公共卫生研究摘要 (2025-12-23)
共收录 56 篇研究文章
1. The Risk of Suicide Attempts After Head Injury: A Matched UK Population-Based Cohort Study.
期刊: Neurology 发表日期: 2026-Jan-27 链接: PubMed
摘要
Traumatic brain injuries are associated with an increased risk of suicide; the risk of suicide after other head injuries, particularly in the general population, remains unclear. We aimed to determine whether people with head injuries are at higher risk of suicide compared with people without head injuries. A 20-year population-based matched cohort study was conducted using nationally representative electronic primary health care records linked to Hospital Episode Statistics and Office for National Statistics data. Adults (≥18 years) with a head injury were matched 1:4 with individuals without a head injury by age, sex, and geographical location. Individuals without data linkage or with a history of self-harm or suicide attempt before the head injury were excluded. The primary outcome was risk of suicide attempt (including death by suicide). Secondary outcomes were risk factors of suicide attempt and risk of death by suicide. Subgroup analysis was conducted to investigate risk of suicide attempt by age group, sex, social deprivation level, ethnicity, and history of mental health conditions. Adjusted hazard ratios (HRs) were calculated using Cox proportional hazards regression. The mean age of people with and without head injuries was 52.4 years (SD 22.7), and 51% were female. Of 389,523 people with head injuries, 5,107 suicide attempts were recorded (incidence rate 2.4 per 1,000 person-years) compared with 9,815 among 1,489,675 adults without head injuries (incidence rate 1.6 per 1,000 person-years), resulting in an adjusted HR of 1.21 (95% CI 1.17-1.25). Risk factors of suicide attempt were first 12 months after head injury, higher deprivation, and a history of a mental health condition. The adjusted HR for death by suicide was 0.74 (95% CI 0.66-0.84); this became nonsignificant after controlling for competing risk of death (sub-HR 0.91, 95% CI 0.81-1.03). Risk of suicide attempt was higher in all subgroups investigated, including those without any baseline mental health condition. These findings have implications for clinical practice and health policy. The development and testing of suicide risk assessment and prevention strategies for people with head injuries should be investigated, especially within the first 12 months after head injury and irrespective of mental health history.
2. The Relationship Between Age and Recovery After Spinal Cord Injury: A Longitudinal Cohort Study.
期刊: Neurology 发表日期: 2026-Jan-27 链接: PubMed
摘要
Spinal cord injury (SCI) incidence is rising among the elderly, yet the relationship between age and recovery remains controversial. The aim of this study was to evaluate the relationship between age and neurologic and functional outcomes and to identify an age cutoff associated with a decline in recovery. We conducted a prospective cohort study using data from patients with traumatic and ischemic SCI enrolled in the European Multicenter Study about Spinal Cord Injury between 2001 and 2022. Linear regression models assessed the relationship between age and changes from baseline to 1 year after SCI in the total motor score (TMS) of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) and in the Spinal Cord Independence Measure (SCIM) total score. Additional analyses examined the relationship between age and the evolution of ISNCSCI light-touch and pinprick scores, as well as ambulation parameters (6-minute walking test, 10-meter walking test, and Walking Index for Spinal Cord Injury). Models were adjusted for baseline scores, sex, year of injury, American Spinal Injury Association Impairment Scale (AIS) grade, and level of injury. The age cutoff was determined using a change-point model. A total of 2,171 patients (median age 47 years, 77.9% male, 51.9% injured at the cervical level, and 50.0% with a motor complete injury [AIS-A and AIS-B]) were included in the analysis. Increased age was not associated with changes in TMS (p = 0.896) but was significantly associated with reduced SCIM improvement (p < 0.001), with an estimated decline of 4.3 SCIM points per decade of age. Sensory outcomes were not significantly affected by age (Δlight-touch: p = 0.273; Δpinprick: p = 0.520) while ambulation recovery declined with increasing age (all outcomes p < 0.01). A noticeable reduction in functional recovery was observed in patients older than 70 years. Older age does not seem to affect neurologic recovery but is linked to poorer functional and ambulation outcomes. These findings, including the identified age cutoff, should inform future clinical trial design and guide tailored care strategies for older adults with SCI. ClinicalTrials.gov Identifier NCT01571531.
3. Evaluation of Naloxone Uptake Disparities Among Harm Reduction Clients in Rhode Island: A Deeper Dive Using Disaggregated Race and Ethnicity Data.
期刊: Rhode Island medical journal (2013) 发表日期: 2026-Jan-05 链接: PubMed
摘要
Although opioid overdose deaths decreased between 2022 to 2024, racial and ethnic disparities persisted during this time. The goal of this analysis was to explore disparities in naloxone uptake by racial and ethnic identity and harm reduction supply preference. This article builds upon prior work and disaggregates race and ethnicity categories that were previously aggregated due to small numbers. Clients were divided into three mutually exclusive groups based on the type of harm reduction supplies they requested: 1) those who requested injection supplies only, 2) those who requested smoking supplies only, and 3) those who requested both injection and smoking supplies. We calculated descriptive statistics and odds ratios to investigate racial and ethnic disparities in naloxone uptake. Overall, Black and Hispanic clients were significantly less likely to receive naloxone compared to their White counterparts. Racial and ethnic disparities in naloxone uptake varied after accounting for supply preference. The clearest racial and ethnic disparities were observed among clients who requested smoking supplies. It is important to consider multiple factors when designing harm reduction and overdose prevention interventions, including racial and ethnic identity, culture, preferred substance, and preferred route of administration. People with lived experience should continue to be included when designing interventions. Given the rapidly changing nature of the illicit drug supply and the emergence of novel substances, anyone who uses illicit substances is at risk of an opioid overdose. Harm reduction agencies should continue to educate stimulant users about their risk of opioid overdose and the benefits of naloxone.
4. Rehabilitation Environments: New Insights to Guide Stroke Inpatient Service Redesign.
期刊: Stroke 发表日期: 2026-Jan 链接: PubMed
摘要
Inpatient rehabilitation plays a pivotal role in the stroke recovery continuum. We have previously shown how rehabilitation clinical guidelines and health care design guidelines may not fully align to support recovery needs. Building on our previous work describing the current stroke inpatient rehabilitation service, we aimed to articulate and propose recommendations for an optimal inpatient service through the integration of stakeholder feedback, clinical guidelines, and health care design principles. We used value-focused thinking, living-lab, and codesign principles to evaluate a re-imagined stroke rehabilitation service. Participants reviewed 21 care process activity blocks derived from our previous work, with proposed changes to the admission, discharge processes, and weekday routines (morning, afternoon, and evening) of a typical Australian inpatient stroke service. Participants used an agreement scale to rate the proposed changes against predefined objectives focusing on safety, efficiency, emotional well-being, and opportunities for practice, rest, and autonomy. The reimagined stroke service was reviewed and iteratively refined through further validation sessions with selected participants. Twenty-six stakeholders participated in our evaluation, including stroke survivors, caregivers, clinicians, researchers, and health care facility designers and planners. Nineteen activity blocks were rated, generating 152 individual votes and 15 recommendations for service improvement. Overall, the agreement rate across all proposed changes was 76%. The highest agreement was observed in the evening (100%) and admission (81%) blocks, with strong endorsement for improved information delivery and environmental flexibility. Lower agreement was noted for discharge (61%), reflecting the complexity and varied perspectives on transition planning. Validation with 7 participants confirmed the relevance and feasibility of most proposed changes, especially those that support personalization, autonomy, and early engagement. Stakeholder-informed redesign of stroke rehabilitation services can enhance alignment between clinical processes and environmental enablers. These findings offer a practical foundation for codesigned models of care that are both evidence-based and experientially grounded.
5. Global vaccination coverage and disease incidence in cattle, pigs, and poultry.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Dec-30 链接: PubMed
摘要
Vaccination against livestock diseases is an effective method to prevent and control the spread of pathogens and reduce antimicrobial consumption and livestock production losses. Systematic data on global vaccination coverage could unlock opportunities to expand these outcomes. In this study, we estimate annual vaccination coverage and disease incidence for 104 cattle, porcine, and poultry diseases in 203 reporting countries and territories between 2005 and 2025 using data from the World Animal Health Information System, the Food and Agriculture Organization, and published literature. We provide 686,559 data points and further evaluate 11 diseases most widely targeted by vaccination programs in 2025. The vaccination coverage for global populations at risk of these diseases in 2025 is as follows: for cattle, 16.64% (95% CI: 16.63 to 16.66) against foot and mouth disease, 33.80% (33.43 to 34.38) against lumpy skin disease, 7.46% (6.71 to 8.81) against Brucella abortus, 11.57% (10.29 to 13.36) against anthrax, and 7.93% (6.27 to 14.09) against rabies. For pigs, 6.56% (6.56 to 6.57) against classical swine fever, 4.96% (3.28 to 8.76) against anthrax, and 8.08% (5.10 to 17.20) against rabies. For poultry, 17.62% (17.37 to 18.04) against Newcastle disease, 16.71% (16.42 to 19.01) against infectious bronchitis, 9.17% (8.59 to 13.67) against infectious laryngotracheitis, 15.04% (14.63 to 18.63) against infectious bursal disease, and 8.81% (7.94 to 11.97) against Marek’s disease. Expanding vaccination efforts in India and Argentina for cattle; China and Russia for pigs; and China, Brazil, and Iran for poultry may yield the greatest reductions in global livestock disease burden.
6. Complex multiannual cycles of Mycoplasma pneumoniae: Persistence and the role of stochasticity.
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2025-Dec-30 链接: PubMed
摘要
The epidemiological dynamics of Mycoplasma pneumoniae is characterized by poorly understood complex multiannual cycles. The origins of these cycles have long been debated, and multiple explanations of varying complexity have been suggested. Using Bayesian methods, we fit a dynamical model to half a century of M. pneumoniae surveillance data from Denmark (1958 to 1995, 2010 to 2025) and uncover a parsimonious explanation for the persistent cycles, based on the theory of quasicycles. The period of the multiannual cycle (approx. 5 y in Denmark) is explained by susceptible replenishment due, primarily, to loss of immunity. While an excellent fit to shorter time series (a few decades), the deterministic model eventually settles into an annual cycle, unable to reproduce the persistent cycles. We find that environmental stochasticity (e.g., varying contact rates) stabilizes the multiannual cycles and so does demographic noise, at least in smaller or incompletely mixing populations. The temporary disappearance of cycles during 1979 to 1985 is explained as a consequence of stochastic mode-hopping. The circulation of M. pneumoniae was recently disrupted by COVID-19 nonpharmaceutical interventions (NPIs), providing a natural experiment on the effects of large perturbations. Consequently, the effects of NPIs are included in the model and medium-term predictions are explored. Our findings highlight the intrinsic sensitivity of M. pneumoniae dynamics to perturbations and interventions, underscoring the limitations for long-term prediction. More generally, our findings provide further evidence for the role of stochasticity as a driver of complex cycles across endemic and recurring pathogens.
7. Cannabis-Based Products for Chronic Pain : An Updated Systematic Review.
期刊: Annals of internal medicine 发表日期: 2025-Dec-23 链接: PubMed
摘要
Benefits and harms of cannabinoids for chronic pain are uncertain. To update an evidence synthesis on cannabinoids for chronic pain. Ovid MEDLINE, PsycINFO, Embase, the Cochrane Library, and Scopus to 28 July 2025. Randomized placebo-controlled trials. Data extraction, risk of bias, and strength of evidence were dually reviewed. Cannabinoids were categorized by tetrahydrocannabinol (THC)-to-cannabidiol (CBD) ratio (high, comparable, or low), source (synthetic, purified, extracted), and administration method. 25 short-term (1 to 6 months) randomized controlled trials (n = 2303; 64% neuropathic pain) assessed cannabinoids. Oral synthetic/purified high THC-to-CBD (THC only) may slightly reduce and oromucosal, extracted, comparable THC-to-CBD ratio products probably slightly reduce pain severity (pooled differences, -0.78 and -0.54 points, respectively, [0 to 10 scale]), with moderate or large increased dizziness, sedation, and nausea. Among THC-only products, nabilone moderately reduced pain severity but dronabinol did not (pooled differences, -1.59 and -0.23 points, respectively). Low THC-to-CBD interventions may not improve outcomes. Although low THC-to-CBD mixed THC/CBD products may increase dizziness, sedation, and nausea, CBD alone may not increase harms. Variability within categories; lack of product details; unclear U.S. availability of studied products; restricted to English-language studies. Comparable and high THC-to-CBD ratio cannabinoid products may result in small improvements in pain and increased common adverse events during short-term treatment of primarily neuropathic pain; among high-ratio THC-only products, nabilone (but not dronabinol) reduced pain. Low THC-to-CBD products may not improve outcomes. Studies are needed on long-term outcomes and other cannabis product types. Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services (PROSPERO: CRD42021229579).
8. Optimizing SloMo, a Digitally Supported Therapy Targeting Paranoia, for Implementation: Inclusive, Human-Centered Design Study.
期刊: JMIR human factors 发表日期: 2025-Dec-22 链接: PubMed
摘要
Despite the promise of digital therapeutics in providing scalable interventions for psychosis, translating them from clinical trials to routine care is challenging. SloMo is an evidence-based, digitally supported cognitive behavioral therapy for psychosis comprising a web-based therapy platform and mobile app. The therapy encourages individuals to slow down for a moment, to address fast-thinking habits fueling paranoia. SloMo has received a NICE Early Value Assessment recommendation for use in the National Health Service to address evidence gaps related to its use in the real world, and an implementation study is underway. This study aimed to optimize the SloMo software for implementation by addressing limitations of the first release, reducing technology complexity, and improving user experience, to increase equitable outcomes. An inclusive, human-centered design methodology was used to optimize SloMo. The redesign sought to reduce the technology’s complexity and improve the user experience for diverse patients and therapists. The Double Diamond framework structured the iterative redesign, integrating insights from patient and public involvement consultants, therapists, and a transdisciplinary co-design team. The Double Diamond process was facilitated through 24 transdisciplinary workshops. These were supported by the following methods: identifying implementation barriers through desk research of SloMo’s evidence and qualitative interviews with experts by experience (n=2); redefining user needs; iteratively developing solutions through user testing sessions with service user consultants (n=32); and validating the minimum viable product through think-aloud testing sessions with therapist (n=10) and service user (n=11) consultants. Users wanted a form of cognitive behavioral therapy for psychosis that was usable, trustworthy, enjoyable, personalized, normalizing, and memorable. The redesign, therefore, included a minimalist user interface, more diverse lived experience vignette content, enhanced agency over data, greater representation of protected characteristics and their intersectionality, and intuitive navigation. Feedback from a purposively sampled patient and therapist sample validated the redesign as it was associated with a strong user experience, particularly in relation to usability and usefulness. The study produced a redesign of the SloMo software optimized for real-world use, whilst retaining fidelity to the therapeutic content of the previous version. Through an inclusive, human-centered approach, the optimized design of SloMo addresses barriers to adoption by reducing complexity and fostering accessibility. This study underscores the value of integrating lived experience involvement into digital therapeutics to support scalable, equitable, and sustainable mental health care solutions.
9. Implementation of a Mobile Digital Tool Supporting Medication for Opioid Use Disorder Treatment Improves Retention: Stepped-Wedge Cluster Randomized Controlled Trial.
期刊: Journal of medical Internet research 发表日期: 2025-Dec-22 链接: PubMed
摘要
Despite its proven efficacy, retention in medication for opioid use disorder (MOUD) remains low, with structural and systemic barriers-such as access to care and treatment setting-alongside individual factors, including personalization and motivation, contributing to high rates of discontinuation. Digital interventions offer a promising approach to address many of these barriers; however, robust evidence for their effectiveness in improving retention and engagement with treatment remains scarce. This study aims to evaluate the impact of Recovery Connect-a white-labeled version of Recovery Path and a digital remote patient monitoring app used as part of a blended treatment model for opioid use disorder-on patient retention, treatment continuance, and medication adherence. A stepped-wedge cluster randomized trial was conducted across 9 outpatient MOUD clinics, organized into 8 clusters. Clusters were sequentially transitioned from usual care to a digitally enhanced model incorporating Recovery Connect, which provided real-time monitoring, psychoeducational and skill-based content, and messaging between patients and clinicians. The primary outcome was 30-day retention in treatment following exposure (implementation of the app in the clinic), linkage (downloading and connecting to the app), or engagement (levels of app usage). Secondary outcomes included treatment continuance-defined as receiving at least 75% of expected doses-and the number of daily doses taken within the first 3, 7, and 30 days after admission. Cluster-controlled discrete-time survival analyses were conducted, adjusting for patient- and clinic-level covariates. Patients admitted to clinics that had implemented the app (n=1205) showed increased retention (922/1205, 75.5%) compared with those in clinics that had not (203/319, 63.6%, P<.001). Patients who downloaded and linked with a mental health professional on Recovery Connect had an 81.3% likelihood of retention, compared with 72.0% (P<.001) among those not linked. Linkage also significantly predicted higher treatment continuance and a greater number of daily doses taken during the first 7 and 30 days (P<.001). Low, moderate, and high engagement levels were associated with progressively higher 30-day retention compared with no engagement (P<.001). This study provides evidence that implementing Recovery Connect (Recovery Path) significantly enhances patient retention and treatment continuity in outpatient opioid use disorder care. Early linkage and engagement during the first week were strong predictors of positive outcomes, underscoring the value of early, proactive digital support. These findings reinforce the effectiveness of blended digital-clinical models, aligning with broader evidence that integrating remote monitoring enhances continuity of care and supports recovery. Policy implications include the need for reimbursement mechanisms, workflow integration, and ethical, privacy-preserving implementation to enable scalable and equitable adoption of digital tools in substance use treatment. ClinicalTrials.gov NCT07140926; https://clinicaltrials.gov/ct2/show/NCT07140926.
10. A Machine Learning Model Based on Clinical Factors to Predict the Efficacy of First-Line Immunochemotherapy for Patients With Advanced Gastric Cancer: Retrospective Study.
期刊: JMIR medical informatics 发表日期: 2025-Dec-22 链接: PubMed
摘要
The development of immunotherapy has provided new hope for patients with advanced gastric cancer (AGC). However, due to the high heterogeneity of the disease, the efficacy of first-line immunochemotherapy varies among patients. There is still a lack of simple and effective models to predict the efficacy of immunochemotherapy in this setting. This study aimed to identify critical factors and develop predictive models to evaluate the efficacy of first-line immunochemotherapy in patients with AGC using clinically available data. The goal was to offer evidence-based guidance for clinical practice and enable personalized treatment strategies. To evaluate the effectiveness of first-line immunochemotherapy in AGC, we retrospectively collected clinical data from The First Affiliated Hospital of Nanjing Medical University between January 2018 and October 2023. The data collected were divided into a training set (168/240, 70%) and an internal validation set (72/240, 30%). Additionally, a temporal validation cohort of 76 patients recruited from November 2023 to September 2024 was assembled to further evaluate the predictive performance of the models. We used univariate and multivariate Cox regression analyses, along with the least absolute shrinkage and selection operator (LASSO) regression, and integrated clinical expertise to identify key predictors of treatment efficacy and to construct the LASSO-Cox model. We developed 4 models (LASSO-Cox, random survival forest [RSF], extreme gradient boosting, and survival support vector machine) and evaluated their performance using the C-index, area under the curve (AUC), calibration curves, and decision curve analysis. The optimal model was interpreted using Shapley additive explanations, and its risk scores were used to stratify patients for Kaplan-Meier survival analysis. Among the 4 prognostic models developed in this study, the RSF model demonstrated superior predictive accuracy and discrimination for progression-free survival, as evidenced by its higher AUC, concordance index, continuous AUC curves, and calibration curves compared with the other 3 models. Additionally, decision curve analysis showed that the RSF model offered greater net clinical benefit. The Shapley additive explanations results identified that age, histological subtype, the proportion of CD19+ B cells, CD16+CD56+ natural killer cells, and the presence of liver metastasis were key prognostic factors influencing patient outcomes. Patients in the low-risk group, as determined by the RSF model’s risk score, exhibited a significantly higher progression-free survival rate than those in the high-risk group, further validating the value of the RSF model for risk stratification. This study is the first to use machine learning algorithms to develop a predictive model for the efficacy of first-line immunochemotherapy in AGC, and to identify key predictors of treatment outcome. The results indicate that the RSF model not only enables precise stratification of patients likely to benefit but, more importantly, provides quantifiable decision support for individualized clinical strategies, underscoring its potential value in clinical decision-making.
11. Highly Pathogenic Avian Influenza (HPAI H5N1, Clade 2.3.4.4b, genotype C2.1) in Commercial Ring-Necked Pheasants During the 2022 Outbreak in the United States.
期刊: Canadian journal of microbiology 发表日期: 2025-Dec-22 链接: PubMed
摘要
Highly pathogenic avian influenza (HPAI) virus H5N1 clade 2.3.4.4b was introduced into North America in 2021. In 2022, clade 2.3.4.4b spilled into domestic poultry in the United States (U.S.), resulting in the largest HPAI outbreak in U.S. history. In December 2023, H5N1 2.3.4.4b was detected on an upland game bird farm in Pennsylvania. History, clinical signs, and gross lesions were suggestive of marble spleen disease. However, HPAI was identified by real-time reverse-transcriptase polymerase chain reaction; gene sequencing confirmed genotype C2.1 with phylodynamic analyses providing evidence of a wild bird introduction. Predictive mathematical modeling estimated the time of virus introduction onto the farm (15 days [95% C.I., 11 - 23] before the date of confirmed detection) being similar or longer than previously described for domestic poultry. Although bioexclusion measures were unable to prevent the initial exposure due to industry rearing practices, biocontainment procedures appeared to prevent spread. The lessons learned from this case may be important for other animal agriculture commodities, especially those species that are infrequently handled or observed and may have inaccurately calculated mortality levels. This well characterized outbreak and other experiences with natural infection should be taken as opportunities to better understand the field dynamics of this virus.
12. Understanding the social determinants of Aedes-borne diseases in Iran: A qualitative exploration of challenges and policy solutions.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Dec-22 链接: PubMed
摘要
Aedes-borne diseases pose escalating public health challenges globally, influenced not only by ecological and biological factors but critically by social determinants of health (SDH). In Iran, emerging local transmission of dengue highlights these diseases as effective proxies to examine the impact of social and environmental factors on health equity. However, evidence on context-specific drivers and effective responses remains scarce. This study aimed to identify key SDH and propose prioritized interventions to inform evidence-based policymaking. This mixed-method study included a two scoping review on SDH of Aedes-Borne Diseases and SDH-focused interventions, complemented by qualitative data from in-depth interviews with 21 national and provincial health experts in Iran. Data were analyzed using an inductive content analysis approach and MAXQDA 25 software was used throughout the analysis. The identified interventions were prioritized through a multi-criteria decision analysis, incorporating expert input via an online checklist and digital platform, based on four key criteria: effectiveness, feasibility, social acceptability, and political support. Findings reveal that socioeconomic inequalities, weak community awareness, and limited health system capacity substantially drive disease risk. Notably, the local emergence and spread of dengue serve as a sensitive indicator reflecting broader social vulnerabilities affecting health outcomes. Integrated multisectoral strategies-encompassing health education, environmental management, digital surveillance, and cross-sector collaboration-are vital for effective control. Priority actions include healthcare worker training, embedding disease prevention within educational curricula, and tailored communication leveraging native languages and trusted community leaders. The study underscores that Aedes-borne diseases are not only biological threats but also reflections of underlying social and structural inequities. By framing dengue and related diseases as sentinel indicators of SDH, policymakers can better design integrated and equity-oriented strategies. Controlling Aedes-borne diseases requires a shift from disease-centric approaches toward comprehensive, SDH-informed strategies that strengthen community engagement, improve environmental and health infrastructure, and enhance cross-sector coordination. The prioritized interventions identified in this study provide a practical roadmap for strengthening preparedness and response in Iran and similar settings.
13. Efficacy of omega-3 fatty acids as a functional food: a multifaceted approach to health reinforcement.
期刊: Journal of the science of food and agriculture 发表日期: 2025-Dec-22 链接: PubMed
摘要
Omega-3 fatty acids (omega-3s) are polyunsaturated fatty acids linked with numerous health benefits. Omega-3s exhibit multifaceted activities through various mechanisms. Eicosapentaenoic acid (EPA) alleviates oxidative stress by lowering reactive oxygen species and improving oxidative stress in brain tissues and acts against neurodegenerative disorders. It has the potential to regulate cell membranes, decrease inflammation, improve endothelial activities, reduce triglycerides (TGs), weaken oxidative stress, and encourage cardiovascular, metabolic and immunological health. Docosahexaenoic acid (DHA) modulates mitochondrial activity, enhances mitochondrial biogenesis and facilitates fatty acid oxidation, which lowers lipid accumulation and helps energy metabolism and is effective in obesity. Omega-3s such as EPA, DHA and alpha-linolenic acid show anticancer activity, promote apoptosis, decrease the proliferation of cancer cell and enhance chemotherapy efficacy. Moreover, DHA has potential effects during pregnancy and fetal development. Omega-3s are often inadequate in our diet and play a significant therapeutic function in several disorders. They have been documented by global health specialists as essential constituents of the human diet. Their relevance depends on their ability to act as a nutritional intervention with significant uses in health promotion. Consequently, dietary nutrition is associated with disease prevention and enhanced clinical results. The growing demand for health-related products and innovations is expected to have an impact on developing dietary patterns. As a result, omega-3s are increasingly incorporated into functional foods and supplements. This analysis highlights omega-3s ability to improve health outcomes as well as prevent chronic diseases. © 2025 The Author(s). Journal of the Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
14. Influencing factors of depressive and anxiety symptoms among caregivers of Alzheimer's disease patients: A cross-sectional study.
期刊: Journal of Alzheimer’s disease : JAD 发表日期: 2025-Dec-22 链接: PubMed
摘要
BackgroundAlzheimer’s disease (AD) burdens patients and caregivers psychologically and emotionally. Identifying factors influencing caregivers’ emotional symptoms is crucial for their mental health.ObjectiveThis study investigated the prevalence of depressive/anxiety symptoms among AD caregivers and identified key influencing factors.MethodsA cross-sectional study was conducted from 2021 to 2023, involving 169 dyads of AD patients and their primary caregivers. Caregivers were assessed for depressive symptoms (HAMD >7) and anxiety symptoms (HAMA >6), quality of life (QoL), and dementia-related knowledge. Patients were evaluated for neuropsychiatric symptoms and cognitive function. Multivariable logistic regression and Spearman correlation analyses were used to identify key influencing factors.ResultsAmong 169 caregivers (mean age 56.97 ± 14.19 years, 62.13% female), depressive and anxiety symptom incidence was 24.85% and 25.44% (comorbidity 13.6%). Better dementia knowledge (“Risk/Health Promotion”: OR = 0.79, 95% CI: 0.67-0.93; “Care Precautions”: OR = 0.81, 95% CI: 0.69-0.95) was protective against caregiver depressive symptoms, while patient anxiety symptoms (OR = 1.09, 95% CI: 1.01-1.17) and sleep/night problems (OR = 1.14, 95% CI: 1.05-1.24) increased risk. Increased caregiver age was protective against caregiver anxiety symptoms (OR = 0.94, 95% CI: 0.9-0.97), but patient anxiety symptoms (OR = 1.10, 95% CI: 1.03-1.18) and caregivers’ lower QoL (OR = 1.10, 95% CI: 1.01-1.19) were risk factors. Furthermore, caregivers’ HAMD scores were negatively correlated with dementia knowledge.ConclusionsDepressive/anxiety symptoms are common in AD caregivers, influenced by patient anxiety, sleep issues, caregiver age, QoL, and dementia knowledge. Targeted interventions to support caregiver mental health and knowledge are crucial.
15. Follicle stimulating hormone, luteinizing hormone and adiposity trajectories in postmenopausal women.
期刊: Climacteric : the journal of the International Menopause Society 发表日期: 2025-Dec-22 链接: PubMed
摘要
Postmenopause is characterized by changes in reproductive hormones and body composition. Preclinical evidence suggests that follicle stimulating hormone (FSH) may increase adiposity, but epidemiologic research is limited. This study examined whether postmenopausal FSH and luteinizing hormone (LH) are related to adiposity changes. The sample included 675 postmenopausal women enrolled in the Women’s Health Initiative (WHI) Buffalo Osteoporosis and Periodontal Disease (OsteoPerio) study with dual-energy X-ray absorptiometry measures. Adiposity measures included visceral adipose tissue (VAT), subcutaneous adipose tissue, body mass index, and total and percent body fat. Group-based trajectory models and generalized estimating equation models estimated associations of baseline FSH and LH with 17-year adipose trajectories and longitudinal measures of adiposity, respectively. The study estimated three trajectories for adiposity measures, corresponding to low, medium and high levels of adiposity over time. Higher baseline concentration of FSH and LH was associated with reductions in adiposity measures over time. An increase of 1 mIU/ml in FSH was associated with a 0.55 cm2 reduction in VAT (95% confidence interval [CI]: -0.69, -0.40); and an increase of 1 mIU/ml in LH was associated with a 0.81 cm2 reduction in VAT (95% CI: -1.09, -0.52). Higher circulating FSH and LH were associated with lower adipose trajectories and lower adiposity levels in older postmenopausal women, counter to our hypothesis. Future research is needed on the relationship between gonadotropins and adiposity during the postmenopausal period. During the menopausal transition, women experience an increase in body fat and a drastic rise in follicle stimulating hormone (FSH) and luteinizing hormone (LH). This study evaluates whether FSH and LH is related to changes in body fat during the postmenopause period. We found that higher levels of FSH and LH are significantly associated with less body fat among older postmenopausal women, regardless of time since menopause or whether the woman used hormone therapy.
16. Long-term outcomes of adjuvant radiation in elderly Asians with early stage IIA breast cancer after breast-conserving surgery: a population-based study.
期刊: Breast cancer (Tokyo, Japan) 发表日期: 2025-Dec-22 链接: PubMed
摘要
17. A nomogram based on preoperative CT secondary signs and clinical factors to predict post-PCNL fever in patients with Escherichia coli infection.
期刊: Urolithiasis 发表日期: 2025-Dec-22 链接: PubMed
摘要
18. Problem Gambling Transmission. An Eight-wave Longitudinal Study on Problem Gambling Among Affected Others.
期刊: Journal of gambling studies 发表日期: 2025-Dec-22 链接: PubMed
摘要
There is growing recognition that those close to someone with problem gambling experience stress and strain. Research suggests they may also be at risk of developing gambling problems themselves, but this remains an underexplored area. The present study examined how exposure to problem gambling within family or friend networks relates to affected others’ own gambling, and whether strong social connections reduce this risk. Using an eight-wave longitudinal dataset (N = 1530) with hybrid multilevel regression modeling, we analyzed within-person and between-person effects of exposure to a family member’s or friend’s problem gambling on affected others’ own gambling. We further examined the protective role of social connectedness to family and friends. Gambling problems were assessed with the Problem Gambling Severity Index (PGSI) and social relationships with the Social and Emotional Loneliness Scale for Adults (SELSA). Results indicated that individuals were more likely to develop problem gambling when they reported that a family member or a friend had gambling problems. Strong family relationships buffered against this risk, whereas friendships did not provide the same protection. These findings suggest that social relationships play an important role in shaping problem gambling among affected others and highlight the need to consider family and peer contexts in prevention and intervention strategies.
19. Secukinumab improves pregnancy outcomes in recurrent spontaneous abortion with T helper 17 cells/T regulatory cells imbalance: a retrospective cohort study.
期刊: European journal of clinical pharmacology 发表日期: 2025-Dec-22 链接: PubMed
摘要
This study aimed to evaluate the efficacy and safety of secukinumab, an Interleukin-17A (IL-17A) inhibitor, in patients with recurrent spontaneous abortion (RSA) associated with T helper 17 cells / T regulatory cells (Th17/Treg) imbalance. This retrospective cohort study evaluated 108 RSA patients with confirmed Th17/Treg imbalance (Th17/Treg ≥ 0.6 or IL-17A > 4.74 pg/mL) at a single center. Patients were divided into secukinumab (n = 54; 3 mg/kg subcutaneously plus standard therapy) and control (n = 54; standard therapy alone) groups. Primary outcomes included live birth rate and immunological parameters (Th17/Treg ratio, IL-17A levels), with secondary assessments of neonatal outcomes and safety. The secukinumab group demonstrated significantly higher live birth rates (83.33% [45/54] vs 64.81% [35/54]; P = 0.047), with an odds ratio (OR) of 2.71 (95% Confidence Interval (CI): 1.10-6.73), and greater reductions in Th17/Treg ratios (P = 0.010) and IL-17A levels (P = 0.001) compared to controls. No congenital anomalies, maternal or neonatal infections, or treatment-related serious adverse events were observed in either group. For RSA characterized by Th17/Treg imbalance, secukinumab demonstrates both clinical efficacy and an acceptable safety profile, suggesting its therapeutic utility.
20. Deep Self-Reinforced Multi-View Subspace Clustering for Cancer Subtyping.
期刊: IEEE journal of biomedical and health informatics 发表日期: 2025-Dec-22 链接: PubMed
摘要
Identifying cancer subtypes is crucial for understanding disease progression and guiding precision medicine. With advances in high-throughput experimental technologies, the integration of multiple types of omics data for cancer subtype identification has become increasingly feasible. However, despite the promising performance of existing integrative cancer subtyping methods, efficiently integrating and clustering multi-omics datasets remains challenging due to the high levels of noise inherent in omics data, which impede the accurate characterization of relationships among samples. To address these challenges, we propose a novel deep multi-view subspace clustering model that incorporates a self-reinforced learning strategy. This strategy iteratively improves the quality of self-representation, which is critical for accurately capturing sample relationships and enabling effective clustering. Specifically, during model training, the proposed method learns a highly reliable self-representation through a good-neighbor learning mechanism, allowing it to model more accurate and robust inter-sample relationships. Building upon this reliable self-representation, we further develop a learnable view-graph fusion framework that integrates complementary information across multiple omics views to derive a consensus representation for clustering, thereby guiding the overall learning process. In addition, we introduce a local graph-guided learning mechanism based on an initial graph constructed from the raw data. This mechanism serves as an effective regularization strategy to prevent the model from converging to suboptimal solutions, thereby enhancing stability and robustness during training. Extensive experimental results demonstrate that the proposed method consistently outperforms several state-of-the-art approaches, validating its effectiveness and robustness for cancer subtype identification.
21. Hierarchical Glucose-Sensitive Hydrogel for Anti-IL-17 Antibody Delivery Enhances Alveolar Bone Regeneration in Diabetic Conditions.
期刊: ACS applied materials & interfaces 发表日期: 2025-Dec-22 链接: PubMed
摘要
Diabetic alveolar bone regeneration is impaired by hyperglycemia-driven metabolic dysfunction and IL-17-mediated chronic inflammation, both of which suppress osteogenesis. To address immune dysregulation within the diabetic microenvironment, we engineered a glucose-responsive hierarchical hydrogel (CH/IL-17Abs@GOx/CAT) via dual-component 3D printing. This architecture spatially segregates glucose oxidase (GOx) and catalase (CAT) to enhance the efficiency of the enzymatic cascade and incorporates IL-17 antibodies (IL-17Abs) for targeted immunomodulation. The hydrogel demonstrated bone-mimetic mechanical properties and favorable biocompatibility. Compared to EDC/NHS coimmobilized controls, it exhibited superior glucose sensitivity. Under hyperglycemic inflammatory conditions, the hydrogel suppressed pro-inflammatory cytokines (TNF-α, IL-6) while elevating IL-10 levels. Rat bone marrow mesenchymal stem cells displayed higher alkaline phosphatase (ALP) activity, greater mineralization, and upregulation of osteogenic genes (OPG, RUNX2, COL1A1). In diabetic rats with alveolar bone defects, Western blot and qPCR confirmed reduced pro-inflammatory factors (TNF-α, IL-6) and elevated anti-inflammatory IL-10, accompanied by concurrent STAT3 downregulation and osteogenic gene activation (OPG, RUNX2, COL1A1) at 2 weeks. Critically, immunofluorescence colocalization analysis provided direct spatial evidence that the hydrogel disrupted the pathogenic interaction between IL-17 and phosphorylated STAT3 within the defect microenvironment. By 8 weeks, micro-CT and histology revealed robust bone regeneration, characterized by mature collagen deposition and trabecular reconstruction. Immunohistochemistry confirmed persistent expression of osteogenic proteins (OPG, COL1A1). Major organs showed no pathological changes, confirming systemic biosafety. This glucose-responsive system integrates immunomodulation with osteogenic promotion, offering a promising strategy for diabetic bone repair by addressing the dual challenges of hyperglycemia and IL-17-mediated inflammation, thus presenting a targeted alternative to conventional growth factor-based therapies.
22. Colanic acid-mediated phage resistance enhances virulence in high-risk global clone Escherichia coli ST410.
期刊: PLoS pathogens 发表日期: 2025-Dec-22 链接: PubMed
摘要
The global rise of multidrug-resistant Escherichia coli ST410 presents a growing clinical threat. We isolated a highly lytic phage targeting ST410, but rapid resistance emerged both in vitro and in vivo. Beyond receptor mutations, we identified a hypermucoid mutant that evades phage infection primarily through colanic acid overproduction, providing broad phage resistance. This colanic acid overproduction also led to diminished macrophage phagocytosis in vitro and accelerated mortality in mice. Transcriptomic and genetic analyses linked this phenotype to activation of the Rcs pathway. Notably, naturally occurring ST410 isolates with colanic acid-overproducing phenotypes were also observed, suggesting that capsule-mediated immune evasion may arise in clinical populations. To overcome resistance, we designed a rational four-phage cocktail with diverse receptors, achieving robust therapeutic efficacy in infection models. Our findings highlight that phage resistance can be accompanied by enhanced virulence potential through capsule-mediated immune evasion, with colanic acid playing a central role, emphasizing important considerations for phage therapy design.
23. Environmental impact of 100% fruit juice consumption and inclusion in sustainable diets in Europe.
期刊: International journal of food sciences and nutrition 发表日期: 2025-Dec-22 链接: PubMed
摘要
Current evidence supports moderate consumption of 100% fruit juices (FJ) due to their contribution to fruit consumption and nutrient intake. Over the last decade, major attention has been paid to the environmental impact of dietary choices and the place of food groups in a sustainable diet. The present paper provides a comprehensive overview of both production and consumption of 100% FJ, as well as modelling studies which propose optimised intakes within health and environment parameters. While the production of FJ has certain hotpoints which contribute to its environmental pressure, as do all foods and beverages, the actual FJ consumption generates a relatively small share of the food-related carbon and water footprint. Moreover, the available scientific literature on optimised dietary patterns tends to place 100% FJ within healthy and sustainable dietary patterns. Based on European consumption patterns, the average carbon footprint of FJ, nectars and vegetable juices was 2.6% of food-related greenhouse gas emissions. This was significantly lower than animal foods and grains and similar to the fruit/vegetable category (with lower amounts of FJ consumed). Considering their potential role in health as a source of vitamins, minerals and phytochemicals, as well as their acceptable environmental impact, moderate FJ consumption is consistent with global recommendations on fruit intake as part of a healthy and sustainable dietary pattern.
24. Biosynthesis of 17-Carbon Terpenoids in Bacteria.
期刊: Journal of the American Chemical Society 发表日期: 2025-Dec-22 链接: PubMed
摘要
Terpenoids are the largest group of specialized metabolites with broad biological activities and applications. While terpenoid biosynthesis was long thought to generate only backbones with multiples of five carbons, the discovery of bacterial 16-carbon terpenoids challenged this view. Here, we expand our understanding of terpenoid biosynthesis by identifying and characterizing 17-carbon terpenoids. Through genome mining and functional analysis, we reveal a diverse array of structurally complex C17 terpenoids synthesized via a conserved pathway. Two methyltransferases successively modify farnesyl diphosphate into a C17 diphosphate precursor, which terpene synthases convert into distinct C17 scaffolds. Phylogenetic analysis shows that C17 terpene synthases evolved multiple times from C16-associated enzymes, while the latter can also generate C17 terpenoids. These findings establish C16 synthases as an evolutionary reservoir for C17 biosynthesis, broadening our understanding of terpenoid diversity and evolution, while paving the way for the biological, chemical, and biotechnological exploration of this new terpenoid class.
25. Molecular detection of Histoplasma capsulatum in environmental samples collected from South African caves.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Dec-22 链接: PubMed
摘要
Histoplasma capsulatum naturally occurs in cave soil enriched by bat guano. South African caves are documented as probable sources of exposure for speleologists, casual visitors, or guano miners with several outbreaks of acute pulmonary histoplasmosis reported since 1977. Sporadic cases of disseminated histoplasmosis occur in South Africans living with advanced HIV disease. However, detection from the environment has not been confirmed. We used molecular assays to detect and confirm the presence of H. capsulatum in regularly-explored caves. Environmental samples were collected by a speleologist from seven South African caves from December 2020 to September 2021 in the Gauteng, Northern Cape and Western Cape provinces of South Africa and stored at 2-8 °C. DNA was extracted directly from the samples using DNeasy PowerSoil Pro Kit. In-house internal transcribed spacer (ITS) panfungal polymerase chain reaction (PCR), pan-dimorphic reverse transcriptase-quantitative (RT-q) PCR and nested Hc100 PCR assays were used to detect H. capsulatum. Sequence identity was confirmed using the National Centre for Biotechnology Information (NCBI) BLAST tool following Sanger sequencing of the Hc100 nested-PCR product. H. capsulatum was detected in five of the seven caves. Of 56 samples tested, 18 (32%) were positive from three caves in Gauteng Province [cave 1 (3/10); cave 2 (7/10); cave 3 (5/10)], one cave in the Western Cape Province [cave 4 (2/5)] and one cave in the Northern Cape Province [cave 6 (1/10)]. These samples were positive either by RT-qPCR or Hc100 PCR assays. Both RT-qPCR and Hc100 PCR assays were positive in 21% (12/56) samples. Seven percent (4/56) of samples were only RT-qPCR assay-positive and 4% (2/56) only Hc100 PCR-positive. Phylogenetic analysis of the Hc100 gene product from 10 samples (with good-quality sequences) identified four groups. Group 1 consisted of three samples from caves 1, 3, and 6 (Gauteng/ Northern Cape); Group 2 included four samples from caves 1, 2, and 3 (Gauteng); Group 3 had one sample from cave 4 (Western Cape); and Group 4 included two samples from caves 1 and 3 (Gauteng). None of the 56 samples tested positive with the ITS PCR assay. H. capsulatum is probably present in several regularly-explored caves with bat populations. This finding should be confirmed by culture. The RT-qPCR and the Hc100 PCR assays could be useful tools for wider environmental surveillance.
26. Workplace-Based Glucose Screening for Type 2 Diabetes in French Civil Servants: Prospective Observational Cohort Study.
期刊: JMIR public health and surveillance 发表日期: 2025-Dec-22 链接: PubMed
摘要
Type 2 diabetes (T2D) remains one of the most underdiagnosed chronic conditions worldwide, despite its major contribution to cardiovascular and metabolic morbidity. In 2024, an estimated 589 million adults were living with diabetes globally, more than 90% of whom had T2D, and the prevalence is projected to reach 853 million by 2050. In France, approximately 4.1 million adults are affected, and nearly 1 in 4 individuals with diabetes remain undiagnosed. Therefore, early detection is essential to prevent complications. Workplace prevention strategies could improve early detection, particularly among employed adults with limited access to regular medical screening. In France, a health prevention organization has implemented a systematic glucose screening program for civil servants to identify individuals at risk of T2D or prediabetes. As the French public service includes 5.7 million workers-approximately 1 in 5 of the national workforce-this setting provides a unique opportunity to reach large, diverse, and often underserved segments of the adult population. This study aimed to assess the effectiveness of a systematic diabetes screening program as a preventive public health measure by determining the rate of newly detected diabetes cases and characterizing associated cardiometabolic risk factors within a large population of French civil servants. A retrospective observational study was conducted using data from a glucose screening program between January 2022 and February 2025. Participants with postprandial blood glucose levels >1.40 g/L were included in a follow-up cohort. Sociodemographic, clinical, and biological data were collected. Comparisons were performed using the chi-square or Fisher exact test for categorical variables and the Student t test (2-tailed) for continuous variables (P<.05). Analyses were restricted to complete cases to ensure robust comparisons. Among 16,785 screened participants, 981 (5.8%) had postprandial glucose levels >1.40 g/L and 134 (0.8%) were eligible for the follow-up cohort. Participants were 59.5% (n=78) women and 40.5% (n=53) men, with a mean age of 51.3 (SD 8.9) years. Overall, 37.6% (n=50) of participants were overweight, 25.4% (n=34) were obese, 61.6% (n=77) reported insufficient physical activity, and 63.2% (n=84) had a family history of diabetes. Of the 134 eligible individuals, 70 (52.2%) completed medical follow-up, and among them, 9 (12.9%) received a confirmed diagnosis of T2D. Newly diagnosed individuals were predominantly male (n=7, 78%; P=.04) and more likely to be overweight or obese (n=9, 89%; P=.04). No significant differences in age, sex, or BMI were observed between followed and lost-to-follow-up participants. Systematic glucose screening in occupational or social health context identifies individuals at risk of diabetes or prediabetes and supports its integration into preventive health strategies to enhance early detection and reduce long-term complications. Larger prospective or randomized studies are warranted to confirm long-term benefits on diagnosis, care engagement, and cardiometabolic outcomes.
27. Occupation-based intervention for subacromial pain syndrome: A pilot randomized controlled trial.
期刊: Journal of back and musculoskeletal rehabilitation 发表日期: 2025-Dec-22 链接: PubMed
摘要
BackgroundSubacromial pain syndrome (SAPS) frequently causes functional limitations. Conventional therapies target impairments, whereas occupation-based approaches emphasize meaningful activity engagement to enhance functional recovery.ObjectiveThis pilot randomized controlled trial explored the feasibility and preliminary efficacy of an occupation-based intervention (OBI) for SAPS.MethodsThirty adults aged 18-65 years with chronic SAPS were randomly assigned to OBI (n = 15) or no-treatment control (NT, n = 15). OBI provided twelve sessions over four weeks, mixing preparatory exercises with meaningful tasks chosen via the Occupational Performance Measure (COPM). Outcomes were pain and disability (Shoulder Pain and Disability Index, SPADI), COPM performance and satisfaction, sleep, fatigue, and life satisfaction (SWLS). Nonparametric analyses were used with Wilcoxon signed-rank and Mann-Whitney U tests; effect sizes were rank-biserial r and Cliff’s Δ.ResultsOBI produced large within-group reductions in SPADI pain (r = 0.88) and disability (r = 0.87), marked improvements in COPM performance and satisfaction (r ≈ 1.0), and better sleep (r = 0.79; between-group Δ = -0.56, p = 0.009). Fatigue decreased substantially within OBI (r = - 0.94) but the between-group contrast was small and not significant. The NT group showed no statistically significant change on any outcome; SWLS remained stable in both arms.ConclusionA four-week occupation-based program is feasible and yields clinically meaningful improvements in pain, disability, sleep, and occupation-centred outcomes in people with SAPS. These preliminary findings support larger trials comparing OBI with standard rehabilitation to confirm efficacy and long-term benefits.
28. The effect of emotional intelligence on the acceptance and use of technologies used İn occupational health and safety: A systematic literature review.
期刊: Work (Reading, Mass.) 发表日期: 2025-Dec-22 链接: PubMed
摘要
BackgroundWhile the complexity of today’s business environments links the adoption of occupational health and safety (OHS) technologies with individual and institutional factors, emotional intelligence (EI) plays an important role in this process. It contributes to the development of a safety culture.ObjectiveThis study aims to analyze the effect of EI on the acceptance and use of OHS technologies using the systematic literature review (SLR) method.MethodsThis systematic literature review selected and evaluated 39 academic studies examining the relationship between OHS and EI in the context of technology acceptance and use between 2010 and 2025 using PRISMA and Mixed Methods Assessment Tool (MMAT) methods in Scopus, PubMed, Web of Science, and SpringerLink databases with the specified keywords.ResultsWhile the 39 studies evaluated according to the MMAT criteria generally offered high methodological quality and consistent analyses, it was observed that the themes of EI, occupational health and safety, and technology adaptation came to the fore, especially with the increasing number of publications after 2021.ConclusionsThis systematic review demonstrates that EI is a key determinant of accepting and using OHS technologies. Improvements are needed in methodological consistency and contextual diversity. Integrating EI as a mediating structure in technology acceptance models can enhance the effectiveness of OHS practices. Developing employee EI skills accelerates technology adoption within the Unified Technology Acceptance and Use Model 2 (UTAUT2) model, strengthening individual and organizational OHS performance.
29. Process-based VOC emission characteristics, environmental impact and health risk assessment in typical breweries in Beijing.
期刊: Environmental science. Processes & impacts 发表日期: 2025-Dec-22 链接: PubMed
摘要
Brewing is an understudied but influential source of VOC emissions in the food manufacturing industry. In this study, we conducted a first comprehensive analysis of process-based VOC concentration characteristics, ozone formation potential (OFP), secondary organic aerosol formation potential (SOAFP) and health risks in two typical breweries in Beijing that use malted barley, hops, water, and yeast. In Brewery A, 35 to 53 distinct VOC species were detected, with total mass concentrations ranging from 148.17 ± 18.64 µg m-3 to 15 225.91 ± 1912.51 µg m-3. Brewery B demonstrated comparable patterns, with 28 to 49 species detected at concentrations between 104.49 ± 8.48 µg m-3 and 10 368.87 ± 879.47 µg m-3. Process-stage analysis identified boiling and fermentation stages as the key stages with the highest VOC concentrations, dominated by oxygenated VOCs (OVOCs) such as acetaldehyde, acetone, ethyl acetate, and 2-butanone, as well as the alkane isobutane. Atmospheric dispersion modeling (AERMOD) indicated negligible public health risks from organized stack emissions. In contrast, occupational health assessment revealed significant risks for workers from fugitive emissions, with the cumulative hazard index (HI) far exceeding the threshold. The OFP and SOAFP results, representing the secondary pollutant formation potential of the source mixtures, highlighted OVOCs and aromatics as priority control species for mitigating the secondary pollution potential. The findings demonstrate that VOC control strategies must be differentiated, with large-scale breweries prioritizing organized emissions, while small breweries urgently need to control fugitive emissions. This study aims to promote the implementation of VOC regulations and occupational health protection strategies within the brewing industry.
30. Sex and race/ethnicity differences in the 24-hour movement behaviors among adolescents in the Future of Families and Child Wellbeing Study (FFCWS).
期刊: Journal of racial and ethnic health disparities 发表日期: 2025-Dec-22 链接: PubMed
摘要
To compare components of the 24-hour movement behaviors (physical activity, sedentary behavior, sleep) across sex and race/ethnic groups among a diverse sample of adolescents to identity potential gaps and opportunities for intervention. The sample consisted of 704 adolescents (15.4 ± 0.6 years; 51% Black; 53% female) from year 15 of the Future of Families and Child Wellbeing Study. Twenty-four-hour movement behaviors were measured over a week-long period using waist- and wrist-worn accelerometry. Sex, racial, and ethnic differences in 24-hour movement behaviors were examined with chi-square and t-test analyses. Female adolescents, on average, spent less time in light physical activity (LPA) and in moderate-to-vigorous physical activity (MVPA) than male adolescents. Additionally, female adolescents spent more time in sedentary behavior and had longer daily total sleep time than adolescent males. Black adolescents had higher average LPA than White adolescents. Black adolescents also had higher average MVPA and LPA than Hispanic/Latino adolescents. Hispanic/Latino youth had longer total sleep time, and more sedentary time than Black youth. No other significant differences were observed across these demographic groups. There is a continued need for interventions to promote physical activity and sleep among adolescents, with a particular focus on increasing sleep duration among boys and physical activity among girls and Hispanic/Latino adolescents.
31. Redefining surgical ergonomics: a systematic review of ergonomic outcomes in robotic urological surgery.
期刊: Journal of robotic surgery 发表日期: 2025-Dec-22 链接: PubMed
摘要
Urological surgeons have been shown to suffer with significant musculoskeletal (MSK) discomfort during their careers directly attributed to their work. Robot-assisted surgery (RAS) is believed to offer superior ergonomics to traditional forms of surgery but concerns still exist around their use. This systematic review collates the currently available literature on the ergonomic outcomes of RAS in urology and offers comparison to other surgical modalities. The preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines formed the basis of this review, and the study protocol was registered in PROSPERO (CRD420250650617). A thorough database search was conducted in MEDLINE/PubMed and EMBASE, with twenty-two articles eventually included in the review. Data analysis included a narrative synthesis, and sub-group meta-analysis where data homogeneity allowed. Overall, RAS offers a more ergonomic environment for urological procedures than laparoscopic, open, or endoscopic surgery. Questionnaire-based studies demonstrated favourable use among urological surgeons, although numerous issues persist such as neck and back pain. Postural and muscular assessments similarly showed improvements in ergonomy for RAS. However, prolonged poor ergonomic joint positions, and moderate activation of upper body muscles were noted in all forms of surgery. Task load indexes demonstrated lower physical demand among RAS. While RAS offers a superior ergonomic environment to minimally invasive and open surgical techniques in urology, numerous challenges still exist. Continued study is needed, and formal ergonomic assessments should become standard protocol for any emerging robotic systems to ensure that proper ergonomy is maintained across a diverse surgical population.
32. Research Advances on the Impact of Gut Microbiota on COPD: Exploring New Perspectives on the Microbiota-Gut-Lung Axis.
期刊: Current microbiology 发表日期: 2025-Dec-22 链接: PubMed
摘要
33. Addressing the disease burden of systemic lupus erythematosus.
期刊: Modern rheumatology 发表日期: 2025-Dec-22 链接: PubMed
摘要
Systemic lupus erythematosus (SLE) is an autoimmune disease that causes organ damage and negatively affects a patient’s quality of life (QoL). Despite the recent remarkable progress in treatment, patients continue to experience a substantial disease burden. In SLE, which is more common in young people, this casts a sizable shadow over patients’ social activities. Treatment goals are to control disease activity, minimise treatment-related adverse events, avoid organ damage, and optimise health-related QoL. However, optimising QoL remains challenging, as many unresolved issues remain, including subjective symptoms, which are difficult for physicians to perceive. As such, physicians must work to understand this burden from the patient’s perspective and pursue improved patient QoL. In this review, we discuss issues associated with disease burden and health-related QoL faced by patients with SLE in their daily lives, along with available treatments and management practices that can be implemented to optimise them. To enable SLE patients to live a normal life, we must transform current SLE care to move beyond symptom control to drive clinical remission, assessing and addressing the disease burden patients face in daily life.
34. Unlocking potentials of a prenylated flavonoid: Xanthohumol's role in combating inflammatory conditions and Rhematic diseases.
期刊: Cytokine 发表日期: 2025-Dec-21 链接: PubMed
摘要
Xanthohumol, a prenylated flavonoid derived from hops (Humulus lupulus), has garnered significant attention for its multifaceted therapeutic potential. This review highlights xanthohumol’s ability to modulate key signaling pathways, including NF-κB, STAT3, and Nrf2, which are central to inflammation, oxidative stress, and cancer progression. As a flavonoid, xanthohumol exhibits potent antioxidant and anti-inflammatory properties, making it effective in alleviating inflammatory conditions such as osteoarthritis, rheumatoid arthritis, and inflammatory bowel disease. In cancer, xanthohumol demonstrates remarkable efficacy by inhibiting tumor growth, angiogenesis, and metastasis through the suppression of critical pathways like CXCR4 and STAT3. Preclinical studies have shown that xanthohumol selectively targets cancer cells while sparing normal cells, underscoring its potential as a safe and effective anticancer agent. Beyond its anti-inflammatory and anticancer effects, xanthohumol also plays a significant role in metabolic regulation. It improves glucose homeostasis, lipid metabolism, and gut microbiota composition, offering therapeutic benefits for metabolic syndrome and diabetes. Clinical trials and preclinical research further validate xanthohumol’s safety and efficacy, with emerging evidence supporting its use in managing chronic diseases. This review provides a comprehensive overview of xanthohumol’s mechanisms of action, therapeutic applications, and future directions in clinical research, positioning it as a promising natural compound for the prevention and treatment of a wide range of diseases.
35. Implementation of a participatory ergonomic program to reduce musculoskeletal pains among micro-enterprise workers: social network as data transformative pathway.
期刊: Applied ergonomics 发表日期: 2025-Dec-21 链接: PubMed
摘要
This study evaluated the effectiveness of a participatory ergonomics program to reduce musculoskeletal pain among car repair technicians in small workshops (<5 employees) in Iran. Thirty-six participants assessed ergonomic risks and interventions before and after implementation using the Nordic Musculoskeletal Questionnaire and ergonomic checkpoints. WhatsApp was used to facilitate communication and feedback due to geographical dispersion. Five key ergonomic interventions were implemented across 36 micro-enterprises, with 31 participants (86 %) completing all stages of the program. In total, 44 ergonomic improvements were carried out across four major risk domains: manual material handling, workstation design, hand tools, and lighting. Six months after implementation, the prevalence of musculoskeletal pain decreased significantly-by 73 % in the neck, 80 % in the shoulders, 86 % in the elbows, 50 % in the wrists/hands, and 47 % in the knees (p < 0.05). These findings demonstrate that participatory, low-cost interventions supported by social networking tools can effectively improve ergonomic risk factors in micro-enterprises.
36. Patient-level Value Analysis: A Model for Implementing the Concept of Value-based Healthcare Into Clinical Practice.
期刊: The Journal of the American Academy of Orthopaedic Surgeons 发表日期: 2025-Dec-10 链接: PubMed
摘要
As interest in incorporating value-based healthcare (achieving better health outcomes for patients relative to costs) into clinical practice and policy expands, there is a growing need for a well-understood and easily implemented methodological approach. Patient-level value analysis (PLVA) quantifies patient outcomes (using patient-reported outcome measures [PROMs]) in the context of total costs of care (using time-driven activity-based costing). When both aspects are paired, optimal value is achieved. There are six steps to perform PLVA: (1) defining the care pathway, (2) identifying low- and high-value interventions, (3) defining PROMs of interest, (4) determining costs, (5) evaluating the relationship between PROMs and total costs of care, and (6) identifying potential value drivers. This approach equips users with information on how to minimize variation, implement best practices, and encourage the delivery of high-value care. The primary objectives of this article are (1) to compile a synthesis of PLVA literature and (2) to use the Capability, Opportunity, Motivation-Behavior model and the Theoretical Domains Framework to provide orthopaedic surgeons with tactical guidance for implementation of PLVA.
37. Award for Distinguished Professional Contributions to Institutional Practice: Brigitte Khoury.
期刊: The American psychologist 发表日期: 2025-Dec 链接: PubMed
摘要
This award is intended to recognize outstanding practitioners in psychology. Brigitte Khoury is an exceptional clinical psychologist, educator, and advocate whose contributions to the field of psychology and institutional practice have left a lasting impact on individuals, communities, and the profession as a whole. As the founding director of the Clinical Psychology Training Program at the American University of Beirut (AUB) and the Director of the Arab Regional Center for Research, Training, and Policy Making in Mental Health, Khoury has played a transformative role in shaping the next generation of psychologists. Her work focuses on advancing psychological well-being, particularly in the areas of sexuality and reproductive health, refugee mental health, and international comparative psychology. Khoury’s service in the Title IX Office further exemplifies her dedication to institutional practice. As an investigator and counselor for victims of sexual harassment, she has applied her clinical expertise to contribute to fair and sensitive investigations while also providing support to survivors. Her trauma-informed approach has fostered a safer institutional environment. Khoury’s role within the American Psychological Association, the Arab Union of Psychological Science, and the World Federation for Mental Health highlight her global influence. Khoury’s exceptional contributions make her a deserving recipient of the APA Award for Distinguished Professional Contributions to Institutional Practice. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
38. Supporting family caregivers: Variations in caregiving among families managing chronic health conditions.
期刊: The American psychologist 发表日期: 2025-Dec 链接: PubMed
摘要
Families nationwide experience major changes when their person is affected by a chronic health condition. This article champions the needs of biological, extended, and chosen family members (FMs) who provide caregiving, and urges the field to both understand the nuances of caregiving and tailor effective strategies for serving this often-overlooked group. We use three exemplar conditions-neurocognitive disorder, early psychosis, and substance use disorder-to compare the characteristics that influence family caregiving outcomes. We offer recommendations on ways to better serve both patients and their families by building research, practice, and policy. As the U.S. population grows, the prevalence of health problems will increase, and new generations of FMs will adopt the caregiving role. The demand for psychological services to support families will likely increase as well. Health care providers and other clinicians may face challenges in addressing the needs of families, especially for conditions for which multiple effects on caregivers is least understood. However, there is hope that ongoing research, education, policy, and awareness will better position the field to support these families moving forward. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
39. Award for Distinguished Contributions to Research in Public Policy: David l. Blustein.
期刊: The American psychologist 发表日期: 2025-Dec 链接: PubMed
摘要
This award honors a psychologist who has made a distinguished empirical and/or theoretical contribution to research in public policy, either through a single extraordinary achievement or a lifetime of work. In recognition of his exceptional leadership and scholarly contributions, APA is honored to present the 2025 APA Award for Distinguished Contributions to Research in Public Policy to David L. Blustein. Blustein is a highly distinguished psychologist whose scholarship has reshaped vocational psychology and significantly influenced public policy. Through his Psychology of Working Theory, Blustein helped redefine how psychologists understand the role of work in people’s lives, especially for those who are marginalized and economically disenfranchised. Blustein’s scholarship has led the field in addressing structural inequities in access to decent work, providing an evidence-based foundation for more inclusive policies in employment and education. With over 200 publications in leading journals, his influence spans disciplines and borders, shaping national and international discourse on work, education, and psychological health. In addition, through decades of mentorship, Blustein has cultivated a generation of scholars and practitioners committed to social justice. His legacy continues through the transformative research, theory, and advocacy he has inspired. Blustein’s lasting impact on public policy and psychological science exemplifies the APA’s mission to apply psychological research to benefit society and improve lives. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
40. Dairy farmers have minimal knowledge of bovine tuberculosis: A cross-sectional study in Bhutan.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Dec 链接: PubMed
摘要
Bovine tuberculosis (bTB) is a chronic disease of cattle and the leading cause of zoonotic tuberculosis. In Bhutan, there is no dedicated program for bTB despite the country being situated in the bTB enzootic region, where a large section of population relies on cattle and raw milk and, dairy products are widely consumed.To contribute to the design of future education, surveillance, mitigation, and control programs, we investigated the knowledge, attitudes, and practices relevant to bTB among dairy farmers. We surveyed 264 farmers in Thimphu, Paro, and Haa Dzongkhags. These farmers contribute to supplying the eight milk outlets in the capital, Thimphu. We found that only 11 farmers (4.2%; confidence interval 95%: 2.1% - 7.3%) were aware that bTB existed, and only five of them (1.9%; CI 95%: 0.6% - 4.3%) were aware that bTB is a zoonosis. Risk perception and practice followed a gradient of variation from Thimphu to Haa, but overall, we found a correlation between bTB risk perception for animals and humans. Farmers and traders, along with the consumption of meat and sick animals, were perceived as occupations and activities involving the highest risk of zoonotic infection. Contact with animals entering the herd and with neighbouring cattle were perceived as the highest risk for animal infection. Most farmers in Haa consume raw milk and dairy products they produced by themselves, whereas farmers in Paro and Thimphu prefer powdered milk. Using generalised low-rank models and k-means clustering, we found that dzongkhag of residence and attitudes toward zoonotic infection prevention explained most variability in the data. The severe knowledge deficits about bTB are particularly concerning given the zoonosis is present in Bhutan, is prevalent in neighbouring countries, and negatively affects cattle health and well-being, diminishing fertility, milk, and overall productivity, ultimately impacting farmers’ livelihoods and undermining Bhutan’s nutritional and economic reliance on this sector. Urgent short and mid-term activities should be prioritised to identify bTB high-risk areas, educate farmers, and mitigate bTB impacts.
41. Failure of pyriproxyfen at recommended application frequency and doses to control Aedes mosquitoes in Thailand.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Dec 链接: PubMed
摘要
Mosquito-borne diseases like malaria, dengue fever, and Zika virus remain global health concerns. Pyriproxyfen is effective in controlling mosquitoes by disrupting their development. This study seeks to assess pyriproxyfen’s ability to prevent Aedes aegypti emergence from water sources. It is part of a trial evaluating pyriproxyfen’s impact on reducing mosquito infestation and dengue transmission, verifying its persistence and effectiveness in real-world and laboratory conditions. The study was conducted in Khon Kaen province (northeastern region) and Prachuap Khiri Khan province (western region) of Thailand. We assessed pyriproxyfen residual effectiveness, inhibition of mosquito larval emergence and active ingredients among batches in a pyriproxyfen-based mosquito control trial in Khon Kaen. In Prachuap Khiri Khan we evaluated pyriproxyfen effectiveness across various water sources. The active ingredients in two pyriproxyfen batches were analyzed in a Sumitomo laboratory and in an independent laboratory. Thirty days after field water containers were treated with pyriproxyfen the inhibition of mosquito larval emergence declined to ~60% and 60 days post-treatment the inhibition of emergence was just ~10%. Two batches of pyriproxyfen tested in the laboratory had > 85% inhibition of emergence and the active ingredient concentrations varied from 0.45-0.52%, close to the manufacturer’s specifications of 0.5%. In laboratory experiments, the inhibition of mosquito emergence of pyriproxyfen in different water sources started declining after 42 days. Rain- and groundwater had higher inhibition rates (20-30%) than tap water (~10%) after 98 days. Emergence inhibition rates correlated negatively with water pH (F(1,118) = 5.626, p < 0.001) and positively with total dissolved solids, conductivity, and salinity of the water (F(1,118) = 48.302, p < 0.001), (F(1,118) = 37.022, p < 0.001), and (F(1,118) = 36.699, p < 0.001), respectively. Pyriproxyfen failed to control Aedes mosquitoes at the recommended application frequency and doses in the field. The potential reasons for lack of effectiveness may be caused by environmental factors, such as pH, water source, and other water characteristics or social factors, such as homeowners’ behaviors and water storage practices. The study underscores the importance of understanding environmental and social factors to tailor application strategies and ensuring sustained efficacy through regular monitoring, particularly in diverse contexts.
42. Master Protocol Design With Hybrid Control for Efficient Early-Phase Trial Consolidation.
期刊: JCO precision oncology 发表日期: 2025-Aug 链接: PubMed
摘要
Master protocols represent transformations, enabling multiple therapies or diseases under a single protocol. These designs streamline therapeutic development by reducing redundancies. Suited for evolving fields such as oncology and global emergencies such as the COVID-19 pandemic, master protocols have been exemplified by studies such as RECOVERY, Solidarity, and I-SPY 2, which accelerated effective treatment identification (with I-SPY 2 focused on molecular subtypes). Recent oncology examples, such as MORPHEUS, evaluate immunotherapy combinations with shared controls. Despite advantages, their application in early-phase oncology remains underutilized amid growing regulatory emphasis on randomization for robust evidence. US Food and Drug Administration (FDA) Oncology Center of Excellence (OCE) initiatives, such as Project Optimus and Project FrontRunner, emphasize randomization in early-phase oncology trials. However, these initiatives pose challenges, including larger sample sizes, patient and physician reluctance to randomization, and high failure rates from poor accrual. To address these, this article adapts master protocol designs to consolidate early-phase trials for novel therapeutics sharing a common backbone therapy, integrating hybrid controls from published standard-of-care data to minimize randomization to the control arm. By consolidating trials under a shared standard-of-care control arm, the proposed master protocol design reduces total sample size by as much as 55% when compared with independent trials (with control arm sizes 2.4-2.9 times lower), lowers costs and duration, and enhances enrollment through reduced randomization to controls. Incorporating hybrid controls from prior studies and sharing information among arms with common background standard-of-care further improve efficiency, increasing power (reaching 90% overall) while controlling type I error rates acceptable levels. Master protocol designs with hybrid controls and Bayesian information sharing enable the efficient integration of randomization into early-phase oncology trials, enhancing efficiency, cost-effectiveness, and patient-centricity while aligning with FDA OCE initiatives.
43. Recompression and Adjunctive Therapies in DCI Management in Divers: A Review of RCTs.
期刊: Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc 发表日期: 2025 链接: PubMed
摘要
Decompression illness (DCI) poses significant risks for divers, particularly in remote locations with limited resources. Few randomized controlled trials (RCTs) exist, necessitating a review to consolidate current evidence and support evidence-based treatment protocols. This review evaluates RCT evidence on the effectiveness of recompression treatment and adjunctive therapies for diving-related DCI. This review included RCTs assessing recompression treatment or adjunctive therapies in managing DCI. Exclusions were non-human studies, trials on DCI prevention, non-English publications, incomplete trials, and those involving non-diving DCI. Databases searched from inception to May 15, 2023, included Ovid MEDLINE, CENTRAL, CINAHL, and EMBASE. Citation chasing was performed on June 1, 2023, using Web of Science. Risk-of-bias assessments were guided by considering the Cochrane risk-of- bias tool for randomized trials. Two RCTs were identified. One trial (n=180) indicated that tenoxicam might reduce the number of required recompressions from three (range 1-8) to two (range 1-6). The other trial (n=41) showed that a shorter initial recompression treatment table could decrease the number of recompressions (median one vs. two) in cases of mild DCI. Limitations included unblinded participants, small participant numbers, non-protocol interventions, participant blinding, and incomplete outcome data. Recommendations for future research include reaching a consensus on a universal scoring system to support the clear definition and selection of participants, subgroup analyses, and inter-trial comparisons.
44. Increased ventilatory response to carbon dioxide after dive training.
期刊: Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc 发表日期: 2025 链接: PubMed
摘要
Divers are reported to have a lower ventilatory response to elevated levels of carbon dioxide (CO₂) than non-divers. Hypoventilation with CO₂ retention during diving is potentially dangerous. It is unknown if CO₂ retention is largely inherited or develops during diving training. We aimed to investigate if a military dive training course would influence the ventilatory response to CO₂. Novice rebreather Divers with Amphibious Rangers as controls were tested at baseline, after 12 weeks of water exercise training, and after 15 weeks of diving: participants rebreathed in a Douglas bag filled with an initial 100% oxygen, resulting in increasing levels of inspiratory CO₂ (iCO₂). The test was performed until symptom-limitation or an expiratory CO₂ of 8.0 kPa. To decrease conscious control of breathing, participants were distracted with a memory game during the test. Differences between groups and over time were analyzed using independent and paired t-tests. Ten Divers and six Amphibious Rangers completed baseline testing and eight Divers completed all tests. Divers had a statistically significant higher Minute Ventilation (V’E) after dive training, compared to after water exercise training and baseline, at all levels of iCO₂. However, the change in Hypercapnic ventilatory response (HCVR) before and after dive training across pCO₂ values 5.0-7.9, did not reach statistical significance. At baseline, Amphibious Rangers had a non-significant higher V’E compared to Divers at higher levels of iCO₂. A military rebreather diving program might be associated with increased ventilatory response to CO₂.
45. Decompression at 1.3 versus 1.6 bar and Nitrogen Elimination and Venous Gas Emboli: A Randomized Controlled Trial.
期刊: Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc 发表日期: 2025 链接: PubMed
摘要
The optimal depth for decompression stops is unclear. We hypothesize that a decompression stop at 1.3 bar, compared with 1.6 bar, decreases post-dive whole-body nitrogen washout volumes and venous gas emboli (VGE). In this randomized crossover trial, divers performed wet air dives of 40 minutes at 3.4 bar (340 kPa) with a seven-minute-long decompression stop at either 1.3 bar (Deco 1.3) or 1.6 bar (Deco 1.6) in randomized order. The primary outcome was the difference in post-dive whole body nitrogen washout volume, analyzed using multilevel linear regression. The secondary outcome was the difference in peak VGE detected by cardiac two-dimensional ultrasound, graded using the Eftedal-Brubakk scale, and analyzed with Wilcoxon matched-pairs signed-rank tests. Sixteen divers completed both Deco 1.3 and Deco 1.6. Post-dive whole body nitrogen washout volumes were measured in eight of the 16 participants and were lower with Deco 1.3 than Deco 1.6 (696 ml [95% confidence interval [CI], 601 to 790] versus 1068 ml [95% CI, 962 to 1174]), mean difference of 373 ml (95% CI, 243 to 502). Deco 1.3 had lower peak bubble grades than Deco 1.6 (interquartile range 2-3 versus 3-4; P=0.005), but the median grade was the same at 3. Decompression stop at 1.3 bar instead of 1.6 bar decreased post-dive whole body nitrogen washout volume and VGE. These findings may inform the development of future decompression models.
46. Systematic Review of Otologic Adverse Events in Hyperbaric Oxygen Therapy.
期刊: Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc 发表日期: 2025 链接: PubMed
摘要
Hyperbaric Oxygen (HBO₂) Therapy has been associated with some risks and adverse events. Previous studies examining otologic complications from HBO₂ therapy vary in their reported incidence of adverse events. This study aims to systematically review the otologic complications associated with HBO₂ therapy and investigate contributing risk and protective factors. A systematic review was conducted to identify studies reporting otologic adverse effects due to HBO₂ therapy. Utilizing PRISMA 2020 guidelines, titles and abstracts were screened before conducting a full-text analysis. Studies reporting the incidence of otologic complications and studies reporting risk or protective factors for otologic complications were included. A search for articles on HBO₂ therapy otologic complications yielded 2,027 articles, of which 183 were relevant to the research question. Ultimately, 54 studies met the inclusion criteria. Fifteen percent of the 18,284 patients treated with HBO₂ therapy experienced adverse events. Of the middle ear barotrauma (MEB) that occurred, 42.8% was mild, and 6.4% was severe. The major risk factors were increasing age, female sex, head and neck pathology, sensory neuropathy, and pre-treatment difficulty equalizing ear pressure. The main protective factor was experience with effective equalization techniques. 15% of patients experienced otologic complications due to HBO₂ therapy. Older age, female sex, and a history of head and neck or neurological conditions may increase the risk for MEB. Increased monitoring of higher-risk patients during initial treatment sessions and proper equalization techniques may help prevent MEB during HBO₂ therapy. This is the most comprehensive systematic review on the topic to date.
47. Evaluation of the efficacy of modified low-dose HBO₂ therapy.
期刊: Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc 发表日期: 2025 链接: PubMed
摘要
The COVID-19 pandemic, being an airborne disease, posed a challenge in providing Hyperbaric Oxygen (HBO2) Therapy in multiplace chambers by increasing the risk of cross-infectivity while on air break inside the chamber. The standard regimen consisting of two air breaks was modified, and a new low-dose HBO₂ therapy regimen with no air breaks was introduced to mitigate the risk of cross- infection. This study aimed to evaluate the efficacy of the modified HBO₂ therapy regimen compared to the standard HBO2 therapy regimen for patients with soft tissue radiation injury. A retrospective observational study compared the modified low-dose HBO₂ therapy regimen of 2.4 Atmosphere Absolute (ATA) for 60 minutes without air-break vis-a-vis the standard regimen of 2.4 ATA for 100 minutes with two air breaks of five minutes each. Patients with soft tissue radiation injury in the form of radiation cystitis and radiation proctitis were selected for comparison in the study. Data was retrieved from patients who underwent the standard and modified regimen during the COVID-19 pandemic. Late Effects Normal Tissue (LENT)/ Subjective Objective Management Analytic (SOMA) questionnaire-based scoring was compared for 30 sessions of HBO₂ therapy. Standard biostatistical methodology was used to compare the outcomes of both regimens. The mean LENT SOMA score decreased from the baseline to the end of 30 sessions in the HBO₂ therapy protocols. Overall, mean values decreased more for the patients who were offered the standard regimen of HBO₂ therapy. A modified low-dose HBO₂ therapy treatment regimen achieved statistically significant therapeutic benefits. However, the results were statistically more promising for the patients who underwent the standard HBO₂ therapy regimen.
48. Safety Of Hyperbaric Oxygen Therapy In Patients Aged 75 And Older: A Multicenter Retrospective Study.
期刊: Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc 发表日期: 2025 链接: PubMed
摘要
The increasing life expectancy presents new challenges in managing elderly patients requiring hyperbaric oxygen (HBO₂) therapy. This retrospective study evaluates the safety and adherence to HBO₂ guidelines in patients aged 75 years and older, focusing on side effects and adverse events. Data from 69 elderly patients treated between 2019 and 2023 at two Sicilian hyperbaric centres were analyzed. Demographics, indications for HBO₂, comorbidities, treatment protocols, and side effects were collected. Pre-treatment evaluations included ENT checkups, ECG, chest X-rays, and laboratory tests. Patients underwent HBO₂ sessions at 2.4-2.8 ATA, with clinical monitoring pre-and post-treatment. 1,799 HBO₂ sessions were performed in 69 patients (mean age 78 years; 59.4% male). The most common indications were progressive necrotizing infections (33.3%), sudden sensorineural hearing loss (17.3%), and chronic radiation-induced tissue injuries (14.5%). Side effects occurred in 14 patients (20.3%), primarily middle ear barotrauma (8.7%), sinus barotrauma (4.3%), confinement anxiety (4.3%), hypoglycemia (1.4%), and chest pain (1.4%). Most side effects were resolved with prompt care, and no life-threatening events were recorded. Adherence to guidelines and meticulous pre-treatment evaluations minimized risks. HBO₂ is a safe therapeutic option for elderly patients when strict pre-treatment evaluations and monitoring protocols are implemented. Despite this population’s increased vulnerability, the incidence of side effects was comparable to that in younger cohorts. Future research is warranted to optimize treatment protocols and explore outcomes in larger elderly populations.
49. Necrotizing Soft Tissue Infections.
期刊: Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc 发表日期: 2025 链接: PubMed
摘要
e initial terminology used to describe 2,642 cases of necrotizing infections as “hospital gangrene” was coined by Dr. Joseph Jones, surgeon of the Confederate Army in 1871 [1]. Later in 1883, Dr. Jean- Alfred Fournier characterized necrotizing infections to the perineum. Necrotizing fasciitis was initially described and named “hemolytic streptococcal gangrene” by Meleney in 1924 [2]. He described an illness characterized by gangrene of subcutaneous tissues, followed by rapid necrosis of the overlying skin from involvement of the blood vessels supplying the skin, which are found in the affected fascial layers. All his patients grew hemolytic streptococci on cultures, and the patients were all seriously ill. Surgical extirpation appeared to be the best therapeutic approach then and remains so. The actual term Necrotizing Fasciitis was credited to Dr. Wilson much later in 1952 [3]. Media often refers to this entity as infection with «Flesh-eating bacteria.”The annual incidence of NSTI varies considerably but is often reported at approximately four per 100,000 in developed countries [4]. Mortality rates highlight the severity of disease with a 90-day mortality of 18% reported in a multi-center study including more than 400 patients [5].
50. Case Report: Complete Coverage Of Chronic Sickle Cell Leg Ulcer Using Hyperbaric Oxygen Therapy Combined With Skin Grafting.
期刊: Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc 发表日期: 2025 链接: PubMed
摘要
A chronic leg ulcer is a serious complication of sickle cell anemia. The ulcers are treatment- resistant, recur frequently, and are associated with more severe disease. Treatment options for chronic leg ulcers in patients with sickle cell disease are limited. Hyperbaric oxygen (HBO₂) therapy is a promising therapy for the management of sickle cell chronic leg ulcers as it relieves hypoxia, promotes angiogenesis, and reduces wound inflammation. A 35-year-old male with sickle cell anemia with a chronic leg ulcer for one year, despite regular wound dressing and antibiotics, was then successfully managed through HBO₂ therapy followed by skin grafting. HBO₂ therapy was effective in this case and has also shown effectiveness as an adjunct therapy in the management of sickle cell-related chronic leg ulcers in other case reports. This supports the need for further research in this area.
51. A dual-stochastic real options model for sports tourism investment: A case study in China.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
As the deep integration of sports and tourism continues, sports tourism projects are emerging as an important driver of regional economic transformation and consumption upgrading. However, these projects typically exhibit strong revenue seasonality, long construction cycles, and high market uncertainty, which makes traditional static evaluation methods inadequate for capturing investment feasibility and risk structures. Based on the theory of investment under uncertainty, this study develops a dual-stochastic real options model that couples an Ornstein-Uhlenbeck process with exogenous seasonality (ES-OU) for revenues and a Geometric Brownian Motion (GBM) for construction costs, to characterize the dynamic investment boundary and optimal entry timing under multiple risk constraints. The model is solved using a hybrid numerical framework that combines the Crank-Nicolson-ADI finite-difference scheme with Monte Carlo simulation, ensuring both accuracy and stability. Using the Fanjingshan Mountain Sports Experience Base in Guizhou as a comparable case, parameters are calibrated and simulations conducted with Guiyang’s tourism income and the CSI 300 Building Materials Index. The results show an optimal investment boundary of approximately CNY 196 million per quarter, an investment trigger probability of 62.4%, and a median trigger time of about 3.75 years, indicating a pronounced “delay-and-time-the-entry” decision pattern. Further analysis identifies construction cost and the long-run mean of revenues as the key economic drivers of entry timing: higher costs significantly postpone investment triggers, whereas improved revenue expectations advance entry. These findings validate the feasibility and explanatory power of the real options model in the sports tourism context, reveal the dynamic mechanism of investment behavior under joint revenue-cost uncertainty, and provide quantitative guidance for investment timing, risk identification, and policy design in sports tourism projects.
52. Experiences of participants in ETEC controlled human infection model studies.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Controlled human infection model (CHIM) studies raise ethical issues due to intentional exposure of healthy volunteers to a pathogen. In this study we examine the experiences of participants who have chosen to participate in enterotoxigenic Escherichia coli (ETEC) CHIM studies in a single research center. An interviewer-administered paper-based survey was conducted with participants in an ETEC CHIM study at the Center for Immunization Research (CIR) from 2009-2020. We analyzed participant characteristics, study experiences, and perceived risks before and after study participation. 48 participants in ETEC studies were interviewed. 81.3% of participants identified as Black or African American, 43.8% completed at most high school, and 39.6% of interviewees had incomes of less than $18,500 in the last year. Most respondents enjoyed participating and were glad they joined. Participants most frequently identified interactions with research staff, compensation, and food quality as the most positive aspects of their experiences. There was a significant reduction in the perceived risk of the ETEC study after completing participation compared to perceived risk before joining. Despite the expected side effects of ETEC CHIM studies, most participants believe the benefits outweigh the risks and would participate again.
53. Depressive symptoms and suicidal ideation associated with women's experience of recent economic intimate partner violence in Gauteng, South Africa: A cross-sectional study.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
This study investigated the prevalence of economic intimate partner violence (IPV) and its association with mental health outcomes among women in Gauteng Province, South Africa. Economic IPV, involving controlling behaviours related to employment, earnings, housing, and financial support, is a critical yet understudied form of abuse with potential impacts on women’s mental health. A secondary analysis was conducted using data from a representative survey of 491 women collected in 2010. Past-year economic IPV and other IPV forms were assessed through an adapted World Health Organization questionnaire. Depressive symptoms were measured by the Centre for Epidemiologic Studies Depression (CES-D) scale, and suicidal ideation was assessed for the past four weeks. Multivariate logistic regression models adjusted for socio-economic status, child abuse, partner control, other IPV types, and life trauma were employed to examine associations between economic IPV, depressive symptoms, and suicidal ideation. Results showed that 9% of women experienced past-year economic IPV, 24.2% reported depressive symptoms, and 8% had suicidal thoughts in the prior month. After adjusting for confounders, economic IPV remained significantly associated with increased odds of depressive symptoms and suicidal ideation. Younger women (18-24 years) were more likely to report suicidal thoughts than older women. These findings highlight economic IPV as a significant and often overlooked form of abuse that co-occurs with other IPV types and has strong links to adverse mental health outcomes. The study demonstrates the need for integrated approaches that combine economic empowerment and mental health support within gender-based violence services in Gauteng, South Africa. Policies should prioritize accessible, youth-friendly interventions with an emphasis on early detection and support for vulnerable young women, including those out of school. Although the cross-sectional data limits causal inference, the evidence calls for ongoing community-based programs addressing economic abuse as part of comprehensive violence prevention and mental health promotion efforts.
54. Green synthesized silver nanoparticles from Moringa: Potential for preventative treatment of SARS-CoV-2 contaminated water.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Biogenic silver nanoparticles have been reported as good antimicrobial candidates. In this study, we synthesized and characterized silver nanoparticles using aqueous leaf extracts of Moringa oleifera (AgNPmo) and investigated their antimicrobial and antiviral activities. The AgNPmo demonstrated antibacterial activity against Pseudomonas aeruginosa and Staphylococcus aureus, with concentration-dependent zones of inhibition ranging from 6.5-15.5 mm and 0-7 mm, respectively. Cytotoxicity was assessed on Vero cells using a CCK-8 assay, which revealed an IC50 value of 38 µg/ml, indicating relatively low toxicity at effective concentrations. The antiviral activity against SARS-CoV-2 was confirmed using quantitative RT-PCR: AgNPmo exposure led to a time- and dose-dependent increase in Ct values for ORF1ab and N genes, with the strongest inhibition observed after 48 h. These results provide direct evidence of both antimicrobial and antiviral activity. The green synthesis using Moringa extracts offers added advantages by employing phenolic and flavonoid compounds as natural reducing and capping agents, making the process eco-friendly and biocompatible. While direct wastewater treatment was not tested, these findings highlight the advantages of Moringa leaf extract as a natural reducing and capping agent that enabled rapid, eco-friendly AgNP formation, while the resulting AgNPmo demonstrated antimicrobial and antiviral activity. Thus, AgNPmo represents a promising, sustainable option for point-of-use disinfection and potential environmental water treatment.”.
55. Cannulation-related wound complications after extra corporeal life support: A retrospective cohort study in a Dutch intensive care unit.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Extracorporeal life support (ECLS) is a high-risk therapy for acute cardiac or respiratory failure. After weaning, wound healing at the cannulation site is often disrupted, leading to discomfort, delayed recovery, increased nursing workload, and higher costs. Available data on this issue is limited. This study describes the epidemiology of cannulation-related wound complications (CRWCs) in ECLS patients, defined as impaired wound healing at the cannulation site >72 hours after decannulation. A retrospective, single-center cohort study was conducted in the Intensive Care Unit of St. Antonius Hospital in the Netherlands. Between 2018 and 2023, successfully weaned ECLS patients treated with venovenous (VV) or venoarterial (VA) ECLS for more than 24 hours were included. Descriptive statistics were used to describe the incidence and characteristics of CRWCs. Risk factors for CRWCs were assessed using univariate logistic regression at the patient and insertion-site levels. A total of 73 patients were included in this study, of whom 33 (45%) had 37 CRWCs. CRWCs were characterized by fluid leaks (90%), wound dehiscence (70%), tissue necrosis (76%), and/or wound infection (49%). CRWCs were primarily located at the groin and the first signs appeared after seven days (IQR 5-9 days). Identified risk factors included increased age, lower BMI, lower nadir serum albumin, VA cannulation, surgical insertion, and dual cannulation. Wound healing was still incomplete in 17 (51%) patients at the time of hospital discharge. CRWCs occur in nearly half of all successfully weaned VV and VA ECLS patients, mostly at the groin. Due to the severity of the patient’s illness and the acute clinical setting, the identified risk factors cannot always be avoided. This study raises awareness, aiding in the early and better identification of at-risk patients and recognizing a CRWCs as a serious complication as early as possible.
56. General practitioners' experiences of managing low back pain in primary care in Ireland: A qualitative phenomenological study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Low back pain (LBP) is one of the most common symptoms presented in general practitioner (GP) consultations worldwide and is a leading cause of disability. Despite LBP clinical guidelines advocating for non-pharmacological, primary care-based management, management often diverges from recommendations. The objective of this study was to explore the lived experiences of GPs’ management of LBP in primary care, using a qualitative method. Twelve GPs across multiple Irish primary care settings were interviewed using a semi-structured guide developed in line with international LBP management guidelines. Interviews were conducted either in-person or via Zoom and audio recorded. The interviews were transcribed and the data were analysed using reflexive thematic analysis. Three key themes were identified. LBP is a common issue with increasing patient complexity. GPs frequently encounter LBP in patients with multimorbidity, particularly in lower socioeconomic settings, complicating diagnosis and management. Secondly, GPs spoke about the complexity of managing LBP. Challenges identified included patient pressure for imaging, limited utility of available imaging, variability in medication prescribing, and patient misunderstandings of physiotherapy. The final theme discussed how the current healthcare system is not fit for purpose. Structural issues such as inequitable access to physiotherapy and the two-tiered public/private healthcare system were cited as major barriers. GPs expressed a need for better resources, education, and support to align care with clinical guidelines. The management of LBP in Irish primary care is deeply affected by systemic inequities. Both system-level reform-particularly around equitable access to care-and the development of supportive and accessible resources are needed to empower GPs to successfully manage this significant public health issue.