公共卫生研究摘要 (2025-12-12)
共收录 54 篇研究文章
1. The Association of Mild Kidney Disease With Coronary Artery Disease Is Stronger for People Living With HIV.
期刊: Journal of acquired immune deficiency syndromes (1999) 发表日期: 2026-Jan-01 链接: PubMed
摘要
To examine the association between mild kidney disease and coronary plaque parameters using coronary computed tomography angiography in people living with HIV (PWH) compared with people without HIV in Uganda. Cross-sectional secondary analysis. We studied 165 participants aged >45 years with ≥1 cardiovascular risk factor (78 PWH on stable antiretroviral therapy, 87 HIV-negative). Kidney function was assessed using estimated glomerular filtration rate (eGFR) and albumin-creatinine ratio (ACR). Coronary artery disease (CAD) was characterized by segment involvement score (SIS), segment stenosis score (SSS), and coronary artery calcium score. Multivariable Tobit regression assessed associations of kidney function measures with CAD parameters, testing for differences by HIV status. The median (interquartile range) age was 57.0 (53-62) years, 62.4% of subjects were female, and 87.3% had hypertension. Among PWH, mildly impaired eGFR (<90 mL/min/1.73 m2) was associated with higher SIS [β 3.31, 95% confidence interval (CI): 0.41 to 6.21, P = 0.03] and SSS (β 5.95, 95% CI: 0.54 to 11.36, P = 0.03). The association with SIS remained significant after adjusting for age, gender, and 10-year ASCVD score (β 2.58, 95% CI: 0.10 to 5.06, P = 0.04). Associations of ACR with coronary plaque were not statistically significant for participants with or without HIV (all P > 0.07). In PWH, mildly reduced eGFR was associated with greater coronary plaque burden (SIS, SSS) but not coronary artery calcium; ACR showed no associations with any CAD measures. Incorporating kidney function measures into cardiovascular risk assessment may be valuable in HIV care.
2. Impact of a Revised Ryan White Part A HIV Care Coordination Program on Viral Suppression and Durable Viral Suppression.
期刊: Journal of acquired immune deficiency syndromes (1999) 发表日期: 2026-Jan-01 链接: PubMed
摘要
In 2018, the New York City Health Department implemented a revised care coordination program (CCR) to facilitate delivery and strengthen the impact of an already effective intervention among people with HIV (PWH) struggling with viral suppression (VS). We examined CCR effects on 12-month VS and 36-month durable VS (DVS). Using merged population-based HIV surveillance and Ryan White programmatic data, we identified PWH enrolled in the CCR between August 2018 and March 2021 and a contemporaneous group of CCR-eligible yet not enrolled PWH. We used inverse probability-weighted models to estimate CCR effects, stratified by baseline treatment status: lacking evidence of VS, newly diagnosed, inconsistently suppressed, and consistently suppressed. Comparing the CCR with usual care, the adjusted relative risk [aRR] of VS was 1.91 (95% CI: 1.67 to 2.19) among those lacking evidence of VS, 1.30 (95% CI: 1.17 to 1.45) among those newly diagnosed, 1.14 (95% CI: 1.05 to 1.23) among those inconsistently suppressed, and 1.04 (95% CI: 0.94 to 1.16) among those consistently suppressed. Comparing the CCR with usual care, the aRR of DVS was 1.39 (95% CI: 1.09 to 1.77) among those lacking evidence of VS, 1.29 (95% CI: 0.98 to 1.71) among those newly diagnosed, 0.92 (95% CI: 0.79 to 1.09) among those inconsistently suppressed, and 1.07 (95% CI: 0.88 to 1.30) among those consistently suppressed. Relative to usual care, the CCR enhanced VS across most baseline treatment status groups and showed promise for DVS among PWH lacking evidence of VS or newly diagnosed.
3. The Impact of Childhood Household Violence on HIV-Related Outcomes in People With HIV in the United States: The Role of Psychological Distress and Social Stressors.
期刊: Journal of acquired immune deficiency syndromes (1999) 发表日期: 2026-Jan-01 链接: PubMed
摘要
Psychological distress (eg, depression) and social stressors (eg, HIV-related stigma) can affect HIV-related outcomes such as antiretroviral therapy adherence and health-related quality of life (HRQL). Limited research on adverse childhood experiences such as childhood household violence (CHV) has shown a similar impact on HIV-related outcomes, particularly virologic suppression, although little is known about mediating pathways with factors such as psychological distress and social stressors. Data from the Centers for AIDS Research Network of Integrated Clinical Systems cohort were analyzed. This article examines the relationship between CHV and HIV-related outcomes, and potential differences between those with and without CHV by age (<50 vs. ≥50 years). Bivariate comparisons, linear regressions, and mediation analyses between CHV and other variables were used to assess association with outcome measures. Among 7705 people with HIV, CHV was reported by 19% (n = 1498). CHV was associated with lower antiretroviral therapy adherence (P < 0.001), more HIV symptoms (P < 0.001), and lower HRQL (P < 0.001). In addition, CHV exposure was associated with worse depressive symptoms (P < 0.001), increased panic symptoms (P < 0.001), lower social support (P < 0.001), greater self-report of HIV stigma (P < 0.001), and more exposure to intimate partner violence (P < 0.001). Psychological distress and social stressors mediated the relationship between CHV and adherence, HIV symptoms, and HRQL, with depressive and panic symptoms accounting for the greatest proportion mediated. CHV has an adverse impact on social and psychological factors in adulthood for people with HIV. Depressive symptoms and panic symptoms are potential targets for interventions.
4. Tūtakarerewa-Indigenous advocacy and structural racism in bowel cancer screening in Aotearoa New Zealand.
期刊: The New Zealand medical journal 发表日期: 2025-Dec-12 链接: PubMed
摘要
Aotearoa New Zealand has one of the highest bowel cancer rates in the world. Bowel cancer incidence is increasing for Māori (the Indigenous people of Aotearoa), while trending downwards for non-Māori. Over half of Māori who get bowel cancer are diagnosed before the age of 60 years and are more likely than non-Māori to die within 2 years. Pacific people also experience bowel cancer inequities. In 2016, a national bowel screening programme for Aotearoa was announced, with an age range of 60-74 years. However, equity modelling showed that the proposed programme would disproportionately benefit non-Māori and that lowering the screening age for Māori and Pacific peoples to 50 years could achieve equal health gains. Over subsequent years, Māori cancer leaders advocated for policy change to lower the bowel screening age by 10 years for Māori. They used academic publications, presentations, letters, position statements, media stories and meetings with government leaders. Despite this advocacy, in 2020, the Government announced it was not going to lower the bowel screening age for Māori and Pacific peoples. The advocates persevered. They were supported in their efforts by new data that further confirmed the increasing bowel cancer incidence for Māori. In 2022, the Government committed to lowering the bowel cancer screening age to 50 for Māori and Pacific peoples. However, what followed was a tardy, phased rollout in only three regions. A year on, a new government embarked on a politically motivated agenda to reject ethnically targeted policies, with further significant equity changes to the programme announced. This paper summarises the lobbying efforts of cancer leaders and the government response, revealing structural and institutional racism, represented by inaction and active rejection of evidence-based advice. We describe the perseverance required to advocate for equity in the face of structural racism and the cost to Māori lives while inaction and racism persist.
5. Reform, repeal, replace: a case study of policy whiplash in New Zealand's health sector.
期刊: The New Zealand medical journal 发表日期: 2025-Dec-12 链接: PubMed
摘要
For over a decade, New Zealand pursued a comprehensive reform of its outdated medicines legislation, culminating in the passage of the Therapeutic Products Act 2023 (TPA) in 2023. In a policy reversal, the Act was repealed by a new government in 2024. This study provides an analysis of this policy cycle to understand the drivers of the reform, its subsequent repeal and the implications for future health policy. We take a political economy perspective, foregrounding health policy instability and its consequences for patients, clinicians and Māori health interests. We conducted a qualitative documentary policy analysis of 25 key government and stakeholder documents, including legislation, regulations, cabinet papers and select committee reports with their submissions. We employed a framework method for a systematic thematic analysis of the corpus to map and interpret the policy narratives. The impetus for the TPA was a consensus that the Medicines Act 1981 and its associated regulations from 1984 and 1985 were “no longer fit for purpose”. The repeal was driven by an ideological shift, reframing the TPA as an unacceptable “regulatory burden”. This has tangible consequences, including the loss of a pre-market approval framework for medical devices and the erasure of legislative provisions designed to protect and recognise Rongoā Māori (traditional Māori healing). The TPA policy cycle is a case study in the fragility of evidence-based health reform. It demonstrates that without a durable, cross-party political consensus, long-term policy projects are highly vulnerable to being dismantled by short-term shifts in political ideology, with downstream harms from regulatory instability. It also illustrates how a targeted “micro‑reform” can generate outsized system‑level consequences.
6. Abdominal aortic aneurysm in women in Aotearoa New Zealand.
期刊: The New Zealand medical journal 发表日期: 2025-Dec-12 链接: PubMed
摘要
Women with an abdominal aortic aneurysm (AAA) in Aotearoa New Zealand experience inequity at every stage of diagnosis and management. We currently treat women too late in their disease course, where increased age, comorbidities, larger AAA diameter, preventable ruptures, loss of eligibility for simple endovascular repair (EVAR) and clinical “turn down for surgery” rates all add to higher AAA mortality. There is scope for great improvements in cardiovascular risk reduction for people living with a small AAA and for considering the inclusion of women in proposals for an AAA screening programme.
7. Genotyping and molecular dynamic simulations reveal the role of MSH2 DNA repair polymorphisms in lung cancer risk.
期刊: Journal of biomolecular structure & dynamics 发表日期: 2025-Dec-11 链接: PubMed
摘要
Lung cancer is the leading cause of cancer-related mortality worldwide and arises from a complex interplay of genetic predispositions and environmental exposures. Epidemiological studies have shown that alterations in key DNA repair genes, such as MSH2, can significantly impact an individual’s susceptibility to cancer. In the present study, we focused on MSH2 polymorphisms and their potential role in increasing the risk of lung cancer. Our analysis revealed that four out of six polymorphisms showed a strong association with increased risk of lung cancer in individuals carrying heterozygous or mutant genotypes, specifically 118 T > C, 1032 G > A, T > C/-6, and Asn127Ser. Among these, the T > C/-6 polymorphism exhibited the strongest effect, conferring a 13-fold increased risk of lung cancer (Pcorr = 0.0006) in patients with the variant allele. Stratified analysis further indicated subtype-specific associations: in adenocarcinoma (ADCC) patients, the T > C/-6 variant was linked to a 12-fold higher risk (Pcorr = 0.0018), while in squamous cell carcinoma (SQCC) and small-cell lung carcinoma (SCLC) patients, the same polymorphism was associated with a 2-fold (Pcorr = 0.0006) and 16.5-fold increased risk, respectively, particularly in carriers of the combined or mutant genotypes. MDR analysis predicted the best interaction model (MSH2 118 T > C, IVS 1 + 9 G > C, T > C/-6) with a maximum CVC of 10/10 and the least prediction error of 0.355, accompanied by a significant p-value. Furthermore, MD simulations reveal that the Gly322Asp polymorphism in MSH2 induces pronounced structural destabilisation, which may compromise DNA binding and repair efficiency.
8. Effectiveness of 2023-2024 Coronavirus Disease 2019 (COVID-19) Vaccines in Pregnant Women.
期刊: Obstetrics and gynecology 发表日期: 2025-Dec-11 链接: PubMed
摘要
Pregnant women are at higher risk of severe coronavirus disease 2019 (COVID-19) compared with nonpregnant women of reproductive age. During 2023-2024, the Centers for Disease Control and Prevention recommended COVID-19 vaccination for everyone aged 6 months or older, including pregnant women. Using a test-negative design, we assessed the effectiveness of 2023-2024 COVID-19 vaccines against COVID-19-associated emergency department (ED) and urgent care setting encounters among pregnant women aged 18-45 years presenting for care with COVID-19 symptoms from September 2023 to August 2024. Vaccine effectiveness against COVID-19-associated ED and urgent care encounters of one 2023-2024 COVID-19 vaccine dose was 58% (95% CI, 24-77%) among pregnant women and 37% (95% CI, 29-44%) among nonpregnant women of the same age. The 2023-2024 COVID-19 vaccines were associated with a decrease in COVID-19-associated ED and urgent care encounters among pregnant women and nonpregnant women of reproductive age.
9. Domperidone Use in Lactation and Risk of Severe Postpartum Mental Health Outcomes.
期刊: Obstetrics and gynecology 发表日期: 2025-Dec-11 链接: PubMed
摘要
To evaluate whether postpartum domperidone use is associated with new-onset psychosis and other severe mental health outcomes. We conducted a retrospective cohort study of people who filled a prescription for domperidone within 56 days of delivery between March 1, 2006, and March 1, 2022, in Ontario, Canada. Those who filled a domperidone prescription were matched 1:1 based on propensity score to an equal number of those who did not. The primary outcome was any health care contact for incident psychosis in the subsequent 365 days, with a secondary outcome of any psychiatric emergency department (ED) visit or hospitalization. Cox proportional hazards regression was used to compare outcome risk between people who initiated domperidone and those who did not. We identified 2,237,806 births, and 7,096 (0.3%) were followed by the individuals filling a publicly funded domperidone prescription within 56 days postpartum. After exclusions, 4,629 domperidone-exposed and 116,644 unexposed individuals remained. Overall, 4,585 domperidone-exposed individuals were propensity score matched to an equal number who were unexposed, resulting in good balance across all measured baseline characteristics. Compared with matched postpartum individuals who did not initiate domperidone, domperidone use was not associated with psychosis (6.4/1,000 person-years vs 6.4/1,000 person-years; hazard ratio [HR] 1.00, 95% CI, 0.60-1.67) in the postpartum period. We found no association between domperidone use and ED visits or hospital admissions with mental health diagnoses (38.0/1,000 person-years vs 43.4/1,000 person-years, HR 0.88, 95% CI, 0.71-1.08). Initiation of domperidone postpartum was not associated with an increased risk of new-onset psychosis or ED visits or hospital admissions with mental health diagnoses.
10. Preferences Among U.S. Women for Cervical Cancer Screening with Self-Collected Specimens for Human Papillomavirus Testing.
期刊: Obstetrics and gynecology 发表日期: 2025-Dec-11 链接: PubMed
摘要
To examine preferences for human papillomavirus (HPV) specimen self-collection, and collection location, in a nationally representative sample of reproductive-aged women in the United States. This cross-sectional analysis used household population-based data from the National Survey of Family Growth (January 2022-December 2023) and was limited to women aged 21-49 years without a history of hysterectomy or cervical cancer (sample n=4,465). Survey weights and design variables were applied to generate nationally representative population frequencies and percentages of preference for HPV self-collection compared with clinician collection, and preference for collection location (ie, at home or in office). Among eligible U.S. women, 42.9% preferred HPV self-collection, 28.5% preferred clinician collection, and 28.6% expressed no preference. An estimated 41.7 million (71.5%) U.S. women aged 21-49 years were open to HPV self-collection (either preferring it or having no preference), including 9.7 million women who were underscreened or never screened. Among women who were open to HPV self-collection, more than half (52.1%) preferred self-collection at home, 14.7% preferred to do self-collection in a doctor’s office, and 33.2% had no preference for location. More underscreened or never-screened women preferred HPV self-collection (54.0%) and at-home collection (59.3%) compared with those who were up to date with screening (40.3% and 50.2%, respectively, P<.001). Preference for self-collection also varied by race and Hispanic origin, education, income, parity, sexual orientation, and prior experience of nonvoluntary vaginal intercourse. In this nationally representative study, more than 7 in 10 U.S. women aged 21-49 years were open to HPV self-collection for cervical cancer screening, with more than half favoring at-home collection. Preference was higher among women who were not up to date with screening. These findings provide timely evidence to inform future policy decisions and implementation strategies to improve access to cervical cancer screening.
11. Clinician- and Facility-Level Factors Associated With Receipt of Nonguideline Chemotherapy Regimens in Women With Stage I-IIIA Breast Cancer.
期刊: JCO oncology practice 发表日期: 2025-Dec-11 链接: PubMed
摘要
We examined clinician- and facility-level factors associated with selection of nonguideline chemotherapy at treatment initiation in women with stage I-IIIA breast cancer (BC). The Optimal Breast Cancer Chemotherapy Dosing Study collected information on chemotherapy delivery in an integrated health care delivery system. This analysis included 9,758 women treated with chemotherapy for stage I-IIIA BC between 2006 and 2019 at Kaiser Permanente Northern California (KPNC). Prevalence ratios (PRs) and corresponding 95% CIs were estimated for the clinician and facility factors in relation to nonguideline regimen (NGR) use. Analyses were stratified by time (pre- and post-2015) to reflect the period before and after KPNC’s transition to a subspecialized care model. Secondary outcomes focused on nonguideline drug combinations (NGDCs) and nonguideline administration schedules (NGASs). Women treated by clinicians with substantially greater time since medical school (30+ years v <10 years since medical school) were more likely to receive NGR (PR, 1.38; 95% CI, 1.01 to 1.88; P trend = .01) with significant associations observed for both NGDC and NGAS. While not associated in the primary analysis, larger practice size (10+ oncologists) was associated with a lower likelihood of NGDC use compared with smaller practices (<5 oncologists; PR, 0.43; 95% CI, 0.26 to 0.70; P trend = .01). Time stratification revealed that, in the study’s early years, clinician sex and years since medical school were associated with NGR use, but neither association remained post-2015. Clinician and facility characteristics significantly influenced the use of NGR in stage I-IIIA BC treatment. Notably, associations diminished over time, suggesting that health system changes in care delivery may enhance guideline adherence and reduce the impact of nonclinical factors on treatment decisions.
12. A Multiple Technology-Based Physical Activity Intervention for Latina Adolescents: Results From the Chicas Fuertes Randomized Controlled Trial.
期刊: JMIR mHealth and uHealth 发表日期: 2025-Dec-11 链接: PubMed
摘要
Latina adolescents report low levels of moderate-vigorous physical activity (MVPA) and high lifetime risk of lifestyle-related diseases. There is a lack of MVPA interventions targeted at this demographic despite documented health disparities. Given their high rates of mobile technology use, interventions delivered through mobile devices may be effective for this population. This paper examines the efficacy of the Chicas Fuertes intervention in increasing MVPA across 6 months in Latina adolescents. Participants were Latina adolescents (aged 13-18 years) in San Diego County who reported being underactive (<150 min/wk of MVPA). All participants received a wearable fitness tracker (Fitbit Inspire HR); half were randomly assigned to also receive the multimedia intervention. Intervention components included a personally tailored website, personalized texting based on Fitbit data, and social media. The primary outcome was change in minutes of weekly MVPA from baseline to 6 months, measured by ActiGraph accelerometers and the 7-Day Physical Activity Recall Interview. Changes in daily steps using Fitbit devices were also examined to test intervention efficacy. Participants (N=160) were 15.85 (SD 1.71) years old on average, and mostly second generation in the United States. For ActiGraph-measured MVPA, participants in the intervention group (n=83) increased from a median of 0 (IQR 0-24) minutes/week at baseline to 64 (IQR 19-72) minutes/week at 6 months compared to control participants, who showed increases from a median of 0 (IQR 0-26) at baseline to 41 (IQR 7-76) minutes/week at 6 months (P=.04). Self-reported MVPA increased in the intervention group from a median of 119 (IQR 62.5-185) minutes/week at baseline to 147 (IQR 96-181) minutes/week at 6 months compared to control participants, who showed increases from a median of 120 (IQR 48.8-235) at baseline to 124 (IQR 100-169) minutes/week at 6 months (P=.03). Steps also increased in both groups, with the intervention group showing significantly greater increases (P=.03). This intervention was successful in using a tailored technology-based strategy to increase MVPA in Latina adolescents and provides a promising approach for addressing a key health behavior. Given the scalable technology used, future studies should focus on broad-scale dissemination to address health disparities.
13. Substitution Preferences for Sugar-Sweetened Beverages Among US Adults by Sociodemographic Characteristics - SummerStyles 2021.
期刊: American journal of health promotion : AJHP 发表日期: 2025-Dec-11 链接: PubMed
摘要
PurposeThis study examined preferences to consider low-calorie, no sugar substitution options for sugar-sweetened beverage (SSB) among US adults. This could help develop tailored public health strategies to reduce SSB consumption and related health risks.DesignQuantitative, cross-sectional study.SettingUnited States.SampleThis study used 2021 SummerStyles survey data for 2552 US adults recruited from an online panel of approximately 60 000 non-institutionalized adults.MeasuresThe outcome measure was considering a non-sugar SSB substitute (Yes or no) for six different beverage options among individuals consuming SSBs who would consider a substitute. Exposure measures were sociodemographic characteristics and frequency of SSB consumption.AnalysisLogistic regression models were used to estimate adjusted odds ratios (ORs) for preference to consider each substitution option.ResultsPlain water was considered by 71% of respondents as a substitute; 36% considered flavored water, 27% sparkling water, 25% herbal tea, 19% diet drinks, and 18% unsweetened coffee. Preferences varied by demographic characteristics. Individuals reporting an annual household income of <$35 000 had 0.6 (95% confidence interval (CI): 0.4, 0.9) times lower odds to consider plain water than those with income ≥$100 000, and individuals with obesity had 1.9 (95% CI: 1.4, 2.6) times greater odds of considering diet drinks compared to those with healthy weight or underweight.ConclusionPopulation subgroups of regular SSB-consuming adults exhibit varying preferences for SSB substitutes, which can inform tailored public health messaging and interventions.
14. Mapping the Quality of German-Language Health Information on the Treatment of Knee Osteoarthritis: Cross-Sectional Analysis.
期刊: JMIR infodemiology 发表日期: 2025-Dec-11 链接: PubMed
摘要
Patients with knee osteoarthritis have a considerable need for information about their condition, its progression, and available treatments. Decision-making is often complex and requires evidence-based health information material (HIM). When medical consultations do not sufficiently address patients’ needs, many seek additional information independently. This study aimed to examine the quality of German-language HIM on knee osteoarthritis treatment and its suitability for supporting informed choice. In particular, the study analyzed the content of the HIM and assessed the balance in the presentation of treatment options. A descriptive cross-sectional study was conducted. HIM was identified through a combination of search strategies, including a systematic internet search using commonly used German terms related to the treatment of knee osteoarthritis. Identified HIMs were independently assessed by 2 raters using the validated Mapping the Quality of Health Information (MAPPinfo) checklist, which operationalizes the criteria of the Guideline Evidence-Based Health Information. Information quality was calculated on a scale from 0% to 100%, representing compliance with the quality standard. A descriptive content analysis was also carried out to examine the range and balance of treatment options presented, as well as the reporting of benefits and complications associated with total knee arthroplasty (TKA). The presence of certification was recorded. A total of 94 HIMs were included. On average, the material met 14.6% (SD 9.4%) of the quality criteria. HIM from public and nonprofit providers performed better (mean 40.1%, SD 3.6% and mean 37.2%, SD 23.1%, respectively) than those from other providers. Overall, 14 HIMs presented treatment options in a balanced manner. Among the 78 HIMs that covered TKA, 38.5% (n=30) did not report any benefits, and 35.9% (n=28) omitted potential complications. Certified HIMs showed only moderately higher information quality than uncertified material (mean 26.8%, SD 16% vs mean 12.7%, SD 5.9%). Our results highlight the urgent need to improve the quality of German-language HIM on knee osteoarthritis. The deficits identified are fundamental and affect all dimensions of information quality. Although HIM from public or nonprofit organizations has better information quality, this does not facilitate informed choice. The frequent omission of complications and benefits of TKA and the unbalanced presentation of treatment options can influence decisions. Until structural improvements are made, patients seeking quality information should favor material from public or nonprofit providers. Additionally, the MAPPinfo checklist could form the basis of a differentiated certification system to make information quality more transparent for patients.
15. Origin recognition complex subunit 1 functions as an oncogenic driver and therapeutic target in cancer.
期刊: Discover oncology 发表日期: 2025-Dec-11 链接: PubMed
摘要
ORC1 is a core protein governing DNA replication initiation and cell cycle regulation, exhibiting significant overexpression in multiple malignancies where it correlates with advanced disease stage and poor prognosis. It drives tumor progression through diverse mechanisms including activation of ERK/JNK and Wnt signaling pathways, inhibition of ferroptosis via SLC7A11, and promotion of epithelial-mesenchymal transition. Its expression is regulated through multiple layers including m6A modification by IGF2BP1, the XIST/miR-140-5p axis, transcription factors like ETV4, and epigenetic regulators including EZH2. ORC1 represents a promising therapeutic target, as its inhibition induces replication stress, cell cycle arrest, and enhances sensitivity to existing chemotherapeutic agents. Future research should focus on developing specific ORC1 inhibitors and exploring their synergistic potential with immunotherapy and targeted therapies.
16. Decoding bacterial extracellular vesicles: A review on isolation and characterization techniques.
期刊: Archives of microbiology 发表日期: 2025-Dec-11 链接: PubMed
摘要
Bacterial extracellular vesicles (bEVs) are membrane-bound phospholipid bilayered vesicles in the size range of 20-400 nm. These primarily include outer membrane vesicles (OMV) released by Gram negative bacteria and membrane vesicles (MV) released by Gram-positive bacteria. These vesicles are typically enriched in several molecules including nucleic acids, virulence proteins, toxins, and several others that aid in their crucial roles of transport of biomolecules, cell-cell communication, and microbial pathogenesis. An understanding of bEVs can help researchers develop anti-infective therapies targeting microbes unresponsive to antibiotics. The cornerstone of bEV research lies in effective isolation and characterization. Classical workflows include isolation with ultracentrifugation, size exclusion chromatography, and characterization with nanoparticle tracking analysis. Newer techniques for isolation and characterization include acoustic trapping and resistive pulse sensing respectively. Current review discusses recent developments in extracellular vesicle (EV) research, modifications to improve bEV yield, and provides a brief description of bEV cargo, whose understanding can aid in choosing the appropriate isolation and characterization strategy.
17. "Continuously Touching ROS into NO" by Hemodialysis Membranes for Preventing Hemodialysis-Associated Thrombocytopenia.
期刊: ACS applied materials & interfaces 发表日期: 2025-Dec-11 链接: PubMed
摘要
Hemodialysis membranes would easily accelerate excessive oxidative stress, leading to platelet adhesion and aggregation, which cause exacerbation of hemodialysis-associated thrombocytopenia. Notably, nitric oxide (NO) gas exerts an inhibitory effect on platelet activation by targeting key signaling molecules. Hence, we propose a strategy to inhibit platelet activation and adhesion by turning “harmful reactive oxygen species (ROS)” into “beneficial NO”, thereby preventing hemodialysis-associated thrombocytopenia. In this study, polydopamine-l-arginine (PDA-LA) molecules are coated onto the membrane surface to mainly enhance the mitigation of oxidative stress, while oxidized hyaluronic acid-l-arginine (OHA-LA) molecules are stably cross-linked into the membrane to ensure the sustained NO release for inhibition of platelet adhesion. As a result, the reactive oxygen and nitrogen species (RONS) scavenging capacities are improved to follow: H2O2 (50%), 2,2-diphenyl-1-picrylhydrazyl (DPPH•, 85.60%), 2,2’-azinobis(3-ethylbenzothiazoline-6-sulfonate) radical (ABTS•+, 82.81%), and O2•- (0.125 U/mg). Surprisingly, the concentration of continuously released NO is still approximately 0.590 μM after six cycles (0.557 μM in the first cycle). Importantly, the platelet adhesion experiment demonstrates a sustained inhibition of platelet adhesion, diminished by a factor of 100 per square centimeter (100/cm2). In a simulated sieving experiment, the BSA rejection ratio (97.52%) and urea sieving ratio (98.38%) both meet the basic requirements for hemodialysis membranes. Thus, the obtained PES/PVA/OA@PA membrane is a promising candidate for preventing hemodialysis-associated thrombocytopenia.
18. Pandemic security needs national leadership.
期刊: Science (New York, N.Y.) 发表日期: 2025-Dec-11 链接: PubMed
摘要
In a world facing escalating risks from conflict, climate change, and emerging infectious diseases, health systems are the first line of defense for protecting people, economies, and stability. Although pandemic preparedness is often framed as a global endeavor, readiness can only be successfully realized through strong national approaches that work alongside global strategies. The tools and networks already exist to help countries achieve this. What remains is the sustained commitment of governments to finance and implement those tools.
19. AI tools aim to speed up outbreak modeling.
期刊: Science (New York, N.Y.) 发表日期: 2025-Dec-11 链接: PubMed
摘要
DARPA program could help researchers build transparent, editable models of viral spread in days instead of weeks.
20. Addressing Weather-Related Physical and Mental Health Issues: An Eco-Case Management Approach.
期刊: Professional case management 发表日期: 2025-Dec-11 链接: PubMed
摘要
The purpose of this article is to enhance a person-centered approach in case management, disability management, and allied disciplines by taking into account the environmental factors affecting people’s physical, mental, and emotional health. Drawing from recent research, as well as the example of health support for agriculture producers and workers, the article underscores the weather-related risks that impact people because of where and how they live and work. The article addresses professional case managers and allied professionals such as disability management specialists in a variety of settings, including acute care, subacute/rehabilitation, workers’ compensation, occupational health and safety, primary care, and community-based care. In response to evidence of the rising health risks from weather-related events, professional case managers should expand how they assess individuals (known as “patients” in some settings) to identify their existing and potential risk factors, including where people live and work and the weather-related risks that may be present in those environments. A case management assessment of an individual’s weather-related health risks could not only inform a particular treatment episode but also help avoid preventable setbacks and recurrence of illnesses. If those risks are not addressed, they could lead to costly emergency department visits and/or hospitalization.
21. Relative impact of psychosocial factors on burnout across healthcare professional roles.
期刊: Occupational medicine (Oxford, England) 发表日期: 2025-Dec-11 链接: PubMed
摘要
High demands and limited resources characterise the work of healthcare professionals, often resulting in negative outcomes, including burnout. Yet, how burnout is affected by demands and resources may vary depending on professional roles. This study examines (i) the relative impact of psychosocial work factors (high job demands and low job resources) on subsequent burnout complaints, and (ii) how different healthcare professional roles may moderate the relationship between psychosocial work factors and burnout complaints. Data were drawn from the Longitudinal Occupational Health Survey in Healthcare in Sweden in 2022 and 2023. The analytical sample comprises 4132 healthcare professionals, with 40% being physicians, 39% registered nurses (RNs) and 21% nurse assistants (NAs). The Burnout Assessment Tool was used to assess burnout complaints, and various scales were used to measure different job demands and resources. Dominance analysis investigated the relative impact of each exposure included in the analysis (psychosocial work factors) on burnout complaints. Thereafter, a moderation analysis was performed by the healthcare professional role, that is physicians, RNs and NAs. Generally, work-life interference was the most important psychosocial work factor in the development of subsequent burnout complaints. Further, work tasks, effort-reward imbalance and work-life interference had a stronger negative effect on physicians’ burnout complaints than on RNs. Effort-reward imbalance also had a stronger negative effect on NAs’ level of burnout complaints compared to RNs. Addressing burnout and supporting healthcare professionals’ well-being requires tailored interventions for specific work-related factors alongside broader strategies for the widespread challenges of burnout.
22. Agricultural Worker Housing: A Review and a New Framework for Action.
期刊: New solutions : a journal of environmental and occupational health policy : NS 发表日期: 2025-Dec-11 链接: PubMed
摘要
Housing is a social determinant of health, acting as both a driver and indicator of social inequity. For migrant and seasonal farmworkers, it is difficult to tease apart the interaction between the environmental and social factors related to their housing, in conjunction with extreme poverty, immigration, precarious employment, and linguistic, cultural, and educational factors. The relationship of housing with employment and the transient nature of farmworkers’ occupancy add to the complexity. To assess the strengths, weaknesses, and research gaps and to identify areas requiring further investigation, we performed a critical review of the scientific and gray literature on farmworker housing and health. We propose a framework to focus research and suggest housing policy interventions to improve the health and wellbeing of this essential workforce.
23. Self-Efficacy Is Associated with Health Behaviors Related To Obesity and Cardiovascular Risk Among Hispanic/Latinx and Somali Immigrants To the United States.
期刊: Journal of immigrant and minority health 发表日期: 2025-Dec-11 链接: PubMed
摘要
Self-efficacy theory proposes that confidence to engage in a health behavior is associated with engaging in that specific behavior. Most research examining self-efficacy has been conducted with white young adult populations. This cross-sectional analysis examined the association of self-efficacy (i.e., confidence) for healthy eating and physical activity in two immigrant communities. At enrollment into the Healthy Immigrant Community study, a clinical weight management and cardiovascular risk reduction intervention set in southeastern Minnesota, 475 participants completed assessments about their confidence for healthy eating and physical activity. Measurements also included self-reports of dietary quality and intake, physical activity, quality of life, and biometric assessments. Study materials were available in English, Spanish, and Somali. In total, 450 adults (Hispanic/Latinx = 267; Somali = 183) completed measures at baseline and were included for analysis. Their average age was 45 years (range 18-87) and 59% were female. Confidence for healthy eating was significantly correlated with self-report of eating healthy snacks (p = < 0.0001) and less consumption of high-calorie drinks (p = 0.02) and regular soda (p = < 0.0001). Confidence to be physically active was significantly correlated with more self-reported physical activity (p = < 0.01). Confidence to eat healthy and be physically active appears to be correlated with having a healthier diet and higher levels of physical activity. Given the large sample size and strength of the associations, it also appears that the theoretical model of self-efficacy can be effectively measured and applied within these immigrant populations. Self-efficacy theory may be useful in understanding potential mediating mechanisms when designing future interventions with immigrant communities.ClinicalTrials.gov registration: NCT05136339; April 23, 2022.
24. Assessing the efficacy of a low-cost air pollution monitoring device for environmental and occupational exposure assessments.
期刊: Environmental monitoring and assessment 发表日期: 2025-Dec-11 链接: PubMed
摘要
Low-cost particulate matter (PM) sensors are increasingly used for personal and environmental air quality monitoring due to their affordability and accessibility. Recent advancements make these sensors suitable for occupational settings, but their accuracy in such settings remains uncertain. This study calibrated the AirBeam 2 and AirBeam 3 against the Thermo Scientific Personal DataRAM PDR-1500 to assess their efficacy at measuring high PM concentrations, such as those in occupational exposure settings, using engine exhaust and biomass smoke as PM sources. Laboratory calibrations were conducted using a sealed chamber. Linear and polynomial regressions assessed agreement with the PDR-1500, while breakpoint analyses identified thresholds where sensor performance shifted. Field calibrations using the AirBeam 2s evaluated real-world performance and user preferences. The AirBeam 2 exhibited a novel issue where PM₁ readings exceeded PM₂.₅ at concentrations > 50 µg/m3, which was corrected through reprogramming. Polynomial models outperformed linear ones for both devices and the AirBeam 3 performed better with engine exhaust than biomass smoke (linear calibration coefficients 0.192 vs 0.102, respectively), while the AirBeam 2 performed better with biomass smoke than engine exhaust (coefficients 0.323 vs 0.274, respectively). Breakpoints suggested the AirBeam 2s may be better for high concentrations, while the AirBeam 3s were more sensitive at lower concentrations. In the field, the AirBeam 2s recorded lower mean PM concentrations than the PDR-1500 and were more influenced by environmental conditions, yet participants (n = 9) who were recruited to perform field calibrations with both devices preferred the AirBeam. While sensor performance can vary by PM source, concentration, and environmental factors, these findings suggest AirBeams can be a useful option for preliminary occupational exposure assessments after careful calibration and validation prior to use.
25. Is Appendiceal Cancer a Risk of Nonoperative Management of Pediatric Uncomplicated Appendicitis?
期刊: The Journal of surgical research 发表日期: 2025-Dec-10 链接: PubMed
摘要
Nonoperative management (NOM) of pediatric uncomplicated appendicitis is becoming increasingly common. As most appendiceal cancer in children is incidentally diagnosed after appendectomy, there is a theoretical risk of missed appendiceal cancer with NOM. The objective of this study was to determine the incidence of appendiceal cancer in children who otherwise met the criteria for NOM. This study is a secondary analysis of a multi-intuitional, nonrandomized interventional trial comparing surgery to NOM of uncomplicated appendicitis in children 7 to 17 y across ten tertiary children’s hospitals between May 2015 and October 2018. Inclusion criteria for this study were (1) imaging confirmed uncomplicated appendicitis without evidence of abscess, fecalith, or phlegmon and appendiceal diameter ≤1.1 cm; (2) white blood cell count between 5000/μL and 18,000 μL; and (3) abdominal pain for less than 48 h before presentation. Pathology was reviewed for all children who underwent laparoscopic appendectomy, including those who chose primary appendectomy and those who failed NOM within 1 y. Appendiceal cancer was defined as any type of cancer, including carcinoid. A total of 826 patients (median age 12.5 y, interquartile range 10.4-14.8, 38% females) underwent an appendectomy during the study period, with 698 of these patients choosing upfront appendectomy and 128 patients undergoing appendectomy after failed NOM (242 of the 370 patients who chose NOM in the trial were successfully managed nonoperatively). Of the 128 patients who failed nonoperative management, 53 (41%) failed therapy and underwent laparoscopic appendectomy during initial admission, with pathology reports available for 52 patients, and 75 (59%) developed recurrent appendicitis and underwent appendectomy, 74 patients had available pathology reports. Among the 824 patients with available pathology reports, there were no appendiceal cancers (95% confidence interval 0%-0.36%). In children with uncomplicated appendicitis who qualify for NOM, the incidence of appendiceal cancer is exceedingly rare. Therefore, the risk of appendiceal cancer should minimally factor into counseling and decision-making between surgery and NOM in uncomplicated appendicitis in children.
26. Recommendations for addressing threats to the nursing profession: An agenda from research leaders.
期刊: Nursing outlook 发表日期: 2025-Dec-10 链接: PubMed
摘要
The nursing profession is at a critical juncture, facing numerous synergistic challenges that impact research, education, and practice; specifically, a critical nursing shortage, disinvestment in nursing education and practice, decreased federal funding for nursing research, and the continued invisibility of nursing’s impact. Addressing these concerns is essential for ensuring the health and well-being of our society. Associate Deans for Research from around the United States convened to discuss key threats to nursing, and ultimately population health. Herein, these challenges are addressed, and recommendations are provided. We also propose an agenda to: (a) rigorously evaluate the workforce shortage and address causative factors; (b) increase nurses’ engagement in political advocacy and government affairs to enact legislation in support of nursing research, education, and practice; (c) expand the valuation of extramural research funding and dissemination to broaden the metrics of scholarly success; and (d) promote public visibility of nursing’s value and impact.
27. Blunt Cerebrovascular Injury in Trauma-Fixed or Modifiable Risk Factor for Stroke?
期刊: The Journal of surgical research 发表日期: 2025-Dec-10 链接: PubMed
摘要
The epidemiology of blunt cerebrovascular injury (BCVI) lacks consistent findings. We sought to describe the epidemiology of BCVI and the outcomes associated with current treatment strategies within the Trauma Quality Improvement Program registry. We analyzed data from patients ≥15 years of age with a blunt mechanism. BCVI was classified as low grade (1-2) and high grade (3-5). From 2017 to 2023, there were 5,798,774 patients that met inclusion. There were 53,940 had a documented BCVI, of which 36,183 were low grade and 19,747 were high grade. Among those without a BCVI, the incidence of stroke was 0.2% (n = 13,459, 95% confidence interval [CI] 0.2-0.2) compared to those with BCVI 3.3% (n = 1763, CI 3.1-3.4). Among those with a BCVI, those with stroke had a higher median composite injury severity score (29, 20-38 versus 20, 12-29, P < 0.001). Unadjusted stroke risk was as follows based on receipt versus nonreceipt: heparin (5% versus 3%, P < 0.001), low-molecular weight heparin (3% versus 3%, P = 0.080), aspirin (4% versus 3%, P = 0.077), and none (2% versus 4%, P < 0.001). Among those with low-grade BCVI, after adjusting for age, sex, injury severity score, and comorbidities, and mechanism of injury, the following associations with stroke: heparin (odds ratio 2.01, 95% CI 1.30-3.08), LWMH (1.12, 0.73-1.72), aspirin (1.67, 1.01-2.78), and no prophylaxis (0.63, 0.40-0.99). For high-grade: heparin (1.71, 1.13-2.59), LMHW (1.15, 0.76-1.73), aspirin (1.74, 1.06-2.86), and none (0.60, 0.39-0.92). Unadjusted and adjusted stroke risk between those with and without anticoagulation or antiplatelet therapy demonstrated no benefit. Our findings call into question whether stroke is a modifiable event. High-quality trials are needed.
28. Reciprocal effects between illicit drug use and mental health conditions among healthcare workers in Sweden: A one-year follow-up study.
期刊: Drug and alcohol dependence 发表日期: 2025-Dec-05 链接: PubMed
摘要
Research suggests a comorbidity between illicit drug use and mental health conditions. However, it remains unclear whether illicit drug use serves as a risk factor for, or a consequence of, mental health conditions in healthcare workers (HCWs). This study aimed to 1) examine the prevalence of illicit drug use among HCWs in Sweden and 2) investigate the bidirectional relationship between illicit drug use and mental health conditions(i.e., depression and burnout). Data from the 2022 and 2023 Longitudinal Occupational Health Survey in Healthcare Sweden (LOHHCS) were used. The data included 3280 HCWs (50.3 % physicians and 49.7 % nurses). Questionnaires assessed illicit drug use frequency, burnout complaints (BAT-12), and depression (SCL-CD6). Cross-lagged panel models (CLPMs) were used to examine the reciprocal relationships over the two studied time-points between illicit drug use and mental health conditions. The prevalence of illicit drug use in 2022 was 1.3 %, which increased slightly to 1.6 % one and a half years later, in 2023. Using two-wave panel data, results revealed a bidirectional effect between illicit drug use and burnout. However, while depression was associated with subsequent illicit drug use, the reversed association was not observed. These findings suggest that illicit drug use plays different roles in relation to burnout and depression among healthcare workers. This highlights the importance of integrated treatment strategies and preventive measures that address both illicit drug use and mental health conditions-especially burnout-simultaneously.
29. Access to medications for opioid use disorder among primary care patients with homeless experience in the Department of Veterans Affairs.
期刊: Drug and alcohol dependence 发表日期: 2025-Dec-05 链接: PubMed
摘要
Primary care settings tailored for persons with experience of homelessness (PEH) could enhance opioid use disorder treatment delivery, but evidence is lacking. To examine medication treatment for opioid use disorder (MOUD) among PEH who received homeless-tailored primary care in the Department of Veterans Affairs (VA). Receipt of MOUD was assessed from electronic health records among VA primary care patients with experience of homelessness and OUD in 2016-2020. We estimated the proportion who received MOUD over time and applied mixed effect Poisson models with entropy balance weighting to estimate differences in MOUD by primary care type (homeless-tailored vs. mainstream). Secondary analyses examined the consistency of findings across 18VA service regions. The percentage of eligible PEH (n = 45,864) receiving any MOUD rose from 42.1 % to 51.0 % over time. Half (51.3 %) of those initiating MOUD received > 30 days MOUD over one year. In unadjusted models, the proportion receiving MOUD was slightly higher in homeless-tailored primary care, compared to mainstream primary care (48.8 % vs 46.4 %, Unadjusted Incidence Rate Ratio=1.09, 95 % CI=1.03-1.16). After covariate adjustment, there was no statistical difference between groups (Adjusted IRR=0.97, CI=0.92-1.02). This proved broadly consistent across VA service regions. Concomitant with a national VA initiative to tailor primary care services for PEH, half of diagnosed patients received MOUD. Yet evidence of durable treatment was low, and the homeless-tailored clinics did not outperform mainstream clinics. Efforts to tailor primary care for PEH may require specialized addiction staffing and implementation support to improve MOUD care in these settings.
30. Exceptional stability of a Gd-free extracellular fluid MRI contrast agent based on manganese porphyrin.
期刊: Journal of inorganic biochemistry 发表日期: 2025-Dec-05 链接: PubMed
摘要
Metal-ligand stability plays a central role in medicinal bioinorganic chemistry, as it impacts not only the efficacy but also the safety profiles of metal-based therapeutic and diagnostic agents. Gadolinium-based contrast agents (GBCAs) have been widely applied in clinical magnetic resonance imaging (MRI) scans for decades to enhance the detection of otherwise hardly visible diseases. However, evidence of metal dissociation from Gd chelates in vivo have raised safety concerns and led to the withdrawals of several clinically approved GBCAs in recent years. Here we report an exceptionally high stability of Mn(III)tetracarboxylporphyrin (MnTCP), a Gd-free extracellular fluid CA with high MRI contrast enhancement efficiency at clinic magnetic fields. The stability of MnTCP was systematically investigated under challenging conditions known to cause metal dissociation or transmetallation of GBCAs, as well as most other chelated metal complexes. The kinetic inertness of MnTCP was demonstrated at low pH and high temperature, and no sign of metal dissociation was observed. Incubation of MnTCP with excess of various endogenous metal ions, as well as metal chelators also did not cause any observable transmetalation under neutral or acidic conditions up to 50 days. Moreover, MnTCP is highly stable against reduction by endogenous species, preventing the formation of labile Mn(II)-complex. These findings are consistent with in vivo and intracellular behaviors of MnTCP observed in previous studies. The abnormally high stability of this tetradentate coordination complex can be attributed to structural rigidity, aromaticity and strong metal-ligand orbital interactions.
31. Geogenic determinants of indoor radon exposure in İzmir (West Türkiye).
期刊: Applied radiation and isotopes : including data, instrumentation and methods for use in agriculture, industry and medicine 发表日期: 2025-Dec-02 链接: PubMed
摘要
Radon, a naturally occurring product of uranium decay, is the second leading cause of lung cancer. İzmir Province in western Türkiye, situated within the Aegean extensional regime, comprises complex fault-bounded basins that favor indoor radon accumulation. This study evaluates the spatial variability and geogenic controls of indoor radon to delineate radon-prone zones with public-health relevance. Indoor radon was measured in 79 dwellings distributed across major lithologies and structural settings; detectors were deployed in basements to capture soil-gas infiltration. Concentrations ranged from 12 to 366.5 Bq/m3 (mean 118 Bq/m3), exceeding the national average of 81 Bq/m3; 32 % of sites surpassed the EPA action level of 148 Bq/m3. Highest values cluster in Bornova, Buca, and Kemalpaşa, coincident with fault-controlled sedimentary basins and permeable units. Spatial mapping highlights the dominant influence of lithology and fault proximity on radon distribution and underscores the limitations of uniform, national-scale mitigation policies. We advocate targeted, geology-aware health policies and urban-planning measures for monitoring and mitigation in geogenically vulnerable districts. These findings contribute to medical geology by providing region-specific evidence of radon risk in one of Türkiye’s most seismically active metropolitan areas. These outputs provide decision-ready evidence for monitoring, mitigation, and building-code updates in seismically active metropolitan settings.
32. Interplay of IL-6, GDF-15 and Sarcopenia in Patients With Bladder Cancer Undergoing Radical Cystectomy and Its Implications on Survival.
期刊: Journal of cachexia, sarcopenia and muscle 发表日期: 2025-Dec 链接: PubMed
摘要
Sarcopenia has emerged as a significant predictor of adverse outcomes in cancer. Specifically, this is also true for patients with bladder cancer undergoing radical cystectomy (RC). This retrospective study investigates the roles of the biomarkers interleukin-6 (IL-6) and growth differentiation factor-15 (GDF-15), in the context of sarcopenia, assessing their impact on oncological and survival outcomes. Preoperative serum IL-6 and GDF-15 levels were analysed in 179 patients undergoing RC. Their association with sarcopenia, adverse pathological features and survival outcomes was investigated. Elevated IL-6 and GDF-15 levels were significantly correlated with the presence of sarcopenia (p = 0.04 and p = 0.03, respectively). IL-6 and GDF-15 levels in serum showed a positive correlation (Spearman r = 0.45, 95%CI 0.32-0.56, p < 0.01). Higher IL-6 and GDF-15 levels were also associated with higher tumour stages (both p < 0.01), positive lymph nodes (p = 0.02 and p < 0.01) and unfavourable surgical margins (both p < 0.01). Patients with both sarcopenia and high IL-6 or GDF-15 levels exhibited significantly worse overall survival and cancer-specific survival in multivariate Cox regression analysis. These findings highlight the interplay between IL-6, GDF-15, sarcopenia and tumour progression, suggesting that IL-6 and GDF-15 may serve as valuable prognostic biomarkers and potential therapeutic targets. Further research is warranted to explore targeted therapeutic strategies aimed at mitigating sarcopenia and systemic inflammation in this patient population.
33. Risk factors and control of Opisthorchis viverrini in the Lower Mekong Basin: A systematic review.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Dec 链接: PubMed
摘要
Opisthorchis viverrini (OV) is a major public health concern in the Lower Mekong Basin. This study aimed to synthesize all field-based empirical research examining risk factors and control strategies for OV in the Lower Mekong Basin (LMB). We performed a systematic review of published literature (1990-2024) on field-based OV studies that examined risk factors and control strategies in LMB. The literature search included two databases: PubMed and Scopus. We included field-based studies that analysed or reported on OV risk factors or control strategies using quantitative or mixed methods and were written in English. We excluded secondary research articles, laboratory-based research, qualitative only research and studies conducted outside LMB. All prospective studies underwent quality assessment using the Newcastle-Ottawa Scale or the Cochrane Risk of Bias tool II prior to final inclusion. We identified 807 citations from PubMed and Scopus. From those, 56 studies were included in the review and three additional studies were identified from citation searches of included studies in the review. Studies were extracted and analysed by research focus. Among the included studies, 45 were conducted in Thailand, 11 in Laos, two in Vietnam, and one in Cambodia. Factors associated with OV infection were explored in 51 studies, and 11 studies reported on control strategies. General education was found to be an important protective factor for OV infection. Consumption of raw or undercooked fish was the most reported risk factor. Anthelmintic treatment was the primary control strategy across studies. This review summarises risk factors and control strategies reported in LMB since 1990. We found that sociodemographic, environmental, and economic factors were important predictors of OV infection. Given the multitude of risk factors for infection identified in this study and the complex lifecycle of OV, we recommend a One Health approach, that recognises the interconnectedness of human, animal and environmental health, for future health promotion and control strategies. PROSPERO registration ID: CRD42022357080.
34. The Healthy Environments and Active Living for Translational Health (HEALTH) Platform: A smartphone-based system for geographic ecological momentary assessment research.
期刊: PLOS digital health 发表日期: 2025-Dec 链接: PubMed
摘要
Smartphones have become a widely used tool for delivering digital health interventions and conducting observational research. Many digital health studies adopt an ecological momentary assessment (EMA) methodology, which can be enhanced by collecting participant location data using built-in smartphone technologies. However, there is currently a lack of customizable software capable of supporting geographically explicit research in EMA. To address this gap, we developed the Healthy Environments and Active Living for Translational Health (HEALTH) Platform. The HEALTH Platform is a customizable smartphone application that enables researchers to deliver geographic ecological momentary assessment (GEMA) prompts on a smartphone in real-time based on spatially complex geofence boundaries, to collect audiovisual data, and to flexibly adjust system logic without requiring time-consuming updates to participants’ devices. We illustrate the HEALTH Platform’s capabilities through a study of park exposure and well-being. This study illustrates how the HEALTH Platform improves upon existing GEMA software platforms by offering greater customization and real-time flexibility in data collection and prompting participants. We observed survey prompt adherence is associated with participant motivation and the complexity of the survey instrument itself, following past EMA research findings. Overall, the HEALTH Platform offers a flexible solution for implementing GEMA in digital health research and practice.
35. From sex differences to sex inequalities in life expectancy: A cross-country observational benchmarking analysis.
期刊: PLoS medicine 发表日期: 2025-Dec 链接: PubMed
摘要
The answer to whether females or males have better health, and which sex is the more disadvantaged, has depended in part on the metric and how the inequality is measured. This study introduces a new method for analyzing and interpreting sex inequalities in health outcomes-defined as the avoidable sex differences in health outcomes-that is systematic and potentially more objective. For this paper, we focus on life expectancy at different ages. We introduce the adjusted sex ratio as a measure of sex inequalities and determining sex disadvantage. First, we calculated the sex ratio of life expectancy at ages 0, 5, 15, 35, 50, and 70. To understand what is achievable under favorable conditions, we identified countries in the 5th percentile of the highest life expectancy for each sex and used these values as benchmarks, and calculated the sex ratio of these best-performing countries (“frontier”). We calculated the country- and age-specific adjusted sex ratio by dividing country sex ratios by frontier sex ratios. This assumes that theoretically, under the current risk and healthcare environments, females all over the world have the potential to live up to the life expectancy of the females in the frontier countries, and separately, all males to their male-specific frontier. An adjusted ratio of greater than one indicates male disadvantage, while below one indicates female disadvantage. To avoid overinterpreting small differences, we defined a narrow range around equality (ratio of 1) within which we do not label either sex as disadvantaged. Before adjustment, males in all countries (except two) and at all ages had lower life expectancy than females. After adjustment, between 13% (at age 0) and 33% (at age 70) of the 237 countries shift from male to female disadvantage in life expectancy. More than half of the countries remain male-disadvantaged, indicating that males are generally disadvantaged in terms of life expectancy in most countries, even after our adjustments. India and approximately half of the countries in the Middle East and North Africa, North Atlantic, sub-Saharan Africa, and Western Pacific and Southeast Asia show female disadvantage. The number of countries with female disadvantage rises with age, especially in sub-Saharan Africa and Western Pacific and Southeastern Asia. Central and Eastern Europe show substantial male disadvantage across nearly all ages, even with adjustment. Our frontier selection and buffer range are empirical choices, and other definitions could be equally valid. Although our sex-specific benchmarks use the best-performing countries for each sex, they are not meant to represent purely biological differences, as observed sex gaps in life expectancy may also reflect unmeasured genetic variation, environmental exposures, and their interactions with sex. This study provides a novel, potentially more objective method for assessing sex inequalities in health outcomes, and presents the trends across countries, age, and time.
36. Shifts in Assembly Rules and Loss of Zooplankton Functional Diversity Across Hypereutrophic Fishponds.
期刊: Ecology letters 发表日期: 2025-Dec 链接: PubMed
摘要
Freshwater species are facing massive declines, often driven by eutrophication. Identifying which facets of biodiversity are sensitive is crucial, as species loss does not always translate to reduced ecosystem functioning and functional diversity. We examined how assembly rules shape zooplankton functional diversity in hypereutrophic fishponds. Higher eutrophication was hypothesised to cause functional homogenization through reduced functional diversity, habitat filtering, and trait convergence. Higher eutrophication indeed reduced functional diversity metrics, whereas species richness was kept stable. Functional richness, dispersion, and dissimilarity shifted from limiting similarity, where niche partitioning and competition shape community structure, to random (incidence data) and habitat filtering (biomass) with increasing eutrophication. Functional divergence transitioned from random to habitat filtering, whereas redundancy increased at higher trophic states. Trait convergence was the dominant process, with the environment selecting species with similar traits. Biodiversity assessments and managers should consider how functional diversity and ecosystem functions respond to anthropogenic and environmental changes.
37. Epidemiology and care of burns in rural Rwanda: A prospective cohort study.
期刊: Burns : journal of the International Society for Burn Injuries 发表日期: 2025-Nov-28 链接: PubMed
摘要
Burns are the fourth most common type of injury presenting to emergency departments in Rwanda; however, research related to the epidemiology of burn injuries is limited. The objectives of this study were to investigate the epidemiology and treatment of burns in a rural region of Rwanda to better inform local public health initiatives. Data collection took place at Kibogora Level Two Teaching Hospital in the Western Province of Rwanda from July 2023 to November 2024. Patients enrolled in the study included all burn patients who presented to the hospital during the study period. Data were collected through patient interviews and electronic medical records using a standardized form. Eighty burn patients presented to the hospital during the study period. Children most often presented with burn injuries, with 70 % (n = 56) of the study population being 0-15 years old. Scald was the most common type of burn (n = 60, 75 %). Burns were mostly related to cooking activities (n = 60, 75 %). Traditional medicine was used as first aid in 57.5 % (n = 46) of the cases. Time from injury to treatment was > 24 h in 32.5 % (n = 26) of the patients. Complications were common at 43.8 % (n = 35), with the most frequent type being burn wound infection (n = 30, 37.5 %). All patients survived their burn injuries. Prevention efforts should prioritize reaching children and their caregivers while highlighting kitchen safety and the dangers of hot liquids that can cause scald burn injuries. Burn wound infection prevention is also a priority for education.
38. Trends in Proportion of Delirium Among Older Emergency Department Patients in South Korea, 2017-2022.
期刊: The western journal of emergency medicine 发表日期: 2025-Nov-26 链接: PubMed
摘要
Delirium is a critical neuropsychiatric condition that surged among older adults during the coronavirus disease 2019 (COVID-19) pandemic, likely due to social isolation resulting from distancing measures. In this study we examined trends in delirium-related emergency department (ED) visits before and during the pandemic using nationwide data from South Korea, with a focus on different phases of social distancing, to inform healthcare strategies for older adults during public health crises. We obtained data from the National Emergency Department Information System (2017-2022). Changes in ED visits were assessed across pre-pandemic (January 2017-January 2020), early pandemic (February 2020-March 2022), and late pandemic (April 2022-December 2022) phases using interrupted time series analysis. A total of 80,442 delirium-related ED visits among adults ≥ 65 years of age were recorded. The interrupted time series analysis showed a significant step increase in ED visits during the early pandemic phase (relative risk [RR] 1.290, 95% CI 1.201-1.386; 29.0% increase), followed by a decrease in the late pandemic phase (RR 0.922, 95% CI 0.868-0.981; 7.8% decrease). The most substantial increase was for individuals 65-74 year of age during the early pandemic period (RR 1.406, 95% CI 1.264-1.564) reflecting a 40.6% increase in visits to the ED. Indirect ED visits, such as institutional referrals, also notably increased (RR 1.275, 95% CI 1.184-1.373) reflecting a 27.5% increase. Delirium-related ED visits among older adults showed a notable 7.8% decrease during the late pandemic period, with key risk groups identified, particularly adults 65-74 of age (40.6% increase) and those referred from institutions (27.5% increase) during the early pandemic period. These findings may help inform targeted interventions and public health responses in similar healthcare settings. Despite limitations including reliance on diagnostic codes, lack of subgroup analysis by COVID-19 status, potential duplicate visit counts, and limited regional granularity this study offers important insight into delirium care needs during crisis periods. Further research should further explore causal mechanisms and the specific impact of COVID-19 infection on delirium incidence.
39. Anticoagulation Treatment in Patients with Septic Thrombophlebitis of the Internal Jugular Vein.
期刊: The western journal of emergency medicine 发表日期: 2025-Nov-26 链接: PubMed
摘要
Septic thrombophlebitis of the internal jugular vein (STIJV), or Lemierre syndrome, is a rare, life-threatening condition. Anticoagulant use for managing STIJV remains unclear due to ambiguous diagnostic criteria and a lack of robust evidence. We evaluated the clinical benefits and risks of anticoagulants in patients with STIJV. In this retrospective study we used data from over 1,700 hospitals, retrieved from a nationwide Japanese database. We used multivariate logistic regression and propensity score matching to adjust for confounding variables (age, sex, Charlson Comorbidity Index, level of consciousness, use of mechanical ventilation, use of disseminated intravascular coagulation, admission to intensive care unit, history of diabetes, use of noradrenaline, diagnosis of acute renal failure, and diagnosis of cerebral infarction). We also conducted instrumental variable estimation to account for the impact of unmeasured covariates. The primary outcome was in-hospital mortality; the secondary outcomes were 90-day mortality, major bleeding events, and length of stay (LOS) in hospital. Among the 523 patients diagnosed with STIJV between April 1, 2014-March 31, 2022, 343 (65.6%) were excluded due to lack of appropriate treatment initiation for STIJV. Overall, 180 patients (34.4%) met the inclusion criteria; the data of 156 patients (31.1%) were ultimately analysed. Of these, 86 (55.1%) received anticoagulants, which neither significantly improved nor worsened survival outcomes. The in-hospital mortality was 3.39% and 1.69% and 90-day mortality was 2.54% and 1.69%, respectively, in patients who did and did not receive therapy, (P = .56 and .99, respectively). The adjusted odds ratio (AOR) for in-hospital and 90-day mortality was 0.858 (95% CI, 0.126-5.826, P = .88) and .991 (95% CI, .932-1.055, P = .79), respectively. The LOS was longer in those receiving anticoagulants (mean, 29.2 vs 21.8 days, AOR 11.7 days longer, 95% CI, 4.11-19.20, P < .01), potentially due to dose adjustment or clinical decision-making. Subgroup analysis comparing unfractionated heparin and direct Xa inhibitors showed similar in-hospital mortality outcomes: 4.54% in the unfractionated heparin group (AOR 2.361, 95% CI, 0.32-17.40; P = .40) and 3.03% in the direct Xa inhibitor group (AOR 0.444, 95% CI, 0.032-6.23; P = .55), respectively. In the largest study of septic thrombophlebitis of the internal jugular vein to date, we found that early initiation of anticoagulation treatment was not statistically associated with survival. Therefore, anticoagulant use should be determined based on individual patient characteristics. Further research is warranted to improve the quality of evidence for this rare disease.
40. National Survey on Infection Prevention and Control in United States Emergency Departments.
期刊: The western journal of emergency medicine 发表日期: 2025-Nov-26 链接: PubMed
摘要
In the emergency care setting, implementation of infection prevention and control (IPC) practices can be challenging due to numerous factors including emergency department (ED) crowding and boarding of patients, high staff-turnover rates, and acuity of patient needs. Understanding how the unique nature of the ED environment impacts IPC implementation is essential to reducing healthcare-associated infections and to improving patient safety. In this study we aimed to assess ED leaders’ perceptions of IPC practices to identify areas for potential intervention and inform targeted process improvement initiatives. Between January-July 2023, ED leaders across the United States were queried about their IPC practices using the National Emergency Department Inventories (NEDI)-USA survey, which is administered annually to all EDs in the US. An expanded survey was administered in a subset of EDs to assess healthcare personnel training for IPC, reported adherence to recommended practices and policies related to disinfection of reusable medical equipment and environment, use of personal protective equipment, hand hygiene practices, patient care space cleaning and disinfection, use of transmission-based precautions signage, risk perceptions of how healthcare personnel practice contributes to healthcare-associated infections and barriers to appropriate room cleaning. Of the 289 facilities surveyed, 159 (55%) responded, and among responding EDs, 67 (42%) reported seeing ≥ 40,000 patients in the prior year. Regarding healthcare personnel training, 84% (131/156) of ED leaders reported that ≥80% of their ED healthcare personnel were correctly trained in IPC procedures according to their hospital’s policies. Perception of healthcare personnel compliance with IPC practices, however, was lower. Although 75% (118/157) of EDs reported > 80% compliance with correct N95 respirator use, compliance with transmission-based precaution signage was identified as a significant gap, with 30% (47/159) of EDs reporting that they never, rarely, or only sometimes posted signs for patients who required them. Further, 69% (61/89) of EDs reported that they never, rarely, or only sometimes posted transmission-based precaution signs for patients in hallways or overflow treatment spaces. This national survey found that ED leaders perceive that their healthcare personnel have a high level of knowledge of IPC policies and compliance with some, but not all, IPC policies in the ED. The overall high perceptions of compliance stand in contrast to prior published observations of poor IPC practice in ED settings, suggesting complex relationships between perception and practice that may impact patient safety outcomes. These findings can guide future targeted interventions to improve IPC compliance, reduce healthcare-associated infections, and improve patient safety in emergency settings.
41. Epidemiology of emergency department visits for burn injuries in the United States, 2014-2023.
期刊: Burns : journal of the International Society for Burn Injuries 发表日期: 2025-Nov-20 链接: PubMed
摘要
Burn injuries cause significant morbidity and mortality. By better understanding the epidemiology and seasonality of such injuries, burn education and prevention efforts can be improved. The purpose of this investigation is to provide an update to the epidemiology of burn injuries in the United States (US). This retrospective study analyzes data from the National Electronic Injury Surveillance System (NEISS) from 2014 to 2023. The NEISS collects data on emergency department visits from approximately 100 hospitals throughout the US. Data were analyzed using R version 4.4.3. to calculate annual burn estimates, injury rates, frequencies and acute periods of increased incidence. Between 2014 and 2023, emergency departments in the US treated an average of 206,856 burn injuries annually. These injuries occurred mainly in the home (66.8 %) and in males (53.1 %), with a peak incidence in children under 5 (20.6 %). This study found no significant increasing or decreasing trends in incidence over time; however, burn injury incidence and associated products fluctuated based on season, with an increased incidence occurring around July 4th. Burn injuries significantly affect the US population. Public health and primary care workers may utilize information provided by this study to better target patient education on burn injury prevention.
42. Limiting Albuterol Use by EMS at the Start of the COVID-19 Pandemic: A Retrospective Analysis of Rapid Deimplementation.
期刊: The western journal of emergency medicine 发表日期: 2025-Nov-18 链接: PubMed
摘要
Deimplementation is the process through which an existing practice, procedure, or protocol is discontinued. Past deimplementation efforts in emergency medical services (EMS), such as reduction of liberal oxygen administration, backboard use, and lights and sirens responses, have been slow in rates of change and had varying levels of adoption. Our objective in this study was to analyze the deimplementation of albuterol administration in the beginning of the 2019 novel coronavirus (COVID-19) pandemic for the adoption of deimplementation guidelines, rate of change, and factors leading to this change in EMS practice. Using the 2020 National Emergency Medical Services Information System (NEMSIS) dataset, we analyzed the change in EMS calls with albuterol administration following the US Centers for Disease Control and Prevention (CDC) advisory recommending limiting aerosol-generating procedures in response to the COVID-19 pandemic. The 2020 NEMSIS dataset included 43,488,767 total records, and 449,290 (1.0%) records included at least one albuterol administration. Calls with albuterol administration dropped 61.7% in a near-linear fashion in the six weeks following the publication of the CDC’s guidance (from March 8-April 18, 10,426 absolute reduction; from 16,891 to 6,465, in average calls per week with albuterol administration). In the period before the guidance, there were on average 16,891 calls with albuterol administration of 640,597 (2.6%) calls per week. In the period after the guidance, there were, on average, 6,465 calls with albuterol administration of 601,943 (1.1%) calls per week. Therefore, while total EMS calls declined by 6% during the transition period, the proportion of albuterol calls within this decline went down by 1.5% (2.6% to 1.1%), reflecting rapid deimplementation. Deimplementation of albuterol administration in the beginning of the COVID-19 pandemic was significant in its rate and success in adherence to guidelines when compared to other changes in EMS policies, procedures, and protocols. A better understanding of deimplementation can guide future EMS efforts to phase out ineffective practices while minimizing disruption to care.
43. [Addressing obesity successfully requires action at both individual and societal levels, and across several sectors].
期刊: Lakartidningen 发表日期: 2025-Nov-07 链接: PubMed
摘要
Costs related to overweight and obesity, including costs of health care and productivity losses of production, correspond to 2 % of Sweden’s Gross Domestic Product (GDP) and is projected to reach 2.4 % of GDP by 2060. In middle income countries, obesity costs to society increase even faster, projected to reach 4-5 % of GDP by 2060. However, the total cost of obesity is not just financial, but also social and environmental. Addressing obesity successfully requires action at both individual and societal levels, and across several sectors. Treatment at the individual level needs to be combined with general preventive actions. International examples of such actions include Health Holland, the Commissioner for the Wellbeing of Future Generations in Wales, and VicHealth in Australia. With inspiration from these initiatives, the organization A healthier Sweden aims to facilitate turning knowledge into practice for systems change for better health.
44. Haematospirillum jordaniae Infections after Recreational Exposure to River Water, Pennsylvania, USA, 2020.
期刊: Emerging infectious diseases 发表日期: 2025-Nov 链接: PubMed
摘要
Haematospirillum jordaniae was first identified as a human pathogen in 2016. In this article, we describe 4 patients who had H. jordaniae infections identified in 2020 and who had temporally and spatially linked environmental exposures. Three of the 4 patients reported leg injuries while participating in recreational river water activities in south-central Pennsylvania, USA. In 2024, we detected H. jordaniae in river samples collected at locations identified during patient interviews. All patients sought emergency department services for clinical assessment; however, the causative bacterial isolate was not initially identified. H. jordaniae was identified as the bacterial cause months after patient treatment and discharge. Although H. jordaniae infections are considered rare, the true occurrence is unknown. Additional information about the organism’s ecology and environmental seasonality could guide public health messaging and increase awareness among healthcare providers.
45. Decolonial psychology: Inherently indigenous and globally centered.
期刊: The American psychologist 发表日期: 2025-Nov 链接: PubMed
摘要
Western sciences have been interpreted through the hierarchical and reductionist lenses of colonial cultures that have historically excluded other cultural interpretations of science. Decolonizing psychology requires cultural models inherently antithetical to colonial assumptions that advance scientific hierarchies and reductionism. Indigenous psychologies operate from a relational worldview that sees inherent connectivity and respects that relationality. Scientific rigor and significance are interpreted through those cultural lenses as a function of social and environmental responsibility beyond psychology. Indigenous psychologies emphasize planetary and intergenerational relationality as necessary for individual wellness, decolonizing current conceptualizations emphasizing autonomy, reductionism, and self-oriented psychology. An Indigenous relational vision of equitable psychology aligns well with the United Nations Sustainable Development Goals and the American Psychological Association’s commitment to advancing health and mental health equity and human rights. Global alliances among Indigenous psychologists have emerged to decolonize psychology. Examples of applied localized Indigenous psychologies used to decolonize the field are discussed. The global decolonizing potential of Indigenous conceptualizations of psychology will not only strengthen the discipline but may also serve to broaden psychology’s positive global impact. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
46. [Diagnosis and management of chronic hand eczema in practice].
期刊: Praxis 发表日期: 2025-Nov 链接: PubMed
摘要
Chronic hand eczema is a common inflammatory skin disease that significantly impairs quality of life and affects approximately 10 % of the population. Common causes include occupational exposure to chemicals or wet work (irritant or allergic contact dermatitis) as well as endogenous factors such as atopic diathesis. Diagnosis is based on medical history, clinical examination, and, if necessary, further testing (e. g., patch testing). Treatment involves a holistic approach consisting of avoidance of triggers, intensive skin care and the application of topical corticosteroids, calcineurin inhibitors, or newer treatments such as topical JAK inhibitors. In severe cases, systemic therapies may be necessary. Early diagnosis and treatment are essential to prevent chronicity, improve patients’ quality of life, and maintain their ability to work. Diagnose und Management chronischer Handekzeme in der Praxis. Das chronische Handekzem ist eine häufige entzündliche Hauterkrankung, die die Lebensqualität erheblich beeinträchtigt und etwa 10 % der Bevölkerung betrifft. Häufige Ursachen sind berufliche Exposition gegenüber Chemikalien oder Feuchtarbeit (irritatives oder allergisches Kontaktekzem) sowie endogene Faktoren wie eine atopische Diathese. Die Diagnose erfolgt durch Anamnese, klinische Untersuchung und gegebenenfalls weitere Testungen (z. B. Epikutantest). Die Behandlung umfasst eine ganzheitliche Therapie, bestehend aus Vermeidung von Auslösern, intensiver Hautpflege und der Anwendung von topischen Kortikosteroiden, Calcineurininhibitoren oder von neu z. B. topischen JAK-Inhibitoren. In schweren Fällen können systemische Therapien notwendig sein. Die frühzeitige Diagnose und Behandlung sind entscheidend, um die Chronifizierung zu verhindern, die Lebensqualität der Patienten zu verbessern und die Arbeitsfähigkeit zu erhalten. Schlüsselwörter: Handekzem, irritatives Kontaktekzem, allergisches Kontaktekzem, atopische Dermatitis, Hautschutz, Epikutantest, topische Glukokortikoide, Calcineurininhibitoren.
47. Comparison of Pretreatment in European Society of Cardiology Acute Coronary Syndrome Guidelines.
期刊: The western journal of emergency medicine 发表日期: 2025-Oct-22 链接: PubMed
摘要
Most patients with acute coronary syndrome (ACS) die before hospitalization. Early diagnosis and effective interventions can prevent the disease from worsening. In this single-center, retrospective study we aimed to investigate the appropriateness of the pretreatment of patients referred to the emergency department of our hospital, a percutaneous cardiac intervention (PCI) center, with a prediagnosis of ACS under the previously published European Society of Cardiology guidelines (2017 and 2020) and the new guidelines published in 2023. Based on the date of publication of the European Society of Cardiology’s most recent ACS guidelines (August 25, 2023), we divided patients admitted between August 25, 2022-August 24, 2024, into two groups: patients who were evaluated and received pretreatment under the previous guidelines; and patients who were evaluated and received pretreatment under the new guidelines. Of 1,675 patients screened for enrollment who were referred to our PCI center with prediagnosis of ACS, after exclusion criteria, we report on 1,450 (86.6%). Pretreatment (before PCI) compliance rate with all aspects of the previous and new guidelines was low, at 9.8%. Study patients were 69.9% (n = 1,013) male with mean age of 63.9 ± 13.0 years. Comparing the compliance rate between the new versus previous guidelines, for individual components, we found better compliance for aspirin administration (72.6 vs. 66.2%) and anticoagulants (40.3 vs. 22.7%), while for P2Y12 inhibitors, we found lower compliance (58.9 vs. 70.0%, all p< .001). For the subset of patients with ST-elevation myocardial infarction, P2Y12 inhibitors were used less appropriately under the new vs. previous guidelines (31.4 vs. 55.0%, p < .001). The compliance rates with the previous and new guidelines for ACS pretreatment by physicians working in hospitals without PCI centers were low. Pretreatment compliance during the new guideline period was lower than compliance during the prior guideline period.
48. Prevalence and Impact of Violence Against Healthcare Workers in Brazilian Emergency Departments: A National Survey.
期刊: The western journal of emergency medicine 发表日期: 2025-Oct-17 链接: PubMed
摘要
Workplace violence (WPV) is a significant occupational hazard in healthcare, with emergency departments (EDs) recognized as high-risk environments. Although globally significant, data from Latin America remain scarce. In this study we aimed to evaluate the prevalence and effects of WPV on healthcare workers in Brazilian EDs. We conducted a cross-sectional survey of healthcare workers in Brazilian EDs. Respondents indicated verbal and physical violence experienced within the preceding six months, along with associated psychological and occupational impacts. Univariable models identified significant associated factors, followed by multivariable models to determine independent associated factors of WPV. We reported results as adjusted odds ratios (aOR) with 95% confidence intervals. Statistical analyses were performed in R v4.4.1, and significance was defined as P < .05. The response rate was 19.1% (1,255/6,570), Of those responses, 61.3% (769/1,255) met the inclusion criteria and were included in the analysis. Of all respondents, 84.0% were physicians. Respondents indicated 79.6% (612/769) occurrence of WPV, including verbal abuse (79.5%) and physical assault (12.1%). Physical assaults against co-workers were witnessed by 40.3% of respondents. Perpetrators included visitors (85.3%), patients (80.7%), and co-workers (35.8%). The absence of institutional preventive measures was associated with increased WPV (aOR, 2.47; 95% CI, 1.71-3.57; P < .001), while the presence of security staff reduced WPV (aOR, 0.61; 95% CI, 0.42-0.89; P = .01). Indicated impact included post-traumatic stress symptoms (88.4%), considering leaving their job (49.5%), impaired workplace performance (75.2%), and time off work (10%), including 11.5% permanently leaving. Workplace violence is highly prevalent in Brazilian EDs, with substantial psychological and occupational consequences. The absence of protocols or preventive measures may increase WPV risk, emphasizing the urgent need for public policies to protect healthcare workers in emergency settings.
49. Prevalence and determinants of work-related ocular symptoms among dentists of Bangladesh: A cross-sectional study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The present study aims to investigate the prevalence of work-related ocular symptoms and their associated factors among Bangladeshi dentists. This cross-sectional study was conducted among 747 practicing dental surgeons working in government and private facilities across Bangladesh. Participants were recruited using snowball sampling, and an online semi-structured questionnaire was used for data collection. The study collected sociodemographic information, clinical practice details, and ocular symptoms-related information. Regarding ocular symptoms, the participants were asked to report the occurrence of common ocular symptoms (e.g., eye itching, eye pain, blurring) in the last month. The study found a high prevalence of ocular symptoms among dentists, with the most common being eye itching (46.85%), blurring of vision (41.1%), and eye pain (40.7%). Female dentists were more likely to report ocular symptoms, with males having lower odds of eye pain (AOR: 0.53, 95% CI: 0.40-0.85) and itching (AOR: 0.58, 95% CI: 0.40-0.85). Smoking was a strong predictor of eye pain (AOR: 1.33, 95% CI: 1.19-3.11) and itching (AOR: 1.92, 95% CI: 1.19-3.11). Dentists working > 28 hours per week (AOR: 1.91, 95% CI: 1.07-3.44) and attending >5 patients/day (AOR: 1.51, 95% CI: 1.08-2.12) had higher odds of developing eye pain, while routine ocular checkups were associated with lower odds of eye pain (AOR: 0.62, 95% CI: 0.44-0.89). Ocular symptoms are highly prevalent among Bangladeshi dentists, emphasizing the need for regular eye checkups, ergonomic practices, and workload adjustments to mitigate occupational risk factors and protect visual health.
50. Prehypertension and its associated factors among government employees in Tilottama Municipality of Rupandehi District, Nepal.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Government employees are vital workforce of the nation comprising individuals in the working age group. These employees have to face an increased workload, limited decision-making scope, lack of support from fellow workers, regular night shifts, limited physical mobility which puts them at increased risk for hypertension. Detecting prehypertension is essential to prevent related complications and reduce risks of future health issues such as an increased risk of developing high blood pressure (hypertension), heart disease, stroke, kidney damage, and other cardiovascular problems. This study aimed to assess the prevalence of prehypertension and its associated factors among the government employees of Tilottama Municipality, Nepal. A cross-sectional study was conducted among 333 government employees from 15 June 2023 to 10 November 2023. A systematic random sampling technique was used to select participants. A structured questionnaire was adapted from the WHO STEPs Survey. Data were cleaned and then exported to IBM SPSS Statistics 20.0 for analysis. Demographic characteristics of respondents were described using descriptive statistics. Multivariate logistic regression was conducted to determine the association between individual characteristics and prehypertension. Statistical significance was set at p-value < 0.05. The mean (±SD) age of the 333 participants was 36.9(±8.89) years. Most of them were females (54.1%). This study found that 29.4% of participants were prehypertensive, and 14.1% were hypertensive. Participant’s age, sex, working department, family history of hypertension, presence of diabetes, BMI, waist-hip ratio, ever-alcohol consumption and duration of service were found to be significantly associated with prehypertension in bivariate analysis. Meanwhile, working department (Adjusted Odds Ratio AOR: 3.2, CI: 1.4-7.0), family history of hypertension (AOR: 1.9, CI: 1.1-3.4), and BMI (AOR: 1.7, CI: 1.0-3.1) were found to be significantly associated with prehypertension. This study concluded that a significant proportion of government employees had prehypertension and hypertension. Targeted health promotion programs should be implemented in non-health departments. Regular hypertension screening program and healthy workplace settings such as healthier food choices, physical activity, stress management techniques, and smoke-free zones should be promoted in each institution, with a focus on hypertension prevention and control for employees.
51. "I think it is our responsibility, but not solely our responsibility": A qualitative study exploring teachers' perspectives on promoting mental health in Northwest London primary schools.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
In England, 1 in 5 children and young people (CYP; aged 8-25 years) has a probable mental disorder with higher rates among those living in poverty, and among white children compared with other ethnic groups. However, in the UK, research shows that the prevalence of mental health conditions and associated service use differs among some ethnic minority groups (e.g., Asians) suggesting potential unmet mental health need. Early interventions have been shown to improve life outcomes, and UK government policies encourage the promotion of mental health and wellbeing in schools and colleges, but poor mental health continues to rise. Despite evidence showing that mental health problems occur as early as age 5 years, limited research focusses on primary schools (children aged 5-10 years). Northwest London (NWL), UK, is a diverse region in London, is in the top 20% most deprived, and has a high demand for CYP mental health services. The aim of our study was to explore teachers’ perspectives of promoting positive mental health in NWL primary schools. We created a semi-structured interview based on policy guidance. Nine teachers were recruited and interviewed during June and July 2024. Thematic analysis identified six overarching themes: (1) mental health needs; (2) responsibility; (3). factors contributing to poor mental health; (4). barriers and (5) facilitators to providing support; and (6) collaboration. Subthemes included lack of skills to address the broad spectrum of mental health needs, funding, resources, and lack of support systems to ensure all children receive the right support at the right time. Our study highlights implementation gaps for promoting mental health policy in diverse real-world settings, and suggests that whilst schools play an important role for early mental health intervention, wider complexities limit sufficient support provision. Our findings have potential implications for mental health promotion policies in school settings.
52. DynamicSeq2SeqXGB for PM2.5 imputation in extremely sparse environmental monitoring networks.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Environmental monitoring networks face critical data gaps that compromise public health protection and regulatory compliance, with missing data rates often exceeding 40% in operational settings. This study validates DynamicSeq2SeqXGB, a novel hybrid model that integrates a sequence-to-sequence encoder-decoder for temporal pattern extraction with an XGBoost regressor for robust gap reconstruction under extreme sparsity. Data from five monitoring stations in Pavlodar, Kazakhstan, collected over a 15-month period from May 23, 2024 to July 19, 2025, were analyzed representing severely compromised infrastructure (completeness rates 23.3-57.5%). The methodology employs adaptive context processing and implements hierarchical decomposition for extended outages. Two data preparation strategies were evaluated: selective compression applying quality thresholds versus full compression retaining all available observations. Benchmarking against classical methods using synthetic gaps of 5-72 hours demonstrated DynamicSeq2SeqXGB’s superiority in 96% of cases under full compression and 100% under selective compression (average 48.8% improvement for both strategies) with corresponding MAE values of 3.7-8.5 μg/m3 across the Pavlodar stations. Notably, full and selective compression showed equal overall effectiveness (50% win rate each), with optimal strategy depending on station-specific characteristics. External validation on the Beijing dataset (Guanyuan station, 2016) with controlled degradation confirmed cross-regional transferability, achieving MAE of 8.50 μg/m3 and coefficient of determination (R2) of 0.944 (68-79% improvement over baselines). The method successfully reconstructed PM2.5 time series even at 23.3% completeness, demonstrating robust performance for operational deployment in severely degraded monitoring networks.
53. The effects of 12 weeks of chiropractic spinal adjustments on physiological biomarkers in adults: A pragmatic randomized controlled trial.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Longer-term effects of chiropractic care on neuroplasticity, stress, and immune biomarkers remain unclear. This study evaluates the effects of chiropractic care on physiological biomarkers, including brain-derived neurotrophic factor (BDNF), cortisol (saliva, blood, hair), and inflammatory cytokines [interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), C-reactive protein (CRP), B-lymphocytes (CD19), T-helper cells (CD4), cytotoxic T cells (CD8), and natural killer cells (CD56)] in subclinical spinal pain patients. Parallel-group, pragmatic randomized controlled trial conducted at the Rehabilitation Center of Railway General Hospital, Rawalpindi, Pakistan. Intervention: 12 weeks; follow-up: 16 weeks (May-December 2022). Participants with subclinical spinal pain were randomly assigned by using simple lottery method to either 12 weeks of chiropractic or sham care. We aimed to recruit up to 150 participants over three months; however, given the pragmatic nature of the trial and logistical constraints, including the availability of chiropractors, the final number enrolled was determined by how many eligible participants could be recruited during this time. Adults aged 20-60 years with subclinical spinal pain (n = 106 randomized; 88 completed 12-week measures; 73 completed 16-week follow-up). Among those who finished 12 weeks: chiropractic, 26 males/15 females, mean age 37.49 ± 12.39 years; sham, 24 males/23 females, mean age 26.85 ± 7.13 years. The primary outcome blood BDNF and secondary outcome, including saliva, blood and hair cortisol, IL-6, TNF-α, IFN-γ, CRP, CD19, CD4, CD8, and CD56 levels were measured at baseline, after 12 weeks of intervention, and at a 16-week follow-up. Linear and linear mixed-effects regression models were used to assess the effect of care and time on biological measures. Significant between-group differences were observed after 12 weeks of intervention, with higher salivary cortisol 5 ± 2 [0, 10], p = 0.045 and blood BDNF150 ± 60 (40, 270), p = 0.009 and IL-6 1.0 ± 0.3 [0.5, 1.5], p < 0.001 levels in the chiropractic care group. At the 16-week follow-up, blood cortisol -9 ± 4 [-17, -1], p = 0.024, IFN-γ - 22 ± 7 [-35, -9], and TNF-α -2 ± 1 [-5, 0], p = 0.028 levels increased in the sham group. Within-group comparisons showed a non-significant 10 ± 20 [-20, 50], p = 0.439 reduction in hair cortisol levels in the chiropractic group at 12 weeks, along with increased levels of blood cortisol, BDNF, CD8, CD4, IL-6, and CD19. 12 weeks of Chiropractic care modulates biomarkers linked to neuroplasticity, inflammation, and stress. Increases in brain-derived neurotrophic factor and interleukin-6 suggest enhanced neuroplasticity and inflammatory responses, while decreases in tumor necrosis factor-alpha indicate a regulatory effect on systemic inflammation. These findings support the notion that chiropractic care modulates physiological systemic biomarkers, which may underscore its benefits on clinical outcomes. ClinicalTrials.gov NCT05369156.
54. Psychometric properties of the social isolation and social network scale in community-dwelling older adults: Construct validity, reliability, and sensitivity.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Social isolation is associated with numerous negative health outcomes in older adults. Despite growing concerns about social disconnection, there remains a need for psychometrically sound instruments that comprehensively assess both social isolation and social networks, particularly in culturally diverse contexts. This study aimed to evaluate the psychometric properties of the newly developed Social Isolation and Social Network (SISN) Scale among community-dwelling older adults in South Korea. A total of 350 community-dwelling older adults aged >65 years completed the SISN and Korean version of the Lubben Social Network Scale (LSNS-K). Psychometric properties were assessed using reliability analysis (internal consistency and test-retest), construct validity (confirmatory factor analysis), and diagnostic accuracy (receiver operating characteristic [ROC] curve analysis). The SISN demonstrated excellent internal consistency (Cronbach’s α = 0.94) and test-retest reliability (intraclass correlation coefficient = 0.929, 95% confidence interval [CI]: 0.902-0.948). Confirmatory factor analysis supported the two-dimensional structure of social isolation (χ² (14) = 38.151, root mean square error of approximation [RMSEA] = 0.070, comparative fit index [CFI] = 0.983, Tucker-Lewis index [TLI] = 0.974) and social network (χ² (44) = 106.295, RMSEA = 0.064, CFI = 0.976, TLI = 0.964). The SISN showed a strong correlation with the LSNS-K (r = 0.785, p < .001). ROC curve analysis revealed gooddiscriminative ability (area under the curve = 0.900, 95% CI: 0.866-0.933), with an optimal cutoff score of 3.24 (sensitivity 81.8%, specificity 88.2%) for identifying social isolation risk. The SISN provided strong preliminary evidence of reliability and validity as a measure of social isolation and networks among older Korean adults. While these findings support its potential for research and clinical applications, the limited representativeness of the sample warrants cautious interpretation. Future studies with more diverse populations are recommended to strengthen generalizability.