公共卫生研究摘要 (2026-01-04)
共收录 61 篇研究文章
1. Groundwater quality and risk in the Ganga River Basin: an integrated machine learning appraisal.
期刊: Environmental geochemistry and health 发表日期: 2026-Jan-03 链接: PubMed
摘要
Groundwater supports the livelyhoods of hundreds of millions across the Ganga River Basin (GRB), yet its quality is increasingly stressed by geogenic and anthropogenic factors. Using a high-density 2022-dataset from 3417 wells, this study integrates Self-Organizing Maps (SOM), saturation indices, Nonnegative Matrix Factorization (NMF), the Entropy Water Quality Index (EWQI), and Monte Carlo-based health risk assessments. SOM analysis identified four distinct clusters (Davies-Bouldin = 1.45), resolving three dominant regimes: salinity-driven (Na+-Cl-) zones in the west and deltaic regions, widespread freshwater (Ca2+-Mg2+-HCO3-) recharge zones, and localized nitrate (NO3-) and sulfate (SO42-) hotspots. NMF decomposition further attributed these to four processes: salinization/mixing, carbonate/sulfate dissolution with nitrate inputs, geogenic cation exchange, and anthropogenic overprints on saline backgrounds. The study shows that only 30% of samples fall into excellent or moderate quality categories, while poor quality categories cluster in the western basin. Health risk modeling indicates significant vulnerability for children, with Hazard Quotient (HQ) exceedance in 28% of sampling locations for nitrate and in 25% for fluoride. These results provide a 2022-baseline to target salinity controls and protect vulnerable communities through coupled geospatial and machine learning diagnostics.
2. Integrated geochemical and geophysical assessment of groundwater salinization, Kujang block, eastern India.
期刊: Environmental geochemistry and health 发表日期: 2026-Jan-03 链接: PubMed
摘要
This study examines the hydrogeochemical behavior and salinization processes affecting groundwater in the Kujang area, Eastern Odisha, India. Groundwater was very hard during both pre-monsoon (PRM) and post-monsoon (POM) periods due to elevated total hardness (TH). The chemical composition displayed high concentrations of Na⁺, Cl⁻, Mg2⁺, electrical conductivity (EC), total dissolved solids (TDS), and TH, reflecting saltwater-freshwater mixing within the coastal aquifer. The ionic dominance sequence Mg2⁺ > Na⁺ > Ca2⁺ > K⁺ = Cl⁻ > HCO3⁻ > SO42⁻ indicates saline influence. Multivariate statistical analyses (PCA and correlation), combined with the Base Exchange Index (BEX), Seawater Mixing Index (SMI), and ionic ratios, suggested the effects of seawater intrusion. Additional factors contributing to groundwater salinity include over-pumping, agricultural return flow, and wastewater infiltration. Simpson’s ratio [Cl⁻/(HCO3⁻ + CO32⁻)] suggests that most samples fall within moderate to injurious contamination categories. The Hydrochemical Facies Evolution (HFE) diagram revealed that 86% of PRM and 64% of POM samples were affected by seawater intrusion and cation exchange. Vertical Electrical Sounding (VES) profiles demonstrated heterogeneous subsurface conditions with saline horizons at both shallow and deeper levels. Entropy water quality index (EWQI) analysis revealed that 55% (PRM) and 42% (POM) of groundwater samples with EWQI > 100 were categorized as poor to extremely poor. Therefore, the groundwater quality was found to be largely unsuitable for drinking purposes. This is the first integrated EWQI-VES-based assessment for the Kujang Block, providing a comprehensive understanding of groundwater salinization and insights for sustainable aquifer management.
3. Robotic-assisted radical prostatectomy in patients 80+ years: a multi-centre experience.
期刊: Journal of robotic surgery 发表日期: 2026-Jan-03 链接: PubMed
摘要
Prostate cancer (PCa) is a major health concern in ageing populations. While guidelines often preclude older men from robotic-assisted radical prostatectomy (RARP), outcomes are not well defined. We evaluated functional and oncological outcomes of RARP in patients ≥ 80 years. A multi-centre review of prospectively maintained surgical databases from three high-volume robotic surgeons was performed. Men ≥ 80 years old who underwent RARP between 2016 and 2024 were included. Demographic, surgical, functional, and oncological outcomes were analysed. Thirty men (mean age 82.6 years) were included. Fifteen, five and ten patients had ISUP Grade Group 2-3, 4 and 5 diseases, respectively. Twenty (20/30, 67%) patients had high-risk disease, with 16 clinical stage ≥ T2c. Mean operative time was 132 min and mean estimated blood loss was 187 mLs. Two complications occurred, one Clavien-Dindo grade II and one grade III. Median follow-up was 30.5 months (IQR 11.5-45.3). At 12 months, 16 out of 23 patients (70%) were pad-free or using one safety pad, and 4 (4/23, 17%) required one pad/day. Pathology revealed locally advanced disease in 22 (22/30, 73%) patients (≥ T3), and 6 (6/22, 20%) patients with a positive surgical margin. Biochemical recurrence is defined as PSA ≥ 0.2 ng/ml (Bellera et al. Ann Oncol 23(8):2166-2172, 2012) and it was observed in 11 patients (11/30, 37%), with 7 patients receiving further treatment. Small cohort size and retrospective analysis limit generalisability. RARP is safe and feasible in carefully selected octogenarians, showing acceptable functional and oncological outcomes. Older men should not be precluded from surgery based on age alone. This study supports offering RARP to these men after counselling on peri-operative risks and alternatives.
4. Sputum Eosinophils Predict Annual Remission of the Frequent Exacerbator Phenotype in COPD: A Prospective Cohort Study.
期刊: Lung 发表日期: 2026-Jan-03 链接: PubMed
摘要
The frequent-exacerbator (FE) phenotype guides COPD management, yet its year-to-year stability and the role of airway eosinophilia in FE remission are uncertain. In a single-center prospective cohort (n = 289), patients were classified as FE (≥ 2 moderate or ≥ 1 severe exacerbation in the prior year; n = 88) or non-FE (n = 201) and followed 12 months. FE patients were labeled FE-persistent or FE-remitted at 1 year. Clinical data, spirometry, CT, fractional exhaled nitric oxide (FeNO), blood counts, and induced-sputum cytology were collected. Logistic regression identified correlates of remission; ROC/AUC with bootstrap validation and calibration assessed models. FE prevalence was 30.4%; 58.0% of FE patients remitted. Compared with non-FE, FE had higher SE% and more eosinophilic/mixed sputum phenotypes. Within FE, remitters had better lung function and greater airway eosinophilia. Each 1% SE% increase independently predicted remission (OR 1.21, 95% CI 1.03-1.47); SE% ≥ 3% tripled the odds (OR 3.76, 95% CI 1.29-11.91). Prior severe exacerbations and CT-defined chronic bronchitis predicted persistence (ORs 0.21-0.27). Models showed good discrimination (AUC 0.785-0.799; bootstrap-corrected 0.750-0.773) and calibration (Brier 0.179). FE status is dynamic; over half remit within a year. Airway eosinophilia-especially SE% ≥ 3%-independently associates with FE remission, while prior severe exacerbations and CT-chronic bronchitis indicate persistence. Incorporating sputum cytology with history and imaging may enable earlier re-stratification and treatable-trait-guided COPD care.
5. Digital mobility outcomes to describe real-world walking during recovery from a hip fracture: the Mobilise-D perspective.
期刊: European geriatric medicine 发表日期: 2026-Jan-03 链接: PubMed
摘要
The burden of disease caused by fragility fractures, and hip fractures in particular, is significant both from a personal and a societal perspective. Digital technologies such as wearable devices now allow a real-world assessment of walking and physical mobility, describing temporal and spatial measures. Built on a transparent technical validation, the Mobilise-D consortium validated a set of digital mobility outcomes (DMOs) alongside a longitudinal clinical validation study (CVS). This article provides a description of DMOs along with supervised mobility assessment and patient-reported outcomes collected at entry of the CVS study in a sample of home-dwelling participants with a proximal femoral fracture (PFF) recruited within 1 year after surgery. Participants who underwent surgical treatment for a low-energy PFF were recruited from five sites in three high-income European countries. The first visit encompassed a clinical assessment (~ 3 h) and subsequent 7-day measurement of real-world mobility with a single wearable device. We categorized participants into four recovery phases according to the assessment time after surgery: acute phase (≤ 14 days after surgery, hospital stay), post-acute phase (15-42 days after surgery, mostly rehabilitation), extended recovery phase (43-182 days post-surgery, typically post-discharge at home), and long-term recovery phase (183-365 days post-surgery). All variables were reported descriptively for each phase using mean and standard deviation or median and 25th-75th percentile depending on their distribution. We enrolled 564 PFF participants (66% women). The mean age was 77.5 (SD 9.6) years. Almost 90% of all participants (n = 505) had a valid digital mobility assessment (wear time of > 12 h per day and at least 3 valid days). DMO domains such as amount (e.g., number of steps), pace (e.g., walking speed), and pattern (bout distribution) demonstrated large differences across phases. The observed variation in walking amount and pace and pattern across recovery phases indicate that DMOs provide a granular analysis of real-world mobility of hip fracture survivors. When confirmed by longitudinal analyses, including results on minimal important differences, the use of selected DMOs will provide a novel approach for monitoring, predictive modelling, prognosis, stratification, and evaluation of clinical trials and hip fracture services.
6. General Practitioner Service Use Before and After Long-Term Workplace Injury: A Retrospective Cohort Study.
期刊: Journal of occupational rehabilitation 发表日期: 2026-Jan-03 链接: PubMed
摘要
In Australia, general practitioner (GP) consultations for work-related injuries are funded by workers’ compensation and GP care for non-work-related conditions is funded by public health insurance (Medicare Benefits Schedule, MBS). This study aimed to measure changes in the proportion and frequency of GP consultations after a long-term work injury, including both Medicare and workers’ compensation funded care, and to assess the proportion of GP services funded by each scheme. This retrospective cohort study linked administrative GP records from MBS and workers’ compensation systems in New South Wales, Australia. The study included injured workers with long-duration (2 + years) compensation claims and community comparators. Primary outcome measures included the proportion and frequency of GP services, measured in the year pre-injury, and each of the first two years post-injury. Mixed-effects negative binomial regression was used to compare outcomes between groups during all three study periods. The cohort included 3170 injured workers and 7636 community controls. The annual median GP services increased from 5 (Interquartile range 2-10) pre-injury to 19 (IQR 12-27) in the first-year post-injury and decreased to 16 (IQR 10-23) in the second year. Compared to the community control cohort, injured workers used 3.6 (95% CI 3.33, 3.81) and 2.7 (95% CI 2.54, 2.91) times more GP services in the first- and second-year post-injury, respectively. This increase in annual median service use was observed among those funded by workers’ compensation, while services subsidised by Medicare remained similar across all three study periods. GP service use by injured workers with long-compensation claims increased substantially post-injury and remained high for two years. Workers also continued receiving Medicare-subsidised services at a similar level to pre-injury, presumably for managing non-work-related conditions. An integrated care model may provide holistic support to injured workers needing care for both workplace-injury-related and other conditions.
7. Neurofeedback as an Adjunct to Pharmacotherapy in OCD: A Randomized Controlled Trial on Symptom Reduction.
期刊: Applied psychophysiology and biofeedback 发表日期: 2026-Jan-03 链接: PubMed
摘要
Treatment response remains one of the key challenges in managing patients with obsessive-compulsive disorder (OCD). This study aimed to investigate the efficacy of combining neurofeedback with pharmacotherapy in treating OCD. We conducted a single-blind, randomized clinical trial at Farschian Hospital in Hamadan, Iran. Forty-five patients with OCD were randomly assigned to three groups (n = 15 per group): experimental, placebo, and control. The experimental group received 25 neurofeedback sessions (three 45-minute sessions per week) alongside pharmacotherapy. The placebo group followed a similar protocol but without actual neurofeedback administration. The control group received pharmacotherapy alone. Data were analyzed using SPSS-22. The results demonstrated a significant improvement in the mean total obsession score, including both thought and compulsion subscales (p < 0.01). The experimental group showed significantly greater improvement in all outcome measures compared to both control groups (p < 0.05). No significant difference was observed between the placebo and control groups (p > 0.05). These findings suggest that combining neurofeedback with pharmacotherapy significantly reduces OCD symptom severity compared to either treatment alone. Neurofeedback may serve as an effective, novel, and non-invasive complementary therapy for OCD when combined with standard pharmacological treatment.Trial registration The trial was registered at the Iranian registry of clinical trials ( www.irct.ir ; registration number: IRCT2015030321313N1).
8. Robot-assisted excision of thyroglossal duct cyst: a scoping review.
期刊: Journal of robotic surgery 发表日期: 2026-Jan-03 链接: PubMed
摘要
The objective of this study is to comprehensively describe the use of robotic surgery for the excision of thyroglossal duct cysts (TGDCs) in the literature. PubMed, Scopus, Cochrane Library, and EMBASE databases were searched. Screening, selection, data extraction, and quality analysis were performed by two independent authors using pre-defined criteria. Conflicts were resolved by independent senior authors. Descriptive statistics were used to summarize the data. From 25 unique articles, 14 articles were selected, describing 26 distinct patients with lingual (n = 16), suprahyoid (n = 1), or infrahyoid (n = 9) TGDCs treated with robotic surgery. The median age was 11 years (IQR = 17). A simple transoral approach was performed for all lingual TGDCs (n = 16). Suprahyoid and infrahyoid TGDCs were treated using transvestibular sublingual (n = 1), postauricular (n = 8), and bilateral axillary-breast (n = 1) approaches. No intraoperative complications were reported. Post-operative complications included minor bleeding (n = 1), oral-cutaneous fistula (n = 1), nerve weakness (n = 1), and seroma (n = 1). No recurrences were reported across a median follow-up of 16 months (IQR = 7.5). The current available evidence is limited to small case series and reports. This study demonstrates low complication rates, no reported recurrences, and favorable recovery in patients undergoing TGDC excision, supporting the role of robotic surgery as a safe and effective option in select cases.
9. Divergent occupational heat stress strategies required for Northern and Southern China under climate change.
期刊: International journal of biometeorology 发表日期: 2026-Jan-03 链接: PubMed
摘要
Observable climate change has led to an increase in compound heat events, thereby amplifying the economic impacts of labor heat stress and necessitating intervention strategies. Current research lacks high-resolution precision in projecting future heat stress and quantifying adaptation strategies, which is particularly critical for China given its spatial disparities in climate, workforce distribution, and economic development. This study integrates high-resolution CMIP6 climate models, a Wet-bulb Globe Temperature (WBGT) algorithm, and localized Exposure-response Functions (ERFs) to project heat-induced labor productivity loss across China under the SSP5-8.5 scenario. It systematically analyzes and quantitatively compares the effectiveness of two adaptation strategies (shading and work schedule adjustments) while estimating direct economic losses in outdoor heavy labor industries. This study precisely identifies the thermal stress hotspots categorized as primary (South China: loss rate > 11%, increment 5-7%), secondary (middle-lower Yangtze River: 7-11% loss, 3-5% increment), and tertiary hotspots (Yangtze River Delta & North China Plain: 6-9% loss, 2-4% increment) based on productivity loss magnitudes. Our findings also reveal that optimal strategies diverge north-south along the 33°N: shading dominates in the south and schedule adjustments in the north due to distinct heat patterns, though future climate trends may reduce the efficacy of time shift adjustments nationwide. Additionally, economic loss estimation reveals surging heat-induced losses in agriculture and construction over two decades (annual growth rates of 11.16% and 20.69%, respectively), with combined strategies potentially reducing direct losses by 65-70% in hotspot provinces. These findings enable province- and industry-specific intervention designs considering regional climate variations and strategy effectiveness.
10. Tuberculosis in children under 5 years of age in a low-burden setting: sociodemographic and epidemiological characteristics and healthcare utilization over a 10-year period (2010-2021).
期刊: European journal of pediatrics 发表日期: 2026-Jan-03 链接: PubMed
摘要
To describe the sociodemographic and epidemiological characteristics and healthcare utilization patterns-primary healthcare (PHC) use, emergency department (ED) visits, and hospital admissions-of children under 5 years of age born in Portugal between July 1, 2010, and June 30, 2021, and diagnosed with TB during the same period. This is a quantitative, observational cohort study of 58 children diagnosed with TB and reported to the National Epidemiological Surveillance System (SINAVE) before age 5. Data were obtained through linkage of five population-based databases. Descriptive statistics and bivariate analyses were conducted. Incidence rates of PHC, ED visits, and hospital admissions were calculated per 1000 person-days. Most TB cases (81.0%) were diagnosed between ages 1 and 5; 55.2% were male, and 72.2% resided in metropolitan areas. Over half (58.6%) were unvaccinated with BCG. Unvaccinated children were diagnosed earlier than vaccinated peers (p < 0.01), though no significant differences were found in the clinical presentation of TB, risk factors, or healthcare utilization. Pulmonary TB was most common (51.7%), and 68.4% of children were hospitalized. PHC services were underutilized (32.7%), while ED visits were more frequent, primarily for infectious and respiratory conditions. One child died, with TB diagnosed post-mortem. TB in young children remains a public health concern in Portugal, especially in unvaccinated populations. Strengthening PHC access and preventive care is essential to improve early detection and outcomes. • TB causes substantial morbidity and mortality, particularly in children under 5 years of age. • Pediatric TB remains underdiagnosed and underrepresented in research, surveillance, and national policies. • BCG vaccination was associated with later onset of TB. • Children under five with TB represent a particularly vulnerable group; thus, it is critical to promote preventive care to ensure early diagnosis and effective follow-up.
11. Racial Disparities in Stroke Care before and during COVID-19 in a Universal Health System: A Multiple-Group Interrupted Time-Series Analysis.
期刊: Journal of racial and ethnic health disparities 发表日期: 2026-Jan-03 链接: PubMed
摘要
The COVID-19 pandemic, marked by surges in healthcare demand and resource shortages, may exacerbated existing health disparities, particularly among marginalized racial groups. Black populations, in particular, often face reduced access to timely and quality care, worsening health outcomes. This study examines how a universal healthcare system responded to the pandemic and whether it mitigated racial disparities in stroke care. Using a multiple-group interrupted time-series analysis, we analyzed panel data (2016 to 2021) from Colombia to assess the impact of the pandemic on stroke-related healthcare access, treatment duration, and mortality among Black and White populations. Results showed that the Colombian healthcare system provided a protective effect for the White population. While healthcare access decreased for both groups during the pandemic, treatment durations differed. Black patients experienced a sharp increase in hospital stay duration immediately after the onset of COVID-19, followed by a steady decline of roughly 1% every two months. In contrast, White patients’ treatment durations did not decline but instead continued to increase over time. Additionally, although pre-pandemic mortality rates were consistently higher among Black individuals, this disparity widened during the pandemic. While the White population saw a reduction in discharge mortality rates during the pandemic, the rates for Black individuals increased (3%). These findings demonstrate the limitations of universal health coverage in addressing racial disparities during crises. Policy responses should prioritize strengthening healthcare infrastructure in underserved areas and addressing implicit biases in care delivery to ensure equity during health crises.
12. Retrospective analysis of the impact of antidepressants with anti-acid sphingomyelinase activity on survival of patients with glioblastoma.
期刊: Journal of neuro-oncology 发表日期: 2026-Jan-03 链接: PubMed
摘要
13. Moral Distress Among Family Caregivers: A Concept Analysis.
期刊: Journal of advanced nursing 发表日期: 2026-Jan-03 链接: PubMed
摘要
To examine and define the concept of moral distress among family caregivers by identifying its key attributes, antecedents and consequences. Concept analysis. This study was guided by Walker and Avant’s concept analysis framework. A comprehensive literature search was conducted to identify relevant studies, with 12 articles included in this analysis. PubMed, CINAHL, Scopus and PsycINFO databases were searched for articles published between February 2000 and May 2025. Three defining attributes of moral distress in family caregivers were identified: self-directed negative emotions, internal conflict and feelings of powerlessness and helplessness. Antecedents included caregiving burden, role conflict, ethical dilemmas, complex decision-making and internal and external constraints. Consequences encompassed long-term health effects, social withdrawal, burnout and moral residue. These findings led to a conceptual definition of moral distress in family caregivers. Moral distress in family caregivers is a significant and underrecognised issue that affects caregiver well-being and the quality of care they provide. This concept analysis offers a clear conceptual definition, providing a foundation for developing research instruments and interventions. Healthcare professionals should recognise moral distress in family caregivers as a key factor impacting both caregiver well-being and patient care. Support through education, counselling and peer groups can reduce moral distress and foster more ethical, collaborative care environments. This study addressed the lack of clarity surrounding moral distress in family caregivers. It identified key attributes, antecedents, and consequences, and developed a clear conceptual definition. These insights will inform research, practice and policy. The findings will benefit caregivers, improve patient care and support healthcare teams. This study followed Walker and Avant’s framework and employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in article selection. No patient or public involvement.
14. EXPRESS: Nationwide Trends in Pneumonia-Associated Mortality and the Impact of the COVID-19 Pandemic.
期刊: Journal of investigative medicine : the official publication of the American Federation for Clinical Research 发表日期: 2026-Jan-03 链接: PubMed
摘要
BackgroundPneumonia-related mortality in the U.S. has shown a notable decline. However, epidemiological analyses of the COVID-19 pandemic’s impact on these trends are limited. We evaluated pneumonia mortality trends pre-and-post the pandemic.MethodsAge-adjusted mortality rates (AAMR) per 100,000 were obtained from the CDC WONDER database through ICD-10 codes. Data was stratified based on sex, region, and state. Temporal trends were assessed with Average Annual Percentage Changes (AAPC).Results3.54% of all deaths (n=2,360,261) between 1999-2023 were due to pneumonia. Males exhibited a 1.3-fold higher AAMR compared to females (AAMR: 20.4 vs. 15.3; p= 0.003). However, pneumonia accounted for a greater proportion of all-cause mortality among females than males (2.42% vs. 2.06%). Overall, a significant decline in mortality was observed from 1999 to 2018, followed by a sharp rise. No significant AAMR trends were noted over the full study period (AAPC -0.32%; p= 0.81), but excluding COVID-19 deaths revealed a significant decline (AAPC -3.41%; p< 0.005). Marked geographic disparities were observed, with the highest median AAMR in Arkansas (24.9, IQR 6.8) and the lowest in Florida (9.4, IQR 6.3). The East South-Central region exhibited significantly higher pneumonia mortality rates (p< 0.001).ConclusionThe pre-existing declining trend of pneumonia associated mortality was markedly affected by the COVID-19 pandemic. Our findings underscore the need for tailored public health interventions and further research into demographic and geographic factors influencing pneumonia outcomes.
15. Chiropractic spinal manipulative therapy versus physical therapist-led exercise and the risk of cauda equina syndrome in adults with lumbar disc herniation, stenosis, or radiculopathy.
期刊: PM & R : the journal of injury, function, and rehabilitation 发表日期: 2026-Jan-03 链接: PubMed
摘要
Cauda equina syndrome is a surgical emergency often caused by lumbar disc herniation. Spinal manipulative therapy is commonly used for lumbar spine disorders, but case reports have raised concerns it may precipitate cauda equina syndrome. One cohort study suggested no increased risk, although it did not focus on patients with lumbar spine disorders pertinent to cauda equina syndrome, such as disc herniation, stenosis, or radiculopathy/sciatica. To address this evidence gap, we tested the null hypothesis that there is no increased risk of cauda equina syndrome following spinal manipulative therapy among adults with these lumbar spine disorders compared to matched controls receiving physical therapist-led therapeutic exercise (PTE). Using a retrospective cohort design, we queried a U.S. research network (TriNetX) including patients aged ≥18 years with a lumbar spine disorder and excluding those with preexisting cauda equina syndrome, incontinence, serious spinal pathology, and recent spine surgery/injection. Data spanned 2005-2025. Patients were divided into cohorts: (1) spinal manipulative therapy administered by a chiropractor or (2) PTE without spinal manipulative therapy. Propensity score matching controlled for confounding variables. Outcomes included the risk ratio of cauda equina syndrome (primary), and bladder catheterization and bowel incontinence as additional cauda equina syndrome markers (secondary). After matching, there were 34,376 patients in each cohort. Comparing the spinal manipulative therapy cohort to PTE cohort, the incidence and risk of cauda equina syndrome did not significantly differ (risk ratio=0.88 [95% CI, 0.43-1.79]; p = .715). The risk of bladder catheterization (risk ratio = 0.50 [95% CI, 0.39- 0.64]; p < .001) and fecal incontinence (risk ratio = 0.50 [0.37, 0.68]; p < .001) was significantly lower in the spinal manipulative therapy cohort. Among adults with lumbar disc herniation, stenosis, and/or radiculopathy, we did not identify an association between spinal manipulative therapy and an increased risk of cauda equina syndrome.
16. Dynamic trends and influencing factors of self-care behaviours among Chinese older adults with chronic heart failure during vulnerable period: a longitudinal study.
期刊: European journal of cardiovascular nursing 发表日期: 2026-Jan-03 链接: PubMed
摘要
To explore the trends of self-care behaviours among Chinese older adults with chronic heart failure (CHF) during the vulnerable period (VP) and to analyze influencing factors. This was a longitudinal study. From October 2022 to July 2023, 255 patients were recruited from a tertiary hospital in Shanghai, China. Data regarding self-care behaviours (self-care maintenance, symptom perception, and self-care management), self-care confidence, illness perception, self-efficacy, social support, HF knowledge, and demographic and clinical information were collected during hospitalization (T1) utilizing validated questionnaires and electronic health records. Follow-up behavioural data were collected at 2 weeks (T2), 4 weeks (T3), 2 months (T4), and 3 months (T5) post-discharge. Repeated measures ANOVA was used to identify the trends of self-care behaviours, and the generalized estimation equation was used to explore influencing factors. Self-care maintenance scores reached 70 at T2, T4, and T5, while self-care management scores exceeded 70 at time points from T2 to T5. Symptom perception scores never reached 70 any single time point. There were significant temporal variations across all 3 domains, characterized by a rapid improvement at 2 weeks post-discharge, followed by subsequent stabilization or decline (P < 0.05). Residential area, educational level, cardiac function, self-care confidence, and HF knowledge were key influencing factors (P < 0.05). Self-care behaviours among patients improved within the first two weeks post-discharge but tended to stabilize or decline thereafter, indicating a critical window for targeted interventions. Health care professionals should tailor self-care promotion strategies to both the temporal patterns of behaviours and patient-specific characteristics.
17. Hemodynamic Study of Plaque Progression and Regression Based on Coronary CTA Imaging using Computational Fluid Dynamics Method: Preliminary Results.
期刊: Journal of cardiovascular translational research 发表日期: 2026-Jan-03 链接: PubMed
摘要
This study evaluated coronary computed tomography angiography (CCTA)-based computational fluid dynamics (CFD) for predicting plaque dynamics in coronary artery disease. We retrospectively analyzed 22 patients (34 lesions) with paired CCTAs (mean interval 2 years). Lesions were categorized as progression (increase in diameter stenosis ≥ 5%), stable (change within - 5% to 5%), or regression (decrease in diameter stenosis ≥ 5%). Hemodynamic indices were normalized to adjacent non-diseased segments. Logistic regression identified predictors: normalized minimum wall shear stress (odds ratio (OR) = 0.38, p < 0.001) and maximum helicity (OR = 1.44, p = 0.016) predicted progression; average vorticity (OR = 0.13, p = 0.019) and gradient oscillatory number (OR = 0.10, p = 0.001) predicted regression. Receiver operating characteristic (ROC) analysis showed good discrimination (area under the curve (AUC) = 0.78 for progression, 0.83 for regression). These noninvasive imaging- and hemodynamic-derived markers, which were independently associated with lesion progression, may enhance coronary artery disease risk stratification by identifying high-risk plaques beyond stenosis severity, thereby informing individualized follow-up and treatment.
18. Targeting Triglycerides in Cardiovascular Disease Prevention: Evidence, Mechanisms, and Emerging Therapies.
期刊: Current cardiology reports 发表日期: 2026-Jan-03 链接: PubMed
摘要
The goal of this review is to evaluate the evolving role of triglycerides (TGs) and TG-rich lipoproteins (TRLs) in cardiovascular disease (CVD) risk and prevention. We examine the mechanistic rationale, genetic and epidemiological evidence, and therapeutic potential of targeting TGs in residual risk reduction, particularly in high-risk populations. Emerging data from Mendelian randomization studies and large clinical cohorts support a causal link between elevated remnant lipoproteins and atherosclerotic CVD, in which apolipoprotein B may be the principal driver. Although traditional triglyceride-lowering agents have produced mixed results on cardiovascular outcomes, emerging therapies-such as ApoC-III and ANGPTL3 inhibitors-show robust lipid-lowering effects, while selective PPAR modulators have thus far not demonstrated cardiovascular benefit. However, outcome data remain limited. Residual CVD risk persists despite aggressive LDL-C reduction, especially in patients with diabetes, metabolic syndrome, or chronic kidney disease. Selective TG-lowering strategies targeting TRLs-especially those that decrease apolipoprotein B-may provide clinical benefit in high-risk phenotypes. Ongoing trials will clarify whether these promising agents confer meaningful cardiovascular protection and warrant integration into future guidelines.
19. Fucoxanthin regulates macrophage pyroptosis through the PI3K/AKT/mTOR signalling pathway.
期刊: Molecular biology reports 发表日期: 2026-Jan-03 链接: PubMed
摘要
Pyroptosis has been reported to occur in several diseases, such as atherosclerosis, nonalcoholic steatohepatitis, and endometriosis. Although fucoxanthin has several biological properties (particularly anti-inflammatory properties), the mechanism through which fucoxanthin modulates or inhibits pyroptosis pathways is unclear. The present study aimed to determine whether fucoxanthin ameliorate endometriosis by preventing macrophage pyroptosis. A model of localized cell death in M2 macrophages induced by lipopolysaccharide (LPS) and adenosine triphosphate (ATP) was developed. Fucoxanthin decreased the ATP- and LPS-induced pyroptosis of M2 macrophage. Pretreatment with fucoxanthin alleviated oxidative stress and decreased the release of Reactive Oxygen Species (ROS) and LDH from M2 macrophages. Fucoxanthin pretreatment decreased the mRNA expression levels of GSDMD, NLRP3, caspase-1, IL-18, and IL-1β and inhibited the activation of the NLRP3 inflammasome and decreased the protein expression levels of Caspase-1 and GSDMD. In addition, fucoxanthin treatment reduced inflammatory signalling and decreased the expression and release of the IL-18 and IL-1β inflammatory factors. Fucoxanthin prevents macrophage pyroptosis by inhibiting the mammalian target of rapamycin (mTOR), protein kinase B (AKT), and phosphatidylinositol 3-kinase (PI3K) signalling pathway. Clinical trial number: not applicable.
20. Bone fragility and atypical femoral fractures in SLE: role of disease activity, infection, and treatment.
期刊: Journal of bone and mineral metabolism 发表日期: 2026-Jan-03 链接: PubMed
摘要
To determine the incidence and risk factors of fragility fractures and atypical femoral fracture (AFF)-related events in patients with systemic lupus erythematosus (SLE) receiving long-term glucocorticoid (GC) therapy. A retrospective analysis was conducted of 170 SLE patients followed from 2016 to 2023. Data on GC use, bisphosphonate (BP) therapy, bone-related events, and clinical characteristics were collected. Risk factors for fragility fractures and AFF-related events, including localized periosteal thickening (LPT), were analyzed using multivariate logistic regression. Although the median daily dose of prednisolone decreased over time, 82.9% of patients still met the criteria for pharmacologic intervention for GC-induced osteoporosis in 2023, and most continued to receive > 5 mg/day of GC. The median duration of BP therapy was 10.4 years, with 69 patients maintaining BP treatment throughout the observation period (median, 12.5 years). Fragility fractures and AFF-related events occurred in 7.6% and 5.8% of patients, respectively. Fragility fractures were independently associated with SLE flares and infection-related hospitalizations, whereas AFF-related events were significantly associated with prolonged BP use. Despite a gradual reduction in GC dosage, many patients with longstanding SLE remain at elevated risk for fractures. The comparable frequencies of fragility fractures and AFF-related events highlight the clinical relevance of both complications. The prevention of SLE flares and infections may contribute to lowering the risk of fragility fractures. In addition, careful monitoring for AFF/LPT is warranted in patients receiving long-term BP and GC therapy.
21. Synergistic effects of organic fertilizer on ciprofloxacin retention in semiarid alkaline soils.
期刊: Environmental geochemistry and health 发表日期: 2026-Jan-03 链接: PubMed
摘要
The widespread practice of manure fertilization in arid farmlands raises concerns about antibiotic pollution; however, its impact on antibiotic adsorption in alkaline soils remains poorly understood. This study investigates how chicken manure amendments change the environmental fate of ciprofloxacin (CIP) in semiarid alkaline soils. Through batch experiments conducted under varying pH, ionic strength, and manure application levels, it was found that manure addition significantly enhanced CIP retention, with the distribution coefficient (Kd) increased by 108% from 183 to 381 L/kg. This enhancement is attributed to mechanisms such as hydrogen bonding and hydrophobic interactions. Desorption hysteresis was also observed to increase by 16%, indicating more stable binding and reduced leaching potential. Importantly, the suppressive effect of competing cations (e.g., Ca2+ and Mg2+) was buffered by manure-derived organic matter; under unamended conditions, adsorption was reduced by up to ninefold. Based on these findings, manure application at 3-5% (w/w) is projected to reduce CIP mobility by over 30%, offering a practical strategy to mitigate groundwater contamination risks. This study provides a theoretical foundation for developing manure management practices that minimize antibiotic leaching, thereby supporting the groundwater quality protection and sustainable agricultural production.
22. Tailoring of Cerium Oxide Nanosheets Having Superior Peroxidase Catalytic Activity for Colorimetric Detection of Hydrogen Peroxide.
期刊: Journal of fluorescence 发表日期: 2026-Jan-03 链接: PubMed
摘要
The exploitation of an extremely sensitive and reliable nanozyme based colorimetric sensor for highly sensitive detection of hydrogen peroxide (H2O2) in living body system is extensively carping owing to fact that it garnered a prime role in causing toxic diseases. In this work, a highly novel catalyst named as Cerium oxide (CeO2) nanosheets (NSs) was precisely prepared by using a simple one pot hydrothermal method, thereby dowered with a strong intrinsic peroxidase like capability of catalyzing the oxidation-reaction of colorless 3,3’,5,5’-tetramethylbenzidine (TMB) to generate a blue color reaction in the presence of H2O2. Hence, a sensitive visible assessment platform related to CeO2 NSs was engineered, which not only exhibited a wider detection range of 0.01-1000 µM with R2 value of 0.9998, but also perceives exceptional selectivity, tremendous cycling and long term stability. Further, the sensor also evaluates lowest detection limit (LOD) 0.29 ± 0.03 µM and quantification limit (LOQ) of 2.3 ± 0.03 µM. In addition, it also endorses impressive practicality with stronger sensitivity and favorable accuracy in serum samples. Thus, this research-work not only contributed upon CeO2 NSs an outstanding capacity to detect H2O2, but also expands the realm of applications for CeO2 NSs in the domains of environmental preservation, biomedical diagnosis and forensic sciences.
23. Biomass-mediated nanomaterials for petroleum refinery waste remediation: a comprehensive review of mechanisms and applications.
期刊: Environmental monitoring and assessment 发表日期: 2026-Jan-03 链接: PubMed
摘要
The global petroleum sector is an important contributor to economic growth and industrialization, yet its activities generate large quantities of hazardous waste products, including hydrocarbons and heavy metals, increasing significant environmental, ecological, and health challenges. In recent years, the field of nanobioremediation, particularly through biomass-mediated nanomaterials, has emerged as a promising alternative for effective waste treatment. Nanomaterials synthesized from biogenic sources such as microbes, plants, and algae have unique properties such as high surface area, catalytic activity, and biocompatibility, which significantly enhance adsorption, catalytic degradation, and transformation of toxic contaminants. For example, plant-extract-synthesized iron nanoparticles have demonstrated over 85-92% degradation of polycyclic aromatic hydrocarbons (PAHs) within 10 days, outperforming conventional chemical remediation methods (40-60%) while reducing treatment costs by up to 30-40%. Compared to conventional remediation methods, biomass-derived nanomaterials offer superior removal efficiencies, reduced operational costs, and improved environmental safety, while minimizing secondary pollution. This review provides an in-depth exploration of their synthesis, characteristics, and applications, with emphasis on comparative performance against traditional remediation techniques.
24. An analysis of diet sustainability among different dietary patterns in the Portuguese adult and elderly population.
期刊: European journal of nutrition 发表日期: 2026-Jan-03 链接: PubMed
摘要
Dietary patterns influence human and environmental health. Shifts toward convenience and ready-to-eat ultra-processed foods have contributed to the rising prevalence of malnutrition, chronic disease, and ecological harm. This study examined the associations between dietary patterns and diet sustainability among Portuguese adults. Data from 2287 individuals aged 18-84 years were obtained from the last National Food, Nutrition, and Physical Activity Survey (2015-2016). Three dietary patterns were identified based on food composition and processing: Traditional, Diet Concerns, and Unhealthy; while four dietary patterns were categorized according to food preparation location: At home by themselves, At home by relatives or friends, By food retail, and By restaurants/canteens. Diet sustainability was assessed using the Diet Sustainability Score (DSS), encompassing health-related nutritional, environmental, economic, and sociocultural dimensions. Linear regression models adjusted for sex, age, education and energy intake were used to estimate associations between dietary patterns and DSS. Traditional (β = 1.27, p < 0.001) and Diet Concerns (β = 1.60, p < 0.001) patterns were significantly associated with higher DSS compared to the Unhealthy pattern. In terms of food preparation location, only the By restaurants/canteens pattern was significantly associated with lower DSS (β = - 0.76; p < 0.001) compared to the At home by themselves pattern. Younger, urban, and more educated individuals were more likely to follow the Unhealthy or the By restaurants/canteens patterns. These findings underscore the need to consider what people eat, how and where food is prepared. Promoting traditional, minimally processed, and home-prepared meals may be essential to advancing sustainable diets, particularly among younger and urban populations.
25. Effects of organized physical activity on quality of life and Phantom pain among adults with lower limb amputation: a systematic review and meta-analysis.
期刊: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 发表日期: 2026-Jan-03 链接: PubMed
摘要
While some studies report improved outcomes following exercise-based interventions, the overall findings regarding their impact on individuals with lower limb amputation (LLA) remain inconsistent. Therefore, there is a need to synthesize the available evidence. In this regard, this systematic review and meta-analysis aimed to clarify the effects of organized physical activity on quality of life (QoL) and phantom limb pain (PLP) in adults with LLA. This review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD42024582703). Eight databases were searched in November 2024, including PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, SPORTDiscus, ICI World of Papers, and ClinicalTrials.gov. Search terms combined concepts related to amputation, physical activity, quality of life, and phantom limb pain. Studies were included if they examined adults aged 18-60 with lower limb amputation and reported outcomes on quality of life or phantom limb pain following structured physical activity interventions. Only studies using validated outcome measures were considered. Six studies met the inclusion criteria for the systematic review. Three studies (reporting four independent effect sizes) were included in the meta-analysis of QoL outcomes. The pooled effect size was small and not statistically significant (SMD = -0.06, 95% CI: -0.29 to 0.16; p = 0.58), with no observed heterogeneity (I2 = 0%). Narrative synthesis indicated that most studies found either non-significant or short-term improvements in QoL. Only one study reported a reduction in phantom limb pain (PLP; NPRS: 9 to 2), precluding a meta-analysis for this outcome due to insufficient data. Current evidence does not provide statistically significant support for improvements in QoL following organized physical activity among adults with lower-limb amputation, while effects on PLP remain unclear due to limited and heterogeneous data. Further high-quality research using standardized, context-sensitive outcome measures and well-defined intervention protocols is needed. A more person-centered and contextually grounded understanding of QoL may help capture meaningful recovery outcomes in this population.
26. Building Strong Foundations in the NICU: Reducing Risk Factors of Postpartum Depression Through Occupational Therapy.
期刊: Maternal and child health journal 发表日期: 2026-Jan-03 链接: PubMed
摘要
Giving birth to a premature infant is a major risk factor for maternal postpartum depression (PPD), which may negatively impact parent-child bonding and result in long lasting behavioral and neurodevelopmental risks for the infant. Strong Foundations: An Occupational Therapist-Led, Activity-Based Support Group was developed to address the increased risk of PPD for mothers in the Neonatal Intensive Care Unit (NICU). The objectives of this formative pilot program evaluation were to assess the feasibility and potential effectiveness of this unique program. Participants were selected from mothers with infants in the Level II NICU of a community hospital in the Greater Boston area. Group sessions, led by a certified neonatal occupational therapist, included Infant-Care Techniques, Meditation and Gentle Movement, and Creative Discussion Activity Classes provided over 4 weeks. Participants completed pre- and post-surveys on self-efficacy, stress, social support, and program feedback. This program was found to be moderately feasible. Comparison of pre- and post-Likert scale scores demonstrated neutral or positive change. Two areas, “perception of maternal role” and “desire to remain in contact with other participants” revealed a directional, however not statistically significant, increase. Participant responses to open-ended questions demonstrated that the program was well received. Using an activity-based support group, such as the Strong Foundations program, is an avenue to support mothers in the NICU as it addresses the three main contributing factors of maternal confidence, stress level, and support network. PPD is a critical health care problem. The opportunity to reach the NICU mothers while they visit their infants is one that should not be overlooked.
27. Regional variation in serum ficolin levels and their association with disease activity and clinical manifestations in systemic lupus erythematosus (SLE) patients from India.
期刊: Immunologic research 发表日期: 2026-Jan-02 链接: PubMed
摘要
The lectin pathway, activated by ficolins, contributes to systemic lupus erythematosus (SLE) pathogenesis, but ficolin data remain inconsistent across populations. Present muti-centric cross-sectional study assessed serum ficolin-1, -2, and - 3 levels and their associations with clinical features and disease activity among SLE patients from five Indian regions (Mumbai, Assam, Meghalaya, Manipur, and Nagaland). Serum levels of ficolin-1, ficolin-2, and ficolin-3 were measured using ELISA. Disease activity was assessed using the SELENA-SLEDAI score. Statistical analyses were performed using non-parametric tests, with p < 0.05 considered significant. Serum ficolin levels differed significantly by region. Ficolin-1 and ficolin-2 levels were positively correlated with the renal involvement in SLE patients from Mumbai (r = 0.218; p < 0.001 and r = 0.199; p = 0.001, respectively), while ficolin-1 levels were also correlated with lupus nephritis (LN) in SLE patients from Manipur (r = 0.247; p = 0.040). In Assam, ficolin-2 levels were significantly reduced in patients with mucocutaneous manifestations (r=-0.258; p = 0.014), and ficolin-3 levels showed a negative correlation with musculoskeletal manifestations (r=-0.217; p = 0.040). In Mumbai, ficolin-1 levels were positively associated with disease activity (r = 0.139; p = 0.018), and ficolin-3 levels correlated positively with anti-dsDNA autoantibodies (r = 0.172; p = 0.004). Conversely, ficolin-3 levels showed a negative correlation with anti-dsDNA (r=-0.470; p < 0.001) in Assam. The present study demonstrated significant regional variations in ficolin levels among SLE patients across India. Association of ficolin-1 and ficolin-3 with specific organ involvement suggested their potential as possible immunological indicators in SLE. These findings suggested the importance of considering regional and ethnic differences in SLE management and warranted further validation through larger, longitudinal studies.
28. A dual-mode sensor based on an intramolecular catalytic hairpin assembly strategy for detecting survivin mRNA.
期刊: Mikrochimica acta 发表日期: 2026-Jan-02 链接: PubMed
摘要
A dual-mode sensor based on intramolecular catalytic hairpin assembly strategy (intra-CHA) is proposed for Survivin mRNA detection. Intra-CHA, a triplex complex of tetraferrocene-labeled H1/H2, shortens H1-H2 distance and increases their local concentrations, accelerating reaction by 2.8-fold vs. free-CHA. Ruthenium-based covalent organic frameworks (RuCOFs) with Ru(dcbpy)32+ as luminophore has dual fluorescence-electrochemiluminescence (FL-ECL) properties. EDTA-incorporated RuCOFs@EDTA expands active sites, enhancing ECL efficiency 8-fold. Intra-CHA system is covalently conjugated to RuCOFs@EDTA through amide bond linkages. Target mRNA-triggered strand displacement reactions induce structural reconfiguration of the intra-CHA probes, resulting in controlled spatial segregation of tetraferrocene from the RuCOFs@EDTA interface. This results in the recovery of FL and ECL signals, enabling rapid and highly sensitive detection of Survivin mRNA. Experimental results show that the detection limits reach 0.04 fM (in the FL mode) and 0.009 fM (in the ECL mode) respectively, with excellent selectivity, stability, and reproducibility. The system has been successfully applied to detect Survivin mRNA in actual serum samples, providing a novel strategy for Survivin mRNA detection and paving the way for developing future diagnostic strategies for early cancer screening.
29. Exploring the use of preoperative MRI for assessing the anatomical location of positive surgical margin at robot-assisted radical prostatectomy (RARP).
期刊: World journal of urology 发表日期: 2026-Jan-02 链接: PubMed
摘要
Robot-assisted radical prostatectomy (RARP) is an effective treatment for localized prostate cancer (PCa), but positive surgical margins (PSMs) occur in up to 22% cases. This study quantifies the relationship between the tumor location on preoperative MRI and PSM location on final pathology examination. We retrospectively reviewed PCa patients who underwent both prostate MRI and RARP between January 1, 2022 and December 31, 2022. The RARP specimens were divided into 14 regions, and concordance between MRI-detected lesions (PIRADS > 2) and PSM locations was assessed. Data from 464 patients revealed PSMS in 130 (28%) patients, totaling 187 PSMs. Concordance between tumor and PSM location was found in 152 PSMs (81%). Of these, 38% corresponded with a T3 lesion on MRI, and 72% showed pathological T3 at the PSM location. Most PSMs (46%) were at the apex. The median size was 6.0 mm (IQR 1.9-10.3). In contrast, 19% of PSMs were in regions without MRI-detected lesions, mainly located at the apex (43%) and bladder neck (29%). In this group, 34% had no positive biopsy on the corresponding side. PSMs in this group showed pathological T3 in 66% of cases. The median size was 3 mm (IQR 2.5-7.0 mm), and 46% had a pathological ISUP Gleason score ≥ 2. This study highlights the role of preoperative MRI assessment in predicting PSM locations during RARP. In 81% of cases, PSMs corresponded to MRI-detected lesions (PI-RADS > 2), suggesting that MRI can help by guiding surgical planning and potentially reduce PSM rates.
30. Prognostic impact of smoking and alcohol consumption in male patients with diffuse large B-cell lymphoma: a multicenter retrospective study.
期刊: Blood research 发表日期: 2026-Jan-02 链接: PubMed
摘要
Previous studies have been inconsistent concerning the associations of smoking and alcohol consumption with the prognosis of diffuse large B-cell lymphoma (DLBCL). This study aimed to investigate the associations of smoking and drinking status with overall survival (OS) in male patients with DLBCL. A total of 371 male patients with newly diagnosed DLBCL were retrospectively enrolled from eight medical centers. Smoking and drinking status were assessed as binary variables (yes or no). Inverse probability of treatment weighting (IPTW) based on propensity scores was applied to adjust for potential confounders. Kaplan-Meier survival analysis and Cox proportional hazards models were used to assess associations. Overall, 17.3% (n = 64) were smokers, and 12.7% (n = 47) reported alcohol consumption. After weighting, smoking was not associated with OS (HR = 1.192, 95% CI: 0.546-2.605, P = 0.665), nor was alcohol consumption (HR = 0.864, 95% CI: 0.174-4.288, P = 0.808). Subgroup analyses showed interactions between smoking and age (P for interaction = 0.003), and between drinking and EBV DNA status (P for interaction = 0.004). Sensitivity analyses using complete-case data and three-category exposure variables yielded consistent findings. In this multicenter cohort of male DLBCL patients, neither smoking nor alcohol consumption was associated with the prognosis of DLBCL. Among EBV-positive patients, alcohol use was associated with a trend toward poorer prognosis, highlighting the need for further research.
31. 68Ga-FAPI PET/CT for non-invasive characterization and activity assessment of ulcerative colitis and Crohn´s disease.
期刊: European journal of nuclear medicine and molecular imaging 发表日期: 2026-Jan-02 链接: PubMed
摘要
Inflammatory Bowel Diseases (IBD) comprise ulcerative colitis (UC) and Crohn’s disease (CD). Management of IBD requires assessment of disease activity, severity, extent and complications. Here, we describe the signal behavior of both CD and UC in 68Gallium- fibroblast activation protein inhibitor-based radiopharmaceuticals-46-positron emission tomography (68Ga-FAPI-46-PET) and evaluate the potential of 68Ga-FAPI-46-PET for activity assessment in IBD. This analysis includes data of 43 IBD patients and 43 control patients examined by 68Ga-FAPI-46-PET/computed tomography (CT). Disease activity of IBD patients was assessed by colonoscopy. FAPI-positive gastrointestinal tract (GIT)-findings and healthy appearing GI structures were contoured. Non-IBD related FAPI-positive GIT-findings were ruled out by interdisciplinary consensus. Static and dynamic PET-parameters of FAPI-positive IBD lesions and healthy appearing GI structures were extracted and PET signalling was analyzed with respect to IBD subtype and disease activity. We examined 20 CD patients and 23 UC patients (29 with active, 14 with inactive disease). FAPI-uptake in most healthy appearing GI structures of IBD patients was significantly increased compared to controls. Of 80 FAPI-positive GIT-findings, 14 were ruled out as non-IBD related and 66 FAPI-positive IBD lesions were analyzed. We observed equally high lesional FAPI-uptake in CD and UC. All patients with active disease showed at least one intensively FAPI-positive IBD lesion, while only 4/14 patients with inactive disease showed any FAPI-positive IBD lesion. Lesional and patientwise FAPI-uptake was significantly higher in active than in inactive disease. FAPI-positive IBD lesions showed a characteristic kinetic behaviour with two types of uptake patterns - one showing a continuous increase and the other an early peak followed by a plateau. 68Ga-FAPI-46-PET/CT appears promising for assessing disease activity in terms of fibroblast activation in both CD and UC.
32. Optimal time between decompressive craniectomy and cranioplasty to reduce the risk of complications: A retrospective study.
期刊: Neurosurgical review 发表日期: 2026-Jan-02 链接: PubMed
摘要
Cranioplasty (CP) is performed after decompressive craniectomy (DC), with complication rates of 15-40%. Risk factors and ideal timing for CP are unclear. This study investigates risk factors for complications after CP and the best time to perform a CP. This retrospective single-center study includes patients admitted to the neurosurgical department of the University Hospital Zurich between 01.2013 and 05.2023, who underwent a CP following a supratentorial DC. Demographics, comorbidities, indication for the DC, material used, complications, time between DC, CP and onset of complication were collected. The investigated complications are infections, bleeding, bone flap resorption or others requiring surgery. A multivariable logistic regression was performed to identify risk factors for the occurrence of complications. A Classification and Regression Tree (CART) was performed to identify the best time for CP. The result was tested with a Cox regression and a ROC analysis. Overall, 141 patients were included, of whom 39% (n=55) developed a complication. No difference in sex, age, comorbidities, DC-indication, material used was found, except for a trend for CP-time (shorter time for patients with vs without complication, 84±44 vs 102±70 days, p=0.065). In the CART analysis, day 122.5 was the best time cut-off for reducing complications (sensitivity 87%). In our case-series, we could not identify risk factors for complications after CP, except possibly for CP-timing. A longer time between DC and CP seems to be associated with less complications, with day 122.5 as the cut-off time.
33. Pitfalls of insomnia management in the elderly: A narrative review.
期刊: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology 发表日期: 2026-Jan-02 链接: PubMed
摘要
Insomnia is a common sleep disorder characterized by difficulty initiating or maintaining sleep, significantly impacting daytime functioning and quality of life. Its chronic nature, high prevalence among older adults, and association with multiple comorbidities make it a pressing health concern. Here, we provide an overview of insomnia in the elderly, highlighting the gap between scientific guidelines and real-world clinical practice and the common pitfalls in managing this fragile patient population. We performed a comprehensive literature review to synthesize recent findings on insomnia pathophysiology, diagnosis, and treatment in the aging population. Insomnia in the elderly is frequently intertwined with comorbidities, which both contribute to and are exacerbated by sleep disturbances. The diagnostic process is complex, requiring differentiation between primary insomnia and conditions influenced by comorbidities, medications, and age-related sleep changes. A comprehensive clinical assessment remains the cornerstone of diagnosis. Treatment prioritizes non-pharmacological strategies, with cognitive-behavioral therapy for insomnia as the first-line approach, though accessibility remains a challenge. Pharmacotherapy should be reserved for short-term use, with careful consideration of adverse effects. However, pharmacological treatment often becomes chronic and deviates from clinical recommendations, relying on off-label medications. Insomnia management is further complicated by polypharmacy, which disrupts sleep and increases the risk of drug interactions and side effects, including falls and cognitive decline. A multidimensional, patient-centered approach is essential for managing insomnia in older adults. Addressing comorbidities, optimizing pharmacological strategies, and improving access to non-pharmacological treatments are crucial steps towards enhancing outcomes and quality of life in this vulnerable population.
34. Empowering Kuwaiti adults with cancer: oncology nurses' perspectives on home-based self-management.
期刊: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 发表日期: 2026-Jan-02 链接: PubMed
摘要
Breast and colorectal cancers are among the most prevalent malignancies in Kuwait. As cancer care shifts toward outpatient and home-based models, this study explored oncology nurses’ perspectives on how Kuwaiti adults with these cancers navigate home-based self-management and identified strategies used to empower patients in this process. A qualitative study using a constructivist grounded theory approach was conducted in 2022 at a specialized cancer care center in Kuwait. Semi-structured interviews were held with seven purposively selected oncology nurses, each with at least 2 years of oncology experience. Data were analyzed through constant comparison and theoretical coding. The central theme, “Holistic empowerment and self-management in cancer care amidst systemic challenges,” reflected the nurses’ multifaceted role in supporting patients’ recovery and adaptation. Nurses emphasized that structured health education and family involvement enhanced confidence in managing medications, wound care, and rehabilitation at home. Emotional and psychological support during care transitions, particularly at discharge or palliative stages, strengthened patient motivation and trust. However, resource shortages, language barriers, and socioeconomic disparities constrained empowerment efforts. Collaboration with community organizations provided essential financial and emotional support to fill systemic gaps. Oncology nurses play a pivotal role in facilitating self-management among cancer survivors in Kuwait. Strengthening their capacity through targeted training, cultural competence, and policy support can improve survivorship outcomes. These findings underscore the need for culturally competent, system-supported empowerment strategies to enhance survivorship care.
35. Disparities in Pediatric Firearm Injury Care: A Comparison of Chronic Illness Pathways.
期刊: Prevention science : the official journal of the Society for Prevention Research 发表日期: 2026-Jan-02 链接: PubMed
摘要
Pediatric firearm injuries represent a leading cause of morbidity and mortality in the USA, yet clinical care models for youth with firearm injuries remain fragmented and unstandardized. Unlike other serious pediatric conditions such as asthma and cancer, which benefit from established interdisciplinary care pathways, firearm injuries are often treated as isolated events without structured follow-up or coordinated support systems. This absence of standardized clinical guidelines reflects broader systemic biases in how these injuries are perceived and managed within health care. Drawing on the Injury Equity Framework and established chronic disease management models, we propose comprehensive, trauma-informed clinical guidelines for pediatric firearm injury care spanning primary, secondary, and tertiary prevention. These guidelines emphasize universal firearm safety screening integrated into routine pediatric visits, standardized protocols for acute trauma care with automatic interdisciplinary team activation, and structured longitudinal follow-up addressing medical, behavioral health, and social needs. By comparing current fragmented approaches to evidence-based care pathways used in asthma and cancer management, we identify critical gaps in continuity and comprehensiveness of firearm injury care and offer specific, actionable recommendations to close these gaps.
36. Is Too Noisy as Bad as Too Quiet? The Inverted U-shaped Relationship between Noise and Sleep Duration.
期刊: Noise & health 发表日期: 链接: PubMed
摘要
Sleep is a crucial behavioral determinant of physical and psychological well-being. With the rapid urbanization of China, noise pollution has become a growing concern, and its impact on sleep has raised substantial public health attention. This study aims to investigate the potential non-linear relationship between environmental noise and individual sleep duration, and the moderating roles of urban green space and city size. We conducted a longitudinal analysis using data from the China Health and Retirement Longitudinal Study. City-level noise exposure was quantified using the Baidu Noise Index, a novel approach in this context. Data on urban population and green space coverage were obtained from the National Bureau of Statistics of China. Fixed-effects regression models were employed to estimate the impact of noise on sleep duration, and moderation analysis was applied to explore the roles of green space and city size. An inverted U-shaped association was observed between noise levels and sleep duration (linear β = 0.746, P < 0.001; quadratic β = -0.955, P < 0.001), with an inflection point at 0.391 [95% confidence interval (CI): [0.320, 0.566]]. Moreover, this inverted U-shaped pattern was attenuated in cities with higher green space coverage (quadratic interaction β = 0.822, P < 0.05) and larger population (quadratic interaction β = 1.072, P < 0.001). This study underscores the multifaceted relationship between noise exposure and sleep duration, providing a theoretical foundation for urban planning and health policy formulation, particularly in optimizing urban sound environments and promoting green space development.
37. Infrasound in Biology and Medicine: Insights into Mechanisms, Health Outcomes and Research Perspectives - A Narrative Review.
期刊: Noise & health 发表日期: 链接: PubMed
摘要
The study of infrasound represents an underexplored domain with profound implications for human health and operational readiness, particularly within civil, defence and security settings. Human exposure to these frequencies is on the rise due to both natural and anthropogenic factors, such as occupational conditions, wind farms, warfare tactics and transportation. This review critically examines the dualistic nature of infrasound by consolidating the current evidence based on qualitative exposure-effect pattern, pathophysiological signatures across animal models and controlled human experiments. By synthesizing current scientific literature, this article highlights the observed effects of infrasound on human well-being, while identifying key research gaps in mechanistic understanding. Moreover, this review underscores the necessity for systematic research aimed at elucidating the cellular and systematic pathways underlying infrasound-induced physiological complexities, and advocates for the development of a robust real-time bio-surveillance system tailored to monitor the exposure related-health outcomes. Additionally, recent technological advancements are explored, with a forward-looking perspective on its integration into next-generation diagnostic modalities and non-invasive therapeutic interventions. By integrating insights from both defence and health perspectives, the review emphasizes on the need to acknowledge infrasound as both a potential health hazard and a promising therapeutic modality, thereby shaping future directions in scientific research, healthcare policy and protective countermeasure development.
38. Social media platforms for ethical post-publication promotion.
期刊: Clinical rheumatology 发表日期: 2026-Jan-02 链接: PubMed
摘要
39. Effects of a Standardised Medical-Dental Collaborative Protocol on Acute Stroke Rehabilitation: A Multicentre Prospective Cohort Study.
期刊: Journal of oral rehabilitation 发表日期: 2026-Jan-02 链接: PubMed
摘要
Acute stroke often causes complications such as aspiration pneumonia, which can be prevented through oral hygiene. However, evidence supporting individualised oral care remains limited. We developed a multidisciplinary oral function management protocol and evaluated its benefits in patients with acute stroke, including its impact on aspiration pneumonia. In this prospective multicentre cohort study, data from 1616 patients with acute stroke admitted to participating hospitals between 31 July 2017, and 27 January 2021 were analysed. Hospitals implemented our oral function management program (Protocol group) or provided conventional oral care (control group). To minimise confounding by baseline severity, propensity scores were estimated using stroke severity and initial complications; patients were matched 1:1 using nearest-neighbour matching with a calliper of 0.2, resulting in 313 matched pairs (n = 626). Primary outcome was the incidence of aspiration pneumonia; secondary outcomes were hospital stay length and oral function improvement. No significant differences in aspiration pneumonia onset rates were detected between the protocol and control groups (p = 0.7639). Compared to controls, the protocol group showed significant improvements in oral hygiene (p < 0.0001), tongue mobility (p = 0.0292), and FOIS scores (p = 0.0005). Time from admission to discharge evaluation (p < 0.0001) and total length of hospital stay (p = 0.0018) were significantly reduced. Compared to administration of conventional oral care, implementation of this Protocol facilitated earlier oral management and feeding/swallowing rehabilitation, potentially reducing hospital stays and enhancing oral functions. The protocol may enhance oral functionality and reduce hospitalisation duration by systematising multidisciplinary oral management and swallowing rehabilitation, alongside supporting conventional pneumonia prevention strategies.
40. Continuous Infusion of Aztreonam-Avibactam After High Loading Dose for an Infection Caused by an OXA-48- and NDM-1-Co-producing ST147 Klebsiella pneumoniae.
期刊: Infectious diseases and therapy 发表日期: 2026-Jan-02 链接: PubMed
摘要
Infections caused by metallo-β-lactamase-producing Enterobacterales offer limited therapeutic options. Aztreonam-avibactam (ATM-AVI) provides a promising alternative, but its approved intermittent regimen is complex and can lead to substantial drug waste. We describe a case of mastoiditis with a retrotympanic abscess due to OXA-48- and NDM-1-producing Klebsiella pneumoniae, managed with continuous infusion (CI) of ATM-AVI after a full-vial loading dose, supported by therapeutic drug monitoring (TDM) and whole-genome sequencing (EPISEQ CS V2.0, bioMérieux). A 35-year-old man previously treated abroad for meningitis and brain abscesses presented with residual deep-seated infection caused by OXA-48- and NDM-1-producing K. pneumoniae. After initial treatment with ceftazidime-avibactam plus aztreonam, therapy was switched to ATM-AVI using a full-vial loading dose followed by CI. TDM demonstrated sustained plasma levels of both drugs, and the patient improved without adverse events. CI of ATM-AVI following a high loading dose was feasible, safe, and allowed optimized pharmacokinetic/pharmacodynamic (PK/PD) exposure while preventing drug wastage. Larger studies are warranted to determine the clinical utility of CI ATM-AVI across different MIC ranges. Serious infections caused by certain bacteria have become very difficult to treat. Some strains, such as Klebsiella pneumoniae that produce two enzymes called New Delhi metallo-β-lactamase and oxacillinase-48, can block the effect of almost all commonly used antibiotics. Because of this resistance, doctors have very few treatment options left, and patients may develop deep-seated infections that are hard to control. Aztreonam combined with avibactam is a new antibiotic pairing that can overcome this type of resistance. Aztreonam is not broken down by the New Delhi enzyme, and avibactam protects it from other enzymes. However, the usual way of giving this treatment can be complicated and can lead to unnecessary waste of the medication. In this study, we describe the case of a young man with a rare and severe ear and skull infection caused by these highly resistant bacteria. We used an alternative method of giving aztreonam and avibactam: we administered a full first dose and then provided the treatment continuously through an infusion pump. This approach aimed to keep the antibiotic level steady in the body and avoid wasting medication. We monitored the levels of both drugs in the patient’s blood and found that they stayed within the expected range. The patient improved without any side effects, and the infection resolved. This case shows that continuous infusion of aztreonam–avibactam may be an effective and practical treatment for severe infections caused by bacteria that resist most antibiotics. More research is needed to confirm these findings in larger groups of patients.
41. Machine learning for automated differentiation of parkinson's disease and its mimics using ¹²³I-mIBG scintigraphy: insights from a multicentre real-world cohort (ITA-mIBG study).
期刊: European journal of nuclear medicine and molecular imaging 发表日期: 2026-Jan-02 链接: PubMed
摘要
To assess machine learning (ML) classifiers trained on harmonised multicentre ¹²³I-mIBG planar scintigraphy for differentiating Parkinson’s disease (PD) from non-PD parkinsonian syndromes and to determine whether early imaging alone may ensure accurate discrimination. This retrospective study included patients with suspected PD who underwent early (~ 15 min) and delayed (~ 240 min) imaging and received a definitive diagnosis after ≥ 12 months. Harmonised region of interest (ROI) placement and ComBat correction were applied. Early and late heart-to-mediastinum (H/M) ratios and washout rate (WR) were calculated. Differences were tested by Mann-Whitney U test, and cut-points identified by ROC analysis. Logistic regression, Gaussian naïve Bayes, and support vector machine were trained on these features with Z-score normalisation and synthetic minority oversampling technique (SMOTE). 127 patients were analysed (85 PD, 42 non-PD). Early and late H/M ratios were significantly lower in PD than non-PD (early H/M 1.45 ± 0.20 vs. 1.80 ± 0.20; late H/M 1.33 ± 0.22 vs. 1.68 ± 0.21; both p < 0.001). WR was modestly higher in PD (8.74 ± 5.76% vs. 6.49 ± 6.19%, p = 0.024). Optimal cut-points for PD were: early H/M ≤ 1.62 (accuracy 80.3%, sensitivity 83.3%, specificity 78.8%, and AUC 0.878), late H/M ≤ 1.52 (83.5%, 83.3%, 83.5% and 0.866) and WR ≥ 6.03% (70.1%, 70.6%, 69.0% and 0.645). ML achieved mean accuracy 78.9-80.7%, sensitivity 81.9-84.0%, specificity 68.6-78.0%, and AUC 0.850-0.875. Classifiers trained on ¹²³I-mIBG semi-quantitative indices accurately distinguished PD from non-PD. Early H/M ratio alone provided excellent discrimination, supporting early-imaging; prospective validation is warranted.
42. One-step detection of Chlamydia psittaci using recombinase polymerase amplification and CRISPR/Cas12b.
期刊: AMB Express 发表日期: 2026-Jan-02 链接: PubMed
摘要
The development of rapid, sensitive, and user-friendly diagnostic methods for Chlamydia psittaci (C. psittaci) is critical for early diagnosis and effective control of infections. Current techniques, such as qPCR and next-generation sequencing, face limitations in accessibility and practicality for point-of-care testing (POCT). In this study, we present the WPTTS platform (one-step recombinase polymerase amplification (RPA)-CRISPR/Cas12b assay using weak protospacer adjacent motif (PAM) recognition with two-temperature shifting), which leverages the temperature-dependent PAM stringency of Alicyclobacillus acidophilus Cas12b (AapCas12b) to overcome the challenges of one-step CRISPR detection. By employing weak PAM sequences and a two-temperature protocol (37 °C for amplification, 60 °C for detection), WPTTS minimizes interference between RPA amplification and CRISPR cleavage, achieving a sensitivity of 102 copies/reaction-equivalent to two-step methods-while maintaining operational simplicity. The platform also demonstrates enhanced specificity, enabling single-base resolution at critical target positions. Clinical validation with 40 samples confirmed its superior performance, with 95% positive agreement and 100% negative agreement compared to qPCR. This study highlights the potential of WPTTS as a robust, rapid, and highly sensitive tool for POCT applications in C. psittaci detection and broader infectious disease diagnostics.
43. Non-TNF-targeted drugs in rheumatic diseasescombined with latent tuberculosis infection.
期刊: Clinical and experimental medicine 发表日期: 2026-Jan-02 链接: PubMed
摘要
Rheumatic diseases(RD), a collection of autoimmune disorders affecting connective tissues, have a global prevalence of approximately 3%-5%. Characterized by immune-mediated attacks on the body’s own tissues, these conditions lead to inflammation and tissue damage. Rheumatic disease patients frequently receive glucocorticoids, immunosuppressants, and biological agents, potentially elevating the risk of latent tuberculosis infection (LTBI) reactivation and Mycobacterium Tuberculosis (MTB) dissemination. Tumor necrosis factor-α(TNF-α)is crucial in immune responses, and TNF-targeted therapies could raise the risk of advancing from LTBI to active tuberculosis(TB). Compared to TNF inhibitors, non-TNF-targeted drugs-including IL-6, JAK, and B-cell inhibitors-pose a lower TB reactivation risk but may still modulate immune responses and defense against MTB. Our review synthesizes clinical research advancements in non-TNF-targeted therapies for rheumatic diseases, focusing on their association with TB reactivation risk. Non-TNF-targeted therapies demonstrate a reduced TB reactivation risk in rheumatic disease treatment, yet they necessitate rigorous TB screening and surveillance. Comprehensive infection status evaluation and prophylactic anti-tuberculosis treatment are essential for LTBI patients prior to therapy. The risk of TB infection is heightened in rheumatic disease patients undergoing biological therapy, particularly with TNF inhibitors. Despite the lower risk with non-TNF-targeted therapies, stringent screening and ongoing monitoring are imperative. Clinical practice should involve thorough patient assessment, personalized treatment planning, and preventive anti-tuberculosis strategies to balance therapeutic efficacy and infection risk. Further studies are warranted to elucidate the link between non-TNF-targeted therapies and TB risk and to refine treatment strategies for rheumatic diseases.This review seeks to investigate the potential TB reactivation risk associated with non-TNF-targeted therapies in rheumatic diseases and to offer theoretical foundations and novel perspectives for their clinical use.
44. Adverse drug-event detection using the tree-based scan statistics (TreeScan) and comparison with common mining methods: new user, propensity score-matched cohorts.
期刊: European journal of clinical pharmacology 发表日期: 2026-Jan-02 链接: PubMed
摘要
45. Exploring the interaction between symbiotic bacteria from seagrass-associated sponges and biofilm-forming bacteria.
期刊: International microbiology : the official journal of the Spanish Society for Microbiology 发表日期: 2026-Jan-02 链接: PubMed
摘要
Marine sponges rely on their intricate and varied bacterial communities to sustain their ecological balance and health. The structure and role of bacterial communities are affected by environmental factors and sponge species. One ecological function of symbiotic bacteria is to prevent the formation of biofilms by pathogenic bacteria that could potentially compromise sponges’ health. This study investigates the antibiofilm activities of symbiotic bacteria isolated from seagrass associated sponges residing under dynamic conditions. Bacteria were isolated from various sponge species from seagrass ecosystem and assessed for their capacity to inhibit biofilm-forming bacteria discovered on submerged wood and fiber panels in contaminated marine habitats. A double-layer experiment was conducted utilizing Zobell 2216E media to evaluate antagonism among 44 bacterial isolates derived from nine sponge species. Twenty-five isolates exhibited inhibitory activity against five biofilm-forming bacteria, with FP2 being the most substantially inhibited strain. Eight symbiotic bacteria exhibited high to very high antibiofilm activity. Statistical analysis revealed groupings of bacteria with similar inhibition patterns, indicating a potential association with specific inhibitory mechanisms. The 16 S rRNA sequencing research revealed that the symbiotic bacteria are categorized into the Firmicutes and α- and γ-Proteobacteria groups, with potential unique strains identified. The findings suggest that bacteria from seagrass-associated sponges and their secondary metabolites could aid in the development of compounds for biofilm prevention and management.
46. Application of sensors and artificial intelligence in algal bloom monitoring: a knowledge map, research hotspots, and future trends based on CiteSpace.
期刊: Environmental monitoring and assessment 发表日期: 2026-Jan-02 链接: PubMed
摘要
Harmful algal blooms (HABs) pose escalating ecological, economic, and public health threats across global aquatic ecosystems. This study presents a comprehensive bibliometric analysis of the research landscape at the intersection of sensor technologies and artificial intelligence for HAB monitoring. Using 1278 peer-reviewed publications (2005-2024) retrieved from the Web of Science Core Collection and analyzed via CiteSpace, we explored publication trends, collaboration networks, keyword evolution, and citation bursts. The results reveal exponential growth in research output since 2019, with the USA and China leading in productivity and international collaboration. Thematic evolution has shifted from marine-focused remote sensing to AI-driven freshwater monitoring, emphasizing real-time sensing, multi-source data fusion, and early warning systems. Despite technical progress, key challenges persist, including data heterogeneity, limited model interpretability, and poor cross-regional transferability. This study outlines strategic directions-such as digital twin construction, physics-informed AI, and transfer learning-to guide the development of scalable, explainable, and climate-aware monitoring systems. By mapping the intellectual structure and emerging frontiers of this field, our findings provide a foundation for interdisciplinary innovation and evidence-based environmental governance.
47. Feed-driven transfer and bioaccumulation of phthalate esters in aquaculture pond ecosystems.
期刊: Environmental monitoring and assessment 发表日期: 2026-Jan-02 链接: PubMed
摘要
This study investigates the trophic transfer and bioaccumulation of phthalate esters (PAEs) in aquaculture ponds within China’s Pearl River Delta. Two representative food chains (omnivorous and carnivorous) were analyzed using stable nitrogen isotope analysis and lipid-normalized contaminant concentrations. Human health risks associated with dietary PAE exposure were evaluated following USEPA risk assessment guidelines. Concentrations of ∑13PAEs varied considerably among fish species. The highest level was detected in bighead carp (2.84 mg/kg ww), while the lowest was found in largemouth bass (0.19 mg/kg ww). The six priority PAEs constituted 77.23 to 90.59% of the total ∑13PAEs, with di-2-ethylhexyl phthalate (DEHP) alone accounting for over 50% in fish tissues. Long-chain PAEs exhibited significant biomagnification in the omnivorous food chain, with a trophic magnification factor (TMF) of 2.45 for DEHP. In contrast, metabolic degradation was the dominant process in the carnivorous chain. The human health risk assessment indicated low overall carcinogenic and non-carcinogenic risks, with hazard quotients well below 1 and carcinogenic risks ranging from 10⁻6 to 10⁻4 for the majority of fish species. Nonetheless, certain species such as bighead carp showed a marginally higher cancer risk (6.60 × 10⁻5 ± 3.61 × 10⁻5). The findings provide new insights into the behavior of PAEs in aquaculture ecosystems and support the development of monitoring and management strategies for environmental pollutants.
48. Advances in rhizobial technology: driving sustainable agriculture in the 21 st century.
期刊: Archives of microbiology 发表日期: 2026-Jan-02 链接: PubMed
摘要
Rhizobial technology has become a transformative tool for environmentally friendly and sustainable agriculture. Rhizobia are key nitrogen-fixing bacteria that enhance soil fertility and reduce reliance on synthetic nitrogen fertilisers. In addition to nitrogen fixation, they act as effective plant growth promoters by producing phytohormones, mobilising nutrients, and improving root development. Advances in bioinoculant engineering now support efficient symbiotic associations in both leguminous and non-leguminous crops, offering a green strategy to boost agricultural productivity. Rhizobia also help plants withstand abiotic and biotic stresses, and many strains display strong biocontrol abilities by producing antimicrobial compounds and suppressing phytopathogens. However, their field performance can be inconsistent due to poor survival during storage, competition with native microbes, environmental conditions, and limited farmer awareness. To overcome these challenges, strategies such as co-inoculation with compatible microbes, encapsulated formulations, genetic enhancement, improved agronomic practices, pathogen management, and farmer awareness are being developed to increase inoculant stability and effectiveness. Overall, rhizobial technology serves as a cornerstone of smart, sustainable farming, supporting food security, environmental protection, and the restoration of soil health for future green agriculture.
49. Association of Original and Revised Pooled Cohort Equations With Cardiovascular and Cerebrovascular Mortality.
期刊: CNS neuroscience & therapeutics 发表日期: 2026-Jan 链接: PubMed
摘要
Cardiovascular (CVD) and cerebrovascular diseases (CeVD) are leading causes of mortality. The Pooled Cohort Equations (PCE) are widely used for ASCVD risk prediction, but face calibration concerns, particularly in diverse populations. The Revised Pooled Cohort Equations (RPCE) were developed to address these limitations. While prior research has evaluated these models for ASCVD, less is known about their performance for CVD and CeVD mortality outcomes. This study aimed to comprehensively compare the association of PCE and RPCE with CVD mortality and combined CVD and CeVD mortality, including subgroup analyses by race and gender, within a nationally representative US adult population. We analyzed 16,584 primary prevention participants (aged 40-79 years) from National Health and Nutrition Examination Survey (1999-2018), linked to National Death Index mortality data. We calculated 10-year ASCVD risk using both PCE and RPCE. Bland-Altman plots assessed score agreement. Cox proportional hazards models evaluated the association of standardized PCE and RPCE scores with CVD and combined CVD and CeVD mortality, adjusting for confounders and stratifying by race and gender. Both PCE and RPCE were significantly associated with CVD mortality (adjusted hazard ratio (HR) for PCE: 1.91 [95% CI: 1.82-2.01]; RPCE: 1.65 [95% CI: 1.59-1.72]) and combined CVD and CeVD mortality (adjusted HR for PCE: 1.91 [95% CI: 1.82-2.00]; RPCE: 1.65 [95% CI: 1.60-1.72]). Bland-Altman analyses revealed PCE consistently overestimated risk compared to RPCE, with differences increasing at higher risk levels. RPCE demonstrated improved calibration, especially in racially diverse populations, where PCE overestimation was more pronounced. Both PCE and RPCE are robust prognostic tools for vascular mortality. However, RPCE offers improved calibration, particularly in racially diverse populations, by providing more conservative yet comparably predictive risk estimates. These findings highlight the importance of selecting risk models tailored to target populations to optimize prevention and avoid potential overtreatment.
50. Effectiveness of magnesium sulfate in combination with physical rehabilitation for postpartum recovery in hypertensive mothers.
期刊: Pakistan journal of pharmaceutical sciences 发表日期: 2026-Jan 链接: PubMed
摘要
Women with hypertensive postpartum syndrome (HDP) are more prone to negative emotions that affect their recovery, while magnesium sulfate has an anti-anxiety effect. This study aims to evaluate the efficacy of magnesium sulfate therapy, administered intravenously or intramuscularly, in preventing complications such as eclampsia and managing blood pressure (BP) in patients with hypertension. This research adopted a quantitative research paradigm and participants were assigned to the intervention and the control groups (70 participants each). The control group received their regular postpartum medical care that included antihypertensive medications and health education but did not receive magnesium sulfate treatment and designated physical rehabilitation. The data collected were then sorted and categorized genetically and were analyzed using the SPSS software program version 25.0 to enhance reliability of statistics. The intervention group demonstrated significant improvements across physical, emotional and functional recovery, including BP compared with the control group. There was significant lowering of both systolic (-20.1 mmHg) and diastolic (-14.2 mmHg) BP, reduced fatigue, improvement in quality of life and decrease in pain (All P < 0.05). A regression analysis confirmed the treatment and health promotion as the positive indicators of the recovery rates while body mass index (BMI) and increased baseline diastolic BP as negative indicators. The convergence of pharmacological and non-pharmacological approaches made postpartum management more effective in terms of short-term as well as extended health problems. These results are a robust starting off point for the application of a more comprehensive postpartum care framework in clinical care.
51. Pharmacological perspectives on integrating sports and medicine: Collaborative models for drug therapy optimization and health promotion.
期刊: Pakistan journal of pharmaceutical sciences 发表日期: 2026-Jan 链接: PubMed
摘要
The cross-disciplinary integration of sports and medicine has become an important trend. This integration not only creates conditions for optimizing disease treatment plans and enhancing the efficacy of drug therapy, but also provides a new path for promoting public health and improving the efficiency of health resources. The integration of sports and medicine offers opportunities to optimize drug therapies and improve health outcomes. This study applies structural equation modeling to analyze the interplay between sports activity, pharmaceutical interventions and health promotion. By integrating quantitative and qualitative indicators-such as resource allocation, participation rates and drug utilization patterns-the research identifies pathways to enhance collaborative governance in sports-medicine fusion. Strategic investment in sports and medicine can jointly enhance medication compliance, health outcomes, and resource utilization efficiency, and has clarified the key path for promoting the collaborative governance of sports and medicine integration. The research results provide a basis for formulating comprehensive policies that integrate physical exercise and drug intervention, which is conducive to promoting the deep integration of sports and medicine and achieving an improvement in the overall health level of the population.
52. RUNX2 Represses the EWS-FLI1-mediated Transcription in Ewing's Sarcoma Cells.
期刊: Cancer genomics & proteomics 发表日期: 2026 链接: PubMed
摘要
Ewing’s sarcoma is an aggressive pediatric malignancy driven by specific chromosomal translocations, predominantly leading to the oncogenic fusion protein EWS-FLI1. Runt-related transcription factors 1 and 2 (RUNX1 and RUNX2), which are key transcription factors involved in osteoblastic differentiation and skeletal morphogenesis, are not expressed in Ewing’s sarcoma. Our study aimed to elucidate the relationship between the RUNX genes and EWS-FLI1. We used Ewing’s sarcoma cell lines (A673 and NCR-EW2). EWS-FLI1 knockdown was achieved using shRNA, while inducible expression of RUNX1, RUNX2, EWS-FLI1, or EWS-ERG was performed using a Tet-on system. Gene and protein expression levels were quantitatively assessed by qPCR and Western blot analysis, respectively. Cell growth was evaluated using spheroid formation and cell viability assays. Truncated RUNX1 or RUNX2 constructs were employed to identify functional domains, with their intracellular localization confirmed by immunostaining. We observed low expression of RUNX1 and RUNX2 in Ewing’s sarcoma cells. Notably, EWS-FLI1 knockdown increased RUNX2 gene expression. Conversely, inducible expressions of either RUNX1 or RUNX2 suppressed the expression of EWS-FLI1 target genes and inhibited cell proliferation and spheroid formation. Additionally, the RUNT domain of RUNX1 and RUNX2 was not essential for their inhibitory effect on EWS-FLI1 target gene expression. Importantly, both EWS-FLI1 and EWS-ERG down-regulated RUNX2 gene expression in hTert-RPE1 cells. EWS-FLI1 suppresses RUNX2 gene expression in Ewing’s sarcoma cells, and re-expressing RUNX2 inhibits cell growth. These findings suggest that RUNX2 has a negative impact on the oncogenic process in Ewing’s sarcoma.
53. Targeting men to improve maternal and child health and nutrition: A qualitative process evaluation of a mass media campaign in Tanzania's Lake Zone.
期刊: PloS one 发表日期: 2026 链接: PubMed
摘要
Undernutrition in the 1000 days following conception can cause lasting damage. In Tanzania malnutrition is directly or indirectly responsible for 35% of all deaths among children under five. The ASTUTE project, delivered in the five Lake Zone regions of Tanzania (Mwanza, Shinyanga, Geita, Kagera, Kigoma), aimed to reduce the prevalence of child stunting by improving child and maternal nutrition practices. The project incorporated a mass media campaign designed to change behaviours, with a particular emphasis on shifting gender norms and engaging men. This paper focuses on the qualitative findings relating to the impact of the campaign on men’s knowledge, attitudes, norms and behaviours. Throughout the period of radio and TV broadcasting, a qualitative process evaluation was conducted to assess the impact of the campaign on knowledge, attitudes, norms and behaviours. Between October 2017 and February 2020, a total of 59 focus group discussions were conducted with mothers, fathers and elder caregivers of a child aged under two years. Data were analyzed thematically. Fathers reported that radio and TV spots increased their participation in maternal health by accompanying their partners to the ANC, supporting their nutrition intake, and reducing the workload of the mother during pregnancy. Radio and TV spots were also reported to increase men’s engagement in child health by encouraging exclusive breastfeeding and nutritious complementary feeding. Mass media campaigns that target men’s behaviour can have beneficial effects on maternal and child health. In particular, radio and TV messages targeting men appear to be able to mitigate some barriers arising from gender norms and women’s social position in Tanzania.
54. Potential Folate-Depleting Effect of Organochlorine Pesticide Exposure in Elevating Homocysteine Levels.
期刊: Environmental pollution (Barking, Essex : 1987) 发表日期: 2025-Dec-31 链接: PubMed
摘要
Organochlorine pesticides (OCPs) are persistent environmental contaminants linked to adverse health outcomes, including neural tube defects, though their mechanisms remain unclear. This study investigated the effects of OCP exposure on homocysteine metabolism by depleting folate through a cohort study (103 pre-folic acid (FA) supplementation and 83 post-FA supplementation women) and animal experiments. In pre-FA supplementation women, concentrations of most OCPs were significantly associated with decreased plasma folate and elevated homocysteine. Bayesian Kernel Machine Regression (BKMR) confirmed an inverse combined effect of OCP mixtures on folate and a positive effect on homocysteine. Rat models confirmed the findings in humans, demonstrating that DDT exposure decreased folate levels and increased homocysteine levels. Conversely, in post-FA supplementation women, these associations disappeared. Further analysis revealed that FA supplementation exhibited significant inverse associations with several OCPs, including α-Hexachlorocyclohexane (α-HCH), β-Hexachlorocyclohexane (β-HCH), Endosulfan-β (β-ES), Heptachlor epoxide (HEPCE), isodrin, dieldrin, o,p’-Dichlorodiphenyltrichloroethane (o,p-DDT), o,p’-Dichlorodiphenyldichloroethylene (o,p-DDE), p,p’-Dichlorodiphenyldichloroethylene (p,p-DDE), and o,p’-Dichlorodiphenyldichloroethane (o,p-DDD). Mediation analysis indicated that folate partially mediated the effect of OCPs on homocysteine (mediation proportion: 13-27%). While FA supplementation effectively accelerated the metabolism of OCPs in rat. In conclusion, OCP exposure elevates homocysteine levels by depleting folate. FA supplementation counteracts this effect by reducing OCP accumulation in vivo. These findings underscore the importance of nutritional status-particularly folate levels-in assessing OCP-related health risks. Future research should explore the molecular mechanisms by which OCPs disrupt folate metabolism and how nutritional interventions can mitigate associated health risks.
55. Comprehensive Evidence-Based Guidelines for Regenerative Therapies in the Management of Chronic Low Back Pain: 2025 Update from the American Society Of Interventional Pain Physicians (ASIPP).
期刊: Pain physician 发表日期: 2025-Dec 链接: PubMed
摘要
Regenerative medicine is an evolving medical subspecialty dedicated to enhancing the body’s natural healing mechanisms to repair or replace damaged tissues. By using autologous or allogeneic biologics, it offers the potential to restore function where conventional therapies have shown limited success. While this field holds great promise and continues to generate enthusiasm among both patients and clinicians, it remains in early stages of clinical validation. Therefore, it must be approached with careful optimism and responsible application, ensuring that its presentation, promotion, and use in clinical settings are grounded in evidence and ethical standards. To provide updated, evidence-based recommendations for the role of regenerative therapies in managing moderate to severe chronic low back pain. A multidisciplinary panel of experts, convened by the American Society of Interventional Pain Physicians (ASIPP), systematically reviewed the current evidence and incorporated patient perspectives to develop practical, evidence-informed recommendations. The process included defining key clinical questions, reviewing the literature, formulating evidence-based statements, and reaching consensus through structured discussions and formal voting. A total of 35 authors contributed to the development of these guidelines, with 33 experts participating in the formal consensus process. Altogether, 19 recommendations were generated, with all of them achieving 100% agreement. These recommendations were informed by a comprehensive review of systematic reviews, randomized controlled trials (RCTs), and observational studies encompassing a broad range of regenerative therapies.Evidence was appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology to determine certainty levels. Both qualitative and quantitative analyses were applied to synthesize the best available data, resulting in evidence-based recommendations summarized below.Intradiscal Injections (PRP): Evidence Level: III, Fair; Consensus-Based Clinical Recommendation: ModerateIntradiscal Injections (BMAC): Evidence Level: III, Fair; Consensus-Based Clinical Recommendation: ModerateEpidural Injections (PRP): Evidence Level: III, Fair; Consensus-Based Clinical Recommendation: ModerateFacet Joint Injections (PRP and MSCs): Evidence Level: IV, Limited; Consensus-Based Clinical Recommendation: Moderate Sacroiliac Joint Injections (PRP): Evidence Level: IV, Limited; Consensus-Based Clinical Recommendation: Low Functional Spine Unit Injections Evidence Level: Very Low; Consensus-Based Clinical Recommendation:Low. The primary limitation of these guidelines is the scarcity of high-quality studies, with much of the available evidence derived from small or heterogeneous trials. Regenerative therapies should be considered only after a thorough diagnostic evaluation confirming clinical necessity. Treatment decisions must account for the patient’s medical condition, preferences, and expectations. Patients should be fully informed about the nature, potential benefits, risks, and costs of regenerative treatments, most of which are not covered by commercial insurance.These therapies may be used alone or in conjunction with other evidence-based modalities, such as structured exercise, physical therapy, behavioral therapy, or conventional medical management. Clinicians must follow all applicable U.S. Food and Drug Administration (FDA) regulations and adhere to safety and ethical standards outlined in these guidelines. Based on current evidence, lumbar intradiscal injections of platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) are supported by Level III evidence. Lumbar epidural PRP injections are also supported by Level III evidence, while PRP injections for lumbar facet joints and sacroiliac joints are supported by Level IV evidence. Given the emerging status of biologic therapies and the limited quality of existing studies, the panel provides moderate, consensus-based recommendations for the use of all biologics in the lumbar spine.
56. Relationship Between Workplace Noise Exposure and Sleep in Tanzania.
期刊: Noise & health 发表日期: 链接: PubMed
摘要
High noise levels during daytime work may cause sleep disturbances amongst workers, but research findings are inconclusive so far. This study aims to compare sleep amongst workers exposed to high and low daytime noise during work in a developing country, where workplaces often have high noise levels. A cross-sectional study was conducted amongst 181 metal industrial workers (high-noise-exposed workers) and 72 office cleaners (low-noise-exposed workers) in Tanzania. The average noise levels were 97.9 and 76.6 dBA for the high- and low-noise-exposed workers, respectively. An interview-based questionnaire was used to collect data on sociodemographic characteristics, sleep variables, the Epworth sleepiness scale (ESS) and the Bergen insomnia scale (BIS). Data were analysed using descriptive statistics, t-tests, Kruskal-Wallis tests, Pearson chi-square tests and logistic regression analysis. The mean BIS score for high-noise-exposed workers was 13.2, with 40.3% reporting insomnia and 39.8% reporting excessive daytime sleepiness (ESS ≥ 11). The low-noise-exposed workers had a mean BIS score of 15.4, with 51.4% reporting insomnia and 41.7% reporting excessive daytime sleepiness. The crude odds ratio (OR) of insomnia when exposed to high noise was 1.56 (95% CI = 0.90-2.718, P = 0.111), and the crude OR for excessive daytime sleepiness was 1.08 (95% CI = 0.62-1.88, P = 0.782). Insomnia and daytime sleepiness were not different between groups when adjusting for age, marital status, education, smoking, alcohol, coffee consumption and daytime rest periods. No differences were found between daytime high- and low-noise-exposed workers in relation to self-reported sleep variables. The results must be interpreted with caution due to the use of self-reports and possible unmeasured confounders.
57. Distortion-Product and Transient-Evoked Otoacoustic Emissions Before and After Noise Exposure During Drummer Rehearsals.
期刊: Noise & health 发表日期: 链接: PubMed
摘要
This study aimed to evaluate sound exposure levels in drummers and analyses changes in distortion product otoacoustic emissions (DPOAEs), transient-evoked otoacoustic emissions (TEOAEs), and the contralateral suppression (CS) of otoacoustic emissions (OAEs) before and after a controlled rehearsal session. This study had a pre-experimental design and included volunteer drummers. The subjects responded to surveys to explore general hearing health and musical practice habits. Hearing tests were performed under controlled conditions: DPOAEs and TEOAEs were used to determine the activity of the outer hair cells (OHCs), and the CS of DPOAEs and TEOAEs were applied as indicators of the functioning of the medial olivocochlear efferent system. The drummers subsequently performed freely for 20 min, and their noise exposure was measured. Immediately after completing the rehearsal, the volunteers repeated the tests. Descriptive analysis and comparisons of the tests were used to examine the differences in the response of DPOAEs and TEOAEs. Eighteen drummers were exposed to noise levels above 103 dBA, with over 60% not using hearing protection. Statistically significant changes (P < 0.05) in DPOAE amplitudes were found at 4000, 6000, and 10,000 Hz for the right ear and at 1000 and 6000 Hz for the left ear. For TEOAEs, significant differences (P < 0.05) occurred at 2000 (right ear) and 2800 Hz (left ear). Asymmetries in cochlear function and CS were also observed, suggesting functional differences between ears that were possibly linked to chronic noise exposure. The findings underscore the cochlear susceptibility to high frequencies and emphasize the importance of preventive strategies in this musician population.
58. Audiological Symptoms Experienced by Taxi Drivers at Two Taxi Ranks in Johannesburg, South Africa.
期刊: Noise & health 发表日期: 链接: PubMed
摘要
Noise-induced hearing loss (NIHL) is among the most common occupational health conditions worldwide. In South Africa, thousands of informal taxi drivers are chronically exposed to high traffic and environmental noise; however, data on their hearing health, awareness of audiology or access to hearing conservation programmes are lacking. This study investigated occupational noise exposure, auditory and nonauditory symptoms, knowledge of hearing risks and health-seeking behaviours among minibus taxi drivers in Johannesburg. A cross-sectional, quantitative design was used. Eighty-six male taxi drivers completed structured questionnaires on demographics, work history, exposure, symptoms, knowledge and health-seeking behaviour. Data were analysed using descriptive statistics, chi-square tests and logistic regression. All participants were male. Most firstly, encountered occupational noise between the ages 20 and 30 and worked 12-16 hours daily, with 16-37 years of cumulative exposure. Tinnitus (64%) and hearing difficulties (40%) were the most common, with 78% noticing hearing changes during peak hours. Noise exposure was significantly associated with tinnitus, hearing difficulties, diabetes, perceived hearing changes and the belief that noise affects work. Logistic regression identified tinnitus [odds ratio (OR) = 1634] and hearing difficulties (OR = 166) as the strongest predictors of hearing change. Only 27% had undergone hearing testing, and over half were unaware of audiologists’ roles. Knowledge of hearing risks and audiology was linked to high testing uptake. Johannesburg taxi drivers are at high risk for NIHL because of chronic exposure, long shifts and lack of protective measures. Limited awareness of audiology and poor health-seeking behaviour further increase vulnerability.
59. Effects of Aircraft Noise on Pilots' Auditory Perception.
期刊: Noise & health 发表日期: 链接: PubMed
摘要
This study aimed to investigate the effects of aircraft noise on pilots’ auditory perception and develop evidence-based control strategies. A cross-sectional study was conducted between March 2021 and May 2024. Participants were divided into two main groups: a pilot group (n = 92) and a control group of 67 healthy individuals without occupational noise exposure. For subgroup analyses, the pilot group was further categorised into three subgroups according to aircraft type: helicopter (n = 28), fighter (n = 30) and passenger aircraft (n = 34). The Results section presents comparisons across four groups in total (control + three pilot subgroups). Hearing test data were used to evaluate the effects of aircraft noise on auditory perception and propose effective prevention and control strategies. The control group included more females than the pilot group (P < 0.05). No significant difference in baseline data was observed among the three groups (P > 0.05). Significant differences were detected in the pure tone audiometry results of 0.25, 0.5, 1, 2, 3 and 4 kHz among the four groups (P < 0.001). The signal-to-noise ratio (SNR) in the 2-6 kHz band was significantly lower in fighter jet crews compared with controls (median difference range: 2.0-9.0 dB), with the largest difference at 6 kHz (Δ9.0 dB, χ2 = 91.37, P < 0.001). Helicopter crews also observed SNR reductions of approximately 5.5 dB at 4 and 6 kHz (P < 0.001). Only a slight decrease in the 2 kHz threshold was observed for the passenger aircraft crew (Δ0.5 dB, P = 0.002). We found no significant difference between the groups at 1 kHz (P = 0.794). Significant differences were noted in the Weinstein Noise Sensitivity Scale scores of the four groups (P < 0.001). Aircraft noise threatens pilots’ auditory health and flight safety, requiring integrated technical, protective and managerial control measures.
60. Voice Problems in School Teachers: A Cross-Sectional Study from Madinah, Saudi Arabia.
期刊: Noise & health 发表日期: 链接: PubMed
摘要
No data on voice problems in school teachers in Madinah, which is a key academic hub of Saudi Arabia, is currently available. To the best of our knowledge, no prior cross-sectional study was conducted to assess the prevalence, severity and risk factors of voice problems in this population. The Voice Handicap Index-10 (VHI-10) was employed to evaluate the prevalence and severity of voice disorders in teachers from various schools in Madinah. A demographic questionnaire was employed to collect data on established risk factors. This study of 217 school teachers in Madinah, 19.4% reported experiencing current voice issues. The median score on the VHI-10 was 3 (with an interquartile range of 9), demonstrating significantly higher scores in teachers who were exposed to classroom noise (P = 0.008), who spoke in environments with background noise (P = 0.001) and who reported daily work-related stress (P = 0.021). Clinical factors, including vocal cord paresis (P < 0.001) and corticosteroid use (P = 0.008), were associated with elevated voice handicap scores. Although these symptoms were prevalent, the tendency to seek assistance was minimal. Only 24.0% consulted a specialist, and only 4.8% received therapy. Voice issues were prevalent in school teachers and were closely associated with classroom noise, vocal strain and a range of clinical complications. Despite the high incidence of these symptoms, the rates of seeking help and participating in therapy were notably low.
61. Population Annoyance by Below-Limit Industrial Noise from the Mining Industry: A Questionnaire Survey Methodology.
期刊: Noise & health 发表日期: 链接: PubMed
摘要
The operation of open-pit mines relies on powerful equipment that produces noise emissions reaching up to 120 dB. Populations living in the vicinity of mines often complain about noise even when the noise levels are below the permissible limits. This study aims to assess noise perception and related environmental risks among residents living near the Turow open-pit lignite mine, located at the tri-border of the Czech Republic, Poland, and Germany. A modified ISO/TS 15666:2003 questionnaire was used to collect data from residents in exposed areas (n = 59 of 230 adult residents) and in a control area (n = 54 of 360 adult residents) during 2022 to 2023. All adult residents were contacted. The χ2 test and a binary logistic regression model at the 5% significance level were used for the analysis. Industrial noise, described as “humming” and “rumbling,” was identified as the primary concern in exposed areas (P = 0.030), with residents reporting high levels of annoyance and a perceived worsening of the noise situation over the past 5 years. Another significant problem was dust pollution (P = 0.024). The overall perceived quality of life in the exposed area was more than two times worse than that in the control area (odds ratio = 2.25, 95% confidence interval: 1.01-4.99). Despite the small number of exposed residents and the low response rate in this study, its findings suggest that even legally acceptable noise levels can significantly affect the perceived quality of life of residents.