公共卫生研究摘要 (2025-12-08)
共收录 57 篇研究文章
1. Hepatitis B virus vaccination in people with HIV: what's new?
期刊: Current opinion in HIV and AIDS 发表日期: 2025-Dec-08 链接: PubMed
摘要
Despite longstanding recommendations for HBV vaccination in people with HIV, coverage has remained low, and vaccine effectiveness has historically been limited due to poor immune responses and rapid waning of protection. This review summarizes recent advances in HBV vaccination strategies, updated guidelines, and emerging risks related to the increasing use of long-acting antiretroviral therapy and worsening vaccine mistrust. People with HIV experience reduced vaccine immunogenicity and faster waning of protective antibodies. The adjuvanted HepB-CpG vaccine, which includes a TLR-9 agonist, has demonstrated superior seroprotection and durability in both vaccine-naive and previously vaccinated individuals with HIV. Updated guidelines now recommend HepB-CpG as the preferred vaccine. The use of long-acting antiretroviral therapy and oral ART combinations without HBV activity has renewed attention to gaps in HBV immunity and the potential for new HBV infection or HBV reactivation. HBV vaccination remains fundamental to HBV prevention in PWH, especially as antiretroviral strategies evolve. Broader use of HepB-CpG vaccine, attention to serologic monitoring, and proactive vaccination before antiretroviral switches are essential to reduce HBV-related morbidity and support HBV elimination efforts.
2. Campfire Smoke as a Plausible Trigger for Vasospastic Angina: Insights From a Case Report.
期刊: The American journal of case reports 发表日期: 2025-Dec-07 链接: PubMed
摘要
BACKGROUND Vasospastic angina (Prinzmetal angina) has been linked to many risk factors, including tobacco smoking. Although numerous studies have reported associations between air pollutants and cardiovascular outcomes, the relationship with vasospastic angina remains poorly documented. We report the case of a 45-year-old man with normal coronary arteries who developed episodes of chest pain due to vasospastic angina following inhalation of campfire smoke. CASE REPORT A 45-year-old man with a history of eczema, dyslipidemia, Gramineae allergy, and past tobacco use participated in a 3-day camping trip during which he was regularly exposed to campfire smoke. Two days later, and with an otherwise negative environmental history, he began experiencing episodes of chest pain at rest. Exercise-stress electrocardiography was clinically negative. Coronography showed no significant stenosis. Cardiac magnetic resonance imaging (MRI) showed no myocardial fibrosis. Positron emission tomography (PET) showed no myocardial ischemia or necrotic sequelae. The diagnosis of vasospastic angina was eventually confirmed by an acetylcholine provocation test. While exposure to campfire smoke may have acted as a trigger, other contributing factors, including prior tobacco use, allergy history, and potential genetic susceptibility, could also have contributed to the development of vasospastic angina in this patient. CONCLUSIONS This case report suggests that air pollution exposure, such as campfire smoke, can act as a trigger for vasospastic angina and highlights the need for further studies to assess this relationship. From a public health perspective, identifying and avoiding potential triggers remains an important measure that can complement existing preventive strategies for cardiovascular diseases.
3. Peripheral Intravenous Access Rates Obtained by Emergency Medical Services in Pediatric Patients: A Retrospective Study.
期刊: Medical science monitor : international medical journal of experimental and clinical research 发表日期: 2025-Dec-07 链接: PubMed
摘要
BACKGROUND Peripheral intravenous (IV) access is a fundamental pre-hospital procedure performed by emergency medical services (EMS) personnel and remains the primary route for drug administration. Pediatric IV cannulation is often challenging in out-of-hospital settings. The aim of this study was to evaluate the frequency of peripheral intravenous access being established in pre-hospital settings by EMS staff in pediatric patients. MATERIAL AND METHODS This retrospective study analyzed 6331 records of emergency medical services (EMS) dispatches involving patients under 18 years of age between 2020 and 2022. The study protocol included an assessment of cannulation rate depending on the patient’s age, case characteristics, ICD 10 (International Classification of Diseases, Tenth Revision) diagnosis and whether the patient required transport to a hospital. RESULTS Peripheral intravenous access was established in 1073 of 6331 pediatric patients (16.94%). The cannulation rate increased significantly with age, from 1.03% in infants (<1 year) to 75.12% in adolescents (12-18 years) (p<0.001). Logistic regression analysis identified age, trauma (OR=1.96), poisoning (OR=3.88), and transfer by Helicopter Emergency Medical Services (HEMS) (OR=5.86) as predictors of IV cannulation (p<0.001). CONCLUSIONS The overall rate of peripheral intravenous access establishment in pediatric patients in pre-hospital settings is relatively low, with the lowest rates observed in children under 1 year of age. Age, trauma, poisoning, and referral to HEMS teams significantly increased the likelihood of cannulation. It is essential to develop evidence-based algorithms and targeted training to support EMS personnel in managing vascular access in critically ill children.
4. Identification of risk factors for latent tuberculosis infection in Xinjiang using machine learning.
期刊: BMC public health 发表日期: 2025-Dec-07 链接: PubMed
摘要
Latent tuberculosis infection (LTBI) is a significant reservoir for active tuberculosis development. Identifying key risk factors is crucial for prevention strategies. Machine learning techniques can uncover complex relationships between risk factors and disease outcomes. Data were collected from China’s Tuberculosis Management Information System. LTBI was defined by positive tuberculin skin tests. A case-control design comparing LTBI (n = 669) with active tuberculosis (ATB, n = 669) patients was employed. Propensity score matching (1:1) was performed using age, gender, and education level. Four machine learning models (random forest, XGBoost, support vector machine, and neural network) were developed for feature importance analysis. Least Absolute Shrinkage and Selection Operator (LASSO) regression and logistic regression identified key risk factors. Bootstrap resampling (n = 1,000 iterations) assessed model stability with 95% confidence intervals. Shapley Additive Explanations (SHAP) analysis provided feature importance interpretation. A risk nomogram was constructed and evaluated using receiver operating characteristic curves, calibration plots, and decision curve analysis. Among 1,338 matched participants, XGBoost demonstrated superior performance (AUC = 0.898, accuracy = 85.7%, sensitivity = 84.2%, specificity = 86.9%). SHAP analysis revealed age group (mean |SHAP value|=0.818) as the most influential predictor, followed by medical insurance type (0.599), income group (0.523), and education level (0.439). Logistic regression identified 11 significant risk factors: age (OR = 2.35, 95%CI: 1.86-2.96), BMI (OR = 0.81, 95%CI: 0.71-0.93), smoking status, occupational dust exposure, diabetes, medical insurance type, immunosuppressant use, education level, silicosis, anemia, and TB contact history. The nomogram showed good discrimination (AUC = 0.839) and clinical utility, identifying 64.44% of subjects as high-risk with 53.62% confirmed as true positives at 20% risk threshold. This study successfully identified key LTBI risk factors using machine learning approaches. The developed nomogram provides a practical tool for targeted screening in resource-limited settings. Interventions targeting modifiable factors such as smoking cessation and occupational dust control may reduce LTBI and active TB burden.
5. The effectiveness of bisphosphonates vs denosumab in people with dementia or frailty post hip fracture: a multi-database cohort study.
期刊: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA 发表日期: 2025-Dec-07 链接: PubMed
摘要
Brief rationale: The effectiveness of bisphosphonates versus denosumab after hip fracture, especially in people with dementia or frailty, remains unclear. Bisphosphonates were associated with a higher rate of subsequent fracture and a lower mortality rate in men. There are no differences by dementia or frailty status. Significance of the paper: Sex may influence antiresorptive treatment choice. The relative effectiveness of first-line antiresorptive medications post-hip fracture in people with dementia or frailty is not understood. We investigated the risk of a subsequent fracture and death in people prescribed bisphosphonates or denosumab following hip fracture, including in people with dementia and frailty. Parallel population-based cohort studies were conducted in Australia, Hong Kong, Taiwan, and the United Kingdom. People aged ≥ 50 prescribed or dispensed a bisphosphonate or denosumab within 60 days of discharge following their first hip fracture were included. Subgroup analyses were conducted for people with dementia, frailty, women, and men. Outcomes were second hip fracture, any subsequent fracture, and death. Inverse probability of treatment weighted Cox and competing risk models were used to estimate hazard ratios (HR) and subdistribution hazard ratios (sHRs) with 95% confidence intervals (CIs) for outcomes. Results across jurisdictions were combined using meta-analyses. There were 18,292 bisphosphonate users and 8560 denosumab users. Bisphosphonates versus denosumab were associated with similar rates of second hip fracture (sHR 1.13; 95% CI 0.76-1.69) and mortality (HR 0.99; 95% CI 0.94-1.04), but higher rates of any subsequent fracture (sHR 1.16; 95% CI 1.11-1.21), including in men (sHR1.27; 95% CI 1.15-1.42) but not in women (sHR 1.23; 95% CI 1.00-1.52), or in people with dementia or frailty. Men who used bisphosphonates had lower rates of mortality (HR 0.90; 95% CI 0.81-0.99) than men who used denosumab. Bisphosphonate users had higher rates of subsequent fracture than denosumab users. Mortality rates in men were lower with bisphosphonates than denosumab. There were no significant differences by dementia and frailty status.
6. Secular trends in incidence, survival, and health status at diagnosis of dementia in Sweden, 2007-2022.
期刊: Alzheimer’s research & therapy 发表日期: 2025-Dec-07 链接: PubMed
摘要
Although past screening cohorts have suggested a decline in the risk of dementia, it is important to monitor the population-level incidence and survival of diagnosed dementia, to inform care utilization and public health policies. This study provides nationwide analyses on time trends in the incidence of dementia diagnosis in Sweden between 2007 and 2022, as well as 5-year survival after a dementia diagnosis. Data from the total Swedish population aged ≥ 61 years during the period 2007-2022 were used. Incident dementia diagnoses were identified from specialist care and dispensed anti-dementia drugs. The annual incidence rate of dementia diagnosis was calculated for the period 2007-2022. The proportion of individuals that survived 5 years after dementia diagnosis was compared across years of diagnosis. Health status at dementia diagnosis was assessed by calculating Charlson Comorbidity Index and Hospital Frailty Risk Score. Annual incidence rate of dementia diagnosis decreased from early 2010s and onwards, particularly among older age groups of 80-89 and ≥ 90 years. Mean age at dementia diagnosis remained constant, i.e., 82.2 years during 2007-2009 and 82.2 years during 2019-2022. The proportion of individuals with frailty at diagnosis increased from 74.3% in 2007-2009 to 80.6% in 2019-2022 (odds ratio (OR) = 1.42, 95% confidence interval (CI): 1.39-1.46); the proportion of individuals with comorbidities also increased over the same period. The proportion that survived 5 years since dementia diagnosis remained constant at 33% during 2007-2017 but improved over time when accounting for comorbidity and frailty level at diagnosis. While the incidence of dementia diagnosis has declined from early 2010s and onwards, patients diagnosed today are on average frailer and more comorbid than those diagnosed 15 years ago, which partly explains the lack of improvement in dementia survival over time. Enhancing healthcare planning for people with dementia diagnosis and improving their survival is still highly relevant.
7. Urban-rural differences and bidirectional association between social participation and cognitive function among Chinese older adults: a 10-year prospective cohort study.
期刊: Archives of public health = Archives belges de sante publique 发表日期: 2025-Dec-07 链接: PubMed
摘要
China is experiencing rapid population aging and increasing dementia cases. Although existing evidence suggests a link between social participation (SP) and cognitive function (CF) in older adults, few studies have explored their long-term patterns and interplay across urban-rural groups. We utilized five waves (2011, 2013, 2015, 2018 and 2020) of multivariate longitudinal data from the China Health and Retirement Longitudinal Study, categorizing participants into urban and rural groups by residence. A group-based dual trajectory model was employed to examine the heterogeneous trajectories and bidirectional association of social participation and cognitive function among 4,133 participants. Binary and multinomial logistic regression analyses were used to explore the predictors of different trajectories. A multigroup cross-lagged panel model was applied to explore the bidirectional associations between social participation and cognitive function. Among the rural participants, three social participation trajectories were identified: “No SP” (45.2%), “Low SP” (47.5%) and “Moderate SP” (7.3%), and the urban areas included two: “No SP” (62.3%) and “Low SP” (37.7%). There were three patterns of cognitive function in rural areas: “Low-Decline CF” (28.4%), “Moderate-Decline CF” (39.0%) and “High-Decline CF” (32.6%), while urban areas had two: “Low-Decline CF” (49.8%) and “High-Decline CF” (50.2%). Sleep duration was a common risk factor for SP and CF in rural participants (p < 0.05). Individuals with higher levels of social participation were also more likely to exhibit better cognitive function (rural: 79.08%; urban: 65.89%). The cross-lagged analysis showed that cognitive function at the previous wave had a significant positive effect on subsequent social participation (p < 0.05). The long-term developmental trajectories of social participation and cognitive function are synchronized, primarily driven by the positive effect of cognitive function on social participation. Rural older adults exhibited greater heterogeneity in their trajectories and more complex predictors than their urban counterparts. Interventions targeted at the urban‒rural context are recommended to reduce cognitive decline and promote health equity.
8. Changes in height-for-age of Egyptian children from 1995 to 2014: implications for improving child health outcomes.
期刊: BMC public health 发表日期: 2025-Dec-07 链接: PubMed
摘要
Stunting is a serious health problem in Egypt. Stunting rates and height-for-age z-score (HAZ) distributions changed notably in Egypt over time, yet the factors that led to these changes remain unknown. This study examines the factors associated with these changes and provides important considerations for designing interventions to achieve the Sustainable Development Goal (SDG) of ending all forms of malnutrition by 2030. Leveraging data from Egypt’s Demographic and Health Survey for the years 1995, 2003, and 2014, we employ a Recentered Influence Function (RIF) approach that goes beyond the conventional way of measuring stunting as a binary indicator to examine changes across the entire HAZ distribution. The RIF decomposes changes in the HAZ distribution over time into differences attributable to changes in the levels of the determinants of nutrition (covariate effects) and in the strength of the association between these determinants and HAZ (coefficient effects). The stylized facts show a puzzling increase in stunting rates despite improvements in the level of the determinants of nutrition. Our RIF results attribute the change in stunting rates and other parts of the HAZ distribution primarily to changes in the association between the determinants of nutrition and HAZ (coefficient effects) rather than in the level of the determinants (covariate effects). The results also show that the determinants of nutrition could have heterogeneous impacts at different quantiles of the HAZ distribution. To reduce stunting rates and achieve the SDG of ending malnutrition, our findings highlight the need for targeted interventions. Interventions should be geographically targeted, promote gender and income equality, improve maternal nutrition, and expand access to better sanitation facilities. This is in addition to wealth redistribution and reforming Egypt’s subsidy program to focus on nutritious food.
9. Body and Mind Programme for recovery from breast cancer: Evaluation of the impact of health promotion intervention carried out in a multidisciplinary team on health-promoting behaviours: a quasi-randomised-controlled clinical trial.
期刊: BMC psychology 发表日期: 2025-Dec-07 链接: PubMed
摘要
10. An umbrella review of maternal pre-pregnancy characteristics and prior cesarean section as risk factors for stillbirth.
期刊: BMC pregnancy and childbirth 发表日期: 2025-Dec-07 链接: PubMed
摘要
Stillbirth is the death of a fetus at or after 20 weeks of gestation, making up 60% of perinatal deaths and having significant psychosocial and economic impacts. The present umbrella review assessed maternal risk factors before pregnancy and prior cesarean associated with stillbirth based on meta-analytic studies. We conducted a search of three major databases until January 2025, focusing on meta-analyses that evaluated environmental risk factors associated with stillbirth. We evaluated the strength of evidence for identified maternal characteristics associated with stillbirth using the validated Ioannidis classification system. We calculated summary effect estimates, 95% confidence intervals (CIs), heterogeneity (I²), 95% prediction intervals, small-study effects, excess significance biases, and sensitivity analyses. To assess the quality of the meta-analyses, we employed the AMSTAR 2 tool. This umbrella review included five studies, comprising eight meta-analyses that evaluated 365,158 cases of stillbirth across a total sample size of 70,124,598 participants. Race (black vs. white), chronic hypertension, and maternal age ≥ 35 years showed highly suggestive associations with stillbirth (Class II), while obesity and overweight showed suggestive associations (Class III). Associations for previous cesarean, and pre-existing diabetes were weak (Class IV). Given high heterogeneity and low AMSTAR-2 ratings, these findings should be interpreted as hypothesis-generating rather than causal. These results synthesize meta-analytic evidence on maternal characteristics associated with stillbirth. The overall certainty is limited by considerable heterogeneity, and the low/critically low quality of included reviews; therefore, causal inferences are not warranted.
11. Global, regional, and national temporal trends in the prevalence of environmental heat and cold exposure among older adults aged 60-99 years, 1990-2021: an age-period-cohort analysis based on the Global Burden of Disease Study 2021.
期刊: BMC medicine 发表日期: 2025-Dec-07 链接: PubMed
摘要
Environmental heat and cold exposure (EHCE), a threat magnified by global climate change, is a major preventable cause of death in older adults worldwide but remains an under-recognized public health problem. To address this gap, this study aimed to analyze long-term trends in the prevalence of EHCE in the older adults from 1990 to 2021, as well as age, period, and cohort effects. Using data from the Global Burden of Disease Study 2021, we conducted an age-period-cohort (APC) analysis of the prevalence of EHCE among the older adults aged 60-99 years across 204 countries and territories. The age-standardized prevalence rate (ASPR) was calculated, and the net drift and local drift were used to assess overall and age-specific trends. The APC model was employed to disentangle the effects of age, period, and birth cohort on the changes in the prevalence of EHCE. All analyses were stratified by sociodemographic index (SDI) levels to account for regional differences. From 1990 to 2021, the number of global EHCE cases among the older adults increased by 52.48%, reaching 4.43 million (95% UI: 3.88 to 5.10 million), while the ASPR decreased by 33.60%. The global net drift in the prevalence of EHCE was -1.48% annually, with significant regional variations: high SDI regions experienced the smallest decline (-0.17% per year), whereas high-middle SDI regions experienced the greatest decline (-2.95% per year). APC analysis revealed that age effects were most pronounced in high SDI regions. Conversely, in high-middle SDI regions, socioeconomic improvements and strengthened healthcare systems contributed to a negative correlation between age and the risk of EHCE. Period and cohort effects demonstrated a general decline in the prevalence of EHCE, with the most significant improvements in high-middle SDI regions. Although the number of EHCE cases has increased because of population growth and aging, the relative burden of EHCE has declined globally as a result of improvements in public health infrastructure and climate adaptation measures. However, high SDI regions face persistent challenges and a slower decline in the prevalence of EHCE, highlighting the need for targeted interventions.
12. Innate immune cell-derived BAFF induces non-canonical NF-κB activation to promote inflammatory response of ICOSL+ B cells in diabetic autoimmunity.
期刊: Molecular therapy : the journal of the American Society of Gene Therapy 发表日期: 2025-Dec-06 链接: PubMed
摘要
Type 1 diabetes (T1D) is an autoimmune disease resulted from the failure of the immune system to maintain self-tolerance, leading to autoimmune destruction of pancreatic β cells. Although T1D has traditionally been considered as a T cell-driven disease, recent studies have found that B cells play an indispensable role in the pathogenesis. Here, we identified a subset of B cells expressing the inducible T cell co-stimulator ligand (ICOSL), which is associated with T1D progression in cohorts of diabetes patients as well as mouse models of T1D. Functional analyses revealed that ICOSL+ B cells contribute to T1D through their enhanced capacity for co-stimulation, proliferation, and inflammatory cytokine production. Furthermore, we demonstrated that innate immune cells promote the generation of pathogenic ICOSL+ B cell via a B-cell activating factor (BAFF) - non-canonical NF-κB (ncNF-κB) signaling axis. Notably, genetic deletion or antibody-mediated blockade of ICOSL inhibited the pro-inflammatory responses of B and T cells, and ameliorated autoimmune progression in two mouse models of T1D. Taken together, our findings elucidate a novel role of innate immune cells-BAFF-ICOSL+ B cells axis in bridging innate and adaptive immunity and provide potential diagnostic and therapeutic targets for T1D.
13. Association of the endothelial activation and stress index with cognitive function in older adults: a cross-sectional study with machine learning.
期刊: European journal of medical research 发表日期: 2025-Dec-06 链接: PubMed
摘要
Age-associated memory impairment (AAMI) is a predementia state linked to endothelial dysfunction. The endothelial activation and stress index (EASIX) quantifies endothelial injury, yet its association with cognitive function remains unvalidated in population studies. This study aimed to evaluate the relationship between EASIX and cognitive performance. Data from adults aged ≥ 60 years in the NHANES 2011-2014 were analyzed. Multiple linear regression assessed associations between EASIX and cognitive function scores. LASSO regression selected variables, and six machine learning models (e.g., Random Forest and XGBoost) were developed. SHAP values interpreted feature importance. Among 2,763 participants, EASIX showed a significant negative correlation with all cognitive scores (P < 0.05). The ElasticNet model outperformed other models. SHAP analysis identified EASIX as one of the top four influential variables, with cognitive function levels demonstrating a declining trend as EASIX score increased, particularly among older adults. EASIX is significantly negatively associated with cognitive function, especially in advanced age. Although the cross-sectional design precludes causal inference, it shows promise as a blood-based biomarker for early screening and risk assessment of cognitive decline, supporting its potential clinical utility.
14. Space-time distribution of classical scrapie in Italian sheep: assessing the effectiveness of the National Genetic Selection Plan.
期刊: Veterinary research 发表日期: 2025-Dec-06 链接: PubMed
摘要
Scrapie is a contagious neurodegenerative disease of sheep and goats sustained by prions. The aim of this study was to assess the effectiveness of selective interventions in Italy by describing the temporal trends and geographical distribution (a) of scrapie prevalence and (b) of the application of the National Genetic Selection Plan (NGSP). Poisson models were used to study temporal trends of disease prevalence (in terms of prevalence ratios, PR), whereas NGSP genotyping data from rams tested between 2005 and 2022 were used to study the temporal trend and geographical distribution of the percentage of susceptible animals. In addition, change-point regression analysis was used to identify changes in the trend. The trend in prevalence at the national level shows an increase in the period 2005-2015 (PR = 1.09, 95% CI 1.04-1.15), followed by a sharp decline between 2016 and 2022 (PR = 0.88, 95% CI 0.83-0.93). The proportion of susceptible rams shows a decreasing temporal trend, both along 2005-2022 (PR 0.97, 95% CI 0.96-0.98) and in the two periods (respectively, 2005-2015: PR 0.92, 95% CI 0.89-0.96; 2016-2022: PR 0.94, 95% CI 0.89-0.98). Change-point regression analysis identified a nationwide trend shift between 2015 and 2020, with Sardinia showing an earlier change between 2012 and 2015. The analysis of temporal trends showed geographical heterogeneity associated with different control strategies, especially in Sardinia, where the early targeted interventions in 2009 anticipated most of the provisions of the second NGSP.
15. Aortic root replacement versus preservation in acute type A aortic dissection repair: meta-analysis of reconstructed time-to-event data.
期刊: Journal of cardiothoracic surgery 发表日期: 2025-Dec-06 链接: PubMed
摘要
Outcomes of aortic root replacement (ARR) versus conservative root approach (CRA) in patients undergoing acute type A aortic dissection (ATAAD) repair remained controversy. The present study was a pooled meta-analysis of Kaplan-Meier-derived individual patient data (IPD) from comparative studies published by September 29, 2024. Forty studies met our eligibility criteria, comprising 11,734 patients (4212 in the ARR group and 7522 in the CRA group). In the overall population, the overall survival was similar between the ARR and CRA groups (hazard ratio [HR], 0.95; 95% CI, 0.87-1.02; p = 0.17, log-rank test p = 0.47), while ARR was associated with lower risk of reoperation compared with CRA (HR 0.72; 95% CI, 0.59-0.87; p < 0.001, log-rank test p < 0.001). Subgroup analysis revealed that valve-sparing root replacement (VSRR) was associated with better overall survival compared with CRA (HR 0.74; 95% CI, 0.60-0.91; p = 0.004, log-rank test p = 0.003), while Bentall procedure was not (HR 1.06; 95% CI, 0.93-1.20; p = 0.37, log-rank test p = 0.39). The restricted mean survival time (RMST) was overall 12.9 months longer with VSRR compared with CRA (p = 0.009). The meta-regression analyses did not find statistically significant coefficients for the covariates of age, male sex, hypertension, diabetes, Marfan syndrome, bicuspid aortic valve, aortic root diameter and ascending aorta diameter in the CRA arm. In patients underwent ATAAD repair, the overall survival was comparable between ARR and CRA, while ARR was associated with lower risk of reoperation compared with CRA. VSRR was associated with better long-term survival compared with CRA, while Bentall procedure was not.
16. Syphilis in pregnant women living with HIV/AIDS in Brazil and the relationship between coinfection and mother-to-child transmission of HIV.
期刊: BMC public health 发表日期: 2025-Dec-06 链接: PubMed
摘要
17. Sociodemographic Factors Associated With Psychological Aggression Toward Children in Bangladesh Based on Nationally Representative Data.
期刊: Acta paediatrica (Oslo, Norway : 1992) 发表日期: 2025-Dec-06 链接: PubMed
摘要
Psychological aggression in early childhood negatively affects development and is increasingly recognised as a public health concern in countries including Bangladesh. This study aimed to estimate its prevalence and identify associated risk factors among children in Bangladesh. A total of 19 784 data from the 2019 Bangladesh Multiple Indicator Cluster Survey (MICS) was used to conduct a cross-sectional study of children aged 5-14. The study examined relationships between sociodemographic factors and psychological aggression toward children through both bivariate and multivariate analyses. Among children aged 5-9, about nine out of 10 experienced psychological aggression, and parents’ belief in this behaviour was the strongest associated factor. Child and family characteristics such as age, region, education, ethnicity, income, functional difficulties, presence of younger siblings, and child engagement in income activities were significantly associated with psychological aggression. Older children, non-Bengali families, and income-earning children had a lower risk, while parental belief in aggression was the strongest predictor. Almost all children in Bangladesh experience any form of psychological aggression, primarily influenced by parental beliefs. Sociodemographic factors including parental education, child functional status, and household composition also play a role. Targeted interventions promoting non-violent and positive parenting are essential to protect children’s psychological well-being.
18. Life Identification Number (LIN) codes for the genomic taxonomy of Corynebacterium diphtheriae strains.
期刊: Genome medicine 发表日期: 2025-Dec-06 链接: PubMed
摘要
19. Impact of accelerometer epoch summary measure on associations between physical activity and all-cause mortality in Whitehall II and UK Biobank.
期刊: Scientific reports 发表日期: 2025-Dec-06 链接: PubMed
摘要
Accelerometer data are commonly reduced into epoch summary measures (ESMs) for analysis, e.g. ENMO (Euclidean Norm Minus One), MAD (Mean Amplitude Deviation), MIMS (Monitor Independent Movement Summary) or Counts. We compared associations with all-cause mortality of the volume and intensity of physical activity when derived from those four measures in the Whitehall II and UK Biobank cohorts. Volume (Average Acceleration, AvAcc) and intensity (Intensity Gradient, IG) were derived from each ESM. Associations with mortality were estimated using Cox models. 3733 (25.1% female, median age 68.3 years) and 89,848 (56.4% female, 63.5 years) participants were included from Whitehall II and UK Biobank, respectively. Median (IQR) follow-up was 11.0 (10.7, 11.3) and 8.0 (7.5, 8.5) years, with 563 (15.1%) and 3656 (4.1%) deaths. Associations with mortality were largely consistent between ESMs with the lowest mortality risk for those high (above the median) in both AvAcc and IG (Whitehall: HR = 0.59-0.68; Biobank: 0.55-0.61, reference: low/low), and IG associated with lower mortality risk, irrespective of AvAcc. AvAcc was associated with lower mortality irrespective of IG in Biobank only. In conclusion, associations of AvAcc and IG with mortality are broadly consistent across common ESMs, supporting comparability of activity-health findings across studies using different ESMs.
20. Infection with Helicobacter pylori and the age at onset of coeliac disease in the "HUNT4" survey.
期刊: BMC research notes 发表日期: 2025-Dec-06 链接: PubMed
摘要
This study aimed to determine whether H. pylori or its antigens affect the age at which coeliac disease (CeD) was diagnosed. Participants over 20 years old from the HUNT4 survey were screened for CeD by measuring serum immunoglobulin A and immunoglobulin G antibodies against transglutaminase-2. H. pylori status was defined by detecting H. pylori-specific immunoglobulin G. H. pylori + participants had a mean age of 62.3 years, compared to 54.8 years for negative participants. In those with previously undiagnosed CeD (n = 43), higher antibody levels against GroEL were associated with an older age at sampling (67.2 years for GroEL-positive vs. 50.8 years for negative). Smaller age differences were noted for gGT (6.0 years), UreA (8.6 years), and HpcC (6.4 years), while vacA and cagA showed only minor differences. Participants with CeD and H. pylori + were older than those who were H. pylori-. The presence of antigens such as GroEL, gGT, and UreA appeared to be associated with this age difference. Aside from H. pylori infection in childhood, a cohort effect of H. pylori infection may partly explain the differences.
21. VIRGO2: an enhanced gene catalog of the vaginal microbiome provides insights into its functional and ecology complexity.
期刊: Nature communications 发表日期: 2025-Dec-06 链接: PubMed
摘要
Despite the importance of the cervicovaginal microbiome, the mechanisms that govern its composition and drive its impact on host physiology remain poorly understood. With the aim to expand our understanding of the function and ecology of the vaginal microbiome, we present VIRGO2, an enhanced non-redundant gene catalog comprising over 1.7 million well-annotated genes from body-site specific microbes and viruses. Analyses using VIRGO2 reveal insights such as including the identification of previously uncharacterized vaginal bacteria, features of the vaginal mycobiome and phageome, and differential expression of bacterial carbohydrate catabolic genes. Constructed from over 2500 metagenomes and 4000 bacterial genomes, VIRGO2 broadens geographic representation and microbial diversity compared to its predecessor. This updated catalog enables more precise profiling of taxonomic and functional composition from metagenomic and metatranscriptomic datasets. VIRGO2 is a critical resource for integrative analyses of vaginal microbial communities and their interactions with host tissues, thereby enhancing our mechanistic understanding of vaginal health and disease.
22. Survival impact of anti-CD38-based quadruplet regimens in transplant-ineligible newly diagnosed multiple myeloma: a network meta-analysis and reconstructed individual patient data meta-analysis.
期刊: Blood cancer journal 发表日期: 2025-Dec-06 链接: PubMed
摘要
Frontline therapy for transplant-ineligible newly diagnosed multiple myeloma (TI-NDMM) has advanced with anti-CD38 monoclonal antibody (mAb)-based regimens. Although quadruplet combinations incorporating daratumumab and isatuximab have demonstrated improved response rates and progression-free survival (PFS), comparative overall survival (OS) data remain limited. We performed a systematic review, network meta-analysis (NMA), and reconstructed individual patient data meta-analysis comparing survival outcomes of quadruplet versus triplet regimens in TI-NDMM. This study adhered to Cochrane and PRISMA guidelines and was registered prospectively (PROSPERO CRD420251033401). A comprehensive literature search through April 2025 identified randomized clinical trials (RCT) evaluating quadruplet and triplet regimens involving daratumumab, isatuximab, bortezomib, lenalidomide, and dexamethasone in any combination, compared to their backbone regimens, reporting OS and PFS. Four RCT (n = 2,038) were included. At 60 months, estimated PFS rates were: D-VRd (66.4%), I-VRd (63.2%), D-Rd (51.9%), and VRd (42.6%). Both D-VRd and I-VRd significantly improved PFS compared with D-Rd (HR 0.65; 95% CI 0.48-0.87; and HR 0.68; 95% CI 0.52-0.89) and VRd (HR 0.51; 95% CI 0.39-0.67; and HR 0.53; 95% CI 0.41-0.67). D-Rd also showed superior PFS over VRd (HR 0.77, 95% CI 0.64-0.93; P = 0.007). At 60 months, OS rates were: D-VRd (72.8%), I-VRd (72.2%), D-Rd (67.1%), and VRd (67.0%). Pooled analyses demonstrated that quadruplets significantly improved both PFS (64.7% vs. 46.3%; HR 0.57, 95% CI 0.47-0.69; P < 0.0001) and OS (72.5% vs. 67.1%; HR 0.78, 95% CI 0.63-0.96; P = 0.02) compared to triplet regimens. The OS benefit of quadruplets was consistent in comparisons against both D-Rd (HR 0.77; 95% CI: 0.60-0.98; P = 0.04) and VRd (HR 0.77; 95% CI: 0.62-0.97; P = 0.02). In the NMA, quadruplet regimens ranked highest for complete response, PFS, and OS. This meta-analysis supports anti-CD38 mAb-based quadruplet regimens as superior frontline therapy in TI-NDMM, significantly improving overall survival.
23. Applying Critical Feminist and Critical Race Theory to Address the Cultural and Financial Needs of Black/African American Women With Cancer: A Narrative Review.
期刊: The American journal of hospice & palliative care 发表日期: 2025-Dec-06 链接: PubMed
摘要
Black/African American women with breast and gynecologic cancers face stark end-of-life (EOL) inequities rooted in structural racism, gendered oppression, and financial toxicity. Despite abundant evidence of outcome gaps, theory-driven guidance for equitable, culturally responsive EOL care is limited. This narrative review argues for integrating Critical Race Theory (CRT) and Critical Feminist Theory (CFT) into EOL care frameworks to address the cultural and financial needs of Black/African American women. Drawing on interdisciplinary literature from healthcare, philosophy, sociology, and economics, we examined systemic barriers at the end of life, critiqued current care models, and illustrated how CRT and CFT provide transformative frameworks for clinical practices, research, and policy reform. We summarize philosophical views of death and dying and cultural perspectives on grief and end-of-life practices, then analyze disparities in death, dying, and EOL care especially financial inequities and roles of structural racism and gender-based oppression. Finally, we presented how CRT and CFT illuminate the complex interplay of race, gender, and socioeconomic status and inform structural transformation. Embedding CRT and CFT in healthcare systems is essential to advancing inclusive, justice-oriented EOL care models that reflect lived realities and promote dignity, equity, and culturally attuned support.
24. Toward inclusive primary health care: understanding health needs of women in India's informal economy through a socioecological framework.
期刊: BMC health services research 发表日期: 2025-Dec-06 链接: PubMed
摘要
25. Language as a pillar of cultural safety: evaluating hospital-based healthcare workers' knowledge of First Nations languages and interpreter services in East Arnhem Land, Australia.
期刊: BMC health services research 发表日期: 2025-Dec-06 链接: PubMed
摘要
26. City of Detroit, Hamtramck, Highland Park, and School of Choice: School Aged Environmental Risk Exposures.
期刊: Journal of urban health : bulletin of the New York Academy of Medicine 发表日期: 2025-Dec-06 链接: PubMed
摘要
This research studies the levels of environmental pollutants related to four different school of choice types in the cities of Detroit, Hamtramck, and Highland Park in 2021. It is hypothesized that public and for-profit charter schools will be located in older buildings and in areas of greater pollution. Indicators of pollution exposure included Superfund and Brownfield sites, location and pounds of Toxic Release Inventory, and mean blood lead levels of the children, which were geospatially joined to a 1-mile buffer surrounding the four school of choice types within the study area. The age of the school buildings was examined to estimate the potential for internal toxic exposures. The spatial relationship between neighborhood racial segregation, poverty, and schools of choice types was also assessed. Within the study area, public and for-profit charter schools and their surroundings exert the potential for greater internal and external pollution exposure to children. For-profit charter schools were significantly the oldest, potentially exposing students to a variety of toxicants. All schools were located in racially segregated and relatively high-poverty neighborhoods, with public and for-profit schools exhibiting the highest poverty percentages. Public policy, such as siting guidelines and school building maintenance, should be used to decrease these potential exposures to hazards and avoid worsening existing inequalities. Addressing them is important to prevent further disadvantage to already vulnerable children.
27. Kernel Density Bandwidth Specification in Neighborhood Violence Prevention Research.
期刊: Journal of urban health : bulletin of the New York Academy of Medicine 发表日期: 2025-Dec-06 链接: PubMed
摘要
Place-based interventions may reduce violence, but approaches for capturing nearby incidents using kernel density estimation (KDE) vary. KDE smooths geospatial point data, like crime incidents, using a user-specified bandwidth often selected through data-driven approaches that rely on the underlying point pattern. Because point patterns vary by outcome, time, and context, data-driven methods can produce bandwidth sizes that are misaligned with the spatial extent of a place-based intervention, potentially limiting the ability to detect its effect. To illustrate the inferential challenges associated with data-driven bandwidth selection approaches, this study aimed to (1) quantify variability in bandwidths selected through data-driven methods and (2) examine the impact of bandwidth size on simulated intervention effects. We used violent crime data for Philadelphia (2013-2023). For Aim 1, we calculated bandwidth sizes for each crime-year combination using two default data-driven selection criteria and compared selected sizes across crime types and years. For Aim 2, we used a hypothetical place-based intervention with a known effect (30% reduction in nearby assaults) and ran simulations to examine how the intervention effect, estimated using Poisson regression, changed based on the bandwidth size used to estimate the crime density surface. Bandwidth sizes varied significantly by data-driven selection method, crime type, and year (range: 45.9-48,450 ft). For the simulated intervention, “true effects” (i.e., the reduction of nearby assaults attributed to the intervention) were only detectable at bandwidths between 200 and 2900 ft. Larger bandwidths resulted in estimates that incorrectly suggested the intervention was ineffective or increased crime. Data-driven bandwidth selection can obscure or distort intervention effects. Researchers should be critical and transparent when selecting KDE parameters in place-based violence prevention research.
28. Analysis and optimal control of a fractional order influenza epidemic model.
期刊: Scientific reports 发表日期: 2025-Dec-06 链接: PubMed
摘要
The interplay between ambient air pollution and seasonal influenza poses a growing public health challenge. Traditional epidemiological models often neglect cumulative environmental effects, limiting understanding of prolonged pollution’s impact on influenza transmission. We developed a fractional-order SEIIHRD model using the Atangana-Baleanu Caputo (ABC) derivative. This ABC derivative, with its non-singular Mittag-Leffler kernel, is chosen to capture inherent short- and long-term system memory effects. Our model incorporates this system memory, interpreted as lingering effects from persistent air pollution, and differentiates between mild and severe infections. We derive the basic reproduction number, analyze model dynamics, and apply fractional optimal control theory for intervention strategies reducing transmission and enhancing recovery. Numerical simulations reveal that lower fractional orders ς significantly prolong outbreaks compared to classical models, necessitating longer, sustained control efforts. The results demonstrate timely, appropriately sustained control measures can effectively mitigate disease spread. Optimal intervention durations are highly sensitive to system memory strength, emphasizing accounting for historical dependencies in control policy design. These findings offer new insights for managing influenza outbreaks, especially where prolonged environmental influences are a concern, and show fractional calculus’s utility in capturing complex historical influences on disease dynamics.
29. Exhalation-synchronous robotic abdominal compression for user-centered respiratory assistance and training in neurological patients.
期刊: Journal of neuroengineering and rehabilitation 发表日期: 2025-Dec-06 链接: PubMed
摘要
Patients with respiratory weaknesses due to neurological disorders or aging often face usability challenges with conventional mechanical ventilators, which directly move air in and out of the lungs via the ventilation mask. To address these challenges, Exo-Abs was developed to support a wide range of respiratory functions through synchronous abdominal compression. Its control previously relied on continuous full-phase measurements from multiple sensors to ensure control performance across a wide dynamic range. However, accommodating long-term usage scenarios remained challenging, as practical features such as allowing breaks between breaths or adapting to different installation environments were limited. Here, we present a user-centered solution designed to address these real-world usage conditions. Although consecutive compression-and-recoil cycles are commonly considered essential for this type of assistance, we found that well-synchronized abdominal compression with Exo-Abs can immediately augment the corresponding breath, when applied above a certain intensity. Based on this finding, we proposed an exhalation-synchronous control strategy for the system that involves strict control policy over the exhalation phase (compression) and sparse control policy over the inhalation phase (release). A streamlined sensor configuration was also implemented to improve use scenarios, allowing users to take breaks freely and supporting long-term use. To evaluate the improved practicality of Exo-Abs, we conducted an experimnt in which the device was used in place of a conventional mechanical ventilator during prescribed respiratory therapy sessions for hospitalized patients. Notably, all participants were able to use the system for up to approximately two hours, demonstrating the feasibility of the proposed control scheme for long-term usage. The efficacy of assistance was evaluated by utilizing the mathematical model individualized to each participant. Results for primary respiratory performances showed an average 23.25% increase in the peak volumetric flow rate per breath (ranging from 13.99 to 57.81% depending on the user) and an average 19.46% increase in the maximal volume of air moved in and out per breath (ranging from 7.23 to 45.60% depending on the user). During assistance, Exo-Abs applied between 76 and 91 N of compressive force synchronously to each breath. Secondary analysis based on individualized mathematical models showed an average increase of 1.80 cmH[Formula: see text]O in mean pleural pressure per breath (23.44% of their spontaneous pleural pressure; ranging from 7.99 to 43.93% depending on the user) and an average 0.07 J increase of the mechanical work per breath (23.49% of their spontaneous work; ranging from 8.22 to 45.35% depending on the user). This study demonstrates that Exo-Abs can enhance respiratory performance in patients with weakened respiratory muscles, even in long-term usage scenarios. Along with the simplifications in the control policy and user interface, Exo-Abs has been shown to provide effective respiratory assistance over various breathing patterns and respiratory training contexts. The contribution of this study extends beyond demonstrating a user-centered system with improved usability and practicality, as it also establishes an objective evaluation framework for respiratory biomechanics.
30. Ethical challenges, responses and reasoning in co-creation for health promotion: a scoping review.
期刊: BMC medical ethics 发表日期: 2025-Dec-06 链接: PubMed
摘要
People involved in co-creation act as embedded moral agents as they bear a relational responsibility. The approaches taken or decisions made by individuals when facing ethical challenges during co-creation have important ethical ramifications for the process. Literature in the field of co-creation lacks an in-depth and systematic exploration of individual responses and reasoning that shape ethical decision-making. The current scoping review aims to identify authors’ responses and related moral reasoning as reported within the academic literature, to the ethical challenges encountered during co-creation for health promotion. A scoping review was conducted to identify articles that reflected on ethical challenges encountered during co-creation. Fifteen scientific articles were included following the title, abstract and full-text screening. Subsequently, a qualitative interpretative analysis was performed to extract and link the following data items: ethical challenge, response and (moral) reasoning. The resulting coding schemes, consultation with ethicists and researcher memos contributed to the synthesis of the results. Integrating discussions throughout co-creation in combination with adopting a flexible attitude and communicating expectations were frequently reported responses. Institutional procedures and pragmatic considerations influenced responses greatly. Moral reasoning was partly shaped by principles of co-creation, normative ethical frameworks and, personal moral codes, values and perceptions. Academic authors’ responses to ethical challenges in co-creation were largely influenced by their intention or willingness to adhere to the principles of research integrity within this context. Ethical frameworks like the ethics of care and public health ethics provided guidance, though some authors did not explicitly engage with these frameworks, suggesting a disconnect between theory and practice. An extensive description of authors’ moral reasoning remains absent. Future research might consider performing meta-ethnographies to account for more detailed information about moral reasoning in responding to ethically challenging situations in co-creation for health promotion.
31. Physical activity trajectories and cognitive decline among older adults in China: a longitudinal cohort study.
期刊: BMC geriatrics 发表日期: 2025-Dec-06 链接: PubMed
摘要
Cognitive decline is a critical public health concern among older adults. While physical activity (PA) is a recognized modifiable factor for mitigating cognitive deterioration, the specific impact of long-term PA trajectories on the rate of cognitive decline remains understudied, particularly in China. A longitudinal cohort of 3,471 participants aged ≥ 60 years from the China Health and Retirement Longitudinal Study (CHARLS) was analyzed. PA trajectories were identified via group-based trajectory modeling (GBTM) on the basis of self-reported PA data from four waves (2011, 2013, 2015, and 2018). Global cognitive function, assessed by episodic memory and mental intactness, was measured repeatedly. Associations between PA trajectories and cognitive decline were analyzed using linear mixed models adjusted for demographic, lifestyle, and health-related factors. Two distinct PA trajectories were identified: a high decreasing trajectory group (43.4%) and a low increasing trajectory group (56.6%). The high decreasing trajectory group initially had higher PA levels but experienced a slight decline, whereas the low increasing trajectory group started with lower PA levels but showed gradual increases. Participants in the high decreasing trajectory group exhibited significantly slower declines in global cognition (β = 0.106, 95% CI: 0.072, 0.140, P < 0.001) and mental intactness (β = 0.116, 95% CI: 0.078, 0.154, P < 0.001) compared to the low increasing trajectory group. Subgroup analysis revealed that participants aged ≥ 75 years, females, those with higher education levels, and rural residents experienced slower cognitive decline. Sensitivity analyses confirmed the robustness of these findings. Sustaining higher levels of physical activity over time is associated with a slower rate of cognitive decline in older Chinese adults. This protective effect is especially pronounced in specific demographic subgroups.
32. TRIP13 alters mitochondrial function and promotes bortezomib resistance in multiple myeloma.
期刊: Scientific reports 发表日期: 2025-Dec-06 链接: PubMed
摘要
Bortezomib (BTZ) resistance remains a major therapeutic challenge in multiple myeloma (MM). This study investigates the role of thyroid hormone receptor interactor 13 (TRIP13) in MM progression and BTZ resistance. Analysis of public datasets and clinical bone marrow samples revealed that TRIP13 is significantly upregulated in MM and that its expression correlates with advanced disease stage and poor overall survival. In vitro, TRIP13 overexpression (TRIP13-OE) in MM cell lines significantly enhanced cell proliferation, reduced BTZ-induced apoptosis, and alleviated G2/M cell cycle arrest. Functional assays further showed that TRIP13-OE cells preserved mitochondrial membrane potential, reduced mitochondrial calcium overload, and maintained ATP production following BTZ exposure. Quantitative polymerase chain reaction (qPCR) analysis demonstrated that mitochondrial regulatory genes were upregulated in TRIP13-OE cells, particularly mitochondrial calcium uniporter (MCU). Co-immunoprecipitation following BTZ treatment confirmed a specific interaction between TRIP13 and MCU, while immunofluorescence labeling showed their cytoplasmic co-localization. These findings uncover a previously unrecognized role of TRIP13 in regulating mitochondrial integrity under proteotoxic stress, thereby contributing to BTZ resistance. Targeting TRIP13 may represent a novel therapeutic approach to improve outcomes in MM patients.
33. Income-related inequality and horizontal inequity in healthcare utilization under population aging and labor market changes in Japan.
期刊: International journal for equity in health 发表日期: 2025-Dec-06 链接: PubMed
摘要
34. Association between the diagnosis of diet-related non-communicable diseases and the use of nutritional labeling among Mexican, Mexican American, and non-Mexican American adults: a cross-sectional study from the International Food Policy Study 2021-2022.
期刊: BMC public health 发表日期: 2025-Dec-06 链接: PubMed
摘要
35. The increase of monocyte/high-density lipoprotein cholesterol ratio precedes recurrent thrombosis in patients with antiphospholipid syndrome.
期刊: Rheumatology (Oxford, England) 发表日期: 2025-Dec-06 链接: PubMed
摘要
The monocyte-to-high-density lipoprotein cholesterol ratio (MHR) is an emerging biomarker associated with inflammation and oxidative stress, being linked to cardiovascular events in patients with chronic kidney disease or those with diabetes. Given that monocyte activation plays a central role in the pathogenesis of thrombosis in antiphospholipid syndrome (APS), and that HDL-cholesterol suppresses monocyte activation, we aimed to investigate whether MHR could serve as a predictor for recurrent thrombotic events in APS patients. This retrospective longitudinal study included 107 patients diagnosed with APS at Hokkaido University Hospital. The MHR at the time of APS diagnosis was calculated and compared between patients with and without subsequent thrombotic recurrence. Among patients who experienced recurrence, MHR values were compared between two time intervals prior to the event: 0-6 months and 6-36 months. The median [IQR] age at diagnosis was 46 [31-56] years, with a median follow-up duration of 14.4 [11.6-17.8] years. Thrombotic events recurred in 31 patients, including 22 arterial and 9 venous events. The MHR at diagnosis did not significantly differ between patients with and without recurrence (5.0 [3.4-8.0] vs 5.3 [3.5-8.6], p = 0.57). However, among patients with recurrent thrombosis, average MHR values during the 0-6 months preceding the event were significantly higher than those measured 6-36 months prior (6.1 [4.3-8.3] vs 5.1 [3.8-8.6], p = 0.04). Our findings suggest that MHR increases in the 6 months preceding recurrent thrombotic events in APS patients, indicating that it may serve as a dynamic, time-sensitive biomarker for predicting thrombotic recurrence in thrombotic APS.
36. The Impact of Community-Organised/Sponsored Activities on Health Outcomes in Older Adults: A Systematic Review.
期刊: The Gerontologist 发表日期: 2025-Dec-06 链接: PubMed
摘要
The global ageing population calls for innovative strategies to support healthy ageing. Community organised/sponsored activities (COAs) are community-led non-clinical activities, typically facilitated by community centres, volunteers or peers, designed to promote social participation, interpersonal connections and enhanced wellbeing. COAs are increasingly promoted to enhance older adults’ health. As research on their health impact is fragmented, this systematic review aims to synthesise evidence on the relationship between distinct COAs and health outcomes among older adults, focusing on physical, mental, behavioural health, and overall wellbeing. A search of PsycINFO, CINAHL, PubMed, Scopus, and Web of Science identified peer-reviewed empirical studies published between 2004 and 2024. Eligible studies examined COAs and health outcomes in older adults. Study quality was assessed using the Effective Public Health Practice Project (EPHPP) tool, and thematic analysis classified activities into six types across four health dimensions. Twenty-one studies met the inclusion criteria. Physical, social, and volunteer activities consistently correlated with improved physical health outcomes, including enhanced mobility and reduced disability risk. Social activities also correlated with better mental health, reducing depressive symptoms. However, associations between educational/cultural and health promotion activities with behavioural health were less clear. Studies lacking specified activity types produced mixed findings, highlighting a need for standardised classifications. COAs significantly contribute to healthy ageing, particularly enhancing physical and mental health. Future research should adopt standardised classifications and longitudinal designs to clarify causal relationships and subgroup differences, guiding targeted activities and fostering age-friendly communities.
37. Efficacy of Credelio Quattro™ (lotilaner, moxidectin, praziquantel, and pyrantel chewable tablets) and Credelio™ (lotilaner) chewable tablets in the prevention of Borrelia burgdorferi transmission from infected Ixodes scapularis in dogs.
期刊: Parasites & vectors 发表日期: 2025-Dec-06 链接: PubMed
摘要
Borrelia burgdorferi, the causative agent of Lyme disease, is a zoonotic vector-borne pathogen transmitted by various Ixodes tick species. Lyme disease, while commonly asymptomatic, can induce fever and intermittent lameness in dogs. Highly effective acaricidal products with a rapid onset of action along with prompt removal of attached ticks are important aspects of successful Lyme disease prevention strategies. Two studies were conducted with a total of 30 dogs each. Dogs were randomized to receive a control sham dose, Credelio Quattro, or Credelio. Treatment was administered on Day 0 in a fed state. On Day 28, all dogs were experimentally infested with wild-caught adult Ixodes scapularis. Blood samples for B. burgdorferi antibody analysis utilizing the SNAP 4Dx Plus and Lyme Quant C6 tests were collected on Days 27, 49, 63, 77, 91, and 105. Skin biopsies were collected from four different areas of heavy tick attachment from each dog for polymerase chain reaction (PCR) detection of B. burgdorferi on Day 104 or 105. All control dogs demonstrated adequate I. scapularis infestation rates on Day 33 in both studies. In Study 2, on Day 27, one control dog tested positive for B. burgdorferi on the Lyme Quant C6 test, prior to experimental tick infestation, and therefore was excluded from analysis. A total of eight out of 10 (Study 1) and nine out of nine (Study 2) control dogs tested positive for B. burgdorferi on at least one test after Day 27. One dog in the Credelio Quattro-treated group tested positive for B. burgdorferi on SNAP 4Dx Plus on Day 105 in Study 1 but was negative on all other tests and study days. None of the dogs treated with Credelio tested positive for B. burgdorferi at any point during either study. The laboratory studies described herein confirm that a single dose of lotilaner, at the minimum effective dosage of 20 mg/kg, administered as Credelio Quattro, in combination with moxidectin, praziquantel, and pyrantel or Credelio, is effective for the prevention of transmission of B. burgdorferi from infected I. scapularis for a full month in dogs.
38. Multisectoral approaches to the prevention and control of vector-borne diseases: lessons learned from case studies.
期刊: Parasites & vectors 发表日期: 2025-Dec-06 链接: PubMed
摘要
In this report, we summarize the main outputs of the final workshop on multisectoral approaches (MSAs) to vector-borne diseases (VBDs) supported by the Special Programme for Research and Training in Tropical Diseases. We discussed the results of case studies from different countries investigating the collaboration between sectors such as health, education, environment, agricultural, and water and sanitation, among others, to combat VBDs such as malaria and arboviral diseases. Over 4 days, principal investigators of case studies presented their outcomes and invited experts highlighted the importance of MSA for effective control of VBDs. This multisectoral approach is novel and adds value to the research field by using a comprehensive strategy through coordinated efforts to address difficult public health topics, like vector-borne disease prevention and treatment. The participants had the opportunity to brainstorm and propose solutions related to limited financial resources to support MSA activities, the difficulty of engaging and collaborating with stakeholders from nonhealth sectors, and the sustainability of engaging committees that work across disciplines. Discussions emphasized the necessity of MSA and the importance of innovative technologies and multidisciplinary research, including strategic solutions that can help countries develop, implement, and sustain MSA for the prevention and control of VBDs. The workshop concluded with a commitment to strengthen international partnerships and implement comprehensive MSA to effectively control VBDs in marginalized communities.
39. Impact of dental caries on the quality of life of preschool children: a cross-sectional study within a birth cohort.
期刊: BMC oral health 发表日期: 2025-Dec-06 链接: PubMed
摘要
Early Childhood Caries (ECC) is a common oral health problem that negatively affects their quality of life and everyday function. The Early Childhood Oral Health Impact Scale (ECOHIS) is a validated tool for measuring Oral Health-Related Quality of Life (OHRQoL) in preschoolers. Although the Persian version of ECOHIS exists, the relationship between dental caries and OHRQoL has not been sufficiently investigated in Iranian preschool populations. This study aimed to examine the association between ECC and OHRQoL in children aged 2 to 6 years within the PERSIAN birth cohort in Isfahan, Iran. A cross-sectional study was conducted between April and October 2023 on a subset of the PERSIAN birth cohort-Isfahan. A total of 350 children aged 2-6 years were initially recruited, of whom 347 were included in the final analysis. Clinical examinations were performed to record decayed, missing, and filled primary teeth (dmft) and parents completed the ECOHIS questionnaire. Children received oral health education and fluoride varnish. The association between dmft and OHRQoL was analyzed using chi-square tests, independent t-tests, and multivariate logistic regression, with adjustments made for confounding variables. Higher dmft scores were significantly associated with lower OHRQoL in both child and parent sections of the ECOHIS questionnaire (p < .001). According to multivariate logistic regression, each unit increase in dmft was associated with greater odds of low child OHRQoL (OR = 1.23, 95% CI: 1.16-1.31), low parent OHRQoL (OR = 1.32, 95% CI: 1.23-1.41), and lower parental satisfaction (OR = 1.35, 95% CI: 1.26-1.45). Household income was significantly associated with parent-reported OHRQoL (OR = 0.27, 95% CI: 0.12-0.61). Dental caries were associated with lower OHRQoL of preschool children and their families. These findings emphasize the need for early detection, preventive strategies, and targeted oral health education, especially among low-income households. However, the results should be interpreted with caution due to the limited sample size, particularly within the moderate-income subgroup. Enhancement of public health initiatives and considering oral health in early childhood care programs may help reduce the burden of ECC and improve quality of life in this vulnerable population.
40. Comparative survival outcomes of lobectomy versus total thyroidectomy in T1 and T2 papillary thyroid cancer with more than five positive lymph nodes.
期刊: Scientific reports 发表日期: 2025-Dec-06 链接: PubMed
摘要
The surgical approach for papillary thyroid cancer (PTC) by either lobectomy or total thyroidectomy (TT) has long been a topic of debate, especially for patients with intermediate-risk PTC, such as T1 and T2 stage patients with more than five positive lymph node metastases (LNM). This study analyzed a population-based retrospective cohort of T1 and T2 PTC patients with more than five positive LNM from the SEER database (2004-2017), comparing clinicopathologic features and survival outcomes between those undergoing lobectomy and TT. Cox proportional hazards regression analysis to explore prognostic factors of survival. Propensity score matching (PSM) was used to balance covariates. The study included 5,610 patients, with 5,322 (94.87%) receiving TT and 288 (5.13%) undergoing lobectomy. Patients in the TT group had higher rates of N1b stage diagnoses, multifocal lesions, and more lymph nodes examined and more lymph nodes positive. Survival analysis showed no difference in overall survival (OS) between the groups (p = 0.177), but a significant difference in cancer-specific survival (CSS) (p < 0.001). After 1:1 PSM, there were no significant difference in OS (p = 0.089) and CSS (p = 0.350). Additionally, stratified analysis showed no significant difference in OS and CSS between patients treated with TT plus radioactive iodine (RAI) ablation and those who underwent lobectomy (both p > 0.05). This cohort study suggests that T1 and T2 PTC patients with more than five positive LNM have no additional survival benefit of TT over lobectomy. If RAI ablation is not planned, lobectomy may be an effective alternative.
41. Mitochondrial DNA mutations in head and neck squamous cell carcinoma: a systematic review and meta-analysis.
期刊: BMC cancer 发表日期: 2025-Dec-06 链接: PubMed
摘要
Head and neck squamous cell carcinoma (HNSCC) cause approximately 95% of head and neck malignancies. Clinicopathological predictions are limited, and mitochondrial DNA (mtDNA) mutations have emerged as possible biomarkers. This systematic review and meta-analysis aimed to quantify the relative contributions of several mitochondrial genome regions to the overall mutational burden in HNSCC, thereby contextualizing their potential biological importance. A systematic review and meta-analysis were conducted in accordance with the PRISMA criteria. PubMed, EMBASE, Scopus, and Web of Science were searched up to May 2025. Eligible studies reporting somatic mtDNA mutations in HNSCC were included. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. Proportional meta-analyses under random-effects models determined pooled mutation shares for six mtDNA regions. Seventeen studies were included. The D-loop was the major hotspot (67%, 95% CI: 0.28-0.91; I2 = 93.2%). ND mutations represented 29% (95% CI: 0.20-0.40), predominantly in ND1, ND2, ND4, ND5, and ND4L. COX (12%), rRNA (13%), and tRNA (9%) mutations contributed variably, while CYTB mutations were less frequent but constant (8%, I2 = 0%). Considerable heterogeneity was seen in most regions. The D-loop and ND genes dominate the mutational spectrum of HNSCC. While these findings highlight recurrent alternations in mtDNA, further studies are required to evaluate their potential as a biomarker for diagnosis and prognosis.
42. Clinical outcomes of exclusive enzyme therapy (laronidase) in a cohort of patients with mucopolysaccharidosis type I.
期刊: Orphanet journal of rare diseases 发表日期: 2025-Dec-06 链接: PubMed
摘要
Mucopolysaccharidosis type I (MPS I), is an autosomal recessive disorder caused by a deficiency in the enzyme α-L-iduronidase (IDUA), leading to the accumulation of glycosaminoglycans (GAGs) in tissues. Early diagnosis and treatment [i.e., bone marrow transplantation and/or enzyme replacement therapy (ERT) with laronidase] are essential to prevent irreversible damage. The long-term effectiveness of exclusive ERT has been primarily described in attenuated phenotypes, while only a few cases have been reported in severe phenotypes. This study is a retrospective analysis summarising the collective experience of disease progression in 48 patients with severe and attenuated MPS I who were treated exclusively with laronidase over a median of 10 years at the Lyon Reference Centre for Hereditary Metabolic Diseases in France. Patients were categorised by genotype and further stratified by age at treatment initiation. The study assessed the evolution of urinary excretion of GAGs, pulmonary function, cardiac involvement and evolution, height, cognitive impairment, functional status, orthopaedic and ear-nose-throat (ENT) procedures, sleep apnoea, and carpal tunnel syndrome. Descriptive statistical analysis methods were used. ERT reduced the GAGus levels by 88% in severe MPS I and by 71% in attenuated MPS I, of which 47% and 65% patients, respectively achieved normal age-related GAG levels at the last follow-up. ERT provided stable or consistent improvement in forced vital capacity, slowed progression of adverse cardiac course and improved auditory transmission in majority of the severe and attenuated patients. At the last follow-up, 84% attenuated patients had normal cognitive development. In alive Hurler patients, cognitive development was very heterogenous; however, 73% patients had a developmental quotient (DQ) ≥ 70. Laronidase was effective in improving statural growth of attenuated patients treated before 9 years of age. Early ERT and regular multidisciplinary management are effective in slowing disease progression in severe and attenuated patients with MPS I and helping to maintain autonomy in patients with attenuated MPS I, ensuring a better quality of life.
43. Intraoperative recognition of persistent left superior vena cava during right internal jugular central line placement in mitral valve replacement: a case report.
期刊: Journal of medical case reports 发表日期: 2025-Dec-06 链接: PubMed
摘要
Persistent left superior vena cava is a rare congenital venous anomaly, present in approximately 0.3-0.5% of the general population and in up to 10% of patients with congenital heart disease. Although typically asymptomatic and often discovered incidentally, persistent left superior vena cava may complicate central venous catheter placement and transesophageal echocardiography confirmation during cardiac surgery. Unrecognized persistent left superior vena cava can lead to misinterpretation of guidewire position, unnecessary catheter manipulation, and procedural delays. A 65-year-old white woman (body mass index 26 kg/m2; American Society of Anesthesiologists physical status III) with severe degenerative mitral regurgitation, hypertension, and well-controlled type 2 diabetes mellitus presented for elective mitral valve repair. After uneventful induction of general anesthesia, a right internal jugular central venous catheter was placed under ultrasound guidance without resistance, arrhythmia, or abnormal waveform. Intraoperative transesophageal echocardiography-using standard bicaval, midesophageal four-chamber, and midesophageal long-axis views-failed to visualize the guidewire or catheter tip within the superior vena cava or right atrium despite correct placement technique and a normal central venous pressure waveform. Given stable hemodynamics and appropriate venous return, the catheter was secured in place, and mitral valve repair proceeded without incident. Postoperative contrast-enhanced computed tomography identified a persistent left superior vena cava draining into an enlarged coronary sinus, accounting for the atypical guidewire trajectory. The central line remained functional throughout, and the patient was extubated on postoperative day 1. She experienced an uncomplicated recovery and was discharged home on postoperative day 4. When transesophageal echocardiography fails to confirm central venous catheter position despite proper technique, rare anatomical variants such as persistent left superior vena cava should be considered. Employing targeted transesophageal echocardiography interrogation of the coronary sinus and adjunctive imaging modalities can facilitate prompt recognition. Awareness of persistent left superior vena cava prevents unnecessary catheter manipulation, reduces procedural delays, and enhances patient safety during cardiac surgery.
44. Seasonal enhancement of the viral shunt catalyzes a subsurface oxygen maximum in the Sargasso Sea.
期刊: Nature communications 发表日期: 2025-Dec-06 链接: PubMed
摘要
Subsurface oxygen maxima (SOMs) occur directly beneath the mixed layer of stratified water columns across oligotrophic open ocean basins and have been associated with physical transport processes and localized increases in phytoplankton net primary productivity (NPP). We explore the hypothesis that viral lysis (i.e., the ‘viral shunt’) increases nutrient recycling and enhances NPP, supporting SOM formation in stratified water columns, focusing on a recurring SOM at the Bermuda Atlantic Time Series (BATS) in the Sargasso Sea. Reanalysis of historical BATS data showed enhanced Prochlorococcus and virus-like particle abundances associated with SOMs. Instances of high rates of primary and secondary production observed with oxygen supersaturation further implicate a biological mechanism for SOM formation. Leveraging metatranscriptomes, metaviromes, and polony-based data collected during a Lagrangian cruise (October 2019), we link the viral shunt to SOMs, including evidence of elevated cyanophage abundance and infection of Prochlorococcus, and transcriptomic evidence of increased organic matter uptake (i.e., catabolic activity) by copiotrophic bacteria. Cruise data also showed Prochlorococcus nitrogen metabolism transcripts consistent with increased responsiveness to bacterial remineralization. These findings illustrate the biogeochemical impacts of enhanced viral lysis in marine systems, including the potential role of the viral shunt in facilitating SOM formation in the oligotrophic oceans.
45. Mechanistic snapshots of lipid-linked sugar transfer.
期刊: Nature communications 发表日期: 2025-Dec-06 链接: PubMed
摘要
Enzymes undergo dynamic conformational changes during catalysis, yet conventional high-resolution structural methods typically capture only the most stable states. Here, we address this gap using rapid UV photolysis of a chemically caged substrate with cryogenic time-resolved electron microscopy (cryo-TREM). We elucidate the catalytic mechanism of GtrB, a membrane-bound glycosyltransferase that transfers glucose from UDP-glucose to the lipid carrier undecaprenyl phosphate. We visualized how GtrB, which has an active site ~15 Å from the membrane, transitions during the catalytic cycle to move each substrate in proximity for catalysis. From a single dataset, we resolved distinct conformational states: the initial substrate-bound state, a catalytically poised intermediate, and the product-bound state. Through molecular dynamics simulations and biochemical analyses, we identify coordinated movements within the active site that drive catalysis. These findings provide a molecular framework for understanding how glycosyltransferases function and highlight a broadly applicable strategy for capturing dynamic enzymatic states in native-like environments.
46. Foliar nickel fertilization enhances photosynthesis and defines critical leaf levels and optimal rate in maize.
期刊: Scientific reports 发表日期: 2025-Dec-06 链接: PubMed
摘要
Nickel (Ni) use in agriculture has expanded, especially the foliar application of this micronutrient, which has had positive effects on the health and grain yield of several crops. Thus, critical levels of the element in the leaves and the optimal dose for the maize crop need to be identified. The aim of this study was to evaluate the effect of foliar application of Ni doses on gas exchange, nutrition, biochemistry, physiology and grain yield of maize plants. Field experiments were carried out in randomized block design with four replicates and five doses of foliar Ni fertilizing: 0; 20; 40; 80 and 160 g ha- 1, divided into two applications, totaling 20 plots. A single application of Ni increased the total chlorophyll content by 38% with 70 g ha- 1 Ni in year I and 44% in year II when 80 g ha- 1 Ni was applied. Photosynthesis also improved, increasing by 46% in year I and 45% in year II. Ni content in the leaves varied from 1.02 to 3.35 mg kg- 1 in year I and from 0.33 to 6.32 mg kg-¹ in year II, while the content in the grains increased from 0.68 to 1.03 mg kg-¹ Ni in year I and from 0.13 to 1.05 mg kg- 1 in year II. Yield peaked at 46.50 g ha- 1 Ni in year I and 92.50 g ha- 1 in year II, increasing grain yield by 15.62% and 5%, respectively, compared to the control (no Ni). The appropriate range of Ni in the leaves was 1.29 to 1.86 mg kg-¹ in year I and 1.40 to 3.60 mg kg-¹ in year II, with toxic levels above 2.43 mg kg-¹ and 5.80 mg kg-¹, respectively, reducing grain yield by approximately 32% in year I and 6% in year II. Overall, foliar Ni fertilization improved photosynthesis and grain yield when applied within moderate ranges, although the magnitude of the response varied substantially between years. These results indicate that Ni use in maize should not rely on a single fixed dose but should instead be calibrated according to environmental conditions and crop responses. Grain Ni levels remained within acceptable limits, reinforcing that moderate foliar Ni application can be used safely when properly managed.
47. Mitochondrial superoxide dismutase controls metabolic plasticity in pancreatic cancer.
期刊: Cell communication and signaling : CCS 发表日期: 2025-Dec-06 链接: PubMed
摘要
The role of reactive oxygen species (ROS) in cancer is debated. One main antioxidant enzyme is mitochondrial superoxide dismutase (SOD2) which has been shown to influence tumor initiation and metastatic progression in several cancer types. To investigate the impact of Sod2 deletion on pancreatic cancer biology and metabolism, we used CRISPR/Cas9 gene editing to generate 3 independent Sod2-deficient cell lines from murine KrasG12D pancreatic cancer cell lines and analyzed them for proliferation, colony forming, mitochondrial respiration and RNA expression. In addition, mass spectrometry and isotope tracing were performed. Proliferation and wound healing capacity were significantly impaired in Sod2 deficient cell lines. Myc levels were significantly elevated in Sod2-deficient cells, and mitochondrial respiration was consecutively increased. This resulted in increased tolerance to glucose deprivation. Mechanistically, we detected a significantly reduced activity of succinate dehydrogenase (SDH) in Sod2-deficient cells. This resulted in increased peroxynitrite formation which was the cause of increased Myc activation. These findings reveal that Sod2 shapes cellular metabolism in pancreatic cancer through peroxynitrite formation and Myc activation.
48. A light-induced microprotein triggers regulated intramembrane proteolysis to promote photo-sensing in a pathogenic bacterium.
期刊: Nature communications 发表日期: 2025-Dec-06 链接: PubMed
摘要
Light, a ubiquitous environmental stimulus, shapes behavior and physiology across all domains of life. While photoreceptors are widespread in bacterial genomes, their functional roles and signal transduction mechanisms in non-photosynthetic bacteria remain understudied. Light represses biofilms and virulence factors through a bacteriophytochrome photoreceptor BphP and response regulator AlgB in the human pathogen Pseudomonas aeruginosa. Here, we used transposon mutagenesis screening to identify a conserved hypothetical microprotein, DimA, as the master activator of the photo-sensing cascade. Transcriptomics, luciferase reporter assays and physiological assays revealed that deletion of dimA abolishes light-dependent suppression of virulence factors and biofilms. Mechanistically, we demonstrated that DimA activates the site-I protease AlgW, triggering regulated intramembrane proteolysis of the anti-sigma factor MucA, liberating sigma factor AlgU (σ22), which promotes algB expression. We discovered a positive feedback loop where light-activated AlgB upregulates dimA expression, thereby amplifying the photosensory response. This work establishes DimA as a crucial activator of photo sensing and expands our understanding of bacterial adaptation to changing light environments.
49. Occupational physical activity and incidence and mortality of 14 cancers in 404,249 adults.
期刊: Nature communications 发表日期: 2025-Dec-06 链接: PubMed
摘要
Leisure physical activity is considered protective against several cancers, but the impact of physical activity at work remains unclear. We analyze data from over 400,000 Norwegian adults followed for a median of 27 years to examine how different levels of occupational physical activity are associated with cancer incidence and mortality. Participants report their typical work activity as sedentary, walking, walking-and-lifting, or heavy labor. Here we show that individuals with more physically active jobs have a lower risk of developing several cancers (i.e., endometrial, colon, breast, rectal, and prostate), and to a lesser extent, the risk of breast cancer mortality. However, occupational physical activity is also associated with increased risk of esophageal and kidney cancer death. These findings suggest that occupational physical activity may lower the incidence of some cancers but are associated with a higher mortality from other cancer types. Understanding these patterns could help tailor public health recommendations related to physical activity and occupational health.
50. Educational intervention effects on nurses' knowledge, attitudes, and practice toward handling cytotoxic drugs in their workplace.
期刊: BMC nursing 发表日期: 2025-Dec-06 链接: PubMed
摘要
51. Deficiency of Toll-like receptor 2 is a driver of sex-related compositional and structural rearrangements of membrane lipids.
期刊: Communications chemistry 发表日期: 2025-Dec-06 链接: PubMed
摘要
The behavior and function of membrane microdomains is shaped by the intricate liaison between the most complex glycosphingolipids-gangliosides, cholesterol and specific classes of transmembrane proteins. Toll-like receptor 2 (TLR2), a pattern recognition receptor localized in lipid rafts, is implicated in different membrane-associated events, some of which overlap between gangliosides and TLR2, such as pathogen recognition and neuroinflammation. Aiming to determine whether TLR2 deficiency influences on the composition and arrangement of membrane lipids, we examined cortical tissue of TLR2-deficient and control mice by in-depth glycolipidomic profiling along with transcriptomic analysis of genes involved in ganglioside and cholesterol metabolism. A multi-level experimental approach, including powerful high-resolution mass spectrometry techniques, provided a detailed lipidomic data and elaborate structural characterization of brain gangliosidome and sterolome in TLR2 deficiency. The results demonstrate the presence of distinct brain glycolipidomic and sterol pattern as well as lipid redistribution within the membrane fractions in TLR2 deficiency. In addition, the findings speak in favor of a sex-specific structural and functional partnership of TLR2, gangliosides and cholesterol in the brain tissue that may act as a connection point integrating extracellular stimuli and modulating neuroimmune response in a sex-dependent manner.
52. Time-updated FIB-4 index predicts coronary artery calcification progression in individuals with metabolic dysfunction-associated steatotic liver disease.
期刊: Scientific reports 发表日期: 2025-Dec-06 链接: PubMed
摘要
Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disorder worldwide and is increasingly recognized as a multisystem disease that elevates cardiovascular disease (CVD) risk. Liver fibrosis, rather than steatosis itself, is considered the primary determinant of prognosis in MASLD. The Fibrosis-4 (FIB-4) index, a simple noninvasive fibrosis score, has been linked to adverse hepatic outcomes, but its value for predicting subclinical atherosclerosis remains unclear. We investigated whether time-updated FIB-4 predicts coronary artery calcification (CAC) progression in a large cohort of asymptomatic Korean adults. A total of 60,445 participants who underwent repeated coronary computed tomography and liver ultrasonography during health examinations between 2012 and 2023 were included. CAC progression, defined as incident CAC (Agatston score ≥ 1) or a significant increase in existing CAC, was assessed using time-dependent Cox regression models. Elevated FIB-4 was significantly associated with higher risk of CAC progression among participants with MASLD, independent of established CVD risk factors. In stratified analyses, the association was stronger in men and in individuals older than 40 years. These findings indicate that the time-updated FIB-4 index shows a modest association with subclinical atherosclerosis progression, primarily among men aged ≥ 40 years with MASLD, and may serve as an accessible marker reflecting subclinical cardiovascular risk rather than a validated predictor of risk stratification improvement.
53. The changing landscape of heart failure: translating management into the modern era.
期刊: European journal of internal medicine 发表日期: 2025-Dec-05 链接: PubMed
摘要
Heart failure (HF) is a complex clinical syndrome associated with high morbidity and mortality, accounting for approximately 2 % of total healthcare expenditures. Despite advances in pharmacological and device-based therapies, HF continues to affect over 70 million people globally, with an increasing prevalence driven by an aging population. The classification remains imperfect due to the pathophysiological complexity of the syndrome. Recent attention has focused on aetiological characterisation, particularly in non-ischaemic cardiomyopathies, where genetic testing may provide diagnostic, prognostic, and therapeutic insights. Left ventricular reverse remodeling (LVRR) and the recognition of HF with improved ejection fraction (HFimpEF) have highlighted the dynamic nature of HF and the importance of continued therapy despite apparent recovery. Guideline-directed medical therapy (GDMT), based on four foundational drug classes for HFrEF, has demonstrated significant benefit, yet its implementation remains suboptimal. For HFpEF, all effective drugs have however failed to reduce mortality. Device therapy, including implantable cardioverter-defibrillators (ICDs), cardiac resynchronisation therapy (CRT) and valve replacement offers additional benefit in select patients and may facilitate optimisation of medical therapy. New avenues such as multiomic profiling, gene therapy, and artificial intelligence (AI) are expanding our ability to phenotype HF, predict disease progression, and personalize treatment strategies. This viewpoint summarises the current understanding of HF, with an emphasis on the classification, aetiology, phenotypes and evidence-based management including newer therapies and their scope of use across the spectrum of LVEF.
54. Pediatric stroke: From emergent evaluation to rehabilitation.
期刊: Current problems in pediatric and adolescent health care 发表日期: 2025-Dec-05 链接: PubMed
摘要
Pediatric stroke, though less common than adult stroke, is a significant cause of morbidity and mortality in children, affecting neonates, infants, and adolescents. Strokes in children could be due to ischemic, hemorrhagic, or venous-thrombotic events. Timely recognition and intervention to optimize neurologic outcomes and minimize long-term disability is most critical. Clinical symptoms are dependent on location of the stroke, but pediatric-specific challenges include higher prevalence of stroke mimics and more frequent seizures. Rapid diagnosis hinges on detailed history, neurologic examination, and emergent imaging, with MRI and angiography preferred for evaluating ischemia and vascular anomalies. Hyperacute treatments include intravenous thrombolysis and mechanical thrombectomy. Risk factors are often multifactorial, including congenital heart disease, sickle cell disease, and thrombophilia. Acute complications may involve cerebral edema, hemorrhagic conversion, and post-stroke epilepsy. Rehabilitation is essential and begins early in the intensive care unit. A multidisciplinary team-including physical, occupational, and speech therapists alongside physiatrists-supports recovery. Rehabilitation intervention includes uses of orthoses to improve function, prevent complications, impairment specific treatment including constraint-induced movement therapy (CIMT) and goal-oriented hypertonia management. Cognitive and communication impairments also require tailored therapies and school reintegration planning. Although neural plasticity offers potential for recovery, many children experience persistent motor, cognitive, and psychosocial deficits. Early, aggressive rehabilitation and coordinated outpatient care are key to maximizing functional outcomes and improving long-term quality of life.
55. Aging, place, and the life course of societies.
期刊: Journal of aging studies 发表日期: 2025-Dec 链接: PubMed
摘要
This article presents a novel perspective from which to study aging and place. Adopting a Deweyan pragmatist perspective, aging and place are viewed through the lens of ongoing situations. Each situation is the dynamic expression of a co-constituted relationship between the aging person and place, a relationship shaped by processes of place integration in a quest for a sense of being in place. Habit and constant adaptation to changing circumstances are key elements of maintaining person/place harmony. In a world of constant uncertainty, change resulting in disharmony becomes problematic, provoking a need to act in response on an individual, community, or societal level. We illustrate how contemporary mega-trends, including accelerating technological advance (especially artificial intelligence), climate change, and evolving 21st century neoliberal and populist political economies, threaten the places where older adults reside as they shape the life course of societies, with the potential for a dystopian future. The threat is increasingly acute in places where changes are exacerbating longstanding generational, ethnic, economic, social, cultural, and regional disparities and generating new ones. An alternative path is possible. Adopting a progressive pragmatist approach to social inquiry and problem solution on the level of the community, we suggest the possibility of a more positive future. Engaging older adults, an important source of social capital, in this endeavor will be critical. Significant change in the current situation, with the objective of enhancing person/place harmony with equity and social justice for all, may not be rapid. It may take generations.
56. Author's response to comment re. "Nutri-Score effectiveness at improving consumer nutrition literacy, food choices, health, and healthy eating pattern adherence: A systematic review".
期刊: Nutrition (Burbank, Los Angeles County, Calif.) 发表日期: 2025-Nov-06 链接: PubMed
摘要
57. Generative AI in degenerative lumbar spinal stenosis care: A NASS guideline-compliant comparative analysis of ChatGPT and DeepSeek.
期刊: Journal of orthopaedic surgery (Hong Kong) 发表日期: 2025 链接: PubMed
摘要
BackgroundThis study aims to compare the performance of two artificial intelligence (AI) models, ChatGPT-4.0 and DeepSeek-R1, in addressing clinical questions related to degenerative lumbar spinal stenosis (DLSS) using the North American Spine Society (NASS) guidelines as the benchmark.Methods15 clinical questions spanning five domains (diagnostic criteria, non-surgical management, surgical indications, perioperative care, and emerging controversies) were designed based on the 2013 NASS evidence-based clinical guidelines for the diagnosis and management of DLSS. Responses from both models were independently evaluated by two board-certified spine surgeons across four metrics: accuracy, completeness, supplementality, and misinformation. Inter-rater reliability was assessed using Cohen’s κ coefficient, while Mann-Whitney U and Chi-square tests were employed to analyze statistical differences between models.ResultsDeepSeek-R1 demonstrated superior performance over ChatGPT-4.0 in accuracy (median score: 3 vs 2, P = 0.009), completeness (2 vs 1, P = 0.010), and supplementality (2 vs 1, P = 0.018). Both models exhibited comparable performance in avoiding misinformation (P = 0.671). DeepSeek-R1 achieved higher inter-rater agreement in accuracy (κ = 0.727 vs 0.615), whereas ChatGPT-4.0 showed stronger consistency in ssupplementality (κ = 0.792 vs 0.762).ConclusionsWhile both AI models demonstrate potential for clinical decision support, DeepSeek-R1 aligns more closely with NASS guidelines. ChatGPT-4.0 excels in providing supplementary insights but exhibits variability in accuracy. These findings underscore the need for domain-specific optimization of AI models to enhance reliability in medical applications.