公共卫生研究摘要 (2025-12-03)
共收录 58 篇研究文章
1. Wet Nursing and Human Milk Sharing: Reviving Sustainable Systems to Prioritise Breastfeeding.
期刊: Maternal & child nutrition 发表日期: 2026-Mar 链接: PubMed
摘要
The 2025 call of the World Alliance for Breastfeeding Action (WABA) is to prioritise breastfeeding through creating sustainable support systems. This is based on the strong foundations of breastfeeding and the unique properties of human milk to nourish, protect and provide optimal physical, emotional and cognitive growth for the infant. Empowering women to establish and maintain lactation is critical for the short- and long-term health of mothers and infants; reducing infant and maternal morbidity; reducing healthcare costs; and building healthy societies. Studies have demonstrated this can be done effectively and sustainably using peer educators to provide support, knowledge and self-efficacy to establish and maintain breastfeeding. However, rates of breastfeeding remain far below global targets. Safe and sustainable support options are needed for mothers who struggle with an insufficient milk supply, despite lactation support. These options include wet nursing and safe human milk sharing. When these are not possible/feasible, donor milk from human milk banks should be considered. Creating support systems requires investing in financial and human resources to protect, promote and support breastfeeding through revisiting these sustainable approaches.
2. Holding Together in Hard Times: Family Cohesion as a Moderator of Mental Health Amidst Community Violence.
期刊: Journal of community psychology 发表日期: 2026-Jan 链接: PubMed
摘要
This study assessed (1) the prevalence of witnessing violence and personal victimization, (2) links between community violence exposure (CVE) and depressive and PTSD symptoms, and (3) family cohesion as a moderator in these associations among rural Mexican adults. Data were drawn from a larger mixed methods study with 200 Mexican adults (ages of 20-60; Mage = 40.7; 79.5% women) from the State of Mexico. Preliminary analyses indicated that participants reported more experiences of witnessing violence than personal victimization. Hierarchical regression analyses revealed that only witnessing violence was significantly associated with depressive and PTSD symptoms. Family cohesion did not moderate these associations. Qualitative content analysis was conducted to further explore and contextualize a subset of participants’ experiences with community violence. Findings underscore the high prevalence of CVE among rural Mexican adults and its significant associations with mental health. This study expands the predominantly urban-focused CVE literature and highlights the need for culturally and contextually informed prevention and intervention efforts.
3. Plasma concentrations of the inflammatory adipokine lipocalin-2 are not affected by chronic alcohol exposure in rats or acute alcohol administration in people with alcohol use disorder.
期刊: The American journal of drug and alcohol abuse 发表日期: 2025-Dec-02 链接: PubMed
摘要
Background: The immune system and inflammation have emerged as critical components in alcohol use disorder (AUD). The inflammatory molecule lipocalin-2 (LCN2) has been investigated in alcohol-associated liver disease, and assessment of LCN2 concentrations may aid in prevention and treatment of AUD. However, it is unknown how LCN2 concentrations fluctuate in response to acute and chronic alcohol exposure.Objectives: We examined plasma LCN2 concentrations in rats made alcohol-dependent via chronic, intermittent alcohol vapor exposure, and in people with AUD after acute alcohol administration. We hypothesized that chronic and/or acute alcohol exposure would alter LCN2 concentrations.Methods: Plasma LCN2 concentrations were measured in alcohol-dependent (n = 9) and nondependent (n = 8) male rats. LCN2 concentrations were also examined in two human laboratory studies with cue-reactivity and oral/intravenous alcohol administration in 15 (80% males) and 16 (68.8% males) participants with AUD, respectively.Results: A significant effect of Timepoint (morning versus afternoon; p = .001) but not of chronic alcohol exposure on LCN2 concentrations were found in rats. No significant effects were found after acute alcohol administration in humans.Conclusions: Chronic alcohol exposure in rats or acute alcohol administration in people with AUD had no impact on LCN2 concentrations. In rats, LCN2 concentrations were lower in the morning than in the afternoon, indicating time-related variations in LCN2 concentrations. Together, these findings suggest that LCN2 might play a role in the circadian rhythm, which is often disrupted in people with AUD. However, prospective studies are needed to further examine LCN2’s potential clinical relevance in AUD.Clinical Trials Numbers: NCT01751386, NCT01779024.
4. Tick-Borne Diseases in Urban and Periurban Areas: A Blind Spot in Research and Public Health.
期刊: Annual review of entomology 发表日期: 2025-Dec-02 链接: PubMed
摘要
Tick-borne zoonotic diseases continue to emerge in North America and Europe. Of particular concern are pathogens transmitted by Ixodes ticks, such as Borrelia spp., the causal agents of Lyme disease (Lyme borreliosis). Because Ixodes ticks are adapted to forested habitats with high humidity and depend on wildlife for feeding and movement, research has focused on natural or rural landscapes. Demographic and land-use transitions, however, have created novel ecosystems in urban and periurban areas with high potential for human exposure. We describe post-World War II land processes giving rise to these ecosystems and explore resource-based habitat concepts and top-down community ecology perspectives aimed at predicting tick-borne disease (TBD) risk. We review studies in Europe and North America that demonstrate TBD risk in urban areas and potential drivers for TBD emergence. We identify missed opportunities for data measurements and reporting and propose metrics to quantify landscape connectivity to facilitate future syntheses or meta-analyses.
5. FHIR Standard-Based Oncology Data Model for Cancer Screening: Design and Implementation Study.
期刊: JMIR cancer 发表日期: 2025-Dec-02 链接: PubMed
摘要
Cancer is a leading cause of death worldwide. Early detection through screening, diagnosis, and effective management can reduce cancer mortality. Risk assessment is crucial for improving outcomes by identifying high-risk individuals based on family history, genetics, lifestyle, and environment. Such targeted screening enhances accuracy and resource efficiency. However, the complex nature of oncology data-which includes clinical observations, lab results, radiology images, treatment regimens, and genetic information-presents significant challenges for data interoperability and exchange. This study proposes an oncology data model (ODM) based on the Fast Healthcare Interoperability Resources (FHIR) standard to facilitate the capturing, sharing, and processing of oncology data across various cancer care stages. We particularly focused on screening and risk assessment for 5 cancers: breast, cervical, esophageal, lung, and oral, within the Meghalaya Fourth Industrial Revolution for Sustainable Transformation Cancer Care pilot project in India. The ODM incorporates data elements from a cancer patient’s journey across 5 phases: encounter, risk assessment, clinical investigation, treatment, and outcome. Essential oncology data elements were modeled using the Health Level 7 FHIR Revision 4 standard. Custom FHIR profiles were developed for cancer-specific use cases, with terminology mapped to Systematized Nomenclature of Medicine-Clinical Terms, Logical Observation Identifiers Names and Codes, and the International Classification of Diseases, 10th Revision. The implementation guide (IG) was created using FHIR Shorthand, SUSHI Unshortens Short Hand Inputs, and the Health Level 7 IG Publisher. Technical and clinical validation and a stakeholder usability assessment were conducted using a demonstration tool designed for implementer training and adoption. The data model enhances interoperability across the cancer care continuum, from screening to treatment. The resulting IG includes 25 oncology-specific resource profiles and 50 standardized terminology value sets that support both semantic and syntactic interoperability. Central to the model are the FHIR Questionnaire and QuestionnaireResponse resources, customized for structured data collection in clinical and community settings, supporting cancer screening workflows. Technical validation yielded FHIR conformance and terminology binding, while clinical validation by oncologists and public health experts confirmed the usability and relevance of 5 screening questionnaires. The demonstration tool promoted stakeholder engagement and practical evaluation of the FHIR profiles. The FHIR-based ODM offers a unified framework for structured, interoperable cancer data exchange from screening to after treatment. This study marks the first comprehensive Indian initiative to apply FHIR standards for oncology screening and risk assessment. Integrating with national digital health systems, like the Ayushman Bharat Digital Mission, can ensure consistent data sharing across screening programs, hospitals, and registries. Future work will focus on real-world model deployment, evaluation in multiple districts, expanding to treatment and survivorship data, and promoting national adoption to inform cancer policy, research, and precision oncology efforts.
6. Patients' Preferences Regarding Traditional Chinese Medicine for the Treatment of Chronic Obstructive Pulmonary Disease: Protocol for a Mixed Methods Study.
期刊: JMIR research protocols 发表日期: 2025-Dec-02 链接: PubMed
摘要
Chronic obstructive pulmonary disease (COPD) is now one of the top 3 causes of death worldwide. Traditional Chinese medicine (eg, herbal prescriptions and acupuncture), which has a long history of managing respiratory diseases, has shown positive effects in COPD management by alleviating dyspnea, improving lung function, and reducing the risk of acute exacerbations. Patients’ values and preferences are undeniably important in medical decision-making and may affect treatment outcomes and patient adherence. This study aims to investigate the preferences for traditional Chinese medicine of patients with COPD, the clinical outcomes they are concerned about, and the trade-offs involved in evaluating the factors that influence treatment selection, such as clinical effectiveness, cost, and adverse effects. We will first update previous evidence through a systematic review of randomized controlled trials, examining the efficacy, safety, cost-effectiveness, and patient satisfaction of traditional Chinese medicines for COPD. Subsequently, an exploratory sequential mixed methods study will be conducted comprising qualitative and quantitative components. In this design, qualitative findings are collected first to inform and guide the subsequent quantitative data collection. Semistructured interviews will be conducted to explore in depth the preferences of patients with COPD for traditional Chinese medicine. Insights from these interviews will then be used to design questionnaires that quantitatively investigate the relative importance of different factors influencing patients’ treatment decisions. Data integration will take place by connecting and interpreting the results from both the qualitative and quantitative steps, providing a comprehensive understanding of patient preferences. This study was approved by the ethics committee of Guangdong Provincial Hospital of Traditional Chinese Medicine on November 6, 2023 (ZM2023-405). A total of 18,188 articles published after 2016 were initially identified in English- and Chinese-language databases. The outline of the semistructured interview guide for this study has been developed. Further clinical evidence updates, qualitative interviews, and discrete choice experiments are still ongoing and will be completed by April 2026. This mixed methods study might provide important insights into the preferences of patients with COPD for traditional Chinese medicine, assessing trade-offs among efficacy, safety, cost, and other key factors that influence treatment decisions. This study is expected to deepen the understanding of patient-centered decision-making in the treatment of COPD. The findings are anticipated to guide clinical practice, inform policy development, and optimize the integration of traditional Chinese medicine with respiratory care. DERR1-10.2196/75426.
7. Enrichment of the Canadian Partnership for Tomorrow's Health Study: Protocol for Administering Multiple Online Dietary and Movement Behavior Assessment Tools in a Longitudinal Cohort Study.
期刊: JMIR research protocols 发表日期: 2025-Dec-02 链接: PubMed
摘要
Suboptimal diet quality and physical inactivity are key risk factors for chronic disease and disability in Canada. However, the lack of high-quality population-level data hinders the development of evidence-based strategies to support improvements in diet quality, movement behaviors (physical inactivity, activity, and sleep), and health. The lack of data is also a barrier to developing capacity in diet and physical activity assessment and epidemiology in Canada. This protocol describes the development of the largest known repository of dietary intake and movement behavior data in Canada by drawing upon an existing longitudinal cohort study, the Canadian Partnership for Tomorrow’s Health (CanPath). In the short-term, the data will be used to examine associations between system factors (eg, retail food environments) and dietary intake. In the longer-term, data will be available to pursue a range of research questions, including longitudinal associations between diet, movement behavior, and health outcomes. Participants in CanPath (>330,000 adults) who can complete online questionnaires are eligible and will be asked to complete a baseline web-based questionnaire including questions on demographic characteristics and screeners capturing dietary intake and movement behaviors. Subsequently, participants will be invited to complete an online 24-hour dietary recall using the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24-Canada-2018) and an online 24-hour activity recall using Activities Completed Over Time in 24 Hours (ACT24). Repeat recalls will be administered 1-2 weeks later. A subset of participants will be invited to complete 2 additional ASA24-Canada-2018 and Activities Completed Over Time in 24 Hours recalls 6 months later. One year after baseline, participants will be invited to complete past-year diet and movement behavior questionnaires. In Québec, dietary intake and movement behavior data are from 3000 CanPath participants enrolled in the NutriQuébec study. Participant addresses will be linked to geospatial data on the food, built, and social environment. Data collection began in 2025. As of manuscript acceptance (November 4, 2025), 3171 participants had been recruited. Data processing and cleaning will be completed in 2027, and analyses will occur in 2028. It is anticipated that dietary intake and movement behavior data will be available for up to 100,000 adults. This protocol outlines the collection of detailed data on dietary intake and movement behavior in a large cohort spanning all provinces in Canada. In addition to allowing examination of a range of research questions related to diet, movement behavior, and health, the combination of assessment tools will support methodological research, including expanding analytical strategies to mitigate the effects of error in dietary and movement behavior data. This effort will also build capacity in the collection, processing, and harmonization of dietary and movement behavior data among cohorts and provide a training ground for emerging researchers. PRR1-10.2196/71680.
8. Prevalence and Factors Associated With Depression Among Antenatal and Postnatal Women Attending Government Health Clinics in Selangor, Malaysia: Protocol for a Cross-Sectional Study.
期刊: JMIR research protocols 发表日期: 2025-Dec-02 链接: PubMed
摘要
Maternal mental health concerns either during pregnancy or the postpartum period are a public health challenge. Depression, anxiety, and stress can lead to poorer outcomes in the antenatal and postpartum periods. There is evidence that the effect of stress, anxiety, and depression during pregnancy negatively affects fetal neurodevelopment and children’s developmental outcomes. Early diagnosis can improve treatment outcomes and prevent negative impacts on the mother and baby. Identifying risk factors, such as age, socioeconomic status, mental health history, and family dysfunction, and clinical manifestations are important for public health programs. This study aims to determine the prevalence of depression and associated risk factors among antenatal and postnatal women attending government health clinics in Selangor. A multicenter cross-sectional study will be conducted among antenatal and postnatal women attending government health clinics (Klinik Kesihatan) in Selangor, Malaysia, from August 1, 2024, to December 31, 2026. We will perform a simple random sampling in all 9 districts in Selangor to select 1 government health clinic in each district. The inclusion criteria for this study are women aged 18 years and older who are either pregnant or delivered a newborn or stillborn child within the preceding 6 weeks. We will use a published screening tool (Edinburgh Postnatal Depression Scale) to determine the level of depression among antenatal and postnatal women. We will also collect data on sociodemographic characteristics, obstetric factors, and psychosocial support. We will obtain ethics approval from the relevant ethics boards prior to data collection. Data will be analyzed using SPSS version 26.0 (IBM Corporation) and we will conduct a descriptive analysis to determine the prevalence of depression. We will calculate the level of depression among antenatal and postnatal women and score it based on a previous study conducted in Malaysia, with a score of ≥12 indicating the presence of depression. The association between depression and risk factors will be determined by multiple logistic regression analysis. P values less than .05 will be considered statistically significant. Depression is one of the mental health complications that may arise following childbirth. Therefore, the findings of this study on the prevalence and associated risk factors of depression among antenatal and postnatal women in Selangor may help women address this challenge and improve maternal mental health during pregnancy and after birth. PRR1-10.2196/63663.
9. What Is the Cost Impact of Second Opinions in Oncology? A Retrospective Review.
期刊: JCO oncology practice 发表日期: 2025-Dec-02 链接: PubMed
摘要
Second opinions in oncology may optimize treatment plans, resulting in improved outcomes such as prognosis and morbidity. Changes in treatment plans are often de-escalations in treatment intensity. However, data on the cost impact of changes in cancer treatment resulting from second opinions are limited. We used a cohort of 120 patients who presented to a high-volume cancer center for a second opinion and also had a documented first opinion-30 patients each from four disease types: colorectal, head and neck, lung, and myeloma. For the 43 total patients who had a change in treatment from the second opinion compared with the first opinion, we estimated costs of treatment for the first and second opinions across the modalities of surgery, radiation, and drug treatment. Among the 43 patients with a change between the first and second opinions, seven patients had a higher cost from the second opinion, 31 had a lower cost, and five had the same cost. Averaged across all 120 cases-43 with changes in treatment and the rest without-mean cost savings were $15,015 in US dollars (USD) per patient, ranging by disease type from $2,517 USD (lung) to $43,437 USD (myeloma). Decreases in cost were due to less-intensive surgery or drug therapy regimens, or shifts from treatment to no treatment (observation). Further investigation is needed across cancer types and in other settings to confirm the finding of de-escalations and resulting cost savings from second opinions.
10. The quality of addiction treatment in persistent poverty counties versus non-persistent poverty counties: the role of Medicaid.
期刊: The American journal of drug and alcohol abuse 发表日期: 2025-Dec-02 链接: PubMed
摘要
Background: Substance use disorders are more prevalent in areas of extreme poverty. Few studies have evaluated the differences in quality of addiction treatment associated with persistent poverty status (counties where at least 20% of residents have been in poverty for 20 years or more) and Medicaid access.Objective: This study aims to (1) investigate whether there is a difference in the quality of addiction treatment between counties identified as persistent poverty counties and those not and (2) determine the effect of Medicaid expansion on quality.Methods: We analyzed data from the National Substance Use and Mental Health Services Survey and the US Census American Community Survey. We performed fixed and random effects regression analysis to determine the likelihood of access to high-quality care, including evidence-based behavioral health services, medications for addiction, staff accreditation, medical treatment, recovery services, increased access to treatment, personalized-treatment plans, and long-term services.Results: Adjusted regression results revealed that persistent poverty county status was associated with a higher likelihood of access to high-quality care in states that expanded Medicaid (OR = 1.37, 95% CI 1.10, 1.70). Persistent poverty counties were also more likely to provide medical services, rapid access to treatment, and personalized treatment plans. However, only access to medical services remained significant in the unadjusted model in states that did not expand Medicaid (OR = 2.10, 95% CI 1.03, 4.30).Conclusions: Substance treatment providers in persistent poverty counties were more likely to provide higher quality care, but Medicaid expansion played an important role. Implications for substance treatment policy and practitioners are discussed.
11. Cybersecurity Risks and Vulnerabilities in Robotic-Assisted Surgery.
期刊: Human factors 发表日期: 2025-Dec-02 链接: PubMed
摘要
ObjectiveThis study identifies cybersecurity vulnerabilities and risks in robotic-assisted surgery (RAS) and proposes a cybersecurity framework and an assessment tool for RAS systems.BackgroundRAS systems are increasingly integrated into networks which raise cybersecurity concerns. These systems can enhance surgical outcomes but are potential cyberattack targets, which can affect clinician care, patient safety, and organizational operations.MethodSurveys and interviews were conducted with stakeholders (clinicians, researchers, cybersecurity professionals, and hospital administrators) to collect perspectives on RAS cybersecurity. Thematic analysis was used to develop an RAS cybersecurity framework. Then, stakeholders contributed to creating an RAS cybersecurity assessment tool using Failure Modes, Effects and Criticality Analysis (FMECA).ResultsSurvey responses (n = 84) revealed that 48.8% of respondents were familiar with RAS cybersecurity. Only 24.6% of clinical respondents were aware of their organization’s cybersecurity policy. Interviews (n = 15) identified vulnerabilities such as inadequate training, limited communication between manufacturers and healthcare systems, and gaps in regulations. Failure modes focused on consequences of cyberattacks on RAS systems, with severity assessments related to patient health and technology reliability/integrity completed and outcome actions identified.ConclusionUnderstanding RAS cybersecurity challenges is still in its infancy. Key vulnerabilities include insufficient training, limited data sharing, and external threats. The framework illustrates the interconnectedness of stakeholders, while the FMECA assessment tool addresses current vulnerabilities in RAS systems.ApplicationRAS cybersecurity vulnerability and risks should be carefully considered when integrating systems into healthcare organizations, and the RAS cybersecurity assessment tool can be used by stakeholders to systematically identify and analyze potential cybersecurity failure modes.
12. Digital Health for Australia: Bridging the Rural, Regional, and Remote Health Gap.
期刊: Interactive journal of medical research 发表日期: 2025-Dec-02 链接: PubMed
摘要
In rural Australia, recent trends reveal an exponential increase in the rates of physical inactivity, central obesity, metabolic syndrome, and cancer in the population. The limited rural health workforce, which is struggling to meet this growing burden, is boosted by digital technologies such as My Health Record, Cardihab, Healthdirect, and MindSpot, all of which offer opportunities for improved diagnostics, monitoring, and management of chronic diseases. However, implementing proven digital health technologies in rural communities has been challenging on numerous fronts. This perspective aims to (1) highlight the rural health gap and propose a way forward in implementing evidence-based digital health technologies in the rural, regional, and remote communities of Australia and (2) guide future rural health policy.
13. Developing innovative talent training models in Guangxi universities: research within the new humanities model.
期刊: Psychology, health & medicine 发表日期: 2025-Dec-02 链接: PubMed
摘要
In the evolving global landscape, developing innovative abilities has become the new goal of higher education in the world. Within this framework, universities face a significant task of developing training models that cultivate top innovative minds, so that these individuals acquire the skills needed to face complex challenges in modern times. This study employed a cross-sectional analysis involving sample size of 340 randomly selected students majoring in the Humanities field in Guangxi province, China. Here, data is collected using validated instruments measuring key constructs, including Course Design and Teaching Methods, Educational Philosophy, Educational Resources and Environment, and Faculty Development on Teaching Effectiveness. Confirmatory factor analysis (CFA) indicated good model fit with indices of CFI = 0.971, RMSEA = 0.035, SRMR = 0.037, and GFI = 0.905. Structural Equation Modeling (SEM) revealed that Course Design and Teaching methods significantly mediated the relationship between educational environment factors and talent quality with standardized path coefficients of χ2 = 549.686, p < 0.261, and χ2/df = 1.409. These findings support the hypothesis framework highlighting the critical role of teaching effectiveness in enhancing talent development within the New Humanities educational context. Implications for educational practice and policy in Guangxi universities are discussed. Results of mediation analysis confirmed that the connection amongst the training factors and Teaching Effectiveness is fully mediated by Critical Factors in Training Models. Descriptive statistics show high internal consistency and good convergent validity. The study finds that well-designed teaching methods are more critical for enhancing Teaching Effectiveness, while other factors, although relevant, are less important.
14. Comparison of carbon emissions, water use, and dialysis waste between incremental and full-dose peritoneal dialysis: A cohort study.
期刊: Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis 发表日期: 2025-Dec-02 链接: PubMed
摘要
IntroductionIncremental peritoneal dialysis (PD) may confer environmental benefits compared to full-dose PD due to reduced resource use. We aimed to quantify and compare carbon emissions, water consumption, and waste generation between incremental and full-dose PD in a cohort of incident PD patients.MethodsWe compared environmental metrics, including carbon emissions, water consumption, and waste generation between incremental and full-dose PD, using prospectively collected data between June 2019 and May 2024 at the Western Renal Service, Sydney, Australia. Carbon emissions were quantified using standardized coefficients from a published life-cycle analysis, while water and waste volumes were estimated using literature-based assumptions. Group comparisons were conducted using the Mann-Whitney U test, with a two-sided p-value <0.05 considered statistically significant.ResultsAmong 365 incident patients (187 incremental, 178 full-dose), followed for a median of 20 months (interquartile range 13-37), incremental PD had lower median annual per-patient carbon dioxide equivalent emissions (1016 vs. 1360 kg), blue water consumption (24,090 vs. 25,548 L), landfill waste (212 vs. 271 kg), gray water generation (8213 vs. 10,549 L), and recycling volume (73 vs. 131 kg), compared to full-dose PD (all p < 0.001). Incremental PD yielded estimated savings of 201,087 kg carbon dioxide equivalent emissions, over 5 million liters of blue water, 1.8 million liters of gray water, 27,223 kg of landfill waste, and 16,219 kg of recyclable materials.ConclusionIncremental PD was associated with a lower environmental impact than full-dose PD, highlighting its potential contribution to environmentally sustainable dialysis care.
15. Clinician Experiences and Perspectives on Intimate Partner Violence Screening for Older Patients: Implications for Research and Practice.
期刊: Journal of applied gerontology : the official journal of the Southern Gerontological Society 发表日期: 2025-Dec-02 链接: PubMed
摘要
Research on intimate partner violence (IPV) screening and response has focused largely on women of reproductive age, yet all patient populations may experience IPV and benefit from identification and response in the healthcare setting. Through analysis of in-depth interviews, this study examines perspectives of clinicians across a variety of healthcare disciplines and roles on conducting IPV screening and response protocols with older patient populations, often previously excluded from routine IPV screening. Study findings reveal mixed experiences with older patient response to being asked about possible IPV in their relationships and mixed clinician perceptions about the value and necessity for routine IPV screening among older adult patient populations. The findings point to a need for increased patient and clinician education about IPV risk among older adults and possible reconsideration of approaches to assessment of both IPV as well as other forms of elder abuse among older patient populations.
16. Association between multiple long-term conditions and tooth loss among middle-aged and older Indians: A population-based cross-sectional study.
期刊: Community dental health 发表日期: 2025-Dec-02 链接: PubMed
摘要
Oral health, though linked with overall health and well-being, is often neglected in low- and middle-income countries such as India. Tooth loss, primarily caused by dental caries and periodontal disease, has been associated with malnutrition, obesity, cardiovascular disease, diabetes, and even mortality. Despite the increasing burden of multiple long-term conditions (MLTCs), limited research in India has explored the association between tooth loss and MLTCs. The study aimed to estimate the prevalence of complete tooth loss and assessed its association with MLTCs using nationally representative data from the second wave of the Study on Global Ageing and Adult Health (SAGE). The study utilized data from the second wave of SAGE conducted in 2015 in India. Data collection covered six states using a multistage stratified sampling approach. MLTCs were defined as the co-occurrence of two or more chronic conditions, assessed via self-reported diagnoses and clinical measurements. The analysis included 7,595 participants aged ≥45 years. Statistical analyses were conducted using weighted estimates and logistic regression models. The prevalence of loss was 12%, while 25.1% of individuals had MLTCs. Among those with MLTCs, 15.4% experienced tooth loss. Tooth loss was significantly associated with MLTCs and ageing. The likelihood of tooth loss was higher in individuals with MLTCs [AOR: 1.30 (95% CI: 1.06-1.59), p-value: 0.012]. Tooth loss and MLTCs were found to be associated among adults aged ≥45 years in India, emphasizing the need to integrate oral health into chronic disease management strategies.
17. Assessment of Obstructive Sleep Apnea Risk and Predictors in Chronic Schizophrenia: A Cross-Sectional Study.
期刊: International journal of psychiatry in medicine 发表日期: 2025-Dec-02 链接: PubMed
摘要
ObjectiveThis study examined the prevalence and predictors of obstructive sleep apnea (OSA) risk in patients with chronic schizophrenia.MethodsA cross-sectional survey was conducted with 441 institutionalized patients with schizophrenia at hospital. Participants completed the Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and STOP-Bang Questionnaire (SBQ) assessing risk of OSA. Logistic regression analysis was used to identify factors associated with OSA risk (SBQ score ≥3).ResultsOSA risk was identified in 236 participants (53.5%). Each 1-cm increase in waistline was associated with an 8% increased risk of OSA (OR = 1.08), and each 1-point increase in insomnia severity score was associated with a 9% increased risk (OR = 1.09).ConclusionsOver half of patients with chronic schizophrenia were at elevated risk for OSA, with insomnia severity and central obesity as the main correlates. Early screening, ongoing monitoring, and collaboration with mental health professional staff are essential for timely intervention, tailored care, and health promotion.
18. To err is human, to persist is diabolical: Are we repeating the same cost and insurance coverage mistakes again with injectable PrEP?
期刊: Journal of acquired immune deficiency syndromes (1999) 发表日期: 2025-Dec-02 链接: PubMed
摘要
Long-acting injectable pre-exposure prophylaxis (PrEP) is the most promising biomedical HIV prevention innovation since the release of oral PrEP in 2012, but its reach may be undermined by inadequate access. The high list price of injectable PrEP has been cited as a critical driver of access issues for cabotegravir-formulated injectable PrEP, challenges that are likely to persist for the recently approved, twice-yearly injectable PrEP drug, lenacapavir. In this Viewpoint piece, we argue that now is the time to take stock of our recent progress with the rollout of injectable cabotegravir in order to learn from our mistakes for lenacapavir for PrEP. An online, U.S. national cohort study of sexual and gender minority individuals that are vulnerable to HIV. We report preliminary longitudinal data (2022-2025) on interest in and uptake of long-acting injectable cabotegravir. During their first assessment, 61% reported that they were either “somewhat interested” or “very interested” in bimonthly injectable PrEP. However, by their twelve-month assessment, only 42 individuals had taken up injectable PrEP, and at their twenty-four-month assessment 57 individuals were on injectable PrEP. Participants reported several challenges when beginning and maintaining access to injectable PrEP, including challenges at the provider and clinic-level, as well as with regard to insurance coverage and payment/cost issues. Emerging data suggests high interest in injectable PrEP but low uptake, with some participants reporting challenges obtaining insurance coverage, alongside other clinic-level barriers. It is our hope that assessments of current and persisting barriers to cabotegravir can offer preliminary but critical insights for the rollout of lenacapavir.
19. [Development of survey instruments for assessing walkability and bikeability for the prevention indicator system of the German federal states].
期刊: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz 发表日期: 2025-Dec-02 链接: PubMed
摘要
Physical activity is an important behavioural determinant of health that can be influenced by designing a physical activity-friendly environment. The aim of this work was to develop survey instruments for walkability and bikeability for the prevention reporting of the federal states. As part of the project “Monitoring physical activity and promoting exercise - developing indicators for the federal states’ prevention indicator system in Germany (KAB-Mon)” (01/05/2023-30/04/2026), the development and review of two instruments designed to subjectively assess the two prevention indicators walkability and bikeability were carried out in three steps. In Step 1, a systematic literature review was conducted. In Step 2, an expert survey followed in which 9 and 7 experts from 6 disciplines evaluated the items of both instruments using the specific criteria in an online survey. Step 3 involved cognitive testing through guided interviews with a total of 18 participants. The expert survey was analysed using mean comparisons, while the cognitive interviews were evaluated descriptively. Based on the expert feedback, the walkability instrument was shortened from 16 to 13 items, and the bikeability instrument from 19 to 14 items. Following the cognitive testing, both instruments were supplemented with a fifth response option (“don’t know/no answer”). The instruments developed through this project provide a solid scientific approach for the subjective assessment of walkability and bikeability in the German-speaking context. HINTERGRUND: Bewegung ist eine wichtige verhaltensbezogene Gesundheitsdeterminante, die durch die Gestaltung einer bewegungsfreundlichen Umwelt beeinflusst werden kann. Ziel der Arbeit war die Entwicklung von Befragungsinstrumenten zur Erfassung von Walkability und Bikeability für die Präventionsberichterstattung der Länder. Im Rahmen des Verbundprojekts „Monitoring von körperlicher Aktivität und Bewegungsförderung - Entwicklung von Indikatoren für das Präventionsindikatorensystem der Länder (KAB-Mon)“ (01.05.2023–30.04.2026) wurden zunächst mittels Literaturrecherche bestehende Befragungsinstrumente zur Messung von Walkability und Bikeability identifiziert, auf deren Grundlage Entwürfe für eigene Instrumente entwickelt wurden. Nach einer Bewertung durch 9 bzw. 7 Expertinnen und Experten anhand zuvor festgelegter Kriterien im Rahmen einer Online-Befragung wurden die Instrumente überarbeitet. Anschließend erfolgten leitfadenbasierte Interviews mit 18 Teilnehmenden, in denen die Instrumente getestet und bewertet wurden. Die Ergebnisse der Online-Befragung wurden durch Mittelwertvergleiche analysiert, die kognitiven Interviews qualitativ ausgewertet. Die Befragung der Expertinnen und Experten führte zu einer Kürzung des Walkability-Instruments von 16 auf 13 Items sowie des Bikeability-Instruments von 19 auf 14 Items. Nach dem kognitiven Test wurden beide Instrumente um eine fünfte Antwortoption („weiß nicht/keine Angabe“) ergänzt. Die im Rahmen des Projekts entwickelten Instrumente bieten einen fundierten wissenschaftlichen Ansatz zur subjektiven Erfassung von Walkability und Bikeability im deutschsprachigen Raum.
20. Respiratory-Swallowing Phase Pattern and Swallowing Impairment in Individuals With Parkinson's Disease.
期刊: Journal of speech, language, and hearing research : JSLHR 发表日期: 2025-Dec-02 链接: PubMed
摘要
Swallowing and respiratory impairments in Parkinson’s disease (PD) may contribute to atypical respiratory-swallowing phase patterning. This exploratory study aimed to (a) quantify swallowing impairment and airway protection, (b) determine respiratory-swallowing phase pattern at swallow initiation, and (c) test the association between swallowing impairment, airway protection, and respiratory-swallowing phase pattern in PD. A total of 31 adults with PD and dysphagia underwent simultaneous videofluoroscopy and respiratory inductance plethysmography following the Modified Barium Swallow Impairment Profile (MBSImP) protocol. Endpoints included MBSImP swallow-by-swallow (SS) and overall impression (OI) scores, Penetration-Aspiration Scale (PAS) scores, and respiratory-swallowing phase pattern at swallow initiation. Historical data from 84 healthy controls aged 40 years and above were used for MBSImP and PAS comparisons. Logistic regression models with random effects assessed impact of patient group on MBSImP, PAS, and respiratory-swallowing phase patterns, and the associations between MBSImP, PAS, and respiratory-swallowing phase patterns. PD demonstrated significantly increased odds for higher (worse) OI scores on lip closure (p = .0002), tongue control (p < .0001), bolus preparation/mastication (p = .016), oral residue (p = .036), laryngeal elevation (p = .001), laryngeal vestibular closure (p = .001), esophageal clearance (p = .011), and higher maximum PAS scores (p = .017). Additionally, swallowing was initiated during inspiration on 26% of trials and was associated with higher odds of impairment in initiation of pharyngeal swallow (p = .038), laryngeal vestibular closure (p = .026), tongue base retraction (p = .013), and PAS scores (p = .017). PD patients demonstrated greater frequency of swallows initiated during inspiration with higher MBSImP and maximum PAS scores relative to healthy controls. Replication of these findings in large, homogenous PD samples may clarify the relevance for retraining typical respiratory-swallowing phase patterning benefiting swallowing improvement.
21. Acceptability of Health Information Technology by Health Care Professionals: Where We Are Now and How We Can Fill the Gap.
期刊: Journal of medical Internet research 发表日期: 2025-Dec-02 链接: PubMed
摘要
Digital health is expected to improve the efficiency and quality of health. Health information technologies (HIT) imply allocated time, appropriate training, and new types of responsibility, whose physical and mental impact on health care professionals (HCPs) has emerged as an important issue. The present review provides updated data and opinions about such potential impact and discusses the relevance of programs established to better characterize barriers and facilitators of HIT implementation. The extent of internet-based health care information and digital apps imposes new responsibilities on HCPs in helping patients select reliable sources and incorporate them in the understanding and self-management of the disease. Several reviews also identified exhaustion, depersonalization, workload, over-alerting, poor work-life integration, and job unsatisfaction as potential drivers of electronic health record (EHR)-associated clinician burnout and HIT unacceptability. Paradoxically, the increasing use of generative artificial intelligence (AI) in the decision-making process may in turn introduce an additional layer of complexity due to required specific skills and associated cognitive overload and stress. Regarding EHRs, various approaches like more proportionate use, better adequation of available commercial tools, or multidisciplinary workflows within the clinic and building of new specialty-specific tools are expected to reduce clinician burden. Studies that focused on EHR paved the way for further multidisciplinary projects designed to define the factors and dimensions impacting overall digital environment including AI, and to identify relevant ways of optimizing its acceptability by HCPs. The way of preventing and alleviating the adverse effects of digital health is a major challenge that all HIT stakeholders should be aware of.
22. Lipoprotein(a) and Chronic Kidney Disease: Insights into New Therapeutic Opportunities.
期刊: Clinical journal of the American Society of Nephrology : CJASN 发表日期: 2025-Dec-02 链接: PubMed
摘要
Lipoprotein(a) [Lp(a)] was discovered more than six decades ago. Since then, it has evolved from a subject of curious experiments performed by a few scientists to an extensively explored therapeutic target for prevention and management of cardiovascular disease (CVD). This has prompted an intense search for therapies and agents with potent Lp(a)-specific lowering effects on the horizon. Some of these agents are already in clinical trials to clarify whether lowering high Lp(a) levels would result in reductions in CVD events. The road to this point has been filled with many challenges, where landmark genetic discoveries opened new avenues and set the stage for interventions. While there is no doubt that genetics play a key role in determining Lp(a) level, accumulating evidence also support a role for some clinical conditions in influencing Lp(a) levels. Chronic kidney disease (CKD) is a prevalent condition associated with elevated Lp(a) levels. Most available data show elevated Lp(a) levels predict CVD risk in patients with CKD. Given the growing evidence for a relationship between Lp(a), CVD, and CKD as well as ongoing cardiovascular outcomes trials of Lp(a)-specific agents, we provide an overview of recent evidence on this topic. We focus on recent studies in CKD patients on treatment modalities affecting Lp(a) level as well as on existing gaps in knowledge and future research directions related to clinical care and CVD risk reduction in patients with CKD.
23. Dengue in the Anthropocene: intersections of environmental change, disease epidemic, management and current challenges in global health.
期刊: Pathogens and global health 发表日期: 2025-Dec-02 链接: PubMed
摘要
Dengue fever, the most prevalent mosquito-borne viral disease, has experienced a tenfold increase in incidence over the past two decades, posing a significant global public health challenge. In 2023, more than five million cases and over 5000 dengue-related deaths were recorded, with exceeding numbers in 2024. This narrative review provides a comprehensive summary of the current epidemiology, clinical features, diagnostic methods, prevention and management strategies for dengue fever, with a particular focus on the influence of climate changes and human activities on the spread of this vector-borne disease. Factors such as climate change, urbanization, and population movements have contributed to the expanding geographic distribution and increased incidence of dengue. Additionally, this review highlights the challenges associated with accurate disease surveillance and underscores the importance of integrated strategies-including climate-adaptive surveillance, vector control, and public health policies-to mitigate the impact of dengue. This information is essential for clinicians and policymakers to implement effective surveillance and prevention measures, ultimately reducing the incidence and burden on public health.
24. Understanding the trends, clustering, and risk factors of pinworm infection in preschool settings: A repeated cross-sectional multi-center study between 2019 and 2024.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Dec-02 链接: PubMed
摘要
Pinworm (Enterobius vermicularis) remains the most prevalent helminth among preschool-aged children worldwide. Despite China’s rapid development and decades of mass deworming, pinworm infection persists as a significant paediatric public-health problem. In this study, we aimed to understand the trends, clustering, and risk factors of pinworm infection in preschool settings of Jiangsu, China. A repeated cross-sectional study was conducted in 45 counties of Jiangsu Province from 2019 to 2024. Multi-stage cluster convenience sampling was applied. Each year, one rural preschool and one urban preschool were selected per county. The sample size for each school was 229 to obtain a 5% margin of error, an arbitrary design effect of 1.5 for a prevalence estimate of 10%, and a 10% nonresponse rate. A total of 27,925 children were investigated. Adhesive cellophane tape swabs were collected for confirmation of pinworm infection. A preschool-level permutation approach was used to evaluate clustering effects of pinworm infections within preschools, measured by infection rate ratio (IRR). Risk factors of pinworm infections were assessed by multiple logistic regression. Mediation analysis was conducted between the risk factor and pinworm infection. The overall pinworm infection rate was 0.48%, ranging form 1.22% in 2019 to 0.11% in 2024 and showing a downward trend (χ2 = 52.436, P < 0.001). Significant within-preschool clustering effect was observed in 2019 (IRR = 5.95, 95% lower CL = 3.77) and 2021 (IRR = 1.96, 95% lower CL = 1.35). Risk factors for preschool pinworm infection included migrant children (OR=3.911, 95%CI = 2.749-5.610) and older age (OR=1.443, 95%CI = 1.209-1.730). Mediation analysis indicated that parental education and family income collectively explain 55.2% of the association between migrant status and infection. Pinworm infections among preschool children demonstrate a within-preschool clustering effect. Despite the observed decline in infection rate of pinworms, targeted interventions are necessary in preschools, especially for migrant children. This study contributes to the broader understanding of enterobiasis and support the development of strategies to protect children’s health in preschools.
25. Cross-sectional assessment of Angiostrongylus cantonensis transmission risk mediated by invasive apple snails in Jiangsu province of China.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Dec-02 链接: PubMed
摘要
Angiostrongylus cantonensis, a zoonotic nematode responsible for eosinophilic meningitis, is acquired in China principally through ingestion of raw or under-cooked invasive apple snails-the vector implicated in almost all Chinese outbreaks to date. Despite the widespread distribution of these snails in Jiangsu Province of China, systematic assessments of infection risks and public awareness remain limited. We carried out a cross-sectional study in six prefectural-level cities in Jiangsu. In total, 732 wild apple snails were collected from different habitats and screened for A. cantonensis larvae by pepsin-HCl digestion and microscopy. 74 local farmers markets were inspected for the sale of live or processed apple snails. Simultaneously, a validated Knowledge, Attitudes, and Practices (KAP) questionnaire was conducted with 630 randomly selected residents. Data analysis employed SPSS for descriptive statistics and multivariate linear regression was used to identify predictors of higher scores. All wild-caught snails tested negative for A. cantonensis, and no apple snails were found for sale in any market. Overall, the public demonstrated a high level of knowledge and positive attitudes towards the risks posed by apple snails; however, gaps in practice were evident: 40.3% of respondents reported not separating utensils used for raw foods from those used for cooked foods, and 78.7% reported snail sightings to authorities, while only 22.1% had ever used the Apple Snail Inspector (ASI) mini-program. KAP scores differed significantly among different demographic groups. Multivariable linear regression analysis revealed that age, city of residence, and education level were significant predictors of KAP scores. While no infected snails were detected in this study, the potential risk of transmission remains because of the widespread presence of competent apple snails. Targeted health education programs that address behavioral gaps among older and less-educated residents could further minimize the threat of A. cantonensis introduction and safeguard both public health and ecological security.
26. Monocyte-eosinophil signaling axis promotes vaccine-mediated protection against SARS-CoV-2.
期刊: PLoS pathogens 发表日期: 2025-Dec-02 链接: PubMed
摘要
COVID-19 vaccines provide robust protection against severe disease, hospitalization, and death. Neutralizing antibodies are a strong correlate of protection and can prevent SARS-CoV-2 infection of the lungs. We used a conventional laboratory mouse model combined with high- or low-dose vaccination to understand the early immunological response following SARS-CoV-2 infection in the lungs of vaccinated mice. The lungs of high-dose vaccinated mice were completely protected against SARS-CoV-2 infection whereas low-dose vaccinated mice were partially protected. We observed a greater influx of total monocytes, macrophages, dendritic cells, neutrophils, and eosinophils in the lungs of low-dose vaccinated mice compared to naïve infected mice. The different proportions of innate immune cells in the lungs indicated that infection in low-dose vaccinated mice induces a unique inflammatory environment compared to naïve infected or uninfected mice. A prominent feature of infection of low-dose vaccinated mice was infiltration of eosinophils in the lungs, which we observed across different COVID-19 vaccines and SARS-CoV-2 variants. Single cell transcriptional profiling of lung parenchymal immune cells showed that viral RNA was predominantly associated with eosinophils. Eosinophils from low-dose vaccinated mice were transcriptionally distinct from naïve mice after challenge and showed an IFN-γ biased signature. Further, monocytes from low-dose vaccinated mice expressed eotaxin-2, suggesting a monocyte-eosinophil signaling axis. Antibody mediated depletion of eosinophils in low-dose vaccinated mice resulted in increased virus replication and dissemination in the lungs. These findings demonstrate the protective nature of eosinophils during SARS-CoV-2 infection in the context of vaccination and highlight quantitative and qualitative differences in the immune response in a model for vaccine breakthrough infection.
27. Not So Fast: Incomplete Assumptions of Adverse Thyroid Effects from PFAS Exposure.
期刊: Environmental science & technology 发表日期: 2025-Dec-02 链接: PubMed
摘要
28. Analyzing first aid in textbooks used by non-medical and paramedical students in Nepal: A need of further attention for snakebite management!
期刊: PLoS neglected tropical diseases 发表日期: 2025-Dec-02 链接: PubMed
摘要
Despite the remarkable burden of snakebite envenoming (SBE) and placement of public health importance of SBE at global and national levels, a huge gap still exists in the first aid of snakebites. Herein, we aimed to evaluate the currently used textbooks to know improvements in advising standard first aid of snakebites in textbooks used in Nepalese schools and universities after a similar study published in 2013. We evaluated 46 recently edited textbooks used for teaching safety and first aid in Nepal during January-April 2024 involving thematic analytical approach. We performed an analytical review of safety and first aid in textbook. The counts of harmful or useless advice for first aid significantly decreased [p < 0.001] and standard first aid significantly increased [p < 0.001]. But, the proportions of advice for emergency transport, and going to an appropriate healthcare facility provided with anti-snake venom (RAFA) negligibly increased [p = 0.367 (right)]. However, 6-75% errors reflected the persistent use of teaching materials containing non-recommended first aid measures. Therefore, it is essential to update these textbooks including evidence-based, standard first aid for snakebites to increase the advice for appropriate care of snakebites at pre-hospital condition. We suggest authors revising those textbooks including the advice for application of pressure-immobilization bandaging (PIB) and local compression-pad immobilization (LCPI) by trained first aider and other first aid that can be applied by general people. PIB delays the onset of systemic neurotoxic venom effects due to krait bites. LCPI delays systemic venom effects and minimize local toxicity (i.e., destruction of tissue at the site of the bite) due to cobra and all viperid snake venoms.
29. Prevalence and risk factors associated with Taenia solium cysticercosis in pigs in Oyam district, Uganda.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Dec-02 链接: PubMed
摘要
Taenia solium cysticercosis is a disease known as porcine cysticercosis (PC) in swine/pigs but also taeniosis and cysticercosis in humans. The larval stage of the pork tapeworm (T. solium) has for decades been responsible for lowering economic productivity of pigs and has direct human health defects. This study assessed the disease situation in pigs to provide baseline data for appropriate disease control in humans and pigs in Oyam district following a significant improvement in latrine coverage in Uganda. A study was conducted in Oyam district in which blood was obtained from 394 pigs and analyzed for the presence or absence of circulating antigens of T. solium using a commercial enzyme-linked immunosorbent assay (cysticercosis Ag ELISA). The sampled pigs were also subjected to lingual examination for the presence or absence of T. solium cysts. Furthermore, structured questionnaires were administered to pig owners to collect information about pig management systems, feeding, housing, sex, breed and ages of pigs as well as awareness of T. solium cysticercosis and its control. The association of risk factors with prevalence of porcine cysticercosis was assessed using chi-square and logistic regression analyses at the 95% confidence level. These results were then compared with those of Nsadha et al. (2010). The overall prevalence of PC was 27% (Lingual examination) and 33% (ELISA), indicating a 17% increase in infection rates in the district from the result of Nsadha et al. (2010). While latrine coverage increased below 50% to 74 an increase of 24%. Local breeds, age of pigs, poor household hygiene, consuming pork and tethering and free-range husbandry systems were significant predictors of infection. There was no significant association between the possession or use of latrine and prevalence of PC in the study area. PC is still endemic in Oyam District and significant risk factors are: breeds, age, husbandry practices, pork consumption and household hygiene. Therefore, efforts to expand latrine coverage should be accompanied by improvements in latrine quality, community sensitization, and broader investments in sanitation infrastructure in the study area and in other settings with similar epidemiological profiles. Furthermore, future studies could factor in the impact of environmental contamination and latrine status to give a comprehensive picture of the epidemiology of the infection in the area.
30. Four-Year Effects of a Computer-Based Brief Alcohol Intervention Targeting Alcohol Users in the General Population: Randomized Controlled Trial.
期刊: Journal of medical Internet research 发表日期: 2025-Dec-02 链接: PubMed
摘要
Brief alcohol interventions aim at motivating individuals to reduce their drinking and encompass a multitude of activities with limited duration or frequency such as counseling or individualized feedback. Brief interventions are effective in alcohol users who exceed the low-risk drinking limits. Considering the health risks associated with alcohol consumption below these limits, brief interventions should be targeted at all alcohol users to maximize their public health impact. The study aimed (1) to test the long-term effects of a brief alcohol intervention consisting of computer-generated individualized feedback letters among individuals who consume alcohol, irrespective of how much; and (2) to explore how intervention effects may be moderated by alcohol use severity and school education. In the waiting area of the municipal registry office in Greifswald, Mecklenburg-Western Pomerania, Germany, a general population sample of 1646 adults (n=920, 55.89% women; mean age 31.0, SD 10.8 y) who reported alcohol use at least once in the past year were randomized to an intervention (n=815, 49.51%) or a control group (n=831, 50.49%). The intervention comprised up to 3 computer-generated individualized feedback letters based on the transtheoretical model of behavior change at baseline and after 3 and 6 months. The control group received assessment only at the same time points and no feedback. The outcome was a change in self-reported number of drinks per week from baseline to follow-up after 36 and 48 months. Moderators of intervention efficacy were self-reported alcohol use severity (low risk vs at-risk drinking) and school education (<12 y vs ≥12 y) at baseline. Data were analyzed using latent growth modeling with full-information maximum likelihood estimation, ensuring an intention-to-treat analysis. Bayes factors (BFs) were calculated to estimate the sensitivity of evidence. Unadjusted and adjusted models revealed no group difference after 36 months (incidence rate ratio 1.05, 95% CI 0.87-1.27; BF=0.37). After 48 months, a decrease in weekly alcohol consumption was observed in the control group and no change in the intervention group (incidence rate ratio 1.29, 95% CI 1.05-1.57; BF=0.16), indicating strong evidence against the hypothesized intervention effect. Intervention efficacy was not moderated by alcohol use severity or school education at baseline. In a randomized controlled trial, no evidence for the efficacy of individualized feedback letters was found after 3 and 4 years. Unexpectedly, drinking reductions in the control group and no change in the intervention group were observed 4 years after the study start. Intervention strategies effective in at-risk drinkers may necessitate adaptation for applicability to alcohol users as a whole.
31. Latent profile analysis of return-to-work readiness and self-efficacy among breast cancer survivors who have not returned to work post-surgery.
期刊: Journal of cancer survivorship : research and practice 发表日期: 2025-Dec-02 链接: PubMed
摘要
To identify latent subgroups of return-to-work readiness (RRTW) and self-efficacy (RTW-SE) in postoperative patients with breast cancer who had not resumed employment and to examine predictors of subgroup membership. Using convenience sampling, 323 postoperative patients with breast cancer who had not returned to work were recruited from a tertiary hospital in Sichuan Province, China. Latent profile analysis was conducted to examine heterogeneity in RRTW and RTW-SE scores. Two subgroups were identified: a low readiness/low self-efficacy group (33.1%) and a high readiness/high self-efficacy group (66.9%). Scores on all RRTW dimensions, except pre-contemplation and RTW-SE, were higher in the high readiness group than in the low readiness group. Logistic regression showed that having a bachelor’s or higher degree (odds ratio [OR] = 4.959), return-to-work intention (OR = 5.545), and not cohabitating with a spouse (OR = 2.305) were significantly associated with subgroup membership. Our findings highlight the need for stratified interventions, such as cognitive support, enhanced social resources, and personalized rehabilitation, to help patients transition from the “patient role” to the “occupational role.” Tailored return-to-work support is needed for breast cancer survivors. Interventions should address individual differences in readiness and self-efficacy through cognitive-behavioral strategies, targeted counseling, and strengthened social support. Collaborative efforts between healthcare providers and employers are essential to develop personalized plans that bridge the gap between recovery, intention, and sustainable workforce reintegration.
32. Physical activity and Alzheimer's disease risk across genetic susceptibility: a prospective UK Biobank study using accelerometer data.
期刊: Journal of neurology 发表日期: 2025-Dec-02 链接: PubMed
摘要
Physical activity (PA) has been associated with reduced Alzheimer’s disease (AD) risk, but whether protective effects vary across genetic risk levels remains unclear. Previous studies were limited by self-reported PA measures and simplified genetic models. In this study, we aimed to examine the association between accelerometer-measured physical activity and the risk of incident AD in a large population-based cohort, and to explore potential interactions between PA and polygenic risk scores for AD. We analyzed 93,578 UK Biobank participants aged 40-70 years with accelerometer data and genome-wide genotyping. PA was measured continuously (milligravity, mg) and dichotomized at the optimal point from maximally selected rank statistics. Genetic risk was assessed using polygenic risk scores (PRS) and APOE ε4 status. Cox models estimated hazard ratios for incident AD across genetic risk strata during median 15.5-year follow-up. Among 401 AD cases, high PA reduced risk by 48% (HR 0.517; 95% CI 0300-0.891), while high PRS increased risk nearly twofold (HR 2.423; 95% CI 1.757-3.343). PA’s protective association remained consistent across all PRS and APOE ε4 strata. No significant multiplicative or additive interaction was found between PA and genetic risk (RERI = - 0.566, 95% CI - 4.574-3.441). Dose-response analysis revealed maximum benefit with optimal threshold at 21.7 mg corresponding to light-intensity activity. Objectively measured PA substantially reduces AD risk regardless of genetic predisposition. Even light-intensity activity provides meaningful protection, supporting PA as a broadly applicable preventive strategy across all genetic risk levels.
33. What is the Impact of Risk Factors on Communicable Diseases among Migrant Workers in the Gulf Cooperation Council: a Systematic Review.
期刊: Journal of epidemiology and global health 发表日期: 2025-Dec-02 链接: PubMed
摘要
The Gulf Cooperation Council region hosts large numbers of migrant workers, which has important implications for public health. Studies have documented varied disease risks among these populations. This paper examines risk factors for communicable diseases among migrant workers in this region. It darws on a social-ecological model to explore the interplay of individual, social, environmental, and structural factors. The paper also outlines policy areas where action may strengthen public health outcomes. This study conducted a systematic review following PRISMA guidelines. We searched PubMed, Scopus, Embase, Web of Science, CINAHL, and Global Health. We identified 113 records through database searches, screened 72 unique records after duplicate removal, and assessed 24 at full-text for eligibility. Extracted data were managed using standardized Excel-based forms, cross-checked for accuracy, and synthesised narratively by grouping studies according to disease type and risk-factor domains following established guidance. We applied co-occurrence analysis of risk factors across studies. Data synthesis used a narrative approach to compare findings across heterogeneous study designs, focusing on recurring patterns in reported. Co-occurrence analysis using Pearson correlations, Jaccard coefficients, and phi coefficients (bootstrap 95% CIs) showed susbtantial convergent validity. Healthcare access and language barriers each appeared frequently alongside labour camps. Crowded conditions were often linked with low awareness. Migration from endemic countries showed little overlap with occupational exposure. Communicable disease risks among migrant workers in the GCC arise from multiple, interacting factors. Healthcare access barriers and labour camp housing repeatedly emerged among the most prominent co-occurring risk factors. Communicable disease risks among migrant workers in the GCC largely reflect structural conditions, particularly housing, healthcare access, and legal and occupational vulnerabilities, highlighting the need for coordinated regional policies that strengthen surveillance, improve living conditions, and expand equitable access to care.
34. Comparison of first-line immuno-oncology combinations with molecular targeted therapy in patients with advanced renal cell carcinoma undergoing hemodialysis: a real-world multicenter retrospective study.
期刊: International journal of clinical oncology 发表日期: 2025-Dec-02 链接: PubMed
摘要
Patients with advanced renal cell carcinoma (RCC) undergoing hemodialysis are often excluded from clinical trials. We aimed to evaluate real-world outcomes of first-line molecular targeted therapy (MTT) and immuno-oncology (IO) combination therapies in patients with advanced RCC receiving hemodialysis. We retrospectively analyzed data from 88 patients undergoing hemodialysis who received first-line systemic therapy for advanced RCC at 18 institutions in Japan between 2008 and 2023. Patients were divided into three groups by first-line regimen: MTT (n = 53), IO-IO (n = 18), or IO-tyrosine kinase inhibitor (IO-TKI, n = 17). Treatment response, progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (TRAEs) were evaluated. Prognostic factors were identified using univariate and multivariate Cox regression analyses. The median PFS and OS were 3.9 and 18.9 months, respectively. The IO-IO and IO-TKI groups achieved significantly longer PFS than that in the MTT group (median PFS 3.5, 5.4, and 7.5 months, respectively; p = 0.003); OS did not differ significantly between the groups. Grade ≥ 3 TRAEs occurred in 30.2%, 33.3%, and 41.2% of the MTT, IO-IO, and IO-TKI groups, respectively. Multivariate analysis identified poor Eastern Cooperative Oncology Group performance status, longer hemodialysis duration (≥ 10 years), and first-line regimen as independent PFS predictors. International Metastatic RCC Database Consortium risk classification and hemodialysis duration independently predicted OS. Systemic therapy, including IO-IO and IO-TKI regimens, demonstrated acceptable safety profiles for patients with advanced RCC undergoing hemodialysis. IO combination therapy significantly improved PFS, supporting its utility as a first-line treatment option.
35. Effects of physical exercise in patients undergoing haematopoietic stem cell transplantation: systematic review and meta-analysis.
期刊: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 发表日期: 2025-Dec-02 链接: PubMed
摘要
To evaluate the effects of physical exercise on key clinical outcomes (such as quality of life (QoL), aerobic capacity, fatigue, and muscle strength) in patients undergoing haematopoietic stem cell transplantation. PRISMA systematic review and meta-analysis from inception to April 2025. PubMed, Embase, Cochrane Library, Web of Science and Scopus databases were searched for eligible studies. Methodological quality and risk of bias were evaluated with the Pedro scale and the Risk-Of-Bias Tool for randomized trials (ROB2.0) respectively. An initial search retrieved 5217 articles. Finally, 20 studies were included in the qualitative synthesis and 7 in the meta-analysis. Exercise showed a small, non-significant effect on QoL (SMD = 0.23; p = 0.072), and a significant moderate effect on functional capacity (SMD = 0.43; p = 0.002). No significant effects were found on fatigue (SMD = - 0.05; p = 0.819) or handgrip strength (SMD = 0.21; p = 0.201), although a large and significant effect was observed for lower limb strength (SMD = 1.48; p < 0.001). Meta-regression analyses indicated that longer intervention duration was significantly associated with greater improvements in fatigue. Physical exercise improves functional capacity and lower limb strength in transplant patients, while effects on quality of life and fatigue are less consistent. Longer interventions are associated with greater improvements in fatigue. These results support the implementation of prolonged exercise programmes to optimize post-transplant recovery.
36. Predicting Chemotherapy Response in Patients With Advanced or Metastatic Pancreatic Cancer Using Machine Learning.
期刊: JCO clinical cancer informatics 发表日期: 2025-Dec 链接: PubMed
摘要
Selecting an optimal first-line chemotherapy regimen for advanced or metastatic pancreatic cancer is challenging because of varying efficacy and toxicity profiles of fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) and gemcitabine/nab-paclitaxel (GnP). This study aimed to develop machine learning (ML) models that predict survival outcomes and guide treatment selection using routinely available clinical data. We retrospectively analyzed 191 patients who received systemic chemotherapy for advanced or metastatic pancreatic cancer at Gangneung Asan Hospital and the Asan Medical Center between 2014 and 2023. Seventeen demographic and clinical variables, along with survival outcomes, were collected. The data set was stratified and split into training and test sets (4:1). CatBoost-based ML models were trained to predict 12-month overall survival (OS) for each regimen. A minimal subset of variables was selected using 5-fold cross-validation to optimize receiver operating characteristic (ROC)-AUC. Patients were classified as high or low risk based on model-derived thresholds. The median age of the cohort was 62 years, and 64% was male. The ML models achieved ROC-AUCs of 0.81 for FOLFIRINOX and 0.82 for GnP. Predictive accuracies on test data were 0.77 and 0.80, respectively. Median OS differed significantly between predicted high- and low-risk groups: 9 v 15 months for FOLFIRINOX (hazard ratio [HR], 2.8; P < .0001) and 9 v 18 months for GnP (HR, 2.5; P < .01). In addition, 27% of patients predicted to be high risk for FOLFIRINOX were classified as low risk for GnP, and 32% vice versa. ML models trained on multicenter data can effectively predict early mortality risk and help personalize chemotherapy selection in advanced or metastatic pancreatic cancer, potentially improving clinical outcomes.
37. Development of a Dynamic Counterfactual Risk Stratification Strategy for Newly Diagnosed Patients With AML Treated With Venetoclax and Azacitidine.
期刊: JCO clinical cancer informatics 发表日期: 2025-Dec 链接: PubMed
摘要
The objective of this study was to develop a flexible risk stratification strategy for AML that is specific for venetoclax plus azacitidine (ven/aza), addresses real-world data (RWD) issues, and is also adaptable to different use cases. A series of tunable risk models (RMs) were generated from a dynamic counterfactual machine learning (ML) strategy. These used a range of features from diagnostic AML samples and were tested using objective metrics on a single-institution cohort of 316 newly diagnosed patients treated with ven/aza. RM performance was tested using various model assumptions, data elements, and end points and with applications to an external AML real-world cohort (RWC). Favorable, intermediate, and adverse risk groups were identified in a series of ML-based RMs using different assumptions, for genetic-only or genetic-plus-phenotypic data elements and with overall survival and event-free survival as end points. Most RMs demonstrated equitable patient distribution (approximately 20%-40% in each risk group), significant separation between risk strata (log-rank-based P values <0.001), and predictability computed by time-dependent survival AUC values of 0.60-0.70. Similar performance was observed when the proposed RM strategy was adapted and compared with the European Leukemia Net 2022 using the external RWC. The proposed ML strategy addresses a variety of RWD considerations and is readily tunable through coding and parameter updates for different contexts and use case needs. This strategy represents a novel approach to developing more effective RMs for AML and possibly other diseases.
38. Number Of States Providing Medicaid Hearing Aid Coverage For Adults Increased; Variability Was Substantive, 2017-23.
期刊: Health affairs (Project Hope) 发表日期: 2025-Dec 链接: PubMed
摘要
This study examined state-level Medicaid hearing aid coverage for adults ages twenty-one and older across the United States. Using policy surveillance principles, we compiled a cross-sectional data set detailing hearing aid coverage policies from fifty states and Washington, D.C., as of December 31, 2023. We then merged these data with individual-level American Community Survey data to estimate national rates of Medicaid hearing aid coverage and identify how coverage varies according to demographic characteristics. We identified thirty-two states with Medicaid hearing aid coverage for adults, with substantial variability in policy features of that coverage. Approximately 70 percent of Medicaid beneficiaries ages twenty-one and older lived in a state with coverage. Women, working-age adults, and Black adults had slightly lower odds of coverage, whereas Hispanic and Latino and other or multiple race beneficiaries had higher odds of coverage. Expanding and standardizing Medicaid coverage of hearing aid benefits in line with best practices could improve access and utilization.
39. California's Heat Standard And Heat-Related Deaths Among Outdoor Workers.
期刊: Health affairs (Project Hope) 发表日期: 2025-Dec 链接: PubMed
摘要
Heat exposure impairs decision making and increases injury and death risk among outdoor workers. Since 2022, five US states have adopted outdoor heat standards, but these recent policies cannot yet be evaluated with the available data. We examined California’s 2005 outdoor heat standard, which is the only standard that was in place before 2022. Using negative binomial regression with wild cluster bootstrapped standard errors, we compared heat-related deaths among outdoor workers in California with those in neighboring states during the period 1999-20. California’s policy showed increasingly strong associations with reduced deaths over time, with no decline during initial implementation (2005-09) but estimated reductions of 33 percent after enforcement increased (2010-14) and 51 percent after policy revisions (2015-20). Although these period-specific reductions were not individually statistically significant, a Wald test indicated that the combined effect during the period 2010-20 was statistically significant. These findings suggest that when properly designed and enforced, comprehensive heat standards can protect vulnerable workers as temperatures rise.
40. Hospital Finances, Operations, And Patient Experience Remain Stable After Oregon's Hospital Payment Cap Was Implemented.
期刊: Health affairs (Project Hope) 发表日期: 2025-Dec 链接: PubMed
摘要
Hospital prices are an important driver of rising US health care spending, prompting states to explore policies to control hospital price growth. In October 2019, Oregon implemented a hospital payment cap, limiting hospital payments to 200 percent of Medicare payments for care provided to state employees. The policy generated $50 million in annual savings for the state and its members, but its impact on hospitals’ finances, operations, and care delivery remains unclear. We used a synthetic difference-in-differences analytic design to examine the effect of Oregon’s payment cap on net patient revenues, patient care expenses, and operating margins. We found small and nonsignificant changes in Oregon hospitals’ revenues, expenses, and margins after implementation of the cap. Consistent with these findings, we observed limited changes in hospital operations and the patient experience of care. Overall, we found little evidence that Oregon’s payment cap disrupted hospital operations or care delivery.
41. New York's Basic Health Program Increased Subsidized Insurance Coverage From Preconception To The Postpartum Period.
期刊: Health affairs (Project Hope) 发表日期: 2025-Dec 链接: PubMed
摘要
Prepregnancy access to care and continuous health insurance coverage from preconception to postpartum are modifiable drivers of maternal health. The Basic Health Program (BHP) provision of the Affordable Care Act (ACA) allows states to provide low-income people with earnings above the Medicaid income threshold with insurance coverage that is more affordable than Marketplace plans. This study used data from the Pregnancy Risk Assessment Monitoring System from the period 2015-20 and a difference-in-differences design to evaluate the impact of New York’s BHP on two insurance outcomes: preconception coverage through New York’s state BHP or Marketplace and continuous publicly subsidized coverage during and after pregnancy following prepregnancy BHP or Marketplace coverage. Compared with coverage in comparison states with no BHP, New York’s BHP increased preconception BHP and Marketplace coverage by 8.8 percentage points and increased continuous publicly subsidized coverage pre- to postpregnancy by 6.9 percentage points. The BHP was not associated with a change in preconception uninsurance. The BHP could be an important state-level policy to improve coverage affordability and stability from preconception to the postpartum period, especially given the present uncertainty of federal funding for Medicaid and Marketplace coverage.
42. Utilizing the AANA Wellness Ambassador Microcredential as a Component of Resident Registered Nurse Anesthetist Education.
期刊: AANA journal 发表日期: 2025-Dec-01 链接: PubMed
摘要
The purpose of this pilot educational program evaluation was to explore the integration of the American Association of Nurse Anesthesiology (AANA) Wellness Ambassador Microcredential (MC) into a nurse anesthesiology educational program’s (NAEP) curriculum and evaluate its impact on resident registered nurse anesthetists’ (RRNAs) wellness-related knowledge and competencies. Eighteen third-year RRNAs enrolled in a Professional Aspects of Anesthesia course completed the MC. Following completion, the RRNAs completed a 39-item survey assessing satisfaction, perceived relevance, and self-reported competency gains developed using the Kirkpatrick Model of instructional design. Results indicated high satisfaction, with 89.5% finding the content engaging and over half rating the quality as excellent. Self-reported improvements were observed across all nine wellness competencies, particularly in knowledge of wellness resources and application of holistic health principles. The interactive format and real-world applicability were especially valued. Participants reported increased confidence in addressing wellness-related challenges and a greater likelihood of utilizing and recommending wellness resources such as the AANA Helpline (800-654-5167). Findings support early and longitudinal integration of wellness education within the NAEP to foster resilience, reduce burnout, and promote a culture of well-being in nurse anesthesiology. While limited by sample size and self-reported data, this pilot project demonstrated the potential use of MC as scalable, competency-based tools for enhancing wellness education. Future research should include longitudinal and multisite evaluations to further validate outcomes and inform broader implementation strategies.
43. Description of three new Dryocola species: Dryocola mayonis sp. nov., Dryocola sharpae sp. nov.and Dryocola baronae sp. nov., isolated from human clinical samples.
期刊: International journal of systematic and evolutionary microbiology 发表日期: 2025-Dec 链接: PubMed
摘要
Three previously uncharacterized bacterial species, designated strains BD586T, BD613T and BD626T, isolated from human clinical specimens, were identified at Mayo Clinic, Rochester, Minnesota, USA. Initial identification efforts using matrix-assisted laser desorption ionization-time-of-flight MS and partial 16S rRNA gene sequencing proved inconclusive. Comprehensive analysis involving phenotypic characterization, biochemical assays and whole-genome sequencing was undertaken. The isolates were Gram-negative, motile, facultatively anaerobic rods, occurring singly, in pairs and in short chains; BD613T additionally formed small aggregates. The isolates tested positive for catalase and negative for oxidase. Their colonies appeared smooth, white, opaque and non-haemolytic. Growth was observed at 35 °C under aerobic, anaerobic and CO₂-enriched conditions, as well as in media with NaCl concentrations up to 10% and at pH 7-9. Phylogenetic relationships were inferred from core gene alignments, average nucleotide identity and digital DNA-DNA hybridization comparisons. Results confirmed the placement of BD586T, BD613T and BD626T within the recently established Dryocola genus, while also indicating their novelty as distinct species. The major cellular fatty acids were C16:0 and C17:0 cyclo. Based on these findings, a formal description of three new species, Dryocola mayonis sp. nov. (type strain BD586T=TSD 474T, =NCTC 15089T, =DSM 119465T), Dryocola sharpae sp. nov. (type strain BD613T=TSD 475T, =NCTC 15090T, =DSM 119466T) and Dryocola baronae sp. nov. (type strain BD626T=TSD 476T, =NCTC 15091T, =DSM 119479T), is proposed, and the genus description of Dryocola is emended to refine its genomic, morphological and chemotaxonomic boundaries.
44. Bacillus velezensis SQR9: a model biofertilizer strain for beneficial plant root-rhizobacterium interaction.
期刊: Science China. Life sciences 发表日期: 2025-Nov-28 链接: PubMed
摘要
Plant growth-promoting rhizobacteria (PGPR) are beneficial microorganisms residing in the rhizosphere that enhance plant growth and health. While fundamental research on established PGPR strains has focused on their biological functions and interactions with plants, in-depth investigations of root colonization mechanisms and microbial interactions within the rhizosphere remain limited. This review presents Bacillus velezensis SQR9 as a model PGPR strain, affirming its inclusion of conventional plant-beneficial mechanisms, including antimicrobial metabolite production, induced systemic resistance, resource competition, phytohormone production, along with novel mechanisms unique to SQR9, such as root development enhancement, nitrogen uptake promotion, and abiotic stress tolerance. The complex processes and molecular mechanisms of root colonization-including spore germination, chemotaxis, adhesion, immune evasion, and biofilm formation-are summarized. Furthermore, the influence of SQR9 on plant microbiomes and its interactions with other soil microorganisms are examined, paving the way for leveraging beneficial microbial interactions to enhance the functionality of PGPRs. We also assess the biotechnological potential of SQR9, supported by multiple patents and successful commercial applications in biofertilizer production. By elucidating the specific roles and benefits of B. velezensis SQR9, this review serves as a practical guide for developing innovative PGPR-based solutions aimed at enhancing crop yields and promoting sustainable agricultural practices.
45. The impact of household physical distancing and its timing on the transmission of SARS-CoV-2: Insights from a household transmission evaluation study.
期刊: Epidemics 发表日期: 2025-Nov-26 链接: PubMed
摘要
Studies on SARS-CoV-2 household transmission often assume random mixing, overlooking detailed contact patterns and the timing of physical distancing. To address this, we examined interactions within 280 households, including 280 index cases and 544 members, enrolled from April 2020 to April 2021 in Nashville, Tennessee, and central Wisconsin. Eligible households were enrolled within 7 days of index case symptom onset if at least one member was initially asymptomatic. Participants were monitored for 14 days, with symptoms and respiratory specimens collected daily, and contact data retrospectively assessed at three time points: the day before index case symptom onset, the day before enrollment, and 14 days post-enrollment. We fitted Exponential Random Graph Models to the contact pattern to identify drivers of household contact. We used the fitted household models to inform a two-level mixing model to account for community infection risk, and we calibrated it to the infection data. We then used the calibrated model to study different implementation of physical distancing. Contact patterns showed a significant reduction in physical interactions after infection awareness, particularly avoidance of index cases, with a 77% reduction in contact density (95% CI [65%-84%], p<0.001). Simulations from the two-level mixing model indicated that initiating contact reductions at symptom onset could lower secondary infections by over 25% in households of 4-5 members. These results demonstrate how behavior changes following infection awareness reduce transmission. Implementing physical distancing earlier, at symptom onset, could further limit secondary infections and enhance household transmission control.
46. Assessing the Relationship Among Childhood Maltreatment, Personality Dysfunction, and Externalizing Behavior.
期刊: Journal of personality disorders 发表日期: 2025-Nov 链接: PubMed
摘要
Research has sought to understand the relationship among childhood maltreatment, maladaptive personality, and antisocial behaviors. However, most of the literature overlooks possible gender differences by using primarily male samples. The current study examined these relationships, focusing on the mediating role of personality dysfunction, in samples of women who are incarcerated (N = 200) and undergraduate students (N = 187). Correlations revealed moderate to strong associations among childhood trauma, personality psychopathology, and antisocial behavior (rs = .31-.66). The findings demonstrated a mediation pathway from childhood trauma to BPD (β = .37) and ASPD/psychopathy (βs = .25-.34) to antisocial behavior (βs = .35-.67). This study provides a comprehensive understanding of the associations among childhood trauma, personality psychopathology, and antisocial behavior. Additionally, it expands existing research by presenting a mediation model, demonstrating the role of personality dysfunction in mediating the relationship between childhood maltreatment and antisocial behavior in women.
47. The influence of chronic hepatitis B virus infection on fatty acid composition in erythrocyte membranes and plasma, and its effect on lipoxin A4 and resolvin D1 levels.
期刊: Folia medica Cracoviensia 发表日期: 2025-Jul-31 链接: PubMed
摘要
This study aimed to assess the impact of chronic hepatitis B on fatty acids (FA) composition in erythrocyte membranes (RBC) and plasma, and its effect on lipoxin A4 and resolvin D1 levels. Sixty participants were enrolled: 30 hepatitis B patients (15 with cirrhosis, 15 without) and 30 healthy controls. Fatty acids content in plasma and RBC membranes was analyzed by gas chromatography. Serum lipoxin A4 (LXA4) and resolvin D1 (RvD1) were measured via enzyme immunoassay. Principal component analysis (PCA) assessed correlations between fatty acid composition, LXA4 and RvD1 levels. Hepatitis B patients with cirrhosis exhibited significantly lower plasma lipoxin A4 (1812 pg/mL) compared to controls (2230 pg/mL) and non-cirrhotic hepatitis B patients (2453 pg/mL). Plasma n-3 FA levels (15.4% vs. 8.7%) and the n-3/n-6 ratio (0.8 vs. 0.4) were significantly reduced in cirrhotic patients. PCA data revealed associations between LXA4 and saturated fatty acids, and between n-3 FA and RvD1 pathways, suggesting disrupted lipid-mediated inflammation resolution. Erythrocyte membranes showed elevated trans C18:1 in cirrhotic hepatitis B. Chronic HBV infection, especially with cirrhosis, alters fatty acid profiles and reduces lipoxin A4 level, contributing to persistent hepatic inflammation and highlighting potential lipid-targeted therapies.
48. Tracheoesophageal prostheses in voice rehabilitation after total laryngectomy.
期刊: Folia medica Cracoviensia 发表日期: 2025-Jul-31 链接: PubMed
摘要
Loss of voice in patients after total laryngectomy is a significant issue that medicine has been grappling with since the 19th century. Scientific literature reports unequivocally confirm the substantial impact of total laryngectomy on patients’ quality of life, which directly translates into their psychological well-being. The purpose of this study is to compile and organize the latest scientific findings on tracheoesophageal prostheses and subsequently integrate the description of this treatment modality with its rehabilitative aspects. In light of the growing number of patients using TEP, this paper also aims to reintroduce and clarify the topic for a broad range of ENT surgeons and other physicians who are increasingly likely to encounter TEP patients in clinical practice. The tracheoesophageal prosthesis (TEP), first described in 1972 by Professor Erwin Mozolewski and independently introduced into the English-language literature in 1980 by Blom and Singer, has become a key method for voice rehabilitation in patients who have undergone total laryngectomy and currently, used prostheses function based on a one-way air valve implanted in a surgically created tracheoesophageal fistula. This method is considered highly effective, as it is utilized in over 90% of cases. In addition to providing better voice quality compared to other techniques, the TEP prosthesis also positively impacts the overall quality of life of the patients who use it. Scientific studies highlight the analysis of quality of life and the effectiveness of voice rehabilitation as key endpoints in assessing the success of both surgical and rehabilitative treatment in laryngectomized patients. Over the years, various methods of voice rehabilitation have been developed in an effort to find the best approach that meets the needs of patients.
49. Challenges and opportunities in managing pregnant patients with abnormal cervical cytology and positive HPV result in Poland: a single-center retrospective analysis.
期刊: Folia medica Cracoviensia 发表日期: 2025-Jul-31 链接: PubMed
摘要
The study examined the natural progression of squamous intraepithelial lesions (SIL) and human papilloma virus (HPV) infection during pregnancy, comparing initial and postpartum results. It also assessed delivery mode’s impact on outcomes and strategies to improve follow-up care for women with abnormal cervical cancer screening results. This retrospective study analyzed data from 59 pregnant women with SIL/positive HPV, assessing variables such as cytology, HPV status, and delivery mode. Statistical tests included Wilcoxon rank-sum and Fisher’s exact tests. The average age of patients was 29 years. Over 50% were primigravidas. A significant reduction in abnormal cytology was observed postpartum (89.83% vs. 62.50%, p = 0.009), with an increase in normal results (10.17% vs. 37.50%). No significant differences were found in HPV status (88.89% vs. 81.25%, p =0.655). Colposcopy findings were stable for 76.32% of patients between Visits 1 and 2, with 50% stability between Visits 2 and 3. Postpartum, 30.43% showed regression, while 8.70% showed progression (p = 0.017, padj < 0.050). Higher regression rates were observed after vaginal birth compared to the cesarean section (45.45% vs. 15.38%, p = 0.182) but no significant differences were found (p = 1.000). Almost 60% of patients were lost to postpartum follow-up. Further studies with a larger population of Polish patients are needed. Cervical cancer screening should be optimized and integrated into a national registry. Pregnant patients with abnormal screening results should be managed by experts, and strategies to enhance patient compliance must be implemented.
50. Analysis of events of the night from 1946 to 1947 in Zelczyna, Malopolskie.
期刊: Folia medica Cracoviensia 发表日期: 2025-Jul-31 链接: PubMed
摘要
Some of the events concerning various killings in Polish history to this day remain unclear. Even though there were some historical studies done about the shootings we describe, there still remained the forensic side to verify. By doing so we have uncovered facts that change our view of that night established previously by various documents and historical articles, which all described deaths of the victims as executions. The aim of the study is to verify any circumstances of deaths that occurred during the shootings nearby Zelczyna in 1946/47. 6 autopsy protocols and archival documents from 1947 were analyzed to compare with the official course of events with results of autopsies. Around midnight 31.12.1946/01.01.1947 a group of several armed men, later established to be anti-communist partisans, launched two attacks on local militia men (ORMO) in and around the village of Zelczyna, killing 6 people. Firearms used were not identified in the autopsy reports due to lack of cartridges in the bodies. Autopsy protocols show that the victims were shot in random places on the bodies, which indicates deaths in action, with the exception of one victim. Those reports also contained inaccuracies regarding names and number of the victims. Autopsy results do not confirm previous description of events, with only one of the victims showing signs which could suggest execution. All the other victims, judging by their wounds were most likely killed in action.
51. Unintentional Fall Deaths in Adults Age 65 and Older: United States, 2023.
期刊: NCHS data brief 发表日期: 2025-Jun 链接: PubMed
摘要
Adults age 65 and older have higher death rates from unintentional falls than other age groups, and falls are the leading cause of injury-related death in this population. National Vital Statistics System underlying cause-of-death mortality data for 2003-2023 were used in this study of unintentional fall deaths in adults age 65 and older, by sex, age group, and race and Hispanic origin. Unintentional fall deaths were identified using International Classification of Diseases, 10th Revision underlying cause-of-death codes W00-W19. Crude rates (deaths per 100,000 population) were calculated. Pairwise comparisons were conducted using the z test ( p < 0.05), and trends were assessed using the Joinpoint Regression Program (Version 5.0.2). The U.S. rate of unintentional fall deaths for adults age 65 and older was 69.9 per 100,000 population in 2023, with rates varying by state. In 2023, the unintentional fall death rate for adults age 65 and older was higher for men (74.2) compared with women (66.3). Rates for both men and women increased with increasing age. Among adults age 85 and older, White non-Hispanic adults had the highest rate of unintentional fall deaths, and Black non-Hispanic adults had the lowest rate. For both men and women, rates of unintentional fall deaths increased between 2003 and 2023 for adults ages 65-74, 75-84, and 85 and older.
52. Comparison between Legiolert and real time PCR in the detection of Legionella pneumophila from environmental water samples.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Legionellosis is a resvpiratory disease of public health concern. Identification and quantification from environmental sources are crucial for identifying outbreak origins and providing information for risk assessment and disease prevention. Legionella pneumophila is typically detected and quantified using the culture method, which is considered the gold standard, but it has some critical limitations. The Legioler/Quanti-Tray test can be used as an alternative method to simplify the testing process and reduce the time required to obtain the result. In this study, we compare the new liquid culture method Legiolert™ and real-time PCR with traditional plate culture, assessing the performance of PCR and culture methods for detecting L. pneumophila in potable water samples. We analyzed 75 environmental water samples in parallel using the Standard method (ISO 11731:1998), Legiolert, and real-time PCR for the detection of L. pneumophila. The McNemar test was used to assess the difference in accuracy between the Legiolert and real-time PCR methods, showing that the culture test was more accurate than the molecular biology method. The study confirmed that the Legiolert test is specific, easy to use, and may serve as an alternative to standardized procedures for the quantification of L. pneumophila in water. However, due to its high sensitivity and rapid result acquisition, we believe it could be used as a screening tool to quickly ascertain the absence of the microorganism.
53. Using country-level variables to discover country clusters beyond traditional health policy and performance metrics: An unsupervised machine learning approach for HIV healthcare delivery and financing.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
HIV remains a major public health challenge, with 1.4 million new infections and 31.6 million people accessing antiretroviral treatment in 2024. In many countries, HIV services have been provided through vertical programs, which, although highly successful in bringing treatment to people living with HIV since the early 2000s, are unlikely to sustain progress beyond donor dependency. The increasing push towards Universal Health Coverage (UHC), while facing reduction in international assistance, are prompting countries search for innovative strategies to effectively deliver HIV services through national systems, supported by domestic financing. Developing country-tailored HIV financing and service delivery approaches will be critical to reaching the end of AIDS as a public health threat and sustaining gains by and beyond 2030. Our study aims to develop an innovative data-driven approach to identify clusters of countries with similar challenges in defining their HIV response sustainability pathways. These clusters provide a framework for mutual learning, allowing countries to co-develop context-specific solutions to HIV financing and service delivery. We utilized unsupervised machine learning (ML) methods, including partitional, hierarchical, spectral, and density-based algorithms, to identify clusters of countries based on HIV epidemic and response data among 134 LMICs. We pooled open-source data from repositories covering indicators related to HIV epidemic and response, UHC commitment and progress, legislation surrounding human rights and HIV response, wealth and equity. We identified four country clusters, which did not align with conventional global regions but instead cut across them, revealing more nuanced groupings. Clusters were located in (1) South Asia, East Africa, and Oceania; (2) Sub-Saharan Africa and the Caribbean; (3) Eastern Europe, Middle East, Latin and Southern Africa; (4) Latin America, Asia, Middle East, North Africa, Oceania and the Caribbean. Our study is an early example of how ML techniques can be applied to health policy and (public) health performance.
54. Mixed-methods evaluation and behavior change interventions to improve hand hygiene resources and practices among healthcare workers in polyclinics and health centers in Belize, 2023.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Hand hygiene (HH) is an effective public health measure to prevent the spread of infections in healthcare settings. A previous study in Belize showed gaps in HH practices in hospitals and large polyclinics; however, there are limited national data assessing access to and use of HH resources in smaller outpatient primary care facilities, especially in rural areas. In February 2023, facility assessments were conducted at 26 health centers and polyclinics in Belize to assess the availability of HH resources. Of these, 12 pilot healthcare facilities (HCF) were selected for additional evaluation, which included observation of HH practices, hand dirtiness assessments, and in-depth interviews. Following the evaluation, a six-week (August - September 2023) hand hygiene champion intervention was implemented at the 12 pilot HCFs to promote HH practices. Follow-up assessments were conducted during September - November 2023 to evaluate the impact of the intervention. Descriptive statistics and adjusted odds ratios were calculated to assess HH resources, adherence, and dirtiness. Thematic analysis was conducted for the in-depth interviews. Most (87%) patient care rooms at the HCFs had either a handwashing station with soap and water or a functional alcohol-based hand rub dispenser. Following the intervention, there was a significant increase in hand hygiene adherence (HHA) among healthcare workers (aOR = 4.21; 95% CI = 2.70, 6.56). Overall, HHA was more common during invasive procedures (aOR = 1.82; 95% CI = 1.07, 3.09) and after patient contact (aOR = 1.68; 95% CI = 1.12, 2.52). The median hand dirtiness score increased from 8 to 9, indicating less visible debris. In-depth interviews found that healthcare workers viewed the intervention as a helpful reminder but encountered challenges such as having few staff, lack of time, and lack of resources during program implementation. The observed increase in HHA and positive feedback from healthcare workers suggests that a peer-led program may be an effective strategy to improve HHA in HCFs. Future programs may consider tailoring the intervention to the resource and adherence gaps observed at each facility to increase impact.
55. Exploring a One Health approach to sustainability with international One Health and Global Health Security experts - differences, similarities and trade-offs between sectors.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
Sustainability in global health remains inconsistently defined and operationalised across human, animal, and environmental health sectors. As the One Health approach gains global traction-particularly in addressing complex, ‘wicked’ health problems such as pandemics, antimicrobial resistance, and ecosystem degradation-there is a growing need for shared conceptualisations of sustainability to support cross-sectoral collaboration and ultimately, long-term impacts. This study explores how One Health and health security experts from diverse disciplines understand and construct the meaning and determinants of sustainability. We conducted a qualitative study underpinned by the Social Construction Framework (SCF) through semi-structured interviews with 29 global experts from human, animal, and environmental health domains. Participants were purposively sampled from key technical advisory bodies, including the One Health High-Level Expert Panel, the World Bank Pandemic Fund, and the Quadripartite. Data were collected via online interviews between July 2023 and March 2024, transcribed verbatim, and analysed thematically using an inductive approach. Participants offered multi-dimensional definitions of sustainability; they distinguished between process-oriented (e.g., institutional longevity, financing, local ownership) and outcome-oriented (e.g., ecological regeneration, intergenerational well-being) views. Human health experts emphasised health system continuity, while animal health participants highlighted economic and disease control outcomes. Environmental experts framed sustainability around planetary resilience and equity. Cross-sectoral convergence was found on key determinants: political commitment, stable financing, workforce capacity, community ownership, and adaptability. Our findings underscore that sustainability in One Health is a socially constructed and sectorally influenced concept. Differences in framing, deservingness, and measurement priorities reflect different sectoral mandates, but also reveal potential trade-offs and synergies. To operationalise One Health effectively, an integrated sustainability framework is needed - one that aligns sectoral priorities, recognises diverse metrics, and fosters long-term, adaptive collaboration. This study provides an empirical basis for shaping such a framework, rooted in the lived experiences and perspectives of global experts.
56. Spatial analysis of fast-food accessibility and obesity among adults in Malaysia nationwide.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
With the rising prevalence of obesity in Malaysia, addressing the obesogenic environment is increasingly urgent. While fast-food environments were linked to obesity and poorer diet quality in Western populations, evidence on this association in Malaysia remains limited. This study evaluated the association between accessibility to fast-food restaurants (FFR) and Body Mass Index (BMI) among adults aged 18-59 years from the National Health and Morbidity Survey (NHMS) 2015. After exclusions due to data requirements, 14,584 respondents from the initial 19,935 were included. FFR locations were obtained from websites of major franchises. Fast-food (FF) proximity was distance to the nearest FFR from each respondent’s residence. FF spatial access was the sum of inverted distances to all FFR within an 8 km Euclidean distance and subsequently categorized into none, low, moderate, and high. Multilevel linear regression adjusted the associations of BMI for socio-demographics, district population density, and district median income. Among the respondents studied (51.5% female), mean BMI was 26 kg/m2 and median FF proximity was 2.6 km, where 77.3% had spatial access to at least one FF restaurant within 8 km from their residence. The overall association between FF proximity and BMI was not significant but modified by sex (p-heterogeneity <0.001). An exponential decrease in FF proximity was associated with 0.7 kg/m2 (p < 0.001) increase in BMI among males and 0.4 kg/m2 (p < 0.05) decrease among females. Compared to those with no FF access, males with Low, Moderate, and High FF access had higher BMI (0.6, 0.6, and 1.0 kg/m2, p-trend = 0.001), while females had lower BMI (-0.3, -0.6, and -0.9 kg/m2, p-trend < 0.001). The findings suggest that environmental exposures do not affect all population groups equally. Therefore, public health strategies and future research on obesogenic environments should consider the influence of social, cultural, and the broader environmental factors.
57. Modifiable risk factors for inflammatory bowel disease in Kuwait: A cross-sectional analysis.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Inflammatory bowel disease (IBD), a lifelong inflammatory condition of the gastrointestinal tract, is influenced by complex interactions between genetics and environmental exposures. While IBD rates have increased globally, largely due to Westernized lifestyle shifts, the contributors to IBD in Kuwait remain poorly understood. This cross-sectional study aimed to explore lifestyle, dietary, and occupational exposures associated with IBD in this unique population. A total of 520 adults (412 with IBD and 108 without IBD) completed a 40-item online questionnaire assessing early-life, lifestyle, occupational, and dietary exposures. Of the IBD participants, 174 had ulcerative colitis (UC) and 238 had Crohn’s disease (CD). The questionnaire was adapted from a previously validated tool, but was not formally validated in the Kuwaiti population. Associations between these factors and IBD status were analyzed using multivariable logistic regression with adjusted odds ratios (AORs) and 95% confidence intervals (CIs) reported after adjusting for potential confounders. Factors associated with increased odds of IBD included male sex (AOR = 2.487, p = 0.005), younger age (AOR = 0.964, p = 0.004), positive family history (AOR = 2.141, p = 0.023), mentally demanding jobs (AOR = 1.818, p = 0.039), alcohol consumption (AOR = 6.508, p = 0.016), frequent spicy food intake 1-2 times/week (AOR = 2.631, p = 0.008), and prior parasitic infection (AOR = 0.484, p = 0.042). A history of appendectomy was also associated (AOR = 7.158, p = 0.003). Several modifiable exposures were found to be associated with IBD status in Kuwait. These findings underscore the multifactorial nature of IBD. However, the cross-sectional design, reliance on self-reporting, and use of a non-validated instrument limit causal interpretation. Future longitudinal research is needed to better understand temporal relationships.
58. Occupational pesticide exposure and safety assessment among farmers in Hohoe municipality: An ethnographic qualitative study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Occupational pesticide exposure poses significant health risks, particularly among smallholder farmers in developing countries like Ghana, where such exposures are common due to widespread subsistence agricultural activities. The Environmental Protection Agency (EPA) of Ghana is responsible for registering and monitoring pesticide use and regulating the presence of unregistered or banned products on the local market; however, this regulation is ineffective. Farmers frequently acquire pesticides directly from vendors who may not possess sufficient training, and the lack of stringent measures facilitates the accessibility of hazardous products. Furthermore, while regulations mandate safe handling and disposal practices, there are also possible oversights at the community level, leaving farmers largely dependent on their own knowledge, practices, or what they have learnt from other colleagues. This study explores the safety practices, perceived exposure levels, and awareness among rural farmers in the Hohoe municipality of Ghana. A qualitative ethnographic approach was adopted, involving in-depth interviews with 13 purposively selected farmers with over five years of farming experience. Data was collected using semi-structured interviews guide informed by prior literature. Thematic analysis was conducted using ATLAS.ti version 25, with open and selective coding techniques. Four major themes emerged: knowledge and practices of pesticide use, health risks and exposure, safety practices, pesticide storage and disposal. Most farmers (approximately 10 out of 13) reported using Glyphosate as their primary herbicide, followed by Paraquat Dichloride and 2,4-D, relying on vendor recommendations for application methods. Common health complaints included eye and skin irritation, waist pain, and temporary vision loss. While some farmers used PPE like boots and gloves, many lacked complete protective gear, especially eye protection. Pesticide containers were often stored at home or discarded on farms or by burning, indicating poor disposal practices. Awareness of pesticide expiry dates and proper dosage was inconsistent. The study reveals substantial gaps in pesticide safety knowledge and practices among rural farmers, posing significant public health risks. Targeted interventions, including regular training on safe pesticide handling, PPE use, and environmentally sound disposal methods, are critical to reducing occupational exposure and its associated health burdens.