公共卫生研究摘要 (2026-01-01)
共收录 51 篇研究文章
1. ERAdP facilitates biogenesis of dense core vesicles in Paneth cells to enhance intestinal defense.
期刊: The Journal of experimental medicine 发表日期: 2026-Feb-02 链接: PubMed
摘要
Paneth cells secrete antimicrobial peptides (AMPs) to modulate composition of gut microbiota and host defense. AMPs are typically packaged into dense core vesicles (DCVs) and secreted into the intestinal lumen. However, the mechanisms underlying DCV biogenesis and secretion are still elusive. Here we identified that ERAdP was highly expressed in Paneth cells that acted as a sensor for a bacterial second messenger c-di-AMP. ERAdP deficiency caused impaired DCV biogenesis and dysfunction of Paneth cells. Mechanistically, by sensing c-di-AMP, ERAdP interacted with NLRP6 and further recruited ANXA2 onto the DCV membrane in Paneth cells. The ERAdP-NLRP6-ANXA2 complex facilitated DCV biogenesis, which enhanced antibacterial ability of intestines. Disruption of ERAdP-NLRP6-ANXA2 axis led to loss of DCVs in Paneth cells and increased susceptibility to bacterial infection. Of note, ERAdP-NLRP6-ANXA2 proteins were lowly expressed in IBD patients, and c-di-AMP treatment enhanced antibacterial capacity in antibiotic-treated mice. Our findings reveal that c-di-AMP stimulation might provide a potential therapeutic strategy for infectious disease and gut inflammation.
2. Life without sex: Lack of desire or traumatic retire?
期刊: Proceedings of the National Academy of Sciences of the United States of America 发表日期: 2026-Jan-06 链接: PubMed
摘要
3. Early Childhood Caries: A Family Centered Preventable Disease- Risk Determinants, Clinical Spectrum and Contemporary Management.
期刊: Mymensingh medical journal : MMJ 发表日期: 2026-Jan 链接: PubMed
摘要
Early childhood caries (ECC) is encountered as a serious oral health issue, chiefly in deprived areas. ECC remains a global concern, troubling babies and pre-school-aged children across nations. The widespread nature of ECC is notable and it is reportedly found in approximately 85.0% of individuals from low socioeconomic backgrounds. Due to its origins and solutions that are developed within the family environment, ECC is often referred to as a family-centered disease. ECC is a condition that affects infants and toddlers, characterized by the presence of decayed, missing, or filled teeth in children up to 71 months old. Maxillary primary incisors are the initial teeth to be affected. Decalcification of enamel appears as a white area in the cervical third of the tooth. At the early stage, if not identified and treated accordingly, lesion progression occurs and the clinical crown is destroyed. A wide range of cariogenic microbes, fermentable carbohydrates and certain environmental factors are recognised as the primary threats in the initiation and progression of ECC. ECC is a commonly found childhood illness; fortunately, it is an avoidable condition. Inappropriate feeding practices, marginalised populations, ignorant parents and the absence of facilities for dental treatment are principal contributing factors to the high prevalence of ECC. This appraisal focuses on the risk factors and emphasizes approaches to managing ECC.
4. Level of Depression, Anxiety and Stress among the Police Professionals in Bangladesh: A Nationwide Cross-sectional Study.
期刊: Mymensingh medical journal : MMJ 发表日期: 2026-Jan 链接: PubMed
摘要
Regular exposure to stressful situations makes police professionals more susceptible to mental health disorders. Despite the vital role in upholding law and order, the frequency of psychological problems among police professionals in Bangladesh is under-explored. This study aimed to assess the mental health status of the police professionals working at different level across Bangladesh by measuring the level of depression, anxiety and stress. A nationwide cross-sectional survey was carried out between January 2022 and December 2022, with 413 police professionals from all eight divisions and 27 districts of Bangladesh, who were purposively chosen to participate. Data were collected through a semi-structured questionnaire including the Depression, Anxiety and Stress Scale (DASS-21), personal and professional information. Descriptive statistics and bivariate analyses were conducted in SPSS version 26.0. According to DASS-21 score the results showed that 40.0% police personnel had ‘normal’ level of depression; 29.3% had ‘normal’ level of anxiety and 65.6% had ‘normal’ level of depression. While significant number of police personnel had severe to extremely severe symptoms of depression (29.6%), anxiety (48.7%) and stress (18.4%). Unintentional joining to the police force was associated with much greater levels of stress, anxiety and depression than joining by own choice or parental choice. Overall, the study showed that Bangladeshi police professionals have a significant mental health burden, with higher prevalence rates than other countries. That seems to be worsened by organizational stresses, stigma and a lack of welfare support, highlighting the necessity for structural changes, routine screening and counseling interventions.
5. Assessment of Serum Ferritin in Patients with Type 2 Diabetes Mellitus.
期刊: Mymensingh medical journal : MMJ 发表日期: 2026-Jan 链接: PubMed
摘要
Type 2 diabetes mellitus (T2DM) is developed through the coexistence of β-cell dysfunction and insulin resistance. T2DM causes multiple complications, increase mortality and morbidity that make huge social and economic burden. Bangladesh is experiencing a rising prevalence of the disease, posing major challenges for health policy planners. Circulating ferritin concentrations may be related with the advanced risk of T2DM, regardless of iron status. Dysregulation of ferritin and glucose level may exert reciprocal effects. The goal of this study was conducted to evaluate and compare serum ferritin between type 2 diabetic patients and non diabetic apparently healthy groups. This cross-sectional analytical type of study was completed in the Biochemistry department of Mymensingh Medical College and samples were collected from the Endocrinology department of Mymensingh Medical College Hospital, Mymensingh, from July 2023 to June 2024. Through the purposive non-random sampling approach, total 132 study subjects were selected according to inclusion and exclusion criteria. Among them, 66 patients with type 2 diabetes mellitus, diagnosed according to ADA criteria, aged from 30 to 65 years of both male and female, were selected as Group I (Case). Another 66 non diabetic apparently healthy individuals of the same age and sex matched, were selected as Group II (Control). Informed written consents were taken. Baseline parameters were accumulated and recorded in pre-designed data collection sheets. Fasting serum glucose and serum ferritin levels were analysed, Mean±SD was used to express all values. Statistical analysis was done by using SPSS (statistical product and service solutions) version 26.0 windows package. By using Student’s unpaired ‘t’ test, quantitative continuous variables were compared between groups of study subjects and qualitative variables by Chi-square test. By using Pearson’s correlation coefficient test correlations were done. Following comprehensive analysis, it was revealed that highly significant (p<0.001) raised of serum ferritin level in patient with T2DM (185.83±57.19μg/L) case group when compared with non diabetic (102.59±40.56μg/L) control group. Also showed that, highly significant positive correlations of fasting serum glucose with serum ferritin level in patients with T2DM (r=0.542, p<0.001). This study will provide fruitful information to the clinicians to advance their knowledge to overall management of T2DM. So, it is suggested timely evaluation and regular monitoring of serum ferritin in T2DM.
6. Prescribing Pattern of Antihypertensives in Hypertensive Patients with Chronic Kidney Disease in a Tertiary Care Hospital in Bangladesh.
期刊: Mymensingh medical journal : MMJ 发表日期: 2026-Jan 链接: PubMed
摘要
Hypertension (HTN) is both a cause and effect of Chronic kidney disease (CKD) and affects the vast majority of CKD patients. HTN control is important for those patients who are suffering from CKD. The risk and progression of CKD may reduce by controlling HTN. Now a days CKD is globally increasingly prevalent condition and is strongly associated with circumstance of cardiovascular disease (CVD). CKD is a rising health problem and one of the major causes of mortality. Control of HTN plays a major role in preventing its progression to end stage kidney disease and death. The objectives of the study were to evaluate the class, dosing schedule of antihypertensive prescribed in CKD and the percentage of monotherapy and combination therapy. This cross-sectional, observational study was conducted in the Department of Pharmacology in collaboration with the Department of Nephrology out patients’ Department in Mymensingh Medical College Hospital, Bangladesh from January 2021 to December 2021. Most commonly used single drug is Calcium channel blocker (13.27%) and most commonly used combination therapy is Calcium channel blocker (CCB) and Angiotensin II receptor blockers (ARBs). It is concluded that in CKD with HTN, majority of patients were treated with combination therapy. CCB was found to be the commonest prescribed antihypertensive in monotherapy and in combination therapy. According to JNC8 guideline majority of the BP goals were achieved.
7. Trimetazidine Ameliorates Progression of Diabetic Nephropathy by Reducing Serum Creatinine Level in Streptozotocin Induced Diabetic Rats.
期刊: Mymensingh medical journal : MMJ 发表日期: 2026-Jan 链接: PubMed
摘要
Trimetazidine (TMZ) has anti-ischemic effects by increasing glutathione peroxidase and membrane damage caused by reactive oxygen species (ROS) and also production of trimethylamine N-Oxide (TMAO) which causes cytoprotection and provides the renoprotective effect. This preclinical trial was conducted in Animal rat house of Pharmacology Department at BSMMU, Dhaka, Bangladesh from 1st March to 31st 2017 for 30 days, this experimental study sixty-six (66) rats were divided into eight groups. Group I and II received no medication. Three groups (IIIa, IVa and Va) of rats were induced diabetic nephropathy by streptozotocin (STZ). Parallel to these groups, three combined treatment groups (IIIb, IVb and Vb) treated by trimetazidine concomitant with STZ. IIIa and IIIb were sacrificed on 22nd day to detect incidence of nephropathy, groups IVa and IVb were sacrificed on 43rd day to detect onset of nephropathy and groups Va and Vb were sacrificed on 57th day to detect progression of nephropathy. Biochemical indices like the status of oxidative stress were assessed by serum creatinine levels. In streptozotocin treated groups, serum creatinine was significantly (p<0.01) higher when compared to control. In TMZ treated group, whereas serum creatinine was significantly (p<0.01) lower when compared with STZ induced nephropathy groups of rats. It may be assumed from the present study that trimetazidine has cytoprotective as well as prevent renal damaged because of its special antioxidant effects, which can delay the onset, severity and progression of nephropathy induced by STZ in rats by reducing serum creatinine level.
8. Clinical Evaluation and Comparison of Parental Satisfaction between Anterior Strip Crown and Conventional Composite Restoration: A Randomized Controlled Trial.
期刊: Mymensingh medical journal : MMJ 发表日期: 2026-Jan 链接: PubMed
摘要
Dental caries is among the most common oral diseases in children, and restoring primary incisors is particularly challenging due to the need for strength, durability, and esthetics. Conventional composite restorations are widely used, while anterior strip crowns-transparent, celluloid preformed crowns- are also increasingly applied with promising esthetic outcomes. However, evidence comparing their clinical performance is limited. The study aimed to compare the clinical efficacy and parental satisfaction of anterior strip crowns with conventional composite restorations in primary anterior teeth. A randomized controlled trial was conducted in the Department of Pedodontics, Bangladesh Medical University, Bangladesh from October 2021 to September 2022. Sixty maxillary primary incisors from 28 children were included. Satisfaction of parents about color, size, shape and appearance was estimated using a Likert scale. Clinical efficacy was evaluated in terms of retention, marginal adaptation, and surface texture based on USPHS criteria at 3, 6 and 9 months. Data were analyzed using SPSS (version 26.0) with Chi-square and Independent t-tests; p<0.05 was considered significant. Of the 60 teeth, 28 were central and 32 lateral incisors. Over 9 months, no statistically significant differences (p>0.05) were found between the two groups in most criteria. After 9 months, marginal adaptation was rated “very good” in 73.3% of strip crown cases (Group A) and 60.0% of composite cases (Group B), without significant difference. Surface smoothness matched surrounding enamel in 80.0% of Group A and 50.0% of Group B, with significant differences at 3 and 9 months (p<0.05). Anterior strip crowns demonstrated higher parental satisfaction and better clinical outcomes, particularly in surface smoothness, compared to conventional composite restorations. Although most differences were not statistically significant, strip crowns appear to be a more favorable option for restoring carious primary maxillary anterior teeth.
9. Serum Testosterone and Estradiol in Men with Psoriasis and Their Association with Disease Severity among Adult Male Patients.
期刊: Mymensingh medical journal : MMJ 发表日期: 2026-Jan 链接: PubMed
摘要
Psoriasis is a chronic, immune-mediated systemic disease with skin manifestations and multisystem involvement, including effects on the reproductive system. Its pathogenesis involves genetic, environmental, and immunological factors. Cytokines (TNF-α, IL-1, IL-6, IFN-γ) released during inflammation inhibit Leydig and Sertoli cells of testes and affect aromatase activity, leading to testosterone and estradiol imbalance. The study was designed to evaluate serum testosterone and estradiol levels in male psoriasis patients and their association with disease severity. This cross-sectional analytical study was conducted in the Department of Biochemistry, Dhaka Medical College from July 2023 to June 2024 with 50 diagnosed male psoriatic patients (Group A) and 50 healthy controls (Group B) selected from Out-Patient-Department of Dhaka Medical College Hospital. The study subjects were matched according to age, sex and other socio-demographic factors. Subjects were assessed via history, examination, and biochemical tests. Disease severity was evaluated using Psoriasis Area and Severity Index (PASI) and erectile dysfunction via International Index of Erectile function (IIEF-5) questionnaire. Serum total testosterone and estradiol were measured by competitive fluorescence immunoassay. Mean ages were 33.04±6.02 years (Group A) and 29.64±5.71 years (Group B). In Group A, 44.0% had mild (PASI <10) and 56.0% had moderate-severe (PASI ≥10) psoriasis; 26% had a family history and 34% reported erectile dysfunction. Median testosterone was 1.9ng/ml in Group A vs. 6.4ng/ml in Group B (p=0.001) and estradiol was 7 pg/ml vs. 18.5 pg/ml (p=0.003). Moderate-severe psoriasis patients had lower testosterone (1.7ng/ml) and estradiol (4.6pg/ml) than mild cases (3.7ng/ml and 8.8pg/ml, respectively). PASI scores showed significant negative correlations with testosterone (rho = -0.809, p=0.001) and estradiol (rho = -0.715, p=0.001). Psoriasis severity was significantly associated with erectile dysfunction. Male psoriatic patients have significantly lower testosterone and estradiol levels than healthy controls, with severity negatively correlating with both hormones and associated with erectile dysfunction.
10. Exploring cold sensitivity among workers with hand-arm vibration syndrome.
期刊: Occupational medicine (Oxford, England) 发表日期: 2025-Dec-31 链接: PubMed
摘要
Previous research on functional impairments due to vascular effects in workers with hand-arm vibration syndrome (HAVS) has focused on the upper extremities with little attention to the lower extremities. To examine the severity and factors associated with cold intolerance and sensitivity in the hands and feet of workers with HAVS. A survey and retrospective chart review were used to collect demographics, work conditions and disease characteristics on workers undergoing HAVS assessments. Data also included workers’ scores on the Cold Intolerance Symptom Severity (CISS) questionnaire, which was adapted to evaluate the upper and lower extremities separately. Associations between upper and lower extremity scores were explored using Spearman correlations and Wilcoxon signed rank tests, and regression models were used to evaluate whether variables of interest predicted CISS total scores. Participants (N = 93; 55% response rate) worked primarily in mining and construction, were exclusively male, and had a mean age of 48 years. Cold intolerance and sensitivity were commonly reported in the feet and correlated with hand symptoms, but most CISS individual questions and total scores were significantly higher for the hands (versus feet). Regression models indicated that QuickDASH and Stockholm vascular scale scores significantly predicted CISS total scores for the hands, while exposure to foot vibration, plethysmography severity scores of the feet and QuickDASH scores significantly predicted CISS total scores for the feet. Clinicians should assess and treat cold intolerance and sensitivity in both the hands and feet of workers with HAVS to improve workers’ daily functioning.
11. Efficacy or Effectiveness of Zinc-Biofortified Staples in Improving Biomarkers of Zinc Status: A Systematic Review.
期刊: Nutrition reviews 发表日期: 2025-Dec-31 链接: PubMed
摘要
Zinc-biofortified staple crops offer a potentially cost-effective and sustainable approach to address zinc deficiency in low- and middle-income countries. Scientists have developed and released several zinc-biofortified staple crops varieties globally and assessed their efficacy in improving biomarkers of zinc status. However, there are inconsistencies in result across the studies. The objective of the present research was to systematically explore the existing literature to assess the efficacy of zinc-biofortified staple crops in improving zinc status. We performed a comprehensive literature search using 5 electronic databases: SCOPUS, Medline, CINAHL, Embase, and Web of Science, focusing on randomized controlled trials reporting the efficacy of zinc-biofortified staple crops in improving zinc status. The initial search was conducted during April 14-16, 2024, with an updated search on April 8, 2025. The protocol was registered with PROSPERO (CRD42025603758). In this review we identified 1869 articles from the 5 databases, with 1068 studies screened for title and abstract. Full-text review was conducted on 20 articles, and the 7 were ultimately included for this review based on eligibility. Among the 7 studies included in the review, only a crossover study reported an increase in plasma zinc at the midpoint, which was abolished at the endpoint. One study reported improvement in infection-related morbidity, while another reported increased hair zinc. Exploration of the included studies revealed several methodological issues, such as not adjusting plasma zinc for inflammation and ignoring loss of zinc during cooking, as well as overlooking the potential treatment effect of habitual intake of zinc and its bioavailability. Plasma zinc concentration remains largely unaffected by consumption of biofortified staple crops. Further research addressing the abovementioned limitations are crucial to determine the efficacy of zinc-biofortified staple crops in improving the zinc status of populations. PROSPERO registration No. CRD42025603758.
12. Renal Resistive Index and Cardiovascular Events, Cardiovascular Mortality, and All-Cause Mortality: Protocol for a Systematic Review and Meta-Analysis.
期刊: JMIR research protocols 发表日期: 2025-Dec-31 链接: PubMed
摘要
The renal resistive index (RRI) is a noninvasive indicator of renal vascular resistance and systemic hemodynamic status. Elevated RRI values have been consistently associated with subclinical vascular damage and target organ injury. Observational studies within the past decade have suggested that RRI may also serve as a prognostic marker for adverse cardiovascular outcomes and mortality. However, the evidence remains scattered and heterogeneous, and no systematic review has yet synthesized this body of literature. This systematic review aims to evaluate the association between elevated RRI and the risk of cardiovascular events, cardiovascular mortality, and all-cause mortality in adult populations. This protocol has been developed in accordance with the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines. We will include observational studies (prospective and retrospective cohort studies and nested case-control studies) involving adults (≥18 years) with RRI measurements obtained through Doppler ultrasound. Studies focused on pediatric populations, pregnant women, and patients undergoing dialysis will be excluded. The primary exposure will be elevated RRI, typically defined as RRI of ≥0.70, compared to lower or normal values. The primary outcomes are cardiovascular events, cardiovascular mortality, and all-cause mortality with a minimum follow-up of 6 months. A comprehensive search will be conducted in PubMed, Embase, Web of Science, and Scopus, as well as in gray literature sources. Two independent reviewers will screen articles, extract data, and assess risk of bias using Version 2 of the Cochrane revised risk-of-bias tool for randomized controlled trials and the Risk of Bias in Nonrandomized Studies of Interventions and Risk of Bias in Nonrandomized Studies of Exposure tools for nonrandomized studies of interventions and exposure, respectively. Meta-analyses will be conducted if at least 3 studies report comparable data, and effect estimates will be calculated using raw data whenever possible. Subgroup and meta-regression analyses will be used to explore heterogeneity, whereas sensitivity analyses will be conducted to assess the robustness of the observed results. The Grading of Recommendations Assessment, Development, and Evaluation framework will be applied to evaluate the overall quality of evidence. A preliminary exploratory search has been conducted to map the existing literature and confirm the absence of prior systematic reviews on this topic. The formal study selection and data extraction are expected to begin upon protocol acceptance with review completion anticipated by December 2026. By systematically synthesizing the available literature, this review will provide a comprehensive overview of the prognostic value of RRI in predicting cardiovascular outcomes and mortality. The findings may inform clinical decision-making, enhance cardiovascular risk stratification, and identify research gaps for future studies focused on standardizing RRI assessment and its clinical applications.
13. The impact of COVID-19 self-isolation on healthcare workers' psychological wellbeing: a systematic review.
期刊: Occupational medicine (Oxford, England) 发表日期: 2025-Dec-31 链接: PubMed
摘要
Self-isolation is a key public health strategy for infectious disease control. Globally implemented during the COVID-19 pandemic, self-isolation remains an essential strategy in ongoing mitigation efforts. Healthcare workers (HCWs) often face isolation due to occupational exposure to infectious diseases and may face unique psychological challenges. This systematic review synthesized evidence on (i) the impact of self-isolation on HCWs’ psychological wellbeing, (ii) factors associated with wellbeing, and (iii) the effectiveness of interventions to improve wellbeing during or after isolation for COVID-19. A pre-registered systematic review (PROSPERO: CRD42024559971) was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane guidelines. Searches in PsycInfo, Embase, MEDLINE, PubMed and grey literature included studies on HCWs’ psychological wellbeing during or after self-isolation. Risk of bias was assessed using ROBINS-E (Risk of Bias in Non-randomized Studies for Exposure) or CASP (Critical Appraisal Skills Programme) tools. From 20,798 records screened, 19 studies (10 quantitative, 7 qualitative, 2 mixed methods) were included. Quantitative findings on anxiety, depressive and stress symptoms were inconsistent. Qualitative studies consistently reported distress, loneliness and stigma. Factors associated with wellbeing included socio-cultural influences and protective factors. No studies assessed interventions targeting wellbeing during self-isolation. Self-isolation appears to have variable effects on HCWs’ wellbeing, including significant challenges and opportunities for resilience. Public health strategies should prioritize timely, clear communication, accessible evidence-based psychological support and practical resources. Future research should prioritize evaluation of interventions to mitigate psychological harm and support HCWs during infectious disease outbreaks.
14. Exploring Predictors of Counselors' Acceptance of Virtual Reality Exposure Therapy With Resistance and Job Contexts as Moderators: Cross-Sectional Mixed Methods Study.
期刊: Journal of medical Internet research 发表日期: 2025-Dec-31 链接: PubMed
摘要
Exposure therapy effectively treats anxiety disorders but faces implementation barriers, including cost, time constraints, and reluctance from therapists and clients. Virtual reality exposure therapy (VRET) offers a controlled digital alternative addressing these issues. However, adoption remains limited, with previous studies focusing mainly on hospital settings without considering individual or workplace factors. This study examined factors affecting counselors’ VRET acceptance across diverse settings. We used the Unified Theory of Acceptance and Use of Technology (UTAUT) extended with job stress and resistance to change. Open-ended questions provided a deeper understanding of counselors’ perspectives on VRET. A cross-sectional mixed methods study was conducted with 258 certified counselors across various settings, including universities, public institutions, and private clinics. Participants watched a 4-minute VRET introduction video and completed a survey measuring UTAUT variables (performance expectancy, effort expectancy, facilitating conditions, and social influence), resistance to change, and job stress. Stepwise forward selection multiple linear regression with moderation analyses was conducted to identify key predictors and test interaction effects. Open-ended responses (N=257, 290 meaning units) on VRET applicability and improvement suggestions were analyzed using team-based thematic analysis with iterative consensus coding. Performance expectancy (β=.404, 95% CI 0.297-0.512, P<.001) and social influence (β=.387, 95% CI 0.280-0.494, P<.001) significantly predicted VRET adoption intentions (R2=0.494). Moderation analysis revealed that routine seeking weakened performance expectancy impact (β=-.160, 95% CI -0.277 to -0.043, P<.01), low job control strengthened it (β=.162, 95% CI 0.280-0.494, P<.005), and high job demands reduced social influence effects (β=-.150, 95% CI -0.263 to -0.036, P=.01). The narrow confidence intervals indicate precise estimation of these moderation effects. Younger counselors were more sensitive to contextual moderators, while older counselors prioritized performance expectancy. Thematic analysis identified 3 themes: counselor evaluation criteria for VRET, emphasizing content diversity and scientific validation; considerations for promoting and introducing VRET to counselors, addressing implementation challenges; and areas requiring continuous improvement for VRET field implementation, emphasizing professional competence and system reliability. This study advances VRET acceptance research by examining certified counselors across diverse nonhospital settings-unlike prior hospital-focused physician studies-and extending UTAUT with profession-specific moderators. Performance expectancy and social influence emerged as primary predictors, with routine seeking and job context significantly moderating these effects across age groups. Thematic analysis revealed that counselors evaluate VRET as a supplementary tool requiring scientific validation, diverse content, and structured training rather than technological usability alone. Findings inform practical strategies as follows: disseminating effectiveness evidence, leveraging professional networks, addressing work environment barriers for high-demand contexts, and developing age-appropriate approaches. Insights guide content developers, policymakers, and researchers implementing VRET beyond hospital settings.
15. Characterization of Post-Viral Infection Behaviors Among Patients With Long COVID: Prospective, Observational, Longitudinal Cohort Analyses of Fitbit Data and Patient-Reported Outcomes.
期刊: JMIR formative research 发表日期: 2025-Dec-31 链接: PubMed
摘要
Long COVID encompasses a range of health problems that can be highly debilitating. While some research has relied on self-reported measures of symptoms and functioning, few studies have characterized symptoms in relation to behaviors and physiology measured objectively through wearable devices. The primary aim of this study was to identify longitudinal patterns in physical activity, physiology, and patient-reported outcomes (PROs) among patients with long COVID at a Federally Qualified Health Center in the United States. The secondary aim was to identify meaningful subgroups or phenotypes within this cohort and examine how PROs and symptoms overlay with physical activity characteristics. This was a prospective, observational, longitudinal cohort study recruiting a subset of low-income patients enrolled in the Long COVID and Fatiguing Illness Recovery Program. From March 2022 to May 2023, a total of 172 patients with long COVID or myalgic encephalomyelitis/chronic fatigue syndrome were given Fitbit Charge 5 (Fitbit Inc) devices and instructed to wear them continuously for up to a year. Patients completed PRO questionnaires (PROMIS-29 [Patient-Reported Outcomes Measurement Information System-29] and symptom questionnaires, etc) at baseline, 3, and 6 months. Inclusion in longitudinal analysis required at least 20 hours of valid wear data per day for a minimum of 7 days. The World Health Organization guideline on moderate to vigorous physical activity (MVPA) was used to differentiate MPVA-active and MVPA-inactive patients. Linear mixed effects regression was performed to assess longitudinal associations between physical activity levels and PROs. Among 172 patients, 80.2% (n=138) were female, 75.6% (n=130) were White, 45.3% (n=78) were unemployed, and 94.8% (n=163) had estimated annual income below US $50,000. Of these patients, 82 (47.7%) met valid wear criteria, providing 50.5 days of Fitbit data on average. At baseline, MVPA-inactive patients (n=41) reported statistically more severe problems regarding physical function, fatigue, and dyspnea than MVPA-active patients (n=41) on both continuous and categorical scales, with P<.05 from both Student t tests (2-tailed) and chi-squared tests. Longitudinal analysis found that MVPA-inactive patients showed a decreased ability to participate in social roles (estimated group difference=-4.21 T-score points over 3 months, 95% CI -6.64 to -1.78, P<.001) and a higher intensity of sleep symptoms (estimated group difference=2.06 severity score points over 3 months, 95% CI 0.40 to 3.71, P=.02) over time. This study showed that patients with long COVID could remain MVPA-active despite experiencing symptoms. These findings provide insights into the relationship between PROs, physical activity, and long COVID, which suggests the importance of considering individual activity profiles when tailoring treatment plans, especially in a low-income population. The findings of this study should be interpreted as hypothesis-generating, considering its exploratory nature and limitations, including high attrition rates and missing data.
16. Digital Health Literacy and Its Role in Awareness of and Access to Sexual Health Products and Services Among Displaced Youth in Uganda's Informal Urban Settlements: Community-Based Cross-Sectional Study.
期刊: Journal of medical Internet research 发表日期: 2025-Dec-31 链接: PubMed
摘要
Digital health interventions can enhance sexual health equity among marginalized and underserved populations, including displaced youth. However, there is limited understanding of displaced youth’s digital health literacy (DHL) and its association with knowledge of and access to sexual health products and services. This study aims to identify patterns of DHL among displaced youth and assess how these patterns are associated with awareness of and access to sexual health products and services, while considering gender differences. We conducted a cross-sectional tablet-assisted survey in Kampala, Uganda. We used peer-driven sampling to recruit displaced youth aged 16-24 years living in 5 informal urban settlements. We identified DHL patterns using latent profile analysis. Gender-disaggregated multivariate probit models were constructed to estimate the relationship between DHL and awareness of and access to sexual health products and services (eg, sexual and reproductive health [SRH] information, external condoms, condom use training, sexually transmitted infection testing, and HIV testing). Among the participants (N=445), our latent profile analysis identified 4-DHL classes named: low (class 1, 51/444, 11.5%), moderate (class 2, 99/444, 22.2%), high (class 3, 138/444, 31%), and very high (class 4, 157/444, 35.3%). Our adjusted multivariate probit model indicated that, compared to class 1, class 4 participants were more likely to know where to access condom use training (marginal effect [ME]=0.23; P<.001), external condoms (ME=0.19; P<.001), and HIV testing (ME=0.23; P<.001). We also noted gender-based differences. Men with very high DHL, compared with those with low DHL, were more likely to know where to access SRH information (ME=0.46; P<.001) and condom use training (ME=0.40; P<.050), while women with very high DHL were more likely than those with low DHL to report knowing how to access condom use training (ME=0.12, SE=0.06; P<.050), external condoms (ME=0.34; P<.001), and HIV testing (ME=0.22, SE=0.10; P<.050). Regarding access to sexual health products and services in the last 3 months, class 4 respondents reported higher access to condom use training (ME=0.13, SE=0.04; P<.001), external condoms (ME=0.14; P<.050), and HIV testing (ME=0.24; P<.050) than class 1 respondents. Gender differences showed that among men, those with very high DHL were more likely to access condom use training (ME=0.28; P<.010) than those with low DHL. In contrast, among women, those with very high DHL were less likely to access SRH information (ME=-0.20; P<.001). Our findings reveal a generally high level of DHL but suboptimal awareness of and access to SRH services among urban displaced youth in Kampala. Improving SRH among urban displaced populations will require gender-responsive and culturally grounded digital sexual health interventions to increase awareness of and access to sexual health products and services.
17. Women's Occupational Tobacco Dust Exposure in Indonesia (T-CHARM): Protocol for a Prospective Cohort Study.
期刊: JMIR research protocols 发表日期: 2025-Dec-31 链接: PubMed
摘要
The consumption of tobacco is regarded as a contributing factor to several diseases. However, the impact of tobacco dust exposure (TDE) on tobacco workers has not been extensively investigated. This protocol introduces the design and implementation of the Tobacco Dust Cohort for Health Assessment and Risk Monitoring (T-CHARM) study, a prospective cohort study aimed at evaluating the health impacts of TDE. This prospective cohort study will recruit women working in tobacco processing who are nonsmokers and women who do not work for the tobacco industry and are nonsmokers living in a nearby area (unexposed group), with a total of 400 expected participants. The impact of TDE on health, including metabolic syndrome parameters; complete blood count; and cardiovascular, liver, renal, and lung function, will be evaluated in relation to urine cotinine levels. Air quality and chemical substances in the air and leaves will also be analyzed. The data will be subsequently analyzed using appropriate statistical tools. A total of 120 respondents have participated as of August 2025. Another 80 respondents will be recruited, laboratory analysis is ongoing, and baseline results are expected by the end of 2025. The strength of the T-CHARM study’s approach is its detailed occupational and environmental factors and longitudinal health data from the corporate clinic or the district health center, as well as links to cancer and mortality registries and self-reported health. The current phase of the study focuses on baseline data collection for long-term follow-up. The cohort will be monitored for up to 20 years, depending on sustained funding. T-CHARM offers a robust framework for understanding the chronic health effects of occupational TDE. DERR1-10.2196/84231.
18. Night shift work in early pregnancy and risk of preterm birth among Dutch nurses in the Nightingale Study.
期刊: Occupational medicine (Oxford, England) 发表日期: 2025-Dec-31 链接: PubMed
摘要
Working night shifts may influence hormonal balance and may increase risk of PTB. To assess the association between night shift work during early pregnancy and PTB risk in the Dutch Nightingale Study; a large cohort of (former) female nurses. The baseline cohort included 59 944 nurses, of whom 44 638 reported a first birth. Women reported lifetime reproductive and occupational histories in questionnaires in 2011 and 2017. Night shift work during pregnancy was classified as yes/no, number of nights worked per month and number of nights worked in a row per month. PTB was defined as early PTB (≥24-31+6 weeks of gestation) or late PTB (≥32-36+6 weeks) and PTB (<37 weeks) versus a term delivery (≥37 weeks). The association between night shift work and PTB risk was assessed in 44 638 nulliparous women using multivariable, multinomial logistic regression. In total, 3197 (7%) women had experienced PTB. The risk of PTB was not associated with working night shifts (adjusted odds ratio (OR)=1.02, 95% confidence interval (CI)=0.94-1.11 for women who did compared to women who did not work night shifts), but women who worked night shifts during early pregnancy had lower risk of early PTB compared to women who did not work night shifts (adjusted OR = 0.75, 95% CI = 0.60-0.94). This study among 44 638 nulliparous women found no association between working night shifts and risk of PTB. Contrary to earlier studies, we could adjust for PTB risk factors such as workload, maternal disease history and fertility treatment.
19. Predicting Atrial Fibrillation Ablation Outcomes: Machine Learning Model Development and Validation Using a Large Administrative Claims Database.
期刊: JMIR cardio 发表日期: 2025-Dec-31 链接: PubMed
摘要
Atrial fibrillation (AF) ablation is an effective treatment for reducing episodes and improving quality of life in patients with AF. However, long-term AF-free rates after AF ablation are inconsistent across the population, ranging from 50% to 75%. Patient selection relies on individual clinical assessment, highlighting a critical gap in population-level predictive analytics. While existing risk scores (eg, CHADS₂ [congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, and stroke], CHA₂DS₂-VASc [congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke, vascular disease, age, and sex category], CAAP-AF [coronary artery disease, left atrial diameter, age, AF, antiarrhythmic drugs, and female sex category]) have been applied to predict AF ablation outcomes, their performance in administrative claims data remains unclear. Leveraging large administrative claims databases represents an opportunity to develop standardized, scalable prediction models that could inform population health management and resource allocation at a national level. This study utilizes machine learning (ML) models on claims data to explore if integrating International Classification of Diseases (ICD) billing codes outperforms traditional stroke and AF risk scores in predicting 1-year AF ablation outcomes. We analyzed claims data from the Merative MarketScan Research Medicare database (2013-2020) to identify 14,521 patients who underwent AF ablation. To predict 1-year AF-free outcomes, we developed logistic regression and extreme gradient boosting (XGBoost) models using demographic characteristics, comorbidity indices, and ICD diagnostic codes from the 2 years preceding ablation. Model predictions were compared with claims-based implementations of established risk scores-CHADS2, CHA2DS2-VASc, and a modified CAAP-AF (without left atrial diameter and the number of failed antiarrhythmic drugs). The ML models were also assessed on subgroups of patients with paroxysmal AF, persistent AF, and both AF and atrial flutter from October 2015 onward. Among 14,521 patients (mean age 71.5, SD 5.31 y; n=5800, 39.94% female), AF ablation success occurred in 54.01% (n=7843). XGBoost achieved areas under the receiver operating characteristic curve (AUCs) of 0.528, 0.521, and 0.529 for the whole, female, and male AF ablation groups, respectively, and better discrimination than CHADS2, CHA2DS2-VASc, and the modified CAAP-AF in all AF ablation groups (whole population, female, and male). While CHA2DS2-VASc and the modified CAAP-AF showed higher recall (>0.798), their precision (<0.540) was lower than XGBoost (0.552-0.556). In subgroup analyses of International Classification of Disease, Tenth Revision (ICD-10) patients (n=7646), the models incorporating ICD codes demonstrated better performance than those using only demographic and comorbidity data across most AF subtypes, with the highest AUC (0.544) observed in patients with paroxysmal AF. While the ML models achieved statistically significant improvements over claim-based implementations of established clinical risk scores (AUC 0.528-0.544 vs 0.498-0.505), the modest predictive performance highlights challenges in predicting procedural outcomes using administrative data that lack key clinical variables (eg, left atrial size and medication details). Our findings establish that while standardized outcome prediction using nationally available administrative data is technically feasible, current performance is insufficient for clinical decision-making and better suited for health system quality monitoring and comparative effectiveness research applications.
20. Prescribing Experiences, Potentials, and Challenges of Digital Health Applications in the Field of Hormones and Metabolism: Cross-Sectional Survey Study of Health Care Providers in Germany.
期刊: JMIR formative research 发表日期: 2025-Dec-31 链接: PubMed
摘要
In 2020, the global prevalence of overweight and obesity was approximately 42%. One of the most common associated conditions is type 2 diabetes mellitus, which had a global prevalence of around 10.5% in 2021. Digital health applications (DiHA), which can be prescribed as certified medical devices in Germany, have been shown to effectively support disease management in patients with overweight and diabetes mellitus. However, little is known about DiHA-prescribing behavior of health care providers (HCPs) specializing in hormones and metabolism or about potential barriers to prescribing these applications. This study aimed to assess HCPs’ experience with and willingness to prescribe DiHA in the field of hormones and metabolism. In addition, it sought to examine the patient-relevant health care effects that HCPs perceive as potentially achievable or have already observed with DiHA use, as well as the barriers they perceive to prescribing these applications. An online questionnaire was developed based on preliminary studies and a literature review consisting of 86 items covering 6 key areas: experience and willingness to prescribe, health care effects, barriers, scientific evidence, digital affinity, and sociodemographics. The anonymous survey was distributed via the German Diabetes Association to 6035 HCPs in Germany between August 2 and October 9, 2024. Descriptive analyses, as well as correlation and regression analyses, were conducted. A total of 350 HCPs participated in the survey (response rate=5.8%). Although the low response rate may limit generalizability, the findings provide insights into prescribing behavior within this specialty. More than half (187/350, 53.4%) had never prescribed any of the 54 DiHA available at the time of the survey, with 47.6% (89/187) citing a lack of experience as the primary reason. Among those who had prescribed a DiHA (163/350, 46.6%), the majority (139/163, 85.3%) had prescribed 1 of the 8 DiHA available for obesity or diabetes mellitus. Looking ahead, 42.9% (149/348) of all surveyed HCPs stated that they were either very unlikely (83/348, 23.9%) or somewhat unlikely (66/348, 19%) to prescribe these DiHA in the next 12 months. The greatest perceived benefits of DiHA were improvements in self-management, health literacy, and adherence. The main barriers to prescribing DiHA in the field of hormones and metabolism included inadequate reimbursement for ancillary medical services, poor compatibility with existing practice software, and a lack of digital affinity or motivation among patients. DiHA have not yet been fully integrated into standard health care. To improve prescribing, we recommend integrating DiHA into medical guidelines, ensuring proper reimbursement, and involving HCPs in the pricing and health-economic evaluation of DiHA. The recommendations outlined should be considered to maximize DiHA’s potential and improve HCPs’ acceptance, providing valuable insights for health policy to enhance the integration, reimbursement, and use of DiHA.
21. Hidden Workers in Aging Australia: Protocol of Intersectionality-Informed Mixed Methods Study.
期刊: JMIR research protocols 发表日期: 2025-Dec-31 链接: PubMed
摘要
Australians are living longer and are expected to remain in the workforce for longer; yet, many older adults struggle to secure employment despite being willing and able to work. A growing share of these individuals are “hidden workers,” those underused in the labor market due to missed hours, long-term unemployment, or withdrawal from job seeking despite the capacity to work. This group reflects a global trend of aging yet underused workforces, and in Australia, they represent a significant proportion of the working-age population. Addressing the challenges of hidden workers is crucial, as their inclusion could help meet labor market demands, alleviate fiscal pressures of aging, and promote healthier, more equitable aging trajectories. This intersectional mixed methods study has 3 overarching aims. First, to investigate how intersecting social identities (eg, age, gender, cultural background, health status, and caregiving responsibilities) shape hidden workforce participation and associated health outcomes among aging Australians. Second, to compare hidden workers with currently employed populations in order to identify health discrepancies between the 2 groups. Third, to explore the lived experiences of hidden workers, focusing on how intersecting and multiply disadvantaged identities impose additional burdens on employment outcomes and health status. Together, these aims will generate an integrated understanding of both structural and lived dimensions of hidden work, providing evidence to inform more equitable labor market and health policies. This study uses an explanatory sequential mixed methods design to investigate the health, resources, and employment experiences of aging hidden workers in Australia. In phase 1, an online cross-sectional survey was administered to 1166 participants (696 hidden workers aged more than 45 years and 470 current workers), capturing variables on employment history, health, discrimination, workplace social capital, caregiving, and socioeconomic status. Validated instruments, including the Workplace Age Discrimination Scale, Intersectional Anticipated Discrimination Scale, and Workplace Social Capital Index, were incorporated to ensure reliability. Phase 2 will involve semistructured interviews with a purposive subsample (30 participants) identified from survey results, focusing on lived experiences of workforce exclusion and intersecting barriers. In phase 3, quantitative and qualitative findings will be integrated through triangulation and complementarity to provide a comprehensive understanding of hidden workers’ challenges and assets, generating evidence to inform policy and stakeholder recommendations. As of September 2025, the online survey has been completed, phase 2 interviews are underway, and phase 3 integration is scheduled for completion by mid-2026. This study will generate the first intersectional evidence on the health and employment challenges of hidden aging workers in Australia. These insights will inform tailored policy interventions that can support re-engagement, reduce inequities in health and well-being, and strengthen workforce participation. Ultimately, the findings will contribute to addressing skills shortages while promoting social and economic inclusion of aging Australians. DERR1-10.2196/83401.
22. In vitro evidence to support amphotericin B and flucytosine combination therapy for talaromycosis.
期刊: PLoS neglected tropical diseases 发表日期: 2025-Dec-31 链接: PubMed
摘要
Talaromyces marneffei causes talaromycosis, a life-threatening fungal disease with limited treatment options. The standard treatment of amphotericin B (AmB) induction followed by itraconazole consolidation still results in 15% to 30% mortality. This study aimed to investigate the potential of AmB and flucytosine (5FC) combination therapy to enhance antifungal activity. The in vitro antifungal activity of AmB and 5FC alone and in combination against 60 T. marneffei clinical isolates was evaluated using a validated colorimetric antifungal susceptibility assay and the checkerboard method. The minimum inhibitory concentration (MIC) was defined as the lowest drug concentration inhibiting ≥ 95% fungal growth (MIC95) for both AmB and 5FC. The combination effect between AmB and 5FC against T. marneffei was determined using fractional inhibitory concentration index. Combination effects were further tested using a time-kill assay. The MIC95 was 0.25 - 2 μg/mL (geometric mean [GM] 0.68 μg/mL) for AmB, and 0.03 - 0.5 μg/mL (GM 0.28 μg/mL) for 5FC. Full synergy was observed in 4 isolates (7%), and indifference was observed in the remaining 56 isolates (93%). The time-kill experiments revealed a concentration-dependent fungicidal activity of AmB, and concentration-independent fungistatic effect of 5FC. Synergy between AmB and 5FC was confirmed, showing greater than 2-log10 reduction in colony forming units when used in combination. No antagonism was observed. Our study demonstrated in vitro evidence of synergistic activity between AmB and 5FC against T. marneffei, providing the evidence to support in vivo and clinical trial testing of AmB and 5FC combination therapy, and dosing reduction strategies of 5FC.
23. Application of the Health Promotion Model to Reduce No-Shows in an Ambulatory Setting: A Quality Improvement Initiative.
期刊: Journal of nursing care quality 发表日期: 2025-Dec-31 链接: PubMed
摘要
No-shows in ambulatory clinics negatively impact patient care, operational resources, and health outcomes. The average no-show rate of the local endocrinology medical practice office was consistently above its benchmark of 8%. A quality improvement project utilized Plan-Do-Study-Act cycles and Pender’s Health Promotion Model (HPM) to reduce no-shows. Interventions included identifying no-show appointment trends, educating nurse navigators on HPM and associated guidelines, conducting telephone call outreach to patients at high risk for no-shows, and implementing holistic nurse-patient interactions. Telephone call outreach had a 50.6% connection rate. No-show rates decreased from 14.9% to 13.9% over 8 weeks. Telephone calls provided insights into perceived experiences and social determinants of health factors. The project reaffirmed the importance of a multimodal approach and human interaction in reducing no-shows, as well as highlighting the value of nursing care, evidence-based promotion, and the incorporation of theory when implementing operational improvements.
24. 2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 1: State of the Science and Introduction of a New Adolescent Model.
期刊: Sports medicine (Auckland, N.Z.) 发表日期: 2025-Dec-31 链接: PubMed
摘要
This paper is the first of two publications comprising a 2025 update to the 2014 Consensus Statement on treatment and return-to-play guidelines on the Female Athlete Triad (Triad), defined as three inter-related components including energy status, reproductive function, and bone health. The Triad is initiated by exposure to varying degrees of energy deficiency with or without disordered eating/eating disorders with primary pathological outcomes to the reproductive and skeletal systems. This first paper includes a detailed update on the scientific underpinnings of the Triad and introduces a new Triad model specific to the adolescent female athlete. Energy deficiency and “metabolic compensation” are added to the energy status continuum to describe adaptations that reflect energy conservation. Ovarian steroid hormone exposure and functional hypothalamic oligo-amenorrhea are added to the reproductive function continuum. Bone stress injury is added to the bone health continuum. Rates of change are depicted for the induction and recovery of clinical outcomes within the adult model. Evidence-based statements are presented throughout the paper and supported by a high number of level A and B grades.
25. 2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 2: Clinical Guidelines for Screening, Diagnosis, Treatment, and Return to Play for Adolescents and Adults.
期刊: Sports medicine (Auckland, N.Z.) 发表日期: 2025-Dec-31 链接: PubMed
摘要
This is the second of two publications comprising the 2025 update to the 2014 Consensus Statement on treatment and return to play guidelines on the Female Athlete Triad (Triad). This paper pairs with the 2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 1: State of the Science and Introduction of a New Adolescent Model (Sports Medicine, 2025), to focus on evidence-based revisions for screening, diagnosis, treatment, and clearance and return to play. Revised recommendations for managing eating disorders (ED)/disordered eating (DE) and non-pharmacological and pharmacological treatment of bone loss and abnormal menstrual cycles are included, as are the most recent clearance and return to play recommendations, inclusive of adolescent athletes. Recent research supports the adoption of revised criteria for defining and treating energy deficiency, moving away from the concept of an energy-availability threshold. Energy deficiency-induced menstrual disturbances can be reversed with a moderate increase in food intake and modest weight gain, but restoration of menses alone is not associated with high rates of ovulation or increased ovarian steroid levels until multiple consecutive normal length menstrual cycles are achieved. Revised guidelines for the diagnosis and treatment of functional hypothalamic oligo/amenorrhea are included with guidance on the confounding effects of hyperandrogenemia. Gynecological age and psychological stress are factors impacting the individual susceptibility to the Triad. The bone health spectrum of the Triad now includes bone stress injuries. Routes of administration via epidermal patch versus oral for pharmacological treatment of low bone density are discussed. The diagnosis, treatment, and return to play approaches for adolescents with the Triad are unique compared with those employed for adults and require age-appropriate clinical guidelines. The strength of the evidence-based statements is graded using an accepted taxonomy in which randomized controlled trials and observational data are considered the highest level of evidence.
26. Utilizing "Delocalized Electron Sailing" Strategy to Modulate Eg Orbital Occupancy of Dual-Atom Piezo-Catalyst for Ultrasound-Enhanced Immunotherapy.
期刊: Small (Weinheim an der Bergstrasse, Germany) 发表日期: 2025-Dec-31 链接: PubMed
摘要
The combination of immunogenic cell death (ICD) and immune checkpoint blockade (ICB) represents a promising strategy for inhibiting tumor growth and metastasis. Herein, we developed a dual-atom piezo-catalyst platform (denoted as FeCu-DSPCs) combined with α-PD-1/CTLA-4 to achieve effective immunotherapy against triple-negative breast cancer. Mechanistically, unlike traditional sonodynamic therapy, FeCu-DSPCs exhibited a robust piezoelectric response through a built-in polarized electric field without relying on the piezoelectricity of the substrate material, which promoted the valence electron transfer and captured delocalized electrons. This “Delocalized Electron Sailing” (DES) strategy accelerated the rate-determining step of cascade reactions through the increased, eg, orbital occupancy, resulting in explosive generation of reactive oxygen species (ROS). Therapeutically, FeCu-DSPCs disrupted both the energy metabolism cycle and redox balance, triggering endoplasmic reticulum (ER) stress and the release of damage-associated molecular patterns (DAMPs). Consequently, potent antitumor immune responses are elicited, including M1 macrophage polarization, dendritic cell (DC) maturation, and enhanced T cell infiltration. The combination of FeCu-DSPCs with α-PD-1/CTLA-4 effectively overcame the immunosuppressive tumor microenvironment and inhibited lung metastasis in mouse models. This work establishes a visionary bridge between dual-atom catalysts (DACs) and nanomedicine, paving the way for further exploration of carbon-based piezoelectric phenomena in cancer immunotherapy.
27. N6-methyladenosine within transmissible gastroenteritis virus genomic RNA inhibits its replication via efficient recognition by RNA sensor RIG-I.
期刊: Journal of virology 发表日期: 2025-Dec-31 链接: PubMed
摘要
N6-methyladenosine (m6A) is the most abundant internal modification in eukaryotic RNA and plays diverse roles in RNA metabolism. Increasing evidence indicates that m6A is also present in viral RNAs, where it exerts virus-specific effects. While several studies have shown that m6A can facilitate viral replication, its antiviral mechanisms remain less understood. In this study, we used transmissible gastroenteritis virus (TGEV) as a model to investigate the inhibitory role of m6A in viral infection. We demonstrated that m6A modification is present in the TGEV genome and suppresses viral replication. The m6A reader proteins bind to viral RNA and reduce the stability of m6A-modified transcripts. Notably, TGEV infection increased global m6A levels in host RNA, particularly in interferon (IFN)-associated genes. Inhibition of m6A methylation significantly diminished IFN gene expression. Furthermore, compared to other viruses, TGEV genomic RNA displayed an abnormally higher m6A ratio, which can be distinguished by RIG-I to promote an immune response. Collectively, our findings reveal that high m6A modification enhances RIG-I-mediated sensing of TGEV RNA, leading to the activation of IFN responses and inhibition of viral replication. This study provides new insights into the complex regulatory functions of m6A during viral infection and host antiviral defense.IMPORTANCEN6-methyladenosine (m6A) is one of the most prevalent RNA modifications in viral genomes, but its functional impact varies widely across viruses. While m6A often promotes viral replication, it can exert inhibitory effects in certain viruses, particularly within the Flaviviridae and Coronaviridae families. Despite growing evidence of this antiviral role, the underlying mechanisms remain largely unclear. Here, we used transmissible gastroenteritis virus (TGEV), a swine coronavirus, as a model to explore the inhibitory function of m6A. We show that the TGEV genome harbors a relatively high density of m6A modification compared to other viruses and host mRNA, which are efficiently detected by the host pattern recognition receptor RIG-I. This interaction enhances innate immune activation and restricts viral replication. Our findings uncover the mechanism by which abnormal m6A modification can be sensed to activate antiviral immunity and provide deeper insight into the multifaceted role of m6A in host-virus interactions.
28. Adaptation, cross-cultural validation, and assessment of measurement properties of the French-Canadian version of the Determinants of Implementation Behavior Questionnaire (DIBQ) for use regarding sexual health services in stroke rehabilitation.
期刊: Topics in stroke rehabilitation 发表日期: 2025-Dec-31 链接: PubMed
摘要
Clinicians report that numerous personal and environmental factors affect their ability to address sexuality in their practice. However, no validated tool in any language exists to assess these factors. To translate and cross-culturally validate the Determinants for Implementation Behavior Questionnaire (DIBQ) to sexual health (SH) services for Canadian French speaking stroke rehabilitation clinicians and assess its measurement properties. The DIBQ was adapted for sexual health services and translated into Canadian French using a back-translation process. The resulting DIBQ-SH was pretested, improved, and was then sent to clinicians of seven rehabilitation centers in Quebec, Canada, for testing. Exploratory factor analysis, Cronbach’s alpha, intraclass correlation coefficients (ICC), standard error of measurement (SEM), minimal detectable change (MDC), and floor and ceiling effects analysis were computed. A sample of 184 clinicians completed the DIBQ-SH. Factor analysis revealed a six-factor solution explaining 55.2% of the variance. Internal consistency for the total score (α = 0.94) and subscales “Capabilities” (α = 0.91), “Support and resources” (α = 0.87), “Emotions” (α = 0.83), “Planning and delivery” (α = 0.85), “Beliefs” (α = 0.83), and “Motivation” (α = 0.78) was considered “good” to “very good.” Test-retest reliability was “good” for the total score and 5/6 subscales (ICC = 0.79-0.88), excluding the “Beliefs” subscale, which was “critical” (ICC = 0.59). SEM and MDC were also presented. The DIBQ-SH showed good measurement properties for assessing factors that influence provision of sexual health services among French Canadian speaking clinicians who provide services to persons with stroke.
29. Genomic and phenotypic analysis of ST25 A. baumannii identifies virulence-associated clades and capsular/outer core locus types.
期刊: mSphere 发表日期: 2025-Dec-31 链接: PubMed
摘要
The increase in the infection caused by Acinetobacter baumannii is sustained by the selection of distinct epidemic clonal lineages, which are frequently resistant to a broad range of antimicrobials and possess virulence traits responsible for their persistence in the contaminated environment and spread among patients. The present study aimed to perform an integrated genomic and phenotypic analysis to assess the virulence features of ST25 isolates. A. baumannii isolates assigned to the ST25 epidemic clonal lineage shared high genomic similarity and clustered in four clades (I, II, III, and IV), with clade IV further subdivided into CIVa, CIVb, CIVc, and CIVd. Capsular locus (KL) KL14 was the predominant KL type (47%). Accessory genome analysis showed the presence of tartrate metabolism genes only in CII genomes. CIVb and CIVd ST25 A. baumannii isolates showed higher ability to infect Galleria mellonella larvae than CI, CII, CIII, and CIVc isolates. Hydrogen peroxide resistance was higher in CI, CII, CIVb, and CIVd isolates compared with CIII and CIVc isolates. In desiccation survival tests, CIII, CIVb, and CIVd isolates exhibited prolonged survival. In addition, CI, CII, CIII, CIVb, and CIVd isolates showed higher serum resistance than CIVc isolates. Also, KL14 type and lipooligosaccharide outer core locus (OCL) OCL6 type isolates were significantly more resistant to oxidative stress, to desiccation, and possessed a high ability to kill G. mellonella larvae. A positive and significant correlation was found between AdeB and AdeJ efflux pump expression and hydrogen peroxide resistance.IMPORTANCEIn this study, we characterized the genotypic and phenotypic features of A. baumannii strains assigned to the ST25 epidemic clonal lineage, which were isolated from humans, animals, and the environment. We found that ST25 A. baumannii isolates, irrespective of their antimicrobial resistance, showed peculiar virulence features among clades, isolates assigned to clade IVb and IVd showing the highest virulence and elevated resistance to serum and desiccation. Also, a positive significant correlation was found between the presence of KL14 and outer core locus 6 genotypes and resistance to oxidative stress, resistance to desiccation, and the ability to kill G. mellonella larvae. Phenotypic differences reflected clade identity rather than isolate origin, suggesting that specific virulence traits contribute to the environmental persistence and pathogenic potential of A. baumannii ST25 isolates.
30. Ghana Heart Initiative Training for Cardiac Arrest Management Among Health Care Professionals: Outcomes Evaluation Study (2019-2024).
期刊: JMIR formative research 发表日期: 2025-Dec-31 链接: PubMed
摘要
Health care professionals must stay updated with the latest guidelines for basic life support (BLS) and advanced cardiac life support (ACLS) to effectively assist patients during cardiac emergencies. Since its launch in 2018, the Ghana Heart Initiative has significantly enhanced the skills and knowledge of health care professionals in managing cardiovascular diseases, including cardiac emergencies. This study aims to assess the knowledge and skills of BLS and ACLS among health care professionals immediately after training in Ghana. This cross-sectional, training-based study involved 541 and 302 health care professionals trained in BLS and ACLS, respectively. Among them, 229 BLS and 124 ACLS-trained participants completed the questionnaires immediately after the training, and their data were included in the final analysis. Knowledge was assessed using a standardized questionnaire and an instructor-led skills evaluation based on the updated 2018 and 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. This study shows that 74.6% (171/229) of the health care professionals had adequate knowledge and skills in BLS. Those working in tertiary health care facilities were 80% less likely (adjusted odds ratio [AOR] 0.20, 95% CI 0.07-0.59; P=.003) to have adequate BLS knowledge and skills than those in primary health care facilities. Health care professionals from regions such as Volta and Oti were 4.94 times more likely to have adequate BLS knowledge and skills compared to those from Bono East (AOR 4.94, 95% CI 1.17-20.80; P=.03). Over 73.3% (91/124) of health care professionals had adequate knowledge and skills in ACLS. Males were 7.05 times more likely (AOR 7.05, 95% CI 2.69-18.46; P<.001) than females to possess adequate ACLS knowledge and skills. Given an opportunity to learn and practice, health care professionals in Ghana attain adequate knowledge and skills in BLS and ACLS.
31. Mental health disparities across demographic and social groups in Abu Dhabi.
期刊: Discover mental health 发表日期: 2025-Dec-31 链接: PubMed
摘要
Mental health disparities are increasingly shaped by intersecting demographic and socioeconomic conditions. Anchored in the Social Determinants of Health framework, this study investigates variations in mental well-being among adults in Abu Dhabi using data from the 5th Cycle of the Abu Dhabi Quality of Life Survey (2023-2024), which included over 100,000 respondents. Drawing on a subset of 65,203 adults, we analysed key mental health indicators-such as sadness, anxiety, loneliness, fear, difficulty concentrating, and boredom-across population groups using descriptive statistics and ANOVA. The findings reveal statistically significant disparities by age, gender, nationality, education level, household head status, and employment sector. Notably, youth aged 15-29 reported the highest emotional stress, while females and non-Emiratis exhibited higher negative mental health indicators compared to their counterparts. Non-heads of households and private-sector employees also displayed elevated distress levels, reflecting structural vulnerabilities in occupational and social roles. These results underscore the multidimensional nature of mental health and the influence of systemic inequalities on psychological well-being. The study offers timely, locally grounded evidence to inform targeted mental health interventions and inclusive policy development in Abu Dhabi’s rapidly evolving sociocultural landscape.
32. Test-negative designs with various reasons for testing: statistical bias and solution.
期刊: Epidemiology (Cambridge, Mass.) 发表日期: 2025-Dec-29 链接: PubMed
摘要
Test-negative designs are widely used for post-market evaluation of vaccine effectiveness, particularly in cases when randomized trials are not feasible. Unlike classical test-negative designs, which only include healthcare seekers with symptoms, recent test-negative designs have involved individuals with various reasons for testing, especially in an outbreak setting. While including these data can increase sample size and hence improve precision, concerns have been raised about whether they introduce bias into the current framework of test-negative designs, thereby demanding a formal statistical examination of this modified design. In this article, using statistical derivations, causal graphs, and numerical demonstrations, we show that the standard odds ratio estimator may be biased if various reasons for testing are not taken into account. To eliminate this bias, we identify three categories of reasons for testing, namely symptoms, mandatory screening, and case contact tracing, and characterize associated statistical properties and estimands. Based on our characterization, we show how to consistently estimate each estimand via stratification. Furthermore, we describe when these estimands correspond to the same vaccine effectiveness parameter and, when appropriate, propose a stratified estimator that can incorporate multiple reasons for testing and improve precision. We demonstrate the performance of our proposed method through simulation studies and a real-data analysis.
33. The global epidemiology of botulism outbreaks from open-source intelligence, 2017-2024.
期刊: The American journal of emergency medicine 发表日期: 2025-Dec-20 链接: PubMed
摘要
Botulism is a rare but potentially fatal illness caused by botulinum neurotoxin, with outbreaks reported globally in humans, animals, and the environment. In the absence of a global surveillance system, open-source intelligence (OSINT) offers real-time insight into botulism activity. Using the Artificial-Intelligence-driven OSINT early warning system EPIWATCH®, we extracted a dataset published between 31 December 2016 and 1 January 2025 and filtered by our search terms to identify botulism outbreaks. Data collected included country, event date, location, symptoms, outbreak type (human/animal), case numbers, hospitalisations, antitoxin treatment, deaths, source and origin of outbreak, botulism type, toxin strain, and time from exposure to symptom onset. Analyses were conducted using STATA/BE 17.0. OSINT identified 296 botulism outbreaks, of which 259 (87.5 %) were in humans, totalling 1097 cases and 47 deaths. There were 37 animal outbreaks (12.5 %), accounting for 27,537 cases and 27,287 animal deaths. The highest number of human outbreaks occurred in Ukraine (56.0 %, n = 145), the Russian Federation (10.8 %, n = 28), and the United States of America (7.0 %, n = 18). Common symptoms included dysphagia (11.0 %), nausea (9.0 %), and generalised weakness (8.8 %). The primary transmission routes were foodborne (79.5 %), iatrogenic (3.1 %) and wound (3.1 %, n = 8). The most frequently implicated sources were dried fish (33.2 %), canned fish (5.4 %) and canned meat (4.6 %, n = 12). Toxin strain was rarely reported (97.7 %). OSINT-based surveillance, despite some limitations, provides a new mechanism for insight into global botulism patterns, particularly where traditional reporting is limited.
34. Transformative biomaterials innovations for healthcare: Quantitative insights into translation of labscale research to inventions in global landscape.
期刊: Biomaterials advances 发表日期: 2025-Dec-19 链接: PubMed
摘要
The expansive domain of Biomaterials Science represents a pivotal axis in the advancement of basic and translational research, bearing significant societal implications for human health worldwide. Within the methodological limitation (2004-2023), a comprehensive scientometric review enabled us to critically explore the growth of research output (70746 publications) and inventions (66434 patents) across various micro-topics, which include hydroxyapatite, hydrogels, protein adsorption, silk fibroin, mesenchymal stem cells, electrospinning, dental implants, Mg-alloys, chitosan, Ti-alloys, additive manufacturing, decellularisation and polyurethane. Intriguingly, the compound annual growth rate (CAGR) of research publications is three times that of patents in the case of Mg-alloys, while comparable CAGR values were recorded for additive manufacturing. Most importantly, this review identifies a notable discrepancy between the number of publications and patents in a specific micro-topic, e.g., naturally derived and decellularized tissue. An emphasis was placed on h-index/g-index metrics as well as comparing multi-country versus single-country publications of the most productive 20 countries, in our eforts to highlight the global influence, visibility and contributions of the top 20 WoS-indexed journals to advance scientific knowledge across disciplines. Despite several decades of research to develop new biomaterials, fewer than 15 biomaterials, either synthetic or naturally derived, have been approved by global regulatory agencies. This gap can be addressed through more invention-driven and industry-focused innovation programs within a strict regulatory framework, as analysed in this review using collaboration network maps and other quantitative metrics related to patents. The policy recommendations, together with the proposed roadmap, call for cohesive international efforts to bridge existing research gaps, foster innovation, and implement strategic policies to ensure the accelerated translation of labscale research to regulatory approved implantable biomaterials and medical devices.
35. Behavioural drivers of on-farm biosecurity implementation in livestock: A literature overview with insights for research.
期刊: Preventive veterinary medicine 发表日期: 2025-Dec-18 链接: PubMed
摘要
Global livestock intensification heightens disease risks, making effective biosecurity crucial. However, the inconsistent adoption of biosecurity measures and the behavioural drivers behind this variability are not fully understood. This review assessed the current state of knowledge and identified evidence gaps regarding drivers influencing stakeholders’ decision-making and the implementation of biosecurity practices, to clarify why well-established measures are not consistently applied and to guide research addressing the factors shaping biosecurity implementation. Following PRISMA 2020 guidelines, a systematic search up to October 2023 was conducted across PubMed, Web of Science, and Scopus. Using a literature overview methodology, we retrieved relevant review articles on biosecurity decision-making (first phase), from which we identified relevant original research cited within them (second phase). Thematic analysis used the Capability, Opportunity and Motivation Behaviour (COM-B) model, with the Theoretical Domains Framework (TDF) guiding the coding procedure. Of 811 reviews initially retrieved, 37 were included. From these, 205 original research articles were identified, of which 78 were included. Most original studies originated from Europe and Central Asia (n = 38), highlighting geographical biases. Research mainly targeted farmers (n = 78), with few studies targeting veterinarians (n = 6). While 45 articles addressed all three COM-B components, beyond half (n = 46) reported four or fewer TDF domains, suggesting important knowledge gaps in the literature. Future studies should target understudied regions, TDF domains (e.g. Skills, Goals and Reinforcement) and stakeholders (e.g. farmers) to effectively implement biosecurity measures. This will help the livestock sector adopt evidence-based biosecurity and adhering to it, improving animal health and resilience worldwide.
36. Symptoms of Small Fiber Neuropathy in Patients With Dry Eye Disease.
期刊: Cornea 发表日期: 2025-Dec-15 链接: PubMed
摘要
Small fiber neuropathy (SFN) is a neurologic condition affecting small-diameter nerve fibers, including those innervating the ocular surface. In this study, we aim to assess the prevalence and characteristics of SFN symptoms in patients with dry eye disease (DED). This was a prospective study conducted at 2 academic eye centers. DED symptoms were assessed using the Ocular Surface Disease Index (OSDI) questionnaire, and adult patients with an OSDI score ≥13 and a clinical diagnosis of DED at Mass Eye and Ear and Beth Israel Deaconess Medical Center were included in the study. Ocular pain was assessed using the Ocular Pain Assessment Survey (OPAS). SFN symptoms were measured using validated Small-Fiber Symptom Survey (SSS) questionnaire, with scores ≥32.5 considered abnormal. DED signs including corneal fluorescein staining (CFS), tear breakup time (TBUT), tear production, and corneal sensitivity were assessed. Patients received standard DED treatments, and their responses were reassessed after 6 to 12 months. Among 31 participants with DED (23-87 years, 80.6% female), 38.7% had abnormal SSS scores. SSS scores correlated with DED symptoms (r = 0.43 P = 0.017) and ocular pain (r = 0.62 P = 0.0003); correlated negatively with CFS (r = -0.42 P = 0.018); and did not correlate with TBUT, tear production, or corneal sensitivity. Despite standard treatments and stable clinical signs, most patients with severe SFN symptoms reported worsening dry eye symptoms in follow-up. This study demonstrates that SFN symptoms were prevalent in DED population and positively correlated with ocular pain and dry eye symptoms and negatively with CFS. Patients with severe SFN symptoms reported less favorable responses to standard dry eye treatments.
37. Interaction with SMS text-reminders correlate with improved medication adherence and readmission rates for congestive heart failure patients: A retrospective cohort study.
期刊: PLOS digital health 发表日期: 2025-Dec 链接: PubMed
摘要
Short message service text reminders (SMS nudges) aimed to help vulnerable patient populations remember to fill their prescriptions are becoming more common but accurately measuring their effects on improving prescription fill and readmission rates remains challenging. Patients who presented to the emergency department (ED) with a primary diagnosis of congestive heart failure (CHF) were included in the study. We conducted a retrospective cohort study of CHF patients who did and did not interact with SMS nudges, then matched patients who were prescribed medications at any point in their hospital visit with records of subsequent prescription fills. Patients that interacted with SMS nudges had 19% higher odds of filling prescriptions overall (1.19 OR (95% CI: 1.15 - 1.24), p < 0.001) and 6% lower odds of being readmitted to the hospital (0.94 (95% CI: 0.9 - 0.99), p = 0.009) than patients who did not interact with SMS nudges. Interactive SMS nudges via a novel tool may improve prescription fill rates across multiple groups of CHF patients, and contribute to a reduction in readmissions.
38. Lethal Heat and Humidity Events.
期刊: Annual review of environment and resources 发表日期: 2025-Oct-06 链接: PubMed
摘要
Climate change increasingly threatens global health as more frequent extreme heat events, combined with varying humidity levels, exacerbate both direct and indirect health risks, strain energy resources, and lead to economic loss. Vulnerable populations, including the elderly, young children, and those with preexisting health conditions, face greater risks due to lower physiological adaptive capacity. Those from socioeconomically disadvantaged communities are also vulnerable because of increased exposure and reduced capacity. While research has expanded our understanding of the physiological effects of extreme heat and humidity, challenges persist, including inconsistent data, lack of unified heat wave definitions, and limited knowledge of their impact on mortality and morbidity especially in specific populations. Addressing these challenges requires enhanced data and a comprehensive evaluation of humidity’s modifying effects. Global collaboration to strengthen heat health action plans is essential, with future efforts focusing on enhancing the accessibility and effectiveness of interventions, especially in underresourced regions.
39. Dental anomalies in subjects with non-syndromic cleft lip and palate.
期刊: Stomatologija 发表日期: 2025 链接: PubMed
摘要
Cleft lip and palate (CLP) is a common congenital defect where dental anomalies are seen at a higher rate compared to the general population. The study aimed to identify, compare and correlate dental anomalies in non-syndromic cleft lip and palate subjects. A total of 100 patients with cleft lip and palate were evaluated for the presence of dental anomalies. After informed consent, clinical and radiological examination of the patients was performed. Cone beam computed tomography sections were analysed and dental anomalies present were recorded. The observations were tabulated and the data was subjected to statistical analysis. Ninety six percent of the cleft population had at least one dental anomaly. Patients with unilateral cleft lip and palate showed the highest prevalence of dental anomalies. Missing teeth (87%) were the most common dental anomaly followed by ectopic eruption, microdontia, enamel hypoplasia and impacted teeth. Other dental anomalies like odontomes and pulp stones were found at a lower prevalence rate. Patients with CLP are highly susceptible to the occurrence of dental anomalies. Thorough clinical and radiographic examination, careful planning and implementation of specialized services are needed in an effort to provide early diagnosis and comprehensive treatment.
40. A multi-level explanatory-sequential mixed-methods study of perinatal toxicology practices in New York State: Protocol.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Maternal morbidity and mortality (MMM) rates from drug overdoses have increased, especially among pregnant and postpartum women aged 35-44. However, there is limited understanding of how current toxicology testing practices are implemented in hospital settings and how well they support, or undermine, linkage to care. The goal of the study is to understand variations in toxicology testing use among pregnant and postpartum women, explore hospital- and individual-level differences, and assess outcomes. Using the Socio-cultural Framework for the Study of Health Service Disparities (SCF-HSD) we will perform a mixed-methods study to understand testing policies and practices in NY State. Aim 1 will employ multilevel statistical models using New York State Medicaid claims data (2021-2024) to identify predictors of perinatal toxicology testing and characterize hospital-level variation across hospitals. Aim 2 will involve one-on-one interviews with hospital administrators and clinical staff to document and analyze testing policies and practices, capturing diverse perspectives on testing rationales, attitudes, and adherence. Aim 3 will integrate quantitative and qualitative evidence through a mixed-methods design, incorporating perspectives of individuals with lived experience, via focus group sessions to inform and refine hospital policy recommendations. Our findings will inform how to improve disparities in toxicology testing for pregnant and postpartum women. Addressing these challenges requires shifting emphasis toward standardized, evidence-based toxicology testing protocols, strengthening pathways to supportive services, and advancing policy reforms that reduce stigma and inequities in care.
41. Spatial divergence between self-rated health and body mass index in China: Exploring the role of economic status using China Family Panel Studies (CFPS) 2016 and 2020.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Health disparities across China remained a major public health concern, with both individual and regional economic conditions shaping variations in health outcomes. In the context of the “Healthy China 2030” initiative, this study used data from the 2016 and 2020 waves of the China Family Panel Studies (CFPS) and applied multivariate multilevel logistic regression models to examine the associations between economic status at the individual and province levels and two key health indicators: self-rated health (SRH) and body mass index (BMI). The results showed that, at the individual level, a higher total value of durable consumer goods was negatively associated with having a normal BMI, whereas higher travel expenditure, per capita living space, and total cash and deposits were associated with a greater likelihood of reporting good SRH. At the province level, higher mean income exhibited a negative association with normal BMI and moderated the effects of household economic resources: income growth reduced health disparities in some dimensions (e.g., living space, cultural and entertainment spending) but widened them in others (e.g., vehicle purchase expenses). Spatial mapping further indicated that southern provinces tended to exhibit healthier BMI distributions but lower levels of good SRH compared with northern regions, revealing a clear spatial divergence between subjective and objective health measures. These findings highlighted the complex, multilevel, and spatially uneven relationships between economic status and health in China. Policy efforts should aim to strengthen household economic resilience, reduce regional health inequalities, and tailor interventions to local contexts to promote health equity nationwide.
42. Work-related musculoskeletal disorder among midwives, a threat for maternity care.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Work-related musculoskeletal disorder is a limiting, painful condition that affects the muscular, skeletal, articular, and nervous tissues of the body. The condition is mainly associated with poor working conditions and awkward body positions. Health professionals, including midwives, are among the most affected workforce globally. The condition affects the health of the professionals and the quality of care that professionals are expected to provide. However, there is a scarcity of information on the magnitude of the condition, its effect on midwifery practice, and associated factors. Objectives: This study aimed to assess the magnitude of work-related musculoskeletal disorder, its effect on midwifery practice, and associated factors among midwives in North Shoa Zone, Amhara Regional State, Ethiopia. An institution-based cross-sectional study assessed the magnitude of work-related musculoskeletal disorder (WRMSD), the effect on midwifery practice, and associated factors. The Nordic Musculoskeletal Disorder Scale was used to assess the presence of WRMSDs in the nine regional body parts and its effect. A stepwise backward elimination logistic regression model was used, and significant association was declared at a p-value of less than 0.05. A total of 473 (252 (53.3%) female and 221 (46.7%) male) midwives participated in this study. Overall, in the last 12 months, 355 (75.05%, 95% CI: 71.15% - 78.95%) midwives were affected by WRMSD, which was seen in any one of the nine regional body parts. About 45% (162) of them reported being unable to perform their daily tasks while they were affected, and 27% (96) of them sought treatment for their condition. The lower back was the most affected axial body part, reported by 300 (63.4%, 95% CI: 59% - 68%) midwives. Working in awkward or uncomfortable positions was significantly associated with the development of WRMSD (AOR: 1.81, 95% CI: 1.15-2.87). Similarly, awkward positions significantly affected the development of area-specific WRMSD in the lower back, upper back, neck, and limbs. Working in the same position for a longer time, seeing clients daily, and moving heavy objects were among the risk factors associated with developing area-specific WRMSD among midwives. The magnitude of work-related musculoskeletal disorders is high among midwives, and a significant number of them were unable to perform their daily tasks. The lower and upper back are the most commonly affected areas. Working in uncomfortable positions and attending to large clients daily were common risk factors. Therefore, training midwives about safe working positions and reducing the workload is commendable.
43. Growing third places: A qualitative study of experiences and perceived benefits of a campus community garden as a nature-based health intervention.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
This study explored the experiences and perceived health and wellbeing benefits of participating in a campus community garden among university staff, students, and faculty. Community gardens are increasingly recognized for their potential to positively impact physical, mental, and emotional health, as well as increase social connection. Their impact within university settings, specifically in Canadian post-secondary contexts, remains underexplored. This qualitative study was conducted at a large Canadian university. Fourteen participants affiliated with the campus community garden (including students, staff, and faculty) participated in semi-structured, in-depth interviews. Data were analyzed using thematic analysis. Four key themes emerged: (1) the garden as a “third place”, (2) deepened connection to nature, (3) empowerment through knowledge and ability to grow food, and (4) community building. Findings suggest that campus community gardens offer a cost-effective and accessible approach to supporting mental wellbeing, food security, and connectedness to nature in post-secondary settings. By functioning as a third place and fostering engagement with nature, campus community gardens may provide students and staff with meaningful opportunities for community integration, improved wellbeing and personal growth. These findings support integrating community gardens into campus wellness strategies and sustainability initiatives.
44. Prevalence and associated factors of multi-ethnic adolescent idiopathic scoliosis in Longlin, Southwestern China: a school-based cross-sectional study.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
To determine the prevalence of adolescent idiopathic scoliosis (AIS) and its associated factors among multi-ethnic schoolchildren in Southwestern China. A cross-sectional school-based study was conducted involving 22,814 students aged 10-18 years. Screening comprised the Adams forward bend test; positives underwent radiographic confirmation (Cobb angle ≥10°). Demographic and behavioral data were collected via questionnaires. Multivariate logistic regression identified independent associated factors. The screening positive rate was 3.83%, and the confirmed AIS prevalence rate was 1.37%. While no significant ethnic difference existed in screening positive rates (p = 0.078), the confirmed prevalence rates differed (p = 0.029), being relatively higher in Yi (1.52%) and GeLao (1.54%) adolescents. Girls showed a significantly higher screening positive rate than boys (4.64% vs. 3.12%, p < 0.001), but no statistically significant gender difference was found in the confirmed prevalence rates (p = 0.157). Notably, the positive predictive value was higher in boys (40.90%) than girls (31.72%). Multivariate analysis revealed several factors independently associated with AIS, including abnormal BMI, lack of desk/chair adjustment, poor sleep posture, physical inactivity, improper reading/writing posture, excessive electronic device use, insufficient outdoor activity, inadequate sleep, and frequent sweet consumption. The AIS prevalence in this multi-ethnic region aligns with global figures. School screening coupled with health interventions targeting modifiable associated factors is essential for AIS prevention and control. Comprehensive health promotion and early intervention targeting the identified significant factors should be an important future direction for AIS prevention.
45. Adherence to Mediterranean diet and physical activity practice in general population: an intersectional analysis of inequalities by sex and economic status.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
Inequalities in physical activity (PA) practice and adherence to Mediterranean diet (MD) between sex or socioeconomic groups have been described. We analyzed inequalities using an intersectional approach combining sex and economic difficulties (ED) in a population-based adult sample from Girona (Spain). Cross-sectional study including 1,425 inhabitants. ED were assessed with a self-reported question on perceived ability to make ends meet and dichotomized (with/without ED). Sex and ED were employed to form four intersectional positions (men/women × with/without ED). PA was assessed using the Minnesota-Regicor questionnaire, total weekly metabolic equivalents of task were calculated, and PA was dichotomized as low (first quartile) and not low. Adherence to MD was measured with the PREDIMED questionnaire and dichotomized as non-adherence/adherence. Sociodemographic and lifestyle characteristics were registered. We estimated crude and adjusted prevalence differences in low PA practice and non-adherence to MD corresponding to joint, referent, and excess intersectional inequalities using linear binomial regression models with identity link, which directly estimate prevalence differences in percentage points (pp). The discriminatory accuracy of the models was assessed using the area under the receiver operating characteristic curve (AUC-ROC). The prevalence of low PA was higher among women and increased by the presence of ED (26.7% vs. 40.9%). Overall, 27.8% reported ED and the four intersectional positions ranged from 10.5 to 40.3%. The adjusted joint disparity in low PA between women with ED (doubly disadvantaged) and men without (doubly advantaged) was 20.8 pp, of which 11.6 pp represented excess intersectional inequality. For non-adherence to MD, only the referent disparity for sex was statistically significant (8.54 pp). The AUC-ROC ranged from 0.62 for low PA to 0.67 for non-adherence to MD, with small increases when adding the intersectional groups. In this study, inequalities in adherence to MD were modest, mainly by sex and with low discriminatory accuracy, suggesting that population-wide interventions, complemented by attention to sex differences, may be more appropriate than targeted strategies. In contrast, low PA was markedly higher in women with ED than in men without. This highlights the importance of intersectional inequalities in PA and the need for universal policies that also prioritize socioeconomically disadvantaged women.
46. Analysis of heart rate variability and its influencing factors in different blood pressure groups in Changchun City.
期刊: Frontiers in public health 发表日期: 2025 链接: PubMed
摘要
To evaluate the Heart rate variability (HRV) in different blood pressure populations, analyze its influencing factors, rank their importance, and propose targeted health strategies. A total of 240 individuals with different blood pressure levels were recruited from a group in Changchun City, Jilin Province, using cluster sampling. Heart rate variability was assessed using the DHD-6000 HRV detector, and influencing factors were evaluated through questionnaires such as the “Health Risk Assessment Questionnaire,” Pittsburgh Sleep Quality Index (PSQI), Subjective Cognitive Decline Questionnaire (SCD-Q9), Generalized Anxiety Disorder 7-item scale (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Additionally, medical electronic sphygmomanometers (YXY-6) were used to collect blood pressure values. The study comprehensively evaluated Heart rate variability and its influencing factors in different blood pressure populations. Among the different blood pressure populations in Changchun City, 12 individuals had hypotension (5.0%), 121 had normal blood pressure (50.4%), 87 had prehypertension (36.3%), and 20 had hypertension (8.3%). The detection rate of low TP was 30.4%, indicating weakened autonomic nervous system regulation in this population. Random forest model variable importance ranking showed that hyperlipidemia had the most significant impact on this population. Multivariate linear regression analysis revealed that blood pressure, lipids, marital status, alcohol consumption, age, and exercise had statistically significant effects on Heart rate variability (p < 0.05). Heart rate variability is influenced by multiple factors including lifestyle, blood pressure, lipids, age, and marital status. Among these, hyperlipidemia has the greatest impact on Heart rate variability. Compared to individuals with normal blood pressure, those with prehypertension and hypertension exhibit reduced autonomic nervous system activity and regulatory function. It is recommended to develop reasonable exercise plans, improve unhealthy lifestyle behaviors, control blood pressure and lipids, enhance autonomic nervous system function, and reduce the risk of cardiovascular events.
47. Exposure to heavy metals, bisphenol A, and phthalates: Implications for precocious or delayed puberty.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
This study examined the associations between exposure to heavy metals, bisphenol A (BPA), and phthalates and precocious or delayed puberty. This study was a cross-sectional study using the data obtained from the Korea Environmental Exposure and Health Survey in Children and Adolescents. Blood samples were collected to measure lead, mercury, and cadmium levels, whereas spot urine samples were analyzed for BPA, phthalate metabolites, and creatinine levels. Sexual maturation status was assessed using self-measured Tanner stages. Our analyses involved single- and multi-exposure binomial logistic regression models adjusted for age, body mass index, presence of siblings, urban residence, and socioeconomic status. In the multi-exposure models, we applied quantile g-computation mixture analysis to calculate odds ratios (ORs) for precocious and delayed puberty. In the study cohort of 1,424 individuals, precocious puberty was identified in 50 (3.5%) individuals, whereas delayed puberty was identified in 54 (3.8%) individuals. In the single-exposure models, a higher mono-benzyl phthalate concentration was associated with a higher risk of delayed puberty in girls (OR = 2.75, 95% confidence interval: 1.34, 5.66). In the mixture exposure models, exposure to a mixture of BPA and phthalate metabolites was associated with precocious puberty in boys and delayed puberty in both sexes, although the risk estimates were imprecise. Our findings add to the increasing evidence suggesting that exposure to environmental chemicals may contribute to delayed puberty.
48. Provision of a liquefied petroleum gas cookstove and fuel during pregnancy and infancy and linear growth trajectories between birth and 12 months: Evidence from the multi-center Household Air Pollution Intervention Network (HAPIN) trial.
期刊: PLOS global public health 发表日期: 2025 链接: PubMed
摘要
Exposure to particulate pollution from cooking with solid biomass fuels is associated with impaired child linear growth. We examined the effect of a liquefied petroleum gas (LPG) cookstove randomized controlled trial during pregnancy and infancy on linear growth trajectories among infants born to women enrolled during pregnancy. The Household Air Pollution Intervention Network (HAPIN) randomized controlled trial enrolled 3195 pregnant women (9 to <20 weeks’ gestation) from rural areas in Guatemala, Peru, India, and Rwanda who relied primarily on biomass fuels for cooking. Women in the intervention group received an LPG cookstove and fuel for approximately eighteen months, while those in the control group continued to use biomass for cooking. We measured the infants’ recumbent length at birth and 3, 6, 9 and 12 months of age and calculated length-for-age z-score (LAZ). We conducted a multiple group latent class growth analysis among the 2802 infants who finished the study and had ≥ 3 length measurements across the five timepoints to examine if latent classes differed by study arm. We identified three latent classes of linear growth, based on visual inspection of mean LAZ and model fit statistics, which represent higher, medium, and lower LAZ trajectories. Approximately 13.2% of infants belong to the high LAZ trajectory, 53.8% of infants belong to the medium LAZ trajectory and 33.0% belong to the low LAZ trajectory. The distribution of infants in each latent class did not differ by intervention assignment. Provision of an LPG cookstove and fuel during pregnancy and infancy did not alter linear growth trajectories among the offspring. Clinical Trials Registration Number ClinicalTrials.gov NCT02944682.
49. Whole-genome sequencing of Burkholderia glumae strains from Thailand reveals potential horizontal gene transfer with Burkholderia pseudomallei.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Burkholderia glumae is an emerging phytopathogen that causes bacterial panicle blight in rice and has been implicated in rare human infections. In Thailand, B. glumae and the human pathogen Burkholderia pseudomallei coexist in rice fields. Given the high genomic plasticity of Burkholderia species, including frequent genome rearrangements, variability in mobile genetic elements, and recombination events that facilitate horizontal gene transfer, there are concerns about the emergence of novel traits that may affect both plant and human health. In this study, we performed whole-genome sequencing and a comparative genomic analysis of 16 B. glumae strains isolated from rice fields across seven Thai provinces. Our phylogenomic analysis, based on core-genome single-nucleotide polymorphisms, revealed high genetic diversity and a polyclonal population structure, with evidence of a globally distributed clonal lineage. All isolates harbored plasmids and diverse prophage elements, which indicated extensive mobilome variability. A total of 572 putative horizontally transferred genes were identified. Most of these genes originated from unclassified or plant-associated Burkholderia species. Notably, two strains shared a chromosomal island that carried genes that were very similar to those found in B. pseudomallei. This genomic region contained genes associated with mobile genetic elements, phage defense, and a type VI secretion system, including genes that encode a PAAR domain-containing protein, a putative nuclease, and an immunity protein. Our findings highlight the genomic heterogeneity of B. glumae in Thailand and provide evidence of interspecies horizontal gene acquisition from human pathogenic B. pseudomallei. The presence of B. pseudomallei-derived genes in B. glumae chromosomes underscores the potential for genetic exchange in shared environmental niches, which could affect the evolutionary dynamics and pathogenicity of B. glumae. Hence, our findings also emphasize the critical need for environmental surveillance and genome-based monitoring to track emerging genomic combinations relevant to both plant and human health.
50. Development and validation of the leisure lifestyle and satisfaction assessment: A comprehensive tool for evaluating leisure engagement.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Leisure activities play a pivotal role in enhancing the overall well-being and quality of life in people with schizophrenia. Leisure lifestyle and satisfaction provide important leisure-related information on how people with schizophrenia effectively engage in and benefit from leisure activities. The aim of the study was to develop a new measure with two sections (leisure lifestyle and leisure satisfaction): the leisure LIfestyle and SAtisfaction measure (LISA). Literature review, expert consultation, and cognitive interviews were conducted to develop and verify the content of the two sections. The leisure satisfaction section was examined for construct validity, Rasch reliability, and ceiling/floor effects. Eight experts reviewed the content, and 15 people with schizophrenia participated in a cognitive interview. Subsequently, 200 people with schizophrenia from one psychiatric center completed the two sections of the measure. The leisure lifestyle section comprised three items designed to assess personal values associated with engaging in leisure activities and preferences for leisure activities in the present and future. The leisure satisfaction section included 14 items to assess the level of satisfaction derived from engagement in leisure activities and demonstrated unidimensionality with infit and outfit mean squares ranging from 0.77 to 1.27 and 0.75 to 1.27, respectively, while the eigenvalue of the first contrast was 2.2. The leisure satisfaction section showed a sufficient Rasch reliability of 0.90 and no ceiling/floor effect (0.5-3.5%). The LISA can simultaneously assess leisure lifestyle and satisfaction, offering detailed insights into the leisure activities that people with schizophrenia are attracted to and their perceived enjoyment of these activities. The participants of this study were recruited from a single institution and we excluded people with schizophrenia with severe cognitive impairments, which may restrict generalizability. Future research is warranted to recruit people with schizophrenia from multiple institutions to cross-validate our findings.
51. Domain-specific physical activity and depressive symptoms in Korean adults: An isotemporal substitution study using KNHANES data.
期刊: PloS one 发表日期: 2025 链接: PubMed
摘要
Although the mental health benefits of physical activity are well-established, they appear more pronounced when engaging in leisure activities rather than work-based efforts. This phenomenon is often referred to as the physical activity paradox. While leisure activity is often linked to reduced likelihood of depression, the influence of occupational physical activity remains less clearly understood, especially during periods of social disruption such as the COVID-19 pandemic. This study analyzed data from 26,454 Korean adults aged 19 years and older who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) in 2014, 2016, 2018, 2020, and 2022. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), and domain-specific physical activity was measured with the Global Physical Activity Questionnaire (GPAQ). Isotemporal substitution modeling examined associations between reallocating 30 minutes of activity among occupational, transport, and leisure domains and depressive symptoms. Subgroup analyses were conducted across three time periods: pre-pandemic (2014-2018), early pandemic (2020), and later pandemic (2022). In the full sample, reallocating 30 min from occupational-type moderate-to-vigorous physical activity (MVPA) to leisure MVPA was associated with lower odds of depressive symptoms (odds ratio [OR]: 0.805, 95% confidence interval [CI:] 0.694-0.934), whereas the reverse substitution was linked to higher odds (OR: 1.242, 95% CI: 1.071-1.441). These associations were statistically significant during the pre-pandemic period but did not reach significance during the early or later pandemic phases. The observed associations between physical activity and depressive symptoms appear to vary by activity type and the social context. The potential mental health benefits of leisure-based activity may be weaker during periods of societal disruption, such as the COVID-19 pandemic. These findings highlight the need for physical activity guidelines that consider both domain-specific patterns and the psychosocial environment in which activity takes place.