公共卫生研究摘要 (2025-12-06)
共收录 59 篇研究文章
1. An Introduction to Regression Discontinuity Design and Potential for Application in Neurology.
期刊: Neurology 发表日期: 2026-Jan-13 链接: PubMed
摘要
Regression discontinuity design (RDD) offers a rigorous approach for estimating causal effects using observational data where randomized clinical trials are not feasible by leveraging cutoff-based treatment rules, effectively accounting for confounding when certain assumptions hold true. RDD remains underused in neurologic research, with most existing applications in neurology emerging only in the past 5 years. We introduce RDD and explain how effects can be estimated within this framework, including a discussion of the key assumptions required for valid causal inference. In addition, we highlight the relevance and potential applications of RDD in neurologic research, particularly in contexts where treatment decisions are based on clinical or policy thresholds. We also outline best practices and limitations associated with this method, with the aim of encouraging thoughtful applications of RDD in neurologic research.
2. Impact of Cerebral Microbleeds on Tau-Associated Cognitive and Structural Decline.
期刊: Neurology 发表日期: 2026-Jan-13 链接: PubMed
摘要
Cognitive impairment in older adults is influenced by coexisting β-amyloid (Aβ), tau, and cerebral small vessel disease (CSVD). Cerebral microbleeds (CMBs) are associated with Aβ and CSVD, but their role on tau-related neurodegeneration remains unclear. We investigated whether the CMBs modify tau-related disease progression. A longitudinal, prospective cohort study was conducted involving participants with mild cognitive impairment, Alzheimer disease dementia from the memory disorder clinic of the single tertiary center, or cognitively unimpaired from the community. All participants underwent cognitive assessment, MRI, 18F-flutemetamol PET for Aβ, and 18F-MK-6240 PET for tau at baseline. Cognitive tests were performed annually and MRI at 2 years. Cognitive decline was defined by score changes over this period and cortical atrophy as annual cortical thickness change. Linear regression analyses were conducted after stratifying by total or lobar CMB presence. Among the 201 participants (mean age 71.3 ± 7.0 years, 66.7% female), 95 had CMBs and 106 did not. Baseline Aβ or tau burden did not significantly differ between the 2 groups while white matter hyperintensity volume and lacunes were greater in the CMB group. Cross-sectionally, greater tau burden correlated with worse cognition, as measured by the Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) or Mini-Mental State Examination (MMSE) in both groups. Longitudinally, baseline tau burden was associated with CDR-SOB progression in the non-CMB group (β = 1.558, SE = 0.249, p < 0.001), but not in the CMB group (β = -0.031, SE = 0.405, p = 0.940; p-for-interaction = 0.001). Similar group differences were found for MMSE changes (non-CMB: β = -2.365, SE = 0.566, p < 0.001; CMB: β = -0.816, SE = 0.653, p = 0.217; p-for-interaction = 0.073). Stratification by lobar CMBs confirmed significant interaction effects for both CDR-SOB (p-for-interaction = 0.007) and MMSE (p-for-interaction = 0.045) scores. Imaging analysis showed more extensive cortical atrophy in the CMB group, but tau-related cortical atrophy was widespread only in the non-CMB group and minimal in the CMB group. In the non-CMB group, tau burden was strongly associated with cognitive decline and cortical atrophy. By contrast, the CMB group exhibited greater CSVD burden and pronounced neurodegeneration not explained by tau, suggesting that additional mechanisms such as CSVD related to cerebral amyloid angiopathy or neuroinflammation may contribute to disease progression in this group.
3. Effectiveness of a Remote Intervention Program for Self-Management Behaviors in Adolescents and Young Adults With Inflammatory Bowel Disease Based on the Self-Determination Theory: Randomized Controlled Trial Across 2 Centers.
期刊: Journal of medical Internet research 发表日期: 2025-Dec-05 链接: PubMed
摘要
The prevalence of inflammatory bowel disease (IBD) has been on the rise, with adolescents and young adults experiencing the highest incidence rates. For these young patients, self-management behaviors are critical to maintaining disease remission and improving quality of life and yet their current self-management status remains suboptimal. This study aimed to evaluate the impact of a remote and multicomponent intervention program (integrating health education, solution-focused intervention, peer support, and mindfulness training) on the self-management behaviors and related mental health outcomes in young adults and adolescents with IBD. From July 2024 to January 2025, we conducted a 2-arm, single-blind randomized controlled trial. Adolescents and young adults with IBD (aged 13-24 years) were recruited from gastroenterology wards of 2 tertiary hospitals in Chongqing, China, and randomized 1:1 to the intervention (extra multicomponent program) or control (routine care) group. Outcomes (self-management behaviors, perceived social support, basic psychological needs, anxiety, depression, and disease activity) were assessed postintervention (T1) and 12 weeks later (T2). Intention-to-treat analysis was used: normally distributed data via mixed-design analysis of variance, and nonnormal data via rank sum and Friedman tests. A total of 74 participants (mean age 18.95, SD 2.96 years; 53/74, 72% males) were enrolled (37 per group) with no baseline differences. Compared with the control group, the intervention group showed significantly higher self-management scores at both T1 (mean difference -16.676, 95% CI -24.370 to -8.982; P<.001, η2=0.206) and T2 (mean difference -14.189, 95% CI -22.594 to -5.784; P=.001, η2=0.136), along with higher perceived social support scores at T1 (mean difference -9.000, 95% CI -13.932 to -4.068; P=.001, η2=0.155) and T2 (mean difference -6.649, 95% CI -11.890 to -1.407; P=.01, η2=0.082). Basic psychological needs scores were also higher in the intervention group at T1 (mean difference -4.946, 95% CI -8.323 to -1.569; P=.005, η2=0.106) and T2 (mean difference -3.946, 95% CI -7.720 to -0.172; P=.04, η2=0.057), while anxiety (T1: P=.04; T2: P=.007) and depression (T1: P=.048; T2: P=.03) scores were lower. In addition, the intervention group had a higher disease activity remission rate at T2 (P=.03). This study extended the application of self-determination theory to adolescents and young adults with IBD, offering a novel theoretical basis for self-management practice in this population. It was shown that this multicomponent intervention was a valuable addition to standard care in enhancing self-management behaviors and related mental health outcomes while lowering disease activity. In addition, its alignment of intrinsic behavioral motivation with nurse-driven clinical settings boosted clinical operability of the intervention. Chinese Clinical Trial Registry ChiCTR2400086703; https://www.chictr.org.cn/showproj.html?proj=235313.
4. Efficacy and Reliability of Mobile Uroflowmetry in Patients With Benign Prostatic Hyperplasia Undergoing Transurethral Resection: Prospective Multicenter Observational Pilot Validation Study.
期刊: Journal of medical Internet research 发表日期: 2025-Dec-05 链接: PubMed
摘要
Accurate assessment of voiding patterns before and after surgery for lower urinary tract symptoms is critical in patient care, but it places heavy burdens on both the patient and the clinic. While methods for telemedicine have been devised, no technology for acoustic assessment of urinary patterns has been prospectively evaluated for clinical use. This study aims to assess the precision of a mobile app-based uroflowmetry and compare it with in-office uroflowmetry measurements for the management of patients undergoing surgical treatment for benign prostatic hyperplasia (BPH). This study was designed as a prospective, multicenter, observational pilot validation study conducted at 3 tertiary centers. A total of 46 patients with BPH who had not received any previous treatment within 4 weeks of their initial outpatient clinic visit were prospectively enrolled. After diagnosis, participants with BPH conducted subsequent uroflowmetry measurements by using a sound-based mobile app, proudP, for at least 4 days during the pretreatment period, followed by transurethral resection of prostate (TURP). Additional measurements were taken at the preoperative visit and 4-day periods after 2, 6, and 12 weeks of treatment initiation, with concurrent in-office measurements. Uroflowmetry parameters, including maximum flow rate (Qmax) and voided volume, were compared. Patient satisfaction was evaluated using a scale ranging from 0 to 10 at the end of the 12-week study. TURP resulted in a mean Qmax improvement of 7.2 mL/s at conventional uroflowmetry, which correlated with a mean improvement of 5.1 mL/s when measured by the app. A statistically significant correlation (P<.05) was observed between the 2 methods. The app-based uroflowmetry effectively reflected the improvement in voiding symptoms over time after the initiation of medical treatment, with statistically significant improvement in total International Prostate Symptom Scores (IPSS; -4.7), IPSS obstructive (-5.7), IPSS irritative (-2.6), and quality of life (-5.9; all P<.05). Overall, the participants reported a high level of satisfaction, with a mean score of 9.5 (SD 0.8) points at the conclusion of the study. The findings of this study demonstrate that app-based uroflowmetry (proudP) measurements serve as an accurate and reliable indicator of perioperative surveillance in patients undergoing TURP for BPH. By enabling personalized and portable uroflowmetry, clinicians can easily monitor treatment response as well as observe the risk of postoperative acute urinary retention.
5. Comparing Patient Simulation With a Humanoid Robot or a Human Actor in Terms of Training Success and Acceptance: Pilot Questionnaire Study.
期刊: JMIR formative research 发表日期: 2025-Dec-05 链接: PubMed
摘要
The addition of simulated patients to medical and nursing training makes it possible to create a link between theory and practice. This makes what has been learned more realistic and allows the complexity and multilayered nature of many illnesses to be reflected in a real-life setting. However, the selection, training, and supervision of actors as simulated patients is time consuming and expensive. In this study, we investigated how differently students and nurses perceive 2 different methods of patient simulation. The aim of this pilot study was to investigate whether patient behavior simulated by a humanoid robot is comparable to patient simulation by actors in videos in terms of training success and user acceptance. Participants were asked to recognize the symptoms presented by the humanoid robot and make a diagnosis. For comparison purposes, we asked a second group of participants to make a diagnosis based on a video featuring a human patient actor. We asked the participants (medical students and nursing staff; N=21) to conduct a psychopathological assessment. Group 1 (n=11) used the humanoid robot as a patient simulator, and group 2 (n=10) watched the identical symptoms in a video with a human actor as patient. The participants had a mean age of 28.7 (SD 3.5) years. The students were in their sixth semester and had, on average, 7.6 (SD 3.3) years of professional experience in the medical field. The correct diagnosis was made 90% (9/10) of the time based on the video with the human patient actor and 91% (10/11) of the time based on the robot. One participant in each group made the wrong diagnosis, constituting a total error rate of 10% (2/21). In general, participants with the humanoid robot as patient simulator felt more confident that their diagnosis was correct compared to those with the human actor as patient (humanoid robot: 9/11, 82% were neutral to very confident and 2/11, 18% were uncertain to very uncertain; human actor: 9/10, 90% were neutral to very confident and 1/10, 10% were uncertain or unsure). The simulations of the human actor in the video were judged to be more realistic overall than those of the humanoid robot as patient simulator. However, the differences between the simulation methods in relation to the result (diagnosis) were very small. The results of our pilot study show a good performance of the robot in the simulation of selected psychiatric patient cases. We conclude that a humanoid robot could be a useful addition to patient simulators in medical education and discuss future directions.
6. Digital Training for Mental Health Promotion in Young People With Climate Change-Related Distress: Protocol for a Feasibility Randomized Controlled Trial.
期刊: JMIR research protocols 发表日期: 2025-Dec-05 链接: PubMed
摘要
Efforts in mental health research have long focused on the care and long-term outcomes of mental disorders. More recently, a shift in focus has occurred toward mental health promotion and prevention. One priority target population for promotion and prevention is youth with climate change-related distress. In light of the real-world threat of climate change, adaptive emotion regulation and engagement in meaningful action are 2 important strategies for promoting mental health. Ecological momentary interventions (EMIs) allow for the delivery of accessible interventions for young people with climate change-related distress, but evidence on their feasibility or beneficial effects is currently lacking. We aimed to examine the feasibility and initial signals of efficacy of the Climate Mind and Act (CliMACT) training, a novel hybrid EMI for mental health promotion in youth with climate change-related distress. A 2-arm, parallel-group, and assessor- and analyst-blinded feasibility randomized controlled trial (RCT) will be conducted in 50 young people aged 14-25 years with climate change-related distress, who will be allocated on a 1:1 ratio to the experimental condition (CliMACT training + care as usual [CAU]) or the control condition (CAU only). CliMACT involves 3 sessions with a mental health professional and 6-week access to a smartphone-based EMI to support the real-world transfer of training content based on compassion-focused interventions and acceptance and commitment therapy. The EMI delivery schemes involve enhancing (introducing new EMI components), consolidating (training of EMI components), and adaptive (triggered in moments of higher negative affect) components. CAU involves access to all standard health care and social services. Feasibility criteria of the trial methodology include recruitment, randomization, and retention. Feasibility outcomes of delivering the CliMACT training include participant satisfaction, participant adherence, and mental health professionals’ fidelity to the training protocol. Initial signals of efficacy on mental health candidate outcomes and mechanisms will be explored. As feasibility criteria for a priori planned subgroup analyses, credibility criteria will be established and distributions of indicators for health inequities explored. Feasibility criteria for measuring costs of care and service use and health-related quality of life for an economic evaluation in a future definitive RCT will include exploring response distributions across groups. Candidate outcomes and mechanisms will be assessed at baseline, post training, and 4-week follow-up, using self-report and 6 days of ecological momentary assessment. The first enrollment took place in December 2024. Data collection was completed by August 25, 2025. Results are expected for publication in 2026. To our knowledge, this is the first study to establish the feasibility and initial signals of efficacy of an EMI, targeted specifically at young people with climate change-related distress. If feasibility can be established, the trial will inform a future fully powered efficacy-effectiveness RCT, accompanied by an economic evaluation. ISRCTN ISRCTN33613914; https://doi.org/10.1186/ISRCTN33613914. DERR1-10.2196/77764.
7. Endoscopic endonasal surgery for prolactin-secreting adenoma: a retrospective multicenter study by the neuroendoscopy section of the Italian Society of Neurosurgery.
期刊: Journal of neurosurgery 发表日期: 2025-Dec-05 链接: PubMed
摘要
Although dopamine agonist (DA) therapy still represents the standard of care for prolactinomas, a reconsideration of the role of transsphenoidal surgery has been promoted in recent years. The aim of this multicenter retrospective study was to assess the short- and long-term results of the endoscopic endonasal approach (EEA) for prolactinomas, analyzing which factors have a favorable prognostic role. All consecutive prolactinomas operated on in 12 Italian neurosurgical centers between 2013 and 2023 were included. For each case, preoperative clinical and neuroradiological features were considered, as well as surgical complications and short- and long-term results. The series included 215 patients (44.2% males, mean age 39.7 [SD 16.6] years), accounting for 4.5% of all pituitary surgeries in these centers. The majority of prolactinomas (67.9%) were macroprolactinomas. Radical tumor resection was achieved in 171 patients (79.5%), and 3-month biochemical remission in 154 patients (71.6%). The most common surgical complication was postoperative CSF leak (2.8%). Endocrinological sequelae consisted of new onset of anterior hypopituitarism in 10.7% of cases, transient diabetes insipidus (DI) in 3.3%, and permanent DI in 2.3%. Long-term remission (mean follow-up 33.5 [SD 25.0] months) was achieved in 75.4% of patients, 14 patients (6.5%) presented with tumor recurrence/progression, and 1 (0.5%) demonstrated tumor evolution to carcinoma. The EEA is a valid option for the treatment of prolactinomas, with better results for micro tumors and regular macro tumors. This study found that preoperative prolactin values < 184 ng/ml were associated with higher chances of biochemical remission, as was larger pituitary surgery center volume. Currently, the most common surgical indications for prolactinomas are represented by cases that are not responsive or intolerant to DAs. However, interesting future perspectives considering EEA as a possible co-first-line therapy in selected patients have been recently proposed.
8. Artificial Intelligence-Enabled Mobile Health Intervention (mDiabetes) to Reduce Diabetes Risk Behaviors in Rural India: Quasi-Experimental Pre-Post Study.
期刊: Journal of medical Internet research 发表日期: 2025-Dec-05 链接: PubMed
摘要
India faces a dual burden of diabetes and prediabetes. Although mobile health (mHealth) interventions have shown promise in promoting healthy lifestyle changes, most interventions deploy generic, “one-size-fits-all” messages that do not consider individual behavioral patterns, motivational states, or changing needs over time. This formative evaluation study aimed to assess the effectiveness of an artificial intelligence (AI)-enabled, personalized mHealth messaging intervention (mDiabetes) compared to traditional, nonpersonalized mHealth messaging in promoting engagement with diabetes risk reduction behaviors among adults in Gulbarga, Karnataka, South India. A quasi-experimental pre-post study was conducted among adults without diabetes (N=1048). Participants were divided into intervention and control groups. The control group received static diabetes prevention messages via WhatsApp, while the intervention group received customized messages twice a week based on individual feedback through reinforcement learning algorithms. Data on demographics, diabetes knowledge, and lifestyle behaviors were collected via home interviews. Chi-square tests and t tests were performed to assess group differences. Intervention effects were evaluated using multivariable logistic regression for binary outcomes and ANCOVA for continuous outcomes. Adjusted odds ratios (aORs) with 95% CIs were reported, and Bonferroni correction was applied for multiple comparisons. A total of 1048 (96.9%) participants (n=661, 63.1%, female) completed the 6-month follow-up. At endline, no significant between-group differences were observed for primary outcomes. Both groups had similar odds of meeting the physical activity goal (≥30 minutes/day) at endline (aOR 1.0, 95% CI 0.7-1.3, P=.74). Baseline activity (aOR 2.1, 95% CI 1.5-3.1, P<.001) and age >50 years (aOR 3.8, 95% CI 1.6-9.3, P=.003) were significant predictors of endline physical activity, while employment was associated with lower odds of physical activity (aOR 0.2, 95% CI 0.1-0.3, P<.001). Daily fruit intake was modestly higher in the intervention group (aOR 1.4, 95% CI 0.8-2.3, P=.24), and participants aged 26-35 years had higher odds of daily fruit intake (aOR 4.7, 95% CI 1.9-11.8, P=.001), while employment was associated with lower odds (aOR 0.3, 95% CI 0.1-0.8, P=.02). The mean BMI difference at endline was -0.0 kg/m² (95% CI -0.6 to 0.5, P=.95), and baseline BMI was a strong predictor of endline BMI (P<.001). Exploratory behavioral outcomes revealed no significant differences: stair use (aOR 0.9, 95% CI 0.7-1.4, P=.79), walking for chores (aOR 2.4, 95% CI 1.0-6.1, P=.06), helping with household chores (aOR 1.0, 95% CI 0.4-2.3, P=.94), and farm work (aOR 1.3, 95% CI 0.9-1.8, P=.19). Both AI-enabled and traditional mHealth interventions have similar effectiveness in promoting diabetes prevention behaviors in rural India. Simple, well-designed mHealth interventions delivered through an accessible platform like WhatsApp can achieve meaningful behavior change without the need for complex AI technology. The comparable effectiveness suggests the potential for scalable, cost-effective, equitable diabetes prevention strategies in resource-limited settings.
9. Reassessing the minimal clinically important differences of patient-reported outcomes in cervical myelopathy: a patient-centered approach from the Canadian Spine Outcomes and Research Network.
期刊: Journal of neurosurgery. Spine 发表日期: 2025-Dec-05 链接: PubMed
摘要
The objective of this study was to determine minimal clinically important difference (MCID) values for patient-reported outcomes (PROs) including the 12-Item Short-Form Health Survey (SF-12) Physical Component Summary (PCS), SF-12 Mental Component Summary (MCS), and Neck Disability Index (NDI) in patients with degenerative cervical myelopathy (DCM) undergoing surgery, and to assess whether MCID values vary by baseline disease severity. The authors retrospectively analyzed prospectively collected data from the Canadian Spine Outcomes and Research Network for DCM patients treated surgically between 2015 and 2023. Inclusion required a baseline modified Japanese Orthopaedic Association (mJOA) score and 3- or 12-month follow-up PROs with domain-specific anchor responses. Patients were stratified by baseline mJOA score into mild (score ≥ 15), moderate (score 12-14), and severe (score < 12) groups. MCID values for the SF-12 PCS, SF-12 MCS, and NDI were calculated using anchor-based receiver operating characteristic curve analysis, with responder status defined by anchor questions. Discriminative performance was assessed via area under the curve, and 95% confidence intervals were estimated by bootstrapping. Among 290 patients meeting inclusion criteria, 77 (26.6%) were classified as having mild myelopathy, 120 (41.4%) moderate, and 93 (32.1%) severe. In the overall cohort, the MCID values were estimated as 8.9 (95% CI 7.5-10.9) for SF-12 PCS, 4.3 (95% CI 2.3-5.6) for SF-12 MCS, and 13.5 (95% CI 11.5-15.5) for NDI. Stratified SF-12 PCS MCID values increased from an estimated 4.8 (95% CI 1.1-7.7) in mild cases to 8.4 (95% CI 6.1-11.3) in moderate and 14.8 (95% CI 10.4-17.7) in severe cases. The NDI MCID values similarly rose from 10.5 (95% CI 6.5-12.5) to 15.0 (95% CI 10.5-19.0) to 17.5 (95% CI 14.5-21.0) across the mild, moderate, and severe groups, respectively. In contrast, the SF-12 MCS MCID values were 4.5 (95% CI 1.4-7.4) for mild, 3.8 (95% CI 0.4-5.8) for moderate, and 4.4 (95% CI 1.9-8.3) for severe patients, which did not differ significantly across severities. MCID values for PROs in DCM patients undergoing surgery increase with baseline severity. These findings indicate the importance of stratifying patients by disease severity to enhance the clinical relevance of MCID values, facilitate personalized treatment goals, and improve outcome assessments.
10. Bayesian modeling of Escherichia coli contamination in household drinking water in Bangladesh: evidence from the Multiple Indicator Cluster Survey 2019.
期刊: International health 发表日期: 2025-Dec-05 链接: PubMed
摘要
From a public health standpoint, there is merit in determining the levels of Escherichia coli in drinking water, but surveillance datasets often report censored values that may hinder traditional statistical analysis. This study aims to identify sociodemographic factors associated with the presence of E. coli in household drinking water in Bangladesh using Bayesian models for censored data, utilizing data from 6069 households in the Multiple Indicator Cluster Survey 2019. In terms of censoring, we considered two different Bayesian regression strategies: Bayesian Tobit Poisson regression and Bayesian Censored Generalized Poisson regression. The Bayesian Censored Generalized Poisson regression model was identified as the optimal model for analyzing household fecal contamination. Regression analysis revealed significant associations between household E. coli levels and various factors including division, livestock ownership, location of water sources, treatment of drinking water, household head education, wealth index, source of drinking water, place of handwashing and toilet facility. Households using tube wells had lower E. coli levels than those using other sources. Furthermore, households using pit latrines had 1.03 times higher contamination levels than those using flush latrines. Levels of fecal contamination in household water in Bangladesh were alarming. Our findings underscore the need for targeted policy interventions in specific population segments to address household fecal contamination, highlighting the link between sociodemographic and environmental factors with E. coli levels in drinking water.
11. Characterizing Survivors Living With Likely Incurable Cancer: A Closer Look at an Emerging Population.
期刊: JCO oncology practice 发表日期: 2025-Dec-05 链接: PubMed
摘要
The number of individuals living with advanced and metastatic cancer that is likely incurable is rapidly growing. These individuals, treated with the intent to prolong life and maximize the quality of life, often experience cancer as a chronic disease and undergo treatment with multiple lines of therapy. Because of their experience with cancer as a chronic disease, this subgroup of survivors has unique survivorship challenges and corresponding needs. In recognition of this consideration, the Multinational Association of Supportive Care in Cancer and ASCO published standards and practice recommendations relevant to the delivery of quality survivorship care for this emerging population. As nascent research, clinical, and policy efforts focused on individuals living with advanced and metastatic cancer have expanded, a corresponding need to accurately and consistently define this population has emerged. To date, however, there is a lack of terminological clarity for this emerging survivor subgroup. To address the gap, this article discusses how the lack of clear, consistent definition of individuals living with advanced and metastatic cancer that is likely incurable represents a critical barrier to advancing research and improving clinical care for these individuals. We explore situations in which stage (advanced or metastatic) and treatment intent (curative vs noncurative) diverge. We propose that the essential characteristic that defines this survivor subgroup and differentiates them from individuals in other phases of survivorship is that they undergo noncurative treatment with the goal of prolonging life and improving quality of life, regardless of the anatomic stage. Finally, we discuss emerging strategies to identify individuals living with likely incurable cancer from the electronic health record and cancer registries for the purposes of research and clinical care.
12. Promoting Responsible DeepSeek Deployment in Health Care: Scoping Review Comparing Grey and White Literature.
期刊: Journal of medical Internet research 发表日期: 2025-Dec-05 链接: PubMed
摘要
DeepSeek is an open-source large language model (LLM), and it has greatly accelerated LLM adoption in health care. Its rapid deployment has sparked concerns regarding its impact on patient outcomes and safety. However, little is known about how DeepSeek is used and regulated in health care. This study aimed to (1) systematically review the characteristics of DeepSeek deployed in the top 100 hospitals in China, and (2) compare the performance and risks of DeepSeek between hospital disclosures and research evidence. We searched the official websites and WeChat accounts of the top 100 hospitals in China and the databases of Web of Science and PubMed, using the terms “DeepSeek” and “large language models.” Searches were limited to records after January 15, 2025, when DeepSeek was first released. All searches were conducted on May 20, 2025, with an update on June 28, 2025. We extracted the basic characteristics of DeepSeek; its aims, evaluation approach, performance, and risks; and hospital regulations. A coding framework was developed covering the application scenarios, evaluation dimensions, and risk sources of LLMs. The risk of bias was assessed using the Joanna Briggs Institute checklist. We identified a total of 58 DeepSeek models in 48 out of the top 100 Chinese hospitals and found 27 studies in the literature. The first hospital deployment of DeepSeek was recorded on February 10, 2025, and deployment rapidly expanded to 37 hospitals within a month. Concurrently, most related research studies (20/27, 74%) were published after May 2025. Among deployments and studies that reported version information, DeepSeek-reasoner (R1) was the most frequently used model, and private deployment was the predominant approach. DeepSeek was mainly used to assist in clinical decision-making, including patient diagnosis and treatment recommendation. Among hospital disclosures, only 36% (21/58) clearly indicated a predeployment assessment, 22% (13/58) presented assessment results, and 9% (5/58) identified potential risks and countermeasures. We found poor transparency in hospital reporting, with none of the disclosures presenting evaluation details. Hospitals were more likely to report higher performance and fewer risks for DeepSeek. This is one of the first scoping reviews to reveal the rapid, widespread deployment of DeepSeek in China’s leading hospitals, primarily for clinical decision support. The deployment of DeepSeek in China’s leading hospitals poses potential risks to patient outcomes and safety. We highlight the urgent need for existing regulations to be expanded to downstream developers and users to promote the responsible use of LLMs in health care. Hospitals need to use a more rigorous validation process and adopt a more transparent reporting policy. The main limitations of this review include the restriction to top-tier hospitals and the inherent constraints of gray literature. These factors should be considered when interpreting the findings.
13. Epidemiology and severity risk factors of dengue virus infection during the 2023-2024 outbreak in Colombia.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Dec-05 链接: PubMed
摘要
During 2023-2024, the Americas faced its largest dengue epidemic to date. We used a detailed dengue classification to identify patients with serious manifestations of dengue and aimed to describe risk factors for occurrence. From April 2023 to September 2024, we conducted a prospective in-hospital active case-finding cohort study at the Hospital Universitario del Valle (HUV) in Colombia, enrolling patients of all ages with virologically confirmed dengue (VCD). Sociodemographic and clinical data were collected, and the dengue virus (DENV) genome was sequenced for serotyping and genotyping. Multivariable logistic regression modeling identified factors associated with “serious manifestations of dengue”, defined as severe dengue (2009 WHO classification) or dengue with warning signs (DwWS) with a more severe course, including vascular leakage (increases in hematocrit >20%, pleural effusion or ascites with hemodynamic/respiratory compromise); bleeding with hemodynamic instability or requiring blood transfusion; thrombocytopenia <20,000 or organ dysfunction (myocarditis, encephalitis or liver failure). Among 600 patients (median age 13 years, 55% male), serotyping and genotyping were possible for 340 (57%) and 296 (49%) samples, respectively. The most frequent serotypes were DENV-2 (32%) and DENV-3 (15%), and lineages 2II_F.1.1.2 (19%) and 3III_C.1 (15%). Serious manifestation of dengue occurred in 167 (28%) patients, including 22 with severe dengue and 145 DwWS cases with a more severe course. Independent risk factors for serious manifestations of dengue were living outside of city limits, presenting with edema and higher leukocyte counts, whereas lower odds were observed for patients with higher platelets and lymphocyte counts, and infections other than DENV-2. History of dengue infection showed no significant effect on the risk of serious clinical manifestations across the different serotypes. This outbreak involved multiple dengue virus serotypes and genotypes and predominantly affected children and adolescents. Identification of the risk factors described here could enable earlier recognition of patients with serious dengue manifestations. In this cohort, serotype 2 was associated with higher risk but given the unpredictable dynamics of severe dengue, efforts should strive for tetravalent protection, regardless of prior dengue exposure.
14. The recombinant zoster vaccine induces trained immunity in monocytes through persistent downregulation of TGFβ.
期刊: PLoS pathogens 发表日期: 2025-Dec-05 链接: PubMed
摘要
Older adults have decreased vaccine efficacy, but the adjuvanted recombinant VZV-gE zoster vaccine (RZV) is highly efficacious. We investigated memory-like innate immune responses after RZV and aftrer the zoster vaccine live (ZVL), which is much less efficacious. RZV increased NK, monocyte, and DC activation in response to in vitro VZV-gE stimulation for up to 5 years post-vaccination, while ZVL increased only DC responses to VZV for up to 90 days. In purified monocyte and NK cell cocultures, RZV recipients showed increased responses to VZV-gE, HCMV and HSV antigenic stimulation post-vaccination. ATAC-seq analysis of purified monocytes revealed decreased accessibility in areas of TGFβ1. scRNA-seq and immunoproteomics confirmed decreased TGFβ1 transcription and translation, respectively. Exogenous supplementation and inhibition of TGFβ1 modulated in vitro monocyte responses to VZV-gE. In conclusion, RZV generated homologous (VZV-gE) and heterologous (HCMV, HSV) trained immunity in monocytes through genomic repression of the regulatory cytokine TGFβ-1. Cytokine modulation may represent a novel mechanism of generating trained immunity in myeloid cells.
15. Prevalence, Risk Factors, Disease-Related Knowledge, and Vaccination Attitudes and Behaviors for Long COVID Among French Civil Servants: Cross-Sectional Survey.
期刊: JMIR public health and surveillance 发表日期: 2025-Dec-05 链接: PubMed
摘要
Long COVID affects millions worldwide, straining health systems and workforce stability. This first nationwide survey among French civil servants combines epidemiological assessment with a Knowledge, Attitudes, and Behaviors approach. Long COVID remains a diagnostic and epidemiological challenge with evolving symptoms and uncertain categorization, particularly among self-suspected cases. Beyond prevalence and risk factors, understanding behavioral dimensions is essential to developing prevention strategies and maintaining workforce resilience. This study aimed to (1) assess the prevalence of long COVID among French civil servants; (2) identify associated sociodemographic, occupational, and health-related factors; (3) assess disease-related knowledge of long COVID and (4) examine attitudes and behaviors regarding COVID-19 vaccination. This cross-sectional survey was conducted in 2024 among active or retired civil servants in France. A Knowledge, Attitudes, and Behaviors-validated questionnaire, based on World Health Organization guidelines, was used. Responses were compared across 4 COVID-19 status groups (no COVID, COVID-19 without long COVID, diagnosed long COVID, and suspected long COVID). Statistical analyses included univariate tests and multivariable logistic regressions to identify factors associated with diagnosed or suspected long COVID. Among 3962 eligible respondents, 61 (1.54%; 95% CI 1.20-1.97) reported a formal diagnosis of long COVID and 241 (6.08%; 95% CI 5.38-6.87) without diagnosis. Diagnosed long COVID was significantly associated with long-term sick leave (odds ratio [OR] 1.15, 95% CI 1.03-6.28; P=.04) and long-term illness coverage (OR 0.72, 95% CI 0.27-0.92; P=.03). Suspected long COVID was associated with being in a relationship (OR 1.65, 95% CI 1.08-2.52; P=.02), widowed (OR 2.25, 95% CI 1.18-4.31; P=.01), and uncertain (OR 1.90, 95% CI 1.32-2.74; P<.001) or incomplete COVID-19 vaccination status (OR 1.67, 95% CI 1.16-2.42; P=.01). Knowledge scores differed significantly across groups (ANOVA F3,3476=24.31, P<.001; χ²6=54.92, P<.001), with diagnosed cases showing the highest proportion of high knowledge (13/61, 21%) compared to 12.4% in the non-COVID group. Among 61 diagnosed cases, 36 (59%; 95% CI 46.4-70.5) were vaccinated, 13 (21%; 95% CI 12.9-33.2) intended to get vaccinated, and 12 (20%; 95% CI 11.6-31.3) remained unvaccinated; among suspected cases, these proportions were 173 (71.8%; 95% CI 65.9-77.1), 30 (12.4%; 95% CI 8.8-17.3), and 38 (15.8%; 95% CI 11.6-21.0), respectively. Unlike previous studies that examined the clinical or behavioral factors separately, this nationwide analysis linked epidemiological data with knowledge and vaccination behaviors. Among French civil servants, long COVID remains underdiagnosed, where absenteeism and sick leave threaten essential services. The study highlights disparities in disease-related knowledge, vaccination attitudes, and behaviors, underlining the importance of workplace health education and systematic screening. Vaccination is associated with lower odds of long COVID, reinforcing its preventive value. Thus, findings reveal organizational implications and support workplace-based prevention strategies integrating vaccination promotion, early detection, and health literacy to sustain the resilience of public services.
16. Participatory Animation for Health Promotion in Digital-Based Health Interventions: Viewpoint on Methodology and Application.
期刊: Online journal of public health informatics 发表日期: 2025-Dec-05 链接: PubMed
摘要
Digital-based health interventions (DHIs), defined as health services delivered electronically, have demonstrated effectiveness in promoting health outcomes. However, DHIs often suffer from low user retention, a challenge attributed to limited attention to sociocultural determinants and insufficient user engagement strategies. This paper explores participatory animation (PA), a collaborative methodology that engages community partners in co-creating animated content, as a strategy to improve DHI retention and effectiveness. Drawing from existing literature, this viewpoint examines the theoretical foundations and practical affordances of PA for enhancing DHIs. We describe PA as a multistep production process that integrates participant-driven oral and visual design contributions into multimedia outputs for use in DHIs. Here, PA shows promise in producing engaging and culturally resonant content, with the potential to improve intervention uptake and sustain user engagement. Despite these affordances, PA remains underused in health research. Given the growing urgency to develop effective, equitable DHIs, PA offers a novel, community-informed approach for enhancing both design and implementation. This paper positions PA as a methodological frontier for DHI science.
17. 'Brain Health' - The emergence of a new healthy construct and its role in everyday life.
期刊: The Gerontologist 发表日期: 2025-Dec-05 链接: PubMed
摘要
Emerging public health discourse increasingly frames brain health and dementia prevention as matters of personal responsibility and urge individuals to adopt modifiable behaviours across the life course. This study examines how adults at different life stages perceive dementia risk and engage with brain health practices, with particular attention to how these behaviours are socially structured and culturally mediated. Using a life course perspective and an abductive critical realist approach, this qualitative study draws on semi-structured interviews with 33 participants (aged 19-81) recruited across three generational cohorts: younger adults (n = 11), middle-aged adults (n = 8), and older adults (n = 14). Abductive thematic analysis was employed to examine how participants understand brain health, dementia, and responsibility for the management and prevention of these aspects of late-life health. Participants articulated diverse and age-contingent understandings of brain health. While younger adults associated prevention with aspirational self-optimisation, middle-aged adults emphasised routine, sustainability and caregiving-informed insight. Older adults, often informed by lived proximity to dementia, described adaptive strategies to preserve brain health amidst physical limitations. Across all groups, health practices were framed through an ethos of personal accountability, though often enacted within structurally constrained contexts. Findings emphasise the need to critically engage with how dementia prevention discourse is differentially internalised across the life course. Public health strategies should balance behavioural interventions with honest acknowledgement of the structural conditions which stratify distributions of brain health risk and opportunities for prevention.
18. The Scale-Up of a Digital Health Intervention (Healthy Beginnings for HNEKids) Targeting the First 2000 Days: Protocol for a Randomized Controlled Trial.
期刊: JMIR research protocols 发表日期: 2025-Dec-05 链接: PubMed
摘要
Digital health interventions, delivered directly to parents’ mobile phones, could transform the delivery of health care during the first 2000 days of a child’s life. Healthy Beginnings for Hunter New England Kids (HB4HNEKids) is an innovative SMS text message-based model of care that provides age-and-stage relevant preventative health information to parents during the first 2000 days. While HB4HNEKids demonstrates promise for population-wide scale-up, the optimal method for achieving universal, cost-efficient, and equitable scale-up remains unclear. This protocol outlines a randomized controlled trial that evaluates 2 models for scaling up HB4HNEKids: an “opt-in” clinician-initiated model (intervention) and an “opt-out” system-initiated model (control). The trial will assess program reach (the number and proportion of eligible parents receiving HB4HNEKids) and participant representativeness to identify the most effective, equitable, and efficient approach to scaling up care for families during the first 2000 days. A randomized controlled trial will be conducted in 6 Child and Family Health Service (CFHS) sectors (39 CFHS units) within the Hunter New England region of New South Wales, Australia. The 6 CFHS sectors will be randomized in a 1:1 ratio to one of 2 arms, stratified by sector location and average number of births per annum. The intervention arm (a clinician-initiated opt-in model of care) will involve a series of implementation support strategies delivered to CFHS staff (ie, training, audit, and feedback) to support clinicians in connecting eligible families to the HB4HNEKids program. The control arm (a system-initiated opt-out model of care) will use existing health service data to identify participants meeting the predefined eligibility criteria to automatically initiate the commencement of HB4HNEKids messages to families (ie, will not require input from CFHS staff). The primary outcome will assess the reach and representativeness of participants receiving HB4HNEKids. Secondary outcomes will include child health behaviors (breastfeeding rates; age of introduction to solids; child fruit, vegetable, and discretionary food intakes; as well as child immunization rates) captured via parent survey, as well as the cost-effectiveness. This trial commenced in July 2024, and as of July 2025 enrolled 4212 participants. Data collection (via parent survey) commenced in January 2025 and is projected to end in July 2027. Currently, little is known about the most effective model of scaling up digital health interventions. This trial will generate novel evidence for informing the effective scale-up of evidence-based health promotion programs that aim to provide universal care, which are needed to maximize the potential population health gains. Australian New Zealand Clinical Trials Register ACTRN12624000655549p; https://tinyurl.com/4krc9za5. DERR1-10.2196/81390.
19. Inhibitory Control, Attentional Bias, and Palatable Food Consumption in Adolescents: A Laboratory Feasibility Randomized Controlled Trial.
期刊: JMIR formative research 发表日期: 2025-Dec-05 链接: PubMed
摘要
Understanding relationships among inhibitory control, attentional bias to food cues, and food consumption in nonclinical adolescent samples can inform preventive efforts for disordered eating and associated health risks. This pilot study conducted preliminary testing of an inhibitory control training intervention on attentional bias toward food cues, hedonic appetite, and food consumption, as well as examined inhibitory control’s relationship with hedonic appetite, food consumption, binge eating, and cognitive restraint. Participants (N=43; mean age 15.1, SD 1.7 years; 31/43, 72% female) were randomized to a food cue-specific go/no go inhibitory control training intervention or control group, took part in a laboratory “taste test,” and completed surveys and a dietary recall. Additional data were collected for subsamples through an eye tracking task (15/43, 35%) and cognitive tasks (19/43, 44%). The go/no go intervention showed preliminary associations with attentional bias toward food cues. There were preliminary associations between inhibitory control and sugar consumption measured via dietary recall, binge eating symptoms, and cognitive restraint, which should be examined in a fully powered study. The role of inhibitory control should be examined in larger studies to inform strategies for promotion of healthy eating behavior and prevention of disordered eating in adolescents.
20. Prenatal NO2 Exposure and Bronchopulmonary Dysplasia in Offspring: ceRNA Network-Mediated Cell Cycle Dysregulation in Alveolar Type II Cells.
期刊: Environmental science & technology 发表日期: 2025-Dec-05 链接: PubMed
摘要
Epidemiological studies have established a correlation between prenatal nitrogen dioxide (NO2) exposure and the incidence of respiratory diseases in offspring. However, the sex-specific outcomes of respiratory system development, critical risk windows, and underlying epigenetic mechanisms remain unclear. In this study, we established a prenatal NO2 exposure model and found that prenatal NO2 exposure induced pulmonary dysfunction and structural abnormalities in neonatal offspring (particularly airflow limitation, airway obstruction, and alveolar development) and impaired airway secretory functions and angiogenesis. These alterations resulted in bronchopulmonary dysplasia (BPD)-like symptoms on postnatal day 14 in a sex-independent manner. Transcriptomic analysis of lung tissues from prenatal NO2-exposed and BPD model mice revealed that differentially expressed genes were significantly enriched in cell-cycle-related biological processes. We further confirmed that prenatal NO2 exposure disrupted the cell cycle in alveolar type II (AT2) cells. Mechanistically, prenatal NO2 exposure elevated hypoxia-inducible factor 1α (HIF-1α) expression in the lungs of neonatal offspring, which disrupted the transcription of long non-coding RNA (lncRNA) NONMMUT016369.2 and changed the expression of cell cycle-related genes (E2f8 and Cep55) through a competing endogenous RNA (ceRNA) mechanism, thereby contributing to structural and functional lung impairments and ultimately promoting the development of BPD in offspring. This study provides experimental evidence for the respiratory health risk in offspring posed by prenatal NO2 exposure and reveals a potential intervention target for prevention.
21. Extracellular Vesicle-Packaged MIR4435-2HG Facilitates Cigarette Smoke-Induced Bladder Cancer Progression through Enolase 1-Dependent Glycolytic Reprogramming.
期刊: ACS nano 发表日期: 2025-Dec-05 链接: PubMed
摘要
Epidemiological studies have reported that cigarette smoking promotes bladder cancer progression, but the corresponding biological mechanisms must be elucidated. Cigarette smoking-related extracellular vesicle (EV)-packaged long noncoding RNAs (lncRNAs) derived from bladder tumors were identified via RNA sequencing, tissue microarrays, and single-cell RNA sequencing. The clinical value of candidate EV-packaged lncRNAs was evaluated in the urine and plasma of bladder cancer patients with smoking history. The underlying mechanism of EV-packaged lncRNAs was explored using CRISPR/Cas9, Seahorse, and N4-acetylcytidine (ac4C) acetylation experiments in vivo and in vitro. The EV-packaged lncRNA MIR4435-2HG, which was originally secreted by M2 macrophages in response to exposure to the cigarette smoking-related carcinogen 4-aminobiphenyl (4-ABP), exhibited an abundant expression pattern. Mechanistically, 4-ABP promoted M2 macrophage polarization and increased fused in sarcoma (FUS) expression by inducing signal transducer and activator of transcription 6 (STAT6) phosphorylation, contributing to the direct packaging of MIR4435-2HG into M2 macrophage-derived EVs and subsequent delivery to recipient tumor cells. The nuclear EV-packaged MIR4435-2HG subsequently bound N-acetyltransferase 10 (NAT10) and increased the stability of the glycolysis regulator Enolase 1 (ENO1) through the ac4C modification; cytoplasmic EV-packaged MIR4435-2HG sponged miR-143-3p, increased ENO1 expression, and ultimately activated PI3K-Akt signaling for glycolytic reprogramming to promote tumor development. In addition, recipient tumor cells internalized EV-packaged MIR4435-2HG and simultaneously secreted chemokines to recruit monocytes, establishing a potential feed-forward loop between M2 macrophages and tumor cells. This study identified EV-packaged MIR4435-2HG as a crucial bladder cancer marker that mediates intercellular communication during cigarette smoke exposure, suggesting a promising approach for bladder cancer prevention and treatment.
22. Plant compartments and regional variations shape the community structures and functional composition of endophytic fungi of Citrus aurantium.
期刊: Canadian journal of microbiology 发表日期: 2025-Dec-05 链接: PubMed
摘要
Although Citrus aurantium has enormous medicinal and ecological value in southern China, little research has been conducted into the composition and functions of endophytic fungi in it. To better explore the characteristics of the endophytic fungal community in C. aurantium, ITS rRNA gene analyses were used to characterise the endophytic fungal microbiome across 3 plant compartments and 3 regions. The results shown that a total of 12109 OTUs were obtained and further divided into 15 phyla and 768 genera. Ascomycota was the dominant phylum. Fusarium, Alternaria, Mortierella, Plectosphaerella, Cladosporium, Colletotrichum, Trichomerium, Botryotrichum, and Aspergillus were the dominant genera. The endemic and dominant genera of endophytic fungi in C. aurantium exhibited plant compartment specificity. The assembly of endophytic fungal communities was dominated by homogeneous selection of deterministic processes. The endophytic fungal genera of C. aurantium predominantly exhibited positive interactions (with a proportion > 99%). The dominant functions of endophytic fungi in C. aurantium were pathotroph and saprotroph. The composition (niche: R2=0.09, P=0.001; site: R2=0.06, P=0.021) and functional components (niche: R2=0.117, P=0.002; site: R2=0.122, P=0.006) exhibited significant plant compartment and region specificity. The results of this study reveal the characteristics of the endophytic fungal community of C. aurantium, and provide a theoretical reference for the further development and utilization of endophytic fungal resources.
23. Moderators of a mHealth Intervention for Adolescent Physical Activity: Intervention Refinement Study.
期刊: JMIR pediatrics and parenting 发表日期: 2025-Dec-05 链接: PubMed
摘要
An adaptive text messaging intervention to promote adolescent physical activity has demonstrated feasibility, acceptability, and preliminary efficacy in a recent proof-of-concept study. To inform future intervention development, a secondary analysis of the data examined how physical activity is influenced by mood, environment, and physical feelings of energy and fatigue. This study aims to understand how both macro- and microtemporal variables (eg, psychological and environmental variables at both levels) influence the efficacy of a brief mobile health intervention (ie, NUDGE) for physical activity. Using a matched control design, we evaluated the effect of daily positive and negative affect, perceptions of the weather, energy, and fatigue as moderators of the effect of the intervention on 21 intervention participants and 21 matched controls. Consistent with study hypotheses, macrotemporal (levels of the variable on a 3-week timescale) moderators of intervention effectiveness were observed for positive affect (P<.001), negative affect (P=.03), energy (P<.001), fatigue (P<.001), and perceived weather barriers (P<.001) for moderate-to-vigorous physical activity. These effects were observed more consistently for moderate-to-vigorous physical activity than for sedentary behavior, which was only significant for energy (P<.001). No effects for microtemporal variables (at the day level) were observed. There appears to be an optimization opportunity for mobile health physical activity interventions that can be achieved by personalizing intervention features and content based on approximately monthly assessments of affect, physical feeling states, and perceived weather barriers.
24. Multi-Omics and High-Spatial-Resolution Omics: Deciphering Complexity in Neurological Disorders.
期刊: GigaScience 发表日期: 2025-Dec-05 链接: PubMed
摘要
The world has witnessed a steady rise in neurological diseases, which represent a heterogeneous group of disorders characterized by complex pathogenesis involving disruptions at multiple molecular levels, including genomic, transcriptomic, proteomic, and metabolomic levels. These disorders, often caused by genetic mutations, metabolic imbalances, immune dysregulation, and environmental factors, pose significant challenges to global public health due to their high prevalence, mortality, and disability burden. The advent of high-throughput technologies, such as next-generation sequencing and mass spectrometry, has provided valuable insights into the underlying mechanisms of disease, especially the development of multi- and high-spatial-resolution omics technologies, enabling the interaction of multiple levels of biology and analysis of the complex molecular networks and pathophysiological processes. This review provides a comprehensive analysis of the latest advancements in multi- and high-spatial-resolution omics, with a focus on their applications in precision diagnostics, biomarker discovery, and therapeutic target identification in brain diseases. The study also highlights the current challenges in the clinical implementation and discusses the future directions, with artificial intelligence being anticipated to enhance clinical translation and diagnostic accuracy significantly.
25. Species-Specific Foliar Absorption and Translocation of Nanoplastics in Leafy Vegetables Revealed through Isotopic, Physiological, and Transcriptomic Analyses.
期刊: ACS nano 发表日期: 2025-Dec-05 链接: PubMed
摘要
Understanding the foliar absorption and translocation of atmospherically deposited nanoplastics (NPs) in crops is critical for food safety, yet species-specific mechanisms remain inadequately understood, hindering accurate risk assessment for edible crops. In this study, the isotopic tracing (2H-labeled polystyrene NPs) was employed to systematically compare NPs uptake in three leafy vegetables: cherry radish, water spinach, and lettuce. Stable isotope analysis revealed species dependent accumulation under foliar spraying of NPs, with the highest levels observed in leaves of cherry radish (5.1 to 216.3 μg/g dw), followed by water spinach and lettuce. NPs were translocated to roots of cherry radish and lettuce but restricted to stems of water spinach. Scanning electron microscopy visualized NPs in stomatal cavities and roots of cherry radish and lettuce, as well as in the nodes of water spinach. Mechanistic studies linked these differences to three factors: leaf structure and vascular architecture affected NP absorption and transport; plant physiological traits regulated NP content in leaves; and transcriptomic data indicated that gene expression related to the abscisic acid-ROS-Ca2+ mediates stomatal closure pathway. Our findings elucidate how NPs are absorbed and translocated across plant species and highlight species-specific responses to atmospheric NP pollution and associated risks.
26. Cognitive Functioning and Work in People With Severe Mental Illness Living in Urban and Rural Areas in India.
期刊: Schizophrenia bulletin 发表日期: 2025-Dec-05 链接: PubMed
摘要
Evidence on the role of cognition in employment of people with severe mental illness (SMI) living in India and other developing countries is limited. This study examined the relationship between cognitive functioning and work in people with SMI living in urban and rural areas in India. Cognition (evaluated with the Montreal Cognitive Assessment: MoCA) and vocational functioning were assessed in 340 persons with SMI (59% schizophrenia-schizoaffective) receiving private psychiatric outpatient treatment at two hospitals in western India. Participants with higher levels of cognitive functioning were more likely to be employed than those with lower levels, including both those living in urban and rural areas. Among employed participants, better cognitive functioning was associated with working at more complex and skilled jobs that paid higher wages. There were no differences in cognitive functioning between participants working for a family-run business (eg, a farm) vs. an independent employer, suggesting that families operating such businesses did not provide more work accommodations for cognitive impairment to their relatives with SMI than independent employers. Impaired cognitive functioning is an important predictor of unemployment in people with SMI in both rural and urban regions in India. Providing interventions for enhancing cognitive functioning may increase the ability of unemployed people with SMI in developing countries to work for both family-operated businesses and independent employers, thereby improving their economic standing and the welfare of their families.
27. Coexposure of French workers to night and/or shift work and chemical substances.
期刊: Annals of work exposures and health 发表日期: 2025-Dec-05 链接: PubMed
摘要
Workers in various sectors can be exposed to multiple occupational hazards, including chemical substances and night or shift work. However, the health effects of such coexposures remain largely unexplored, and we lack data on the individuals concerned. This study aimed to quantify the number of French workers coexposed to chemical substances and night or shift work and provide statistical indicators for each sector and occupation. The analysis was based on data from the 2010 and 2017 SUMER surveys, which assessed occupational exposure in a representative sample of French workers. These data were crossed with workforce estimates from the French National Statistics Institute (INSEE) to estimate the total number of workers exposed. Four groups were defined on the basis of work schedules: (i) shift work without night work, (ii) shift work with night work, (iii) permanent night work (without shift work), and (iv) day work. The prevalence of chemical exposure in these groups was compared based on descriptive statistics. Of a total of 26.8 million French workers, about 6.5 million are exposed to night and/or shift work, with a higher prevalence among men (4.2 million) than women (2.3 million). The proportion of workers who were also exposed to at least one chemical substance was significantly higher among night or shift workers (36% to 49%) than among day workers (26%). The sectors most affected were healthcare, transport, construction, and manufacturing. Common chemicals included disinfectants (alcohols, quaternary ammonium compounds, and bleach), diesel exhaust, and industrial lubricants. Our results highlight the extent of coexposure to chemical substances and night or shift work among French workers. Given the potential health risks, particularly in the healthcare and industrial sectors, preventive measures should be implemented. Future research should investigate the long-term health effects associated with these combined occupational risk factors.
28. Nationwide Heart Failure Telemonitoring: Disparities in Enrollment Based on Sex.
期刊: JACC. Advances 发表日期: 2025-Dec-04 链接: PubMed
摘要
29. Occurrence and Patient Characteristics of Aldosterone Dysregulation in Routine Clinical Care: A Population-Based Study.
期刊: JACC. Advances 发表日期: 2025-Dec-04 链接: PubMed
摘要
Current guidelines recommend screening for elevated aldosterone-renin ratio (ARR) in high-risk hypertensive patients. However, the definition, occurrence, and population-level characteristics of aldosterone dysregulation (AD) remain unclear. The purpose of this study was to examine the occurrence of AD and associated clinical characteristics. We conducted a population-based cohort study using health registries with complete laboratory test results for all Danish residents. We examined the annual proportion of ARR testing and AD occurrence, defined as ARR ≥27.7 pmol/mIU (1 ng/dL per mIU/L), in the general and hypertensive population. Clinical characteristics associated with testing and AD were described, and analyses were repeated using different ARR thresholds (138.7 pmol/mIU and 225.8 pmol/mIU). Among 5.42 million Danish adults, 18,650 underwent ARR testing during 2017-2024. Testing was four-fold higher in hypertensive adults than in the general population. In 2023, AD prevalence per 100,000 was 39.1 in hypertensive adults compared to 10.0 in the general population. Among tested hypertensive adults, 25.0% met the AD threshold ARR ≥27.7 pmol/mIU, while 4.5% and 1.8% met stricter AD thresholds (138.7 and 225.8 pmol/mIU). Hypertensive adults with AD had longer hypertension duration (7.1 vs 5.2 years) and used more concurrent antihypertensive drugs. In this first nationwide study of AD, detected AD was 4 times more prevalent in adults with hypertension compared to the general population. One in 4 hypertensive adults tested met the AD threshold of ARR ≥27.7 pmol/mIU and they had higher intensity of antihypertensive therapy.
30. Computational and design of experiment strategies to improve differentiation and quantitation of trace-level cannabinoids by copper cationization paper spray mass spectrometry.
期刊: The Analyst 发表日期: 2025-Dec-03 链接: PubMed
摘要
The medicinal and recreational use of cannabis products is quickly rising from increased worldwide legalization and decriminalization. Despite this, current analytical methods have compromises when analyzing common isobaric cannabinoids, such as cannabidiol (CBD) or (-)-trans-Δ9-tetrahydrocannabinol (THC). We report on the use of computational chemistry, combined with design of experiment (DoE), to optimize and develop a paper spray mass spectrometry (PS-MS) method with on-paper cationization to simplify workflow for trace level differentiation and quantitation of THC and CBD. Computational methods allowed for pre-screening of candidate metal ions prior to experimental measurements, with promising candidates then being evaluated by electrospray ionization high resolution mass spectrometry (ESI-HRMS). A direct mass spectrometry method using copper cationization with PS-MS was then developed and optimized using DoE. Copper cationization with both ESI and PS-MS tandem mass spectrometry demonstrated the best CBD/THC selectivity and sensitivity, with 1% interference between CBD and THC copper adduct product ions with ESI. DoE results increased the analytical performance of the PS-MS method for quantifying cannabinoids in methanol, acetonitrile/water, and saliva matrices. Methanolic detection limits were 10 ng mL-1 for CBD and 20 ng mL-1 for THC by PS-MS allowing rapid (one-minute measurement), direct mass spectrometry differentiation, whereas detection limits in both saliva and acetonitrile/water matrices were <2 ng mL-1 for THC and CBD. This work illustrates the advantages of using DoE and computational chemistry to develop PS-MS and ESI methods for the rapid differentiation and quantitation of isobaric cannabinoids.
31. Dynamic shifts in outpatient antibiotic prescribing for pediatric upper respiratory infections in South Korea, 2002-2019: A national cohort study.
期刊: Journal of infection and public health 发表日期: 2025-Dec-01 链接: PubMed
摘要
Antibiotic resistance is a global health concern, driven by inappropriate use. Contemporary data on antibiotic prescribing patterns for pediatric upper respiratory infections (URIs) are needed to evaluate trends and guide stewardship efforts. We examined longitudinal trends in antibiotic prescribing for pediatric URIs in South Korea, stratified by antibiotic class and patient age group. We conducted a retrospective study using the National Health Insurance Service (NHIS) pediatric sample cohort in South Korea (2002-2019). The dataset included 639,702 outpatient visits with a primary URI diagnosis among 369,702 children < 18 years. Children with complex chronic conditions were excluded, and antibiotic prescriptions were grouped into six classes. Primary outcomes were the antibiotic prescribing rate (per URI visit) and antibiotic exposure days (per 1000 person-years), stratified by age group and antibiotic class. Temporal trends were assessed using joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). The proportion of antibiotic prescriptions for pediatric URIs declined from 80.2 % to 49.1 % (APC -0.27 % per year; 95 % CI -0.62-0.04). Narrow-spectrum penicillin use decreased, macrolide remained relatively stable, and broad-spectrum penicillin initially increased and later stabilized. Antibiotic exposure days per 1000 person-years increased overall (AAPC 1.88 %, 95 % CI 1.59-2.21), with the highest exposure in children aged 1-5 years, peaking around 2008 before gradually declining. Other age groups were largely stable. Antibiotic prescribing declined modestly overall, while broad-spectrum penicillin increased and narrow-spectrum agents decreased, with exposure highest in children aged 1-5 years. Sustained outpatient stewardship is needed to reduce unnecessary use and prioritize narrow-spectrum therapy when indicated.
32. Development of a Composite Measure to Identify Priority Areas of Need for Cancer Screening Interventions.
期刊: JCO clinical cancer informatics 发表日期: 2025-Dec 链接: PubMed
摘要
Cancer centers and health systems are tasked with deciding where to deploy community interventions to reduce the burden of cancer within their catchment areas. Few methods exist to prioritize communities in a systematic manner, considering features of individuals, populations, systems, and policies. We developed a geographically informed index to prioritize census tracts based on community need, with an initial focus on identifying communities in need of breast cancer screening (BCS) interventions. This study used publicly available data to select variables known to be associated with disparities in BCS rates. Variables were identified from five categories: economic stability, education access and quality, neighborhood and built environment, social and community context, and health status and health care access and quality. Data were analyzed at the census tract level across the Sidney Kimmel Comprehensive Cancer Center catchment (N = 1,216). Principal component analysis was applied to 23 variables, and five principal components were selected to construct a composite measure using a weighted sum. The resulting index values were used to stratify the data set for further analysis and mapped for visualization. The analysis produced the Community Need Priority Index (CNPI)-BCS, with values ranging from 0 to 1 (mean, 0.259; standard deviation [SD], 0.161). The top quintile (Q5, n = 243) represented the highest-need communities. Q5 tracts were primarily concentrated in Philadelphia, Camden, and Delaware counties. Philadelphia County had the highest average (mean, 0.364; SD, 1.78) and the most tracts in the top quintile (45%, n = 175). Montgomery county had the lowest average (mean, 0.169; SD, 0.092). This novel methodological approach considered the complex nature of multiple, intersectional barriers to good health to identify priority areas of need within cancer center catchment areas.
33. Impact of SPOP Mutations on Clinical Outcomes in Metastatic Prostate Cancer.
期刊: JCO precision oncology 发表日期: 2025-Dec 链接: PubMed
摘要
Previous studies suggest that SPOP mutations result in increased sensitivity to androgen receptor pathway inhibitors (ARPIs) but are limited by lack of granular data. We hypothesize that SPOP mutations are associated with improved outcomes across the spectrum of advanced prostate cancer (PC). Using the real-world clinicogenomic Prostate Cancer Precision Medicine Multi-Institutional Collaborative Effort database, we analyzed outcomes based on SPOP mutation status. The primary end point was overall survival (OS) from the diagnosis of metastatic disease. Secondary end points included real-world progression-free survival (PFS) and PSA90 response. Among 2,097 patients with metastatic PC, 5.5% (N = 115) had SPOP-mutated tumors. Compared with SPOP wild-type, patients with SPOP mutations were older at diagnosis (median 65 v 63 years; P = .001) and had higher (≥8) Gleason sum (68% v 54%; P = .02), higher incidence of lung metastasis (17% v 6%; P = .001), and increased frequency of intraductal features (13% v 5%; P < .001). SPOP mutations were associated with improved PSA90 response with first ARPI exposure in the castrate-resistant setting (60% v 40.6%; OR, 2.20 [95% CI, 1.15 to 4.19]; P = .02) but not in the castrate-sensitive setting (78.9% v 71.5%; OR, 1.49 [95% CI, 0.66 to 3.37]; P = .43). Median PFS with first ARPI did not differ in SPOP-mutated versus wild-type group in both the castrate-sensitive (24.2 v 19.2 months; hazard ratio [HR], 0.80 [95% CI, 0.49 to 1.32]; P = .39) and castrate-resistant settings (15.0 v 12.4 months; HR, 0.81 [95% CI, 0.58 to 1.12]; P = .20). In multivariable analysis, SPOP mutations were associated with improved OS (HR, 0.65, P = .02). SPOP mutations were associated with longer OS despite the presence of aggressive clinical features. The distinct clinical and molecular features of SPOP-mutated PC support its consideration as a unique molecular subtype with prognostic implications.
34. Impact of RAS-MAPK Pathway Genetic Alterations on Radiotherapy Response in Metastatic Lung Adenocarcinoma.
期刊: JCO precision oncology 发表日期: 2025-Dec 链接: PubMed
摘要
To determine whether driver gene alterations in metastatic non-small cell lung carcinoma (NSCLC) spine metastases are associated with local tumor control after radiotherapy (RT). Patients with NSCLC who underwent RT for spine metastasis and tumor genetic profiling were ascertained. Associations between driver gene mutations incidence of local failure were analyzed, followed by competing risk analysis for significant associations. The results were validated using in vitro clonal survival assays of CRISPR-engineered NSCLC cell lines. A total of 181 patients were analyzed, with a median follow-up of 15.2 months (IQR, 8.0-31.9 months). The 3-year risk of local failure was 0.15 (95% CI, 0.10 to 0.20). Patients harboring NF1 or BRAF driver alterations experienced higher 3-year local failure rates (NF1: 0.33 [0.09-0.61] v 0.13 [0.09-0.19]; P = .002); BRAF: 0.31 [0.08-0.57] v 0.13 [0.09-0.19]; P = .04). NF1 loss-of-function mutations conferred radioresistance in one of two NSCLC cell lines tested in vitro. Based on the convergence of NF1 and BRAF signaling, the RAS-mitogen-activated protein kinase (MAPK) pathway was further interrogated. KRAS mutations overall were not associated with local failure. However, comutation of KRAS/TP53 exhibited a trend toward elevated 3-year local failure, 0.31 (0.11-0.55) versus 0.13 (0.08 v 0.19), P = .05. RAS-MAPK pathway driver alterations accounted for 53% of all local failures (P < .0001) and showed an elevated 3-year risk of local failure (0.36 [0.2-0.51] v 0.09 [0.05-0.15]; P < .001), including when treated with stereotactic body RT (0.28 [0.1-0.5] v 0.05 [0.02-0.11]; P = .001). Driver alterations in the RAS-MAPK signaling pathway confer radioresistance in metastatic NSCLC. These genetic alterations may serve as biomarkers to personalize RT strategies or as targets to enhance radiosensitivity.
35. Clinical Presentation of MTAP Deletions in Real-World Settings: Lessons for the Clinical Development of Novel Targeted Therapies.
期刊: JCO precision oncology 发表日期: 2025-Dec 链接: PubMed
摘要
Homozygous deletions of methylthioadenosine phosphorylase (MTAP) enzyme are common across human cancers and are associated with poor prognoses. Currently, to our knowledge, there are no approved therapies targeting MTAP-deleted tumors, although there is significant ongoing research in this area. The aim of this study was to analyze the prevalence, clinical impacts, and comutational landscapes of patients with MTAP deletions in a network of community-based oncology clinics. We conducted retrospective analyses of clinicogenomic data from 21 community oncology practices in the Sarah Cannon Research Institute (SCRI) network. Clinical data from electronic health record systems, including drug administration dates, diagnosis dates, and molecular data from commercial next-generation sequencing vendors, were aggregated in SCRI’s web-based precision medicine platform, Genospace. Overall survival (OS) and time to next therapy (TTNT) were analyzed using Kaplan-Meier plots and Cox proportional hazards regression. Patient data were deidentified before analysis. Among 10,936 patients analyzed in this study, 9.4% had homozygous MTAP deletions (MTAP-del). MTAP-del was prevalent in glioblastoma (58.2%) and mesothelioma (40.5%) and least common in breast (4.0%) and colorectal cancers (1.4%). Overall, MTAP-del patients had diminished OS (25.4 months v 52.1 months, P < .0001), with pronounced deficits in MTAP-del mesotheliomas (12.8 months v 23.0 months, P = .0478) and urothelial carcinomas (22.9 months v 36.0 months, P = .0549). MTAP-del patients receiving chemotherapy had shortened TTNT intervals overall (8.1 months v 10.1 months, P = .0002), and for urothelial (5.4 months v 6.4 months, P = .0195) and gastroesophageal carcinomas (7.2 months v 8.8 months, P = .0412). MTAP-del patients had distinct mutational landscapes, compared with MTAP-prof patients, including lower rates of TP53 mutation. MTAP is a key biomarker in precision oncology; this work describes the clinical outlook for these patients within the community-oncology setting. These insights can inform future study design, as MTAP-directed therapies continue their development.
36. Wildfire-related PM2.5 and respiratory transmitted disease among Chinese children and adolescents from 2008 to 2019: A retrospective study.
期刊: PLoS medicine 发表日期: 2025-Dec 链接: PubMed
摘要
Exposure to fine particles (PM2.5) from wildfires is known to cause deaths and chronic diseases, but its effect on respiratory infections, especially in children and adolescents, is not well characterized. We aimed to comprehensively assess the association between short-term exposure to wildfire-related PM2.5 and the incidence and mortality of respiratory transmitted diseases in children and adolescents. Data on daily counts of incident and mortality cases of respiratory transmitted diseases in persons aged 4-24 years old were collected from China Information System for Disease Control and Prevention, covering 501 cities from 2008 to 2019. Daily concentrations of wildfire-related PM2.5 were estimated using machine learning and chemical transport models at a 0.25°×0.25° spatial resolution. We used time-stratified case-crossover design with conditional logistic regression to estimate the association between short-term exposures to wildfire-related PM2.5 and incidence and mortality of respiratory transmitted diseases, adjusting for temperature, relative humidity, precipitation, and total PM2.5. There were 6,089,271 incident cases and 1,034 mortality cases of 10 respiratory transmitted diseases included in our analyses. Each 5 μg/m3 increase in the lag 0-28-day (average of current day and previous 28 days) for wildfire-related PM2.5 was associated with a 6.8% (95%CI: 5.0%, 8.7%) increase in the daily incidence rate of respiratory transmitted diseases, which is greater than that of a 1.2% (1.0%, 1.4%) increase associated with the same increase of non-wildfire-related PM2.5. A 5 μg/m3 increase in wildfire-related PM2.5 was associated with a 28.6% (21.0%, 36.8%), 5.2% (2.3%, 8.3%), 12.6% (9.5%, 15.8%), and 13.6% (5.6%, 22.2%) increase in the incidence of seasonal influenza, scarlet fever, rubella, and measles, respectively. Although wildfire-related PM2.5 constitutes only 2.7% of the total PM2.5, it contributes significantly to respiratory transmitted diseases, accounting for 10.8% of all PM2.5-associated cases. In areas where the annual concentration of wildfire-related PM2.5 is lower than 1.5 μg/m3, the proportion of cases associated with wildfire-related PM2.5 reached 29.7%. Study limitations include potential exposure misclassification from using city-average wildfire PM2.5 as a proxy for individual exposure and an inability to adjust for some potential confounders. Short-term exposure to wildfire-related PM2.5 was associated with increased incidence of respiratory transmitted diseases, surpassing the impact observed with non-wildfire-related PM2.5. This phenomenon is not restricted to regions with high pollutant concentrations; even populations residing in areas with lower concentrations of wildfire-related PM2.5 are at an increased risk of these respiratory conditions. Consequently, there emerges a pressing global imperative to confront the escalating challenges presented by climate change and the intensifying menace of wildfires.
37. Meteorological and environmental drivers of West Nile virus prevalence in Culex pipiens mosquitoes in Emilia-Romagna, Italy in 2013 to 2022.
期刊: PLoS pathogens 发表日期: 2025-Dec 链接: PubMed
摘要
As West Nile Virus (WNV) is expanding its geographical range across Europe, there is an urgent need to characterise and better understand its transmission drivers to inform public health surveillance, disease control, and preparedness planning. We utilised 10 consecutive years of large-scale and fine-resolution WNV entomological field surveillance data from the Emilia-Romagna region in northern Italy, to evaluate the relationships between WNV infection rates in Culex mosquitoes and environmental and climatic conditions as well as WNV presence in the avian reservoir. We used fine-scale spatiotemporal regression models including non-linearities, to assess the drivers of presence and prevalence of WNV-positive mosquitoes. We validated the model estimates against reported cases of human WNV neuroinvasive disease in the region. We found evidence of established hotspots of mosquito WNV infection across multiple years. The presence of WNV in local birds was positively associated with presence and prevalence of WNV-positive mosquitoes (mean regression coefficients: 0.776 (95% CrI, 0.469, 1.08) and 0.226 (95% CrI, 0.053, 0.399) respectively), and the proportion of agricultural land use was positively associated with presence of WNV-positive mosquitoes (4.20 (95% CrI, 2.65, 5.75)). We identified a minimum temperature threshold around 13°C, below which mosquito WNV infection was reduced. Our findings provide evidence of the impact of temperature and environment on Culex populations and WNV infection dynamics at the local level, which were highly correlated with human case reports. The estimated role of the minimum temperature and the observed and projected increase in this variable under climate change suggest that WNV will continue to represent a risk for human and animal health in the region in future decades. Future work should focus on better understanding the mechanisms behind infection drivers, on the optimal implementation of surveillance and control activities around high-risk areas, and on the assessment of how specific land use practices could represent potential solutions to WNV infection.
38. Influenza Immunization at Midlife and the Risk of Parkinson Disease.
期刊: JAMA network open 发表日期: 2025-Dec-01 链接: PubMed
摘要
Influenza infection could be associated with a long-term increase in the risk of Parkinson disease (PD). However, the benefit of influenza immunization as a preventive measure for PD remains unknown. To assess whether immunization for influenza at midlife (between age 40 and 50 years) is associated with a decreased risk of PD. This cohort study used electronic medical records from the UK’s Clinical Practice Research Datalink Aurum. The study cohort comprised individuals vaccinated for influenza between 40 and 50 years of age (hereafter, with influenza immunization at midlife) from 1995 to 2017 and unvaccinated controls (hereafter, without influenza immunization at midlife) matched 1:1 on age, sex, socioeconomic status, and calendar month of the vaccination. All analyses were conducted between January and May 2025. The primary outcome was incident PD. A modified intention-to-treat exposure definition with a 2-year lag period was applied to assess the risk of incident PD associated with influenza immunization at midlife vs no influenza immunization at midlife. Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% CIs of the study outcome. Inverse probability of censoring weighting was used to account for selection bias, and propensity score matching was used for confounding control. Secondary analyses assessed potential effect size modifiers. Sensitivity analyses explored the implications of different potential biases. The study cohort included 1 191 209 individuals (mean [SD] age, 44 [3] years; 673 920 females [56.6%]), of whom 612 974 received influenza immunization at midlife and 578 235 did not receive influenza immunization at midlife . Influenza immunization at midlife vs lack thereof was not associated with the risk of PD overall (crude incidence rates per 1000 person-years, 0.16 vs 0.10; matched HR, 0.96; 95% CI, 0.76-1.22). Results varied over time, with the lowest point estimate approximately 8 years after vaccination (HR, 0.75; 95% CI, 0.52-1.08), but none of the differences were statistically significant. Results also varied by seasonality, with a lower point estimate for those vaccinated during influenza season (matched HR, 0.62; 95% CI, 0.33-1.15) compared with those vaccinated outside of influenza season (matched HR, 1.07; 95% CI, 0.81-1.42). Stratification by age, sex, or vaccination prior to cohort entry did not modify the association. Sensitivity analyses supported the findings of the primary analysis. This cohort study found that influenza immunization at midlife was not associated with the risk of PD in the overall population. Potential benefits for PD risk occurring several years after vaccination or in specific patient subgroups require further investigation.
39. A scalable natural language processing framework for drug repurposing in chemotherapy-induced adverse events from clinical narrative records.
期刊: European journal of cancer (Oxford, England : 1990) 发表日期: 2025-Nov-29 链接: PubMed
摘要
Preventing chemotherapy-related adverse events (AEs) remains an unmet clinical challenge. Preclinical studies have suggested protective effects of several existing agents, but translation into human evidence has been limited. We aimed to establish proof of concept (PoC) for drug repurposing by applying a natural language processing (NLP)-based framework to electronic health record (EHR) narratives, thereby bridging preclinical findings with clinical validation. We retrospectively analyzed 56,326 patients with cancer treated at the University of Tokyo Hospital (2004-2023). A transformer-based NLP model extracted symptomatic AEs from clinical notes. Candidate preventive drugs identified from preclinical evidence were assessed using propensity score matching and Cox proportional hazards models. We evaluated angiotensin II receptor blockers (ARBs) for fluoropyrimidine-induced oral mucositis and ramelteon for platinum-induced peripheral neuropathy, with laxatives serving as a negative control. NLP demonstrated high accuracy (precision 0.81-0.83; recall 0.95-0.97). After matching, ARB co-administration was significantly associated with reduced mucositis incidence (hazard ratio [HR] 0.58, 95 % confidence interval [CI] 0.44-0.77; P < 0.001), representing a clinical PoC consistent with mechanistic preclinical data. Ramelteon showed an exploratory protective signal against neuropathy (HR 0.60, 95 % CI:0.38-0.93; P = 0.024). No preventive association was observed for laxatives. This study introduces a scalable NLP-epidemiology framework for non-invasive, real-world validation of drug repurposing candidates. The ARB finding provides human-level PoC evidence supporting prospective clinical testing, while the ramelteon signal warrants further exploration. Our approach demonstrates how EHR narratives can operationalize translational research, prioritizing safe, accessible agents for improving the tolerability of cancer treatment.
40. Placental angiogenic biomarkers in relation to prenatal bisphenol and phthalate exposure.
期刊: Placenta 发表日期: 2025-Nov-26 链接: PubMed
摘要
Placental development, involving rapid vascularization, is regulated by concentration gradients of numerous growth factors and hormones. Placental growth factor (PlGF) promotes vasculogenesis and angiogenesis in the placenta, while soluble fms-like tyrosine kinase-1 (sFlt-1) inhibits these processes. An elevated ratio of sFlt-1/PlGF in maternal serum is predictive of preeclampsia. Exposure to two classes of ubiquitous endocrine-disrupting chemicals, bisphenols and phthalates, has also been previously linked to preeclampsia development. We investigated the relation of urinary concentrations of bisphenols and phthalate metabolites, measured up to three times during pregnancy, with serum concentrations of sFlt-1, PlGF, and their ratio in the New York University Children’s Health and Environment Study. Linear mixed models were used to analyze up to three measurements of PlGF and sFlt-1 adjusted for gestational age at the time of serum collection. We found that higher molar sum concentration of bisphenol A and bisphenol S was associated with lower sFlt-1 (-0.12, 95 % CI: -0.22, -0.03), higher PlGF (0.08, 95 % CI: -0.01, 0.18), and lower sFlt-1/PlGF ratio (-0.12, 95 % CI: -0.21, -0.02). Phthalic acid and metabolites of anti-androgenic and low molecular weight phthalates were similarly associated with higher PlGF and lower sFlt-1/PlGF, but only after 20 weeks of gestation. The unexpected relationship between prenatal bisphenol and phthalate exposure and lower sFlt-1/PlGF warrants further investigation. Our results suggest that the effect of these endocrine-disrupting chemicals on placental health may be more complicated than what is currently understood through these angiogenic biomarkers.
41. Extrinsic Noise or Intrinsic Coupling: Dissecting Correlated Fluctuations in Gene Transcription.
期刊: Physical review letters 发表日期: 2025-Nov-21 链接: PubMed
摘要
Understanding stochastic gene transcription requires distinguishing between intrinsic molecular randomness and extrinsic environmental variability. Traditionally, these components are identified as the independent and correlated fluctuations between identical gene copies within the same cell. However, intrinsic gene-gene interactions can introduce additional correlations, challenging this standard approach. Here, we develop a new noise decomposition framework based on a theoretical model of stochastic transcription for an intrinsically coupled gene pair under fluctuating environments. By analytically deriving correlated fluctuations of nascent RNA, we disentangle intrinsic coupling from extrinsic noise based on their distinct relationships with the mean and variance of gene activation probabilities across varying environments. Applying this framework to single-cell transcription data from Drosophila embryos, we uncover previously unidentified couplings between sister alleles and between alternative promoters of an endogenous gene. Our findings offer a versatile approach for deciphering intrinsic gene-gene interactions in stochastic transcription within fluctuating environments.
42. Rejection sensitivity as a mechanism linking childhood maltreatment and peer rejection to adolescent dating violence.
期刊: Current opinion in psychology 发表日期: 2025-Nov-20 链接: PubMed
摘要
Adolescent dating violence is a growing public health concern that threatens youth well-being worldwide. Early exposure to invalidating environments, such as parental maltreatment and peer rejection, can foster patterns of violence in later romantic relationships. Drawing on developmental theories of attachment and social learning, we synthesize evidence linking these early adverse experiences to dating violence. Specifically, we examine how maltreatment distorts attachment security and models aggression as a relational tool, and how peer rejection compounds these effects by normalizing hostility and impairing emotion regulation. We propose that rejection sensitivity is a central mechanism linking early invalidating relationships to adolescent dating violence. Findings underscore the need for prevention programs addressing both family and peer contexts of violence.
43. Sediment flux and stony coral health in the nearshore US Virgin Islands.
期刊: Marine environmental research 发表日期: 2025-Nov-19 链接: PubMed
摘要
Human activities in tropical watersheds are increasing rates of terrestrial silt and clay deposition to nearshore environments and negatively impacting coral reef ecosystems. We sampled sediment flux across a range of coral reef environments in the US Virgin Islands, Caribbean Sea using standard sediment traps and evaluated the relationship of sediment particle size and quality (organic, carbonate, terrigenous) on coral health. We found high variability in rates of sediment deposition that corresponded temporally to storm and swell events. However, this was driven spatially by distinctions between nearshore and offshore habitats and orientation to Atlantic swell regimes, suggesting that sediment impacts also have a strong spatial component on Caribbean reefs. We found that increasing fluxes of silt-clay and terrestrial sediments in nearshore environments were linearly related to a higher prevalence of coral bleaching, old partial mortality and overall health impairment at a site. In contrast to expectations, total sediment and organic fluxes in nearshore environments were not related to any measure of coral health. The result from total sediment flux suggests that sediment quality is as more important to coral health than overall quantity and should be incorporated into coral reef sediment monitoring studies.
44. Retrospective analysis of survival of patients with HER2-positive breast cancer with microscopic residual invasive disease after neoadjuvant chemotherapy.
期刊: Breast disease 发表日期: 2025 链接: PubMed
摘要
BackgroundTrastuzumab emtansine (T-DM1) is indicated for HER2-positive early breast cancer with residual invasive disease after neoadjuvant chemotherapy (NAC). However, the extent of benefit T-DM1 will provide over trastuzumab plus pertuzumab (HP) in patients with microscopic residual invasive disease after NAC remains unclear.MethodsData of patients with HER2-positive breast cancer who were treated with HER2-targeted therapy as NAC and completed HP or T-DM1 as adjuvant therapy from October 2018 to October 2022 were retrospectively extracted from the institutional database. Invasive disease-free survival (IDFS), overall survival (OS), and safety were analyzed.ResultsOf the 110 patients, 61 achieved pCR (55.4%), and 49 had residual invasive disease. Of the 49 patients, 29 received HP, and 20 received T-DM1 as adjuvant therapy. The proportion of ypT1aN0 was 31.0% (n = 9/29) in the HP group and 45.0% (n = 9/20) in the T-DM1 group. The 3-year IDFS and OS were 96.6% and 95.0%, and 96.6% and 100% in the HP and T-DM1 groups, respectively. The 3-year IDFS and OS of patients with ypT1aN0 were 100% in both groups. The most common adverse events of any grade in the T-DM1 group were aspartate aminotransferase increased (90%) and alanine aminotransferase increased (85%) aminotransferase and platelet count decreased (70%).ConclusionThe 3-year IDFS and OS of patients with ypT1aN0 disease who received HP or T-DM1 as adjuvant therapy were comparable.
45. Economic evaluations of community health worker programs focussed on neglected tropical diseases in low- and middle-income countries (2015-2024): A scoping literature review.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
Neglected tropical diseases (NTDs) are a diverse group of more than twenty diseases caused by parasitic, bacterial, and viral infections, affecting more than one billion individuals worldwide. Economic evidence can help guide the investment in Community Health Workers (CHWs) who can help expand access to preventive and curative NTD services in low- and middle-income countries (LMICs). A scoping review was conducted across ten databases and grey literature, covering studies published between August 2015 and July 2024. Search terms related to “Community Health Workers” and “Economic Evaluations” were used. Studies were screened via Covidence software based on inclusion and exclusion criteria. Data on study methodology, costs, and outcomes were extracted, tabulated in Microsoft Excel, and analysed. Of the 29 included scenarios (n = 10 studies), 7 were about community mass drug administration and 22 focused on other topics - such as disease-specific prevention and treatment (e.g., dengue). Across scenarios, the most commonly reported outcomes were cost per service delivered (ranging from $0.13-$5.33) and cost per capita (ranging from $10.24-$21.09). Five scenarios reported on cost-effectiveness, with varied results (40-50% of scenarios were reported as cost effective). One study found that interventions were more likely to be cost-effective when they leveraged integrated care as opposed to vertical approaches. The evidence base for economic evaluations regarding CHW involvement in NTD programs is highly limited. From the 10 studies identified there was no clear conclusion with regards to cost-effectiveness or affordability of CHWs in NTD programs in LMICs. To better understand the critical role CHWs can play in both prevention- and treatment-focused NTD programs, further evidence of the cost-effectiveness and affordability of such interventions is needed.
46. The association between local hospital segregation and hospital quality for medicare enrollees.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
There is considerable racial segregation in U.S. hospitals that residence alone cannot explain. Little is known about how this patient sorting affects racial inequalities. We use 2019 Medicare claims data linked to CMS Overall Hospital Quality Star Ratings to measure how the sorting of Black patients to different hospitals within the same healthcare markets affects racial gaps in hospital quality. Defining a hospital’s market based on driving time, we use the local hospital segregation (LHS) index to measure racial sorting within a market; this measures the hospital’s disproportionate share of Black patients relative to the hospital’s market. In the sample of 2,163 hospitals, we find a 10 percent point increase in the LHS was associated with a 79% increase in the risk of being admitted to a lower-quality hospital. Thus, hospitals receiving a disproportionate share of Black patients due to market segregation are of systematically lower quality. A better understanding of hospital choice drivers could help reduce racial inequalities in health outcomes.
47. Trends in cognitive outcomes in middle-aged Americans across three birth cohorts.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Middle age is a key life course period for targeting modifiable risk factors for late-life cognitive decline. Although the prevalence of chronic conditions that are risk factors for cognitive impairment has increased in middle-aged adults since the 1990s, little is known about corresponding trends in cognitive trajectories and incidence of cognitive impairment. We conducted a cohort study of 7,852 participants ages 50-56 enrolled from 1998-2010 in the Health and Retirement Study (HRS) without cognitive impairment at baseline. Participants were followed biennially to examine cognitive trajectories and new-onset cognitive impairment by age 65, based on the HRS cognitive test battery. We used mixed effects models to examine change in cognitive scores and Cox regression models to compare incidence of cognitive impairment no dementia (CIND) across three birth cohorts (1942-1947, “War Babies”; 1948-1953, “Early Baby Boomers”; 1954-1959, “Mid Baby Boomers”). Mid Boomers had lower baseline cognitive scores compared to earlier cohorts but a slower rate of cognitive decline. Hazards of CIND were higher among White Early and Mid Boomers compared to War Babies in the first half of follow-up, but lower in the second half. In both trajectory and incidence analyses, those with lower educational attainment and racial/ethnic minorities were at higher risk for worse cognitive outcomes. Findings show mixed trends in cognitive outcomes among middle-aged Americans. Overall, Mid Boomers had lower baseline cognitive scores but slower decline compared to earlier cohorts. However, disparities in cognitive outcomes persisted among those with lower educational attainment and racial/ethnic minorities.
48. Availability and readiness of health facilities for non-communicable disease services in Ethiopia: Evidence from the nationally representative health facility survey 2022.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
In response to the escalating non-communicable disease (NCD) challenge, effective management of NCDs requires sustained investments in infrastructure, trained health workforce, and the consistent availability of guidelines. Therefore, this study assessed both the availability and readiness of health facilities (HFs) to provide NCD-related services, while also examining how facility characteristics and health system factors are associated with service readiness. We analysed data from the nationally representative Ethiopia Service Provision Assessment (ESPA) survey 2021-22 to determine the availability and readiness of HFs for cardiovascular diseases (CVDs), diabetes, chronic respiratory diseases (CRDs) and mental, neurological and substance (MNS) use disorders-related services using the WHO Service Availability and Readiness Assessment manual. Readiness score was measured as the average availability of tracer items in percent, and HFs were considered ‘ready’ for NCDs management if they scored ≥70 (out of 100). We performed weighted multivariable logistic regression to identify factors affecting NCD service readiness. Approximately 93% reported offering services for diabetes, CVDs, and CRDs, while only 26% provided MH services. Overall service readiness remains critically low when applying the 70% readiness threshold. Only 15.68% of facilities were deemed ready for diabetes, 10.64% for CVDs, 3.14% for CRDs, and 11.52% for MNS use disorders-related services. Public facilities demonstrated significantly higher preparedness than private facilities. A number of factors have been associated with better service readiness, including the location of the facility, the level of the facility, having a quality control unit, conducting regular administrative meetings and receiving external supervision. This study reveals that overall service readiness for NCDs remains significantly low across HFs in Ethiopia. Public facilities and facilities located in urban settings demonstrated significantly higher levels of service readiness, highlighting substantial disparities in resource availability, integration with national health programs, and access to support systems. These findings underscore the need for Ethiopia’s health system to move beyond service availability and focus on enhancing the preparedness of care delivery, with particular emphasis on equity and integration.
49. Impact of pregabalin reclassification as a controlled substance in Egypt on gabapentinoid and opioid utilization: A repeated cross-sectional study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Pregabalin is commonly used for treating pain but is also recognized for its misuse potential. In response to rising abuse, Egyptian health authorities reclassified pregabalin as a controlled substance in August 2019, aiming to curb misuse and regulate its distribution. This study evaluated the impact of the 2019 policy on gabapentinoid (pregabalin and gabapentin) and opioid sales in Egypt. An interrupted time-series analysis using Autoregressive Integrated Moving Average (ARIMA) models was conducted on IQVIA MIDAS® quarterly volume sales data obtained under license from IQVIA for the period 2012-2023. Copyright IQVIA. All rights reserved. Drug volume sales were standardized per 1,000 individuals based on population estimates. ARIMA modelling was used to capture immediate and delayed effects of the August 2019 policy change. Percent changes for 3-, 6- and 12-months were also calculated. Overall gabapentinoid sales increased steadily until the second quarter of 2019. Following reclassification, a significant decline in total gabapentinoid sales (-67%) was observed, driven by a 99% drop in pregabalin sales, while gabapentin sales surged by 198%. ARIMA analyses of gabapentinoid sales showed a significant short-term effect (pulse: p < 0.001) and a notable gradual long-term change (ramp: p = 0.008). In contrast, opioids exhibited a significant short-term sustained increase (step: p = 0.010) but a non-significant gradual long-term change (ramp: p = 0.256), with sales rising by up to 49.5% at one year post-policy. Reclassifying pregabalin effectively reduced its utilization but prompted a shift to gabapentin use. Our findings highlight the complexity of drug policy interventions, underscoring the need for continuous monitoring to mitigate unintended substitution effects and better understand policy impacts of the treatment of pain.
50. Awareness of antimicrobial resistance and antibiotic use among poultry farmers in Accra, Ghana: A cross-sectional survey.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Antimicrobial resistance (AMR) in livestock production is an escalating global public health threat, fuelled in part by the misuse of antibiotics in animal farming. This study aimed to assess the knowledge, attitudes, and practices regarding antimicrobial use and AMR among poultry farmers in Accra, Ghana. A cross-sectional survey of 400 poultry farmers in five communities across the Greater Accra Region was conducted using a structured questionnaire. The survey collected data on demographics, AMR awareness, antibiotic usage practices (treatment, prophylaxis, or growth promotion), and commonly used antibiotic classes from 14th March to 26th September 2023. Descriptive statistics summarized the findings. Associations between farmer characteristics (age, gender, education, location) and antimicrobial self-medication (treating poultry without veterinary consultation) were evaluated using chi-square tests. A multivariate logistic regression model identified independent demographic predictors of self-medication, with significance set at p < 0.05. Most farmers (70%) reported self-medicating sick poultry without veterinary consultation, and only 35% of respondents were aware of the concept of AMR. Antibiotics were predominantly used for treating illness (63% of farmers), while 20% used them for prophylaxis and only 4% for growth promotion. The most administered antibiotic classes were tetracyclines (26%), nitrofurans (24%), aminoglycosides (18%), penicillins (17%), and fluoroquinolones (10%). Male farmers and those over 30 years had significantly higher rates of antimicrobial self-medication than female and younger farmers (p < 0.001), and in multivariate analysis, being male (odds ratio ~4.9), age > 30 years (OR ~4.6), and farming in a rural area (OR ~2.7) were independent predictors of self-medication with antibiotics. Inappropriate antibiotic use is highly prevalent among poultry farmers in Accra, and awareness of AMR is low. These findings underscore an urgent need to strengthen veterinary oversight and enforce regulations on antibiotic sales. Educating farmers through a One Health approach is also recommended to promote prudent antibiotic use and curb the rise of antimicrobial resistance.
51. Population Health Physical Therapy--Walk with a Doc in an Underserved Community with Academic, Housing Sector, and Health Department Partners: A Case Report.
期刊: Journal of allied health 发表日期: 2025 链接: PubMed
摘要
Individuals living in underserved communities often have difficulty being physically active, and there is limited research on how allied health professionals can change this. This study aimed to determine if an intersectoral academic-community partnership could implement a Walk With a Doc (WWAD) program in an underserved community. A city Housing Authority, Health Department, and Doctor of Physical Therapy (DPT) academic program conducted a WWAD program in a housing unit in a severely disadvantaged neighborhood. In an 8-week pilot, nine participants walked 46.7 km over 50 attendances. A commitment to regular communication between partners and participants was key to the success of the WWAD intervention, which continues to this day. A WWAD program was successfully implemented, and a strong working relationship focused on the health and wellness of an underserved population was created through this academic-community partnership. An intersectoral partnership can successfully implement a WWAD program in an underserved community. The success of this partnership highlights an opportunity for health science professionals to help underserved communities be more physically active.
52. Knowledge, attitude and practices among Healthcare Workers towards Pulmonary Plague Infection following an outbreak in Madagascar, 2017: A pilot study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
To assess training needs of healthcare workers (HCWs) on pulmonary plague (PP) control after the large PP outbreak in Madagascar 2017. In 2018, we conducted a knowledge, attitudes and practices (KAP) survey among HCWs (PP cases and comparison group) in Antananarivo and Toamasina. Proportions were calculated, differences between groups were tested for significance. Knowledge levels were similar for HCW PP cases and the HCW comparison group. Among 59 HCW over 90% named the distinctive disease forms of plague (bubonic (93%), pulmonary (98%)), and 72% the causative agent. Washing hands was mentioned as protective measure by 56%, while 93% reported to have always washed hands after performing medical procedures. Only 3.5% reported managed PP cases before the outbreak; 38% reported to have felt confident performing invasive procedures while caring for PP cases at the beginning versus 62% at the end of the outbreak. HCW who remained uninfected reported more often than PP cases to have worn multiple or single use medical coats ((93% vs. 53%, p = 0.001; 60% vs. 20%, p = 0.028), and less frequently to have paid for chemoprophylaxis out of pocket (11% versus 50%; p = 0.008). Despite the good overall knowledge, specific knowledge gaps and the mismatch between knowledge and practice of basic hygiene measures and low confidence in providing care for PP cases after the outbreak indicate a persisting need for training.
53. Sense-checking the approach to quantitative sensory testing to detect chemotherapy-induced peripheral neuropathy.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
People with chemotherapy-induced peripheral neuropathy (CIPN) have abnormalities in Quantitative Sensory Test (QST) findings. However, the predictive utility of QST for the early detection of CIPN in individuals has not been demonstrated. This will require longitudinal QST during chemotherapy treatments. However, QST is time-consuming, requires expertise and complex, costly equipment which has largely prevented its adoption in routine clinical practice. We aimed to assess approaches to develop a reliable, straightforward, time efficient and sensitive sensory testing method. Guided by patient partner input and previous literature, we selected thermal and vibration detection thresholds as target QST parameters. A series of iterative experiments was conducted to determine the optimal body test site and to develop a novel vibration testing protocol. The thenar eminence emerged as the best candidate due to higher sensitivity to all stimulus modalities, lower variance and less age-related change compared to the feet. We demonstrated significant differences in thermal thresholds between healthy participants and people with CIPN measured at the thenar but not the feet. The vibration testing protocol, employing a linear resonant actuator, performed better than a calibrated tuning fork being sufficiently sensitive to identify age-related and body site differences in sensory function well as tracking sensory loss induced by local anaesthetic nerve block. These findings establish a testing framework to deliver QST at a single convenient body site with a reduced set of modalities to efficiently track multifibre sensory function for patients at risk of developing neuropathy.
54. Temperature-humidity synergistic effects on predominant intestinal infectious diseases in Shenzhen, China: A predictive modeling framework for epidemiological early warning systems.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The prevalence of intestinal infectious diseases (IIDs) in densely populated cities substantially escalates the burden of disease. An ecological study on the epidemiological trends of predominant IIDs-hand, foot, and mouth disease (HFMD), viral diarrhea (DV), and non-viral diarrhea (DN)-was conducted in Shenzhen, China (2012-2022), aiming to elucidate the associations of meteorological factors, including extreme temperatures, seasonal variations, and temperature-humidity interactions with IID transmission, and to establish a monitoring and early warning framework. We assessed temperature-related morbidity’s short-term lagged effects, long-term cumulative impacts, and seasonal patterns using distributed lag non-linear models, finding that high temperatures (30°C) significantly increase HFMD and DN risks, low temperatures (13.8°C) worsen DV infections, and high temperatures have specific pathogenic effects on individuals aged 0 and over 20 years. Humidity-mediated seasonal variations in the incidence of IIDs were identified within equivalent temperature ranges. Generalized additive models (GAMs) further decoded the incidence patterns of IIDs across population subgroups under temperature-humidity interactions. An early warning model based on temperature-humidity indicators successfully predicted HFMD and DV outbreaks, establishing a novel framework for future epidemiological analyses grounded in temperature-humidity evidence. This study provides actionable insights for optimizing region-specific public health interventions and strengthening early risk mitigation strategies.
55. Lime-based supplement reduces calcium oxalate stone recurrence: A multicenter randomized controlled trial.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Recurrent urolithiasis is a major clinical challenge, with more than 50% of patients experiencing recurrence within 5 years. While potassium citrate effectively reduces recurrence, poor adherence due to cost and gastrointestinal side effects limits its long-term use. Citrus-based interventions, such as lime juice, have shown potential in enhancing urinary citrate and alkalinity but require further validation. This study evaluated the efficacy of a lime-based phytochemical-rich regimen (LPR) in preventing stone recurrence and reducing urinary inflammation in post-operative urolithiasis patients. This multicenter, double-blind, randomized controlled trial aimed to evaluate the efficacy and safety of a novel lime-based preparation called LPR in preventing kidney stone recurrence over 24 months. In a double-blind, randomized, placebo-controlled, multicenter trial, 173 patients with calcium oxalate urolithiasis who had undergone successful stone removal were enrolled from six hospitals in Thailand. Participants were randomized to receive either LPR or placebo for 24 months. The primary outcome was the incidence of stone recurrence confirmed by computerized topography (CT). Secondary outcomes included changes in urinary protein excretion and urinary interleukin-8 (IL-8) level, a pro-inflammatory cytokine implicated in renal inflammation and stone formation. Kaplan-Meier survival analysis and multivariate Cox regression were used to assess recurrence risk. Of 173 enrolled participants, 151 completed the study. The recurrence rate at 2 years was significantly lower in the LPR group (14%) compared to placebo (45%) (p < 0.001). Kaplan-Meier analysis demonstrated a hazard ratio (HR) of 0.24 (95% CI: 0.13-0.44; log-rank p < 0.0001) favoring LPR. Among completers, LPR significantly reduced urinary IL-8 level (p = 0.017) and 24-hour urinary protein excretion (p = 0.032) compared to baseline and placebo. No serious adverse events were reported, and adherence was high in both groups. LPR, a lime-based supplement rich in citrate and flavonoids, significantly reduced the 2-year recurrence rate of calcium oxalate stones by approximately 76%. This effect may be mediated by increased urinary citrate excretion, alkalinization, and attenuation of renal inflammation, as evidenced by reduced urinary IL-8 and proteinuria. LPR was well tolerated, with minimal adverse effects, and may serve as a safe, cost-effective adjunct for secondary prevention in patients intolerant to conventional alkali therapy.
56. Eye health in farmers: The impact of environmental and occupational factors.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Farmers face higher health risks due to constant exposure to environmental and occupational hazards. Prolonged sun exposure increases the risk of UV-related eye damage (e.g., cataracts and pterygium), and frequent contact with dust, pesticides, and airborne debris can lead to chronic eye irritation, infections, and long-term vision problems. The physical demands of farm work, along with limited access to protective eyewear and healthcare, further compound these risks, and make eye health a significant concern in agricultural communities. This cross-sectional study examines the prevalence of eye ailments among farmers, exploring the environmental, occupational, and demographic factors contributing to these conditions. Data were collected from 893 participants and analyzed using a descriptive-correlational methodology to identify associations affecting farmers’ eye health. Individuals whose primary or secondary profession is agriculture reported a greater impact of climate on their eye health (p=0.003), while farmers experienced a more significant effect of agricultural activities on their vision (p=0.007), despite being more likely to use protective equipment. However, no meaningful correlation was found between farming and the prevalence of specific eye illnesses. These findings emphasize that farmers are particularly vulnerable to environmental and occupational factors that negatively impact the daily eye health. Despite their increased use of protective equipment, they still reported significant effects from climate conditions and agricultural activities. This suggests that current protective measures may be insufficient or. inconsistently used. While no direct correlation was found between farming and ipecific eye illnesses, the cumulative impact of environmental exposure on vision health remains a concern. Hence, there is a need for improved protective strategies, increased access to eye care, and targeted interventions to mitigate the occupational risks faced by farmers.
57. Virtual Reality vs Traditional Lecture-Based Methods in Radiation Safety Continuing Medical Education.
期刊: Radiologic technology 发表日期: 2025 链接: PubMed
摘要
To compare the effectiveness of virtual reality (VR)-based continuing medical education (CME) with traditional lecture-based methods in enhancing radiation safety knowledge among health care professionals. Thirty-six health care professionals, including scrub nurses, cardiologists, and orthopedic surgeons, completed VR-based (RadSafe VR; Virtual Medical Coaching) and traditional training. Evaluations taken before and after training assessed knowledge retention, learner satisfaction, and radiation safety practices. Occupational eye dose radiation exposure also was monitored for 40 weeks using dosimeters. VR training improved knowledge retention by 30% at 3 months after training compared with traditional methods. Eye dose exposure decreased by 25%, indicating the intervention effectively reduced occupational radiation risks. In addition, 85% of participants preferred VR training because of its interactive and immersive features. VR training demonstrated superior efficacy in reducing radiation exposure while fostering behavioral adherence to safety protocols. This aligns with prior studies that emphasize VR’s ability to address the limitations of traditional methods of CME such as limited engagement and practical application. The sustained reductions in radiation exposure observed in this study suggest VR has the potential to promote long-term improvements in safety culture among health care professionals. VR-based CME improved radiation safety knowledge retention and significantly reduced radiation exposure. Its integration into training programs offers a cost-effective and successful approach to advancing safety protocols in clinical practice. Further research is warranted to confirm these outcomes.
58. Graduate Policy Class Has a Lasting Impact on Health Science Student Political Knowledge and Skill.
期刊: Journal of allied health 发表日期: 2025 链接: PubMed
摘要
Graduate students in nursing and occupational therapy programs are required by accrediting agencies to receive education in healthcare policy and to engage in advocacy. This study assesses the impact of policy classes on students’ political astuteness at the end of their programs of study. The study used a longitudinal, follow-up design to determine changes in political astuteness from beginning to completion of graduate programs or coursework. Students enrolled in the nursing and OT graduate programs at a mid-sized southeastern university completed a modified Political Astuteness Inventory (PAI) at the start and end of their program of study. Seventy-eight students participated in the study at the beginning of their program and 47 participated following the end of their program. The mean of all student scores on the Political Astuteness Inventory (PAI) showed a significant increase at the completion of their programs. Providing dedicated policy instruction has potential to increase political astuteness among graduate health science students. The political astuteness of those directly involved in health care is key to shaping effective, equitable healthcare policy.
59. Safety in Occupational Therapy Education: Student Perceptions of Emotional and Physical Safety Beyond the Classroom.
期刊: Journal of allied health 发表日期: 2025 链接: PubMed
摘要
This study investigates the perceptions of safety among entry-level doctoral occupational therapy (OT) students during their Level II fieldwork and capstone experiences. The significance of safety, defined as emotional comfort and the ability to express oneself authentically, is emphasized in fostering learning outcomes and mental health. The paper highlights that institutions providing safe spaces enhance acceptance and conversely, a lack of emotional safety, often due to microaggressions, adversely affects student retention and mental health. An author-created survey was utilized at the conclusion of the program to 45 third-year OT students. The 10-item survey assessed perceived physical and emotional safety during fieldwork/clinical rotations and capstone, occurrences of microaggressions, and possible solutions to improve student’s sense of safety. The majority of respondents reported feeling physically (95%) and emotionally (72%) safe overall. However, Level II fieldwork/clinicals was identified as the setting where students reported the most frequent lack of safety. Six main themes impacting safety perceptions were identified: expectations, reflection/advocacy, education/preparation, communication, coping strategy, and the acknowledgment that some students may not require interventions. Findings suggest that allied health academic programs should take steps to ensure that the safe spaces created during didactic portions of the curriculum extend into clinical and experiential settings. This approach will not only improve learning outcomes but also support students’ mental health and their ability to provide quality healthcare. Future research should focus on evidence-based practices to support student safety in clinical education.