公共卫生研究摘要 (2026-01-02)

2026年01月02日

公共卫生研究摘要 (2026-01-02)

共收录 63 篇研究文章

1. Lost and found: Rediscovering microbiome-associated phenotypes that reshape agricultural sustainability.

期刊: Science advances 发表日期: 2026-Jan-02 链接: PubMed

摘要

Modern agriculture faces an urgent need to improve nutrient use efficiency while reducing environmental impacts. Here, we show that ancestral traits controlling rhizosphere microbiome functions can be reintroduced into elite maize through targeted teosinte introgressions. Using near-isogenic lines, we mapped microbiome-associated phenotypes (MAPs) derived from teosinte that suppress nitrification and denitrification-key microbial processes contributing to nitrogen loss. These introgressions altered root exudate chemistry, resulting in distinct microbial assemblies and enhanced nitrogen retention. We identified candidate loci and exudate metabolites responsible for suppressive activity and demonstrated their functional effects in vitro. These findings reveal a genetic and biochemical basis for rewilding microbiome-mediated ecosystem services in crops, offering a scalable path toward sustainable nutrient management in global agriculture.

2. Microbial dynamics in coral reef waters: Diel cycles in contrasting seasons.

期刊: Science advances 发表日期: 2026-Jan-02 链接: PubMed

摘要

Coral reefs are dynamic ecological hotspots, yet their influence on surrounding microbial plankton remains poorly studied. High-frequency diel sampling of Red Sea reef waters during mesotrophic winter and oligotrophic summer conditions revealed distinct prokaryotic and microeukaryotic communities compared to nonreef waters, along with previously undescribed diel cycles. Sequencing of 16S and 18S ribosomal RNA gene amplicons showed enrichment in sequences affiliated with copiotrophs, specialized hydrocarbon degraders, parasites, and mutualistic symbionts. Symbiodiniaceae sequence reads consistently peaked at midday. Cell counts by flow cytometry revealed that reef water contained 20 to 60% fewer bacteria and up to 75% fewer microalgae than adjacent open seawaters. In winter, cell drawdown was often more pronounced at dusk, while summer cell density showed no consistent diel pattern. Heterotrophic protist densities increased up to 80% in reef water at night, suggesting predation as a regulatory force on microbial populations. Our findings show that the reef not only reshapes microbial communities but also imposes a pronounced diel structure on planktonic life.

3. Genome-wide association study reveals genetic architecture and evolution of human retinal pigmentation.

期刊: Science advances 发表日期: 2026-Jan-02 链接: PubMed

摘要

Pigmentation varies widely across humans and is shaped by melanin quantity, type, and spatial distribution. Retinal pigmentation protects against light-induced damage, yet its genetic and evolutionary bases remain unclear. We developed a deep learning framework (DeepGRP) to quantify retinal pigmentation from high-resolution fundus images and conducted a genome-wide association study (GWAS), identifying 42 signals, including 26 previously unidentified loci, with single-nucleotide polymorphism-based heritability of 21.4%. Single-nucleus assay for transposase-accessible chromatin by sequencing and RNA sequencing of human fetal retinal tissues revealed key cellular contributors, including retinal pigment epithelium and photoreceptor cells. Among candidate genes, ARHGAP18 emerged as a previously unrecognized regulator of melanogenesis. Evidence of polygenic adaptation in Europeans suggests selection driven by snow-reflected light at high latitudes. A polygenic risk score for retinal pigmentation correlated with a 4.8-fold higher risk of myopia and a 1.5-fold lower risk of skin cancer. These findings demonstrate the power of deep learning for large-scale ocular phenotyping and reveal insights into the genetic and evolutionary architecture of retinal pigmentation.

4. Multidimensional mapping of stimulation-responsive regulatory elements and candidate causal variants in T cell activation.

期刊: Science advances 发表日期: 2026-Jan-02 链接: PubMed

摘要

Genome-wide association studies (GWASs) have elucidated numerous noncoding variants linked to immune-related disorders, yet the intricate context-specific mechanisms governing their effects remain poorly defined. Here, we leverage CD4+ T cell activation as a model to integrate multilayered genomic data and interrogate the dynamic regulatory mechanisms underpinning these genetic associations. We have applied a cistromic strategy to systematically identify and prioritize stimulation-responsive cis-regulatory elements (CREs) and key genes essential for T cell activation. Using capture Hi-C and tiling CRISPR activation screening at the CD28 locus, we reveal a pivotal CRE harboring a causal small insertion variant, rs5837875, that modulates CD28 activation in an allele-specific manner. Mechanistically, we demonstrate that ZNF384 mediates stimulation-responsive chromatin looping between the rs5837875-containing enhancer and the CD28 promoter, culminating in heightened CD28 expression and aberrant T cell hyperactivation. Our integrative and context-dependent strategy establishes a comprehensive pathway for deciphering the missing regulatory mechanisms of complex disease.

5. Caspase-2 deficiency drives pathogenic liver polyploidy and increases age-associated hepatocellular carcinoma in mice.

期刊: Science advances 发表日期: 2026-Jan-02 链接: PubMed

摘要

Hepatocyte polyploidization promotes liver homeostasis by enhancing resistance to cellular stress. Caspase-2, a proapoptotic protease, restricts polyploidization by deleting polyploid and aneuploid cells. While caspase-2 protects against diet-induced hepatic injury, it also acts as a tumor suppressor by controlling genomic instability and oxidative stress. To investigate these roles, we assessed hepatic ploidy dynamics, liver damage, and age-associated tumorigenesis in caspase-2-deficient and catalytically inactive mutant mice. We found that caspase-2 loss promotes early-onset hepatocyte hyperpolyploidy, accompanied by progressive liver inflammation, fibrosis, oxidative liver damage, ferroptosis, and higher incidence of spontaneous hepatocellular carcinoma in aged animals. Proteomic profiling revealed a pathogenic polyploidy-associated signature associated with caspase-2 deficiency and increased predisposition to liver disease and malignancy. These findings establish caspase-2 enzymatic activity as a critical regulator of hepatic genome stability and preventing age-related liver cancer that strongly argue against therapeutic caspase-2 inhibition as a strategy for managing liver injury or cancer risk.

6. Circadian-shaped immune variability predicts infection outcome.

期刊: Science advances 发表日期: 2026-Jan-02 链接: PubMed

摘要

Disease risk and severity are influenced by genetics, epigenetics, and environmental factors. However, immune responses vary even among genetically similar or related individuals, shaped by inherited and noninherited factors. Using Caenorhabditis elegans, we found that pathogen susceptibility can be predicted by preinfection biomarkers. Individuals with high-basal expression of irg-5, an infection response gene regulated by the p38 mitogen-activated protein kinase-1 (PMK-1) pathway, were more susceptible to Pseudomonas aeruginosa infection. A genome-wide screen identified the myeloid ecotropic viral integration site-1 (MEIS) homeobox protein UNC-62 as a regulator of irg-5 expression, acting through PMK-1 and GATA binding erythroid-like transcription factor (ELT-2). Further analysis revealed that maternal circadian timing shaped offspring immune heterogeneity and inhibition of clock genes eliminated the effects induced by maternal timing. These findings highlight circadian-driven immune variability as a potential adaptive strategy for resilience against infection.

7. A distinct lineage pathway drives parvalbumin chandelier cell fate in human interneuron reprogramming.

期刊: Science advances 发表日期: 2026-Jan-02 链接: PubMed

摘要

Direct lineage reprogramming of glial cells to induced neurons has the potential for restoring brain circuits and function in neuronal disorders and states. We introduce three-dimensional (3D) human glia reprogramming into neurons with a GABAergic interneuron phenotype using stem cell-derived human glia. Single-nucleus RNA sequencing of the converted cells demonstrates distinct neuronal clusters within 2 weeks, including a parvalbumin (PV) cluster with high neuronal maturity and features of chandelier interneurons. A lineage trajectory analysis of the glia-to-neuron conversion reveals a distinct lineage pathway to PV chandelier fate, including various neuronal developmental stages and the establishment of synaptic machinery. This analysis reveals PV fate-important genes that are previously unknown to neural reprogramming with promising functional importance for future derivations. Our data demonstrate successful human glia conversion into interneurons with features of bona fide PV subtype and highlight the reprogramming trajectory with key transitional genes. This advancement holds promise for future human brain cell engineering and repair.

8. Genetic resistance to leukemia.

期刊: Science (New York, N.Y.) 发表日期: 2026-Jan 链接: PubMed

摘要

A genome-wide association study identifies a genetic variant that reduces the risk of leukemia.

9. Magical thinking will not prevent future pandemics or improve public health.

期刊: Science (New York, N.Y.) 发表日期: 2026-Jan 链接: PubMed

摘要

10. "I don't think people realise how important they are": a mixed methods evaluation of Samaritans' services.

期刊: Journal of mental health (Abingdon, England) 发表日期: 2026-Jan-01 链接: PubMed

摘要

Since the first suicide helpline was established in 1953, telephone support helplines have expanded globally. One such helpline is Samaritans. Previous studies on Samaritans have explored volunteers’ perspectives and examined the number of calls users make. The aim of this study was to capture the users’ experiences of Samaritans’ helpline in Ireland. A mixed methods methodology, incorporating quantitative (cross-sectional) and qualitative (qualitative descriptive) elements was adopted. Participants accessed surveys via Samaritans’ website. At the end of the survey, participants could self-select to partake in 1:1 online interviews. Quantitative data were analysed using descriptive statistics; qualitative data were analysed using reflexive thematic analysis. A total of 395 respondents completed the survey. Telephone was the most prominent format of contact with Samaritans, at 88.6% (n = 350). Mental health was cited as the main reason callers connected with Samaritans. Almost half of respondents felt supported a lot (47.3%, n = 187). Qualitative analysis identified three themes: Availability, Accessibility, Anonymity; Connecting with Volunteers; and Expectations of Samaritans’ Services. Samaritans’ services are highly valued by those who engage with them. However, there is a need to enhance public awareness about the specific supports Samaritans provide, and the formats of contact that are available.

11. Inherited resilience to clonal hematopoiesis by modifying stem cell RNA regulation.

期刊: Science (New York, N.Y.) 发表日期: 2026-Jan 链接: PubMed

摘要

Somatic mutations that increase the fitness of hematopoietic stem cells (HSCs) drive their expansion in clonal hematopoiesis (CH) and predispose individuals to blood cancers. Population variation in the growth rate and potential of mutant clones suggests that genetic factors may confer resilience against CH. Here, we identified a noncoding regulatory variant, rs17834140-T, that protects against CH and myeloid malignancies by selectively down-regulating the RNA-binding protein MSI2 in HSCs. By modeling variant effects and mapping MSI2 binding targets, we uncovered an RNA network that maintains human HSCs and influences CH risk. Variant rs17834140-T was associated with slower CH expansion, and stem cell MSI2 levels modified ASXL1-mutant HSC clonal dominance. These findings leverage natural resilience to illuminate posttranscriptional regulation in human HSCs, suggesting that inhibition of MSI2 or its targets could be rational strategies for blood cancer prevention.

12. International Cost-Effectiveness Analysis of Nivolumab Versus Brentuximab Vedotin for Patients With Advanced-Stage Classic Hodgkin's Lymphoma.

期刊: Hematological oncology 发表日期: 2026-Jan 链接: PubMed

摘要

Programmed death-1 (PD-1) blockade offers a survival advantage over antibody-drug conjugate (ADC) treatment in classic Hodgkin lymphoma (cHL). As such, an updated pharmacoeconomic analysis of these different therapeutic strategies is indicated. This study therefore assessed the cost-effectiveness of nivolumab combined with doxorubicin, vinblastine, and dacarbazine (N-AVD) to that of brentuximab vedotin with AVD (BV-AVD). A three-state Markov model was developed to assess lifetime costs and efficacy for N-AVD and BV-ACVD regimens as treatments for adolescent and adult cHL patients from the perspectives of payers in China and the USA, using respective willingness to pay (WTP) thresholds of $37,608 and $150,000 per quality-adjusted life year (QALY). Primary analytical outcomes included direct medical costs, lifetime efficacy, incremental cost-effectiveness ratio (ICERs), and incremental net health benefit (INHB). Model stability was tested through sensitivity and subgroup analyses. N-AVD treatment yielded 1.41-2.01 and 1.06-1.39 QALYs over BV-AVD for cHL patients in the USA and China, respectively. Incremental healthcare costs for first-line N-AVD treatment were -$746,249 to $393,009 and -$109,358 to $292,324 compared to BV-AVD treatment, for corresponding ICERs of -$432,098/QALY to $288,541/QALY and -$79,173/QALY to $275,376/QALY in the USA and China, respectively. Sensitivity analyses suggested that the utility of progression-free survival had an influence on the results of these cost-effectiveness analyses. N-AVD and BV-AVD are cost-effective approaches to treating patients with cHL in both the USA and China. N-AVD and BV-AVD may respectively be best suited to use as treatments for adolescents and elderly individuals.

13. Invasion of Epicardial-Derived Cells to the Trabeculae Mediated by NFPs-Fgf Signaling Regulates Ventricular Compaction.

期刊: Circulation. Heart failure 发表日期: 2026-Jan-01 链接: PubMed

摘要

Left ventricular noncompaction cardiomyopathy (LVNC; OMIM No. 604169) is anatomically characterized by excess trabeculation and deep intertrabecular recesses. It is the third most prevalent pediatric cardiomyopathy. Despite its clinical significance, the pathogenesis of LVNC remains uncertain. We examined Numb expression in epicardial cells (EpiCs) and epicardial-derived cells (EPDCs) using a mCherry::Numb knock-in mouse line; used Tbx18Cre/+ and inducible WT1CreERT2/+ to generate epicardium-specific Numb and Numblike double knockouts (epicardial Nb;Nl double knockout [EDKO]) and inducible EpiC-specific Nb;Nl knockout, respectively; monitored EpiCs/EPDCs invasion into the myocardium by lineage tracing; assessed LVNC defects via the ratio of noncompact to compact zone thickness/area; utilized single-nuclei mRNA sequencing and biochemical tools to determine the disrupted molecular mechanisms of EDKOs; and used pharmacological approaches to rescue defects in EDKOs. Cardiac structural and functional changes in adult stages were examined using echocardiography and histochemistry. Sample sizes ranged from 3 to 9 hearts across experiments. Numb is enriched in EpiCs and EPDCs. In EDKO hearts, EPDCs displayed abnormal differentiation, and their migration was arrested at the outer compact zone, resulting in the absence of EPDCs in the inner compact zone and trabeculae. The EDKO hearts displayed LVNC, and inducible EpiC-specific Nb;Nl knockouts (induced at embryonic day 10.5) recapitulated the defects. Single-nuclei mRNA sequencing revealed the upregulation of Fgfr1 (fibroblast growth factor receptor 1) in epicardium and the downregulation of Fgf (fibroblast growth factor) ligands in cardiomyocytes in EDKOs. Exogenous Fgf2 supplementation to pregnant females partially rescued epithelial-mesenchymal transition and compaction defects in EDKO hearts. Female EDKOs survived to adulthood and maintained LVNC. Ablation of NFPs (numb family proteins) in EpiCs disrupted the invasion and differentiation of EPDCs and the communication between cardiomyocytes and other cells, and caused LVNC. The epithelial-mesenchymal transition and compaction defects can be partially rescued by exogenous Fgf2 supplementation. Our findings highlight an essential role for the epicardial NFPs-Fgf/Fgfr axis in regulating ventricular compaction.

14. Tobacco cessation strategies in military personnel: A meta-analysis of randomized trials.

期刊: Preventive medicine reports 发表日期: 2026-Jan 链接: PubMed

摘要

To evaluate the effectiveness of behavioural and pharmacological tobacco cessation interventions among active-duty military personnel and veterans. We followed PRISMA guidelines to assess the efficacy of behavioural and pharmacological interventions on tobacco cessation in military populations. Randomized controlled trials were identified through PubMed (from 1966), Web of Science (from 1900), Scopus (from 1960), and the Cochrane Library/CENTRAL (from 1991) from database inception to July 2024. Random-effect models were used to estimate odds ratios and 95 % confidence intervals. Five randomized controlled trials involving a total of 2619 participants were included. Seven-day point prevalence abstinence was significantly increased at short-term (≤ 3 months) (OR 2.03 [95 % CI: 1.49, 2.77], low certainty) and long-term (≥ 6 months) (OR 1.53 [95 % CI: 1.12, 2.09], low certainty) follow-ups among those receiving interventions compared with controls. Subgroup analyses were conducted by type of personnel, tobacco product, intervention type, and sex. These findings highlight the need for stronger, accessible, and military-tailored cessation programs, particularly for veterans who show lower quit rates. Expanding high-quality randomized trials that test modern cessation approaches in diverse military populations is essential to inform future policy and clinical practice.

15. Strategies to advance gender equity in anaesthesia leadership: a state-of-the-art review.

期刊: Anaesthesia 发表日期: 2026-Jan-01 链接: PubMed

摘要

Gender equity for anaesthetists remains elusive, despite patient and clinician benefits. Many strategies have been proposed to promote gender equity, yet women remain under-represented in anaesthesia leadership compared with men. This review identifies contemporary implemented strategies to improve gender equity in anaesthesia leadership. We searched databases for studies published from January 2019 to March 2024, including reports of implementation. We employed state-of-the-art review methodology to provide a current understanding of this complex sociocultural problem, using Cook’s and Stufflebeam frameworks for categorisation and deductive data extraction and analysis based on context, inputs, processes and outcomes. We screened 257 abstracts and identified 18 studies for analysis; 14 were conducted in the USA. The most prominent individual interventions were mentorship and sponsorship. These were supported by organisational interventions including professional development curricula; policies; and leadership roles supporting diversity. Two studies reported how programmes were iteratively developed. Reported success metrics included quantitative (increased diversity in leadership, achieving promotion) and qualitative outcomes (networks and wellbeing). Evidence for best practices to address gender equity in anaesthesia leadership is emerging. Prospective determination of key outcomes enables monitoring of success, including representation and wellbeing. Organisational support, in the form of policies and leadership roles linked to diversity outcomes, amplifies the benefits of mentorship and sponsorship. Future interventions should report the context in which the interventions were mobilised, associated costs and details of the iterative programme delivery and development process. WHAT WE DID?: We looked at many recent studies to find out what people are doing right now to help make leadership in anaesthesia more fair for women. We searched for studies from 2019 to 2024 and chose 18 that explained real actions taken to improve gender fairness. WHY DID WE DO IT?: Women are still not employed as often as men in top anaesthesia jobs, even though fairness helps both patients and doctors. Many ideas have been suggested, but we wanted to know which ones are actually being tried and whether they seem to work. WHAT WE FOUND?: The most common helpful actions were mentorship (helping someone learn and grow) and sponsorship (supporting someone so they can get new opportunities). Hospitals and organisations also used policies, training programmes and leadership roles that focused on fairness and diversity. Some programmes showed success by increasing the number of women in leadership and helping people feel more supported and connected. The best results happened when organisations backed these efforts with clear plans and leaders responsible for making fairness a priority. Overall, the research shows that solutions that address the problem at different levels improve fairness, but there is still more work to do.

16. Quantifying host-microbe interactions with bacterial lineage tracing.

期刊: Science (New York, N.Y.) 发表日期: 2026-Jan 链接: PubMed

摘要

Using genomic barcodes to trace bacterial lineages within a host reveals previously unobservable dynamics of infection, including the impact of infection bottlenecks, routes of bacterial dissemination, and patterns of within-host evolution. Barcoding introduces trackable diversity to otherwise isogenic bacterial populations. Comparing the barcodes within an inoculum to those within the host quantifies the “founding population,” which reveals the magnitude of population collapse caused by host bottlenecks. Furthermore, comparisons of the founders between tissues can reveal the patterns of pathogen dissemination. On longer timescales, the emergence of dominant barcoded lineages can also be used to detect within-host evolution. Collectively, barcoding studies quantify the hidden parameters that underlie bacterial colonization and create a quantitative framework for modeling and preventing infectious disease.

17. Adaptive spread of a sexually selected syndrome eliminates an ancient color polymorphism in wall lizards.

期刊: Science (New York, N.Y.) 发表日期: 2026-Jan 链接: PubMed

摘要

Genetically determined color morphs are found in many animals. Polymorphism can be maintained by social selection if competitive interactions allow each morph to increase in frequency when rare. This reliance on negative frequency-dependent selection should make color polymorphism vulnerable to the appearance of novel phenotypes that disrupt competitive interactions among morphs. We show that the origin and adaptive spread of a sexually selected syndrome in common wall lizards (Podarcis muralis) selectively eliminates alleles coding for alternative color morphs that have been maintained for millions of years. The results demonstrate how the arrival of a novel phenotype can disrupt balancing selection, providing a link between rapid phenotypic evolution and the loss of color polymorphisms.

18. Removal of m-Toluidine from aqueous solution using H3PO4-activated carbon from Balanites aegyptiaca seeds.

期刊: Journal of environmental science and health. Part A, Toxic/hazardous substances & environmental engineering 发表日期: 2026-Jan-01 链接: PubMed

摘要

Environmental pollution caused by industrial activities, vehicle emissions, and improper waste disposal poses serious risks to human health and the ecosystem. This study investigates the adsorption of m-toluidine (m-T) using activated carbon derived from Balanites aegyptiaca seeds (BASC) via H3PO4 chemical activation. The BASC was characterized using scanning electron microscopy and Fourier transform infrared spectroscopy and analyzed for its moisture, ash, volatile matter, and carbon content. The material exhibited a high surface area of 675.0 m2 g-1, an iodine number of 581 mg g-1, and a point of zero charge (pHpzc) of 4.42. Batch adsorption experiments were performed to assess the effects of pH, contact time, and temperature. Results showed that adsorption efficiency increased with temperature. The adsorption behavior is favorable and followed the Temkin isotherm, pseudo-second-order kinetic model, and a three-step intraparticle diffusion mechanism. Thermodynamic analysis revealed that the adsorption process was endothermic, spontaneous, and associated with increased system entropy. These results underscore the potential of adsorption as an efficient wastewater treatment approach for eliminating organic contaminants such as m-T from actual aqueous environments.

19. A Brief Occupational Therapy Foot Care Program for Community-Dwelling Older Adults and the Social Connectedness Implications.

期刊: Occupational therapy in health care 发表日期: 2026-Jan-01 链接: PubMed

摘要

Individuals with type II diabetes are at risk of serious medical complications, which require daily patterns of health management. A single group, pre-post study was conducted to determine the impact of a new, brief occupational therapy foot care program for undeserved older adults with prediabetes or type II diabetes (n = 19). Culturally responsive, in-person programming included two one-hour modules of educational videos and guided practice with foot care equipment under the supervision of a licensed occupational therapist. Using a researcher-developed questionnaire, knowledge regarding the regularity of assessing feet and lifestyle factors associated with diabetes increased post-intervention. An upward positive trend was observed with all questions posed, and a statistically significant increase in satisfaction regarding routine associated with diabetes was observed (p = 0.013). Results suggest the utility of a brief foot care program to address diabetes-related outcomes and the health management implications of social connectedness.

20. Occupational exposure to microorganisms for operators of jet-vac trucks.

期刊: Archives of environmental & occupational health 发表日期: 2026-Jan-01 链接: PubMed

摘要

This study examines bioaerosol exposure and associated biomarker levels in combination vacuum-jet truck (“jet-vac”) operators servicing the sewer network in Denmark. Personal exposures (n = 42) and end-of-shift serum samples (n = 30) were collected from 28 workers across four exposure groups: “Stormwater,” “Wastewater,” “Combined,” and “Other” (non-sewage related work). Geometric means of bacterial and fungal exposure levels were 938 and 301 colony forming units per cubic meter of air (CFU/m³), respectively. “Stormwater” workers had significantly higher serum amyloid A (SAA) levels than the “Other” group (p = 0.019). SAA was negatively associated with endotoxin exposure (p = 0.014) across exposure groups. Community compositions differed between exposure groups. Micrococcus was the most abundant bacterial genus in the “Other” and “Wastewater” groups, while Bacillus was the most abundant genus in the “Stormwater” and “Combined” group. Five known human pathogens were identified, including Aspergillus fumigatus and Clostridium perfringens. This first study of jet-vac operators highlights the need for further research on bioaerosol exposures in a larger cohort of workers.

21. Self-Reported Physical Work Demands in the Dutch Working Population from 2014 to 2023: A Repeated Cross-Sectional Study.

期刊: IISE transactions on occupational ergonomics and human factors 发表日期: 2026-Jan-01 链接: PubMed

摘要

Occupational ApplicationsThirty-four percent of the Dutch working population work in physically demanding jobs, and this proportion remained relatively stable over time. Self-reported physical work demands were higher in those with a lower (compared to higher) education level. Specific self-reported physical work demands (substantial force exertion, repetitive movements, uncomfortable body postures, and vibrations) differ between genders, age groups, and occupational sectors. Our findings show that physical work demands remain prevalent in the Dutch working population, indicating the necessity for a better understanding of the health effects of these work demands and occupational interventions and policies targeting these work demands. Our results identify specific groups on which such interventions and policies could be focused. Background Physical work demands are associated with various adverse health outcomes. However, it remains unknown whether self-reported physical work demands have changed over time and in what sociodemographic groups they are most prevalent.Purpose We aimed to: 1) evaluate the prevalence of self-reported physical work demands in the Dutch working population; 2) assess associations of time period and sociodemographic characteristics with physical work demands; and 3) identify the most physically demanding occupations.Methods Repeated cross-sectional data of the Netherlands Working Conditions Survey, with different samples collected annually between 2014 and 2023, were used (n = 488,494). Four physical work demands were self-reported: significant force exertion, repetitive movements, uncomfortable body postures, and exposure to body vibrations. Multinomial logistic regression analyses were applied to estimate the associations between time period and sociodemographic characteristics (gender, age, and education level) as independent variables and the four physical work demands. To list the 10 occupations in which physically work demands were most prevalent, we defined a physically demanding job based on a combination of the frequency and number of physical work demands.Results Over time, there was a small reduction in self-reported regular repetitive movements (OR [95%CI]: 0.97 [0.97-0.97]), but not in any of the other self-reported physical work demands. We found that physical work demands differed between genders, were higher with lower (compared to high) education levels, and were relatively lower among older (compared to younger) workers. Thirty-four percent of Dutch working population work in physically demanding jobs, with carpenters and joiners identified as physically most demanding occupations.Conclusions In the Netherlands, self-reported physical work demands remained high and largely unchanged over the last decade. Physical work demands differ between sociodemographic groups, the knowledge of which helps to identify high risk groups to focus interventions on.

22. Impact of Sleep-disordered Breathing Management in Primary Care on Systemic Hypertension Control: Protocol for the METASLEEP Implementation Trial.

期刊: Open respiratory archives 发表日期: 2026 链接: PubMed

摘要

Hypertension is the leading cause of cardiovascular disease, with nocturnal blood pressure (BP) abnormalities (nocturnal hypertension and non-dipping BP) linked to heightened risk. Obstructive sleep apnea (OSA), a modifiable contributor to impaired nighttime BP regulation, commonly co-occurs with hypertension. Primary care (PC) represents a strategic setting for their integrated management. The METASLEEP study aims to develop, implement, and evaluate a novel PC-based hypertension care model incorporating OSA diagnosis, treatment, and home monitoring to improve BP control. To describe the rationale, design, methodology, and baseline participant characteristics of the 2024 initiation phase of the METASLEEP trial. Prospective, longitudinal, real-world implementation study conducted across 10 Spanish regions (ClinicalTrials.gov NCT05986487). Adults with hypertension and no prior OSA diagnosis undergo 24-h ambulatory BP monitoring (ABPM) in PC (target n = 1523). Participants with nocturnal hypertension and/or non-dippers receive PC-led OSA diagnostic testing, treatment, and home monitoring via an under-mattress sensor. Follow-ups at 6 and 12 months evaluate changes in nighttime BP (primary) and other clinical outcomes. By end of 2024, 553 patients completed baseline ABPM. Of these, 288 (52.1%) showed nocturnal BP abnormalities: 248 (44.8%) had nocturnal hypertension and 211(38.4%) were non-dippers. Participants were middle-aged, overweight, and frequently had comorbid dyslipidemia, obesity, and diabetes. OSA prevalence was 22.6% mild, 34.1% moderate, and 35.3% severe. CPAP treatment was initiated in 79.4% of moderate-to-severe cases. METASLEEP introduces a novel PC-based model integrating OSA diagnosis and management within hypertension care. Early data reveal notably high prevalence of undiagnosed OSA in hypertensive patients. La hipertensión es la principal causa de enfermedad cardiovascular, y las anomalías nocturnas de la presión arterial (PA) (hipertensión nocturna y PA non-dipping) se asocian a un mayor riesgo. La apnea obstructiva del sueño (AOS), un factor modificable que contribuye a la alteración de la regulación nocturna de la PA, suele coexistir con la hipertensión. La atención primaria (AP) representa un entorno estratégico para su manejo integrado. El estudio METASLEEP tiene como objetivo desarrollar, implementar y evaluar un nuevo modelo de atención a la hipertensión basado en AP que incorpore el diagnóstico, el tratamiento y la monitorización domiciliaria de la AOS para mejorar el control de la PA. Describir la justificación, el diseño, la metodología y las características basales de los participantes de la fase de inicio de 2024 del ensayo METASLEEP. Estudio prospectivo y longitudinal de implementación en la práctica clínica real, realizado en 10 comunidades autónomas españolas (ClinicalTrials.gov NCT05986487). Adultos con hipertensión y sin diagnóstico previo de AOS se someten a monitorización ambulatoria de la PA (MAPA) de 24 horas en AP (n objetivo = 1523). Los participantes con hipertensión nocturna y/o non-dippers reciben pruebas diagnósticas de AOS dirigidas por AP, tratamiento y monitorización domiciliaria a través de un sensor debajo del colchón. Los seguimientos a los 6 y 12 meses evalúan los cambios en la PA nocturna (resultado principal) y otros resultados clínicos. A finales de 2024, 553 pacientes completaron la MAPA basal. De estos, 288 (52,1%) mostraron anomalías de la PA nocturna: 248 (44,8%) tenían hipertensión nocturna y 211 (38,4%) eran non-dippers. Los participantes eran de mediana edad, con sobrepeso y con frecuencia presentaban dislipidemia, obesidad y diabetes comórbidas. La prevalencia de AOS fue del 22,6% leve, del 34,1% moderada y del 35,3% grave. El tratamiento con CPAP se inició en el 79,4% de los casos moderados a graves. METASLEEP introduce un novedoso modelo basado en AP que integra el diagnóstico y el tratamiento de la AOS en la atención de la hipertensión. Los primeros datos revelan una prevalencia notablemente alta de AOS no diagnosticada en pacientes hipertensos.

23. Health effects of ionizing radiation exposure in the brain: MELODI perspectives on potential implications of emerging evidence for radiation protection.

期刊: Mutation research. Reviews in mutation research 发表日期: 2025-Dec-31 链接: PubMed

摘要

There is a growing body of epidemiological evidence for elevated risks of a variety of multifactorial diseases such as cancer, neurodegenerative diseases (e.g., Parkinson’s disease and dementia) and cerebrovascular diseases (e.g., stroke) following radiation exposure of the brain. Implications of available scientific evidence for radiation protection need to be assessed, e.g., in terms of radiation effect classification (tissue reactions vs stochastic effects), dose and dose-rate effectiveness, target identification (at levels of cells, tissues and organs inside/outside the brain) for dose monitoring and risk management, radiation weighting approach for the mixed radiation field, and individual differences in radiation responses (e.g., with sex, age, populations, genetics, epigenetics, comorbidity, co-exposure). On the other hand, whole brain irradiation has clinically been tested to treat neurodegenerative diseases, particularly Alzheimer’s disease. Action of radiation seems to represent a double-edged sword (i.e., detrimental to the healthy brain vs therapeutic to the diseased brain) not only for cancer, but also for non-cancer diseases. Justification of radiation exposure and optimization of radiation protection would therefore be of critical importance. This paper gives a brief overview of emerging evidence for radiation effects in the brain, and considers its potential implications for radiation protection.

24. IT solutions for health workforce shortages: improving administrative processes and care access-a comparative study of five European countries.

期刊: European journal of public health 发表日期: 2025-Dec-31 链接: PubMed

摘要

The healthcare sector faces a critical shortage of healthcare workers, creating significant challenges in healthcare delivery. The use of Information Technology (IT) solutions in healthcare presents potential remedies to reduce the negative consequences of this problem. The purpose of this study was to identify IT solutions implemented to mitigate the effects of medical shortages and improve administrative processes and care access. The study used a systematic approach integrating desk research, national expert consultations and comparative analysis to examine IT solutions in healthcare systems. Five European countries were selected for the in-depth analysis: Poland, the Netherlands, Spain, Finland, and Croatia. The impact on administrative processes, care access, and the functioning of healthcare systems was assessed. The study identified a variety of regulatory frameworks, common implementation strategies and the institutions responsible for these activities. All compared countries used telemedicine, e-prescriptions and various types of health applications. It was found that the most frequently used IT solutions were electronic health record (EHR) and e-prescription systems. However, IT training, its organization, financing and mandatory nature differed in individual countries. In addition, common barriers were identified across all countries, such as financial constraints and interoperability issues. Integrating IT solutions offers opportunities to address health workforce shortages and enhance healthcare efficiency. Tailored strategies and collaborative efforts are essential to address financial constraints and interoperability issues. Implementing best practices identified in this study can improve administrative processes and care access. Future research should prioritize longitudinal impact assessments and explore new technologies to optimize healthcare IT solutions.

25. Enhancing postpartum hemorrhage management in Sri Lanka: A pilot study to assess the impact and appropriateness, acceptability, and feasibility of a locally co-created quality improvement intervention.

期刊: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 发表日期: 2025-Dec-31 链接: PubMed

摘要

Postpartum hemorrhage (PPH) remains a leading cause of maternal mortality in low-resource settings; however, no previous study has tested a quality improvement (QI) intervention in the specific low-resource setting of Sri Lanka. This study aimed to explore the impact, appropriateness, acceptability, and feasibility of a multifaceted QI intervention to improve adherence to evidence-based PPH management guidelines in Sri Lanka. Based on a pre-intervention assessment, multifaceted QI interventions were co-created in collaboration with local health professionals and the Ministry of Health, including six components. Data on PPH case management practices and clinical outcomes were compared between the pre-intervention and post-intervention periods. Data on appropriateness, acceptability, feasibility, and cost were collected using the Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure. Significant improvements were observed in adherence to standards of care and key clinical outcomes. In case management, among the 45 audited standards, eight showed significant improvements. The intervention achieved near-universal compliance with critical PPH management standards, including documentation (100%), timely uterotonic administration (100%), and early diagnosis protocols (96.1% blood loss estimation). Regarding clinical outcomes, a clinically meaningful reduction in blood transfusion rates (20.4% to 3.8%, P = 0.053) and in near-miss events (18.4% to 11.5%, P = 0.443) was observed. The intervention was rated highly by stakeholders, with mean scores of 4.6 for acceptability, 4.5 for appropriateness, and 4.0 for feasibility, although feasibility concerns were raised regarding nurse champion roles and near-miss reviews. The QI intervention was appropriate, acceptable, and feasible and significantly enhanced PPH management and outcomes in Sri Lanka, suggesting potential scalability.

26. Disseminated Coccidioidomycosis With Central Nervous System, Oropharyngeal, Pulmonary, and Cutaneous Involvement.

期刊: Mayo Clinic proceedings 发表日期: 2025-Dec-31 链接: PubMed

摘要

27. Cardiorespiratory fitness in young and newly diagnosed patients with multiple sclerosis: A cross-sectional study.

期刊: Multiple sclerosis and related disorders 发表日期: 2025-Dec-29 链接: PubMed

摘要

Cardiorespiratory fitness (CRF) is impaired in patients with multiple sclerosis (MS) regardless of age, but evidence is limited among young and newly diagnosed patients. The aim of the study is to assess CRF using a maximal exercise test on a treadmill and to examine the relationships between CRF, physical activity level, fatigue, depression, and quality of life (QoL) in young patients newly diagnosed with MS. This cross-sectional study analyzed baseline data from a sample of 43 patients with MS who completed a maximal exercise test on a treadmill, measurement of body composition, and answered the Beck Depression Inventory second edition, modified Fatigue Impact Scale, and 36-item Short Form Survey QoL. CRF was significantly lower among patients newly diagnosed with MS (aged 20-45 years) compared to normative values (paired Wilcoxon test, p < 0.001). The median absolute differences between normative values and patients’ maximal oxygen uptake (VO2max) was 8.5 ml/kg/min (interquartile range [IQR]: 2.4-13.4 ml/kg/min), and the median relative differences was 28.3 % (IQR: 7.1-53.9 %). VO2max significantly negatively correlated with fatigue (rS = -0.37, p = 0.013), but not depression (rS = -0.01, p = 0.971). Significant positive correlations were found between VO2max and multiple subscales of QoL, including physical functioning (rS = 0.50, p = 0.001), social functioning (rS = 0.41, p = 0.007), pain (rS = 0.41, p = 0.006), and role limitations due to physical health (rS = 0.31, p = 0.047). Young patients with newly diagnosed MS already exhibit substantially reduced CRF compared with normative values. Lower VO2max is associated with higher fatigue and poorer physical and social aspects of QoL. These findings highlight the need for interventions aimed at improving CRF as an integral component of rehabilitation programs.

28. Diabetes with low body mass index in India: A secondary analysis of NFHS-5 data.

期刊: Diabetes & metabolic syndrome 发表日期: 2025-Dec-26 链接: PubMed

摘要

The International Diabetes Federation (IDF) recently recognized “Type 5 Diabetes” (“T5DM”) as a distinct entity. Proponents estimate a burden of 6 million cases in India. However, the applicability of this classification in the Indian context, which is dominated by Lean Type 2 Diabetes (T2D), remains debated. We conducted a secondary analysis of the National Family Health Survey-5 (2019-2021), comprising 788,974 respondents, to estimate the prevalence of young and middle-aged people (15-49 years) with low BMI Diabetes in India. The proxy phenotype was defined as: BMI <18.5 kg/m2 (or age-appropriate z-scores for adolescents), and either Fasting Blood Glucose ≥126 mg/dL, Random Blood Glucose (RBG) ≥200 mg/dL, or self-reported diabetes. The analysis identified 1351 individuals meeting the low BMI diabetes phenotypic criteria. The weighted prevalence of low BMI Diabetes was 0.19 (95 % CI: 0.18 to 0.21). While the raw sample was predominantly female due to survey design, weighted analysis revealed significantly higher prevalence in males (Female: 0.18 vs. Male: 0.25; p = 0.006). Cases were significantly concentrated in the poorest wealth quintiles (54 %), contrasting with the affluent demographic typically associated with T2D. Extrapolating to the national population and adjusting for 50 % undiagnosed cases, we estimate 2.42 million Indians aged <50 years have low BMI diabetes. The prevalence of “T5DM” is likely to be substantially lower than previous estimates, even after accounting for underdiagnosis. The primary diabetes burden in non-obese Indian adults is likely Lean T2D driven by visceral adiposity rather than malnutrition.

29. Prevalence and Historical Trends of Trachoma in Egypt: A Systematic Review and Meta-Analysis.

期刊: The Yale journal of biology and medicine 发表日期: 2025-Dec 链接: PubMed

摘要

Trachoma remains a leading cause of preventable blindness that has long persisted in Egypt. Global estimates tend to undervalue the actual national prevalence, and no previous analysis has comprehensively mapped the temporal and regional trends within the country. The present study addresses these gaps to guide elimination efforts and policy planning. To estimate the prevalence of active and chronic trachoma and associated visual impairment and blindness in Egypt through a comprehensive systematic review and meta analysis. We prospectively registered with PROSPERO (CRD420251070078) and adhered to PRISMA 2020 and Cochrane standards. Three independent reviewers searched 10 databases without language restrictions for population-based, cross-sectional surveys that reported WHO-graded trachoma outcomes. Two reviewers independently screened records, extracted data, and assessed bias using the Joanna Briggs Institute (JBI) checklist; Grading of Recommendations, Assessment, Development and Evaluations (GRADE) appraised evidence certainty. We transformed proportions using the Freeman-Tukey double arcsine transformation, pooled estimates using random-effects meta-analysis and directly age-standardized them to Egypt’s 2000-2020 population structure. We performed sensitivity, subgroup, and meta-regression analyses to explore heterogeneity. From 16 cross sectional surveys (n = 45 934), the pooled age standardized prevalence estimates were as follows: active trachoma in children (1-9 years) 10.8% (95% CI; 7.0-14.6), visual impairment in those cases 5.3% (95% CI; 3.2-7.5), chronic trachoma in adults (≥ 15 years) 7.2% (95% CI; 4.0-10.4), associated visual impairment 1.6% (95% CI; 1.0-2.2), and blindness 0.7% (95% CI; 0.1-1.9). Sensitivity, subgroup, and meta regression analyses demonstrated consistent estimates and no evidence of small study effects. Despite substantial declines, active and chronic trachoma remain well above elimination thresholds in Egypt. These findings underscore the need for sustained implementation of the SAFE strategy-particularly enhanced water, sanitation, and hygiene (WASH) infrastructure, ongoing surveillance, and targeted surgical outreach-and call for harmonized survey methods to guide and evaluate future control efforts.

30. Neglected by Design: Occupational Parasitic Infections in India's Lower Castes.

期刊: The Yale journal of biology and medicine 发表日期: 2025-Dec 链接: PubMed

摘要

Occupational exposure remains a major driver of parasitic infections in India, largely due to caste-based discrimination that severely limits job opportunities for certain communities. Historically marginalized groups, particularly Scheduled Castes (SC) and Scheduled Tribes (ST), often have little choice but to engage in high-risk occupations such as manual scavenging, landless farming, inland and coastal fishing, tea-estate labor, informal mining, and backyard pig-rearing. Passed down through generations of exploitation, these occupations typically involve minimal or no personal protective equipment and significantly raise the risk of infections like hookworm, strongyloidiasis, visceral leishmaniasis, lymphatic filariasis, Taenia solium cysticercosis, and schistosomiasis. Because social discrimination, even in 2025, restricts these groups from accessing safer employment options, they remain trapped in a cycle of poverty and disease. Add to this their living conditions like mud houses, open defecation practices, segregation, non-secure informal jobs without proper healthcare access, and low literacy, and it is clear why these curable infections persist despite national efforts like mass drug administration and vector control. Addressing this issue effectively means directly tackling caste-driven occupational segregation. Workplace-based preventive treatment, targeted surveillance, and equity-focused policies are essential to sustainably eliminate these parasitic infections and finally close these deep-rooted health disparities that are not commonly addressed in both policy-making and literature.

31. Bidirectional Associations Between Obesity and Depressive Symptoms: Results From the Multiethnic Postmenopausal Cohort of the Women's Health Initiative Study.

期刊: The American journal of geriatric psychiatry. Open science, education, and practice 发表日期: 2025-Dec 链接: PubMed

摘要

Although obesity and depression are prevalent among postmenopausal women, few cohort studies have examined the association between obesity and depression among this population. We examined longitudinal and bidirectional associations between obesity and depressive symptoms among U. S. postmenopausal women. We analyzed data from Women’s Health Initiative (WHI) study. Sample consisted of 95,238 postmenopausal women, aged 50-79, from the WHI study who had obesity and depression data at baseline and 3-year follow-up. The dataset included anthropometric measurements of height and weight and the Burnam self-report screening instrument for depression. We conducted logistic regression analyses to assess the bidirectional association between obesity and depressive symptoms, adjusting for confounding factors, including age, race, ethnicity, years since menopause, marital status, education, employment status, and family income. At baseline, 11.3% of the women reported depressive symptoms and 25% were categorized as obese (body mass index ≥ 30 kg/m2). Women who were obese at baseline were significantly more likely to report depressive symptoms at 3-year follow-up (OR = 1.26, 95% CI: 1.19-1.34) compared to women who were not obese. Women who reported depressive symptoms at baseline had higher odds of being obese at 3-year follow-up (OR = 1.33, 95% CI: 1.20-1.46) compared to women who did not. Age, race, ethnicity, and years since menopause did not modify the associations. Our findings of longitudinal and bidirectional associations between obesity and depressive symptoms highlight the importance of addressing both diseases among postmenopausal women in the U.S.

32. Building Diverse, Equitable, and Inclusive Organizational Culture to Support Worker Mental Health and Wellbeing: A Qualitative Study of Employer and Worker Perspectives in Ontario Construction Skilled Trades.

期刊: Safety and health at work 发表日期: 2025-Dec 链接: PubMed

摘要

This study explored Ontario construction skilled trades employer and worker perspectives on workplace diversity, equity, and inclusion (DEI) and the promotion of worker mental health and wellbeing through building DEI organizational culture. A phenomenological qualitative study was conducted. Fifty-two (N = 52) participants were recruited and interviewed. Interview data were analyzed using a six-step thematic approach. Three themes were developed: 1) Challenges in organizational culture: participants reported that sexism and biased beliefs on the professional competency of workers from under-represented groups were prevalent within their organizations. Participants highlighted business leadership’s role in building DEI organizational culture and addressing issues that have affected their organizational reputations and worker retention. 2) Barriers to promoting DEI: a meritocratic hiring approach was identified and restricted the opportunities for under-represented groups. Participants identified a lack of accommodations available in their workplace environment, and some reported lacking awareness of DEI-related issues. 3) Strategies to promote DEI: participants suggested that increasing early career opportunities could help apprentices from under-represented groups build experience and make informed career decisions. These opportunities may also help employers understand an apprentice’s qualifications. Establishing various resources and peer support systems to support the mental health and wellbeing of under-represented workers was also suggested. Multiple challenges existed within the current skilled trades organizational culture, including sexism, biases, hiring barriers, and insufficient accommodations and awareness. Creating career opportunities and social support systems is needed to address these challenges and support worker mental health and wellbeing.

33. Phase II trial on nivolumab plus hypofractionated radiotherapy in patients with metastatic mucosal melanoma: PORTER-M3 trial.

期刊: Immuno-oncology technology 发表日期: 2025-Dec 链接: PubMed

摘要

The response rate of nivolumab monotherapy for mucosal melanoma is only ∼20%. The objective of this phase II trial was to evaluate the efficacy and safety of nivolumab in combination with radiotherapy for metastatic mucosal melanoma. The eligibility criteria were: histological diagnosis of metastatic mucosal melanoma, Eastern Cooperative Oncology Group performance status of 0 or 1, and presence of measurable lesions. Patients received nivolumab with concurrent radiotherapy for measurable lesions, for a total dose of 25 Gy in five fractions per week. The primary endpoint was the response rate of all lesions (overall response rate, ORR). The study was considered to have met its primary endpoint if at least 6 of the 17 patients had a response (ORR ≥35.3%). The secondary endpoints were the disease control rate, progression-free survival, overall survival, and toxicity. Eighteen patients were enrolled, and 17 were evaluable for efficacy. The ORR was 41.2%, with two patients showing complete response, five partial response, and four stable disease. The median progression-free and overall survival were 4.9 months [95% confidence interval (CI) 2.2-15.1 months] and 20.1 months (95% CI 7.5-31.5 months), respectively. Immune-related adverse events of grades 3 or 4 occurred in 35.2% (6/17) of the patients. The radiation-related adverse events were grade 3 radiation dermatitis in one patient and grade 3 radiation pneumonitis in one patient. Concurrent radioimmunotherapy consisting of nivolumab and radiotherapy showed promising efficacy with a manageable safety profile in patients with metastatic mucosal melanoma, warranting further evaluation in large studies.

34. Genetic Risk, Self-Harm, and Violence in Schizophrenia: A Narrative Review of Implications for Early Identification and Intervention.

期刊: Clinical neuropsychiatry 发表日期: 2025-Dec 链接: PubMed

摘要

This narrative review examines clinical, genetic, and epidemiological evidence on schizophrenia (SCZ) to identify predictors of self-harm and violence, summarize genetic contributors to SCZ including pleiotropy and links between polygenic burden and negative/disorganized symptoms, and evaluate implications for early identification and predictive tools. We synthesized findings from large-scale genome-wide association studies, rare variant and polygenic risk research, gene-environment interplay, epidemiological studies on suicide and violence, and clinical trials of early-intervention programs for SCZ. SCZ involves a complex genetic architecture that includes hundreds of common risk variants and rarer coding and structural mutations. These genetic factors interact with environmental exposures, particularly childhood adversity and substance use, to shape vulnerability trajectories. Suicidality is a leading cause of excess mortality in SCZ, especially in early disease phases. Violence risk is modest overall but elevated in individuals with untreated psychosis or comorbid substance misuse. Emerging findings suggest that polygenic burden is linked to negative and disorganized symptoms, which in turn associate with worse clinical outcomes. Early, sustained, multicomponent intervention improves symptoms, functioning, and treatment adherence and may reduce self-harm and indirectly mitigate violence by addressing modifiable risk factors. Emerging machine learning models, though not yet widely validated, show promise in identifying individuals at higher risk of suicide or aggression by integrating clinical, demographic, and biological features. Integrating genetic, clinical, and environmental data can enhance risk stratification and support precision prevention in SCZ. Polygenic risk scores are not yet clinically predictive alone but may add value when combined with symptom profiles and early-life adversity for early identification and detecting susceptibility to negative/disorganized symptoms. Near-term priorities include externally validating prediction tools, standardizing screening for trauma exposure and substance use within early-psychosis services to guide monitoring intensity and relapse-prevention planning, and scaling coordinated specialty care.

35. [Complexities of myocardial revascularization in patients over 75 years with acute coronary syndrome.].

期刊: Advances in gerontology = Uspekhi gerontologii 发表日期: 2025 链接: PubMed

摘要

Acute myocardial infarction is the leading cause of hospitalization and mortality in elderly patients. The objective of this review is to demonstrate the importance of a comprehensive geriatric examination in cardiology, a balanced approach to choosing a myocardial revascularization method and postoperative patient management. The results of modern studies in emergency cardiology practice were studied and analyzed in such electronic bibliographic databases as Web of Science, Scopus, PubMed, Elibrary. This review presents known surgical strategies for myocardial revascularization, therapeutic options for postoperative management, the impact of geriatric syndromes and COVID-19 on the prognosis and outcome of the disease, clinical and angiographic difficulties in managing elderly patients with myocardial infarction. Острый инфаркт миокарда является основной причиной госпитализации и смертности у пожилых пациентов. Цель обзора — демонстрация важности комплексного гериатрического обследования в кардиологии, взвешенного подхода при выборе метода реваскуляризации миокарда и послеоперационного ведения пациентов. Были изучены и проанализированы результаты современных исследований в рамках экстренной кардиологической практики в электронных библиографических базах Web of Science, Scopus, PubMed, Elibrary. В обзоре представлены известные хирургические стратегии реваскуляризации миокарда, терапевтические варианты ведения в послеоперационном периоде, влияние гериатрических синдромов и COVID-19 на прогноз и исход заболевания, клинические и ангиографические сложности ведения пациентов старческого возраста с острым инфарктом миокарда.

36. [Association of the vertebral artery with cardiovascular disease risk factors in middle-aged and elderly individuals.].

期刊: Advances in gerontology = Uspekhi gerontologii 发表日期: 2025 链接: PubMed

摘要

Objective - to assess the association between structural changes in the vertebral arteries and cardiovascular disease risk factors in middle-aged and elderly individuals. The study included 387 patients (196 men and 191 women) aged 45-74 years (mean age 57,7±7,3 years) from a therapeutic profile. Vertebral artery parameters, anthropometric, hemodynamic, and biochemical indicators, as well as the prevalence of cardiovascular risk factors, were analyzed in middle-aged (n=225) and elderly (n=162) groups. Elderly patients had significantly higher mean values of systolic and diastolic blood pressure, serum creatinine concentration, and lower estimated glomerular filtration rate (eGFR) compared to middle-aged patients. The prevalence of arterial hypertension (66% vs. 44,8%, p<0,05), chronic kidney disease (32,1% vs. 18,2%, p<0,05), anemia (27,7% vs. 14,2%, p<0,05), and hyperglycemia (22,2% vs. 5,3%, p<0,05) was significantly higher in the elderly group. A reduction in the internal diameter of the right and left vertebral arteries was observed in 13,7% and 9,7% of middle-aged patients, respectively, and in 13,5% and 4,3% of elderly patients. Vertebral artery diameter correlated with age (r=-0,217), body mass index (r=0,152), red blood cell count (r=0,197), total cholesterol concentration (r=-0,138), low-density lipoprotein cholesterol (r=-0,125), high-density lipoprotein cholesterol (r=-0,129), and estimated eGFR (r=-0,188). In elderly patients, significant cardiovascular risk factors include increased blood pressure, anemia, hyperglycemia, and decreased glomerular filtration rate. To improve the effectiveness of secondary prevention of cardiovascular complications, regular monitoring of hemodynamic parameters, blood glucose levels, and kidney function should be performed, considering the condition of the vertebral arteries. Цель исследования — оценка связи структурных изменений позвоночных артерий с факторами риска сердечно-сосудистых заболеваний у лиц среднего и пожилого возраста. В исследование были включены 387 пациентов 45–74 лет терапевтического профиля (средний возраст — 57,7±7,3 года), из них 196 мужчин и 191 женщина. Были изучены параметры позвоночных артерий, антропометрические, гемодинамические и биохимические показатели, а также частота факторов риска сердечно-сосудистых заболеваний в средней (n=225) и пожилой (n=162) возрастных группах. У пациентов пожилого возраста выявлены статистически значимо более высокие средние значения САД и ДАД, концентрации креатинина крови и более низкая расчетная СКФ по сравнению с пациентами среднего возраста. Частота артериальной гипертензии (66% против 44,8%, p<0,05), ХБП (32,1% против 18,2%, p<0,05), анемии (27,7% против 14,2%, p<0,05) и гипергликемии (22,2% против 5,3%, p<0,05) была значительно выше в пожилой группе. Уменьшение внутреннего диаметра правой и левой позвоночных артерий у лиц среднего возраста наблюдали в 13,7 и 9,7% случаев соответственно, а в подгруппе пожилых пациентов — в 13,5 и 4,3%. Диаметр позвоночной артерии коррелировал с возрастом (r=–0,217), ИМТ (r=0,152), количеством эритроцитов (r=0,197), концентрацией общего холестерина (r=–0,138), холестерина ЛПНП (r=–0,125), холестерина ЛПВП (r=–0,129) и расчетной СКФ (r=–0,188). У пожилых пациентов значимыми факторами сердечно-сосудистого риска являются повышение АД, анемия, гипергликемия и снижение СКФ. Для повышения эффективности вторичной профилактики сердечно-сосудистых осложнений необходим регулярный контроль гемодинамических показателей, уровня гликемии и функции почек с учетом состояния позвоночных артерий.

37. [Association between depression syndromе and functional disorders in elderly residents of the European North of Russia.].

期刊: Advances in gerontology = Uspekhi gerontologii 发表日期: 2025 链接: PubMed

摘要

Depression syndrome is one of the most common syndromes among the elderly and is directly associated with functional independence and quality of life. This study aimed to investigate the association between the severity of depression syndrome and functional disorders among individuals aged 60 to 74 years. In 2023, a cross-sectional study was conducted on arandom-samplein Arkhangelsk (n=611). Participants were examined for depression syndrome using the Beck Depression Scale. Functional disorders were evaluated using hand dynamometry, the Short Physical Performance Battery, the Montreal Cognitive Assessment, visual and hearing acuity tests. Zero-inflated negative binomial regression was used to analyze the associations between the severity of depression syndrome and functional disorders. After adjustment for age, education, marital status, financial difficulties, low physical activity, and all functional disorders, higher depression syndrome severity was associated with preasthenia gravis (an early stage of frailty) in both men and women and with hearing loss in women only. These findings underscore the importance of taking a gender-sensitive approach to screening for and preventing depression syndrome in older adults, especially those with complex age-related functional disorders. Депрессивный синдром является одним из часто встречающихся синдромов у лиц пожилого и старческого возраста, непосредственно связанных со снижением функциональной независимости и качества жизни. Цель исследования заключалась в изучении взаимосвязи депрессивного синдрома с функциональными нарушениями в возрасте 60–74 лет. В 2023 г. в Архангельске проведено поперечное исследование на случайной выборке (n=611). Обследование включало оценку выраженности признаков депрессивного синдрома с использованием шкалы Бека. Для выявления функциональных нарушений использовали кистевую динамометрию, краткую батарею тестов физического функционирования, Монреальскую шкалу оценки когнитивных функций (MoCA), оценивали остроту зрения и слуха. Связь балльной оценки по шкале депрессии Бека с функциональными нарушениями оценивали с использованием негативного биномиального регрессионного анализа c учетом инфляции нулевых значений. При коррекции на возраст, образование, семейное положение, финансовые трудности, гиподинамию и при одновременном включении в регрессионную модель всех рассматриваемых функциональных нарушений, выраженность признаков депрессивного синдрома была выше при наличии преастении (начальная стадия старческой астении) как у мужчин, так и у женщин, и с ухудшением слуха, но только у женщин. Полученные результаты подчеркивают необходимость гендерно-ориентированного подхода к скринингу и профилактике депрессивного синдрома у пожилых людей, особенно при наличии комплексных возраст-ассоциированных функциональных нарушений.

38. [Automated system for personalization of therapeutic management tactics for comorbid elderly patients with type 2 diabetes mellitus.].

期刊: Advances in gerontology = Uspekhi gerontologii 发表日期: 2025 链接: PubMed

摘要

The aim of the study was to develop and clinically test a comprehensive automated system for personalizing therapeutic management tactics for comorbid elderly patients with type 2 diabetes mellitus (T2DM). Research design: longitudinal, non-interventional; type: case study; duration 6,5 years. The general sample included patients of all ages (n=1261) with impaired carbohydrate metabolism registered in the specialized local registry of the developed software Automated Workplace of an Endocrinologist for outpatient admission of patients with DM (AWPE DM). A group of elderly patients with T2DM with comorbid pathology (n=462) was selected from the sample in order to develop modules for a medical decision support system based on an analysis of clinical and metabolic parameters. In the course of the study, the following elements of the personalization system were developed: a formalized protocol for outpatient consultation of a patient with diabetes; AWPE DM is a computer program that allows the collection and storage of primary patient medical information in digital format in an outpatient setting.; a database (local registry) that provides the systematization and accumulation of medical information in the form of structured electronic medical documents; a comprehensive medical decision support system that allows you to personalize the therapeutic tactics of managing comorbid elderly patients with T2DM based on embedded algorithms. Various ways of applying the modules of the medical decision support system in daily outpatient practice during clinical approbation are considered. Цель исследования — разработка и клиническая апробация комплексной автоматизированной системы персонализации терапевтической тактики ведения коморбидных пожилых пациентов с сахарным диабетом 2-го типа (СД2). Дизайн исследования — лонгитюдное, неинтервенционное; тип — регистровое; продолжительность — 6,5 лет. В генеральную выборку были включены пациенты всех возрастных групп (n=1261) с нарушениями углеводного обмена, зарегистрированные в специализированном локальном регистре разработанного программного обеспечения Автоматизированное Рабочее Место Эндокринолога для амбулаторного приема пациентов с СД (АРМЭ СД). Из выборки выделена группа пожилых пациентов с СД2, имеющих коморбидную патологию, (n=462) для разработки модулей Системы Поддержки Принятия Врачебных Решений (СППВР) на основе анализа клинико-метаболических показателей. В процессе исследования разработаны следующие элементы системы персонализации: формализованный протокол амбулаторной консультации пациента с СД; АРМЭ СД — программа ЭВМ, позволяющая собирать и хранить первичную медицинскую информацию о пациенте в цифровом формате в условиях амбулаторного приема; база данных (локальный регистр), обеспечивающая систематизацию и накопление медицинской информации в виде Структурированного Электронного Медицинского Документа (СЭМД); комплексная СППВР, позволяющая персонализировать терапевтическую тактику ведения коморбидных пожилых пациентов с СД2 на основании заложенных алгоритмов. Рассмотрены различные способы прикладного использования модулей СППВР в повседневной амбулаторной практике в ходе клинической апробации.

39. [Inflamaging in elderly patients with sarcopenic obesity.].

期刊: Advances in gerontology = Uspekhi gerontologii 发表日期: 2025 链接: PubMed

摘要

The aim of the study was to investigate the relationship between C-reactive protein (C-RP), platelet-to-lymphocyte ratio (PLR), and the presence of sarcopenic obesity (SO) among elderly patients. Out of 380 elderly participants, 46 had SO, accounting for 12,1% of those examined. Of these, 69,6% were female and 30,4% were male. The comparison group included 52 elderly individuals without SO. Patients with SO were more likely to experience chronic non-communicable diseases, reduced physical activity, falls, cognitive impairments such as age-related memory loss, smoke more frequently, and drink alcohol less frequently. A significant increase in PLR and CRP values was associated with the SO status. A strong correlation between PLR and CRP indices was found (p=0,735, p<0,001). CRP had a negative association with muscle mass, walking speed, hand compression strength, and overall performance. The PLR index also had a negative correlation with these variables. A positive relationship was found between pbf and both CRP and PLR. ROC analysis allowed us to identify the PLR index as a predictor of SO with an AUC of 0,862 and a threshold value of 217. The sensitivity of the model was 86,4% and the specificity was 88,5%. The diagnostic effectiveness was 87,5%. Therefore, the PLR index can serve as an accessible marker for identifying elderly patients at high risk of SO when combined with CRP assessment. Цель исследования — изучение взаимосвязи С-РБ, соотношения количества тромбоцитов и лимфоцитов (PLR) и наличия саркопенического ожирения (CO) у пациентов пожилого возраста. Из 380 пациентов СО выявлено у 46, что составило 12,1%, из них 69,6% женщин и 30,4% мужчин. Группа сравнения — 52 пациента пожилого возраста без CO. Пациенты с СО статистически значимо чаще имели хронические неинфекционные заболевания, сниженную физическую активность, синдром падений, когнитивные нарушения в виде возрастной забывчивости, чаще курили и реже употребляли алкоголь. Установлено статистически значимое повышение значений индекса PLR и С-РБ, связанное со статусом CO. Определена высокая корреляция индекса PLR и С-РБ (ρ=0,735, р<0,001). С-РБ имел отрицательную связь с мышечной массой (ρ=–0,487, р<0,001), скоростью ходьбы (ρ=–0,632, р<0,001), силой сжатия кисти (ρ=–0,792, р<0,001) и общей работоспособностью (ρ=–0,732, р<0,001). Индекс PLR имел отрицательную связь с мышечной массой (ρ=–0,611, р<0,001), силой сжатия кисти (ρ=–0,665, р<0,001), скоростью ходьбы (ρ=–0,723, р<0,001) и общей работоспособностью (ρ=–0,733, р<0,001). Положительная связь установлена между процентом жировой массы (PBF), С-РБ (ρ=0,708, р<0,001) и индекса PLR (ρ=0,861, р<0,001). ROC-анализ позволил установить индекс PLR в качестве предиктора CO (AUC=0,862; 95% ДИ 0,785–0,939, p<0,001) с пороговым значением PLR=217, чувствительность модели составила 86,4%, специфичность — 88,5%, диагностическая эффективность — 87,5%. Таким образом, индекс PLR можно использовать как доступный маркер для выявления пациентов с высоким риском CO. Оценка С-РБ в комбинации с PLR повышает диагностическую возможность прогнозирования высокого риска CO у пациентов пожилого возраста.

40. [Organization of emergency medical care for older age groups of the population.].

期刊: Advances in gerontology = Uspekhi gerontologii 发表日期: 2025 链接: PubMed

摘要

Increasing life expectancy up to 78 years is a target indicator of the state policy. Emergency medical care is an important link in ensuring longevity of elderly citizens. The aim of the study: to study the frequency and structure of emergency medical care for older age groups of the population. The study analyzed the frequency of emergency medical aid calls for women 55 years and older and men 60 years and older according to the data of sectoral statistical observation for 2010-2013 and federal statistical observation for the Russian Federation for 2014-2023. Statistical and analytical methods of research were applied. Spreadsheets MS Office Excel 2016 were used for data processing. Older individuals (women aged 55 years and older and men aged 60 years and older) accounted for 19,2±0,8 million emergency medical services, representing 42,6±1,3% of the total number of patients and 51,4±1,5% of adult (18 years and older) emergency medical services patients. An upsurge in the number of referrals was recorded during the COVID-19 pandemic. The number of deaths in the ambulance is 4,1±0,9 thousand, 2010-2023, of which 51,1±1% were women aged 55 years and older and 48,9±1% were men aged 60 years and older. The structure of mortality is characterized by a higher proportion of «sudden diseases and conditions» (88,2±2,3 and 78,5±5,2%, respectively) and a low proportion of «accidents» (7,5±2,4 and 17,5±5,3%, respectively) in the reasons for calling ambulance crews to these patients. Emergency care is a demanded type of medical care for older people. The results of the study show that among this category of patients who applied for emergency medical care, women aged 55 and older and men aged 60 and older prevail. At the same time, the structure of ambulance calls is dominated by «sudden diseases and conditions», which indicates the need for timely organization of medical care, including hospitalization in specialized medical organizations. Увеличение ожидаемой продолжительности жизни до 78 лет — целевой показатель политики государства. Скорая медицинская помощь (СМП) является важным звеном в обеспечении долголетия граждан старшего возраста. Цель исследования — изучение частоты и структуры вызовов СМП старшим возрастным группам населения. В работе проведен анализ обращаемости за СМП лиц среднего и пожилого возраста — женщин 55 лет и старше и мужчин 60 лет и старше по данным отраслевого статистического наблюдения за 2010–2013 гг. и федерального статистического наблюдения по РФ за 2014–2023 гг. Применяли статистический и аналитический методы исследования. Для обработки данных использовали электронные таблицы MS Office Excel 2016. Лица старшего возраста составляют 19,2±0,8 млн, получивших СМП. Это 42,6±1,3% от общего числа пациентов и 51,4±1,5% от числа взрослых (18 лет и старше) пациентов СМП. Увеличение числа обращений было зафиксировано в период пандемии COVID-19. Число умерших в автомобиле СМП в 2010–2023 гг. составило 4,1±0,9 тыс. человек, из них 51,1±1% женщин 55 лет и старше и 48,9±1% мужчин 60 лет и старше. Структура летальности отличается более высокой долей внезапных заболеваний и состояний (88,2±2,3 и 78,5±5,2% соответственно) и низкой долей несчастных случаев (7,5±2,4 и 17,5±5,3% соответственно) в вызовах бригад СМП к этим пациентам. СМП является востребованным видом помощи для населения старших возрастных групп. Результаты исследования показывают, что в данной категории пациентов преобладают женщины 55 лет и старше и мужчины 60 лет и старше. При этом в структуре вызовов превалируют «внезапные заболевания и состояния», что свидетельствует о необходимости своевременной организации медицинской помощи, в том числе с госпитализацией в специализированные медицинские организации.

41. [Development of digital services for the elderly in St. Petersburg: Advantages and disadvantages. The «Silver unified card».].

期刊: Advances in gerontology = Uspekhi gerontologii 发表日期: 2025 链接: PubMed

摘要

Currently, the discourse of aging is moving away from the once popular idea of de-socialization, mirroring the socialization of youth, in the direction of preserving the achieved social statuses and diversity of roles for the elderly. At the same time, legislation on the elderly, even the relatively new Law on Social Services, which entered into force on 01.01.20215, sees them as needing care, weak, and lacking the necessary information skills. The social group of the elderly makes up a significant part of the population of St. Petersburg (more than 20% according to 2023/2024). Understanding the importance of this social group for the city of the region is reflected in infrastructure development plans and social policy aimed at improving conditions for the elderly in St. Petersburg, including access to services in digital form. The most in-demand digital service today is the Unified Map of St. Petersburg, which was used to conduct a survey of older users in the summer of 2024. The number of elderly people using a variety of digital information resources is growing rapidly, and at the same time, the number of elderly people who are excluded from the digital world or have only minimal digital skills. Their concerns are quite reasonable in the current situation, so comparing the pros and cons of accelerated digitalization in the daily lives of the elderly is the task of this article. В настоящее время дискурс старения уходит от некогда популярной идеи десоциализации, зеркальной к социализации молодежи, в направлении сохранения пожилыми людьми достигнутых социальных статусов и разнообразия ролей. В то же время, законодательство о пожилых, даже относительно новый Закон о социальном обслуживании, вступивший в силу 01.01.2015 г., определяет их как нуждающихся в заботе, слабых, не владеющих необходимыми информационными навыками. Социальная группа пожилых составляет значительную часть населения Санкт-Петербурга (более 20% по данным 2023/2024 гг.). Понимание значимости этой социальной группы для города, региона находит отражение в планах развития инфраструктуры и социальной политики, направленной на улучшение условий для пожилых людей в Санкт-Петербурге, в том числе доступа к услугам в цифровой форме. Наиболее востребованным цифровым сервисом сегодня является Единая карта петербуржца (ЕКП), с помощью которой был проведен опрос пожилых пользователей летом 2024 г. Быстро растет число пожилых, использующих разнообразные информационно-цифровые ресурсы, и в то же время число пожилых, исключенных из цифрового мира или овладевших только минимальными цифровыми навыками. Их опасения вполне резонны в сложившейся ситуации, поэтому сопоставление плюсов и минусов ЕКП, которая является частью ускоренной цифровизации в повседневной жизни пожилых, является задачей данной статьи.

42. Spirituality, Culture and Job Satisfaction in the Holistic Assessment of Nurses' Well-Being at Work: A Cross-Sectional Survey Study.

期刊: Journal of nursing management 发表日期: 2025 链接: PubMed

摘要

Nurses’ well-being at work has become a global concern due to persistent stressors such as staff shortages, shift work, emotional demands and limited autonomy. Most existing studies take a deficit-centred perspective, focussing on burnout or work stress and ignoring the complexity of holistic well-being. The aim of this study was to assess nurses’ levels of well-being at work across six well-being domains and explore its relationship with job satisfaction, health status and functional limitations. A cross-sectional survey was conducted among 767 nurses working in various healthcare institutions in Slovenia. The six-dimensional well-being scale for nurses, which was translated and psychometrically validated for this study, was used to assess physical, emotional, intellectual, social, occupational and spiritual well-being. The overall median score for nurses’ well-being at work was 2.97 (on a scale of 1-5), slightly below the neutral midpoint (M = 3.00). Among the dimensions, physical (M = 3.12), emotional (M = 3.18) and spiritual (M = 3.21) were rated lowest, while social (M = 3.60) and occupational (M = 3.58) were rated highest. Nurses with long-term health conditions or activity limitations gave significantly lower scores for well-being in the physical, emotional and occupational domains (p < 0.001). Higher job satisfaction was positively correlated with general well-being (r s  = 0.327, p < 0.001). Age and length of service were weakly negatively correlated with several domains of well-being (p < 0.001). Nurses’ well-being at work has many facets and is influenced by personal health, job satisfaction and professional context. A holistic model can highlight strengths and weaknesses that are often overlooked in traditional, burnout-centred approaches. Nurse managers should incorporate well-being into HR policy through relationship-centred leadership, flexible working practises and values-led support. Interventions should include reflective spaces, mentoring and learning opportunities tailored to emotional, intellectual and spiritual development. Monitoring dimensions of well-being as a key performance measure can lead to sustainable improvements in healthcare.

43. A lack of evidence for disability-inclusive maternal health interventions and promising progress: an updated systematic review.

期刊: Frontiers in global women’s health 发表日期: 2025 链接: PubMed

摘要

Pregnant women with disabilities experience significantly higher rates of adverse pregnancy outcomes compared to those without disabilities. Evidence-based interventions that address disability-related barriers during pregnancy are essential to reducing health disparities. We aimed to update a 2014 systematic review to identify interventions designed for pregnant women with disabilities. We conducted a systematic review of studies published between 2012 and 2025 to identify interventions addressing disability-related barriers during pregnancy and birth. We found a striking absence of evidence with no eligible studies identified from 22,719 publications. While we found multiple studies that evaluated the safety and efficacy of medications to manage disability-associated conditions during pregnancy, none of these studies focused on the potential disabling impact of the health conditions for pregnant women with disabilities, our intended focus. However, in our discussion, we describe three recent pilots, including co-produced resources for pregnant patients with disabilities, educational interventions for midwives, and an innovative patient empowerment tool, that suggest the field may be at a turning point. Our systematic review did not find evidence of disability inclusive maternal health interventions to improve pregnancy and childbirth experiences. However, we point to limited but promising studies for their use of co-production and patient engagement principles underscoring the potential for accelerating progress when research is conducted with, rather than on, disabled communities. While the pilots serve as proof of concept that disability-inclusive reproductive health research is both necessary and achievable, investments in disability inclusive maternal healthcare could yield significant returns for those with disabilities.

44. Building a healthcare data warehouse: considerations, opportunities, and challenges.

期刊: Frontiers in digital health 发表日期: 2025 链接: PubMed

摘要

The increasing digitalization of health systems is accelerating the transition towards a new era of data-driven, evidence-based care. This has profound implications for clinical practice, performance evaluation, policy making and biomedical research. At the heart of this transformation lies a healthcare data warehouse (DW), which functions as a critical infrastructure for aggregating, standardizing, and analyzing diverse clinical and administrative data. When well-designed and implemented, DWs provide clinicians with timely access to comprehensive, longitudinal patient data, enabling more informed decision-making, enhancing care quality, and improving outcomes. For researchers, these repositories offer opportunities for population-level analytics, predictive modeling, and large-scale health service research, enabling insights into disease patterns, healthcare utilization, and system inefficiencies. Centralizing clinical and administrative data in a DW allows for more frequent, nuanced analyses, increasing the precision and responsiveness of care. However, developing an effective DW requires careful consideration of system architecture, data governance, and interoperability. These foundational components support the robust ETL/ELT frameworks that ensure data quality, consistency, and readiness for analysis across diverse and evolving data streams. Beyond supporting individual patient care, DWs act as essential drivers of scalable research, operational efficiency, and evidence-based health policy. Their successful implementation marks a pivotal step toward achieving personalized, high-quality, and cost-effective healthcare in the digital transformation age. This paper reviews the existing literature to outline the process of building and implementing a data warehouse, introducing real-world disease-specific applications. BiotherDW connects theoretical frameworks with practical healthcare applications by demonstrating how traditional data warehouse design can be adapted for national-scale digital health infrastructures.

45. Association of disability with COVID-19 outcomes in older adults: a prospective analysis of the US health and retirement study.

期刊: BMJ public health 发表日期: 2025 链接: PubMed

摘要

The COVID-19 pandemic disproportionately impacted the ageing population and persons with disability. Previous studies have used cross-sectional or descriptive designs, limiting the establishment of robust associations. Our objective was to examine prospective associations between functional disability and COVID-19 outcomes in ageing US adults. This study included 9390 Health and Retirement Study participants from the 2018 wave, representing 64 044 633 adults aged 50 years or older, who completed the 2021 Pandemic Mail-in Survey. Baseline functional disability comprised activities of daily living (ADL) and instrumental ADL. COVID-19 outcomes included infection, emergency room utilisation, hospitalisation, length of hospital stay and post-COVID conditions (PCC). Multivariate regression and propensity-score weighting were applied to assess prospective associations between baseline functional disability, vaccination and COVID-19 outcomes. Targeted learning was applied to assess the association between functional disability and COVID-19 within each vaccination stratum. Mediation analysis was used to quantify the proportion of effects of functional disability on COVID-19 infection and PCC, mediated through vaccination. 1460 (16.2%) participants reported infection, 7985 (86.1%) were vaccinated and 178 (11.4%) of COVID-19 infected had PCC. Functional disability was associated with increased risk of infection (OR: 1.28, 95% CI 1.01 to 1.64) and PCC (OR: 2.24, 95% CI 1.05 to 4.47), while vaccination was protective against infection (OR: 0.53, 95% CI 0.42 to 0.67). Vaccination mediated a small portion of the effect of functional disability on infection and PCC, while showing no effect modification. Comprehensive strategies beyond vaccination are needed to decrease infections and prevent PCC for vulnerable ageing adults with functional disability. As the first study to prospectively investigate associations between functional disability, vaccination status and COVID-19 outcomes using nationally representative data, these findings provide a robust foundation for future research and policy decisions to protect vulnerable populations during public health emergencies.

46. Interdisciplinary intervention to improve mental health and academic adaptation of adolescents with chronic diseases: integration of educational psychology and public health.

期刊: Frontiers in psychology 发表日期: 2025 链接: PubMed

摘要

Building on an interdisciplinary perspective that links educational psychology and public health, this study investigated the integrated effects and underlying mechanisms of a cross-disciplinary intervention on mental health and academic motivation among university students living with chronic illness. Using a quasi-experimental design, 312 undergraduates with chronic conditions were randomly assigned to an experimental group (n = 156) and a control group (n = 156). The experimental group participated in an eight-week comprehensive program incorporating emotional regulation training, health-related cognitive restructuring, and enhancement of academic self-efficacy, whereas the control group received standard psychological counseling. Pre- and post-intervention measures included the PHQ-9, GAD-7, Rosenberg Self-Esteem Scale, Perceived Control Scale, and Learning Motivation Questionnaire. Multilevel regression and structural equation modeling were used to examine intervention effects and mediation mechanisms. Analyses indicated that participants in the intervention group showed marked improvements in both mental health and academic motivation: mean reductions of 4.8 and 4.1 points in depression and anxiety (p < 0.001), increases of 3.9 and 4.0 points in self-esteem and perceived control (p < 0.001), and a mean gain of 9.3 points in learning motivation (p < 0.001). Improvements in mental health were strongly associated with enhanced motivation (r = 0.52, p < 0.001) and acted as a partial mediator of the intervention effects. Social support further amplified these effects, with teacher and family support exerting the most pronounced moderating influences (β = 1.20 and 1.05, p < 0.001). Variation across illness types suggested that the intervention was sensitive to health-specific conditions. Taken together, these findings suggest that mental health functions as a bridge in the development of academic motivation and that interdisciplinary interventions may enhance psychological recovery and academic adaptation through the synergistic processes of emotional regulation and social support. Theoretically, this research provides empirical evidence for the integration of educational psychology and public health. Practically, it offers a foundation for universities to design systematic support mechanisms tailored to students with chronic illness. These results highlight the importance of embedding mental health promotion within broader educational equity agendas so that sustained institutional support may jointly advance psychological well-being and academic development.

47. Towards Proactive Recovery: A BCW Guided Nursing Intervention Protocol for Health Behavior Promotion in First-Episode Stroke Patients.

期刊: Patient preference and adherence 发表日期: 2025 链接: PubMed

摘要

Stroke is a disease with high incidence, disability, recurrence, mortality, and economic burden, and its occurrence and progression are closely associated with unhealthy lifestyle behaviors. For first-episode stroke patients, the post-stroke period is not only critical for physical recovery but also a key window for initiating behavioral modifications to improve long-term outcomes. Current health behavior intervention programs predominantly target stroke survivors in the acute or subacute phase, while insufficiently addressing long-term rehabilitation and the establishment of sustainable health behavior habits. This study aims to investigate the efficacy and sustainable impact of a 6-month proactive health behavior guidance intervention on proactive health behavior ability, medication compliance, physical exercise, coping with psychological stress, and anxiety and depression. The guidance will last for 6 months with four sections from hospitalization to 6 months post-discharge. The data will be measured at six time points: baseline, 3 months after discharge, intervention ends, 1 month post-intervention, 3 months post-intervention, and 6 months post-intervention. Outcomes including proactive health behavior, prevention knowledge, health belief, social support, depression, and anxiety were measured at 6 time points. Data were analyzed with SPSS 26.0, GEE models, and Bonferroni correction (P<0.01). This protocol, developed within the BCW framework, effectively integrates behavioral guidance, psychological support, and family involvement to address poor adherence and unhealthy lifestyles among stroke survivors. Covering the acute, transitional, and long-term phases, it combines hospital-based education with home-based follow-up through face-to-face, digital, and video modalities. This multi-modal and family-centered approach enhances accessibility, continuity, and sustainability of health behavior changes, thereby improving functional recovery, reducing recurrence risk, and supporting the long-term integration of proactive health behaviors. ChiCTR2400090433 (Date of registration: September 29, 2024).

48. Public perceptions and emotional trends of psychotherapy: a 15-year analysis across English and Spanish language communities on X (twitter).

期刊: Frontiers in digital health 发表日期: 2025 链接: PubMed

摘要

Mental health disorders have been rising globally, and social media platforms provide a unique opportunity to examine public perceptions of psychotherapy. However, little is known about how different therapeutic modalities are discussed across linguistic and cultural contexts. To analyse how psychotherapies are discussed on X (formerly Twitter) over a 15-year period, comparing thematic content and emotional tone between English and Spanish-speaking communities’ tweets. We collected 102,946 public tweets from 2008 to 2022, including 76,878 in English (74.7%) and 26,068 in Spanish (25.3%), related to four therapies: Acceptance and Commitment Therapy (ACT), Cognitive Behavioural Therapy (CBT), Psychoanalytic/Psychodynamic Therapy (PAT), and Narrative Therapy (NT). Topic modelling was performed using BERTopic. Emotion classification was conducted using DistilRoBERTa and Robertuito pre-trained transformer-based language models based on Ekman’s six basic emotions. CBT was the most frequently mentioned therapy (51,250 tweets, 49.8%), followed by ACT (18,196 tweets, 17.7%). In English tweets, the main theme was professional therapy promotion (CBT: 29,383 tweets), and fear was the most prevalent emotion. In Spanish tweets, personal experiences were more common, particularly in ACT (2,528 tweets), while anger dominated tweets about PAT (2,825 tweets), linked to a lack of understanding. Joy emerged as the dominant emotion in Spanish tweets about ACT and NT. The volume of tweets increased notably from 2020 onwards, especially in English, coinciding with the COVID-19 pandemic. Clear linguistic differences shape the public discourse around psychotherapy. English tweets emphasise clinical utility and are marked by fear, whereas Spanish tweets focus on individual experiences, with emotions ranging from joy to frustration. These findings underscore the importance of culturally adapted mental health communication strategies on social media.

49. Student health initiatives for enhanced disease surveillance in Ghana.

期刊: Frontiers in public health 发表日期: 2025 链接: PubMed

摘要

Student Health Initiatives for Enhanced Disease Surveillance (SHIEDS) is a student-driven program that aims to strengthen infectious disease surveillance and enhance healthy lifestyles within university communities in Ghana. This study aimed to assess SHIEDS feasibility and implementation at the Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana. Between 29th June and 6th July 2024, educational campaigns were conducted, through radio and social media, to raise awareness about sexually transmitted infections (STIs) among the student population. These campaigns ended with free screening for two STIs: human immunodeficiency virus (HIV) and Hepatitis B virus (HBV). Participants provided verbal feedback that were reviewed and included in a recommendation report for the KNUST administration. Positive cases were offered counseling and referred for confirmatory testing at the University Hospital, KNUST, Ghana. The SHIEDS awareness campaigns reached more than 20,000 people through social media and the radio outreach benefitted over 3,000 students, with 4 and 5-star ratings for overall program delivery and media campaigns, respectively. A total of 228 students, with mean age of 23 years (range of 18-29) consented to screen for STI by rapid diagnostic testing. The combined STI positivity rate was 0.87%, with rates of 1.01% for HBV and 0.77% for HIV detection among males and females, respectively; all being self-reported old cases on active treatment. Review of student feedback recommended screening for other STIs including gonorrhea, syphilis and chlamydia, and instituting SHIEDS as an annual event in the university calendar. Feasibility studies in other universities will inform program standardization and implementation across Ghana. Our findings indicated a healthy student community, which could serve as reference for future SHIEDS programs in KNUST, with scaling up at the national level.

50. Machine learning-based model for predicting metabolic dysfunction-associated steatotic liver disease using non-invasive parameters in young adults.

期刊: Frontiers in endocrinology 发表日期: 2025 链接: PubMed

摘要

Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly being diagnosed in young adults and is associated with long-term hepatic complications. Early detection remains challenging in asymptomatic individuals, highlighting the need for accurate and non-invasive risk assessment tools. We developed and validated a machine learning (ML)-based model to predict MASLD in adults aged 20-40 years. A total of 13,047 participants from the Gangnam Severance Hospital were included in the training set, and 1,335 participants from the Yongin Severance Hospital were included in the external validation set. MASLD was defined as hepatic steatosis on ultrasonography with at least one cardiometabolic risk factor. Three models were constructed using stepwise variable addition: Model 1 (age, sex), Model 2 (Model 1 + body mass index [BMI], mean blood pressure), and Model 3 (Model 2 + bioelectrical impedance analysis [BIA] metrics, including percentage of body fat [PBF] and skeletal muscle index [SMI]). Logistic regression (LR), random forest (RF), and extreme gradient boosting (XGB) were also applied. In internal validation, Model 3 achieved the highest area under the receiver operating characteristic curve (AUROC): 0.90 (LR), 0.91 (RF), and 0.91 (XGB), with accuracies up to 0.81. External validation confirmed a strong performance with AUROCs of 0.89 (LR), 0.88 (RF), and 0.88 (XGB). BMI and PBF were the strongest predictors, whereas a higher SMI was unexpectedly associated with greater MASLD risk. Our ML-based model using non-invasive parameters accurately predicted MASLD risk in young adults and may facilitate early screening in clinical practice.

51. [Vascular dysfunction: processes due to aging, approaches to restorative therapy and prevention (part 1).].

期刊: Advances in gerontology = Uspekhi gerontologii 发表日期: 2025 链接: PubMed

摘要

Currently, clinical, genetic and environmental factors of aging have been identified; it has been established that signs of human aging can be attributed to diseases due to their compliance with ICD-11 criteria. Causal events leading from endothelial dysfunction to the development of atherosclerosis are associated with age-related changes and aging. In this regard, much attention is paid to the study of biological aging in humans, which will stimulate the development of new therapeutic strategies. The prevalence of cardiovascular diseases (CVD) increases significantly with age. Risk factors and predictors of cardiovascular events, such as hypertension, atherosclerosis, diabetes, are observed with greater frequency in older people. The main factor in vascular aging is endothelial dysfunction, characterized by impaired endothelium-dependent signaling processes. Vascular endothelium plays a fundamental role in the regulation of vascular tone and structure, maintaining vascular homeostasis through complex interactions with cells in the wall and lumen of the vessel, balancing the production of vasodilators, the main one of which is nitric oxide (NO). Endogenously generated NO has, in addition to paracrine, an endocrine function, causes a remote physiological reaction in various organs and stimulates cellular signaling. Endothelial dysfunction is defined as combined changes in the endothelial phenotype that contribute to the development of atherosclerosis and acute coronary syndromes. Activities aimed at eliminating endothelial dysfunction lead to a decrease in the risk of developing CVD. В настоящее время определены клинические, генетические и экологические факторы старения. Установлено, что признаки старения человека возможно отнести к заболеваниям в связи с его соответствием критериям МКБ-11. Причинно-следственные события, приводящие от эндотелиальной дисфункции к развитию атеросклероза, связаны с возрастными изменениями и старением. В связи с этим, большое внимание посвящено изучению биологического старения человека, что позволит стимулировать разработку новых терапевтических стратегий. Распространенность сердечно-сосудистых заболеваний значительно увеличивается с возрастом. Факторы риска и предикторы сердечно-сосудистых событий, таких как гипертензия, атеросклероз, диабет, наблюдают с большей частотой у пожилых людей. Основным фактором старения сосудов является эндотелиальная дисфункция, характеризующаяся нарушением эндотелийзависимых сигнальных процессов. Сосудистый эндотелий играет фундаментальную роль в регуляции сосудистого тонуса и структуры, поддержания сосудистого гомеостаза путем сложных взаимодействий с клетками в стенке и просвете сосуда, балансируя выработку вазодилататоров, основным из которых является оксид азота (NO). Эндогенно генерируемый NO обладает, кроме паракринной, эндокринной функцией, вызывает отдаленную физиологическую реакцию в различных органах и стимулирует клеточную сигнализацию. Эндотелиальная дисфункция определена как сочетанные изменения эндотелиального фенотипа, способствующие развитию атеросклероза и острого коронарного синдрома. Меры, направленные на устранение дисфункции эндотелия, ведут к снижению риска развития сердечно-сосудистых заболеваний.

52. [Comparative Evaluation of DNA Extraction Methods from Fecal Samples: Statistical Analysis of Commercial Kits and Laboratory Protocols Using Real-Time PCR Data].

期刊: Molekuliarnaia biologiia 发表日期: 2025 链接: PubMed

摘要

The emergence of new data on the association between the composition of the intestinal microbiota and various human diseases has generated increasing interest in microbiome research. In this context, selection of the DNA extraction method represents a critical stage in the design of the experiment, significantly affecting the reliability and reproducibility of results. This study presents a comparative analysis of 12 DNA extraction methods, including nine commercial kits and three laboratory protocols. We evaluated the taxonomic representation, including Gram-positive (Lactobacillaceae, Coprococcus spp., Streptococcus sp., Clostridium leptum) and Gram-negative bacteria (Enterobacteriaceae, Akkermansia muciniphila, Fusobacterium nucleatum, Bacteroides fragilis). The extraction efficiency was assessed by the DNA yield, expressed in GE/pL of eluate or in GE/-µL of feces, as well as by the frequency of low-abundance taxa loss. Clustering of the methods according to the type of lysis was demonstrated: mechanical lysis provided stable and high DNA yields, particularly for Gram-positive bacteria, while chemical and enzymatic methods showed lower efficiency. We determined that the lysis type and pre-processing of intact fecal samples are the key factors affecting the DNA extraction efficiency and preservation of the native taxonomic profile. The best results were demonstrated by the QIAamp® PowerFecal® Pro DNA Kit (Qiagen) and the combination of AmpliTest UniProb + AmpliTest RIBO-prep kits (Center for Strategic Planning, Federal Medical-Biological Agency, Russia), both of which outperformed other methods in terms of DNA yield. The QIAamp® Fast DNA Stool Mini Kit (Qiagen) showed minimal losses of low-abundance taxa. These findings can be used for the standardization of gut microbiota DNA extraction methodologies and the development of domestic protocols.

53. [The Role of NOX2-Mediated Oxidative Stress in Initiation of Acute Amyloid Toxicity].

期刊: Molekuliarnaia biologiia 发表日期: 2025 链接: PubMed

摘要

Although the role of NADPH oxidase 2 (NOX2) in the development of Alzheimer’s disease (AD) is widely recognized, its contribution to the initial stages of amyloid-induced pathology remains unclear. Intraventricular administration of β-amyloid (Aβ) causes acute amyloid toxicity, leading to neurodegenerative changes similar to AD. The acute phase, lasting several days, is a critical time window for studying early pathological mechanisms. In this work, we assessed the level of oxidative stress in the brain of BALB/c mice at the early stages of amyloid toxicity and the role of NOX2 in these processes. Analysis of key markers of oxidative stress in various fractions of brain homogenate on day 4 after Aβ administration showed that individual parameters demonstrated only a tendency to change, without reaching statistical significance. However, principal component analysis (PCA) revealed a clear separation between the Aβ-treated and control groups, indicating the need for a comprehensive rather than isolated analysis of biochemical changes at early stages of pathology. It is noteworthy that the centroids of the groups in PCA were located along the same straight line, and the group receiving Aβ together with the NOX2 inhibitor occupied an intermediate position between the control and Aβ groups. This indicates partial suppression of oxidative stress through NOX2. At the same time, the NOX2 inhibitor completely prevented Aβ-induced microgliosis in the hippocampus, confirming that the concentration used was sufficient to suppress NOX2-dependent microglial activation. The in vivo data demonstrate that oxidative stress induced by Aβ administration may not be entirely mediated by NOX2, although this mechanism plays an important role in the initiation of the pathological process in AD.

54. Atherosclerotic plaque, cardiovascular risk, and lipid-lowering strategies: a narrative review.

期刊: Frontiers in cardiovascular medicine 发表日期: 2025 链接: PubMed

摘要

Atherosclerosis, driven primarily by cumulative exposure to low-density lipoprotein cholesterol (LDL-C), is the major cause of atherosclerotic cardiovascular disease (ASCVD). This narrative review examines the pathogenesis of atherosclerosis, linking risk factors, inflammatory pathways, and lipid abnormalities to the formation and progression of atheromatous plaques. Plaque characteristics such as volume, lipid content, fibrous cap thickness, and minimum lumen area are closely associated with cardiovascular outcomes, particularly the risk of major adverse cardiac events (MACEs). Intensive LDL-C lowering through statins, ezetimibe, PCSK9 inhibitors, and emerging agents like bempedoic acid has demonstrated clear benefits in regressing plaques, stabilizing their morphology, and significantly reducing cardiovascular risks. Despite guideline recommendations advocating intensive lipid-lowering strategies, real-world practice reveals considerable gaps, with many high- and very-high-risk patients failing to achieve LDL-C targets. Contributing factors include poor adherence, underuse of combination therapies, and treatment inertia. Early detection and preemptive management of subclinical atherosclerosis, particularly among younger individuals, are gaining attention as strategies to intercept the progression of disease before clinical events occur. Moreover, elevated lipoprotein(a) levels are increasingly recognized as an independent causal factor for ASCVD, and ongoing trials are evaluating specific Lp(a)-lowering therapies. Overall, optimizing lipid management through intensive, early intervention, patient adherence, and personalized treatment approaches holds the key to reducing the global burden of ASCVD. Addressing residual risks and refining early detection strategies will further advance the prevention and management of this chronic, progressive vascular disease.

55. Enabling genomic surveillance from 30 years of linked English sentinel network data: The Wellcome Quinquagenarian (QQG) Biomedical Resource.

期刊: Wellcome open research 发表日期: 2025 链接: PubMed

摘要

The World Health Organisation recommends integrating viral genome sequences and sentinel surveillance data. We report progress in linking clinical, virology, and sequence data to enable genomic surveillance of influenza, respiratory syncytial virus (RSV), and severe-acute-respiratory-syndrome coronavirus-2 (SARS-CoV-2). We linked individual-level clinical data from the Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) sentinel network to virology results from the UK Health Security Agency (UKHSA) reference virology laboratory. We identify where publicly accessible repositories, the Global Initiative on Sharing All Influenza Data (GISAID), or others hold viral genome sequence data from test-positive cases. Our metadata also identifies test-negative controls contemporaneous to test-positive cases. We summarise the scope of data availability in the Wellcome Quinquagenarian (QQG) biomedical resource. We report respiratory virus sampling for influenza, RSV, and SARS-CoV-2 between 1992 and 2023. Samples were collected from a nationally representative subset of RSC general practices participating in the virological surveillance programme.QQG contains 13,665 positive influenza samples, 3,791 positive RSV samples, and 5,068 positive SARS-CoV2 samples. There were 2,819 sequenced influenza genomes, of which 97.1% were linked to clinical records, 1,251 sequenced RSV genomes of which 96.8 were linked to clinical records, and 2,486 sequenced SARS-CoV-2 genomes of which 98.9% were linked to clinical records. We have described the scale of QQG, created to enable genomic surveillance linked to clinical metadata to facilitate research on the impact of different viral variants on clinical outcomes, vaccine effectiveness, and therapeutic strategies.

56. Global burden and trends of pelvic inflammatory disease associated with sexually transmitted infection excluding HIV from 1990 to 2021.

期刊: Frontiers in global women’s health 发表日期: 2025 链接: PubMed

摘要

Pelvic inflammatory disease (PID) is mainly induced by the sexually transmitted infection (STI). However, the global burden and trends of STI excluding human immunodeficiency virus (HIV)-associated PID (non-HIV PID) has not been specifically assessed. The prevalence and years lived with disability (YLDs) were collected from the Global Burden of Disease (GBD) 2021 database. The disease burden was evaluated with the case numbers, age-standardized rates (ASR) and estimated annual percentage changes (EAPC). According to the SocioDemographic Index (SDI), frontier and health inequality analysis were conducted. Autoregressive Integrated Moving Average (ARIMA) model was applied to predict the future trends of Non-HIV PID. The age-standardized prevalence rates (ASPR) and YLDs of non-HIV PID was 27.02/100,000 and 3.68/100,000 in 2021 globally. Except for the decline of gonococcal-associated PID, the EAPC of chlamydial and other non-HIV PID were stable. The countries with fastest-growing prevalence were Brazil (4.19 [2.92, 5.47]), Spain (3.98 [3.19, 4.77]), Greece (3.05 [2.55, 3.55]), Portugal (2.76 [2.22, 3.29]), which suggested the increased burden of non-HIV PID in these years. Moreover, the non-HIV PID was mainly concentrated in 30-34 years, which was most common in the low and low-middle SDI. Additionally, prevention of non-HIV PID should also be concerned in the high SDI regions, especially for United Kingdom, Canada, Japan, and Singapore, which would also increase in the next 30 years. The burden and prevention of non-HIV PID were still arduous and required a long-term effort, especially for the 30-34 years, which need more attentions even for the developed countries.

57. Methodological Lessons Learned From a Longitudinal Study of Overdose Vulnerability Among People Experiencing Homelessness Who Co-use Fentanyl and Stimulants in San Francisco, CA, USA.

期刊: International journal of qualitative methods 发表日期: 2025 链接: PubMed

摘要

The U.S. overdose crisis is now driven by polysubstance use involving fentanyl and stimulants. We received funding through the National Institutes on Drug Abuse’s Helping to End Addiction Long-Term (HEAL) initiative to conduct longitudinal qualitative research on polysubstance use among people experiencing homelessness (PEH) in San Francisco, California. An Intersectional Risk Environment Framework was used to examine the interaction between social, structural, and environmental factors and overdose vulnerability. During the data collection period, San Francisco implemented multiple policies that increased the criminalization of PEH, and several service organizations closed or had limited services, necessitating a combination of methods to capture structural and community shifts in real-time. We recruited participants from community partner sites in four San Francisco neighborhoods to obtain a diverse study sample, enrolling 66 participants. We conducted semi-structured qualitative interviews, starting with baseline and life history interviews, and six-month follow-up. We recruited a subset of participants to take part in photovoice and ethnographic activities. All study visits were compensated. Our study approach centered participant autonomy and expertise throughout the research process. We employed a combination of multiple intentional and innovative methods designed to build trust at the community and participant levels, improve data quality, and enhance study retention including: (1) meaningful long-term reciprocal community engagements with stakeholders and service delivery organizations; (2) diverse, intersectional recruitment and equitable compensation to promote autonomy; (3) conducting life history interviews that addressed intersectional trauma histories after the first baseline interview; (4) addressing follow-up challenges with compensated check-ins, establishing a study community-based location, and hiring a community consultant; and (5) facilitating deep phenomenological data collection through photovoice and ethnography. This paper discusses the rationale for these combined approaches and lessons learned from conducting longitudinal qualitative research with a community in real-time during enhanced risk for criminalization and overdose fatality.

58. Generalized Dermatitis Caused by Staphylococcus aureus in the European Bison.

期刊: Case reports in veterinary medicine 发表日期: 2025 链接: PubMed

摘要

Bacterial dermatitis in animals caused by staphylococci is considered secondary and often results from prior conditions related to environmental factors (like ectoparasites, skin injuries, temperature, and humidity) and internal factors (such as deficiency conditions, immunological dysfunction, and underlying diseases). The case represents a generalized dermatitis in a female European bison calf caused by Staphylococcus aureus. Clinically, dermatitis with symptoms of alopecia and crusting was observed. The skin appeared scaly, dry, and rough, covered with thick crusts and showed no signs of itching. Upon the removal of the crusts, inflamed, swollen, and oozing lesions were revealed underneath. Based on the laboratory results, the definitive therapy was initiated. After a lengthy treatment course, the bison’s condition improved, and new fur covered its body. This case emphasizes the necessity of targeted measures for timely etiological diagnosis. Furthermore, careful health monitoring and proactive disease management are essential for wildlife species, which rely directly on human actions for their preservation.

59. Telehealth within occupational therapy in primary care settings - an interview study.

期刊: Scandinavian journal of occupational therapy 发表日期: 2025-Jan 链接: PubMed

摘要

The Swedish Government is implementing a Transition To Integrated and Person-Centred Care, with telehealth as a key component. This transition affects both patients and healthcare professionals, including occupational therapists. However, knowledge about occupational therapists’ views on telehealth in their practice is limited. To explore and describe how occupational therapists within regional primary care reason about telehealth in an occupational therapy practice context. A qualitative interview study was conducted, using semi-structured interviews with 14 occupational therapists. Data was analysed using systematic text condensation. The occupational therapists reasoned about telehealth in three main areas: Through the lens of the patient, Through the lens of their profession, and In relation to the context. The study indicates that conventional occupational therapy is not always feasible through telehealth. To fully utilize telehealth, the occupational therapists see a need to adopt new ways of working. They emphasized the importance of retaining in-person meetings, and that further developed telehealth could constitute a valuable complement to the service they provide. These insights regarding telehealth could guide the profession and support development in relation to the transition to integrated care and person-centred care, ultimately benefiting those who need occupational therapy.

60. Identifying and Evaluating Predictors of Well-Being Among Nurses Working in Saudi Arabia: A Cross-Sectional Study.

期刊: Journal of nursing management 发表日期: 2025 链接: PubMed

摘要

Nurses face numerous challenges in clinical settings that can negatively affect their well-being. Little is known about bedside nurses’ well-being in Saudi Arabia. Therefore, this study explored the well-being of nurses working in Saudi Arabia and identified the contributing factors. This was a cross-sectional study that utilized convenience sampling. Data were collected from 550 nurses working in the Saudi healthcare sector. The Nurse Well-Being Index was utilized to measure the well-being. Data were analyzed using descriptive statistics, analysis of variance, and logistic regression. The findings showed that 74.2% of nurses were at an increased risk of poor well-being, with frontline nurses facing a further increased risk of poor well-being (83%). Results showed significant associations between nurses’ well-being and level of education (p = 0.002), workplace (p < 0.001), practice setting (p < 0.001), working region (p < 0.001), bed capacity (p = 0.017), quality of nursing care (p < 0.001), and job satisfaction (p < 0.001). The regression analysis revealed that nurses’ well-being was significantly influenced by years of experience (OR = 0.881, p = 0.027), working region-western region (OR = 2.720, p = 0.031), practice setting-critical care and medical-surgical (OR = 7.492, p < 0.001; OR = 3.222, p = 0.047, respectively), and quality of nursing care (OR = 4.639, p = 0.003). This study revealed that most nurses were at an increased risk of poor well-being. It also provided insights into various individual, organizational, and job-related factors that contribute to well-being. Future studies are needed to identify different aspects of nurses’ well-being to develop strategies for improving their well-being and reduce burnout and other detrimental health outcomes.

61. Task-constrained self-initiated attention shifts are indexed by frontal-midline theta ramping.

期刊: Frontiers in human neuroscience 发表日期: 2025 链接: PubMed

摘要

In everyday vision, we often shift attention internally without external cues. These self-initiated attention shifts are fundamental to voluntary behavior but are poorly understood because most studies use cue-based paradigms that predetermine when and where to shift attention. To address this gap, we designed a multi-sequential-choice rapid serial visual presentation (RSVP) paradigm with identical visual inputs to dissociate internal and external determinants of attention across three voluntary shift types: task-constrained self-initiated, externally instructed, and unconstrained free-viewing. Participants viewed four simultaneous streams of letters and made overt attention shifts among them, while EEG was recorded. We time-locked theta (4-7 Hz) and alpha (8-12 Hz) oscillations to shift onset and found distinct signatures for each condition. Notably, a frontal-midline theta ramping was observed before self-initiated shifts but not before instructed or free-viewing shifts, suggesting a preparatory buildup of cognitive control specific to internally driven shifts. Concurrently, sustained suppression of posterior alpha occurred before self-initiated shifts. In contrast, instructed and free-viewing shifts showed relatively higher posterior alpha. These findings suggest that internally generated, goal-driven shifts engage an anticipatory frontal control mechanism indexed by theta increase and reduce posterior inhibition, whereas externally cued or unguided shifts do not. By isolating these condition-specific neural dynamics under identical external stimuli, our study identifies a unique oscillatory signature, frontal-midline theta ramping, associated with task-constrained self-initiated attention shifts.

62. Acceptability of Telehealth-Delivered Occupational Therapy Among Individuals With Long COVID Using the Theoretical Framework of Acceptability: A Qualitative Study.

期刊: International journal of telemedicine and applications 发表日期: 2025 链接: PubMed

摘要

Long COVID still challenges healthcare systems worldwide. Tailored treatments are scarce. In the ErgoLoCo study, we have developed and tested a telehealth-delivered occupational therapy intervention for people affected by long COVID. Acceptability from both recipients and providers is a prerequisite for implementing such new interventions. This study is aimed at exploring the perceptions of people with long COVID and occupational therapists regarding the intervention’s acceptability and telehealth delivery approaches. Semistructured interviews were conducted with 13 participants who experience long COVID and received the ErgoLoCo intervention delivered as teletherapy sessions or prerecorded videos. Eight occupational therapists who guided the teletherapy sessions participated in a focus group. Materials were analyzed following qualitative descriptive methods and interpreted using the theoretical framework of acceptability (TFA). Occupational therapists and long COVID clients considered the occupational therapy approach a positive experience. While all participants in the teletherapy group found the occupational therapy approach helpful in coping with long COVID symptoms and regaining participation in meaningful occupations, perceptions varied in the group supplied with prerecorded videos. Some saw the intervention as helpful, but all emphasized the need for professional support from occupational therapists to use the program more effectively. The occupational therapists emphasized the need to tailor the therapy content to clients’ needs to ensure effective and successful management of occupational challenges. The study highlights telehealth-delivered occupational therapy’s potential benefits and challenges for individuals with long COVID. It contributes to understanding the challenges and potential of telehealth-delivered occupational therapy for long COVID rehabilitation. This study’s key finding is the importance of personalized and professionally guided telehealth interventions. Trial Registration: German Clinical Trial Registry identifier DRKS00029990.

63. Unmasking metabolic disruptors: The NEMESIS project's quest for Novel Biomarkers, Evidence on Adverse Effects, and Efficient Methodologies.

期刊: Open research Europe 发表日期: 2024 链接: PubMed

摘要

Metabolism disrupting chemicals (MDCs) elicit negative effects on metabolically active organs such as the liver and the pancreas, altering normal metabolic processes. Chemicals that are known, or suspected MDCs include compounds found in everyday consumer products and food, making low-dose, continuous exposure inevitable for humans. Through the discovery of chemically induced metabolic disruption, a concern has surfaced whether and how MDCs impact human health and the development of metabolic diseases. This has accelerated research around the topic, and it has been found that exposure to MDCs is linked to increased incidence of metabolic diseases including obesity and liver steatosis. Effective regulatory action is hindered by the lack of accurate methods to identify MDCs. The NEMESIS project addresses this regulatory gap by investigating the mechanisms through which MDCs cause metabolic disruption. The project aims at identifying novel biomarkers of exposure and link exposure to disease outcomes. As chemical toxicity testing is rapidly moving towards new approach methodologies (NAMs), NEMESIS promotes non-animal methodologies by employing state-of-the-art in vitro methods, epidemiological data, systems biology approaches, and seeks to replace mammalian in vivo experiments with alternative models. By understanding mechanisms of MDC-induced metabolic health effects, and through the development of reliable effect biomarkers and testing strategies, the NEMESIS project aims to facilitate more effective regulatory measures to improve and protect the health and well-being of EU citizens. The project is particularly focused on maximizing its impact through effective dissemination and communication efforts, to ensure that the project’s message and results reach a broad audience and are tailored to different population groups. These actions will improve the risk assessment of MDCs and ensure that the EU citizens are informed and protected from the harmful effects of MDCs and can adapt their consumer patterns and behaviors to prevent exposure.