公共卫生研究摘要 (2025-12-22)
共收录 55 篇研究文章
1. Transitions in and out of Loneliness During the COVID-19 Pandemic: A Latent Class Analysis of Older Adults in England.
期刊: Sociology of health & illness 发表日期: 2026-Jan 链接: PubMed
摘要
Disease control measures during the COVID-19 pandemic may have intensified loneliness among older adults, though experiences varied based on individual vulnerabilities and resources. This study examines loneliness trajectories among older adults using the English Longitudinal Study of Ageing, spanning four waves: two pre-pandemic (Wave 8: 2016-2017; Wave 9: 2018-2019) and two COVID-19 substudies (June-July and November-December 2020). The sample included 4492 respondents (17,968 observations). Latent class growth analysis identified four loneliness trajectories: ‘not lonely’ (73.5%), ‘pandemic loneliness’ (12.7%), ‘transitioned out of loneliness’ (6.9%) and ‘enduring loneliness’ (6.8%). Multinomial regression analysis explored predictors of trajectory membership. Younger age (50-74), being female, depression, COVID-related worries and disrupted daily routines increased the likelihood of belonging to ‘pandemic loneliness’ rather than ‘not lonely’. Optimism and strong partner support increased the likelihood of remaining ‘not lonely’ or transitioning out of loneliness. The pandemic’s unintended effects, including routine disruptions and financial concerns, heightened loneliness risks, whereas psychosocial resources provided critical resilience. To prepare for future public health crises, policies should strengthen mental health support, promote social and economic stability and enhance social connection and resilience. Addressing psychosocial factors is essential to reducing loneliness and protecting older adults’ well-being during and beyond periods of crisis.
2. Surface-Enhanced Raman Spectroscopy Detection of Per- and Polyfluoroalkyl Substances in Aqueous Film-Forming Foams.
期刊: Environmental science & technology 发表日期: 2025-Dec-21 链接: PubMed
摘要
Identifying the presence and identity of per- and polyfluoroalkyl substances (PFAS) in complex mixtures is critical for water treatment, hazardous waste cleanup, and the identification of workplace hazards. The cost and scale of conventional methods for PFAS detection often make rapid and portable detection challenging. Here, we use concave cubic gold nanoparticles for surface-enhanced Raman spectroscopy (SERS) to detect PFAS in parts per million concentrations, differentiating the 6 PFAS─PFHpA, PFNA, PFDA, PFOA, PFHxS, and PFOS─regulated in the Commonwealth of Massachusetts by the Department of Environmental Protection (MassDEP). Calculated Raman spectra, solid-state Raman spectra, and 19F NMR are used to further understand the physicochemical properties of these 6 PFAS. Quantitative analysis of PFOA and PFOS can be achieved from 0.1 to 10 ppm, while PFAS can be differentiated from three common fluorinated pharmaceuticals, and perfluoroalkyl carboxylic acids (PFCA) can be differentiated from C7 to C10 based on the length of the perfluoroalkyl backbone. Finally, we highlight that SERS can be used to identify PFAS in real-world aqueous film-forming foams (AFFFs), as confirmed separately by mass spectrometry. These results advance our ability to detect and analyze PFAS in real-world samples relevant to environmental monitoring and analysis.
3. Neighbourhood effects on tree survival in Huangshan secondary forest community.
期刊: Plant biology (Stuttgart, Germany) 发表日期: 2025-Dec-21 链接: PubMed
摘要
Understanding inter- and intraspecific interactions is central to community ecology. Using data from two censuses of a subtropical secondary forest in Huangshan, China, we analysed survival rate for over 54,000 saplings across 83 species. We quantified four neighbourhood density indices, conspecific (CI), heterospecific (HI), phylogenetic (PhyI), and functional (FunI), to test how neighbour density influences tree survival. In parallel, we calculated neighbourhood diversity along species, phylogenetic, and functional axes to test how neighbour diversity shapes species’ survival probabilities spanning four different spatial scales. Generalized linear mixed models revealed that HI and FI significantly decreased survival, highlighting intense interspecific competition in early successional stages. In contrast, PhyI positively affected survival, suggesting habitat filtering among related species. Neighbourhood diversity exhibited scale-dependent effects. Finally, we identified species with high specific leaf area and phosphorus content grew faster but experienced higher mortality. These findings underscore the importance of incorporating phylogenetic and functional neighbourhood metrics to understand demographic processes and community assembly, particularly in recovering forest ecosystems.
4. Evaluating Nurses' Perspectives on the Acceptability and Practicality of Comfort Rounding for Personalised Nutritional and Mobility Care in Surgical Wards: A Mixed-Methods Feasibility Study.
期刊: Journal of advanced nursing 发表日期: 2025-Dec-21 链接: PubMed
摘要
To evaluate nurses’ perspectives on factors influencing the acceptability and practicality of comfort rounding, focussing on personalised nutritional and mobility care. Mixed-methods feasibility study. Focus group interviews with nurses were conducted before, during and at the end of the implementation period (2022-2023). A questionnaire assessed acceptability and practicality among nurses at the end of the implementation. Data were analysed using directed content analyses and descriptive statistics. Comfort rounding’s acceptability and practicality were influenced by nurses’ attitudes, knowledge and skills, patient characteristics and the nurse-patient relationship. Barriers included workload, time pressure, team culture and the extensive, rigid design of comfort rounding. Questionnaire responses demonstrated nurses perceived added value of comfort rounding and frequently engaged patients in activities related to nutrition and mobility. However, it was not performed as originally intended. Nurses considered personalised nutritional and mobility care important and frequently provided it during ‘usual care’. However, nurses were critical of comfort rounding’s acceptability and practicality and did not perform it as intended. Comfort rounding’s concept does not align well with current nursing practice. Greater tailoring to nurses’ preferences or alternative approaches to structuring personalised nutritional and mobility care are recommended. What problem did the study address: Hospitalised patients often receive suboptimal nutritional care and are largely inactive. The challenge is to integrate personalised nutritional and mobility care effectively into standard nursing practice to enhance patient safety and well-being. Comfort rounding could improve patient safety and satisfaction; however, there is no research evaluating the feasibility of comfort rounding in relation to personalised nutritional and mobility care. What were the main findings: Comfort rounding was generally perceived as valuable and aligned with existing care routines, but its rigid structure was often considered impractical. Comfort rounding was not performed as originally intended due to the influence of individual, social and organisational factors. Flexibility in execution emerged as a critical factor for successful integration. Where and on whom will the research have an impact?: Comfort rounding can enhance attention to nutrition, mobility and patient participation when adapted to local contexts and delivered with flexibility. Policymakers and nurse leaders should avoid rigid protocols and instead support tailored implementation strategies alongside the practical delivery of locally tailored interventions. Consolidated criteria for reporting qualitative research and Checklist for Reporting of Survey studies. Nurses were involved in all stages of the study, contributing through focus group interviews and completing a questionnaire to help develop and evaluate comfort rounding. PaNaMa Research Management System, number 112832. What does this paper contribute to the wider global clinical community? ○ Comfort rounding may support fundamental care delivery. ○ Acceptability and practicality of comfort rounding depend on flexibility.
5. Nurses' Experiences of Providing Bereavement Care: A Systematic Review and Synthesis of Qualitative Research.
期刊: Journal of advanced nursing 发表日期: 2025-Dec-21 链接: PubMed
摘要
To identify and synthesise the available evidence of nurses’ perceptions and experiences of providing bereavement care. Systematic literature review of qualitative studies with meta-synthesis of findings. We searched six databases, PubMed, Web of Science, the Cochrane Library, Embase, CINAHL, and PsyINFO. Initial search in October 2023, and updated in December 2024. The systematic review was conducted in accordance with the JBI methodology for systematic reviews of qualitative evidence. Two reviewers independently conducted study selection and data extraction, and quality appraisal was assessed using the Critical Appraisal Skills Program tool for qualitative research. Data synthesis was conducted using thematic analysis. A total of thirteen studies were included, revealing nine sub-themes and three descriptive themes: challenges in bereavement care, coping strategies, and multifaceted job requirements. Six sub-themes were graded as high confidence and the other three were moderate confidence. Bereavement care is a personalised, long-term and complex process, presenting nurses with unique challenges and requirements that must be measured through the authentic experiences of this group. Educational and practice policies should focus on nurse-centred strategies. Through this meta-synthesis, we can demonstrate to healthcare administrators how to enhance nurses’ bereavement care practice experiences and meet their needs, thereby advancing future palliative care development and fostering professional fulfilment. This systematic review synthesises evidence concerning nurses’ experiences of providing bereavement care, revealing the multidimensional challenges, coping strategies, and professional demands encountered in practice. The findings offer significant implications for nursing education, clinical practice, and health policy development. Currently, research on nurses delivering bereavement support remains insufficient; further investigation into this group could help bridge gaps between grief counselling theory and practice while highlighting the identified societal issues they face. Not applicable. PROSPERO: CRD42024590469.
6. Prevalence of type 2 diabetes among global Indigenous adult populations: a systematic review.
期刊: Diabetologia 发表日期: 2025-Dec-21 链接: PubMed
摘要
Despite evidence documenting high prevalence of type 2 diabetes among several Indigenous populations, a comprehensive systematic review of type 2 diabetes among global Indigenous Peoples has not been recently conducted. Our aim was to report region-, time-, age- and sex-specific type 2 diabetes prevalence among Indigenous adult populations globally. MEDLINE, Embase and CINAHL were searched for English-language studies published between 1 January 1980 and 3 March 2023. Studies reporting type 2 diabetes prevalence and/or cases of diabetes among global Indigenous adult populations aged 18 years and older were included. Type 2 diabetes prevalence data were extracted for the overall Indigenous population, sex, age group and year. Summaries of extracted data were tabulated, and are presented using comprehensive tables and figures. A modified Newcastle-Ottawa quality assessment scale reflective of Indigenous-specific criteria was applied to assess paper quality. The search identified 2332 studies, of which 202 met the inclusion criteria. The included studies represented at least 187 Indigenous populations from 37 countries, although the exact number of populations is approximate, as some studies did not name specific Nations/Tribes/Groups for populations from different geographic regions. Diabetes prevalence ranged from 0 to 40%, with a mean of 73% of Indigenous populations reporting type 2 diabetes prevalence above the estimated global prevalences for every decade between 1980 and 2020. Prevalence increased over time and with age for many populations, with the highest reported prevalence (50.5%) in the 45-54 year age group. Type 2 diabetes prevalence was notably high among Indigenous women, with 73% of studies reporting higher prevalence for Indigenous women than for Indigenous men. Potential limitations include publication bias, which may have led to fewer studies being included in this review. Type 2 diabetes prevalence among Indigenous adult populations was markedly higher than the global averages in every decade from 1980 to 2020, with a mean of 73% of populations reporting higher prevalence. These findings underscore the persistent and disproportionate burden of diabetes experienced by many Indigenous communities over several decades. Future work should aim to generate representative data on type 2 diabetes prevalence across global Indigenous populations, investigate factors that contribute to alarmingly high and notably low diabetes prevalence, and support Indigenous-led, culturally safe, Indigenous population-specific health practices to prevent and manage type 2 diabetes and achieve equitable outcomes. There was no funding source for this study. PROSPERO registration no. CRD42021258623.
7. Factors influencing complete abstinence during Thailand's temporary alcohol abstinence campaign.
期刊: Scientific reports 发表日期: 2025-Dec-21 链接: PubMed
摘要
Thailand’s temporary abstinence campaign aims to persuade drinkers to abstain from alcohol for three months during Buddhist Lent. In recent years, a decline in the popularity of the campaign has been observed. This study aims to determine factors associated with success in complete abstinence during the campaign period and to determine whether the associations change over time to provide insight into the decline in complete abstinence. This study analyzes pooled data of 5898 current drinkers from three waves (2015, 2018, and 2021) of the campaign evaluation survey. The primary outcome is complete abstinence during the campaign. Multivariable analysis indicated that campaign media exposure was associated with complete abstinence (OR, 1.42; 95% CI 1.17-1.72). Similarly, the year 2018, older age, lesser drinking frequency prior to the campaign, and higher level of affordability were positively associated with complete abstinence. There was a statistically significant interaction between year and drinking frequency prior to the campaign (p < 0.001). The decline in complete abstinence was plausibly explained by reduced campaign media exposure, increased drinking frequency among drinkers, and the 2021 period effect (presumably COVID-19). Diversifying campaign media distribution across traditional, community-based, and digital platforms may enhance the campaign’s success by ensuring wider exposure to campaign messages.
8. Influence of Social Determinants of Health on Adherence to Lifestyle Modifications in Individuals With Prediabetes: A Mixed Methods Study.
期刊: Journal of advanced nursing 发表日期: 2025-Dec-21 链接: PubMed
摘要
To explore the relationship between social determinants of health and adherence to lifestyle recommendations, and how these determinants can help explain contextual and interpersonal factors contributing to adherence among individuals with prediabetes. Explanatory sequential mixed methods study integrating a cross-sectional quantitative analysis with an ethnomethodological qualitative approach grounded in critical social paradigm. The quantitative phase used data from the intervention arm (n = 86) of the PREDIPHONE trial, a randomised controlled study evaluating the effectiveness of a nurse-led telephone intervention for lifestyle changes in glycaemic control. Adherence was measured using a composite index, analysed as both a continuous and categorical variable. Correlation analysis examined adherence and age. Chi-square and ANOVA tests were used to analyse differences in participant characteristics across adherence quartiles. The qualitative phase included individual semi-structured interviews and a focus group with participants showing high or low adherence. Thematic content and discourse analysis were employed, ensuring validity through triangulation, reflexivity and discourse saturation. Employment status was identified as a significant factor, with unemployed or retired participants showing better adherence. Although no statistical differences in adherence were found by social class or gender, lower social class participants reported financial barriers to healthy eating and time constraints limiting physical activity (PA). Women reported facing greater challenges due to caregiving responsibilities, whereas men benefited from household support. Employment status emerged as a determinant of time availability for self-care, alongside social class and gender in adherence to lifestyle modifications. Women, especially those from lower social classes, experienced heightened barriers to adherence, underscoring the need for tailored, gender-sensitive and equity-focused interventions. Addressing social determinants is essential for effective lifestyle advice among individuals with prediabetes. The study highlights the role of social class and gender in adherence. STROBE and COREQ guidelines. Through interviews and focus group.
9. A rare cause of persistent cholestatic jaundice: gallbladder amyloidosis.
期刊: Clinical journal of gastroenterology 发表日期: 2025-Dec-21 链接: PubMed
摘要
Gallbladder amyloidosis is an exceptionally rare condition that may clinically mimic extrahepatic cholestasis. An 81-year-old man presented with persistent cholestatic jaundice and recurrent right upper quadrant pain. Laboratory evaluation showed conjugated hyperbilirubinemia and elevated cholestatic liver enzymes without signs of inflammation. Imaging studies, including ultrasound, MRCP, and CT, demonstrated gallstones and gallbladder wall thickening but no bile duct dilation or obstruction. Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound were unremarkable. Because of ongoing pain and cholestasis, laparoscopic cholecystectomy was performed. Histopathological examination revealed chronic fibrosing cholecystitis with marked submucosal and vascular deposition of amorphous eosinophilic material, showing apple-green birefringence under polarized light after Congo red staining, consistent with amyloid. Immunohistochemistry favored transthyretin (ATTR) amyloid deposition. Postoperatively, the patient recovered uneventfully with resolution of pruritus and normalization of bilirubin. Extensive systemic evaluation excluded generalized amyloidosis, indicating a localized form of gallbladder amyloidosis. This case underscores the importance of considering infiltrative diseases such as amyloidosis in the differential diagnosis of unexplained cholestatic jaundice, particularly when imaging fails to show mechanical obstruction. Recognition of this entity may prevent unnecessary invasive interventions and emphasizes the diagnostic value of histopathological confirmation following cholecystectomy.
10. Meningococcal Disease in Older Adults: Challenges in Diagnosis and Management.
期刊: Infectious diseases and therapy 发表日期: 2025-Dec-21 链接: PubMed
摘要
Invasive meningococcal disease (IMD) in older adults frequently presents with atypical clinical manifestations, including bacteremic pneumonia, often without classical meningeal signs or sepsis, which presents clinicians with diagnostic challenges, and may delay treatment, which contributes to the high mortality observed in older adults. Within the broader resurgence of IMD observed since relaxation of quarantine measures introduced to mitigate the impact of the COVID-19 pandemic, there has been a notable increase in reporting of such atypical cases. The aim of this review is to summarize epidemiological, diagnostic, and treatment aspects of non-meningeal forms of IMD in older patients, with a focus on meningococcal pneumonia. By convention, laboratory confirmation requires N. meningitidis detection by culture, polymerase chain reaction (PCR), or antigen detection. In most cases, presentation of meningococcal pneumonia is similar to that of other forms of community-acquired pneumonia, and cerebrospinal fluid sampling may be non-informative. This places a premium on early blood culture for N. meningitidis, allied with testing of respiratory samples (e.g., broncho-alveolar washes). Many cases are linked to isolates of serogroups Y and W. When confirmed, treatment with third-generation cephalosporins is generally preferred. Chemoprophylaxis and vaccination of close contacts is essential for controlling onward meningococcal disease transmission and prevention of further cases.
11. Blastic plasmacytoid dendritic cell neoplasm (BPDCN): international, multi-center collaboration and global registry program.
期刊: Discover oncology 发表日期: 2025-Dec-21 链接: PubMed
摘要
Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN) is a rare and aggressive hematologic malignancy originating from plasmacytoid dendritic cell precursors. BPDCN shares common diagnostic and clinical features with other hematologic malignancies and various dermatological disorders. Differential diagnosis and treatment are challenging and require awareness by the dermatologist, hemato-oncologist, pathologist for detailed diagnostic and therapeutic workup. The outcomes remain poor, and the optimal treatment for the disease is yet to be established, emphasizing the need for a more comprehensive and globally inclusive approach. In response to these challenges, we initiated an international, multi-center collaboration and established a global registry program for BPDCN patients. The registry collected both retrospective and prospective data on demographics, clinical presentations, diagnostic criteria, treatment regimens, and outcomes for cases diagnosed after Jan 2010. Data for this report was obtained from 36 patients across 16 centers in 12 countries, with ongoing contributions from additional centers. Preliminary analysis revealed a male predominance (78%), with a median age at diagnosis of 63 years, involving all age groups. The immunophenotype (CD123 + , CD4 + , CD56 +) was consistently observed in a majority of patients (88.8%), validating its diagnostic utility and paramount significance in the BPDCN diagnosis. Treatment responses varied based on initial regimens, with ALL-like approaches demonstrating more favorable outcomes compared to AML-like strategies, which were given to younger patients. Notably, relapse rates remained high. The BPDCN International Registry Program provides a valuable tool in consolidating global data and fostering collaboration among researchers and clinicians. This collaborative effort involving multiple countries on several continents not only aims to advance our comprehension of BPDCN but also lays the groundwork for standardized treatment protocols for improving outcomes for BPDCN patients worldwide.
12. BioCNTs Mediated Delivery of Systemically Mobile Small RNAs via Leaf Spray to Control Both Tomato DNA and RNA Viruses.
期刊: Advanced science (Weinheim, Baden-Wurttemberg, Germany) 发表日期: 2025-Dec-21 链接: PubMed
摘要
Tomato viral diseases severely restrict the safe and efficient tomato production, and current control methods are lacking. Therefore, the development of green and efficacious biopesticides is imperative. The initiation of RNA interference (RNAi) by topically applied double-stranded RNA (dsRNA) or short hairpin RNA (shRNA) has potential applications in crop protection. However, the instability and limited mobility of exogenous naked RNAi molecules severely limit their practical large-scale application. Here, a robust method combining dsRNA and shRNA-mediated silencing technology with single-walled carbon nanotubes (SWCNTs)-based nanocarriers (BioCNTs) is developed to prevent tomato mosaic virus, tomato spotted wilt virus, and tomato yellow leaf curl virus through exogenous spraying. This method is nontoxic to tomato plants and enables effective delivery of dsRNA or shRNA for long-term silencing. By integrating shRNAs and tRNA-like structure (TLS) with BioCNTs, we developed a highly effective biopesticide with systemic mobility. After 14 days of spraying, the control efficacy remained high in the upper unsprayed leaves. These findings indicate that BioCNTs-mediated dsRNA/shRNA has strong inhibitory effects, and TLS enables systematic movement of shRNA in plants, maintaining long-term virus silencing efficacy. Therefore, the simple and low-cost BioCNTs-TLS system holds significant potential as an effective, green, and sustainable tool for controlling plant viral diseases.
13. ePlanet - An educational game and platform for Planetary Health.
期刊: Medical teacher 发表日期: 2025-Dec-21 链接: PubMed
摘要
Planetary Health addresses the interconnections between environmental changes, social systems and human health. Despite its growing recognition, integration into medical education remains limited due to overloaded curricula and educators’ unfamiliarity with the subject. The ePlanet project developed modular, open-access educational tools, incorporating serious gaming and challenge-based learning (CBL). Teaching guides support educators in implementing the materials. The ePlanet online serious game - freely available in English and Spanish at https://eplanet.care/game/ engages students in real-life scenarios on sustainable healthcare, nutrition, air pollution and heat, and infectious diseases. Complementary CBL modules develop competencies in systems thinking, advocacy, sustainability, and health equity. The ePlanet materials provide a lightweight approach for integrating Planetary Health into medical education without curricular restructuring. The game’s availability in multiple languages and its open access format make it globally accessible. Pilot testing showed that serious gaming can effectively introduce Planetary Health in medical contexts. Future steps include presenting ePlanet at international conferences, integrating the materials into digital learning environments, and using them for faculty development.
14. Decoding environmental influences on soft corals of the genus Sinularia in the Red Sea: insights from untargeted metabolomics.
期刊: Environmental science and pollution research international 发表日期: 2025-Dec-21 链接: PubMed
摘要
Soft corals are significant members of the reef ecosystem, and their existence is threatened by extensive anthropogenic activities and the associated climate change. In this context, Sinularia species were collected from different locations across the Egyptian Red Sea coast with varying environmental conditions (i.e., Hurghada and Marsa Alam), to comprehensively explore their metabolic response to stress, and to identify markers of their resilience to environmental stressors. Untargeted metabolomics encompassing GC-MS (gas chromatography-mass spectrometry) and UPLC-HRMSMS (ultra-high-performance liquid chromatography coupled to high-resolution mass spectrometry) were employed to explore the respective changes in their primary and secondary metabolome. The recorded metabolome reflected the stressful and competitive environmental conditions existing in Hurghada despite the lower sea temperature. Sinularia samples collected from Hurghada showed higher levels of glycerol and free amino acids in addition to cembranes and hydroxylated steroids, versus higher total amino acid content in Marsa Alam samples. Glycerol is linked to stress in corals, acting as an energy reserve and mediating homeostasis, while free amino acids act as osmolytes in stressed organisms. In contrast, total amino acid content reflects active protein synthesis, metabolic flexibility, and sufficient nutritional resources. This study underscores how metabolomics can provide holistic insights into the biochemical adaptations of corals, enabling a deeper understanding of how climate change and human-induced stressors reshape reef health at the molecular level. Observed biochemical changes highlight that coral reefs are greatly affected by the escalating human activities, which significantly contribute to the degradation of marine habitats, posing a severe threat to coral ecosystems.
15. Research progress on unsaturated fatty acid synthesis in microalgae.
期刊: Biotechnology letters 发表日期: 2025-Dec-21 链接: PubMed
摘要
Polyunsaturated fatty acids (PUFAs) have attracted significant attention for their roles in human health, particularly in cardiovascular protection. As a promising source of PUFAs, microalgae have become a research hotspot due to their rapid growth and ability to accumulate large amounts of PUFAs under stress conditions. This paper reviewed the recent progress in microalgal PUFAs research, focusing on analyzing PUFA content in different microalgal species, the effects of environmental factors on PUFAs synthesis, as well as related biochemical pathways. Additionally, this paper explored strategies for enhancing PUFA production in microalgae using metabolic engineering and gene editing, and outlined current research challenges.
16. Comparison of Pi10 and PiSlope calculation methods and association with lung function.
期刊: European radiology 发表日期: 2025-Dec-21 链接: PubMed
摘要
The average wall thickness of a theoretical airway with a lumen perimeter of 10 mm (Pi10) and the slope of the luminal perimeter of airways against their wall thickness (PiSlope) are CT-derived biomarkers of airway remodeling in chronic obstructive pulmonary disease (COPD). However, numerous calculation methods for Pi10 have been used across studies, leading to substantial variability in Pi10 values. This study evaluated reliability among 10 Pi10/PiSlope methodologies and their associations with lung function. CanCOLD participants underwent full-inspiration CT scans; CT airway segmentation was performed using VIDA software. Ten literature-based methods were used to calculate Pi10 (regression-derived wall thickness at 10 mm perimeter) and PiSlope (slope of wall area/perimeter plot). The 10 methods varied in their approaches: some focused on specific airway sizes (Patel, Van Tho, Nakano, Telenga), others limited measurements to certain airway generations (Gietema, Park, Dudurych) or covered broader airway size ranges and generations (Bhatt, Jobst, Smith). Reliability was assessed via intraclass correlation (ICC); lung function associations were assessed using regression. Pi10 and PiSlope were calculated for 1351 participants (67 ± 10 years; 550 women). Pi10 and PiSlope measurement methods with higher airway counts (Patel, Nakano, Smith, Jobst, Bhatt) showed excellent reliability (ICC > 0.90, p < 0.05). Compared to Pi10, PiSlope demonstrated stronger, consistent negative associations with FEV1, FEV1/FVC, and FEF25-75% across all methods, especially in those with fewer airways. These results provide insight into which Pi10/PiSlope calculation methods may generate more reliable findings and indicate PiSlope may provide a more comprehensive measure of airway remodeling in COPD. Question CT Pi10/PiSlope measures airway remodeling in COPD, but calculation methods vary. Are CT Pi10/PiSlope reliable and provide comparable associations with lung function across various methodologies? Findings Pi10/PiSlope calculation methods that included a higher number of CT airways were more reliable, and PiSlope showed stronger associations with lung function than Pi10. Clinical relevance These results provide insight into which methods may generate more reliable findings, aiding interpretation of results between studies, and support the potential of PiSlope as a reliable biomarker for monitoring airway remodeling in COPD.
17. Associations between plasma ANGPTL4 levels and the risk of 24 cancers: a prospective cohort study.
期刊: Cytokine 发表日期: 2025-Dec-20 链接: PubMed
摘要
Angiopoietin-like 4 (ANGPTL4) is a hepatokine involved in metabolism and inflammation and has been implicated in oncogenesis, yet its relationship with cancer risk in humans remains unclear. We analyzed 35,716 cancer-free UK Biobank participants with baseline plasma ANGPTL4. Multivariable Cox models and restricted cubic splines assessed associations with 24 site-specific incident cancers; bidirectional two-sample Mendelian randomization (MR) evaluated causality. During a median follow-up of 12.5 years, 9304 incident cancer cases occurred. Compared with the lowest quartile (Q1), the higher quartiles (Q2, Q3, and Q4) of ANGPTL4 levels were significantly associated with the risks of ten cancers, including cancers of the bladder, breast, cervix uteri, colorectum/anus, esophagus, kidney, liver, mesothelial/soft tissues, multiple myeloma, and ovary (hazard ratios ranging from 1.02 to 3.98). Risks generally increased across ANGPTL4 quartiles, and spline analyses supported approximately linear dose-response patterns. Adding ANGPTL4 to an age-sex model improved discrimination across several sites (ΔC-index 0-0.071), with statistical significance observed only for breast cancer. Associations were directionally consistent but heterogeneous by age, sex, and BMI. Forward MR provided no evidence that genetically proxied ANGPTL4 causally increases cancer risk. In reverse MR, genetic liability to liver cancer showed a nominal positive association with circulating ANGPTL4, suggesting ANGPTL4 may be elevated as part of tumor-related biology. Higher circulating ANGPTL4 is associated with increased risk of multiple cancers, with sex-and tissue-specific heterogeneity. Although MR does not support a universal causal role, ANGPTL4 remains a promising pan-cancer biomarker for risk stratification and early prevention.
18. Spatial distribution prediction and scale effect analysis of urban daytime noise based on remote sensing images: a case study of Chengdu.
期刊: Journal of environmental management 发表日期: 2025-Dec-20 链接: PubMed
摘要
Public health and urban sustainable development are seriously affected by urban road traffic noise. Conventional urban noise monitoring has high cost, narrow coverage, and slow updating; therefore, efficient monitoring is urgently required. In this paper, we merge high-resolution remote sensing imagery with end-to-end deep learning models based on ResNet and ViT architectures to explore the prediction performance of daytime urban noise with imagery of diverse spatial resolutions. The whole urban region of Chengdu was chosen for investigation. We generated an image dataset with nine distinct spatial resolutions via resampling, ranging from 0.25 m to 50 m, to assess resolution-dependent performance. Both ResNet and ViT models were trained and validated on this dataset. Surprisingly, results showed that prediction accuracy exhibited a nonlinear pattern of initially increasing and then decreasing with improving resolution. Imagery at 2-m resolution achieved the highest accuracy. Multi-scale fusion experiments did not lead to significant performance gains, suggesting that scale stacking may introduce redundant or conflicting spectral information without improving generalization. The findings suggest that the 2-m resolution balances detailed information and broader spatial context, making it the optimal choice for predicting urban noise distribution. A two-dimensional Fourier spectral analysis further revealed that the 2 m imagery achieves the most balanced distribution of high- and low-frequency components, providing a physical explanation for its superior performance. This approach provides a novel pathway for environmental noise monitoring and establishes a foundation for studies on scale effects and resolution selection.
19. The Impact of Historical and Modern-Day Redlining on Firearm Violence: A Decade-Long Multilevel Study of 38 States.
期刊: Journal of racial and ethnic health disparities 发表日期: 2025-Dec-20 链接: PubMed
摘要
20. Suicide Risk and Protective Factors Among Asian American Adults and Older Adults in the California Health Interview Survey (CHIS).
期刊: Journal of racial and ethnic health disparities 发表日期: 2025-Dec-20 链接: PubMed
摘要
Suicide is an increasing public health crisis, especially impacting older adults and racial/ethnic minority groups. The aim of this study was to investigate risk and protective factors for suicidal ideation among Asian American adults by age, as well as differences in suicidal ideation and health care needs across age and subethnic groups. This cross-sectional study used data from the 2021-2022 California Health Interview Survey and included adults aged 18 and older who self-identified as Asian. Measured variables included age, sex, subethnicity (Chinese, Korean, Japanese, Vietnamese, Filipino, South Asian, Southeast Asian, Other Asian), suicide risk factors, mental health care barriers, and protective social environment indicators. Suicidal ideation and behavioral healthcare needs (i.e., for mental illness or substance use) were the outcomes of interest. Of 7240 participants, the largest subgroups were Chinese and Filipino respondents. Older adults reported lower levels of suicide ideation and behavioral healthcare needs compared to the younger age group. Among Asian subethnic groups, Other Asian and Korean Americans reported the highest levels of suicidal ideation (23.1% and 20.7%) and behavioral healthcare needs (20.5% and 18.4%). Healthcare discrimination was uniquely associated with suicidal ideation among older Asian adults (PR 4.19, p < .001). Other risk factors included a history of intimate partner violence, household mental health history, psychological distress, chronic pain, and healthcare costs. Findings identified significant age and subethnic differences in suicidal ideation. Despite having a lower overall risk, older Asian adults remain susceptible to healthcare discrimination and ongoing mental distress that elevates their risk for suicidality.
21. Racialized economic segregation in relation to fecundability in a preconception cohort study.
期刊: Journal of urban health : bulletin of the New York Academy of Medicine 发表日期: 2025-Dec-20 链接: PubMed
摘要
Racialized economic segregation is a known determinant of health disparities that has been associated with adverse pregnancy outcomes. However, no study has investigated its association with fecundability, the per-cycle probability of conception. We analyzed data from 10,438 U.S. participants enrolled in Pregnancy Study Online (2013-2022), an internet-based preconception cohort study. Eligible participants were aged 21-45 years, assigned female at birth, and trying to conceive without fertility treatment use. Using baseline residential addresses, we calculated segregation based on the Index of Concentration at the Extremes (ICE) from the American Community Survey 5-year estimates. ICE ranges from -1 (“disadvantaged”) to 1 (“privileged”). We operationalized ICE metrics at the census tract level: economic segregation (ICEincome: ≥ $100 k vs. < $25 k), racial segregation (ICEwhite/black: non-Hispanic White vs. non-Hispanic Black), and racialized economic segregation (ICEincome + white/black: non-Hispanic White ≥ $100 k vs. non-Hispanic Black < $25 k). We used proportional probabilities regression models to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs), adjusting for precision variables. We observed a monotonic inverse association for increasing quintiles of ICEincome and ICEincome + white/black with fecundability, but less evidence of associations with ICEwhite/black. For instance, relative to ICEincome + white/black quintile 5 (“most privileged”), FRs for quintiles 4, 3, 2, and 1 (“most disadvantaged”) were 0.92 (95% CI = 0.86-0.99), 0.84 (95% CI = 0.78-0.90), 0.84 (95% CI = 0.78-0.90), and 0.79 (95% CI = 0.73-0.86), respectively. Living in the most disadvantaged neighborhoods with respect to racialized economic segregation was associated with a moderate decrease in fecundability.
22. Do Fossil Fuel Subsidies Crowd Out Health Expenditure? A Country-Level Longitudinal Analysis.
期刊: Health economics 发表日期: 2025-Dec-20 链接: PubMed
摘要
Annually, countries allocate hundreds of millions of dollars to subsidize fossil fuels, often at the expense of public health and environmental sustainability. This undermines progress toward Sustainable Development Goals (SDG) 3 (Good Health and Well-Being) and 13 (Climate Action). Despite this, the impact of fossil fuel subsidies (FFS) on social protection expenditure, including health, remains poorly quantified. This study aimed to determine whether FFS crowd out health expenditure globally, using panel data from 126 countries covering the period 2015-2019. An instrumental variable approach, relying on countries’ exposure to international energy trade and fluctuations in crude oil price, was employed to capture exogenous variation in FFS and estimate a causal relationship. The analyses revealed that in 2019, 17 countries spent more than five percent of GDP on FFS, with FFS expenditure exceeding health expenditure in 15 of those countries. Specifically, a 1% increase in FFS per capita, driven by rising international oil prices and weighted by countries’ exposure to international energy trade, led to a 0.05% (95% CI -0.08% to -0.02%) decrease in domestic health expenditure per capita. These findings underscore the detrimental impact of FFS on health expenditure, presenting another reason to eliminate FFS to achieve SDG3 in addition to avoiding further dangerous climate heating.
23. Implementing a multimodal antimicrobial stewardship programme in primary care in Kosova-a protocol for implementation and evaluation.
期刊: Implementation science communications 发表日期: 2025-Dec-20 链接: PubMed
摘要
Antimicrobial resistance is a growing global health crisis, with primary care settings being a major contributor due to inappropriate antibiotic prescribing. In Kosova, the overuse of antibiotics for upper respiratory tract infections remains a critical challenge, especially in primary care, driven by limited diagnostic tools, regulatory gaps, and prescribing behaviours. This paper presents the protocol for implementing and evaluating a multimodal antimicrobial stewardship programme in primary healthcare facilities to promote rational antibiotic use and reduce antimicrobial resistance. The primary aim of the intervention is to improve the appropriate use of antibiotics for acute upper respiratory tract infections by implementing an antimicrobial stewardship programme in primary healthcare facilities, and use the knowledge from implementation to implement the programme on a larger scale in other primary care centres or other levels of care. A mixed-methods implementation research approach will be adopted to examine the impact of the antimicrobial stewardship programme in Kosova, incorporating quantitative and qualitative methods. The multimodal antimicrobial stewardship programme is complemented by research components designed to measure implementation processes and programme performance. These research components are designed in line with multiple conceptual frameworks, such as RE-AIM and the Consolidated Framework for Implementation Research, as the theoretical basis. The study component focusing on the implementation of the antimicrobial stewardship programme in the pilot municipalities will examine barriers to and facilitators of change across all domains of potential influence, i.e., innovation/intervention, participants, inner setting, outer setting, and implementation process. The conjoint analysis examines a subgroup of participants, i.e., prescribers of antibiotics, and their preferences regarding antibiotic prescribing. The cost-effectiveness component contributes to the review of key outcomes of the intervention, i.e., antibiotic use and costs. In contrast, the cost of intervention analysis provides valuable information on inner and outer settings, i.e., the cost implications of implementation relevant to potential scale-up. The Chamber of Doctors of Kosova and its Institutional Review Board formally approved the project under Decision No. 122/24, dated 26.08.2024. All knowledge from the programme implementation will be disseminated through relevant channels and tools. By piloting an antimicrobial stewardship programme aligned with national and international guidelines, key national stakeholders aim to strengthen stewardship practices through training, diagnostics, and continuous quality improvement. This intervention addresses critical gaps between antimicrobial resistance policy commitments and practical implementation in Kosova’s primary care. The mixed-methods research design of study components, grounded in the relevant implementation science frameworks, will generate evidence on barriers, enablers, and economic impact, informing policy updates and scale-up strategies. While focused on Kosova, findings are expected to provide valuable lessons for other low- and middle-income countries facing similar antimicrobial resistance challenges.
24. Knowledge, perceptions, and health education needs regarding hepatitis B virus among HBsAg-positive pregnant women in Taiyuan, China: a cross-sectional study.
期刊: BMC public health 发表日期: 2025-Dec-20 链接: PubMed
摘要
25. Self-referential judgments from the same personality trait scales show increased representational similarity in mPFC.
期刊: Communications psychology 发表日期: 2025-Dec-20 链接: PubMed
摘要
Self-report questionnaires are widely used across psychology and related disciplines, yet the cognitive and neural processes underlying how individuals generate responses to such items remain poorly understood. Here, we investigated whether items from the same psychological scale evoke similar neural activation patterns in the medial prefrontal cortex (mPFC), a region consistently implicated in self-referential processing. While undergoing functional magnetic resonance imaging (fMRI), 32 participants completed a self-reference task in which they judged how well 72 personality-related questionnaire items (e.g., from the Big Five, emotion regulation, and well-being scales) described themselves. Using representational similarity analysis (RSA), we found that items from the same scale elicited more similar multivoxel activation patterns in the mPFC compared to items from different scales. This effect was specific to the self-reference task and was not observed during a semantic judgment control task using the same items. Furthermore, the mPFC encoded not only categorical scale membership but also a small but consistent graded component of psychological similarity among scales, as reflected in inter-scale behavioral correlations. Importantly, these effects remained significant even after controlling for sentence-level semantic similarity using multiple regression RSA, indicating that the observed neural structure reflects psychological rather than linguistic similarity. These findings suggest that the mPFC integrates internally constructed evidence in a construct-sensitive manner during self-report. They also provide insight into how psychological assessment corresponds to neural representation.
26. Parental estimates of children's weight status: evidence from Serbian children aged 6-9 years.
期刊: BMC pediatrics 发表日期: 2025-Dec-20 链接: PubMed
摘要
Numerous studies have found that parents underestimate the overweight and obese weight status of their children, which may lead to future health risks. The purpose of the paper was to examine how parents in Serbia perceive their children’s weight status. A nationally representative sample of 6-9-year-old children (n = 2700) was evaluated as part of the World Health Organization’s (WHO) European Childhood Obesity Surveillance Initiative (COSI). The children’s body mass index (BMI) was categorized as BMI-for-age Z-scores based on the 2007 WHO-recommended growth references. The family questionnaires, which were filled in by parents or caregivers, contained, among others, questions seeking to identify the adults’ perceptions of their children’s weight status. The weight distribution of the participant children was the following: 2% of the children were in the category of ‘thinness’, 20.6% were in ‘overweight’ and 14,7% were in the category ‘obese’. A total of 83.2% of the parents accurately perceived their child’s healthy weight (normal weight), however, 71% of the parents underestimated the overweight status of their children and 91,2% of the parents failed to acknowledge the obese status of their child according to the WHO definition. Childhood obesity should be continuously monitored; existing health promotion interventions should be more strictly controlled. This study found that parents need more health-related education in the future, with close cooperation of schools and stakeholders in raising healthier generations.
27. Methylglyoxal potentiates palmitic acid-induced endothelial dysfunction and atherogenesis in human endothelial cells.
期刊: BMC cardiovascular disorders 发表日期: 2025-Dec-20 链接: PubMed
摘要
Endothelial dysfunction is a key pathological mechanism in atherosclerotic cardiovascular disease, and methylglyoxal (MGO) has been identified as a major contributor to endothelial cell damage through its overabundance. In this study, the effects of MGO on atherosclerotic human endothelial cells were investigated. Human Umbilical Vein Endothelial cells (HUVECs) were first pre-treated with 1 mM palmitic acid (PA) for 24 h to induce lipotoxic conditions and then treated with 60 and 400 µM MGO for an additional 24 h. A total of six experimental groups were included: Control, 60 µM MGO, 400 µM MGO, PA, PA + 60 µM MGO, and PA + 400 µM MGO. Intracellular lipid accumulation was investigated using Oil-Red O staining. Apoptotic changes were assessed by flow cytometry, while nitric oxide (NO) levels were measured using the Griess assay. Gene expression patterns associated with angiogenesis, inflammation, lipoprotein, and cholesterol metabolism were investigated by real-time PCR. Based on findings, the distribution of lipid droplets was detected exclusively in the PA-treated group, while no such accumulation was observed in the MGO (60 and 400 µM)-treated groups. Furthermore, co-treatment with PA-MGO (60 and 400 µM) significantly reduced apoptosis, while PA with 60 µM MGO elevated NO levels (p < 0.05). HUVECs’ exposure to MGO remarkably upregulated levels of LPL, LPA, IL-8, and IFN-γ (p < 0.05), whereas IL-6 levels were elevated only in the PA-MGO group (p < 0.05). The PA-MGO combination significantly altered the expression of angiogenesis-related genes (p < 0.05). MGO dose-dependently exacerbated the harmful effects of PA on HUVECs through increased inflammatory responses, impaired angiogenesis, and induction of nitrosative stress. Additionally, high concentrations of MGO altered the expression of genes related to lipid metabolism, including LPL and LP(a). Overall, the results indicate that MGO and PA may play a synergistic role in the occurrence of inflammation, lipid and angiogenesis disorders, and endothelial damage associated with CVDs.
28. A Preliminary Examination of Reward Processing and Loneliness in Cigarette Smokers.
期刊: Substance use & misuse 发表日期: 2025-Dec-20 链接: PubMed
摘要
Loneliness is associated with a broad range of mental and physical health outcomes, including higher rates of substance use. However, the mechanisms underpinning this association remain unclear. Acute nicotine exposure can increase response to reward, but chronic exposure may reduce response via withdrawal. This could theoretically impact pursuit and engagement with nonsmoking rewards, including social interaction. The purpose of this study was to conduct a preliminary examination of the relationship between reward and loneliness among people who smoke cigarettes. Participants (N = 85) completed questionnaires on reward processing tendencies (i.e., anticipation and consummation), environmental reward availability, and loneliness. Unadjusted analyses revealed negative correlations between all reward measures and loneliness (p’s < 0.05). In adjusted analyses, anticipatory (but not consummatory) reward processing was negatively associated with loneliness, and this effect was partially explained by an indirect effect through environmental reward availability. These results suggest anticipatory reward processing may play a particularly important role in loneliness among people who smoke cigarettes. Further research explicating the direct impact of chronic nicotine use on anticipatory reward processing and interventions targeting reward processing for this population is warranted.
29. ZAP inhibits double-stranded RNA virus infection by degrading negative-strand RNA and blocking the elongation phase of viral protein synthesis.
期刊: Cell reports 发表日期: 2025-Dec-20 链接: PubMed
摘要
Zinc-finger antiviral protein (ZAP) is a crucial host restriction factor that recognizes CpG dinucleotides in single-stranded RNAs, yet its role in double-stranded RNA (dsRNA) virus replication remains uncharacterized. Here, we demonstrate that ZAP broadly inhibits dsRNA viruses, including bluetongue virus (BTV) serotypes and epizootic hemorrhagic disease virus (EHDV) but not rotavirus (RV). Using BTV as a model, we reveal that ZAP inhibits replication via two mechanisms: (1) ZAP interacts with eukaryotic translation elongation factor 1A to block elongation during viral protein synthesis and (2) it binds preferentially to negative-sense RNA strands to stimulate their degradation. Additionally, BTV-NS1, encoded by segment 5, antagonizes ZAP by impairing its RNA-binding ability. Notably, synonymous CpG enrichment in BTV segment 5 significantly attenuated viral replication both in vitro and in vivo. Together, these findings uncover a dynamic interplay between ZAP and dsRNA viruses and suggest CpG-elevated BTV as a potential live-attenuated vaccine candidate.
30. A prospective investigation of early-onset colorectal cancer risk factors-pooled analysis of three large-scale European cohorts.
期刊: British journal of cancer 发表日期: 2025-Dec-20 链接: PubMed
摘要
Colorectal cancer (CRC) incidence is rising among adults under 55 years, but its causes remain unclear. Large-scale prospective studies are needed to identify risk factors for early-onset CRC (EOCRC). We pooled three large European prospective cohort studies, examining 14 known or suspected risk factors with EOCRC (diagnosed <55 years, N = 1369) and later-onset CRCs (LOCRC) (diagnosed ≥55 years, N = 13,490). Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs). Higher body mass index (BMI, per 5 kg/m2 increase), was strongly associated with EOCRC in men (HR 1.33, 95% CI: 1.18-1.51), particularly for early-onset colon cancer (HR 1.55, 95% CI: 1.32-1.82), compared to later-onset disease (HR 1.25, 95% CI: 1.19-1.31) (Phet = 0.01). Weaker associations with BMI were observed for women and rectal cancers. Similar sex and subsite specific trends were observed for waist circumference and waist-to-hip ratio. Current smoking (HR 1.24, 95% CI: 1.07-1.44) and alcohol use (HR 1.15, 95% CI: 1.06-1.25) increased EOCRC risk, and physical activity (HR 0.71, 95% CI: 0.54-0.95) was protective. Adiposity, physical inactivity, smoking, and alcohol consumption are risk factors for EOCRC. Risk factors were largely similar between EOCRC and LOCRC, except for adiposity, with stronger EOCRC association in men.
31. Novel treatment strategies and key research priorities for patients with breast cancer and central nervous system (CNS) metastases.
期刊: NPJ breast cancer 发表日期: 2025-Dec-20 链接: PubMed
摘要
Despite improvements in surgical techniques, advances in delivery of radiation therapy, and development of therapies with central nervous system (CNS) activity, the presence of CNS metastases from breast cancer is frequently associated with a poor prognosis. In 2023, the leadership of the Breast International Group and National Cancer Institute’s National Clinical Trials Network convened a CNS working group to identify key challenges and discuss ways that international collaborations could push forward progress in the field. This review reflects initial discussions of the working group and addresses (1) the possible role of screening for CNS metastases, (2) optimal sequencing of local and systemic therapies among patients with human epidermal growth factor receptor 2 (HER2)-positive CNS metastases, (3) management of leptomeningeal disease, and (4) the importance of developing innovative clinical trials for treatment and prevention of CNS metastases across breast cancer subtypes that is informed by preclinical data/basic science, with seamless knowledge translation to allow for rapid clinical adoption.
32. Ultrasound radiomics and deep learning for predicting antral follicle count and anti-Müllerian hormone.
期刊: Scientific reports 发表日期: 2025-Dec-20 链接: PubMed
摘要
To overcome inter-observer variability in conventional antral follicle count (AFC) assessment and AMH testing limitations, we developed an AI-powered framework using routine 2D ultrasound to standardize ovarian-reserve evaluation in assisted reproductive technology (ART). This multicenter retrospective study analyzed 395 women with infertility from two affiliated hospitals. The cohort was divided into training (n = 210), internal-test (n = 91), and external-test (n = 94) cohorts. We established three prediction models: radiomics model, 674 IBSI-compliant features; deep-learning model, ResNet50-based feature extraction; fusion model, hybrid approach combining both modalities. Model performance was validated against the manual AFC and serum AMH levels. Sequential classification categorized patients into low, moderate, or high ovarian-response risk groups. Strong correlation and consistency existed between routine 2D ultrasound image AFCs and three-dimensional dynamic-scan AFCs. The deep learning-radiomics fusion model displayed superior AFC prediction (R²=0.743 internal/0.583 external), surpassing the performance of single-modality models (radiomics: 0.586/0.572; deep learning: 0.737/0.541). For AMH prediction, the fusion model maintained generalizability (external R²=0.509 vs. 0.420 radiomics and 0.352 deep learning, p < 0.05). In ovarian-response stratification, the fusion model achieved an AUC of 0.881 (95%CI: 0.828-0.925), which was 8.0% higher than that of individual models, with 69.1% sensitivity and 84.6% specificity for identifying high-risk patients requiring stimulation-protocol modifications. The developed AI framework enables standardized ovarian-reserve evaluation using routine 2D ultrasound, effectively bridging imaging limitations by synergizing radiomics and deep learning. Meanwhile, the model achieves clinical applicability by enabling personalized ovarian-stimulation protocol optimization, demonstrating particular value in resource-limited clinical environments without requiring advanced imaging infrastructure.
33. Vitamin B6 form produced by Lactobacillus induces metabolic disorder and suppresses multi-pathogenic bacteria.
期刊: Communications biology 发表日期: 2025-Dec-20 链接: PubMed
摘要
Vitamin B6 comprises six vitamers, pyridoxal, pyridoxine, pyridoxamine, pyridoxal 5’-phosphate (PLP), pyridoxine 5’-phosphate (PNP), and pyridoxamine 5’-phosphate (PMP), recognized for pleiotropic functions in mitigating oxidative stress and modulating metabolic homeostasis. This study reveals that PMP exhibits broad-spectrum antibacterial activity against pathogens, including Aeromonas hydrophila (A. hydrophila), Staphylococcus aureus, Pseudomonas aeruginosa, and Salmonella. In vitro assays demonstrated that high-dose PMP disrupts bacterial membrane integrity, triggering extensive extracellular DNA leakage and bactericidal effects. Furthermore, we identified Pediococcus acidilactici GR-6 and Lactobacillus fermentum GR-7, isolated from crucian carp gut, that synergistically synthesize vitamin B6 de novo during pathogens co-culture, achieving ≥63% inhibition of polymicrobial pathogens. Integrated genomic, proteomic and metabolomic analyses confirm that GR-6/GR-7 consortium regulates pyridoxal kinase and pyridoxine 4-dehydrogenase, maintaining vitamin B6 primarily as pyridoxine (84%) and PMP (16%). In A. hydrophila-infected crucian carp, dietary supplementation with GR-6/GR-7 consortium increases survival by 50%, with restored gut microbiota diversity and attenuated systemic inflammation (Alkaline phosphatase, Lysozyme and GSH/GSSG ratio). Metabolomics showed that probiotics-mediated elevation of intestinal content PMP level directly inhibits A. hydrophila infection. Collectively, this study establishes PMP as a novel probiotic metabolite that directly eliminates pathogens and resolving gut microbiome-host metabolic dysregulation.
34. Acute toxic encephalopathy induced by organic solvent exposure: a case report of diagnostic challenges and occupational health implications.
期刊: International journal of emergency medicine 发表日期: 2025-Dec-20 链接: PubMed
摘要
Toxic encephalopathy, which results from exposure to neurotoxic substances, poses a considerable clinical challenge, especially for occupational groups like painters and construction workers. This case report describes a 35-year-old female painter who experienced acute toxic encephalopathy, presenting with severe headache, nausea, and vomiting. Initially, her condition was misdiagnosed as cervical spondylosis. However, recognizing her occupational exposure to organic solvents was essential for arriving at the correct diagnosis. This case highlights the importance of thorough evaluations, particularly detailed occupational histories, to avoid misdiagnosis and ensure timely management of such conditions. Neuroimaging results showed bilateral symmetric white matter changes, which supported the diagnosis of organic solvent toxicity. This finding aligns with existing literature that discusses how lipid solubility can disrupt neuronal function. The patient’s positive outcome following prompt treatment underscores the critical need for early recognition of toxic encephalopathy, as it can significantly improve recovery chances. This case enhances our understanding of the complexities associated with diagnosing acute encephalopathy caused by organic solvents and underscores the urgent need for healthcare providers to be more aware of occupational hazards.
35. Climate change health risks and workplace protective strategies for construction workers.
期刊: Scientific reports 发表日期: 2025-Dec-20 链接: PubMed
摘要
Climate change increasingly threatens occupational health, with construction workers facing elevated risks due to prolonged outdoor exposure. Although individual risk factors are well documented, workplace-level protective strategies integrating multi-stakeholder perspectives remain limited. To develop an integrated framework identifying climate change factors threatening construction workers’ health, examine associated health impacts, and propose evidence-based workplace protective strategies. Three focus group interviews were conducted with 23 construction sector experts, including eight government officials specializing in outdoor labor conditions and fifteen industry health managers with extensive experience in climate-related occupational health management. Data were collected between January and March 2021 and analyzed using systematic thematic analysis following established qualitative frameworks. Analysis revealed four interconnected themes comprising 24 categories: (1) climate factors affecting construction workers (heat waves, humidity, cold waves, fine particulate matter); (2) health problems encompassing direct physiological effects (heat stroke, cardiovascular events, respiratory dysfunction) and indirect outcomes (musculoskeletal disorders, increased accident rates); (3) systemic and organizational barriers including inadequate rest facilities, insufficient budgets, inflexible schedules, and limited managerial awareness; and (4) protective strategies requiring policy integration, including climate-specific regulatory standards, weather-contingent scheduling, multi-level education programs, enhanced health manager capacity, mandated rest facilities, and advanced protective technologies. This study presents the first comprehensive practitioner-informed framework integrating climate risks, health impacts, and protective strategies for construction workers. Effective protection demands coordinated policy action, organizational investment, and technological innovation rather than fragmented safety measures. The framework provides actionable guidance for policymakers and industry stakeholders globally. As findings reflect Korean construction sector practitioners’ perspectives, future research should include climate scientists and validate findings across diverse settings.
36. Quantifying ocean monitoring effort and cost in the Southern California Bight over the last 25 years.
期刊: Journal of environmental management 发表日期: 2025-Dec-19 链接: PubMed
摘要
Ocean monitoring to assess the status and trends of the physical, chemical, and biological integrity of the coastal zone is critical for successful environmental decision making. The National Research Council found in 1990 that ocean monitoring in the Southern California Bight (SCB), while extensive, was largely ineffective for decision making and numerous steps have been taken since to improve monitoring. Here, we repeat a study conducted in 1997 to inventory ocean monitoring throughout the SCB to answer three questions: (1) How much ocean monitoring is conducted in the SCB in terms of effort and cost? (2) How does this ocean monitoring effort and cost vary amongst different habitats, indicators, and monitoring agencies? (3) How does ocean monitoring effort and cost compare to ocean monitoring 25 years prior? We found that 64 organizations conducted ocean monitoring in 2022, compared to 115 monitoring organizations in 1997. Despite roughly half the number of monitoring agencies, the number of samples collected more than tripled from 244,917 to 919,858 per year. The cost of ocean monitoring also doubled from 62 million dollars ($62M) in 1997 (inflation adjusted to 2022 dollars) to $138M in 2022. The majority (58 % of samples and 52 % of costs) of the ocean monitoring effort in the SCB is conducted by agencies with National Pollutant Discharge Elimination System (NPDES) permits, a requirement imposed by state and federal regulators. The reduction in number of monitoring agencies is in part attributable to fewer NPDES dischargers between 1997 and 2022. The largest monitoring effort was for beach water quality monitoring, a direct outcome of legislation to protect public health of beach goers. While this ocean monitoring effort may appear large, the effort amounts to <0.5 % of the region’s ocean-generated revenue.
37. The multifaceted mechanisms of microplastic inhibition of tomato plant growth: oxidative toxicity, metabolic perturbation, and photosynthetic damage.
期刊: Plant physiology and biochemistry : PPB 发表日期: 2025-Dec-19 链接: PubMed
摘要
The ubiquity of microplastics (MPs) currently endangers vegetation, ecological balance, and public health. Although biodegradable plastics (BP) are potential alternatives to conventional plastics, the mechanisms underlying their effect on plants remain unclear. This study investigated the effect of biodegradable MPs (BMPs) on tomato seedlings, focusing on oxidative stress, leaf metabolism, and photosynthetic pigment synthesis. BMPs (poly (butylene adipate-co-terephthalate) (PBAT) and polylactic acid (PLA)) had a significant negative effect on tomato seedling growth compared to conventional MPs (polyethylene (PE) and polypropylene (PP)). The findings indicated that BMPs could exert stronger toxic effects on tomato seedlings than conventional MPs, as demonstrated by integrated biomarker response indices. The high degree of oxidative toxicity severely disrupts leaf metabolism, particularly the amino acid, lipid, and tricarboxylic acid (TCA) cycle. Photosynthetic pigment synthesis was inhibited more by BMPs, with key gene expression in chlorophyll (Chl) and heme pathways down-regulated, decreasing the precursor content. Exposure to BMPs Chl a and b levels were reduced by 5.25 %-43.75 % and 24.74 %-56.25 %, respectively, compared with conventional MPs. Findings from this study enhance our understanding of food safety risks associated with BMPs.
38. Patients' radiation exposure during TIPS creation in a high-volume referral hospital.
期刊: Radiography (London, England : 1995) 发表日期: 2025-Dec-19 链接: PubMed
摘要
Transjugular Intrahepatic Portosystemic Shunt (TIPS) creation is one of the most complex and radiation-intensive procedures in abdominal interventional radiology. Radiation-induced skin injuries may occur at doses above 2 Gy. This study aimed to evaluate patient radiation exposure during TIPS performed in a single high-volume referral center (>20 procedures/year). A retrospective review was conducted of 359 consecutive TIPS performed between July 2017 and December 2024. Real-time ultrasound guidance was systematically used for portal vein targeting. Radiation exposure was assessed using cumulative air kerma at the interventional reference point (Ka,r) and fluoroscopy time (XrT). Data were analyzed according to patient body mass index (BMI) and angiographic equipment. The mean Ka,r was 0.18 ± 0.22 Gy, with a maximum of 1.56 Gy. No patient exceeded the 2 Gy trigger level, and no skin injuries were reported at follow-up. Mean XrT was 775 ± 606 s, with only two cases exceeding 60 min (cumulative Ka,r 0.15 ± 0.18 Gy vs 0.24 ± 0.27 Gy, p = 0.0004). Obese patients showed higher Ka,r values (p < 0.0001), although none reached the 2 Gy threshold. Radiation exposure during TIPS creation in this high-volume center remained consistently below thresholds associated with skin injury, even in obese or complex patients. Performing TIPS in high-volume referral centers with systematic ultrasound guidance and optimized low-dose protocols can maintain radiation exposure well below harmful thresholds with respect to tissue effects, even in complex patients. These findings emphasize not only the need for structured radiation protection strategies and centralization of complex procedures, but also the active involvement of all professionals responsible for radiation safety whose expertise is crucial in dose optimization and ensuring the highest standards of patient care. LEVELS OF EVIDENCE 2B: retrospective cohort study.
39. Noninvasive Brain Stimulation (NIBS) Techniques Application in Voice Disorders: A Systematic Review.
期刊: Journal of voice : official journal of the Voice Foundation 发表日期: 2025-Dec-19 链接: PubMed
摘要
Voice disorders substantially compromise communication ability, occupational performance, and overall quality of life. Although behavioral and surgical interventions constitute the current standards of care, their effectiveness is often inconsistent, particularly in complex or treatment-resistant conditions. In recent years, noninvasive brain stimulation (NIBS) modalities (such as repetitive transcranial magnetic stimulation and transcranial direct current stimulation) have emerged as promising adjunctive approaches aimed at enhancing neuroplasticity and modulating cortical excitability within voice-related neural circuits. This systematic review aimed to synthesize and critically evaluate the existing evidence concerning the therapeutic efficacy of NIBS in the management of voice disorders. Adhering to the preferred reporting items for systematic reviews and meta-analyses 2020 framework, a comprehensive literature search was performed across PubMed, Embase, Scopus, Web of Science, Cochrane Library, and Google Scholar through May 2025. Eligible studies included any NIBS intervention applied to participants with clinically diagnosed voice disorders. Methodological quality and evidence levels were appraised using the National Heart, Lung, and Blood Institute and National Health and Medical Research Council assessment tools. Eight studies fulfilled the inclusion criteria, encompassing randomized controlled trials, open-label investigations, and single-case reports. Collectively, the findings revealed preliminary yet encouraging improvements in acoustic, perceptual, and self-reported vocal outcomes, particularly when stimulation targeted the primary motor or sensorimotor cortices. Nonetheless, notable heterogeneity, limited sample sizes, and incomplete blinding contributed to a low overall certainty of evidence. While current evidence indicates potential therapeutic value of NIBS for specific voice disorders, robust, large-scale randomized trials incorporating neuroimaging and extended follow-up are essential to refine stimulation protocols and establish clinical effectiveness.
40. Disc Level-Specific outcomes of intradiscal condoliase injection for lumbar disc herniation: A multicenter retrospective study.
期刊: Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 发表日期: 2025-Dec-19 链接: PubMed
摘要
The efficacy of intradiscal condoliase injection for lumbar disc herniation (LDH) may vary depending on the affected disc level. This is especially relevant in upper lumbar herniations, where anatomical constraints can complicate surgical treatment. Although condoliase has emerged as a less invasive option, disc-level-specific outcomes remain underexplored. This multicenter retrospective cohort study included 262 patients with LDH who underwent either intradiscal condoliase injection (CD group, n = 207) or microendoscopic discectomy (MED group, n = 55). Patients were categorized by herniation level: upper lumbar (L1/2, L2/3, L3/4) and lower lumbar (L4/5, L5/S1). The primary objective was to examine whether the effectiveness of condoliase differs by disc level. MED outcomes were included for reference. Primary outcomes included improvement in numerical rating scale (NRS) scores for leg and back pain at 1 year, responder rate (≥50 % improvement in leg pain), and reoperation rate. Intermediate-term (3-6 month) NRS data were also analyzed in a subset. Condoliase demonstrated consistent efficacy across disc levels, with particularly favorable outcomes at upper lumbar levels. At L1/2-L3/4, the CD group achieved a 100 % responder rate and the greatest mean improvement in leg pain (6.9 ± 2.4). At L3/4, outcomes in the CD group were superior to those in the MED group (100 % vs. 57.1 % responder rate). At L4/5, while condoliase was effective, reference data from the MED group showed greater leg pain relief (7.2 ± 2.5 vs. 5.0 ± 2.8) and a higher responder rate (100 % vs. 81.2 %). At L5/S1, both treatments produced similar results. Improvements in low back pain were modest and comparable across levels and groups. In the subset analysis, MED showed faster early symptom relief at L4/5, but condoliase provided steady improvement over time. The effectiveness of condoliase injection therapy differs by disc level and appears particularly favorable at upper lumbar levels. Condoliase represents a safe, minimally invasive alternative for treating upper lumbar LDH. These findings support disc-level-based treatment selection when choosing between condoliase and surgical intervention.
41. Differential factor effects in comorbid depressive and anxiety symptoms (CDAS): A machine learning approach to individualized mental health promotion.
期刊: Journal of affective disorders 发表日期: 2025-Dec-18 链接: PubMed
摘要
Depression and anxiety comorbid presents greater severity than isolated symptoms. Traditional analyses often fail to capture complex interactions among multidimensional risk and protective factors. To develop a predictive model distinguishing young Chinese adults with comorbid depressive and anxiety symptoms (CDAS) from asymptomatic individuals using machine learning within Antonovsky’s salutogenic framework, identifying protective factors as Generalized Resistance Resources (GRRs) and heterogeneous risk subtypes for precision-targeted interventions. Data from 2951 Chinese young adults (aged 19-35) from the PBICR2021 database were analyzed. Fifteen features spanning psychological, physiological, social, and environmental dimensions were selected through Lasso Regularization and the Boruta algorithm. Six machine learning models were trained and evaluated. SHAP analysis interpreted key predictive factors, with bidirectional hierarchical clustering identifying risk subtypes. Decision curve analysis validated clinical utility. Random Forest achieved optimal performance (AUC = 0.905, PR-AUC = 0.703), with good calibration (Brier Score = 0.097, ECE = 0.088). SHAP revealed differential association patterns: solo exercise (swimming, sports equipment), avoidant emotional regulation, obesogenic behaviors and stress were positive linked to CDAS among Chinese youth, while self-efficacy, family health, social support and healthcare access (as GRRs) were protective. Hierarchical clustering analysis of SHAP values identified three CDAS subtypes with distinct factor combination patterns. Decision curve analysis validated clinical utility within 2-67 % risk thresholds. Protective and risk factors showed opposite associations between comorbid versus asymptomatic groups among Chinese young adults. Protective factors operationalize Antonovsky’s GRRs, while three heterogeneous subtypes support precision-targeted preventions. The 15-feature model demonstrated clinical utility within 2-67 % risk thresholds for scalable community screening.
42. PUMA upregulation promotes the necroptosis of hepatocytes in trichloroethylene-sensitized mice via mtDNA-mediated ZBP1 pathway.
期刊: Toxicology letters 发表日期: 2025-Dec-18 链接: PubMed
摘要
Occupational medicamentose-like dermatitis due to trichloroethylene (OMDT) caused by trichloroethylene (TCE) is a systemic allergic disease mainly manifested by acute inflammatory reactions in the skin and mucosa. In addition to fever, skin and mucosal damage, superficial lymph node enlargement and tenderness, OMDT patients often have severe multi-organ damage, with liver function damage being the most common. The degree of liver function injury can seriously affect the cure rate of OMDT, but the mechanism of injury has not been fully elucidated. The aim of our study was to explore the mechanism of mitochondrial DNA (mtDNA) release and the role of mtDNA in trichloroethylene-sensitized liver injury. Previous studies found amounts of tumor necrosis factor TNF- α in the liver of mice sensitized to TCE. Moreover, we found a leakage of mtDNA during TCE sensitization. Mitochondrial DNA Exposure to cytosol can activate innate immune responses and play a key role in immune liver injury induced by TCE, but the mechanism by which mtDNA is released to the cellular cytoplasm is unknown. In this study, we found that TNF-α promotes the upregulation of PUMA (p53 upregulated modulator of apoptosis) pro-apoptotic proteins in the liver of TCE-sensitized mice, and then PUMA promotes mtDNA release by regulating the mitochondrial BAX / BAK apoptotic pore, and subsequently activates the DNA sensor ZBP1 (Z-DNA Binding Protein 1), which ultimately leads to RIPK3 / MLKL-dependent necroptosis in hepatocytes.
43. Under pressure: the lifelong cardiovascular health of children and youth with primary hypertension.
期刊: The Lancet. Child & adolescent health 发表日期: 2025-Dec-17 链接: PubMed
摘要
Global cardiovascular health promotion across the lifespan requires a comprehensive approach prioritising early life interventions. Paediatric hypertension is an increasingly recognised public health issue and an important modifiable risk factor for reducing future cardiovascular morbidity and mortality. This Review discusses the epidemiology, risk factors, diagnosis, and management of paediatric hypertension. We highlight the increasing prevalence of paediatric hypertension, its higher rates in low-income and middle-income countries (LMICs), and review its multifactorial causes globally, including genetic, environmental, and lifestyle influences. Barriers to early detection, particularly in LMICs, such as poor awareness of childhood-onset hypertension among families and health-care providers, are elucidated. Studies emphasising the short-term and long-term consequences of paediatric and youth hypertension and evidence-based diagnostic and management strategies, including non-pharmacological and pharmacological interventions, are also discussed. The management of hypertension in youth requires integrating public health strategies with clinical care to establish a robust foundation to improve lifelong health outcomes.
44. Ethylene production from chlorinated organic hazardous wastes by thermal plasma pyrolysis.
期刊: Journal of hazardous materials 发表日期: 2025-Dec-16 链接: PubMed
摘要
Chlorinated organic hazardous wastes (COHW) from the chemical industry threaten human health and environment due to persistent toxicity and resistance to degradation. Conventional treatments often suffer from incomplete degradation or poor resource recovery. This work proposed an efficient COHW conversion to ethylene (C2H4) for dual COHW treatment and chemical production. Tetrachloroethylene (C2Cl4), a representative of COHW, was selected to develop a hydrogen thermal plasma pyrolysis reaction kinetic model, which was validated through experiments. The particle evolution in the reactor was investigated, and the cascade reaction pathway of C2Cl4 = > acetylene (C2H2) = > C2H4 was unveiled, providing a theoretical foundation for product composition regulation. To address the trade-off between low carbon black (C(B)) formation and high C2H4 selectivity in the pyrolysis with conventional single-stage quenching, a novel two-stage quenching strategy was proposed: rapid quenching (above 1300 K) suppresses C2H2 to C(B) conversion, followed by appropriate slow quenching (below 1300 K) intensifying C2H2 hydrogenation to C2H4. This coupling enhances the C2H4 selectivity and yield. The optimized experiments achieved 100 % chlorine removal, a C(B) yield reduction of 94 %, a C2H4 selectivity of 43.3 %, and a C2H4 yield of 40.2 %, making a 110 % improvement over single-stage quenching and surpassing all reported COHW-derived C2H4 yields.
45. Investigating the effectiveness of mobilisation alarms to prevent hospital falls using disinvestment: A randomised clinical trial.
期刊: International journal of nursing studies 发表日期: 2025-Dec-15 链接: PubMed
摘要
Mobilisation alarms are commonly used in hospitals to prevent falls in patients who are at high risk for falls, yet the evidence for their effectiveness is uncertain. To investigate the effectiveness of mobilisation alarms to prevent falls in hospitals. This was a 3-group, concurrent, non-inferiority, stepped wedge, clinical trial with an embedded parallel, cluster randomised design that adopted a disinvestment approach. Disinvestment from the intervention was carried out from 1st April 2023 to 31st January 2024. This study was conducted in one private health service and four public health services in Metropolitan Melbourne, Australia. Acute and sub-acute hospital wards with at least a 3 % rate of use of mobilisation alarms. Twenty-two wards were screened and found eligible for the trial, 18 wards were recruited and randomised. A random subsample of patients in the recruited wards completed questionnaires. Two conditions were evaluated against the “current” condition of high alarm use (>3 %), a “reduced” rate of use of mobilisation alarms (<3 % but >0 %) and “eliminated” use of alarms (0 %). Rate of falls was the primary clinical outcome; data for a range of other measures were collected for secondary clinical and intervention outcomes. There were 11 acute wards and 7 sub-acute wards with 157,037 occupied bed days observed; 1319 individual patients completed questionnaires. Non-inferiority of the “reduced” condition compared to the “current” condition was demonstrated [95 %, one-tailed, non-inferiority confidence limit of 2.00 falls/1000 occupied bed days (OBDs) increase] but not for the “eliminated” condition (3.68 falls/1000 OBDs increase). Superiority of any intervention condition was not demonstrated over another [“current” vs “reduced”: 0.22 falls/1000 OBDs (two-tailed, 95 % CI: -1.89 to 2.34), “current” vs “eliminated”: 0.90 (-2.41 to 4.21), “reduced” vs “eliminated”: 0.67 (-2.12 to 3.47)]. Patients’ frequency of sleep disturbance due to alarms was reduced in the “eliminated” condition [ordered logistic coefficient 0.47 (0.08 to 0.87)]. Reduction in use of mobilisation alarms was not inferior to usual care, but complete elimination was uncertain. The trial was registered with the Australian New Zealand Clinical Trials Registry, trial ID: ACTRN12621000823875p (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621000823875p). Registered on 28/06/2021, first enrolment on 26/10/2022.
46. Association of short-term exposure to ozone with total and cause-specific mortality: A systematic review and meta-analysis.
期刊: Journal of hazardous materials 发表日期: 2025-Dec-15 链接: PubMed
摘要
Global ozone (O3) levels have increased by 30-70 % over the past century, raising growing concerns about their impacts on human health under climate change. However, previous reviews have been regionally limited and lacked standardized exposure metrics or cause-specific analyses. To address these gaps, we systematically reviewed and quantitatively synthesized estimates from existing studies to evaluate associations of short-term O3 exposure with total and cause-specific mortality. We identified 178 eligible time-series and case-crossover studies published up to August 2025, including 760 effect estimates across diverse regions. Exposure data were standardized to daily maximum 8-hour averages, and relative risks (RRs) corresponding to a 10 μg/m3 increase were pooled. With high certainty of evidence, short-term O3 exposure was positively associated with total mortality (RR: 1.0033; 95 % CI: 1.0031-1.0036), cardiovascular mortality (RR: 1.0046; 95 % CI: 1.0042-1.0050), and respiratory mortality (RR: 1.0047; 95 % CI: 1.0040-1.0053). Heterogeneity was acceptable, and results were robust across sensitivity analyses. Potential nonlinear exposure-response relationships were identified, with thresholds ranging from 42.1 to 100 µg/m3. The estimated population attributable fractions of short-term O3 exposure were 0.182 %, 0.252 %, and 0.258 % for total, cardiovascular, and respiratory mortality, respectively. Risk of bias was generally low to moderate. These findings highlight a measurable global health burden attributable to short-term O3 exposure and provide the most up-to-date evidence supporting stricter O3 air quality standards, particularly in low- and middle-income countries.
47. Small countries face specific challenges in health workforce sustainability, but policy responses are a testbed for resilience for all countries.
期刊: Health policy (Amsterdam, Netherlands) 发表日期: 2025-Dec-15 链接: PubMed
摘要
While countries across Europe are facing challenges in building and sustaining a health workforce, small countries (official population of under 2 million people) face specific challenges that go beyond resource constraint. Limited population size constrains training capacity, specialist care provision, and career development opportunities, making these systems highly vulnerable to workforce shortages. Experiences in Cyprus, Luxembourg, North Macedonia, and the Caribbean Netherlands illustrate these dynamics. Cyprus and Luxembourg have expanded in-country medical education and postgraduate training to reduce the need for training abroad. In contrast, North Macedonia trains sufficient health professionals but struggles with outmigration. Island territories face additional logistical and geographic barriers. The Caribbean Netherlands rely on rotations and cross-border care for many healthcare services. Small countries are like a microscope that magnifies both the problems and the policy responses and may thus serve as a testbed for all health systems confronting workforce challenges. Small country experiences underscore the need for collaborative solutions to respond to the health workforce crisis, including enhanced training opportunities, mitigation of migration risks and improved retention. Ensuring resilience of the health workforce in the face of demographic and mobility pressures requires effective planning and integrated strategies addressing remuneration, working conditions, and professional development across all roles and sectors.
48. Estimating the potential of climatic factors for global generation of microplastics from agricultural plastic films.
期刊: Journal of hazardous materials 发表日期: 2025-Dec-14 链接: PubMed
摘要
Microplastics (MPs) released from agricultural plastic films (APFs) represent an emerging environmental hazard to soil health and food security. However, global-scale quantification of MPs generation from APFs remains scarce. This study combined national APFs usage data with the emission factors (EFs) model, and implemented Monte Carlo simulations to address uncertainties in annual MPs generation under varying wind speed (WS) and solar irradiance (SI). The results indicated that the theoretical global annual MPs generation from APFs was estimated at 6.15 × 104 tonnes, Asia being the leading continent. Among all the countries, China, India and Mexico constituted the top three contributors. Emission intensities of MPs in permanent cropland were markedly greater in Japan and South Korea than elsewhere. In most countries, more than 75 % of annual MPs generation occurred during the eight months with peak WS or SI. WS demonstrated a significant link to the mass generation of MPs (MMP), whereas SI promoted film aging, highlighting the stronger role of WS. This study provides a spatially explicit assessment of global MPs generation from APFs and reveals the intra-annual distribution pattern, facilitating the development of targeted strategies to control MPs pollution.
49. Clinical Nurses' Perceptions of Digital Nursing Technology: A Qualitative Analysis Using the Theory of Planned Behaviour (TPB).
期刊: Nursing open 发表日期: 2025-Dec 链接: PubMed
摘要
This study explored factors influencing clinical nurses’ adoption of digital nursing technologies (DNT) and examined their perceptions and behavioural intentions using the Theory of Planned Behaviour (TPB). A qualitative content analysis was conducted, guided by the TPB framework. In depth interviews were conducted with 21 clinical nurses between March and April 2023. Data were analysed using qualitative content analysis to identify themes related to DNT perceptions and experiences. Seven main themes and 23 subthemes emerged. Nurses recognised benefits such as reduced workload, improved accuracy, enhanced efficiency, and expanded nursing services. Challenges included learning difficulties, limited perceived usefulness, data security concerns, and technical errors. Facilitators of adoption included supportive colleagues, role models, structured training, user-friendly technologies, adequate resources, positive prior experiences, and patient-centered design, while cultural resistance, lack of managerial support, and unclear regulatory guidance impeded use. Effective adoption of DNT requires targeted educational programs to enhance nurses’ digital competencies, user-friendly technology interfaces, and clear institutional policies. Addressing both individual and organisational factors is critical for safe and sustainable integration of digital technologies into nursing practice. This study adhered to the consolidated criteria for reporting qualitative research (COREQ) guidelines. No patient or public involvement.
50. Adherence to Guidance About Complementary Feeding and Vitamin D Supplementation in Infants: The Role of Information Sources.
期刊: Nursing open 发表日期: 2025-Dec 链接: PubMed
摘要
To identify the characteristics of parents with poor adherence to guidelines around introduction of solid foods and supplementation with Vitamin D, and to assess the role of different sources of information in adherence to these guidelines. A cross-sectional survey which was part of a birth cohort study following pregnant mothers and their infants in a UK city. 390 parents who had consented to take part in a birth cohort study were sent a postal questionnaire when their infant was around 6 months old. 220 parents completed this questionnaire about their infants’ diet and the sources of information they had used to make decisions about introducing complementary foods to their infant. Around half (54%) of parents adhered to current guidelines to delay the introduction of solid foods until after their infants were 24 weeks, and adherence to guidelines was positively associated with maternal age and education level as well as with the use of formal information sources such as a Health Visitor or leaflets. Vitamin D supplementation rates of infants by exclusively breastfeeding mothers were low (35%) but increased over time. The internet was a particularly significant source of information used by parents to make feeding decisions for their infants. In this sample, adherence to guidance around the introduction of solid foods and Vitamin D supplementation was low. Health professionals must develop strategies to communicate these guidelines more effectively. Members of a PPI group were involved in the study design and development of study materials, including marketing materials.
51. Deriving Insights From an Occupational Incident Reporting System to Enhance Understanding of Musculoskeletal Incidents Among Nurses and Midwives.
期刊: Nursing open 发表日期: 2025-Dec 链接: PubMed
摘要
To describe nurse, midwife and injury characteristics of musculoskeletal incident workplace compensation claims (WorkSafe) in Victoria, Australia; to determine the ratio between lost work for musculoskeletal compensation claimants, compared to hours worked by the Victorian nursing and midwifery workforce; to modify a risk-identification framework for workplace incidents involving staff-assisted patient movement reported in the Victorian Health Incident Management System (VHIMS), specific to incidents that occur during staff-assisted patient movement, and apply the coding framework to VHIMS incidents to report the risk factors associated with these incidents. Observational data collected prospectively between July 2017 and December 2021 via WorkSafe, and via VHIMS from two Victorian health services, were extracted. A 7-item risk-identification coding framework was modified over three iterations and tested to describe VHIMS workplace incidents that occurred during staff-assisted patient movement and resulted in staff musculoskeletal incidents, or a patient fall. Of 1936 Victorian nursing workforce compensation scheme claims audited (mean claimant age 43 years (SD 13), 90% female and 4% midwives), the mean incapacity was 152 days (SD 199), resulting in 5700 h of lost work, at a cost of $AUD14,325,109, per year. For every 206 h worked by this workforce, there was 1 h lost due to a musculoskeletal incident compensation claim. Of the 748 health service VHIMS staff incidents, most involved the trunk (60%), and risk factors included patient participation or behaviour (72%) and load (65%). Of the 1935 health service VHIMS patient falls, most occurred during transfers (39%) or walking (30%), and risk factors included patient participation or behaviour (94%) and load (55%). Nursing and midwife musculoskeletal incidents carry significant individual and workforce costs. Risk factors were identified with the modified risk-identification framework, which could be used to support clinical teams in developing data-driven solutions to prevent staff incidents and patient falls. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) extension for cross-sectional studies. No Patient or Public Contribution. As this study used an observational design, trial registration was not required.
52. Burnout and Psychological Distress During the Iron Swords War: First Responders at Greater Risk.
期刊: Stress and health : journal of the International Society for the Investigation of Stress 发表日期: 2025-Dec 链接: PubMed
摘要
The October 7, 2023, attack on Israel marked a traumatic escalation in the Israel-Gaza conflict, placing immense psychological pressure on first responders (FRs). This study examined whether the relationship between burnout and psychological distress was moderated by profession (FR vs. non-FR) during the ‘Iron Swords’ war. Data were collected between December 2024 and February 2025, from a convenience sample and snowball sampling of 885 Israeli participants (257 FRs and 628 non- FRs). Participants completed validated measures of burnout and distress, along with socio-demographic information. Hierarchical regression analyses revealed that burnout significantly predicted distress across the full sample. No main effect of FR on distress was found. However, a significant interaction emerged: burnout’s effect on distress was significantly stronger among FRs than non-FRs. The findings suggest that FRs are more vulnerable to the psychological toll of burnout, particularly in trauma-exposed environments. These results align with the Conservation of Resources (COR) theory, highlighting the depletion of emotional resources as a key mechanism driving distress under chronic occupational strain. The study underscores the importance of assessing burnout alongside trauma exposure when evaluating FR mental health. Clinically, results emphasise the need for early identification and tailored interventions targeting burnout among FRs, with an emphasis on resilience-building, psychological flexibility, and organizational support (e.g., peer debriefings, workload management). Future longitudinal research is needed to clarify causality and examine profession-specific effects. Overall, burnout appears to be a key amplifier of wartime distress in FRs, with implications for intervention policy and mental health strategy during crisis contexts.
53. Impact of Postdiagnosis Health Behaviors and Behavior Changes on Prognosis in Colorectal Cancer Patients: Evidence From Real-World Data.
期刊: Cancer medicine 发表日期: 2025-Dec 链接: PubMed
摘要
Colorectal cancer (CRC) is a prevalent cancer worldwide, but encouraging healthier lifestyle choices among survivors may improve their prognosis. We aimed to evaluate health habits adopted after diagnosis and their impact on prognosis. For this population-based retrospective cohort study, we used data from the Cancer Public Library Database (CPLD), which consists of four major population-based public sources in Korea with cancer patients diagnosed between 2012 and 2019. Information on anthropometric measures, physical activity, alcohol consumption, and smoking status before and after cancer diagnosis was used. Hazard ratios (HRs) for all-cause deaths with 95% confidence intervals (CIs) were estimated via the Cox proportional hazards model. Among the 7553 CRC patients, postdiagnosis physical activity was significantly related to decreased risk of death among those who were diagnosed with stage I or III CRC (p for trend < 0.05). The analysis of 4588 patients revealed that increased physical activity (stage I: adjusted HR [aHR] = 0.60, 95% CI = 0.29-1.22; stage II: aHR = 0.86, 95% CI = 0.49-1.52; stage III: aHR = 0.60, 95% CI = 0.36-0.99) or smoking cessation (stage I: aHR = 0.81, 95% CI = 0.28-2.35; stage II: aHR = 0.36, 95% CI = 0.16-0.81; stage III: aHR = 0.89, 95% CI = 0.42-1.87), were associated with poor prognosis compared to those who consistently remained physically inactive or continued to smoke. The present study provides compelling evidence on the benefits of increased physical activity and smoking cessation after CRC diagnosis for improved survival.
54. Habitat Radiomics Predict HPV Status in Oropharyngeal Cancer.
期刊: Cancer medicine 发表日期: 2025-Dec 链接: PubMed
摘要
This study developed a habitat-based radiomics classifier from CT images to predict HPV status in oropharyngeal cancer (OPC). We analyzed pretreatment CT scans from 192 OPC patients. Tumor habitats were generated using a two-level unsupervised clustering approach, and radiomics features were calculated from both intratumoral and habitat-defined subregions. HPV ground truth was based on p16 IHC, and the ROSE algorithm was used to address class imbalance (85% HPV-positive). LASSO regression was used for feature selection. We developed and compared three separate models for statistical performance to predict HPV status: habitat radiomics classifier, intratumoral radiomics classifier, and combined radiomics classifier (habitats and intratumoral). Classifier performance was assessed using area under the receiver operating characteristic curve (AUCROC), and SHAP (SHapley Additive Explanations) was utilized to interpret features contributing to classifier predictions. Kaplan-Meier analysis was conducted to compare survival outcomes of HPV ground truth versus the radiomics classifier. The habitat radiomics classifier significantly outperformed the intratumoral radiomics classifier, achieving AUCs of 0.970 (95% CI, 0.942-0.997) in the training cohort and 0.937 (95% CI, 0.843-1.00) in the test cohort. The combined radiomics classifier did not significantly improve performance. SHAP revealed that radiomic features of compact/spherical shape and uniform texture were associated with HPV-positive tumors, reflecting lower morphologic and textural heterogeneity than HPV-negative tumors. For the survival analysis, the HPV habitat radiomics classifier is indistinguishable from HPV ground truth in predicting overall survival (p = 0.52 for HPV-negative ground truth vs. HPV-negative classifier; p = 0.75 for HPV-positive ground truth vs. HPV-positive classifier). The habitat radiomics classifier provides an imaging-based algorithm to predict HPV status in OPC by capturing spatial patterns of tumor heterogeneity that reflect biological differences between HPV-positive and HPV-negative tumors. This approach demonstrated strong performance, with additional support from SHAP-based interpretability and Kaplan-Meier survival analysis suggesting its potential clinical relevance.
55. [Intersubjectivity and modes of care in health: eco-ethno-social sensitivity and critical technological competence for quality-equity in digital health].
期刊: Salud colectiva 发表日期: 2025-Jul-30 链接: PubMed
摘要
In this essay, we propose that Mendes Gonçalves’ theory of the labor process in health can contribute to a critical theory of digital health capable of deconstructing technological alienation within digital transformation processes in the health sector. First, we identify modes of care and models of technological organization of healthcare delivery. Second, we analyze the collective-informational mode of care oriented toward sociotechnical health networks, highlighting collaborative practices rooted in territories and local realities. Third, we propose a theoretical platform for understanding digital transformation in health, based on the articulation of the following concepts: sociotechnical appropriation, metapresence, critical technological competence, quality-equity, and eco-ethno-social sensitivity. Finally, we outline the epistemological and theoretical foundations necessary for a “digital epistemodiversity,” understood as an ecology of knowledges in which technical objects, sociotechnical systems, human agents, and transhuman beings may coexist, interact, and produce systemic changes in the health field, with the protagonism of healthcare workers and broad popular participation. En este ensayo, proponemos que la teoría del proceso de trabajo en salud de Mendes Gonçalves puede contribuir a una teoría crítica de la salud digital capaz de deconstruir la alienación tecnológica en los procesos de transformación digital en el área de la salud. En primer lugar, se identifican modos de cuidado y modelos de organización tecnológica de la atención sanitaria. En segundo lugar, analizamos el modo de cuidado colectivo-informacional orientado a las redes sociotécnicas de salud, destacando las prácticas colaborativas arraigadas en los territorios y las realidades locales. En tercer lugar, se propone una plataforma teórica para la comprensión de la transformación digital en salud, a partir de la articulación de los siguientes conceptos: apropiación sociotécnica, metapresencia, competencia tecnológica crítica, calidad-equidad, y sensibilidad eco-etno-social. Finalmente, esbozamos la fundamentación epistemológica y teórica necesaria para una “epistemodiversidad digital”, entendida como una ecología de saberes, en la que los objetos técnicos, los sistemas sociotécnicos, los agentes humanos y los seres transhumanos puedan coexistir, interactuar y producir cambios sistémicos en el campo de la salud, con el protagonismo de trabajadores y trabajadoras de la salud y una amplia participación popular.