公共卫生研究摘要 (2025-12-17)
共收录 51 篇研究文章
1. High Relapse Rate in Anti-CASPR2 Disease: Implications for Prolonged Immunotherapy.
期刊: Neurology(R) neuroimmunology & neuroinflammation 发表日期: 2026-Jan 链接: PubMed
摘要
Anti-contactin-associated protein-like 2 (CASPR2) disease-previously considered a subtype of anti-voltage-gated potassium channel (VGKC-complex) encephalitis-is a relatively new disease entity, and information on long-term outcomes and relapses is limited. We investigated long-term clinical outcomes and factors associated with higher relapse rates. In addition, we compared different treatment strategies. In this nationwide observational cohort study, patients with anti-CASPR2 disease were included. Clinical data were collected at diagnosis and during follow-up, both retrospectively and prospectively. Forty-four patients with anti-CASPR2 disease were included (42 male patients [96%]; median age at onset 66 years [interquartile range (IQR) 61-71; range 40-86]). The median follow-up time was 55 months (IQR 38-78; range 8-200). Sixty percent of the patients experienced at least one relapse. Most patients experienced similar but fewer symptoms during relapse(s). However, new symptoms could occur during a relapse episode, mainly involving the peripheral nervous system. The median time to relapse was 10.5 months (IQR 6-14; range 3-58). Twelve of the 44 patients were diagnosed with cancer, with 3 cancers identified only at relapse. We found significantly higher anti-VGKC-complex concentrations at diagnosis (p = 0.043) and a higher occurrence of seizures (p = 0.041) in relapsing patients. In 94%, a clear correlation was observed between anti-VGKC-complex concentrations and the clinical status (59% decrease from diagnosis to post-treatment stage, 122.5% increase during the first relapse). In our total cohort, tapering with oral steroids seemed effective in reducing relapses during administration (annual relapse rate [ARR] 0.12) but did not prevent relapses beyond the taper. Second-line therapy also appeared effective (ARR 0.09) while steroid-sparing agents provided limited benefits (ARR 0.22). In patients prone to relapse, repeated courses of rituximab seem necessary to prevent further relapses (hazard ratio 26.33, p < 0.0005 in post-second-line treatment group; ARR 0.09 vs 0.81). The relapse rate in anti-CASPR2 disease is much higher than previously reported. In patients prone to relapse, (repeated) courses of rituximab appear to be most effective in preventing future relapses beyond acute therapy and tapering with oral steroids. Anti-VGKC-complex concentrations in serum can aid in monitoring of relapses and disease course in most of the patients. It is recommended to repeat tumor screening when patients relapse. This study provides Class IV evidence that, in anti-CASPR2 disease, prolonged immunotherapy is associated with reduced relapse rates.
2. Surveillance of adverse events following immunisation in Australia annual report, 2022.
期刊: Communicable diseases intelligence (2018) 发表日期: 2025-Dec-17 链接: PubMed
摘要
This report summarises Australia’s spontaneous surveillance data for non-COVID-19 vaccine adverse events following immunisation (AEFI) for 2022, reported to the Therapeutic Goods Administration (TGA). National spontaneous (passive) surveillance data for coronavirus disease 2019 (COVID-19) vaccine AEFI reported to the TGA are analysed and discussed in a separate companion publication. There were 3,642 AEFI reports for non-COVID-19 vaccines administered in 2022, representing an annual AEFI reporting rate of 14.0 per 100,000 population, compared with 13.4 per 100,000 population in 2021. This very small increase in the AEFI reporting rate in 2022 could potentially be related to the combination of several factors: a gradual return to pre-pandemic AEFI reporting patterns; new vaccination programs in response to outbreaks of emergent vaccine preventable diseases (Japanese encephalitis and mpox); and a change in the reporting activities of pharmaceutical sponsors. AEFI reporting rates for individual vaccines in 2022 were similar to 2021.
3. Surveillance of adverse events following immunisation in Australia annual report, COVID-19 vaccines, 2022.
期刊: Communicable diseases intelligence (2018) 发表日期: 2025-Dec-17 链接: PubMed
摘要
This report summarises Australia’s spontaneous surveillance data for adverse events following immunisation (AEFI) for COVID-19 vaccines given in 2022 reported to the Therapeutic Goods Administration (TGA). The TGA strongly promoted and facilitated adverse event reporting in preparation for and during the COVID-19 vaccine rollout as a core component of the most intensive vaccine safety monitoring ever conducted in Australia. There were 18,398 AEFI reports for COVID-19 vaccines administered in 2022, corresponding to an annual AEFI reporting rate of 89.6 per 100,000 doses of COVID-19 vaccines administered. The annual AEFI reporting rate for non-COVID-19 vaccines in 2022 was 18.8 per 100,000 doses administered to people of all ages. Overall, the most frequently reported symptoms were adverse events consistent with the expected side effects from vaccines, as reported in clinical trials. These were classified as ‘gastrointestinal nonspecific symptoms and therapeutic procedures’, headache, chest pain, myalgia and pyrexia. The most frequently reported adverse events of special interest were myocarditis and/or pericarditis, followed by thrombosis and thromboembolism, and anaphylaxis. Of all COVID-19 vaccine AEFI reports, 160 (0.9%) included a fatal outcome, of which over 60% were in people aged ≥ 60 years. Of these 160 reports, only one was assessed by a Vaccine Safety Investigation Group (VSIG) as a death likely to be causally linked to vaccination. This report confirms the value of spontaneous post-marketing vaccine pharmacovigilance, especially in the context of new vaccines using novel technologies and a near whole-of-population pandemic vaccination program. Ongoing safety monitoring continued to review and respond to reports of rare, unexpected conditions, such as myocarditis/pericarditis, with investigations resulting in changes to vaccine recommendations and product information. Overall, COVID-19 vaccine safety monitoring continued to demonstrate a reassuring safety profile for these vaccines, especially among children and adolescents aged 11 years and below, in whom COVID-19 vaccines were used for the first time in 2022 in Australia.
4. Australian National Enterovirus Reference Laboratory annual report, 2024.
期刊: Communicable diseases intelligence (2018) 发表日期: 2025-Dec-17 链接: PubMed
摘要
Having been declared polio-free by the World Health Organization (WHO) in 2000, Australia remains at risk of poliovirus importation until the virus is eradicated globally. Australia monitors for poliovirus by conducting surveillance for cases of acute flaccid paralysis (AFP) in children less than 15 years of age, as recommended by the WHO. Cases of AFP in children are notified to the Australian Paediatric Surveillance Unit or the Paediatric Active Enhanced Disease Surveillance System, and faecal specimens are referred for virological investigation to the National Enterovirus Reference Laboratory. In 2024, no cases of poliomyelitis were reported from clinical surveillance and Australia reported 2.04 non-polio AFP cases per 100,000 children, thereby meeting the WHO’s performance criterion for a sensitive surveillance system. Non-polio enteroviruses including enterovirus A71 were identified from clinical specimens collected from 14 AFP cases. Australia also performs enterovirus and wastewater surveillance to complement the clinical surveillance system focussed on children. In 2024, there were 21 different non-polio enterovirus types detected in 764 clinical specimens referred for enterovirus typing, while an ambiguous vaccine-derived poliovirus type 2 was detected through wastewater surveillance. In 2024, there were 99 cases of wild poliovirus reported from the two remaining endemic countries, Afghanistan and Pakistan. Another 319 cases of poliomyelitis due to circulating vaccine-derived poliovirus were reported across 21 countries.
5. Epidemiology of invasive group A streptococcal disease in the North East of Melbourne: insights from surveillance data.
期刊: Communicable diseases intelligence (2018) 发表日期: 2025-Dec-17 链接: PubMed
摘要
Invasive group A streptococcal disease (iGAS) was made a notifiable condition in Australia in July 2021 and in Victoria in February 2022. The North Eastern Public Health Unit (NEPHU) in metropolitan Melbourne began managing iGAS cases in May 2023 with little prior knowledge of local epidemiology. Case numbers in NEPHU increased by 139% from 64 in 2022 to 153 in 2023. The incidence rate increased from 3.5 per 100,000 population in 2022 to 8.4 per 100,000 population in 2023. The case fatality rate in NEPHU during this period was 6.9%, with almost half of all deaths among individuals aged 70 years and above. Chronic conditions were commonly reported in the cases’ clinical histories, with 29% of NEPHU cases reporting an underlying illness. International trends of increased incidence of iGAS have been reflected in the NEPHU catchment, albeit with only two years of surveillance data. Monitoring trends in iGAS is an ongoing priority for NEPHU, to better understand disease patterns within the catchment area and to inform public health actions.
6. An outbreak of genomically clustered group A Streptococcus in a school community, Victoria, 2023.
期刊: Communicable diseases intelligence (2018) 发表日期: 2025-Dec-17 链接: PubMed
摘要
In 2023, a global increase in invasive group A streptococcal disease (GAS) caused serious illness and death. The North Eastern Public Health Unit (NEPHU) in Victoria, Australia, identified an outbreak of GAS in a school in July 2023; we investigated to describe the epidemiology, to identify risk factors for severe disease, and to implement control measures. We defined confirmed cases as those with laboratory, clinical and epidemiological evidence. Probable cases had clinical evidence with an epidemiological link to a confirmed case but no laboratory evidence. Absentee data were collated for students preceding the onset of the index case. We developed an online, self-administered survey for all students to identify contacts with clinically compatible illnesses. Cultures were genomically sequenced. We identified 11 cases (five confirmed, six probable) among the cohort of 38 (a 29% attack rate), with onset dates from 24 July to 27 August 2023. The index case had a severe invasive GAS infection requiring hospitalisation; eight of 11 cases (73%) reported sore throat and one reported scarlet fever as their primary syndrome. Fifteen of 28 students (54%) were absent from the school during the period preceding the index case’s onset. We monitored for two incubation periods following the onset of the last case to 5 September 2023 (six days), with no further cases identified. Isolates all typed as emm1, with genomic clustering consistent with localised transmission. This outbreak demonstrated group A Streptococcus (GAS) transmissibility in a school with multiple clinical manifestations.
7. Comparing two acute post-streptococcal glomerulonephritis outbreaks in the Torres Strait and Northern Peninsula Area, Queensland.
期刊: Communicable diseases intelligence (2018) 发表日期: 2025-Dec-17 链接: PubMed
摘要
In late 2023, an outbreak report of acute post-streptococcal glomerulonephritis (APSGN) in the Torres Strait documented seven confirmed cases and one probable case. This prompted an island-wide mass drug administration of oral trimethoprim/sulfamethoxazole to children aged 12 months to 17 years of age, possibly the first of its kind in response to an APSGN outbreak. In early 2024, an APSGN outbreak was declared with one confirmed and two probable cases, in the nearby Northern Peninsula Area of Cape York. The public health response to this outbreak included screening all children between 12 months and < 17 years of age for skin sores and sore throats, with treatment provided as deemed clinically appropriate. Both outbreaks reported nil further cases in the four months following each response. The relative merits of the different approaches will be discussed.
8. Where the cooling water drifts: an outbreak of Legionella pneumophila serogroup 1 in the central business district of Sydney, December 2023 - January 2024.
期刊: Communicable diseases intelligence (2018) 发表日期: 2025-Dec-17 链接: PubMed
摘要
Legionnaires’ disease causes severe pneumonia. Outbreaks are infrequent in Australia, with cooling water systems (CWS) regulated to reduce risk. In summer 2024, a Legionella pneumophila serogroup 1 (Lp1) outbreak was detected in visitors to the Sydney central business district (CBD). We investigated to identify cases and to control the source. Case-patients were detected through routine laboratory notifications and classified as per surveillance case definitions. Case-patients were interviewed to determine symptoms, and environmental exposures 2-10 days prior to symptom onset. We mapped exposures sites and walking routes to identify areas for investigation. CWS in shared exposure areas were inspected and tested for Legionella. Historical results from routine CWS testing were reviewed. Genomic sequencing was performed on environmental and patient isolates. Clinician and public alerts were issued, and CBD building managers were reminded to maintain CWS. The investigation identified 15 legionellosis case-patients: two had Lp1 positive sputum cultures, 14 were hospitalised, and six required intensive care. All case-patients visited the CBD during the period 12-26 December 2023. Between 3-12 January 2024, testing was performed on 166 CWS across 118 CBD sites, and on three water fountains. Lp1 was cultured from one CWS. Genomic sequencing from five environmental and two clinical isolates showed a probable link. The positive CWS was decontaminated but continued to have Lp1 detected, possibly due to ongoing dust contamination, necessitating additional maintenance. Weeks later, a case-patient diagnosed in Europe, who had visited key exposure locations in the CBD during 21-23 December 2023, was epidemiologically linked to the outbreak; this took the total number of case-patients to 16. Our investigation indicated that a contaminated CWS may have been the source of this outbreak, with contamination potentially precipitated by nearby construction. This emphasises the importance of strengthening Australian CWS regulations to reduce Lp1 outbreak risk, and of timely reporting under International Health Regulations to identify additional outbreak cases.
9. A large foodborne outbreak of Salmonella Typhimurium linked to bánh mì, Western Australia, 2024.
期刊: Communicable diseases intelligence (2018) 发表日期: 2025-Dec-17 链接: PubMed
摘要
In March 2024, the Department of Health in Western Australia investigated an outbreak of Salmonella linked to a food venue serving bánh mì (Vietnamese sandwiches). Outbreak cases were notified via laboratories, health services, local government, and cases referring sick co-exposed individuals. Structured interviews were conducted to determine demographic, illness and food exposure histories, and descriptive analyses were performed. The investigation identified 146 outbreak cases linked to the food venue. All outbreak cases had symptoms of salmonellosis, and 34 cases (24%) were hospitalised. Descriptive analysis found a strong association between illness and the consumption of bánh mì (139 cases) or tofu salad (three cases) from the food venue. This finding was supported by environmental and laboratory evidence, with Salmonella Typhimurium multilocus variable-number tandem repeat analysis linking 112 cases (77%) to samples from the food venue’s benchtop blender and tofu mix. The contaminated blender had been used to make three products: chicken and pork liver pâté, raw-egg mayonnaise, and a crispy rice tofu. The liver was undercooked before blending and was suspected to be the most likely source of the outbreak. To control the outbreak, the venue stopped using the blender and switched to using commercial mayonnaise, and staff were trained on safer cooking and hygiene processes. The outbreak highlights the critical importance of application of food safety standards in commercial kitchens, especially in relation to commonly used appliances, and to raw liver and mayonnaise products. Furthermore, it demonstrated that open and timely communication between food businesses, local government, laboratories and health agencies are key to the rapid identification of, and response to, foodborne outbreaks.
10. 2025 Review of Public Health Laboratory Network Australia Neisseria gonorrhoeae National Nucleic Acid Amplification Testing Guidelines.
期刊: Communicable diseases intelligence (2018) 发表日期: 2025-Dec-17 链接: PubMed
摘要
Since the introduction of Neisseria gonorrhoeae nucleic acid amplification tests (NG-NAATs) into routine clinical use, false-positive results caused by cross-reaction with non-gonococcal Neisseria species have been an issue, particularly in specimens from the pharynx. Therefore, since 2005 in Australia, a confirmatory assay has been recommended, with a positive result issued only when both assays are concordant. At the request of the Public Health Laboratory Network (PHLN) Australia, the National Neisseria Network (NNN) met to review the 2015 PHLN NG-NAATs Guidelines in October 2024, in the context that some later generation N. gonorrhoeae NAATs have claims for testing pharyngeal samples without the need for supplemental testing for confirmation. Adequacy of performance in this context was considered by the NNN as a positive predictive value of 95% in line with World Health Organization guidance. Based on the 2024 review, it is recommended that: • Supplementary testing continue to be performed for all non-urogenital (pharyngeal and rectal) samples. • Supplementary testing be at the discretion of individual laboratories, based on local validation data demonstrating adequate performance based on WHO recommendations, for urogenital samples. Additional testing should continue to be considered when testing low-risk populations.
11. Cyberbullying and Mental Health in Children and Adolescents.
期刊: Annual review of clinical psychology 发表日期: 2025-Dec-16 链接: PubMed
摘要
Cyberbullying is a growing public health concern given its increasing prevalence, connection to mental health problems, and broader concerns about youth social media use. In this review, we define cyberbullying and its forms and provide information on prevalence and trends. We then contextualize cyberbullying within the larger research literature on digital technology use and mental health, detailing how this relationship varies depending on individual characteristics and how the technologies are being used. We then summarize the research on concurrent and long-term impacts of cyberbullying victimization and perpetration on internalizing and externalizing symptoms as well as the impacts on youth well-being. Mediating and moderating mechanisms that exacerbate risk and protect youth from adverse mental health impacts of cyberbullying are then explored. The evidence supporting cyberbullying prevention in school-based contexts and involving families is then presented. Finally, we discuss challenges in existing research, areas in need of further empirical investigation, and implications for practice and policy.
12. Challenges in Graphene-Based Biosensing: Exploring Critical Limitations and Strategies.
期刊: ACS sensors 发表日期: 2025-Dec-16 链接: PubMed
摘要
Pristine graphene, owing to its remarkable electrical and structural properties, has garnered significant interest as a sensing platform for such applications. In this study, we evaluate the use of 1-ethyl-3-(3-(dimethylamino)propyl) carbodiimide (EDC) and N-hydroxysuccinimide (NHS) chemistry to functionalize pristine graphene for the detection of antigens, essential for food safety and public health. However, our investigation reveals critical limitations in the reproducibility of both electrical and spectroscopic measurements post-functionalization. The unpredictable activation of pristine graphene surfaces via EDC-NHS coupling leads to inconsistent antigen immobilization, resulting in a high variability in sensor performance. Our studies, supported by Raman spectroscopy, indicate the absence of functionalization of the graphene surface via EDC-NHS chemistry. Our findings suggest that optimizing the functionalization protocol or employing alternative surface modification techniques, such as defect engineering or using linker molecules, is necessary to achieve consistent and reliable detection. This study sheds light on the challenges of using EDC-NHS chemistry with pristine graphene and provides a roadmap for improving sensor reproducibility in the detection of penicillin and cephalexin.
13. Analysis of Complaints After Suturing of Emergency Trauma: A Retrospective Study.
期刊: The Journal of craniofacial surgery 发表日期: 2025-Dec-16 链接: PubMed
摘要
Worldwide, the management of emergency trauma has turned into a significant public health challenge, and exploring the causes of complaints after suturing of emergency trauma is crucial for improving patient satisfaction. Aiming to understand the patients’ requirements, this study retrospectively analyzed all medical disputes resulting from emergency trauma suturing at the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences from 2017 to 2022. A descriptive analysis was conducted using Microsoft Excel to organize and summarize the information systematically. Subsequently, based on the causes of complaints, the complaints were categorized according to the standardized coding classification method of Reader et al SPSS software was used for the chi-square test to analyze the difference in complaint resolution efficiency between years. A total of 86 medical disputes were recorded during the study, and the number of complaints increased year by year. Patient complaints focused on hospital management and the doctor-patient relationships, rather than clinical problems. Complaints were mainly divided into clinical (23.26%), management (44.19%), and relationships (32.56%), among which the most frequently involved subcategories were treatment (31.15%) and security incidents (24.59%). Most complaints are resolved within a week. The majority of complaints were related to hospital management (including bureaucracy and financial issues) and doctor-patient relationships (particularly staff attitudes), rather than clinical issues.
14. Framework for enhancing project clients' commitment to health and safety in the Ghanaian construction industry.
期刊: International journal of occupational safety and ergonomics : JOSE 发表日期: 2025-Dec-16 链接: PubMed
摘要
Objectives. The health and safety (H&S) commitment level among construction project clients often remains minimal. Therefore, there is a need for a structured framework that delineates actionable strategies to enhance clients’ commitment to H&S. This study identified drivers for enhancing clients’ commitment to H&S and further developed a guiding framework to enhance clients’ commitment to H&S. Methods. The study employed a qualitative research design, utilizing a structured interview guide to gather data purposively from 22 professionals. Thematic analysis was used to analyse the textual data, and Pareto analysis was conducted to prioritize the identified critical and non-critical drivers. Results. The identified critical drivers were health and safety regulations reform, cost savings and reduced expenses, risk management and liability reduction, effective stakeholder engagement, strong relationships between clients and contractors, clients’ health and safety education, and high expectations from project stakeholders. The framework revealed that education, monitoring and innovation foster clients’ accountability and ensure sustained H&S performance. Conclusion. The study informs clients about effective strategies for integrating H&S concerns into their decision-making. The framework also serves as a basis for policy recommendations, providing data-driven insights into the development of regulations and guidelines for enhancing clients’ commitment to H&S.
15. Use of the ME-BYO Index, a Mobile Health App, During an Online Strength Training Program in Adults: Fidelity, Feasibility, and Acceptability Study.
期刊: JMIR human factors 发表日期: 2025-Dec-16 链接: PubMed
摘要
Although various apps have been developed to support health behaviors, they are mostly commercial, possibly limiting the number of users. The ME-BYO index was developed by Kanagawa Prefecture in 2019 to comprehensively and numerically measure and visualize an individual’s current health status and future disease risk by quantifying data. The ME-BYO index is free of charge, so it can be made available to as many prefectural residents as possible for health promotion. Effective online strength training programs are being developed that, when combined with ME-BYO index measurements, will help with both exercise habits and health management. In this study, we aimed to validate the fidelity, feasibility, and acceptability of self-measurement using the ME-BYO index during the implementation of an online strength training program. Participants were 23 adults aged 40 years or older who did not regularly perform muscle strengthening exercises. The strength training program was performed twice a week for 8 weeks (16 sessions in total), and the ME-BYO index was explained to the participants so that they could self-measure the ME-BYO index with a smartphone on the day of the strength training program, before its implementation. The ME-BYO index during the study period was continuously collected from the app, and the ME-BYO index adherence rate was calculated. Questionnaires were used to assess the feasibility (difficulty of measurement and motivation to improve lifestyle) and acceptability (intention to maintain measurement and appropriate frequency of measurement) of implementing and continuing the ME-BYO index measurements. Changes in the ME-BYO index between the first and second halves of the program period, examination of items strongly related to changes in the ME-BYO index, and a comparison of physical fitness and health outcomes before and after the program period were conducted. The mean ME-BYO index adherence rate during the strength training program was 89.4% (SD 17%). Regarding acceptability, the participants were highly motivated to continue measuring the ME-BYO index (77%), and the appropriate frequency of measurement was once a week and twice a week (31% and 31%, respectively). Panel data analysis of the self-measured ME-BYO index showed no significant change in the ME-BYO index score; however, it increased to a higher score. Examination of the items that increased the overall score indicated that systolic blood pressure, mental resilience, and Mini-Cog scores were the relevant factors. The pre- and postprogram measurements showed no significant changes in items other than physical fitness. The fidelity, feasibility, and acceptability of measuring the ME-BYO index during a regular online strength training program were high, suggesting that self-measurement of the ME-BYO index could be used to implement and maintain healthy behaviors. These findings suggest that the ME-BYO index can be recommended as a basic health app.
16. The prevalence of effective campus alcohol policies: results from a national probability sample of campuses.
期刊: Journal of American college health : J of ACH 发表日期: 2025-Dec-16 链接: PubMed
摘要
To collect and analyze campus alcohol policies (CAPs), a first “line of defense” for protecting students from alcohol-related harm, from post-secondary schools. A national probability sample of 45 post-secondary schools, stratified by length of undergraduate program (two versus four-year), region, and school size. CAPs were scored in three areas: (1) compliance with federal law; (2) clarity of language; and (3) effectiveness. Bivariate regression models tested whether and how policies varied by institution-level characteristics. Most schools (76%) complied with federal alcohol policy requirements but used “very difficult” language. “Wet” campuses in the Northeast scored the lowest for policy effectiveness, while “dry” campuses with more housing tended to have stronger policies. CAPs actively shape campus drinking environments, but effective ones are unevenly utilized. Future research should explore the impact of CAPs and state alcohol policy environments on specific alcohol-related consequences, both for student drinkers and students experiencing harms from others’ drinking.
17. Firearm Violence and Health in Policymaker Discourse: Mixed Methods Social Media Analysis.
期刊: JMIR formative research 发表日期: 2025-Dec-16 链接: PubMed
摘要
Since 2019, firearm violence has remained the leading cause of death for US children and adolescents aged 1-19 years. This crisis has spurred action from policymakers, health professionals, and advocates. However, political polarization has contributed to divergent views on the causes and appropriate responses to firearm violence. Communication by elected officials, especially on social media, plays a critical role in shaping public opinion and policy agendas. Understanding how state policymakers discuss firearm violence, including the use of causal blame, calls to action, and health-related narratives, can inform more effective public health strategies. This study aimed to examine how Pennsylvania state legislators discuss firearms and firearm violence on social media and assess the extent to which their messaging aligns with public health perspectives. We conducted a 2-phase mixed methods analysis of X (formerly known as Twitter; X Corp) posts by Pennsylvania state legislators from May 27, 2017, to July 26, 2022. Posts were grouped into 3 time periods surrounding the Tree of Life Synagogue mass shooting in Pittsburgh. Using a Boolean search strategy, we identified 4573 posts related to firearms and firearm violence. After removing reposts and non-English content, we randomly sampled 1491 (32.6%) original posts authored by 152 unique legislators. Posts were coded using a structured codebook based on the Multiple Streams Framework to capture rhetorical framing, causal blame, and policy content. Interrater reliability was high (Holsti coefficient >0.8). We used chi-square tests and multivariable logistic regression to assess associations between rhetorical elements and policy mentions, adjusting for time period. Mass shootings were the most frequently referenced category of firearm violence, peaking after the Tree of Life shooting (22/43, 51% vs 91/118, 77.1% vs 140/220, 63.6%; P=.004), while firearm suicide was rarely discussed. Posts using advocacy frames were nearly 5 times more likely to mention policy (adjusted odds ratio [aOR] 4.67, 95% CI 3.55-6.16), whereas those referencing mass shootings (aOR 0.54, 95% CI 0.37-0.77) or emotional appeals (aOR 0.53, 95% CI 0.40-0.69) were significantly less likely to do so. Most posts used general advocacy (aOR 2.97, 95% CI 2.13-4.13) and vague blame (aOR 8.26, 95% CI 6.02-11.35), resulting in nonspecific policy suggestions. Posts that attributed blame to firearm access were strongly associated with specific policy proposals (aOR 6.37, 95% CI 4.29-9.47) and inversely associated with general policy mentions (aOR 0.26, 95% CI 0.17-0.42). Only 9.4% (133/1422) of posts used health frames; when present, they more often referenced physical consequences (58/133, 43.6% vs 216/1358, 15.9%; P<.001). Pennsylvania legislators primarily focused on mass shootings and relied on emotional or symbolic language without proposing specific policies. Health frames were rare and typically focused on consequences rather than prevention. Findings highlight an opportunity to support policymakers with health-informed messaging strategies to promote actionable firearm violence prevention policies, particularly those addressing prevention.
18. Prevalence and Determinants of Adherence to Statin Therapy: A Systematic Review and Meta-Analysis.
期刊: European journal of preventive cardiology 发表日期: 2025-Dec-16 链接: PubMed
摘要
To estimate the prevalence of good adherence to statin therapy and identify demographic and clinical factors associated with adherence among adults prescribed lipid-lowering therapy (LLT) for atherosclerotic cardiovascular disease (ASCVD) prevention. We conducted a systematic search of PubMed and Scopus through May 2025 to identify randomized controlled trials, cohort, nested case-control, and cross-sectional studies evaluating adherence to statin monotherapy. Data were extracted on study design, participant demographics, comorbidities, adherence assessment method and duration, and statin type. A random-effects meta-analysis was performed. Study quality was assessed using the Newcastle-Ottawa Scale, and risk of bias in randomized trials was evaluated with the Cochrane RoB 2 tool. Subgroup and sensitivity analyses examined adherence variations by follow-up duration (<1, 1, >1 year), alternative adherence thresholds, and study quality. “Primary” non-adherence (failure to initiate prescribed therapy) was not reported in any of the included studies. Seventy-six studies encompassing 5,898,141 participants (median follow-up 24 months) were included. The pooled prevalence of good adherence (≥80% medication use) was 62.4% (95% CI: 58.3-66.5%), lower in primary (57.5%) than secondary (64.4%) prevention settings. Factors associated with lower adherence included female sex (RR=0.92), Black race (RR=0.66), smoking (RR=0.94), depression (RR=0.89), and heart failure (RR=0.96). Higher adherence was observed among older adults (RR=1.34), individuals with myocardial infarction (RR=1.28) or hypertension (RR=1.12), those with ≥2 comorbidities (RR=1.25), and patients with polypharmacy (RR=1.32). Subgroup and sensitivity analyses yielded consistent results. Adherence to statin therapy remains suboptimal and is significantly influenced by demographic and clinical factors. Targeted strategies are needed to improve adherence, particularly in high-risk groups. Statins are widely prescribed for the prevention and treatment of atherosclerotic cardiovascular disease (ASCVD), yet adherence to long-term therapy remains suboptimal. This systematic review and meta-analysis synthesizes evidence from 76 studies, including nearly 6 million individuals, to estimate adherence rates and identify the associated demographic and clinical determinants.Key finding 1: The pooled prevalence of good adherence (defined as ≥80% medication consumption) was 62.4%, with lower adherence observed in primary prevention (57.5%) compared to secondary (established ASCVD) prevention setting (64.4%). Decreased adherence is noted among women, younger adults, individuals with depression, current smokers, persons of Black or Hispanic ethnicity and heart failure patients.Key finding 2: Higher adherence is observed among older adults and those with a history of myocardial infarction, hypertension, or multiple comorbidities. Notably, polypharmacy (≥5 medications) is associated with greater adherence (a finding that contrasts with prior reports), which potentially reflects more intensive medical supervision or higher perceived cardiovascular risk in these populations and consorts with the higher adherence rates in those patients with established ASCVD. These findings underscore the persistent challenge of ensuring sustained statin use, particularly among populations with higher ASCVD risk. Despite robust clinical guidelines and extensive evidence of benefit, nearly 4 in 10 patients fail to maintain adequate adherence levels. Given the association between poor adherence and increased cardiovascular morbidity and mortality, targeted interventions—especially for high-risk groups—are warranted. Understanding adherence patterns is essential for optimizing the real-world effectiveness of lipid-lowering therapies and improving long-term cardiovascular outcomes.
19. Contributing factors influencing occupational burnout among healthcare professionals in medical institutions of Henan Province: A preliminary analysis.
期刊: Work (Reading, Mass.) 发表日期: 2025-Dec-16 链接: PubMed
摘要
BackgroundHealthcare worker burnout is a global public health crisis, yet evidence on its urban-rural disparities in resource-limited regions like China’s inland provinces remains scarce.ObjectiveThis study assessed socio-demographic and occupational predictors of burnout among healthcare workers in Henan Province, China.MethodsA cross-sectional, descriptive, and correlational study was conducted from August-September 2024 among 5189 healthcare workers across urban and rural settings. Burnout was measured using the Maslach Burnout Inventory (MBI). Predictors included work setting, work pressure, promotion opportunities, childcare support, and resource levels.ResultsBurnout patterns showed stark urban-rural contrasts. Rural workers had less than half the risk of emotional exhaustion (EE) (OR = 0.38-0.40), likely due to more manageable workflows. In contrast, urban workers under high pressure faced nearly ten times the risk (OR = 9.57), driven by clinical and academic demands. Adequate promotion opportunities were linked to a 23% lower risk of burnout (OR = 0.77). Notably, strong childcare support (for ≥2 children) halved the risk of EE (OR = 0.46). Despite an overall low sense of personal accomplishment in the sample, rural workers reported significantly higher odds (OR = 2.55-2.88) of high PA.ConclusionsStructural job demands and cultural factors significantly influence burnout disparities. While derived from a study in Henan Province, these findings offer insights likely applicable to other resource-limited settings internationally. Interventions prioritizing workload redistribution, transparent career pathways, and family-friendly policies are essential to mitigate burnout and enhance workforce sustainability in resource-limited settings. Clinicians and policymakers should integrate Job Demands-Resources (JD-R) principles with cultural context to optimize institutional support systems across diverse healthcare environments.
20. Rationale and description of Tied by Tiredness: A blended care intervention for fatigue after acquired brain injury.
期刊: Clinical rehabilitation 发表日期: 2025-Dec-16 链接: PubMed
摘要
AimThe development of a new intervention designed to reduce persistent fatigue following acquired brain injury through personalised support.RationaleFatigue is a common and long-lasting consequence after brain injury. Evidence indicates that tailored, multimodal interventions targeting individual experiences are more effective than standardised approaches.Materials and proceduresThe intervention combines real-time data collection using the Experience Sampling Method via a dedicated mHealth app with a workbook containing practical instructions and an online secure feedback environment. Patients complete eight short daily assessments for three consecutive days each week, collecting detailed information on fatigue and contextual factors such as mood, physical activities and social situations.Providers, setting, and deliveryTied by Tiredness is delivered by psychologists or occupational therapists in rehabilitation or outpatient settings to adults with acquired brain injuries aged 18 and over. In face-to-face therapy sessions, patient-collected data are used to tailor personalised feedback and advice on strategies, emphasising collaborative decision-making and active engagement.Dose and personalisationPatients attend six weekly 1-h sessions. Intervention strategies are adjusted to individual needs and goals throughout the programme, based on ongoing assessment data.Unique featuresContinuous personalisation and the integration of real-time data into therapy sessions distinguish this intervention.Purpose and implicationsThe programme aims to provide insight into the personal and environmental factors that contribute to a person’s fatigue, enabling patients to implement cognitive and behavioural strategies for effective daily fatigue management. Tied by Tiredness represents a novel, practical approach to supporting self-management after brain injury.Trial registrationOverview of Medical Research in the Netherlands (OMON), ID: NL-OMON21265.
21. Thermochemolysis-gas chromatographic detection of oxidized fatty acids in a single Drosophila melanogaster individual.
期刊: Analytical sciences : the international journal of the Japan Society for Analytical Chemistry 发表日期: 2025-Dec-16 链接: PubMed
摘要
Thermochemolysis-gas chromatography-mass spectrometry (Thermochemolysis-GC-MS) was applied to detect fatty acid oxidation products in a single Drosophila melanogaster individual (dry weight: 100-400 µg). Linoleic acid oxidized under UV irradiation was first analyzed to identify characteristic oxidation products, including azelaic acid. Using tetramethylammonium hydroxide (TMAH) as an organic alkali reagent, azelaic acid was successfully detected as its dimethyl ester in D. melanogaster individuals reared on linoleic acid-supplemented diets. The use of m/z 185 as a diagnostic ion in extracted ion chromatograms allowed for sensitive determination of azelaic acid in control and linoleic acid-treated D. melanogaster individuals. The treated groups exhibited notable increases in azelaic acid content, which demonstrates the method’s ability to evaluate statistically significant differences based on individual-level data.
22. Impact of Management-Integrated Learning Materials on the Promotion of Child- and Family-Centered Care in Peripheral IV Placement.
期刊: Comprehensive child and adolescent nursing 发表日期: 2025-Dec-16 链接: PubMed
摘要
Child- and family-centered care (C&FCC) is critical in pediatric nursing, but often difficult to implement consistently, particularly during high-stress procedures such as peripheral intravenous (IV) line placements. This two-arm quasi-experimental study evaluated the effectiveness of learning support materials developed to enhance nurse managers’ knowledge of and attitudes toward promoting C&FCC and encouraging its implementation during peripheral IV line placements. It conducted a two-arm quasi-experimental study in Japan between October 2022 and April 2023. Nurse managers from pediatric departments were allocated to the intervention (n = 69) and control (n = 67) groups using an alternating assignment method stratified by facility. This study involved three surveys as follows: a pre-survey (T1), post-survey 1 (T2, within 2 days of T1), and post-survey 2 (T3, 1 month after T2). The intervention group received a comprehensive learning package, including management strategies and C&FCC promotion tools, while the control group was provided with a limited guide without management content. In this study, the primary outcome was the behavioral component of attitude - namely, nurse managers’ motivation and confidence to promote C&FCC. The secondary outcomes were knowledge of department management in C&FCC and intention to create a C&FCC promotion core team. Adjusted T3 effects, controlled for baseline and prespecified covariates, were estimated using analysis of covariance. For the primary outcome, the intervention produced significant adjusted improvement at T3 (β = 10.04, standard error [SE] = 3.93, t = 2.56, p = .012). The adjusted effect was not significant for knowledge (β = ‒1.03, SE = 0.72, t = 1.44, p = .153). A greater proportion of nurse managers expressed an intention to establish a C&FCC promotion core team in the intervention group than in the control group. In the context of peripheral IV placement, management-integrated C&FCC learning materials appear effective in enhancing nurse managers’ motivation and confidence to lead C&FCC implementation and may help cultivate a child- and family-centered organizational culture in pediatric care.
23. Noise-Resilient Bioacoustics Feature Extraction Methods and Their Implications on Audio Classification Performance: Systematic Review.
期刊: JMIR biomedical engineering 发表日期: 2025-Dec-16 链接: PubMed
摘要
Bioacoustics classification plays a crucial role in ecological surveillance and neonatal health monitoring. Infant cry analysis can aid early health diagnostics, while ecological acoustics informs conservation. However, the presence of environmental noise, signal variability, and limited annotated datasets often hinders model reliability and deployment. Robust feature extraction and denoising techniques have become critical for improving model robustness, enabling more accurate interpretation of acoustic events across diverse bioacoustic domains under real-world conditions. This review systematically evaluates advancements in noise-resilient feature extraction and denoising techniques for bioacoustics classification. Specifically, it explores methodological trends, model types, cross-domain transferability between clinical and ecological applications, and evidence for real-world deployment. A systematic review was conducted by searching 8 electronic databases, including IEEE Xplore, ScienceDirect, Web of Science, ACM Digital Library, and Scopus, through December 2024. Eligible studies entailed audio-based classification models and applied empirical or computational evaluations of bioacoustics classification using machine learning or deep learning methods. In addition, studies also included explicit or implicit consideration of noise. Two reviewers independently screened studies, extracted data, and assessed quality. Risk of bias was assessed using a customized tool, and reporting quality was evaluated using the TRIPOD (Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis) checklist. Of the 5462 records, 132 studies met the eligibility criteria. The majority (112/132, 84.8%) of studies focused on model innovation, with deep learning and hybrid approaches being the most dominant. Feature extraction played a critical role, with 96.2% (127/132) of studies clearly demonstrating feature extraction. Mel frequency cepstral coefficients, spectrograms, and filter bank-based representations were the most common feature representations. Nearly half (62/132, 47%) of the studies incorporated noise-resilient methods, such as adaptive deep models, wavelet transforms, and spectral filtering. However, only 14.4% (19/132) demonstrated real-world deployment across neonatal care and ecological field settings. The integration of noise-resilient techniques has significantly improved classification performance, but real-world deployment and proper use of denoising strategies in various datasets remain limited. Cross-domain synthesis reveals shared challenges, including dataset heterogeneity, inconsistent reporting, and reliance on synthetic noise. Future work should prioritize harmonized benchmarks, cross-domain generalization, and deployment, as well as opportunities for transferability.
24. Stratifying the Rate of Disease Progression by Progression Likelihood Scores in Children and Adolescents With Stage 1 and Stage 2 Type 1 Diabetes in Germany.
期刊: Diabetes care 发表日期: 2025-Dec-16 链接: PubMed
摘要
To stratify the progression rate to clinical stage 3 type 1 diabetes in children with early-stage disease. The Fr1da study tested 211,464 children aged 1.75-10 years for islet autoantibodies. Children with early-stage type 1 diabetes were classified as stage 1 or stage 2 by oral glucose tolerance test (OGTT) and hemoglobin A1c (HbA1c) using current American Diabetes Association criteria and were followed 3-6 months. We applied our previously developed progression likelihood score (PLS), a composite of HbA1c, 90-min OGTT glucose, and islet antigen 2 antibodies (IA-2A) titer, and developed a non-OGTT-based score using multivariable Cox proportional hazards models to stratify progression rates to stage 3. Of 485 children who participated in staging, 360 (74.2%) were diagnosed with stage 1. Of these, stage 3 developed in 105 (median follow-up 3.3 years). PLS stratified the 2-year risk for stage 3 from 43.7% (95% CI 24.3-58.1) in children with high PLS to 4.7% (1.7-7.7) and 0% in those with intermediate or low PLS. Adding the variable obesity improved the existing model. In children with stage 2 with a single dysglycemic abnormality, PLS could stratify 2-year risk for stage 3 from 42.4% (95% CI 22.8-57.0) to 5.6% (0.0-15.6). A non-OGTT-based score based on IA-2A titer categories, HbA1c, obesity, and autoantibody positivity for IA-2 juxtamembrane epitopes could identify individuals with low (1.7%) and moderate (24.6%) 2-year risk. The PLS and a novel non-OGTT-based score can stratify the short- to medium-term progression rates to stage 3 and should be considered for guiding monitoring practices and clinical trial eligibility.
25. Contaminated Tijuana River Contributes to Regional Particulate Matter (PM) Levels Highlighting Overlooked Water-Air Transfer of Gaseous PM Precursors.
期刊: Environmental science & technology 发表日期: 2025-Dec-16 链接: PubMed
摘要
The San Diego-Tijuana border region has experienced rapid urbanization and industrial growth with unmitigated environmental consequences. For nearly a century, the Tijuana River (TR) has carried untreated sewage and industrial waste into the United States, contributing to a long-recognized and ongoing water pollution crisis. However, the impact of this pollution on air quality has been almost entirely overlooked until very recently. Analysis of low-cost air sensor data reveals that gases released from the polluted TR directly contribute to the formation of fine aerosols, increasing PM1 (particulate matter <1 μm) concentrations, particularly when river flow is high and atmospheric dispersion is low. Analysis of PM1 size distributions revealed the enhancement of smaller particle fractions, and persistently high PM1-to-PM2.5 ratios (≥0.56 ± 0.15) showed that submicrometer particles constitute the majority of fine PM mass. Combined with recent evidence of elevated gas-phase emissions from the polluted TR, these results point to secondary aerosol formation─driven by the chemical transformations of river-emitted gaseous precursors─as a major source of PM1. Concentrations peaked near a turbulent riverine hotspot, particularly at night when intensified flow and stable conditions promoted secondary aerosol formation. These findings identify a previously unrecognized source of urban air pollution, showing that the river-to-air transfer of particulate precursors can perpetuate poor air quality and heighten environmental justice and public health concerns.
26. Seroprevalence and risk factors for Toxoplasma gondii infection in wild, domestic and companion animals in urban informal settlements from Salvador, Brazil.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Dec-16 链接: PubMed
摘要
Toxoplasma gondii is a globally neglected zoonotic parasite, particularly prevalent in socioeconomically vulnerable areas. Various animal species serve as reservoirs for T. gondii across different regions, including domestic cats, livestock, and a variety of wild and synanthropic animals. In urban areas, especially informal settlements, the close coexistence of humans, domestic animals, and wildlife may influence local transmission dynamics. This study evaluated the seroprevalence and associated risk factors for T. gondii infection in domestic and synanthropic animals from two low-income neighborhoods in Salvador, Brazil. A cross-sectional study was conducted in the neighborhoods of Marechal Rondon and Pau da Lima from October 2021 to February 2023. Blood samples were collected from domestic animals (288 dogs, 112 cats, 27 chickens, and six horses) and synanthropic species (54 brown rats and 75 big-eared opossums). Serological tests were performed using an indirect immunofluorescence antibody test. Questionnaires were used to collect environmental, demographic, and socioeconomic data from households where sampling took place. Generalized linear mixed models were applied to identify predictors of exposure. Seroprevalence was highest in chickens (66.7%), followed by dogs (37.2%), rats (24.1%), cats (22.3%), opossums (20%), and horses (16.7%). No significant factors were found to be associated with T. gondii seroprevalence in chickens, horses, rats, or opossums. Nevertheless, in dogs and cats, homemade diets increased the odds of infection by nearly six times compared to commercial feeding. Dogs from Pau da Lima were twice as likely to be infected as those from Marechal Rondon. These findings underscore the importance of promoting safe pet management, improving sanitation, and monitoring sentinel species to mitigate zoonotic risks in urban informal settlements.
27. Relationship between levels of burnout and self-efficacy with hand grip strength and hand dexterity among nursing students: Cross-sectional study.
期刊: Work (Reading, Mass.) 发表日期: 2025-Dec-16 链接: PubMed
摘要
BackgroundNursing practice demands a high level of manual dexterity and hand grip strength for tasks such as medication administration, patient handling, and operating medical equipment. Burnout and self-efficacy are common psychological factors among nursing students that may potentially influence the development or expression of these physical skills. However, the nature of this relationship is not well understood.ObjectiveTo investigate the relationship between levels of self-efficacy and burnout, with hand grip strength and hand dexterity, in nursing students at King Saud University.MethodsA cross-sectional study was conducted with 57 nursing students average age was 21.98 ± 1.70 years. Maslach Burnout Inventory-Student Survey and General Self-Efficacy Scale were used. Hand dexterity was evaluated using Purdue Pegboard Test and hand grip strength was assessed using a dynamometer. Correlation analysis was used to determine the associations between the variables.ResultsNo significant correlations between overall burnout or its emotional exhaustion and cynicism sub-scores, and hand function (p > .05). However, professional efficacy showed a significant positive correlation with Purdue Pegboard Assembly (rs = .29, p = .03) and Purdue Pegboard Both Hands scores (rs = .32, p = .01). General self-efficacy also correlated positively with Purdue Pegboard Assembly (rs = .34, p = .009), but no other significant correlations were observed.ConclusionsThese results may have implications for student support and interventions aimed at enhancing self-efficacy, potentially optimizing the development of skills critical for future nursing practice.
28. Workplace safety communication: A systematic review of GHS pictogram comprehension in Iranian work settings.
期刊: Work (Reading, Mass.) 发表日期: 2025-Dec-16 链接: PubMed
摘要
BackgroundDespite the wide usage of Globally Harmonized System (GHS) pictograms in Iranian work settings, there is limited evidence that workers comprehend these signs. Misinterpreting GHS signs can result in hazardous exposures, accidents, and reduced workplace safety.ObjectiveThis study vitally reviews available research to determine the level of comprehension of GHS symbols among Iranian workers.MethodsIn this systematic review, a comprehensive search was performed in international databases (Embase, Scopus, PubMed, and Web of Science) and Persian (SID, IranMedex, Magiran, and IranDoc). Relevant articles in these databases were extracted by searching keywords such as GHS pictograms, chemical labeling comprehension, and Iran from 2015 to 2025. To extract the required data, all parts of the studies were reviewed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020.ResultsOut of the 14 collected articles, 10 articles were selected as final articles, of which five, three, one, and one article dealt with laboratory staff and students, industrial workers, hospital service workers, and farmers, respectively. The signs “flammable substances” (Comprehension Ratio (CR) (%): 39.5-98.8) and “risk of explosion” (CR (%):13-100) had the highest and the signs “skin irritant” (CR (%): 1.6-82) and “gas under pressure” (CR (%): 3.5-88.8) had the lowest comprehension among the GHS signs. Training, safety culture, education level, and gender were among the factors affecting the perception of these pictograms.ConclusionThis systematic review reveals that although GHS pictograms are a critical tool in safety communication, their inadequate perception in Iranian workplaces remains a significant challenge. This review highlights the requirement to review the design (e.g., simplifying signs or adding text labels), training (e.g., local language programs customized to a particular setting), and implementation (e.g., periodic assessments and specific workplace adjustments) of these international signs, taking into account local and cultural characteristics.
29. Sexual function and sexual quality of life Among female healthcare workers in a shift work system.
期刊: Work (Reading, Mass.) 发表日期: 2025-Dec-16 链接: PubMed
摘要
BackgroundShift work is a major occupational health issue, disrupting circadian rhythms and increasing risks for physical, psychological, and social problems. Its impact on sexual function and sexual quality of life among female healthcare workers remains underexplored.ObjectiveThis study examined the impact of shift work on sexual function and sexual quality of life among female healthcare workers and highlighted its occupational health implications within a prevention, assessment, and rehabilitation framework.MethodsA descriptive cross-sectional study was conducted with 390 female healthcare workers in Turkey employed in rotating shifts. Data were collected using a Participant Information Form, the Female Sexual Function Index (FSFI), and the Sexual Quality of Life Questionnaire-Female (SQOL-F). Analyses included descriptive statistics, independent t-tests, one-way ANOVA and Multivariable linear regression.ResultsLonger professional experience, working in high-stress units (intensive care/emergency), ≥ 4 monthly night shifts, and >45 weekly working hours were significantly associated with poorer FSFI and SQOL-F scores (p < 0.05). Conversely, ≥ 32 h of rest after shifts was linked to higher scores. In multivariable analysis, FSFI and FGSIS scores were lower among participants who reported that shift/on-call work affects sexual desire (p < 0.001).ConclusionsShift work negatively affects sexual function and sexual quality of life among female healthcare workers. These outcomes should be recognized as critical occupational health issues. Adequate rest periods, reduced night-shift frequency, and psychosocial support programs are essential preventive and rehabilitative strategies. Worker-centered institutional policies that balance service continuity with employee health may enhance both well-being and healthcare system sustainability.
30. Musculoskeletal and work characteristics of Brazilian reproduction veterinarians with shoulder and neck symptoms: A cross-sectional study.
期刊: Work (Reading, Mass.) 发表日期: 2025-Dec-16 链接: PubMed
摘要
BackgroundMusculoskeletal symptoms are common among bovine practitioners, yet evidence on their prevalence and associated factors remains limited in developing countries.Objectiveto determine the prevalence of shoulder pain and associated factors in Brazilian veterinarians involved in the reproductive management of beef cattle, and to compare shoulder muscle strength and handgrip strength between the dominant and non-dominant sides.MethodsIn this cross-sectional study, 148 veterinarians were recruited during an annual conference. Sociodemographic, occupational and lifestyle factors were assessed. Pain intensity, disability (Shoulder Pain and Disability Index-SPADI, and Neck Disability Index-NDI), lifestyle (Fantastic Lifestyle Questionnaire), and muscle strength (shoulder abduction, lateral rotation and handgrip dynamometry) were evaluated. Predictors of shoulder pain were identified through a binary logistic regression analysis (n = 98), and variables were compared between the dominant and non-dominant sides (n = 50) using the Wilcoxon test.ResultsShoulder pain was reported by 69% of veterinarians. Neck pain increased the odds of shoulder pain, whereas work-related factors were not associated. Current smokers were less likely to report shoulder pain than non-smokers. Participants were mostly men (mean aged 35 years) with moderate pain intensity, low SPADI and NDI scores and good lifestyle habits. Shoulder muscle strength did not differ between sides; although dominant handgrip was greater than non-dominant.ConclusionShoulder pain is highly prevalent among Brazilian veterinarians working in the reproductive management of beef cattle. Neck pain appears to be a key associated factor for shoulder pain, but not work characteristics, highlighting the importance of early stages of rehabilitation management to prevent further musculoskeletal disorders.
31. Building capacity for patient-engagement in neuromuscular disease research: A network project.
期刊: Journal of neuromuscular diseases 发表日期: 2025-Dec-16 链接: PubMed
摘要
Patient-oriented research is increasingly recognized as an important methodology in health sciences. Benefits of patient engagement include aligning research priorities to those living with health conditions, developing better recruitment strategies and protocols, and integrating findings more meaningfully. However, for research teams to work well with patient-partners, training for all stakeholders is needed. While training exists, none consider the uniqueness of the neuromuscular disease experience. To address this gap, our team of researchers, clinicians, and patient-partners collaborated to increase the capacity for patient-engagement in neuromuscular disease research. Our methods included: 1) conducting a landscape of available resources, and 2) using adult education principles and a backwards design process to develop unique training modules. The result is an online platform with three modules focusing on the neuromuscular disease context, addressing the inclusion, diversity, equity, and accessibility needs of those with neuromuscular diseases, and building teamwork skills. Early evaluation of the first two modules indicates high satisfaction and knowledge gain. Through this process, we have learned about the barriers of patient-oriented research, how to support the required system culture shift, and how to plan for long-term sustainability.
32. Sex Differences in the Association Between Occupational Environment Exposures and Cognitive Function Outcomes in Later Life.
期刊: The journals of gerontology. Series B, Psychological sciences and social sciences 发表日期: 2025-Dec-16 链接: PubMed
摘要
Sex differences in later-life cognitive function have been shown to be partially related to the over- and under-representation of male and female workers in different types of occupations. However, another important factor that has not been systematically evaluated is whether cognitive benefits or consequences of specific occupational exposures differ by sex. Our study addresses this knowledge gap. This study uses longitudinal data drawn from the Health and Retirement Study (HRS) linked to occupational data based on the Occupational Information Network (O*NET) database. We examined two established composite occupational exposure measures shown to influence cognitive function: occupational complexity and occupational hazards. Ordinary least squares regression models were used to evaluate whether the association between occupational exposures and late-life cognitive function was dependent on sex, including when accounting for early-life factors. Sex moderated the association between occupational exposures and later-life cognitive function. Specifically, older men-but not women-experienced both significant cognitive benefits in association with occupational complexity (Δy/Δx=0.06, p<0.01) and cognitive detriments in association with occupational hazards (Δy/Δx= -0.05, p<0.01), even when controlling for early life factors. Findings suggest that differences in how men and women respond to occupational exposures may be an important factor contributing to sex-based disparities in later-life cognitive outcomes. Future research is needed to determine how both work and non-work exposures across the life course differently shape long-term cognitive health outcomes in men and women in later life.
33. Glassy carbon electrodes modified with Au@NiCo-glycerolates for non-enzymatic detection of glucose in beverages.
期刊: Talanta 发表日期: 2025-Dec-15 链接: PubMed
摘要
Monitoring of glucose (Gluc) levels in commercial beverages plays a vital role in preventing and managing diabetic disease effectively in the human body. As a method for monitoring Glu, a bimetallic nickel and cobalt glycerolates decorated with gold (Au@NiCo-Gly) composite was prepared using a solvothermal approach. A series of characterization analytical techniques has been employed to confirm the synthesis of the Au@NiCo-Gly composite, including Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDX). The performance of the electrochemical sensor was evaluated by using CV and EIS in 0.50 M KOH as a supporting electrolyte. The use of these electrodes for FIA-amperometric quantification of glucose was highly efficient for glucose quantification under optimized experimental parameters. The developed sensor demonstrated a low detection limit of 0.0168 mM and a limit of quantification of 0.0560 mM. The practical applicability of the developed sensor was validated by detecting Gluc in beverage samples with recovery rates (111.5 %) falling within acceptable analytical standards. These findings highlight the Au@NiCo-Gly/GCE modified electrode as a promising candidate for efficient, sensitive, and selective monitoring of Gluc in beverage samples.
34. Role of stability and triangulation-based methods to improve identification of risk factors for lameness in ewes.
期刊: Preventive veterinary medicine 发表日期: 2025-Dec-13 链接: PubMed
摘要
Lameness has serious impact on sheep health and profitability. In the UK, the largest-scale questionnaire investigating risk factors for lameness (107 questions and 1260 respondents) identified 20 significant variables using stepwise Poisson regression. It is now known that stepwise procedures with wide data can result in overfit models. This research reanalysed these data, using methods that minimise the likelihood of overfitting and therefore reduce the probability of identifying false positive variables. Poisson and log-normal regression models were built with six different variable selection methods, stability selection and triangulation. Six variables were selected in the final triangulated models associated with a reduced prevalence of lameness, fewer than the 20 variables selected in the original analysis. These six variables covered early treatment of individual sheep, treating sheep with any severity of lameness, avoiding routine foot trimming and avoiding footbathing to treat underrunning footrot. Early treatment of individual lame sheep had the highest population attributable fraction for reduction of lameness. Our results highlight the importance of addressing overfitting when fitting models to wide data and the usefulness of triangulating results across different model types. The results strengthen the evidence that the greatest reduction in lameness nationwide would be achieved if farmers treated the first lame sheep in a group rather than waiting until more become lame.
35. Building an institutionalised in-service field epidemiology capacity-building program: Experiences and lessons learned from the China Field Epidemiology Training Program for Veterinarians (CFETPV).
期刊: Preventive veterinary medicine 发表日期: 2025-Dec-12 链接: PubMed
摘要
The increasing threats of zoonotic and transboundary animal diseases highlight the urgent need for a skilled veterinary epidemiology workforce. Before 2010, China had limited capacity in this field. To address this gap, the China Field Epidemiology Training Program for Veterinarians (CFETPV) was established as a competency-based, in-service training program. This study assesses the contributions of CFETPV in enhancing epidemiology practice within animal health services, supporting alumni professional development, and enabling institutional integration in the government system. A quantitative study design was employed, drawing on two alumni surveys conducted in 2019 and 2024, alongside routine program monitoring, administrative data and program progress briefs. Surveys assessed alumni’s application of epidemiological competencies in field study, teaching and policy engagement. Descriptive analyses summarised alumni profiles and contributions. Since 2010, CFETPV has trained 265 professionals through its introductory course and graduated 153 from the two-year program across 31 provinces. Trainees completed 305 field practices during the training. After graduation, alumni conducted 730 epidemiological investigations and studies, contributed to 297 risk assessments, supported major disease control efforts and informed 98 national and provincial guidelines. In 2019, CFETPV became fully funded by the Chinese government, achieving full integration into the national veterinary service. The successful integration was supported by an adaptive competency framework aligned with national priorities, strong alumni support, robust local trainer and mentor networks and consistent stakeholder engagement. These experiences offer insights for countries developing competency-based, in-service veterinary epidemiology training embedded within public veterinary services to strengthen animal health systems and One Health capacity.
36. Recent advances in on-site sensing systems for detecting pesticide positive list system (PLS) violations in agricultural products.
期刊: Food chemistry 发表日期: 2025-Dec-10 链接: PubMed
摘要
The persistent use of pesticides in agriculture has raised critical concerns regarding food safety and public health, as agricultural commodities frequently exceed the MRLs established under PLS frameworks. Traditional techniques such as gas chromatography and liquid chromatography coupled with mass spectrometry offer high precision detection, but they are limited by their reliance on centralized laboratories, higher cost, and prolonged completion times, rendering them unsuitable for on-site application. In response, considerable advances have been made toward the development of portable onsite sensing platforms that are capable of real-time pesticide detection. This review investigates the recent advances in on-site sensing technologies, specifically emphasized on incorporating biorecognition elements, nanomaterials, and digital tools. However, challenges such as limited multiplexing capabilities, matrix interferences, and the absence of standardized protocols notably remained present. Therefore, future research should focus on device miniaturization, multiplex detection, AI-assisted data analysis, and harmonization of regulatory standards to ensure MRL compliance.
37. Proteomic profiling of Monascus-fermented djulis (Chenopodium formosanum) identifies ACE-inhibitory peptides through integrated in silico and in vitro approaches.
期刊: Food chemistry 发表日期: 2025-Dec-09 链接: PubMed
摘要
This study identified angiotensin-converting enzyme (ACE) inhibitory peptides generated during Monascus purpureus fermentation of djulis (Chenopodium formosanum). Protein hydrolysates from fermented dehulled djulis showed the highest ACE inhibition, reaching 40.71 ± 2.95 % on day 8 (captopril: 43.33 ± 3.53 %). In silico screening (BIOPEP database) and proteomics highlighted DAAGYVADK (DK9) as a potential candidate. Molecular docking indicated a binding affinity of -9.174 kcal/mol (captopril: -5.77). The binding was mainly stabilized by 7 hydrogen bonds with ACE active site residues Glu384, His353, Lys511, Gln281, Asn277, Ala354, and Arg522. Moreover, enzyme-kinetic analysis indicated competitive inhibition by increased Km with unchanged Vmax. Furthermore, absorption, distribution, metabolism, excretion, and toxicity (ADMET) predictions suggested low toxicity and favorable pharmacokinetic properties for DK9. These findings support Monascus-fermented dehulled djulis as a promising substrate to generate natural ACE-inhibitory peptides and identify DK9 as a lead peptide for further development.
38. Consumo de alimentos ultraprocesados y el aumento del riesgo de obesidad en adultos en Zanzíbar, Tanzania.
期刊: Nutricion hospitalaria 发表日期: 2025-Dec-03 链接: PubMed
摘要
an increase in ultra-processed food consumption and obesity prevalence has become a major global concern. This study aims to determine the association between ultra-processed food consumption and the increased risk of adult obesity in Zanzibar, Tanzania. a cross-sectional analysis of anthropometric and dietary data from 531 adults aged ≥ 18 years was conducted. Food intake was assessed through 24-hour records on three non-consecutive days. The NOVA classification system was used for ultra-processed food identification, i.e., industrially manufactured derived from foods with added sugar, salt, color, and flavors such as sweet, confectionery, soft and carbonated drinks, fast foods, packaged snacks, etc. Weight (kg) and height (m2) were used to determine the body mass index, and the waist-to-hip ratio was calculated; general and abdominal obesity were then diagnosed. Regression models were performed to evaluate the association between ultra-processed food and obesity while adjusting for socio-demographic and physical exercise. A two-tailed statistical test with a p-value of < 0.05 was identified as statistically significant. the prevalence of obesity and central obesity was 16.9 % and 46.9 %, respectively. Average energy consumed was 2256.71 kcal/day, of which 18.5 % derived from UPF. As UPF consumption increases from the lowest to the highest quintile, mean BMI (from 23.73 kg/m² to 25.85 kg/m²) and WHR (from 0.864 to 0.902) show a gradual rise with regression coefficient of (β = 2.12 [1.23 to 3.22]) for obesity and (β = 0.038 [0.023 to 0.053]) for abdominal obesity. UPF consumption is associated with an increased risk of obesity, highliting the need of holistic public health solution in Zanzibar, Tanzania.
39. Is home always the best place to live? Preferences for place of residence and long-term care among the community-dwelling oldest old in Finland.
期刊: European journal of public health 发表日期: 2025-Dec-01 链接: PubMed
摘要
The aging in place policy emphasizes the older people’s own desire to live at home. However, there is limited evidence on preferences for place of residence and long-term care, especially regarding the oldest old people. This study aims to fill this knowledge gap by identifying the preferences and associated factors of community-dwelling people aged 90+. Survey data, including a total age cohort of 90 years and older in one geographic area in Finland was analyzed descriptively and with multinomial logistic regression. The total study population was 1834 of which two-thirds were community-dwellers. Of the community-dwellers 71% preferred to live at their current homes, 18% preferred to live at their current homes if they received more help, and 11% would prefer to live in a residential care facility. Those who preferred to live at home had better functioning, rarely experienced dizziness, tiredness, loneliness, and pain, were more often satisfied with their life, and had better self-rated health compared to other preference groups. Preferences shifted gradually: the poorer the respondents’ health, functional capacity, and well-being, the more likely they preferred to get more help at home or live in residential care. One-third of the respondents either preferred to have more help in their current home or to move to residential care, indicating that home was not the best place for them to live at that time. Findings suggest that the preferences for living at home are not stable but a dynamic process among the oldest old people.
40. Effects of early water, sanitation, handwashing, and nutrition interventions on child development at school age: a follow-on study of a cluster-randomized trial in rural Bangladesh.
期刊: PLoS medicine 发表日期: 2025-Dec 链接: PubMed
摘要
A previous cluster-randomized controlled trial in Bangladesh found that individual or combined water, handwashing, sanitation, and nutrition interventions during pregnancy and after birth improved developmental outcomes of children at 1 and 2 years of age. In this study, we aimed to determine if these intervention effects were sustained for children at school age. Clusters of pregnant women were enrolled between May 31, 2012 and July 7, 2013 and block-randomized into chlorinated drinking water (W); improved sanitation (S); handwashing with soap (H); combined WSH; nutrition counseling and provision of lipid-based supplements (N); combined WSH + N, or a double-sized passive control arm (C) with no intervention visits (N = 5,551). The primary outcomes of the main trial after the 2-year intervention were 7-day diarrhea prevalence and length-for-age z-score, measured in 4,584 children of enrolled pregnant women. We conducted a post hoc, follow-up of all initially enrolled mothers and their children 5 years after intervention completion, when children were 7 years old. Primary outcomes were child cognition assessed using the Wechsler Pre and Primary Scale of Intelligence (WPPSI-IV), along with assessments of fine motor abilities, behavior, school achievement, and executive function; secondary outcomes were maternal mental health and stimulation in the home environment. We conducted intention-to-treat analyses using generalized linear models to calculate unadjusted and adjusted comparisons between each arm and the control group, accounting for block-level clustering. Between September 2019 and February 2021, we re-enrolled 4,175 households from all 720 original clusters, with the full set of child development assessments conducted on 3,833 children across 718 clusters. Children in the WSH + N, N, and S arms had improved cognitive scores on one or more domains compared to the control arm, with adjusted effect sizes between 0.10 (95%CI: 0.00, 0.20) and 0.15 (0.03, 0.27). Children in the W, H, N, WSH, and WSH + N arms demonstrated improved prosocial behaviors (adjusted effect sizes between 0.20 (0.07, 0.33) and 0.31 (0.16, 0.46)) and reduced difficult behaviors (adjusted effect sizes between -0.15 (-0.28, -0.01) and -0.31 (-0.45, -0.17)). No intervention effects were observed for fine motor, executive functioning, or school achievement outcomes. Maternal depressive symptoms were improved in the WSH + N, H, and N arms (adjusted effect sizes between -0.14 (-0.24, -0.03) and -0.21 (-0.31, -0.11)), and the stimulating home environment was improved in all intervention arms (adjusted effect sizes between 0.17 (0.01, 0.33) and 0.40 (0.25, 0.56)). Children whose families had higher wealth at baseline and those who were male tended to have larger effect sizes on the FSIQ. Data collection for this study was interrupted by a 6-month pause at the start of the COVID-19 pandemic. The main limitation of this study is loss to follow-up. At 7 years of age, we found small, sustained benefits of early water, sanitation, handwashing, and nutrition interventions on child cognitive and socioemotional outcomes, the stimulating home environment, and maternal mental health. Future work to determine the mechanisms underlying these intervention effects will further inform the design of early interventions to improve child health and development. Trial registration: Follow-up trial: ClinicalTrials.gov, NCT04443855. Original WASH-Benefits Bangladesh (WASH-B): ClinicalTrials.gov, NCT01590095.
41. Proportion of Female Physicians in a Specialty and Median Annual Payments in Ontario, Canada.
期刊: JAMA network open 发表日期: 2025-Dec-01 链接: PubMed
摘要
It is unclear why areas of medicine overrepresented by female physicians receive lower pay. One theory is devaluation-that work done by women is systematically devalued over time. To assess whether an increase in the proportion of female physicians in a specialty is associated with a decrease in the median annual payments for that specialty. In 2022, a population-based, repeated cross-sectional analysis was conducted using routinely collected data of all active physicians in Ontario, Canada, from 1992-1993 (1993) to 2019-2020 (2020). For each year, the percentage of female physicians and total annual median payments for each specialty were calculated. Random-effects linear regression models were constructed to evaluate the association between the percentage of female physicians and median payments overall. Additionally, we conducted a sensitivity analysis of the subgroup of physicians with 1.0 or more full-time equivalency (FTE). The physician workforce increased from 18 572 in 1993 to 31 374 in 2020 with the number of female physicians increasing from 4151 (22.3%) to 13 205 (42.1%). The mean (SD) age for all physicians in 2020 was 49.6 (12.8) years, and for female physicians in 2020 was 46.2 (11.5) years. Median annual payments increased from $183 033 to $316 570. Regression results found that an absolute 1 percentage point increase in the percentage of female physicians in a specialty over 1 year was associated with a $2183 lower increase in median payments than expected overall (95% CI, -$3932 to -$434; P = .02) and a $3235 lower increase for female physicians (95% CI, -$4888 to -$1583; P < .001), but not for male physicians (-$554; 95% CI, -$2373 to $1264). This repeated cross-sectional study did not find evidence to directly support the theory of devaluation, yet the results underscore that occupational segregation, both across and within specialties, is associated with the gender pay gap. These findings should prompt medical leaders and policymakers to reconsider what activities are monetarily valued in medicine and whether these align with what patients and the public consider most valuable from a care perspective.
42. Sex and gender differences in co-occurring substance use and depressive disorders: a systematic review.
期刊: The American journal of drug and alcohol abuse 发表日期: 2025 链接: PubMed
摘要
Background: Major depressive disorder (MDD) and substance use disorders (SUDs) frequently co-occur, influenced by sex (biological) and gender (sociocultural) factors. The extent and consistency of these differences across substance types in populations with co-occurring MDD remains unclear.Objectives: This systematic review synthesizes evidence on sex and gender differences in the prevalence, clinical characteristics, and treatment outcomes of individuals with co-occurring MDD and four SUDs: alcohol use disorder (AUD), cannabis use disorder (CUD), opioid use disorder (OUD) and cocaine use disorders (CoUD).Methods: Following PRISMA guidelines, we searched PsycINFO, MEDLINE, and Embase for peer-reviewed studies from inception to present. Eligible studies examined co-occurring MDD and at least one SUD, and disaggregated outcomes by sex or gender.Results: Forty-seven studies were included (N = 648,414), spanning diverse age groups and geographic regions. Women with SUDs were more likely to experience co-occurring MDD, particularly in AUD and OUD; findings were less consistent for CUD and CoUD. Men with MDD were more likely than women to report co-occurring AUD. Co-occurring MDD-SUD conferred increased suicide risk, particularly among women. Treatment-related findings were mixed: some evidence suggested MDD increased relapse risk in men but buffered relapse in women. Common methodological limitations included inconsistent definitions of sex and gender and reliance on cross-sectional designs.Conclusion: Sex and gender shape the risks and treatment trajectories of co-occurring MDD and SUDs, underscoring the need for personalized screening, suicide prevention, and relapse management strategies. Greater conceptual clarity and inclusion of gender-diverse individuals could inform equitable clinical practices and targeted interventions.
43. Assessment of carbacetam effect on the mitochondria of hippocampal neurons in rats of different sexes with experimental metabolic syndrome.
期刊: Wiadomosci lekarskie (Warsaw, Poland : 1960) 发表日期: 2025 链接: PubMed
摘要
Aim: To study carbacetam effect on the mitochondria of hippocampal neurons in rats of different sexes simulating metabolic syndrome. Materials and Methods: The experiments were conducted on non-linear laboratory albino male and female rats with the body weight of 0,220-0,250 kg. To create the pattern, the rats were kept (60 days) on a high-fat diet (fat enrichment was provided by the addition of solid pork lard) with free access to fructose solution (100 g/L). Carbacetam was injected into the peritoneum in the dose of 5 mg/kg once a day during 14 days. Results: Simulated metabolic syndrome was found to manifest by a decreased light scattering and an increased relative rate of mitochondrial swelling in the hippocampal mitochondrial fraction; increased free radical lipid and protein oxidation with more marked changes in males. When rats with metabolic syndrome receive carbacetam during 14 days, in their mitochondrial fraction light scattering and relative rate of mitochondrial swelling decrease, both in males and females. The content of products reacting with 2-thiobarbituric acid and protein oxidative modification decrease, and catalase activity in males and females increases, superoxide dismutase activity increases in males only. Conclusions: Thus, a decreased intensity of mitochondrial swelling and improved condition of the antioxidant system of the hippocampal mitochondria of rats with metabolic syndrome irrespective of their sex is indicative of the effective correction of GABA receptors by means of carbacetam under conditions of the experiment.
44. Moving from reactive response to proactive prevention of emerging infectious diseases: Socio-ecological systems mapping in the Democratic Republic of the Congo.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
Emerging infectious diseases such as Ebola and Mpox pose significant public health challenges in the Democratic Republic of the Congo (DRC). Effective prevention policies require a clear understanding of the socio-ecological systems (SES) in which these diseases emerge. This study examined the SES influencing emerging infectious disease prevention in the DRC through five participatory modelling workshops conducted at national, provincial, and community levels using causal loop diagrams (CLDs). Participants were selected through stakeholder analysis to ensure cross-sectoral representation. A structured process guided the co-creation of integrated system maps, beginning with disease-specific models and culminating in validated shared maps. A total of 162 stakeholders participated across the workshops, most of whom were affiliated with government institutions (83%), with smaller proportions from civil society, academia, and technical assistance organizations. The Agriculture and Animal Health sector represented 36% of participants, followed by Human Health (31%) and Environmental Health (13%). Most participants had over 10 years of experience. Analysis of the CLDs revealed that while the number of infected individuals remained the central driver triggering feedback responses, the mechanisms of influence differed by governance level. National and provincial systems were shaped by public investment in One Health systems, political commitment, and governance capacity, whereas community-level dynamics were dominated by socio-economic conditions, hunting practices, and local sensitization. Overall, the findings highlight that current governance remains largely reactive, emphasizing response over prevention. Strengthening One Health governance will require a shift toward proactive health promotion supported by institutionalized coordination, sustained investment, and inclusive community engagement.
45. Pediatric consensus of autoimmune hepatitis.
期刊: Boletin medico del Hospital Infantil de Mexico 发表日期: 2025 链接: PubMed
摘要
The Mexican Association of Hepatology held this Consensus on Autoimmune Hepatitis in the Pediatric Population with the aim of providing physicians with useful information for diagnosis and treatment. A group of pediatric and hepatology gastroenterologists and a transplant surgeon reviewed the medical literature. The Delphi method was applied sending the statements to the participants to be analyzed and voted on the level of agreement and discussed during virtual sessions, 46 statements were approved with the recommendations for the autoimmune hepatitis diagnosis, early management to prevent disease progression, cirrhosis complications, and for the treatment failure, adverse events detection, alternative therapy and liver transplant indications. Autoimmune hepatitis is a rare entity in pediatrics diagnostic and therapeutic challenge. Updated recommendations for diagnosis and treatment with pediatric doses are presented. La Asociación Mexicana de Hepatología llevó a cabo el presente Consenso Hepatitis Autoinmune en Población Pediátrica con el fin de proveer a los médicos de información útil para su diagnóstico y tratamiento. Participaron un grupo de gastroenterólogos/hepatólogos pediatras y de cirugía de trasplante, quienes revisaron la literatura médica. Se aplico el método Delphi para obtener el nivel de acuerdo de los enunciados emitidos; estos fueron enviados a los participantes para ser analizados, votados y en sesiones virtuales fueron discutidos; se elaboraron 46 enunciados aprobados, con las recomendaciones para el diagnóstico, el tratamiento oportuno y evitar la progresión de la enfermedad, desarrollo de cirrosis y sus complicaciones, así como las alternativas terapéuticas en caso de falla al tratamiento, la detección de eventos adversos y las indicaciones de trasplante hepático. Al ser una entidad rara en pediatría, la hepatitis autoinmune continúa siendo un reto diagnóstico-terapéutico, por lo que se presentan las recomendaciones de diagnóstico y tratamiento con dosis pediátricas de manera actualizada.
46. The role of lipoprotein (a) in the development of cerebral atherosclerosis.
期刊: Wiadomosci lekarskie (Warsaw, Poland : 1960) 发表日期: 2025 链接: PubMed
摘要
Aim: To review information sources on this issue in order to provide up-to-date knowledge on the pathogenesis of this condition. Materials and Methods: The PubMed, Embase, and the Cochrane Library databases were searched for studies from inception to April 16, 2022, without language restrictions. Databases were searched for studies from inception 2010 to December, 2024, without language restrictions. Key words for search: Lipoprotein(a), Lp[a], dyslipidemia, classical vascular risk factors, cardiovascular disease, cardiovascular risk, cardiovascular risk factor, cerebral atherosclerosis. More than 37 sources was analyzed. Conclusions: Cardiovascular diseases remain the leading cause of disability and mortality globally. While dyslipidemia is a well-established risk factor for coronary atherosclerosis and myocardial infarction, its role in the development of intracranial atherosclerosis is less well characterized. Current evidence suggests that plasma measurement of lipoprotein(a) [Lp(a)] using validated assays is sufficient for cardiovascular risk stratification, obviating the need for genetic testing of Lp(a). Advanced diagnostic methods have demonstrated that elevated Lp(a) levels are associated with increased vascular wall inflammation, reinforcing its causal role in atherogenesis. Intracranial atherosclerosis, a major cause of ischemic stroke, is linked to a heightened risk of recurrent cerebrovascular events and the progression of vascular cognitive impairment. Although Lp(a) is a recognized risk factor for stroke, its predictive value appears to be lower than that for coronary heart disease or composite cardiovascular outcomes. Therefore, the clinical implications of elevated Lp(a) levels in relation to carotid and intracranial atherosclerosis merit further investigation, particularly in the context of stroke prevention and vascular dementia.
47. The impact of intermittent fasting on cognitive function and neuroprotection: A literature review.
期刊: Wiadomosci lekarskie (Warsaw, Poland : 1960) 发表日期: 2025 链接: PubMed
摘要
Aim: To summarise current knowledge on the effects of intermittent fasting on cognitive functions and neuroprotective mechanisms, with particular attention to Alzheimer’s disease and Parkinson’s disease. Materials and Methods: A narrative review based on twelve peer-reviewed publications on the effects of intermittent fasting on cognitive function, neuroprotection, and circadian rhythms. Preclinical data and selected clinical studies indicate that intermittent fasting improves memory, attention, and executive functions, which is associated with activation of autophagy, reduction of oxidative stress, improved mitochondrial function, and increased levels of brain-derived neurotrophic factor. In Parkinson’s disease, intermittent fasting limits alpha-synuclein aggregation and protects dopaminergic neurons, whereas in Alzheimer’s disease it reduces beta-amyloid deposition and enhances synaptic plasticity. Intermittent fasting also influences the gut-brain axis and circadian rhythm alignment, which may further support neuroprotection. Conclusions: Intermittent fasting is a promising adjunct strategy in the management of neurodegenerative diseases. However, well-designed, randomised clinical trials are needed to confirm its effectiveness and safety.
48. Rabies: known and unknown historical aspects.
期刊: Wiadomosci lekarskie (Warsaw, Poland : 1960) 发表日期: 2025 链接: PubMed
摘要
Aim: To provide a comprehensive historical overview of rabies, with a focus on its early recognition, cultural significance, and advancements in treatment from antiquity to the modern era. Materials and Methods: A literature review was conducted using electronic databases such as Scopus and PubMed to gather data on rabies incidence, transmission patterns, and public health interventions across various Latin American countries. The search covered publications from 1950 to 2025. The following keywords and their combinations were used: rabies, hydrophobia, Lyssa, Lyssavirus, history of rabies, rabies vaccine, Louis Pasteur, ancient medicine rabies, rabies Greece, canine rabies, public health interventions. Conclusions: Although significant progress has been made in reducing rabies cases in Latin America through widespread vaccination campaigns and animal control strategies, the disease continues to pose a public health concern in certain areas. This persistence is particularly attributed to challenges in rural and remote regions, bat-mediated transmission, and deficiencies in disease surveillance. Continued investment in preventive measures, public education, and targeted interventions-especially among vulnerable populations-is crucial for achieving the complete elimination of rabies in the region.
49. Clinical and laboratory markers in predicting the probability of alveolitis occurrence.
期刊: Wiadomosci lekarskie (Warsaw, Poland : 1960) 发表日期: 2025 链接: PubMed
摘要
Aim: Our aim was to identify the markers necessary to predict the probability of alveolitis in case of tooth extraction under the conditions of a clinical laboratory and within the workplace of a dental surgeon. Materials and Methods: 160 patients were under our supervision. Since men and women may undergo tooth extractions throughout their lives, we selected adult patients (from 18 to 75 years old) including 100 men and 60 women. The effectiveness of classical methods was studied and compared according to the treatment protocol and drug treatment regimens developed by us based on a range of laboratory and comprehensive clinical studies. Patients in the main group and the comparison group were identical by age, gender, pathology, and the conducted treatment. Patients who required outpatient tooth extraction were regarded as the inclusion criteria for the research. Depending on the treatment, all patients were divided into three groups, randomized by age, gender, and duration of the disease. Results: According to the results of our research, OHI indicators, which were conducted for 14 days, showed that the average statistical value of OHI constituted (2.01±0.11) points the day after the extraction in Group II in case of scheduled tooth extraction corresponding to indicators of a satisfactory state of hygiene. Conclusions: 1. The inclusion of pectin-containing medication in the complex of preventive measures is fully justified in relation to the occurrence of inflammatory complications after tooth extractions in modern conditions of a doctor’s work at an outpatient clinic. 2. The wound surface of the socket of the extracted tooth should be covered with a bandage. 3. Under the conditions of a clinical laboratory and within a workplace of a dental surgeon, the markers necessary to predict the probability of alveolitis in case of a tooth extraction are the following: clinical indicators of normalization of the oral cavity hygienic state, a significant decrease in the intensity and prevalence of the inflammatory process in the gums, changes in the oral fluid pH towards the alkaline side.
50. Ambient temperature, suicide, and urbanicity: A nationwide time-stratified case-crossover study in South Korea.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Several studies have examined the nationwide or multi-region relationship between ambient temperature and suicide mortality; however, evidence of comprehensive roles of urbanicity that can affect temperature, suicide, and risk-risk populations was limited. To reduce the gaps in knowledge, this study examined the nationwide ambient temperature-suicide association and heterogeneous high-risk populations by urbanicity levels and sex/age groups, based on a time-stratified case-crossover design with national mortality data (2015-2019). In the total population (65,645 suicides), we found an inverted J-shaped relationship between ambient temperature and suicide, and across all populations, higher temperature was associated with an increased risk of suicide mortality. Nevertheless, the association differed by urbanicity level, sex, and age group. First, in the total population, metropolitan and less-urban areas showed the stronger ORs (odd ratios between the maximum suicide temperature and 20th percentile of the temperature; metropolitan OR: 1.471, 95% CI: 1.141-1.898; less-urban OR: 1.631, 95% CI: 0.968-2.747) than mid-urban areas. In metropolitan areas, stronger ORs were observed in individuals aged 65 years or older (1.926, 1.175-3.157) and 0-44 years (1.575, 0.951-2.608) than in those aged 45-64 years. In mid-urban areas, all subgroups showed no evident association except for people aged 65 years or older. Whereas, less-urban males showed a marginally higher OR (1.667, 0.911-3.051) than less-urban females, although we could not observe sex differences in other areas. Our findings provide evidence for establishing more precise urban health policies and social interventions to reduce the risk of suicide related to ambient temperatures.
51. A New Test for Evaluating the Psychological Impact of COVID-19 in Nurses.
期刊: Dimensions of critical care nursing : DCCN 发表日期: 链接: PubMed
摘要
During the COVID-19 pandemic, many health care workers were involved and suffered significant physical and psychological strain, and nursing was one of the main players. Clearly and objectively establishing the psychological impact on nurses during the pandemic is necessary for long-term recovery and to be prepared for new outbreaks in the future. The aims of this study were to evaluate the perceived impact on nurses at risk of psychological stress at work during a major health care crisis and determine the psychological impact and its influencing factors. An online questionnaire was designed and distributed between April 9 and April 19, 2020, in Spain. The comprehensive self-conducted questionnaire included demographic information and the Psychological Stress and Adaptation at work Score. For the analysis, descriptive statistics, logistic regressions, and receiver operating characteristic curves were determined. A total of 825 nurses (33% working in intensive care units and emergency departments) answered the questionnaire. A logistic regression analysis revealed that nurses with higher psychological stress scores experienced more physical overload (P = .02), higher psychological overload (P < .01), poor teamwork (P = .02), more distress due to new circumstances (P < .01), more personal impact of how society responded to COVID-19 (P < .01), anticipation of negative future consequences (P < .01), and worse balance between family and work (P < .01). The area under the curve for the cutoff point of Psychological Stress and Adaptation at work Score 40 was 0.82 (95% confidence interval, 0.79-0.91), with 70% sensitivity and 81% specificity. The positive predictive value was 72%, and the negative predictive value was 80%. Psychological Stress and Adaptation at work Score is a rapid and accurate test for evaluating the psychological well-being of health care staff that can be used when crisis prevents the use of conventional stress diagnosis methods. Higher psychological impact was observed in nurses who worked in the intensive care unit and in the hospital ward.