公共卫生研究摘要 (2025-12-19)
共收录 58 篇研究文章
1. Measles in Pregnancy: Clinical Considerations and Challenges.
期刊: Obstetrics and gynecology 发表日期: 2026-Jan-01 链接: PubMed
摘要
Measles is a highly contagious infectious disease caused by the measles virus. Recent declines in population-level immunity and outbreaks linked to imported cases have led to the highest U.S. incidence of measles since its elimination in 2000. Measles infection during pregnancy is associated with increased risk of pneumonia, need for respiratory support and mortality, prematurity, and stillbirth. Although perinatal transmission is rare, congenital measles is linked to higher infant mortality. No licensed antiviral therapies or curative treatments exist, making prevention critical. Measles-containing vaccines are safe and 97% effective in preventing infection when two doses are administered. Measles vaccination is contraindicated during pregnancy; obstetricians and gynecologists should strongly recommend vaccination to all nonpregnant susceptible patients.
2. In Reply.
期刊: Obstetrics and gynecology 发表日期: 2026-Jan-01 链接: PubMed
摘要
3. Disparities in Chronic Pancreatitis Care in Appalachian Kentucky.
期刊: Pancreas 发表日期: 2026-Jan-01 链接: PubMed
摘要
4. Regional variations in cardiovascular risk predictions: a comparative analysis of Framingham, SCORE2, and WHO models across 53 countries.
期刊: Journal of global health 发表日期: 2025-Dec-19 链接: PubMed
摘要
Risk prediction models for cardiovascular diseases (CVDs) have been widely applied in clinical practice and in designing prevention policies globally, yet their accuracy across different regions with distinct epidemiological profiles remains uncertain. We examined the regional variation in risk distribution and agreement between these models. We analysed 53 nationally representative health surveys in seven regions. Using the World Health Organization (WHO), SCORE2, and Framingham CVD risk prediction models, we estimated the respondents’ 10-year CVD risk and categorised them into low-, moderate-, or high-risk groups. We included 86 430 individuals aged 40-69 years without a history of CVD in our analysis. Globally, CVD risk estimates differed substantially across models (WHO: 7.75%; 95% confidence interval (CI) = 7.70-7.80; SCORE2: 3.72%; 95% CI = 3.69-3.75; Framingham: 12.42%; 95% CI = 12.34-12.50). We also noted regional disparities in identifying moderate- and high-risk subjects, particularly in South Asia (WHO: 12.57%; 95% CI = 11.63-13.51; SCORE2: 18.24%; 95% CI = 17.14-19.33; Framingham: 29.40%; 95% CI = 28.11-30.70), sub-Saharan Africa (WHO: 16.30%; 95% CI = 15.78-16.83; SCORE2: 22.69%; 95% CI = 22.09-23.28; Framingham: 33.85%; 95% CI = 33.18-34.52), East Asia & the Pacific (WHO: 21.06%; 95% CI = 20.57, 21.55; SCORE2: 31.03%; 95% CI = 30.47, 31.59; Framingham: 45.54%; 95% CI = 44.93-46.14), and Latin America & the Caribbean (WHO: 23.09%; 95% CI = 21.48-24.70; SCORE2: 41.56%; 95% CI = 39.68-43.44; Framingham: 55.83%; 95% CI = 53.94-57.72), with greater than two-fold differences across models. Agreement in classifying individuals into low-, moderate-, or high-risk groups remained relatively high across risk models (63.1%), but varied considerably across regions, from 73.91% in South Asia to 47.54% in Latin America & the Caribbean. The CVD risk estimates produced by the WHO, SCORE2, and Framingham models varied significantly across regions, with poor consistency in identifying at-risk individuals in some regions. These discrepancies may lead to undertreatment and inefficient use of otherwise limited healthcare resources. Region-specific adaptations are needed to enhance risk targeting, promote equity, and improve the overall effectiveness of primary prevention.
5. Association of circadian syndrome with the risk of physical, psychological, and cognitive multimorbidities: a prospective cohort study based on the China Health and Retirement Longitudinal Study.
期刊: Journal of global health 发表日期: 2025-Dec-19 链接: PubMed
摘要
Multimorbidity involving physical, psychological, and cognitive decline is a major public health challenge with poorly understood upstream risk factors. Circadian syndrome (CircS), which integrates metabolic, sleep, and mood dysregulation, is a potential predictor of this condition. We aimed to investigate the prospective association between baseline CircS and the incidence of distinct multimorbidity patterns. We conducted a prospective cohort study of 8262 participants aged ≥45 years from the China Health and Retirement Longitudinal Study, who were free of specified multimorbidity at baseline in 2011. We defined CircS as the presence of ≥4 of 7 components: central obesity, hypertension, dysglycaemia, dyslipidaemia, low high-density lipoprotein cholesterol, abnormal sleep duration, and depressive symptoms. We used multivariable Cox proportional hazards models to estimate hazard ratios (HR) for four incident multimorbidity patterns over a seven-year follow-up. Over a median follow-up of seven years, baseline CircS was significantly associated with a higher risk of incident physical-psychological-cognitive multimorbidity (HR = 1.48, 95% confidence interval (CI) = 1.09, 2.02) and psychological-cognitive multimorbidity (HR = 1.38; 95% = CI 1.06, 1.79) after full adjustment. We noted a significant dose-response relationship. The population attributable fraction of CircS for physical-psychological-cognitive multimorbidity was 16.8%. Associations were more pronounced in women and participants without baseline chronic conditions. CircS is a significant, integrative risk factor that precedes the onset of complex multimorbidity, particularly patterns involving cognitive and psychological decline. The co-occurrence of metabolic, sleep, and mood dysregulation appears to synergistically accelerate disease clustering. Our findings identify CircS as a critical target for early risk stratification and suggest that prevention strategies should promote circadian health.
6. Prevalence and associated factors of malaria among pregnant women in Maraki Health Center, North West, Gondar, Ethiopia.
期刊: Journal of vector borne diseases 发表日期: 2025-Dec-19 链接: PubMed
摘要
Malaria during pregnancy remains a significant public health concern, contributing to maternal and neonatal morbidity and mortality. This study aimed to assess the prevalence of malaria and its associated factors among pregnant women attending antenatal care (ANC) at Maraki Health Center, Northwest Ethiopia, 2025. A facility-based cross-sectional study was conducted among 271 pregnant women using structured interviews and laboratory testing (RDT and microscopy) for malaria diagnosis. Socio-demographic, clinical, behavioral, and environmental data were collected. Binary and multiple logistic regression analyses were performed to identify factors associated with malaria infection. The prevalence of malaria among the participants was 13.4%. Factors independently associated with malaria infection included not using insecticide-treated nets(ITN), (AOR=3.2; 95% CI: 1.4-7.5), not receiving Intermittent Preventive Treatment in Pregnancy with Sulfadoxine-Pyrimethamine (IPTp-SP), (AOR = 2.8; 95% CI: 1.1-6.9), attending fewer than four ANC visits (AOR = 4.6; 95% CI: 1.9-11.2), living near stagnant water (AOR = 2.5; 95% CI: 1.1-5.8), and attending Antenatal care during the rainy season (AOR = 1.9; 95% CI: 1.0-3.7). The prevalence of malaria among pregnant women in the study area was considerable. Behavioral and environmental factors significantly contributed to malaria risk. Strengthening Insecticide-Treated Net (ITN) distribution, ensuring Intermittent Preventive Treatment in Pregnancy with Sulfadoxine-Pyrimethamine (IPTp-SP uptake), promoting regular ANC attendance, improving environmental sanitation, and increasing malaria prevention education, particularly during the rainy season, are recommended to reduce the burden of malaria in pregnancy.
7. Investigation of Amanita molliuscula poisoning outbreaks in Heilongjiang province, China.
期刊: Clinical toxicology (Philadelphia, Pa.) 发表日期: 2025-Dec-18 链接: PubMed
摘要
In late August 2024, a cluster of cases of mushroom poisoning causing acute liver injury occurred in a county in Heilongjiang Province, China, resulting in two fatalities. This study aimed to identify the toxic mushroom species, quantify toxin concentrations, and characterize the clinical presentation and outcomes of the poisoning. We conducted a retrospective analysis of epidemiological data, clinical manifestations, and management approaches. The suspected mushrooms were identified using morphological and molecular techniques. The concentrations of six amatoxins in mushroom, blood, and urine samples were measured using ultra high-performance liquid chromatography-tandem mass spectrometry. Eight mushroom poisoning outbreaks involving 19 individuals (11 males, eight females) from seven families were documented. Eighteen patients exhibited gastrointestinal symptoms, while one remained asymptomatic. Severe liver injury developed in 12 patients, including three who progressed to liver failure; two of these patients died, and the third recovered following liver transplantation. The causative mushroom was identified as Amanita molliuscula, which had been mistaken for the edible Agaricus bisporus. Both mushroom and biological samples tested positive for α-amanitin and β-amanitin. As far as we are aware, these are the first reported outbreaks of Amanita molliuscula poisoning. The high mortality (two deaths) and need for liver transplantation in one patient underscore the severe toxicity of this species and the life-threatening nature of its poisoning. Amanita molliuscula contains α-amanitin and β-amanitin in this region of China, with hepatotoxicity as the primary clinical manifestation. Fulminant liver failure was the leading cause of death, though liver transplantation proved effective in one case. Given that toxic wild mushrooms often resemble edible varieties and cannot be reliably distinguished visually, improved public education and surveillance are crucial to mitigating the risks associated with wild mushroom consumption.
8. Association of Prepregnancy Cardiometabolic Markers With Early Childhood Weight in a Study of Hispanic Dyads.
期刊: Obstetrics and gynecology 发表日期: 2025-Dec-18 链接: PubMed
摘要
To investigate associations between prepregnancy cardiometabolic risk factors and early childhood weight status, independent of genetic susceptibility. The ancillary study of the HCHS/SOL (Hispanic Community Health Study/Study of Latinos) included 227 dyads consisting of Hispanic/Latina mothers who had singleton live births between baseline and visit 2 and their children, aged 3-9 years. Child outcomes included body mass index (BMI) z-scores, and weight status categories. Maternal prepregnancy biomarkers included fasting triglycerides, high-density lipoprotein cholesterol (HDL-C), glucose, insulin, blood pressure, BMI, and waist circumference. Child DNA was used to calculate a polygenic risk score for obesity. Linear and logistic regression models adjusted for confounders and child genetic risk. On average, 10.9 years elapsed between maternal baseline assessment and child anthropometry. At baseline, 4.8% of women reported having diabetes or hypertension, one-third had obesity (BMI 30 or higher), and more than half had elevated waist circumference or low HDL-C. Among children (mean age 7.5 years), 17.2% were categorized as having overweight and 27.8% were categorized as having obesity. Higher maternal BMI, larger waist circumference, and higher fasting insulin and diastolic blood pressure were significantly associated with higher child BMI z-scores. A 1-SD increase in maternal BMI (6.1 units) or waist circumference (13.3 cm) was linked to greater odds of child overweight or obesity. Elevated maternal insulin was associated with having a child with overweight status, and higher diastolic blood pressure with having a child in the obesity category in minimally adjusted models. Prepregnancy cardiometabolic risk factors in Hispanic/Latina women are associated with higher BMI and obesity risk in their children, independent of genetic predisposition. These findings highlight the prepregnancy period as a critical window for interventions to improve intergenerational health outcomes.
9. Guideline comparison for fatty liver disease: European (EASL-EASD-EASO) and Asian (APASL) perspectives.
期刊: Expert review of gastroenterology & hepatology 发表日期: 2025-Dec-18 链接: PubMed
摘要
Metabolic dysfunction-associated fatty liver disease (MAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) represent an increasing global health challenge for modern medicine. Europe and Asia have responded with region-specific guidelines -respectively, European Association for the Study of the Liver (EASL)-European Association for the Study of Diabetes (EASD)-European Association for the Study of Obesity (EASO) for MASLD and Asian Pacific Association for the Study of the Liver (APASL) for MAFLD- that reflect different epidemiology, clinical priorities and healthcare systems. We compare the two guidelines on the basis of three main points: 1) definitions and diagnostic strategies, 2) treatment and in particular lifestyle and pharmacological options, and 3) surveillance approaches. Sources include the 2024 EASL-EASD-EASO joint guidelines and the 2025 APASL clinical practice guidelines. Both guidelines agree on the central role of lifestyle management and early diagnosis. However, there are several differences in diagnosis, pharmacotherapy, and surveillance. The European approach supports targeted fibrosis assessment using fibrosis-4 and transient elastography. On the other hand, the Asian-Pacific framework provides broader coverage, including special populations. What our analysis suggests is a harmonization, to be reached via global consensus, that balances precision medicine with inclusivity and that supports collaborative, cross-regional research that focuses on closing the gaps of current knowledge.
10. Community-Based Adaptation and Evaluation of a Peer-Led Intervention to Address Alcohol Use and HIV in Pregnant and Breastfeeding Women in South Africa: Protocol for the "Mentor Mothers Plus" Randomized Control Trial.
期刊: JMIR research protocols 发表日期: 2025-Dec-18 链接: PubMed
摘要
In South Africa, pregnant and lactating women (PLW) face a dual burden of high alcohol use and HIV prevalence, both of which adversely affect maternal and infant health. However, few interventions address alcohol use and HIV risk concurrently in this population. This study seeks to adapt and pilot-test in a randomized controlled trial (RCT) the peer-led multisession intervention Mentor Mothers Plus (MM+) to integrate alcohol reduction strategies with HIV prevention and care support (in a seroneutral intervention) among PLW in Saldanha Bay, Western Cape, South Africa. Using the ADAPT-ITT (assessment, decision, adaptation, production, topical experts, integration, training, testing) framework, we adapted the evidence-based Mentor Mother (MM) model, originally aimed at reducing vertical HIV transmission among mothers with HIV. Our mixed methods design includes (1) qualitative research, including in-depth interviews (IDIs) and focus group discussions (FGDs), to assess drivers of perinatal alcohol use and HIV risk; (2) intervention adaptation through community-based participatory workshops with stakeholders to refine the MM+ intervention in order to include culturally and contextually strategies; and (3) a pilot RCT with 100 pregnant women (≥16 years old, reporting recent alcohol use) randomized in a 1:1 ratio to the MM+ intervention (motivational interviewing [MI], including HIV and alcohol reduction messaging) or enhanced standard of care (SOC). Primary RCT outcomes include reduced alcohol use, via phosphatidylethanol (PEth) blood levels at 6-month follow-up. Secondary outcomes include uptake and adherence to pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) among women with HIV, as well as intervention fidelity, feasibility, and acceptability. Community research included 2 FGDs with health workers (n=6) and community leaders (n=7) and 31 interviews with partners and peers of PLW. Data showed that women are motivated to reduce alcohol use for child health but face barriers (eg, misconceptions about safety of alcohol use, poverty, trauma, and intimate partner violence [IPV]). Alcohol use is with friends/family members/partners and tied to financial stress, unplanned pregnancy, and poor mental health. MM+ support preferences emphasize nonjudgmental, peer-based mentorship, family involvement, and faith/community engagement. Gaps include stigma around HIV and contraceptive services. Communities recommend mentor mothers with lived experience, providing culturally relevant, empathetic support, and linking to social and clinical services. In August 2025, a community workshop refined the intervention, emphasizing the need for trustworthy mentor mothers with lived experience. Priorities included culturally relevant information on alcohol use, HIV prevention, family planning, trauma and interpersonal violence support, and flexible delivery. Next steps involve finalizing materials, training mentor mothers, and launching the RCT. Our community-based, participatory study, MM+, offers a promising approach to address co-occurring alcohol use and HIV among PLW. Stakeholder engagement enhances contextual relevance and supports future scalability. The RCT will evaluate efficacy of the model in reducing alcohol and improving HIV outcomes. Clinicaltrials.gov NCT06962592; https://clinicaltrials.gov/study/NCT06962592. DERR1-10.2196/78856.
11. Umoja Health: Building Community Coalitions to Achieve Health Equity From COVID-19 to Cancer.
期刊: American journal of public health 发表日期: 2025-Dec-18 链接: PubMed
摘要
Umoja Health (UH) is a community-led approach to address long-standing disparities in health. UH was founded in 2020 at the request of members of the University of California, San Francisco Cancer Center Community Advisory Board. UH started with a focus on COVID-19 testing in San Francisco Bay Area Black/African American communities and evolved to address chronic disease and cancer in diverse communities. We detail UH’s approach to addressing the separation between public health and health care, highlighting the coalition’s effects on local health equity. (Am J Public Health. Published online ahead of print December 18, 2025:e1-e5. https://doi.org/10.2105/AJPH.2025.308322).
12. Association of blood pressure levels in the nonhypertensive range with mortality among people without traditional risk factors.
期刊: Journal of hypertension 发表日期: 2025-Dec-18 链接: PubMed
摘要
While emerging evidence suggests guideline-defined nonhypertensive blood pressure (BP) may encompass heterogeneous risk, the relationship between BP variations within nonhypertensive ranges and mortality risk remains inadequately characterized among individuals without traditional cardiovascular risk factors. This study investigated whether nonhypertensive range of SBP, DBP, and pulse pressure (PP) are associated with long-term mortality in a healthy population. This study included 80 730 UK Biobank participants without traditional cardiovascular risk factors and with nonhypertensive BP (SBP <140 mmHg, DBP <90 mmHg, and PP <60 mmHg). Participants were followed up for all-cause, cardiovascular, and noncardiovascular mortality. Associations were assessed using multivariable Cox proportional hazards models with restricted cubic splines. Over a median follow-up of 13.7 years, 2553 deaths occurred. SBP and PP showed significant nonlinear associations with all-cause mortality (P-overall <0.01), while DBP showed a linear inverse association (P-overall = 0.049). Compared to the third quintile, the lowest PP quintile (<40 mmHg) was associated with 26% higher mortality risk (hazard ratio 1.26, 95% confidence interval [95% CI] 1.10-1.44), and the highest quintile (53-60 mmHg) with 14% higher risk (hazard ratio 1.14, 95% CI 1.01-1.28). The lowest SBP quintile (<114 mmHg) was associated with 16% higher risk (hazard ratio 1.16, 95% CI 1.02-1.32) compared to the third quintile (120-126 mmHg). Even within nonhypertensive ranges, the lowest and highest quintiles of PP level, as well as low-normal SBP and DBP levels, were associated with increased mortality risk in a healthy population.
13. Association of hypertension disorders of pregnancy and left ventricular remodeling after 15 years follow-up: findings from the Bogalusa Heart Study.
期刊: Journal of hypertension 发表日期: 2025-Dec-18 链接: PubMed
摘要
Hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) are linked to later-life cardiovascular disease, but their impact on midlife cardiac health is unestablished. Therefore, we examined their associations with midlife left ventricular remodeling. This study included 408 and 451 women from the Bogalusa Heart Study cohort with information on HDP and GDM, respectively. Of these, 34 had HDP and 41 had GDM. Mean echocardiographic follow-up was approximately 15 years after pregnancy. Outcomes included left ventricular mass index (LVMi), ejection fraction (LVEF), and left ventricular geometry (concentric remodeling, concentric or eccentric hypertrophy). Multivariable regression was adjusted for demographic and prepregnancy cardiometabolic factors. Effect modification by age and race and mediation by postpregnancy cardiometabolic factors were evaluated. Median age at first pregnancy was 22.0 years and 33.0% were Black. HDP was associated with greater LVMi in midlife (standardized β = 0.37, 95% confidence interval [CI]: 0.01-0.72, P = 0.04), but not with LVEF. HDP was also associated with greater odds of concentric remodeling (odds ratio = 2.48, 95% CI: 1.03-6.00, P = 0.04). Postpregnancy BMI mediated 19.47% of the association between HDP and LVMi (P = 0.01). GDM was not associated with left ventricular structure or function after adjustment. Interaction terms by age and race were not significant. HDP is associated with adverse left ventricular remodeling, partly mediated by postpregnancy BMI. These findings underscore the need for early echocardiographic monitoring and postpartum weight management in women with HDP to reduce long-term cardiovascular risk.
14. The role of personal social networks in social participation for adult burn survivors: A cohort study.
期刊: Clinical rehabilitation 发表日期: 2025-Dec-18 链接: PubMed
摘要
ObjectiveTo describe the structure and composition of personal social networks in burn survivors and examine their associations with social participation.DesignA 6-month cohort study.SettingCommunity.Participants23 adult burn survivors.Main MeasuresParticipants completed the Personal Network Survey and Life Impact Burn Recovery Evaluation Social Interactions and Social Activities short forms at baseline, 3-month, and 6-month. Personal Network Survey assesses individual social network in two categories: network structure depicts the architecture of social connections, while network composition describes the characteristics of network members. Life Impact Burn Recovery Evaluation measures social participation after burn injury.ResultsThe average age of the 23 participants was 49.1 (SD 12.5) years, with an average of 45.0% (SD 25.9%) total body surface area burned. Friends and family were the major relationship types, while camaraderie, emotion, and advice were the major support types. Multilevel models results showed that within-person smaller (β=-0.91; 95% CI = -1.48, -0.33; p = .004) and more close-knit (β=-1.29; 95% CI = -2.22, -0.37; p = .009) networks, as well as between-person networks in which burn survivors had fewer advisors (β=-40.97; 95% CI = -69.56, -12.38; p = .008) and received less health support (β=-20.35; 95% CI = -37.91, -2.79; p = .030), were significantly associated with better social participation.ConclusionThe findings advance the current understanding of burn survivors’ social networks and their impact on social participation and lay the foundation for developing targeted strategies to promote social engagement and well-being by optimizing network composition and the balance of received support.
15. Associations between healthy lifestyle practices and cardiovascular disease risk among Chinese adults: a nationwide cohort study.
期刊: Postgraduate medical journal 发表日期: 2025-Dec-18 链接: PubMed
摘要
Cardiovascular disease (CVD) is the leading global cause of mortality and imposes substantial health and economic burdens. However, the overall relationship between combined lifestyle factors and CVD incidence among Chinese adults remains poorly defined. This study aimed to explore the association between healthy lifestyle factors and CVD risk in a nationwide Chinese cohort. We included 7349 participants from 2011-2012 and followed them until 2018. Lifestyle was assessed using seven factors (blood pressure, blood glucose, cholesterol, body mass index (BMI), tobacco exposure, physical activity, and sleep duration), and participants were categorized into three groups based on the number of ideal factors. Cox regression models were used to analyze data. Participants with intermediate and unfavorable lifestyles had 29.74% and 59.71% higher CVD risks, respectively, compared to those with favorable lifestyles. Former smokers, individuals with elevated blood glucose, higher BMI, and inadequate sleep duration also had increased CVD risks. Subgroup and sensitivity analyses showed consistent trends. This nationwide cohort study highlights that healthy lifestyle practices are significantly associated with reduced CVD risk. Promoting healthy behaviors through public health strategies is crucial to mitigating CVD risk. Key messages What is already known on this topic: Modifiable lifestyle factors are established drivers of CVD, but composite lifestyle scores lacked nationally representative evidence in China’s aging population before this study. What does this study add: Unhealthy lifestyles, including factors such as blood pressure, glucose levels, and BMI, significantly increased the risks of CVD and stroke in Chinese adults. Conditions like obesity, hyperglycemia, and poor sleep independently elevated these risks across all subgroups. How this study might affect research, practice, or policy: This study advocates multifactorial lifestyle interventions into public health policies, targeting high-risk populations, and prioritizing research on the scalability of these interventions.
16. State Vaccine Law and Policy-A New Threat to Public Health.
期刊: JAMA 发表日期: 2025-Dec-18 链接: PubMed
摘要
This Viewpoint discusses the importance of understanding the evolution and current trajectory of state-level vaccine requirements for assessing the stability of the nation’s immunization infrastructure.
17. "How do I reduce the fear of missing out?" analyzing Reddit discussion of how people deal with the fear of missing out when reducing their alcohol use.
期刊: Experimental and clinical psychopharmacology 发表日期: 2025-Dec-18 链接: PubMed
摘要
Alcohol use remains a public health concern due to the harm it can have on both the drinker and those around the drinker. One emerging factor that could be targeted by interventions is the fear of missing out (FoMO). FoMO is the sense that others are having rewarding experiences that you are missing out on, and research has found a link between FoMO and both alcohol use and harm. The aim of this study was to identify and describe how people who are aiming to reduce their drinking overcome or deal with FoMO to inform future intervention content. To address this aim, we collected and analyzed the content of 2,476 posts on Reddit about FoMO and alcohol use. Suggestions identified to reduce FoMO included reframing FoMO to focus on the positives of disconnecting from alcohol, focusing on other nonalcohol-related activities, finding friends who do not drink, and attending events sober. Results provide a foundation for future research into interventions that target FoMO, with the possibility for future research to expand upon these data to develop an evidence-based harm-reduction method. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
18. Impaired Windkessel function and proximal aortic stiffness: Linking vascular ageing to cognitive decline.
期刊: Experimental physiology 发表日期: 2025-Dec-18 链接: PubMed
摘要
Central arterial stiffening, particularly of the proximal aorta, is increasingly recognised as a pivotal contributor to cardiovascular disease, dementia, and mild cognitive impairment. Loss of Windkessel function amplifies pulsatile pressure, reduces diastolic perfusion and accelerates microvascular damage in the brain. Evidence from epidemiological studies, magnetic resonance imaging investigations and longitudinal data demonstrates disproportionate age-related stiffening of the proximal aorta and its strong association with cognitive decline. Importantly, this process is modifiable: aerobic exercise and unique environmental adaptations, such as those observed in Japanese Ama divers, preserve proximal aortic elasticity. Targeting central arterial stiffness may represent a promising strategy for preventing both vascular disease and brain dysfunction.
19. Alcohol consumption dynamics and day-to-day experiences of alcohol-related problems: Combining transdermal alcohol concentration sensors and daily self-reports in young adults' natural settings.
期刊: Experimental and clinical psychopharmacology 发表日期: 2025-Dec-18 链接: PubMed
摘要
Day-level alcohol-related problems (ARPs)-such as craving, difficulty limiting/stopping, tolerance, impairment, and withdrawal-may signal risk for alcohol use disorder in young adults’ natural settings. ARPs may relate to how people drink (e.g., intensity, speed, duration), but these consumption dynamics are difficult to assess accurately through self-reports. We tested the association between ARPs and alcohol consumption dynamics in young adults using wearable transdermal alcohol concentration (TAC) sensors and daily diaries. College students (N = 79; 55.7% female, 86.1% White, Mage = 20.1) who frequently engaged in heavy episodic drinking wore TAC sensors and completed daily diaries over four consecutive weekends (89.9% completion rate). ARPs were measured the morning after drinking events. Three consumption dynamics were extracted from TAC data: speed (rise rate), intensity (peak), and duration (rise duration) of drinking. Analyses using unadjusted models showed that young adults reported more ARPs on days with faster rise rates, higher peaks, or longer rise durations compared with their own slower, lower, and shorter days. Adjusted models including all three TAC features showed that faster rise rates and longer rise durations were independently associated with ARPs, but higher peaks were not. These findings provide novel evidence that the speed and duration of drinking-not just the amount-may be key targets for ARP prevention among young adults. These insights would not have emerged without the rich, objective measurement of drinking dynamics offered by TAC sensors. TAC features may help indicate existing alcohol-related impairment, warranting investigation of their prospective links to alcohol use disorder risk. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
20. Survey on the Actual Use of Topical Anti-Inflammatory Drugs Among Patients with Atopic Dermatitis.
期刊: Dermatology and therapy 发表日期: 2025-Dec-18 链接: PubMed
摘要
Atopic dermatitis (AD) is a chronic inflammatory skin condition requiring long-term management to maintain remission and prevent relapse. Appropriate use of topical anti-inflammatory medications is an important factor in improving symptoms in patients with AD. This study aimed to investigate the treatment methods for maintaining remission and application of anti-inflammatory topical therapy. This observational study was conducted in October 2022, using medical claims data from DeSC Healthcare Inc., linked with survey data collected from users of kencom®, a health promotion application. Eligible patients were adults aged ≥ 19 years with a confirmed AD diagnosis and prescription history. The survey evaluated (1) the actual treatment situation during the remission maintenance phase; and (2) instructions, actual status and adherence for application of anti-inflammatory topical therapy. A total of 626 patients who answered the kencom® survey and met eligibility criteria were included. Of these, 42.3% were instructed to stop medication once eczema improved, while 34.2% were instructed to continue during remission. Regarding instructions for the amount applied, the most common response was “No specific instructions” (44.2%), followed by “Fingertip-unit (FTU)” (27.2%). In actual practice, “FTU” was the most common amount (42.2%). Regarding application area, the most frequent instruction and actual practice were “Apply only to areas with eczema with remaining inflammation” at 52.6% and 62.5%, respectively, followed by “Apply not only to the eczema or remaining inflamed areas but also the surrounding areas” at 24.0% and 37.2%. Regarding the application method, “Apply thinly” was the most common instruction and actual practice at 32.7% and 48.4%, respectively. Treatment adherence rates were generally high, at over 60%. Guidance from healthcare professionals has a crucial role in the proper use of topical therapies for AD. It is essential to ensure that topical medications are used properly to help patients achieve their treatment goals.
21. Moderate to Severe Acute Migraine Attacks: An Opinion Paper on the Use of Triptans and Triptan-NSAIDs Combinations in Individualized Treatment Plans.
期刊: Neurology and therapy 发表日期: 2025-Dec-18 链接: PubMed
摘要
This opinion paper on the acute treatment of migraine addresses the definition and recognition of acute migraine attacks, highlighting the variety of symptoms and manifestations. It describes the available treatments and guidelines, noting significant country-specific variations. The paper also discusses the prescribers’ knowledge and updates, recognizing the segment-specific differences. Despite nonsteroidal anti-inflammatory drugs (NSAIDs) and triptans being universally recommended as first-line treatments, their visibility in the field has diminished due to the promotion of newer medicines. The authors, a panel of 15 experts from six European countries, emphasize the underutilization of triptans and advocate for their prescription, and also their use in combination with NSAIDs, when NSAIDs alone are not sufficiently effective. The panel specifically considered the sumatriptan succinate-naproxen sodium combination, which was recently introduced in Europe and may be beneficial in patients not responding to NSAIDs, particularly for special patient groups, such as those with menstrual-related acute migraine or migraine attacks with prolonged pain or postdrome. Finally, the consensus highlights the need for individualized treatment plans and the importance of considering patient preferences and specific symptoms, integrating evidence-based recommendations with patient-centered care to optimize migraine management.
22. Systemic health implications of dental prescribing in general practices.
期刊: Quintessence international (Berlin, Germany : 1985) 发表日期: 2025-Dec-18 链接: PubMed
摘要
Dental prescribing is a crucial component of general dental practices, enabling the management of pain, control of infection, and promotion of postoperative recovery. Analgesics, antibiotics, and antiseptic mouthwashes are frequently prescribed as short-term adjuncts to definitive dental treatments, such as extractions, endodontic, and periodontal therapies. These medications can significantly affect cardiovascular, renal, hepatic, metabolic, and the microbiome beyond the oral cavity. In this review, we aim to summarize the systemic health effects of three medication classes frequently prescribed by general dentists and discusses their mechanisms, clinical implications, and stewardship opportunities. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first-line treatment for dental pain, but even a brief course can affect renal function, blood pressure, and gastrointestinal integrity in susceptible patients. Acetaminophen is an important analgesic for mild to moderate dental pain though its cumulative dosing may increase the risk of hepatotoxicity. Opioids are historically prescribed after tooth extractions, endodontic and periodontal surgeries, but they offer no advantage over non-opioid analgesics and contribute to opioid misuse in the community. Gabapentinoids are emerging as lower-risk opioid alternatives in patients who cannot use NSAIDs or acetaminophen, but their use also requires caution. Antibiotics continue to be prescribed for conditions that are not clinically indicated but may increase the risks of antimicrobial resistance, gut microbiome dysbiosis, and Clostridioides difficile infection. Mislabeling of penicillin allergies is widespread and may promote the use of higher-risk alternatives such as clindamycin. Antiseptic mouth rinses, particularly chlorhexidine, can effectively reduce oral microbial load but may disrupt nitrate-reducing oral bacteria and alter nitric oxide-mediated vascular function. General dental practitioners should integrate systemic health awareness when prescribing these medications to ensure safety and advance antimicrobial and pharmacologic stewardship in daily practices.
23. Characteristics of exercise- and nutrition-based continuing education for health-care professionals to support community-living older adults in Canada.
期刊: Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme 发表日期: 2025-Dec-18 链接: PubMed
摘要
Health-care professionals (HCPs) have an important role in disseminating and implementing exercise and nutrition care to older adults to support aging in place. We performed an environmental scan to examine the availability of exercise- and nutrition-based continuing education (CE) resources for kinesiologists, physiotherapists, exercise physiologists, occupational therapists, dietitians, and pharmacists in Canada relating to the specific needs of community-living older adults. Data were collected between 2023 and 2024 using websites of provincial and national organizations for HCPs, advocacy organizations for chronic conditions, and aging institutes; communication with knowledge users; and a targeted Google search. Sixty-nine courses were identified that have been active within the past 5 years. Notably, only 9% focused exclusively on nutrition compared to 64% that focused exclusively on exercise. Also, most courses (74%) delivered content aimed at age-adjacent chronic health conditions, while few described their content with respect to healthy aging specifically. While courses emphasized evaluation and application in their course objectives, these goals were inconsistent with the fact that most courses had short durations (<1.5 hours) and were delivered virtually and asynchronously. Our work suggests that the organizations we scanned provide limited education on nutrition for older Canadians. Furthermore, across both exercise and nutritional education, in-person or hybrid options to support the training and application of practical skills are lacking. Exercise and nutrition-focused CE development would support HCP learners to help their older clients age in place.
24. A cellular basis for heightened gut sensitivity in females.
期刊: Science (New York, N.Y.) 发表日期: 2025-Dec-18 链接: PubMed
摘要
Visceral pain disorders, such as irritable bowel syndrome, exhibit a marked female prevalence. Enhanced signaling between enterochromaffin (EC) cells in the gut epithelium and mucosal sensory nerve fibers likely contributes to this sex bias. We identified an estrogen-responsive paracrine pathway in which two enteroendocrine cell types, peptide YY (PYY)-expressing L cells and serotonergic EC cells, communicate to increase gut sensitivity in females. We demonstrate that estrogen signaling up-regulates the bacterial metabolite short-chain fatty acid receptor Olfr78 on colonic L cells, increasing PYY release and their sensitivity to acetate. Elevated PYY acts on neighboring EC cells by means of NPY1R, thereby enhancing serotonin release and gut pain. We propose that hormonal fluctuations, in conjunction with internal (stress) or environmental (diet) factors, amplify this local estrogen-responsive colonic circuit, resulting in maladaptive gut sensitivity.
25. Risks of per- and polyfluoroalkyl substance exposure through marine fish consumption.
期刊: Science (New York, N.Y.) 发表日期: 2025-Dec-18 链接: PubMed
摘要
Global food trade expansion has enriched diets worldwide but also heightened concerns about contaminant spread. Per- and polyfluoroalkyl substances (PFAS) can persist in the environment for decades, yet their risks through food trade remain unclear. The global median estimated daily intake (EDI) of C8-PFAS (perfluorooctanoic acid and perfluorooctane sulfonate) (0.023 nanograms per kilograms per day) was mapped from 212 marine fish species, which indicated higher EDIs in North America, Oceania, and Europe. Furthermore, European countries play a pivotal role in C8-PFAS trade flows, markedly reshaping exposure pathways and driving increased exposure in many nations. These dynamics highlight the importance of establishing food-safety regulations and international trade standards. Although perfluorooctane sulfonate hazard index decreased by 72% after its 2009 regulations, unregulated long-chain PFAS continue to pose elevated risks.
26. A colorimetric method for detecting virulent bacteriophage to Vibrio cholerae in fecal and environmental samples.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Dec-18 链接: PubMed
摘要
Vibrio cholerae are often infected with pathogen-specific virulent bacteriophages (phages) that may be found associated with V. cholerae or independently from the bacteria, especially in environmental water samples. When detected, these phages can serve as a surrogate for detection of V. cholerae and they also have an important role in the ecology of V. cholerae. Vibriophages can be detected using plaque or molecular (PCR) assays, but these methods are time-consuming and require specialized laboratory resources. To increase the accessibility of phage detection for epidemiologic applications, we developed a simple, rapid, and inexpensive colorimetric assay to detect vibriophage that can be scaled quickly to screen large numbers of samples. The assay uses resazurin and V. cholerae AC6169 that is susceptible to vibriophages ICP1, 2, and 3. Resazurin is a dye that turns from blue to pink when added to a culture broth with growing bacteria. We hypothesized that when a bacteria-free test sample, such as filtered wastewater containing vibriophage is added to culture broth with AC6169 and resazurin, the phages will lyse the bacteria preventing their growth, and the color of the broth will remain blue. However, if there are no vibriophages in the sample, the bacteria will grow rapidly, and the culture broth will turn pink. We developed the assay using ICP1 spiked samples of environmental water, stool and frozen bile peptone and found it to be sensitive with a limit of detection of 4-40 plaque forming units/ml. This colorimetric assay provides a convenient method to detect vibriophages on a larger scale than was possible earlier. Its use should help to better understand the role of vibriophage as a surrogate for detecting V. cholerae and better understand their role in the pathogenesis, ecology, and epidemiology of cholera.
27. Coal Workers' Pneumoconiosis-Associated Deaths - United States, 2020-2023.
期刊: MMWR. Morbidity and mortality weekly report 发表日期: 2025-Dec-18 链接: PubMed
摘要
Coal workers’ pneumoconiosis (CWP) is a preventable, progressive occupational lung disease caused by inhaling respirable coal mine dust, a complex mixture commonly containing coal, crystalline silica, and other silicate minerals. Early pneumoconiosis can be asymptomatic, but advanced disease often leads to disability and premature death. To describe CWP-associated mortality among U.S. residents aged ≥15 years by industry and occupation, CDC conducted an exploratory analysis of National Vital Statistics System multiple cause-of-death data for 2020-2023, the most recent years that include information on decedents’ usual industry and occupation. During 2020-2023, CWP was listed on the death certificate of 1,754 decedents (age-adjusted CWP-associated death rate = 1.3 per 1 million). By industry group, the highest number of CWP-associated deaths occurred among workers in the mining industry (1,255). The highest proportionate mortality ratios (PMRs) were among persons employed in the mining industry (PMR = 50.0) and the construction and extraction occupations (6.2). Among workers employed in the mining industry, the highest PMR was among underground mining machine operators (164.6). The continuing occurrence of CWP-associated deaths underscores the potential value of a comprehensive prevention program (maintaining efforts to control occupational coal mine dust exposures, combined with early disease detection efforts and medical care) and supports potential benefits of ongoing surveillance.
28. Straining Under Contradiction? Contradictory Class Locations and Job Strain in the United States.
期刊: International journal of social determinants of health and health services 发表日期: 2025-Dec-18 链接: PubMed
摘要
Research suggests lower-level supervisors may suffer greater burdens of mental illness and substance use than workers and upper management, a pattern that may arise from their contradictory class location. For example, lower-level supervisors may be compelled to discipline subordinates and enforce policies over which they have little say, and contend with antagonism from workers, exposing them to stressors like job strain. However, to our knowledge, no U.S. studies have investigated whether job strain is elevated among lower-level supervisors. We addressed this gap using 2002-2022 General Social Survey data (n = 9261). We classified respondents as workers, lower-level supervisors, higher-level supervisors, top executives, petit bourgeoisie, or capitalists using self-employment and supervisory-authority items, and created a continuous job-strain score using five job-control and six job-demands items. Age- and gender-adjusted Poisson models suggested job strain decreased approximately linearly across classes, as mean scores were 6% (95% CI: 3%-8%) lower among lower-level supervisors and 23% (95% CI: 19%-27%) lower among capitalists than among workers. Patterns were similar for job control alone. However, lower-level supervisors did report elevated job demands, including 14% (95% CI: 10%-17%) greater mean scores than workers. Patterns persisted after thorough confounder adjustment. Our findings suggest job strain may not explain lower-level supervisors’ burdens of mental illness and substance use.
29. Dehumanized yet agentic? When and how organizational dehumanization mediates the effects of abusive supervision on burnout and interpersonal helping behavior.
期刊: Journal of occupational health psychology 发表日期: 2025-Dec-18 链接: PubMed
摘要
Drawing from the dehumanization model and human agency theory, we examined the psychological processes underlying the relations of abusive supervision with employees’ well-being (i.e., burnout) and performance (i.e., interpersonal helping behavior), through the sequential mediation of organizational dehumanization (OD), (in)authenticity and powerlessness, and the moderation of employee chronic self-efficacy. We tested our hypotheses in a three-wave time-lagged study with supervisor-employee dyads in China (Study 1, N = 203 dyads) and a four-wave longitudinal study in North America (Study 2, N = 314). Results from both studies supported all of our hypotheses. OD mediated the relations of abusive supervision with employee burnout and interpersonal helping. Furthermore, OD and inauthenticity serially mediated the relation between abusive supervision and employees’ burnout, whereas OD and powerlessness serially mediated the relation between abusive supervision and employee interpersonal helping behavior. Employees’ chronic self-efficacy moderates the serial mediating effects of OD in the relationship of abusive supervision with burnout and interpersonal helping behavior. The current research extends the dehumanization theory (Haslam, 2006) through the lens of human agency (Bandura, 1989), furthering our understanding on OD processes. It also expands the theoretical understanding on abusive supervision through introducing OD as a critical mediational mechanism and examining human-agency-related mediational and moderational mechanisms, above and beyond past literature focused on resource- and justice-related theoretical processes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
30. The association between virus-induced spinal cord pathology and the genetic background of the host.
期刊: Journal of neuropathology and experimental neurology 发表日期: 2025-Dec-18 链接: PubMed
摘要
Theiler’s murine encephalomyelitis virus (TMEV) infection in mice has been used to study diverse neurological diseases, including multiple sclerosis and epilepsy. In this investigation, 5 strains of collaborative cross (CC) mice were infected with TMEV and examined clinically and histologically at days 4, 14, and 90 post-infection (dpi). All CC strains tested exhibited lumbar spinal cord and/or ventral peripheral nerve lesions by 14 dpi; CC027, CC023, and CC078 strains exhibited lesions at 4 dpi. At 90 dpi, lesions were remnants of the inflammatory responses associated with earlier infection; there was skeletal muscle atrophy in the CC023 strain. Increased microglial/macrophage reactivity was observed in all strains at 4 and 14 dpi, but not at 90 dpi. TMEV mRNA expression was greatest in the CC023 and CC078 strains at the acute timepoints; TMEV was completely cleared in all mice at 90 dpi. The neuropathological and clinical profiles in CC023 mice, mainly at 14 dpi, share some clinical and histologic features with those in amyotrophic lateral sclerosis patients. This work demonstrates how viral infection might interact with the genetic background of a susceptible individual to contribute to the onset, clinical presentation and persistence of lesions despite viral clearance.
31. [Assessment of the earning capacity of patients with rheumatoid arthritis].
期刊: Zeitschrift fur Rheumatologie 发表日期: 2025-Dec-18 链接: PubMed
摘要
The assessment of the earning capacity of patients with rheumatoid arthritis must be uniform, comprehensible, and reproducible. The aim of this monocentric retrospective cross-sectional study was to identify suitable assessments that have predictive value in relation to the prognosis for earning capacity. A total of 283 patients were included. Of these, 43 (15%; cohort 1) had a suspended or severely compromised earning capacity and 240 (84%; cohort 2) had a positive prognosis for their ability to work. The disease activity of cohort 1 was slightly higher than in cohort 2 (Disease Activity Score 28 [DAS28]: 2.4 ± 1.2 vs. 2.3 ± 0.8; p < 0.05, r = 0.11). Highly significant, clinically relevant differences were found in everyday activities (Hannover functional questionnaire [FFbH]: 61 ± 15 vs. 80 ± 14; p < 0.001, r = 0.38) and hand strength (19 ± 11 kg vs. 23 ± 10 kg, p < 0.001, r = 0.29). The 6‑minute walk test showed clear, clinically relevant differences (430 ± 89 m vs. 552 ± 84 m, p < 0.001, r = 0.32), as did the Timed-up-and-go-Test (TUG; 10.4 ± 4.5 s vs. 7.9 ± 3.9 s, p < 0.01, r = 0.35) and in the Chair-rising-Test (CRT; 23 ± 11 s vs. 11 ± 4.6 s; p < 0.001, r = 0.44). The scores for anxiety and depression were only slightly higher in cohort 1 than in cohort 2 (Patient Health Questionnaire 4 [PHQ-4]: 5.0 ± 3.2 vs. 4.0 ± 2.4, p < 0.001, r = 0.27), as were the scores for fatigue (Modified Fatigue Impact Scale [MFIS] psych: 2.9 ± 0.6 vs. 2.1 ± 0.8, p < 0.001, r = 0.34; MFIS cog: 2.3 ± 0.8 vs. 1.6 ± 0.9, p < 0.001, r = 0.25; MFIS psych-soc: 2.9 ± 0.8 vs. 1.8 ± 1, p < 0.001, r = 0.30). The erosion status (according to the Larsen score) did not differ significantly between cohorts 1 and 2. The data obtained indicate that the FFbH, 6‑minute walk test, TUG, CRT, and hand strength are particularly helpful in assessing the occupational prognosis of patients with rheumatoid arthritis. Die Begutachtung der Erwerbsfähigkeit von Patienten mit rheumatoider Arthritis muss einheitlich, nachvollziehbar und reproduzierbar sein. Ziel dieser monozentrischen retrospektiven Querschnittstudie war es, geeignete Assessments zu identifizieren, die einen prädiktiven Wert in Bezug auf die Erwerbsprognose haben.Es wurden 283 Patienten eingeschlossen. Von diesen hatten 43 (15 %; Kohorte 1) eine aufgehobene oder schwer bedrohte Erwerbsfähigkeit und 240 (84 %; Kohorte 2) eine positive Erwerbsprognose.Die Krankheitsaktivität von Kohorte 1 war leicht höher als in Kohorte 2 (DAS28: 2,4 ± 1,2 vs. 2,3 ± 0,8; p < 0,05, r = 0,11). Es fanden sich hochsignifikante, klinisch relevante Unterschiede in den Alltagsaktivitäten (FFbH: 61 ± 15 vs. 80 ± 14; p < 0,001, r = 0,38) und in der Handkraft (19 ± 11 kg vs. 23 ± 10 kg; p < 0,001, r = 0,29). Im 6‑Minuten-Gehtest zeigten sich deutliche, klinisch relevante Unterschiede (430 ± 89 m vs. 552 ± 84 m, p < 0,001, r = 0,32), ebenso im Timed-up-and-go-Test/TUG (10,4 ± 4,5 s vs. 7,9 ± 3,9 s, p < 0,01, r = 0,35) und im Chair-rising-Test/CRT (23 ± 11 s vs. 11 ± 4,6 s; p < 0,001, r = 0,44).Die Werte für Angst und Depression waren in Kohorte 1 nur leicht höher als in Kohorte 2 (PHQ-4: 5,0 ± 3,2 vs. 4,0 ± 2,4, p < 0,001, r = 0,27), ebenso wie die Werte für Fatigue (MFIS psych: 2,9 ± 0,6 vs. 2,1 ± 0,8, p < 0,001, r = 0,34; MFIS kog: 2,3 ± 0,8 vs. 1,6 ± 0,9, p < 0,001, r = 0,25; MFiS psych-soz: 2,9 ± 0,8 vs. 1,8 ± 1, p < 0,001, r = 0,30). Der Erosionsstatus (nach Larsen-Score) unterschied sich nicht signifikant zwischen Kohorte 1 und 2.Die gewonnenen Daten deuten darauf hin, dass insbesondere der FFbH, der 6‑Minuten-Gehtest, der TUG, der CRT und die Handkraft hilfreich bei der Begutachtung der Erwerbsprognose von Patienten mit rheumatoider Arthritis sind.
32. Quantitative X-ray diffraction analysis of quartz in bulk samples: outcomes of an international interlaboratory test on three standardized methods.
期刊: Annals of work exposures and health 发表日期: 2025-Dec-18 链接: PubMed
摘要
The quantification of crystalline silica (quartz) in materials helps communicate the potential risk of exposure when the materials are then included in a work process that could generate an aerosol of particulate. Although many analytical laboratories have developed procedures for quantification of quartz in bulk samples, these procedures are not standardized and are generally limited to their individual needs. Therefore, the International Standards Organization (ISO) working group for silica measurement (ISO/TC146/SC2/WG7 Silica) developed an international standard that describes 3 analytical methods for the determination of quartz in bulk samples by X-ray diffraction (XRD): the external standard method for samples prepared on filters, the internal standard method, and the spiking method. This paper describes the results of an interlaboratory measurement comparison in which the 3 XRD standardized methods were evaluated to verify if the 3 methods produce results that agree with each other. Simple analytical systems, represented by 4 binary mixtures of quartz added to another mineral, were prepared. Sub-samples of the 4 test powders were delivered to the 7 participating laboratories from 6 countries that agreed to participate in this study. The precision of each measurement method, calculated as a percentage of quartz weight within the range 10 to 16 wt%, was similar for the 3 XRD methods. The repeatability SDs, sr, ranged between 0.4 and 0.8 (relative SD, RSDr, between 4.3% and 8.7%) for thin specimens on filter, 0.4 to 1.1 (RSDr between 4.2% and 10.6%) for the internal standard method, and 0.3 to 1.2 (RSDr between 3.7% and 11.9%) for the spiking method. The reproducibility SDs, sR, of the results in the studied wt% range were between 1.1 and 2.1 (RSDR between 12.7% and 21.5%) for the method of thin specimen on filter, 1.1 to 1.4 (RSDR between 7.5% and 14.1%) for the internal standard method and 1.1 to 2.6 (RSDR between 9.5% and 23.7%) for the spiking method. These methods obtained equivalent results at 2 concentration levels of 10% and 16% in these binary mixtures. A further step of interlaboratory testing should be implemented to investigate the performance of the 3 methods at the lower quartz concentration values.
33. Influence of seasonal, technical, and lithological parameters on exposure to dust and crystalline silica in the French natural stone industry.
期刊: Annals of work exposures and health 发表日期: 2025-Dec-18 链接: PubMed
摘要
European directives play a key role in establishing occupational exposure limit values within the European Union. Directive 98/24/EC and national regulations, such as French Decree 2021-1763, have recently introduced strict limits for exposure to non-specific dust, significantly impacting sectors such as natural stone processing. This study analyzes workers’ exposure to inhalable and respirable dust across 8 representative industrial facilities in France, focusing on granite, hard limestone, soft limestone, and sandstone. Measurements were conducted to quantify exposure levels across 5 different processes, considering key parameters such as seasonal variations, wet and dry processes, as well as dust reduction measures. Results show significant seasonal fluctuations, with higher exposures in summer, particularly during granite finishing work, where inhalable dust concentrations exceeded regulatory thresholds by up to 120 times. Wet processes demonstrated effective dust reduction, decreasing concentrations by more than 90% compared to dry methods. However, exposure to crystalline silica frequently exceeds regulatory limits, highlighting a persistent health risk for workers. The study also assessed the effectiveness of technical devices, such as suction booths and water curtains, as well as the impact of wearing a mask on occupational exposure. If suction booths and hoses have proven to be highly effective, their performance remains limited during high-emission operations. In that case and in the absence of adequate engineering controls, filtering facepiece (FFP3) masks would be appropriate.
34. Recurrent Depression With Catatonic Excitement in a Patient With Moyamoya Disease: A Case Report.
期刊: The journal of ECT 发表日期: 2025-Dec-12 链接: PubMed
摘要
We report the case of a 76‑year‑old woman with a 25‑year history of neuropsychiatric symptoms and Moyamoya vasculopathy, first identified in 2016. She presented in March 2025 with severe catatonic excitement and began electroconvulsive therapy (ECT) starting in April, showing marked clinical improvement within 3 sessions. Genetic testing confirmed moyamoya disease (MMD) with a pathogenic RNF213 mutation, associated with increased risk of infarction or hemorrhage. After trials with several anesthetic agents, dexmedetomidine (DEX) combined with remifentanil was selected, enabling stable anesthesia with a consistent electrical dose of 192 mC across 35 sessions over 5 months. The main challenges included hemodynamic stability in MMD, prevention of post‑ictal agitation in advanced age and catatonia, and preservation of seizure quality despite repeated ECT. This case highlights the safe and effective use of ECT with DEX and remifentanil in a patient with genetically confirmed MMD with catatonic symptoms.
35. Follow-up outcomes from the first national fibromuscular dysplasia clinic in the United Kingdom.
期刊: Journal of hypertension 发表日期: 2025-Dec-10 链接: PubMed
摘要
Fibromuscular dysplasia (FMD) is a rare disease with diverse clinical presentations. The need for a bespoke clinic providing individualized care was deemed a patient priority at the United Kingdom’s (UK) first patient information day on FMD. In response, a multidisciplinary clinic was established at Salford Royal Hospital in November 2019, integrating renal, neurology, interventional radiology, and neuro-radiology expertise. It has since evolved into the UK’s first national FMD clinic. This study aimed to describe baseline patient characteristics and identify contributing factors in disease progression. This prospective observational study included 215 patients reviewed over 5 years. All underwent brain-to-pelvis imaging at least once to radiologically confirm FMD. FMD mimics were identified more often than expected (n = 87, 40.4%), predominantly due to sub-optimal imaging artefacts. Of 128 confirmed FMD patients, median age was 49 years; focal FMD patients were younger than multifocal FMD patients [median (interquartile range or IQR): 44 (27-58) vs. 45 (36-49) years; P = 0.038]. Sixty-seven percent were Caucasian and 85.3% female, and 66.7% had multivessel disease, 29.3 and 19.6% had aneurysms or dissections at presentation. Multifocal disease, aneurysms and dissections were more common in multivessel disease. Follow-up data defined risk factors for clinical or radiological disease progression: younger age at FMD onset [odds ratio (OR) 0.97, P = 0.042], current smoking (OR 3.78, P = 0.006), baseline history of hypertension (OR 6.2, P = 0.017). This study emphasizes the importance of a dedicated multidisciplinary FMD service for confirming diagnosis and identifying FMD mimics to facilitate personalized care. Early diagnosis, smoking cessation and blood pressure management are key to preventing disease progression.
36. Association of Omega-3 and Omega-6 with neurodegenerative disorders: a UK biobank prospective cohort study.
期刊: Parkinsonism & related disorders 发表日期: 2025-Dec-09 链接: PubMed
摘要
While Omega-3 and Omega-6 fatty acids have been implicated in neurodegenerative disorders (NDDs), existing epidemiological evidence remains inconclusive. We aim to clarify these relationships in a large population-based cohort from the UK Biobank. We conducted Cox proportional hazards regression analyses to assess the association between baseline serum Omega-3 and Omega-6 levels and incident NDDs, adjusting for sociodemographic and lifestyle factors. Over a mean follow-up of 13.3 years, higher Omega-6 level at baseline was associated with a lower risk of incident Parkinson’s disease (PD) (HR = 0.76, P = 1.11E-06, 95 % CI = 0.68-0.85) and dementia (HR = 0.83, P = 8.79E-08, 95 % CI = 0.78-0.89). Elevated Omega-3 level at baseline was linked to a lower risk of incident multiple sclerosis (MS) (HR = 0.17, P = 0.001, 95 % CI = 0.06-0.48). Nominally significant associations were also observed between Omega-3 level and reduced risk of PD (HR = 0.67, P = 0.03, 95 % CI = 0.46-0.97) and dementia (HR = 0.79, P = 0.04, 95 % CI = 0.63-0.99), as well as Omega-6 and lower risk of MS (HR = 0.73, P = 0.03, 95 % CI = 0.55-0.97). The large prospective study demonstrates distinct neuroprotective profiles for Omega-3 and Omega-6 fatty acids in NDDs. These subtype-specific associations advance our understanding of nutritional factors in neurodegeneration and highlight potential avenues for targeted prevention strategies.
37. The role of expert pertinence for epistemic trust during the COVID-19 pandemic and beyond.
期刊: Current opinion in psychology 发表日期: 2025-Dec-08 链接: PubMed
摘要
The COVID-19 pandemic spotlighted the critical role of scientific expertise in epistemic trust. Diverse experts entered the public arena and became visible in debates, confronting non-experts with the question of whom to trust-especially when experts contradicted each other, changed recommendations, or were intermingled with unreliable voices. This article highlights the pertinence of scientific expertise (i.e., the alignment between a source’s expertise and the claims it advances) as key factor for epistemic trust. While judgments of expertise are recognized as essential, little is known about how non-experts assess its pertinence. More research is needed to examine non-experts’ skills to assess the pertinence of expertise and how these skills can be enhanced through education and science communication.
38. The association between triglyceride-glucose index and emotional states in adults with different blood pressure status: a cross-sectional study.
期刊: Journal of hypertension 发表日期: 2025-Dec-08 链接: PubMed
摘要
This study aimed to investigate the association between the triglyceride-glucose (TyG) index and emotional states, including depression, anxiety, and stress, in adult men and women, considering their blood pressure (BP) status. This cross-sectional study was conducted within the framework of the Tehran Lipid and Glucose Study, including 5379 adults (53.43% female). Participants were categorized into three groups based on their BP status: normotensive, suspected, and diagnosed hypertension. The TyG index was calculated, and emotional states were assessed using the Depression Anxiety Stress Scale-21 (DASS-21). Linear regression models were used to evaluate the mentioned association. Our findings showed a significant positive association between the TyG index and emotional states, including depression, anxiety, and stress, only in women with diagnosed hypertension. Specifically, a one-unit increase in the TyG index was associated with an approximately 3-point increase in the scores of depression (β = 3.09, P = 0.007), anxiety (β = 3.09, P = 0.009), and stress (β = 3.09, P = 0.007). No significant associations were observed between the TyG index and emotional states in men or across other BP groups. The study highlights a stronger association between women’s emotional well being and their metabolic health compared to men. Additionally, it underscores the critical importance of addressing emotional health in women with high TyG and diagnosed hypertension.
39. Deciphering the role of hsa-piR-775 in primary ovarian insufficiency through FOXG1 modulation.
期刊: Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology 发表日期: 2025-Dec 链接: PubMed
摘要
Primary Ovarian Insufficiency (POI) impacts 3.5% of women under 40, with its etiology largely unknown. Piwi-interacting RNAs (piRNAs) have emerged as potential biomarkers for gynecological conditions, including POI. We hypothesized that hsa-piR-775 plays a critical role in POI pathogenesis by regulating FOXG1 expression. We performed piRNA sequencing on serum samples from POI patients and controls using the Illumina sequencing platform. Bioinformatics analysis for target prediction was conducted using TargetScan and miRanda to identify potential downstream targets of differentially expressed piRNAs (DEPs). qPCR and luciferase reporter assays for in vitro validation to explore the function and targets of DEPs, with a focus on hsa-piR-775. Among 43 DEPs, hsa-piR-775 was notably upregulated in POI patients. Target gene prediction and enrichment analysis implicated FOXG1, a gene associated with ovarian function, as a potential target of hsa-piR-775. In vitro validation confirmed hsa-piR-775 can influence FOXG1 mRNA, reducing FOXG1 expression. These findings suggest hsa-piR-775 influences POI progression by modulating FOXG1 levels. We demonstrate that hsa-piR-775 is upregulated in POI and regulates FOXG1 expression, revealing a novel pathogenic mechanism. This supports piRNAs’ potential as biomarkers and therapeutic targets in POI. Future studies should focus on validating these findings in larger cohorts and exploring piRNA-based therapeutic interventions for POI.
40. Impacts of COVID-19 pandemic on early life gut microbiome.
期刊: Gut microbes 发表日期: 2025-Dec 链接: PubMed
摘要
Increased hygiene and sanitation are theorized to predispose to developing atopic diseases, a process potentially mediated by the gut microbiome. We hypothesized that the gut microbiome maturation has been altered by COVID-19 lockdown measures during the first year of life, a critical period when environmental exposure shapes human microbiome development. The two large pre- and during-COVID-19 mother-baby pairs cohorts in the Greater Bay Area of China provided the unique opportunity to assess the effect of increased hygiene standards on early gut microbiome maturation. Our results showed that the gut microbiome diversity, composition, and developmental trajectory were significantly altered between pre- and during-COVID-19 cohorts. Functionally, there was decreased richness in both antimicrobial peptide resistance genes and antibiotic resistance genes in the during-COVID cohort. Specially, Staphylococcus epidermidis carried a lower copy number of fluoroquinolone and beta-lactam antibiotics resistance genes while Klebsiella pneumoniae possessed a higher copy number of fluoroquinolone antibiotic resistance genes in gut microbiota of infants born during the COVID-19 pandemic. Our study underscores the importance of considering the microbiome when evaluating hygiene measures and the need for future research to ascertain the role of the gut microbiome in disease development.
41. How Old Are You, Actuarily?
期刊: AMA journal of ethics 发表日期: 2025-Dec-01 链接: PubMed
摘要
Advances in epigenetic age estimation are now applied in actuarial science to make risk assessment more precise. But such health insurance underwriting practices pose ethical and legal questions about discrimination, privacy, and equity in biological data use. Legal adaptations, such as Canada’s Genetic Non-Discrimination Act (GNDA) of 2017, aim to protect persons against genetic discrimination but do not evolve as quickly as epigenetic technology. This article examines the GNDA’s regulatory limitations and highlights the need for more adaptable legislative strategies.
42. Exploring the influence of the bladder microbiome on BCG immunotherapy outcomes for high-risk non muscle invasive bladder cancer.
期刊: Minerva urology and nephrology 发表日期: 2025-Dec 链接: PubMed
摘要
Intravesical Bacillus Calmette-Guérin (BCG) is an established adjuvant therapy for high-risk superficial bladder cancer, though its efficacy varies among patients. Recent interest in the urinary microbiome comprising microorganisms inhabiting the urinary tract stems from its potential impact on various urological conditions, including bladder cancer. Our study investigates the possible relationship between the bladder microbiome and BCG therapy outcomes in a preliminary and explorative analysis. We conducted a retrospective, descriptive study involving 31 high-risk bladder cancer (BC) patients treated with BCG. BC tissues were collected pre-treatment, and formalin-fixed paraffin-embedded (FFPE) samples were analyzed. DNA extracted from these samples underwent high-throughput 16S rRNA amplicon sequencing targeting the V1-V3 regions. Our cohort consisted of 15 BCG-resistant patients and 16 responders. Median instillation numbers were six (IQR: 6-9) for resistant patients and twelve (IQR: 14-15) for responders, with a median follow-up length of six months (IQR: 3.3-9.5) and 43 months (IQR: 24-55), respectively. Significant differences were observed in the microbiome: BCG responders showed higher median percentages of Firmicutes (1.1 vs. 0.3, P=0.0293) and Verrucomicrobiota (0.9 vs. 0.1, P=0.0285). Additionally, Fusobacteriota was more prevalent among responders (75% vs. 33.3%, P=0.0198), while Cyanobacteria were more common in resistant patients (73.3% vs. 31.3%, P=0.0191). Our preliminary findings illuminate the bladder microbiome’s role in influencing BCG therapy outcomes, underscoring the complex microbial interplay affecting treatment efficacy in urological diseases. This explorative study sets the groundwork for ongoing data collection and future research pathways aimed at further delineating these relationships.
43. Associations Between the Maternal Diet Index and Childhood Asthma: The NorthPop and Healthy Start Cohorts.
期刊: Clinical and translational allergy 发表日期: 2025-Dec 链接: PubMed
摘要
A novel maternal diet index (MDI), characterizing offspring asthma- and allergy-associated maternal intake during pregnancy was constructed and validated in Healthy Start, USA. This study aims to (1) externally validate the asthma findings from Healthy Start in the NorthPop Birth Cohort Study (NorthPop) in Sweden; and (2) characterize the diet and demographics of the two cohorts. The MDI was computed as a weighted combination of seven components associated with offspring allergies and asthma, including vegetables and yogurt (associated with decreased odds) and cold cereals, fried potatoes, juice, red meat, and rice (associated with increased odds). Doctor diagnoses provided childhood asthma incidence and timing. Parametric Weibull time-to-event analysis evaluated associations between the MDI, dichotomized at the median (72.2) for Healthy Start, and offspring asthma. The NorthPop and Healthy Start mean MDI values differed significantly (p < 0.001) and in NorthPop, only 6.1% had MDI < 72.2. Data from 6446 mother-child dyads in NorthPop yielded a crude hazard ratio (HR) for asthma of 0.70 (95% confidence interval [CI] 0.50-0.98, p = 0.037) and a fully adjusted HR of 0.84 (0.55-1.29; p = 0.428) for MDI > 72.2 versus < 72.2 (n = 4655). The fully adjusted HR for 945 Healthy Start dyads was significant at HR 0.41 (0.29-0.57; p < 0.0001). Results show that in a population with different maternal dietary patterns and demographics compared to the source population, MDI > 72.2 was not an independent predictor of offspring asthma. Further proof of the utility and generalizability of the MDI needs to be tested in other populations.
44. Management of radiation-induced gynecological toxicities: AFSOS-SFCE-GFRCP clinical practice guidelines.
期刊: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society 发表日期: 2025-Nov-24 链接: PubMed
摘要
Radiation-induced gynecological toxicities are frequently under-recognized, under-diagnosed, and insufficiently managed. These adverse effects negatively impact patients’ quality of life and may compromise oncological outcomes by delaying or interrupting cancer treatment. This guideline aims to define best clinical practices for the prevention, identification, and management of both acute and late radiation-induced gynecological toxicities. The French Association for Supportive Care in Cancer (AFSOS) convened a multidisciplinary task force to perform a literature review and apply a consensus methodology to establish these guidelines. External validation was conducted by an independent panel of experts. Optimal management involves a 3-phase approach: before, during, and after radiotherapy. Patients should receive pre-treatment counseling on potential gynecological and sexual side effects, along with preventive hygienic and dietary guidance. During treatment, acute toxicities such as vulvitis, vaginitis, urethritis, and proctitis should be actively managed. Post-radiotherapy care must address vaginal dryness, stenosis, synechiae, premature menopause, lymphedema, and sexual dysfunction, with integration of onco-sexological support as needed. Awareness and proactive management of radiation-induced gynecological toxicities are critical for maintaining quality of life and ensuring treatment continuity. This guideline provides structured recommendations to support clinicians in delivering comprehensive, patient-centered supportive care.
45. Hormone replacement therapy in gynecologic cancer: oncologic safety and alternative therapies.
期刊: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society 发表日期: 2025-Nov-20 链接: PubMed
摘要
Recent advances in surgery and new therapies have greatly improved outcomes for gynecologic cancers, leading to more long-term survivors and a stronger focus on quality of life. Treatments such as surgery, radiation, and chemotherapy often cause iatrogenic menopause, leading to reduced quality of life and long-term health consequences. Hormone replacement therapy is the most effective option for managing menopausal symptoms. However, its use in patients with gynecologic cancer remains controversial because of concerns regarding oncologic safety. We conducted a comprehensive literature review evaluating the safety of hormone replacement therapy in survivors of endometrial, ovarian, cervical, vulvar, and vaginal cancers and uterine sarcomas, as well as in patients with hereditary cancer syndromes. Systemic hormone replacement therapy is safe in women with low-risk, early-stage endometrial cancer, most ovarian cancer sub-types, cervical cancer regardless of histology, and vulvar or vaginal cancers. However, contra-indications exist in specific scenarios such as advanced or non-endometrioid endometrial cancer, uterine sarcomas, and certain ovarian cancer sub-types (granulosa-cell tumors). In these cases, both non-systemic hormonal and non-hormonal alternatives have shown efficacy in managing menopausal symptoms. Hormonal therapies for genitourinary syndrome of menopause, including vaginal estrogens, ospemifene, and vaginal dehydroepiandrosterone, have demonstrated efficacy in relieving symptoms and improving urogenital health. Non-hormonal approaches, such as vaginal moisturizers, lubricants, and vaginal laser therapy, can also provide symptom relief. Non-hormonal therapies proven effective for managing vasomotor symptoms and sleep disturbances include cognitive behavioral therapy, clinical hypnosis, gabapentin, fezolinetant, and selective serotonin or serotonin-norepinephrine re-uptake inhibitors. Personalized treatment decisions should be guided by cancer type, recurrence risk, patient preferences, and quality-of-life considerations. It is essential to balance oncologic safety with symptom relief and long-term health outcomes in this growing population of cancer survivors.
46. Folate receptor alpha as a successful biomarker in the treatment of low-grade serous ovarian cancer patients using preclinical and clinical models.
期刊: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society 发表日期: 2025-Nov-08 链接: PubMed
摘要
Low-grade serous ovarian cancer is a rare epithelial ovarian cancer subtype characterized by high resistance to chemotherapy. Development of novel, effective, targeted treatments for recurrent low-grade serous ovarian cancer remains an unmet medical need. We evaluated FOLR1 expression in a cohort of low-grade serous ovarian cancer patients and the preclinical and clinical activity of mirvetuximab soravtansine, an antibody-drug conjugate targeting FOLR1, in vivo in a patient-derived xenograft model and in a heavily pretreated low-grade serous ovarian cancer patient progressing after chemotherapy, aromatase inhibitor, and MEK inhibitor treatment. FOLR1 expression was evaluated in 27 low-grade serous ovarian cancer patients using immunohistochemistry. The efficacy of mirvetuximab soravtansine was assessed in vivo in a low-grade serous ovarian cancer patient-derived xenograft model in severe combined immunodeficient mice, as well as in a patient harboring a recurrent low-grade serous ovarian cancer resistant to standard treatment modalities. FOLR1 expression was detected in all 27 (100%) low-grade serous ovarian cancer cases, with 21 of 27 (78%) of the samples demonstrating 2+/3+ in ≥75% of tumor cells. In vivo studies in mice demonstrated that mirvetuximab soravtansine inhibited tumor growth and prolonged survival in a low-grade serous ovarian cancer patient-derived xenograft model derived from a patient progressing after chemotherapy/aromatase inhibitor/MEK inhibitor. Clinical evidence further supported the therapeutic activity of mirvetuximab soravtansine in a FOLR1-positive low-grade serous ovarian cancer patient, as indicated by a prolonged partial response after 8 months of treatment. FOLR1 is overexpressed in a large percentage of low-grade serous ovarian cancers. Mirvetuximab soravtansine may represent a novel treatment option for low-grade serous ovarian cancer patients progressing after standard treatment modalities. Clinical trials with mirvetuximab soravtansine in FOLR1-positive low-grade serous ovarian cancers are warranted.
47. Enabling sustainability through co-adaptation: a process evaluation of a school-based physical activity program.
期刊: Health promotion international 发表日期: 2025-Oct-30 链接: PubMed
摘要
Schools represent strategic settings for adolescent health promotion across multiple domains, including physical activity (PA). Despite the development of numerous effective programs, sustaining their impact within the school context remains a key challenge. This process evaluation explores how mechanisms, participant experiences, and contextual factors shaped the design, implementation and potential sustainability of the replicated Sigue la Huella (SLH) program (originally designed to increase PA and reduce sedentary time) in a new secondary school in Spain. Grounded in the Replicating Effective Programs framework and co-creation principles, the intervention was co-adapted and implemented over a three-year period through an iterative, collaborative process. The approach emphasized contextual relevance, gradual transfer of responsibility, and long-term sustainability. Participants (ntotal = 43) included teachers (i.e. school implementers), the school principal, students, parents, and policymakers. Data were collected through field notes, focus groups, and interviews. Using the Framework Analysis, findings were organized into thematic matrices capturing stakeholder perspectives across co-adaptation and three implementation phases. While the core structure of SLH was retained, delivery strategies were adapted to reflect school priorities and constraints. Key enablers of sustainability included strategic planning, flexible implementation, stakeholder empowerment, and institutionalization. However, challenges such as training needs, coordination gaps, and competing initiatives persisted. In essence, the processes of co-adaptation, accompanied by a staged withdrawal of research implementation support, have been found to foster school ownership, high-fidelity delivery, and institutionalization creating optimal conditions for autonomous sustainability while recognizing context-dependent challenges.
48. Tumor Mutations in Minority Populations Versus Non-Hispanic Whites Across Tumor Types.
期刊: JCO precision oncology 发表日期: 2025-Oct 链接: PubMed
摘要
To investigate tumor mutation variations across different racial/ethnic groups to better understand implications for targeted cancer therapies. A retrospective analysis of 5,045 patients at University of New Mexico Comprehensive Cancer Center who underwent tumor genetic testing between January 2015 and April 2022 was conducted. Data were standardized from internal genetic tests, FoundationOne, and Guardant next-generation sequencing panels. Chi-square tests, one-way analysis of variance, and negative binomial regression estimated differences in mutation rates across race/ethnicity, adjusting for cancer type, age, testing year, and number of genes screened. Primary outcomes included tumor mutation rates and their variation across racial/ethnic groups. Specific focus was placed on mutation frequencies in common genes, and association between race/ethnicity and mutations detected, adjusted for covariates. Among 5,045 patients-Hispanic/Latino (30%), American Indian (5.7%), Asian/Hawaiian Native (1.9%), Black (1.5%), non-Hispanic White (41%), and other/unknown (19.7%)-mutations were identified most commonly for Asian/Hawaiian Native individuals, with a rate of 0.068 mutations per gene screened (95% CI, 0.051 to 0.090), followed by White individuals (rate = 0.061, 95% CI, 0.051 to 0.072). Fewest mutations were identified for Black individuals, with a rate of 0.045 mutations per gene screened (95% CI, 0.033 to 0.061). Single-gene comparisons suggested BRAF mutations to be most prevalent in non-Hispanic Whites (5.8%, P = .015) while EGFR mutations were most common in Asian/Hawaiian Native patients (10.53%, P = .005). This study highlights substantial heterogeneity in tumor mutations across racial/ethnic groups while emphasizing the need for wider understanding of genomics and tailored approaches in cancer treatment. Findings underscore the need for equitable genomic testing, tailored therapies, and inclusive cancer care. Further research is necessary to bridge existing disparities, ensuring comprehensive, personalized cancer treatment for all patients.
49. Integrated Genetic Information of Metabolic Dysfunction-Associated Steatotic Liver Disease-Related Traits Improves Hepatocellular Carcinoma Risk Stratification and Screening.
期刊: JCO precision oncology 发表日期: 2025-Oct 链接: PubMed
摘要
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major cause of hepatocellular carcinoma (HCC), yet current screening strategies overlook the genetic complexity of MASLD. We hypothesized that capturing this complexity through a multitrait polygenic approach could improve HCC prevention. Using genome-wide association data for 10 MASLD-related traits in individuals of European ancestry, we constructed a meta-polygenic risk score (metaPRS) in the UK Biobank. We evaluated its performance in HCC prediction and its utility in stratified screening. Risk advancement period (RAP) analysis estimated how much earlier individuals in different genetic risk groups reach comparable risk levels. The metaPRS that incorporated genome-wide variants achieved a C-statistic of 0.686 for HCC prediction, outperforming existing PRSs. Individuals in the top 20% of genetic risk had a 5.33-fold higher HCC risk than those in the bottom 20%. RAP analysis showed that high-risk individuals reached the HCC risk threshold 11.91 years earlier than the intermediate group, whereas low-risk individuals reached it 5.49 years later, suggesting a shift in recommended screening age from 65 to 43 years. Genetic stratification by the metaPRS also improved the predictive performance of noninvasive fibrosis scores (eg, Forns score). Combining high genetic risk with an elevated Forns score yielded a 10-year HCC risk of 2.68%, compared with 0.01% in the lowest-risk group-reducing the number needed to screen from 7,918 to 27. The MASLD-related metaPRS supports effective population risk stratification and enables a layered HCC screening strategy combining genetic risk profiling with targeted clinical assessment.
50. The effect of training given to patients with Chronic Obstructive Pulmonary Disease in line with the Health Promotion Model on self-efficacy: a randomized controlled trial.
期刊: Health education research 发表日期: 2025-Sep-29 链接: PubMed
摘要
This study was conducted to evaluate the effect of the training given to Chronic Obstructive Pulmonary Disease (COPD) patients in line with Health Promotion Model (HPM) on the self-efficacy level of the individual. This study was conducted as a randomized controlled trial with patients hospitalized in the chest diseases intensive care unit of a state hospital. The study was conducted with 140 patients (intervention group = 70, control group = 70). The intervention group received four sessions of training prepared in line with the HPM. Self-efficacy was assessed with the COPD Self-Efficacy Scale. The self-efficacy levels of those in the intervention group increased significantly after the intervention compared with before the intervention, while the mean scores of those in the control group decreased significantly. The post-test self-efficacy scale scores of the intervention group were significantly higher than those of the control group. In this study, the training applied to individuals with COPD in line with HPM was effective in increasing the self-efficacy level of individuals. After the training, the competence level of individuals in managing respiratory distress increased significantly, while in the control group, which did not receive any intervention, the competence level in managing respiratory distress decreased in 3 months.
51. Cancer education and capacity in sub-Saharan Africa-where do we stand?
期刊: Health education research 发表日期: 2025-Sep-29 链接: PubMed
摘要
Cancer is a controllable disease with advanced medical approaches and stakeholder collaborative efforts. Despite significant financial investments in cancer research, progress remains limited, particularly in sub-Saharan Africa (SSA), where most cancer types remain understudied. This review provides a comprehensive analysis of current trends in cancer education, awareness, and screening uptake in SSA. It also identifies prospects for advancing cancer education and sustaining research efforts in the region. We included 86 studies in this review, synthesizing evidence from systematic reviews and meta-analyses to present an unbiased overview of SSA-specific trends. A structured table was derived from 52 studies, comprising 26 on cervical cancer, 10 on breast cancer, and 16 on other cancer types. The review highlights positive outcomes from awareness campaigns of the included designs. However, low participant retention in trials and underdeveloped research infrastructure in SSA have hindered the translation of awareness into clinical trial participation and vaccine uptake. While the review identifies promising preventive, predictive, and personalized approaches for cancer awareness in SSA, it calls for more rigorous study designs with robust data analysis to address potential biases. Furthermore, sustained financial and cultural support is critical to align future research with SSA’s healthcare priorities and societal perceptions.
52. Antibiotic dispensing behaviors for pediatric diarrhea: A qualitative study of informal healthcare providers in rural Bangladesh.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Antibiotic resistance is a significant public health concern and requires coordinated efforts to promote antibiotic stewardship. In rural Bangladesh, informal healthcare providers known as “village doctors” are a primary source of antibiotics for a range of ailments, including pediatric diarrhea. This qualitative study explored the factors influencing antibiotic dispensing practices for pediatric diarrhea among village doctors in the Chattogram district of Bangladesh. In May 2023, we conducted in-depth interviews with 18 village doctors and analyzed the data using thematic analysis approach. The resulting themes were mapped onto the five domains of the Social Ecological Framework (SEF) to identify the multi-level drivers of antibiotic dispensing practices. At the individual level, antibiotic provision for treatment of pediatric diarrhea is influenced by village doctors’ clinical knowledge, training, and beliefs about antibiotics. At the interpersonal level, village doctors often alter their antibiotic dispensing practices based on patient and caregiver demands and influences from pharmaceutical companies. Organizational level factors include financial incentives from medication sales and pharmaceutical companies, resource constraints, diagnostic limitations, and a competitive healthcare landscape. We also identified that cultural expectations for rapid recovery through antibiotics and widespread community access to antibiotics at the community level. Finally, at the policy level, we identified weak regulatory frameworks, inadequate enforcement mechanisms, and healthcare system challenges that position village doctors as essential but unregulated providers. The findings highlight the multi-level drivers for inappropriate antibiotic use. Effective interventions should enhance clinical training, address economic incentives, promote community education, and establish clear regulatory frameworks. Future strategies should consider the interconnected nature of these influences rather than targeting isolated levels.
53. 30-day survival and injury severity in traffic accidents in Iran: A mixed-method study protocol.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Today, one of the greatest global challenges, particularly in developing countries, is traffic accidents and their associated consequences. The severity of injuries from these accidents often leads to serious outcomes for victims, including long-term disabilities and high mortality rates. Deaths from traffic accidents may occur at the scene, during transportation, or in hospitals. In light of the existing challenges in coordination between law enforcement and healthcare systems regarding traffic accident fatalities in our country, this study aims to: 1. Determining the 30-day survival rate and its relationship with injury severity among traffic accident victims in Khorramabad in 2025. 2. Identifying key challenges and proposing effective solutions for improving traffic accident management in Khorramabad. This mixed-methods study will be conducted in three phases: 1. Phase 1 (Quantitative): A prospective cohort study will investigate the relationship between injury severity (as measured by scales such as ISS)and 30-day survival rates. 2. Phase 2 (Qualitative): Purposive sampling will be used to conduct semi-structured interviews with stakeholders (victims, families, EMTs, healthcare providers, etc.). Qualitative data will be analyzed via inductive content analysis (Hsieh & Shannon approach) to identify challenges and solutions in traffic accident management. 3. Phase 3 (Integration): Findings from Phases 1 and 2 will be finalized and presented to policymakers, managers, and experts. The Delphi method will be used to prioritize challenges/solutions and finalize evidence-based recommendations.Results will be disseminated through: Peer-reviewed publications in reputable journals. Policy briefs tailored for officials to improve traffic accident management.
54. Cost of Sauti ya Vijana (SYV), a mental health intervention for young people living with HIV in Tanzania: Results from a pilot randomized controlled trial.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
Sauti ya Vijana (SYV) is a ten-session, group-based mental health and life skills intervention targeting young people living with HIV (YPLWH) in Tanzania. By addressing mental health distress and promoting self-efficacy and resilience to HIV-related stigma and disclosure, SYV aims to improve adherence to antiretroviral therapy (ART) and virologic suppression. A pilot randomized controlled trial (RCT) of SYV was conducted in Moshi, Tanzania, from April 2016 to August 2020. We aimed to estimate the cost of SYV delivery in the pilot RCT, identify key cost drivers, and inform future scale-up. We used a hybrid costing methodology and an intent-to-treat approach to estimate the cost of SYV delivery in the two-arm pilot RCT. Cost data were obtained from project records and interviews with key project personnel. Our estimates included start-up, service delivery, research-related costs, and program administrative fees. Human resources were costed in terms of full-time equivalents for salaried personnel. Costs are reported in 2022 USD. The pilot study included 58 participants in the SYV arm and 47 in the standard-of-care arm. The total cost to deliver SYV to the 58 participants in the SYV arm was approximately US$137,618·05. The total per-participant cost was US$2,372·72, the total non research cost was US$56,111·70, and the non-research cost per participant was US$967·44. Research-related costs comprised 59·23% (US$81,506·35) of the total cost. The most significant individual drivers of the total cost were research-related ART concentration in hair tests used to measure adherence (US$42,136·43), salaries for group leaders (US$33,607·94), and viral load tests (US$22,385·55). Our findings show that research-related expenses made up over half of the total costs of SYV delivery. Thus, a scale-up of the intervention without the additional trial components for measuring intervention efficacy would have better budgetary implications due to a smaller research footprint. These findings should guide policymakers in expanding SYV and similar mental health interventions for YPLWH.
55. Caregivers' perspectives on factors influencing adolescent girls' engagement in sexual risk-taking in Uganda: A qualitative study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Sub-Saharan Africa is home to two-thirds of people living with HIV globally, and women and girls (all ages) account for 62% of all new HIV infections in the region. Sexual risk-taking puts adolescent girls at risk for adverse health outcomes, including HIV/AIDS. Caregivers’ beliefs about adolescent sexual risk-taking have implications for how and when they would discuss this topic with their children. In this study, we conducted semi-structured in-depth interviews with 58 caregivers of adolescent girls to explore their perspectives on factors that influence adolescent girls’ decisions to engage in sexual risk-taking in Uganda. We employed a thematic analysis approach, combining both inductive and deductive methods to analyze the data. A range of protective and risk factors was identified across personal, proximal, and distal contexts. At the personal level, future goals, concerns about negative health consequences, religiosity, temperament, and puberty were identified as contributing factors. At the proximal level, family and peer-related factors were mentioned. At the distal level, poverty and program counseling were discussed. Study results point to the need for combination interventions that include both caregivers and their daughters to reduce sexual risk-taking among adolescent girls in Uganda.
56. Expert Consensus on Indicators of Social Determinants of Health: A Modified Delphi Study.
期刊: Journal of primary care & community health 发表日期: 2025 链接: PubMed
摘要
The purpose of this study was to gain consensus on Social Determinants of Health indicators among researchers actively publishing on SDH. We used a modified Delphi Method, an approach to gather expert opinions and gain consensus. We recruited participants in February 2024 via email from a PubMed search of researchers who had published on SDH in the last year. Participants (n = 22) completed 3 rounds of surveys. In each survey participants ranked the importance of each indicator. Fourteen participants completed all 3 surveys. Participants agreed to add indicators of Income (n = 14), Transportation (n = 14), Access to Quality Education (n = 13), Experiences of Racism and Discrimination (n = 12), Type of Healthcare Coverage (n = 11), Adverse Childhood Events (n = 9), Access to Higher Education (n = 8), Costs of Care (n = 8), and Provider Cultural and Linguistic Competency (n = 8). Participants agreed on significant modifications to an existing SDH framework, including adding more nuanced indicators on education, insurance coverage, transportation, and social context. However, the low response rate and over-representation of early career researchers indicate that further study is needed. Future research may also include a qualitative interview component to more fully understand participant rationale for responses. Our future goal is to develop a SDH instrument for use in population level public health surveillance based on the consensus of SDH indicators. To achieve this goal, additional research is needed to include a broader range of SDH researchers.
57. From cervix to multisite: Detection of lower genital tract lesions in a 10-year cross-sectional colposcopy clinic study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
To evaluate detection rates of multisite lesions (cervical, vaginal, vulvar) among women attending colposcopy clinics. Our cross-sectional study included 20,486 patients between 2014 and 2023 in Shanxi China. Detection rates for cervical, vaginal, and vulvar lesions were retrospectively analyzed across strata by HPV status, cytological diagnosis, and clinical manifestations (vaginal bleeding/discharge). Multinomial logistic regression was applied to calculate odds ratios for high-grade lesions and squamous cell carcinoma (SCC). High-risk HPV (hr-HPV) infection was detected in 16,636 of 20,486 women (81.2%), and 9,137 (44.6%) had ASC-US+ cytology. Following cervical lesion detection on histopathology among hr-HPV-positive women (CIN2/3: 19.9%; SCC: 5.3%; AIS/ADC: 0.4%), additional lesions were identified at other anatomical sites: vaginal lesions (VaIN2/3: 3.6%; SCC: 1.1%; AIS/ADC: 0.04%) and vulvar lesions (VIN2/3: 0.4%; SCC: 0.1%) were further identified. Overall, 21.6% of hr-HPV-positive women exhibited high-grade lesions (CIN/VaIN/VIN2/3), with 5.6% demonstrating multi-focal SCC and 0.4% showing AIS/ADC. Stratified analysis revealed that patients even with negative HPV or cytology result still had relative high detection rate of high-grade lesions. Among these HPV-negative women, those reporting vaginal bleeding/discharge carried an elevated risk, with 3.2% having high-grade lesions and 10.5% having SCC. The integrative examination combining hr-HPV, cytology, and vaginal bleeding/discharge identified 3,753 high-grade lesions and 1,154 cancers. Integrating the assessment of hr-HPV testing, cytology, and clinical symptoms (e.g., vaginal bleeding or discharge) could help finding more cases of multisite lesions (cervical, vaginal, vulvar). This is especially important for some high-risk women, including those who visit the colposcopy clinics, and more attention should be paid to the multisite examination.
58. Attitudes of blood and plasma donors towards biobanking for longitudinal health research.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Blood and plasma donations provide a unique opportunity for setting up a biobank. Remainders of donations can be stored together with questionnaire data to allow for longitudinal health research. Insight in the attitude and understanding of potential concerns of donors towards biobanking allows incorporating their perspective in the set-up of biobanks as such. In an online survey in July/August 2021 among 409 Dutch donors, we asked about their attitudes towards the collection and storage of remainders of donations, questionnaires, and DNA, and towards the storage period, data sharing and linkage, and feeding back results and outcomes. The overall attitude of participating donors towards biobanking remainders of donations is very positive with 99% indicating willingness to provide their consent and 94% to fill out questionnaires. Most respondents (74%, n = 292/395) would agree to a long-term storage of 30 years. When asked about potential concerns, respondents mostly mentioned personal data security (30%), commercial use of data (11%) and misuse of data (5%). Also, 40% (n = 155/390) showed some hesitance towards the storage of DNA, including 28% (n = 111/390) who would give conditional consent if being informed on for instance DNA utilisation. Finally, the majority would like to receive feedback of research results, and indicated this to contribute to a greater likelihood of biobank participation. Our findings show high support among surveyed donors for the storage of donation remainders in a biobank, provided high data security standards and clear communication about data protection measures and usage of biobank data and materials.