公共卫生研究摘要 (2025-12-15)

共收录 59 篇研究文章

1. "I Just Get a Different Feeling in This Class": Belonging as Affective Praxis at a Dutch Urban Secondary Education School.

期刊: Journal of community psychology 发表日期: 2026-Jan 链接: PubMed

摘要

While research on the belonging of diverse student populations has grown over the past decades, it tends to overlook the ways subjective feelings of youth are embedded within inequitable societal and institutional structures. Drawing on concepts from critical affect theory, this article studies the experiences of racialized students at an urban secondary school to identify how teachers’ affective practices structure their belonging in pedagogical spaces. The study included 16 students (7 female; 9 male), all of whom were adolescents aged between 14 and 17. The findings based on qualitative interviews with students and a constant comparative analytical method illustrate the ongoing role of earlier racialization experiences in figuring into their affective histories and shaping their present encounters with teachers. Student narratives particularly demonstrate how the systematic dismissal of their feelings, presence, and questions by teachers reinforced an atmosphere of alienation in their previous schools. Alternatively, in their current schools, teachers’ attunement to students’ emotions and diverse learning experiences, along with their ability to tune into students’ lifeworlds through humor and friendly banter, seemed to generate an atmosphere of belonging. It is through such humanizing pedagogical practices that students who are marginalized by dominant power structures are affirmed as engaged learners who deserve equitable attention, care, and joy. By studying belonging as an affective praxis, this paper expands our understanding of belonging as a relational and political phenomenon, highlighting the need to develop teachers’ critical emotional literacy and praxis.

2. High-pressure injection injury with concrete to the hand and forearm.

期刊: Joint diseases and related surgery 发表日期: 2026-Jan-01 链接: PubMed

摘要

High-pressure injection injuries to the upper extremities are uncommon yet serious, particularly when they involve substances such as concrete. These injuries, frequently occurring in industrial environments, can lead to substantial tissue damage and functional impairment. A 24-year-old male patient who incurred a high-pressure concrete injection injury to his left hand and forearm while employed at a construction site was admitted. The injury, originally seeming minor, involved concrete penetration into the thenar region and extended through the forearm, resulting in significant damage to muscles, tendons, and nerves. The immediate medical care comprised immersion of the injured arm in warm water, administration of intravenous antibiotics, and tetanus prophylaxis, succeeded by rapid debridement in the operating room. Through a series of surgeries, comprising sequential debridements and reconstructive interventions, hand function of the patient was acceptable regarding the occupational return. Radiographic imaging was essential in evaluating the severity of injury and informing surgical choices. Preoperative radiological clarification of the extension of the upper extremity to the anatomical regions with high pressure is of utmost importance in determining the location and size of the surgical incision to remove the vital initial debridement and cement from the anatomical regions as much as possible. This case highlights the significance of prompt identification, assertive treatment, and sequential surgical procedures in high-pressure injection injuries. The necessity for proactive workplace safety protocols and heightened awareness of the potential severity of these injuries is underscored. We believe that this case report enhances the comprehension of the difficulties and problems associated with treating high-pressure concrete injection injuries to the upper extremities.

3. Bilateral trapezium and multiple metacarpal base fractures: An uncommon case report.

期刊: Joint diseases and related surgery 发表日期: 2026-Jan-01 链接: PubMed

摘要

Although fractures of the trapezium are extremely rare, the bone plays a crucial role in grip and pinch movements of the hand. These fractures may be associated with a concomitant fracture of the first metacarpal base and dislocation of the carpometacarpal joint. A 19-year-old male presented with bilateral hand and wrist pain following a motorcycle accident. Imaging revealed a comminuted Walker type V trapezium fracture and a second metacarpal base fracture on the right side and a non-displaced Walker type IV trapezium fracture with second, third, and fourth metacarpal base fractures on the left. The left trapezium fracture was managed conservatively, while metacarpal fractures were treated with percutaneous Kirschner wire (K-wire) fixation. On the right, closed reduction and percutaneous K-wire fixation were applied for the comminuted trapezium and associated metacarpal base fractures. The patient achieved complete bone union at one-year follow-up with no range of motion limitation. However, hand grip and key pinch strength were below normative values bilaterally, likely due to trauma, with slightly better results on the nonoperatively treated side. In conclusion, this case emphasizes the importance of high clinical suspicion and advanced imaging in the diagnosis of trapezium fractures, particularly in high-energy trauma. Individualized treatment strategies based on fracture type and displacement can result in satisfactory radiological and functional outcomes even in complex bilateral cases.

4. Reduced lateral hinge stress and fracture risk in double-hinge medial open-wedge high tibial osteotomy: A finite element study.

期刊: Joint diseases and related surgery 发表日期: 2026-Jan-01 链接: PubMed

摘要

This study aims to describe the double-hinge medial open wedge high tibial osteotomy (DH-MOWHTO) with two lateral hinges and to investigate its feasibility and its utility in prevention of lateral hinge fractures (LHFs) using a finite element analysis (FEA) model. Three osteotomies were modeled. Model 1 (DH-MOWHTO) involved two monoplanar osteotomies from the same starting point, while Models 2 and 3 were standard monoplanar osteotomies using one osteotomy line from Model 1. They were compared in terms of maximum von-Mises stress value (MPa) in the hinges at 10° correction angle, gap distance at 10° correction angle (mm), force required to achieve a 10° correction angle (N), and total surface area (mm2 ) of osteotomy surfaces contacting the saw. In DH-MOWHTO, the maximum anterior hinge stress at 10º correction angle was reduced by 28.1 to 39.6% and the maximum posterior hinge stress was reduced by 19.2 to 60.1% compared to single monoplanar osteotomies. The average stress reduction in the hinges was 36%. The force required for a 10° correction was approximately 78 N, 114 N and 85 N for Models 1, 2 and 3, respectively. The model with two monoplanar osteotomies had approximately 1.8 and 2 times more osteotomy surface area than Models 2 and 3, respectively. In this FEA study, two lateral hinges can be created in MOWHTO and lower hinge stresses can be obtained by applying lower forces with this osteotomy. In the light of these findings, DH-MOWHTO may be a novel osteotomy technique to avoid LHF.

5. Clinical and radiographic outcomes of arthroscopic repair versus conservative management for medial meniscus posterior root tears: A comparative cohort study.

期刊: Joint diseases and related surgery 发表日期: 2026-Jan-01 链接: PubMed

摘要

This study aims to compare clinical and radiographic outcomes of arthroscopic repair versus conservative management in patients with medial meniscus posterior root tears (MMPRTs). Between January 2019 and December 2021, a total of 41 patients (9 males, 32 females; mean age: 49±12 years; range, 35 to 68 years) who underwent MMPRT repair and 123 patients (11 males, 112 females; mean age: 52±7 years; range, 26 to 74 years) who refused to undergo MMPRT repair and were managed conservatively were included in the study. Surgical candidates had neutral or mild varus alignment (≤5°), preserved joint space, and Kellgren-Lawrence (K-L) Grade 1-2 osteoarthritis. Baseline K-L grades, Lysholm Knee Scores (LKS), and International Knee Documentation Committee (IKDC) scores were recorded. The mean follow-up was 32±11 (range, 24 to 60) months in the repair group and 28±6 (range, 24 to 48) months in the control group (p=0.025). Baseline LKS scores were similar between the groups (p=0.685), while IKDC scores were lower in the repair group (p=0.001). At final follow-up, the repair group showed higher LKS scores (78±19 vs. 65±32; p=0.021) and greater improvements in LKS (+46±25 vs. +36±38; p=0.046) and IKDC scores (+38±18 vs. +26±27; p=0.002). No repair patients progressed to K-L Grade 4, compared to 11% of controls (p=0.027). No repair patients required further surgery, whereas 20% of conservative patients did, including 7% undergoing arthroplasty. Arthroscopic MMPRT repair yielded a more favorable functional improvement, no subsequent surgeries, and improved radiographic preservation compared to conservative management, supporting early surgical intervention in selected patients.

6. Risk factors for recurrent shoulder dislocation after arthroscopic Bankart repair: The role of age, lesion type, and middle glenohumeral ligament variations.

期刊: Joint diseases and related surgery 发表日期: 2026-Jan-01 链接: PubMed

摘要

The aim of this study was to evaluate the effect of patient characteristics, including middle glenohumeral ligament (MGHL) morphological types, on the risk of redislocation following arthroscopic labral repair. Between February 2018 and May 2020, a total of 138 patients (105 males, 33 females; mean age: 26.5±9.8 years; range, 13 to 65 years) who underwent arthroscopic Bankart repair for traumatic anterior shoulder instability were retrospectively analyzed. Demographic data, the presence of an anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesion, and information regarding the morphology of the MGHL were collected. Clinical outcomes were assessed using the Oxford Shoulder Instability Score (OSIS) and the Visual Analog Scale (VAS). The morphology of MGHL was classified through the analysis of surgical video recordings. Among the patients, ALPSA lesions were observed in 40% of cases. Redislocation occurred in 18% of patients and was significantly associated with younger age and ALPSA lesions. Multivariate logistic regression revealed that younger age at the time of surgery (odds ratio [OR]=0.936, p=0.047) and the presence of ALPSA lesions (OR=2.953, p=0.027) were independent predictors of redislocation. The morphology of MGHL showed no significant association with recurrence. The OSIS and VAS scores improved significantly postoperatively (p<0.001), and stable patients had more favorable final patient-reported outcome measures compared to those with redislocation. Although variations in MGHL morphology did not independently influence outcomes, younger age and presence of ALPSA lesions were identified as predictors of postoperative instability following arthroscopic Bankart repair. Based on these findings, the increased risk of redislocation in younger patients and those with ALPSA lesions should be carefully considered during treatment planning.

7. OPTIModel scoring for metastatic bone tumors: A data-driven tool for surgical planning and prognosis.

期刊: Joint diseases and related surgery 发表日期: 2026-Jan-01 链接: PubMed

摘要

This study aims to evaluate the predictive accuracy and clinical applicability of the OPTIModel Scoring System in Turkish patients with long bone diaphyseal metastases and to compare its survival predictions and surgical recommendations with real-world outcomes. Between April 2013 and June 2021, a total of 108 patients (52 males, 56 females; mean age: 64.5±10.6 years; range, 45 to 83 years) with histologically confirmed metastatic bone disease affecting the diaphysis of long bones and who underwent surgical treatment were retrospectively analyzed. The OPTIModel Scoring System was applied to estimate survival and guide surgical planning. The prognostic accuracy of the model was statistically analyzed. The patients were stratified into low-, intermediate-, and high-risk groups based on their predicted survival. The most common primary tumors were breast (24.1%), lung (23.1%), and multiple myeloma (13.0%). The femur (46.3%) was the most frequently affected site. The OPTIModel-predicted median survival was 10 months (95% confidence interval [CI]: 7.9-12.1), comparable to the real-world median survival of 13 months (95% CI: 10.8-15.2). Agreement between OPTIModel’s surgical recommendations and real-world procedures was substantial (kappa [κ]=0.74, 95% CI: 0.63-0.85, p<0.001). The Kaplan-Meier analysis revealed no significant difference between predicted and real-world survival distributions (p=0.126). The ROC analysis yielded an area under the curve [AUC] of 0.61 (95% CI: 0.52-0.70), indicating moderate prognostic accuracy. The OPTIModel Scoring System demonstrated substantial agreement with real-world surgical decisions and moderate accuracy in survival prediction for Turkish patients with metastatic long bone diaphyseal tumors. While the model provides valuable insights for clinical decision-making, further refinements incorporating emerging oncological advancements and biomarker-based risk stratification are needed. Future multi-ethnic validation studies are essential to enhance its applicability in diverse populations.

8. Incidence and clinical predictors of postoperative urinary retention following total hip and total knee arthroplasty: A single-center, prospective study.

期刊: Joint diseases and related surgery 发表日期: 2026-Jan-01 链接: PubMed

摘要

This study aims to evaluate the incidence and clinical predictors of postoperative urinary retention (POUR) following total joint arthroplasty (TJA) and to evaluate whether preoperative bladder voiding efficiency (BVE) can independently predict POUR. Between September 2023 and May 2024, a total of 200 patients (66 males, 134 females; median age: 69 years; range, 32 to 90 years) scheduled for primary total hip or knee arthroplasty were prospectively analyzed. Patients were classified into POUR (n=33) and non-POUR (n=167) groups. Demographic characteristics, urological history, operative variables, the International Prostate Symptom Scores (IPSS), and bladder scanner measurements were collected and compared. The overall incidence of POUR was 16.5% (33/200). Compared to the non-POUR group, the POUR group exhibited significantly higher IPSS (p<0.001) and lower BVE (p=0.0016). Higher body mass index (p<0.001), hypertension (p<0.001), and diabetes mellitus (p<0.001) were significantly associated with POUR development. Higher preoperative IPSS and lower BVE seem to be independently associated with POUR following TJA. Notably, BVE emerges as a novel and clinically meaningful predictor. Routine preoperative assessment of BVE and IPSS may aid in the early identification of high-risk patients, enabling the implementation of targeted strategies to prevent POUR and its associated complications.

9. Nothing About Us Without Us in the First 1000 Days: Developing Inclusive Early Years Support With Disabled Families.

期刊: Sociology of health & illness 发表日期: 2026-Jan 链接: PubMed

摘要

This article reports on co-design workshops with 11 disabled families (‘co-designers’) as part of developing a ‘universal’ (for all families) early years programme in health and social care. The programme aims to enhance caregiver and infant well-being. Given well-documented limitations of existing support for disabled families, ensuring disability inclusion from the outset was essential. The term ‘disabled families’ refers to 2 configurations: families where a parent is disabled and families of disabled children. Intensive workshops employed barrier mapping and solution generation activities. Thematic analysis revealed four domains where co-designers identified exclusionary practices and proposed inclusive alternatives: physical and environmental accessibility, programme design flexibility, content inclusivity and professional practice and empowerment. Co-designers demonstrated how institutional ableism operates through inaccessible venues, rigid attendance policies, normative developmental milestones and dismissal of parental expertise. Solutions moved beyond surface accommodations towards fundamental transformation. Co-designers proposed accessible venues with sensory considerations, flexible attendance, strength-based content, comprehensive facilitator training validating experiential knowledge and enabled peer support. This study demonstrates that meaningful inclusion requires dismantling rather than retrofitting exclusionary systems. Co-designers’ insights provide both structural critique of institutional ableism and practical design principles for inclusive provision, showing how participatory approaches can generate alternative possibilities for equitable family support.

10. Causal associations of specific immunoglobulin G N-glycosylation subtypes with osteoporosis: A two-sample Mendelian randomization.

期刊: Joint diseases and related surgery 发表日期: 2026-Jan-01 链接: PubMed

摘要

This study aims to examine whether genetically predicted immunoglobulin G (IgG) N-glycosylation patterns (IGPs) affect osteoporosis risk using a two-sample Mendelian randomization (MR) method. In a collaborative effort involving the Medical Research Council (MRC) Human Genetics Unit and the FinnGen consortium, we conducted genome-wide association studies (GWAS) to explore the relationship between 77 IGPs (8,090 samples) and osteoporosis (438,872 samples). Utilizing the inverse-variance weighted (IVW) method as our primary analytical tool, we delved into these complex genetic associations. To further substantiate our findings, we employed additional complementary methods such as MR-Egger, weighted median, and weighted mode. Sensitivity analyses, including MR-Pleiotropy RESidual Sum and Outlier (MR-PRESSO), MR-Egger, Cochran’s Q, and leave-one-out methods, were used to test the core MR assumptions and validate the robustness of the results. This multi-faceted approach allowed us to detect underlying causal relationships with greater confidence. The IGP4 exhibited a protective effect against osteoporosis with an odds ratio (OR) of 0.77 (95% confidence interval [CI]: 0.63-0.95, p=0.012). In contrast, IGP45 demonstrated a modest risk increase with an OR of 1.10 (95% CI: 1.01-1.19, p=0.021). Similarly, the results of the present MR study suggest that IGP56 also showed a protective trend, with an OR of 0.86 (95% CI: 0.78-0.96, p=0.006). To confirm our findings, we conducted rigorous sensitivity analyses utilizing MR-PRESSO, MR-Egger, Cochran’s Q, and leave-one-out methods. These analyses revealed no evidence of heterogeneity or horizontal pleiotropy, thereby reinforcing the robustness and reliability of our findings. Our study results indicate that IgG45 contributes positively to osteoporosis, whereas IgG4 and IgG56 exhibit a negative correlation. Nonetheless, additional research is crucial to understand their mechanisms and devise broader preventive strategies for osteoporosis.

11. Blood pressure variability: From predictive marker to intervention target-breaking the vicious cycle of hypertensive target organ damage.

期刊: Clinical and experimental hypertension (New York, N.Y. : 1993) 发表日期: 2025-Dec-31 链接: PubMed

摘要

Hypertensive target organ damage (TOD) is a pivotal driver of cardiovascular events and mortality. Despite widespread control of traditional blood pressure (BP) averages, TOD progression persists in some patients, underscoring the independent and significant role of blood pressure variability (BPV). Accumulating evidence has established BPV not only as an independent predictor of TOD risk but also as an active contributor to its pathogenesis by propelling the vicious cycle of “hypertension-arteriosclerosis.” This article systematically reviews the epidemiological evidence supporting BPV as an independent risk factor, elucidates its mediating pathways through mechanisms such as endothelial dysfunction, inflammatory activation, and arterial stiffness, and discusses recent advances and future directions in precision management strategies focused on attenuating BPV. This review aims to provide a novel theoretical basis and practical guidance for risk assessment and individualized treatment in hypertension. We advocate shifting the clinical paradigm from solely targeting mean BP to integrating BPV control into a comprehensive management strategy. This integrated approach is critical for disrupting the vicious cycle of TOD and achieving effective prevention of cardiovascular events.

12. The effect of common medications on the efficacy of immune checkpoint inhibitors.

期刊: Cancer 发表日期: 2025-Dec-15 链接: PubMed

摘要

Medications such as proton pump inhibitors (PPIs), antihistamines, and nonsteroidal anti-inflammatory drugs have been linked to immune checkpoint inhibitor (ICI) efficacy in patients with non-small cell lung cancer (NSCLC), but these associations may reflect unmeasured confounding rather than true pharmacologic effects. This study evaluated whether commonly prescribed medications influence ICI outcomes, using a national patient sample and a negative control cohort. The authors identified Veterans Health Administration (VHA) patients with stage IV NSCLC treated with first- or second-line ICI therapy (n = 3739) or chemotherapy (n = 6585) from 2005 to 2023. Baseline use of 20 common medication classes and an immunomodulatory drug score were assessed. Propensity-weighted Cox regression evaluated associations between each medication class and overall survival (OS) or time-to-next treatment (TTNT) in the ICI group. For any medication with a nominally significant association (p < .05), the same analysis was repeated in the chemotherapy group to test for nonspecific effects. After propensity weighting, 14 of 20 medication classes showed no association with OS or TTNT in the ICI cohort. Loop diuretics, anticoagulants, opioids, penicillin antibiotics, and fluoroquinolone antibiotics were associated with worse outcomes, but similar effects were seen in the chemotherapy group. A higher immunomodulatory drug score was also associated with inferior outcomes among ICI patients, but this association was likewise present in the chemotherapy cohort. In this study, commonly prescribed medications did not appear to alter ICI efficacy in stage IV NSCLC. Prior associations reported in the literature may be attributable to unmeasured confounding rather than true drug-immunotherapy interactions.

13. Fenethylline (Captagon) in West Asia: chemical profile, socio-political drivers, public health impact, and strategies for regional control.

期刊: Journal of addictive diseases 发表日期: 2025-Dec-14 链接: PubMed

摘要

The illicit production, trafficking, and consumption of Captagon an amphetamine-type stimulant (ATS) has surged dramatically in West Asia, posing complex public health, security, and socio-political challenges. Originally synthesized as a therapeutic agent, Captagon’s potent stimulant effects have made it a favored substance among combatants and youth in conflict zones, notably in Syria and neighboring countries. This comprehensive review synthesizes current knowledge on Captagon’s chemical properties, pharmacology, and associated health consequences, alongside the socio-cultural, religious, regulatory, and geopolitical factors underpinning its endemic presence in West Asia. We critically examine the roles of conflict economies, fragile governance, and regional rivalries in sustaining illicit markets and assess the fragmented regulatory frameworks and enforcement challenges. Drawing on successful drug control models from low-prevalence countries, we propose integrated, context-sensitive strategies emphasizing governance reform, regional cooperation, public health expansion, and socio-economic interventions. Significant knowledge gaps remain, particularly regarding epidemiology, trafficking networks, and demand drivers, underscoring the urgent need for interdisciplinary research and enhanced real-time surveillance. Our findings highlight that multidimensional, regionally coordinated efforts, informed by robust evidence, are essential for mitigating the Captagon crisis and its far-reaching impacts in West Asia.

14. Bruton's Agammaglobulinemia: Case Series and Literature Review From King Fahad Central Hospital, Jizan, Saudi Arabia.

期刊: The American journal of case reports 发表日期: 2025-Dec-14 链接: PubMed

摘要

BACKGROUND X-linked agammaglobulinemia (XLA), also known as Bruton’s agammaglobulinemia, is a rare genetic disorder caused by mutations in the Bruton tyrosine kinase (BTK) gene. This defect leads to a substantial reduction in B cells and immunoglobulins, predisposing patients to recurrent severe infections. Early diagnosis and regular immunoglobulin replacement therapy are essential for effective disease management. CASE REPORT This report describes 2 male pediatric patients diagnosed with XLA at King Fahad Central Hospital in Jizan, Saudi Arabia. The first case involved a 14-month-old boy with recurrent respiratory infections, developmental delay, and frequent hospital admissions. Despite receiving immunoglobulin replacement therapy, his condition deteriorated due to poor treatment adherence, ultimately resulting in death. The second case involved a 3-year-old boy with recurrent respiratory infections and severe neutropenia. Genetic testing confirmed a BTK gene mutation. Consistent intravenous immunoglobulin therapy and close monitoring improved infection control and clinical stability, although he remained at risk for infections. CONCLUSIONS These cases emphasize the importance of early genetic diagnosis and strict adherence to immunoglobulin therapy in managing XLA. The differing outcomes underscore the critical role of treatment compliance in preventing severe complications and improving long-term prognosis. In regions with high consanguinity, genetic testing and family counseling are vital for early detection and optimal disease management.

15. The Effectiveness of Peer Support Interventions for Improving Cocaine and Crack Cocaine Treatment Outcomes: A Systematic Review.

期刊: Substance use & misuse 发表日期: 2025-Dec-14 链接: PubMed

摘要

Cocaine use disorder (CUD) has been linked to unique challenges and behaviors that may have an impact on how peer support functions regarding persons with CUD. For individuals with active substance use, peer support has been linked to positive impacts in areas such as treatment retention and recovery outcomes. As a result, this paper examines the effectiveness of peer support for the treatment of CUD. Literature searches were conducted in four databases for studies examining peer support interventions for cocaine and/or crack cocaine users. Article selection was undertaken in two stages: abstract screening and full-text screening. A narrative synthesis approach was used for data analysis. Four studies reported statistically significant results in cocaine use outcomes, underlining the potential effectiveness of peer support interventions in positively facilitating changes in cocaine use outcomes. Three studies demonstrated that peer support interventions positively influence participation in substance use treatment and related activities. Overall, treatment enrollment rates were high among the studies reviewed. The inconsistent reporting on peer training across studies was discovered. Lastly, the general lack of qualitative studies poses a limitation in completely understanding the intricacies of peer support on CUD treatment. Peer support interventions show promise in improving cocaine use outcomes, but difficulties such as methodological issues and limited research remain.

16. Association between Infant Birth Size Classification and Development of Morbidities in the Neonatal Intensive Care Unit (NICU): A Cohort Study.

期刊: Neonatology 发表日期: 2025-Dec-14 链接: PubMed

摘要

Morbidities of prematurity are often analyzed as if their epidemiology is shared, but this assumption may mask key differences in morbidity risk. This study assesses the association between three birth size metrics and development of chronic lung disease (CLD), severe retinopathy of prematurity (sROP), severe intraventricular hemorrhage (sIVH), and severe necrotizing enterocolitis (sNEC) when stratified by gestational age (GA) with morbidity-specific GA ranges and covariates. For each morbidity, data from the Pediatrix Clinical Data Warehouse (2013-2018) were included for GAs with at least 1% morbidity. Birth weight, length, and head circumference were classified as small (SGA), appropriate (AGA), or large for GA (LGA) using the Olsen curves. Odds ratios and 95% confidence intervals (AGA as referent) for each morbidity by GA were calculated using logistic regression, adjusting for morbidity-specific adjustors. SGA weight increased the odds of CLD (OR: 1.6-2.9) and sROP (OR: 1.7-3.6) for most GAs and sNEC (OR: 1.6-1.8) in at least half of the GAs, but not sIVH at any GA. LGA weight decreased the odds of CLD in some GAs and increased the odds of sIVH only at 27 weeks GA, but was not associated with sROP or sNEC at any GA. Results were similar for length and head circumference. CLD, sROP, sNEC, and sIVH are associated with GA, birth size, and covariates differently. CLD and sROP were consistently associated with size classification and GA, while sNEC demonstrated variability in its association. However, sIVH was rarely associated with birth size in this sample.

17. Socioeconomic Inequalities in the Transition to Nursing Home Care: Longitudinal Evidence from a Population Based Study in Switzerland.

期刊: Journal of aging & social policy 发表日期: 2025-Dec-14 链接: PubMed

摘要

Lower socioeconomic status (SES) is linked to earlier nursing home admission, but it is unclear if this remains true after accounting for health needs. This study examines SES-related inequalities in nursing home admission, controlling for health needs in an area of Switzerland with universal home-based care for older adults. Data were from the Lausanne Cohort 65+ study, including 3650 participants. SES was measured by education level, occupational class, and receiving means-tested benefits (a proxy for low income). Health needs were assessed with a set of physical and mental health variables. Cox proportional hazard models are controlled for demographics and health needs. Over 6 years, 115 (3.2%) participants were admitted to a nursing home. Lower education and receiving means-tested benefits were linked to earlier nursing home admission. However, after adjusting for all SES variables and health needs, associations between socioeconomic inequalities and nursing home admission did not remain significant. Lower SES is initially associated with earlier nursing home admission, but this is substantially explained by functional and cognitive impairment. The study suggests that access to long-term care in Switzerland is horizontally equitable but emphasizes the importance of preventing functional and cognitive decline in lower SES groups.

18. Strengthening Care for Children (SC4C), an Integrated Paediatrician-General Practitioner Model for Reducing Hospital Referral Rates: A Stepped-Wedge Cluster Randomised Controlled Trial.

期刊: The Medical journal of Australia 发表日期: 2025-Dec-14 链接: PubMed

摘要

To assess the effectiveness of Strengthening Care for Children (SC4C) for reducing the number of referrals by general practitioners of patients under 18 years of age to hospital services. Stepped-wedge cluster randomised trial; data collected for up to 16 months after the intervention. General practices in North Western Melbourne and Central and Eastern Sydney primary health networks, 1 May 2021-30 September 2023. General practitioners who worked at least two clinical sessions each week, saw patients under 18 years of age, and for whom at least 1 month of referrals data during the control period were available; families of people under 18 years attending these practices. Weekly (6 months) then fortnightly (6 months) general practitioner-paediatrician co-consultations; monthly paediatrician-led case discussions; weekday phone and email support by paediatricians. Proportion of general practitioner visits in which patients were referred to publicly funded hospital outpatient clinics or emergency departments (patient level), overall and by baseline referral rate. Referrals after completion of the intervention; general practitioner confidence regarding child health care; low value care for frequent childhood conditions; family preference for general practitioner or paediatrician care. One hundred and thirty participating general practitioners from 22 general practices conducted 50,101 consultations during the control period; 125 general practitioners from 21 general practices received the intervention and undertook 96,804 consultations. Patients were referred to hospitals in 2.3% of control period consultations and 1.9% of intervention period consultations (risk difference, -0.34 [95% confidence interval {CI}, -0.69 to 0.004] percentage points). Among general practitioners with high referral rates at baseline (5% or higher), patients were referred to hospital outpatient or emergency department in 7.3% of control period consultations and in 3.0% of intervention period consultations (risk difference, -4.28 [95% CI, -6.59 to -1.97] percentage points); the referral rate was also lower after the intervention period (sustainability vs. control periods: 2.9% vs. 5.8%; risk difference, -2.92 [95% CI, -5.36 to -0.48] percentage points). The proportions of general practitioners confident about their knowledge and skills regarding child health care were larger during the intervention than the control period. Quality of care and family preference for general practitioner-led care for their children remained high across the study. No adverse events were recorded. Strengthening primary care for children reduces the frequency of hospital referrals of children by general practitioners with high referral rates, increases rates of general practitioner confidence about caring for children and maintains family preference for general practitioner-led care. Australian New Zealand Clinical Trials Registry ACTRN12620001299998 (prospective). The demand for hospital outpatient and emergency services for children is rising in high income countries. Integrated care models in which paediatricians support care by general practitioners could reduce the number of hospital referrals. An integrated general practitioner–paediatrician model did not reduce hospital referrals overall, but sustainably reduced referrals of children by general practitioners who had previously referred 5% or more of patients under 18 years of age. To relieve pressure on hospitals and improve equitable access to specialist care, this care model could be expanded to include general practices in areas with high numbers of children and general practitioners with high referral rates.

19. Employee Background Check Policies in Long-Term Care Facilities in the United States.

期刊: The Gerontologist 发表日期: 2025-Dec-14 链接: PubMed

摘要

Employee background checks can help protect older adults in long-term care facilities. The National Background Check Program (NBCP) offers federal support to strengthen employee background check systems. Yet, regulations on provider requirements, disqualifying offenses, and administrative processes differ across states. We examine differences between NBCP (N = 27) and non-NBCP (N = 23) states across three domains: (1) types of LTC providers required to conduct background checks (2) disqualifying offenses considered by each state, and (3) processes used to administer background checks. We also assess regulatory changes across these domains from 2005 to 2024 across all 50 states. We conducted policy surveillance of state regulations on employee background check programs applicable to individuals seeking work at long-term care facilities. Our sample includes all 50 states, with 27 receiving an NBCP grant. We assess current regulations across three policy domains and review how these regulations have evolved since 2005, when the NBCP pilot program was initiated. NBCP states have expanded background check regulations to include a broader range of long-term care providers and disqualifying offenses following the grant. However, minimal differences were observed between the two groups in background check processes such as fingerprinting and registry reviews. While many NBCP states have adopted measures like disqualifying offenses and RAP back systems, their overall impact on hiring practices, F-tags and quality of care remains uncertain.

20. Prevalence of sexual and gender minority (SGM) affirmative policies in long-term care facilities in Minnesota.

期刊: The Gerontologist 发表日期: 2025-Dec-14 链接: PubMed

摘要

Sexual and gender minority (SGM) older adults are more likely to use long-term care (LTC) than their cisgender, heterosexual counterparts. However, LTC settings may lack SGM-affirming policies necessary for inclusive care. This study analyzed the prevalence of SGM-affirming policies in nursing homes (NH) and assisted living facilities (ALF) in Minnesota and examined differences across facility characteristics. A survey was conducted across 165 NH and 266 ALF in Minnesota. Facilities were assessed by their explicit inclusion of 28 SGM-affirmative policies, like nondiscrimination and training policies, with a mean index score calculated to determine the overall prevalence of affirming policies. Differences by facility type (NH vs ALF), location (rural vs. urban), ownership (non-profit vs. for-profit), and religious affiliation (religious vs. secular) were assessed in multinomial logistic regression. Latent class analysis compared lower (n = 244) and higher (n = 153) performers across facility characteristics. Across LTC facilities, there was an average of 11.30 SGM-affirming policies out of 28 policies assessed. Lower performing facilities reported fewer SGM-affirming policies (mean = 7.34) than higher performing facilities (mean = 17.24). No significant differences in policy prevalence were found between NH and ALF; between rural and urban facilities or by ownership status. However, striving facilities were more likely to be secular than religious. The prevalence of SGM-affirming policies was distributed binomially, suggesting facilities fall within two categories (lower performers and high performers). Efforts should focus on adopting SGM-affirmative policies across all LTC facilities to ensure equitable and inclusive care for SGM older adults.

21. Shaping and Reinforcing Personal Views of Aging Among Older Adults: The Role of Non-Kin Social Interactions.

期刊: The Gerontologist 发表日期: 2025-Dec-14 链接: PubMed

摘要

Older adults’ personal views of aging (VoA) can shape health and well-being outcomes. This study explores how non-kin social interactions within a Continuing Care Retirement Community (CCRC) influence the development and reinforcement of personal VoA before and during the COVID-19 pandemic. This qualitative study was nested within an ongoing ethnographic project in a midwestern U.S. CCRC. Data included 22 resident interviews contextualized by two months of ethnographic fieldwork and participant observation. Interviews and field notes were analyzed using thematic analysis to explore how non-kin social interactions affect the multidimensional aspects of VoA, including losses and growth in physical functioning, cognitive abilities, and socio-emotional experiences. Findings show that non-kin interactions played a dual role in buffering against and reinforcing negative VoA. They buffered residents by replenishing social networks, reducing isolation, encouraging health behaviors, and fostering solidarity. At the same time, peer and staff interactions reminded residents of decline and death, reinforcing stereotypes and leading to othering and patronizing behaviors. These dynamics mirror prior studies yet highlight the unique salience of non-kin ties in CCRCs. The timing of data collection suggests that the pandemic amplified rather than fundamentally altered the benefits and risks of peer influence on VoA. Personal VoA is multidimensional and sensitive to social environments. Friendships and non-kin ties are pivotal in shaping how older adults interpret their own aging, with potential to both promote and undermine positive VoA and well-being.

22. Neighborhood built environment and loneliness dynamics among older Chinese immigrants in the United States.

期刊: The journals of gerontology. Series B, Psychological sciences and social sciences 发表日期: 2025-Dec-14 链接: PubMed

摘要

This study investigates the associations between built environment characteristics and changes in loneliness over time among older Chinese immigrants, as well as the potential mediating roles of social factors. Data were drawn from the Population Study of Chinese Elderly in Chicago (PINE, 2011-2020), involving 2,550 participants residing in 170 Census tracts who provided repeated measures of loneliness. Neighborhood-level data were obtained from the National Neighborhood Data Archive (NaNDA) and the American Community Survey (ACS). Built environment measures captured walkability, presence of amenities, open spaces, and public transit. Potential mediators were assessed at baseline, including social networks, perceived social support, social engagement, and sense of community. Latent growth curve zero-inflated Poisson models were used to assess longitudinal associations between the built environment and loneliness. Participants reported low baseline loneliness, with a significant decline over time. Longer block lengths were associated with higher initial loneliness (B = 0.005, p = 0.046). More public transit stops were linked to lower initial loneliness (B = -0.003, p = 0.005) but also a slower rate of decline (B = 0.001, p = 0.009). No significant mediation effects were found for social networks, social support, social engagement, or sense of community, possibly driven by the nonsignificant relationships between these mediators and loneliness. Findings underscore the nuanced role of walkability and transit access in shaping loneliness among older Chinese immigrants. Addressing loneliness in aging immigrant populations requires multi-level strategies, including inclusive urban design, enhanced social infrastructure, and culturally responsive community engagement.

23. From sick care to healthspan: educating the longevity physician for health maintenance and health promotion.

期刊: Biogerontology 发表日期: 2025-Dec-14 链接: PubMed

摘要

This paper focuses specifically on the education and upskilling of medical doctors, proposing how longevity-related competencies can be incorporated first through continuing medical education (CME) pathways and, eventually, into formal medical curricula. As longevity medicine evolves from research into clinical practice, education has emerged as its defining challenge. While the science of ageing advances rapidly, most physicians remain unprepared to translate biological, technological, and preventive insights into responsible medical care. Emerging foundational fields such as biogerontology, which investigates the biological mechanisms of ageing across organisms, and its clinically oriented derivative geroscience, have created new expectations for translational capacity in healthcare. This paper extends previous conceptual work by outlining potential educational domains, proposing a structured education, and outlining a pedagogical and accreditation model for incorporating longevity-related competencies into medical training pathways. The framework integrates geroscience, digital diagnostics, and healthspan-oriented care within established medical education and quality assurance standards. By exploring potential pathways from postgraduate to continuing education, longevity medicine may contribute to more coherent and evidence-aligned practice. Education may represent one enabling factor in efforts to shift, where feasible, from predominantly reactive care toward more proactive approaches to health maintenance.

24. Genome Mining Guided Discovery of Macrocyclic Sesterterpenoids with Anti-MRSA and Anti-Neuroinflammatory Activities.

期刊: Journal of agricultural and food chemistry 发表日期: 2025-Dec-14 链接: PubMed

摘要

Terpenoids exhibit antioxidant, antimicrobial, and health-promoting activities, and are widely utilized in the food industry. In this study, a new bifunctional terpene synthase (BFTPS) and its associated gene cluster were identified in Colletotrichum cereale 00173 through a genome mining approach. Heterologous expression of the BFTPS and its gene cluster in Aspergillus oryzae NSAR1 led to the production of a 14-membered macrocyclic sesterterpene, colcerepene (1), and four hydroxylated derivatives, colcerepenoids A-D (2-5). The biosynthetic pathway of compounds 1-5 was further elucidated through feeding experiments. Notably, compound 1 exhibited antibacterial activity against methicillin-resistant Staphylococcus aureus (MRSA) with an MIC value of 6.25 μM. This study is the first report of anti-MRSA activity in macrocyclic sesterterpenoids, expanding the functional space of macrocyclic sesterterpenoids as promising leads for developing agents against foodborne pathogens.

25. Lung injury, oxidative stress and impaired functioning in a model of prolonged ozone exposure in female mice are associated with macrophage proinflammatory and profibrotic activation and altered bioenergetics.

期刊: Toxicological sciences : an official journal of the Society of Toxicology 发表日期: 2025-Dec-14 链接: PubMed

摘要

Prolonged exposure to ozone causes lung injury and persistent inflammation, pathologies associated with emphysema and asthma. Herein, we characterized inflammatory cells in the lungs using a murine model of prolonged ozone exposure, with the long-term goal of assessing their role in disease pathogenesis. Mice were exposed to air or ozone (1.5 ppm, 2 h, 2x/wk, 6 wk). Bronchoalveolar lavage fluid (BAL) and cells and lung tissue were collected 24 h after the final exposure. Alveolar/bronchiolar hyperplasia, epithelial degeneration and mononuclear cell infiltration were observed following ozone exposure; BAL protein, cells, fibrinogen, and SP-A and SP-D were also increased, along with markers of oxidative stress, and impaired pulmonary function. Flow cytometric analysis of infiltrating myeloid cells revealed that after ozone exposure, the majority of these cells were mature infiltrating macrophages. These were comprised mainly of anti-inflammatory/profibrotic macrophages, with a smaller number of proinflammatory macrophages. Proinflammatory genes (Il1β, Ccl3, Ccl17, Ccl22, Tnfα) and NF-κB activity were increased in BAL cells from ozone exposed mice (>97% macrophages); profibrotic genes (Mmp12, Mmp28, Tgfβ), but not anti-inflammatory genes (Il10, Arg1), were also upregulated. Following ozone exposure, glycolytic activity and oxidative phosphorylation increased in BAL cells, consistent with proinflammatory and profibrotic activation, respectively. These findings are important as they provide a rationale for evaluating the role of inflammatory macrophages in the pathophysiological response to prolonged ozone exposure.

26. Neighborhood Built Environments and Social Inclusion Among Older Adults with Memory Problems: A Caregiver Survey.

期刊: The Gerontologist 发表日期: 2025-Dec-14 链接: PubMed

摘要

Population aging underscores the need for a comprehensive understanding of the multi-level factors that support aging in place. Physical environments are closely linked to social environments, and caregivers often observe how these environmental features shape the everyday experience of people with memory problems. This study examines how caregivers’ perceptions of neighborhood built environments are associated with their perceptions of the social inclusion of people with memory problems in communities. A statewide survey was conducted in Texas, involving 95 caregivers of individuals with memory problems (defined as having significant memory impairment that impacts daily functioning). Descriptive statistics summarized neighborhood characteristics and caregivers’ perception of the community’s social inclusion. Logistic regression predicted two target outcomes of social inclusion for people with memory problems: (1) respect and support and (2) intergenerational exchange (e.g., age-integrated social interactions). For neighborhood characteristics, legibility-related environmental features were more commonly present than those related to accessibility or safety. For social inclusion, caregivers perceived positive community respect and support for people with memory problems but limited intergenerational interaction. Legibility of neighborhood environments was positively associated with caregivers’ perceptions of respect and support for people with memory problems, while accessibility was associated with intergenerational exchange. The findings underscore the role and potential of neighborhood environments for improving social inclusion for people living with memory problems. They suggest that improving legibility and accessibility of neighborhood environments can foster respect and social support and intergenerational exchanges central to aging in place.

27. Job rotation among Moroccan radiographers: A qualitative study.

期刊: Journal of medical imaging and radiation sciences 发表日期: 2025-Dec-13 链接: PubMed

摘要

Job rotation is a common strategy in radiologic departments, yet its perceived benefits and drawbacks remain underexplored, particularly among Moroccan radiographers. This study aims to investigate perceptions of job rotation and its impact on motivation, stress, competencies, productivity, and occupational risks. A qualitative exploratory study was conducted using semi-structured interviews with radiographer working in public hospitals. Interviews were transcribed verbatim and analyzed using thematic analysis to identify recurring patterns and key insights. Six major themes emerged: (1) Workstation Rotation Organization, which revealed flexibility and staff input in rotation planning; (2) Motivation, where most reported enhanced engagement; (3) Stress, with rotation seen as a strategy to reduce stress through task variety; (4) Risk, where job rotation was generally viewed as redistributing occupational risks; (5) Competencies, highlighting broader skill development but mixed views on specialization; and (6) Productivity, showing varied opinions about its impact on efficiency. Radiographer value job rotation for improving adaptability, motivation, and reducing stress. However, concerns persist regarding its impact on technical mastery and risk adaptation. Effective rotation policies should incorporate staff input, ensure equitable distribution, and consider the balance between skill generalization and specialization.

28. Cerebrovascular events after head and neck radiation therapy: A systematic review and Meta-Analysis.

期刊: Oral oncology 发表日期: 2025-Dec-13 链接: PubMed

摘要

Several studies have demonstrated increased risk of cerebrovascular events, including carotid stenosis, stroke & transient ischemic attack, following head and neck radiation therapy (RT) for head and neck cancer (HNC). This systematic review reports the incidence of cerebrovascular events (CVEs) and the relative rate (RR) of ischemic stroke in patients treated with RT compared to non-RT populations. A comprehensive database search identified publications reporting the incidence or RR of CVEs following RT. Citations were retrieved, and data was extracted where appropriate. Risk of bias was assessed, and meta-analyses were conducted to present pooled estimates of the incidence of CVEs after RT and the RR of ischemic stroke. 2,598 citations were retrieved, of which 50 met criteria for inclusion. The incidence of carotid stenosis ranged from 0 %-40 % over median follow-up duration of 6-68 months (mean = 6-150 months). The incidence of ischemic stroke was 8.98 per 1,000 person-years (95 % CI: 4.66 - 17.30). The relative rate of ischemic stroke was higher in patients treated with radiation therapy with a HR of 1.33 (95 % CI: 1.21 - 1.45) when compared to a reference population (HR of 1) of those treated with surgery and a HR of 1.29 (95 % CI: 1.13 - 1.47) when compared to the general population as the reference group. HNC patients face an increased risk of ischemic stroke following head and neck radiation therapy. The magnitude of this heightened risk remains elusive in the contemporary era of intensity-modulated radiation techniques and should be addressed in future studies.

29. Time-managed PAPR use enables a balanced approach to infection control and personal freedom.

期刊: Scientific reports 发表日期: 2025-Dec-13 链接: PubMed

摘要

Full lockdowns during airborne-disease pandemics impose substantial socio-economic costs. To address this, to the best of the author’s knowledge, three prior contributions were made for the first time: (i) proposed a concept in which medical-grade Powered Air-Purifying Respirators (PAPRs) used by the general public can serve as an engineering alternative to lockdowns; (ii) disclosed a proof-of-concept PAPR with aerosol-blocking performance comparable to medical devices at a parts cost of USD 40; and (iii) demonstrated via mathematical modeling that if more than 55% of the population wears PAPRs continuously-or if everyone wears them intermittently to a moderate extent-the effective reproduction number Rt can be reduced from 2.0 to 0.9. Building on these prior results, this study proposes and prototypes an IoT-based management framework-the PAPR Wearing-Status Networked Management System (PWS-NET)-that seeks to reconcile governmental infection control with individuals’ freedom to choose the time and place of non-wearing. The core metric is Saved Allowance Time (SAT), i.e., an accumulative daily allowance for mask-off periods. The prototype integrates three components: (a) real-time wearing detection for PAPRs using a differential-pressure sensor, (b) user-declared location via a smartphone application, and (c) a rule-based web server that updates SAT on a daily basis. Scenario tests that emulate realistic use conditions confirmed correct operation of SAT updates and violation judgments, as well as effective real-time visual feedback to users. Constructed entirely from off-the-shelf components, the prototype is intended as a starting point for large-scale field studies aimed at integrating SAT-based governance into public-health policy for future outbreaks.

30. The mediating role of risk perception in the relationship between chemical safety knowledge, GHS awareness and safety behavior.

期刊: Scientific reports 发表日期: 2025-Dec-13 链接: PubMed

摘要

Exposure to hazardous chemicals remains a critical challenge in industrial settings, leading to significant adverse health outcomes and substantial economic losses annually. This study aimed to investigate the mediating role of risk perception in the relationship between chemical safety knowledge, GHS awareness, and safety behavior. This analytical modeling study was conducted among 360 workers from four chemical-enterprise scales (micro, small, medium, and large) in 2024. Data were collected using standardized questionnaires. Data analysis were performed using SPSS v.26. The mediating role was examined using structural equation modeling (SEM) in AMOS v.24, and model fit was assessed using indices such as CFI, RMSEA, and χ²/df. The findings exhibited a general lack of familiarity with less commonly used pictograms, such as toxic materials (80.56% unfamiliarity), and a high reliance on informal training in small enterprises (84.62%). Data analysis illustrated that enterprise size significantly influenced safety knowledge and awareness levels (P < 0.001). Large enterprises demonstrated the highest knowledge scores (27.08 ± 3.05) and safety behavior (3.65 ± 0.53), while micro and small enterprises scored the lowest. Furthermore, risk perception was significantly higher in large enterprises (3.94 ± 0.26) compared to small (3.65 ± 0.33) and micro-enterprises (3.33 ± 0.36; P < 0.001). Path analysis confirmed that risk perception acts as a significant mediating variable, strengthening the relationship between safety knowledge, GHS awareness, and safety behaviors (β = 0.203, P < 0.001). This study addresses a gap in the literature concerning the mechanisms through which key chemical safety variables interact and underscores the urgent need for targeted interventions, such as realistic hazard simulations, standardized bilingual labels, and digital technology integration, to enhance chemical safety across organizational scales.

31. AI-powered models for overcrowding prediction at TUMS hospitals.

期刊: Scientific reports 发表日期: 2025-Dec-13 链接: PubMed

摘要

When the emergency department (ED) of a hospital reaches its saturation capacity, adverse events such as increased waiting times, increased mortality, clinical mistakes, and a financial burden escalate. Accurate overcrowding forecasting renders a powerful alarming tool for increasing the operational efficiency of hospitals. This study provides a novel contribution by leveraging a time series dataset for 5 hospitals of Tehran University of Medical Sciences (TUMS) to predict daily ED-overcrowding. Firstly, we identified 121 possible features per ED. Then, in the attribute selection, we used a new time series features selection method using minimum redundancy and maximum relevance (mRMR) with mutual information selector, and elastic net, both implemented via time series cross validation with growing window (TSCVG). In time series modeling, we implement several base learners, namely linear regression, elastic net, neural network, long short-term memory (LSTM), support vector machine (SVM), random forest, least square boosting, and a convolutional neural network with Bayesian tuning upon TSCVG folds. These base learners are combined by using ensemble methods, namely weighted and quantile averaging, and variance-penalized Bayesian Model Averaging (VP-BMA). Results indicated that reducing the initial feature set using the feature selection method significantly improves the modeling performance for all EDs. It is observed that the binary calendar feature and the delays of the target are frequently selected in all EDs. According to the VP-BMA model component analysis, the SVM and LSTM showed the most reliable performance across all EDs. As a result, ED A indicated a stable performance across most overcrowding thresholds (ROC ≈ 0.95-0.98), EDs C and E a reasonable at moderate cutoffs, while EDs B and D showed poor performance in all overcrowding thresholds.

32. Effectiveness of an online biopsychosocial cognitive-behavioural preventive intervention to improve wellbeing and mental health during pregnancy. Randomized controlled trial (BienGestar).

期刊: BMC pregnancy and childbirth 发表日期: 2025-Dec-13 链接: PubMed

摘要

Pregnancy is a period of significant psychological, physiological, and social change, which can increase vulnerability to emotional distress. While many interventions focus on detecting and treating symptoms of anxiety and depression during pregnancy, fewer target the promotion of wellbeing. The BienGestar study aims to evaluate the effectiveness of a digital, biopsychosocial, cognitive-behavioural intervention designed to promote mental health, wellbeing, and physical health during pregnancy and the postpartum period in a community-based sample of healthy pregnant women. The study is a randomized controlled trial with two parallel arms: an intervention group and a control group. Participants will be recruited through public health centers in Catalonia, Spain. Eligible participants are pregnant women less than 15 weeks of gestation, aged 18 or older, with access to an internet-connected device and able to understand and read Spanish. After providing informed consent and completing baseline assessments, participants will be randomized into one of the two groups. The intervention consists of a 20-week structured program delivered through a secure online platform, with daily activities and psychoeducational content adapted to the gestational stage. Outcomes will be assessed at baseline (gestational week 15), post-intervention (gestational week 36), and postpartum (45 days after delivery). Primary outcomes include mental wellbeing, life satisfaction, and symptoms of anxiety and depression. Secondary outcomes include prenatal attachment, self-efficacy, birth experience, and infant health indicators. Obstetrical and neonatal data will be collected from medical records. All analyses will follow the intention-to-treat principle, and a per-protocol analysis will also be conducted to assess the intervention’s efficacy among participants who adhered to the program. This study introduces a novel, health-promotion-focused approach to perinatal mental health care. By targeting psychological wellbeing rather than emotional distress, and by offering a fully online, self-guided intervention integrated into primary care, BienGestar may contribute to scalable, preventive strategies to support women throughout pregnancy. If effective, the intervention could be implemented broadly as part of routine prenatal care to enhance maternal wellbeing and infant outcomes. ClinicalTrials.gov: NCT06871397. Prospectively registered on March 11, 2025.

33. Sleep Deprivation Induces Anxiety-like Behaviors in Mice by Impairing ApoE/AMPK/mTOR-Mediated Autophagy.

期刊: Molecular neurobiology 发表日期: 2025-Dec-13 链接: PubMed

摘要

Sleep Deprivation (SD) severely disrupts emotional regulation, predisposing individuals to mood disturbances and anxiety. However, the precise mechanisms underlying anxiety triggered by sleep loss remain elusive. In this study, a mouse model of chronic SD was established using a continuously running treadmill paradigm for 28 days. SD induced anxiety-like behaviors and hippocampal ApoE downregulation. Furthermore, SD downregulated the expression of the autophagy-related protein ATG5 and upregulated p62. In addition, SD inhibited AMPK phosphorylation and induced mTOR phosphorylation. Levels of pro-inflammatory cytokines, including TNF-α, IL-1β, and IL-18, were markedly increased. Immunofluorescence staining revealed a notable increase in the activation of microglia and astrocytes in the hippocampi of SD mice. Either hippocampal overexpression of ApoE via bilateral AAV injection or rapamycin treatment significantly alleviated anxiety-like behaviors, enhanced autophagy, and reduced neuroinflammation in SD mice. Thus, SD induces anxiety by suppressing autophagy level. This effect is mediated through the inhibition of ApoE-dependent AMPK phosphorylation and the concomitant promotion of mTOR phosphorylation, revealing a potential therapeutic target.

34. Primary SARS-CoV-2 exposure by vaccination or infection shapes immune responses to omicron variants among a Spanish cohort.

期刊: Nature communications 发表日期: 2025-Dec-13 链接: PubMed

摘要

The comparison between vaccine-induced and infection-acquired adaptive immunity, and their co-occurrence -referred to as “hybrid immunity”- is of great interest and remains an area with significant knowledge gaps. Given that most of the population already has hybrid immunity to COVID-19, a key question is whether the order of infection-acquired and vaccine-induced immunity affects the immune response. Here, we analyze the humoral and T-cell responses in a Spanish cohort with longitudinal blood sampling spanning 2020-2023. We observe higher anti-RBD antibody levels against Omicron in individuals initially exposed to SARS-CoV-2 antigens via vaccination compared to those first exposed through natural infection. This difference diminishes with an increasing number of exposures. The dynamics of antibody levels over time correlate with clinical protection: those first-infected have higher protection early on, whereas those first-vaccinated show greater protection later, especially with the arrival of the Omicron variant. This phenomenon may reflect immune imprinting. In contrast to the humoral response, the T-cell response is higher in individuals first exposed through infection, although T-cell findings may be underpowered because of limited sample size. Our study provides valuable insights into the impact of initial antigen exposure on humoral and cellular responses to SARS-CoV-2.

35. Cross-cultural validation of the Weight Stigma Exposure Inventory (WeSEI): secondary data analysis from Taiwan, China, Hong Kong, Indonesia, Türkiye, and Malaysia.

期刊: Journal of eating disorders 发表日期: 2025-Dec-13 链接: PubMed

摘要

The Weight Stigma Exposure Inventory (WeSEI) is a newly developed instrument designed to assess weight stigma exposure across both interpersonal and non-interpersonal contexts. While prior studies have supported its use in individual regions, its cross-cultural applicability has not been comprehensively evaluated. The present study examined the psychometric properties and cross-cultural measurement equivalence of the WeSEI across six culturally diverse jurisdictional regions in Asia (i.e., Taiwan, China, Hong Kong, Indonesia, Türkiye, and Malaysia). A total of 7,787 participants completed the 35-item WeSEI via various online platforms. The WeSEI assesses weight stigma exposure across seven domains: social media, traditional media, television/movies, parents/siblings, friends/peers, significant others, and strangers. Rasch analysis was conducted to evaluate item fit, rating scale functioning, person separation reliability, and unidimensionality for each domain. Differential item functioning (DIF) was assessed across sex, weight status, and jurisdictional region. The WeSEI demonstrated strong internal consistency, acceptable item fit, and unidimensionality across all domains, with only two items showing misfit (i.e., Friends/Peers_2 and Significant Other_2). Person separation indices exceeded 2.0 for each domain, confirming the scale’s ability to distinguish individuals with varying levels of stigma exposure. Minimal DIF was observed by sex and weight status, supporting measurement equivalence across these groups. However, 19 out of 35 items showed significant jurisdictional region-level DIF, particularly those related to slim-normative attractiveness and family-based stigma. Malaysian participants consistently endorsed these items more than Chinese participants, suggesting cultural variation in the exposure of weight stigma. The WeSEI is a psychometrically sound and culturally responsive tool for assessing weight stigma exposure across diverse populations in Asia. Cultural adaptation is recommended for cross-national comparisons.

36. Carbohydrate competition by Enterobacteriaceae enhances colonization resistance to carbapenem-resistant hypervirulent K. pneumoniae.

期刊: Microbiome 发表日期: 2025-Dec-13 链接: PubMed

摘要

Carbapenem-resistant hypervirulent K. pneumoniae (CR-HvKP) is a growing public health threat due to its virulence and limited treatment options. While prevalent in hospitals, its presence in livestock, particularly pigs, is poorly understood. The gut microbiome provides colonization resistance, but how it restricts CR-HvKP remains unclear. To further elucidate the colonization resistance mechanisms of the gut microbiota against CR-HvKP, we analyzed stool samples from piglets (L), nursery (N), fattening (F), and sows (PS) using microbiome modeling (Micolo) and competition assays. ST290 K. pneumoniae isolated from PS inhibited CR-HvKP via carbohydrate competition, with a pronounced effect observed for sucrose. Niche-specific supplementation with methyl pyruvate was found to partially alleviate this ecological inhibitory effect. Carbohydrate-based interventions could be explored as potential therapeutic or prophylactic strategies to combat CR-HvKP colonization, thereby potentially improving animal and public health outcomes. Video Abstract.

37. Socioeconomic vulnerability and the management of domestic animal hosts in urban environments: a one health issue.

期刊: BMC veterinary research 发表日期: 2025-Dec-13 链接: PubMed

摘要

Within socioeconomically vulnerable communities, dogs and cats are also exposed to deficient sanitation infrastructure, conditions of mistreatment, and malnutrition. This scenario promotes the maintenance of pathogen reservoirs, posing risks to domestic and wild animals, as well as to humans. Considering this context, our objective is to demonstrate how socio-environmental conditions influence the reduction in quality of life and the vulnerability status of these animals, making them more prone to infections and the transmission of zoonotic pathogens. In a cross-sectional study, we applied questionnaires to volunteer pet guardians in the neighborhoods of Marechal Rondon (MR) and Pau da Lima (PDL), Salvador, Bahia, Brazil, and collected blood and stool samples from dogs and cats for hematological and parasitological studies. A population of dogs and cats treated at a private veterinary service was used as a control for hematological analyses. Statistical analysis of the variables of interest was performed using univariate mixed generalized linear models, multimodel inference, and quantitative model classification based on Akaike’s Information Criterion (AIC) and the weighting of the relative contribution of each variable to the average model. We sampled 202 dogs and 128 cats in MR and 132 dogs and 42 cats in PDL. Among the dogs, 242 underwent blood counts, and 137 underwent stool parasitology tests. Among the cats, 96 underwent blood counts, and 30 underwent parasitology tests. We observed significant differences in the average values of HCT, PPT, and Eos between animals from the communities and the control group, both for dogs and cats. Different individual animal variables, household characteristics, and environmental factors were associated with changes in hematological and parasitological parameters, thus affecting the overall health of the dogs and cats. This study highlights the need for basic animal health measures, such as sterilization, improved nutrition, deworming, and controlling street access, to reduce the competence of these animals as hosts of infectious agents, considering the vulnerability of these communities. Therefore, it is necessary to expand public policies focused on the promotion and prevention of comprehensive health, extending these measures to animal health.

38. Predictors of anemia among lactating women in ethiopia: Using 2016 EDHS; application of ordinal logistic regression model.

期刊: Scientific reports 发表日期: 2025-Dec-13 链接: PubMed

摘要

39. Fibroblast growth factor signals drive the metastatic behavior in small cell lung cancer.

期刊: British journal of cancer 发表日期: 2025-Dec-13 链接: PubMed

摘要

Early metastatic spread represents a challenge in fighting small cell lung cancer (SCLC). The molecular mechanisms underlying metastatic dissemination remain unclear in this devastating disease. Invasive traits were investigated in 13 SCLC cell lines using 3D-spheroid formation, sprouting assays, co-cultures and a zebrafish xenograft model. Proteomic analysis was performed to unravel metastatic drivers, which were validated by qPCR, growth factor arrays and specific inhibitors. Overall, 8 cell lines formed spheroids, and half of these displayed invasive sprouting in collagen. The ‘sprouter’ SCLC cells, which all had a YAP1-dominant subtype, showed increased migration in zebrafish larvae and penetrated endothelial cell monolayers to a higher extent, thereby mimicking intra- and extravasation. Proteomics revealed differences in adhesion properties, oncogenic pathways and receptor tyrosine kinase signalling. Sprouter cells showed higher expression levels of mesenchymal cell state markers. Stimulation with fibroblast growth factor 2 (FGF2) further induced invasive sprouting, while blocking the FGF/R axis resulted in a significant reduction of sprouting in vitro and in vivo. The FGF/R axis is a key driver of SCLC metastatic spread in the YAP1-dominant subtype. These data might facilitate the development of potential future therapies targeting FGF/R signalling to prevent SCLC progression and metastasis.

40. Environmental and sanitation determinants of safe food handling practices among food handlers in Kobo Town, northeastern Ethiopia.

期刊: International journal of environmental health research 发表日期: 2025-Dec-13 链接: PubMed

摘要

Foodborne diseases remain a major public health challenge in low- and middle-income countries, driven by inadequate sanitation and unsafe food handling practices. However, little is known about how environmental and workplace conditions jointly influence food hygiene behaviors in small urban towns. Therefore, this study aimed to assess how sanitation facilities and workplace environmental conditions are associated with safe food handling practices among food handlers in Kobo Town, northeastern Ethiopia. A cross-sectional study was conducted among 400 food handlers in Kobo Town, northeastern Ethiopia, from January to March 2025. Structured interviews and direct observations were used to assess sanitation infrastructure, workplace environment, and food handling practices. Logistic regression analysis was performed to identify environmental determinants of safe food handling practices. Only 48% of food handlers practiced safe food handling. The availability of functional hand washing facilities (AOR = 2.1; 95% CI: 1.4-3.2) and adequate kitchen ventilation (AOR = 1.8; 95% CI: 1.2-2.7) were significant predictors of safe practices, while poor sanitation conditions and vector infestation were common environmental risks. These findings indicate that structural and environmental factors play a central role in shaping safe food handling practices, highlighting the need for integrated interventions to strengthen WASH infrastructure, improve kitchen design, and enhance regulatory oversight in low-resource urban settings.

41. Aza-Coating Heptamethine Cyanines for Sensing pH Dynamics of Plants.

期刊: Chemistry, an Asian journal 发表日期: 2025-Dec-13 链接: PubMed

摘要

As a key parameter in organismal growth and development, pH is essential for maintaining internal environmental homeostasis, ensuring normal metabolic processes, and coordinating the functions of various organ systems. In this study, we developed a series of aza-IR780-based heptamethine cyanine ketones that exhibit remarkable pH-responsive behavior, governed by keto-enol tautomerism occurring along the conjugated polyene backbone of the cyanine scaffold. Under neutral conditions, these cyanines predominantly adopt the keto form, displaying a fluorescence emission maximum at approximately 640 nm. In acidic environments, however, they shift to the enol form, resulting in a distinct fluorescence redshift to around 740 nm. This pronounced pH-dependent spectral response enables real-time visualization and monitoring of pH fluctuations within plant tissues. Our work thus offers a promising molecular tool for noninvasively imaging the microenvironment in plants.

42. Morph-specific selection drives phenotypic divergence in color polymorphic tawny owls (Strix aluco) in Northern Europe.

期刊: Communications biology 发表日期: 2025-Dec-13 链接: PubMed

摘要

There is a long tradition in using genetically based color polymorphisms in natural populations to study evolutionary processes. Despite growing evidence for continuous phenotypic variation within discrete morphs, we still know little about how this shapes selective dynamics. Here, using 43 years of plumage color data from a Finnish tawny owl population (Strix aluco), we show that gray and brown morphs exhibit substantial intra-morph variation, which has diverged over time. Plumage in the brown morph became increasingly pigmented, while the gray morph showed an abrupt shift toward lighter coloration. By examining both adult and offspring plumage, we identified morph-specific drivers of these trends: in gray owls, reduced pigmentation appears linked to extreme winters that eroded standing genetic variation, likely constraining their evolutionary response. In contrast, brown morph dynamics were shaped by an interaction between plumage coloration, reproductive success, and breeding timing, along with stronger temperature effects during the pre-fledging period. These findings suggest that intra-morph variation determines each morph’s response to selection pressures, potentially influencing their ability to track shifting phenotypic optima. Our work highlights the relevance of phenotypic variation within genetically discrete morphs for evolutionary processes, including how populations respond to environmental change.

43. A peak comparison index approach for robust microplastic analysis across environmental matrices: validation using meat products.

期刊: Scientific reports 发表日期: 2025-Dec-13 链接: PubMed

摘要

Microplastic contamination in food products raises significant concerns regarding human health and environmental safety, necessitating accurate detection methodologies for complex organic matrices. This study presents an effective framework for microplastic detection in meat by systematically evaluating four chemical digestion methods: hydrogen peroxide (H2O2), hydrochloric acid (HCl), sodium hydroxide (NaOH), and Fenton’s reagent. Among these, HCl and NaOH demonstrated the highest organic matter removal efficiencies while preserving polymer integrity across polyethylene (PE), polystyrene (PS), and polyvinyl chloride (PVC) samples. A novel peak comparison index (PCI) quantitatively assesses spectral alterations, identifying NaOH as the least disruptive digestion method. Furthermore, the systematic comparison of digestion-induced polymer modifications enhances the standardization of microplastic analysis, facilitating methodological harmonization across food systems and broader environmental matrices. These findings establish a robust analytical approach for improving microplastic detection accuracy, strengthening risk assessments, and supporting contamination mitigation strategies within food supply chains.

44. Parental socioeconomic composition of birth cohorts changed during the COVID-19 pandemic.

期刊: Nature communications 发表日期: 2025-Dec-13 链接: PubMed

摘要

The COVID-19 pandemic offers opportunities to study effects of in-utero and early life exposure to environmental changes. However, inferences from such studies may be flawed if the pandemic has changed the socioeconomic composition of parents. Analysing over 77.9 million live births from 15 countries, we estimate changes in the socioeconomic composition of the cohort born between December 2020 and December 2021 using interrupted time series analysis. We find that, compared with their counterfactual compositions, the December 2020-December 2021 birth cohort has a higher proportion of babies born to socioeconomically advantaged parents in Austria, England, Finland, the Netherlands, Scotland, Spain, Wales, and the United States while we observe the opposite change for Brazil, Colombia, Ecuador, and Mexico. These changes in cohort composition may cause between-cohort differences in life course outcomes that are influenced by parental socioeconomic circumstances even if early life exposure to the pandemic had no direct effect on this birth cohort.

45. Protein-nucleic acid language model-assisted design of precise and compact adenine base editor.

期刊: Nature communications 发表日期: 2025-Dec-13 链接: PubMed

摘要

Adenine base editors (ABEs) are powerful tools for gene therapy. However, efficient version of ABEs (e.g. ABE8e) always induce excessive bystander and off-target editing events and are large in size, hindering their potential in clinical disease treatment. Here, we develop a pre-trained Protein-Nucleic Acid Constrained Language Model to design ABE8e with high activity, reduced editing window and decreased size. By further engineering, the smallest ABE8e- PNLM-pcABE- with a 27% size reduction, exhibits high activity, precise 3-nt editing window, and reduced off-target events near background level in HEK293T cells. Compared to ABE8e, PNLM-pcABE has up to 133.5-fold precision improvement in pathogenic mutation correction. By PNLM-pcABE, the albino mouse model carrying desired base mutation is nearly 100% obtained via zygotes microinjection and the expression of PCSK9 substantially decreases in mice receiving in vivo delivery with lipid nanoparticle (LNP), indicating their great potential in gene therapy and disease modeling.

46. The complexity of outcome measure selection within multiple long-term condition research: an analysis of exercise-based rehabilitation trials.

期刊: Trials 发表日期: 2025-Dec-13 链接: PubMed

摘要

Consistent evidence has demonstrated the health benefits of exercise-based rehabilitation across various long-term conditions (LTC); however, evidence in people with multiple LTC (MLTC; or ‘multimorbidity’) is unclear. Development and evaluation of these interventions for MLTC requires a consensus on relevant outcome measures. We aimed to map the outcomes collected and reported in trials of exercise-based rehabilitation in people with MLTC to an existing core outcome set for MLTC (COSmm), and compare to outcomes reported in exercise-based rehabilitation trials of single LTC. A secondary analysis of two systematic reviews assessing exercise-based rehabilitation in MLTC. Outcome measures within included trials were categorised into domains and mapped to the existing COSmm. Domains and measures were also extracted from an overview of systematic reviews investigating exercise-based rehabilitation across single LTC. Two hundred seventeen outcome measures across 59 trials of exercise-based rehabilitation for MLTC were identified. The most common domains were exercise capacity (26 outcomes across 41 trials (69.5%)) and health-related quality of life (18 outcomes across 35 trials (59.3%)). Mapping to COSmm showed consistency in the collection and reporting of outcomes in the domains of physical function, health-related quality of life, mental health, and intervention adherence. However, no outcome measures could be mapped to domains of communication, shared decision-making, prioritisation, or quality healthcare. Analysis of the overview of systematic reviews across single LTC found heterogeneity in outcome measures with common measures being relatively similar to those reported in MLTC populations. Current outcomes collected and reported in published trials of exercise-based rehabilitation for MLTC appear to only partially map to the domains of the COSmm. This review highlights the need to consider the specific core outcome set domains needed for collection in future trials of intervention for MLTC including exercise-based rehabilitation.

47. Responding to a warming planet: a scoping review of climate change literacy, perceived health impacts, and mental health outcomes among African students.

期刊: Archives of public health = Archives belges de sante publique 发表日期: 2025-Dec-13 链接: PubMed

摘要

Climate change represents an urgent global health and environmental challenge, with youth in Africa, who account for over 60% of the continent’s population, being disproportionately affected due to limited adaptive capacities, inadequate education, and fragile mental health systems. Climate change literacy, defined as the ability to obtain, process, and apply climate-related information, is crucial for fostering awareness, adaptive behaviours, and psychological resilience among students. Simultaneously, growing evidence points to the mental health consequences of climate change, including anxiety, distress, and emotional exhaustion. Given the growing urgency to address these converging challenges, a comprehensive understanding of the existing evidence is needed. This scoping review aims to systematically map the literature on climate change literacy, perceived health effects, and climate-related mental health outcomes among African students. It seeks to identify key themes, highlight gaps in knowledge, and inform future research, educational programming, and policy interventions aimed at building climate resilience among African youth. This scoping review followed the PRISMA-ScR guidelines. A comprehensive literature search was conducted across seven databases: PubMed, Scopus, Embase, Web of Science, ScienceDirect, AJOL, and PsycINFO. Peer-reviewed primary studies published between January 2014 and March 2024 were included. Eligible studies involved African students at primary, secondary, or tertiary education level and reported on at least one of the following: climate change literacy, perceived health impacts of climate change, or mental health outcomes related to climate change. Two reviewers independently screened articles, extracted data, and charted key findings. The results were synthesized both numerically and thematically, with a narrative summary used to integrate and interpret the evidence. A total of 5,256 records were retrieved, and finally 23 studies included for final analysis. The 23 included studies, spanning 12 African countries and involving 20,531 participants, revealed considerable variability in students’ climate change literacy, health perceptions, and mental health responses. While university students generally exhibited moderate to high knowledge and positive attitudes, misconceptions and limited behavioural engagement persisted, particularly among primary and secondary school students. Students perceived climate change as a driver of vector-borne diseases, malnutrition, respiratory illnesses, and heat stress. Mental health impacts, including anxiety, depression, and emotional distress, were reported in several studies, yet remain underexplored. Key barriers to climate literacy and engagement included curriculum gaps, limited institutional support, and socio-cultural misconceptions, whereas facilitators included media exposure, peer dialogue, and experiential learning opportunities. This scoping review reveals substantial variability in climate change literacy, perceived health effects of climate change, and mental health outcomes of climate change among African students. While university students generally show higher awareness and engagement, misconceptions, weak curriculum integration, and limited behavioural action persist. Students increasingly recognize climate-related health risks such as vector- and waterborne diseases, malnutrition, and heat-related illnesses yet mental health impacts, including anxiety and emotional distress, remain underexplored. The review underscores the need for standardized, age-appropriate climate education integrated with public and mental health content. It calls for educator capacity building, experiential learning, institutional mental health support, and student empowerment through climate action platforms. A multi-sectoral approach is essential to develop informed, resilient, and engaged African youth to lead sustainable climate solutions. A protocol for this scoping review was pre-registered with the Open Science Framework (OSF) (link: https://osf.io/mrbfn).

48. Environmental exposures associated with the gut microbiome and resistome of pregnant women and children in Northwest Ecuador.

期刊: Nature communications 发表日期: 2025-Dec-13 链接: PubMed

摘要

Inadequate water, sanitation, and hygiene (WASH) infrastructure may increase exposure to antimicrobial resistance (AMR). In addition, close human-animal interactions and unregulated antibiotic use in livestock facilitate the spread of resistant bacteria. We use metagenomic sequence data and multivariate models to assess how animal exposure and WASH conditions affect the gut resistome and microbiome in 53 pregnant women and 84 children in Ecuador. Here we show improving WASH infrastructure and managing animal exposure may be important in reducing AMR but could also reduce taxonomic diversity in the gut. Escherichia coli, Klebsiella pneumoniae, and clinically relevant antimicrobial resistance genes (ARGs) are detected across all age groups, but the highest abundance is found in children compared to mothers. In mothers, higher animal exposure trends towards a higher number of unique ARGs compared to low animal exposure and is significantly associated with greater taxonomic diversity. In addition, mothers with sewer systems or septic tanks and piped drinking water have fewer unique ARGs compared to those without, and mothers with longer duration of drinking water access have lower total ARG abundance. In contrast, few associations are observed in children, likely due to the dynamic nature of the gut microbiome during early childhood.

49. Throat carriage with methicillin-resistant Staphylococcus aureus: a cohort study on the effectiveness of topical eradication treatment.

期刊: Antimicrobial resistance and infection control 发表日期: 2025-Dec-13 链接: PubMed

摘要

Eradication treatment of methicillin-resistant Staphylococcus aureus (MRSA) carriers is an effective strategy to reduce transmission and infection rates. However, throat carriage is associated with treatment failure, and the optimal treatment for these patients remains uncertain. This study evaluated the effectiveness of topical eradication treatment in a cohort of patients with throat carriage and identified risk factors for treatment failure. This population-based cohort study included residents of the North Denmark Region with first-time MRSA throat carriage between January 1, 2017, and December 31, 2020. Exclusions included patients under two years of age, those with occupational livestock exposure, and patients receiving systemic antimicrobial treatment. Successful eradication was defined as being MRSA-free six months after one or two topical treatment courses. Multivariable analysis assessed risk factors for treatment failure, including selected patient, environmental, and strain-related factors. Of 319 MRSA throat carriers, 258 completed the follow-up test six month after treatment. Among patients who completed follow-up, the overall eradication success rate was 43.4%. Throat carriers without additional risk factors for treatment failure achieved a 54.7% success rate, while those with additional risk factors had success rates ranging from 28.6% to 55.6%, depending on specific risk factors. Throat carriage combined with younger age, colonization by non-CC398 MRSA strains, and having MRSA-positive household members were associated with treatment failure. Initial topical treatment may be appropriate for MRSA throat carriers without additional risk factors, with over half achieving long-term eradication. This approach is especially relevant given the potential adverse effects of systemic antibiotics.

50. The impact of loneliness on balance learning ability in aging patients with Parkinson's disease.

期刊: BMC geriatrics 发表日期: 2025-Dec-13 链接: PubMed

摘要

Loneliness is highly prevalent among patients with Parkinson’s disease (PwPD) and, through complex body-brain interactions, increases their vulnerability to health issues, including balance impairments. Despite extensive evidence linking loneliness to cognitive-motor dysfunctions, the direct impact of loneliness on motor learning, particularly dynamic balance learning, has not been comprehensively examined. As the first study in this field, our research investigates the effect of loneliness on the ability to learn dynamic balance in PwPD, addressing a critical research gap in this domain. This study was conducted over six months with the participation of sixty volunteers divided into three distinct groups: 20 PD patients who reported loneliness (loneliness-positive group), 20 PD patients who did not report loneliness (loneliness-negative group), and 20 healthy individuals as the control group. Participants were matched for sex, age, and body mass index (BMI) and were recruited from hospitals and specialized movement disorder clinics. We utilized standardized instruments, including the Mini Balance Evaluation Systems Test (MiniBESTest) to assess balance performance, the de Jong-Gierveld Loneliness Scale (DjG)/ the Three-Item Loneliness Scale (TILS/ the Social and Emotional Loneliness Scale for Parkinson’s Disease (SELSA-PD) to assess loneliness levels, the Rosenberg Self-Esteem Inventory (RSI) to assess self-steem, and the Multidimensional Scale of Perceived Social Support (MSPSS) to assess social support in one day before performing balance learning task. Additionally, balance learning was evaluated using a stabilometer, and parameters such as learning rate, learning curve slope, and short- and long-term memory were analyzed. The results indicated that PwPD in the loneliness-positive group exhibited poorer balance performance (MiniBESTest) and higher scores on various loneliness scales, including DjG, TILS, and SELSA-PD. Additionally, this group did not demonstrate balance learning potential (learning rate and slope) compared to the other groups. In contrast, PD patients in the loneliness-negative group showed improvement in the early stages of balance learning (Block1 vs. Block3: p = 0.001; Block1 vs. Block4: p = 0.001; Block1 vs. Block5: p < 0.001; Block2 vs. Block5: p = 0.014).), while the control group exhibited continuous improvement (p = 0.00). Both the loneliness-negative and control groups retained their balance skills in both short-term and long-term assessments (p > 0.05). This study is the first to directly examine the impact of loneliness on dynamic balance learning in PwPD. The findings revealed that loneliness can act as a significant inhibitory factor in balance rehabilitation for these patients. The results underscore the importance of designing targeted interventions to reduce feelings of loneliness to enhance balanced learning. Furthermore, the study paves the way for future research to investigate the underlying neural mechanisms and explore the effects of social and psychological interventions on improving motor learning in these patients.

51. Atopic diseases in pediatric population: prematurity and small for gestational age.

期刊: BMC pediatrics 发表日期: 2025-Dec-13 链接: PubMed

摘要

Atopic diseases, including asthma, atopic dermatitis (AD), allergic rhinitis (AR), and food allergy, are significant chronic conditions in the pediatric population. Prematurity and small-for-gestational-age (SGA) status are critical factors influencing long-term health outcomes. This study investigated the associations between prematurity, SGA, and the development of atopic diseases in children using a nationwide longitudinal cohort. We analyzed data from Taiwan’s National Health Insurance Research Database (NHIRD), which includes nearly all residents. The cohort comprised infants born between January 1, 2004, and December 31, 2019, excluding those with early death and multiple births. Premature or SGA infants were designated as study cases, while term, appropriate-for-gestational-age (AGA) infants served as controls. Kaplan-Meier analysis estimated cumulative incidence, and log-rank tests compared disease risk across groups. Cox proportional hazards models, adjusted for demographics, pregnancy-related factors, socioeconomic status, and urbanization, were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). A total of 1,758,460 infants (914,713 males; 843,747 females) were included. Prematurity was associated with increased risks of AR (HR, 1.03) and asthma (HR, 1.19 in males; HR, 1.17 in females) but a lower risk of AD (HR, 0.94 in males; HR, 0.95 in females) in the AGA group. SGA was not associated with atopic diseases in term infants. Prematurity was linked to higher risks of asthma and AR and a lower risk of AD, while SGA status showed no association with atopic diseases in term infants. Further studies are needed to clarify underlying mechanisms and assess causality.

52. Lyme Disease: An Emerging Threat.

期刊: The Journal of the Association of Physicians of India 发表日期: 2025-Dec 链接: PubMed

摘要

Lyme disease (LD) is a multisystem inflammatory zoonosis affecting the skin, heart, nervous system, and joints, transmitted by ticks and caused by infection with species of the Borrelia burgdorferi sensu lato (B. burgdorferi s.l.) complex. It is the most common emerging vector-borne disease in the United States. The Centers for Disease Control and Prevention (CDC) estimated the annual occurrence of 3,29,000 cases of LD in the United States during 2005-2010, and it increased to 4,76,000 during 2010-2018. The incidence of various clinical manifestations of LD differs among countries or regions based on the prevalent genospecies of the B. burgdorferi s.l. complex responsible for infection. Ticks of Ixodes spp. are the main vectors involved in the transmission of LD, which occurs mainly during the spring season. However, in North America and Europe, there is a rise in temperature due to global warming, leading to the extension of tick habitats toward northern areas. These ticks now stay active for an extended period of the year, increasing the chances of transmission to humans, and it is postulated to be one of the reasons responsible for the rising cases of LD. Early diagnosis and treatment with appropriate antibiotics can resolve the early manifestations of LD and prevent subsequent complications, which are known to occur if not treated appropriately. The disease is most common in rural areas and is difficult to differentiate clinically from other tropical infections such as rickettsial infections. The literature on LD in India is limited; however, LD has been reported from at least 12 states of India. A recently concluded study by the Indian Council of Medical Research (ICMR) has documented the seroprevalence of this disease in eight sites situated in areas of North (Himachal Pradesh and Haryana) and Northeast India (Meghalaya, Assam, Mizoram, and Tripura). LD remains grossly underdiagnosed in India. The lack of awareness among clinicians regarding the prevalence of LD and the limited availability of diagnostic investigations may have contributed toward it. LD should no longer be confined to textbooks, but it should find a place in the list of differential diagnoses in clinical practice. This review is an endeavor to sensitize physicians regarding LD and its impending rise worldwide due to global warming.

53. Reimagining Type 1 Diabetes Care in India: A Three-decade Reflection on Challenges, Innovations, and Opportunities since the Diabetes Control and Complications Trial.

期刊: The Journal of the Association of Physicians of India 发表日期: 2025-Dec 链接: PubMed

摘要

Three decades after the landmark Diabetes Control and Complications Trial (DCCT), type 1 diabetes (T1D) care in India continues to face systemic, socioeconomic, and technological challenges. Despite a relatively lower incidence compared to high-income countries, India bears a disproportionate burden of T1D-related morbidity and premature mortality due to late diagnoses, fragmented care, limited access to insulin, and underutilization of glucose-monitoring technologies. This editorial explores the current landscape of T1D management in India through the lens of the T1D Index, highlighting critical disparities in care quality, life expectancy, and health-adjusted life years lost. We reflect on the need for a national T1D registry, improved access to advanced therapies such as continuous glucose monitoring (CGM) and automated insulin delivery (AID) systems, and the establishment of multidisciplinary pediatric diabetes centers. The manuscript emphasizes systemic reforms, including public-private partnerships, indigenous manufacturing of diabetes technologies, and expanded education and psychosocial support frameworks. By integrating global best practices with localized solutions, India can bridge the care gap and redefine T1D outcomes for future generations.

54. The Interplay of Age, Obesity Measures, and Micronutrient Deficiencies in PCOS-associated Metabolic Dysfunction Findings from a Retrospective Postobservational Cohort Study.

期刊: The Journal of the Association of Physicians of India 发表日期: 2025-Dec 链接: PubMed

摘要

Polycystic ovary syndrome (PCOS) is a complex endocrine-metabolic disorder with significant age-related, anthropometric, and metabolic variations. Understanding the interplay between age, body composition, and micronutrient status can help identify predictors of metabolic dysfunction and long-term complications in women with PCOS. Most studies assess these factors in isolation, resulting in fragmented evidence and inconsistent conclusions. This study aimed to evaluate the predictive associations of age, anthropometric parameters, and micronutrient levels (vitamin B12 and vitamin D3) with key metabolic, cardiovascular, and nutritional markers in women diagnosed with PCOS. A cross-sectional analysis was conducted among women with PCOS, divided into two age-groups: group I (15-30 years) and group II (31-40 years). One-way analysis of variance (ANOVA) and linear regression analyses were performed to investigate age- and obesity-related differences in metabolic parameters. Pearson’s correlations and regression models were applied to assess the predictive strength of age, body mass index (BMI), waist circumference (WC), vitamin B12, and vitamin D3 on metabolic outcomes. The Benjamini-Hochberg method was applied to control the false discovery rate (FDR) for multiple comparisons and ensure conclusions account for the increased risk of type I error due to multiple comparisons, thereby supporting the validity of the study’s observations. The PCOS cohort exhibited generalized overweight (BMI 23.0-24.9 kg/m2) and obesity (BMI ≥25.0 kg/m2) in 40 and 54% of subjects, respectively; notably, visceral obesity (WC ≥80 cm) was present in 97% of the cohort, underscoring a marked predominance of central adiposity even among those with lower BMI thresholds. The PCOS cohort demonstrated high metabolic risk, with frequent insulin resistance, dyslipidemia, and hypertension; notably, 25% had nonalcoholic fatty liver disease (NAFLD), predominantly mild steatosis, indicating a substantial risk for future cardiometabolic complications. Advancing age was significantly associated with higher fasting blood sugar (FBS) (p = 0.019) and glycated hemoglobin (HbA1c) (p = 0.048), while fasting insulin declined with age (p = 0.048). BMI and WC were strong predictors of metabolic risk, positively impacting fasting insulin, FBS, HbA1c, and blood pressure (p < 0.05), while showing significant negative associations with high-density lipoprotein cholesterol (HDL-C) (p < 0.001). Vitamin B12 and D3 levels showed no significant impact on metabolic parameters. Vitamin B12 was predicted only by age (p < 0.001) and vitamin D3 (p < 0.001), while vitamin D3 was influenced by age (p < 0.001) and vitamin B12 levels (p = 0.041). Central obesity markers-particularly WC and BMI-are robust predictors of metabolic dysfunction in PCOS, offering greater prognostic value than micronutrient levels such as vitamin B12 or D3, which showed limited association with metabolic disturbances in this population. These findings highlight the primacy of early detection and intervention targeting adiposity and insulin resistance to reduce long-term cardiometabolic risk among women with PCOS. Integrated, multifactorial risk assessment remains essential, as age, nutritional deficits, and obesity-related factors independently and collectively drive adverse metabolic outcomes in PCOS, emphasizing the need for comprehensive preventive and management strategies.

55. Clinicopsychological Profile of Geriatrics Patient Visiting the Outpatient Department of a Tertiary Care Center of Western Uttar Pradesh: A Cross-sectional Study.

期刊: The Journal of the Association of Physicians of India 发表日期: 2025-Dec 链接: PubMed

摘要

The geriatric population is highly vulnerable to both clinical and psychological comorbidities; the psychological health of geriatric patients remains underassessed, particularly in government outpatient department (OPD) settings where multiple chronic illnesses, low socioeconomic status, and hospitalization disrupt emotional well-being. To evaluate the prevalence and association of chronic diseases with depression, anxiety, cognitive impairment, and sleep quality in elderly patients. A cross-sectional study was conducted on 100 patients aged ≥60 years attending the medicine OPD. Geriatric depression scale (GDS-15), generalized anxiety disorder scale (GAD-7), mini-mental state examination (MMSE), and Pittsburgh sleep quality index (PSQI) scales were used to assess psychological status. Clinical parameters and recent hospitalization history were also recorded. Hypertension (45%), diabetes (35%), and osteoarthritis (25%) were the most prevalent chronic illnesses. Mild depression (56%), mild anxiety (45%), cognitive impairment (45%), and poor sleep quality (78%) were common. Coronary artery disease (CAD) was significantly correlated with depression (p = 0.008), diabetes with cognitive decline (p = 0.002), and recent hospitalization with cognitive scores (p = 0.006). The study underscores the need for integrated psychological assessment and intervention in geriatric medicine, even in resource-constrained OPD environments. Chronic illnesses such as CAD and diabetes significantly affect psychological well-being in elderly patients. Routine psychological screening is essential in OPDs.

56. Correlation between Serum Uric Acid Level and Left Ventricular Ejection Fraction in Patients with Heart Failure.

期刊: The Journal of the Association of Physicians of India 发表日期: 2025-Dec 链接: PubMed

摘要

Heart failure (HF) is a major public health concern with increasing prevalence worldwide. Serum uric acid (SUA) has been proposed as a potential biomarker in HF, with its levels potentially correlating with the severity of systolic dysfunction. However, the relationship between SUA and left ventricular ejection fraction (LVEF) remains unclear. A cross-sectional study was conducted at DY Patil University School of Medicine, Navi Mumbai, involving 60 patients diagnosed with HF. Patients were categorized based on LVEF into HF with preserved ejection fraction (HFpEF), mid-range ejection fraction (HFmrEF), and reduced ejection fraction (HFrEF). SUA levels were measured, and patients were classified into hyperuricemia or normal uric acid level groups. Demographics, comorbidities, and clinical symptoms were also recorded. Statistical analysis was performed to determine the correlation between SUA and LVEF. Of the 60 patients enrolled, 65% were female, with a mean age of 61-70 years. The majority had HFrEF (70%), followed by HFmrEF (26.67%) and HFpEF (3.3%). Hyperuricemia was observed in 38.3% of patients. A weak negative correlation was found between LVEF and SUA (r = -0.070), which was not statistically significant (p = 0.599). Although hyperuricemia was more prevalent in HFrEF, no significant relationship was established between SUA levels and severity of systolic dysfunction. The study found a weak and statistically insignificant correlation between SUA levels and LVEF in HF patients. This suggests that SUA may not be a reliable biomarker for assessing the severity of systolic dysfunction. Further studies involving larger, more diverse populations are needed to clarify the prognostic role of SUA in HF.

57. A Narrative Review of Strengthening Cardiac Rehabilitation in India: Challenges and Opportunities.

期刊: The Journal of the Association of Physicians of India 发表日期: 2025-Dec 链接: PubMed

摘要

Cardiac rehabilitation (CR) is a critical component of secondary prevention in cardiovascular disease (CVD) management. In India, where CVD prevalence is rising rapidly, CR remains severely underutilized due to multiple systemic barriers. These include limited infrastructure, insufficient funding, low awareness, and inequitable access across urban and rural regions. This review assesses the current CR landscape in India, contrasts it with global benchmarks, and highlights key implementation gaps. It further explores scalable solutions such as telerehabilitation, community-based programs, and integrated multidisciplinary models. The paper emphasizes the need for robust policy frameworks, sustainable funding, infrastructure strengthening, and comprehensive workforce development. Achieving universal access to CR in India demands a multisectoral, collaborative approach involving government agencies, healthcare providers, academic institutions, nongovernmental organizations (NGOs), and private stakeholders. Enhancing CR services is not only a clinical necessity but also a national public health priority.

58. Sodium-Glucose Cotransporter 2 Inhibitors Use and Adverse Kidney Outcomes in Patients Receiving Contrast Media.

期刊: Clinical and translational science 发表日期: 2025-Dec 链接: PubMed

摘要

The kidney benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in patients receiving contrast media remain unclear. This Taiwanese cohort study investigated the short- and long-term effects of SGLT2i on adverse kidney outcomes in patients receiving contrast media between January 1, 2016 and December 31, 2018. Patients who had used SGLT2i in the 90 days prior to receiving contrast media were matched with non-users. Cox proportional hazards regression was used to estimate the hazard ratio (HR) for the composite kidney outcome, which included acute kidney injury (AKI), acute kidney disease (AKD), and a sustained ≥ 30% reduction in estimated glomerular filtration rate (eGFR) confirmed after 3 months. The absolute mean change in eGFR over time was compared using a linear mixed-effects model. The final analysis included 1032 patients (SGLT2i: 344; control: 688). During follow-up, the overall composite adverse kidney event rate was 32.8%. Although the SGLT2i group had a lower event rate (29.94%) than the non-SGLT2i group (34.3%), this difference was not statistically significant (HR, 0.95; 95% CI, 0.75-1.20). Crucially, SGLT2i demonstrated a significant protective effect on long-term kidney function: the hazard for a ≥ 30% eGFR reduction was significantly lower in SGLT2i users (HR, 0.48; 95% CI, 0.29-0.81). Exploratory analyses showed that this benefit-a slower rate of kidney function deterioration-was consistent across subgroups, including men, patients under 65 years, individuals with baseline eGFR < 60 mL/min/1.73 m2, and patients with diabetes. While SGLT2i showed no significant short-term protection against AKI or AKD, these findings strongly suggest that SGLT2i confers significant long-term reno-protective benefits for patients receiving contrast media.

59. [Genetic Aspects of the Application of Tissue-Engineered Constructs in Regenerative Therapy in Cardiology: An Analytical Review].

期刊: Molekuliarnaia biologiia 发表日期: 2025 链接: PubMed

摘要

Traditional methods of treatment and prevention of cardiovascular disease (CVD) are not always effective, especially in severe myocardial injury. One of the promising areas for the treatment of cardiac pathologies is cell transplantation using tissue-engineered constructs from allogeneic stem cells, such as cell sheets. The success of cell therapy depends on the severity of local inflammatory reactions, angiogenesis activity, and the resistance of transplant cells to hypoxia and apoptosis, as well as on their production of the extracellular matrix. Single nucleotide polymorphisms (SNPs) in genes involved in the processes associated with CVD can serve as markers of genetic dysfunction of these genes in the cardiovascular system and be used to predict the efficacy of therapy for heart disease based on tissue-engineered constructs. This review systematizes the information, allowing us to form a panel of such SNPs and analyze it. We identified seven genes at the intersection of pathways that are key to the survival of cellular constructs, VEGFA, TGFB1, FN1, IL6R, ITIH4, NRP1, and CDH13, and selected SNPs rs998584, rs8108632, rs1250259, rs6689306, rs77347777, rs75082222, and rs6565060, which are located in the regions of these genes and associated with CVD according to the Genome-Wide Association Studies (GWAS). These polymorphisms may constitute a minimal panel to search for an association with the efficacy of cell therapy in heart disease.