a streptozotocin injection, and in vitro using hyperglycemic conditions. The diabetic mice received punicalagin pretreatment for 10 weeks. HT22 and BV2 cells under hyperglycemic conditions were pretreated with punicalagin for 48 h. Underlying mechanisms were investigated using the Morris water maze test, western blotting, cellular immunofluorescence and co-culture systems. Punicalagin reduced high blood glucose levels, alleviated learning and memory impairment, and attenuated neuroinflammation in diabetic mice. In addition, punicalagin promoted the expression of the CX3CL1/CX3CR1 axis and the Nrf2/HO-1 pathway. Furthermore, the inhibitory effect of punicalagin on BV2 cell-mediated neuroinflammation was attenuated after the inhibition of CX3CL1/CX3CR1 axis expression. These findings suggest that punicalagin ameliorates cognitive dysfunction and neuronal damage by attenuating neuroinflammation through activation of the CX3CL1/CX3CR1 signaling axis, offering a promising therapeutic strategy for diabetic cognitive dysfunction.
11. Patient Attitudes Toward Ambient Voice Technology: Preimplementation Patient Survey in an Academic Medical Center.
期刊: JMIR medical informatics 发表日期: 2025-Nov-27 链接: PubMed
摘要
Many institutions are in various stages of deploying an artificial intelligence (AI) scribe system for clinic electronic health record (EHR) documentation. In anticipation of the University of California, Davis Health’s deployment of an AI scribe program, we surveyed current patients about their perceptions of this technology to inform a patient-centered implementation. We assessed patient perceptions about current clinician EHR documentation practices before implementation of the AI scribe program, and preconceptions regarding the AI scribe’s introduction. We conducted a descriptive preimplementation survey as a quality improvement study. A convenience sample of 9171 patients (aged ≥18 years) who had a clinic visit within the previous year, was recruited via an email postvisit survey. Patient-identified demographics (age, gender, and race and ethnicity) were collected. The survey included rating scales on questions related to the patient perception of the AI scribe program, plus open-ended comments. Data were collated to analyze patient perceptions of including AI Scribe technology in a clinician visit. In total, 1893 patients completed the survey (20% response rate), with partial responses from another 549. Sixty-three percent (n=1205) of the respondents were female, and most were 51 years and older (87%, n=1649). Most patients identified themselves as White (69%, n=1312), multirace (8%, n=154), Latinx (7%, n=130), and Black (2%, n=42). The respondents were not representative of the overall clinic populations and skewed more toward being female, ages 50 years and older, and White in comparison. Patients reacted to the current EHR documentation system, with 71% (n=1349) feeling heard or sometimes heard, but 23% (n=416) expressed frustrations that their physician focused too much on typing into the computer. When asked about their anticipated response to the use of an AI scribe, 48% (n=904) were favorable, 33% (n=630) were neutral, and 19% (n=359) were unfavorable. Younger patients (ages 18-30 years) expressed more skepticism than those aged 51 years and older. Further, 42% (655/1567) of positive comments received indicated this technology could improve human interaction during their visits. Comments supported that the use of an AI scribe would enhance patient experience by allowing the clinician to focus on the patient. However, when asked about concerns regarding the AI scribe, 39% (515/1330) and 15% (203/1330) of comments expressed concerns about documentation accuracy and privacy, respectively. Providing previsit patient education and obtaining permission were viewed as very important. This patient survey showed that respondents are generally open to the use of an AI scribe program for EHR documentation to allow the clinician to focus on the patient during the actual encounter rather than the computer. Providing patient education and obtaining consent before using AI are important components to gain patient trust. Caution about the results is appropriate, given the low response rate and nonrepresentative profile.
12. AI-Powered Thermography for Diabetic Foot Risk Stratification: Multicenter Cross-Sectional Study.
期刊: JMIR formative research 发表日期: 2025-Nov-27 链接: PubMed
摘要
Diabetic foot complications are among the most severe and costly outcomes associated with diabetes, with high prevalence particularly in the Middle East and North Africa region. Current screening tools are often limited by subjectivity, invasiveness, or scalability challenges, underscoring the need for innovative approaches. This multicenter study aimed to evaluate the performance of an artificial intelligence (AI)-powered thermographic system, Thermal Foot Scan (TFScan), in identifying patients at elevated risk of diabetic foot complications through noninvasive temperature profiling. A multicenter cross-sectional analysis of deidentified routine screening data across 4 regions in Saudi Arabia was conducted enrolling 1120 individuals with diabetes. Participants underwent thermal imaging using a smartphone-compatible infrared camera with AI algorithms analyzing angiosomal temperature patterns and asymmetries. Risk was stratified into 4 categories (very low, low, moderate, and high). Associations between TFScan classifications and clinical risk factors, symptoms of neuropathy, and thermal abnormalities were assessed. While 90.7% (1016/1120) of the participants were classified as very low or low risk, 9.3% (104/1120) were identified as moderate or high risk. This higher-risk group exhibited significantly greater prevalence of key diabetic complications (P<.001). Peripheral artery disease was present in 20.2% (21/104) of moderate- and high-risk participants compared to just 0.8% (8/1016) of lower-risk individuals. Cardiovascular disease (60/104, 57.7% vs 313/1016, 30.8%), neuropathy (12/104, 11.5% vs 37/1016, 3.6%), foot deformities (15/104, 14.4% vs 6/1016, 0.6%), and symptoms of loss of protective sensation (53/104, 51% vs 354/1016, 34.8%) were all significantly more frequent in the high-risk subgroup than in the low-risk group, respectively. Thermal imaging further revealed pronounced abnormalities: temperature asymmetries of ≥2.2 °C were observed in 7.1% (79/1120) of the patients overall, with the highest asymmetry and thermal change index scores concentrated in the moderate- and high-risk groups. These individuals also exhibited greater deviations in angiosomal temperature differences-exceeding 2.2 °C in key vascular territories such as the medial plantar and lateral plantar arteries-suggesting both early inflammatory states and critical perfusion deficits. The TFScan system effectively stratified patients with diabetes into clinically meaningful risk categories, with moderate- and high-risk groups exhibiting a significantly higher burden of vascular, neuropathic, and thermal abnormalities. However, the cross-sectional design, partial reliance on self-report, and low prevalence of advanced complications may limit causal inference. These findings highlight the potential of AI-enhanced thermography to serve as a scalable, objective screening tool for proactive diabetic foot management. Further longitudinal studies are warranted to validate its predictive power and support widespread clinical adoption.
13. GrantCheck-an AI Solution for Guiding Grant Language to New Policy Requirements: Development Study.
期刊: JMIR formative research 发表日期: 2025-Nov-27 链接: PubMed
摘要
Academic institutions face increasing challenges in grant writing due to evolving federal and state policies that restrict the use of specific language. Manual review processes are labor-intensive and may delay submissions, highlighting the need for scalable, secure solutions that ensure compliance without compromising scientific integrity. This study aimed to develop a secure, artificial intelligence-powered tool that assists researchers in writing grants consistent with evolving state and federal policy requirements. GrantCheck (University of Massachusetts Chan Medical School) was built on a private Amazon Web Services virtual private cloud, integrating a rule-based natural language processing engine with large language models accessed via Amazon Bedrock. A hybrid pipeline detects flagged terms and generates alternative phrasing, with validation steps to prevent hallucinations. A secure web-based front end enables document upload and report retrieval. Usability was assessed using the System Usability Scale. GrantCheck achieved high performance in detecting and recommending alternatives for sensitive terms, with a precision of 1.00, recall of 0.73, and an F1-score of 0.84-outperforming general-purpose models including GPT-4o (OpenAI; F1=0.43), Deepseek R1 (High-Flyer; F1=0.40), Llama 3.1 (Meta AI; F1=0.27), Gemini 2.5 Flash (Google; F1=0.58), and even Gemini 2.5 Pro (Google; F1=0.72). Usability testing among 25 faculty and staff yielded a mean System Usability Scale score of 85.9 (SD 13.4), indicating high user satisfaction and strong workflow integration. GrantCheck demonstrates the feasibility of deploying institutionally hosted, artificial intelligence-driven systems to support compliant and researcher-friendly grant writing. Beyond administrative efficiency, such systems can indirectly safeguard public health research continuity by minimizing grant delays and funding losses caused by language-related policy changes. By maintaining compliance without suppressing scientific rigor or inclusivity, GrantCheck helps protect the pipeline of research that advances biomedical discovery, health equity, and patient outcomes. This capability is particularly relevant for proposals in sensitive domains-such as social determinants of health, behavioral medicine, and community-based research-that are most vulnerable to evolving policy restrictions. As a proof-of-concept development study, our implementation is tailored to one institution’s policy environment and security infrastructure, and findings should be interpreted as preliminary rather than universally generalizable.
14. Risk Prediction of Major Adverse Cardiovascular Events Within One Year After Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome: Machine Learning-Based Time-to-Event Analysis.
期刊: JMIR medical informatics 发表日期: 2025-Nov-27 链接: PubMed
摘要
Patients with acute coronary syndrome (ACS) who undergo percutaneous coronary intervention (PCI) remain at high risk for major adverse cardiovascular events (MACE). Conventional risk scores may not capture dynamic or nonlinear changes in postdischarge MACE risk, whereas machine learning (ML) approaches can improve predictive performance. However, few ML models have incorporated time-to-event analysis to reflect changes in MACE risk over time. This study aimed to develop a time-to-event ML model for predicting MACE after PCI in patients with ACS and to identify the risk factors with time-varying contributions. We analyzed electronic health records of 3159 patients with ACS who underwent PCI at a tertiary hospital in South Korea between 2008 and 2020. Six time-to-event ML models were developed using 54 variables. Model performance was evaluated using the time-dependent concordance index and Brier score. Variable importance was assessed using permutation importance and visualized with partial dependence plots to identify variables contributing to MACE risk over time. During a median follow-up of 3.8 years, 626 (19.8%) patients experienced MACE. The best-performing model achieved a time-dependent concordance index of 0.743 at day 30 and 0.616 at 1 year. Time-dependent Brier scores increased and remained stable across all ML models. Key predictors included contrast volume, age, medication adherence, coronary artery disease severity, and glomerular filtration rate. Contrast volume ≥300 mL, age ≥60 years, and medication adherence score ≥30 were associated with early postdischarge risk, whereas coronary artery disease severity and glomerular filtration rate became more influential beyond 60 days. The proposed time-to-event ML model effectively captured dynamic risk patterns after PCI and identified key predictors with time-varying effects. These findings may support individualized postdischarge management and early intervention strategies to prevent MACE in high-risk patients.
15. EndoCompass Project: Research Roadmap for Reproductive and Developmental Endocrinology.
期刊: Hormone research in paediatrics 发表日期: 2025-Nov-27 链接: PubMed
摘要
Endocrine science remains underrepresented in European Union research programs despite the fundamental role of hormone health in human well-being. Analysis of the CORDIS database reveals a persistent gap between the societal impact of endocrine disorders and their research prioritization. At national funding level, endocrine societies report limited or little attention of national research funding towards endocrinology. The EndoCompass project - a joint initiative between the European Society of Endocrinology and the European Society of Paediatric Endocrinology, aimed to identify and promote strategic research priorities in endocrine science to address critical hormone-related health challenges. Research priorities were established through comprehensive analysis of the EU CORDIS database covering the Horizon 2020 framework period (2014-2020). Expert consultation was conducted to identify key research priorities, followed by broader stakeholder engagement including society members and patient advocacy groups. Research priorities encompass variations in sex development, hypothalamic-pituitary-gonadal regulation, and female and male reproductive disorders. Key areas include improving diagnostic capacity through (epi)genetic analysis, optimizing hormonal treatments, developing fertility preservation strategies. Special emphasis is placed on establishing pan-European registries, developing novel reproductive technologies, and exploring environmental impacts on reproductive health. This component of the EndoCompass project provides an evidence-based roadmap for strategic research investment. This framework identifies crucial investigation areas into reproductive and developmental endocrinology pathophysiology, prevention, and treatment strategies, ultimately aimed at reducing the burden of these disorders on individuals and society. The findings support the broader EndoCompass objective of aligning research funding with areas of the highest potential impact in endocrine health.
16. European Association for the Study of Obesity (EASO) position statement on the diagnosis and management of obesity in older adults.
期刊: Obesity facts 发表日期: 2025-Nov-27 链接: PubMed
摘要
Obesity is increasingly prevalent among older adults and is a major contributor to cardiometabolic diseases, functional decline, frailty, and loss of independence. The intersection between population ageing and the obesity epidemic poses major public health and clinical challenges. This European Association for the Study of Obesity (EASO) position statement represents an update of the EASO guideline from 2012, and provides a comprehensive overview of the epidemiology, pathophysiology, clinical consequences, and management of obesity in adults aged ≥65 years. It summarises current evidence and offers practical recommendations for diagnosis and treatment tailored to this age group. 1) Obesity affects up to one third of older adults globally, with prevalence varying by sex and geography; 2) Ageing is associated with changes in body composition, hormonal milieu, and lifestyle factors (diet, physical inactivity, polypharmacy) that favour fat accumulation and sarcopenic obesity; 3) Body mass index alone is insufficient; assessment should include body composition analysis (including fat distribution and muscle mass), psychological status and functional performance; 4) A multimodal approach is recommended, including moderate energy restriction with adequate protein intake, structured multicomponent exercise, behavioural support, and, where appropriate, obesity management medications and/or metabolic bariatric surgery. The focus should be on preserving muscle mass, functional capacity, and quality of life, rather than weight loss alone. Effective management of obesity in older adults should focus on individualized, multidisciplinary strategies that balance the benefits of weight reduction against the risks of sarcopenia, malnutrition, and loss of independence.
17. Exploring End-of-Life Perspectives in Structurally Vulnerable Populations: A Qualitative Focus Group Study.
期刊: Community health equity research & policy 发表日期: 2025-Nov-27 链接: PubMed
摘要
BackgroundPalliative care is a key component of the healthcare system, yet structurally vulnerable populations face significant barriers to accessing it and its support in care planning. This study explored beliefs, needs, and concerns related to palliative care and advance care planning among these populations.MethodsTwo semi-structured focus groups were conducted in major cities in the province of Quebec, Canada, in May and August of 2022. Participants had to be at least 18 years old and be able to speak and understand French. They also had to attend or use the services of a partnered community organization serving the target population. Data was analyzed according to the thematic content analysis approach.ResultsFifteen (15) persons participated: all were Caucasian, and most were women, born before 1960, single, and retired. Misconceptions and a lack of awareness of the various palliative care options were generally observed among participants. Experience with caring for a dying person, access to a family physician, and access to a legal professional were identified as elements promoting awareness of palliative care. Participants raised an urgent need for more accessible information about palliative care and advance care planning, and for more access to care.ConclusionsA good understanding of palliative care options helps individuals and families make informed decisions and be better prepared for the end of life. Structurally vulnerable people urgently need accessible information to support this preparation. This study supports the development of equity-focused policies and tailored interventions to improve access and planning for this population.
18. Community Members' Perspectives on Men's Risk and Protective Health Factors: A Community-Based Participatory Research Study.
期刊: Community health equity research & policy 发表日期: 2025-Nov-27 链接: PubMed
摘要
Despite men’s health playing a significant role in the well-being of infants, children, and women, there is a gap in maternal and child health research which more broadly considers men’s health as a component of family’s and community’s overall well-being and for the sake of men’s own health and well-being, particularly from the perspective of men with marginalized identities, such as Black men, and community members. Therefore, our community-based participatory research study aimed to explore what community members perceive as protective and risk factors for the general health of men in a low-income community using a generic qualitative approach with focus groups and thematic analysis. We identified six protective factor themes (health behaviors, economic stability, expected male responsibilities, healthcare engagement, social network, and faith, spirituality, and driving forces), as well as six risk factor themes (health behaviors, impact of mentorship, experience of driving forces, healthcare avoidance, mental health concerns, and systemic bias, racism, and social inequity). There are actionable steps public health practitioners and policymakers should prioritize, including addressing structural barriers to men’s health, such as by combating discrimination and increasing access to healthcare, removing barriers to mental health care, and creating opportunities for increased social support. These strategies can give way to greater opportunities for men to engage in protective behaviors that can both improve their health across the life-course and positively impact the health of mothers, infants, children, and communities.
19. Evaluating the translational value of preclinical models: Available tools and frameworks, challenges and strategies.
期刊: Alternatives to laboratory animals : ATLA 发表日期: 2025-Nov-27 链接: PubMed
摘要
Recent global initiatives are accelerating the shift toward human-centric approaches, reducing reliance on animal models in preclinical research and other domains. In this changing landscape, objectively evaluating the scientific relevance and merit of research involving animal models, and assessing their translational relevance is increasingly critical. Over the past decade, several tools have been developed to assess translational relevance, accuracy/appropriateness and efficacy of preclinical animal models, evaluate risk-of-bias in preclinical research, support harm-benefit analyses, and facilitate the adoption of non-animal replacement strategies. However, the uptake of such tools remains limited. To address this, a Biomedical Research for the 21st Century (BioMed21) Collaboration workshop on ‘Evaluating translational value of animal models in preclinical research - Tools, challenges, and strategies’, was convened by Humane World for Animals (30 June-1 July 2025). The event brought together tool developers and diverse global interest-holders to review current assessment tools, discuss their strengths, complementarity, limitations and feasibility, and explore opportunities for cross-sector collaboration. This paper summarises key outcomes of these presentations and discussions, highlighting knowledge gaps and barriers to the adoption of these tools and frameworks by researchers, funders and regulators. Strategies to raise awareness and promote the use of the tools and frameworks, to better inform funding decisions, regulatory approval and the appraisal of preclinical research, are also proposed.
20. EndoCompass Project: Environmental Endocrinology.
期刊: Hormone research in paediatrics 发表日期: 2025-Nov-27 链接: PubMed
摘要
Endocrine science remains underrepresented in European Union research programmes despite the fundamental role of hormone health in human well-being. Analysis of the CORDIS database reveals a persistent gap between the societal impact of endocrine disorders and their research prioritization. At national funding level, endocrine societies report limited or little attention of national research funding towards endocrinology. The EndoCompass project - a joint initiative between the European Society of Endocrinology and the European Society of Paediatric Endocrinology, aimed to identify and promote strategic research priorities in endocrine science to address critical hormone-related health challenges. Research priorities were established through a comprehensive analysis of the EU CORDIS database covering the Horizon 2020 framework period (2014-2020). An expert analysis was conducted by leading researchers in environmental endocrinology, integrating literature review, epidemiological evidence, and emerging research priorities to identify key challenges and opportunities across endocrine systems. Research priorities span 5 critical domains: mechanisms and biomarkers of endocrine-disrupting chemical (EDC) actions; environmental pharmaceutical contamination; climate change effects on endocrine function; endocrine consequences of air and water pollution; and mechanisms linking environmental stress to hormone disruption. Special emphasis is placed on understanding developmental programming, transgenerational effects, and implications for public health policy. This component of the EndoCompass project provides an evidence-based roadmap for strategic research investment. The analysis demonstrates that environmental factors like EDCs fundamentally impact multiple endocrine systems, requiring coordinated research approaches. The findings support the broader EndoCompass objective of aligning research funding with areas of highest potential impact in endocrine health.
21. The history of water fluoridation in Scotland.
期刊: Community dental health 发表日期: 2025-Nov-27 链接: PubMed
摘要
Objectives: To examine the history of water fluoridation in Scotland, assessing its implementation, cessation, and impact on dental caries, and to evaluate whether water fluoridation should be reconsidered in future public health strategies. Basic research design: A historical review of water fluoridation in Scotland conducted using peer-reviewed studies, government reports, and legal documents. Data was synthesised chronologically on fluoridation’s impact, legislative challenges, policy shifts, and public attitudes. Main outcome measures: Dental caries prevalence and treatment costs, public and political attitudes toward fluoridation, and legislative and policy developments affecting the implementation or cessation of fluoridation in Scotland. Results: Scottish fluoridation schemes significantly reduced caries prevalence and treatment costs. Fluoridation was discontinued following legal challenges. Post-cessation studies reported rising caries rates and treatment costs. Recent public attitude surveys indicate majority support for fluoridation. While Childsmile has improved oral health, fluoridation remains the most effective passive intervention. Conclusion: Scotland’s fluoridation history highlights the tension between scientific evidence, legal constraints, and public perception. While current policy prioritises individual choice, integrating fluoridation into Childsmile could enhance caries prevention across Scotland. Renewed policy discussions and public engagement are essential for reconsidering fluoridation as part of Scotland’s long-term oral health strategy.
22. Three-Way Decomposition for Applied Health Equity Research: A Practical Tutorial to Understand and Address Inequalities.
期刊: Prevention science : the official journal of the Society for Prevention Research 发表日期: 2025-Nov-27 链接: PubMed
摘要
Mediation analysis is essential for understanding causal mechanisms and designing effective policy interventions. This paper explains a comprehensive framework for implementing VanderWeele’s (2009) three-way decomposition using natural effect models (NEM), focusing on its application in health equity research. While three-way decomposition helps social epidemiologists understand how social exposures influence health outcomes through differential mediator effects, its implementation through NEM has not been fully utilized. Using the R package medflex to implement NEM, we demonstrate the methodology through two case analyses: healthcare expenditure disparities between Medicaid beneficiaries and health insurance enrollees using continuous outcomes, and racial/ethnic disparities in preterm birth using binary outcomes. We provide detailed interpretations of NEM estimates in terms of three-way decomposition and discuss methodological considerations for researchers designing health policies to reduce disparities.
23. Using Time-Varying Effect Modeling to Examine the Association Between Cardiorespiratory Fitness and Global Cognition in Older Adults: A Nationwide Sample.
期刊: American journal of health promotion : AJHP 发表日期: 2025-Nov-27 链接: PubMed
摘要
PurposeResearch demonstrates that cardiorespiratory fitness (CRF) mitigates age-related cognitive decline, but its specific effects across different stages of aging remain unclear. This study aimed to examine the association between CRF and global cognition in older adults, identifying the age ranges during which cognitive differences between older adults with higher and lower CRF levels were most pronounced.DesignCross-sectional.SettingData from the National Health and Nutrition Examination Survey 2011-2014.SampleA total of 2311 U.S. older adults aged 60 to 79 years.MeasuresCRF was estimated using a validated non-exercise regression equation, and participants were categorized into above- and below-median CRF groups. Global cognition was assessed using composite z-scores derived from 3 cognitive tests: CERAD Word Learning subtest, Animal Fluency Test, and Digit Symbol Substitution Test.AnalysisWeighted time-varying effect modeling was employed to examine age-related trends in the association between CRF and global cognition throughout late adulthood. Separate analyses were conducted for older adults with higher and lower CRF levels to explore differences in cognitive trajectories between these groups.ResultsParticipants with higher CRF demonstrated significantly better global cognition than those with lower CRF, particularly between the ages of 61 and 66. The largest difference was observed at age 62, where individuals with higher CRF had a mean composite score of 0.40 (95% CI = [0.27, 0.53]), compared to 0.03 (95% CI = [-0.10, 0.16]) for those with lower CRF.ConclusionPromoting improvements in CRF during key aging periods may serve as an effective strategy to delay age-related cognitive decline.
24. Economic and disease burden of prostate cancer in expanded BRICS nations: systematic analysis of global burden of disease study 1990 - 2021.
期刊: Expert review of anticancer therapy 发表日期: 2025-Nov-27 链接: PubMed
摘要
Prostate cancer is a leading malignancy among men worldwide and an increasing challenge for emerging economies. The expanded BRICS nations represent regions undergoing rapid demographic and epidemiological transitions, yet data on their comparative disease and economic burden remain limited. We analyzed data from the GBD 2021 study to estimate prostate cancer incidence, mortality, DALYs, and mortality-to-incidence ratios (MIRs) from 1990 to 2021 across BRICS+. Temporal patterns were assessed through EAPC. Productivity losses due to premature mortality were calculated using the Human Capital Approach. Incidence and mortality rose sharply in Russia and Egypt, while China and India showed declining mortality despite increasing incidence. MIRs decreased overall, reflecting improved survival, though Ethiopia and Egypt remained high. In 2021, productivity losses were greatest in China (US$73.1 billion) and Russia (US$19.5 billion), with comparatively lower losses in Ethiopia, Saudi Arabia, Egypt, and the UAE. Prostate cancer imposes a heterogeneous but rising health and economic burden across BRICS+ nations. Effective strategies integrating prevention, early detection, equitable treatment-access, and recognition of economic impact are critical to reduce disparities and improve outcomes.
25. Maternal Myo-Inositol Intake and Congenital Heart Defects in Offspring: A Population-Based Case-Control Study.
期刊: BJOG : an international journal of obstetrics and gynaecology 发表日期: 2025-Nov-27 链接: PubMed
摘要
To investigate associations between maternal periconceptional (three months prior through the third pregnancy month) myo-inositol intake and the odds of selected congenital heart defects in offspring. A population-based case-control study using the National Birth Defects Prevention Study (NBDPS) database. United States. Women with singleton live births without major birth defects (controls) and women with singleton live births, stillbirths, or terminations with selected nonsyndromic congenital heart defects (CHD; cases). Descriptive analyses, logistic regression models, ascertainment of myo-inositol intake from supplements and food using a shortened food frequency questionnaire and survey. Odds of CHD. 11 752 cases and 11 415 controls were included. Compared to women not taking myo-inositol supplements, women with any supplemental intake were less likely to have a pregnancy with the selected congenital heart defects as a group (adjusted odds ratio [aOR] = 0.79; 95% confidence interval [CI] 0.66-0.94) or with septal defects alone (aOR = 0.61; 95% CI 0.46-0.81). Compared to women with low total myo-inositol intake from food or supplements, women with high total myo-inositol intake (≥ 500 mg/day) were less likely to have a pregnancy with the selected CHD as a group (aOR = 0.88; 95% CI 0.84-0.93) or conotruncal defects (aOR = 0.87; 95% CI 0.79-0.96); left ventricular outflow tract defects (aOR = 0.87; 95% CI 0.78-0.96); right ventricular outflow tract defects (aOR = 0.85; 95% CI 0.77-0.95); or atrial septal defects (aOR = 0.91; 95% CI 0.83-0.99). An inverse association was observed between maternal myo-inositol intake during the periconceptional period and the odds of selected CHDs in offspring.
26. Building a Delphi-Informed Transitional Care Programme Guided by the Omaha System for Gynaecologic Oncology Patients.
期刊: Journal of clinical nursing 发表日期: 2025-Nov-27 链接: PubMed
摘要
This study aimed to develop and validate a standardised transitional care programme for postoperative gynaecologic cancer patients utilising the Omaha system framework. A preliminary transitional care programme was constructed through literature review, semi-structured interviews and multidisciplinary team discussions. The programme was refined via two rounds of Delphi expert consultations involving 17 oncology nursing specialists. Consensus criteria included expert authority coefficient (Cr), Kendall’s W test and coefficient of variation (CV). The Delphi consultation demonstrated robust expert consensus, with high authority coefficients (Cr: 0.886 in Round 1; 0.906 in Round 2), exceptional participation rates (88.2% and 100% response rates across two rounds) and statistically significant concordance as evidenced by Kendall’s W values (0.233-0.358 and 0.326-0.383; all p < 0.01). All coefficients of variation (CV) metrics fell within acceptable ranges (0.09-0.42 in the initial phase; 0.08-0.27 post-refinement). The Omaha system-based transitional care programme exhibits strong expert consensus, scientific rigour and clinical applicability, providing a structured approach to improving postoperative recovery in gynaecologic cancer patients. This protocol standardises postoperative care transitions for gynaecologic oncology patients by integrating multidimensional assessments (physiological, psychosocial and health behaviour domains) and family-centred education. Clinicians can utilise its evidence-based framework to reduce preventable complications, enhance caregiver preparedness and improve continuity of care between hospital and home settings. Six postoperative gynaecologic cancer patients and eight family caregivers participated in semi-structured interviews to identify unmet transitional care needs. Their insights informed the design of intervention components, including self-management education and psychosocial support strategies. Patients reviewed draft materials for clarity and cultural appropriateness during Delphi Round 2.
27. Using Human-Centered Design and Development to Create a Digital Sick Day Medication Guidance Application for People With Diabetes, Cardiovascular Disease, or Chronic Kidney Disease: Mixed Methods Study.
期刊: JMIR formative research 发表日期: 2025-Nov-27 链接: PubMed
摘要
Diabetes, cardiovascular disease, and chronic kidney disease are associated with high morbidity and costs of care. Medications can reduce long-term complications but may contribute to complications such as hypoglycemia and acute kidney injury during acute illnesses. Sick day medication guidance (SDMG) could help prevent these adverse events, but evidence for effective strategies to deliver this guidance is lacking. We iteratively designed and developed a digital prototype user interface (UI) to deliver SDMG for patient self-management. The application, called “Preventing medication complications during AcUte illness through Symptom Evaluation and sick day guidance” (PAUSE), delivers personalized knowledge and self-management guidance directly to patients to enhance medication self-management during acute illness, with the goal of reducing preventable emergency visits and hospitalizations and improving patient outcomes during acute illness. Using a human-centered design (HCD) approach, we conducted iterative heuristic evaluation and usability testing paired with prototype revisions. Heuristic evaluation involved our team members evaluating the prototype’s UI against established criteria. We also conducted formative usability testing with 6 patients (including a patient-caregiver dyad) to provide subjective lived experience perspectives. We analyzed data deductively and pragmatically to rapidly inform subsequent iterations. We identified 21 and 44 design issues through heuristics evaluation and usability testing, respectively. The development team iteratively revised the PAUSE UI prototype between evaluations, with the final design providing key user flows and integrated supports and reminders for acting on severe acute illness situations that recommend pausing certain medications. Using an iterative HCD approach, we designed and developed a digital health application to deliver SDMG for patient self-management. We addressed feasible technical and workflow barriers using iterative heuristic evaluations and usability testing resulting in a refined SDMG self-management prototype app for patients taking medications commonly used to treat diabetes, cardiovascular disease, and chronic kidney disease. Further research is needed to test the effectiveness of the current PAUSE app in helping people with these chronic conditions self-manage their medications during acute illness and evaluate the feasibility of integrating the app into community-based chronic disease care.
28. Avian-origin influenza A viruses tolerate elevated pyrexic temperatures in mammals.
期刊: Science (New York, N.Y.) 发表日期: 2025-Nov-27 链接: PubMed
摘要
Host body temperature can define a virus’s replicative profile-influenza A viruses (IAVs) adapted to 40° to 42°C in birds are less temperature sensitive in vitro compared with human isolates adapted to 33° to 37°C. In this work, we show that avian-origin PB1 polymerase subunits enable IAV replication at elevated temperatures, including avian-origin PB1s from the 1918, 1957, and 1968 pandemic viruses. Using a model system to ensure biosafety, we show that a small increase in body temperature protects against severe disease in mice and that this protection is overcome by a febrile temperature-resistant PB1. These findings indicate that although elevated temperature itself can be a potent antiviral defense, it may not be effective against all influenza strains. These data inform both the clinical use of antipyretics and IAV surveillance efforts.
29. Political appointee tells CDC to end monkey research.
期刊: Science (New York, N.Y.) 发表日期: 2025-Nov-27 链接: PubMed
摘要
Agency scientists and outside researchers decry the sudden decision.
30. EndoCompass Project: Research Roadmap for Adrenal and Cardiovascular Endocrinology.
期刊: Hormone research in paediatrics 发表日期: 2025-Nov-27 链接: PubMed
摘要
Endocrine science remains underrepresented in European Union research programmes despite the fundamental role of hormone health in human well-being. Analysis of the CORDIS database reveals a persistent gap between the societal impact of endocrine disorders and their research prioritization. At national funding level, endocrine societies report limited or little attention of national research funding towards endocrinology. The EndoCompass project - a joint initiative between the European Society of Endocrinology and the European Society of Paediatric Endocrinology, aimed to identify and promote strategic research priorities in endocrine science to address critical hormone-related health challenges. Research priorities were established through comprehensive analysis of the EU CORDIS database covering the Horizon 2020 framework period (2014-2020). Expert consultation in adrenal endocrinology was conducted to identify key research priorities, followed by broader stakeholder engagement including society members and patient advocacy groups. For adrenal disorders, research priorities span primary and secondary adrenal insufficiency, adrenal tumours, and endocrine hypertension. Key areas include development of biomarkers and replacement therapies, improved understanding of disease mechanisms, diagnostic procedure optimization, and establishment of pan-European registries. Special emphasis is placed on personalized treatment approaches. The adrenal component of the EndoCompass project provides an evidence-based roadmap for strategic research investment. This framework identifies crucial investigation areas into adrenal disease pathophysiology, prevention, and treatment strategies, ultimately aimed at reducing the burden of adrenal disorders on individuals and society. The findings support the broader EndoCompass objective of aligning research funding with areas of highest potential impact on endocrine health.
31. EndoCompass Project: Research Roadmap for Pituitary and Neuroendocrine Tumor Endocrinology.
期刊: Hormone research in paediatrics 发表日期: 2025-Nov-27 链接: PubMed
摘要
Endocrine science remains underrepresented in European Union research programs despite the fundamental role of hormone health in human wellbeing. Analysis of the CORDIS database reveals a persistent gap between the societal impact of endocrine disorders and their research prioritization. At national funding level, endocrine societies report limited or little attention of national research funding toward endocrinology. The EndoCompass project - a joint initiative between the European Society of Endocrinology and the European Society of Paediatric Endocrinology, aimed to identify and promote strategic research priorities in endocrine science to address critical hormone-related health challenges. Research priorities were established through comprehensive analysis of the EU CORDIS database covering the Horizon 2020 framework period (2014-2020). Expert consultation in pituitary and neuroendocrine tumor endocrinology was conducted to identify key research priorities, followed by broader stakeholder engagement including society members and patient advocacy groups. Research priorities encompass congenital and acquired disorders, tumor development and progression, and neuroendocrine neoplasms. Key areas include genetic/epigenetic factors, tumor microenvironment, personalized treatment approaches, developing preclinical models, and implementing artificial intelligence. Special emphasis is placed on aggressive tumors, hypothalamic syndromes, and establishing pan-European biobanks and databases. This component of the EndoCompass project provides an evidence-based roadmap for strategic research investment. This framework identifies crucial investigation areas into pituitary-neuroendocrine disease pathophysiology, prevention, and treatment strategies, ultimately aimed at reducing the burden of these disorders on individuals and society. The findings support the broader EndoCompass objective of aligning research funding with areas of highest potential impact in endocrine health.
32. Assessing photoplethysmography signal quality for wearable devices during unrestricted daily activities.
期刊: Biomedical physics & engineering express 发表日期: 2025-Nov-27 链接: PubMed
摘要
Photoplethysmography (PPG) is widely used in wearable health monitors for tracking fundamental physiological parameters (e.g., heart rate and blood oxygen saturation) and advancing applications requiring high-quality signals-such as blood pressure assessment and cardiac arrhythmia detection. However, motion artifacts and environmental noise significantly degrade the accuracy of PPG-derived physiological measurements, potentially causing false alarms or delayed diagnoses in longitudinal monitoring cohorts. While signal quality assessment (SQA) provides an effective solution, existing methods show insufficient robustness in ambulatory scenarios. This study concentrates on PPG signal quality detection and proposes a robust SQA algorithm for wearable devices under unrestricted daily activities. PPG and acceleration signals were acquired from 54 participants using a self-made physiological monitoring headband during daily activities, segmented into 35712 non-overlapping 5-second epochs. Each epoch was annotated with: (1) PPG signal quality levels (good: 10817; moderate: 14788; poor: 10107), and (2) activity states classified as stationary, light, moderate, or vigorous-intensity. The dataset was stratified into training (80%) and testing (20%) subsets to maintain proportional representation. Fourteen discriminative features were extracted from four domains: morphological characteristics, time-frequency distributions, physiological parameter estimation accuracy, and statistical properties of signal dynamics. Four machine learning algorithms were employed to train models for SQA. The random forest (95.6%) achieved the highest accuracy on the test set, but no significant differences (p=0.471) compared to support vector machine (95.4%), naive Bayes (94.1%), and BP neural network (95.1%). Additionally, the classification accuracy showed no statistically significant variations (p=0.648) across light (95.3%), moderate (97.6%), and vigorous activity (100%) when compared to sedentary (95.8%). All features exhibited significant differences (p<0.05) across high/moderate/poor quality segments in all pairwise comparisons.The results indicate that the proposed feature set achieves robust SQA, maintaining consistently high classification accuracy across all activity intensities. This performance stability enables real-time implementation in wearable devices.
33. An approach for deriving water quality guideline values for antimicrobials that integrates ecotoxicity and antimicrobial resistance endpoints.
期刊: Integrated environmental assessment and management 发表日期: 2025-Nov-27 链接: PubMed
摘要
Antimicrobials pose ecological risks in aquatic environments, particularly to cyanobacteria, aquatic plants and green algae, and with the potential to disrupt microbiomes upon which all biota rely. Beyond direct toxicity, these chemicals also contribute to the emergence and spread of antimicrobial resistance, posing risks to human, animal (including wildlife) and plant crop health, particularly through wastewater discharges and water reuse. Despite these concerns, Australia and New Zealand currently lack environmental water quality guideline values for antimicrobials. Furthermore, existing guideline value derivation frameworks for this region do not consider environmental endpoints to protect against antimicrobial resistance. This study critically reviews international approaches to estimating antimicrobial hazards to identify possible improvements for use in Australia and New Zealand. Through a co-design process with stakeholders across the water sector, a method for deriving guideline values using species sensitivity distributions was developed that integrates both traditional toxicity and antimicrobial resistance endpoints. Critically, the approach includes microbiome data, essential for capturing the impacts of antimicrobials on complex aquatic microbial communities. A case study with ciprofloxacin demonstrated that combining microbiome and single-species data in species sensitivity distributions provides a scientifically robust and data-efficient approach for developing environmental guideline values for antimicrobials. The framework may also have applicability to other contaminants known to influence antimicrobial resistance, such as other pharmaceuticals, metals, pesticides and microplastics. We also identified critical gaps that remain barriers to implementing antimicrobial resistance-inclusive frameworks for deriving water quality guideline values applicable to Australia and New Zealand.
34. Future Trends in Antibiotic Concentrations and Risk Assessment of Selection Pressure Based on Reported Antibiotic Concentrations in Brazil's Aquatic Environments.
期刊: Integrated environmental assessment and management 发表日期: 2025-Nov-27 链接: PubMed
摘要
Antibiotic resistance (AMR) in aquatic environments poses a significant threat to public and environmental health. In this study, antibiotic compounds were used to estimate selection pressure and associated risks using the risk quotient (RQ) methodology. Future antibiotic concentrations were projected through a polynomial regression model based on compiled data from studies on antibiotic levels in Brazilian water bodies, covering the period from 2012 to 2030. The reviewed studies revealed heterogeneity in the types of antibiotics detected, with substantial geographic variation. Overall, ciprofloxacin concentrations detected in different regions of Brazil were classified as medium to high risk, with urbanized areas presenting the highest risks. The North and Northeast regions were underrepresented, limiting the applicability of the conclusions at a national level. Furthermore, the temporal analysis of antibiotic concentrations between 2012 and 2026 indicates a decline from 2012 to 2014, followed by significant recovery and increase until 2018, with stabilization and projected growth until 2030. These findings emphasize the urgent need for national regulations and the incorporation of environmental monitoring, with standardized data collection protocols, into the public health surveillance system to control and mitigate the risks associated with AMR in Brazil.
35. Solar Simulated Degradation Kinetics of Amoxicillin, Carbamazepine, and Diclofenac: A Fluorescence Excitation-Emissions Matrices Deconvolution Approach.
期刊: Integrated environmental assessment and management 发表日期: 2025-Nov-27 链接: PubMed
摘要
There is limited knowledge of pharmaceuticals’ photochemical fate and transformation in the aquatic environment. This study devised a photoirradiation system to effectively study the degradation of amoxicillin (AMO), carbamazepine (CAR), and diclofenac (DIC). This study investigated the degradation of 1.00 mg/L of selected pharmaceuticals individually and in the absence and presence of 1.00 mg/L of Suwannee River natural organic matter (SRNOM). Fluorescence excitation-emission matrices (EEMs) and absorbance measurements were collected at 18-minute intervals to monitor the transformation of AMO, CAR, and DIC in aqueous solution throughout the 8.1-hour photodegradation experiment. Parallel factor (PARAFAC) analysis was used to deconvolute the excitation-emission matrices measurements to track the dissipation of the parent compound and observe underlying changes that resulted in the formation of intermediates and photoproducts. The fluorescence EEMs measurements and validated PARAFAC analysis were robust tools to track the photodegradation of parent pharmaceuticals and photoproducts. Several photoproducts of AMO, CAR, and DIC were observed by decomposing EEMs using PARAFAC analysis. Natural organic matter (NOM) suppressed the degradation of AMO and enhanced the degradation of DIC. The AMO degraded at a faster rate than DIC. Although CAR is not fluorescent, its photoproducts are fluorescent. The presence of NOM suppresses the degradation of CAR photoproducts. Excited states of NOM play a vital role in the degradation of parent compounds. The formation of the photoproducts is a severe environmental health concern because their toxicity is unknown. The study found that the spectrometric techniques can be used to investigate AMO, CAR, and DIC photodegradation in the presence and absence of NOM. Simultaneous fluorescence and absorbance measurements are used to raise awareness of water contamination by pharmaceuticals and their degradation products and guide regulatory authorities in informing water quality guidelines.
36. Multiparent Recombinant Inbred lines crossed to a tester provide novel insights into sources of cis and trans regulation of gene expression.
期刊: Genetics 发表日期: 2025-Nov-27 链接: PubMed
摘要
To understand the relative importance of cis and trans effects on regulation, we crossed multi-parent recombinant-inbred-lines (RILs) to a common tester and measured allele specific gene expression in the offspring. Testing difference of allelic imbalance between two RIL x Tester crosses is a test of cis or trans depending on the RIL alleles compared. The study design also enables to separate two sources of trans variation, genetic and environmental, detected via interactions with cis effects. We demonstrate the effectiveness of this approach in a long-read RNA-seq experiment in female abdominal tissue at two time points in Drosophila melanogaster. Among the 40% of all loci that show evidence of genetic variation in cis, trans effects due to environment are detectable in 31% of loci and trans effects due to genetic background in 19%, with little overlap in sources of trans variation. The genes identified in this study are associated with genes previously reported to exhibit genetic variation in gene expression. Eleven genes in a QTL for thermotolerance, previously shown to differ in expression based on temperature, have evidence for regulation of gene expression regardless of the environment, including the cuticular protein Cpr67B, suggesting a functional role for standing variation in gene expression. This study provides a blueprint for identifying regulatory variation in gene expression, as the tester design maximizes cis variation and enables the efficient assessment of all pairs of RIL alleles relative to the tester, a much smaller study compared to the pairwise direct assessment.
37. Multimorbidity and Atopic Dermatitis in a Population-Based Cohort: Severity-Dependent Association With Distinct Non-Atopic Multimorbidity Patterns.
期刊: The British journal of dermatology 发表日期: 2025-Nov-27 链接: PubMed
摘要
Atopic dermatitis (AD) shows characteristics of a systemic disease due to underlying systemic inflammation and reports on various comorbidities. This study aimed to examine the associations between AD and (non-atopic) multimorbidity in a population-based cohort from the Northern Netherlands and to identify differences in multimorbidity patterns between multimorbid participants with and without AD. We assessed lifetime prevalence of 52 diseases, from 15 domains, combining data from questionnaires, medication records and clinical assessments within the Lifelines Cohort. Lifetime AD was self-reported, physician-diagnosed and disease severity based on the Patient Oriented Eczema Measure. Multimorbidity was defined as lifetime presence of at least two diseases, while non-atopic multimorbidity excluded asthma, rhinitis and food allergy. A composite morbidity score (cMS) indicated the degree of multimorbidity. We analysed associations of AD and AD severity with multimorbidity and cMS using binary and multinomial logistic regression, adjusting for age and sex and additionally adjusting for socioeconomic and lifestyle factors. Patterns of non-atopic multimorbidity based on disease domains were explored using Latent Class Analysis (LCA), stratified by AD presence. Among 37,193 participants, 8.7% had AD. The odds for non-atopic multimorbidity was 1.47-fold higher in participants with AD, particularly for those with moderate-to-severe disease (adjusted Odds Ratio (aOR) 1.74 vs. mild AD aOR 1.41). The association strengthened with higher degrees of non-atopic multimorbidity, reaching 2.09-fold for ≥5 diseases. When considering atopic diseases in the definition of multimorbidity and the cMS, the associations with AD were even stronger. Further adjustments for socioeconomic and lifestyle factors were corroborative. We identified five distinct multimorbidity classes, among participants with and without AD, with two differing across the groups. One class, characterized by the orofacial domain was only present among those with AD, while another class, resemblant of the metabolic syndrome showed more respiratory contribution in AD with further differences regarding cardiometabolic involvement. Participants with AD, especially moderate-to-severe cases, are more likely to experience (non-atopic) multimorbidity and showed unique patterns of non-atopic multimorbidity with regards to orofacial and cardiometabolic diseases. Our findings highlight the importance of promoting awareness for interdisciplinary approaches to managing patients with AD.
38. Community-based Multimodal Rehabilitation Improves Function and Performance in Postural Orthostatic Tachycardia Syndrome (POTS).
期刊: NeuroRehabilitation 发表日期: 2025-Nov-27 链接: PubMed
摘要
BackgroundIndividuals with neurologic impairment, such as brain injury, are more likely to have autonomic dysfunction, including POTS, but often experience a lack of treatment options and access to quality care.ObjectiveExamine the feasibility and outcomes of a group-based multimodal rehabilitation training program.MethodsNineteen females, ages 18-53 (M = 28.6) completed the outpatient training program. The intervention included eight 50-min weekly sessions using an interdisciplinary, multimodal approach, including education, movement, and mindful self-compassion. Participants completed demographic and medical history and assessment for baseline orthostatic intolerance. At pre-training, post-training, and follow-up, participants completed the Modified Fatigue Impact Scale (MFIS), Lower Extremity Functional Scale (LEFS), Rand 36-Item Health Survey 1.0 (RAND-36), Trail Making Test (A and B) (TMT-A, TMT-B), 10-Meter Walk Test (10MWT), and grip strength testing.ResultsAt baseline, participants were significantly below norms in daily function (p < 0.001), grip strength (p ≤ 0.001) gait speed (p < 0.001), fatigue (p < 0.001), and quality of life (p < 0.001). Between pre-training and follow-up, participants showed significant improvement across function in daily life tasks (p < 0.01); grip strength in the dominant (p < 0.01) and non-dominant (p < 0.01) hands; gait speed (p < 0.05); levels of fatigue (p < 0.05); cognitive performance (p < 0.05); and quality of life (p < 0.05).ConclusionIndividuals with POTS face functional challenges that can be significantly and objectively improved through multimodal rehabilitation. There is a need for provider education and further research to optimize care and quality of life for individuals with POTS.
39. The role of education on the association between ethnicity and tooth loss.
期刊: Community dental health 发表日期: 2025-Nov-27 链接: PubMed
摘要
Aim: To explore the association between tooth loss and ethnicity and to assess the mediating role of education in this relationship. Methods: Secondary analysis of cross-sectional data from adults aged 16 and over who participated in the Health Survey for England in 1999, 2000, 2001, 2002, and 2005. Key variables included ethnicity, education, socioeconomic status, and occupational class. Logistic regression and interaction analysis assessed associations between ethnicity and edentulousness, adjusted for education. Results: Edentulousness was less prevalent among younger participants, individuals of Asian descent, and those with higher income, education, and managerial occupations. After adjusting for sociodemographic factors, ethnic disparities persisted. Black Caribbean individuals with no education had 37% [95% CI = 1.04-1.80] higher odds, and those with A-levels had 43% [95% CI = 0.34-0.96] lower odds of tooth loss. Conclusion: There is a complex interplay between ethnicity, education and tooth loss. Public health interventions are needed to target oral health education and improve access to care, particularly for ethnic minorities and lower socioeconomic groups.
40. Beyond Locks and Lectures: What Rural Parents Think Would Be Effective Firearm Safety Messaging and Programming.
期刊: Journal of community health 发表日期: 2025-Nov-27 链接: PubMed
摘要
Firearm-related suicides and unintentional injuries occur at higher rates in rural U.S. communities than in urban areas. While safe storage programs may help reduce these injuries, little is known about how to effectively engage rural, farming populations. This study aimed to identify factors influencing firearm safety programming and messaging among parents in rural households. Focus groups were conducted in 2024 with rural Iowa parents recruited via FFA club advisors and through the University of Iowa mass e-mail system. Inclusion criteria included: (1) residence in Iowa with active farming or ranching operations, (2) at least one child aged 10-19 living in the home, and (3) at least one firearm in the household. Discussions followed a moderator guide to identify primary themes, with sub-themes emerging organically. Transcripts were analyzed using Dedoose software. Three researchers independently coded the data and resolved discrepancies through consensus. Thirty-two participants identified trusted messengers as law enforcement, Department of Natural Resources personnel, and community members affected by firearm violence. Teachers, healthcare professionals, and celebrities were viewed as less credible. Participants emphasized age-specific messaging using realistic examples and visuals and suggested integrating firearm safety into existing programs like school curricula, 4-H, FFA and local safety courses. Views on distributing safety devices like locks and safes were mixed. Tailoring firearm safety interventions to reflect the values and preferences of rural communities may improve engagement and effectiveness. Strategies led by trusted local messengers may be particularly impactful.
41. Simple behavioral routines indirectly aimed at regularizing sleep timing may help improve cardiovascular health.
期刊: Sleep 发表日期: 2025-Nov-27 链接: PubMed
摘要
42. Non-linear association of two models of occupational stress with anxiety, depression, and job burnout among workers of a petrochemical enterprise in China.
期刊: Psychology, health & medicine 发表日期: 2025-Nov-27 链接: PubMed
摘要
This study aimed to explore the job demand-control (JDC) and effort-reward imbalance (ERI) models of occupational stress status among workers of a petrochemical enterprise, as well as their associations with anxiety, depression, and job burnout. Using a cluster sampling method, 1593 workers of a petrochemical enterprise in China were selected as survey participants. The two models of occupational stress, anxiety, depression, and job burnout were assessed by using the Chinese version of the Job Content Questionnaire (JCQ), the Effort-Reward Imbalance Questionnaire (ERIQ), the Self-Rating Anxiety Scale (SAS), the Center for Epidemiological Survey Depression Scale (CES-D), and the Maslach Burnout Inventory-General Survey (MBI-GS), respectively. The detection rates of high JDC model occupational stress, high ERI model occupational stress, anxiety, depression and job burnout were 28.2%, 26.1%, 11.3%, 23.4%, and 78.6%, respectively. Seniority, sleeping time, JDC model and ERI model occupational stress were associated with anxiety; marital status, physical activity, sleeping time, JDC model and ERI model occupational stress were associated with depression; education level, JDC model and ERI model occupational stress were associated with job burnout. The results of the restricted cubic spline plots further indicated that anxiety, depression and job burnout score were non-linear correlated with D/C ratio, anxiety and job burnout score were non-linear correlated with E/R ratio, while depression score was linear correlated with the E/R ratio. Anxiety, depression and job burnout exhibit non-linear associations with JDC model occupational stress, anxiety and job burnout show non-linear correlations with ERI model occupational stress, while depression exhibits a linear correlation with ERI model occupational stress. It is essential to pay attention to the occupational stress levels of workers in petrochemical enterprises, provide continuous psychological support, and implement preventive measures targeting risk factors to help reduce the risk of anxiety, depression, and job burnout.
43. Combined Ergonomic and Physical Activity Interventions for Preventing Work-Related Musculoskeletal Disorders: An Integrated Review.
期刊: Workplace health & safety 发表日期: 2025-Nov-27 链接: PubMed
摘要
Work-related musculoskeletal disorders (WMSDs) account for 30% of workplace injuries, creating significant occupational health and economic burdens. The purpose of this review was to synthesize existing evidence on the effectiveness of combined ergonomic and physical activity interventions compared to single-approach methods in preventing WMSDs among workers engaged in manual handling and repetitive motion. A systematic search across Web of Science Core Collection, CINAHL, Embase, and PubMed was conducted for English-language studies (2019-2024) following PRISMA guidelines. Studies examining ergonomic interventions, manual handling training, or workplace physical activity programs for adult workers were included. The Johns Hopkins Nursing Evidence-Based Practice Model guided quality assessment. Seven studies from six countries met the inclusion criteria: one Level I randomized controlled trial (A quality), four Level II quasi-experimental studies (B quality), and two Level III observational studies (B quality). Combined interventions of ergonomic and physical activity showed potential benefits of pain reductions (neck: 38%, hand/wrist: 37%) and flexibility improvements, though effect sizes varied considerably. Single interventions showed fewer benefits: ergonomic education reduced high-risk MSDs from 35.1% to 0%, while whole-body stretching achieved greater pain intensity reduction (mean difference 3.6) compared to education alone (mean difference 2.5). Intervention durations ranged from 6 weeks to 22 months across healthcare, manufacturing, and industrial workers. Combined ergonomic and physical activity interventions appeared more effective than single approaches for WMSD prevention, demonstrating clinically meaningful improvements with high completion rates. However, study design variability necessitates cautious interpretation. Future research requires standardized trials with long-term and cost-effectiveness analyses.
44. Predicting subtypes of glycogen storage disease type IV: Challenges of hepatic subtypes and genotype-phenotype correlation.
期刊: Molecular genetics and metabolism 发表日期: 2025-Nov-24 链接: PubMed
摘要
Glycogen storage disease type IV (GSD IV) is a rare autosomal recessive disease caused by the deficiency of the glycogen branching enzyme encoded by GBE1. GSD IV can present with variable age of onset and severity of disease processes involving liver, central and peripheral nerves, muscles, and heart. Adult Polyglucosan Body Disease (APBD) is now increasingly recognized as a continuum of the GSDIV spectrum. If the clinical disease presentation includes progressive liver failure, treatment may require liver transplant to prevent morbidity and mortality. The variable presentation of GSD IV, including the hepatic phenotypes, creates diagnostic and treatment challenges. Here we describe a girl presenting with hypotonia and hepatomegaly at age 4 years; genetic analysis revealed compound heterozygosity in GBE1: c.1621A>G p.(Asn541Asp) and c.1655C>T p.(Pro552Leu). Based on her presentation and genotypes, her phenotypic prognosis was not immediately clear. She was monitored closely for liver disease progression including, synthetic dysfunction, cholestasis, or cirrhosis, but her liver function proved stable over time. Recent analysis suggested that liver disease progression is a spectrum and some develop a progressive/severe hepatic form and others stabilize with an attenuated hepatic form. Previous reviews of GSD IV genotype-phenotype correlations have not adequately addressed the prediction of hepatic phenotype based on GBE1 genotypes. We performed an updated comprehensive literature search and genotype-phenotype analysis, while updating the GBE1 genotypes according to the HGVS nomenclature. Our detailed and comprehensive review of GSDIV adds to the previously published literature available on GSD IV genotypes (Li et al. 2010, Iijima 2018, Souza et al. 2021).
45. The association between episodic listening and the burden of primary informal caregivers of cancer patients - An explorative cross-sectional study.
期刊: Patient education and counseling 发表日期: 2025-Nov-23 链接: PubMed
摘要
The growing prevalence of cancer and of the responsibilities of primary informal caregivers calls for exploring the burden of caregivers. Communication with providers has become a major responsibility of caregivers increasing their burden. Despite the harmful consequences of caregiver burden (CB), little is known regarding mitigators of CB. The perceived high quality of communication with providers may be a mitigator of CB which is yet to be tested. Therefore, this study tests the association of episodic listening behaviors of providers and CB among caregivers of cancer patients. We hypothesize that constructive listening behaviors of nurses will shape the extent of CB. In this cross-sectional study, hospitalized oncology patients gave their consent to approach their informal primary caregivers and requested their consent to participate by completing anonymous questionnaires. Study variables included the Zarit Burden Interview and the abbreviated Constructive and Destructive Listening questionnaires. Statistical analyses used Pearson correlations and multivariable linear regression. The sample comprised 80 primary caregivers of cancer patients. 65 % were women, 65 % were religious, and the average age was 51 years. Mean CB was 27.21 (SD-16.39). CB was positively associated with destructive listening (r = 0.400, p = 0.000) and negatively associated with constructive listening (r = -0.223, p = 0.000). Multivariable linear regression identified destructive listening as a significant antecedent (β = 0.265; t = 2.007; p = 0.049), explaining 14.7 % of the variance in CB (R2 = 0.0192; MS = 568.147; df = 6; F = 2.7; p = < 0.002). Although episodic listening is a key component of nursing ethics and fundamental to relationships with patients, caregivers of cancer patients may be ignored. To reduce CB, nurses should eradicate destructive listening and promote constructive listening forging higher quality communication with patients. Insights may guide future research and paths to reduce CB.
46. Green and roasted coffee as novel substrates for kombucha fermentation: Modulation of bioactivity and phenolic profile.
期刊: Food chemistry 发表日期: 2025-Nov-22 链接: PubMed
摘要
Fermentation of coffee beverages with a symbiotic culture of bacteria and yeast (SCOBY) is an emerging alternative to traditional tea-based kombucha. This study examined the effects of SCOBY fermentation on the chemical composition and bioactivity of infusions prepared from green and roasted beans of Coffea arabica and Coffea canephora. Fermentation for 14 days markedly altered the phenolic profile and enhanced the antioxidant, antidiabetic, anti-inflammatory, and anticholinesterase activities. Green C. canephora showed the highest antidiabetic and neuroprotective potential, while roasted coffees exhibited stronger antioxidant effects. Multivariate analyses (PCA and Pearson correlation) revealed close associations between phenolic transformation, sugar metabolism and biological functions. The results demonstrate that coffee, particularly in its green form, is a promising substrate for SCOBY fermentation and may serve as a basis for developing novel functional beverages with targeted health-promoting properties.
47. Plasma exosomes reveal insights into bovine tuberculosis pathogenesis and diagnostic opportunities.
期刊: Veterinary microbiology 发表日期: 2025-Nov-21 链接: PubMed
摘要
Bovine tuberculosis (bTB) is a chronic infectious disease caused by the Mycobacterium bovis (M. bovis). Rapid, cost-effective, and accurate diagnosis of bTB remains a significant clinical challenge globally. In this study, we performed a comprehensive proteomic analysis to evaluate the discriminatory power of plasma and plasma exosomes for bTB diagnosis. We compared protein expression profiles across three groups: M. bovis-negative controls (bTB_N, n = 10), M. bovis-positive cases (bTB_P, n = 10), and co-infected animals (Other_P, n = 10) with Brucella, infectious bovine rhinotracheitis virus (IBRV), and bovine viral diarrhea-mucosal disease virus (BVDV). Quantitative analysis identified 3820 exosomal proteins-2.27-fold more than the 1686 plasma proteins detected. Exosomal proteins exhibited superior sample clustering and discriminative capacity for infected groups. Notably, 227 plasma and 861 exosome-derived proteins were uniquely differentially expressed in bTB (bTB-specific DEPs). Pathway enrichment analysis revealed that exosome-specific DEPs were significantly enriched in TB-related pathways, including neutrophil extracellular trap (NET) formation, endocytosis, and tuberculosis, exhibiting greater biological relevance compared to plasma-specific DEPs. Furthermore, eight candidate proteins (APOE, FBLN5, VDAC1, ABCE1, LMAN1, PLG, SPP1, and SRP9) demonstrated high specificity for bTB discrimination, with two (FBLN5 and SPP1) displaying stage-specific expression patterns during M. bovis infection. This study underscore plasma exosome as a highly promising source of biomarkers for bTB diagnosis, offering enhanced sensitivity and deeper mechanistic insights over conventional plasma proteome.
48. A high-sensitivity magnetic-controlled separable visuable aptasensor based on neutral pH SOD-like dual-metal based MOF on MOF for aflatoxin B1 detection.
期刊: Food chemistry 发表日期: 2025-Nov-21 链接: PubMed
摘要
Aflatoxin B1 (AFB1), a highly toxic and stable mycotoxin, endangers food safety and public health. Current aptamer-nanozyme detection systems often require acidic conditions (pH 3.0-5.5), impairing aptamer-target binding. Here, we developed a neutral-pH colorimetric aptasensor using a biomimetic superoxide dismutase (SOD)-like nanozyme. A bimetallic Mn/Cu-MOF was synthesized via a MOF-on-MOF strategy, combining a Cu-MOF core with a hydroxyl-rich Mn-MOF shell to mimic natural SOD’s catalytic centers and hydrogen-bonding microenvironment. The aptasensor employs AFB1-specific aptamers immobilized on magnetic nanoparticles (Apt@Fe3O4) and cDNA-conjugated Mn/Cu-MOF (cDNA@Mn/Cu-MOF). Target binding displaces cDNA@Mn/Cu-MOF, enabling its SOD-like catalytic reduction of nitro blue tetrazolium (NBT) under neutral pH. The absorbance at 560 nm correlates linearly with AFB1 concentration (0.1-3000 ng/mL), achieving a 0.07 ng/mL detection limit. Recoveries in spiked peanut samples ranged from 91.80 % to 109.08 %. This strategy offers sensitive AFB1 detection and a novel neutral-pH biosensor design paradigm.
49. Melatonin attenuates atherosclerotic plaque vulnerability through SIRT6-dependent regulation of vascular smooth muscle cells senescence.
期刊: Redox biology 发表日期: 2025-Nov-19 链接: PubMed
摘要
Rupture of vulnerable atherosclerotic plaques is a major cause of acute cardiovascular events. Vascular smooth muscle cell (VSMC) senescence promotes plaque vulnerability by impairing fibrous cap integrity. Although melatonin exhibits atheroprotective potential, its capacity to stabilize plaques by targeting VSMC senescence along with the underlying mechanisms, remains unclear. In this study, a vulnerable plaque model was established in ApoE-/- mice by partial ligation of the left carotid artery combined with a high-fat diet. Melatonin treatment substantially enhanced plaque stability, as indicated by decreased plaque burden, increased fibrous cap thickness, and an elevated collagen-to-lipid ratio. These effects were prevented by the MT membrane receptor antagonist luzindole. Melatonin markedly suppressed VSMC senescence in both plaques and hydrogen peroxide-stimulated VSMCs; this suppression was similarly abolished by luzindole. Transcriptomic analysis identified SIRT6 as the most significantly upregulated sirtuin in response to melatonin treatment. Melatonin upregulated SIRT6 expression in a MT membrane receptor-dependent manner. Notably, VSMC-specific SIRT6 knockdown eliminated the beneficial effects of melatonin on plaque stabilization and VSMC senescence attenuation. Mechanistically, melatonin alleviated oxidative stress by activating the Nrf2 antioxidant pathway-an effect nullified by SIRT6 knockdown or inhibition. This study uncovers a novel mechanism by which melatonin mitigates atherosclerotic plaque vulnerability through inhibition of VSMC senescence. This protective action is mediated via MT membrane receptor-dependent activation of the SIRT6/Nrf2 signaling axis, culminating in reduced oxidative stress.
50. Comparative Iron biofortification in Hericium erinaceus: A study of different ionic forms and their uptake efficiency.
期刊: Food chemistry 发表日期: 2025-Nov-19 链接: PubMed
摘要
Iron biofortification of Hericium erinaceus is a promising strategy for enhancing its nutritional profile. This study examined the effects of supplementing growth substrates with various iron forms (FeCl3·6H2O, FeSO4·7H2O, and FeHBED) on iron uptake, accumulation, and metabolic profiles in H. erinaceus fruiting bodies. The results indicated that iron supplementation not only increased iron content but also affected several metabolic pathways, including energy metabolism, oxidative stress response, and biosynthesis. The choice of iron significantly influenced mushroom growth, mineral composition, and metabolite levels. FeCl3·6H2O resulted in the highest iron accumulation, FeSO4·7H2O enhanced biomass production, and FeHBED (water-soluble iron chelate) exhibited unique effects on energy metabolism and antioxidant protection. These findings suggest that iron biofortification could facilitate the development of nutritionally enhanced H. erinaceus products, potentially addressing iron deficiency while preserving the medicinal properties of mushrooms. Further research is necessary to optimise iron biofortification techniques and assess the bioavailability and health benefits of iron-enriched H. erinaceus in human nutrition.
51. Antimicrobial resistance, genomic, and public health insights into Enterococcus spp. from Australian cattle.
期刊: Veterinary microbiology 发表日期: 2025-Nov-07 链接: PubMed
摘要
Enterococci are opportunistic, sometimes life-threatening pathogens with increasing antimicrobial resistance, particularly among clinical human isolates in Australia. While recent studies have ruled out pigs and chickens as major reservoirs of resistant enterococci, the role of cattle remains unclear. This study examines the antimicrobial resistance (AMR) profiles of enterococci from Australian cattle and explores the phylogenetic relationship of bovine E. faecium with isolates from other livestock and human sepsis cases. A total of 1001 bovine faecal samples were tested, yielding E. faecium (n = 343), E. faecalis (n = 92), and E. hirae (n = 284). Minimum inhibitory concentration assays were conducted against 15 antimicrobials. A subset of 67 isolates underwent whole genome sequencing (WGS). Most isolates were wild-type to all tested antimicrobials. Resistance was most common to erythromycin in E. faecium (18.7 %), daptomycin in E. faecalis (12.1 %), and tetracycline in E. hirae (13.3 %). A single E. faecalis isolate was non-wild-type to vancomycin, and nine isolates (E. faecium n = 4, E. faecalis n = 2, E. hirae n = 3) showed linezolid resistance. However, WGS did not detect known resistance genes or mutations for vancomycin or linezolid. Phylogenetic analysis revealed that bovine E. faecium clustered with other livestock isolates and vancomycin-negative human isolates. Antimicrobial resistance among enterococci from Australian cattle is low. These strains are genetically distinct from vancomycin-resistant E. faecium circulating in hospitals, suggesting that cattle are not a significant source of clinically relevant AMR enterococci in Australia.
52. 'Gudhurr-wutu' (strengthen the mob): maximizing the impact of First Nations health and well-being messaging.
期刊: Health promotion international 发表日期: 2025-Oct-30 链接: PubMed
摘要
Dunghutti Country is located within Australia’s number one ‘stroke hotspot’, with incidence almost double the national average. First Nations peoples are disproportionately affected by stroke, with higher incidence and hospitalization rates and a greater risk of dying compared to non-First Nations Australians. Early recognition of stroke symptoms is critical for people to access time-sensitive medical interventions, maximizing recovery potential. Whilst an internationally recognized F.A.S.T (Face, Arm, Speech, Time) message exists to promote rapid recognition of stroke symptoms, community awareness of F.A.S.T is limited. This project aimed to collaboratively design a culturally responsive F.A.S.T health message with and by First Nation’s peoples, thus increasing awareness of stroke symptoms, to improve response for seeking time-sensitive medical care. Guided by a qualitative participatory action methodology, and the use of cross-cultural Yarning as the method, this collaborative project involved six Dunghutti stroke survivors, a Dunghutti artist, a knowledge holder of local Dunghutti language, and a local occupational therapist/researcher, who reviewed the mainstream F.A.S.T health message and reimagined that message in a culturally relevant and meaningful way. Yarning allowed exploration of key themes, identifying three elements necessary to maximize the impact of First Nations health and well-being messaging. Elements included ensuring the health message (i) connects to Country, (ii) connects to understandings of health and well-being, and (iii) connects through relevant content, with First Nations peoples centred within the ideation, development, and message delivery processes.
53. Newspaper framing of food poverty and insecurity on the island of Ireland.
期刊: Health promotion international 发表日期: 2025-Oct-30 链接: PubMed
摘要
Given that news media play key roles in shaping public and policy responses to food poverty and insecurity, this study analysed how newspapers frame these issues across the island of Ireland, comparing coverage between jurisdictions (Republic of Ireland and Northern Ireland) and newspaper types (national versus regional/local). Using LexisNexis and Irish Newspaper Archives, we searched for articles containing ‘food poverty’ or ‘food insecurity’ published between January 2018 and January 2023. We used Entman’s framing theory to code articles for problem definitions, causal interpretations, solutions, moral evaluations, and social actors. Analysis of 80 articles from 14 newspapers revealed coverage peaked during school holiday periods (December and Summer), reinforcing episodic attention to ‘holiday hunger’. Although structural causes appeared in 66% of articles-including inadequate income, living costs, and welfare failures-proposed solutions were predominantly charitable (79%) rather than structural (39%), with food banks cited most frequently. National newspapers more frequently discussed structural causes and policy solutions, while regional publications focused on charitable responses. Articles predominantly featured voices from charities (88%) and government officials (50%), while only 10% incorporated voices from those experiencing food poverty and insecurity. This disconnect between acknowledged structural causes and proposed charitable solutions perpetuates normalization of food poverty and insecurity, obscuring state responsibility for ensuring the right to adequate food. Such framing impedes recognition that this issue in wealthy nations results from political choices requiring systemic reform, not charitable intervention.
54. A Randomized Clinical Trial Comparing Near-Infrared Imaging and Panoramic Radiography for Caries Detection.
期刊: Nigerian journal of clinical practice 发表日期: 2025-Oct-01 链接: PubMed
摘要
Although dental caries is largely preventable, it remains a primary global health concern due to its high prevalence and incidence, as noted by the World Health Organization. Early detection is crucial for prevention, minimization of intervention, and oral health promotion. This study aims to evaluate the most effective diagnostic method for detecting existing caries lesions in patients attending our clinic through a randomized clinical trial. Fifty-four patients underwent both panoramic radiography and near-infrared reflectance imaging (NIRI) for caries detection. A maxillofacial radiologist and a prosthodontist independently assessed the images, each conducting two evaluations. Normality was assessed using the Shapiro-Wilk test and skewness and kurtosis values. Statistical tests were used to compare detection rates and interobserver agreement. Panoramic radiography revealed a mean of 3.26 (radiologist) and 3.30 (prosthodontist) carious lesions, with no significant difference (P = 0.914) and moderate agreement (P < 0.001). NIRI detected significantly more lesions: 6.59 (radiologist) and 6.00 (prosthodontist), showing excellent agreement (P < 0.001) with a small but significant difference (P = 0.023). Both clinicians identified nearly twice as many lesions with NIRI compared to radiography (P < 0.001). NIRI showed superior performance in early caries detection. Compared to panoramic radiography, NIRI is more sensitive and avoids ionizing radiation, making it safer and more comfortable. Its reliability and patient-friendly nature support its use as a promising tool in routine preventive dental care.
55. Perceptions and use of behaviour change interventions for physical activity in chronic respiratory disease in The Republic of Ireland.
期刊: Physiotherapy 发表日期: 2025-Sep-09 链接: PubMed
摘要
Behaviour change interventions may support physical activity behaviour in people with chronic respiratory disease. The most effective interventions for long-term physical activity behaviour change in this cohort remains unclear. This aim of this study was to explore the use and perceptions of behaviour change interventions by both providers of physical activity programmes for people with chronic respiratory disease and by people living with chronic obstructive pulmonary disease (COPD) in The Republic of Ireland. Two anonymous online and paper-copy cross-sectional surveys, piloted and mapped to the COM-B model of behaviour change, were distributed via social media and relevant gate-keepers (e.g Irish Society of Chartered Physiotherapists, COPD Support Ireland) between November 2023 and April 2024. Findings were summarised using descriptive statistics including frequencies, percentages, means and medians. Relationships between variables were investigated using Chi2 (p = 0.05). The response rate to the provider survey was 71% (107/150), and 112 participants responded to the COPD cohort survey. Providers perceived encouragement, pertaining to theoretical constructs such as self-confidence, optimism and reinforcement to be the most effective techniques influencing physical activity behaviour. People with COPD perceived social support, pertaining to theoretical constructs such as interpersonal skills and social identity, to be the most effective interventions influencing their physical activity behaviour. Motivation was frequently identified as a common COM-B component, suggesting important links to this mechanism of action in influencing behaviour. Interventions with motivational components are perceived as effective influencers of physical activity behaviour by providers of physical activity programmes and by those living with chronic respiratory disease. CONTRIBUTION OF THE PAPER.
56. Changing Epidemiology of Lung Cancer in Finland: A Registry-Based Study by Histology and Region.
期刊: Cancer control : journal of the Moffitt Cancer Center 发表日期: 2025 链接: PubMed
摘要
IntroductionThe national epidemiology of lung cancer (LC) in Finland, subdivided by histology and regional data, has not yet been studied in detail. This study examines the incidence, mortality, and mortality-to-incidence ratios (MIR) of LC and its subtypes in men and women during 2000-2019 in different regions of Finland.MethodsAn observational register-based study was conducted using nationwide data from the Finnish Cancer Registry (FCR). The cases were classified into adenocarcinoma (ADC), squamous cell carcinoma (SQC), small cell lung carcinoma (SCLC), and other and unknown histological types. The incidence and mortality were explored nationwide and separately in the 5 collaborative areas for healthcare and social welfare. MIR were used to estimate survival.ResultsThe incidence and mortality of LC declined in men (78.6 to 25.9/100 000) but increased in women (5.0 to 15.1). The incidence of ADC increased from 4.4 to 7.2, while SQC and SCLC decreased from 5.0 to 3.6 and 3.5 to 3.0. The incidence of ADC increased in men and women, surpassing SQC as the most common histology with varying regional pace. The incidence of SQC and SCLC decreased in men but increased in women. MIR showed similar regional improvements to LC survival for ADC and SQC, but not for SCLC.ConclusionThe Finnish LC rates changed slowly from a predominantly SQC and SCLC histology to ADC being the most common LC type. Sex-specific LC rates are converging nationwide. This study reports detailed Finnish LC data to inform future research and public health efforts. This study examined how lung cancer rates and types have changed across different regions of Finland. Using national cancer registry data, we found that adenocarcinoma has become the most common type of lung cancer, while overall patterns and survival rates differ by region and between men and women.
57. Efficacy and Safety of PRaG Therapy in Elderly Patients with Advanced Malignant Tumors: A Prospective, Multicenter Clinical Study Protocol (PRaG 9.0 Study).
期刊: Technology in cancer research & treatment 发表日期: 2025 链接: PubMed
摘要
Background: Current evidence from evidence-based medicine is limited regarding the efficacy and safety of immunotherapy in elderly patients aged 75 years and older with malignant solid tumors. PRaG therapy, which combines PD-1/PD-L1 inhibitors, radiotherapy, and granulocyte-macrophage colony-stimulating factor (GM-CSF), aims to treat patients with advanced, refractory tumors. Preliminary findings indicate that patients aged 75 years and older can benefit from this treatment and can tolerate it well. Objective: This study aims to evaluate the efficacy and safety of the PRaG regimen in elderly patients with advanced malignant solid tumors to provide evidence-based support for immunotherapy in this population. Methods and Analysis: This study involves a multicenter, prospective, single-arm phase II clinical trial designed to enroll 29 patients aged 75 years and older with either newly diagnosed or recurrent metastatic advanced solid tumors that are histologically confirmed. All of the eligible patients will have had to receive at least two cycles of PRaG therapy until disease progression or intolerable adverse effects occurred. The study protocol was approved on September 12, 2023, by the Ethics Committee of the Second Affiliated Hospital of Soochow University (JD-LK-2023-082-I01) and by the ethics committees of all of the participating centers (Trial Registration Number: NCT06112041).