医学最新文献

This study examined whether COVID-19 Vaccine Hesitancy (VH) and COVID-19-related factors interact to influence COVID-19 booster doses uptake among university students in Canada, from a syndemic perspective. A cross-sectional survey was conducted among 4453 students at the University of Waterloo in 2024. VH was measured toward both COVID-19 primary and booster doses. Change in VH scores were computed to capture shifts in hesitancy over time. Logistic regression models assessed the main effects of VH and COVID-19-related factors on booster uptake. Interactions were tested using additive and multiplicative scales. Increased VH was associated with a 23% decrease in booster uptake. Younger ages, not being hospitalized due to COVID-19, not receiving the influenza vaccine, noncompliance with COVID-19 guidelines, and belief in conspiracy theories predicted lower booster uptake. Significant interactions were found between change in VH scores and COVID-19 diagnosis and hospitalization history, guideline adherence, and conspiracy beliefs. For students who did not receive booster doses, the change in VH was greater among those who reported following public health guidance than those who did not. Similarly, for students who did not receive booster doses, the change in VH was greater among those who reported not believing in conspiracy theories compared to those who did. The findings support a syndemic model, indicating that VH and COVID-19-related experiences jointly influence booster uptake. Targeted interventions such as rebuilding trust, addressing misinformation, and reducing stigma may improve booster uptake even if not all barriers are addressed. Further research is needed to examine these interactions.

Objective: To investigate the associations of the neutrophil/albumin ratio (NAR) with type 2 diabetes mellitus (T2DM) in women with a history of gestational diabetes mellitus (GDM).

Methods: We conducted a cross-sectional study involving 782 participants from the National Health and Nutrition Examination Survey. Logistic regression analyses were performed to explore the relationship between NAR and T2DM, adjusting for various confounding factors across different models. Interaction analyses examined the modifying effects of socio-demographic characteristics on the relationship between NAR and T2DM. Mediation analyses were utilized to investigate whether key laboratory indicators and insulin resistance indices mediated the association between NAR and T2DM.

Results: Higher NAR levels were positively associated with T2DM risk. (OR[95%CI]:1.649[1.181,2.309], p = 0.003). Mediation analyses revealed that the effect of NAR on T2DM was entirely mediated through the regulation of red cell distribution width (RDW Coefficient[95%CI]: 0.009[0.001,0.024], p = 0.020) and high-density lipoprotein cholesterol (HDL-C Coefficient[95%CI]: 0.038[0.017,0.067], p < 0.001). Besides, significant interactions and differences were observed in the relationship between NAR and T2DM risk based on body mass index (BMI) (NAR*BMI: interaction coefficient: -0.651, interaction p = 0.027). In individuals with 25 kg/m² ≤ BMI < 30 kg/m², NAR increased the risk of T2DM by regulating the insulin resistance index (HOMA-R) (β[95%CI]: 2.220[0.653,3.787], p = 0.007).

Conclusion: This study revealed that among women with GDM history, NAR may influence the risk of T2DM through the modulation of RDW and HDL-C. Furthermore, NAR and BMI had a significant interaction affecting T2DM risk, particularly prominent in women with 25 kg/m² ≤ BMI < 30 kg/m². Within this subgroup, NAR elevated the risk of T2DM via HOMA-R.

Objective: Benign prostatic hyperplasia (BPH) is a common urinary disease in elderly men, with acute urinary retention (AUR) severely impacting quality of life. Urodynamic abnormalities and prostate-specific antigen (PSA) levels reflect urinary obstruction and prostate enlargement/inflammation. This study was to correlate the two factors with AUR in BPH patients.

Methods: A total of 120 BPH patients were divided into AUR group and non-AUR group, with 60 cases in each group. Clinical, laboratory, and urodynamic data were collected. Independent variables with significant differences in univariate analysis were included in multifactorial logistic regression analysis. The diagnostic value of urodynamic parameters and PSA for AUR in BPH patients was assessed. A spline regression model was established to analyze the relationship between AUR and PSA.

Results: Elevated levels of urodynamic parameters volume at first desire to void (FDV), bladder compliance (BC), total PSA (tPSA), and free PSA (fPSA) were independent risk factors for AUR in BPH patients. FDV and tPSA showed high predictive efficacy, while BC and fPSA relatively weaker. tPSA was positively correlated with both FDV and BC. fPSA was positively correlated only with FDV.

Conclusion: FDV and BC with tPSA and fPSA are significantly elevated in BPH patients with AUR and show a strong association.

The immunomodulatory potential of radiotherapy provides a strong rationale for its combination with immunotherapies and other immunostimulatory agents. However, current combinations yield suboptimal clinical benefits. As the mechanisms behind radiotherapy-induced immunomodulation are gradually unraveled, various key factors have been identified as critical modulators of this process, opening new possibilities for adapting radiotherapy to immunotherapy. Here, we discuss seven factors: dose‒fractionation regimens of radiotherapy (RT), sequence and timing of RT and immunotherapy, radiation field, type of ionizing radiation, normal tissue effects, choice of the lesion to irradiate and identification of biomarkers. Preclinical and clinical studies on the combination of immunotherapy and radiotherapy are discussed, novel immunotherapeutic approaches are highlighted and improvements in study design are suggested.

Rising global temperatures and heatwaves pose major health risks, particularly for pregnant women, infants and other vulnerable groups. Using Photovoice, we aimed to foreground how pregnant and postpartum women in an urban township in Tshwane, South Africa, experience and cope with heat stress. Fourteen women participated in two structured workshops held during the hot season (December 2023-January 2024). The first included reflective discussions on coping with heat and basic photography training. Over two weeks, participants captured over 300 images using disposable cameras or mobile phones. Selected images were reviewed and discussed in the second workshop. Thematic analysis of photographs and workshop transcripts identified three key themes: health impacts, coping strategies and structural challenges. Women preferred staying home on very hot days, where they had greater control over their environment. However, they struggled to soothe overheated infants, which they found distressing. They used simple cooling methods such as bathing or wet cloths but faced constraints including heat-trapping housing materials, inadequate ventilation, and limited access to water and electricity. These challenges led to a state of "un-coping"-where adaptation efforts are insufficient or counterproductive. Viewed through the women's "lens", these findings highlight the need for targeted adaptation strategies to improve climate resilience.

Background: Endometriosis (EMs) is a common gynecological disorder associated with infertility. EMs patients often require assisted reproductive technology (ART) but exhibit lower success rates. This study aimed to characterize the follicular fluid microbiome in EMs patients undergoing in vitro fertilization (IVF) and provide insights into mechanisms underlying lower pregnancy rates.

Methods: Follicular fluid samples were collected from EMs patients and control subjectsundergoing IVF. Microbial DNA was subjected to 16S rRNA gene sequencing. Bioinformatic analyses, including alpha and beta diversity analysis, microbial composition profiling and biomarker identification, were performed.

Results: The follicular fluid microbiome in EMs patients exhibited altered alpha and beta diversity compared to controls. Distinct microbial compositions were observed at various taxonomic levels. Differentially abundant taxa were identified as potential biomarkers for EMs. Microbial profiles were associated with clinical parameters such as oocyte quality and fertilization rates. Models based on microbial profiles were constructed to elucidate the relationship between EMs and IVF outcomes. Functional predictions suggested alterations in metabolic pathways in the follicular fluid microbiome of EMs patients.

Conclusions: This study revealed significant alterations in the follicular fluid microbiome of EMs patients, providing a basis for further research into the role of the microbiome in EMs-related infertility.

Artocarpus altilis methanolic extract (AAM) exhibits potent protective effects against particulate matter (PM)-induced skin damage; however, its poor aqueous solubility and limited skin permeability restrict its topical bioavailability. To overcome these limitations, we developed a polymer-based drug delivery system by fabricating electrospun nanofibers composed of polyvinylpyrrolidone (PVP), hydroxypropyl-β-cyclodextrin (HPBCD), and AAM. The optimized formulation engineering strategy enhanced AAM solubility via increased surface area, reduced crystallinity, and hydrogen bonding interactions with HPBCD/PVP. The nanofiber matrix also provided an occlusive effect, improving skin hydration and facilitating transdermal diffusion through the stratum corneum. In vitro studies demonstrated improved cellular uptake, greater permeability, and enhanced antioxidant activity, leading to superior anti-pollution efficacy compared to raw AAM in a PM-induced HaCaT keratinocyte model. These results highlight AAM-loaded electrospun nanofibers (ANFs) as a biodegradable, and environmentally sustainable platform for delivering plant-derived bioactive ingredient, offering high potential for advanced topical formulations targeting pollution-induced skin aging.

The incidence of prostate cancer continues to increase, making it the second most common malignant tumor among men worldwide. Immunotherapy has emerged as a key therapeutic strategy for treating tumors. Numerous studies have established that the efficacy of tumor immunotherapy is closely associated with the tumor microenvironment and T cell subsets. However, the specific functions of certain T cell subsets in prostate cancer remain incompletely characterized. Therefore, this study aimed to systematically investigate the distribution patterns of T cell subsets within the tumor microenvironment of prostate cancer patients and their correlations with clinicopathological parameters. Therefore, we investigated the impact of T cells on the tumor microenvironment of prostate cancer at the single-cell level. We employed a variety of analytical methods to reveal the functions of T cells, including cell interaction analysis, time-series analysis, enrichment analysis, immune infiltration analysis, and other analytical approaches. By integrating bulk RNA-seq data, we constructed and validated a prognostic risk model based on T cell marker genes. Finally, we utilized the ssGSEA and ESTIMATE algorithms to explore the relationship between the prognostic risk model and immunotherapy. After quality control, 16,999 cells from the single-cell data were retained for downstream analysis. Our study focused on T cells, revealing the communication between various cell types and T cells. Pseudotime analysis showed that different T cell marker genes exhibited differential expression at various time points, corresponding to distinct biological processes. Enrichment analysis indicated that T cell marker genes were enriched in several immune-related pathways. From our analysis, BCAS2, EIF2S2, RIOK3, and ATP6V1E1 were ultimately identified as prognostic markers. Immune infiltration analysis revealed that high-risk patients had lower immune scores, stromal scores, and ESTIMATE scores and greater tumor purity compared to low-risk patients. We analyzed the mechanisms involving T cells in prostate cancer from multiple perspectives, constructed a prognostic model, and conducted immune infiltration analysis. Our findings contribute to the understanding of prostate cancer and its prognosis, providing valuable insights for future research and prognostic assessments in prostate cancer.

Objectives: Migrant Domestic Workers (MDWs) face adverse living and working conditions that place them at a heightened risk of poor mental health outcomes. While prior research has examined MDWs' coping strategies and resilience, little is known about how they understand and engage in self-compassion, an intrapersonal process strongly linked to mental well-being. This study aimed to examine how MDWs conceptualize self-compassion and the sociocultural factors that influence their capacity to practice it.

Methods: Semi-structured interviews were conducted with ten female Filipino and Indonesian MDWs living in Singapore recruited through purposive and snowball sampling. Data were analyzed using reflexive thematic analysis.

Results: Three interrelated themes were generated: (1) grounding self-compassion in self-worth and identity, (2) contextual conditions shaping self-compassion, and (3) enacting self-compassion in everyday life. These themes illustrate the complex interplay between participants' internalized self-perceptions, cultural narratives, and structural conditions that shape their engagement with self-compassion.

Conclusions: The findings contribute to a more nuanced understanding of self-compassion in marginalized caregiving populations. They advocate for the need to address structural determinants of MDWs' well-being and to develop culturally sensitive psychoeducation and interventions.