公共卫生研究摘要 (2025-12-01)
共收录 57 篇研究文章
1. Mindfulness Apps to Improve Depression Severity and Family Management in Parents of Children With Medical Complexity: A Pilot Study.
期刊: Journal for specialists in pediatric nursing : JSPN 发表日期: 2026-Jan 链接: PubMed
摘要
Parents of children with medical complexity (CMC) frequently experience challenges with family management and depression. The purpose of the study was to provide preliminary feasibility, usage, acceptability, and efficacy data following a trial of mindfulness app use in parents of a CMC. In this single-arm intervention pilot study, parents were asked to use a mindfulness mobile application (app) for 10-15 min, 4 days a week. Depression severity and family management were measured using the Patient Health Questionnaire-9 and Family Management Measure, respectively, at baseline and 4 weeks later. A total of 32 parents consented to participate; 28 parents completed all surveys. Self-reported usage data indicate that 8 parents (32%) used the app 4 days a week and 12 parents (50%) used it for at least 10 min/session. The majority rated the app easy to use and would recommend it (n = 26; 92.8%). There was a statistically significant improvement in depression severity and family management scores following app use. Time spent using the app had a strong negative correlation with depression severity scores (p <0.01), however, the number of days used per week of use was not statistically significant. Parents of a CMC are at risk for depression and family management issues. Timely identification of parental mental health is important so interventions can be provided. This pilot study provides promising, preliminary information regarding the feasibility, acceptability, and efficacy of a mindfulness app intervention.
2. Social Determinants of Health Related to Physical Activity in Older Adults With Musculoskeletal Pain in Europe: A SHARE-Based Analysis of 21,679 Participants.
期刊: Physiotherapy research international : the journal for researchers and clinicians in physical therapy 发表日期: 2026-Jan 链接: PubMed
摘要
Physical activity (PA) is a key recommendation for musculoskeletal pain, but social determinants of health (SDH) may limit older adults’ participation. The purpose of this study was to assess the association of SDH with PA in a large representative sample of older Europeans with musculoskeletal pain. A cross-sectional study was conducted based on data from the 9th wave of the SHARE (2021-2022), a representative survey of people aged 50 years and older in 27 European countries and Israel. People with back, hip, knee, or other joint pain were included. The SDH (exposures) examined were education, household income, current job status, and loneliness. Self-reported vigorous or moderate PA were the outcomes. Survey-weighted ordinal logistic regression models were applied, adjusting for age, sex, country, comorbidities, sleep problems, smoking, sadness, and pain characteristics. 21,679 individuals (mean age: 70 years, 64% female) were included. Low educational level was consistently associated with reduced participation in moderate (OR: 0.79; 95% CI: 0.65-0.97) and vigorous PA (OR: 0.68; 95% CI: 0.57-0.82). Loneliness was consistently associated with reduced participation in moderate (OR: 0.78; 95% CI: 0.65-0.93) and vigorous PA (OR: 0.76; 95% CI: 0.67-0.87). Active employment was associated with a lower likelihood of engaging in vigorous PA (OR: 0.69; 95% CI: 0.60-0.79) but not moderate PA. No significant association was observed with income. Our findings highlight the need for educational interventions and targeted strategies addressing social support to promote physical activity in older adults with musculoskeletal pain.
3. MRI-DTI Biomarkers Along the Continuum of Behavioral Variant Frontotemporal Dementia.
期刊: European journal of neurology 发表日期: 2025-Dec 链接: PubMed
摘要
We investigated whether diffusion tensor imaging (DTI) and atlas-based volumetry (ABV) could track specific patterns of brain white matter (WM) microstructure and gray matter (GM) volumes in behavioral variant frontotemporal dementia (bvFTD) and amyotrophic lateral sclerosis with frontotemporal dementia (ALS-FTD). MRI datasets from 65 bvFTD (including 19 with longitudinal MRI), 18ALS-FTD, and 39 controls were analyzed. White matter fractional anisotropy (FA) differences were assessed using unbiased Whole Brain-based Spatial Statistics (WBSS) and a hypothesis-driven complementary approach consisting of Tract-Wise FA Statistics (TFAS) in Tracts of Interest (TOIs) and ABV in Structures of Interest (SOIs). FA maps were correlated with disease severity (FTLD-CDR sum of boxes). A random forest algorithm classified participants employing TOI and SOI data. At baseline, both bvFTD and ALS-FTD exhibited WM changes in several tracts including the uncinate fasciculi, tracts originating in the corpus callosum, and the inferior and superior longitudinal fasciculi. Atrophy was most pronounced in the frontal lobes and caudate nuclei. Longitudinally, bvFTD demonstrated an antero-posterior spread of WM degeneration, particularly along the corpus callosum and inferior longitudinal fasciculus, with relatively modest cortical atrophy progression. Random forest analysis identified the most discriminative TOIs and SOIs including the uncinate fasciculus and the amygdala. Our findings demonstrate a similar pattern of structural and microstructural changes in bvFTD and ALS-FTD, with a specific involvement of the corticospinal tract for ALS-FTD, and support the utility of combined DTI and ABV in tracking disease progression across the FTLD spectrum.
4. Molecular Characterization of Rift Valley Fever Virus From the 2025 Outbreak in Northern Senegal Reveals Lineage H Persistence and Key Polymerase Mutations.
期刊: Journal of medical virology 发表日期: 2025-Dec 链接: PubMed
摘要
Rift Valley fever virus (RVFV) is a mosquito-borne phlebovirus that causes severe febrile and hemorrhagic illness in humans. In September 2025, an outbreak in northern Senegal led to 119 confirmed infections and 15 deaths as of October 7, 2025. We performed rapid genomic sequencing to characterize the virus responsible for this epidemic. RNA from RT-qPCR-confirmed samples was sequenced using the Twist Comprehensive Viral Research Panel on an Illumina iSeq 100 platform. Consensus genomes were analyzed with and compared with all complete RVFV genomes in GenBank. Nine genomes were recovered, including five complete tripartite sequences. All clustered within lineage H, sharing > 99% nucleotide identity with Senegalese isolates from 2020 to 2022. Alongside two conservative mutations (R137K and K1111R in S and M segments, respectively), a single nonconservative D11N substitution in the L polymerase may affect replication efficiency, while Gn and Gc epitopes remained conserved. Phylogenetic analyses confirmed strong genetic continuity with earlier West African isolates, indicating local persistence rather than reintroduction. Lineage H persistence in Senegal, combined with polymerase substitutions under purifying selection, suggests subtle viral adaptation that may affect replication. Conserved glycoprotein epitopes indicate maintained vaccine relevance. Sustained genomic surveillance integrated with clinical and ecological monitoring remains essential to anticipate viral evolution and guide Rift Valley fever control.
5. Species Overlap and Phylogenetic Relatedness Result in Community Statistical Non-Independence (and What to Do About It).
期刊: Ecology letters 发表日期: 2025-Dec 链接: PubMed
摘要
Statistical autocorrelation between sampling units violates independence assumptions in many analyses. Here, we used simulations and empirical analyses to demonstrate how shared evolutionary history between species and species overlap among communities leads to an insidious form of autocorrelation, termed compositional autocorrelation. We simulated compositionally autocorrelated ecosystem functions across communities and assessed the type I error, statistical power and accuracy of slope estimates from naïve linear regression models and mixed models accounting for compositional autocorrelation. Mixed models maintained lower type I error, similar or higher statistical power, and more accurate slope estimates compared to linear regression. Re-analysing an empirical dataset, we found linear regression underestimated uncertainty in species richness effects for eight of 10 ecosystem functions. As species overlap and shared evolutionary history are common features in community data, our results highlight the need to explicitly consider compositional autocorrelation in statistical analyses to ensure correct inferences.
6. Comparative Transcriptomics Reveals a Dual Role of the Epidermal Differentiation Complex in the Skin and the Oesophagus.
期刊: Experimental dermatology 发表日期: 2025-Dec 链接: PubMed
摘要
The epidermal differentiation complex (EDC) is a cluster of genes implicated in the control of the skin barrier. However, some EDC genes are also expressed at high levels in the human oesophagus. To determine whether the expression of EDC genes in the oesophagus is evolutionarily conserved, we performed comparative transcriptomic analyses of the skin and the oesophagus in humans, mice and chickens. Transcriptomes from public databases and newly generated RNA-sequencing data of the chicken oesophagus were compared. We found that the EDC of both mammals and birds contains genes that are predominantly expressed in the skin and others that are predominantly expressed in the oesophagus. Cornulin is strongly enriched in the oesophagus of humans and chickens. Similar to small proline-rich proteins in the human and murine oesophagus, an EDC protein rich in proline is predominantly expressed in the chicken oesophagus. Further oesophagus-enriched EDC genes are specific to phylogenetic lineages. This study indicates that the EDC plays evolutionarily ancient roles not only in the epidermis of the skin but also in the epithelium of the oesophagus. In line with the dual function of the EDC, dysregulation of EDC gene expression is associated with pathological changes in both stratified epithelia.
7. Long-term recurrence risk and temporal dynamics after resection of intracranial meningiomas: A multicenter cohort study with up to 15 years of follow-up.
期刊: Cancer 发表日期: 2025-Dec-01 链接: PubMed
摘要
Meningiomas are the most common primary intracranial tumors, accounting for approximately one third of central nervous system neoplasms. Although most are benign, recurrence remains a clinical concern, particularly in cases of subtotal resection (STR) where complete tumor removal is not feasible due to involvement of critical structures. Adjuvant Gamma Knife radiosurgery (GKRS) is often considered in these patients, yet the long-term effectiveness of GKRS and the temporal dynamics of recurrence beyond 10 years are not well characterized. In this multicenter retrospective cohort study, 949 adult patients who underwent surgical resection for intracranial meningiomas between 2009 and 2017 at two tertiary centers in China were followed through 2024. The primary exposure was extent of resection (gross total resection vs subtotal resection [STR]) and postoperative GKRS. The primary outcome was recurrence-free survival (RFS); secondary outcomes included overall survival, annualized recurrence risk, and biomarker-based stratification. Analyses included Cox models and competing-risk approaches. Median follow-up for RFS was 8.8 years. The 15-year RFS rate was 79.2% (95% CI, 74.2-84.6). In STR cases, a second recurrence peak emerged at 7 to 10 years. GKRS was associated with lower recurrence risk (hazard ratio = 0.50; 95% CI, 0.27-0.90), especially in convexity tumors. Ki-67 > 5% and progesterone receptor negativity showed nonsignificant trends toward higher recurrence. In this large cohort with extended follow-up, STR patients exhibited a second recurrence peak at 7 to 10 years postoperatively. Adjuvant GKRS showed long-term benefit, supporting its selective use and long-term surveillance beyond 10 years.
8. Clinical Dietitians' Perspectives on Nutritional Management in Children's Palliative Care: A Qualitative Study.
期刊: Journal of human nutrition and dietetics : the official journal of the British Dietetic Association 发表日期: 2025-Dec 链接: PubMed
摘要
Feeding disorders and gastrointestinal problems are among the most prevalent concerns in children who are eligible for palliative care. Many of these children require medical nutrition therapy and benefit from the involvement of healthcare professionals with expertise in nutrition, such as dietitians. Dietitians may help alleviate the practical and emotional burden parents experience when caring for their sick child at home. However, research is limited regarding dietitians’ roles and contributions in children’s palliative care. This study explores dietitians’ experiences and perceptions of nutritional management and care of children in palliative care in Norway. Semistructured interviews were conducted with 11 dietitians who provide nutritional management to children in palliative care, and the data were analysed using a reflexive thematic analysis approach, as described by Braun and Clarke. Four themes were developed through this analysis: First, nutrition is a core component of comprehensive palliative care; second, organisational placement affects dietitians’ involvement; third, fragile structures for nutritional care; fourth, close bonds between the family and the dietitian. We found that dietitians face complex feeding and gastrointestinal challenges when working with children and view nutritional care as a responsibility best addressed by a multidisciplinary team, rather than a task for the dietitian to manage independently. Organisational structure impacts a dietitian’s ability to collaborate effectively with other professionals in providing nutritional care. Dietitians’ knowledge of children’s palliative care is primarily experience-based, and they often lack professional support in decision-making processes. Nevertheless, dietitians maintain close, ongoing contact with the families of the children they treat and tailor their approach to meet these families’ needs as the children’s conditions progress. Nutrition is a core component of comprehensive palliative care and can impact the quality of life of children and their families. Therefore, it should be an integrated component of multidisciplinary palliative care for children.
9. Co-designing a just-in-time adaptive mHealth intervention to improve parental support for child physical activity using a no-code app design platform: Development study.
期刊: Applied psychology. Health and well-being 发表日期: 2025-Dec 链接: PubMed
摘要
Parental support significantly influences children’s physical activity (PA) levels. Just-in-time adaptive interventions (JITAIs) delivered through mobile health (mHealth) may provide personalized, dynamic support to parents, though research is limited. 1) Describe the co-design process of a family-based JITAI app designed to help parents support their children’s PA, and 2) evaluate the resources required to co-design this app using a “no-code” platform, Pathverse. Following the Integrate, Design, Assess, Share (IDEAS) and Multi-Process Action Control (M-PAC) frameworks, parents of children 8-12 years not meeting PA guidelines participated in semi-structured interviews (Phase 1). Feedback-informed app features, JITAI tailoring strategies, and prototype refinement (Phase 2). Six parents participated in Phase 1 guided by the IDEAS framework, with parental feedback directly shaping the app design. Parents emphasized family-based content, gamification, and diverse PA activities, while barriers (e.g., time, weather) informed JITAI tailoring. The M-PAC framework guided the selection and delivery of behavior change techniques (e.g., self-monitoring, social support). Development required 320 hours over four months, including decision-tree creation (50), uploading dynamic content (70), and testing (80). A family-based JITAI app was co-designed leveraging the M-PAC framework and Pathverse to integrate parental support for PA, laying the groundwork for future testing.
10. Prenatal fructose exposure independently impacts placental phenotype and female offspring kidney function and liver composition in rats.
期刊: Physiological reports 发表日期: 2025-Dec 链接: PubMed
摘要
Archaeological and anthropological evidence suggests that human ancestors’ diets were rich in fiber, potassium, and complex carbohydrates, while low in sodium, refined sugars, and energy density. Over time, agroindustrialization led to diets poorer in fiber and micronutrients but higher in sodium, simple sugars, and calorie-dense foods. This shift contributed to the rise of noncommunicable diseases (NCDs) such as obesity, type 2 diabetes, and cardiovascular diseases, which now account for 70% of global premature deaths. Maternal nutrition affects fetal development and long-term health. High sucrose or fructose intake during pregnancy can alter placental function, impacting fetal growth and metabolism. Placentae from male and female fetuses may respond differently to maternal diet. However, the effects of excessive maternal fructose intake on the placenta and offspring remain underexplored. In this study, rat dams consuming fructose-sweetened beverages ate less food but drank more, significantly impacting placental volume and vascular structure. Long-term effects on offspring were sex-specific: females showed greater water retention and liver fat accumulation. High maternal fructose intake altered placental anatomy and had sex-specific effects on kidney and liver function in adult offspring, even without further fructose exposure. These findings highlight the importance of maternal diet in preventing future metabolic diseases.
11. Modeling approaches for estimating the effects of risk factors using longitudinal lifecourse exposure data in dementia research.
期刊: Alzheimer’s & dementia : the journal of the Alzheimer’s Association 发表日期: 2025-Dec 链接: PubMed
摘要
Longitudinal data on risk factors at different ages across the lifecourse are essential for gaining important insights into how the timing and accumulation of exposure to risk factors influence the risk of Alzheimer’s disease and related dementias (dementia). With increased interest in the exposome and lifecourse research questions, there have been commensurate increases in data sources and methodological approaches for answering these questions using empirical data. Methodological approaches developed within specific disciplines have largely remained within disciplinary silos, despite their potential for broader applications. By enumerating these approaches in a single place, we aim to expand discovery in lifecourse dementia research and help investigators align their research questions with appropriate analytic methods. In doing so, we seek to guide methodological decision-making and ensure that researchers use appropriate statistical tools to answer important questions about the exposome and lifecourse risk factors for dementia. HIGHLIGHTS: Longitudinal exposure data are valuable for exposome and lifecourse research on dementia. Multiple methodological approaches exist to analyze such data, with different assumptions, advantages, and disadvantages. Some methodological approaches have been used predominantly in specific disciplines but may have wider utility. Additional research is needed to integrate added complexity from the co-occurrence of multiple exposures into existing methods. Comparisons between methods help researchers make informed decisions on the appropriate method for a specific research question.
12. Unveiling the Potential of Lentilactobacillus hilgardii in Malolactic Fermentation: Comparative Genomics and Fermentation Dynamics.
期刊: Microbial biotechnology 发表日期: 2025-Dec 链接: PubMed
摘要
This study aimed to assess the potential of Lentilactobacillus hilgardii as a novel candidate for malolactic fermentation (MLF) in winemaking, through comparative genomics and experimental validation, in direct comparison with Oenococcus oeni. We performed a pangenome analysis on 16 L. hilgardii and 7 O. oeni strains to explore their genetic diversity, focusing on wine-related traits. Functional predictions were generated using genome-scale metabolic models (ModelSEED/KBase), including in silico co-inoculation with Saccharomyces cerevisiae EC1118 and post-alcoholic fermentation simulations. The reference strains L. hilgardii DSM 20176 and O. oeni DSM 20252 were experimentally tested for MLF performance in a synthetic wine-like medium at 25°C and 10°C. Core-genome comparison revealed that 67.9% of the malolactic enzyme sequence is conserved between the two species, with comparable docking affinity to L-malic acid. L. hilgardii harboured unique enzymes with potential oenological interest (phenolic acid decarboxylase, mannitol dehydrogenase, glucosidase) and distinctive stress-related proteins (YaaA, HrcA, ASP23), suggesting improved tolerance to oxidative, temperature, and alkaline stresses. Notably, L. hilgardii showed genomic potential to degrade putrescine, arginine, and ornithine, precursors of ethyl carbamate. Experimentally, L. hilgardii reduced L-malic acid from 2.5 g/L to < 0.1 g/L within 12 days at 10°C, while O. oeni showed no MLF activity at this temperature. At 25°C, both strains completed MLF within 6-7 days. L. hilgardii also consumed > 80% of residual fructose at 10°C, whereas O. oeni showed minimal utilisation. Our results demonstrate that L. hilgardii combines a favourable genomic repertoire for wine adaptation with superior MLF performance at low temperature, suggesting its potential as an alternative to O. oeni in cool-climate winemaking. This work provides the first genome-scale comparative and functional evaluation of L. hilgardii in the winemaking context, highlighting its technological promise to improve fermentation reliability, reduce spoilage risk, and expand the biodiversity of malolactic starters.
13. Olive Pomace Inclusion Alters the Microbial Community of Black Soldier Fly Larvae Frass While Maintaining Fertilizer Quality.
期刊: MicrobiologyOpen 发表日期: 2025-Dec 链接: PubMed
摘要
Olive pomace (OP) is a sludge arising from the production of olive oil, generated in increasing amounts in Portugal. The management of this toxic waste stream is complex and the number of processing plants is limited. In this study, OP was incorporated as a feed component for rearing black soldier fly larvae (BSFL) under industrial conditions. Larvae were reared inside a climate-controlled room with regulated temperature and humidity. The rearing cycle lasted 13 days, after which larvae were harvested. In addition to assessing bioconversion efficiency and larval proximate composition, the resulting frass was examined for its fertilizer potential. Frass was analyzed for plant nutrient content and microbial profile in three forms: fresh, heat-treated (70°C for 1 h), and pelletized. The inclusion of OP in the diets reduced waste-to-biomass conversion efficiency (21.5%DM to approximately 13.3%DM) but did not affect the proximate composition of the larval biomass, which consistently contained around 43%DM crude protein and 20%DM crude fat. Neither the presence of OP nor the applied post-treatments altered the nutrient composition of frass, which contained on average 3.5% total N, 2.6% P2O5, and 5.9% K2O. However, at the highest inclusion level (84%), the abundance of bacterial and fungal groups was significantly reduced. The predominant phyla in the frass were Actinobacteria, Bacteroidota, Firmicutes, Proteobacteria, Ascomycota and Basidiomycota, and the dynamics of microbial communities were influenced by specific micronutrients. The presence of OP led to a significant reduction of potentially pathogenic bacteria and fungi in the frass, indicating a sanitizing effect attributable to this material.
14. Microcystin-LR Triggers Renal Tubular Ferroptosis Through Epigenetic Repression of GPX4: Implications for Environmental Nephrotoxicity.
期刊: Advanced science (Weinheim, Baden-Wurttemberg, Germany) 发表日期: 2025-Nov-30 链接: PubMed
摘要
Environmental toxins represent a growing public health concern. Microcystin-LR (MC-LR), a potent cyanobacterial toxin found in freshwater ecosystems, has been linked to multisystem toxicity. However, its impact on renal pathology - particularly through regulated cell death - remains poorly characterized. This study investigates the molecular basis of MC-LR-induced nephrotoxicity in murine models, focusing on ferroptosis and epigenetic regulation. Using both acute and chronic MC-LR exposure paradigms, marked kidney fibrosis and ferroptosis are observed, evidenced by lipid peroxidation, mitochondrial damage, and collagen deposition. Mechanistically, MC-LR suppressed transcription of glutathione peroxidase 4 (GPX4) in tubular epithelial cells. This downregulation is associated with promoter hypermethylation, increased expression of DNA methyltransferases DNMT1 and DNMT3a, and enhanced recruitment of the transcriptional repressor E2F4 and co-repressor NCoR. Notably, MC-LR directly bound DNMT1 and DNMT3a, stabilizing their protein levels by blocking proteasomal degradation. Pharmacological inhibition of DNA methyltransferases (SGI-1027) or ferroptosis (ferrostatin-1) significantly ameliorated renal injury. These findings uncover a previously unrecognized epigenetic mechanism by which MC-LR drives ferroptosis and kidney damage. Targeting the DNMT-GPX4 axis may offer therapeutic opportunities for mitigating toxin-induced organ injury and protecting public health against environmental biohazards.
15. SMart Nanoparticle-Hydrogel Hybrid System for Synergistic Eradication of Infection and Promotion of Wound Healing.
期刊: Advanced science (Weinheim, Baden-Wurttemberg, Germany) 发表日期: 2025-Nov-30 链接: PubMed
摘要
This study develops an efficient and intelligent photothermal therapy (PTT) system for treating Staphylococcus aureus-infected wounds by integrating a multifunctional hydrogel (PAOC-3@BA) with S. aureus-targeted photothermal nanoparticles (Fe2O3-CS@RBP). The Fe2O3-CS@RBP nanoparticles, functionalized with receptor-binding proteins (RBP) from bacteriophages, selectively recognize S. aureus and generate localized heat under near-infrared (NIR) irradiation for precise bacterial eradication. PAOC-3 hydrogel, loaded with the anti-inflammatory agent baicalin (BA), has a cloud point temperature (Tcp) of ≈47 °C and exhibits strong tissue adhesion and heat-induced contraction. Upon NIR-triggered heating, the hydrogel undergoes a turbidity transition, forming a light-scattering barrier that limits further NIR penetration and maintains a stable therapeutic temperature. This feedback mechanism enhances antibacterial efficacy while preventing tissue overheating. Simultaneously, the hydrogel’s high tissue adhesion and contractile behavior promote wound closure and stimulate BA release to suppress inflammation. The system achieves rapid wound healing within one week, offering effective infection control and tissue regeneration. Overall, this work introduces a smart therapeutic platform that integrates bacterial targeting, self-regulating photothermal therapy, tissue adhesion, and stimulus-responsive drug release, providing a safe and effective strategy for treating bacterial skin infections.
16. Electric scooter injuries in the pediatric population are increasing: an analysis of National injury trends and mechanisms between 2014 and 2023.
期刊: The Physician and sportsmedicine 发表日期: 2025-Nov-30 链接: PubMed
摘要
The use of electric scooters (e-scooters) has surged over the past decade, leading to a notable rise in e-scooter related injuries presenting to emergency departments. This study aims to analyze trends and mechanisms of e-scooter injuries in the United States pediatric population. We hypothesized that there would be a significant increase in pediatric e-scooter injuries from 2014 to 2023, and particularly since the COVID-19 pandemic from 2020 to 2023, with many patients sustaining fractures. The National Electronic Injury Surveillance System (NEISS) was queried for pediatric (age ≤18) electric scooter injuries presenting to US emergency departments between 1 January 2014 and 31 December 2023. Patient demographics, injury location, discharge disposition, and diagnosis were extracted. The mechanisms of injury were categorized based on the injury narrative. Injury trends were analyzed using linear regression analysis. A total of 2,231 pediatric e-scooter injuries (NE = 63,527) were included. The mean age was 11.9 ± 4.0 years old and 63.3% of patients were male. There was a statistically significant increase in pediatric e-scooter injuries from 2014 to 2023 (p = 0.002). Additionally, we identified a 2.4 fold increase in annual post-COVID (2021-2023) average injuries compared to pre-COVID (2014-2019). The most common diagnosis was fractures (NE = 18103, 28.5%). The most common body part injured was the head (NE = 11258, 17.7%). Collisions with other moving vehicles comprised 10.8% of all injuries (NE = 6840). The most common mechanisms of injury were falling off of the e-scooter (NE = 43889, 69.1%). Out of the 432 (19.4%) narratives that reported helmet usage, 72.6% indicated that the patient was not wearing a helmet. Pediatric e-scooter injuries have increased significantly in the past decade, particularly since the COVID-19 pandemic. As e-scooter usage continues to rise, these findings underscore the need for targeted safety measures to protect young riders from fractures and head injuries.
17. Bridging Perspectives: Clinician-Adolescent Agreement on Psychopathological Severity in the European MILESTONE Cohort.
期刊: Journal of clinical psychology 发表日期: 2025-Nov-30 链接: PubMed
摘要
Adolescents transitioning from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) may face challenges in accurately identifying and reporting their mental health symptoms, often leading to discrepancies between clinician and patient evaluations. Using data from the MILESTONE project, this study aims to assess clinician-adolescent concordance over 24 months and identify domains of psychopathology with the highest disparities. Participants were assessed at baseline, 9, 15, and 24 months using the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) scale and were categorized in four diagnostic groups. Hierarchical cluster analysis identified symptom-based subgroups of patients based on clinician and patient-rated HoNOSCA scores. Concordance was evaluated through multilevel linear regression models, while Bland-Altman plots examined agreement between scores across time points. Two clusters of patients were identified: one characterized by lower severity and greater prevalence, the other by higher complexity and fewer individuals. Clinician-patient concordance increased over time, rising from 77% to 83% by the second time point and stabilizing. Concordance varied across diagnostic categories, with anxiety showing the highest agreement and ADHD the lowest. Improved communication, psychoeducation, and tailored interventions may facilitate greater patient-clinician alignment, thereby supporting more favorable outcomes during this critical developmental period. ISRCTN83240263; NCT03013595.
18. Pharmacokinetics and pharmacodynamics: making clinical sense of sex differences in psychopharmacology.
期刊: Expert opinion on drug metabolism & toxicology 发表日期: 2025-Nov-30 链接: PubMed
摘要
In psychopharmacology there is a growing interest in potential sex differences regarding psychotropic drugs, currently used or under development. Preclinical research repeatedly identifies sex differences in pharmacokinetics and pharmacodynamics of psychotropic drugs. However, clinical research either does not consistently corroborate such findings or does not necessarily support their clinical significance. This review succinctly presents the main sex differences in mental disorders (epidemiology, symptomatology), pharmacokinetics (absorption, distribution, metabolism, excretion) and pharmacodynamics (therapeutic effects and adverse drug reactions). The review is based on a curated collection of articles, mainly from the 2000 onwards, listed in the U.S. NLM of Congress, and offers insights on why clinical findings about sex differences in psychopharmacology are inconsistent or of varied clinical importance. In psychopharmacology, sex differences in pharmacokinetics and pharmacodynamics are progressively discovered. Nevertheless, a significant knowledge gap still exists, resulting in an unclear clinical value of sex differences and perhaps suboptimal use of psychotropic drugs in the context of precision medicine. This review puts into context this knowledge gap and proposes how it can be addressed. Optimization of existing treatments and drug development can benefit by a better appreciation of potential sex differences in psychopharmacology.
19. [Chronic thromboembolic pulmonary hypertension - the hidden disease].
期刊: Orvosi hetilap 发表日期: 2025-Nov-30 链接: PubMed
摘要
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but potentially curable form of pulmonary hypertension. Its pathophysiological background involves incomplete thrombus resolution following acute pulmonary embolism, in situ thrombosis, and vascular remodeling. An increase in pulmonary vascular resistance leads to persistent pulmonary hypertension, which, if left untreated, may progress to fatal right heart failure. CTEPH is often considered a “hidden” disease, as its nonspecific symptoms are frequently misattributed to other conditions. To provide an update overview of the epidemiology, pathophysiology, diagnostic challenges, and therapeutic options of CTEPH, with particular emphasis on the role of the general practitioners and the internists in early recognition. A narrative literature review based on the 2022 ESC/ERS guidelines, the most recent European and international registries, and contemporary review. The incidence of CTEPH following pulmonary embolism is estimated at 2-4%, although its true prevalence is likely higher. Diagnostic delays are common, with patients typically presenting to pulmonary hypertension centers 18-24 months after symptom onset. Pulmonary endarterectomy offers a curative treatment option for patients with surgically accessible central lesions. For inoperable or residual CTEPH, balloon pulmonary angioplasty and targeted pharmacological therapy, such as riociguat, have opened new therapeutic perspectives. Diagnosis of CTEPH remains a complex challenge. General practitioners have a pivotal role by considering CTEPH in patients with recurrent dyspnea, exercise intolerance, signs of right heart failure, or persistent symptoms following pulmonary embolism, and by ensuring timely referral to specialized pulmonary hypertension centers. Early diagnosis and evidence-based management of CTEPH can significantly improve both quality of life and survival. As general practitioners and internists are on the frontline, their awareness and education are crucial for early disease recognition. Orv Hetil. 2025; 166(48): 1908-1915. Bevezetés: A krónikus thromboemboliás pulmonalis hypertonia (CTEPH) a pulmonalis hypertonia egyik ritka, de potenciálisan gyógyítható formája. A betegség hátterében a korábban lezajlott tüdőemboliát követő inkomplett thrombusresolutio, in situ thrombosis, vascularis remodelling húzódik meg. Az érellenállás növekedése tartóssá válik, pulmonalis hypertoniát okoz, mely progresszív, fatális jobbszívfél-elégtelenséghez vezethet kezelés hiányában. A CTEPH gyakran „rejtőzködő” betegség, mivel tünetei nem specifikusak, azokat gyakran más kórképekkel lehet összetéveszteni. Célkitűzés: Az összefoglalás célja a CTEPH epidemiológiájának, patomechanizmusának, korszerű diagnosztikai és terápiás lehetőségeinek áttekintése, hangsúlyt helyezve a háziorvosok és a belgyógyászok szerepére a korai felismerés kapcsán. Módszer: Narratív irodalmi áttekintés a 2022. évi ESC/ERS irányelvek, a legfrissebb európai és nemzetközi regiszterek, valamint az elmúlt években megjelent áttekintő közlemények alapján. Eredmények: A CTEPH incidenciája a tüdőemboliát követően 2–4% körüli, de valós előfordulása ennél gyakoribb lehet. A diagnózis felállítása késik, a panaszok megjelenése után átlagosan 18–24 hónappal kerülnek a betegek a pulmonalis hypertonia centrumok látóterébe. A pulmonalis endarterectomia (PEA) centrális laesiók esetén kuratív lehet, ugyanakkor a nem operálható vagy reziduális CTEPH kezelésében a ballonos pulmonalis angioplasztika (BPA) és a gyógyszeres terápia (például riociguat) nyitott új perspektívát. Megbeszélés: A CTEPH diagnosztikája komplex feladat. A háziorvos kulcsszerepe abban áll, hogy a visszatérő dyspnoét, terhelésintoleranciát, a jobb szívfél elégtelenségének tüneteit és a tüdőemboliát követő panaszok fennmaradása esetén gondoljon a CTEPH lehetőségére, és gyanú esetén továbbküldje a beteget pulmonalis hypertonia centrumba. Következtetés: A CTEPH időben történő diagnózisa és korszerű kezelése jelentősen javíthatja a betegek életminőségét és túlélését. A háziorvos és a belgyógyász az első vonalban áll, ezért edukációjuk és éberségük szerepe alapvető a kórkép felismerésében. Orv Hetil. 2025; 166(48): 1908–1915.
20. "I love my baby more than they do": infant feeding decision-making among mothers living with HIV in the United States.
期刊: AIDS care 发表日期: 2025-Nov-30 链接: PubMed
摘要
In the US and other high-income countries, national guidelines traditionally recommended against breastfeeding infants born to women living with HIV (WLHIV), due to the risk of HIV transmission to the infant. In 2023, US guidelines were changed to recommend collaborative decision-making and support for WLHIV who choose to breastfeed. Little is known regarding how WLHIV make the decision of how to feed their babies, leaving clinicians lacking guidance on how to provide effective counseling. We therefore conducted a semi-structured interview study of pregnant and recently postpartum WLHIV in the US. A diverse cohort of 19 WLHIV described weighing multiple considerations against one another based on their preferences and beliefs, with risk of HIV transmission being just one of many interconnected and often conflicting motivations. While some considerations were always associated with a specific feeding choice, others, such as fear of HIV disclosure, influenced some mothers to breastfeed and others to formula feed. In the context of both breastfeeding and formula-feeding, mothers were faced with a continuum of additional feeding-related choices throughout the child’s infancy. WLHIV stressed the importance of receiving personalized infant feeding counseling that acknowledges that their priorities and beliefs may be different from those of their health providers.
21. Internationally Educated Nurses' Experiences of Working in U.S. Long-Term Care Settings.
期刊: Research in nursing & health 发表日期: 2025-Nov-30 链接: PubMed
摘要
Increasing reliance on Internationally Educated Nurses (IENs) in the U.S. healthcare system, particularly in Long-Term Care (LTC) settings, necessitates an in-depth exploration of their transition experiences. The primary purpose of this qualitative study was to understand how IENs describe their experiences transitioning to work with older adults in LTC settings in the United States and the policies and practices that contribute to the successful integration of IENs. A qualitative descriptive design was used, including one-time individual interviews with 22 IENs working in various LTC settings across the United States via Zoom using a semi-structured interview guide. Demographic data were analyzed using descriptive statistics, while NVivo 14 software was utilized to organize the data; verified verbatim transcripts were subjected to thematic analysis. Three key themes were identified: Systemic and Practice-Based Barriers to IEN Integration, Structural and Social Enablers of IEN Integration, and Role of Structured Support Systems in the IENs’ Transition. This study highlighted the critical challenges and facilitators that influence IENs during their integration into LTC settings in the United States. Participants reported concerns, specifically noting experiences of racial discrimination and xenophobia perpetrated by co-workers, patients, and patients’ families. These experiences highlight the complex interpersonal dynamics faced by IENs, underscoring the need for proactive strategies to mitigate discriminatory practices and provide culturally sensitive orientation and mentorship programs to support the smooth integration of IENs into LTC settings. Addressing these challenges can have profound implications for strengthening inclusivity and enhancing the overall resilience of the U.S. nursing workforce, particularly within LTC environments.
22. The impact of NANDA-I, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC) on the improvement of nursing practice worldwide: Systematic review.
期刊: International journal of nursing knowledge 发表日期: 2025-Nov-30 链接: PubMed
摘要
To evaluate the global impact of the NANDA-I, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC) (NNN) standardized nursing terminologies on nursing care quality, consistency, and documentation. Systematic review of experimental and quasi-experimental studies conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and registered in PROSPERO (CRD42024564151). PubMed, Web of Science, and Scopus databases were searched for studies published between May 2019 and June 2024 using predefined Population, Intervention/Exposure, Control, and Outcomes-based keywords. A total of 783 articles were identified; a total of 32 met inclusion criteria after duplicate removal and full-text screening. Quality was assessed using validated tools, including The National Heart, Lung, and Blood Institute, Joanna Briggs Institute, and Mixed Method Assessment Tool checklists. The included studies, mostly from Latin America and Southern Europe, reported positive impacts of the NNN system on clinical reasoning, individualized care planning, documentation quality, and interdisciplinary communication. Barriers included insufficient training, system integration challenges, and limited uptake in regions like North Africa and Asia. Although diverse study designs were used, few evaluated long-term clinical or organizational outcomes. NANDA-I, NIC, and NOC classifications enhance nursing practice by supporting structured care processes and measurable outcomes. Their global implementation remains uneven, highlighting the need for institutional support, educational integration, and region-specific implementation research. Integrating standardized nursing languages into clinical, educational, and policy frameworks can strengthen evidence-based care, improve documentation, and elevate the visibility of nursing contributions to patient outcomes.
23. Breaking down barriers to accessing dementia-friendly eyecare.
期刊: Journal of Alzheimer’s disease : JAD 发表日期: 2025-Nov-30 链接: PubMed
摘要
BackgroundPeople living with Alzheimer’s disease and related dementias experience barriers to accessing routine primary eyecare, increasing risk of preventable sight loss. One barrier is a negative experience with previous eye tests (defined as a comprehensive eye examination involving multiple tests to assess visual function and eye health). We explored eye test experiences for people with dementia and identified improvements. Supporting people with dementia to keep up regular eye tests may reduce risk of preventable sight loss, thereby supporting wellbeing and independence.ObjectiveFrom the perspectives of people living with dementia, family carers and optometrists: 1) Identify ways to improve experiences of having an eye test, and self-managing eye problems at home; and 2) Determine if/how optometrists change their testing and management approach to accommodate dementia.MethodsSemi-structured interviews were conducted with people living with dementia at home, past/current family carers and practicing optometrists. Framework analysis produced an integrated perspective. People with dementia and carers guided the research.ResultsIdentified themes were: 1) Good eyesight matters to people with dementia; 2) Varied impacts of dementia upon the eye test and following eyecare advice at home; 3) Adapting the eye test and eyecare advice to accommodate dementia; 4) What makes a good eye test experience for people living with dementia; and 5) Unmet training and education needs in dementia-friendly eyecare.ConclusionsDementia education/training to support optometrists to accommodate dementia, and encouraging people with dementia and carers to declare a dementia diagnosis before the eye test, could help break down barriers to accessing dementia-friendly eyecare.
24. Pre-Administration of Akkermansia Muciniphila Prevents the Development of Severe Acute Graft-Versus-Host Disease in Systemic Organs.
期刊: Advanced science (Weinheim, Baden-Wurttemberg, Germany) 发表日期: 2025-Nov-30 链接: PubMed
摘要
Acute graft-versus-host disease (aGvHD) remains a significant clinical challenge, with no optimal treatment despite advancements in medical science. This life-threatening condition, characterized by multi-organ involvement and high mortality, is increasingly linked to the gut microbiota. Therefore, this study investigates the protective effects of Akkermansia muciniphila on aGvHD, focusing on its capacity to modulate the gut microbiome and reduce disease symptoms. A. muciniphila is orally administered to mice prior to inducing aGvHD through allogeneic hematopoietic stem cell transplantation. The effects of A. muciniphila administration on the development of aGvHD are assessed through disease activity scoring, histological analysis, metabolite and immune profiling, and gut microbiota analyses. Pre-administration of A. muciniphila significantly reduces aGvHD severity, particularly in the gastrointestinal tract, alleviates gut dysbiosis, and increases the levels of metabolites such as tauroursodeoxycholic acid and short-chain fatty acids. These findings provide the basis for new therapeutic strategies for aGvHD and contribute to improving treatment outcomes for patients with intractable diseases.
25. Pathogenicity and virulence of Cryptosporidium.
期刊: Virulence 发表日期: 2025-Nov-30 链接: PubMed
摘要
Cryptosporidium is a genus of apicomplexan parasites that causes diarrheal disease in humans and animals worldwide. The primary species affecting humans are C. parvum and C. hominis, while other species may also infect humans, specially immunocompromised individuals. Infections are particularly severe in people with weakened immune systems and malnourished children in developing countries. In livestock, especially young ruminants, C. parvum leads to significant economic losses. The parasite occupies a unique epicellular niche and undergoes a complex life cycle involving both asexual and sexual stages. While the mechanisms of parasite invasion, replication, immune evasion, and tissue damage have been challenging to unravel due to earlier technical limitations and lack of genetic tools, recent advances have transformed our understanding. Innovations in genomics, transcriptomics, and molecular genetics have identified key virulence factors and clarified intricate host - parasite interactions. The parasite’s secretory organelles (micronemes, rhoptries, dense granules, and small granules) play central roles by releasing molecules that facilitate host cell attachment, invasion, and modulation of host defenses. This review provides an up-to-date overview of the biology and pathogenic mechanisms of Cryptosporidium, highlighting structural features, invasion strategies, and host immune responses. It also covers recent progress in experimental models, vaccine development, and identification of new molecular targets for treatment and prevention. By synthesizing recent discoveries with previous research, this review offers a current perspective linking fundamental biology to disease outcomes and potential control strategies.
26. Picornavirus VP2 protein suppresses innate immunity through selective autophagic degradation of IKBKE/IKKε.
期刊: Autophagy 发表日期: 2025-Nov-30 链接: PubMed
摘要
Senecavirus A (SVA) belongs to the picornaviruses and has emerged as a promising candidate for oncolytic virotherapy in humans. Understanding the immune suppression mechanisms employed by SVA can help optimize its therapeutic efficacy as an oncolytic virus while simultaneously minimizing its immune suppressive effects on normal tissues. In this study, we identified a novel function of the SVA structural protein VP2 as a key viral immune suppressive factor during SVA infection. VP2 targets and degrades IKBKE/IKKε, a key component of the innate immune pathway, thereby suppressing host innate immune responses. It preferentially interacts with the selective autophagic receptor CALCOCO2/NDP52 (calcium binding and coiled-coil domain 2), which then recognizes the K33-linked ubiquitinated IKBKE and delivers it to phagophores for degradation. The E3 ligase RNF114 is responsible for catalyzing the K33-linked ubiquitination of IKBKE at Lys490, and VP2 significantly promoted this modification, which further accelerated IKBKE degradation. Importantly, we found that picornavirus VP2 proteins share this conserved mechanism in degradation of IKBKE and suppression of host innate immunity. These data elucidate the negative regulatory mechanism involving the VP2-RNF114-IKBKE/IKKε-CALCOCO2 axis, and reveal an immune evasion strategy employed by picornaviruses. These findings will provide valuable insights for the development of picornaviral vaccines and antiviral/antitumor therapeutics.
27. Perceived challenges and solutions to providing rural physical therapy services: A qualitative inquiry of provider experience.
期刊: Physiotherapy theory and practice 发表日期: 2025-Nov-30 链接: PubMed
摘要
Persons living in rural areas face increased rates of multiple chronic health conditions and all-cause mortality. Physical therapy can positively impact disease prevention and wellness; however, a lack of rural providers limits access to physical therapy services and subsequent benefits in rural areas. This study aims to gain insights on physical therapists’ experiences providing rural physical therapy services. This qualitative study employed a phenomenological approach to capture the perspectives of physical therapists practicing in rural Alabama on providing healthcare services. Participants were recruited using convenience and snowball methods, and each participant completed a semi-structured telephone or Zoom interview. Interview data were coded independently by two separate members of the research team with subsequent group verification. Recruitment continued until saturation was achieved. Three themes emerged from 15 participants: 1) System-wide challenges in rural healthcare; 2) Personal considerations in providing rural healthcare; and 3) Proposed solutions to identified challenges. Participants identified inadequate staffing, reduced access to specialty services, and financial concerns as system-wide challenges. Personal considerations included professional isolation, expansive caseloads, and aversion to rural living as challenges, while community pride and responsibility were identified as personal benefits to providing rural healthcare. Proposed solutions included financial incentives for providers, physical therapy student exposure to rural settings, and use of telehealth services. Interactions between themes and subthemes emerged, highlighting potential factors contributing to difficulty adequately staffing rural physical therapists.
28. The return of metabolism: biochemistry and physiology of glycolysis.
期刊: Biological reviews of the Cambridge Philosophical Society 发表日期: 2025-Nov-30 链接: PubMed
摘要
Glycolysis is a fundamental metabolic pathway central to the bioenergetics and physiology of virtually all living organisms. In this comprehensive review, we explore the intricate biochemical principles and evolutionary origins of glycolytic pathways, from the classical Embden-Meyerhof-Parnas (EMP) pathway in humans to various prokaryotic and alternative glycolytic routes. By examining glycolysis across the tree of life, we explore its presence and adaptation in prokaryotes, archaea, bacteria, animals and plants, and the extension of glycolysis into sulfosugar metabolism. Further, we discuss the role of unwanted side reactions, thermodynamic principles, and metabolic control principles that underpin glycolysis and the broader metabolic network, and summarise advanced methods for quantifying glycolytic activity, including new analytical methods, alongside kinetic, constraint-based, and machine-learning based modelling. With a focus on the Pasteur, Crabtree, and Warburg effects, this review further discusses the roles of glycolysis in health and disease, highlighting its impact on global metabolic operations, inborn errors, and various pathologies as well as its role in biotechnology and metabolic engineering.
29. Molecular detection of Toxoplasma gondii in irrigation waters and agricultural soils of Central Luzon, Philippines: implications to human health.
期刊: Journal of environmental science and health. Part. B, Pesticides, food contaminants, and agricultural wastes 发表日期: 2025-Nov-30 链接: PubMed
摘要
Toxoplasma gondii, a parasitic protozoan that causes toxoplasmosis, is estimated to infect a significant percentage of the world’s population. One of the main routes is through consumption of contaminated water, soil, or food containing oocysts. Large scale outbreaks through water contamination were reported across various regions. However, in the Philippines, there is still no data on the occurrence of T. gondii oocysts in environmental matrices. In this study, T. gondii oocysts DNA were detected in irrigation waters and agricultural soils from selected sites in Central Luzon, Philippines, and the genetic diversity of the detected parasite was examined. Using nested PCR amplifying the RE gene, the prevalence of T. gondii oocyst DNA in irrigation water (n = 40) and agricultural soil (n = 40) was at 35 and 25%, respectively. One isolate (W11) was genotyped and showed a mixed genotype (Type I/TypeIII) suggesting recombination or diverse strain exposure. Phylogenetic analysis revealed clustering with CTG strain (GenBank accession no. PX505257), a Type III non-virulent genotype to mice, but associated to cause ocular toxoplasmosis in humans and toxoplasmic encephalitis in immunocompromised patients. Our findings suggest that T. gondii movement in environmental matrices can possibly facilitate transmission of infection and therefore poses a threat to human and animal health.
30. Biocompatible SABRE Hyperpolarization of [1-13C]Ketoleucine for Cellular Metabolic Flux Sensing.
期刊: Chemistry (Weinheim an der Bergstrasse, Germany) 发表日期: 2025-Nov-30 链接: PubMed
摘要
Ketoleucine (α-ketoisocaproate) is a novel hyperpolarized substrate for noninvasive metabolic imaging, enabling rapid, high-sensitivity detection of branched-chain amino acid flux, a pathway that is aberrant in many diseases including cancer and Alzheimer’s disease. Utilizing NMR Signal Amplification by Reversible Exchange (SABRE) with an 80:20 acetone:water solvent system, we achieved >11% polarization of [1-13C]ketoleucine (corresponding to signal enhancement over 230,000-fold at 0.55 T) at 70 mM within 2 min, using parahydrogen as a cheap and fast source of hyperpolarization. A two-stage liquid-liquid extraction and gas stripping protocol removes excess excipients, yielding a biocompatible aqueous solution of [1-13C]ketoleucine (79 ± 10 mM). When mixed with Saccharomyces cerevisiae (Baker’s yeast), hyperpolarized [1-13C]ketoleucine produced strong, long-lasting signals, where downstream metabolites are observed for >200 s, allowing first-order kinetic modeling of CO2 and bicarbonate. These cell experiments demonstrate both the biocompatibility and signal strength of SABRE-hyperpolarized KL, establishing KL as a versatile hyperpolarized agent and opening avenues for real-time investigation of metabolic dysregulation in cancer, neurodegenerative disorders, and beyond.
31. Complement-producing adventitial fibroblasts form an IL-33 alarmin hub that maintains ILC2s during airway allergy.
期刊: Cell reports 发表日期: 2025-Nov-29 链接: PubMed
摘要
Once considered mere scaffolds, mesenchymal stromal cells are now recognized as actively shaping airway immunity. We identify adventitial fibroblasts (AFs) in perivascular/peribronchial cuffs as a dominant source of complement C3. At baseline, a discrete subset of AF co-expresses C3 and IL-33. Upon allergen exposure, these C3+IL-33+ AFs expand and increase their production of both C3 and IL-33, indicating a shift toward an allergic AF phenotype. Disruption of C3 production in AFs abrogates IL-33 expression, underscoring the essential role C3 plays in maintaining an allergic AF phenotype. Functionally, C3 from AFs is required to drive allergen-induced group 2 innate lymphoid cell (ILC2) responses. C3+ AFs not only support ILC2s but are also influenced by ILC2-derived IL-13, which, in turn, promotes AF function, perpetuating the allergic response. These findings reveal that aberrant C3 production by the adventitial stroma orchestrates a pathogenic AF-ILC2 niche that promotes allergic inflammation.
32. Incidence of treatment intensification based on HbA1c trends in people with type 2 diabetes.
期刊: Journal of diabetes investigation 发表日期: 2025-Nov-29 链接: PubMed
摘要
Clinical inertia, the failure to intensify treatment despite unmet glycemic goals, is a key factor in poor glycemic management for type 2 diabetes. No studies have defined clinical inertia based on HbA1c trends. In this study, we aimed to assess treatment intensification according to HbA1c trends. We analyzed data from the Japan Diabetes Comprehensive Database Project based on an Advanced Electronic Medical Record System (J-DREAMS) between 2016 and 2023. Eligible patients with type 2 diabetes had (1) unchanged prescriptions for the past 90 days; (2) two consecutive consultations within 90 days; and (3) HbA1c levels ≥7%, or ≥7.5%, for patients aged ≥65 years at both consultations. Treatment intensification was defined as an addition or increased dose or switch in antidiabetic medications, inclusive of insulin, at the second consultation. Moreover, factors associated with treatment intensification were assessed. Of the 5,683 patients, 1,130 (19.9%) received intensified treatment at the second consultation. Intensification occurred more frequently with higher HbA1c levels or worsening HbA1c trends. However, treatments were not intensified in approximately 50% of the patients, with HbA1c levels >8% or a worsening of >1%. Predictive factors included the HbA1c levels at the second consultation, changes in the HbA1c levels between the first and second consultations, the number of oral hypoglycemic medications, and the use of sulfonylureas or glinides. Physicians should consider HbA1c trends to guide treatment intensification when HbA1c levels exceed target thresholds. Clinical inertia remains an important issue in diabetes management.
33. Assessing sexual and gender identity interaction with the relationship between caregiving and adverse mental health outcomes.
期刊: Journal of mental health (Abingdon, England) 发表日期: 2025-Nov-29 链接: PubMed
摘要
Caregivers often report high stress levels, which may be associated with adverse mental health. Less is known about adult sexual and gender minority (SGM) caregivers’ experienced stress and/or mental health considering they are likely at increased vulnerability to these outcomes due to social stigma, familial estrangement, and discrimination. We tested relationships between caregiving and adverse mental health and if these associations were modified by SGM identity. Using 2023 national BRFSS data (n = 32,151) we examined relationships between caregiving and two outcomes: depression and 14+ days with poor mental health, testing effect modification by SGM identity. Regression analyses, using both SGM and caregiving cross-categories and interaction term models were also conducted. Compared to heterosexual non-caregivers, both caregiving and SGM status were associated with greater depression and having 14+ days of poor mental health, with the highest prevalence of depression among transgender caregivers (aPR = 4.05, CI 3.03-5.00), transgender non-caregivers (aPR = 2.80, CI 2.24-3.25), and cisgender gay caregivers (aPR = 2.52, CI 2.01-2.93). Transgender and cisgender gay and bisexual caregivers also had the highest days with poor mental health. Additionally, interaction term models identified effect modification. Disproportionate adverse mental health outcomes exist among caregivers, modified by SGM status. Longitudinal research is needed to understand these mechanisms and related outcomes including substance use and suicidality.
34. Comparison study for yield and nutritional value in white and colored purple and blue wheat varieties.
期刊: Scientific reports 发表日期: 2025-Nov-29 链接: PubMed
摘要
Colored wheat is rich in nutrients such as minerals, amino acids, and anthocyanins, offering significant health benefits. However, its typically low yield limits cultivation and production efficiency. This study, conducted during the 2021-2023 winter wheat seasons, compared the yield and quality of four purple wheat varieties (Qingyan Purple Wheat No.1 (QYZ-1), QYZ-2, Shannong Purple Wheat No.1 (SNZM1), Nongda 3753 (ND3753)), two blue wheat lines (20064 and 20072), and the modern white-grain wheat Jimai 22 (JM22). Results showed that QYZ-1 had the highest yield due to its higher thousand-grain weight and grain number per unit area. Colored wheat varieties, especially SNZM1 and 20,072, had significantly higher Se, Zn, Fe, and Mn contents compared to JM22. Additionally, colored wheat is rich in Ca, K, Mg, and anthocyanins. QYZ-2 and ND3753 had a diverse range of anthocyanins, while 20,072 had the highest total anthocyanin content. High wet gluten content and gluten index in colored wheat, particularly QYZ-1 and ND3753, indicated excellent processing characteristics. QYZ-1 also had the highest crude protein content. The total and non-essential amino acid contents in colored wheat were significantly higher than in JM22. The study concluded that colored wheat, particularly QYZ-1, shows superior nutritional content and quality. Moreover, the spike number is significantly positively correlated with yield; therefore, we believe that its yield can be further improved by increasing thousand-grain weight while maintaining stable grain numbers per unit area.
35. Association of objectively measured physical activity with phase angle obtained from bioelectrical impedance analysis in older adults with disabilities under the long-term care insurance system.
期刊: Journal of physiological anthropology 发表日期: 2025-Nov-29 链接: PubMed
摘要
The phase angle (PhA), assessed using bioelectrical impedance analysis (BIA), is becoming increasingly popular as an index of muscle quality associated with various health-related outcomes. This study aimed to clarify the relationship between PhA and sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA), which were objectively measured using accelerometers in older adults with disabilities requiring care. We recruited 90 older adults (39 men and 51 women, mean age of 78.7 ± 6.7 years) with disabilities under the long-term care insurance system. Skeletal muscle mass index (SMI) and PhA of the lower limbs were measured using a multifrequency BIA instrument. Daily durations of SB, LPA, and MVPA per day were measured using a triaxial accelerometer. Nutritional status was assessed using the long form of the Mini Nutritional Assessment (MNA). The MVPA duration was significantly associated with lower limb PhA after adjusting for age, sex, SB and LPA durations, MNA score, and medical history (p = 0.037), whereas SB and LPA durations were not associated with lower limb PhA. The duration of SB, LPA, and MVPA were not significantly associated with lower limb SMI, whereas the MNA score was. Lower limb PhA, but not lower limb SMI, was associated with MVPA duration, independent of nutritional status and medical history. Enhancing the duration of MVPA is needed to maintain the PhA and prevent further decline in physical function in older adults who require long-term care due to disabilities.
36. Development and validation of a machine learning-based predictive model for coronary heart disease risk in middle-aged and young adults.
期刊: Heart & lung : the journal of critical care 发表日期: 2025-Nov-29 链接: PubMed
摘要
The incidence of coronary heart disease (CHD) continues to rise among younger populations, necessitating the development of rapid and effective risk prediction models to provide new approaches for secondary prevention of CHD. To construct a clinical prediction model for premature coronary heart disease (PCHD) in the Chinese population based on machine learning algorithms. A retrospective cohort study was conducted young and middle-aged patients undergoing coronary angiography at Northern Jiangsu People’s Hospital (November 2018-May 2023).Feature selection was performed using Lasso regressionwith 10-fold cross-validation, followed by multivariate logistic regression. Seven supervised learning algorithms were evaluated: Logistic Regression (LR), LightGBM (LGBM), Random Forest (RF), Decision Trees (DT), Support Vector Machines (SVM), eXtreme Gradient Boosting (XGBoost), k-Nearest Neighbors (KNN), and Naïve Bayes (NB). This study enrolled a total of 1276 participants, comprising 881 in the PCHD group and 395 in the non-PCHD group. LASSO regression analysis identified nine potential predictors. All sevne machine learning models demonstrated good predictive performance. After excluding overfitted models, the LR model (AUC: 0.82; Sensitivity: 0.654; Specificity: 0.805; Recall: 0.654; F1: 0.749) and SVM model had higher AUC values than XGBoost (AUC: 0.794; Sensitivity: 0.858; Specificity: 0.504; Recall: 0.858; F1: 0.82) in the validation set. Therefore, we used Nomogram and SHAP summary plot to visualize and interpret the LR model and SVM model, respectively. The LR-based nomogram and SVM-SHAP model provide clinically actionable tools for PCHD risk stratification. These models facilitate early identification of high-risk individuals for targeted preventive interventions.
37. "The whole thing is just really difficult": experiences of dental services for children and adults with cerebral palsy in Australia-a qualitative study.
期刊: Disability and rehabilitation 发表日期: 2025-Nov-29 链接: PubMed
摘要
People with cerebral palsy (CP) often experience significant barriers to accessing dental care, yet this area remains under researched in Australia. This study explored how people with CP and their caregivers experience dental services in Australia. Semi structured interviews were conducted with a total of (n = 13) participants, including caregivers of children with CP (n = 4), adults with CP (n = 5) and caregivers of adults with CP (n = 4). Reflexive thematic analysis revealed three key themes: (1) “The whole thing is just really difficult-Difficulties in identifying and accessing dental services for people with CP,” (2) When care stops at the chair-Ableism in oral health care and (3) Person-centred care-How the dental profession can be more welcoming to people with CP. Two of these themes included sub-themes. People with CP experience complex and often overlooked challenges in accessing dental services, influenced by clinical and structural barriers, as well as by systemic failures and the quality of interaction with dental practitioners. When dental care is positive, it is underpinned by trust, effective communication, respect, and genuine partnership. People with CP and their caregivers in this study identified structural and interpersonal barriers to dental service access, while also suggesting practical, inclusive, and coordinated solutions to improve access to dental care. There is a critical need to acknowledge the importance of oral health for people with cerebral palsy.Oral health should be integrated into broader rehabilitation and healthcare plans to support overall well-being and quality of life.Rehabilitation teams should consider the value of including dental practitioners as part of the wider multidisciplinary team.Rehabilitation teams and dental practitioners need to work together to develop integrated care plans, addressing both the physical and oral health needs for people with cerebral palsy.
38. Histology Atlas of the Developing Mouse Digestive System With Emphasis From Prenatal Day 7.5 Through Early Postnatal Development.
期刊: Toxicologic pathology 发表日期: 2025-Nov-29 链接: PubMed
摘要
Digestive system development is a complex process, requiring precise molecular signaling interactions to produce various complex organs arising from a single primordium (the primitive gut tube). Abnormal development of this system is common in humans, leading to birth defects like structural anomalies (e.g., atresias, fistulas, stenosis) and/or functional deficits (e.g., dysautonomia, ileus), all of which impair digestion and passage of ingesta, thereby reducing nutrient uptake. Mouse models of disease (engineered and spontaneous) have provided many insights into the mammalian molecular mechanisms that are essential for guiding normal global and regional anatomic formation of the digestive system. Moreover, an understanding of normal development is an essential resource for identifying and characterizing aberrant phenotypes and toxic effects in embryonic and juvenile mice. This microscopic atlas details key developmental milestones for the upper and lower digestive tracts (including associated glands except liver) in a common wild-type mouse stock. This atlas uses a range of high-resolution, well-annotated color images to follow the evolving digestive system anatomy from initial formation of the primitive gut tube in utero (at embryonic day 7.5) through the appearance of adult-like features at weaning (postnatal day 21 in modern mouse colonies), including comparisons with similar features in humans.
39. New Allergens Approved by the WHO/IUIS Allergen Nomenclature Sub-Committee in 2021-2024 and Their Significance for Future Diagnostics, Regulation, and Research. An EAACI Task Force Report.
期刊: Allergy 发表日期: 2025-Nov-29 链接: PubMed
摘要
The WHO/IUIS Allergen Nomenclature Sub-Committee is an international body of experts that maintains the systematic nomenclature of allergenic proteins by assigning official names to newly identified allergens submitted by researchers. Here, we summarize the data on new allergens approved between 2021 and 2024. The sub-committee assigned names to 112 new allergens with 124 isoallergens/variants as well as 26 new isoallergens/variants of previously named allergens. Most new allergens were respiratory allergens from animals (35 allergens) and plants (25) as well as food allergens from animals (22) and plants (17). Many newly identified allergens reflect globalized allergen exposure and growing research activities outside of Western countries. This is illustrated by allergens from the tropical mite Blomia tropicalis, pollen allergens from tree and weed species native to Asia, and food allergens from regionally important foods such as mango, seafood, silkworm pupae, and natto. The allergen profiles of most relevant sources are well established, but gaps in our knowledge remain, particularly regarding allergens important for populations outside of Europe and North America. The still growing number of known allergens highlights the importance of a consistent, unambiguous allergen nomenclature that evolves with clinical demands and scientific discovery and supports efforts to close existing knowledge gaps.
40. The Impact of Religious Coping Strategies on the Professional Quality of Life Among Turkish Nurses in a University Hospital Setting: A Cross-Sectional, Correlational Study.
期刊: Journal of transcultural nursing : official journal of the Transcultural Nursing Society 发表日期: 2025-Nov-29 链接: PubMed
摘要
Nurses often face demanding environments and workloads that harm their quality of work life (QWL). Religious coping may serve as a culturally relevant protective factor against occupational stress, especially in health care settings. This cross-sectional, correlational study examined the relationship between religious coping and QWL among 400 nurses working in a university hospital in Türkiye’s Central Black Sea region. Data were collected using the Personal Information Form, Professional Quality of Life Scale (ProQOL R-IV), and Religious Coping Scale (RCS). Results showed mean scores of 23.90 ± 7.26 for compassion satisfaction, 20.52 ± 5.26 for burnout, and 16.58 ± 7.54 for compassion fatigue. Positive and negative religious coping were significantly associated with compassion satisfaction. Regression analysis identified gender, job satisfaction, and sleep quality as significant predictors of QWL (p < .05). Findings suggest that enhancing job satisfaction, sleep quality, and adaptive religious coping may improve nurses’ occupational well-being, particularly among male nurses.
41. Prevalence of Anxiety Symptoms by Sociodemographic and Employment Characteristics in a National Sample of Hired Crop Workers: Evidence From the National Agricultural Workers Survey (2018-2022).
期刊: American journal of industrial medicine 发表日期: 2025-Nov-29 链接: PubMed
摘要
Hired crop workers face harsh working conditions, including physical, economic, and social challenges. We present a population-based assessment of anxiety symptoms among a large national sample of hired crop workers in the United States. In-person interviews were conducted with 6108 crop workers during 2018-2022. Generalized anxiety disorder (GAD-2) questions were included in the National Agricultural Workers Survey to provide weighted prevalences of anxiety symptoms and prevalence ratios for the association between anxiety symptoms and crop worker demographics and employment characteristics. The prevalence of anxiety symptoms was 20.6% for scoring ≥ 1 on the GAD-2, and 7.7% for scoring ≥ 3 on the GAD-2. Women had a 73% excess risk of any anxiety (GAD-2 ≥ 1) and an 84% higher risk of severe anxiety (GAD-2 ≥ 3) than men. Men with a medium level of English language ability had a 28%-31% increased risk of anxiety symptoms compared to those with a lower English language ability. Not having workers’ compensation insurance was associated with a 56% reduced risk of having severe anxiety symptoms among men. However, total family income, working directly for an agricultural employer or farm labor contractor, method of payment, unemployment insurance, and health insurance were not significantly associated with anxiety symptoms. Compared to working in California, men working in the Northeast showed a 57% reduced risk of more severe anxiety symptoms. Based on a large national sample of hired crop workers, nearly one in four crop workers suffered from anxiety, with women having a much higher prevalence than men, suggesting the need for mental health services for this population.
42. Association of behaviour-related health risk factors with working life expectancy in adults aged ≥ 50 years: findings from the English Longitudinal Study of Ageing and the Finnish Public Sector Study.
期刊: European journal of ageing 发表日期: 2025-Nov-29 链接: PubMed
摘要
Behaviour-related health risk factors are associated with an increased risk of early exit from the working life, but their contribution to working life expectancy (WLE) remains unclear. We investigated the associations of obesity, alcohol intake, smoking and low levels of physical activity with WLE among adults aged 50 years and older. Individuals working at study baseline with 18 years of follow-up data from the English Longitudinal Study of Ageing (ELSA) (n = 3233) and the Finnish Public Sector study (FPS) were included (n = 65,255). Obesity, alcohol consumption, smoking and low physical activity were self-reported at study baseline. WLE from age 50 to 70 years was estimated using a multi-state modelling, separately for men and women across occupational position categories (low, intermediate and high), with adjustment for age. Our findings suggest that individuals who were obese, smoked, had low physical activity levels and reported heavy alcohol use (only in FPS) could expect to work fewer years than those who did not have these behaviour-related health risk factors. A higher number of risk factors was associated with shorter WLE across sex and occupational position categories in both studies. The difference in WLEs between those with no behaviour-related health risk factors and those with ≥ 2 risk factors was up to 1.5 years in ELSA and less than 1 year in FPS. Having multiple behaviour-related health risk factors is linked to shorter WLE after age of 50 years, a difference that may have important economic implications in societies with ageing populations.
43. Evaluation of the SLS CHARTER care model to support post-stroke care continuity and employment.
期刊: Scientific reports 发表日期: 2025-Nov-29 链接: PubMed
摘要
The Stroke Life Support Central Health Alliance, Registry & Technology Enabled caRe (SLS CHARTER) Programme addresses stroke patients’ rehabilitation needs through timely evaluation and intervention, but it has not been evaluated. This study evaluated the programme’s outcomes over 6 months. The primary outcome was Post Stroke Checklist (PSC) usage per SLS participant. For the final analysis, 206 SLS and 55 control participants from a public healthcare institution in Singapore were included. Secondary economic outcomes included healthcare utilisation and return to work (RTW). Multivariate analyses, adjusted for demographics and clinical factors, used gamma-log link and Poisson regression for healthcare utilisation, and logistic and Cox regression for RTW outcomes, to evaluate associations with intervention status. PSC usage increased from 50.5% 1-month post stroke to 86.9% 6-month post stroke; mean utilisation rose from 1.76 to 4.25. SLS participants reported longer lengths of stay (LOS) in certain rehabilitation institution and less day care visits. Additionally, there was varying RTW for different patient subgroups. Our findings suggest the SLS CHARTER Programme increases PSC usage, which is useful to guide future care coordination programmes. Identification of patients at risk of poorer RTW, for proactive occupational rehabilitation, may help to reduce the economic burden of stroke.
44. Associations between mental health and sociodemographic and work-related factors in Canadian SME workers: an observational study.
期刊: BMC public health 发表日期: 2025-Nov-29 链接: PubMed
摘要
45. How do occupational demands affect return to work after total knee arthroplasty?
期刊: The Knee 发表日期: 2025-Nov-28 链接: PubMed
摘要
Patients who undergo primary total knee arthroplasty (TKA) may return to work at variable times following surgery, the timeline for which is partly affected by the physical intensity of their occupation. The purpose of this study was to evaluate patient satisfaction and limitations when returning to work following TKA. This retrospective review surveyed patients undergoing primary TKA between June 2011 and January 2022, with at least 1 year of follow up, regarding return to work. Of the 914 respondents, 507 (55.5 %) worked preoperatively and were stratified into high intensity (HI) (i.e., laborer, construction), standard intensity (SI) (i.e., walking, climbing stairs), or low intensity (LI) (i.e., sedentary desk jobs) groups. Baseline characteristics and survey responses were compared across groups. Among those who worked preoperatively, 35 (6.9 %), 213 (42 %), and 259 (51.1 %) were in the HI, SI, and LI groups, respectively. Of the 507 patients who worked prior to TKA, 447 (88.2 %) returned to work after surgery and 60 (11.8 %) did not. The HI group was comprised of more young males and more smokers than the SI and LI groups. In the LI group, 30 % returned within 1 month following surgery and an additional 44 % within 2 months. Similarly in the SI group, 11 % returned to work in less than 1 month with an additional 39 % returning within 2 months. In the HI group, 4 % returned within the first month and additional 42 % returned within 2 months. HI workers were more commonly hindered in their return (HI: 30.8 %, SI: 23.1 %, LI: 7.7 %), ‘moderately declined’ in their work ability (HI: 23.1 %, SI: 9.7 %, 3.0 %), and ‘very unsatisfied’ with their return (HI: 11.5 %, SI: 10.8 %, LI: 8.1 %). TKA leads to improvements in work function and satisfaction across all intensity levels, but HI work is associated with longer recovery times and comparatively lower return-to-work satisfaction compared to SI and LI groups.
46. Why nature contact is good for us.
期刊: Trends in cognitive sciences 发表日期: 2025-Nov-28 链接: PubMed
摘要
Nature contact has long been considered salutary. Recently, scientists from a variety of home disciplines have begun to systematically document these benefits through new assessment approaches and considerations of a wide range of negative and positive affective outcomes. They also have expanded the scale of their investigations, increasing their capacity to understand specifics about the characteristics, magnitude, and timing of effects. Although much remains to be learned about why these affective benefits occur, impressive progress has been made in identifying some of the mechanisms linking nature contact to human functioning. In this review, we focus specifically on mechanisms and outcomes related to affective functioning. We discuss emerging insights and highlight promising directions for future research in this rapidly evolving field.
47. Unequal care, unequal health care? Gender differences in health care use after adult care access.
期刊: Social science & medicine (1982) 发表日期: 2025-Nov-23 链接: PubMed
摘要
Access to care among older adults can help identify unmet health needs and increase the use of health care, though in some cases it may substitute some forms of health care. We argue that the balance between these two effects is largely gender dependent: female spouses are more likely to act as informal caregivers and, as a result, are more likely to have neglected their own health needs. To examine this hypothesis, we exploit the variation introduced by Scotland’s Free Personal Care (FPC) programme, a government initiative implemented in 2002 that provides free personal care access to all eligible individuals regardless of their income. Using a Difference-in-Differences (DiD) framework comparing Scotland with the rest of the United Kingdom and a rich longitudinal dataset of men and women aged 65 and over, we first find that FPC significantly increased the uptake of home help services among women, with little change among men. Among women, adult care expansion led to a 3.5-percentage-point rise in inpatient admissions, whereas among men, we find evidence suggesting a modest substitution effect of care for health care. The effects are stronger among older adults who live alone, and those facing socioeconomic disadvantage, or high care needs.
48. Social inequality in health as a political topic in Denmark in the 21st century.
期刊: Social science & medicine (1982) 发表日期: 2025-Nov-20 链接: PubMed
摘要
This study traces the evolution of the ‘(in)equality in health’ concept in parliament debates in Denmark from 1998 until 2024, exploring how the social determinants of health framework has been translated into policy discourse. We analyzed all parliament speeches employing the (in)equality in health concept between 1998 and 2024, and other significant documents of political intent during this period, including government platform papers, party programs and major political agreements. We then quantified the relative dominance of two distinct framings of health inequality by coding the parliament speeches using a large language model. We show that while health inequalities have increasingly been framed ‘broadly’ as a complex issue that notes the importance of social determinants, the practical policy issues connected with health inequalities have increasingly ‘narrowed’ in on the issue of healthcare access and quality. In a paradoxical translation of the social determinants framework, policymakers increasingly frame health inequalities as a complex phenomenon to undermine the use of legislation for structural prevention. The Danish case is illustrative of a dilemma that warrants strategic consideration among proponents of the social determinants of health framework, namely how to simultaneously broaden the policy conversation on health inequalities and prevent this broadness from being instrumentalized against action. We argue that one element of this balancing act could be to engage in more context-specific arguments for particular leverage points and to challenge the pursuit of evidence on ‘what works’ within politically defined boundaries of social change.
49. Economic evaluation of participation in community led organisations for individuals living in disadvantaged areas in the UK.
期刊: Social science & medicine (1982) 发表日期: 2025-Nov-10 链接: PubMed
摘要
This paper presents an economic evaluation of community-led and -owned organisations that deliver activities to support health and wellbeing. Because community-led organisations (CLOs) are a vital part of the social and solidarity economy, they increasingly feature in public health policies targeting disadvantaged populations. However, little is known about the value CLOs generate as few economic evaluations of them exist and those available focus on isolated activities (such as exercise classes) and/or specific populations (e.g., men-only collectives). The novelty of our work lies in the inclusion of multiple CLOs, comprehensive coverage of their activities, breadth of participants studied, and control group methodology applied in creating new knowledge of the health and wellbeing outcomes of CLOs and resources consumed to achieve them. We conducted cost-effectiveness and cost-consequence analyses of data collected via a 12-month longitudinal study. We compared 331 CLO participants in 14 UK-based CLOs to a ‘do nothing’ synthetic control group (n = 100). Health and wellbeing were measured using the ICECAP-A capability measure for adults, EuroQol EQ-5D-5L, Short-form Warwick Edinburgh Mental Wellbeing Scale and the Revised Social Connectedness Scale. Resource use data included health, social care, and other community sector resources. Data collection occurred at four-points over the study period supported by publicly available accounts and data provided by each CLO. We found an incremental cost per year in full capability of £35,813 and an incremental cost per quality adjusted life year of £29,827. Statistically significant improvement in both social connectedness, and mental wellbeing were observed over the 12 month follow up. This work supports CLOs as an intervention to improve health and wellbeing in disadvantaged communities and identifies challenges for traditional evaluation methodology with regards to costing and comparator groups.
50. Staging Invasive Lobular Carcinoma: A Prospective Study on the Efficacy of 18F-Fluoroestradiol (FES)-PET/CT.
期刊: Clinical breast cancer 发表日期: 2025-Nov-08 链接: PubMed
摘要
Invasive lobular carcinoma (ILC) often presents diagnostic challenges on conventional imaging, necessitating advanced imaging strategies for accurate staging. [18F]Fluoroestradiol (FES), a PET radiopharmaceutical, targets estrogen receptor-positive (ER+) lesions, which are prevalent in ILC. This study evaluates the utility of FES-PET/CT compared to standard-of-care (SOC) imaging for staging ER+ ILC. This IRB-approved prospective trial (October 2022-October 2024) enrolled adults with histologically confirmed ER+ ILC at a National Cancer Institute-designated Comprehensive Cancer Center. Participants underwent FES-PET/CT, with optional [18F]Fluorodeoxyglucose (FDG)-PET/CT. The primary endpoint was the percentage of stage changes post-FES-PET/CT compared to SOC imaging, analyzed using a 1-sided binomial proportions test. Imaging was interpreted by a blinded nuclear and breast radiology specialist, with staging per AJCC eighth edition guidelines. Of 27 enrolled participants, 25 underwent FES-PET/CT (2 excluded due to synthesis failure). Mean age was 60.3 years. Pre-FES-PET/CT staging was stage I (16%), II (60%), III (20%), and IV (4%). FES-PET/CT altered clinical staging in 32% of cases (P = .036), identifying occult stage IV disease in 12.5% and histologically confirmed axillary lymph node metastases in 8%. However, it missed axillary metastases in 28% compared to surgical staging. FDG-PET/CT, performed in 15 participants, showed 40% discordance with FES-PET/CT. FES-PET/CT significantly enhances staging accuracy for ER+ ILC, detecting occult metastases that impact clinical management. Its limitations in axillary nodal detection suggest it complements, rather than replaces, surgical staging. Larger trials are needed to validate these findings.
51. Eating Well When Living With an Intellectual Disability-Exploring the Carer: Client Relationship in Residential Settings.
期刊: Journal of applied research in intellectual disabilities : JARID 发表日期: 2025-Nov 链接: PubMed
摘要
Individuals with intellectual disabilities face increased risks of obesity and health issues. Carers in residential settings play a crucial role in shaping their dietary habits. This study explores how carers influence eating behaviours to identify strategies for healthy eating. Seventeen semi-structured interviews were conducted with carers from three community homes. Thematic analysis identified three key themes: (i) whose responsibility is it?; (ii) food autonomy and choice in the context of caring relationships; (iii) opportunities for working together to support dietary choices. Carers strive to encourage healthy eating while respecting residents’ autonomy, particularly in those with cognitive impairments or on psychotropic medications. They use strategies like rapport-building, personalised care, and nutrition education. However, these efforts are limited by gaps in knowledge, time constraints, and variation in application and impact. Findings highlight the practice gap and the need for better training and resources to support carers in promoting healthy food choices while respecting residents’ autonomy. Carers face challenges in balancing the promotion of healthy eating whilst respecting residents’ autonomy, especially when residents have cognitive impairments or are on psychotropic medications. Strategies like rapport‐building and individualised care are used but vary in effectiveness. The findings highlight the critical need for tailored nutritional education and support to enhance the health outcomes of individuals with intellectual disabilities while respecting their autonomy and preferences. The study highlights the importance of integrating comprehensive nutritional training for carers and involving nutritionists and dietitians in care planning. This could improve dietary practices in residential settings, ultimately contributing to better health outcomes for this vulnerable population.
52. Improving Mortality Data Quality in Hospitals: Advocating for the Adoption of the WHO Standard Medical Certificate of Death in Nepal.
期刊: Journal of Nepal Health Research Council 发表日期: 2025-Oct-17 链接: PubMed
摘要
Accurate mortality data is vital for public health planning and policy. In Nepal, non-standardized death certificates, often missing structured causal sequences and critical details, compromise data quality in the Civil Registration and Vital Statistics (CRVS) systems. Implementing the World Health Organization’s (WHO) Medical Certificate of Cause of Death (MCCoD) could enhance accuracy, strengthen mortality statistics, and facilitate evidence-based public health interventions. This retrospective study analyzed inpatient deaths occurring between 13 April 2024 to 15 December 2024. Demographic and clinical data were extracted from medical records. The leading causes of death were identified by analyzing International Classification of Diseases Eleventh Revision (ICD-11) coded data using the Digital Open Rule Integrated cause of death Selection (DORIS) tool. Additionally, the study assessed documentation errors, predominant causes of in-hospital mortality, and evaluated the accuracy of cause-of-death reporting in the Health Management Information System (HMIS). The study analyzed 564 death certificates and corresponding medical records. Chronic liver disease was the leading underlying cause of death (UCOD) accounting 11.17% of total deaths. No certificate was entirely error-free, with nearly all (99.9%) failing to document the time interval between symptom onset and death. Approximately 59% contained unclear abbreviations, while 99.7% listed multiple causes in a single line without proper sequencing. Only 2% followed a causal sequence as: immediate, antecedent, and UCOD. Additionally, inaccurately reported cardiopulmonary arrest as the UCOD in HMIS. Hospital death certification remains critically substandard, undermining mortality data quality. Prioritizing WHO’s MCCoD implementation and clinician training would significantly improve accuracy, supporting SDG targets for reliable cause of death reporting.
53. Health Promoting Lifestyle and Health Related Quality of Life among Hypertensive Patients.
期刊: Journal of Nepal Health Research Council 发表日期: 2025-Oct-17 链接: PubMed
摘要
Health promoting lifestyle refers to the healthy practices that improves health. The objective of the study was to assess health promoting lifestyle and health related quality of life among hypertensive patients attending a tertiary level hospital. Cross sectional study design was used among 255 hypertensive patients, selected purposively from those attending cardiology OPD. Data were collected by using Health Promoting Lifestyle Profile tool and Short Form-36 Health Survey tool through face to face interview. Data were analyzed by using descriptive, inferential statistics with SPSS version 16. Health promoting lifestyle among hypertensive patients was at intermediate level (median score=130) with the highest score in spiritual growth (29.48) and the lowest score in physical activity (12.33) subscale. Health related quality of life among hypertensive patients was good (median score=64.45) with the highest score in mental health (80.61) and the lowest score in role physical (49.90) subscale. Health promoting lifestyle and health related quality of life were found positively correlated (r=0.757) and statistically significant (p <0.001). This study found that increasing age, longer duration of hypertension and presence of comorbidities were associated with lower HRQOL whereas being married and being literate were associated with higher HRQOL (p<0.005). Hierarchical regression analysis revealed that being married, education level, presence of comorbidities and six subscales of health promoting lifestyle (spiritual growth, interpersonal relationship, nutrition, health responsibility, stress management and physical activity) were influencing factors of health related quality of life among hypertensive patients (p<0.005). Health promoting lifestyle is an important factor that influences health related quality of life among hypertensive patients.
54. Status of Physical Activity and Associated Factors among Secondary School Teachers in Pokhara Metropolitan, Nepal.
期刊: Journal of Nepal Health Research Council 发表日期: 2025-Oct-17 链接: PubMed
摘要
Cardiovascular diseases are a leading cause of death globally, with physical inactivity as a significant risk factor. In Nepal, lifestyle-related health issues are rising, necessitating an understanding of physical activity patterns in specific groups like secondary school teachers. This study aims to assess the status of physical activity and associated factors among secondary school teachers in Pokhara, Nepal. A cross-sectional study was conducted from December 2022 to April 2023 among 406 secondary school teachers in Pokhara. Physical activity was measured using the IPAQ-long form, and other variables were collected through self-administered questionnaires. Univariate and bivariate analyses were followed by logistic regression to calculate adjusted odds ratios (aOR) for factors associated with moderate and high physical activity. Most participants were male (53%) and Brahmins/Chhetris (69.2%), with a mean age of 38.65 years. The majority (86.3%) met WHO physical activity guidelines, with 65.3% reporting moderate and 21.5% high activity levels. Higher physical activity was associated with being male (aOR: 2.19, 95% CI: 1.11-4.35), higher education (aOR: 2.88, 95% CI: 1.45-5.73), walking while teaching (aOR: 9.13, 95% CI: 4.20-19.87), and access to walking areas (aOR: 2.28, 95% CI: 1.12-4.62). Male teachers, those with higher education, and those who walked while teaching were more likely to engage in higher physical activity. Access to walking-friendly environments also positively influenced activity levels. Promoting walking friendly spaces and addressing educational and occupational factors could enhance physical activity among teachers. Keyword: Cardiovascular disease; international physical activity questionnaire; metabolic equivalents.
55. Restorative Masculine Integration Theory.
期刊: American journal of men’s health 发表日期: 2025 链接: PubMed
摘要
The Restorative Masculine Integration Theory (RMIT) introduces a strengths-based, systems-oriented framework for promoting healthy masculinity through healing, leadership, and relational engagement. Developed in response to the adverse effects of masculine suppression, such as emotional disengagement, burnout, and polarity collapse, RMIT outlines a five-phase Cycle of Masculine Restoration: reclaimed masculinity, emotional safety and trust, grounded leadership, rebalanced gender polarity, and healing with cultural renewal. These stages are underpinned by core concepts including psychological safety, peer mentorship, emotional literacy, and authentic masculinity. Drawing from interdisciplinary foundations in gender studies, emotional intelligence, trauma-informed practice, polarity theory, and servant leadership, RMIT offers an adaptable framework for use across clinical, educational, organizational, and policy settings. Its alignment with the MANifest Health Theory further strengthens its applicability in men’s health promotion. This manuscript elaborates the theory’s conceptual development, visual model, and practical implications, while identifying future directions for empirical validation and inclusive application. RMIT advances a timely and restorative model for transforming masculine identity into a source of individual and collective resilience.
56. Leveraging HIV prevention programs for breast cancer interventions: A survey of women stakeholders in the informal work sector in Nigeria.
期刊: Women’s health (London, England) 发表日期: 2025 链接: PubMed
摘要
Breast cancer is the leading cause of cancer-related deaths in Nigerian women. Many affected are artisans in the informal work sector with poor access to breast cancer information, which hinder preventive and screening practices. Integrating breast cancer interventions into these HIV programs offers the potential to address the dual burden of communicable and non-communicable diseases. To assess HIV and breast cancer knowledge, screening practices, and the feasibility of implementing integrated programs among artisans in Ibadan, Nigeria. A cross-sectional survey was conducted among women in the informal work sector (artisans) in Ibadan, Nigeria. The study was conducted among 400 female artisans aged 25-65 years using multistage sampling technique. An interviewer-administered questionnaire was used to obtain data on knowledge of breast cancer and HIV. Data were analysed using descriptive and inferential statistics at p < 0.05. Of the 400 respondents, most (64.5%) had secondary level education or less. A quarter were aged ⩾40 years. Only 4.5% had a high level of knowledge about breast cancer compared to HIV (92.7%). One-tenth of the women had ever been screened for breast cancer using clinical breast examination, while the mammography rate for women aged ⩾40 years was 9.0%. In contrast, the proportion who had ever screened for HIV was 74%. Factors positively associated with breast cancer screening included higher education levels and religious affiliation. The majority (95.5%) expressed willingness to participate in integrated HIV and breast cancer interventions. Our findings indicate poor awareness of breast cancer signs/symptoms and screening practices. Integrated HIV and breast cancer programs may serve as a model and offer the potential to expand coverage and reduce missed opportunities for prevention, diagnosis, and treatment.
57. Determining vaccine responders in the presence of baseline immunity using single-cell assays and paired control samples.
期刊: Biostatistics (Oxford, England) 发表日期: 2024-Dec-31 链接: PubMed
摘要
A key objective in vaccine studies is to evaluate vaccine-induced immunogenicity and determine whether participants have mounted a response to the vaccine. Cellular immune responses are essential for assessing vaccine-induced immunogenicity, and single-cell assays, such as intracellular cytokine staining (ICS) and B-cell phenotyping (BCP), are commonly employed to profile individual immune cell phenotypes and the cytokines they produce after stimulation. In this article, we introduce a novel statistical framework for identifying vaccine responders using ICS data collected before and after vaccination. This framework incorporates paired control data to account for potential unintended variations between assay runs, such as batch effects, that could lead to misclassification of participants as vaccine responders or non-responders. To formally integrate paired control data for accounting for assay variation across different time points (ie before and after vaccination), our proposed framework calculates and reports two $ P $-values, both adjusting for paired control data but in distinct ways: (i) the maximally adjusted $ P $-value, which applies the most conservative adjustment to the unadjusted $ P $-value, ensuring validity over all plausible batch effects consistent with the paired control samples’ data, and (ii) the minimally adjusted $ P $-value, which imposes only the minimal adjustment to the unadjusted $ P $-value, such that the adjusted $ P $-value cannot be falsified by the paired control samples’ data. Minimally and maximally adjusted $ P $-values offer a balanced approach to managing Type I error rates and statistical power in the presence of batch effects. We apply this framework to analyze ICS data collected at baseline and 4 wks post-vaccination from the COVID-19 Prevention Network (CoVPN) 3008 study. Our analysis helps address two clinical questions: (i) which participants exhibited evidence of an incident Omicron infection between baseline and 4 wks after receiving the final dose of the primary vaccination series, and (ii) which participants showed vaccine-induced T cell responses against the Omicron BA.4/5 Spike protein.