公共卫生研究摘要 (2025-12-20)
共收录 57 篇研究文章
1. Hope as Praxis: A Process Model of Black Women's Radical Hope and Activism.
期刊: Journal of community psychology 发表日期: 2026-Jan 链接: PubMed
摘要
The United States has long been a site of systemic oppression and grassroots resistance, with Black women serving as pivotal architects of social and political change. Yet, little is known about the psychological processes that sustain Black women’s activism, particularly in times of sociopolitical stress. This qualitative study addresses this gap by exploring radical hope as a psychological and collective process that sustains Black women activists. Using grounded theory methodology, life history interviews were conducted with 16 Black women activists aged 21-42, residing in the Southern and Mid-Atlantic regions of the United States. Participants described radical hope as enacted through three interrelated actions: dynamic relational action, liberatory resistant action, and trans-temporal action. These actions, rooted in ancestral memory, collective well-being, and future vision, informed an empirically derived grounded theory process model of Black women’s activism and radical hope. Grounded in Black feminist thought and counseling and community psychology, this study contributes to the understanding of liberation psychology, gendered racial identity, and activism. Findings highlight the need for research, mental health practice, and policy that support the well-being and leadership of Black women change-makers.
2. Development and Psychometric Testing of the Self-Efficacy for Heart-Healthy Lifestyle Behaviors (SE-HeartLife) Scale in Cardiovascular Disease Prevention.
期刊: The Journal of cardiovascular nursing 发表日期: 2025-Dec-22 链接: PubMed
摘要
Self-efficacy is a key determinant of adoption and maintainance of heart-healthy behaviors. Practicing multiple heart-healthy behaviors together significantly reduces cardiovascular disease risk. However, no validated tool currently exists to assess self-efficacy related to the integrated practice of these behaviors for cardiovascular disease prevention. The aim of this study was to develop the Self-Efficacy for Heart-Healthy Lifestyle Behaviors (SE-HeartLife) scale and test its psychometric properties among community-dwelling adults without a history of cardiovascular disease. A total of 1188 adults in South Korea were recruited. Scale development followed 3 phases: (1) conceptualization and item generation, (2) evaluation of content and face validity, and (3) refinement and psychometric testing. The sample was randomly split into subsample 1 (n = 594) for exploratory factor analysis (EFA) and subsample 2 (n = 594) for confirmatory factor analysis (CFA). The SE-HeartLife was conceptualized as an individual’s perceived confidence in adopting and maintaining heart-healthy lifestyle behaviors in daily life. Of the initial 60 items derived from a comprehensive literature review, 52 were retained following evaluations of content and face validity. The EFA identified 5 underlying factors: SE-Physical-Activity, SE-Unhealthy-Eating-Control, SE-Healthy-Eating, SE-Substance-Use-Control, and SE-Heart-Health-Management. The CFA supported the 5-factor structure, yielding a final 35-item model with acceptable model fit (CMIN/DF = 2.99, standardized root mean squared residual = 0.05, root mean squared error of approximation = 0.06, comparative fit index = 0.93). The scale showed good concurrent and convergent validity, internal consistency, and test-retest reliability. The 35-item SE-HeartLife scale is a psychometrically robust instrument for assessing self-efficacy in the integrated practice of multiple heart-healthy behaviors aimed at preventing cardiovascular disease.
3. Comparing ChatGPT and DeepSeek for Assessment of Multiple-Choice Questions in Orthopedic Medical Education: Cross-Sectional Study.
期刊: JMIR formative research 发表日期: 2025-Dec-19 链接: PubMed
摘要
Multiple-choice questions (MCQs) are essential in medical education for assessing knowledge and clinical reasoning. Traditional MCQ development involves expert reviews and revisions, which can be time-consuming and subject to bias. Large language models (LLMs) have emerged as potential tools for evaluating MCQ accuracy and efficiency. However, direct comparisons of these models in orthopedic MCQ assessments are limited. This study compared the performance of ChatGPT and DeepSeek in terms of correctness, response time, and reliability when answering MCQs from an orthopedic examination for medical students. This cross-sectional study included 209 orthopedic MCQs from summative assessments during the 2023-2024 academic year. ChatGPT (including the “Reason” function) and DeepSeek (including the “DeepThink” function) were used to identify the correct answers. Correctness and response times were recorded and compared using a χ2 test and Mann-Whitney U test where appropriate. The two LLMs’ reliability was assessed using the Cohen κ coefficient. The MCQs incorrectly answered by both models were reviewed by orthopedic faculty to identify ambiguities or content issues. ChatGPT achieved a correctness rate of 80.38% (168/209), while DeepSeek achieved 74.2% (155/209; P=.04). ChatGPT’s Reason function also outperformed DeepSeek’s DeepThink function (177/209, 84.7% vs 168/209, 80.4%; P=.12). The average response time for ChatGPT was 10.40 (SD 13.29) seconds, significantly shorter than DeepSeek’s 34.42 (SD 25.48) seconds (P<.001). Regarding reliability, ChatGPT demonstrated an almost perfect agreement (κ=0.81), whereas DeepSeek showed substantial agreement (κ=0.78). A completely false response was recorded in 7.7% (16/209) of responses for both models. ChatGPT outperformed DeepSeek in correctness and response time, demonstrating its efficiency in evaluating orthopedic MCQs. This high reliability suggests its potential for integration into medical assessments. However, our results indicate that some MCQs will require revisions by instructors to improve their clarity. Further studies are needed to evaluate the role of artificial intelligence in other disciplines and to validate other LLMs.
4. Intersection of Big Five Personality Traits and Substance Use on Social Media Discourse: AI-Powered Observational Study.
期刊: Journal of medical Internet research 发表日期: 2025-Dec-19 链接: PubMed
摘要
Personality traits are known predictors of substance use (SU), but their expression and association with SU in digital discourse remain largely unexamined. During the COVID-19 pandemic, the online social engagement heightened and led to an amplification in SU rates, thereby creating a unique natural opportunity to investigate these dynamics through large-scale digital discourse data. In our study, we offer insights beyond traditional self-report methods, which are crucial for developing timely and targeted public health interventions. We aim to evaluate whether the associations between the Big Five personality traits and SU discourse shifted during the 2019-2021 period, and to conduct a focused analysis of how these traits predict SU and relate to specific substance types, emotional expression, and demographic factors. We analyzed a corpus of several hundred million public posts from a major social media platform from 2019 to 2021. Using a pipeline of natural language processing and deep learning models, we identified SU-related posts and subsequently extracted scores for the Big Five personality traits, emotions, and user demographics. We used trend analysis to compare annual shifts in trait-SU associations, while detailed 2020 data underwent rigorous modeling using logistic regression, correlation analysis, and topic modeling to elucidate the core relationships. Our analysis revealed that Extraversion (odds ratio [OR] 3.22, 95% CI 2.98-3.49) and, most strikingly, agreeableness (OR 4.04, 95% CI 3.71-4.41) were the strongest positive predictors of being a substance user. In stark contrast to the conventional self-medication hypothesis, neuroticism emerged as a robust protective factor against SU (OR 0.29, 95% CI 0.26-0.31). This counterintuitive finding was supported by a decreased association between neuroticism and SU posts at the pandemic’s onset in 2020 (Cohen d=-0.13, 95% CI) and a negative correlation with the expression of negative emotions online. Topic modeling further indicated that SU discourse was frequently embedded in social contexts (social drinking and friendly beverage choices) rather than themes of solitary coping. Our findings challenge traditional models by demonstrating that in large-scale online discourse, SU expression is more powerfully linked to social-affiliative traits than to negative emotionality. The paradoxical protective role of neuroticism suggests that established risk profiles may not apply uniformly to digital environments, particularly during a public health crisis. These insights are vital for refining computational methods for public health surveillance and developing interventions that recognize the potent social drivers of SU in the digital age.
5. Copy Tools in the Electronic Health Record: Perceptions, Implications, and Future Directions.
期刊: JMIR medical informatics 发表日期: 2025-Dec-19 链接: PubMed
摘要
Electronic health records (EHRs) can aid in provider efficiency, but may also lead to unintended consequences, such as documentation burden and increased length of notes. To combat issues related to documentation, copying and pasting (CP) and copying or carrying forward (CF) are tools that have been used to aid in documentation burden. Multiple studies have identified the benefits and challenges of using these tools; however, few studies have identified the unintended consequences of CP and CF, and how the adoption of these tools may affect users. The objective was to describe providers’ perceptions and use of copying tools available in the EHR and describe their suggestions for improvement on these copying tools. Research team members conducted semistructured interviews with faculty members, advanced practice providers, residents or fellow trainees, and medical students at a single academic health sciences center. The Diffusion of Innovations Theory of Unintended Consequences guided the analysis and interpretation of interview results. A total of 22 semistructured interviews were conducted in 2023 and analyzed during 2024. The findings showed that respondents use and value these tools for efficiency and communication purposes. The negative unintended consequences include inaccuracies and errors in documentation and increased patient safety risks. Some respondents experience inner angst or moral injury related to using CP/CF, but they feel that they must use them to satisfy organizational requirements surrounding documentation. The respondents suggested that artificial intelligence will likely help improve documentation tools, as would further training around these types of documentation tools. Some respondents noted feeling both internal and external pressures that influenced when and how they use CP/CF. Respondents noted that they value EHR copying tools for efficiency purposes, but they also understand the risks involved. This tension may lead to moral angst or moral injury. They offered numerous suggestions for lowering the risk, especially by improving the documentation capabilities of the EHR through artificial intelligence. Future research should investigate both technical and educational solutions to relieve the documentation burden and moral angst they are experiencing.
6. Time Spent on Social Media Applications in Relation to Depressive Symptoms During Emerging Adulthood and the Mediating Role of Sleep Quality: Cross-Sectional Observational Study.
期刊: Journal of medical Internet research 发表日期: 2025-Dec-19 链接: PubMed
摘要
The link between social media use and depressive symptoms remains bidirectional. Findings in this area are often compromised by methodological limitations related to measurement and sample size. As a result, it is challenging to assess dose-response relationships and potential causal pathways. This study aims to use objective measurement methods to assess the dose-response relationship and potential mechanisms between social media use and depressive symptoms. This study was conducted in 6 universities in 2022. Social media use duration was assessed based on the monitoring of mobile phone systems, and depressive symptoms were evaluated by the Self-Rating Depression Scale. Logistic regression and restricted cubic spline were used to assess the relationship between social media use and depressive symptoms. Mediation analysis was used to elucidate the biological pathways of sleep quality in the abovementioned relationship. A total of 7401 college students were included in the final analysis, with 4.93% of moderate to severe depressive symptoms. After adjusting for variables such as sociodemographic characteristics and health-related characteristics, there was a significant association between individuals with longer weekly social media use time and depressive symptoms (odds ratio [OR>48h] 1.769, 95% CI 1.303-2.400). Similarly, the association between instant messaging-based social media use duration and depressive symptoms was also significant (OR>24h 1.728, 95% CI 1.225-2.437), while no associations were observed for content-based social use (OR>24h 1.251, 95% CI 0.932-1.680). Restricted cubic splines regression demonstrated a J-type relationship between social media use duration and depressive symptoms. Additionally, sleep quality played a partial mediating role in the relationship between social media use duration and depressive symptoms, with the mediating effect values ranging from 24.10% to 25.25%. Prolonged social media use duration might be associated with an increased prevalence of depressive symptoms in emerging adulthood and may increase the odds of depression by affecting sleep quality, suggesting that early prevention and intervention regarding social media use might help to ameliorate depressive symptoms.
7. Internet Memes as Drivers of Health Narratives and Infodemics: Integrative Review.
期刊: JMIR infodemiology 发表日期: 2025-Dec-19 链接: PubMed
摘要
Digital media memes have emerged as influential tools in health communication, particularly during the COVID-19 pandemic. While they offer opportunities for emotional engagement and community resilience, they also act as vectors for health misinformation, contributing to the global infodemic. Despite growing interest in their communicative power, the role of memes in shaping public perception and misinformation diffusion remains underexplored in infodemiology. This integrative review aims to analyze how memes influence emotional, behavioral, and ideological responses to health crises, and to examine their dual role as both contributors to and potential mitigators of infodemics. The paper also explores strategies for integrating memes into public health campaigns and infodemic management. A comprehensive literature search was conducted across 3 major databases (MEDLINE, Scopus, and Web of Science), identifying a total of 386 records. Following duplicate removal and eligibility screening, 14 peer-reviewed studies published between 2020 and 2025 were included. An integrative narrative approach was used to synthesize evidence on social media behavior, misinformation dynamics, and digital health campaigns. The analysis was grounded in infodemiological and infoveillance frameworks as established by Eysenbach, incorporating insights from psychology, media studies, and public health. Memes function as emotionally salient and visually potent carriers of health-related narratives. While they can simplify complex messages and foster adaptive humor during crises, they are also susceptible to distortion, particularly in echo chambers and conspiracy communities. Findings reveal that misinformation-laden memes often leverage humor and disgust to bypass critical thinking, and their viral potential is linked to emotional intensity. However, memes have also been successfully integrated into prebunking strategies, increasing engagement and reducing susceptibility to false claims when culturally tailored. The review identifies key mechanisms that enhance or hinder the infodemiological value of memes, including political orientation, digital literacy, and narrative framing. Memes are a double-edged sword in the context of infodemics. Their integration into infodemic surveillance and digital health campaigns requires a nuanced understanding of their emotional, cultural, and epistemic effects. Public health institutions should incorporate meme analysis into real-time infoveillance systems, apply evidence-based meme formats in prebunking efforts, and foster digital literacy that enables critical meme consumption. Future infodemiology research should further explore the long-term behavioral impacts of memetic misinformation and the scalability of meme-based interventions.
8. Encouraging Healthier Choices for Children in Restaurants: A Review of Interventions and Health Promotion Strategies.
期刊: Nutrition reviews 发表日期: 2025-Dec-19 链接: PubMed
摘要
Restaurants are normative eating contexts for many families and thus are prime targets for health promotion efforts as restaurant meals are typically high in calories, saturated fat, and sodium. Recently, health promotion efforts have focused on children’s menus in an effort to improve the food intake of children in these settings. The goal of the present narrative review is to summarize the current, peer-reviewed literature describing interventions and other health promotion efforts to improve the healthfulness of children’s meal selection and/or intake in restaurants. Efforts to accomplish this goal were organized into implicit (subtle and typically involving environmental changes) and explicit (direct and typically information-based) strategies and described using a narrative method. Significant changes in children’s ordering of restaurant food were consistently demonstrated in studies using optimal defaults (an implicit strategy) to increase the healthfulness of children’s meals. Future research and policy efforts in this area could further examine this strategy alongside other strategies such as personalized prompts or pricing promotions, evaluating impacts across a wider range of sociodemographic groups. Future studies should also include randomized controlled trials with objective assessments of children’s intake to build upon existing knowledge and improve the healthfulness of the restaurant environment for children.
9. Elderly Activity Life-Space Envelopes (EASE): Development and Feasibility of a Comprehensive, Integrated Protocol for Life-Space Mobility Research in Population Health.
期刊: JMIR research protocols 发表日期: 2025-Dec-19 链接: PubMed
摘要
Life-space mobility (LSM) refers to the movement of people over time and the areas through which they move to achieve life goals of health, employment, security, and participation for active aging. The Elderly Activity Life-Space Envelopes program is a large interdisciplinary mixed methods LSM study in older adults of 50 years and above. The overarching aims were to discover why, where, and when older adults travel and how they get to their destinations. In this paper, we focus on the methodology of the main quantitative phase. This community-based study comprised an in-person multidomain geriatric assessment with physical performance measures, followed by a 14-day travel diary. For the multidomain geriatric assessment, we structurally underpinned important population health constructs including the WHO International Classification of Functioning, Disability and Health, Frailty, and Intrinsic Capacity. We also described home meso-environments by incorporating authoritative open-source environmental attributes. These facilitated the categorization of LSM determinants into health, social, and environmental domains. The LSM outcomes include self-reported and objective geographical information science LSM measures. We further developed a suite of geographical information science LSM outcomes in alignment with our overarching aims. Quota sampling based on age groups, housing typology, and frailty status was applied. A customized, smartphone-based digital travel diary was designed, and barometric sensors were enabled to capture 3D LSM in capable smartphones. We recruited 1131 older adults with an average age of 63.8 (SD 7.6) years. The large majority (n=1062, 95%) successfully documented their travel diary on their smartphones with the rest on paper-based travel diaries. For the digital data, a total of 88,166 node points were recorded. There were 76,741 trips and 106,323 trip legs documented through the e-travel diary platform. Valid vertical LSM data were obtained from 228 participants. The majority (n=842, 75%) lived in public apartments, and 29% (n=326) were prefrail or frail. We provide a practical, feasible yet comprehensive protocol integrating LSM within important population health themes. Also, the development of an objective, systematic outcomes framework will form the basis for future LSM studies in the field. We aim to analyze the interactions between LSM outcomes, explore its diverse determinants, and identify senior travel phenotypes. We hope to develop interdisciplinary policy-driven interventions to ultimately improve the quality of life in older adults.
10. Budget Impact Analysis of Hyperthermic Intraperitoneal Chemotherapy With Interval Cytoreductive Surgery in Ovarian Cancer.
期刊: JCO oncology practice 发表日期: 2025-Dec-19 链接: PubMed
摘要
The OVHIPEC-1 trial demonstrated that adding hyperthermic intraperitoneal chemotherapy (HIPEC) to interval cytoreductive surgery (CRS) for patients with stage III epithelial ovarian cancer results in a significant increase in recurrence-free survival and overall survival. To inform policymakers about the macroeconomic budget, we conducted a budget impact analysis. The expenditure of the Dutch health care system between 2017 and 2025 associated with the introduction of HIPEC for patients with stage III ovarian cancer eligible for interval CRS (target population) was assessed during their entire treatment course (surgical and subsequent treatment). Cost estimates are based on national registry data, national benchmark costs for hospital-related activities, list prices for drugs, therapeutic guidelines, and expert opinion. Sensitivity and scenario analyses were performed to test robustness of the analysis. The Dutch target population is expected to increase from 200 patients in 2017 to 233 patients in 2025, with 80% receiving HIPEC in 2025. Between 2017 and 2025, the impact on the annual surgical budget is €3.5 million, of which €1.8 million is directly attributable to HIPEC and its associated costs. When considering the cost of all ovarian cancer-related treatments, an additional €30,898 per HIPEC patient is spent in 2025, mainly driven by prolonged recurrence-free survival resulting in extended maintenance therapy and treatment for more platinum-sensitive recurrences. This leads to an annual total treatment budget impact of €26 million in 8 years, with €5.7 million directly associated with HIPEC use. Within the Dutch health care system, the surgical budget impact of HIPEC is acceptable and falls within the boundaries for reimbursement of the responsible decision-making bodies. The total budget impact is mostly affected by the high costs of systemic treatment after prolonged recurrence-free survival due to HIPEC.
11. Advancing Methods and Models that Promote Equity in Ambient Air Quality.
期刊: Annual review of public health 发表日期: 2025-Dec-19 链接: PubMed
摘要
Several groups in the United States, including communities of color and low-income communities, are frequently disproportionately exposed to ambient (i.e., outdoor) air pollution, reflecting unjust placement of emission sources, systemic bias, and historic race-based land use planning. Eliminating these inequities is critical for advancing environmental justice. This review synthesizes methodological innovations for characterizing and mitigating ambient air pollution inequities, focusing on the past 10 years, mostly in the United States. Advances in exposure assessment (e.g., empirical models, satellite remote sensing, mobile monitoring, sensor networks) provide new tools for characterizing disparities. Advances in techniques for attributing pollution to specific sources (e.g., reduced-complexity models) reveal how emission-reduction approaches may or may not eliminate disparities. Spatially targeted emission reductions are critical for eliminating relative disparities; conventional approaches (e.g., sectoral emission reductions, national concentration standards) are unlikely to eliminate those disparities. This article provides insights for effective interventions to promote equity in ambient air pollution exposure.
12. Social Media, Health Consciousness, and Cultural Influences on Sugar Reduction Behaviors in Chinese Youth: Extending the Stimulus-Organism-Response Model.
期刊: Journal of medical Internet research 发表日期: 2025-Dec-19 链接: PubMed
摘要
The rising prevalence of sugar-related diseases, such as obesity and diabetes, has intensified efforts to reduce sugar intake, particularly among youth. In China, social media is playing an increasingly significant role in shaping health behaviors, including habits related to sugar consumption, as sugar reduction has become a prominent youth-led movement. This study extends the stimulus-organism-response (SOR) model by incorporating the distinct cultural influence of “face” to investigate the impact of social media on sugar reduction behaviors (SRBs) among Chinese youth, as well as the mediating role of health consciousness (HC) and conformity, and the moderating effects of face concern (FC) and eHealth literacy (EHL). We conducted a national web-based, cross-sectional survey through proportionate probability sampling of 883 Chinese youth in July 2024. Descriptive statistics, Pearson correlations, model fit indices, and partial least squares. Structural equation models were used to examine the relationships among all variables. Nearly half of the 883 participants were female (460/883, 52.1%), 91.9% (812/883) were aged 15-30 years. Most participants (602/883, 68.2%) had undergraduate education levels; the majority (688/883, 77.9%) had a bachelor’s degree or higher, and 654 (74.1%) had a normal BMI. Most participants (575/883, 74.1%) had used social media for 3-10 years. Chinese youth reported relatively high SRB scores (mean 3.62, SD 0.99). Male participants achieved notably higher scores (mean 3.72, SD 0.93), whereas participants aged 15-18 years showed significantly lower SRB scores (mean 3.50, SD 1.05). Structural equation modeling revealed that social media usage positively influenced conformity (β=.51; P<.001) and HC (β=.35; P<.001). These factors, in turn, significantly predicted SRBs (β=.14 and β=.50, respectively; both P<.001). The influence of social media usage on SRBs is primarily facilitated through 2 mediating pathways: HC mediated the relationship (Variance Accounted For=51.5%), while conformity’s mediation was less pronounced (Variance Accounted For=21.05%), indicating a secondary influence. FC (β=.09; P=.02) and EHL (β=.06; P=.04) moderated the respective relationships. This study demonstrates that social media effectively promotes SRBs among Chinese youth. By embedding cultural influences, such as FC, alongside enabling competencies, such as EHL, in an extended SOR model, we enhance our understanding of social media’s influence on health behaviors. The findings highlight cultural nuances in health communication and position the enhanced SOR model as a framework for health promotion. Furthermore, the study underscores the primary mediating effect of HC-surpassing that of conformity-while also delineating the moderating roles of FC and EHL, offering actionable insights for digital-age public health strategies.
13. Ultra-deep targeted next-generation sequencing with peripheral blood in patients with vascular malformations: a cohort of 40 patients.
期刊: Molecular biology reports 发表日期: 2025-Dec-19 链接: PubMed
摘要
Vascular malformations originate from congenital abnormalities in vascular differentiation and formation, and their subtypes exhibit diverse overlapping phenotypes that make differential diagnosis challenging. Recent advances in next-generation sequencing (NGS) technology for tissue specimens have enabled the identification of somatic variants in genes that are associated with vascular malformations, such as those in the RAS/MEK/ERK and phosphoinositide 3-kinase/AKT/mTOR pathways. Liquid biopsy using cell-free DNA (cfDNA) is a minimally invasive alternative method that has recently been applied to vascular malformations. This study aimed to apply ultra-deep targeted NGS using liquid biopsy to detect somatic variants in vascular malformations. A total of 10 mL peripheral blood was collected from 40 patients with vascular malformations, and cfDNA was extracted for liquid biopsy. Ultra-deep NGS (mean coverage: 104,000×) with unique molecular identifier error correction was performed using a custom panel of five genes: BRAF, KRAS, MAP2K1, PIK3CA, and TEK/TIE2. The diagnoses included arteriovenous malformation (AVM, n = 11), PIK3CA-related overgrowth spectrum (PROS, n = 9), and venous malformation (VM, n = 20). Somatic variants were identified in 23 patients, even at a low variant allele frequency of 0.05%. Hotspot BRAF and KRAS variants and a non-hotspot MAP2K1 variant were detected in patients with AVM. Fifteen variants were detected in seven patients with PROS, including hotspot PIK3CA variants in helical domains. Three novel PIK3CA and four novel TEK variants were identified in patients with VM. Liquid biopsy of cfDNA from the peripheral blood enables safe, outpatient-compatible molecular diagnosis, to potentially guide tailored treatment.
14. The role of enteroendocrine cells, hormones, and gut microbiota in anorexia nervosa: a complex interplay of the microbiome-gut-brain axis.
期刊: Molecular biology reports 发表日期: 2025-Dec-19 链接: PubMed
摘要
15. Societal cost-of-illness analysis of self-injection of biologics for patients with rheumatoid arthritis in Japan using claims, surveys, and national statistics.
期刊: Health economics review 发表日期: 2025-Dec-19 链接: PubMed
摘要
16. The role of metabolomics in chronic obstructive pulmonary disease: from analytic techniques to clinical applications.
期刊: Journal of breath research 发表日期: 2025-Dec-19 链接: PubMed
摘要
Chronic Obstructive Pulmonary Disease (COPD) is a complex, progressive inflammatory disorder characterized by airflow limitation and respiratory symptoms. Its heterogeneity is manifested at etiological, pathological and clinical levels, and leads to different phenotypes: chronic bronchitis, emphysema, asthma-COPD overlap, frequent exacerbator and eosinophilic phenotypes. COPD is also associated with systemic manifestations including cardiovascular diseases, muscle dysfunction, osteoporosis and mental-health issues, which require a comprehensive management approach. Key risk factors are tobacco smoke and air pollution, both of which induce oxidative stress and airway remodeling. Although there is still no definitive cure for COPD, an early diagnosis and a multidisciplinary treatment are essential to prevent or slow the disease progression and reduce the mortality rate. Molecular biomarkers, particularly those identified through metabolomics, show promise for early detection, phenotyping and precision therapies. Challenges in biomarker discovery include specimen variability and stability. Overall, metabolomics provides valuable insights into COPD’s molecular pathways, supporting improved diagnosis, prognosis and tailored treatments. In this tutorial, we will explore metabolomics findings from different COPD matrices and their clinical implications for diagnosis, treatment and prognosis.
17. Unlocking the biomedical potential of epigallocatechin-3-gallate: a review on bioactive properties, stability limitations, and nano-delivery innovations.
期刊: Natural product research 发表日期: 2025-Dec-19 链接: PubMed
摘要
Phytochemicals, particularly polyphenols, play a crucial role in modern healthcare due to their preventive and therapeutic properties. Among these, epigallocatechin-3-gallate (EGCG), a potent catechin found in green tea, exhibits exceptional antioxidant, anti-inflammatory, and disease-modulating effects, making it a promising candidate for managing cancer, diabetes, and cardiovascular disorders. However, its clinical translation is hindered by instability and poor bioavailability. Recent advancements in nanotechnology have addressed these limitations through innovative nano-formulations that enhance encapsulation, stability, and targeted delivery, thereby improving therapeutic efficacy. This review comprehensively examines the latest research on EGCG’s health benefits, its pharmacokinetic challenges, and the development of nanomaterial-based delivery systems to maximise its biomedical potential. By critically evaluating current strategies and future directions, this work highlights the transformative role of nano-engineered EGCG in bridging the gap between preclinical promise and clinical application.
18. Identification of Design Requirements for a Software Application for Use by Clinicians That Collects Acute Stroke Treatment Data During Clinical Workflow: Pilot Study.
期刊: JMIR formative research 发表日期: 2025-Dec-19 链接: PubMed
摘要
Clinical registries are critical for monitoring processes of care in diseases and driving quality improvements. However, many smaller hospitals lack the required resources to collect the necessary data to contribute to registries. This study aims to design and evaluate a data collection tool for acute stroke treatment that streamlines the collection of process data and provides tools to aid clinician users while not interfering with clinical workflow. The evaluation will identify key design requirements that facilitate prospective data collection and add value for clinicians. We developed a prototype tool for testing using Figma Pro for use on an iPad. Clinicians were recruited through convenience sampling to test the prototype’s use in a small-scale simulated clinical field experiment, during which participant were asked to think aloud and then complete a series of tasks to mimic a mock stroke treatment while inputting the required data into the prototype. Follow-up semistructured interviews were conducted to gain feedback on how the prototype integrated into the workflow and on the aspects of the prototype they felt helped and hindered their use of it. Qualitative data analysis combined review of the experiment recordings to identify the most frequent errors made during the scenario and deductive thematic analysis from the follow-up interviews to determine user needs for the following prototype iteration. The insights from the feedback identified design requirements that were implemented in the iterated design and documented to provide a reference for future product designers. Three participants were recruited from 2 hospitals between April 18 and June 6, 2024, for the simulated field experiment. The scenario took 10-12 minutes, with 1.2-3.7 minutes spent using the prototype, depending on whether optional features such as the NIHSS (National Institute of Health Stroke Scale) calculator were used. The simple and condensed layout and features such as NIHSS calculators, benchmark metric timers, and the final pop-up summary received the most positive feedback from each participant. Issues identified included small target sizes causing higher error rates, lack of color in important features reducing their visibility, and grouping of mandatory and optional information field layouts leading to a disjointed flow. The key design requirements include prioritizing simple dynamic layouts, sufficient target sizes to prevent errors, useful features with clear visual cues, and prompt data feedback to facilitate seamless integration. A prospective data collection tool for clinicians to use during stroke treatment can add value for clinicians and, with further testing, can be integrated into workflow. The design requirements identified through this study can provide a basis for streamlining the collection of accurate data while increasing the value of the tool for users and should be considered by future product designers to add value to their software and improve user experience.
19. Moving from Classroom to Clinic: Evaluating Academic Preparation for Clinical Exercise Physiologists in Canada.
期刊: Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme 发表日期: 2025-Dec-19 链接: PubMed
摘要
Clinical Exercise Physiologists (CEPs) play an essential role in delivering exercise-based interventions for individuals with chronic disease. While Canada’s primary CEP certification, governed by the Canadian Society for Exercise Physiology (CSEP), outlines core competencies, the absence of program-level accreditation may lead to variability in academic preparation. This environmental scan evaluated the extent to which a subset of Canadian undergraduate programs align with CSEP-CEP certification requirements. Thirteen programs that participate in CSEP’s Recommended Course Map initiative were examined from among 50+ kinesiology and exercise science programs operating nationally. Curricula were reviewed using structured coding of course content, skill assessment practices, and practicum integration. All programs demonstrated strong coverage of foundational knowledge; however, inconsistencies were observed in clinically-focused domains (e.g., health behaviour change, pharmacology), structured skill assessment, and supervised practicum experiences. Only 69% of programs included formal in-curriculum applied skill evaluations that directly address CSEP-CEP competency requirements, and 54% required a for-credit practicum. Practicum hours and settings varied widely, often falling short of national and international benchmarks. Findings highlight the need for stronger curriculum alignment, particularly in applied competencies and experiential learning. These results suggest that integrating structured, competency-based instruction and assessment across coursework and clinical placements would strengthen graduate readiness for both certification and clinical practice in healthcare contexts. This study provides timely insights to inform national CEP education standards and support strategic workforce planning as provinces expand CEP integration into healthcare systems.
20. Quantifying the Environmental Impacts and Human Health Risks of Global Cobalt Mining and Processing.
期刊: Environmental science & technology 发表日期: 2025-Dec-19 链接: PubMed
摘要
Cobalt (Co) is essential for clean energy development, but its extraction and processing have significant environmental and human health costs. We conducted an innovative assessment of the global environmental impacts of cobalt mining and the human health risks associated with mining and processing. We discovered that mining increased deforestation in tropical countries, particularly in South America and Africa with the affected areas of 309.41 and 134.11 km2. Oceania faced a considerable threat to biodiversity due to having the largest proportions (36.58%) and the largest mining area (409.55 km2) within protected areas. The protected area in northern South America (It index = 1316.93) had the highest level of biodiversity threat. The impact of mining on landscape integrity declined with increasing distance from mining areas in Asia, Europe, and North America. Meta-analysis highlighted the serious health risks from cobalt exposure, with miners (urine effect size 3.31) and metal workers (hair and nail effect sizes 5.76 and 5.60) showing significantly elevated Co levels. Children and women were particularly vulnerable to cobalt exposure. Our study quantified the forest loss, biodiversity threat, and landscape disturbance of cobalt mining and the health risks of Co exposure, underpinning the rebound in environmental fragility amid an energy transition.
21. Ability of Basic Physiological Monitoring to Identify Excessive Occupational Heat Strain.
期刊: Journal of occupational and environmental medicine 发表日期: 2025-Dec-19 链接: PubMed
摘要
This study assessed the ability of basic physiological metrics to differentiate between acceptable and unacceptable heat strain. A database of final core temperature (Tre), heart rate (HR), and skin temperature (Tsk) for 880 heat stress trials over a wide range of heat stress and clothing was created. Three case definitions based on Tre, HR, or fatigue were used to classify the trials as cases (unacceptable heat strain) or non-cases (acceptable heat strain). The area under the Receiver Operating Characteristic curve (AUC) characterized the discrimination ability of 15 individual physiological metrics. Generally, AUCs ranged from 0.85 allowing acceptable sensitivity with poor specificity to 0.50 with no predictive power. Tre, HR, and fatigue were independent limits of heat strain. A program of personal monitoring needs to recognize independent reasons to classify an exposure as unacceptable.
22. Imaging findings of intra-articular tumor/tumor-like lesions based on pathologic correlation.
期刊: Japanese journal of radiology 发表日期: 2025-Dec-19 链接: PubMed
摘要
Proper treatment of intra-articular tumor/tumor-like lesions (tenosynovial giant cell tumor, synovial chondromatosis, synovial hemangioma / intra-articular venous malformations, lipoma arborescens, etc.) depends on an accurate diagnosis. This review highlights the imaging findings of intra-articular tumor/tumor-like lesions and the other synovial diseases (gout, amyloid arthropathy, rheumatoid arthritis, ganglion, and postoperative intra-articular tumor) to determine whether they could help in establishing the correct diagnosis. Many synovial proliferative diseases have specific imaging characteristics and an awareness of these characteristics along with their pathological and anatomical features can allow for an accurate diagnosis. Even though a wide spectrum of diseases may involve the synovium, careful MRI assessment used in conjunction with clinical information can lead to a substantial narrowing of the differential diagnosis.
23. Antimicrobial Proteins from Limosilactobacillus fermentum GR-9 Inhibit Pathogens and Alleviate Salmonella Paratyphi B Infection in Mice.
期刊: Probiotics and antimicrobial proteins 发表日期: 2025-Dec-19 链接: PubMed
摘要
24. Just The Facts: Management of Febrile Infants 60 Days Old and Younger.
期刊: CJEM 发表日期: 2025-Dec-19 链接: PubMed
摘要
25. CT findings of lung injury during breast cancer treatment.
期刊: Breast cancer (Tokyo, Japan) 发表日期: 2025-Dec-19 链接: PubMed
摘要
While breast cancer treatment outcomes have improved significantly through multidisciplinary approaches including surgery, chemotherapy, and radiation therapy, the incidence of non-neoplastic pulmonary complications has also increased. Accurate interpretation of chest imaging is essential for managing these adverse events. This review outlines the major radiological findings of pulmonary injury during breast cancer treatment, focusing on two primary categories: drug-associated interstitial lung disease (DILD) and radiotherapy-associated lung injury (RLI). Regarding DILD, its clinical features, risk factors, differential diagnosis, and diverse patterns on high-resolution CT (HRCT) are described. The lung injury characteristics associated with specific drugs used in breast cancer treatment are also examined, placing particular emphasis on clinically important agents like trastuzumab deruxtecan. Regarding RLI, the pathophysiology (including acute radiation pneumonitis and chronic radiation fibrosis), relevant risk factors, and typical CT findings localized to the radiation field are discussed. Atypical manifestations are also addressed, such as radiation-induced organizing pneumonia (OP) outside the radiation field and the unique phenomenon of radiation recall pneumonitis. These complications can present with symptoms and imaging findings that mimic one another as well as other conditions, such as infections and lymphangitic carcinomatosis. This review aims to facilitate the timely and accurate differential diagnosis of pulmonary complications in breast cancer patients, thereby guiding appropriate therapeutic strategies and enhancing patient safety.
26. The Effectiveness of Psychiatric Day Centres: Longitudinal Pilot Study.
期刊: Community mental health journal 发表日期: 2025-Dec-19 链接: PubMed
摘要
Day centres provide low-threshold support for people with severe and prolonged mental illness. However, their effectiveness has not yet been empirically evaluated. This study examines whether regular attendance at day centres improves mental health outcomes. Two surveys were conducted: a cross-sectional survey of 87 service users and a longitudinal study of 16 new admissions (assessments at baseline, one month, and three months after admission). Psychosocial participation limitations (IMET), quality of life (MANSA), symptom severity (SCL-K-9, PHQ-9), self-esteem (G-SISE) and self-efficacy (ASKU) were measured. Descriptive statistics and the Wilcoxon-signed-rank test were used for analysis. Three primary goals for attending a day centre were most important: daily routines, social contacts, and meaningful activities. Significant improvements (p < 0.05) were observed in all outcomes, with large effect sizes (r = > 0.5). This study provides initial evidence that the use of day centres supports recovery from mental illness by restoring key psychosocial functions.
27. Toward integrated risk management of patient falls and patient-assisted injuries: Four indicators to support a joint approach.
期刊: International journal for quality in health care : journal of the International Society for Quality in Health Care 发表日期: 2025-Dec-19 链接: PubMed
摘要
28. Elimination of cervical cancer: the impact of HPV vaccination, primary HPV screening, and expanded access to cancer treatment services.
期刊: Molecular aspects of medicine 发表日期: 2025-Dec-18 链接: PubMed
摘要
In 2022, over 662,000 cases of cervical cancer were diagnosed globally and over 348,000 deaths occurred from the disease, with almost 94 % of these deaths occurring in low- and lower-middle income countries (LMIC). Effective intervention strategies, including prophylactic Human Papillomavirus (HPV) vaccination for adolescents and primary HPV screening for adult women, are highly effective and cost-effective methods of prevention; however, delivering population-wide access to these prevention methods has been challenging, particularly in LMIC. The World Health Organization (WHO) has launched a global strategy for the elimination of cervical cancer as a public health problem through the scale-up of HPV vaccination, cervical screening and precancer and cancer treatment services. In this review article, we present the rationale, history and strategy behind the global cervical cancer elimination efforts, including the evidence underpinning the WHO’s three pillars of cervical cancer control, and essential considerations for implementation, sustainable financing, and health systems implications. Many countries and regions are currently formulating frameworks to achieve cervical cancer elimination within their setting. Here, we consider implementation challenges for both LMIC, and high-income countries (HIC), calling upon the experiences of implementation guided by the WHO Western Pacific Region and Australian frameworks as exemplar settings.
29. Ecosystem response to mercury mitigation and forbidden fishing: A 20-year chronosequence of fish contamination in Baihua Reservoir.
期刊: Ecotoxicology and environmental safety 发表日期: 2025-Dec-18 链接: PubMed
摘要
Environmental remediation including mercury (Hg) source closure, cage-farming prohibition, and sediment capping has been implemented at Baihua Reservoir (BHR) since 2007, which strongly influences Hg bioaccumulation in fish. In this study, total Hg (THg) and methylmercury (MeHg) concentrations were determined in abiotic matrices and fish in 2015-2016 and 2018-2019 and compared with data extracted from previous studies referring to 2002-2006 and 2008-2009. Following these remediation measures, the water quality improved, eutrophication declined, and environmental Hg levels dropped dramatically. By 2018-2019, the aqueous THg and MeHg decreased by 82 % and 89 %, and sediment THg and MeHg decreased by 99 % and 86 %, respectively, compared to 2002-2006 levels. However, prohibition of cage fish farming in BHR shifted fish diets toward plankton, slowing their growth rate and lengthening the food chain by one level. Paradoxically, average fish THg during 2008-2019 increased significantly by 73-168 %, whereas the increase in MeHg (33-137 %) was not statistically significant. The relative proportion of MeHg to THg (%MeHg) in fish transiently peaked at 56 ± 23 % in 2015-2016. The bioaccumulation factor for fish Hg was high, while the trophic magnification rates of Hg were lower and remained low compared to global averages, reflecting efficient initial uptake into the food web but constrained transfer efficiency. This unexpected rise in fish Hg is likely due to the dietary shift to Hg-rich plankton, reduced somatic growth dilution in wild fish, and enhanced Hg trophic transfer. Therefore, ongoing monitoring and updated fish consumption advisories are recommended to mitigate potential health risks.
30. Incident chronic kidney disease in relation to later-life exposure to PM2.5 constituents and extreme temperature events in a national cohort study.
期刊: Ecotoxicology and environmental safety 发表日期: 2025-Dec-18 链接: PubMed
摘要
Accumulating evidence has linked ambient fine particulate matter (PM2.5) and suboptimal temperatures to renal metabolic function in populations. However, it remains unstudied regarding the individual and interactive associations of PM2.5 components and extreme temperature events (ETEs) with the incidence of chronic kidney disease (CKD). A nationwide CKD-free cohort of 6438 participants aged 45 years and above were enrolled from 125 cities across China’s mainland and followed up from 2011 to 2015. Daily estimates of major PM2.5 constituents (black carbon [BC], organic matter [OM], nitrate [NO3-], sulfate [SO42-], and ammonium [NH4+]) and ambient temperatures were assessed using well-validated spatial-temporal models at 0.1° × 0.1° resolution. ETEs were defined using multiple temperature thresholds (2.5-10th percentiles for cold spells, 90-97.5th percentiles for heat waves) and durations (2-4 days). Cox proportional hazards regression models were utilized to evaluate the hazard ratio (HR) of CKD incidence and its 95% confidence interval (CI) associated with long-term exposure to cold spells, heat waves, and PM2.5 constituents. Stratified analyses were conducted to compare PM2.5-related risks between low- and high-frequency groups of ETEs exposure, and ETEs-related risks between low- and high-level groups of PM2.5 exposure. Interactive effects of PM2.5 and ETEs exposures were assessed using interaction terms and the metric of relative excess risk due to interaction (RERI). In the overall population, a 10-μg/m3 increase in PM2.5 mass was associated with an increased risk of CKD incidence (HR=1.104, 95% CI: 1.016-1.201). Among PM2.5 constituents (per 1-μg/m3 increase), NH4+ showed the strongest association (1.149, 95% CI: 1.082-1.221), followed by SO42- (1.145, 95% CI: 1.086-1.206) and NO3- (1.090, 95% CI: 1.056-1.126). Overall, ETEs defined by various thresholds and durations were significantly associated with elevated CKD risks, with HR estimates (per 10-day rise) ranging from 1.047 (95% CI: 1.015-1.080) to 1.330 (95% CI: 1.251-1.415) for cold spells and from 1.038 (95% CI: 1.012-1.065) to 1.144 (95% CI: 1.085-1.207) for heat waves. Stratified analyses showed intensified PM2.5-related CKD risks under high-ETE exposure compared to low-ETE exposure, and higher ETEs-related risks in high-PM2.5 groups than low-PM2.5 groups. We observed generally consistent evidence for the synergistic interaction effects of cold spells and PM2.5 constituents in triggering CKD events (HR >1 for interaction and RERI >0), under multiple definitions of cold spells. Later-life (individuals aged ≥45 years) exposures to PM2.5 constituents and ETEs were individually and interactively associated with an increased risk of incident CKD events in middle-aged and older adults. Our findings highlighted the public health urgency of collective response to climate change crisis and ambient PM2.5 pollution.
31. From ocean to table: marine contaminants and their risks to human health and biodiversity.
期刊: Marine pollution bulletin 发表日期: 2025-Dec-18 链接: PubMed
摘要
Marine ecosystems are increasingly threatened by human-made pollutants such as microplastics (MPs), heavy metals, persistent organic pollutants (POPs), and pathogenic microorganisms. These contaminants endanger biodiversity, disrupt ecosystem functions, and compromise seafood safety. This review synthesized current knowledge on pollutant sources, environmental transport, and trophic transfer, emphasizing their accumulation and magnification through marine food webs and ultimately in humans. Quantitative evidence-such as MP loads of 0.2-5 particles g-1 in bivalves and MeHg concentrations of 0.3-1.5 ppm in predatory fish-illustrates the scale of exposure across trophic levels. Ecotoxicological impacts include endocrine disruption, reproductive impairment, immune suppression, and neurobehavioral alterations, with case studies documenting coral bleaching, shellfish larval mortality, and predator-prey destabilization. Human health risks arise from long-term dietary exposure to MeHg, PCBs, phthalates, and microbial toxins, contributing to neurodevelopmental deficits, carcinogenesis, metabolic disorders, and microbiome-mediated toxicity-defined as pollutant-driven alterations in gut microbial communities that impair immunity and metabolic regulation. The novelty of this review lies in its integration of region-specific contaminant datasets, multi-stressor interaction pathways, and emerging mechanistic biomarkers, offering a systems-level perspective on marine pollution. Despite regulatory progress, gaps remain in enforcement, monitoring, and multi-contaminant risk assessment. Research priorities include multigenerational exposure studies, standardized analytical workflows, and improved detection of emerging hazards such as nanoplastics. Advances in high-resolution metabolomics, AI-based exposure diagnostics, and gnotobiotic models provide promising tools for future research. A holistic strategy combining technological innovation, coordinated policy, and community engagement is essential to safeguard the ocean-to-table continuum.
32. The role of SIGLEC9 in immunosuppression and prognosis in cervical cancer.
期刊: Clinics (Sao Paulo, Brazil) 发表日期: 2025-Dec-18 链接: PubMed
摘要
This study investigates the role of Sialic acid-binding Immunoglobulin-Like Lectin-9 (SIGLEC9), a novel immune checkpoint, in Cervical Cancer (CC) and its interaction with immune cells in the tumor microenvironment. SIGLEC9 expression in CC was analyzed using the TNM plot, TCGA, and Human Protein Atlas databases, alongside its correlation with tumor stage. The relationship between SIGLEC9 expression and immune cell infiltration was explored using TCGA and TISIDB databases. Single-cell analysis focused on SIGLEC9 in macrophages. Protein interactions were assessed through the String, IntAct, BioGRID, and Mentha databases. MUC1 expression was validated via GEO and GEPIA databases. Immunohistochemical staining, western blot, immunofluorescence, and flow cytometry were used for verification. The prognostic significance of SIGLEC9 and SIGLEC9+ Tumor-Associated Macrophages (TAMs) was evaluated. SIGLEC9 was found to be significantly upregulated in CC, with higher levels correlating with poor prognosis. It was expressed in macrophages and T-cells, and elevated SIGLEC9+ TAMs were linked to reduced overall survival. SIGLEC9 plays a crucial role in the progression and prognosis of cervical cancer through its interaction with TAMs and T-cells. These findings highlight SIGLEC9 as a potential target for new immunotherapies in CC.
33. Interactions between upper respiratory microbiota and psychological distress in pulmonary nodule patients: a retrospective nested case-control study based on machine learning and exploratory mediation analysis.
期刊: International journal of surgery (London, England) 发表日期: 2025-Dec-18 链接: PubMed
摘要
The role of upper respiratory microbiota in the context of psychological distress (PD), particularly in patients with pulmonary nodules (PNs), remains largely unexplored. The study investigates anxiety and depression prevalence, clinical risk factors, and upper respiratory microbiota composition in patients with PNs, and their associations. A retrospective nested case-control study (August 2022 to May 2024) surveyed 381 PNs participants using a standardized questionnaire. Univariate analysis and logistic regression examined associations with PD. 16S ribosomal RNA sequencing compared microbiota between groups. Spearman correlation and exploratory mediation analysis explored associations between microbiota, clinical features, and PD. Machine learning algorithms were trained to identify features associated with PD. This study analyzed the sociodemographic and disease characteristics of 381 participants with PNs, revealing that approximately 32% exhibited symptoms of PD. Results showed female patients (OR = 1.77), those with ground-glass nodules (OR = 1.77) and history of nodular disease (OR = 1.94) were associated with a higher prevalence of PD. The main differential bacterial genus between no psychological distress (NPD) and PD groups such as g_Prevotella, g_Neisseria, and g_Haemophilus. The machine learning algorithms revealed that factors such as g_Aggregatibacter, g_Rhodococcus and gender constituted the best predictive group (Area under the curve, AUC = 0.75). Furthermore, exploratory mediation analysis identified associations suggesting that g_Haemophilus (β = 0.738 and β = - 0.523), and g_Dialister (β = 0.452 and β = 0.29) may be involved in the links between BAI and BDI-II scores with clinical factors. Our findings highlight the complex associations among clinical factors, upper respiratory microbiota, and the presence of PD in patients with PNs, laying the groundwork for future research into whether microbiota modulation could be a strategy for improving mental health in PNs patients.
34. Distribution, sediment retention, and carcinogenic risk of polycyclic aromatic hydrocarbons (PAHs) in an urban-industrial river system (Nilüfer Stream, Türkiye).
期刊: Marine pollution bulletin 发表日期: 2025-Dec-18 链接: PubMed
摘要
Polycyclic aromatic hydrocarbons (PAHs) were assessed in surface water and sediments of the Nilüfer Stream, Bursa, Türkiye, to characterize their distribution, sources, water-sediment interactions, and associated ecological and human health risks. Samples collected from seven sites (S1-S7) revealed that the dissolved- and particulate-phase PAH concentrations in the waters ranged from 2.3 to 1118.5 μg/L and 0.3 to 422.0 μg/L, respectively, while sediments contained 32.2-836.6 ng/g dry weight. Upstream sites (S1-S2) exhibited minimal contamination, whereas downstream locations (S3-S7) reflected increasing PAH loads influenced by mixed urban, industrial, and agricultural pressures. Ring-distribution profiles showed LMW dominance in the dissolved phase and stronger MMW-HMW enrichment in particulate phase and sediments, while diagnostic ratios indicated predominantly pyrogenic inputs, particularly traffic emissions and biomass/coal combustion. Principal Component Analysis (PCA) further supported these findings, with PC1 capturing the majority of variance across dissolved- and particulate phases, and sediment as a unified pyrogenic factor, and PC2 distinguishing high-temperature industrial combustion from medium-temperature domestic heating, especially in downstream segments. Ecological risk indices (M-ERM-Q, M-PEL-Q, TEQCARC, MEQ) indicated low-to-moderate potential adverse effects, mainly in sediments. Water-sediment partitioning suggested that sediments act as long-term sinks modulated by organic carbon and hydrodynamics. Incremental Lifetime Cancer Risk (ILCR) values indicated negligible risk at S1-S2 but moderate cancer risk at S3-S7 for adults and children through ingestion and inhalation. Overall, the study provides a comprehensive spatial-temporal evaluation of PAH behavior in a mixed land-use watershed and integrates source-diagnostic and risk-based evidence to support targeted mitigation strategies in urban-industrial river systems.
35. The infodemic-pandemic nexus: Cross-national analysis of online misinformation's impact on population health.
期刊: Social science & medicine (1982) 发表日期: 2025-Dec-17 链接: PubMed
摘要
The COVID-19 pandemic has been parallelled by an “infodemic” - a surge in both accurate and misleading information circulating online. This study examines whether engagement with digital mis- and disinformation contributes to cross-national variation in population health outcomes. Drawing on data from 31 countries over a three-year period, we integrate indicators of online misinformation exposure and COVID-19 case rates, controlling for vaccination uptake, civil protests against public health measures and policy stringency. Using a mixed-effects regression framework that accounts for smoothed time trends and country-specific factors and random effects, we find that greater public engagement with unreliable online content predicts significant future increases in new infection rates. Our findings offer one of the first multinational assessments of the pathways through which digital misinformation shapes real-world health outcomes. We argue that unequal responsiveness to online misinformation can generate divergent epidemic trajectories, underscoring the urgent need for policy interventions targeting the digital information environment.
36. Multifunctional collagen hydrogel accelerates infected wound repair through photothermal disinfection and pro-angiogenic activity.
期刊: Colloids and surfaces. B, Biointerfaces 发表日期: 2025-Dec-17 链接: PubMed
摘要
As the primary physical and immunological barrier against external insults, skin integrity is frequently compromised by trauma, disease, or iatrogenic injury, leading to pathogenic microorganism invasion and infected wounds. The escalating challenges posed by bacterial antibiotic resistance and biofilm formation highlight the urgent need for therapeutic systems that synergistically combine potent antibacterial efficacy with effective tissue regeneration modulation. Therefore, this study developed a multifunctional hydrogel platform integrating rapid photothermal sterilization and pro-regenerative bioactivity. We engineered an aggregation-induced emission (AIE) nanoparticle-loaded type I recombinant humanized collagen hydrogel (AIE@RHCI), achieving rapid UV-triggered crosslinking from liquid to gel state. The hydrogel demonstrates appropriate swelling capacity, controllable degradation kinetics, and favorable mechanical properties, enabling stable adhesion to dynamically deforming skin during movement. The incorporated AIE component exhibits 39.7 % photothermal conversion efficiency under 808 nm near-infrared (NIR) irradiation. In vitro studies confirmed that the AIE@RHCI hydrogel under NIR irradiation reduced methicillin-resistant Staphylococcus aureus (MRSA) viability to 22.2 %, while concurrently achieving 79.8 % biofilm inhibition. Simultaneously, the recombinant collagen matrix promotes vascular endothelial cell migration and accelerates vascularization, with significant upregulation of key pro-angiogenic genes VEGF and CD31. This integrated platform synergistically combines photothermal bactericidal nanoparticles with bioactive recombinant collagen scaffolding, offering a novel and promising therapeutic strategy for the management of antibiotic-resistant wound infections, with potential for clinical translation in chronic and infected wound care.
37. Interactions between Mycoplasma hyopneumoniae strains and the resident lung microbiota in swine.
期刊: Veterinary microbiology 发表日期: 2025-Dec-16 链接: PubMed
摘要
Enzootic pneumonia (EP) in swine, caused by Mycoplasma hyopneumoniae (M. hyopneumoniae), is a chronic respiratory disease that leads to significant economic losses in pig production. Infection with M. hyopneumoniae can induce pulmonary dysbiosis; however, the impact of different strains with varying degrees of virulence on the composition of a healthy microbiota remains incompletely understood. This study investigated alterations in the lung microbiome of pigs experimentally infected with two distinct strains of M. hyopneumoniae (UFV1 and UFV2) using 16S rRNA gene-based metataxonomic analyses and bioinformatics approaches. Pigs were divided into three experimental groups: Control (uninfected), UFV1 (infected with strain UFV1), and UFV2 (infected with strain UFV2). Bronchoalveolar lavage fluid were collected for DNA extraction and sequencing. Alpha diversity was significantly lower in the infected groups compared to the Control. Beta diversity analysis revealed significant differences in microbiota composition among the groups, with a clear separation between the Control group and the infected groups. Mycoplasma was the most abundant genus in both UFV1 and UFV2 groups, whereas the Control group exhibited greater genus-level diversity, including Stenotrophomonas, Comamonas, and Pseudomonas. Linear discriminant analysis (LDA) confirmed the enrichment of Mycoplasma in the infected groups and identified additional differentially abundant genera. Predictive modeling based on microbiota composition demonstrated high accuracy in classifying the groups, with Varibaculum, Pseudomonas, and Actinobacillus emerging as key genera for prediction. The UFV1 and UFV2 strains exhibited distinct lung microbiota profiles, suggesting different infection dynamics and interactions with the resident microbiota. This study provides new insights into the impact of diverse M. hyopneumoniae strains on the porcine lung microbiome, with implications for the development of preventive and control strategies for EP.
38. Parenthood after neonatal care -parenting sense of competence and coparenting three years after discharge.
期刊: Early human development 发表日期: 2025-Dec-15 链接: PubMed
摘要
Many parents of infants in neonatal intensive care units (NICUs) experience trauma and a loss of their parental role, which may affect their parenting following discharge. This study aimed to compare parenting competence and coparenting between parents of NICU and non-NICU infants three years postpartum. We also examined factors influencing parenting among NICU parents. We used a comparative cohort design to collect data from 561 parents who completed a set of questionnaires, including measures of parenting sense of competence, coparenting, dyadic relationship quality, social support, and depressive symptoms. Three years postpartum, no differences were found in parenting sense of competence or coparenting between NICU parents and non-NICU parents. For both NICU mothers and fathers, a higher parenting sense of competence in satisfaction and efficacy was associated with a higher quality in the couple relationship. Mothers reported higher parenting satisfaction if they had not experienced a traumatic birth. Fathers reported higher parenting satisfaction if they had no depressive symptoms, and higher parenting efficacy if they had a longer couple relationship, received greater social support, had a shorter infant hospital stay, or were rooming-in with their partner and infant during hospitalization. Factors associated with more coparenting problems among NICU parents included lower couple relationship quality, a 7-14-day hospitalization for mothers, and lower social support for fathers. This study highlights that early possibilities for parents to initiate parenthood together and receive adequate mental and social support during and after NICU hospitalization should be a priority for enhancing parents’ sense of competence and coparenting.
39. Mechanistic link between eIF4E phosphorylation and viral pathogenesis: Therapeutic insights from a porcine model.
期刊: Veterinary microbiology 发表日期: 2025-Dec-15 链接: PubMed
摘要
Eukaryotic initiation factor 4E (eIF4E), a critical component of the host translational machinery, undergoes dynamic phosphorylation mediated by MNK kinases during viral infection, a process exploited by viruses to facilitate replication. To investigate the therapeutic potential of modulating this pathway, we established a sustained eIF4E hypophosphorylation model through pharmacological inhibition of MNK1/2 via eFT508 (15 mg/kg bw), a selective inhibitor. Oral administration of eFT508 significantly suppressed eIF4E phosphorylation across the piglet intestine and reduced viral replication of porcine epidemic diarrhea virus (PEDV). Furthermore, hypophosphorylation of eIF4E effectively restored antioxidant defenses by regulating the levels of superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH) induced by arecoline treatment. eFT508 treatment also decreased oxidant levels and the production of proinflammatory cytokines, such as IL-6 and TNF-α, upon viral infection with PEDV. We subsequently conducted screening and functional verification via proteomic analysis, and the results revealed that eIF4E phosphorylation regulates downstream proteins, including inflammatory stress regulatory proteins such as TNFAIP3, and inflammatory factors such as NLRP3. These findings suggest that inhibitors targeting the MNK1/2-eIF4E axis confer tissue homeostasis and protection through coordinated anti-inflammatory and antioxidant effects. This work not only elucidates a druggable host factor in virus pathogenesis but also provides preclinical evidence for repurposing eFT508-class compounds in antiviral therapy and livestock resilience enhancement.
40. Fibrinogen as an early predictor of acute organ dysfunction in pelvic fractures.
期刊: Injury 发表日期: 2025-Dec-11 链接: PubMed
摘要
Pelvic fractures are associated with substantial morbidity and mortality, yet the prognostic value of initial fibrinogen levels remains underexplored. We conducted a global retrospective cohort study using data from the TriNetX Global Collaborative Network (2005-2025), with ≥30 days of follow-up. Patients with pelvic fractures and fibrinogen data were included. Propensity score matching adjusted for age, sex, race, ethnicity, comorbidities, and labs. Primary outcomes were mortality and complications in patients with fibrinogen ≤200 mg/dL compared to >200.01 mg/dL. Relative risks (RR) and number needed to harm (NNH) were calculated at 1, 3, 7, 14, and 30 days. Subgroup and sensitivity analyses tested robustness. 10,552 patients were included after matching, with 5276 patients in each cohort. The low fibrinogen group exhibited significantly higher risks of adverse outcomes at 30 days, including acute kidney injury (RR, 1.30; 95 % CI, 1.21-1.41; NNH: 18), shock (RR, 1.51; 95 % CI, 1.40-1.85; NNH: 12), respiratory failure (RR, 1.29; 95 % CI, 1.24-1.34; NNH: 9), acute respiratory distress syndrome (RR, 1.28; 95 % CI, 1.08-1.52; NNH: 84), disseminated intravascular coagulation (RR, 2.06; 95 % CI, 1.70-2.47; NNH: 32), and all-cause mortality (RR, 1.90; 95 % CI, 1.70-2.14; NNH: 15). These associations were consistent across subgroups stratified by age and sex, and held steady in sensitivity analyses using lower fibrinogen thresholds. A fibrinogen level of ≤ 200 mg/dL is associated with increased mortality and acute organ dysfunction in patients with pelvic fractures.
41. Management of Cervical lateral mass fractures -A systematic review.
期刊: Injury 发表日期: 2025-Dec-11 链接: PubMed
摘要
A notable anatomic feature of the facet joint is the lateral mass, which is comprised of the superior and inferior articular processes of the vertebral body. A unique fracture pattern involves a lamina fracture and ipsilateral pedicle fracture resulting in a separation of the lateral mass from the vertebral body, called a floating lateral mass fracture (FLM). FLMs commonly co-occur with vertebral artery or neurologic injury and is usually managed surgically. Few studies have focused on FLMs alone; thus, the objective of the current study is to provide a systematic review regarding the epidemiology and management of FLM. A retrospective protocol was used to search Medline (via PubMed) and Embase to identify all studies focused on floating lateral mass fractures. “floating lateral mass fracture” and “cervical” or “spine” were used in conjunction with boolean terms to find related articles. Single-case studies, unpublished articles, non-English articles, and other systematic reviews were excluded. Studies focusing on C1 lateral mass fractures were also excluded. Data regarding patient characteristics, injury characteristics, diagnostic imaging, and treatment were gathered. A total of 332 patients were identified with floating lateral mass fractures (FLM) of the subaxial cervical spine. There were 217 men (63.4 %) and 68 women (20.5 %) and 47 participants with gender not reported. The mean age was 41.8 ± 7.98 years. The most common levels of injury C6 and C5. Motor vehicle accidents (MVAs) were the most reported index event. Cervical collars were the most used non-operative treatment modality, with most studies specifying the use of hard cervical collar or a halo vest. Vertebral subluxation was later identified in 22 (31 %) patients treated nonoperatively. Anterior cervical discectomy and fusion (ACDF) was the most performed procedure including a one level, with 67 patients (28.2 %) and two-level fusions with 55 patients (23.2 %), totaling to 122 patients (51.4 %). Minimal reports of subluxation post-operatively were reported. Floating lateral mass fractures are an uncommon, but severe, subtype of cervical facet fractures. FLM inherently results in spinal instability, and as a result surgical management is preferred versus non-surgical.
42. Finding health in a disadvantaged place: Ethnic differences in multimorbidity by neighbourhood deprivation in England and Wales.
期刊: Social science & medicine (1982) 发表日期: 2025-Dec-04 链接: PubMed
摘要
This paper brings together research on ethnic inequalities in multimorbidity and differences in multimorbidity by neighbourhood deprivation to ask whether minority ethnic populations in England and Wales face health inequality when living in deprived neighbourhoods. We use four waves of Understanding Society data collected between 2018 and 2023 to identify the presence of two or more chronic conditions (i.e. multimorbidity). An ethnic group-specific neighbourhood deprivation index (EGDI) is linked to individual respondents for 93,568 person waves. Adjusted logistic regression models show that the Bangladeshi and Pakistani minority ethnic groups have 25 % lower probabilities of multimorbidity compared with the White British group. Underdiagnosis of conditions might explain some of this difference in the Bangladeshi group. The relationship between multimorbidity and neighbourhood deprivation was strongest for the health domain of EGDI. For the summary EGDI score, those living in the most deprived neighbourhoods are 1.4 times more likely to report multimorbidity compared with those living elsewhere. South Asian minority ethnic groups appear to be insulated, by 10 percentage points, from these negative neighbourhood effects, relative to the White British majority. These findings are largely consistent for all cause multimorbidity and physical only multimorbidity and an alternative neighbourhood deprivation measurement for all people (i.e. not ethnic-group specific). Our findings suggest that a holistic approach to population health, bringing together medical specialisms and broad public health policy, is required to improve diagnosis of chronic conditions across ethnic groups and to reduce the negative effects of the health context for all.
43. Survey of nutrition-related KAP levels in children and adolescents with earlyonset severe obesity in Qinhuangdao city.
期刊: JPMA. The Journal of the Pakistan Medical Association 发表日期: 2025-Dec 链接: PubMed
摘要
To investigate the nutrition-related knowledge, attitude and practice levels of children and adolescents with early severe obesity, and to analyse the influencing factors. The cross-sectional study was conducted from January 2022 to January 2023 in Qinhuangdao city, China, and comprised children and adolescents with early-onset severe obesity. Based on the median nutrition-related knowledge, attitude and practice level, the subjects were divided into a ‘high’ group A and ‘low’ group B. The baseline data of the two groups was compared, and the relevant factors affecting nutrition-related knowledge, attitude and practice levels were analysed. Data was analysed using SPSS 22. Of the 250 subjects, 127(50.8%) were females, 123(49.2%) were males, 79(31.6%) were aged >14 years, 70(28%) 6-14 years, 69(27.6%) 2-6 years and 32(12.8%) were <2 years. There were 127(50.8%) subjects in group A and 123(49.2%) in group B. The overall mean knowledge, attitude and practice score was 12.52±2.38 (range: 6-19), with median score 13(IQR=4). Body shape assessment, parental obesity, and parents’ education level were the influencing factors of nutrition-related knowledge, attitude and practice levels (p<0.05). Children and adolescents with early-onset severe obesity in Qinhuangdao were found to have a medium level of nutrition-related knowledge, attitude and practice, and the level was influenced by body shape assessment, parental obesity and parental education level.
44. Laparoscopic subtotal cholecystectomy (LSC): a comparison of "Fenestrating" versus "Reconstituting" types.
期刊: JPMA. The Journal of the Pakistan Medical Association 发表日期: 2025-Dec 链接: PubMed
摘要
To compare the outcomes of Fenestrating and Reconstituting subtypes of laparoscopic subtotal cholecystectomy in technically difficult cases. The retrospective study was conducted at the Department of Surgery, Khyber Teaching Hospital, Peshawar, Pakistan, from August 1, 2023, to July 31, 2024, and comprised data of patients who underwent Fenestrating or Reconstituting laparoscopic subtotal cholecystectomy between January 1, 2014, and December 31, 2023, for gallstone disease. Postoperative length of hospital stay, frequency of bile leak, bile collections, requirement of endoscopic retrograde cholangiopancreatography and reoperations were the parameters noted and compared. Data was analysed using IBM® SPSS® Statistics 26.0. Of 1,579 patients, 78(4.9%) had undergone laparoscopic subtotal cholecystectomy. Of them, 6(7.7%) cases were i excluded due to incomplete records, and the final sample comprised 72(92.3%) patients; 44(61.2%) females and 28(38.8%) males with mean age 56.91±16.28 years. Overall, 43(59.7%) patients were in the Fenestrating group and 29(40.3%) in the Reconstituting group. Mean postoperative hospital stay was significantly different between the groups (p<0.05), while the frequency of bile leak, bile collection, requirement of endoscopic retrograde cholangiopancreatography and the rate of reoperations were not significantly different between the groups (p>0.05). Compared to the Fenestrating type, the Reconstituting type of laparoscopic subtotal cholecystectomy resulted in reduced postoperative hospital stay.
45. Outcome of single-stage transanal Swenson pull-through without frozen section in short-segment Hirschsprung's disease.
期刊: JPMA. The Journal of the Pakistan Medical Association 发表日期: 2025-Dec 链接: PubMed
摘要
To evaluate the outcome of single-stage transanal Swenson pull-through without frozen section in paediatric patients with short-segment Hirschsprung’s disease. The single-group, prospective, cohort study was conducted at the Paediatric Surgical Unit, Nishtar Medical University, Multan, Pakistan, from January 2020 to December 2022 and comprised patients aged 1-12 years who were confirmed to have Hirschsprung’s disease through rectal biopsy and demonstrated short-segment involvement on contrast enema. Single-stage transanal Swenson’s pull-through procedure was performed on all patients without the use of frozen sections. Postoperative follow-up lasted 6 months. Data was analysed using SPSS 25. Of the 97 patients, 64(66%) were boys and 33(34%) were girls. The overall mean age was 2.97±1.62 years. Complications were observed in 21(21.65%) patients, with anastomotic stricture being the most common 6(6.19%), followed by increased stool frequency 5(5.15%), enterocolitis 5(5.15%), and anastomotic leakage 3(3.09%). Biopsy of the excised segment revealed that 2(2.06%) pagtients had aganglionic bowel pull-through. The single-stage transanal pull-through, when performed in the absence of frozen section, was found to be safe in the management of short-segment Hirschsprung’s disease.
46. Risk factors for early discontinuation of breastfeeding before two years age.
期刊: JPMA. The Journal of the Pakistan Medical Association 发表日期: 2025-Dec 链接: PubMed
摘要
To assess the risk factors regarding early cessation of breastfeeding. The cross-sectional study was conducted at the Paediatrics Department of Ayub Medical Teaching Institute, Abbottabad, Pakistan, from June 2022 to February 2023, and comprised mother-child dyads who initiated the breastfeeding process at birth, but failed to continue over the subsequent 24 months. Data was collected using a structured proforma through interviews with mothers. Data was analysed using SPSS 26. There were 250 mothers with mean age 28.48±5.73 years, while the mean age of 250 children was 14.64±7.53 months. The mean duration of breastfeeding was 5.05±3.99 months. The major risk factors identified were a combination of breastfeed and bottle-feed in the first month of life in 198(79.2%) cases, maternal diet restriction postpartum 186(74.4%) and no counselling about breastfeeding 168(67.2%). Pacifier use (p= 0.002), combined bottle-feed and breastfeed in the first month of life (p=0.001) and mothers wrongly considering formula milk healthier than breastfeed (p=0.000) were significant predictors of shorter duration of breastfeeding. All the reasons identified as potential risk factors for early discontinuation of breastfeeding were modifiable. Health education-based interventions are needed for optimising breastfeeding practices.
47. Health Informatics in Promoting Breast Cancer Screening: A Systematic Review of Benefits and Challenges.
期刊: JCO clinical cancer informatics 发表日期: 2025-Dec 链接: PubMed
摘要
Breast cancer is a leading cause of cancer incidence and mortality among women globally, with significant disparities in screening uptake. Technology-based tools are emerging and show the potential to promote breast cancer screening (BCS), especially for underserved populations. This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and the population, intervention, comparison, and outcome framework. We reviewed 24 peer-reviewed articles from databases including ProQuest Central, Scopus, ScienceDirect, PubMed, Web of Science, and IEEE Xplore published before February 21, 2025, which explore the efficacy of technology use in promotion of BCS. The included studies used diverse technologies, including videos, mobile health, websites, and sensor-based tools. The tools covered a variety of aspects for BCS promotion, including patient education, reminders, risk assessment, and competency building. Video-based interventions showed mixed results on BCS knowledge enhancement and screening rate promotion. Culturally tailored programs were effective in increasing screening rates among immigrant populations. Short messaging service reminders and web-based decision aids were associated with higher adherence and less decisional conflict. Challenges included technical barriers, limited digital access, and low engagement, which hinder the efficacy of the tools. Technology-based interventions are promising to improve BCS uptake, especially when tailored to cultural and linguistic needs. However, addressing barriers such as digital literacy and accessibility is critical for equitable implementation. Future research should focus on longitudinal studies and diverse populations to optimize these interventions and reduce disparities in screening adherence.
48. Seropositive Rheumatoid Arthritis and Polyhexamethylene Guanidine/Oligo(2-(2-Ethoxy)ethoxyethyl)guanidinium Chloride Exposure Are Associated With a Synergistic Effect on the Risk of Developing Interstitial Lung Disease: Registry Based Cohort-Study.
期刊: International journal of rheumatic diseases 发表日期: 2025-Dec 链接: PubMed
摘要
Humidifier disinfectants (HDs) containing polyhexamethylene guanidine/oligo(2-(2-ethoxy)ethoxyethyl)guanidinium chloride (PHMG/PGH) have a strong association with interstitial lung disease (ILD). Whether PHMG/PGH increases seropositive rheumatoid arthritis (RA) or interacts with RA to raise ILD risk is unknown. We constructed a registry-linked retrospective cohort by linking HD-claimant from the Korean Environmental Industry & Technology Institute (KEITI) to the National Health Insurance Service. Individuals who were aged ≥ 20 years as of January 1, 2003, were followed until death or December 31, 2021. PHMG/PGH exposure was modeled time-varyingly (pre vs. post). Seropositive RA (ICD-10 M05) was identified through claims screening with medical record review; ILD was defined by J84 claims. RA incidence was estimated using Poisson regression. For ILD, we applied time-dependent Cox models for PHMG/PGH exposure and post-RA status, adjusting for demographics, smoking, residence, and other HD components. Additive interaction was quantified by the relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S). Total 3452 adults (mean follow-up 15.9 ± 5.6 person-years) were analyzed; 1.7% developed seropositive RA and 21.6% ILD. RA incidence was 0.830 before exposure and 1.105 after (per 1000 person-years; p = 0.61). ILD hazards were elevated for PHMG/PGH exposure (HR 3.62, 95% CI 3.11-4.20) and for seropositive RA (HR 3.80, 2.70-5.34). Co-occurrence was observed more-than-additive risk: RERI 1.467 (95% CI 0.814-2.120), AP 0.143 (0.079-0.206), S 1.188 (1.049-1.326). PHMG/PGH exposure was not associated with increased incidence of seropositive RA. PHMG/PGH and seropositive RA each independently raised ILD risk, with more-than-additive association when combined. Given the retrospective, internally compared design, mechanistic work is warranted.
49. Migration trajectories, uncertainty and health: a conceptual review.
期刊: Social science & medicine (1982) 发表日期: 2025-Nov-21 链接: PubMed
摘要
Migration trajectories are complex, non-linear movements, including periods of immobility, secondary migration, return and psychosocial changes. A defining feature of these trajectories is uncertainty, resulting from incomplete place-based knowledge and the unpredictable future. We examined how migration trajectories and associated uncertainties have been conceptualised and operationalised in health-related research. We conducted a conceptual review with systematic searches in Medline, Embase, Web of Science, and Global Index Medicus. After duplicate screening, we extracted information on concept definitions, operationalisations and links to health. Uncertainty factors were categorised and mapped followed by a narrative synthesis (PROSPERO protocol: CRD42024579247). From 3836 titles after deduplication, 66 were synthesised which used various designs and mostly focused on forced migrants in high-income countries. Concept definitions and operationalisations varied strongly. Phase models outlining consecutive migration stages were frequently applied, while sometimes also considering non-linearity of trajectories. Uncertainty was mostly mentioned regarding legal status, followed by uncertainty of the future, ‘general’ uncertainty of migration processes, and uncertainty of social relations. Fewer studies considered uncertainty of economic, healthcare, and societal factors. Uncertainties were mostly associated with adverse mental health. The review illustrates a plethora of uncertainties along migration trajectories, with many studies showing negative psychological impacts of legal uncertainty. Current theorisations do, however, not tap the concept’s potential to generate health-related knowledge across migration trajectories, particularly regarding mobility regimes, conceptual meanings and modal time. Avenues for further research include considering positive health outcomes, examining how mobility regimes affect ‘possible futures’, and enhancing methods for studying uncertainty.
50. Rising t i des of res istance: evaluation of h ealth care worke rs aw ar en ess regarding ar tific i al inte l l igenc e to com bat antim icrob i al res i stance in Pakistan.
期刊: JPMA. The Journal of the Pakistan Medical Association 发表日期: 2025-Nov 链接: PubMed
摘要
To determine awareness score regarding the involvement of Artificial Intelligence (AI) to fight against Antimicrobial Resistance (AMR) among the HealthCare Workers of the South and Central Punjab, Pakistan by structured questionnaire to provide actionable educational initiatives and policy recommendations. This descriptive cross-sectional survey was done among the HealthCare Workers of South and Central Punjab, Pakistan, between August 01, 2022 and January 31, 2023. The study was limited to Multan and Lahore cities of South and central Punjab, Pakistan was approved by the institutional ethics review board of Nishtar Medical University Multan. A selfcreated questionnaire was used for collecting data. Version VII of GraphPad Prism was used for the analytical analysis. An independent t-test and analysis of variance (ANOVA) were employed to verify significance among different parameters of study. A p-value of less than 0.05 was utilized to validate statistical significance. During the study, 401 participants completed the online survey. The data findings indicate that women 275 (68.6%) was majority of the respondents between the age group range 21 - 40. Most of the HealthCare Workers 200 (49.9%) had done post graduation and fall among the category of Certified Professional Doctors and Researchers. Moreover, majority of the partakers 225 (56.1%) lived in Lahore city. The significant correlation of Total Awareness Score (TAS) among Sociodemographic parameters was analyzed. Post graduate HealthCare Workers (p=0.0001) and cer tified professional doctors/researchers (p=0.0001) had higher awareness score. In comparison to two different cities, HealthCare Workers of City Lahore (p=0.0324) was observed higher awareness level. Overall, majority of the HealthCare Workers have higher general awareness regarding the involvement of AI in combating antimicrobial resistance and also their implementation of that awareness is negligible.
51. The3+3 Meal Pattern.
期刊: JPMA. The Journal of the Pakistan Medical Association 发表日期: 2025-Nov 链接: PubMed
摘要
This communication reviews the 3 + 3 meal pattern, a pillar of conventional nutritional therapy. It describes the strengths, weaknesses, opportunities and challenges of this type of therapy, and lists indications for its promotion. These can be classified as diagnosis based, disease based, treatment based, temperament based, and responsibilitybased indications. The authors call for renewed focus on this mode of medical nutrition management.
52. Statin practices for ASCVD Prevention: A Cross-Sectional Analysis of Guideline Adherence in a High-Risk Local Patient Population.
期刊: JPMA. The Journal of the Pakistan Medical Association 发表日期: 2025-Nov 链接: PubMed
摘要
To investigate the current practices of statin prescription and use for primary and secondary prevention of atherosclerotic cardiovascular disease. The cross-sectional study was conducted at the Combined Military Hospital, Lahore, Pakistan, from December 2022 to June 2023, and comprised individuals with indication for statin therapy as per international guidelines. Data was collected using a self-designed questionnaire. The subjects were divided into primary prevention group A, comprising individuals aged 40 having one or more risk factors, and secondary prevention group B, comprising patients of all ages with a history of cardiovascular events. Data was analysed using SPSS 23. Of the 397 subjects, 256(64.5%) were in group A and 141(35.5%) were in group B. Overall, 257(64.7%) subjects were males, 392(98.7%) were aged >40 years, and 275(69.3%) were taking statins, with a mean usage duration of 52±70 months. In group A, statin use prevalence was 148(57.8%) compared to 127(90.1%) in group B. Hypertension and diabetes mellitus was found in 293(73.8%) and 269(67.8%) participants, respectively. Individuals with a matriculation-level educational background had significantly higher odds of statin use compared to those below matriculation (p=0.044). There was a high frequency of atherosclerotic cardiovascular disease risk factors, like diabetes mellitus, hypertension and smoking, and statin use was significantly higher in the secondary prevention group compared to the primary prevention group.
53. Population-based epidemiological analysis of acute pyelonephritis and antibiotic prescription in Spain (2009-2018).
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
To estimate the incidence of pyelonephritis in primary care in Spain from 2009 to 2018, assess the associated antibiotic prescriptions, and analyse trends by sex and age. This is a retrospective observational population-based national study using the Database for Pharmacoepidemiological Research in the Public Domain (BIFAP), which contains primary care electronic medical records, and is representative of the Spanish population. Patients with a diagnosis of pyelonephritis were included. Sociodemographic and clinical data were collected. Crude and adjusted incidence rates were calculated per 10,000 person-years by sex and age, and annual and global percentages of antibiotic use were calculated by sex, age, and antibiotic group. Trend analysis was performed using a joinpoint regression model. 24,888 cases of pyelonephritis were recorded with an incidence of 4.2/10,000 person-years (6.6 women vs 1.5 men). An annual decreasing trend was observed in women (AAPC average annual percentage change) -2.7 (95% CI -4.4;-0.9), men -3.0 (95% CI -4.5;-1.5), patients aged 18-64 years -2.9 (95% CI -4.7;-0.9) and ≥ 65 years -4.2 (95% CI -5.8;-2.4). The most frequently used groups of antibiotics were cephalosporins (38.7%), quinolones (30%), combined penicillins (22.2%) and fosfomycin (6.8%). Cephalosporin prescription predominated in women (39.8%), and quinolone prescription in men (40.3%). The most prescribed cephalosporins were third and second generation (21% and 17.7% respectively). A downward annual trend was observed in the global use of antibiotics AAPC -0.8 (95% CI -1.4; -0.2), with an increasing AAPC 1.7 (95% CI -0.6; 3.4) in ≥65 years. Among the groups of antibiotics, the prescription of quinolones AAPC -6.9 (95% CI -31.7;17.3) and penicillins AAPC -8.7 (95% CI -11.2;-6.8) decreased and cephalosporins increased AAPC 19.0 (95% CI 12.2;26). Women had a fourfold higher incidence of acute pyelonephritis than men, with a decreasing trend over the study period. Cephalosporins were the most commonly prescribed antibiotics in women, while quinolones were more common in men. An increasing trend in cephalosporin use and a decreasing in quinolone use were observed.
54. The impact of COVID-19 on walking practices in Korea: Policy implications for Urban health and physical activity resilience.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
This study adopts a socio-ecological model to evaluate the individual- and community-level factors influencing walking practices among urban adults before (2018-2019) and after (2020-2021) the COVID-19 pandemic. Busan, South Korea, characterized by dense urban environments and structured health promotion systems, offers a relevant context to examine pandemic-related changes in physical activity behaviors. The 2018-2021 Korea Community Health Survey was used, targeting adults aged 19 and older living in Busan Metropolitan City. Multilevel logistic regression models were constructed using data from 58,028 individuals (Level 1) and 16 administrative districts (Level 2). The binary dependent variable was walking. The independent variables included individual-level and community-level factors. Model fit was evaluated using the intraclass correlation coefficient, likelihood ratio, and -2 log likelihood. Individual-level variables such as sex, age, household income, subjective health status, and depression significantly correlated with walking before and after the COVID-19 pandemic. Females who perceived their health as poor or experienced depression were less likely to walk. However, the associations between age, household income, and walking practices were inconsistent. Before the pandemic, individuals who reported high trust in their neighbors were more likely to engage in walking practices. After the pandemic, those classified as obese were less likely to engage in walking practice, while individuals who engaged in alcohol consumption showed higher odds of walking practice. Moreover, participants who perceived access to public transportation as good had increased odds of walking. At the community level, pedestrian paths and social network difficulty were negatively associated with walking practice. In contrast, the availability of public sports facilities was positively associated with walking. The COVID-19 pandemic significantly affected urban adults’ walking habits. Factors such as pedestrian paths, sports facilities, and reduced social relationship challenges helped maintain walking practices. These results highlight the need for multilevel interventions that target environmental, social, and individual determinants to promote and sustain walking during and after public health emergencies. In Korea and other high-density Asian cities, these findings provide policy-relevant evidence to guide walkability-oriented urban planning and health promotion strategies that strengthen physical activity resilience in future public health crises.
55. Dry eye disease seasonal pattern and climatic association in Saudi Arabia using Google Trends.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The study aims to investigate the dry eye search term pattern in Saudi Arabia using Google Trends, and to explore the association of weather changes on dry eye disease (DED) search interests. Time series analysis for data that were collected from Google Trends (GTs) on period from January 2011 to October 2024 using Arabic term for Dry Eye with setting allocated in Saudi Arabia. Seasonality was evaluated using Fourier terms in ARIMA regression model. Monthly variation was further evaluated. Climate factors, mean surface air temperature, relative humidity and accumulated precipitate were incorporated into ARIMAX model to find environmental relationship with DED. Kruskal-Wallis test was performed to confirm significant finding in monthly variation. Dry eye disease (DED) related search term demonstrates significant monthly differences (p = 0.008). Monthly effect ARIMA model (R² = 0.93) identified sustained high season from February through August higher than January. June represents maximum annual peak. A significant upward trend of 0.48 per month in RSV is also noted over the 13-year period (p < 0.001). In ARIMAX model, relative humidity is most important associated factor with dry eye search activity (β = -0.26, p = 0.002). This study is the first evidence of seasonality of DED using Google Trends (GTs) in Saudi Arabia and highlighting the growing public health concern of DED. Understanding the disease pattern can aid public health implications to decrease risk of DED. This finding can serve as valuable reference to supplement traditional methods.
56. Vaccination experiences and decision-making in older adult Korean immigrants living in Canada: A qualitative descriptive study.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
Older adult immigrants face unique challenges in accessing healthcare and preventive health measures, including vaccines. While Asian immigrants in North America generally report high vaccine uptake, studies suggest that Korean immigrants may have lower willingness to vaccinate and experience barriers to healthcare utilization. Understanding the vaccination experiences and decision-making processes of this population is critical to addressing disparities in and improving vaccine uptake. Therefore, we conducted a qualitative descriptive study to explore the influenza, pneumococcal, and shingles vaccination experiences, perceptions, and decision-making among older adult Korean immigrants in Canada. Study participants were recruited using convenience, snowball, and purposeful sampling. Semi-structured interviews were conducted with 30 Korean immigrants aged 65 years and older residing in Montreal and Toronto, Canada from September 2023 to July 2024. Interview transcripts and field notes were thematically analyzed, guided by the socio-ecological model. Key themes across intrapersonal-, interpersonal-, institutional-, community-, and policy-levels were identified. Participants reported strong willingness to get vaccinated, largely influenced by healthcare provider recommendations, government guidance, and perceived disease risk. However, gaps in vaccine knowledge, concerns about vaccine safety, and lack of explicit healthcare provider recommendations contributed to non-vaccination. Participants identified trust in the Canadian government and medical professionals as primary motivators to adhere to vaccination guidelines. Some vaccination-specific facilitators and/or barriers were also identified (e.g., financial barriers to shingles vaccination). Strategies to improve vaccine uptake among older adult Korean immigrants could involve supporting healthcare providers or public health efforts to promote vaccinations, encouraging healthcare providers to address concerns and emphasize safety and benefits of vaccinations using shared decision making, and collaborating with faith-based communities to promote vaccinations.
57. Neurodevelopment in children born to women exposed to pesticides during pregnancy.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The global rise in pesticide use, particularly across Africa, raises concerns about maternal occupational exposure during pregnancy and its potential impact on child neurodevelopment. This study examined associations between self-reported maternal pesticide exposure during pregnancy and neurodevelopmental outcomes in children aged 4-6 years. A cross-sectional design was implemented, comprising 432 mother-child pairs from three horticulture-intensive regions in Tanzania. Maternal exposure was assessed through structured interviews, focusing on activities during pregnancy such as pesticide spraying, weeding, and handling contaminated clothing. Children’s neurodevelopment was evaluated using the International Development and Early Learning Assessment (IDELA), which measures motor skills, literacy, numeracy, social-emotional development, and executive function. Linear regression analyses revealed that children of mothers who reported pesticide spraying during pregnancy scored significantly lower in social-emotional (β = -6.813, 95% CI: -11.53 to -2.096, p = 0.005) and executive function (β = -9.317, 95% CI: -16.007 to -2.627, p = 0.006) domains. Overall, children achieved the highest mean scores in fine and gross motor skills (62.11 ± 19.3) and the lowest in executive function (43.97 ± 24.3). Age-related differences were also observed, with six-year-olds consistently outperforming younger children across all developmental domains. These findings suggest an association between maternal pesticide exposure during pregnancy and adverse neurodevelopmental outcomes in offspring. Given that exposure data were self-reported, results should be interpreted cautiously. Nevertheless, the study underscores the urgent need for comprehensive risk assessments incorporating objective exposure measurements, particularly in horticultural settings where women of reproductive age represent a substantial proportion of the workforce.