公共卫生研究摘要 (2025-12-31)
共收录 59 篇研究文章
1. HTLV, CMV, and EBV: Implications for Ocular Tissue Transplantation: Report of the Eye Bank Association of America Medical Advisory Board Policy and Position Review Subcommittee.
期刊: Cornea 发表日期: 2026-Feb-01 链接: PubMed
摘要
Human T-lymphotropic virus (HTLV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV) each have the propensity for infection as well as the development of latency in humans. As many ocular tissue report forms provided by Eye Bank Association of America (EBAA) member eye banks list serological testing results for these viruses, the EBAA Policy and Position Review Subcommittee (PPRS) sought to investigate and clarify the implications of these results. Current EBAA policies regarding HTLV, CMV, and EBV were reviewed. Additionally, a search of articles written in or translated into the English language regarding the aforementioned viruses with a focus on ocular infection and ocular tissue transplantation was performed on PubMed. Current EBAA policies indicate that ocular tissues from donors with seropositivity to HTLV, CMV, and/or EBV can be used for transplantation. The risk of transmission of HTLV was felt to be the most consequential, given its low seroprevalence and its association with adult T-cell lymphoma/leukemia. However, as corneal and limbal tissue are not leukocyte-rich, the risk of transmitting HTLV is low. Despite reports of the isolation of all 3 viruses in ocular tissues, a literature review did not reveal any reported cases of viral transmission through ocular tissue transplantation. Ocular tissues from donors with seropositivity to HTLV, CMV, and/or EBV can be used for transplantation per current EBAA guidelines. Despite the potential for ocular infection by these viruses, there are no reported cases of viral transmission from ocular tissue transplantation, affirming the validity of the current EBAA guidelines.
2. NF1-Specific Growth Charts for Head Circumference Over the First 3 Years of Life.
期刊: Neurology 发表日期: 2026-Jan-27 链接: PubMed
摘要
Macrocephaly is among the most common findings in neurofibromatosis type 1 (NF1) and may be associated with other clinical manifestations of the genetic syndrome. NF1-specific growth charts that account for expected macrocephaly may increase sensitivity for detecting atypical growth. We aimed to produce NF1-specific growth charts of head circumference for the age range of 0-3 years and to assess their potential clinical impact. Using electronic health records from the Children’s Hospital of Philadelphia, we collected head circumference measurements from children with NF1 and a community control cohort seen at scheduled well-child visits. We compared head circumference normalized using Centers for Disease Control (CDC) growth charts between these groups over time. We constructed NF1-specific growth charts using 2 independent methods. Finally, we used mixed-effects models to relate the resulting centile scores to developmental delay assessed with the Survey of Well-being of Young Children. Our data set contained 2,180 observations from 305 individuals (167 male) with NF1 and 104,750 observations from 16,742 individuals (8,809 male) in the community control cohort, all aged 0-3 years. Head circumference was significantly elevated in the NF1 cohort across the age range (p-adjusted <0.05), but the Cohen effect size d varied nonlinearly with age, starting moderate at 1 month (d = 0.56), then small at 4 months (d = 0.28), moderate again at 15 months (d = 0.58), and finally large at 28 months (d = 0.80). NF1-specific growth curves demonstrated slower increases in head circumference in the first 2 months of life, yet more sustained growth over time. Although none of the children with NF1 met the standard for microcephaly according to CDC charts, smaller head circumference benchmarked against NF1-specific charts was correlated with developmental delay (standardized β = 0.24; p < 0.02). We present the first NF1-specific growth charts for head circumference covering the age range of 0-3 years. Macrocephaly in NF1 becomes more exaggerated over time as rate of growth is sustained compared with controls. Smaller head size relative to NF1 growth expectations is not captured by CDC charts yet it nevertheless relates to developmental delay, suggesting that NF1-specific charts may increase sensitivity to clinically concerning patterns of growth in children with NF1.
3. Bone Marrow Mesenchymal Stem Cell-Derived Exosomal miR-4787-3p Promoted Osteogenic Differentiation by Targeting PDCD4 in Osteonecrosis of Femoral Head.
期刊: Journal of biochemical and molecular toxicology 发表日期: 2026-Jan 链接: PubMed
摘要
Impaired osteogenic differentiation serves as a pivotal pathogenic mechanism underlying osteonecrosis of the femoral head (ONFH). This study systematically investigated the pro-osteogenic effects of exosomal miR-4787-3p derived from bone marrow mesenchymal stem cells (BMSCs) in the pathogenesis of ONFH. Bone marrow was collected from both healthy donors and patients with post-traumatic ONFH. BMSC and BMSC-derived exosomes were isolated and characterized. BMSCs were transfected with miR-4787-3p mimic and inhibitor to collect exosomes. These exosomes were used to treat BMSCs stimulated by dexamethasone (DEX). A dual luciferase reporter gene assay was employed to verify the binding of miR-4787-3p and programmed cell death 4 (PDCD4). BMSCs were transfected with PDCD4 shRNA and stimulated by DEX. BMSCs transfected by PDCD4 vectors were stimulated by exosomes and DEX. Cell counting kit-8 assay, Alizarin red staining, and ALP activity detection were performed on BMSCs. Molecular analyses included qRT-PCR and Western blot of osteogenic markers and PDCD4 signaling components. BMSC and BMSC-derived exosomes were successfully isolated. Relative to healthy donors, miR-4787-3p was downregulated in BMSC-derived exosomes from patients with traumatic ONFH. Exosomal miR-4787-3p enhanced BMSCs’ viability and osteogenic differentiation, as evidenced by increased mineralization, ALP activity, and upregulation of ALP/OPN/Runx2. PDCD4 was a target of miR-4787-3p. PDCD4 was up-modulated in BMSCs from patients with traumatic ONFH. PDCD4 knockdown enhanced BMSCs’ viability, Alizarin red staining, ALP activity, ALP, OPN and Runx2 expression. PDCD4 reversed BMSC-derived exosomal miR-4787-3p promotion on BMSCs’ viability, Alizarin red staining, ALP activity, ALP, OPN and Runx2 expression. BMSC-derived exosomal miR-4787-3p promoted BMSCs’ osteogenic differentiation through direct targeting of PDCD4. These findings suggest its potential therapeutic application for ONFH by reversing impaired osteogenesis.
4. Welder's Anthrax Treated with Obiltoxaximab - Louisiana, 2024.
期刊: MMWR. Morbidity and mortality weekly report 发表日期: 2026-Jan-01 链接: PubMed
摘要
In September 2024, the ninth documented case of welder’s anthrax was identified in a previously healthy male welder, aged 18 years, from Louisiana, who was hospitalized with pneumonia and respiratory failure requiring intubation and mechanical ventilation. Welder’s anthrax is a recently described life-threatening pneumonia caused by infection with anthrax toxin-producing Bacillus cereus group bacteria; risk factors for infection are not well-understood. Eight previous cases (six fatal) were reported among welders or metalworkers from Louisiana and Texas. A coordinated state and federal response facilitated use of the anthrax antitoxin obiltoxaximab (Anthim), which was administered in combination with recommended multidrug antimicrobial therapy for inhalation anthrax, including bactericidal agents and protein synthesis inhibitors. The patient’s clinical condition improved rapidly after administration of obiltoxaximab and antimicrobials and drainage of a pleural effusion. He was discharged with a tailored antibiotic regimen after a 26-day hospitalization; all of his pulmonary symptoms had resolved by his 3-month follow-up visit. An environmental investigation identified anthrax toxin genes in 28 (11.4%) of 245 soil and nonporous surface samples collected from the patient’s worksite; however, this investigation did not clearly identify host or occupational factors that contributed to his illness. Enhanced workplace safety protocols and improved engineering and administrative controls could minimize exposure to dust and welding fumes and potentially decrease environmental exposure to infectious disease agents among metalworkers. Welder’s anthrax should be considered in the differential diagnosis of pneumonia among welders and metalworkers, particularly those who live in or have worked in the southern United States. Health care providers should consult with CDC as soon as welder’s anthrax is suspected to facilitate release of anthrax countermeasures, including antitoxins such as obiltoxaximab, as adjunctive therapy.
5. Enhanced Informer Network for Stress Recognition and Classification via Spatial and Channel Attention Mechanisms.
期刊: International journal of neural systems 发表日期: 2025-Dec-31 链接: PubMed
摘要
With the increase in work-related stress, the issue of psychological pressure in occupational environments has gained increasing attention. This paper proposes an enhanced Informer stress recognition and classification method based on deep learning, which guarantees performance by integrating tailored spatial and channel attention mechanisms (SAM/CAM) with the Informer backbone. Unlike existing attention-augmented models, the proposed SAM is designed to prioritize time-sensitive physiological signal segments, while CAM dynamically weights complementary stress-related features, enabling precise capture of subtle stress-related patterns. With this dual attention mechanism, the proposed model can capture subtle changes associated with stress states accurately. To evaluate the performance of the proposed method, the experiments on one publicly available dataset were conducted. Experimental results demonstrate that the proposed method has outperformed existing approaches in terms of accuracy, recall, and F1-score for stress recognition. Additionally, we performed ablation studies to verify the contributions of spatial attention module and channel attention module to the proposed model. In conclusion, this study not only provides an effective technical means for the automatic detection of psychological stress, but also lays a foundation for the application of deep learning model in a broader range of health monitoring applications.
6. Feasibility and Usability of an mHealth App (mLab+) to Guide Users Through HIV and Syphilis Self-Testing: Pilot Randomized Controlled Trial.
期刊: JMIR formative research 发表日期: 2025-Dec-30 链接: PubMed
摘要
HIV self-testing is an important strategy in the US Ending the HIV Epidemic initiative. To facilitate uptake of self-testing, we developed the mLab app, which complements existing self-test options to support the potential for higher uptake of the HIV self-test. Syphilis, a sexually transmitted infection with currently rising prevalence and overlap in risk profiles with HIV, could similarly benefit from the advantages of companion diagnostic mobile apps such as mLab. Due to the success of the mLab app in promoting HIV self-testing during a randomized controlled trial and the scientific evidence of need for at-home syphilis testing, our team developed the mLab+ app, which supports both HIV and syphilis testing through an image processing algorithm that incorporates a duplex HIV and syphilis point-of-care test. We conducted a pilot study to assess the feasibility and usability of the mLab+ app for HIV and syphilis testing. We recruited participants who were assigned male sex at birth and reported sex with another man. Participants came to the Nurse Practitioner Group clinic for baseline and follow-up visits. Participants rated the usability of the app using the Health Information Technology Usability Evaluation Scale and the Post-Study System Usability Questionnaire at their 3-month follow-up visit. The primary outcome was the number of participants who were able to self-administer the DPP HIV-Syphilis test with the assistance of the mLab+ app. Feasibility was measured through recruitment pace, retention over 3 months, app usability, and paradata. Of the 20 participants, 19 identified as male and 1 identified as nonbinary. Most participants (n=16) were able to complete the DPP HIV-Syphilis test with facilitation support from the mLab+ app. The average duration of an app session, from after authentication until log-out or abandonment, was 30 minutes and 33 seconds (SD 21 minutes and 40 seconds). Apart from the 27% (13/48) of sessions that were 5 minutes or less, the distribution of session durations was approximately normal. Users spent the longest time viewing testing screens (ie, timer screens, initial testing screen, test guided walkthroughs, test results, and picture and result upload). The overall mean scores on the Post-Study System Usability Questionnaire (2.65, SD 1.06) and Health Information Technology Usability Evaluation Scale (3.62, SD 1.07) indicated medium to high usability. The retention rate for the 3-month trial was 80% (16/20). The findings support the use of the mLab+ app as a tool for assisting consumers in self-testing for HIV and syphilis. The limitations of the study design warrant further examination outside of clinic settings to better understand the utility of these tools for improving consumer health outcomes.
7. Predictive Value of Machine Learning in Knee Osteoarthritis Progression: Systematic Review and Meta-Analysis.
期刊: Journal of medical Internet research 发表日期: 2025-Dec-30 链接: PubMed
摘要
Machine learning (ML) has been investigated for its predictive value in knee osteoarthritis (KOA) progression. However, systematic evidence on the effectiveness of ML is still lacking, posing a challenge to precision prevention. This systematic review aimed to systematically assess the application status and accuracy of ML in predicting KOA progression and to compare the predictive performance of ML, traditional methods, and deep learning under different datasets, model types, modeling variables, and definitions of KOA progression. Following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement, a systematic search was conducted in Embase, Web of Science, PubMed, and Cochrane Library up to October 10, 2025. Two investigators were independently responsible for study screening, data extraction, and risk-of-bias assessment in included studies using the Prediction Model Risk of Bias Assessment Tool. Meta-analyses were conducted on the concordance index (C-index) and diagnostic 4-fold table using a random effects model, with prediction intervals (PIs) reported. In addition, subgroup analyses were performed by model type, modeling variable, and definition of KOA progression. A total of 32 studies were included. The overall risk of bias was considered low in 8 studies, high in 13 studies, and unclear in 11 studies. For predicting all progression, the pooled C-index was 0.773 (95% CI 0.727-0.821; 95% PI 0.567-1.000) for the clinical feature-based model, 0.798 (95% CI 0.755-0.843; 95% PI 0.646-0.984) for the magnetic resonance imaging (MRI)-based model, 0.712 (95% CI 0.657-0.772; 95% PI 0.526-0.965) for the X-ray-based model, 0.806 (95% CI 0.765-0.849; 95% PI 0.639-1.000) for the MRI+clinical feature-based model, 0.772 (95% CI 0.731-0.815; 95% PI 0.610-0.976) for the X-ray+clinical feature-based model, and 0.731 (95% CI 0.669-0.798; 95% PI 0.518-1.000) for the clinical feature+X-ray+MRI-based model. The clinical feature-based model was established mainly using logistic regression and exhibited accuracy comparable to other ML models. Among image-based models, traditional ML or deep learning possessed higher accuracy. This systematic review used CIs to estimate mean effects and PIs to estimate the potential range of effects in future scenarios. It systematically compared the performance of ML in predicting KOA progression under different model types, modeling variables, and definitions of KOA progression. ML models demonstrate certain discriminatory power in predicting KOA progression, but current evidence should be interpreted with caution due to various sources of significant heterogeneity, such as variations in the definition of KOA progression and validation strategies. Future research should standardize the definition of KOA progression, enhance methodological rigor, and conduct stringent external validation to improve model reliability and facilitate clinical translation.
8. Integrating a Brief Behavioral Intervention Into Case Management for Mothers With Perinatal Substance Use Disorder: Nonrandomized Pilot Feasibility Study.
期刊: JMIR formative research 发表日期: 2025-Dec-30 链接: PubMed
摘要
Perinatal substance use disorders (SUD) are frequently comorbid with depression, anxiety, and posttraumatic stress disorder (PTSD), contributing to adverse maternal and child outcomes. Access to integrated mental health support within existing SUD service frameworks is limited, particularly for pregnant and parenting individuals facing socioeconomic and psychosocial instability. Promoting Healthy Families (PHF) is a brief behavioral intervention designed for delivery by case managers serving high-risk perinatal populations with substance use within programs such as Parent Child Assistance Program (PCAP). This study aimed to evaluate the feasibility of integrating PHF into intensive case management for pregnant and postpartum clients with at-risk perinatal substance use, and to assess preliminary outcomes of measures of maternal depression, anxiety, and PTSD symptoms. In this nonrandomized pilot study (April 2018-September 2021), eligible clients were allocated to either PCAP alone (control) or to PHF delivered within PCAP (intervention). Case managers completed an anonymous feasibility survey addressing ease of delivery and fit with their workflow. Participating clients completed the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 Scale, and PTSD (posttraumatic stress disorder) Checklist (PCL-6) at baseline and at 4, 6, and 12 months. Data collection overlapped with the COVID-19 pandemic, which affected service access and delivery. CMs and 1 program supervisor (n=10) reported that PHF was feasible to deliver within PCAP, and respondents indicated clients benefited somewhat (70%) or a lot (30%). Most (70%) noted an increase in workload and recommended additional supervision and training. The pilot study enrolled 58 clients (29 PHF+PCAP and 29 PCAP), with 60% (35/58) completing all follow-up assessments. While differences between groups over time were not statistically significant, changes were in the predicted direction for PHQ-9 and PCL-6 scores. Symptom improvement rates were high: In the PHF+PCAP group, 85% (25/29) showed ≥5-point decreases in PHQ-9 scores, 68% (20/29) had ≥6-point decreases in Generalized Anxiety Disorder-7 Scale scores, and 93% (27/29) had ≥5-point decreases in PCL-6 scores. PHF can be feasibly delivered within an existing intensive case management program for perinatal SUD, with early signals of mental health improvement across both intervention and control groups. Future adequately powered randomized controlled trials should investigate the effectiveness of brief behavioral interventions within perinatal SUD case management programs, optimal delivery timing, and the potential to enhance mental health care integration for high-risk perinatal populations.
9. Continuous Glucose Monitors Among Adults With Type 2 Diabetes Mellitus in the Primary Care Setting: Qualitative Study Informed by Technology Acceptance Model and Health Belief Model.
期刊: JMIR diabetes 发表日期: 2025-Dec-30 链接: PubMed
摘要
Continuous glucose monitors (CGM) reduce the burden of glycemic monitoring and improve glycemic control, quality of life, and decreased health care use. Despite expanded insurance coverage and adoption, barriers remain, especially in primary care. Existing research largely evaluates specific populations or interventions, leaving limited insight into the broader primary care experience. This study aims to examine the experiences of adults with type 2 diabetes mellitus (T2DM) using CGM in primary care, guided by the Health Belief Model and Technology Acceptance Model. This qualitative study included in-person semistructured sessions (interviews or a focus group), surveys, and electronic health record data. Participants were recruited from 3 urban primary care (internal medicine and internal medicine-pediatrics) clinics affiliated with a large academic health system in Southwest Ohio, United States, with high rates of public insurance (Medicare or Medicaid). Eligible participants were adults (≥18 y) with T2DM and a CGM prescription. Data were analyzed using theme generation guided by directed content analysis in MAXQDA (VERBI Software GmbH) with codes derived from Health Belief Model and Technology Acceptance Model constructs. Survey data were used to triangulate to enhance validity. Overall, 16 participants (interviews: n=12; 1 focus group: n=4) were recruited for the study with a mean age of 56.9 (SD 10.5) years. In total, 69% (11/16) identified as Black, 100% (16/16) as Non-Hispanic, and 69% (11/16) as female, and 94% (15/16) used public insurance. Six themes emerged: disease susceptibility, disease severity, influential drivers, perceived ease of use, perceived usefulness, and attitude toward using CGM. All participants found CGM helpful and would recommend it to others. While affirming numerous barriers well-described in other populations, this study uniquely describes the burden of comorbidities, the trust in CGM data compared to glucometer-based monitoring, and the reliance on receivers to use CGM technology in this patient population. CGM is valued by adults with T2DM in primary care, yet barriers remain. Tailored support for initiation, troubleshooting, and education (especially alarm management and data interpretation) is needed. These insights can inform scalable strategies to enhance CGM use and experience in primary care.
10. User Preferences for an Image-Assisted Dietary Recall: Qualitative Study Comparing 3 Dietary Assessment Methods.
期刊: JMIR human factors 发表日期: 2025-Dec-30 链接: PubMed
摘要
Technology-assisted 24-hour dietary recall (24HR) methods offer the potential for scalable population dietary assessment, but current challenges include balancing accuracy and cost against participant burden and acceptability of these methods. Qualitative methods present a novel approach to understanding potential barriers and enablers to the acceptability of 24HR methods, but remain relatively unexplored. This study aimed to explore users’ experience, acceptability, and preferences for 3 technology-assisted 24HR methods. Participants in a crossover controlled feeding study were invited to undertake a poststudy interview. Initially, the feeding study participants were randomized into one of three separate feeding days where they consumed breakfast, lunch, and dinner on a single day. On the following day, they undertook a 24HR via the Automated Self-Administered 24-hour Dietary Assessment Tool (ASA24), Intake24, or an Image-Assisted Interviewer-Administered 24-hour dietary recall (IA-24HR). When assigned to IA-24HR, participants viewed the images they captured with a mobile food record (mFR) app on the feeding day during the interview. On completing all 3 methods, 26 participants (ages 21 to 56 years) undertook semistructured interviews. The interview audio recordings were transcribed, and inductive content analysis was undertaken. Overall, participants wanted the 24HR methods to be easy, with the technology features of all methods considered helpful. A total of 5 content categories described users’ experiences of the three 24HR methods: (1) “Put my food in the list,” (2) “It’s really hard to know portions,” (3) ASA24 “was a painful process,” (4) access to “images helped jog my memory,” (5) Intake24 is “fairly quick,” and (6) IA-24HR method preference. Participants expressed a preference for taking images with the mFR app. IA-24HR helped participants recall food and beverages consumed and increased perceptions of recall accuracy. This novel qualitative research found that 24HR methods need to be as easy as possible for users. The participant burden of food and beverage identification and portion size estimation was evident across methods. Findings highlight the importance of using qualitative methods to explore user preferences for dietary assessment methods and confirm the need to reduce the user burden associated with 24HR methods. People want embedded technologies to enhance digitized versions of the traditional 24HR methods. The use of their own food images within the mFR app is an example of digital advancements within scalable 24-hour dietary assessments. Australia New Zealand Clinical Trials Registry ACTRN12621000209897; www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=381165. RR2-10.2196/32891.
11. Effectiveness of Interventions for Addressing Digital Exclusion in Older Adults in the Social Care Domain: Rapid Review.
期刊: JMIR aging 发表日期: 2025-Dec-30 链接: PubMed
摘要
Older adults make up the largest proportion of nonusers of the internet. With the increasing digitalization of services, it is important to identify what interventions are effective at reducing digital exclusion in older adults. We aimed to identify what evidence exists on the effectiveness of interventions to address digital exclusion in older adults. This rapid review assessed the effectiveness of interventions to address digital exclusion in older adults aged 60 years or older. Searches were conducted in November 2023 across a range of databases and used supplementary search methods. Searches were limited to comparative studies published from 2018 onward in English. Data were analyzed using a narrative synthesis approach. A total of 21 studies were included that aimed to increase a range of digital literacy skills. Sample sizes ranged from 5 to 381. Intervention approaches varied considerably and were often multicomponent and undertaken in a variety of settings. There is evidence to suggest that a range of interventions can reduce physical, personal, and perceptual barriers and improve older adults’ skills, knowledge, digital literacy, and perceived self-efficacy, reduce technophobia, and increase use of technology. Importantly, findings indicated improvements among a range of subpopulations, including those living in rural areas, at risk of social isolation, who are homebound, of lower socioeconomic groups, and individuals with visual impairment. To achieve improved and sustained digital inclusion in older adults, evidence suggests it may be important to ensure structural barriers, such as access to the internet and affordability of devices, are removed. However, all studies contained methodological limitations and may not be adequately powered to determine effectiveness. The evidence shows the potential benefits of interventions aimed at improving a range of digital skills and increasing technology use in older adults, which could help to address digital exclusion. The findings of this rapid review can inform the development and delivery of future interventions. However, it is important to consider the context in which the included interventions were used and the lack of certainty of the findings. This review also identified a lack of high-quality evidence, as all studies identified contained methodological limitations and may not have been adequately powered to determine effectiveness. In addition, consideration should also be given to those who do not wish to engage with the online world to ensure they are not left behind.
12. Intimate Partner Violence and HIV Prevention Among Transgender and Nonbinary Persons: Protocol for a Prospective Mixed Methods Cohort Study.
期刊: JMIR research protocols 发表日期: 2025-Dec-30 链接: PubMed
摘要
Transgender and nonbinary (TNB) individuals experience intimate partner violence (IPV) at twice the rates of cisgender populations. Although prior research has linked IPV to elevated HIV risk and vulnerability among TNB persons, there is limited understanding of how IPV influences key HIV prevention behaviors, such as HIV and sexually transmitted infection (STI) testing, and initiation and use of pre-exposure prophylaxis (PrEP). IPV experiences among TNB individuals are complex and diverse, varying by type, frequency, severity, and power and relationship dynamics, and often intersect with systemic forms of marginalization. Additional research is needed to investigate the mechanisms linking IPV and HIV outcomes to inform effective, tailored prevention strategies. This prospective mixed methods cohort study seeks to advance understanding of the risk and protective pathways between IPV (both perpetration and victimization) and HIV-related outcomes, including engaging in condomless sex, STI acquisition, PrEP uptake, adherence, and persistence among TNB individuals experiencing IPV. This study includes two sequential phases. Phase 1 consisted of formative qualitative interviews with 32 TNB individuals with recent IPV experience and 10 key informants (eg, service providers and advocates) in the United States. These interviews informed the design of a national, web-based cohort study. Phase 2 will enroll 600 HIV-negative, currently partnered TNB participants living in the United States. Participants will be followed for 24 months, with surveys and at-home biospecimen collection (HIV and STI testing and PrEP adherence) at baseline, 6, 12, 18, and 24 months. Brief surveys assessing changes in key variables will also be completed at 3, 9, 15, and 21 months. Phase 1 was initiated in October 2023, with interviews conducted through October 2024 until thematic saturation was reached. Rapid qualitative analysis was completed between November 2024 and January 2025 to inform measurement selection for the phase 2 surveys. Enrollment for phase 2 began in February 2025 and is expected to continue through December 2025. This study will provide essential insights into how IPV impacts HIV risk and prevention practices among TNB individuals. Results will guide the development or refinement of gender-affirming, trauma-responsive, and culturally grounded IPV and HIV prevention interventions tailored to the needs of TNB communities. DERR1-10.2196/82090.
13. Neighborhood Differences in Omnipresent Policing and Sleep Health in New York City: Protocol for a Multimethod Quantitative Study.
期刊: JMIR research protocols 发表日期: 2025-Dec-30 链接: PubMed
摘要
Poor or insufficient sleep is associated with numerous adverse, potentially serious physical and mental health outcomes. Equally concerning are the substantial racial, gender, and socioeconomic disparities, with minorities and those experiencing poverty disproportionately affected by poor sleep quality and sleep disorders. Both theory and research suggest that sleep health is negatively impacted by concentrated poverty at the neighborhood level due to the deterioration of the built and social environments, thereby creating conditions that disrupt sleep. This research considers an under-studied factor related to these conditions and sleep health-policing and police surveillance. Specifically, the study compares 4 neighborhoods within New York City at different levels of residential segregation. The study design consists of a baseline survey, with 40 residents recruited in each neighborhood, and a 1-week diary phase with a subsample of residents. Neighborhood conditions are also assessed in each of the neighborhoods using a neighborhood audit tool. The study received funding in July 2024. Data collection commenced in September 2024. As of August 2025, we have enrolled more than 100 participants in the baseline survey. Planned analyses will begin once data collection has concluded. This information will help establish the extent to which surveillance and policing differentially impact the lives of New Yorkers as a function of where they live. Specifically, the results should be relevant and important for understanding the impact of novel policing strategies on underprivileged neighborhoods. This exploratory research will be useful for identifying populations and residential settings that may be most at risk for poor sleep health. DERR1-10.2196/82605.
14. County-Level Influenza-Attributable Emergency Department Visits and Their Spatial Correlates in the United States: Cross-Sectional Observational Study.
期刊: JMIR public health and surveillance 发表日期: 2025-Dec-30 链接: PubMed
摘要
The burden of seasonal influenza on emergency department (ED) visits is poorly quantified due to case ascertainment and data availability challenges. This study estimates county-level respiratory ED visits attributable to influenza using time-series models and examines spatial heterogeneity in county-level burden in 3 states. This study aimed to estimate the county-level respiratory ED visits attributable to influenza using time-series models and examine spatial heterogeneity in county-level burden in 3 states. We used daily hospital discharge records to measure community-level influenza activity in California (2005-2018), Georgia (2010-2018), and New York (2005-2018). County-level respiratory ED visit rates attributable to influenza were estimated by quasi-Poisson time-series models, adjusting for temporal trends and environmental factors. Bayesian spatial models were used to assess associations with county-level socioeconomic status, environmental exposures, and chronic health condition prevalence. Influenza-attributable respiratory ED visit rates per 100,000 population were 226 (95% CI 206-246) in New York, 232 (95% CI 206-259) in California, and 547 (95% CI 506-589) in Georgia. A 10% increase in county-level poverty and uninsured rates was associated with higher influenza burden, increasing influenza-attributable respiratory ED visit rates by 160 (95% credible interval [CrI] 127-196) and 217 (95% CrI 168-265), respectively. Long-term PM2.5 (fine particulate matter ≤2.5 µm), humidity, and temperature also exhibited positive associations. Chronic conditions also increased ED visit rates by 1476/100,000 (95% CrI 1167-1778), 588/100,000 (95% CrI 400-747), and 488/100,000 (95% CrI 402-574) per 10% increase in stroke, chronic obstructive pulmonary disease, and diabetes prevalence, respectively. These associations weakened after adjusting for socioeconomic status. Influenza-attributable respiratory ED visit rates exhibit significant spatial heterogeneity that is associated with county-level socioeconomic factors, environmental exposures, and chronic disease prevalence.
15. Comment on Regional Anesthesia and the Risk of Missing Acute Compartment Syndrome Following Tibia Fractures.
期刊: Anesthesia and analgesia 发表日期: 2025-Dec-30 链接: PubMed
摘要
16. Impacts of Sexual and Reproductive Health and Rights Misinformation in Digital Spaces on Human Rights Protection and Promotion: Scoping Review.
期刊: JMIR infodemiology 发表日期: 2025-Dec-30 链接: PubMed
摘要
Sexual and reproductive health and rights (SRHR) are foundational to both individual autonomy and global well-being. Misinformation in this domain poses serious risks by undermining evidence-based decision-making, weakening systems of accountability, and perpetuating social injustices. This scoping review aimed to map and synthesize evidence on the forms, spread, and impacts of misinformation related to SRHR in digital spaces, with a particular focus on implications for the protection and promotion of human rights. We conducted a scoping review of scientific papers and gray literature. It was guided by the JBI (Joanna Briggs Institute) population, exposure, and outcomes framework. The extracted information was documented following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. Thematic analysis was carried out and mapped against human rights standards: (1) equality and nondiscrimination; (2) Availability, Accessibility, Acceptability, and Quality; (3) informed decision-making; (4) privacy and confidentiality; (5) participation and inclusion; and (6) accountability. Of the 254 eligible studies and documents, 133 focused on the information ecosystem, 37 on the individual, 32 on service delivery and health system, 31 on law and policy, and 21 on community levels. SRHR misinformation impacts individuals’ informed SRHR decisions by shaping their beliefs, attitudes, and health-seeking behaviors. It reinforces harmful and discriminatory social norms at community levels and the exclusion of marginalized voices. SRHR misinformation impacts health systems by shaping provider knowledge and practice, disrupting service delivery, and creating barriers to equitable care. It may function as a legal and policy tool to erode SRHR protections. The design of online platforms, digital marketing strategies, and content moderation policies enables misinformation to spread widely while restricting credible SRHR content. SRHR misinformation in digital spaces is a systemic issue that undermines human rights across multiple levels, highlighting the urgent need for integrated, rights-based approaches to research, policy, and intervention.
17. Clinical Effectiveness and Cost-Effectiveness of Collaborative Treatment With Korean and Western Medicine for Primary Headache Disorders: Protocol for a Multicenter Prospective Observational Study.
期刊: JMIR research protocols 发表日期: 2025-Dec-30 链接: PubMed
摘要
Primary headache disorders, including migraine and tension-type headache, are among the most prevalent neurological conditions worldwide, significantly contributing to disability and socioeconomic burden. While Western medicine (WM) predominantly focuses on pharmacological symptom management, Korean medicine (KM) emphasizes a holistic, individualized approach using modalities such as acupuncture and herbal medicine. Collaborative treatment, which combines these approaches, has been proposed as an alternative approach; however, robust evidence on its clinical effectiveness and cost-effectiveness remains limited. This study aims to evaluate the clinical effectiveness and economic value of collaborative treatment compared with usual care (UC) in patients with primary headache disorders in real-world clinical settings. This prospective, 2-arm, multicenter observational study will assess and compare the clinical effectiveness and economic value of collaborative treatment versus UC alone for patients with primary headache disorders. Adults aged ≥19 years with a primary diagnosis of primary headache disorders visiting participating hospitals under South Korea’s national collaborative treatment pilot project will be enrolled. Participants will receive either collaborative treatment (integrating WM pharmacotherapy with KM therapies such as acupuncture, pharmacopuncture, and herbal medicine) or UC (monodisciplinary care with WM or KM alone) based on informed choice. Clinical and cost-related outcomes will be assessed at baseline and 6 and 12 weeks. Clinical outcomes include monthly headache days, the numeric rating scale, the Headache Impact Test, the EQ-5D-5L, and the EuroQol visual analogue scale. The cost-effectiveness evaluation includes the cost per quality-adjusted life year, the incremental cost-effectiveness ratio, and the cost-effectiveness acceptability curve. Both intention-to-treat and per-protocol analyses will be performed. The study protocol was approved by the institutional review boards in July 2025. The study is funded by the Ministry of Health and Welfare, Republic of Korea (grant 202500900001). Participant recruitment commenced in August 2025, aiming to enroll 312 patients across multiple centers. Data collection is currently ongoing and is projected to be completed by December 2027, with results expected to be published in 2028. This study is designed to generate real-world evidence on whether collaborative treatment yields superior clinical outcomes and greater cost-effectiveness compared to UC for primary headache disorders. The findings are expected to address existing evidence gaps by integrating multidimensional clinical and economic measures, supporting informed decision-making for health policy, and contributing to the advancement of collaborative treatment models for headache management within South Korea’s medical system and beyond. DERR1-10.2196/82819.
18. Digital Health Intervention for and Long-Term Health Outcomes of a Divorce Cohort With Linked Danish Data: 5-Year Posttrial Follow-Up of a Randomized Controlled Trial.
期刊: Journal of medical Internet research 发表日期: 2025-Dec-30 链接: PubMed
摘要
Digital health interventions are increasingly promoted as scalable and cost-effective approaches to support mental health and resilience. Short-term benefits are well documented, but evidence on long-term outcomes (beyond 12 mo) remains scarce, particularly when assessed with objective measures in large cohorts. Most studies to date have focused on small samples, relied on self-reported outcomes, and used follow-up periods of less than a year. This leaves uncertainty about whether early changes are sustained over time and whether they can be observed in objective indicators of health. This gap is particularly relevant for stressful life transitions, where the risk of long-term adverse health outcomes is high. Divorce, a common and stressful transition linked to poorer mental and physical health, thus provides an ideal case for investigating the long-term potential of digital health interventions. This study examined the association between SES One, a digital health intervention for Danish divorcees, and mental health medication use, primary care usage, and hospitalizations over a 5-year follow-up period using Danish national health registers. Participants (n=1856) from a randomized controlled trial of SES One in Denmark were followed for 5 years after divorce. Outcomes included mental health medication prescriptions (eg, antipsychotics, anxiolytics, hypnotics, sedatives, and antidepressants), primary care usage (eg, billable interactions with general practitioners, specialist practitioners, and psychologists), and hospitalizations. Odds ratios and incidence rate ratios were calculated to compare outcomes between SES One participants and the control group. Over 5 years, SES One participants did not have significantly lower odds of filling a prescription (odds ratio [OR] 0.836; P=.09) but filled 28% fewer prescriptions overall (incidence rate ratio 0.720; P=.045), indicating a reduce-not-remove effect. No overall differences were observed in primary care usage or hospitalizations. However, participants had 38% (OR 0.624, P=.003) and 27% (OR 0.730, P=.001) lower odds of visiting primary care in years 2 and 3, respectively, and 32% (OR 0.677, P=.046) lower odds of hospitalization in year 4, suggesting possible late-onset effects. The findings advance the field by showing that a targeted digital health intervention can generate measurable long-term health benefits in a large cohort when evaluated with objective registry data. The results suggest that such interventions may reduce reliance on medication and health care services over time, not by eliminating needs entirely but by reducing them. These patterns can be interpreted as reflecting both legacy and late-onset pathways. Long-term evaluations with objective data are essential to fully capture the durability and timing of digital health intervention effects.
19. Elucidation of population-based bacterial adaptation to antimicrobial treatment by single-cell sequencing analysis of the gut microbiome of a hospital patient.
期刊: mSystems 发表日期: 2025-Dec-30 链接: PubMed
摘要
In this study, we used single-cell sequencing to analyze the gut microbiome of an adult male patient with acute cerebral hemorrhage undergoing antibiotic treatment. We identified 92 bacterial species, including 23 Firmicutes and one archaeon from Methanobacteriota, along with 69 unclassified strains. Single-cell sequencing effectively detected bacteria carrying antibiotic resistance genes (ARGs), particularly in unclassified species, and traced the evolution of these genes across diverse bacterial taxa. Notably, the cfr(C) gene was detected in 11 bacterial species following antimicrobial treatment, with mutation patterns characterized in Enterococcus faecalis, Klebsiella pneumoniae, Ruthenibacterium UN-1, and four unclassified species. In total, 29 ARG subtypes across eight types were identified in 13 known, five unknown, and 18 unclassified species, allowing us to trace their evolution routes. In addition, we detected a total of 309 horizontal gene transfer (HGT) events, in which several genes like folE and queE were frequently involved. The products of these genes are known to enhance the ability of the recipient bacterial strains to repair DNA damage and maintain genomic stability, especially following prolonged antibiotic treatment. Comparison between isolated strain genomes (IS-KP1) and single-cell analysis confirmed the presence of at least two K. pneumoniae strains in the patient, with one exhibiting a larger extent of involvement in ARG co-evolution. This strain was found to contain the cfr(C) and fosXCC genes, which were absent in IS-KP1. Klebsiella strains were also found to participate actively in HGT events. In conclusion, the study identified a wide range of ARGs and HGT events within the microbiome. The detection of K. pneumoniae strains with distinct ARG evolution patterns underscores the gut microbiome’s adaptability to environmental changes. These findings facilitate the development of novel antimicrobial strategies by fine-tuning the gut microbiome composition.IMPORTANCEThis study highlights the power of single-cell sequencing to unravel the diversity and dynamics of the gut microbiome during antibiotic treatment in a patient with acute cerebral hemorrhage. By identifying antibiotic resistance genes (ARGs) in both known and unclassified bacterial species, we reveal the intricate evolution and horizontal transfer of resistance traits across taxa. The discovery of distinct ARG patterns, including the emergence of the cfr(C) gene in multiple species and its co-evolution in K. pneumoniae, underscores the gut microbiome’s adaptability to antimicrobial pressures. These findings provide critical insights into the mechanisms driving resistance dissemination and offer potential pathways for developing precision microbiome-based therapies to combat antibiotic resistance.
20. A Highly Sensitive Multiplex Immunosensor for Detecting Three Sulfonylurea Herbicides: From Hapten Design to Molecular Recognition Mechanism.
期刊: Analytical chemistry 发表日期: 2025-Dec-30 链接: PubMed
摘要
Sulfonylurea herbicides (SUs) have the characteristic of persistent residues in the environment and crops, and their threat to environmental safety and human health is becoming increasingly prominent. In this study, three new haptens were designed targeting chlorimuron-ethyl (CRM), chlorsulfuron (CSF), and cinosulfuron (CIN), respectively, and their rationality was evaluated by computer simulation technology. Three monoclonal antibodies (mAbs) were obtained through mouse immunization and cell fusion, and their half-maximal inhibitory concentrations (IC50) were 2.42 ng/mL for CRM, 2.00 ng/mL for CSF, and 1.48 ng/mL for CIN, respectively. Molecular docking revealed that the specific recognition ability of CRM-mAb was mainly mediated by the key amino acid residues (PHE-B36, ALA-B34, ARG-A73, ARG-A73, and ARG-B96) in its binding pocket. Similarly, the key amino acid residues (TYR-A32, PRO-B58, and THR-A105) in the CSF-mAb pocket and the key amino acid residues (ARG-B56, ALA-B57, ALA-A105, ASP-B52, and ASN-B55) in the CIN-mAb pocket ensured their specificity and sensitivity. A multiplex colloidal gold immunochromatographic assay (multi-GNPs-ICA) was constructed based on this, which can simultaneously detect the aforementioned three SUs in paddy water, soil, and rice. Among them, the visual limit of detection (vLOD) is 1-50 ng/mL, the cutoff value is 5-200 ng/mL, and the calculated limit of detection (cLOD) is 0.25-4.29 ng/mL. The detection results of positive samples are highly consistent with those of HPLC-MS, validating the reliability of the multi-GNPs-ICA and demonstrating its significant application potential in rapid on-site screening.
21. Ecological ubiquity and phylogeny drive nestedness in phages-bacteria networks and shape the bacterial defensome.
期刊: PLoS pathogens 发表日期: 2025-Dec-30 链接: PubMed
摘要
Identifying the ecological and evolutionary factors that shape phage-bacterial interactions is key to understanding their dynamics in microbial communities. Yet, such interactions remain poorly characterised in plant agroecosystems. Here, we investigate the ecological determinants of the interaction between a highly diverse set of 23 phages isolated from diseased apricot trees and 44 bacterial strains from the Pseudomonas syringae species complex collected either from diseased apricot trees, healthy plants or non-agricultural environment. Based on their ecological origin, we expected phages to preferentially infect bacterial strains from the same ecological context, forming modular host-range patterns. Contrary to these expectations, we discovered a significantly nested structure, suggesting generalised infection dynamics rather than local adaptation, primarily driven by the broad ecological dynamics of this pathosystem. Analysis of the bacterial genomes showed that both the profiles of anti-phage defence systems and the distribution profiles of prophages are strongly shaped by bacterial phylogeny. Furthermore, while the number of defence systems showed limited correlation with the breadth of bacterial sensitivity to phages, prophage abundance exhibited a strong, non-linear link with phage virulence. Together, these findings provide an ecological and evolutionary perspective on phage-bacterium infection networks and new insights into a better understanding of the role of phages in agricultural ecosystems.
22. Identifying Priority Research Questions for Decentralized Wastewater.
期刊: Environmental science & technology 发表日期: 2025-Dec-30 链接: PubMed
摘要
Decentralized wastewater treatment and reuse represent critical infrastructure across the rural-periurban-urban continuum around the world. Effective, efficient, resilient, and equitable implementation of on-premise technologies and management systems is part of a One Water approach and necessary to protect public health and the environment, yet inconsistent delivery of essential public health services persists in many regions, including across states, tribes, and territories of the United States. We initiated a groundbreaking effort to understand challenges and to identify research opportunities related to the science and practice of decentralized wastewater. A horizon scanning exercise using a bottom up and transparent key questions approach was performed in which research needs were submitted by over 450 professionals working in academia, government, industry, and nonprofit organizations. We then further considered these research needs through facilitated focus group discussions and identified priority research questions through a consensus process during an in-person synthesis workshop. These key questions included technical and management topics, which were partitioned among six research categories: treatment, performance, and resource recovery; resiliency, efficacy, and sustainability; environmental quality and public health; assessment, monitoring, and operation and maintenance; implementation; and regulations, enforcement, and environmental justice. We offer recommendations to answer the priority research questions presented here; doing so promises to advance the science and improve the practice across rural-periurban-urban gradients.
23. AI-generated commentaries and letters to the editor of peer-reviewed publications: editors and authors beware!
期刊: Journal of mental health (Abingdon, England) 发表日期: 2025-Dec-30 链接: PubMed
摘要
24. Perceived impact of autism assistance service dog partnership on occupational participation in children with autism.
期刊: Disability and rehabilitation. Assistive technology 发表日期: 2025-Dec-30 链接: PubMed
摘要
A cross-sectional online survey design was used to illuminate caregivers’ perceived impact of an autism assistant service dog (AASD) partnership on the occupations of their child with autism spectrum disorder. The nine categories of occupation as outlined in the Occupational Therapy Practice Framework: Domain and Process Fourth Edition (OTPF-4) informed this study and include: activities of daily living, instrumental activities of daily living, health management, rest and sleep, education, work, play, leisure, and social participation (AOTA [1], p.7). Participants included 54 caregivers of children with autism that have been partnered with an AASD. Results indicated the occupations perceived to be most strongly and positively impacted were emotional and mental health management (75.5%, n = 40), social engagement with community (75.5%, n = 40), shopping (69.2%, n = 36), medical appointments (63.5%, n = 33), sleep preparation (60.4%, n = 32), care of pets (59.3%, n = 32) and safety awareness (59.3%, n = 32). When determining referrals for AASDs, practitioners should determine if deficits exist in one or more of these pertinent occupations as they are the ones most likely to be positively impacted. In addition, across all occupational categories, with few exceptions, occupational impacts of the AASD were reported as neutral to strongly positive. Finally, based on the positive occupational impacts, occupational therapists and other health professionals should consider integrating the use of AASDs during intervention to enhance outcomes. The AASD partnership appears to be an effective form of assistive technology to increase occupational participation of children with autism.Emotional/mental health management, social engagement with the community, shopping, medical appointments, sleep preparation, safety/safety awareness and care of pets were the occupations perceived to be most strongly and positively impacted by the presence of an AASD.Occupational therapy practitioners and other rehabilitation professionals when possible should consider integrating AASDs into their intervention approaches to potentially enhance outcomes.
25. The Purdue Pegboard test for surveillance of vibration-exposed workers.
期刊: Occupational medicine (Oxford, England) 发表日期: 2025-Dec-30 链接: PubMed
摘要
Assessment of manipulative dexterity using the Purdue Pegboard test (PPT) is widely used to assist in the determination of the severity of sensorineural damage resulting from exposure to hand-transmitted vibration. The aims of this study were to determine the methods of undertaking the test by occupational health professionals performing routine health surveillance for hand-arm vibration syndrome (HAVS) and the interpretation of the results obtained, thereby assessing the level of consistency of undertaking the test and of interpretation and subsequent use of that data for grading the severity of HAVS. A literature review was undertaken of the protocols used and normative data available in published studies. A three-round Delphi study was undertaken among a group of 31 occupational health professionals experienced in routine health surveillance for HAVS. This study revealed a lack of consensus or consistency regarding the detailed method of undertaking the test. No published study was found that reported normative data for the totality of the range of working life, making it necessary to combine data from two or more studies when considering a working population. There is a range of opinion regarding the method of use and interpretation of the PPT in determining the severity of sensorineural damage in HAVS, therefore confirming the subjectivity of conclusions regarding sensorineural grading. While greater consistency should be encouraged, this serves to emphasize the role of the PPT as one consideration in a holistic assessment rather than it being determinative in its own right.
26. Geranylgeranylacetone Alleviates Pulmonary Fibrosis in Mice by Activation of Nrf2 /HO-1/NQO1 Pathway.
期刊: Cell biochemistry and biophysics 发表日期: 2025-Dec-30 链接: PubMed
摘要
27. Under the Radar: Low Rates of Dual-Energy Radiograph Absorptiometry Screening and Associated Fracture Risk in Female Total Shoulder Arthroplasty Patients.
期刊: The Journal of the American Academy of Orthopaedic Surgeons 发表日期: 2025-Dec-29 链接: PubMed
摘要
Osteoporosis is prevalent in patients undergoing total shoulder arthroplasty (TSA) and affects perioperative management and outcomes, including fragility fractures. Despite guidelines recommending dual-energy radiograph absorptiometry (DXA) screening in women at risk for osteoporosis, screening before TSA remains low. With TSA procedures rising, it is important to identify factors that may contribute to low DXA utilization rates. This study aims to (1) evaluate the influence of demographic and social determinants of health on preoperative DXA screening and (2) identify predictors of postoperative fragility fractures. We retrospectively reviewed female patients who underwent TSA from 2016 to 2024 by a single surgeon. Patients meeting guideline-based indications for DXA were included. Multivariable logistic regression identified predictors of DXA utilization. Among patients without prior fragility fractures, time-to-event analysis using Firth penalized Cox regression assessed predictors of postoperative fractures. A bootstrap sensitivity analysis (1,000 iterations) evaluated the stability of smoking-related risk estimates. Of 432 eligible women, only 39.7% (n = 176) received a preoperative DXA screening. In adjusted analysis, married patients had 52% higher odds of receiving screening (odds ratios 1.52, 95% confidence intervals [1.01 to 2.29], P = 0.044), whereas those with public insurance had 54% lower odds compared with privately insured patients (odds ratios 0.46 [0.29 to 0.74], P = 0.001). Among 358 patients without prior fragility fractures, current tobacco use markedly increased postoperative fracture risk (hazard ratios [HR] 14.87 [1.69 to 130.88], P = 0.015). Higher body mass index was protective: overweight (HR 0.27 [0.08 to 0.87], P = 0.028) and obese (HR 0.03 [0.003 to 0.29], P = 0.002) patients had a lower fracture risk. DXA screening is underused in women undergoing TSA. Marital status and insurance type markedly affect screening rates, whereas low body mass index and tobacco use remain strong predictors of fragility fractures. These findings suggest a need for comprehensive bone health management strategies, including improved screening, risk counseling, and optimized osteoporosis management. III.
28. What does 'polysubstance' really mean? Comparing drug-involved deaths in CDC records vs. detailed medical examiner data from Los Angeles.
期刊: The International journal on drug policy 发表日期: 2025-Dec-29 链接: PubMed
摘要
Complex polysubstance use is increasing in the United States. However, most epidemiological literature relies on traditional data sources, especially CDC WONDER, which is limited to employing two ICD-10 codes concurrently. We leverage complete medical examiner records from Los Angeles County to examine the limitations of CDC WONDER data for detecting polysubstance drug deaths. Drug-involved deaths occurring in Los Angeles County were described using the CDC WONDER system and Los Angeles County Medical Examiner data. Annual single-drug involvement rates were compared between the two data sources. The average number of drugs, and the proportion of polysubstance deaths involving 3 or more substances was summarized by year. UpSet plot visualization was employed for complex set analysis. Overall concordance in single-substance death counts between CDC WONDER and medical examiner records was high among n = 6 substances assessed. The average number of drugs reported per death had a skewed distribution and increased from 1.72 in 2012 to 2.29 in 2023. The percentage of polysubstance deaths with 3+ drugs increased from 51% in 2012 to 74% in 2023. The number of unique polysubstance combinations with 3+ substances increased from 11 in 2012 to 57 in 2023. Although concordance is high for single-substance involvement rates, CDC WONDER fails to capture the majority of polysubstance deaths adequately, as about three-quarters of these deaths are incompletely described using its 2-drug limit. This limitation has worsened as deaths increasingly involve more drugs on average. We illustrate a huge variety of polysubstance combinations that can be seen in medical examiner deaths. As the overdose crisis grows increasingly polysubstance in nature, improving the epidemiological tracking of deaths involving multiple drugs, and drugs not captured by ICD-10 codes currently, is of paramount importance.
29. Antibiotics and preterm delivery: The prevalent new-user cohort design to resolve immortal time bias.
期刊: Epidemiology (Cambridge, Mass.) 发表日期: 2025-Dec-26 链接: PubMed
摘要
Observational studies of the association between antibiotics and preterm delivery report conflicting findings. We assessed the effects of third trimester antibiotic use on preterm delivery and low birthweight, using a study design that accounts for immortal time bias. We used the UK’s Clinical Practice Research Datalink to identify pregnant females aged 12-50, over the period 2002 to 2016, reaching 27 weeks of gestation without antibiotic use until that point. We applied the prevalent new-user design, matching each third trimester antibiotic initiator with a reference non-user at the same gestational day, using time-conditional propensity scores. The two matched groups were compared on the incidence of preterm delivery and low birthweight. The full cohort was also analyzed with antibiotic use considered as time-fixed and time-varying exposures. The cohort included 207,027 pregnancies, with 16,865 initiating antibiotics matched to 16,865 non-users. The hazard ratio (HR) of preterm delivery with third trimester antibiotic use was 1.14 (95% CI: 1.04-1.24), compared with non-use. With time-fixed exposure, subject to immortal time bias, the HR was 0.78 (95% CI: 0.73-0.83), while with time-varying exposure, the HR was 1.23 (95% CI: 1.16-1.32). The HR of low birthweight with antibiotic initiation was 1.07 (95% CI: 0.93-1.25) compared with 0.91 (95% CI: 0.83-1.00) under the time-fixed approach. Using the prevalent new-user design, which emulates a randomized trial, antibiotic use late in pregnancy was associated with a modest increased incidence of preterm delivery. Previous inconclusive studies may have resulted from observational methods that introduced, or insufficiently addressed, immortal time bias.
30. Effects of Consecutive Long-Haul Travel on Jet-Lag Symptoms: Case Study of a National Water Polo Team Preparing for World-Class Events.
期刊: International journal of sports physiology and performance 发表日期: 2025-Dec-24 链接: PubMed
摘要
To describe jet-lag symptoms in the days following 3 long-haul transmeridian travel. Twelve male water polo players representing a national team participated in the study. Jet-lag symptoms were assessed following travel from Athens, Greece, to Los Angeles, CA, United States (13.5 h), for participation in the FINA World Cup; from Los Angeles to Athens (13.5 h); and from Athens to Fukuoka, Japan (22.3 h), for the World Championships. The athletes were also characterized in terms of locus of control, chronotype, and circadian rigidity. Symptoms on the first 3 days at each destination were compared using a 2-way analysis of variance (day × destination). Responses were also examined to determine if player characteristics affected the severity or persistence of jet-lag symptoms. Jet-lag symptoms were greatest on the first day and reduced thereafter; scores are in arbitrary units, based on responses to a validated questionnaire. In addition, jet-lag symptoms were greater in Athens after eastbound travel (6.7 [2.4]) than in Los Angeles after westbound travel (3.8 [2.1]) and yet markedly less in Fukuoka after eastbound travel (2.2 [1.6], P < .01). Responses to questions about sleep and mood demonstrated similar patterns, although patterns were not as clear-cut. Personal characteristics had little relation with responses to travel. While the direction and duration of travel have been implied as important factors in the severity and persistence of jet-lag symptoms, we venture that the purpose of travel may play an important role.
31. Curcumin alleviates non-alcoholic fatty liver disease by modulating inflammation, barrier function, and gut microbiota.
期刊: Biochemical and biophysical research communications 发表日期: 2025-Dec-24 链接: PubMed
摘要
Non-alcoholic fatty liver disease (NAFLD) ranks as the most common chronic liver disease with limited effective therapeutic strategies. Curcumin, an active ingredient extracted from the rhizomes of curcuma longa, has long been recognized for its hepatoprotective properties and clinical use in treating various liver diseases. The therapeutic effects of curcumin on the development of NAFLD and its mechanisms were investigated in the present study. Sprague Dawley rats with NAFLD were established by exposure to a high-fat diet(HFD). Curcumin was administered by oral gavage daily. Body weights were measured weekly. After 8 weeks of intervention, samples were harvested to analyze lipid profile and liver function, pathological changes, inflammatory cytokine production, intestinal barrier integrity, and gut microbiota. Curcumin administration mitigated NAFLD progression, evidenced by significant decreases in body mass, liver mass, and its corresponding index, concomitant with improvement in metabolic disorders and liver injury. Moreover, curcumin effectively prevented the increase of pro-inflammatory cytokines in systemic circulation and the liver. The results of PCR demonstrated that the intestinal barrier integrity was improved by curcumin, as evidenced by upregulating the transcriptional levels of ZO-1, Occludin mRNA in colonic tissues.16S rRNA analysis showed that curcumin mainly affected intestinal microbiota diversity, and altered abundances of bacterial taxa at genus, and species levels in rats with HFD. Curcumin ameliorates HFD-induced NAFLD through a multifaceted mechanism involving suppression of inflammation, enhancement of intestinal barrier function, and restoration of intestinal flora. These findings offer novel insights into the potential therapeutic benefits of curcumin in NAFLD.
32. More mindful, more selective, more disordered? A mediation analysis of picky eating in the link between mindful eating and orthorexia nervosa tendency.
期刊: Nutrition (Burbank, Los Angeles County, Calif.) 发表日期: 2025-Dec-22 链接: PubMed
摘要
This study evaluated the relationship between picky eating, mindful eating (ME), orthorexia nervosa (ON) tendency, and diet quality in adults. The secondary aim was to examine whether picky eating mediates the effect of ME on ON tendency. A total of 541 adults (mean age 26.6 ± 10.54 y, 50.6% women) participated. Data were collected using a structured questionnaire via face-to-face interviews and convenience sampling. Picky eating (PE) was assessed with the Adult Picky Eating Questionnaire, ME with the ME Inventory (MEI), ON tendency with the Test of ON-17 (TON-17), and diet quality with the Healthy Eating Index-2020. Dietary intake was measured using a 24-h dietary recall. Among participants, 5.2% had ON, and 41.6% had inadequate diet quality. MEI was positively associated with PE (β = 0.108; P = 0.013) and TON-17 (β = 0.093; P = 0.025). PE was positively associated with TON-17 (β = 0.213; P < 0.001) and negatively associated with Healthy Eating Index-2020 (β = -0.126; P = 0.003). The indirect effect of MEI on TON-17 via PE accounted for 19.8% of the total effect, indicating that PE partially mediated this relationship. The findings suggest that ME is associated with healthier dietary behavior; however, they may also be related to increased orthorexic tendencies. It also showed that PE mediates between MEI and TON-17. Addressing selective eating behaviors and encouraging balanced, ME in public health strategies may help improve diet quality and reduce eating related problems.
33. Association Between Active Outdoor Play and Health Among Children, Adolescents, and Adults: An Umbrella Review.
期刊: Journal of physical activity & health 发表日期: 2025-Dec-22 链接: PubMed
摘要
This umbrella review examined the associations between active outdoor play (AOP) and physical, mental, social, and spiritual health across all ages. A systematic search of 8 bibliographic databases was conducted to identify quantitative, qualitative, and mixed-methods systematic reviews and meta-analyses examining associations between AOP and human physical, social, mental, and spiritual health. Included reviews were written in English or French and published in or after 2014. Assessing the Methodological Quality of Systematic Reviews 2 was used to assess the quality of reviews. Quantitative findings on statistical observations of null, favorable, and unfavorable findings were used to assess the consistency of evidence. Bradford Hill’s criteria was used to assess causality. Six systematic reviews-3 quantitative, 2 mixed-methods, and 1 qualitative-were included in the umbrella review, encompassing 381 articles. Four and 2 reviews were assessed as critically low and high quality, respectively. For physical, social, and spiritual health, 78% (7/9 observations, 2 reviews), 72% (13/18 observations, 3 reviews), and 100% (9/9 observations, 1 review) showed that AOP was favorably associated with the respective health outcomes based on children and adolescent studies exclusively. By contrast, 71% (53/75 observations, 4 reviews) showed that AOP was favorably associated with mental health inclusive of all ages. There was partial support for causality between AOP and all health outcomes. A figure was created to illustrate possible pathways from AOP to health outcomes. Largely positive associations were observed between AOP and physical, social, mental, and spiritual health, especially among children and adolescents. The greatest source of favorable evidence across all ages was on AOP and mental health, highlighting benefits for public health.
34. Enhancing the Socioecological Model to Integrate Equity and Planetary Health: A Framework for Understanding Complex Interventions Shaping Population Health and Active Living.
期刊: Journal of physical activity & health 发表日期: 2025-Dec-22 链接: PubMed
摘要
Physical activity is a major contributor to population health, yet opportunities for active living are inequitably distributed due to social and structural determinants of health. Climate change, urbanization, and social inequalities influence whether individuals engage in physical activity out of necessity or as a free choice. We present an Enhanced Socioecological Model integrating planetary health and the necessity-choice continuum into the classic socioecological framework, providing a tool to assess large-scale interventions originating outside the health sector. After critically synthesizing the Ecological Model of Active Living, the Social Determinants of Health, and the Planetary Health framework, we applied enhanced socioecological model to 2 national affordable-housing programs-Brazil’s Minha Casa, Minha Vida and the US Choice Neighborhoods Initiative. A review of peer-reviewed studies, policy documents, and program reports reveals that peripheral Minha Casa, Minha Vida developments exacerbate necessity-driven mobility through inadequate transit and infrastructure thereby heightening climatic and social vulnerabilities. Conversely, Choice Neighborhoods Initiative’s in situ, mixed-income redevelopment fosters choice-driven activity via transit connectivity, green space, and community amenities. The Enhanced Socioecological Model offers a unifying framework for guiding future research and policy interventions, advancing equitable, climate-resilient urban development while promoting public health.
35. GloW-VSNet: A scribble-based weakly supervised framework for global-view vitiligo lesion segmentation.
期刊: Medical image analysis 发表日期: 2025-Dec-21 链接: PubMed
摘要
Vitiligo lesion identification is essential for quantifying disease severity, monitoring disease progression and assessing treatment response, particularly for objective quantification. However, segmenting vitiligo lesions from clinical images is challenging due to indistinct borders, complex backgrounds, and image artifacts. The difficulty increases when handling small and sparse lesions in global-view photographs. Fully supervised segmentation models require extensively annotated datasets, making the labelling process time-consuming and costly. To address these challenges, we propose GloW-VSNet, a scribble-guided weakly supervised segmentation method for global-view vitiligo detection. Our approach integrates differentiable feature clustering with a spatial attention mechanism based on physician-provided scribble annotations, enabling the model to focus on relevant spatial features and improve segmentation accuracy despite background noise and artifacts. Additionally, we introduce spatial continuity optimization to preserve the natural distribution of vitiligo, enhancing segmentation consistency while reducing computational demands. Extensive experiments on two public vitiligo datasets and two private datasets demonstrate that GloW-VSNet achieves state-of-the-art performance. To our knowledge, this is the first study to explore weakly supervised global-view vitiligo segmentation, addressing a critical research gap. Our method enhances the assessment of disease severity and monitoring of treatment response through an objective assessment for real-world applications. Our code is publicly available at https://github.com/YuhanZheng0327/Weakly-Supervised-Vitiligo-Lesion-Segmentation.
36. Physical Activity Knowledge Among US Community Health Workers.
期刊: Journal of physical activity & health 发表日期: 2025-Dec-18 链接: PubMed
摘要
The knowledge and awareness of physical activity (PA) guidelines is limited among adults in the United States. Community health workers (CHWs) are key to promote health among underserved populations; however, little is known about their knowledge and awareness of the PA guidelines. To assess CHW’s understanding of PA, we administered the questionnaire on knowledge and awareness of the PA guidelines from the Office of Disease Prevention and Health Promotion to CHWs across the country (N = 108, Mage = 42, SD = 9.70, 86% female, 47.2% White). While 77.6% reported recommending PA to clients, only 38% were familiar with the guidelines. The average score on the knowledge survey was low (M = 3.18, SD = 1.50) particularly for dosage-specific items: only 19.4% correctly identified the recommended weekly dose of moderate-intensity PA, 8.4% for vigorous-intensity, and 24.3% for muscle-strengthening activities. Chi-square analyses showed no statistically significant difference in PA knowledge across demographic groups, but those who reported having familiarity with PA guidelines were more likely to correctly respond to the questions on dosage of moderate- (P = .02) and vigorous-intensity PA (P = .02), and muscle strengthening (P = .02). These results highlight a gap in CHWs’ knowledge of PA guidelines. Given their frontline role in health promotion, increasing CHWs’ education on PA guidelines may improve their capacity to effectively promote PA. Future research may consider increasing education on PA among CHWs and examine how this may translate to increased PA participation among the communities they serve.
37. The Political Declaration of the Fourth United Nations High-Level Meeting on Noncommunicable Diseases and Mental Health-Implications for Physical Activity Promotion.
期刊: Journal of physical activity & health 发表日期: 2025-Dec-18 链接: PubMed
摘要
38. Associations of Sleep Duration, Quality, and Timing With Physical Activity and Sedentary Behaviors Among High School Students.
期刊: Journal of physical activity & health 发表日期: 2025-Dec-17 链接: PubMed
摘要
Insufficient physical activity (PA) is associated with obesity, cardiovascular disease, and mortality, yet only 26.1% of US high school students report meeting the 60-minute daily PA guideline. Adolescents’ sleep may contribute to their activity patterns. However, findings in this area have been inconsistent, and few studies have used both objectively measured sleep and PA. Two hundred and sixty ninth-grade students (mean age = 14.7, SD = 0.5) in Minnesota wore wrist actigraphs for 7 days to assess weekday and weekend sleep duration, midpoint, efficiency, latency, moderate to vigorous PA, light PA, and waking sedentary time. Multiple regression analyses, controlling for demographics, assessed whether sleep features were associated with activity levels. Weekday and weekend sedentary time decreased by 25.86 and 19.21 minutes per each additional hour in weekday and weekend sleep duration, respectively. A later weekend sleep midpoint was associated with 8.09 fewer minutes of weekend sedentary time. Sleep duration related to less daily time spent in light PA (8.66 and 9.64 min per every additional hour slept on weekdays and weekends, respectively). Each hour of advancement in weekday sleep midpoint was associated with 14.22 additional minutes of light PA and 3.06 more minutes of moderate to vigorous PA. For each additional percentage point in sleep efficiency, 2.11 minutes less weekend light PA was observed. If sleep can influence activity, modifying sleep could be a path to promoting healthful activity levels. Further, given that PA and sleep may be mutually reinforcing, targeting both behaviors concurrently could provide comprehensive health promotion.
39. Successful Scale-Up in Physical Activity: Is It Simply a Matter of Luck?
期刊: Journal of physical activity & health 发表日期: 2025-Dec-15 链接: PubMed
摘要
40. Associations Between Socioeconomic Factors and Regular Exercise in Japanese Adults: A Cross-Sectional Analysis.
期刊: Journal of physical activity & health 发表日期: 2025-Dec-11 链接: PubMed
摘要
Physical inactivity is a high-priority public health issue because of its negative impact on quality of life and well-being. Although socioeconomic factors (SEF) are known to influence physical activity, few studies have explored their association with regular exercise (RE). This gap highlights the need for further research on the associations between SEF and RE. This cross-sectional study used secondary data from the 2022 Sasakawa Sports Foundation National Sports-life Survey conducted in June and July 2022. The dependent variable was RE, and the independent variables were SEF (education, income, and occupation). A modified Poisson regression analysis was performed. The data of 2318 participants (53% male) with a mean (SD) age of 51 (16) years were analyzed. Those with higher education, higher income, and certain types of occupations were more likely to engage in RE. Subgroup analysis revealed differences in the associations with age, sex, and city size. This study showed that individuals with higher SEF, such as education and income, generally had higher levels of RE. However, part-time worker or nonworker individuals were more likely to be engaged in RE than employees. Each SEF may be differently associated with RE; and therefore, public health interventions should be tailored to specific subgroups defined by SEF to promote RE and reduce health inequalities.
41. Updates on Testing, Treatment, and Prevention of Sexually Transmitted Infections in the United States, 2025.
期刊: Topics in antiviral medicine 发表日期: 2025-Dec 链接: PubMed
摘要
There has been a substantial increase in the prevalence of sexually transmitted infections (STIs) and a widening gap in health care disparities over the past decade. New technologies, emerging public health research, and growing antimicrobial resistance have changed how practitioners counsel patients and diagnose and manage common STIs. Updating practitioners’ understanding of best care practices for patients with STIs is crucial in averting preventable morbidity and mortality. This review covers important changes in the screening, diagnosis, treatment, and prevention of common STIs over the past 5 years.
42. Prevention and Management of Viral Hepatitis in Primary Care.
期刊: Topics in antiviral medicine 发表日期: 2025-Dec 链接: PubMed
摘要
The primary care clinician can play a substantial role in the management and prevention of viral hepatitis infections, which cause a substantial burden of hepatocellular carcinoma and cirrhosis worldwide and in the US. One-time hepatitis B and C virus testing is now recommended as part of universal adult screening measures, and more frequently based on risk factors. Immunization strategies for hepatitis A and B have also been updated, with a new adjuvanted, conjugated hepatitis B vaccine (HepB-CpG) that provides greater efficacy than older vaccines. Management of hepatitis B and C has been streamlined based on current tolerable, effective oral regimens that can reduce the individual’s risks of liver fibrosis and cancer and interrupt the cycles of community transmission. The epidemiology and natural history of these viral infections are summarized and concise updates of screening, diagnosis, treatment, and prevention strategies are provided.
43. Getting to GRIPS with MR-Egger: Modelling directional pleiotropy independently of allele coding.
期刊: PLoS genetics 发表日期: 2025-Dec 链接: PubMed
摘要
Mendelian Randomisation Egger regression (MR-Egger) is a popular method for causal inference using single-nucleotide polymorphisms (SNPs) as instrumental variables. It allows all SNPs to have direct pleiotropic effects on the outcome, provided that those effects are independent of the effects on the exposure, known as the InSIDE assumption. However, the results of MR-Egger, and the InSIDE assumption itself, are sensitive to which allele is coded as the effect allele for each SNP. A pragmatic convention is to code the alleles with positive effects on the exposure, which has some advantages in interpretation but some statistical limitations. Here we show that if the InSIDE assumption holds under all-positive coding of the exposure effects, it cannot hold under all-positive coding of the pleiotropic effects, and argue that this undermines the soundness of MR-Egger. We propose a modification that has the Genotype Recoding Invariance Property (GRIP), achieving the main aim of MR-Egger without the difficulties of allele coding. Our approach, MR-GRIP, is valid under a “Variance Independent of Covariance Explained” assumption (VICE), which amounts to an inverse relationship between exposure effects and pleiotropic effects. Examples and simulations suggest that MR-GRIP can reconcile differences between MR-Egger and alternative methods.
44. Prevalence and intensity of soil-transmitted helminth infections in Narok and Bomet Counties, Kenya: Evidence from program monitoring.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Dec 链接: PubMed
摘要
The backbone of Kenya’s soil-transmitted helminthiasis control program is the periodic distribution of anti-helminthic preventive chemotherapy (PC). PC distribution has been conducted since 2012 through the National School-Based Deworming Programme, which deworms school-age children (SAC, 5-14 years) living in areas at high risk for soil-transmitted helminth (STH) infections. After nearly a decade of deworming, the Ministry of Health sought to generate evidence for program monitoring by estimating the prevalence and intensity of STH infection in Narok and Bomet counties among at-risk groups: preschool-aged children (PSAC, 2-4 years), SAC, and women of reproductive age (WRA, 15-49 years), of which only SAC are covered by the deworming program. During August and December of 2021, we conducted cross-sectional, population-based household surveys in Narok and Bomet counties, using multi-stage, cluster random sampling among resident PSAC, SAC, and WRA. Individual and household questionnaires were administered using an electronic mobile platform. Stool samples were collected and tested for roundworms (Ascaris lumbricoides), hookworms (Necator americanus, Ancylostoma duodenale), and whipworms (Trichuris trichura) using the Kato-Katz method. Stool samples were provided by 1,062 PSAC, 1,922 SAC, and 364 WRA. Results indicated that the prevalence of any STH infection in Bomet county was similar among SAC (16.2% [upper 95% design-corrected confidence interval [U95% CI]: 23.1%]) and PSAC (15.8% [U95% CI: 21.7%]). In Narok county, STH prevalence was marginally higher among PSAC (12.8% [U95% CI: 18.2%]) compared to SAC (11.3% [U95% CI: 16.2%]). Moderate-to-high intensity infection prevalence among PSAC and SAC exceeded the morbidity elimination threshold of 2% in both counties. A. lumbricoides and T. trichura were most identified; few hookworm infections were detected. STH infections remain a public health problem in Narok and Bomet counties. There may be a need to expand PC distribution to include risk groups beyond SAC during deworming exercises, as envisioned in the Breaking Transmission Strategy, to hasten progress toward the achievement of STH as a public health problem.
45. Examining Canadian youth's engagement with food companies via digital media.
期刊: PLOS digital health 发表日期: 2025-Dec 链接: PubMed
摘要
Digital food marketing to youth is concerning given its widespread reach, engagement strategies and influence on lifelong food behaviours. Nonethless, little is known about youth’s engagement (i.e., liking/sharing/following food companies on social media, having food company/restaurant/delivery service apps downloaded) with food companies via digital media, particularly in Canada. This study examined whether youth’s digital engagement with food companies differed by sociodemographic characteristics in Canada. An observational cross-sectional online survey was conducted in 2023 among 1162 Canadian children (aged 10-12 years) and adolescents (13-17 years). Participants self-reported their sociodemographic information and engagement with food companies via digital media. Descriptive analyses and logistic regression models examined differences in engagement by gender, age group, race/ethnicity and income adequacy. Among all participants, 20.9% reported having liked, shared, or followed food/restaurant companies on social media, 23.1% had food/restaurant company apps on their smartphones, and 16.6% had apps for food delivery services. White participants and youth from medium income adequacy households had lower odds of having liked/shared/followed food companies on social media than racial/ethnic minority group participants (OR: 0.59; 95% CI: 0.43, 0.80) and those from low income adequacy households (OR: 0.57; 95% CI: 0.41, 0.80), respectively. Children and White participants had lower odds of reporting food company apps on their smartphones than adolescents (OR: 0.54; 95% CI: 0.41, 0.72) and racial/ethnic minority group participants (OR: 0.48; 95% CI: 0.35, 0.64), respectively. Children and White participants also had lower odds of reporting food delivery service apps on their smartphones than adolescents (OR: 0.52; 95% CI: 0.38, 0.72) and racial/ethnic minority group participants (OR: 0.32; 95% CI: 0.23, 0.44), respectively. No significant differences were observed between genders. Overall, many Canadian youth are engaging with food companies via digital media. Government-led food marketing regulations that extend to social media and food company and delivery service apps are warranted.
46. Environmental changes and risk of plague epidemics in Indonesia.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Dec 链接: PubMed
摘要
Historical epidemiological data indicate that plague epidemics caused thousands of deaths in Indonesia between 1911 and 1956. During this period, silent phases of the disease were observed, followed by re-emergences several years or even decades later in certain regions. The Indonesian government, both at the regional and central levels (notably the Ministry of Health of the Republic of Indonesia), has undertaken decades of epidemic management efforts, including plague surveillance, medical treatments, vector control, and improvements in individual and environmental sanitation. There were a few sporadic outbreaks in 1968, 1987, and 2007. Since then, no further cases have occurred, but this could just be another silent phase. A literature search comprising articles and reports including published and unpublished dissertations, was performed using the PubMed online database, the Directorate General of Disease Prevention and Control, the Ministry of the Health Republic of Indonesia, Institute for Vector and Reservoir Control Research and Development, The Ministry of Health of Indonesia, Provincial Health Offices, Google Scholar, Science Direct, Medicus Index for the Southeast Asian Region (IMSEAR) and co.IMSEAR), and others. All literature referring to plague in Indonesia (1923-2019) was used as a reference for this article. The Global Land Cover 1992-2020 from the European Space Agency database was used to monitor land cover changes with a spatial resolution of 300 meters. The Esri Sentinel-2 Land Cover Explorer database, created by ESRI (Environmental Systems Research Institute, Redland, California, USA) using Sentinel-2 satellite imagery was also used. This database shows global land cover change between 2017 and 2023, using only 2023 data. Seven land cover classes were identified: Water, Forest, Flooded fields, Fields, Urban, Bare ground, and Pasture. Environmental changes, essentially land conversion, have occurred in regions where plague outbreaks were previously recorded, with the exception of Eastern Java. Land conversion, increased human population density, and the heightened risk of human-rodent interactions could contribute to a resurgence of plague epidemics in Indonesia. Vectors and rodent hosts of Yersina pestis are still present in all regions but one with a higher human population density and thus a higher risk of contact. In Eastern Java, the environment remained the same as when plague outbreaks previously occurred. We conclude that the historical areas of plague outbreaks have a potential for silent periods of plague transmission which could last decades. Furthermore, land conversion and the development of human settlements in these regions have led to a higher human presence, thus potentially increasing the risk of contact and transmission. There is therefore today a risk of plague resurgence in Indonesia and the current plague-free period might just be a silent period. In order to prevent outbreaks of plague after a period of silence and to implement an early alert system of plague transmission from animals to humans via fleas, the monitoring of potential Y. pestis circulation in sylvatic areas also needs to be intensified.
47. Dengue virus serotype 4 in Aedes aegypti mosquitoes in Kenya.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Dec 链接: PubMed
摘要
Dengue fever is one of the most globally significant arthropod-borne viral diseases. In 2024, more than 14 million cases and 10,000 deaths were reported across 92 tropical and subtropical countries. Dengue virus (DENV), endemic in Sub-Saharan Africa including Kenya, comprises four serotypes (DENV-1 to DENV-4). While DENV-1 to DENV-3 are widely distributed in the region, DENV-4 is considered rare. However, information on the distribution of DENV serotypes and the genetic diversity within African mosquito populations remains limited. To address this gap, 2,400 Aedes aegypti, the primary vector species of DENV, were collected from southeastern and coastal Kenya between 2016 and 2019 and subjected to viral analyses. Collected samples were screened for orthoflaviviruses using a nested pan-orthoflavi RT-PCR, and positive samples were Sanger sequenced. DENV-4 genotype I was detected in a pool of two female Ae. aegypti collected during a dengue outbreak in Mombasa in 2017, which was predominantly associated with DENV-2. The DENV-4 genome retrieved from this strain was similar to sequences of DENV-4 that have previously been reported from South India. We report the detection and genomic characterization of DENV-4 genotype I in Kenyan mosquito populations. These findings contribute to current knowledge of DENV serotype distribution in southeastern Africa and highlight the need for improved genomic surveillance to guide effective dengue prevention and control strategies.
48. Assessing the diagnostic accuracy of biochemical, anthropometric, and combined indices for metabolic syndrome prediction in a cohort from Qatar Biobank.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Metabolic syndrome (MetS) poses a substantial health risk, particularly in Qatar. This study aimed to compare the diagnostic accuracy of various indices for MetS identification in a well-characterized Qatari cohort from Qatar Biobank (QBB). This cross-sectional study included 692 adults (≥18 years) from the QBB, categorized into MetS and healthy groups using the International Diabetes Federation (IDF) criteria. We compared the distributions of biochemical, anthropometric, and combined indices between groups. Logistic regression assessed associations with MetS, adjusting for demographics. Receiver Operating Characteristic (ROC) analysis evaluated discriminative performance and identified optimal thresholds. Robustness was tested using a 75/25 train-test split. Stratified analyses examined the influence of age, gender, and nationality. The MetS prevalence was 19.1% among participants. Individuals with MetS displayed significantly higher levels of all indices compared to the healthy group. Triglycerides (adjusted odd ratio (AOR): 4.93), waist circumference (AOR: 3.87), and lipid accumulation product (LAP) (AOR: 14.91) showed the strongest associations within their respective categories. LAP achieved the highest discriminative performance (area under the curve (AUC): 0.896; 95% CI: 0.870-0.923), followed by the visceral adiposity index (VAI) (AUC: 0.877) and TyG × waist circumference (AUC: 0.872). LAP’s optimal threshold was 37.1, with a sensitivity of 0.856 and a specificity of 0.789. Combined indices consistently outperformed individual measures. Discriminative accuracy was comparable across genders and nationalities but higher in individuals under 45 years. Combined indices, particularly LAP, demonstrate superior discriminative ability for MetS in this Qatari cohort. Incorporating LAP into routine clinical practice could improve MetS detection and facilitate timely interventions. Further validation in larger, diverse populations is, however, warranted.
49. Exploring barriers of household contact screening of index case contacts of pulmonary tuberculosis cases in Sekela district, Amhara region, Ethiopia: 2023; descriptive qualitative study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Tuberculosis (TB) remains a leading global public health challenge, with about one-third of the world’s population infected and at risk of developing active disease during their lifetime.. Contact screening is crucial strategy for active case detection and to identify more cases. It involves systematic screening of the contacts of known TB patients. There is an ongoing need for research into barriers to contact investigation to better information uptake. Exploring the barriers to Household Contact screening of pulmonary Tuberculosis Cases. A descriptive qualitative study was conducted at Sekela district, West Gojjam zone, Ethiopia. Purposive sampling (heterogenic) technique was used to recruit study participants. Fourteen participants were involved in the study in accordance with data saturation which includes health extension workers, PTB patients; household contacts of TB patients, health center TB focal and district TB officer. Data was collected through in-depth interviews using a semi-structured guide, transcribed word by word and conceptually translated. A thematic analysis was conducted after coding to answer specific study questions. The main barriers for contact screening of PTB case explored were; health care system related barriers like not conducting review meeting power, lack of training, lack of supervision and follow up; barriers from the health care workers; work over load, non-commitment; socio economic barrier, discrimination, preference of traditional healers and culture, difficult geographic area; and barriers from patients and contacts are lack of awareness, low health seeking behavior. The overall explorations of this study identified multiple and interconnected barriers that range from individuals to health system levels which influence contact screening of pulmonary tuberculosis cases in the study area. Not paying attention to contact tracing activity by health system care system results lack of commitment of health care workers not giving health education to community.
50. The practice of drug emergency supply in China during the COVID-19 pandemic: A policy mix perspective.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Public health emergencies such as COVID-19 severely disrupt drug supply chains, creating sudden surges in demand, labor shortages, and regulatory challenges. Existing studies often focus on single supply chain stages, with limited systematic analysis of policy responses across the entire cycle. This study aims to systematically analyze China’s emergency drug supply policies by examining issuing agencies, developmental stages, policy tools, and supply chain links, to identify patterns, complementarities, and existing gaps. A total of 559 policy texts (110 national, 449 provincial) issued between December 2019 and February 2023 were collected. Content analysis and coding were conducted based on a four-dimensional framework. Social network analysis was applied to joint policy issuances to assess institutional collaboration and centrality. National policies emphasized macro-level planning and dynamic adjustment: motivation and symbolic tools dominated in the burst stage, commands and regulations in the remission stage, and symbolic tools in later stages. Provincial policies relied more on rigid enforcement through commands and regulations, gradually shifting toward capacity-building in distribution and use. Finance, healthcare security, and regulatory agencies emerged as network hubs, while the distribution stage received the most policy support. Raw material supply was largely overlooked. National and provincial policies demonstrated complementary functions-national policies providing strategic direction and provincial policies ensuring operational enforcement. However, imbalances in policy tool use, weak shortage monitoring, and insufficient human resource policies remain. Future research should incorporate municipal-level measures, field-based evaluations, and international comparisons to optimize China’s emergency drug supply governance.
51. Iron Must Be in Haemin to Act as a Pro-Inflammatory Stimulus in Cultured Human THP-1 Monocytes.
期刊: Folia biologica 发表日期: 2025 链接: PubMed
摘要
Cardiovascular diseases due to atherosclerosis remain a dominant medical problem. Macro-phages play a crucial role in both atherosclerosis progression and recycling of body iron. Epidemio-logical data point to elevation of body iron stores as one of non-classical cardiovascular risk factors, and we know that iron must be contained within macrophages to be atherogenic. Presumably, iron already contained within circulating monocytes turns cells to a more pro-inflammatory and hence atherogenic phenotype, but experimental evidence for such relationship remains limited. In this study, human monocytic THP-1 cells were loaded with micromolar iron in the forms of transferrin, ferric-ammonium citrate (FAC) and haemin for 2 and 24 hours. Only haemin was cytotoxic. All kinds of iron elevated the labile iron pool at 2 hours, as well as ferritin expression at 24 hours. Expression of scavenger receptors A and B, pro-inflammatory as well as anti-inflammatory cytokines, haem oxygenase and haptoglobin receptor were measured by quantitative PCR. Very few changes, none pro-inflammatory, were observed in response to transferrin or FAC. Haemin suppressed the expression of scavenger receptors, increased the expression of pro-inflammatory, and variably, anti-inflammatory cytokines, and dramatically induced haem oxygenase. The effects of haemin were not prevented by apotransferrin. We conclude that iron must be in the haemin form to act as a pro-inflammatory stimulus in THP-1 monocytes. Non-haem iron might require the presence of other factors to be atherogenic. Haemin treatment of THP-1 cells may represent a convenient experimental model to study the pro-inflammatory effects of haem that are observed in late stages of atherosclerosis.
52. Genomic insights into the expansion of meropenem-resistant GPSC1-CC320 Streptococcus pneumoniae serotype 19A isolates from children under 5 years of age with invasive infections, 2018-2024.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
The global rise of multidrug-resistant (MDR) Streptococcus pneumoniae serotype 19A despite widespread pneumococcal conjugate vaccine (PCV) use poses an emerging challenge for pediatric infectious disease control. In South Korea, the detection of serotype 19A initially declined following PCV13 implementation, but it has recently re-emerged, raising concerns over the evolution and persistence of high-risk clones. We investigated invasive serotype 19A isolates recovered from children under five years of age between 2018 and 2024. Antimicrobial susceptibility testing and whole-genome sequencing (WGS) were conducted to characterize resistance mechanisms, clonal structure, and phylogenetic relationships. Among the 104 invasive pneumococcal isolates, 11 (10.6%) were identified as serotype 19A. All of these belonged to GPSC1/CC320 and were classified as ST320 or ST6400. These isolates exhibited resistance to meropenem but retained susceptibility to cefotaxime, carrying a conserved pbp1a-13, pbp2b-11, and pbp2x-16 combination. Phylogenetic analysis revealed four distinct subclades among the South Korean isolates, each showing high similarity to international strains. To our knowledge, this is the first genomic study of meropenem-resistant 19A in children from South Korea. Our findings suggest that the resurgence of 19A is driven by stable, high-risk MDR. These results underscore the need for clone-level genomic surveillance to preempt emerging threats and inform next-generation vaccine and antibiotic strategies.
53. Seroprevalence of diphtheria and tetanus antibodies among children and adolescents in high- and low-immunization coverage areas in the Lao People's Democratic Republic.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Diphtheria and tetanus remain significant public health concerns in low- and middle-income countries (LMICs), including the Lao People’s Democratic Republic (Lao PDR). Although national infant immunization coverage has improved, substantial subnational disparities persist, and no booster doses are administered beyond infancy. This study aimed to assess population-level immunity to diphtheria and tetanus among children and adolescents in high- and low-coverage areas of Lao PDR. A cross-sectional sero-epidemiological survey was conducted from September to October 2024 in Oudomxay (high coverage) and Xaisomboun (low coverage) provinces. A total of 960 participants aged 1-19 years were selected through multistage cluster sampling. Demographic and vaccination data were collected, and dried blood spots were tested for anti-diphtheria and anti-tetanus immunoglobulin G (IgG) using enzyme-linked immunosorbent assay. Seropositivity was defined as IgG level ≥0.1 IU/mL for diphtheria and ≥0.16 IU/mL for tetanus. Multilevel multivariate logistic regression identified factors associated with seropositivity. A total of 960 participants were enrolled; the response rate was 100%. Overall, 79.1% of participants reported receiving the three-dose pentavalent vaccine (Penta3), with coverage higher in Oudomxay (91.9%) than in Xaisomboun (66.3%). Seropositivity rate for both diphtheria and tetanus displayed a U-shaped age distribution, declining among school-aged children. Oudomxay showed higher seropositivity for both diseases. Multivariate analysis revealed lower seropositivity among participants aged 5-14 years and Hmong participants. Penta3 was significantly associated with tetanus, but not diphtheria, seropositivity. This study identified notable immunity gaps among school-aged children and ethnic minorities in Lao PDR. Findings support introducing WHO-recommended booster doses and implementing targeted strategies to enhance coverage equity and population-level protection.
54. Magnitude of Hepatitis B virus and associated factors among chronic liver disease patients admitted to the medical ward at Sheikh Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia: a retrospective study.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Viral hepatitis is still a major public health problem around the globe, and acquiring adequate and recent epidemiological data on Hepatitis B is important in the prevention and control of the disease. Data on Hepatitis B virus (HBV) among patients with chronic liver disease are scarce in the study area, as well as in Ethiopia at large. To assess the magnitude of Hepatitis B virus (HBV) and its associated factors among chronic liver disease patients admitted to the medical ward at Sheikh Hassen Yabare Comprehensive Specialized Hospital, Jigjiga, Ethiopia. An institution-based retrospective cross-sectional study was conducted in the Sheikh Hassen Yabare Comprehensive Specialized Hospital. A total of 249 study participants were selected by simple random sampling using a computer-generated method. A rapid test of HbsAg using a kit from Henso Medical (HANGZHOU) Co. Ltd. was used. The data were collected using Kobo toolbox and analyzed using SPSS version 29.0. Binary logistic regression was employed to identify statistically significant factors for HBV. Model fitness was checked by the Hosmer-Lemeshow goodness-of-fit test, and multicollinearity across variables was checked using the variance inflation factor. Statistical significance was considered at P < 0.05, and an adjusted odds ratio with a 95% confidence interval was used to measure the strength of the association. The magnitude of HBV among clinically diagnosed chronic liver disease patients was 81/249 (32.53%) (95% CI = 26.9-39.0). Having a history of hospital admission (AOR = 3.60, 95% CI = 1.84-7.04), blood transfusion history (AOR = 2.22, 95% CI = 1.13-4.37), being male (AOR = 2.65, 95% CI = 1.18-5.96) and being exposed to a jaundiced individuals (AOR = 4.52, 95% CI = 2.34-8.72) were also significantly associated with HBV. The magnitude of HBV among clinically diagnosed chronic liver disease patients was high. Being male, having a history of hospital admission, blood transfusion, and contact history with jaundice patients were significantly associated with HBV. The hospital should strictly follow blood transfusion safety protocols and implement proper infection control measures to minimize HBV transmission. Additionally, healthcare providers should screen patients with a history of hospital admission, contact with jaundice patients to facilitate early diagnosis and treatment.
55. MicroRNA mediated regulation in early-onset cardiac hypertrophy: Insights from the hypertrophic heart rat model.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Cardiac hypertrophy is a pathological response to increased myocardial stress and a key contributor to heart failure. The Hypertrophic Heart Rat (HHR) is a well-established model for investigating primary cardiac hypertrophy in the absence of hypertension. This study aimed to characterise the role of microRNAs and their downstream regulatory pathways in neonatal HHRs to identify mechanisms contributing to early-onset hypertrophy. Heart tissue from 2-day-old HHRs and Normal Heart Rats (NHRs) was analysed using microarray profiling to identify differentially expressed miRNAs and mRNAs. Gene Set Enrichment Analysis (GSEA) was performed to identify biological pathways associated with miRNA target genes followed by selected miRNA and genes validated by quantitative reverse transcription PCR (RT-qPCR). Neonatal HHRs demonstrated a significantly elevated cardiac weight index compared to NHRs, with upregulation of hypertrophic markers including NPPA, NPPB, and MAPK1. Microarray analysis revealed 107 differentially expressed miRNAs, among which miR-34a, miR-351, and miR-490* were validated and further analysed. These miRNAs were linked to key hypertrophic pathways including RAS-MAPK and PI3K-AKT along with calcium signalling. miR-34a was experimentally validated to target HTR2A, implicating serotonin signalling in neonatal cardiac remodelling. Additionally, elevated SGPP1 expression suggests increased sphingolipid metabolism, while ITGA7 was reduced and GANC showed a modest decrease, indicating dysregulation in mechano-signal transduction and glycogen metabolism. These findings provide insight into the early molecular drivers of cardiac hypertrophy in neonatal HHR and delineate miRNA-mRNA relationships involved in remodelling. This study lays the groundwork for future investigations into the therapeutic potential of targeting miRNA pathways in the prevention and management of pathological cardiac remodelling.
56. The determinants of health and health status of individuals in police custody in Australia: A scoping review.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
In Australia, the health of people in police custody facilities and the conditions of their detention have been the focus of repeated scrutiny and investigations since the Royal Commission into Aboriginal Deaths in Custody was published in 1991. However, there remains a lack of comprehensive, consolidated evidence on the health needs of this population. To address this gap, we conducted a scoping review to identify and describe the available information on their health status and determinants of health. We followed the JBI methodology for scoping reviews, including searching databases of academic and grey literature, and hand searching websites, citations and review articles published since 2000. Final searches were completed on February 3, 2025. Study characteristics, determinants of health, and health conditions were extracted from included sources, and analyzed by jurisdiction, date, and document type. We identified 172 relevant information sources, including 141 grey literature documents and 31 academic publications, published between 2000 and 2024 from every state and territory in Australia. Sources most frequently used data from New South Wales, Western Australia, and Queensland. More than half (57%) of sources used data from the Drug Use Monitoring in Australia (DUMA) program. Individual (age, gender, Indigenous status) and mental health and drug use characteristics were the most frequently reported data. Other important health determinants such as tobacco use, diet, exercise, stress, exposure to violence, and environmental conditions of police custody were largely underreported. No general health status or burden of illness studies were identified. Available information on the health of people in police custody in Australia is fragmented, mostly drawn from a single program, and focused primarily on mental health and substance use, while data on physical health and broader health determinants are limited. Enhancing systems that routinely monitor and transparently report health priorities for police custody are needed to improve health service provision and support environments that promote detainee health.
57. Exploring DNA methylation profiles in blood samples of canine gastrointestinal lymphoma.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Blood-based testing represents a valuable tool for the detection and monitoring of patient conditions in both human and veterinary medicine. When conventional tissue-based diagnosis is challenging, blood-derived measurements allow for minimally invasive testing. Recent studies across mammalian species, particularly in humans, have explored the use of DNA methylation from whole blood, revealing its potential to predict individual mortality and responses to environmental stresses. While it is well recognized that tumor lesions display altered epigenetic modifications across some mammalian species, little is known about how DNA methylation in blood, as an indirect tissue sample, reflects the status of individuals in dogs. In this study, we conducted whole genome bisulfite sequencing using whole blood samples from twenty dogs diagnosed with canine gastrointestinal lymphoma, which is a prevalent disease in dogs. Comparative analysis with non-lymphoma controls identified over one thousand differentially methylated regions (DMRs). To develop practical predictive models, we narrowed down the number of DMRs from the total identified to a feasible set of probes using machine learning, achieving high accuracy (0.8-0.9) in predicting lymphoma cases. Our research underscores the potential of utilizing DNA methylation from whole blood as predictors and establishes a foundational data infrastructure for genome-wide DNA methylation for canine health monitoring for future studies.
58. Prevalence of ocular trauma and barriers to use of personal protective devices among welders in Hetauda, Nepal.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Welding poses significant ocular hazards in Nepal’s industrial settings; however, data on trauma prevalence and protective barriers remain limited. This study assessed the burden of ocular trauma, personal protective equipment (PPE) practices, and associated risk factors among welders in Hetauda, Nepal. This cross-sectional study conducted in 2024 included 111 welders in Hetauda. Participants underwent comprehensive eye examinations and structured interviews. Logistic regression was used to assess factors associated with ocular trauma. The prevalence of ocular trauma was 62.16%, primarily caused by metal chips (60.87%) and flames (37.84%). Although 78.39% of welders reported using PPE, 72.97% relied on non-certified sunglasses, and only 1.80% used certified protective goggles. Key barriers to appropriate PPE use included the absence of workplace mandates (62.50%) and a belief that protection was unnecessary (64.52%). Significant risk factors for trauma included male gender, lack of safety training (43.48%), and age between 46 and 60 years. Common ocular morbidities were corneal opacity (20.72%) and conjunctival congestion (10.36%). Despite reported PPE usage, the continued high rate of ocular trauma highlights deficiencies in equipment quality and training. Mandating certified eye protection, enforcing workplace safety policies, and integrating occupational health education are critical steps for preventing eye injuries in Nepal’s industrial sector.
59. A systematic review of the effectiveness of self-symptoms monitoring with Patient Reported Outcome Measures in rheumatic disease patients.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
We aimed to provide an up-to-date synthesis of the effectiveness of patient reported outcome measures (PROMs) to self-monitor symptoms compared to conventional follow-up care in rheumatic disease patients. The effect of providing feedback via PROMs was also evaluated. This review was guided by the Preferred Reporting Items for Systematic review and Meta-Analysis guidelines. Articles published before December 2024 were retrieved from PubMed®, Cochrane Library®, Embase®, and PsycINFO® (Ovid). Studies were included if they (1) compared PROMs against no PROMs use, or (2) or if they utilized PROMs as an intervention with feedback provided to healthcare professionals or patients for comparison against PROMs use without feedback. Non-English articles and abstract-only articles were excluded. Results were synthesized in a narrative manner. Methodological quality was assessed using the Risk of Bias tool and the Risk of Bias in Non-randomized Studies of Interventions tool. A total of 18, 159 articles were screened, and 9 articles were included. All 9 studies reported on the use of PROMs as an intervention against a control where no PROMs were used. 4 of the studies included reported improvements in symptom control; 1 study observed improvement in health-related quality of life (HRQoL) when PROMs were used. High patient satisfaction was observed in 5 studies, but the results were statistically insignificant. 1 found that PROMs use facilitated shared decision making. 3 studies reported on clinic visits with mixed results. No studies reported on survival/mortality. Out of the 9 studies, 2 studies compared PROMs with feedback to patients and/or healthcare professionals against PROMS without feedback. There was conflicting evidence whether PROMs with feedback improved patient satisfaction in clinical care. Three studies were identified to be of moderate to high risk of bias. The use of PROMs self-symptom monitoring may contribute to improving symptom control, HRQoL, patient perception, promote shared decision making, and reduce clinic visits. Our study may have limited generalizability to other rheumatic disease beyond RA as most of our study is in rheumatoid arthritis. More studies in other rheumatic diseases are needed. The protocol was registered in OpenSci Framework (https://doi.org/10.17605/OSF.IO/ZU9XM).