公共卫生研究摘要 (2025-12-28)
共收录 59 篇研究文章
1. Annual vaccination with BNT162b2 in Germany can avoid substantial clinical and economic burden of COVID-19 disease.
期刊: Journal of medical economics 发表日期: 2026-Dec 链接: PubMed
摘要
To quantify the clinical and economic burden of Coronavirus disease 19 (COVID-19), and burden potentially avoided with annual vaccination, in German adults in an endemic setting. A decision tree model was constructed to estimate the clinical and economic impact of COVID-19 and projected burden avoided with BNT162b2, a seasonally adapted mRNA vaccine against severe COVID-19 disease. The majority of cost inputs and clinical event probabilities were informed by German real-world evidence from seasons 2022/23 and 2023/24. Vaccine efficacy was derived from US and German studies. Long/Post COVID impact was assessed in scenario analysis. The model estimated up to 20.8 million symptomatic infections per year in adults, including 7.5 million in people aged 60+, and 6.0 million in comorbid adults. This translates to an estimated 198,598 hospitalizations and 24,626 COVID-attributable deaths, with 93.6% of deaths occurring in people aged 60+. The total economic burden including productivity loss was estimated at €1.4 billion in people aged 60+, €2.0 billion in comorbid adults, and €3.9 billion in all working adults. Long/Post COVID increased the economic burden by 1.7 times. Assuming vaccination of 100% of recommended groups, 11.0 million symptomatic infections could be prevented, with the greatest impact in people aged 60+ (estimated 110,362 hospitalizations and 13,685 deaths avoided). For people aged 60+, comorbid adults, and all working adults, the number needed to vaccinate to prevent one symptomatic infection was 7, 4, and 4 people; to prevent one hospitalization, 231, 2,363, and 4,549; and to avoid one death, 1,862, 19,055, and 36,683, respectively. COVID-19 imposes a substantial clinical and economic burden on the German population, which could be mitigated with an expanded COVID-19 vaccination program. Further research into Long/Post COVID is needed. Our study presents considerations highlighting the value of broad vaccination especially for working adults. We aimed to measure the clinical and economic impact of COVID-19 caused by Omicron variant strains of SARS-CoV-2 in Germany and investigate how this impact could be reduced if annual vaccinations were offered to everyone, just as flu vaccinations are. The study used a decision tree model to estimate the number of COVID-19 cases, hospitalizations, and deaths, and their associated costs.We found that, without vaccination, there could be up to 20.8 million symptomatic COVID-19 cases annually, leading to nearly 200,000 hospitalizations and nearly 25,000 deaths, mostly for people aged 60 years and older (60+). The total economic burden was estimated to be €1.4 billion for the 60+ population, €2.0 billion for people with comorbidities, and €3.9 billion for all working adults.If all working adults and people aged 60+ were vaccinated annually, it could prevent 11.0 million symptomatic infections each year, and the major benefits would be for people aged 60+. This could avoid many hospitalizations and deaths, especially in older and high-risk populations.Our study concluded that COVID-19 has a significant impact in Germany, and that this could be reduced with a broader vaccination recommendation. An annual COVID-19 vaccination program including working adults could help reduce the health impacts and economic costs of this disease. Further research is needed to understand the impact of Long/Post COVID.
2. Assessing the Seroprevalence of and Knowledge, Attitudes and Practices Related to Hepatitis B and Hepatitis C Among Dental Health Professionals in the Country of Georgia, 2023.
期刊: Journal of viral hepatitis 发表日期: 2026-Feb 链接: PubMed
摘要
Dental health professionals (DHPs) are at risk for bloodborne viruses. We evaluated hepatitis B and hepatitis C seroprevalence and knowledge, attitudes and practices regarding viral hepatitis in Georgia. We randomly selected 214 dental facilities. DHPs underwent face-to-face interviews and provided blood samples. High knowledge and practice were defined as correctly responding to 70% or more of the questions. Samples were tested for antibodies against hepatitis C virus (anti-HCV) and, if reactive, for HCV RNA; total hepatitis B core antibodies (anti-HBc) and, if reactive, for hepatitis B surface antigen (HBsAg). Specimens reactive for HBsAg were tested for antibody to hepatitis D virus (anti-HDV). Among 519 participants, 6.6% and 7.9% correctly identified all HBV and HCV transmission modes, respectively. Approximately half had high knowledge scores for hepatitis B and hepatitis C. Nurses had lower odds than dentists to have high scores. While 56% agreed that the hepatitis B vaccine is essential for healthcare workers, only 23.9% reported being vaccinated. Overall, 89.4% had high practice scores; 41.6% experienced a blood splash on their face, 43.7% a needle-stick injury and 20.6% an injury with a contaminated instrument. Practice scores were lower among those who had not been screened or vaccinated for hepatitis B. Among 517 blood samples tested, 0.8% were anti-HCV reactive, but none had detectable HCV RNA; 12.2% were anti-HBc reactive and 0.6% were HBsAg reactive. None tested reactive for anti-HDV. Enhanced training and policy reforms are critical to improve hepatitis knowledge, vaccination uptake and infection control practices among DHPs in Georgia.
3. Ryanodine-1-Calstabin Complex Stabilizers in Antidoping Research: Synthesis, Metabolism, and Characterization.
期刊: ChemPlusChem 发表日期: 2026-Jan 链接: PubMed
摘要
Awareness of new potential doping agents and the proactive implementation of detection methods are key aspects of preventive antidoping research. Ryanodine receptor-1-calstabin complex stabilizers (RYR-stabilizers) are a novel class of drug candidates for the treatment of various diseases associated with leaky Ca2+ channels in the cardiac or skeletal muscle. Also, intense physical activity was shown to transiently cause leakage of skeletal muscle Ca2+ channels, and RYR-stabilizers have been shown to restore normal activity and, thus, increase endurance performance. Consequently, such compounds are relevant targets in doping controls, and to date, in particular, compounds S107, JTV-519, ARM 036, and ARM 210 have been subject of antidoping research. In this study, ARM 036 and ARM 210 as well as the commercially available compounds S107 and JTV-519 were synthesized using a multistep approach. Subsequently, all compounds were investigated concerning their in vitro metabolic behavior, and various metabolites were identified. Selected metabolites were then chemically synthesized for comprehensive structure confirmation. The findings of this study will contribute to routine doping control analytical programs and allow for improving existing detection methods.
4. Rural-Urban Differences in the Prevalence and Correlates of Elder Mistreatment.
期刊: Journal of applied gerontology : the official journal of the Southern Gerontological Society 发表日期: 2025-Dec-27 链接: PubMed
摘要
Rural and urban areas differ in terms of age structure, health outcomes, and access to resources, but there is limited research on rural-urban differences in elder mistreatment. This study addresses that gap. We used data from Round 3 of the National Social Life, Health & Aging Project (NSHAP) survey (n = 2,333) to examine rural-urban differences in rates of 11 indicators of elder mistreatment, overall and by individual indicators. We conducted logistic regression models and generated predicted probabilities adjusting for sociodemographic and social well-being characteristics. Elder mistreatment was less common among rural than urban older adults (adjusted predicted probability 41.5% vs. 49.5%, P < 0.01). Rates were also higher for urban older adults for nearly every individual indicator of mistreatment. Rates of elder mistreatment were high (>40%) for both rural and urban older adults, but urban older adults faced a greater risk, requiring attention to urban risk and rural resilience.
5. Bridging gaps in oncofertility: evaluation of reproductive dysfunction and fertility assessment in pediatric cancer survivors.
期刊: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 发表日期: 2025-Dec-27 链接: PubMed
摘要
With improved survival in pediatric cancers, late effects such as reproductive dysfunction and infertility have emerged as a major concern. Oncofertility services remain underdeveloped in India, particularly in public sector institutions. We aimed to evaluate reproductive function and fertility preservation practices in childhood cancer survivors (CCS) attending a tertiary care center in India. This was a cross-sectional study of CCS enrolled at the Pediatric Cancer Survivor Clinic of AIIMS, New Delhi, between January 2022 and December 2024. Survivors ≥ 8 years of age with prior gonadotoxic therapy were included. Hormonal assays, semen analysis, and ovarian reserve evaluations were conducted. Interventions were offered based as indicated. The cohort included 87 males and 45 females, mostly treated for hemato-lymphoid malignancies. Hypogonadism was identified in 76.3% of males based on low testosterone, and azoospermia in 50% of those tested. Among females, 56.8% of those tested had low anti-Müllerian hormone (AMH) levels, and 62.5% of those tested had reduced antral follicle count. Despite high-risk features, fertility preservation uptake was poor. Only five females received hormone replacement therapy. Cultural barriers and financial constraints were major deterrents. There is a high burden of reproductive dysfunction among Indian CCS, with significant gaps in fertility preservation. Early integration of oncofertility services within oncology care is feasible and essential. Structured, multidisciplinary models and non-governmental organization (NGO) support can help bridge current gaps in LMICs.
6. Hospice care for medicaid cancer patients in Puerto Rico: implications on healthcare costs and utilization.
期刊: JNCI cancer spectrum 发表日期: 2025-Dec-27 链接: PubMed
摘要
Hospice services play an important role in end-of-life (EoL) care. In Puerto Rico, Medicaid had no provisions for hospice care until July 2024, representing a significant public health challenge. This study examined the association between hospice coverage policy and EoL outcomes among patients with cancer enrolled in Medicaid. This population-based retrospective cohort study analyzed data of cancer patients enrolled in Medicaid from the Puerto Rico Central Cancer Registry between 2011 and 2022 who died of cancer between 2016 and 2022. Hospice enrollment was categorized into timeframes before death: 1-7, 8-14, 15-30, 31-90, 91-120, and 121-180 days. We compared total costs, healthcare utilization, and death in acute settings by hospice enrollment status. Of 4,481 patients in the study, 21.7% were enrolled in hospice. Non-hospice-enrolled patients had higher healthcare expenditures for the last 7 ($548; 95% CI, $166-$931), 14 ($1,619; 95% CI, $894-$2,344), 30 ($3,410; 95% CI, $2,263-$4,557), 90 ($4,896; 95% CI, $1,987-$7,804), 120 ($6,171; 95%CI, $61-$12,281), and 180 ($19,291; 95% CI, $10,851-$27,731) days than hospice-enrolled patients. Emergency department visit rates and hospitalization rates were higher for all periods (P < .05) for non-hospice-enrolled patients than for hospice-enrolled patients. Similarly, non-hospice-enrolled patients had a higher likelihood of dying in acute settings (P < .05). Hospice enrollment among Medicaid enrollees was associated with lower health expenditure, lower healthcare resource utilization, and a lower likelihood of mortality in an acute setting. The recent policy change to include hospice services coverage in Puerto Rico Medicaid is a positive step that must be sustained beyond 2027.
7. Sclerotherapy as first-line treatment of rectal prolapse in children, including those with anorectal malformations.
期刊: Pediatric surgery international 发表日期: 2025-Dec-27 链接: PubMed
摘要
To evaluate the efficacy of injection sclerotherapy in the management of reducible rectal prolapse (RP) in children. Children with reducible RP who underwent sclerotherapy with Kinurea-H® (quinine dihydrochloride/urea) were retrospectively included, and divided into 2 groups, functional RP (FRP) or organic RP (ORP). Thirty-two patients were included, 18 FRP and 14 ORP (7 anorectal malformation (ARM), 2 anorexia nervosa, 1 Hirschsprung disease, 2 spinal dysraphism, 1 Ehlers-Danlos, 1 short bowel syndrome) with a median age of 4 years. After one injection, the success rate was higher in FRP (78%) than in ORP (21%) (p = 0.0009). After 2-4 injections, success rate was 94% in FRP and 93% in ORP, with a minimal mucosal resection of the fixed portion (less than 5 mm, limited to the ano-cutaneous junction) in 4/7 ARM. Repeated injections were performed at same site in all ORP without ARM, and in only 43% of ORP with ARM. Recurrence of reducible RP after the first injection at one site was associated with ORP (p = 0.03), particularly in ORP without ARM (p = 0.06). Sclerotherapy for reducible RP is efficient after failure of conservative management in FRP and success rate after repeated injections is encouraging in ORP, particularly in ARM.
8. The know-do gap among intrapartum care (IPC) providers in the Dire Dawa Administration, Eastern Ethiopia.
期刊: International journal for quality in health care : journal of the International Society for Quality in Health Care 发表日期: 2025-Dec-27 链接: PubMed
摘要
Intrapartum care (IPC), medical support during labor from onset to two hours post-placenta delivery, is vital for maternal and newborn health. Quality IPC relies on healthcare providers’ knowledge and practices. Deficiencies in either cases cause adverse outcomes. This study examines the knowledge-practice gap (know-do gap) among IPC providers in Dire Dawa Administration (DDA), Eastern Ethiopia. Data from the Fenot project in DDA (December 2020-May 2021) that included nine health facilities, 84 providers, and 865 labor observations was used. A structured questionnaire assessed knowledge, and direct observation evaluated practices. The know-do gap (KDG) was analyzed across six labor and postpartum domains, comparing the observed practices to knowledge reported. Gaps were categorized as know-do match, knowledge-action deficit, or practice surplus. Multinomial logistic regression was performed using STATA 17. The KDG scoring system used binary coding (1 for ‘known/done’, 0 for ‘unknown/not done’) across domains, with scores aggregated as percentages. Assumptions for the multinomial logistic regression were checked via Hausman tests, and model fit was assessed using likelihood ratio tests, confirming good fit (p < 0.001). The overall knowledge of IPC was 69.52%, practice was 59.04% and KDG was 10.48%. Knowledge-action alignment was low: 12.80% (initial labor), 14.30% (first stage), 15.90% (second stage), 14.70% (third stage), 14.90% (neonatal care), and 14.60% (postnatal care). Only 11% of providers showed a complete know-do match, 26.20% had a practice surplus, and 62.80% had a knowledge-action deficit. Multinomial logistic regression revealed a reduced practice surplus with increasing years of service (aRRR = 0.81; 95% CI: 0.73-0.89) and in-service training (aRRR = 0.52; 95% CI: 0.29-0.94). Knowledge-action deficits were associated with to female providers (aRRR = 0.43; 95% CI: 0.23-0.80), additional roles (aRRR = 4.00; 95% CI: 2.38-6.68), provider type (aRRR = 3.79; 95% CI: 1.06-13.56), and rural facilities (aRRR = 2.00; 95% CI: 1.16-3.46). A significant knowledge-practice gap exists in IPC. Factors such as facility location, provider type, gender, experience, and dual roles contribute to this gap. Providers should follow established guidelines and pursue ongoing training to enhance their skills. Health systems must address training, resources, supervision, and mentoring to reduce KDG and enhance IPC quality. Key words: IPC, labor & delivery care, obstetric care, Dire Dawa Administration, Ethiopia.
9. Bioconversion of Groundnut Oil into Polyhydroxyalkanoate (PHA) by Bacillus Subtilis LO1.
期刊: Current microbiology 发表日期: 2025-Dec-27 链接: PubMed
摘要
Polyhydroxyalkanoates (PHAs) are synthesized by microorganisms as cytoplasmic biopolymers in response to nutritional starvation. These biopolymers have diverse applications because of their non-toxic and biodegradable nature and can be an effective alternative to conventional petrochemical polymers as they offer similar qualities. For this purpose, PHA-producing bacterium LO1 was isolated from lubricating oil contaminated soil and identified as Bacillus subtilis (MK071733). Furthermore, LO1 was found to be the most prominent PHA accumulating strain on groundnut oil as carbon source under optimized growth conditions. The optimum growth conditions for PHA synthesis was pH 7, temperature 35 °C, incubation period 72 h, inoculum size 4%, (v/v), groundnut oil 2%, (v/v), and ammonium sulfate 1.5%, (w/v) in mineral salt medium (MSM). Under these optimized conditions, 5.52 g/L of PHA cell dry weight (CDW) was obtained from 9.8 g/L of bacterial dry cell weight (DCW) through two-stage shake flask cultivation. Further, extracted PHA was characterized via Fourier transform infrared spectroscopy (FT-IR) and Gas chromatography-mass spectrometry (GC-MS). These techniques confirmed the presence of mcl-PHA copolymers in the extracted polymer.
10. Diagnosis era-stratified analysis is important in the estimation of the risk of second primary cancer following renal cell carcinoma: reply to letter to the editor.
期刊: International urology and nephrology 发表日期: 2025-Dec-27 链接: PubMed
摘要
11. DNMT3A-mediated Methylation of IRF4 Alleviates Inflammatory Response in Allergic Rhinitis Mice.
期刊: Applied biochemistry and biotechnology 发表日期: 2025-Dec-27 链接: PubMed
摘要
This study explores the mechanism of DNMT3A in inflammatory response in allergic rhinitis (AR) mice. A mouse model of AR was established by ovalbumin induction, followed by injection of DNMT3A overexpression vector. The times of nose rubbing and sneezing within 15 min were recorded. The nasal mucosa tissues were observed by H&E staining. The serum histamine, IgE, IL-1β, IL-10, IFN-γ, and TNF-α were detected by ELISA. The proportion of Th17/Treg cells in lymphocytes was detected by flow cytometry. DNMT3A, IRF4, and CD44 expressions were tested by qRT-PCR or Western blot. ChIP evaluated the DNMT3A enrichment on IRF4 promoter and IRF4 enrichment on CD44 promoter. Methylation-specific PCR determined the methylation level of IRF4 promoter. The binding of IRF4 to CD44 was verified by dual-luciferase assay. DNMT3A was poorly expressed in AR mice. DNMT3A overexpression reduced the times of nose rubbing and sneezing in AR mice, alleviated nasal mucosal tissue injury, reduced the proportion of Th17/Treg cells, and diminished serum inflammatory factors. DNMT3A was enriched on IRF4 promoter and repressed IRF4 expression by enhancing IRF4 methylation level. IRF4 bound to CD44 promoter to elevate CD44 expression. In conclusion, DNMT3A-mediated methylation of IRF4 reduces AR inflammatory response by elevating CD44 expression.
12. Supporting informed decisions about breast cancer screening in communities with known environmental contamination: a pre-post study.
期刊: Cancer causes & control : CCC 发表日期: 2025-Dec-27 链接: PubMed
摘要
This study tested the impact of a breast cancer screening decision aid (DA) that was adapted to include environmental risk information. This was a pre-post study in communities with known per- and poly-fluoroalkyl substances (PFAS) contamination. Participants were 100 women ages 39-49, with no history of breast cancer and no mammogram in the past year. Participants completed a baseline survey, used the DA, then completed a final survey. Baseline surveys measured demographics, PFAS exposure, and PFAS-related risk perceptions. Paired pre-post survey measures included breast cancer risk perceptions, screening knowledge, decisional conflict, and screening intentions. Mean age of participants was 43 years; most non-Hispanic white (97%); 43% resided in micropolitan, small town, or rural areas. Potential PFAS exposure included private well use for 35%; 19% had tested their water for PFAS contamination; 54% used a home water filter. While most (62%) did not experience PFAS-related stress, 27% felt stress about family well-being, and 25% often/constantly worried about the health effects of PFAS in the prior month. Pre-DA, 29% felt likely that they would develop breast cancer in the next 10 years, versus 19% post-DA. Median knowledge scores increased from 8 to 10 out of 10 before and after DA use. Intentions to get a mammogram in the next year slightly decreased from 85 to 78%. Use of a DA incorporating information about environmental risk information reduced perceptions of breast cancer risk and improved knowledge and decisional conflict about breast cancer screening among women living in PFAS-contaminated communities. NCT06098118.
13. Beyond screening: neighborhood-level factors associated with colorectal cancer stage at diagnosis.
期刊: Cancer causes & control : CCC 发表日期: 2025-Dec-27 链接: PubMed
摘要
While increasing colorectal cancer (CRC) screening uptake is a major public health goal, it remains unclear whether screening rates consistently translate to high earlier-stage diagnosis at the community level. This study examined the relationship between screening and early stage CRC diagnosis, identifying barriers that may disrupt this pathway. We used census-tract-level data on CRC patients diagnosed between 2010 and 2019 in the Ohio Cancer Incidence Surveillance System, linked to community-level screening estimates from CDC PLACES (2018). Census tracts were grouped into sociodemographically similar communities using the Max-p regionalization method. We applied geographic weighted regression (GWR) to assess spatial variation in the screening-early diagnosis relationship and used the Variable Selection Using Random Forest (VSURF) algorithm to identify key predictors of early stage diagnosis. Linear regression models evaluated associations between predictors, screening, and early stage diagnosis. 2,952 census tracts were aggregated into 869 communities for analysis. Higher screening rates were not consistently associated with early stage diagnosis, as revealed by GWR, which showed significant regional variation. VSURF identified structural factors, rather than screening uptake, as top predictors of early stage diagnosis. In multivariable models, uninsurance (β - 0.29) and public transportation dependence (β - 0.31) were associated with lower early stage diagnosis, while the screening rate was not independently associated. Structural barriers may disrupt the screening-to-diagnosis pathway at the community level. Our findings underscore the importance of investing in follow-up infrastructure, including navigation and transportation, to ensure that screening achieves its goal of early detection.
14. Obesity in Cardiorenal syndrome: Management Opportunities and Challenges.
期刊: Current hypertension reports 发表日期: 2025-Dec-27 链接: PubMed
摘要
The prevalence of obesity continues to increase globally. There is accumulating evidence of the complex interplay between obesity, cardiovascular disease, particularly heart failure with preserved ejection fraction, and chronic kidney disease (CKD). Here, we review the diagnostic and management considerations for these co-existent conditions and the current evidence regarding the impact of obesity treatments on long term health outcomes. Recent evidence suggests the pathophysiology of obesity, heart failure with preserved ejection fraction and CKD are inextricably linked as adipocytes appear to play a role in promoting renal sodium avidity and volume overload, which are the hallmarks of the cardiorenal syndrome. The clinical landscape of obesity management has changed significantly with the approval of glucagon-like peptide-1 receptor agonists, which have been shown to have cardiovascular and kidney benefit among patients with obesity and a range of comorbid conditions including diabetes, CKD, and heart failure. Improved recognition, diagnosis and management of clinically consequential obesity is emerging as a key factor in improving outcomes for patients with comorbid conditions such as heart failure with preserved ejection fraction and CKD. The incorporation of comprehensive multi-disciplinary management, shared decision making with patients and broader access to therapies is critical to improving clinical outcomes.
15. The impact of tumor-associated inflammatory adhesions on survival and treatment strategies in patients with colon cancer.
期刊: Discover oncology 发表日期: 2025-Dec-27 链接: PubMed
摘要
In colon cancer patients with tumor-associated inflammatory adhesions (TAIA), the preoperative clinical staging is cT4b, but postoperative pathology reveals that the tumor has not invaded surrounding organs (non-pT4b). We aimed to investigate the impact of TAIA on prognosis and treatment strategies for colon cancer patients. Colon cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database (2010 to 2019) and Chinese multicenter cohort were included to compare survival differences between the TAIA and non-TAIA groups. A Cox proportional hazards model was used to evaluate independent risk factors for survival in colon cancer patients. Additionally, we analyzed the impact of adjuvant chemotherapy on survival in TAIA patients. A total of 112,659 colon cancer patients from the SEER database and 881 colon cancer patients from the Chinese database were included in this study. After PSM, both cohorts found that patients in the TAIA group exhibited worse overall survival (P < 0.05) and cancer-specific survival (P < 0.05). Additionally, the Cox multivariate proportional hazards model identified TAIA as an independent risk factor for cancer-specific survival in colon cancer patients (SEER: HR 1.45, 95% CI: 1.40-1.50, P < 0.001; China: HR 2.108, 95% CI: 1.473-3.015, P < 0.001). Subsequently, 36,496 TAIA patients from the SEER database and 229 TAIA patients from a Chinese multicenter database were independently divided into adjuvant chemotherapy and control groups. After PSM, both databases indicated better survival in the adjuvant chemotherapy group. Colon cancer patients with TAIA have a poorer prognosis. Adjuvant chemotherapy can improve the prognosis of TAIA patients.
16. Description of Full-Term Infants Hospitalized for Poor Weight Gain in the First Month of Life.
期刊: Maternal and child health journal 发表日期: 2025-Dec-27 链接: PubMed
摘要
Poor weight gain in infants under one month old is a common reason for hospitalization. We aimed to study the etiologies of poor weight gain in hospitalized full-term infants under one month old, as well as the type of population epidemiology and diagnostic tests performed. The design was a retrospective study, with data obtained from four French hospitals, evaluating full-term infants less than one month who were hospitalized for poor weight gain. Of the 313 children hospitalized for poor weight gain included in our study, the main etiologies were intake deficiency (72.8%), jaundice (12.1%) and infections (8.3%). Our study population comprised 55.9% male, the mean age at the time of hospitalization was 11.4 days (+/- 5), and 64.5% were exclusively breastfed. We found no predisposing factors for intake deficiency. In full-term infants hospitalized for poor weight gain in their first month of life, intake deficiency appears to be the most frequent diagnosis, without other identifiable distinctive factors in our study. Identifying risk factors for intake deficiency and suggesting increased surveillance of at-risk infants could help limit its occurrence, reduce the need for invasive tests carried out and decrease the resulting number of hospitalizations.
17. Secondary peritoneal and retroperitoneal malignancies in the elderly: trends and disparities (1999-2022) with forecasts to 2035 from a national study.
期刊: Cancer causes & control : CCC 发表日期: 2025-Dec-27 链接: PubMed
摘要
Secondary malignant neoplasms of the retroperitoneum and peritoneum (SMNRP) indicate advanced disease and poor prognosis, yet their population-level mortality patterns remain underexplored. This study analyzed national trends and disparities in SMNRP-related mortality among US adults, forecasted future trends, and examined age-adjusted incidence and mortality rates (AAIRs and AAMRs) for the 10 primary cancers most frequently associated with SMNRP. This cross-sectional study used data from CDC WONDER (1999-2022) and US Cancer Statistics. We assessed temporal trends in SMNRP-related (ICD-10: C78.6) mortality in US adults aged ≥ 65, stratified by demographics, primary site of malignancy, and geography. AAMRs, AAIRs, and crude mortality rates (CMRs) were calculated per 100,000 population. Trends were analyzed using the Joinpoint Regression Program to estimate annual and average annual percent changes (APC and AAPC). Future trends were projected through 2035 using ETS and ARIMA models. SMNRP-related AAMRs increased significantly from 1999 to 2022, rising from 3.3 to 12.4 per 100,000 (AAPC = 5.86%, 95% CI 5.56-6.29). Of the 61,583 deaths, 66.1% were females, with higher AAPCs (6.14%, 95% CI 5.93-6.35) than males (5.37%, 95% CI 4.75-6.15). Stratification by primary cancer site showed ovarian (12.9%) and colon (11.6%) cancers as the leading causes of death. AAIRs and cancer-specific AAMRs (irrespective of SMNRP) declined for most cancers. All racial groups showed ≥ threefold increases in AAMR, with Non-Hispanic Whites having the highest AAPC (6.00%, 95% CI 5.60-6.42). The 85 + age group had the highest CMRs. Regionally, the West showed the steepest increase. Urban areas consistently had higher AAMRs. Forecasting models projected AAMRs to reach ~ 24.5 per 100,000 by 2035. SMNRP-related mortality has increased substantially among older US adults. As primary cancer outcomes improve, longer survival increases the risk of metastatic recurrence and progression. Enhanced detection, surveillance, and management are needed.
18. Unraveling breast cancer risk with a focus on menopausal status: a large case-control study.
期刊: Cancer causes & control : CCC 发表日期: 2025-Dec-27 链接: PubMed
摘要
Breast cancer (BC) remains a major global health issue, influenced by modifiable factors like lifestyle and diet, and non-modifiable factors such as genetics. This study assesses their impact on BC among pre- and post-menopausal women in South India using a large, age-matched, population-based case-control design. We analyzed epidemiological risk factors for BC overall and stratified by menopausal status. A total of 3,043 newly diagnosed BC cases from the Regional Cancer Centre, Thiruvananthapuram, and age-matched controls from the general population of Kerala, recruited through face-to-face interviews (2017-2023). Odds-ratios (OR) and 95% Confidence-Interval (CI) were estimated using conditional-logistic regression model. Independent modifiable risk-factors for BC (OR;CI) among all women were frequent fried-food consumption (3.9;3.2-4.7), low vigorous-activity (2.7;2.2-3.4), low moderate-activity (2.4;1.8-3.3), more light-activity (2.2;1.8-2.6), high body-mass-index (1.5;1.1-1.8) and non-modifiable risk-factors were benign-breast-disease (4.9;3.4-7.2), prior-chest radiation (3.4;1.9-5.8), prior-pesticide exposure (2.5;1.4-4.2), family-history of BC (2.0;1.5-2.6) and family-history of other cancers (1.4;1.1-1.6), post-menopause women (1.4;1.02-1.9) and early menarche (1.3;1.03-1.7). In the stratified analyses, the independent factors among pre-menopausal women were fried-food consumption, physical inactivity, high body-mass-index, benign-breast-disease, prior-pesticide exposure, prior-chest radiation, and late first delivery were significant. Among post-menopausal women, the significant factors included fried food consumption, physical inactivity, higher waist-to-hip ratio, history of abortion, thyroid disease, benign-breast-disease, family-history of BC, family-history of other cancers, prior-pesticide exposure and prior-chest radiation. Non-modifiable factors consistently influenced BC risk across groups, modifiable-factors were more critical among post-menopausal women. Targeted prevention strategies that promote physical activity, and weight management could significantly reduce the risk of breast cancer.
19. Assessment of Protective Role of Different Probiotic Strains against Bacterial and Endotoxin-Induced Sepsis in a Mouse Model.
期刊: Probiotics and antimicrobial proteins 发表日期: 2025-Dec-27 链接: PubMed
摘要
Sepsis caused by Gram-negative bacteria such as Escherichia coli and Salmonella enterica is a major contributor to global morbidity and mortality. This study investigated the protective effects of four human milk-derived probiotic strains, Staphylococcus hominis, Staphylococcus epidermidis, Streptococcus salivarius, and Streptococcus lactarius, in murine models of pathogen- and lipopolysaccharide (LPS)-induced sepsis. Mice received probiotic pre-treatment before challenge with LPS, E. coli, or Salmonella enterica typhimurium. Clinical signs, survival, body weight, gross and histopathological lesions, serum biochemical markers, fecal bacterial load, and intestinal cytokine gene expression (TNF-α, IL-6) were recorded. Pathogen- and LPS-challenged groups showed high mortality, significant weight loss, marked intestinal pathology, elevated serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea, and creatinine, increased fecal pathogen counts, and upregulated TNF-α and IL-6 expression. Probiotic pre-treatment improved survival, preserved body weight, reduced lesion severity, normalized biochemical parameters, lowered fecal pathogen load, and downregulated pro-inflammatory cytokines. Among the tested strains, Strep. lactarius provided the most consistent protection in E. coli and LPS models, whereas Strep. Salivarius was most effective against Salmonella-induced sepsis. The results indicate that specific human milk-derived probiotics can reduce systemic inflammation and organ injury in Gram-negative bacterial sepsis.
20. Quantifying the Population-Level Impact of Insomnia on Dementia Among Older Adults in the United States.
期刊: The journals of gerontology. Series A, Biological sciences and medical sciences 发表日期: 2025-Dec-27 链接: PubMed
摘要
Insomnia has been identified as a plausible modifiable risk factor for dementia. Quantifying its population-level impact may inform strategies to reduce dementia risk among older adults in the United States. We used data from the 2022 National Health and Aging Trends Study (NHATS) to classify insomnia as sleep-onset insomnia, sleep-maintenance insomnia, or both, and to identify probable dementia using established algorithms. We obtained relative risks from a published meta-analysis. Using these relative risks and NHATS prevalence estimates, we estimated the population attributable fraction (PAF) of dementia cases attributable to insomnia overall and stratified by age and sex. Among 5,899 participants (44.7% aged ≥ 80 years; 57.9% females; 77.9% non-Hispanic White), 28.7% (95% CI: 26.9%, 30.5%) reported insomnia symptoms and 6.6% (95% CI: 5.9%, 7.3%) had probable dementia. The estimated PAF of probable dementia due to any insomnia was 12.5% (95% CI: 1.0%, 25.0%), and it was slightly higher among females (13.1%, 95% CI: 1.0%, 26.1%) than males (11.6%, 95% CI: 0.9%, 23.3%). The highest PAF was observed in the 65-69 age group (14.4%, 95% CI: 1.1%, 27.8%) among females and in the 70-74 age group (12.8%, 95% CI: 0.9%, 25.8%) among males. An estimated 449,069 (95% CI: 35,049, 923,082) dementia cases in 2022 could have been prevented if insomnia were eliminated. Approximately 13% of dementia cases, almost half a million cases, among U.S. older adults may be attributable to insomnia. Addressing insomnia could be a promising target for dementia prevention efforts in aging populations.
21. Comprehensive Medication Reviews in Medicare Were Not Associated With Reduced Central Nervous System-Active Polypharmacy in 2021.
期刊: Journal of the American Geriatrics Society 发表日期: 2025-Dec-27 链接: PubMed
摘要
Central nervous system (CNS)-active polypharmacy is associated with increased risks such as impaired cognition and falls. In 2021, CNS-active polypharmacy was added as a Medicare Part D display measure to monitor for this risk. Enrollees in the Medicare Part D Medication Therapy Management program are at increased risk of CNS-active polypharmacy and are offered comprehensive medication reviews (CMRs) to optimize their medication management and reduce medication-related safety risks. Evaluate the association of CMRs with CNS-active medication discontinuation among Medication Therapy Management enrollees in 2021. Observational study applying inverse probability of treatment weights to compare the time until discontinuation of at least one medication contributing to CNS-active polypharmacy in CMR recipients versus non-recipients in 2021 using 5% Medicare fee-for-service claims and enrollment data. Of 2702 community-dwelling, Medication Therapy Management program enrollees ≥ 66 years of age with CNS-active polypharmacy, 969 (35.9%) were CMR recipients. Both CMR recipients and non-recipients were taking a median of four CNS-active medications. As compared to non-recipients pre-weighting, CMR recipients were more likely to use certain CNS-active medications, such as antidepressants, antiseizure medications, benzodiazepines, and nonbenzodiazepine sedative hypnotics and opioids. Compared to non-recipients pre-weighting, CMR recipients were also more likely to have more prescribers contributing to the CNS-active polypharmacy and to have a mix of prescriber types involved. Comparable numbers of CMR and non-CMR patients discontinued at least one CNS-active medication within 1 year (11.5% vs. 13.2%). In the weighted analyses, there was no difference in likelihood of discontinuation of at least one CNS-active medication between CMR recipients and non-recipients (hazard ratio = 1.03, 95% confidence interval = 0.94-1.12). CMRs were not associated with reduced CNS-active polypharmacy in older adults in the first year that it served as a Part D Display measure. Future research is needed to better understand why and whether this continues.
22. The clinical utility of imaging in osteoarthritis and its importance in future prediction of total hip replacement; a nested case-control study within the AGES-Reykjavik cohort.
期刊: Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research 发表日期: 2025-Dec-27 链接: PubMed
摘要
Current guidelines are split on the role that imaging has in the clinical assessment of osteoarthritis, yet clinical computed tomography (CT) imaging has now revealed how a 3D approach can improve prediction of total hip replacement (THR) over 2D measures alone. We applied 2D grading and measurement along with 3D cortical bone mapping to ordinary clinical CT imaging of the pelvis in a cohort of healthy older people, aiming to discover which of these features had clinical utility in predicting total hip replacement (THR) within 8 years and which were related to baseline hip pain. Using a nested case-control design in the AGES-Reykjavik study, 74 future THR cases were age and sex-matched with 184 controls from the cohort (age 74±5yrs). Baseline assessment involved a validated hip pain questionnaire and pelvic CT. The following were performance-tested using ROC analysis and Clinical Utility Index: (i) hip pain; (ii) Kellgren and Lawrence grade (K&L grade), (iii) minimum joint space width (mJSW); and (iv) 3D cortical bone thickness (CTh). The clinical utility index for prediction of future THR from baseline pain was poor at 0.28, with the inclusion of imaging improving this to 0.79 (K&L grade) and 0.82 (3D CTh). Self-reported hip pain at baseline was also a poor-to-marginal predictor of THR (AUC=0.63), but 3D cortical thickening at the femoral head was predictive of future THR (0.81). Having radiographic osteoarthritis strongly predicted THR irrespective of hip pain (0.85). Combining hip pain, K&L grade and 3D cortical thickness gave optimal prediction (0.88). Ascertainment bias may have occurred if primary care physicians requested their own radiographs of their patients’ hips. Imaging features from standard clinical CT identifies patients at high risk of progression to surgery for osteoarthritis, regardless of baseline pain. Hip osteoarthritis is a common and debilitating degenerative joint disease that often results in chronic pain and disability affecting individual’s quality of life and potentially leading to other conditions such as obesity, diabetes and cardiovascular disease. Early diagnosis and staging of arthritis offers the opportunity to tailor treatment plans to an individual patient’s circumstances, particularly helping the general practitioner decide who to refer for hospital surgeons to consider definitive replacement of the arthritic hip joint. Our study shows that timely hip x-ray measurements, whether they are standard front-to-back x-rays or more complex 3D scans of older, healthy people with hip pain would greatly increase the general practitioners’ ability to predict those patients who will require future hip replacement for severe osteoarthritis. Conversely, the same simple image results would allow the general practitioner to reassure most patients with hip pain that they will not require surgery for severe osteoarthritis in the coming years. We suspect that in Iceland, where this work was done, doctors and nurses already follow these simple principles so we now suggest looking at outomes in a country such as the UK where general practitioners are strongly advised by national guidelines not to ask for x-rays in their patients.
23. Obstetric Ultrasound Utilization and Expenditures in a Commercially Insured Population (2016-2022).
期刊: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine 发表日期: 2025-Dec-27 链接: PubMed
摘要
To analyze obstetric ultrasound utilization and expenditures per live birth delivery among the commercially insured from 2016 to 2022 and present updated trends and variation in use by type of ultrasound and across subgroups. In this retrospective United States-based cohort study, obstetric ultrasound utilization and expenditures during pregnancy were measured for a cohort of all deliveries with at least 28-week gestation that resulted in a live birth between January 1, 2017 and December 31, 2022, using the Health Care Cost Institute commercial claims database. We report utilization trends and the clinical and sociodemographic factors correlated with utilization using descriptive statistics and negative binomial regression. In our sample of 1,731,823 pregnancies, there were an average of 5.3 (SD ± 3.9) claims for obstetric ultrasounds per live birth delivery. After adjusting for covariates, the number of ultrasounds per live birth increased by 8.3% and inflation-adjusted spending for these ultrasounds increased 5.6% over the 7-year study period (p < .001); though utilization decreased during the COVID-19 pandemic in 2020. Follow-up ultrasound (CPT 76816) was the fastest growing procedure. Obstetric ultrasound utilization and expenditures increased from 2016 to 2022. Information on the variation in patterns and trends related to obstetric ultrasound use may assist policy makers in their assessment of resource utilization and approach to reimbursement design, such as obstetric bundled payments.
24. Using Bottleneck Analysis to Improve Neonatal Emergency Referral and Transport in Surabaya City, Indonesia.
期刊: Asia-Pacific journal of public health 发表日期: 2025-Dec-27 链接: PubMed
摘要
In Indonesia, weaknesses in the neonatal emergency referral and transport system have been identified as important factors in preventable neonatal deaths. To address this, a bottleneck analysis study was conducted in Surabaya using the modified Tanahashi model to identify bottlenecks in four key domains: supply, demand, quality, and the enabling environment. A mixed-method approach was employed. Qualitative data from interviews and focus groups identified gaps and underlying causes. Tracer indicators were used for targeted quantitative data collection through Health Facility Assessments and secondary data review to measure the gap extent. Primary health care facilities lacked trained staff, and bed shortages delayed transfers. Nonstandardized processes hindered transfer efficiency and affected neonatal care at specialized hospitals. Systemic weaknesses were found in data collection, monitoring, interagency coordination, and policy implementation. The bottleneck analysis framework effectively identified critical gaps and guided strategic prioritization for system improvement. Findings highlight the need for reviewing facility standards, modifying staff training, streamlining referral processes, establishing clear oversight roles for referral and prioritizing systematic monitoring and evaluation. The selected tracer indicators offer a framework for assessing neonatal emergency referral systems in other resource-limited settings, supporting efforts to improve neonatal survival through more effective referral and transport mechanisms.
25. Establishment and validation of a clinical threshold criteria for choosing PET imaging tracers for indolent non-Hodgkin's lymphoma.
期刊: EJNMMI research 发表日期: 2025-Dec-27 链接: PubMed
摘要
[18F]FDG PET-CT scan has a lower sensitivity in imaging of indolent non-Hodgkin’s Lymphoma (NHL.) We aimed at identifying a threshold of clinical/pathological indicators which would independently predict [18F]FDG PET-CT scan positivity. For this purpose, we used a retrospective real-world cohort of NHL patients and then validated this criterion on [18F]FDG and [68Ga]Pentixafor scans in a prospective indolent NHL cohort. In the retrospective real-world cohort of NHL, Ki67 was identified as an independent factor that influenced [18F]FDG uptake (r = 0.701). The cutoff value for Ki67 was 36.5% with a maximum area under the curve (AUC) of 0.811 and a Youden index of 0.494 for predicting [18F]FDG imaging positivity. The sensitivity of [18F]FDG PET in retrospective NHL cohort was only 65.2% (101/155) which further decreased to 46.3% in patients with Ki 67 ≤ 35%. In the prospective comparison of patients with Ki67 ≤ 35%, [68Ga]Pentixafor had a higher sensitivity (80.6% (29/36)) than that of [18F]FDG PET-CT scan (30.6% (11/36)). However, in patients with Ki67 > 35%, both the imaging modalities had similar sensitivities of 60% (3/5). A Ki67 of 35% was shown to be a promising threshold criterion for choosing between [18F]FDG or [68Ga]Pentixafor PET tracer in patients with indolent NHL. A Study Evaluating the Value of 68Ga-Pentixafor PET Imaging in the Staging of Hematological Tumor, and Comparing it With 18 F-FDG PET/CT Imaging, NCT06834412. Registered 13 February 2025 - Retrospectively registered, https://register. gov/prs/beta/studies/S000FBBP00000062.
26. Physical activity interventions for Asian Americans in cancer prevention and control: a scoping review.
期刊: Cancer causes & control : CCC 发表日期: 2025-Dec-27 链接: PubMed
摘要
Despite the well-documented benefits of physical activity (PA) for cancer prevention and control, most PA interventions have not been tailored for Asian Americans (AsA), who face rising cancer incidence and a slower decrease in cancer mortality compared to other racial groups. This study aims to systematically review the PA interventions designed for AsA to prevent or manage cancer outcomes. A systematic search of five databases identified interventional studies with PA-promoting components in Asian American adults for cancer prevention or control, published before June 27, 2025, following the Cochrane Collaboration’s PRISMA guidelines. The systematic review identified 860 articles, with five studies meeting inclusion criteria, including four focused on cancer prevention and one on cancer control. Study populations included Filipinos (n = 2), Chinese (n = 1), Koreans (n = 1), and a mixed Asian and Hispanic group (n = 1). Studies were conducted in California (n = 2), Texas (n = 2), and New York (n = 1), with sample sizes ranging from 45 to 1,054 participants and program durations of 8 weeks to 18 months. Only one study exclusively targeted PA promotion; others included components like cancer screening and dietary interventions. All studies incorporated cultural adaptations, primarily language, while some featured culturally specific exercises and social apps. PA was self-reported in all studies, showing improvements post-intervention but limiting accuracy. These findings highlight the potential of PA interventions for AsA in cancer prevention and control, though their urban focus raises concerns about rural accessibility. Future efforts should prioritize rural outreach, enhance cultural adaptations, and assess long-term effectiveness and sustainability.
27. Light, but not moderate or vigorous, physical activity is consistently associated with higher levels of positive psychology resources and outcomes in women with fibromyalgia: a cross-sectional study from the al-Ándalus project.
期刊: Rheumatology international 发表日期: 2025-Dec-27 链接: PubMed
摘要
28. Response to "Letter to the Editor: Pre-Treatment Liver Stiffness is a Stronger Predictor of Hepatocellular Carcinoma Development Than Post-Treatment Liver Stiffness After Hepatitis C Virus Eradication".
期刊: Hepatology research : the official journal of the Japan Society of Hepatology 发表日期: 2025-Dec-27 链接: PubMed
摘要
29. Development and Psychometric Validation of the Comprehensive Core Competence Instrument for Healthcare Professionals.
期刊: Journal of advanced nursing 发表日期: 2025-Dec-27 链接: PubMed
摘要
To psychometrically validate a comprehensive core competence (3C) instrument to measure the core competence of healthcare professionals in clinical settings. Instrument development and validation study. This study focused on the fourth phase of instrument development and validation, which involves refining the scale and assessing its psychometric properties. Secondary data from self-reported assessments of core competency levels by healthcare professionals (628 nurses and 450 physicians) working at healthcare institutions in Oman were used. Structural validity was examined via exploratory factor analysis using oblique rotation (Promax). The stability of factorial validity was assessed through transformation analysis and invariance testing using confirmatory factor analyses. Internal consistency was evaluated using Cronbach’s alpha. The development and validation process produced a 3C instrument including 39 items across 11 factors: research and innovation (4 items), patient sustainable care (5 items), strategic leadership (4 items), safety promotion (3 items), tech integration (3 items), quality excellence (4 items), collaborative care delivery (4 items), professional growth (3 items), communication excellence (3 items), ethics and compliance (3 items) and professional practice (3 items). The instrument explained 65.3% and 67.6% of the total observed variance for nurses and physicians, respectively, with Cronbach’s alpha for each component above the minimum acceptable value of 0.70. The 3C instrument, developed through structured validation, comprehensively assesses healthcare professionals’ core competencies, bridging the gap in existing tools with robust psychometric properties. Healthcare professionals must develop robust and versatile core competencies to address increasing quality and safety patient care demands, escalating costs, unsustainable delivery models and rising stakeholder expectations. The developed 3C instrument is valuable for (1) comprehensively assessing core competencies, (2) suggesting an immediate and short-term action plan and (3) stimulating policies to drive the transformation of the delivery system over the longer term. No patient or public contribution.
30. Immune involvement in neuropsychiatric disorders: Insights from single-cell transcriptomic studies.
期刊: Psychiatry and clinical neurosciences 发表日期: 2025-Dec-27 链接: PubMed
摘要
Neuropsychiatric disorders pose profound challenges to both research and treatment, largely due to their clinical heterogeneity and the limited understanding of their underlying biological mechanisms. While bulk RNA sequencing (bulk RNA-seq) has been widely used to study gene expression, it cannot resolve cell-type-specific signals or detect rare cellular subpopulations. In contrast, single-cell RNA sequencing (scRNA-seq) and single-nucleus RNA sequencing (snRNA-seq) have emerged as transformative technologies, enabling transcriptomic profiling at single-cell resolution. These approaches have revealed immunological alterations across a wide range of disorders. This review introduces recent findings from sc/snRNA-seq studies of immune-related mechanisms in psychiatric disorders-including schizophrenia, bipolar disorder, major depressive disorder, autism spectrum disorder, and attention-deficit/hyperactivity disorder-as well as in neurological conditions such as Alzheimer’s disease, Parkinson’s disease, dementia with Lewy bodies, multiple sclerosis, and anti-NMDA receptor encephalitis. While sc/snRNA-seq overcome averaging effects of bulk RNA-seq by resolving cell types, these methods still face challenges. We outline a roadmap that integrates bulk RNA-seq and sc/snRNA-seq to mitigate the remaining gaps.
31. Promotion of Perinatal Occupational Balance Among Working First-time Mothers: A Quasi-Experimental Study.
期刊: OTJR : occupation, participation and health 发表日期: 2025-Dec-27 链接: PubMed
摘要
Occupational disruption (OD) is common during the perinatal period. Occupational therapy (OT) intervention may improve knowledge of perinatal occupational balance (OB) strategies. The aim of this exploratory study was to evaluate the effectiveness of an OT intervention in increasing knowledge of perinatal OB strategies among working first-time mothers (WFTMs). A total of 30 perinatal WFTMs attended a virtual OT educational workshop that addressed the OB constructs of stress management, energy conservation, sleep hygiene, and routine management. Pre- and post-intervention surveys measured OD and self-reported knowledge of OB strategies. Data were analyzed using descriptive statistics and paired samples t-tests. Participants reported moderate OD across all OB constructs. Statistically significant improvements were noted in knowledge of OB strategies to improve energy conservation (p = .003) and overall OB (p = .001). OT intervention can improve knowledge of OB strategies in perinatal WFTMs. Including OB education in routine perinatal care shows promise. Enhancing Life Balance for Perinatal First-Time Working Mothers With Occupational TherapyMany first-time mothers experience challenges in managing daily activities during pregnancy and after giving birth, which can affect their well-being and routines. This study explored whether a virtual occupational therapy (OT) workshop could help working first-time mothers learn strategies to better manage stress, save energy, get quality sleep, and organize their daily routines. Thirty mothers participated in the workshop and completed surveys before and after the program. Results showed that participants’ knowledge of strategies to conserve energy and improve overall daily balance increased significantly after the workshop. These findings suggest that OT education can help new mothers feel more capable of managing daily life during the perinatal period. Incorporating this type of education into standard care for first-time mothers may support their overall health and well-being.
32. Queer-decolonial pathways to planetary health promotion through Two-Spirit resistance and resurgence in the Deshkan Ziibi: a critical multi-methods analysis.
期刊: Global health promotion 发表日期: 2025-Dec-27 链接: PubMed
摘要
The prevailing climate emergency continues to exacerbate health, economic and power inequities across the Global South and Global North. In particular, Two-Spirit people navigating their intersecting marginal identities confront health inequities stemming from colonially-induced climate disruptions, resource extractivism and land theft; yet, their perspectives are seldom considered in climate policy and practice. This is the case in the Deshkan Ziibi (the Thames River ecosystem in southwestern Ontario, Canada), where there is minimal climate-related literature that prioritizes Two-Spirit and Indigiqueer perspectives in the region. To assess the impacts of the climate crisis on Two-Spirit health in the Deshkan Ziibi and highlight how Two-Spirit kincentric worldviews foster planetary health. A critical multi-method approach was employed. A scoping review synthesized existing literature on Two-Spirit health and climate change, while traditional stories were analyzed through queer-decolonial frameworks to uncover alternative epistemologies and practices of multispecies relationality. Findings reveal that Two-Spirit people in the Deshkan Ziibi experience heightened vulnerability to the climate crisis due to intersecting systems of oppression. However, the research also identifies sites of agency that expose the colonial legacies embedded in dominant climate justice paradigms. This work calls for a re-evaluation of planetary health promotion, governance and interventions by incorporating Two-Spirit worldviews of interconnectedness.
33. A photovoice examination of community strengths and challenges in mental health and wellbeing of young women in three urban communities in Kampala, Uganda.
期刊: Global health promotion 发表日期: 2025-Dec-27 链接: PubMed
摘要
Uganda has a rapidly urbanizing population and the world’s second youngest population. Further, gender inequities contribute to young women in urban Uganda experiencing multiple unmet health and wellbeing needs. However, their perspectives are rarely included in health research or decision making and their lives rarely examined to capture community strengths. We conducted a qualitative study using Photovoice with 15 women aged 18-24 years across three urban sites within Kampala, Uganda. To capture perceptions of strengths, we prompted participants to take photos reflecting ‘TOPOWA’, meaning ‘don’t give up’ in Luganda. Researchers conducted inductive thematic analysis of photos and discussion transcripts and participants contributed to theme validation. Multiple themes emerged from the narrative and visual data across all three sites. This article focuses on the theme of wellbeing and mental health, which encompasses community strengths, protective factors and resilience. Findings provide evidence for health promotion for young women in urban Kampala and similar sub-Saharan African settings through unique, contextual visual and narrative evidence. Notably, existing community strengths are highlighted as potential areas to build upon for health promotion interventions for wellbeing and mental health. Furthermore, findings shaped an ongoing cohort study of mental health trajectories for young women in Uganda.
34. Frequency and Associated Factors of Clotted and Hemolyzed Samples in South Gonder Hospitals, Ethiopia: A Multicenter Cross-Sectional Study, 2023.
期刊: Journal of clinical laboratory analysis 发表日期: 2025-Dec-27 链接: PubMed
摘要
Accurate hematological analysis relies heavily on the integrity of blood samples, which can be compromised by pre-analytical errors such as hemolysis and clotting. This study aimed to determine the frequency and associated factors of clotted and hemolyzed samples in selected hospitals in South Gonder, Ethiopia. This institutionally based cross-sectional study was conducted from September to December 2023 in northwestern Ethiopia at the medical hematology laboratories of selected South Gonder Zone hospitals. Debre Tabor’s specialized referral hospital was selected. Addis Zemen and Nefas Mewcha primary hospitals were chosen at random. Among the 2331 test samples, 829 (35.6%) were clotted, and 269 (11.5%) were hemolyzed. We found a significant association of clotting with contamination, inadequate sample volume, puncture site other than the median cubital region, more than three attempts to collect blood, and the use of a partially filled collection tube when attempting another vein puncture. On the basis of our observations, the findings presented here have a significant impact on patient diagnosis and treatment, leading to delayed or inaccurate diagnoses, inappropriate treatment decisions, increased risk of adverse events, and increased healthcare costs.
35. Association between specific neuroticism symptoms and cardiovascular disease: insights from genetic analysis.
期刊: European archives of psychiatry and clinical neuroscience 发表日期: 2025-Dec-27 链接: PubMed
摘要
Although neuroticism has been linked to cardiovascular disease (CVD), the etiological relevance of individual neuroticism symptoms remains poorly understood. In this study, we employed Linkage disequilibrium score regression (LDSC) and systematic Mendelian randomization (MR) analyses to examine the potential causal effects of specific neuroticism symptoms on CVD. We obtained summary-level data on 13 specific neuroticism symptoms from the UK Biobank (ranging from 366,726-380,506 participants). Summary statistics for CVD originated from three European-descent GWASs with a total of 799,534 participants. LDSC was performed to investigate the genetic associations between specific neuroticism symptoms and CVD. The inversevariance weighted approach was applied to test the causality for the studied associations, together with extensive validation and sensitivity analyses to verify the main results. LDSC revealed significant genetic correlations between most neuroticism symptoms and CVD ri(rg range: 0.0837-0.2041), except for “feeling tense” and “worrying after embarrassment”. Furthermore, MR analyses indicated that genetically predicted neuroticism sum-score was causally associated with increased risk of ischemic stroke (IS) (OR = 1.23; 95% CI = 1.05-1.44) and myocardial infarction (MI) (OR = 1.20; 95% CI = 1.02-1.41). Among individual symptoms, irritableness was associated with intracerebral hemorrhage (OR = 4.15; 95% CI = 1.17-14.68), mood swings was associated with IS (OR = 1.30; 95% CI = 1.01-1.68), coronary artery disease (OR = 1.72; 95% CI = 1.35-2.20), and MI (OR = 1.74; 95% CI = 1.29-2.35), and feeling fed up was associated with IS (OR = 1.32; 95% CI = 1.02-1.71). These results remained robust across multiple sensitivity analyses. Overall, our study provided genetic and causal evidence supporting the role of neuroticism sum-score, irritableness, mood swings, and feeling fed up as risk factors for CVD, highlighting potential targets for early intervention and prevention.
36. Risk Factors for Gestational Stress Urinary Incontinence: Systematic Review and Meta-Analysis.
期刊: International urogynecology journal 发表日期: 2025-Dec-27 链接: PubMed
摘要
Pregnant women’s physical health and quality of life are affected by gestational stress urinary incontinence (GSUI), requiring therapeutic attention to this obstetric issue. To review and analyze the factors influencing GSUI, a literature search was conducted in both Chinese and English databases, including Web of Science, PubMed, Embase, WanFang, and China National Knowledge Infrastructure. Cohort studies, cross-sectional studies, and other studies that fit the population and research focus were included; conference papers and review articles were not. Twenty studies were included. In the univariate analysis, factors influencing GSUI included: previous vaginal delivery, parity, miscarriage, previous infant > 4 kg, age, constipation during pregnancy, pelvic floor muscle training (PFMT), and multiple gravidity. In the multivariate analysis, factors influencing GSUI included previous vaginal delivery, parity, previous infant > 4 kg, age, constipation during pregnancy, PFMT, BMI during pregnancy, and gestational age. Previous vaginal delivery, constipation, and previous infant > 4 kg are key risk factors for GSUI, with PFMT showing a protective effect. Clinicians should integrate preventive strategies into antenatal care to reduce the incidence of GSUI.
37. Bone-Targeted Platinum Nanoframework Prevents Postmenopausal Osteoporosis via Transmembrane Protein 16A Channel Blockade and Reactive Oxygen Species Scavenging.
期刊: ACS nano 发表日期: 2025-Dec-27 链接: PubMed
摘要
Postmenopausal osteoporosis (POP) in women caused by estrogen deficiency leads to an increase in reactive oxygen species (ROS) within the osteoporotic microenvironment, thereby promoting osteoclastogenesis mediated by the receptor activator of the nuclear factor-κb ligand (RANKL)/receptor activator of the nuclear factor-κB (RANK) pathway and further enhancing bone resorption. Currently available therapies based on hormone replacement, bisphosphonates, or denosumab increase the risk of cardiovascular diseases and osteonecrosis of the jaw. Here, we utilized a straightforward and green templating method to synthesize an alendronate (Aln)-modified large mesoporous platinum nanoframework (Pt NF) encapsulated with the transmembrane protein 16A (TMEM16A) channel inhibitor (TF@Pt-Aln). Leveraging the robust hydroxyapatite-binding affinity of alendronate (Aln), TF@Pt-Aln demonstrates precise targeting capability toward bone tissues, effectively releases the TMEM16A inhibitor theaflavin (TF), leading to a decrease in hydrogen ions (H+) excretion and effectively inhibiting the activation of the RANKL-RANK pathway, and attenuates osteoclast activity. Concurrently, the inherent antioxidant properties of both Pt NF and TF scavenge a broad spectrum of ROS, alleviating the ROS-enriched POP microenvironment and further inhibiting osteoclast differentiation. In vivo experimental results have confirmed that TF@Pt-Aln can enhance the trabecular bone mass and microarchitecture by inhibiting abnormal bone resorption, thereby reversing the progression of osteoporosis in ovariectomized (OVX) mouse models. Furthermore, TF@Pt-Aln exhibits excellent biocompatibility and reduces the risk of osteonecrosis of the jaw, rendering it a promising candidate for the clinical treatment of POP.
38. Increase in Fall-Related Fatalities in the Home Following the COVID-19 Pandemic Onset.
期刊: Journal of the American Geriatrics Society 发表日期: 2025-Dec-27 链接: PubMed
摘要
Falls are a leading cause of injury and death in older adults (age ≥ 65 years). The onset of the COVID-19 pandemic in the United States (US) marked a transition into a period of greater social isolation to curb the spread of disease. The pandemic additionally greatly strained the US healthcare system. As a result, older adults participated in less physical activity and experienced greater hesitancy to seek medical care in an effort to minimize their risk of infection. They additionally may have experienced delays and incomplete access to such care. It is possible that such changes worsened frailty and increased vulnerability to falls and fall-related sequelae among this population. We hypothesized that the COVID-19 pandemic led to an increase in fall-related fatalities generally and an increase in fall-related fatalities that occurred in the home. We conducted an interrupted time series analysis using a regression model on monthly fall fatalities among older adults from January 2015 through December 2020. Fall fatality data were extracted from the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER), along with the estimated annual population of US residents aged ≥ 65. The COVID-19 pandemic, defined as starting in the US in March 2020, was the interruption variable. There were 192,586 fall fatalities among older adults in the study period, with a mean of 2614 deaths per month ( σ \(\sigma\) = 228.4) pre-pandemic, and 3051 deaths per month ( σ \(\sigma\) = 215.1) post-pandemic onset. There was no statistically significant change in the incidence of all fall-related fatalities following pandemic onset. However, there was a 25% increase in incidence of fall-related fatalities that occurred within fall victims’ homes, specifically (IRR = 1.25, 95% CI 1.14, 1.36). There was a significant increase in fall-related fatalities within homes among older adults in the US after the onset of the COVID-19 pandemic. During pandemic type situations and times of social distancing, increased social supports and resources must be maintained for older adults to reduce the incidence of falls within the home and fall-related injuries.
39. Moisture regulation induced nitrite-mediated Fe(II) oxidation for cadmium immobilization in paddy soils.
期刊: Environmental geochemistry and health 发表日期: 2025-Dec-27 链接: PubMed
摘要
Cadmium (Cd) contamination in paddy soils poses significant risks to human health and food security, while traditional remediation methods may cause secondary pollution through external amendments. Nitrite oxidized Fe(II) to lepidocrocite and goethite, which immobilized Cd through adsorption and structural incorporation, effectively decreasing Cd mobility. Building on this mechanistic insight, a moisture regulation strategy was applied to enhance nitrite accumulation in paddy soil, and its role in Fe(II) oxidation for Cd immobilization was investigated. Metagenomic analysis identified nitrogen transformation pathways, showing that nitrite accumulation was limited by a higher abundance of ammonia-oxidizing bacteria (AOB, 19.2%) compared to nitrite-oxidizing bacteria (NOB, 11.7%), and predominance of nitrite consumption pathways. Maintaining 50% soil moisture selectively enhanced AOB activity while suppressing NOB, resulting in nitrite accumulation up to 9.56 mg/kg after 90 days incubation, reducing bioavailable Cd from 35 to 16% and increasing residual Cd from 7 to 48%. This study is original in integrating moisture regulation with microbial nitrogen cycling to enhance nitrite accumulation, thereby promoting Fe(II) oxidation and Cd immobilization. It provides a sustainable and chemical-free strategy for Cd management in paddy soils.
40. Spatial analysis of diabetes prevalence and diabetes-related cancer mortality in the united states.
期刊: Cancer causes & control : CCC 发表日期: 2025-Dec-27 链接: PubMed
摘要
Cancer and diabetes are the second and eighth leading causes of death in the United States (US), respectively. There are associations between diabetes and development of certain cancers yet a spatial analysis of their association has not been performed. This study examined the relationship between county-level diabetes prevalence and diabetes-associated cancer mortality in the US to identify disease hotspots and socioeconomic disparities. In this cross-sectional study of 3,108 counties in the continental US, we characterized county-level diabetes prevalence and diabetes-associated cancer mortality rates by conducting hotspot analyses using the Getis-Ord G* statistic to identify county clusters with similar high/low values of diabetes prevalence and cancer mortality rates. We compared demographic and socioeconomic factors among hotspot and coldspot overlaps. Hotspots of diabetes prevalence were in the Mississippi Delta, Appalachian Kentucky and West Virginia, southeastern Virginia, southern Texas, New Mexico, and tribal areas of Arizona and South Dakota. Hotspots for diabetes-associated cancer mortality were in the Mississippi Delta, Appalachian Kentucky, south central Texas, and South Dakota tribal areas. Hot-hot overlaps occupied the Mississippi Delta, Appalachian Kentucky, southern Texas, and South Dakota tribal areas. Compared to cold-cold overlaps, hot-hot cluster counties were more rural with higher percentages of poorly educated, impoverished, and unemployed citizens. Racial economic segregation data suggest that hot-hot clusters are significantly disadvantaged. Diabetes incidence and diabetes-associated cancer mortality share geographic, demographic, and socioeconomic risk factors. Providers should promote eligible cancer screenings and control of other risk factors among patients with diabetes to reduce mortality.
41. How is Self-Rated Health Related to the Social Network in Frail/Pre-Frail Older Adults: A Prospective Cross-Sectional Study Assessing Healthy Aging in Three Less Privileged Urban Neighborhoods.
期刊: Journal of applied gerontology : the official journal of the Southern Gerontological Society 发表日期: 2025-Dec-27 链接: PubMed
摘要
This prospective cross-sectional study examined whether a beneficial social network can buffer the negative association between frailty/pre-frailty and self-rated health among older adults in three less privileged urban neighborhoods. The final sample of 561 Berlin residents aged ≥65 (mean age 75.56 ± 6.66 years, 62.4% female) was assessed using the Frailty Phenotype and the Lubben Social Network Scale. Confounder-adjusted linear regression analyses were performed. The analyses showed that a strong social network is associated with better subjective health for non-frail and pre-frail older adults, but this buffering effect was not observed among frail individuals. We conclude that strengthening social networks may be beneficial for the subjective health of non-frail and pre-frail older adults. This buffering effect may diminish with advanced physiological limitations.
42. Assessing the Accuracy of Global HFC-134a Satellite Observations from Atmospheric Chemistry Experiment Fourier Transform Spectrometer (ACE-FTS) via Aircraft, Balloon, and Model Comparisons.
期刊: Environmental science & technology 发表日期: 2025-Dec-27 链接: PubMed
摘要
HFC-134a is the most abundant hydrofluorocarbon and is a potent greenhouse gas, with rapidly increasing concentrations from use primarily in refrigeration and air conditioning applications. HFC-134a measurements mainly rely on ground-based globally distributed networks with sparse spatial coverage. Atmospheric Chemistry Experiment Fourier Transform Spectrometer (ACE-FTS) observes HFC-134a above 5 km globally, thus bridging observational gaps in the upper atmosphere and facilitating radiative forcing assessments. However, validation of ACE-FTS HFC-134a retrievals remains limited. Here, we evaluate the latest ACE-FTS HFC-134a retrievals using surface, aircraft, and balloon observations, with the GEOS-Chem chemical transport model (CTM) as the intercomparison platform. ACE-FTS HFC-134a retrievals exhibit systematic low biases across all altitudes during 2016-2024, varying from 0.7-15.3% (10-20 km), 12.1-26.6% (below 10 km), to 7.2-22.0% (above 20 km), likely due to retrieval limitations and water vapor interference not fully addressed in the current retrieval algorithm. Interperiod comparison suggests a mean observation-model difference ranging from -12.6% to -10.9%, implying stable ACE-FTS HFC-134a retrievals over time without degradation. This study integrates available in situ measurements with a CTM to indirectly validate HFC-134a observations from space, demonstrating a valuable framework for assessing satellite retrievals of a range of other fluorinated greenhouse gases.
43. Risk Assessment of Inorganic Arsenic Exposure Through the Consumption of Four Marine Species From the Sea of Marmara.
期刊: Environmental toxicology 发表日期: 2025-Dec-27 链接: PubMed
摘要
Concerns regarding inorganic arsenic pollution in the Sea of Marmara have recently grown. This study evaluated arsenic (As) bioaccumulation in four commonly consumed marine species (Engraulis encrasicolus, Trachurus trachurus, Trachurus mediterraneus, Parapenaeus longirostris, and Solea solea) and assessed health risks for consumers. Arsenic concentrations were determined using inductively coupled plasma-mass spectrometry (ICP-MS). Shrimp and common sole had higher iAs concentrations than anchovy and horse mackerel. Estimated daily intake (EDI) values for all species exceeded the updated EFSA benchmark dose lower limit (BMDL05 = 0.06 μg/kg bw/day), suggesting a potential health concern under recommended consumption. Additionally, noncarcinogenic risks (THQ > 1) were identified for shrimp and common sole across all age groups. Carcinogenic risk assessments (TR > 1.0 × 10-4) showed significant risks for shrimp, excluding children aged 1-3 years. Common sole posed carcinogenic risks for individuals aged 18 and above, while anchovy and horse mackerel were only risky for those aged 65 and above. These findings highlight the need for reliable monitoring programs to ensure seafood safety during environmental stressors like mucilage. While pelagic seafood from the Sea of Marmara is generally safe, efforts should focus on risk reduction and guidelines for safe and sustainable consumption.
44. The Impact of Urban Regeneration, Air Pollution, Green Space, and Paved Roads on Problematic Alcohol Use: A Population-Based Study Across 43 Cities in China.
期刊: Substance use & misuse 发表日期: 2025-Dec-27 链接: PubMed
摘要
Evidence on the association between urban regeneration and alcohol use remains limited. This study examines the impact of urban environmental factors, specifically air pollution (measured by PM2.5, a common indicator of fine particulate matter), traffic congestion, and limited green space, on problematic alcohol use, and explores potential social and behavioral mechanisms underlying these relationships. A cross-sectional survey was conducted among 11,954 students from 50 universities across 43 Chinese cities. Individual-level data were collected via self-report questionnaires, while regional environmental data were obtained from the National Bureau of Statistics. Structural equation modeling (SEM) was applied to analyze the mediating pathways. The prevalence of problematic alcohol use was 7.3%. Multilevel logistic regression showed that higher PM2.5 levels were positively associated with alcohol use (ORs = 2.98, 3.48), while more green space (ORs = 0.55, 0.23) and a higher proportion of paved roads (OR = 0.37) were protective factors. SEM results indicated that PM2.5 exerted both a direct effect on alcohol use (β = 0.358, p < 0.01) and an indirect effect mediated by uncertainty stress (indirect β = 0.011). Paved road area had a direct effect (β = -0.009, p < 0.01) and indirect effects through uncertainty stress (indirect β = -0.007) and life stress (indirect β = -0.001). Green space directly reduced alcohol use (β = -0.188, p < 0.01) and also indirectly via lower uncertainty stress (indirect β = -0.011). Improving urban environmental quality, especially reducing air pollution and expanding green infrastructure, may help mitigate problematic alcohol use and promote mental health.
45. Allergic phenotypes and asthma in multiple sclerosis: Epidemiologic and genetic relationships.
期刊: Multiple sclerosis (Houndmills, Basingstoke, England) 发表日期: 2025-Dec-27 链接: PubMed
摘要
Multiple sclerosis (MS) and allergic disorders (ADs) are classically seen as immunologically distinct, and prior studies suggest potential inverse associations and overlapping genetic contributors. Compare the prevalence of asthma, and dietary and environmental allergic phenotypes in persons with MS (PwMS) versus unaffected controls, compare AD prevalence by MS clinical course, and evaluate associations between MS genetic risk, HLA-DRB115:01 and a non-MHC genetic risk score (GRS), and ADs in PwMS. We analyzed survey and genotype data from 1542 PwMS and 700 controls from the Accelerated Cure Project. Logistic regression models were adjusted for key confounders. Genetic analyses included 1252 unrelated non-Hispanic White PwMS, assessing the main effects of HLA-DRB115:01 and the GRS. Benjamini-Hochberg procedure controlled the false discovery rate. PwMS had lower odds of seasonal allergies compared to controls (OR = 0.79; 95% CI: 0.65, 0.96), with a non-significant reduction in primary progressive versus relapsing at onset MS (OR = 0.58; 95% CI: 0.37, 0.92). Among PwMS, HLA-DRB1*15:01 was associated with a higher odds of gluten allergies/intolerance, while the GRS was inversely associated with childhood-onset seasonal allergies. MS is associated with reduced seasonal allergies. MS genetic risk factors appear to shape allergy susceptibility in PwMS.
46. Association of arthritis and total joint arthroplasty with self-reported function in former professional American-style football players.
期刊: PM & R : the journal of injury, function, and rehabilitation 发表日期: 2025-Dec-27 链接: PubMed
摘要
Participation in American-style football (ASF) results in trauma-related concerns including joint injuries. Limited work has described arthritis and knee and hip total joint arthroplasty (TJA) in this population. The association of these conditions to pain interference and physical and mental function has not been well described.
- To characterize demographic, football, and health-related factors in former ASF players associated with arthritis and knee or hip TJA. 2. To investigate the association of arthritis and knee or hip TJA with pain interference and physical and mental function. Cross-sectional cohort study. Academic medical multisite hospital system. Former ASF players who played professionally from 1960 to 2019. Self-completed standardized questionnaires. Surveys included self-reported arthritis and knee and hip TJA, Patient-Reported Outcome Measure Instrument Scale (PROMIS), physical function and mental function, and pain interference scales. Multivariable logistic regression models assessed the association between demographic, football-related, and health characteristics with arthritis and knee and hip TJA. Multivariable linear regression models evaluated the association between arthritis and knee and hip TJA with pain interference and physical and mental function. In 4189 former ASF players (average and SD: 51.8 ± 14.4 years old) over half (n = 2237, 53.4%) had arthritis (n = 1547) or knee or hip TJA (n = 690). Both arthritis and knee and hip TJA were more common in those who were older, with higher body mass index, and prior surgery during playing years and were linemen (p < .05). Additionally, arthritis was more common in players who were never married (p = .01) and with higher concussion symptoms score (p < .001). Knee and hip TJA were more common in players who self-identified as White (p < .001). Both arthritis and knee and hip TJA were associated with greater pain interference and reduced physical function (all p < .001) but not with mental function. More than half of former ASF players reported arthritis or knee or hip TJA. Higher pain interference and reduced physical function in former ASF players with arthritis and knee or hip TJA highlight the importance of advancing strategies to prevent and treat joint conditions.
47. Demographic disparities in temporal trends and geographic variations of malignant pleural and peritoneal mesothelioma incidence in Pennsylvania, 1990-2019.
期刊: Cancer causes & control : CCC 发表日期: 2025-Dec-27 链接: PubMed
摘要
Malignant mesothelioma is a rare but aggressive cancer primarily linked to asbestos exposure. While pleural mesothelioma has been extensively studied, peritoneal mesothelioma remains less understood, especially regarding demographic disparities and geographic variation. This study examined demographic differences in trends and geographic variation in pleural and peritoneal mesothelioma incidence in Pennsylvania over a 30-year period. This population-based study analyzed mesothelioma incidence reported to the Pennsylvania Cancer Registry from 1990 to 2019. Trends were assessed by calculating age-adjusted and age-specific incidence rates and corresponding annual percent changes by sex, race and ethnicity, and age group. County-level standardized incidence ratios (SIRs) were mapped to illustrate the spatial distributions of pleural and peritoneal mesothelioma. Pleural mesothelioma incidence rates were significantly higher among men, White people, and people aged ≥ 60 years. Overall, pleural mesothelioma incidence increased until the early 2000s and declined thereafter. In contrast, peritoneal mesothelioma incidence remained low and stable, except for a significantly increasing trend observed among women and people aged < 60 years. The geographic distributions of peritoneal and pleural mesothelioma incidence across Pennsylvania counties showed overlapping areas of elevated SIRs in the southeastern, western, and north-central regions. This study highlights distinct trends in pleural and peritoneal mesothelioma incidence, along with associated demographic disparities and geographic variation. These findings suggest that pleural mesothelioma incidence likely reflects historical occupational asbestos exposure, whereas peritoneal mesothelioma appears less strongly associated. Further research is warranted to clarify the associations between various sources of asbestos exposure and pleural and peritoneal mesothelioma risk.
48. Nurses' and Anesthesiologists' Perspectives on Family Involvement in the Care of Frail Older Patients in the Holding and Postanesthesia Care Unit: A Qualitative Study.
期刊: Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses 发表日期: 2025-Dec-27 链接: PubMed
摘要
To explore nurses’ views, expectations, and needs regarding perioperative family involvement among frail older patients in the preoperative holding and postanesthesia care unit. Additionally, to explore anesthesiologists’ perspectives as essential stakeholders in these settings. A descriptive exploratory qualitative study. Semistructured interviews were conducted with 12 recovery nurses and 4 anesthesiologists after purposive sampling. An inductive thematic analysis was conducted using MaxQDA software. The study was reported according to the Consolidated criteria for reporting qualitative research. Four main themes emerged: (1) embracing family involvement; (2) clarifying criteria for family involvement; (3) lacking facilities in the department; and (4) managing expectations toward family members. Family involvement among frail older patients was perceived positively, though met with specific conditions for implementation. Nurses are open to perioperative family involvement but need clear criteria identifying frail older patients. Departmental adjustments are also necessary to facilitate family presence in the perioperative setting. Lastly, it is essential to manage family members’ expectations. Anesthesiologists share this perspective. Family involvement in the perioperative care process can improve patient outcomes but must be carefully implemented to avoid practical issues.
49. Co-Designing a Hybrid Virtual Memory Clinic Model for Regional Australia.
期刊: Dementia (London, England) 发表日期: 2025-Dec-27 链接: PubMed
摘要
Dementia is the second leading cause of disease burden in Australia, with regional populations facing limited access to multidisciplinary assessment, leading to delays and poorer outcomes. A hybrid virtual memory clinic (hVMC) combining in-person and virtual assessments is a possible solution. This study aimed to co-design a hVMC model for trialling in regional areas. This cross-sectional qualitative study included four co-design workshops (n = 56) and four interviews with people living with dementia, care partners, clinicians, and administrators. A hVMC model was iteratively developed and refined. Thematic analysis was conducted. The first theme, “we need the right service, right time,” describes regional challenges such as delays in assessment, limited specialist availability, and gaps in post-diagnostic support. The second theme, “the virtual memory clinic must be integrated with existing services,” highlights the need for a person-centred hybrid model involving in-person visits and collaboration with local providers, fostering relationships and reciprocal capacity building. The third theme, “clarity needed on who virtual assessment would suit,” reflects mixed views on eligibility, with general agreement on a cognitive threshold (e.g., Mini-Mental State Examination >20) but uncertainty around its application, suggesting a need for flexibility. Co-design participants also proposed practical features - shared intake, regular in-person assessments, post-diagnostic interventions (e.g., occupational therapy, cognitive programs), and local capacity building - which were iteratively integrated into the model. We present a co-designed hVMC model incorporating key features to support feasibility, access, and continuity of care. The model includes shared intake, quarterly in-person face-to-face assessments, structured post-diagnostic support, and collaboration with local services to build capacity. This model will be tailored to each region and is currently being piloted. Co-designed models must balance stakeholder priorities with implementation feasibility.
50. Occupational Balance, Self-Management, and Quality of Life in Adults With Epilepsy.
期刊: OTJR : occupation, participation and health 发表日期: 2025-Dec-27 链接: PubMed
摘要
Occupational balance, self-management, and quality of life (QoL) are interrelated factors that play a critical role in well-being of individuals with epilepsy. This study examined the associations between occupational balance, self-management, and QoL in adults with epilepsy. A cross-sectional-study included 71 adults with epilepsy. Participants completed the Occupational Balance Questionnaire (OBQ), Epilepsy Self-Management Scale (ESMS), and Quality of Life in Epilepsy Inventory-31 (QOLIE-31). Data were analyzed using Spearman’s rank correlation. OBQ scores showed positive correlations with the ESMS total (r = .331, p < .01) and QOLIE-31 total (r = .251, p < .05). Moderate associations were also found with emotional well-being (r = .424, p < .01) and overall QoL (r = .425, p < .01). Findings suggest that facilitating a healthy balance of daily activities may enhance both emotional well-being and self-management in individuals with epilepsy. For occupational therapists, integrating occupation-centered strategies to foster balance may lead to meaningful improvements in self-care, independence, and long-term QoL, thereby providing clear and practical guidance for clinical interventions in epilepsy care. Understanding the Link between Routines, Self-Management, and Wellbeing in EpilepsyEpilepsy is a condition that causes repeated seizures and can affect many areas of a person’s life, including their physical health, emotions, work, and social relationships. People with epilepsy often face challenges in managing their condition and living a balanced, satisfying life. In this study, we looked at how adults with epilepsy manage their condition, how balanced their daily lives are, and how these factors relate to their overall quality of life. We asked 71 people with epilepsy to fill out surveys about their daily routines, self-care habits, and well-being. We found that people who had a more balanced daily life—meaning they spent their time in a satisfying way across work, rest, social, and personal activities—also managed their epilepsy better and felt better overall. These findings show that helping people with epilepsy achieve a healthy balance in their everyday activities could improve how they feel and how they manage their condition. Occupational therapists can play an important role in supporting this balance.
51. Occupational and psychosocial risk factors for depression among uninsured middle-aged food delivery riders.
期刊: BMC psychology 发表日期: 2025-Dec-27 链接: PubMed
摘要
To assess the prevalence of depression among uninsured middle-aged food delivery riders, to identify occupational and psychosocial determinants, and to develop a predictive nomogram for early risk detection. We conducted a cross-sectional survey of 1,333 uninsured riders aged 40-59 years in China between January 2022 and December 2024. Depressive symptoms were evaluated using the CESD-10 scale. Data on sociodemographic, behavioral, health, and occupational characteristics were collected. Predictors were identified through least absolute shrinkage and selection operator (LASSO) regression and entered into a multivariable logistic regression to construct a predictive model. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), calibration plots, Brier scores, and decision curve analysis. In total, 516 riders (38.7%) met the criteria for depression. Riders with depression were more often female and rural residents and reported poor self-rated health. Key occupational risk factors included frequent near-miss traffic events, higher algorithmic pressure, adverse weather exposure, and a greater number of customer complaints. Protective factors include male sex, better self-rated health, and greater organizational justice. The predictive nomogram demonstrated strong discrimination (AUC 0.828 in the training cohort and 0.853 in the test cohort) and satisfactory calibration. This study developed and validated one of the first nomograms to predict depression in uninsured middle-aged food delivery riders. The model underscores the critical role of occupational stressors and psychosocial resources and provides a practical tool for risk identification.
52. Predictors of prolonged sickness absence after work injuries: a retrospective study using Tukey's Fence in 66,658 Hong Kong workers.
期刊: BMC public health 发表日期: 2025-Dec-27 链接: PubMed
摘要
53. The Impact of Whey and Soy Protein Supplementation on Resistance Training in Young Adults: A Systematic Review and Meta-Analysis.
期刊: Journal of dietary supplements 发表日期: 2025-Dec-26 链接: PubMed
摘要
Protein supplementation, particularly whey and soy protein, are widely used by individuals engaged in resistance exercise training (RET) to enhance lean body mass (LBM) and muscle strength. However, their effectiveness remain unclear due to conflicting study results. This systematic review and meta-analysis evaluated the effect of whey and soy protein supplementation on amino acid bioavailability, LBM, and strength performance in healthy young adults engaged in RET. Database searches were conducted in Cochrane, EBSCO Host, PubMed, and Scopus from inception to October 19, 2024 using a pre-defined search strategy. Initial screening resulted in a total of 1,813 studies that met the eligibility criteria. The inclusion criteria required participants to be trained or untrained young adults aged 18-30 years engaged in RET and taking either whey or soy protein in the form of concentrate or isolate with the primary outcome of LBM and secondary outcomes of bench press, squat, or plasma essential amino acid (EAA). The studies were assessed for risk of bias using the Cochrane RoB 2 tool, and a meta-analysis was conducted using a random-effects model. A total of 12 studies with 261 participants were included after full-text screening with the main reason for exclusion being wrong population. The analysis found no significant effect of either whey or soy protein supplementation on LBM. However, protein supplement increased peak plasma total EAA with whey protein significantly improved bench press (mean difference [MD] 8.87; 95% CI: 5.95-11.79) and squat performance (MD 9.60; 95% CI: 5.61-13.60), with low to no heterogeneity. These findings suggest whey protein supplementation can enhance strength without significantly altering LBM in young adults. However, further large-scale, high-quality randomized controlled trials are needed to establish definitive conclusions on the effects of protein supplementation RET. The review was registered August 30, 2024 in PROSPERO (CRD42024598070).
54. Systematic review and narrative synthesis of behavioral interventions to improve heat-related illness prevention in community and occupational populations.
期刊: BMC public health 发表日期: 2025-Dec-26 链接: PubMed
摘要
Extreme heat is the leading cause of weather-related deaths. Prevention includes personal practices and emergency procedures. Behavioral interventions to improve prevention of heat-related illnesses are a priority. Utilizing systematic review methodology, a comprehensive search strategy was deployed to identify studies reporting evaluations of behavioral heat-illness prevention interventions. Data sources included prominent bibliographic databases and relevant grey literature searches. Inclusion criteria indicated that studies that enrolled adult participants, assessed heat-related outcomes quantitatively, and were published in English from January 2000 to October 2023 be included. Data on study design, intervention features, and outcomes from the retained studies were extracted. A narrative synthesis was conducted, given the small number of studies and heterogeneous features. Seventeen articles reporting on results from 13 studies were retained. Samples included outdoor workers, professional athletes, or community members (total participants = 20,154). Study quality was variable, with only two studies classified as good quality. Outcomes assessed were cognitive variables (e.g., knowledge, attitudes, and intentions), behaviors (e.g., water intake and dehydration), and clinical indicators (e.g., kidney function). Seven studies evaluated a health education intervention, two studies tested warning messages, and two studies focused on provision of personal protection equipment (PPE). Interventions improved self-reported heat-illness knowledge and prevention behaviors, and reduced deaths. Kidney function and health were improved in two studies. The published literature on behavioral heat-related illness prevention interventions was limited, despite frequent periods of high heat. The published evidence suggested that interventions can improve prevention knowledge and behavior and possibly reduce heat injury. Study designs need substantial improvement by including larger samples and randomized designs with comparison groups to avoid threats to internal and external validity in existing data. Policy efforts should be considered along with health education and provision of PPE to ensure populations are adequately protected.
55. Exploring barriers and facilitators to fall prevention among older adults in Saudi Arabia: a qualitative study.
期刊: BMC geriatrics 发表日期: 2025-Dec-26 链接: PubMed
摘要
Falls are a leading cause of injury, disability, and hospitalization among older adults in Saudi Arabia. Despite international advances in fall prevention, local barriers, particularly those related to culture, education, and resource availability, remain insufficiently explored. This study aimed to explore the key barriers and facilitators to fall prevention among adults aged 65 and older in Saudi Arabia, and to examine how cultural, educational, and socioeconomic factors influence implementation efforts. A qualitative descriptive design was employed using semi-structured interviews with 16 healthcare professionals, including nurses, physical therapists, occupational therapists, and general practitioners, recruited from governmental and private hospitals. Interviews were conducted in Arabic, transcribed verbatim, and analyzed using a hybrid inductive-deductive approach. Themes were mapped to the Theoretical Domains Framework (TDF) to ensure theoretical rigor and contextual depth. Participants identified multiple barriers, including patient and caregiver unawareness, cultural stigmas around assistive device use, high workloads, inadequate staff training, and poorly designed environments. Facilitators included comprehensive assessments, tailored education programs, strong family engagement, interdisciplinary teamwork, and availability of assistive technologies. An emergent theme, “person-centered care,” emphasized the need for individualized, flexible strategies beyond the TDF structure. Effective fall prevention in Saudi Arabia requires culturally sensitive, system-wide strategies that address both structural constraints and individual-level beliefs. By enhancing interdisciplinary coordination, improving education, and prioritizing patient-centered approaches, healthcare systems can better support safe aging and reduce fall-related risks among older adults.
56. Proformer: a multimodal proteomics transformer model for multidisease early risk assessment.
期刊: Briefings in bioinformatics 发表日期: 2025-Nov-01 链接: PubMed
摘要
Early identification of individuals at high risk for chronic diseases is crucial for prevention and intervention, yet current risk assessment tools are disease-specific, require extensive clinical data collection, and cannot provide multidisease risk profiles from a single measurement. Several protein large language models have been developed for tasks such as protein structure prediction, function prediction, and sequence design. However, none of these models can be directly applied in clinical settings to predict an individual’s future disease risk. Here, we present a multimodal proteomics Transformer (Proformer) model that integrates protein expression, sequence, and function information for multidisease risk assessment. We trained Proformer using real proteomics data from 47 124 individuals from the UK Biobank to evaluate its performance in discriminating the risk of 20 common chronic diseases. Proformer achieved state-of-the-art (SOTA) performance in all 20 diseases compared with five common machine learning and deep learning models. Compared to three common clinical predictors, Proformer’s 10-year discriminative performance outperforms Age + Sex model for 19 diseases, outperforms the ASCVD risk score for 16 diseases, and outperforms the panel composed of 35 clinical variables for 11 diseases. These results were replicated in the Scotland and Wales cohort from UK Biobank. In conclusion, Proformer enabled users to directly obtain a 10-year risk report for common chronic diseases by inputting their individual proteomics data.
57. Evaluation of the implementation of Maternity Benefit (Amendment) Act, among working mothers of Mysuru: A cross-sectional study.
期刊: The Indian journal of medical research 发表日期: 2025-Oct 链接: PubMed
摘要
Background & objectives The Maternity Benefit Act, introduced in 1961, regulates maternity leave policies for women in various workplaces. The Amendment of 2017 extended maternity leave from 12 to 26 weeks. It also provides benefits for adopting and commissioning mothers, work-from-home options, and mandates crèches in companies with 50+ employees. This study evaluates the awareness and implementation of the Maternity Benefit (Amendment) Act, 2017 among working mothers in Mysuru. Methods A cross-sectional study was conducted over six months (May-November 2022). Data were collected from 300 working mothers through a pre-designed, structured questionnaire administered via one-on-one and telephonic interviews, stored electronically, and managed using secure digital databases. Data were analysed using MS Excel 2010 and SPSS version 25. Results Among participants 82.7 per cent (n=248) of women availed maternity leave. 95.1 per cent (n=285) took leave for 12-26 wk, with 86.3 per cent (n=214) receiving full pay, 10.1 per cent (n=21) partial pay, and 4.1 per cent (n=10) no pay. 12.3 per cent (n=37) used the crèche facility, while 56.7 per cent (n=170) took nursing breaks. This study found that most participants were aware of the Maternity Benefit Act. Awareness of specific provisions, such as paid leave for adoptive or commissioning mothers (n=135, 45.5%), medical bonuses (n=29, 9.7%), and legal provisions (n=31,10.3%), was limited. Most participants reported high satisfaction with the Act’s implementation, though gaps in availability of crèche and awareness of certain provisions were evident. Interpretation & conclusions Robust implementation and increased awareness of the Maternity Benefit Act is needed to enhance its effectiveness. While most participants rated the Act favourably, improvements in crèche provision, awareness of adoptive mother benefits, and employer compliance are needed to bridge gaps and promote gender equality in the workforce.
58. Multi-sensor wearables re-shaping care of chronic heart-failure: A narrative review.
期刊: The Indian journal of medical research 发表日期: 2025-Oct 链接: PubMed
摘要
Heart-failure decompensation often evolves between visits, driving recurrent admissions and cost. Multi-sensor wearables, adhesive patches, smart watches, and garments capture electrocardiography, thoracic impedance, photoplethysmography, respiration, activity, and speech for near-real-time review. Evidence synthesis indicates two signals. First, integrated telemonitoring, combined with structured clinical intervention during the post-discharge vulnerable phase, reduces cardiovascular events and heart failure hospitalisations in randomised programmes. Second, device-level performance metrics (lead time, alert burden, detection accuracy) demonstrate early warning capability but do not alone establish outcome benefit. Implantable multi-sensor algorithms offer a median lead time of approximately one month, accompanied by manageable alert rates. External systems that estimate lung fluid or fuse wearable signals demonstrate promising feasibility, although large pragmatic trials remain limited. Consumer smartwatches achieve high accuracy for detection of atrial fibrillation in general population; however, evidence is lacking for detection of heart failure decompensation, or for improving the outcome. Key implementation issues include AI-validation, workflow-linked triage, cost-effectiveness, cybersecurity, and equitable access for low- and middle-income settings. Multi-sensor monitoring warrants targeted deployment within intervention pathways and rigorous evaluation focused on patient-important outcomes.
59. SARS-CoV-2 vaccine induced humoral & cell-mediated immune responses in Indian cohort of rheumatoid arthritis.
期刊: The Indian journal of medical research 发表日期: 2025-Oct 链接: PubMed
摘要
Background & objectives The COVID-19 pandemic came up with distinct challenges for patients with rheumatoid arthritis indicating higher risk of infection and severity due to SARS-CoV-2. In this study, we performed the immunotyping of humoral and cell-mediated responses in patients with rheumatoid arthritis to assess characteristics and durability of Covid vaccine-induced immune memory. Methods We enrolled 50 individuals with rheumatoid arthritis who had received SARS COV-2 vaccine (Covaxin/Covishield). Of these 26 were assessed within six months of the second vaccine dose (T1) and 24 were evaluated 6-9 months after the third dose (T2). Serum IgG titres were measured using chemiluminescent microparticle immunoassay (CLIA), and lymphocyte immunophenotyping. In vitro challenge with the SARS-CoV-2 spike protein was performed using flow cytometry. Results Patients vaccinated with Covishield showed significantly higher IgG titres and elevated levels of cytokines such as TNFα and IFNγ compared to those vaccinated with Covaxin. The Covishield group also exhibited a higher percentage of antigen-specific and inflammatory T cell subsets, contributing to the overall cytokine pool in patients with rheumatoid arthritis. In vitro stimulation with the SARS-CoV-2 spike protein further activated lymphocytes in Covishield-vaccinated individuals. Interpretation & conclusions Our study presents the increased effectiveness of Covishield in initiating responses compared to Covaxin. Covishield vaccinated patients with rheumatoid arthritis show higher antigen specificity and T cell activation indicating a shift of the immune system towards a Th1 phenotype, which makes it imperative to focus on development of safe and durable vaccines with a continuous follow up for the patients with rheumatoid arthritis to control disease severity.