公共卫生研究摘要 (2025-12-04)

2025年12月04日

公共卫生研究摘要 (2025-12-04)

共收录 54 篇研究文章

1. Kidney Function, Alzheimer Disease Blood Biomarkers, and Dementia Risk in Community-Dwelling Older Adults.

期刊: Neurology 发表日期: 2026-Jan-13 链接: PubMed

摘要

Impaired kidney function has been linked to altered concentrations of blood biomarkers of Alzheimer disease (AD), but the underlying mechanisms and its potential role in dementia development remain poorly understood. We explored the associations between estimated glomerular filtration rate (eGFR), blood-based biomarkers of AD, and dementia development. Data were extracted from the Swedish National Study on Aging and Care in Kungsholmen, an ongoing longitudinal population-based study. Kidney function was assessed using eGFR based on serum creatinine. AD biomarkers (amyloid beta [Aβ42/40], phosphorylated tau [p-tau181 and p-tau217] and total tau [t-tau] proteins, neurofilament light chain [NfL], and glial fibrillary acidic protein [GFAP]) were measured from peripheral blood samples using the Simoa platform. Dementia was diagnosed according to DSM-IV criteria. Quantile regression models assessed the cross-sectional associations between eGFR and AD biomarkers; Cox regression models were used to examine the association of kidney function and biomarkers with incident dementia. At baseline, 2,279 dementia-free participants with available blood samples were included (median age 72 (interquartile range, 61-81) years; 62% female). Lower eGFR was associated with higher median z-score levels of all examined AD blood biomarkers, except Aβ42/40, following a nonlinear relationship. At eGFR = 30 mL/min/1.73 m2, estimated differences were as follows: p-tau181: β, 0.22 [95% CI 0.09-0.35]; p-tau217: β, 0.20 [95% CI 0.10-0.31]; t-tau: β, 0.24 [95% CI 0.05-0.42]; NfL: β, 0.88 [95% CI 0.80-0.95]; GFAP: β, 0.10 [95% CI 0.03-0.16]. During a mean follow-up period of 8.3 (SD, 4.3) years, 362 participants developed dementia. In multivariable-adjusted models, impaired kidney function (eGFR < 60 mL/min/1.73 m2) was not associated with an increased hazard of dementia compared with preserved kidney function (eGFR ≥ 60 mL/min/1.73 m2) (hazard ratio [HR], 0.93 [95% CI 0.72-1.21]). The relationship between increased (high vs low) NfL and dementia was stronger among individuals with impaired (vs preserved) kidney function (HR, 3.85 [95% CI 1.87-7.95] vs HR, 1.84 [95% CI 1.34-2.53], respectively). Impaired kidney function was associated with elevated circulating level of most AD blood biomarkers. However, the presence of impaired kidney function did not independently increase the risk of dementia but rather seemed to accelerate the clinical expression of underlying neurodegenerative pathology.

2. Prevention strategies for organophosphate and pyrethroid pesticide poisoning: case studies of flucythrinate and dichlorvos.

期刊: Reviews on environmental health 发表日期: 2025-Dec-05 链接: PubMed

摘要

Organophosphate pesticides (e.g. dichlorvos) and pyrethroids (e.g. flucythrinate) are widely used in agriculture, yet their toxicity poses significant threats to human health. This study analyses risk factors for poisoning incidents involving these compounds and proposes targeted prevention strategies. Key risk factors encompass exposure pathways, high-risk populations, and socioeconomic determinants. Mitigation requires multi-level interventions, including technological innovation, public education, and personal protection. Case comparisons reveal commonalities and distinctions between flucythrinate and dichlorvos poisoning, underscoring the need for integrated prevention frameworks. The study concludes by identifying limitations in current measures and proposing future research directions and policy recommendations to advance sustainable agriculture and safeguard public health.

3. VAPB is a negative regulator of STING-mediated innate immune signaling.

期刊: Science advances 发表日期: 2025-Dec-05 链接: PubMed

摘要

Stimulator of IFN genes (STING) is an endoplasmic reticulum (ER) signaling receptor involved in the type I interferon response to pathogen- or self-derived cytosolic double-stranded DNA. Excessive activation of STING is associated with many diseases, but the regulatory mechanism of STING activation remains to be further elucidated. Here, we identify VAPB as a negative regulator of STING-mediated innate immune response. VAPB deficiency increases the expression of type I interferons under resting conditions or upon stimulation. Mechanistically, VAPB associates and translocates with STING, thereby regulating STING translocation, oligomerization, and recruitment of TBK1. In vivo, deficiency of VAPB enhances the expression of type I interferons and prevents lethality following HSV-1 infection. Furthermore, VAPB P56S, a pathogenic mutation causing amyotrophic lateral sclerosis (ALS), can promote STING-mediated innate immune response under resting conditions, which might contribute to further understanding of the relationship between cGAS-STING pathway and ALS. Our study identifies VAPB as a critical regulating factor in cGAS-STING-mediated innate immune responses.

4. An ultrasmall theranostic nanozyme for abdominal aortic aneurysm management and therapeutic efficacy monitoring.

期刊: Science advances 发表日期: 2025-Dec-05 链接: PubMed

摘要

Abdominal aortic aneurysm (AAA) is a life-threatening condition lacking effective drug interventions, and its progression is difficult to predict, complicating early clinical management. Here, we present a reactive oxygen species-responsive theranostic nanozyme for AAA early intervention and efficacy monitoring, establishing a feedback loop between treatment and diagnostics. OZn, designed by encapsulating ultrasmall Prussian blue (SPBZn) within oxidation-sensitive dextran, targets aneurysm sites, where it responds to inflammatory microenvironments by releasing SPBZn. In vivo, SPBZn not only mitigated CaCl2-induced aneurysm expansion and AAA progression in rat models but also enabled noninvasive diagnostic monitoring via urinalysis due to its enzymatic activities and renal metabolism. This theranostic nanozyme dynamically regulated therapeutic efficacy and provided feedback on disease progression. By preventing vascular rupture through early intervention and enabling precise drug administration, this work highlights a transformative strategy for integrating diagnostics and therapy to improve AAA management and clinical outcomes.

5. Improving Palliative Care Knowledge and Intentions Among Great Plains American Indians: Efficacy Results From a Randomized Clinical Trial Testing a Culture-Centric Palliative Care Message.

期刊: The American journal of hospice & palliative care 发表日期: 2025-Dec-03 链接: PubMed

摘要

BackgroundPalliative care (PC) has the potential to alleviate symptom burden and enhance quality of life, yet use of PC among American Indians lags significantly behind whites.MethodsThis randomized clinical trial employed a randomized, complete block, posttest-only control group design to evaluate the efficacy of a culture-centric narrative video message to increase knowledge of and communication about PC among AI adults residing in three Great Plains Reservations compared to a general PC message or no message. Measures included participants’ knowledge of and intentions to discuss PC using a posttest survey.ResultsN = 320 individuals completed the survey. Both the culture-centric and general messages demonstrated statistically significant results for increasing participants’ PC knowledge compared to the no message group. The culture-centric message participants had greater odds of feeling the emotions and agreeing with the characters compared to the general message; however, there were no differences noted in intentions to discuss PC.ConclusionsThis study demonstrates the importance of messaging to improve PC knowledge and reduce misperceptions among populations with a history of mistrust of healthcare institutions. Embedding the culture’s values and ways of understanding serious illness care can serve to break down barriers in PC acceptance and provide opportunities for improving quality of life for AIs with serious illness.

6. The Mechanism of Online Health Information Seeking Switching to Online Medical Consultation: Cross-Sectional Study.

期刊: JMIR formative research 发表日期: 2025-Dec-03 链接: PubMed

摘要

Internet health care plays a crucial role in addressing the challenge of distributing high-quality medical resources and promoting the optimal allocation of these resources and health equity in China. Online medical consultation (OMC) plays a more significant role than online health information seeking (OHIS). Currently, the proportion of Chinese patients using OMC is low. Therefore, it is essential to enhance patient engagement with OMC and fully leverage the role of internet health care in optimizing the allocation of medical resources. This study aims to explore the correlation mechanisms of online medical community users’ switching behaviors from OHIS to OMC. This study is based on the knowledge-attitude-practice theory, which combines the social support theory and the health belief model to construct a research model of users’ willingness to transition from OHIS to OMC. The study adopts a questionnaire survey and structural equation modeling method to conduct an empirical study. Gaining knowledge about information support has a significant positive impact on perceived susceptibility (β=.339, P<.001), perceived severity (β=.348, P<.001), and perceived benefits (β=.361, P<.001), while having a significant negative impact on perceived barriers (β=-.285, P<.001). Gaining knowledge about emotional support positively affects perceived susceptibility (β=.220, P<.001) and perceived benefits (β=.149, P<.01) but does not significantly influence perceived severity (β=-.006, P>.05) or perceived barriers (β=.099, P>.05). Perceived susceptibility (β=.123, P<.05), perceived severity (β=.174, P<.001), and perceived benefits (β=.273, P<.001) positively influence patients’ transition to online consultation behavior, whereas perceived barriers (β=-.112, P<.05) negatively impact this switch. In addition, we found that gaining knowledge about information support not only directly affects patients’ behavior in switching to online consultations but also impacts patients’ OMCs through perceived susceptibility (14.23%), perceived severity (13.17%), and perceived benefits (25.28%). In contrast, gaining knowledge about emotional support does not directly influence patient behavior transfer; it operates only through perceived susceptibility (46.95%) and perceived benefit (52.90%). This study integrated the knowledge-attitude-practice framework, social support theory, and health belief model to uncover the internal logic of patients’ behavioral transfers within online health communities. It confirmed the mediating role of the cognitive-emotional dual-drive pathway and health beliefs. The findings provide a scientific basis for the functional design of online health care platforms and for precise health knowledge dissemination strategies.

7. Digital Information Sharing Before Consultations in General Practice: Protocol for a Scoping Review.

期刊: JMIR research protocols 发表日期: 2025-Dec-03 链接: PubMed

摘要

Digital tools that enable patients to submit information before consultations, such as Accurx and eConsult, are increasingly used in general practice. These systems aim to streamline workflows, improve documentation, and optimize consultation efficiency. However, evidence about their implementation, impact on health inequalities, and health care outcomes remains limited and fragmented. This study aims to map and synthesize the evidence on digital tools used for preconsultation information sharing in family or general practice. This scoping review will follow the Joanna Briggs Institute framework and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Searches were conducted on May 12, 2025, in MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), and the Cochrane Library. Gray literature will be identified via Google Scholar and the National Health Service or government websites. Eligible studies will describe or evaluate digital tools used to collect information from patients before general practice consultations. Two independent reviewers will conduct screening and data extraction. Data will be analyzed using narrative synthesis. Database searches identified 6991 records, with 4536 (64.88%) remaining after deduplication. Screening began in June 2025. Full-text screening was completed in November 2025, with data extraction and synthesis planned for completion by February 2026. Results will be submitted for publication in early 2026. This review will summarize evidence concerning the use of digital tools for preconsultation information sharing in general practice. Findings will inform implementation, research priorities, and service improvement in digitally supported care. DERR1-10.2196/82649.

8. Improving Access to HIV Prevention Services in Community Pharmacies in the US Southeast: Protocol for a Hybrid Type 1 Effectiveness-Implementation Study.

期刊: JMIR research protocols 发表日期: 2025-Dec-03 链接: PubMed

摘要

Despite advancements in HIV prevention, many Americans, particularly those from historically underserved communities (eg, racially and sexually minoritized individuals and people who use drugs), continue to face significant barriers to accessing crucial HIV prevention services such as HIV testing and pre-exposure prophylaxis. Integrating these services into community pharmacies is a viable yet underused solution to overcoming access-related challenges. However, few studies have used an implementation science approach to assess the implementation and effectiveness of such services in pharmacy settings. The Pharmacy-Based Access to HIV Prevention Services study aims to develop and evaluate a sustainable pharmacy-based model for increasing access to HIV testing and prevention services (eg, pre-exposure prophylaxis dispensing) in community pharmacy settings. We are using a hybrid type 1 effectiveness-implementation study design to evaluate the implementation and effectiveness of HIV testing and prevention services within community pharmacies, particularly among those that offer non-HIV-related screenings (eg, COVID-19, blood pressure, and cholesterol screening) and those that do not. We apply 3 well-established implementation science frameworks-the Exploration, Preparation, Implementation, Sustainment framework, the Consolidated Framework for Implementation Research, and the Systems Engineering Initiative for Patient Safety-to assess multilevel factors influencing the adoption of HIV prevention services in community pharmacy settings. This study consists of three phases: (1) a mixed methods exploration phase to identify barriers and facilitators of implementing HIV prevention services in community pharmacies, (2) a preparation phase to assess the effectiveness of two HIV training programs designed for pharmacy staff, and (3) an implementation and sustainment phase to evaluate the effectiveness and implementation of HIV prevention services in these settings. The Pharmacy-Based Access to HIV Prevention Services study was funded in June 2023 by the National Institute of Mental Health (R01MH123470) and launched in September 2023. Recruitment and enrollment for the first phase, including data collection, are currently underway. We have exceeded our Phase 1 pharmacy staff survey target, with 310 participant surveys completed (goal: 300). Completion is anticipated by early 2026. Expanding access to HIV prevention services through community pharmacies is a promising and accessible approach to addressing social and health inequities in HIV, supporting the goal of Ending the HIV Epidemic in the United States. Implementation science, with its systematic frameworks, is essential to advancing this goal. Our study is among the first to use an implementation science approach to integrate HIV prevention services within community pharmacies in high-prevalence HIV areas. DERR1-10.2196/72283.

9. Establishing a Pharmacy-Based Pre-Exposure Prophylaxis Program for Young Women Who Sell Sex: Protocol for a Randomized Controlled Trial.

期刊: JMIR research protocols 发表日期: 2025-Dec-03 链接: PubMed

摘要

Sex workers (SWs) are at risk of acquiring HIV infections. Despite this, SWs have low uptake of relevant preventive measures, such as HIV pre-exposure prophylaxis (PrEP). Community-based programs that make PrEP convenient and accessible have the potential to drive PrEP continuation and reduce HIV risk. This study aims to describe the co-development and piloting of the Together Optimizing PrEP Access in Zimbabwe (TOPAZ) intervention-where SWs have the opportunity to access PrEP refills through pharmacies in Zimbabwe. Using a participatory process, the TOPAZ intervention will be collaboratively developed with pharmacy owners and SWs. TOPAZ comprises the provision of safe and convenient spaces for PrEP refill pickups bundled with a gift voucher incentive at pharmacies. Formative research comprising focus group discussions and in-depth interviews with SWs, pharmacists, and stakeholders will inform the development of the preliminary model (aim 1). A cluster-randomized pilot trial will evaluate the impact of the PrEP-in-pharmacy intervention, compared to standard clinic-based pickup in the key populations program, on PrEP retention at 3, 6, 9, and 12 months after initiation (aim 2). The outcome of the pilot trial will be a comparison of PrEP retention at 6 months after initiation between study arms. We will also compare PrEP retention among SWs aged between 18 and 24 years at 6 months and among participants remaining active in sex work at 6 months. We will use the Generalized Estimation Equations model to generate risk differences and 95% CIs for PrEP retention in intervention versus comparison arms. Analysis will follow an intent-to-treat approach. Finally, a mixed methods study will be conducted to understand the potential for scaling TOPAZ for SWs; insights from this study will inform the design of a future effectiveness trial (aim 3). Proctor’s implementation outcomes, namely, acceptability, adoption, appropriateness, feasibility, fidelity, and penetration of the pharmacy-based PrEP refill program, will be evaluated by triangulation of program data and qualitative interviews. This study began the enrollment of participants in March 2024. Data collection ended in May 2025. The final comprehensive analysis of the results will be conducted in February 2026 after all the data have been collected and reviewed comprehensively. This study will report on the feasibility, acceptability, and effectiveness of pharmacy-based PrEP refills to improve PrEP continuation among women who sell sex. If successful, this preliminary study will pave the way for a future effectiveness trial to evaluate this intervention more comprehensively. ClinicalTrials.gov NCT06348069; https://clinicaltrials.gov/study/NCT06348069. DERR1-10.2196/74141.

10. A Threat to Evidence-Based Vaccine Policy and Public Health Security at the FDA.

期刊: The New England journal of medicine 发表日期: 2025-Dec-03 链接: PubMed

摘要

11. Evidence to Action - Single-Dose HPV Vaccination and Cervical HPV Infection.

期刊: The New England journal of medicine 发表日期: 2025-Dec-03 链接: PubMed

摘要

12. Noninferiority of One HPV Vaccine Dose to Two Doses.

期刊: The New England journal of medicine 发表日期: 2025-Dec-03 链接: PubMed

摘要

Multidose human papillomavirus (HPV) vaccination is efficacious, yet the vaccine has been underused globally. Emerging data suggest that a single dose may provide protection. Whether a single dose of HPV vaccine would provide similar protection to two doses is uncertain. In this trial, we assessed whether one dose of an HPV vaccine was noninferior to two doses. Girls 12 to 16 years of age were randomly assigned, in a 1:1:1:1 ratio, to receive one or two doses of a bivalent HPV vaccine or one or two doses of a nonavalent HPV vaccine. The primary end point was new HPV type 16 or 18 infection occurring from month 12 to month 60 and persisting for at least 6 months. The prespecified noninferiority margin was 1.25 infections per 100 participants. We also assessed vaccine effectiveness by comparing HPV16 or HPV18 infection among the trial participants with that among girls and women enrolled in a nonrandomized survey. A total of 20,330 participants were enrolled and underwent randomization, and 3005 unvaccinated participants were enrolled in the survey. The noninferiority analysis showed that one vaccine dose was noninferior to two doses in preventing HPV16 or HPV18 infection. The rate difference between one and two doses of the bivalent vaccine was -0.13 infections per 100 participants (95% confidence interval [CI], -0.45 to 0.15; P<0.001 for noninferiority), and the difference between one and two doses of the nonavalent vaccine was 0.21 infections per 100 participants (95% CI, -0.09 to 0.51; P<0.001 for noninferiority). The vaccine effectiveness was at least 97% in each of the four trial groups. No safety concerns were identified. One dose of either a bivalent or nonavalent HPV vaccine provided protection against HPV16 or HPV18 infection and was not inferior to two doses. (Funded by the National Cancer Institute and others; ESCUDDO ClinicalTrials.gov number, NCT03180034.).

13. Digital Exhaust or Digital Gold? The Value of AI-Generated Clinical Visit Transcripts.

期刊: The New England journal of medicine 发表日期: 2025-Dec-03 链接: PubMed

摘要

14. Particulate Matter Exposure and Progression Trajectories of Cardiovascular Disease, Mood Disorders, Comorbidity, and Mortality: Associations and Underlying Metabolic Mechanisms.

期刊: Environmental science & technology 发表日期: 2025-Dec-03 链接: PubMed

摘要

The role of particulate matter (PM) in the bidirectional relationship between cardiovascular disease (CVD) and mood disorders remains unclear. This UK Biobank-based study included participants without prior CVD or mood disorders at baseline with complete data. Outcomes included CVD and mood disorder incidences, comorbidity, and mortality. During a median 13.8-year follow-up, among 358,119 participants, 145,406 developed CVD, 27,318 mood disorders, 15,443 comorbidity, and 26,703 deaths. Multistate analysis showed PM2.5 exposure significantly increased risks of progression in both trajectories. For trajectory 1, each IQR increase in PM2.5 was associated with HRs (95% CI) of 1.219 (1.216-1.222), 1.080 (1.070-1.091), and 1.033 (1.013-1.053) for progression from baseline to CVD, CVD to comorbidity, and comorbidity to death, respectively. For trajectory 2, each IQR increase in PM2.5 was associated with HRs (95% CI) of 1.227 (1.218-1.237), 1.024 (1.009-1.040), and 1.033 (1.013-1.053) for progression from baseline to mood disorders, mood disorders to comorbidity, and comorbidity to death, respectively. Similarly, PM10 exposure showed weaker positive associations than PM2.5. Lipoproteins and fatty acid metabolites primarily mediated disease progression in these trajectories. Our results demonstrated PM exposure contributes to progression from CVD and mood disorders to comorbidity and mortality, with different mediating metabolites identified at each stage of progression. These results highlight both the importance of PM control and the potential of metabolic pathways as targets for early intervention.

15. Racial Self-Efficacy and Ethnic Identity in the Context of Neighborhood Violence and Internalizing Symptoms Among Black and Latinx youth: An Application of the Minority Stress Theory.

期刊: Community health equity research & policy 发表日期: 2025-Dec-03 链接: PubMed

摘要

BackgroundBlack and Latinx youth are disproportionately exposed to neighborhood violence and related mental health challenges. Racial-ethnic identity shapes how adolescents perceive, interpret, and cope with stressful environmental conditions, yet its role in these associations remains underexplored.MethodsUsing cross-sectional data from 621 Black and Latinx adolescents (mean age = 15.5 years), we applied structural equation modeling to examine associations of perceived neighborhood violence, racial self-efficacy, ethnic identity exploration, and internalizing symptoms of anxiety.ResultsGreater exposure to neighborhood violence was associated with lower racial self-efficacy (β = -0.22, p < .001), which was in turn associated with reduced internalizing symptoms (β = -0.14, p < .001). Ethnic identity exploration was negatively associated with racial self-efficacy (β = -0.10, p < .05) and was not significantly associated with internalizing symptoms (β = -0.04, p > .05).ConclusionsThese findings highlight potential psychosocial processes associated with neighborhood violence and suggest that racial self-efficacy may play a meaningful role in the mental health experiences of minoritized youth.

16. Leveraging Medicaid Claims to Map Complex Chronic Conditions for Emergency Preparedness.

期刊: Journal of public health management and practice : JPHMP 发表日期: 2025-Dec-03 链接: PubMed

摘要

Populations with complex chronic conditions (CCCs), especially those reliant on medical technology, face disproportionate risks during disasters. Medicaid enrollees make up a large portion of these vulnerable populations, yet states often lack rapid identification systems to inform disaster planning. Florida Medicaid developed a claims-based method to identify enrollees with CCCs, including those dependent on medical technology, to support emergency preparedness and response activities. Using the Florida Medicaid Management Information System, the team applied a validated diagnostic and procedural code framework to classify enrollees into 12 CCC categories. Data were analyzed by age, geography, and technology dependence. Health plans received real-time reports before and after hurricanes in 2022 to 2024. Among 4.4 million enrollees, 7.2% had CCCs, and 18.2% of those were technology dependent. Geographic mapping showed higher concentrations in rural and coastal areas prone to disasters. Health plans reported using the data to contact members and coordinate services during hurricane recovery. This effort demonstrates the feasibility and utility of applying claims data to support disaster management. Other states may adapt this approach to improve emergency response and continuity of care for Medicaid’s most medically vulnerable populations.

17. The Yin-yang of HCC management: Reconciling therapeutic hierarchy and transplant benefit in Real-World evidence.

期刊: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society 发表日期: 2025-Dec-03 链接: PubMed

摘要

18. Horizon Scan of Emerging Issues at the Intersection of National Security, Artificial Intelligence, and Human Performance Enhancement.

期刊: Science and engineering ethics 发表日期: 2025-Dec-03 链接: PubMed

摘要

19. Self-Reported Triggers Evaluation of High-Risk Dietary and Environmental Factors Preceding Migraine Onset by Using a Mobile Tracking App (Migraine Insight): Comparative Analysis Study.

期刊: JMIR formative research 发表日期: 2025-Dec-03 链接: PubMed

摘要

Migraines are a significant health concern affecting millions of individuals, often requiring habitual tracking of potential triggers to mitigate or predict episodes. Digital health tools such as mobile apps offer a scalable solution for personalized tracking and pattern recognition. Migraine Insight is one such app that facilitates daily logging to quantitatively assess individualized patterns of events preceding migraine onset. However, while various triggers have been reported in migraine literature, there is limited large-scale electronic user-driven data on the frequency and relative impact of specific triggers. This study aims to address this gap by analyzing user-reported data from Migraine Insight to identify the most frequently reported triggers and evaluate their potential associations with migraine onset. Food-associated migraine triggers were identified by performing a noninterventional, retrospective analysis of self-reported data obtained via the Migraine Insight app. A collaboration was made with the representatives of the Migraine Insight app to extrapolate the data needed for the study. A preliminary keyword list was assessed from a raw data set of 2605 data entry values, extracted from a 30-day period of September 19 to October 18, 2021, to identify high ranking self-reported events, classified by dietary habits, environmental conditions, body physiology, and medications. The variables examined included the following: dietary items, environmental conditions, body physiology, and electronics. Food items were combined into similar groups, considering variable spelling and descriptions of self-reported events. The association of migraine onset after consumption of top 5 dietary products was evaluated to establish the frequency of migraine episodes for all users who reported the items. Collectively, food (n=353) and beverage (n=252) totaled the highest reported entries, with chocolate, wine, tea, coffee, and cheese as the highest ranked foods for prevalence of reporting across all users and for frequency of migraine onset for users who consumed the items within 48 hours. The 4 highest nonfood entries were altered sleep patterns (n=245), stress or anxiety (n=199), rain or storm conditions (n=192), and bright light or brightness (n=191). Statistical analysis showed that chocolate was the only food trigger significantly associated with migraines (P=.003 vs 50%; P=.04 vs average). Consumption of tea approached significance (P=.051), while consumption of coffee, cheese, and wine were not significant. These findings suggest that chocolate is the most consistent dietary trigger. High-risk foods, environmental conditions, stress, and lighting with highest prevalence reporting have previously been reported in medical literature, implicating that a migraine tracking app is a valid alternative to paper-based diaries.

20. Comparing the outcomes of a prosthetic intervention from the perspective of Australian prosthesis users and funders.

期刊: Disability and rehabilitation 发表日期: 2025-Dec-03 链接: PubMed

摘要

Little is known about the perspectives of prosthesis users and funders regarding the outcomes that are most important when receiving/funding a lower-limb prosthetic intervention. In this cross-sectional study, 99 prosthesis users and nine funders rated the importance of 121 International Classification of Functioning, Disability, and Health framework (ICF) second-level categories. Of the 121 ICF second-level categories: seven were important to both prosthesis users and funders, 23 were important to either prosthesis user or funders, and 91 were not important to both prosthesis users and funders. Of the second-level categories important to both prosthesis users and funders, 57% came from the Mobility (d4) chapter. Prosthesis users and funders had different perspectives about the Major life areas (d8) chapter; in particular, second-level categories relating to education and employment. While prosthesis users and funders shared very similar perspectives about what was most important when receiving/funding a prosthetic intervention, there are opportunities to reconcile perspectives where they differ. Understanding the different perspectives will require further research given the myriad of potential explanations. Prosthesis users and funders shared very similar perspectives about what was most important when receiving/funding a prosthetic intervention.Practitioners should engage prosthesis users in meaningful conversations to determine what is most important to them when receiving a prosthetic intervention.In applications for funding, practitioners can convey what is most important to a prosthesis users to help ensure funders have a shared understanding.The Prosthetic Interventions Core Outcome Set (PI-COS) provides a helpful starting point for the selection of outcomes given the high degree of agreement between prosthesis users and funders about what is most important when receiving/funding a prosthetic intervention.

21. Performance of cabin air filters used in waste collection trucks.

期刊: Journal of the Air & Waste Management Association (1995) 发表日期: 2025-Dec-03 链接: PubMed

摘要

Exposures to traffic-related emissions are known to be responsible for diseases and increased mortality. Waste collection truck (WCT) drivers spend most of their time in microenvironments contaminated by these emissions and are also exposed to some pathogenic bioaerosols. To prevent WCT driver exposure, the cabin air filter (CAF) appears as one of the most useful equipment. No standard prescribing CAF efficiency levels for general or professional use was developed. Existing test procedures overlook particles smaller than 300 nm, such as diesel soot or certain bioaerosols, and no previous study has specifically addressed WCT cabin air filters or their clogging under real waste collection conditions. The aim of this work was to evaluate, for a range of particle sizes including ultrafine particles (UFP), the collection efficiency and pressure drop of the CAF media used in WCTs, and to study their evolution after clogging under real waste collection conditions. All the tested CAF models exhibited the typical U-shape curve of fractional collection efficiency with low to medium minimum collection efficiency ranging between 1.3% and 42.5%, depending on the filtration velocity. Statistical analysis indicated that CAF media are relatively homogenous across their filtration area and that variations in efficiency and pressure drop were mainly due to differences in clogging levels or initial state conditions. Compared to data available for private vehicles, CAF clogging appears to be more severe under waste collection conditions. Given the diversity of particulate contaminants, the low to moderate performances of current CAFs, and the exposure of WCT drivers, this study highlights the need for improved and more reliable protection. It is therefore essential to develop specific regulations or standards for CAFs, including systematic measurements of fractional collection efficiency over a broad particle size range, from UFP to micron-sized particles. The issue of preventive CAF replacement should also be addressed.Implications: Waste collection truck (WCT) drivers spend most of their time in micro-environments contaminated by traffic-related emissions and work-related bioaerosols. No previous study has assessed the performance of cabin air filters (CAF) on WCTs as a function of particle size, and their evolution in the event of clogging under real waste collection conditions. This research highlights the fact that WCT cabin air filters exhibit highly variable, and only low to medium, minimum collection efficiencies. Waste collection conditions also accelerated the filter clogging compared with literature data on nonprofessional use of CAFs. Given the size of the particles to which WCT drivers are exposed and their adverse health effects, this study demonstrates the need for more effective and reliable protection. This implies the development of specific regulations and standards for CAF performance and testing, including systematic measurements of fractional collection efficiency over a wide range of particle sizes, from ultrafine to micron-sized particles. These regulations should also explore the definition of more precise and adapted guidelines for CAF replacements to prevent the decrease in air exchange rate and the release in the cabin of deposited particles or of fraction of microbial colonies. Finally, all professional drivers, not just WCT workers, could benefit from such specific regulations.

22. A comprehensive analysis of jurisdiction-specific laws related to scheduling or required prescription drug monitoring of gabapentin in the United States, 2016-2024.

期刊: The International journal on drug policy 发表日期: 2025-Dec-02 链接: PubMed

摘要

Gabapentin prescription use has increased across the United States since the late 2000s. Concerns of potential misuse and growing overdose involvement have led to the passage of jurisdiction-specific policies targeting gabapentin prescribing; however, the current legal landscape of these policies is not well documented or understood. We conducted a comprehensive, longitudinal analysis of policies related to scheduling or required prescription drug monitoring of gabapentin across 51 jurisdictions in the United States from January 2016 through December 2024. Across the study period, 25 jurisdictions (49 %) enacted policies related to gabapentin scheduling or required prescription reporting. Eight (16 %) jurisdictions classified gabapentin as a schedule V controlled substance and mandated reporting of gabapentin prescriptions in the jurisdiction’s prescription drug monitoring program (PDMP) and 17 (33 %) jurisdictions required the reporting of gabapentin prescriptions to the jurisdiction’s PDMP but did not classify gabapentin as a schedule V controlled substance. Both scheduling and mandated reporting policies were largely concentrated between 2016 and 2019. Though policy changes were observed across the entirety of the continental United States, the majority of jurisdictions with policies were concentrated in the Appalachian and Eastern Midwest regions. Our results provide a strong basis for future research on the impact of gabapentin scheduling and prescription drug monitoring policies on prescribing, dispensing, health care utilization, and overdose involvement. Future discussions at the state and federal level can also be informed by this analysis of the current legal landscape of gabapentin prescribing policies in the United States.

23. Geographic dimensions of gastric cancer risk in western Honduras: A spatial ecological analysis.

期刊: Health & place 发表日期: 2025-Dec-02 链接: PubMed

摘要

Gastric cancer is fifth most common cancer globally, with a complex and multifactorial etiology, including human and bacterial genetics, health behaviors, and environmental exposures. Honduras has among the highest rates of gastric cancer in the western hemisphere, and previous research indicates that gastric cancer risk varies geographically at a sub-national scale. We analyzed characteristics of all 788 incident cases diagnosed in western Honduras between 2002 and 2015 for which residence information was available to assess geographic patterns of excess risk and population-level risk factors. We built hierarchal Bayesian Poisson models to implement spatial ecological analysis stratified by sex and gastric cancer sub-type (diffuse, intestinal, mixed/indeterminate) to explore sex and sub-type specific etiologies. We identified differential geospatial patterns of high observed relative risk (i.e., greater than 1.0) for across male/female and diffuse/intestinal strata. Unexplained variance was more spatially structured in models for males, but less so among females, suggesting that unobserved, spatially autocorrelated factors contributing to geographic risk patterns among males in this area. Additionally, ecological associations varied by sex/sub-type strata. Among males, risk of intestinal gastric cancer was elevated with an increase in the percentage of indigenous Maya/Chortí in the population, but this association was not detected in female strata. Our findings demonstrated substantial differences in geographic patterns of risk across sex and ancestry, which implicated that unobserved, sex-stratified factors, such as germline mutations and behaviors, play a role in shaping geographic patterns of cancer risk at the subnational level in western Honduras.

24. Socioeconomic inequality in lifestyle trajectories among middle-aged and older adults: A 10-year longitudinal analysis across the US, UK and China.

期刊: Maturitas 发表日期: 2025-Dec-01 链接: PubMed

摘要

Health-related lifestyles may change throughout the life course and are often socially patterned. However, few studies have identified the association of socioeconomic status with the longitudinal patterns of lifestyle trajectories. This study aimed to identify lifestyle trajectories among middle-aged and older adults across multiple regions, and examine whether these trajectories differed by socioeconomic status. In this multi-cohort study, individual-level data were pooled from three longitudinal studies: the Health and Retirement Study in the US, the English Longitudinal Study on Ageing in the UK, and the China Health and Retirement Longitudinal Study in China. Lifestyle scores were constructed using smoking status, alcohol consumption, physical activities, and sleep quality. Socioeconomic status scores were based on education level and total household income. Group-based trajectory modeling was used to identify participants’ lifestyle trajectories over 10 years. The associations between socioeconomic status and lifestyle trajectories were evaluated using multinomial logistic regression models. Of the 27,401 participants, 16,325 were from the US, 4683 from the UK, and 6393 from China. Three lifestyle trajectories over 10 years were identified: ‘stable high’, ‘stable medium’, and ‘stable low’. Participants with low socioeconomic status were at higher odds of belonging to the ‘stable low’ group, with an odds ratio (OR) of 1.86 (95 % confidence interval [CI] 1.66-2.09), 1.38 (95 % CI 1.12-1.70) and 1.84 (95 % CI 1.45-2.34) in the US, UK and Chinese participants, respectively. Study-specific meta-analysis showed similar associations between socioeconomic status and lifestyle trajectories, with an OR of 1.69 (low vs high socioeconomic status; 95 % CI 1.40-2.05) and 1.18 (middle vs high socioeconomic status; 95 % CI 1.04-1.34). Lifestyle trajectories remained stable over 10 years, and lower socioeconomic status was associated with higher odds of belonging to the ‘stable low’ group. Early-life interventions to minimize socioeconomic inequality should be prioritized to promote sustainable healthier lifestyles in later life.

25. Response to Limburg.

期刊: The American journal of gastroenterology 发表日期: 2025-Dec-01 链接: PubMed

摘要

26. Demographics, Clinical Characteristics, and a Stage-Based Analysis of Treatments and Outcomes for Squamous Cell Carcinoma of the Penis.

期刊: Cancer reports (Hoboken, N.J.) 发表日期: 2025-Dec 链接: PubMed

摘要

Penile squamous cell carcinoma (PSCC) is the most common penile cancer, accounting for ≥ 95% of cases, though it accounts for < 1% of all malignancies in men in the United States. We report an updated, stage-stratified analysis of the efficacy of surgery, radiation, and chemotherapy, including adjuvant and neoadjuvant chemoradiation, with further analysis of demographic and clinical factors. Using the Surveillance, Epidemiology, and End Results (SEER) database, patients with PSCC diagnosed between 2000 and 2018 were identified. Five-year overall survival Cox regression analysis as well as univariate Kaplan-Meier analysis were performed, stratified by demographic and treatment variables. Two thousand seven hundred eight patients with PSCC were identified, with 57.8% being older than 65 years at diagnosis and 94.2% undergoing surgical intervention. With multivariate analysis, increasing disease stage (p < 0.001), age < 65 years (p < 0.001), lower disease grade (p < 0.001) were all associated with increased survival, while treatment with chemotherapy or radiotherapy was both associated with decreased survival (p = 0.002 and < 0.001, respectively). On univariate analysis, less invasive surgery was associated with increased survival among patients with low-grade, local (p < 0.001) or regional (p = 0.03) disease. Among those with high-grade disease, local excision was associated with increased survival (p = 0.008), though among those with regional disease no survival difference was seen (p = 0.86). Patients with regional disease saw increasing survival with four or more lymph nodes dissected (69% vs. 61%, respectively; p = 0.002). Surgical management of penile SCC remains the mainstay treatment, and less invasive surgery is associated with noninferior or improved 5-year overall survival regardless of disease stage and grade. Patients with regional disease had increased survival when four or more lymph nodes were dissected. Future analysis of these trends stratified by disease subhistology and more granular analysis of the role of lymphadenectomy are warranted.

27. Vaccination in the shadow of uncertainty: Exploring the links between government trust and COVID-19 vaccine acceptance.

期刊: Human vaccines & immunotherapeutics 发表日期: 2025-Dec 链接: PubMed

摘要

This study examined the impact of trust in government on COVID-19 vaccination in the Republic of Korea during the 2021-2022 period and determined if this impact is unique to COVID-19 vaccines or can be generalized to other vaccines such as influenza. We utilized the Korea Community Health Survey with 458,311 respondents focusing on individuals aged 65 and older. We conducted chi-square tests to analyze differences in vaccination uptake and multivariable logistic regressions, adjusting for age, education level, employment status, social security income, marital status, and comorbidities to determine the association between government trust and vaccination rates. Significant differences were found in vaccination uptake by the level of trust in government. Logistic regression showed that residents in high trust regions had 66.4% higher odds of COVID-19 vaccination (OR = 1.664, 95% CI [1.444, 1.919], p < .01) and 42.9% higher odds of influenza vaccination (OR = 1.429, 95% CI [1.270, 1.607], p < .01) compared to low trust regions. The influence of government trust was statistically significant for both vaccines, with a relatively larger odds ratio observed for COVID-19 vaccination. These findings indicate that trust in government is vital for the success of public health interventions, particularly during times of significant uncertainty such as the COVID-19 pandemic.

28. Sex Differences in Intimate Partner Violence Lethality Risk Screening Administration and Outcomes.

期刊: JAMA network open 发表日期: 2025-Dec-01 链接: PubMed

摘要

Intimate partner violence (IPV) is a critical public health issue. Health care systems, including the Veterans Health Administration, routinely screen patients for IPV and conduct secondary screening for IPV-related lethality when IPV is detected. Despite studies investigating IPV screening and response in the health care system, there has been limited empirical work on the implementation of screening for IPV-related lethality, especially among men. To examine sex differences in IPV-related lethality screening administration and clinical outcomes. This retrospective cross-sectional study used electronic health record data from veterans screened for IPV at 135 Veterans Affairs medical centers between October 1, 2022, and September 30, 2023. Intimate partner violence screening. The receipt of protocol-concordant IPV-related lethality screening was assessed and subsequent clinical outcomes examined. Mixed-effects logistic regression was used to evaluate associations between sex and outcome variables. Among the 67 379 patients with IPV-positive screens who should have received the secondary IPV-related lethality screening per protocol, 55 482 (82.3%; mean [SD] age, 52.3 [16.1] years; 77.0% men) were administered the secondary screen, with the error rate in screening administration higher among men than women (adjusted odds ratio, 1.42 [95% CI, 1.33-1.51]). Of patients screened, 16.9% reported past-year IPV-related lethality risk. Women were significantly more likely to be at risk of IPV-related lethality compared with men (adjusted odds ratio, 2.29 [95% CI, 2.16-2.41]), with 29.9% of women and 13.3% of men reporting lethality risk. This cross-sectional study of sex differences in IPV-related lethality screening found sex-based differences in the administration and clinical outcomes of IPV-related lethality screening among patients screened for IPV during health care encounters. Nearly 1 in 5 men were misclassified as negative for IPV and, therefore, not administered the IPV-related lethality screen per protocol. Among patients who received the second screen, lethality risk was significantly higher for women across all screening items compared with men. Further research is needed to assess IPV experiences among men, including gaps in health care and opportunities to improve implementation of IPV screening and response for men, as well as to identify effective strategies for connecting all patients at risk of lethal IPV to lifesaving services.

29. Genome-based classification of members in the genus Actinoplanes and its closely related genera and description of Actinoplanes oryzae sp. nov. and reclassification of Couchioplanes caeruleus subsp. azureus as Couchioplanes azureus sp. nov.

期刊: International journal of systematic and evolutionary microbiology 发表日期: 2025-Dec 链接: PubMed

摘要

Members of the genus Actinoplanes and six closely related genera were classified based on their genomic data, including the aa identity value threshold and the position on the phylogenomic trees and 16S rRNA gene phylogenetic trees. We suggested that Couchioplanes, Nucisporomicrobium and Pseudosporangium should be reclassified as the genus Actinoplanes on their genome-based classification. However, the phenotypic data of these three genera remains unclear and requires more closely related strains of these genera to confirm their taxonomic position in the future. The diaminopimelic acid (DAP) of Actinoplanes was meso-DAP or meso-DAP and 3OH-DAP, while Nucisporomicrobium contained meso-DAP. The genus Couchioplanes contains l-lysine, and Pseudosporangium contains meso-DAP and 3OH-DAP. Actinoplanes and these three genera contained MK-9(H4) or MK-9(H6) being the major menaquinones. The major fatty acids of these genera were anteiso- and iso-branched, and their polar lipids comprised phosphatidylethanolamine. Moreover, Couchioplanes caeruleus subsp. azureus was reclassified as Couchioplanes azureus comb. nov. In addition, an endophytic actinobacterium, strain RD1T, isolated from the leaf sample of a Jasmine rice plant (Oryza sativa) in Thailand has been classified. This strain is an aerobic actinobacterium with well-developed substrate mycelia. Aerial mycelia rarely produce poly-sporous-tubular sporangia, and spores are motile. Strain RD1T shared 98.9% of 16S rRNA gene similarity with Nucisporomicrobium flavum NEAU-24T. Actinoplanes lichenis TISTR 2343T shared the highest digital DNA-DNA hybridization, average nucleotide identity blast and average nucleotide identity MUMmer, with values of 40.9%, 89.8% and 91.2%, respectively. The genotypic and chemotaxonomic data confirmed that strain RD1T belonged to the genus Actinoplanes and was recognized as a novel species named Actinoplanes oryzae sp. nov. The type strain is RD1T (=TBRC 17751T=NRRL B-65688T). Genome mining of strain RD1T revealed the biosynthetic genes encoding proteins related to antibiotic production and plant growth promotion.

30. A Phase 3 study to assess the safety and immunogenicity of a quadrivalent meningococcal conjugate vaccine (MenACYW-TT) co-administered with routine pediatric vaccines in healthy infants in the USA and Puerto Rico.

期刊: Human vaccines & immunotherapeutics 发表日期: 2025-Dec 链接: PubMed

摘要

A quadrivalent meningococcal tetanus toxoid-conjugate vaccine, MenACYW-TT, has been developed to provide protection against invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, Y, and W. This Phase 3 study (NCT03537508; April 25, 2018, to September 22, 2023) evaluated the immunogenicity and safety of MenACYW-TT, compared with a licensed quadrivalent meningococcal oligosaccharide diphtheria CRM197-conjugate vaccine (MenACWY-CRM), in healthy infants ≥6 weeks of age when administered concomitantly with routine pediatric vaccines in a four-dose series (3 + 1 schedule). Functional antibodies against each meningococcal serogroup were measured by serum bactericidal antibody assay using human complement (hSBA). Non-inferiority was demonstrated for the first co-primary endpoint of seroresponse rates 30 days after the fourth dose at 12-15 months of age, with serogroup-specific seroresponse rates of 79.4%-97.6% and 77.6%-96.4% for MenACYW-TT and MenACWY-CRM, respectively. Non-inferiority was also demonstrated for the second co-primary endpoint based on proportions of participants with hSBA antibody titers ≥1:8 against each serogroup 30 days after the third dose at 6 months of age, with rates of 77.9-99.0% for MenACYW-TT and 67.7-92.9% for MenACWY-CRM. After four doses, hSBA geometric mean titers were comparable for serogroup A and higher for serogroups C, W, and Y with MenACYW-TT versus MenACWY-CRM. Immune responses to all routine pediatric vaccines administered concomitantly with MenACYW-TT were non-inferior to those following concomitant administration with MenACWY-CRM. MenACYW-TT and MenACWY-CRM were overall well tolerated, and the safety profiles of these vaccines were comparable. This study supports the use of MenACYW-TT in infants aged 6 weeks (42 days) or older.Study registration: ClinicalTrials.gov: NCT03537508.

31. Presenteeism Among Health Care Personnel With COVID-19.

期刊: JAMA network open 发表日期: 2025-Dec-01 链接: PubMed

摘要

Presenteeism-defined as continuing to work during an illness-poses a public health risk in the workplace and is especially hazardous within health care institutions where vulnerable patients may be exposed to nosocomial infections. Understanding the frequency and characteristics of health care personnel (HCP) who report presenteeism while ill with COVID-19 may help mitigate SARS-CoV-2 spread in hospitals and other health care institutions. To determine the frequency of presenteeism among HCP with symptomatic COVID-19, and to evaluate the demographic, occupational, and clinical factors associated with it. This is an observational cohort study that uses data from the Preventing Emerging Infections Through Vaccine Effectiveness Testing (PREVENT) project: a test-negative, case-control vaccine effectiveness study that enrolled HCP who had COVID-19 symptoms at 24 academic medical centers from December 2020 through April 2024. Exposures include demographic, occupational, and clinical characteristics of participants. Having confirmed symptomatic COVID-19 infection and reporting presenteeism; overall frequency of presenteeism through the study period and the association of the exposure characteristics with presenteeism, adjusting for confounders using 3 multivariable models. Presenteeism was defined as HCP who did not stop working during their illness, but the study did not differentiate whether they continued working remotely. A total of 3721 HCP were included in the analysis (2842 [76.4%] aged 18-49 years; 2993 [80.4%] female; 278 [7.5%] Asian, 406 [10.9%] Black, and 2912 [78.3%] White). Overall, 293 (7.9%) reported presenteeism during the study period, and the frequency of presenteeism increased each year of the study period (from 1 of 73 [1.4%] in 2020 to 16 of 105 [15.2%] in 2024). Presenteeism was associated with HCP who have minimal patient contact (adjusted odds ratio [aOR], 3.73; 95% CI, 2.39-4.37), a graduate or professional degree (aOR, 1.90; 95% CI, 1.45-2.50), and income over $100 000 (aOR, 1.74; 95% CI, 1.12-2.69). In this observational cohort study of 3721 HCP, there was an increasing frequency of presenteeism from 2020 through 2024, and job role and socioeconomic factors were associated. More studies are needed to understand the rationale behind the decision to continue working and the exact causes of presenteeism’s rising incidence among HCP with COVID-19.

32. Dissecting the atomic effects of S305 phosphorylation on the aggregation of the core tau peptides of the first intermediate filament.

期刊: Colloids and surfaces. B, Biointerfaces 发表日期: 2025-Nov-27 链接: PubMed

摘要

Tauopathies, containing aging-related Alzheimer’s disease (AD) and contact sports-related chronic traumatic encephalopathy (CTE), etc., are neuropathologically characteristic of the tau protein aggregates in the brain. Targeting the oligomeric species formed in the route of tau fibrilization has been considered a promising therapeutic approach to prevent or treat tauopathies. In vitro experiment reported that S305 phosphorylation (Pho-S305) exerted a protective role in tau aggregation. However, the atomic effect and molecular mechanisms of Pho-S305 on tau aggregation are largely elusive. In this study, we performed replica exchange molecular dynamics (REMD) and classical molecular dynamics (MD) simulations, with a total simulation time of 57 μs, on tau peptides without and with Pho-S305. The protein model was a novel tau fragment (G302-S316), constituting the ordered core of a first intermediate amyloid (FIA) filament of AD- and CTE-specific tau filament. The REMD results revealed that Pho-S305 suppressed the β-sheet formation and weakened the peptide-peptide interaction, thus inhibiting the aggregation of the peptides. Additional MD simulations indicated that the oligomerization dynamics of the peptides were disturbed by Pho-S305. Our findings excavate the mechanistic information underlying the phosphorylation-induced inhibitive effects on tau302-316 aggregation, which may provide potential useful clues for the development of therapeutic avenues for tauopathies.

33. Challenges to menstrual practices in Brazil: an analysis of the Menstrual Health Protection and Promotion Program.

期刊: Ciencia & saude coletiva 发表日期: 2025-Nov 链接: PubMed

摘要

The present article aimed to reflect on the Menstrual Health Protection and Promotion Program, based on the challenges related to the right to menstruate in Brazil. This is a reflective study that addresses the advances and setbacks of menstrual practices in the country. The findings were divided into three categories: “The sanitary pad as a path to truth and life”, “Menstrual precariousness and/or poverty”, and “Education and Health: two pillars of menstrual dignity”. It was identified that it is necessary to develop jointly constructed public policies, addressing menstrual health and education, since the trajectory of menstruating people is still linked to challenges and barriers, where social and cultural rights are not guaranteed, relying only on the free distribution of sanitary pads. In this sense, our research points out the importance of the Program, which is the core subject of this study; however, the need for a more comprehensive approach is highlighted to mitigate this problem, respecting the particularities of the social actors who experience menstrual precariousness. Objetivou-se refletir sobre o Programa de Proteção e Promoção da Saúde Menstrual, a partir dos desafios relacionados ao direito de menstruar no Brasil. Trata-se de um estudo reflexivo que aborda os avanços e retrocessos das práticas menstruais no país. Dividiram-se os achados em três categorias: “O absorvente como caminho à verdade e à vida”, “A precariedade e(ou) a pobreza menstrual” e “Educação e Saúde: dois pilares da dignidade menstrual”. Identificou-se que é necessário o desenvolvimento de políticas públicas construídas de maneira conjunta, abordando a saúde e a educação menstrual, pois a trajetória das pessoas menstruantes, para quem os direitos sociais e culturais não estão garantidos, ainda está atrelada a desafios e barreiras, firmando-se apenas na distribuição gratuita de absorventes. Desse modo, ressalta-se a importância do Programa objeto do estudo, mas vislumbra-se a necessidade de um olhar mais integral que vise a mitigar essa problemática, respeitando as particularidades dos atores sociais que vivenciam a precariedade menstrual. El objetivo de este estudio fue reflexionar sobre el Programa de Protección y Promoción de la Salud Menstrual, con base en los desafíos relacionados con el derecho a menstruar en Brasil. Este estudio reflexivo aborda los avances y retrocesos de las prácticas menstruales en el país. Los hallazgos se dividieron en tres categorías: “La toalla sanitaria como camino hacia la verdad y la vida”, “Precariedad y/o pobreza menstrual” y “Educación y Salud: dos pilares de la dignidad menstrual”. Se identificó la necesidad de desarrollar políticas públicas conjuntas que aborden la salud y la educación menstrual, ya que la trayectoria de las personas que menstrúan aún está vinculada a desafíos y barreras, donde los derechos sociales y culturales no están garantizados, dependiendo únicamente de la distribución gratuita de toallas sanitarias. Por lo tanto, se destaca la importancia del Programa objeto de estudio, pero existe la necesidad de un enfoque más integral que busque mitigar este problema, respetando las particularidades de los actores sociales que experimentan la precariedad menstrual.

34. "How can we better protect ourselves?": Young lesbians' social representations of sexual health.

期刊: Ciencia & saude coletiva 发表日期: 2025-Nov 链接: PubMed

摘要

This article sought to understand the structure of young lesbians’ social representations of sexual health, based on their experiences and practices. This is a descriptive, qualitative study based on the Theory of Social Representations. The Free Word Association Test (FWAAT) was used online for 124 self-declared lesbians, aged 18 to 29 years, and of these, seven responded to a semi-structured interview script. The TALP data was processed using IRaMuTeQ software (prototypical analysis), contextualized by excerpts from the interviews that portray experiences and practices, and scientific references on the subject. The results pointed to the terms ‘condom’, “care” and ‘prevention’ as core elements in the structure of social representations. In the interviews, these terms refer to the importance attributed to protection and disease prevention, although the condom models are not adapted to the sexual practices of trafficked sex. The participants’ practices and experiences also emphasize personal hygiene. The development of effective public policies for lesbian health requires valuing the knowledge they share socially. Objetivou-se conhecer a estrutura das representações sociais de jovens lésbicas sobre saúde sexual, a partir de suas vivências e práticas. Pesquisa descritiva, qualitativa, fundamentada na Teoria das Representações Sociais. Utilizou-se, via on-line, o Teste de Associação Livre de Palavras (TALP) para 124 pessoas autodeclaradas lésbicas, com idade variando de 18 a 29 anos e, dessas, 07 responderam a um roteiro de entrevista semiestruturada. Os dados do TALP foram processados pelo software IRaMuTeQ, contextualizados pelas justificativas e trechos das entrevistas que retratam vivências e práticas e, referências científicas sobre a temática. Os resultados apontaram os termos “camisinha”, “cuidado” e “prevenção”; como elementos centrais da estrutura das representações sociais. Nas entrevistas esses termos remetem à importância atribuída à proteção e à prevenção de doenças, embora os modelos de preservativo não se adequem às práticas sexuais do sexo sáfico. A prática e vivências das participantes ressaltam também os cuidados com a higiene pessoal. O desenvolvimento de políticas públicas efetivas para a saúde de lésbicas perpassa a valorização do conhecimento socialmente compartilhado por elas. El objetivo fue conocer la estructura de las representaciones sociales de las jóvenes lesbianas sobre la salud sexual, a partir de sus experiencias y prácticas. Investigación descriptiva, cualitativa, basada en la Teoría de las Representaciones Sociales. Se utilizó, vía online, el Test de Asociación Libre de Palabras (TALP) para 124 personas que se declararon lesbianas, con edades comprendidas entre los 18 y los 29 años, de las cuales 7 respondieron a un guion de entrevista semiestructurada. Los datos del TALP fueron procesados por el software IRaMuTeQ, contextualizados por las justificaciones y fragmentos de las entrevistas que retratan experiencias y prácticas, y referencias científicas sobre el tema. Los resultados señalaron los términos «condón», «cuidado» y «prevención» como elementos centrales de la estructura de las representaciones sociales. En las entrevistas, estos términos remiten a la importancia que se atribuye a la protección y la prevención de enfermedades, aunque los modelos de preservativos no se adapten a las prácticas sexuales del sexo sáfico. La práctica y las experiencias de las participantes también destacan el cuidado de la higiene personal. El desarrollo de políticas públicas eficaces para la salud de las lesbianas pasa por la valorización del conocimiento socialmente compartido por ellas.

35. "Disease requires medication, right? And children don't, they're for life": HIV prevention according to low-income youth from five cities in Brazil.

期刊: Ciencia & saude coletiva 发表日期: 2025-Nov 链接: PubMed

摘要

The increase in HIV incidence rates among young people contrasts with the discontinuity of educational actions and the invisibility of AIDS in public spaces. Based on socio-anthropological research, this article analyzes conceptions and practices regarding HIV prevention of 139 men and women, aged 15 to 24 years, mostly heterosexual and cisgender, from low-income Brazilian communities in Porto Alegre, São Paulo, Rio de Janeiro, Manaus, and Salvador. The study involved ethnographic observation, interviews, and focus groups. According to the findings, the knowledge about diagnosis and new technologies for prevention and treatment of HIV is limited. HIV transmission is still associated with gays, trans people, and individuals with many partners; the fear of the stigma of AIDS still persists; and there is rare contact with people with HIV. There is a prevailing self-perception that HIV infection is a very distant possibility, especially if condoms are used with strangers; the concern regarding an unintended pregnancy is far greater. The results point to the need for policies that address AIDS stigma and social, racial, and gender inequalities, as well as the need to create spaces for learning and dialogue in schools, health services, and social movements, updating successful experiences and exploring the potential of social networks. O aumento da taxa de incidência do HIV entre jovens contrasta com a descontinuidade de ações educativas e a invisibilidade da Aids no espaço público. A partir de pesquisa socioantropológica, o artigo analisa concepções e práticas sobre prevenção do HIV de 139 homens e mulheres de 15 a 24 anos, majoritariamente heterossexuais e cisgênero, de comunidades de baixa renda em Porto Alegre, São Paulo, Rio de Janeiro, Manaus e Salvador. O estudo envolveu observação etnográfica, entrevistas e grupos focais. Segundo os achados é limitado o conhecimento sobre diagnóstico, novas tecnologias de prevenção e tratamento do HIV. A transmissão do HIV ainda é associada aos gays, pessoas trans e indivíduos com muitos parceiros/as, persiste o receio do estigma da Aids e há raro convívio com pessoas com HIV. Prevalece a autopercepção de que a infecção pelo vírus está distante do campo de possibilidades, principalmente se a camisinha for usada com pessoa desconhecida; há maior preocupação com a gravidez não intencional. Os resultados apontam para necessidade de políticas capazes de enfrentar o estigma da Aids e as desigualdades sociais, raciais e de gênero e de criar espaços de aprendizagem e diálogo, nas escolas, serviços de saúde, movimento social, atualizando experiências exitosas e explorando o potencial das redes sociais. El aumento de la incidencia del VIH entre jóvenes contrasta con la discontinuidad de las acciones educativas y la invisibilidad del sida en el espacio público. Con base en una investigación socioantropológica, este artículo analiza las concepciones y prácticas de prevención del VIH de 139 hombres y mujeres de 15 a 24 años, en su mayoría heterosexuales y cisgénero, de comunidades de bajos ingresos en Porto Alegre, São Paulo, Río de Janeiro, Manaus y Salvador. El estudio incluyó observación etnográfica, entrevistas y grupos focales. Según los hallazgos, el conocimiento sobre el diagnóstico, las nuevas tecnologías para la prevención y el tratamiento del VIH es limitado. La transmisión del VIH aún se asocia a personas homosexuales, transgénero e individuos con múltiples parejas, persiste el temor al estigma del sida y el contacto con personas con VIH es poco frecuente. Prevalece la autopercepción de que la infección por el virus es remota, especialmente si se usa preservativo con una persona desconocida; existe una mayor preocupación por los embarazos no deseados. Los resultados apuntan a la necesidad de políticas que aborden el estigma del SIDA y las desigualdades sociales, raciales y de género, y que creen espacios de aprendizaje y diálogo en escuelas, servicios de salud y movimientos sociales, actualizando experiencias exitosas y explorando el potencial de las redes sociales.

36. Men who have sex with men (MSM): representations and practices for the prevention of sexually transmitted infections.

期刊: Ciencia & saude coletiva 发表日期: 2025-Nov 链接: PubMed

摘要

This is a descriptive, qualitative study, supported by the Theory of Social Representations, in the structural approach. The objective of this study was to analyze the social representations of sexually transmitted infection (STI) prevention practices in the group of men who have sex with men (MSM). One hundred homosexual men, aged 18 to 29 years, participated in the study, who answered a questionnaire for social and practice characterization, and a free evocation form, according to the inducing term “STD prevention”. Free evocations were analyzed with prototypical and similarity analysis techniques. The group investigated in this study was between 26 and 29 years of age (65%), reported the presence of a fixed sexual partner (67%), and 45% had used condoms inconsistently or sporadically in the last 12 months. In the prototypical analysis, the elements that constitute the probable central nucleus were condoms, PrEP, and care, which was reinforced by the similarity analysis. The social representation of the prevention of STIs of MSM is anchored in self-care; however, the type of sexual partnership and trust in the partner are defining factors for adherence or not to infection prevention practices. Estudo descritivo, qualitativo, apoiado na Teoria das Representações Sociais, na abordagem estrutural. Objetivou analisar as representações sociais das práticas de prevenção das infecções sexualmente transmissíveis no grupo de homens que fazem sexo com homens (HSH). Participaram cem homens homossexuais, na faixa etária de 18 a 29 anos, que responderam a um questionário para caracterização social e de práticas, e a um formulário de evocações livres, ao termo indutor “prevenção de DST”. As evocações livres foram analisadas com as técnicas de análise prototípica e de similitude. O grupo investigado tinha idades entre 26-29 anos, (65%); informou presença de parceria sexual fixa (67%) e 45% utilizaram, nos últimos 12 meses, o preservativo de forma inconsistente ou esporádica. Na análise prototípica, os elementos que constituem o provável núcleo central foram preservativos, PrEP e cuidado, o que foi reforçado pela análise de similitude. A representação social sobre a prevenção das infecções de transmissão sexual de HSH está ancorada no cuidado de si, contudo o tipo de parceria sexual e a confiança no parceiro são fatores definidores para a adesão ou não às práticas de prevenção das infecções. Estudio descriptivo, cualitativo, apoyado en la Teoría de las Representaciones Sociales, en el enfoque estructural. Se objetivó analizar las representaciones sociales de las prácticas de prevención de las infecciones de transmisión sexual en el grupo de hombres que tienen sexo con hombres (HSH). Participaron cien hombres homosexuales, en el rango de edad de 18 a 29 años, que respondieron a un cuestionario para la caracterización social y de prácticas, y a un formulario de evocaciones libres, al término inductivo “prevención de ETS”. Las evocaciones libres fueron analizadas con las técnicas de análisis prototípico y de similitud. El grupo investigado tenía edades entre 26-29 años (65%); informó tener una pareja sexual fija (67%) y el 45% utilizó, en los últimos 12 meses, el preservativo de manera inconsistente o esporádica. En el análisis prototípico, los elementos que constituyen el probable núcleo central fueron preservativos, PrEP y cuidado, lo que fue reforzado por el análisis de similitud. La representación social sobre la prevención de las infecciones de transmisión sexual de HSH está anclada en el cuidado de uno mismo, sin embargo, el tipo de pareja sexual y la confianza en el compañero son factores determinantes para la adherencia o no a las prácticas de prevención de las infecciones.

37. Lifestyle Habits as Potential Predictors of Impaired Blood Glucose Regulation in Patients with Chronic Low Back Pain vs. Healthy Controls: A Secondary Analysis of a Randomized Crossover Trial.

期刊: Pain physician 发表日期: 2025-Nov 链接: PubMed

摘要

Chronic low back pain (CLBP) affects over 20% of adults worldwide. Despite the socioeconomic burden caused by this condition, there is no gold standard treatment for CLBP, and its etiology remains nonspecific in 85% of cases. Available evidence indicates that CLBP patients have higher postprandial glycemic responses to beverages that rank high on the glycemic index and that this finding correlates with pain severity. Therefore, understanding modifiable factors that predict blood glucose regulation in CLBP patients could reveal important information for the management of the condition. This study aimed to (1) examine the relationship between predictor variables and the overall glycemic response, measured by the incremental area under the curve (IAUC), and (2) assess the temporal changes in patients’ blood glucose levels immediately after sucrose intake. This dual approach enables a nuanced understanding of both the cumulative and immediate impacts of sucrose intake on glycemic control, facilitating insights into personalized management strategies for mitigating glycemic variability. A secondary analysis of a case-control randomized controlled crossover trial to identify predictive factors for impaired blood glucose regulation. Vrije Universiteit Brussel, Belgium. Individuals with chronic low back pain (CLBP) were randomized to consume either a sucrose or isomaltulose beverage. Body composition, dietary intake, physical activity levels, psychological factors, and blood glucose levels were measured. Multiple linear regression was used to examine the relationship between baseline variables and postprandial glucose response following intake of the high-glycemic index beverages, and a linear mixed model (LMM) was applied to assess the relationship between sucrose intake and identified potential predictors. Our findings revealed that higher weight (P < 0.001; t = -4.06), higher age (P = 0.003; t = 3.06), higher inflammatory dietary properties (P = 0.025; t = 2.28), worse mental health (P = 0.021; t = 2.34), and lower diet quality (P = 0.002; t = 3.22) were associated with a significant predictive value for altered postprandial sucrose responses. This study is a secondary analysis of a crossover case-control trial, so causal interpretations should be made cautiously. Additionally, postprandial glucose was measured using a self-monitoring finger-prick device, which lacked real-time data, and the findings were specific to women and may not apply to men. These results confirm the potential relevance of targeting lifestyle factors in people with CLBP.

38. Is Fibromyalgia a Nociplastic or a Mixed-pain Condition? International, Multidisciplinary Recommendations for Pain Phenotyping in Fibromyalgia Syndrome.

期刊: Pain physician 发表日期: 2025-Nov 链接: PubMed

摘要

Fibromyalgia syndrome (FMS) is a complex condition characterized by numerous symptoms, especially long-lasting widespread pain. Available evidence suggests that the main causes of FMS are nociplastic pain mechanisms, but nociceptive and neuropathic pain components can also be involved, which would in these cases characterize FMS as a mixed-pain condition. In 2021, a comprehensive set of clinical criteria and grading systems was developed in accordance with the International Association for the Study of Pain. The establishment of these criteria is an important step toward precision pain medicine, with great potential for the assessment and treatment of FMS. The aim of this study was to develop clinical recommendations for pain phenotyping, including the phenotyping of mixed pain, in patients with FMS. Narrative review. Within this framework, an international and multidisciplinary group of pain specialists have developed clinical recommendations for integrating a mixed pain phenotype into the current framework of phenotyping FMS. A modified nominal group technique was used to develop the consensus recommendations. A manual is provided to allow clinicians to differentiate between predominant nociplastic pain and mixed pain when phenotyping FMS patients. A 7-step diagnostic approach, performed in 2 parts, is presented and illustrated using 3 case examples to enhance understanding and encourage effective implementation of this approach in research settings and clinical practice. Studies examining the clinometric properties of these recommendations and this grading system for mixed pain in FMS are warranted. The current recommendations systematically summarize the methods that allow individuals with FMS to be classified into nociplastic or mixed pain phenotypes, based on potential nociceptive and neuropathic pain components.

39. A Simple Back Shape Model for Back Curvature Evaluation at the Sagittal Plane Using a Single 2D Image.

期刊: Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference 发表日期: 2025-Jul 链接: PubMed

摘要

Low back pain is a prevalent health problem. To provide appropriate treatment for it, posture evaluation including flexibility of the spine and hip joints is important. However, this evaluation can be subject to variability between therapists. Therefore, an easy method that help therapists carry out objective evaluations is required. We propose a simple back shape model for image-based evaluation of forward flexion and backward extension, which are postures crucial for spine and hip-joint assessment. In an experiment involving 94 healthy adults, the model accurately estimated the boundaries of the back segments with an error of 4 cm compared with those annotated by a physical therapist. Moreover, we confirmed that image features based on the model, such as lordosis and kyphosis angles and curvature of the back, contributed to accurate estimation of posture evaluation labels representing what therapists observe in assessing forward flexion and backward extension with 62.1-89.7% accuracy.Clinical Relevance-The proposed method offers a simple and radiation-free measurement for the spine and hip joints at forward flexion and backward extension postures by utilizing a single 2D RGB image, allowing patients to remain fully clothed. This will contribute to the promotion of objective assessments by physical therapists in clinical practice.

40. A Breathing Phantom Station for Assessing Filter Clogging in Industrial Respirators.

期刊: Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference 发表日期: 2025-Jul 链接: PubMed

摘要

This paper presents the development of a Breathing Phantom Station designed to evaluate filter clogging in industrial respirators under controlled conditions. The station simulates human breathing patterns, enabling precise measurement of filter performance and clogging dynamics over time. By integrating a proposed embedded breathing sensor into the phantom, the system provides quantitative data to assess respirator filters efficiency. During extensive tests, where the Breathing Phantom Station was filled with coal powder, the respirator filters were clogged until their maximum, proving that the proposed sensor can detect the clogging level in real-time. This innovative tool enhances testing accuracy, supporting improved workplace safety standards.Clinical Relevance- Improving respirator filter assessment accuracy, ensuring reliable protection against airborne hazards, and enhancing worker’s safety and occupational health standards.

41. Deep learning-Based Fit Level Detection for Industrial Respirators with Embedded Breath Sensors.

期刊: Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference 发表日期: 2025-Jul 链接: PubMed

摘要

This study introduces a deep learning approach for real-time monitoring of respirator fit and breathing conditions using an embedded breath sensor system. Data from controlled experiments, including breathing frequency monitoring and fit test under OSHA protocols, were analyzed to estimate fit quality under different operating conditions. 21 healthy subjects were measured using the proposed embedded breath sensor system on industrial respirators under conditions of proper fitted- and no- sealed mask. Results show that the developed deep learning model reach up to 80% accuracy to detect the fit level of industrial respirators in real-time, enhancing occupational safety and health by enabling continuous, non-intrusive monitoring of working conditions on industrial environments.Clinical Relevance-Proposed system will support to detect impairing of occupational safety & health conditions and related illness.

42. Single Omnidirectional Camera System for Motorized Mobility Scooters to Measure Driving Operations, User Behavior, and Vehicle Location.

期刊: Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference 发表日期: 2025-Jul 链接: PubMed

摘要

Ensuring the safety of motorized mobility scooters (MMSs) is challenging, particularly for elderly people with reduced physical function due to aging or health conditions. Previous studies have addressed this issue by assessing the driving skills of MMS users using measurement systems. However, these systems often required complex setups to capture the detailed data needed for driving assessment, making them less practical for clinical applications. To address this limitation, this study developed an MMS driving measurement system using a single omnidirectional camera, specifically designed for application in clinical environments. The system measures driving operations, user behavior, and vehicle location during MMS driving through video images captured by the omnidirectional camera and its built-in sensors. This study also proposed evaluation factors related to MMS driving safety based on the collected data and compared these factors under various driving conditions. The experimental results showed that the single-camera system with a simple setup successfully recorded diverse data related to MMS driving. In addition, the recorded data clarified that the driving evaluation factors had significant variations depending on driving conditions, such as driving courses and MMS settings. The MMS driving data collected by this system have the potential as input for computing assessment factors that reflect a user’s driving attentiveness and safety awareness. Further investigation using this system may lead to the development of an effective index for evaluating the MMS driving skills of elderly people.Clinical relevance- This study presents a practical system consisting of a single device for assessing MMS driving skills, in contrast to existing assistive mobility driving measurement systems that require multiple devices. This technology enables physical and occupational therapists to easily obtain quantitative data during MMS driving, which contributes to the objective clarification and development of evaluation methodologies for MMS driving skills.

43. Determinants of Colorectal Cancer: Risk Factors, Knowledge, and Diagnosis in a Cross-Sectional Study of Saudi Adults.

期刊: Cancer control : journal of the Moffitt Cancer Center 发表日期: 2025 链接: PubMed

摘要

IntroductionColorectal cancer (CRC) is the second most prevalent cancer in Saudi Arabia, with a rising incidence among younger adults. Despite the known benefits of early detection and screening, public awareness and screening uptake remain limited. Understanding knowledge, attitudes, and determinants of screening and diagnosis is essential to guide public health interventions and policies.MethodsThis cross-sectional study was conducted between August 2024 and January 2025 among adults aged 18 years and older across Saudi Arabia using a validated Arabic-language self-administered questionnaire. Data were analyzed to assess CRC knowledge, screening practices, and diagnostic patterns, as well as their sociodemographic determinants.ResultsA total of 2113 participants (mean age: 34 ± 9.6 years; 74% female) completed the survey. Overall, 53% demonstrated good CRC knowledge, while screening prevalence was notably low (2%), and 2.1% reported a prior diagnosis. Higher knowledge was observed among males, participants with higher income, and those reporting frequent fiber intake. Higher BMI was associated with lower screening uptake, whereas education level and income influenced diagnosis likelihood. Age was significantly associated with both screening and diagnosis outcomes.ConclusionsThis study highlights moderate CRC knowledge and low screening participation among Saudi adults. Targeted national awareness campaigns, integration of CRC screening into primary healthcare, and digital outreach for younger populations are recommended to enhance early detection, promote preventive practices, and reduce the national CRC burden. This study from Saudi Arabia looked at how much people know about colorectal cancer (CRC), how often they get screened, and what factors affect these things. It found that while over half of the 2113 adults surveyed had good knowledge about CRC, very few had actually been screened (only 2%) or diagnosed (2.1%). Men, people with higher incomes, and those who ate more fiber knew more about CRC. People with higher body weight were less likely to get screened. Interestingly, those with higher education were less likely to be diagnosed. The study suggests that more effort is needed to raise awareness and improve access to screening to catch CRC early, especially among younger adults.

44. Breastfeeding and its dimensions: an integrative review of health students' knowledge.

期刊: Revista brasileira de enfermagem 发表日期: 2025 链接: PubMed

摘要

to analyze Brazilian and international scientific production on undergraduate health students’ knowledge about breastfeeding and the intrinsic dimensions of this topic. an integrative review, carried out in the Embase, MEDLINE/PubMed, CINAHL, LILACS, Web of Science, Scopus, Cochrane and SciELO databases. seventeen articles were identified. The analysis showed that, in most studies, students’ knowledge was restricted to the biological and management dimensions of lactation, while the sociocultural, legislation, breastfeeding protection policy and healthy complementary feeding dimensions were little explored and presented average knowledge. the weaknesses in students’ knowledge pointed to the importance of expanding studies on training future healthcare professionals regarding the multidimensionality of breastfeeding, with a view to improving learning of strategies aimed at promoting, protecting, and supporting breastfeeding.

45. What do future physicians think of traditional, complementary, and integrative medicine (TCIM)? Fifteen years after the inclusion of TCIM in the Swiss constitution.

期刊: PloS one 发表日期: 2025 链接: PubMed

摘要

An increasing recognition of traditional, complementary and integrative medicines’ (TCIM) contributions for public health has driven the development of international policy recommendations for its inclusion into national healthcare systems. While many countries have made advances in the incorporation of TCIM in academic medicine, there are globally only a handful that have a constitutional mandate in this context. The present cross-sectional study focused on one of these, namely Switzerland, some fifteen years after TCIM was included into the country’s Federal Constitution. This research aimed to examine attitudes of the future medical workforce in regard to TCIM within the only European country in which TCIM is mandated by the constitution. More specifically, using an online survey tailored to the country’s socio-political context, this study assessed attitudes, knowledge, and expectancies regarding TCIM among medical students across all Swiss universities that offer degrees in human medicine. Even though Swiss medical schools have consolidated and expanded their TCIM-related curricula compared to earlier assessments, with all of them now offering mandatory TCIM classes, most participants were unaware of this. Nonetheless, two-thirds of the N = 695 participants considered TCIM a valuable extension of conventional medicine that should have a place in medical education. Views diverged greatly between TCIM modalities. Further, we found significant differences as a function of gender and linguistic regions, although in the latter case effect sizes were modest. Knowing the views of medical students as the future generation of physicians, clinical scientists, and often also decision-makers in the context of policy-driven integration is crucial in understanding the future trajectory of TCIM into mainstream healthcare. Based on Switzerland’s unique experience and history in this context this work contributes to the broader discourse on the role of TCIM in national healthcare systems.

46. Myocardial Infarction and Traditional Cardiovascular Risk Factors in Older Patients in Primary Care.

期刊: Revista brasileira de enfermagem 发表日期: 2025 链接: PubMed

摘要

to investigate the prevalence of myocardial infarction and its association with cardiovascular risk factors in older adults in Primary Care. this cross-sectional study involves 1,322 older adults assisted in Basic Health Units in the northernmost part of Brazil. Data were collected in 2020, covering information on myocardial infarction, hypertension, diabetes, hypercholesterolemia, obesity, chronic kidney disease, and smoking. myocardial infarction affected 10.5% of older adults, being more common in men (11.4% vs. 9.8%; p=0.327). Diabetes (OR=5.27; p<0.001), hypertension (OR=5.24; p<0.001), kidney disease (OR=5.20; p<0.001), and obesity (OR=2.87; p<0.001) significantly increased the odds of myocardial infarction. myocardial infarction affected 10% of older adults, and cardiovascular risk factors heightened this probability. Healthy lifestyle promotion and regular health monitoring are essential for its prevention.

47. Moringa oleifera potential for the treatment and prevention of COVID-19 involving molecular interaction, antioxidant properties and kinetic mechanism.

期刊: PloS one 发表日期: 2025 链接: PubMed

摘要

The COVID-19 pandemic, caused by the emergence of the SARS-CoV-2 virus in 2019, has led to a global state of emergency declared by the World Health Organization (WHO). The search for effective therapies against the virus is ongoing, and traditional medicine is emerging as a promising alternative, as many plants with known antiviral potential have been utilized during the pandemic. In this study, we investigated the inhibition of cysteine proteases (Mpro, PLpro, and papain) by bioactive compounds from Moringa oleifera leaves, with the ultimate goal of developing a novel treatment. We conducted a virtual screening based on the structure of the Mpro and PLpro enzymatic targets of SARS-CoV-2, for the selection of compounds with higher inhibitory potential. We then identified 14 bioactive compounds with high binding energy against Mpro and PLpro using AutoDock. Gamma-sitosterol was particularly promising since it showed higher interaction energy with Mpro (-8.6Kcal/mol) and PLpro (-7.4Kcal/mol). Phytochemicals in Moringa oleifera leaves were extracted using aqueous and hydromethanolic solvent system. It was found that polyphenols (4.20-5.01 mg GAE/g DM) and flavonoids (95.86-135.41 mg QE/ g DM) were the major constituents in the extracts. Antioxidant activity in the extracts, particularly DPPH scavenging activity (63.46-123.58 mg TE/g DM) and FRAP activity (48.14-49.66 mg TE/g DM), was high suggesting a potential for the prevention of oxidation and inflammation. Global and multiple alignment were conducted between Mpro, PLpro and papain, and results showed high conservation of the amino acid residues in the active site of the enzymes, suggesting a similar molecular catalysis mechanism. The extracts showed inhibitory activity against papain with the IC50 of 7.5 mg/mL for the hydromethanolic extract and 12.5 mg/mL for the aqueous extract. It was found in kinetic studies that hydromethanolic extract was a competitive inhibitor of papain, while aqueous extract was a hyperbolic non-competitive inhibitor, suggesting the presence of compounds with different interaction profiles to the enzymes. This study demonstrates that Moringa oleifera leaf extracts have substantial antioxidant activity and inhibit the model cysteine protease papain in vitro. These data, together with in silico docking against Mpro and PLpro, identify candidate phytochemicals that merit further evaluation; however, papain inhibition is a preliminary biochemical filter and does not by itself establish antiviral activity against SARS-CoV-2.

48. Identification of highly cross-reactive immunogens in Eimeria tenella sporozoites.

期刊: Parasite (Paris, France) 发表日期: 2025 链接: PubMed

摘要

Avian coccidiosis significantly impairs intestinal health in chickens and remains a major threat to the poultry industry worldwide. Frequent co-infections with three Eimeria species, i.e., Eimeria tenella, E. necatrix, and E. maxima, present challenges for effective vaccine development. Here, we first used two-dimensional gel electrophoresis and silver staining to identify 650 E. tenella sporozoite proteins and then detected 18 cross-reactive immunogens based on Western blotting and proteomic analysis. These immunogens were consistently recognized by hyperimmune sera raised against three Eimeria species of interest. Bioinformatics analysis revealed that these proteins encompass enzymes, motility-related proteins, nuclear factors, and translation machinery, with amino acid sequence identities ranging from 71.1%-98.8% with E. necatrix and 37.9%-87.5% with E. maxima homologues. Seven of these proteins show potential non-classical secretion, and four have transmembrane domains. Overall, these findings point to multiple cross-reactive immunogens as potential candidates for multivalent coccidiosis vaccines. Identification d’immunogènes à forte réactivité croisée dans les sporozoïtes d’Eimeria tenella. La coccidiose aviaire altère significativement la santé intestinale des poulets et représente une menace majeure pour l’industrie avicole mondiale. Les co-infections fréquentes par trois espèces d’Eimeria (Eimeria tenella, E. necatrix et E. maxima) complexifient le développement de vaccins efficaces. Dans cette étude, nous avons d’abord identifié 650 protéines de sporozoïtes d’E. tenella par électrophorèse bidimensionnelle et coloration à l’argent, puis détecté 18 immunogènes à réactivité croisée par Western blot et analyse protéomique. Ces immunogènes ont été systématiquement reconnus par des sérums hyperimmuns dirigés contre les trois espèces d’Eimeria étudiées. L’analyse bioinformatique a révélé que ces protéines comprennent des enzymes, des protéines impliquées dans la motilité, des facteurs nucléaires et des composants de la machinerie de traduction, avec des identités de séquence en acides aminés allant de 71,1 % à 98,8 % avec les homologues d’E. necatrix et de 37,9 % à 87,5 % avec les homologues d’E. maxima. Sept de ces protéines présentent un potentiel de sécrétion non classique, et quatre possèdent des domaines transmembranaires. Dans l’ensemble, ces résultats suggèrent que de multiples immunogènes à réactivité croisée pourraient constituer des candidats potentiels pour des vaccins multivalents contre la coccidiose.

49. Potential effects of plastic waste: microplastics, a global concern.

期刊: Anais da Academia Brasileira de Ciencias 发表日期: 2025 链接: PubMed

摘要

The degradation of plastic materials has led to the emergence of new forms of reduced size (≤ 5 mm); know as microplastics (MPs). The presence of microplastics is a growing concern due to their persistence and, consequently, their ability to disseminate environmental pollutants. This review, in addition to providing an overview of the accumulation of plastic waste, which poses a risk to aquatic organisms and human health, seeks alternatives to mitigate this problem. To this end, we sought to address the main causes, sources, affected sites (soil, air, water), as well as the possible harmful effects caused by the presence of MPs on aquatic organisms and humans. The circular economy system has become an alternative for effectively reducing MPs in nature. In this context, we also presented an overview of trends in MP recycling, pollution control, and how proposed legislation on single-use plastic production is being discussed. Finally, an overview of scientific publications on the subject over the last ten years was presented.

50. Microplastic contamination in neotropical frugivorous bats (Phyllostomidae: Stenodermatinae, Carolliinae) shows no biome-specific differences between Cerrado and Amazon Forest.

期刊: Anais da Academia Brasileira de Ciencias 发表日期: 2025 链接: PubMed

摘要

Microplastic contamination has become an urgent concern for global ecosystems, especially for wildlife health in areas under intense anthropogenic pressures. This study analyzes the presence of microplastics in fruit bats (Phyllostomidae: Stenodermatinae and Carolliinae) in two Brazilian biomes: Cerrado and Amazon. Surprisingly, bats from the Amazon presented higher levels of contamination than those from the Cerrado, challenging the idea that more open and historically modified landscapes, such as the Cerrado, would have higher contamination. Land use and land cover classifications did not influence contamination levels, indicating that habitat-specific factors play a more relevant role. Contamination varied by organ, with the stomach presenting the highest concentrations in both biomes. Interestingly, bats from the subfamily Carolliinae, with more varied diets, presented higher contamination, probably due to dietary exposure and inhalation in anthropogenically altered areas. This study is the first to record microplastics in Cerrado bats and in detoxifying organs such as the liver. Our findings highlight the vulnerability of bats to microplastic pollution and the need for further research into its impacts, as well as suggesting conservation measures in regions of rapidly changing biodiversity.

51. First record of Spirometra spp. eggs in fecal samples from Panthera onca in the Brazilian Pantanal: a One Health approach.

期刊: Revista brasileira de parasitologia veterinaria = Brazilian journal of veterinary parasitology : Orgao Oficial do Colegio Brasileiro de Parasitologia Veterinaria 发表日期: 2025 链接: PubMed

摘要

This study examines the presence of gastrointestinal parasites in fecal samples from free-ranging jaguars (Panthera onca) in the Pantanal biome and assesses their potential as bioindicators of environmental health at the human-animal interface using a noninvasive approach. In 2024, ten fresh fecal samples were collected from the ground at Piuval Lodge in the northern Pantanal, state of Mato Grosso, Brazil. All samples were morphologically consistent with large felids, suggesting a high likelihood of originating from jaguars, based on field evidence. Coproparasitological analysis using sedimentation and flotation techniques identified Spirometra spp. eggs, with a positivity rate of 100%. Additionally, 20% of the samples tested positive for Toxocara spp. and one sample was positive for the genus Ancylostoma. This study highlights that jaguars (Panthera onca) are a potential bioindicator of environmental health and a sentinel species in the Pantanal, thus emphasizing the interaction between wildlife, domestic animals and human activities.

52. Biochemical responses in Kinosternon scorpioides (Testudines: Kinosternidae) as indicators of environmental impacts in a protected area in the Amazon region of Maranhão, Brazil.

期刊: Brazilian journal of biology = Revista brasleira de biologia 发表日期: 2025 链接: PubMed

摘要

Analyzing the health of Amazonian turtle populations is crucial, as these animals are frequently used as a protein source by riverside communities in the region. In this context, this study analyzed the biochemical responses of glutathione s-transferase (GST) and catalase (CAT) in Kinosternon scorpioides, using them as biomarkers of environmental impacts in a protected area in the Amazon region of Maranhão. We examined the blood of 106 K. scorpioides specimens from areas directly and indirectly affected by human activity in the Maranhão Amazon to assess enzyme activities. We showed positive linear correlations between biometrics and GST and CAT activities. Higher GST concentrations were observed in individuals from the breeding ground compared to those in situ. Furthermore, no statistical differences in enzyme activities were identified between animals from urban and vegetated areas (p=0.97325). Enzyme activities were affected by both the environment and the seasonal period, showing considerable variations in the means for GST and CAT (p=0.00077 and p=0.00572, respectively). Based on this, our study generated preliminary data on biomarker utilization in an Amazonian freshwater turtle species, in addition to providing a summary of the biochemical responses in these animals. These results may be valuable for future ecotoxicological studies with other turtle species in the region, in addition to providing biological and environmental data for environmental management agencies developing turtle conservation policies. This information provides new evidence of the correlation between enzymes, environment, and seasonality in K. scorpioides.

53. Length-weight relationship and condition factor of 11 fish species in streams of a protected area in the Acre River basin, northern Brazil.

期刊: Brazilian journal of biology = Revista brasleira de biologia 发表日期: 2025 链接: PubMed

摘要

This study evaluated the length-weight relationship (LWR) and the relative condition factor (Kn) of 11 fish species in streams of the São Francisco Igarapé Environmental Protection Area (APA), located in the Acre River Basin, Amazon. LWR is an essential tool for assessing growth, body condition, and biomass of fish populations, reflecting aspects of species’ well being. Additionally, the relative condition factor (Kn) is a crucial parameter for indicating the physical state and health of species, reflecting the amount of energy accumulated relative to size. The research revealed that the growth coefficient (b) ranged from 2.65 to 3.33, indicating predominantly isometric growth in several species, where weight gain parallels length growth. Fish were collected at seven sampling points using active search methods. Results showed that most species exhibited isometric growth, with Kn values ranging from 0.71 to 1.4, with 8 species showing Kn values greater than 1. These results suggest that the São Francisco Igarapé APA provides favorable conditions for fish growth and health, although some species showed variations in growth and well being indices, possibly due to environmental pressures. This study contributes to the understanding of the biological dynamics of fish populations in the region and provides valuable information for the management and conservation of species in protected areas of the Amazon.

54. Professional competency framework for occupational health nurses in Brazil.

期刊: Revista brasileira de enfermagem 发表日期: 2025 链接: PubMed

摘要

to develop a framework of core competencies for occupational health nurses based on their professional experience. an exploratory qualitative study, carried out with occupational health nurses linked to Brazilian and multinational companies, with data collection from January to May 2021, through an electronic form (sociodemographic data), followed by a semi-structured interview. Inductive thematic data analysis was carried out. The study was approved by the Research Ethics Committee. eight core professional competencies for occupational health nurses were identified: legal; effective communication; staff and service management; relational; improvement of work processes; continuing education; health and safety; and research. Their knowledge and skills were synthesized in a competency framework. the construction of a framework for occupational health nurses should guide managers and training centers in improving these professionals’ knowledge and skills within organizations and academia, aiming at changing their profile and professional recognition.