Tag: pubmed

Salud Publica Mex. 2025 May 30;67(3 (may-jun)):282-286. doi: 10.21149/16555.

ABSTRACT

OBJETIVO: Estimar la seroprotección contra tétanos en la población mexicana para 2022 y como un marcador indirecto de cobertura de la vacuna hexavalente en niños de 1 a 3 años. Material y métodos. Se utilizó una muestra de sangre capilar en papel filtro de 8 487 individuos de la Encuesta Nacional de Salud y Nutrición (Ensanut) Continua 2022. Se estimó el nivel de seroprotección contra tétanos mediante ELISA.

RESULTADOS: A nivel nacional, 88.6% de las personas presentó al menos seroprotección mínima, pero sólo 73.3% tuvo seroprotección suficiente. Los adolescentes (55.5%), adultos de 60+ años (60.9%) y niños de 1-3 años (68.6%) presentaron la menor seroprotección suficiente. Conclusión. La seroprotección fue ligeramente menor al 90% que recomienda la Organización Mundial de la Salud (OMS). Es importante reforzar la vacunación con hexavalente en niños de 1-3 años sin seroprotección, además, aplicar refuerzos a adolescentes y adultos mayores.

PMID:41150925 | DOI:10.21149/16555

Plant Dis. 2025 Oct 28. doi: 10.1094/PDIS-07-25-1563-RE. Online ahead of print.

ABSTRACT

Gnomoniopsis smithogilvyi is the causal agent of brown rot, one of the main diseases of chestnuts that is threatening the sustainability of the global market. Michigan is the leading producer of commercial chestnuts in the United States. After the first isolation of G. smithogilvyi in 2016, chestnut brown rot was identified in 80% of Michigan orchards. The pathogen infects the flowers in the field, with symptoms affecting nut quality at harvest time and during storage. For this reason, fungicide treatments are crucial to prevent infection in the flowers and later in the kernels. This study aims to compare the in vitro efficacy of fifteen different chemical and biologically based fungicides against G. smithogilvyi. The fungicide potential of each product was evaluated for mycelial radial growth and conidial germination by calculating the EC₅₀. FRAC (Fungicide Resistance Action Committee) group 3 fungicides showed the best fungicide activity for both mycelial growth and conidial germination. However, biologically-based fungicides containing Bacillus spp. had no significant differences from FRAC 3, 7, and 11 fungicides. Phosphonates had a statistically lower fungicide activity on conidial germination compared to FRAC 3, 7, 11 and BM02, but same activity against mycelial radial growth. Further investigations should be done to evaluate the potential efficacy of these products in the orchard, considering that there is not always a correlation between in vitro and in planta activity. Our findings will help chestnut growers select chemical and biologically-based fungicides to complement their field practices for chestnut brown rot control, encouraging the rotation between different active ingredients.

PMID:41150912 | DOI:10.1094/PDIS-07-25-1563-RE

Plant Dis. 2025 Oct 28. doi: 10.1094/PDIS-07-25-1379-RE. Online ahead of print.

ABSTRACT

Citrus greening disease, also known as huanglongbing (HLB), is the most serious vector-borne bacterial disease of citrus worldwide and an emblematic case of perennial crop decline due to insect vector-borne disease. There is an immediate global need to provide the citrus industry with relief from HLB and a return to profitable citrus production. Discovery of HLB treatments typically involve various laboratory-based assays, which then advance to greenhouse and eventually field testing in a workflow that takes multiple years. We present a field-forward experimental framework, “Grove-First”, that reverses the traditional laboratory-to-field pipeline by prioritizing outcome-based screening. Grove-First rapidly screens and validates treatments with regulatory-friendly profiles in commercial citrus groves using trunk injection to select treatments that improve tree health and fruit yield over the course of a single growing season. The Grove-First framework represents a generalizable systems approach for translational agricultural research, applicable to perennial crops where disease impact, long development timelines, and real-world variability demand in-field, outcome-based screening. Using this framework, we identified candidate treatments with effects comparable to or better than the standard oxytetracycline (OTC) on visual tree-health and/or yield indices in an initial screen of HLB-positive 8-year-old Valencia sweet orange trees. Expanded trials in commercial citrus groves allowed us to validate the initial screening results at other locations and in other citrus varieties. Grove-First rapidly accelerated the identification and large-scale field testing of HLB therapies, some of which are available for growers to use immediately and others that require further field testing and/or regulatory actions.

PMID:41150910 | DOI:10.1094/PDIS-07-25-1379-RE

JMIR Mhealth Uhealth. 2025 Oct 28;13:e65149. doi: 10.2196/65149.

ABSTRACT

BACKGROUND: Accessible mental health support is essential for military members (MMs), veterans, and public safety personnel (PSP) who are at an increased risk of mental health challenges. Unique barriers to care, however, often leave these populations going untreated. Mental health treatment delivered via apps or websites (ie, digital mental health interventions [DMHIs]) offers an accessible alternative to in-person therapy.

OBJECTIVE: We aimed to synthesize the current literature on apps and web-based programs focused on enhancing MMs’, PSPs’, and veterans’ resilience or well-being. A multidimensional well-being model, I-COPPE (interpersonal, community, occupational, physical, psychological, economic, and overall well-being), was used as a framework guiding the scoping review.

METHODS: A search of 6 databases was conducted using key terms related to (1) population, (2) resilience and well-being constructs, and (3) web- or mobile-based programs. At all levels of screening, at least 2 researchers (RRA, MAM, and CA) reviewed each paper independently. Data were extracted and recorded to include relevant study characteristics including program name and description, target population, number of participants, therapeutic approach, results, limitations, and I-COPPE dimension supported. A narrative synthesis was performed to summarize the eligible studies.

RESULTS: In total, 44 papers were included in the study and 39 unique resilience or well-being apps or web-based programs identified for MMs, PSP, or veterans. The programs largely focused on veteran populations (28/44, 64%). In total, 51% (20/39) of programs relied on cognitive behavioral approaches and most aimed to support posttraumatic stress disorder-related symptoms. In consideration of the I-COPPE model, a majority supported psychological well-being, followed by interpersonal and physical well-being. Most apps were believed to support more than 1 domain of well-being. The main methodologies used in the literature to evaluate digital mental health interventions include randomized controlled trials, secondary analyses, and pilot randomized controlled trials with evaluations of feasibility, acceptability, satisfaction, or qualitative feedback. Generalizability of findings was commonly limited by attrition rates and small sample sizes.

CONCLUSIONS: DMHIs for MMs, PSP, and veterans appear promising due to their accessibility and scalability. More research is needed, however, to determine whether DMHIs are an effective alternative to in-person mental health care. The current review contributes to the literature by compiling evidence of DMHIs and the domains of well-being supported by, and the therapeutic orientation of, these programs. Our review revealed that more research is needed to determine the effectiveness and efficacy of DMHIs offered to these populations.

PMID:41150871 | DOI:10.2196/65149

Int J Soc Determinants Health Health Serv. 2025 Oct 28:27551938251385864. doi: 10.1177/27551938251385864. Online ahead of print.

ABSTRACT

The U.N. Sustainable Development Goals highlighted the importance of good health and healthy well-being (SDG 3). Child health is very important for achieving SDG 3; maintaining proper child health is essential for a developing country like India. Against this backdrop, assessing child health across various states is crucial. Thus, the study developed the composite child health index (CHI) using a novel technique for order preference by similarity to ideal solution (TOPSIS)-based, factor analytic multi-criteria decision-making (MCDM) approach. The index was developed using secondary data compiled from the National Family Health Survey from 2015 to 2020 using 35 child health indicators. Hierarchical and K-means were applied to categorize the various states and union territories based on their CHI values. This analysis reveals significant differences in child health outcomes across Indian states, with two states achieving higher levels and 25 states facing lower levels of child health. Among the states, Nagaland tops the list (CHI = 0.57441), indicating better child health conditions, followed by Odisha (CHI = 0.54384). The states with the lowest scores, Andhra Pradesh (CHI = 0.08406) and Manipur (CHI = 0.1065), have more significant challenges in child health. Thus, there is a need for targeted interventions in the most affected areas.

PMID:41148205 | DOI:10.1177/27551938251385864

Age Ageing. 2025 Aug 29;54(10):afaf316. doi: 10.1093/ageing/afaf316.

ABSTRACT

BACKGROUND: Among various tools developed for mild cognitive impairment (MCI) detection, analysing speech features is a non-invasive and cost-effective approach that shows promise for early detection. This review aimed to systematically synthesise and analyse current evidence on the diagnostic utility of speech-based biomarkers for identifying MCI.

METHODS: A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Scopus, Ovid Medline and PsycINFO databases were searched up to April 2025 without restrictions on language, article status or year.

RESULTS: Of 4432 identified records, 54 peer-reviewed articles met the inclusion criteria. Fixed-effects meta-analyses showed pooled estimates of 80.0% ‘accuracy’ [95% confidence intervals (CI): 70.0%-89.0%, P < .001, n = 21], 78.0% ‘area under the curve’ (95% CI: 70.0%-86.0%, P < .001, n = 21), 80.0% ‘sensitivity’ (95% CI: 71.0%-90.0%, P < .001, n = 22), and 77.0% ‘specificity’ (95% CI: 65.0%-89.0%, P < .001, n = 15) in differentiating MCI from cognitively unimpaired (CU) individuals. Egger’s regression tests indicated no publication bias (P ≥ .299), and the I2 statistic revealed no heterogeneity across studies (I2 = 0.00%, P = 1.00). Four studies also included a subjective cognitive decline group, reporting significant differences in certain speech features compared to CU.

CONCLUSIONS: Speech analysis demonstrates moderate classification performance, with balanced sensitivity and specificity, in distinguishing MCI from CU, suggesting its potential as an accurate and cost-effective diagnostic tool for MCI detection. Further research is needed to address variations in study methodologies, refine speech analysis protocols and validate findings in diverse populations to enhance generalisability.

PMID:41148189 | DOI:10.1093/ageing/afaf316

JAMA Netw Open. 2025 Oct 1;8(10):e2539767. doi: 10.1001/jamanetworkopen.2025.39767.

ABSTRACT

IMPORTANCE: Perioperative cardiac arrest and cardiopulmonary resuscitation (CPR) are associated with significant morbidity and mortality. Despite a growing focus on goal-concordant surgical care and longstanding emphasis on preoperative code status discussions, clinicians lack tools to individualize risk estimates and inform shared decision-making (SDM) regarding perioperative CPR.

OBJECTIVE: To generate and internally validate predictive models for 30-day mortality and nonhome discharge using routinely available preoperative data.

DESIGN, SETTING, AND PARTICIPANTS: A prospective, multicenter, prognostic study of patients within the American College of Surgeons (ACS)-National Surgical Quality Improvement Program (NSQIP), including nearly 700 participating hospitals in the US, from January 1, 2012, through December 31, 2023. Follow-up duration was 30 days. Seven machine learning models were developed using 10-fold cross validation. Participants were patients aged 18 years or older undergoing noncardiac surgery who underwent CPR on the day of surgery.

EXPOSURES: Thirty-three preoperative sociodemographic, clinical, laboratory, and procedural variables were evaluated for their association with 30-day mortality and nonhome discharge.

MAIN OUTCOMES AND MEASURES: The primary outcome was 30-day mortality following CPR. The secondary outcome was nonhome discharge among survivors admitted from home. Performance was evaluated using area under the receiver operating characteristic curve (AUROC), accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and calibration (Brier score and calibration curves). Clinical utility was evaluated using Shapley additive values (SHAP) decision curve analysis (DCA).

RESULTS: Among 6405 patients (median [IQR] age 69 [60-78], 3572 [55.8%] men, 860 [13.4%] Black, 4343 [67.8%] White, and 261 [4.1%] another racial category, including American Indian or Alaska Native, Asian, and Native Hawaiian or Other Pacific Islander), 3710 (57.9%) died within 30 days. The extreme gradient boosting model (CPR Outcome Prediction for Arrest in Surgical Settings [COMPASS]) achieved the best performance (AUROC for mortality = 0.80; 95 % CI, 0.78-0.82; accuracy = 0.73; 95% CI, 0.71-0.75; sensitivity = 0.77; 95% CI, 0.74-0.79; specificity = 0.68; 95% CI, 0.65-0.71; Brier score = 0.18). Among 2478 survivors admitted from home, 822 (33.2%) were discharged to a facility. For nonhome discharge, extreme gradient boosting demonstrated an AUROC of 0.78 (95 % CI, 0.74-0.82), accuracy of 0.76; and Brier score of 0.17. SHAP analysis identified American Society of Anesthesiologists status, case urgency, and frailty as key predictors. DCA indicated greater net benefit of extreme gradient boosting over default strategies (ie, treat all or treat none) across wide threshold ranges.

CONCLUSIONS AND RELEVANCE: In this prospective prognostic study of outcomes following perioperative CPR, extreme gradient boosting generated individualized predictions of outcomes following perioperative CPR that may inform prevention strategies and goal-concordant surgical care.

PMID:41148140 | DOI:10.1001/jamanetworkopen.2025.39767

JAMA Netw Open. 2025 Oct 1;8(10):e2539778. doi: 10.1001/jamanetworkopen.2025.39778.

ABSTRACT

IMPORTANCE: A paradigm shift is currently under way for the treatment of head and neck squamous cell carcinoma (HNSCC). Recent trials have demonstrated potential effectiveness of neoadjuvant systemic therapy (NST), including chemotherapy and immunotherapy; however, data on application of this approach are limited.

OBJECTIVE: To evaluate trends in the use of NST in patients with HNSCC from 2004 to 2022 and factors associated with treatment.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter, retrospective cohort study used the National Cancer Database to identify 312 748 patients diagnosed with HNSCC from January 1, 2004, to December 31, 2022, who received definitive surgery. NST was defined as therapy administered at least 8 weeks before definitive surgery.

EXPOSURES: Sociodemographic factors and clinical characteristics.

MAIN OUTCOMES AND MEASURES: Adjusted risk of receiving neoadjuvant immunotherapy and chemotherapy across the analyzed years.

RESULTS: Among 312 748 patients (mean [SD] age, 63.3 [12.2] years; 218 218 [69.8%] male) who underwent surgery between 2004 and 2022, 1989 (0.6%) received NST, and among these, 1372 (69.0%) received neoadjuvant chemotherapy, 726 (36.5%) received neoadjuvant immunotherapy, and 109 (5.5%) received both. The first year of recorded neoadjuvant immunotherapy was 2007, with a use rate of 0.02%. Use began to increase in 2013 with a rate of 0.14%, peaking at 0.73% in 2019 but decreasing to 0.27% in 2022. From 2007 to 2022, the adjusted risk of receiving neoadjuvant immunotherapy increased by 22.5% per year (risk ratio [RR], 1.22; 95% CI, 1.19-1.26), whereas the adjusted risk of receiving chemotherapy decreased by -2.5% per year (RR, 0.97; 95% CI, 0.96-0.99). Sites with the largest increases in neoadjuvant immunotherapy use since 2013 were the hypopharynx (from 0.25% to 1.30%), gums and other oral cavity (from 0.19% to 0.58%), and tongue (from 0.18% to 0.27%). Patients who received neoadjuvant immunotherapy were more likely to have private insurance (342 [47.1%] vs 125 542 [40.2%]; P < .001), more likely to have stage IV disease (394 [54.3%] vs 100 565 [32.2%]; P < .001), and less likely to identify as Black (33 [4.5%] vs 21 384 [6.9%]; P = .01).

CONCLUSIONS AND RELEVANCE: In this retrospective cohort study of HNSCC, rates of neoadjuvant immunotherapy nearly doubled between 2013 and 2022, whereas neoadjuvant chemotherapy use significantly decreased from 2007 to 2022. These trends highlight the evolving therapeutic landscape for HNSCC and provide context for emerging data on neoadjuvant therapy.

PMID:41148139 | DOI:10.1001/jamanetworkopen.2025.39778

JAMA Netw Open. 2025 Oct 1;8(10):e2539862. doi: 10.1001/jamanetworkopen.2025.39862.

ABSTRACT

IMPORTANCE: There is limited direct evidence of the effects of policies regarding ambient particulate matter with an aerodynamic diameter of 2.5 µm or less (PM2.5) on the risk of hospitalization for cardiovascular diseases (CVD). This evidence is essential for estimating the benefits of meeting specific PM2.5 standards in the regulatory impact analysis.

OBJECTIVE: To estimate the association of strengthening ambient PM2.5 standards with the risk of hospitalization for major CVD outcomes.

DESIGN, SETTING, AND PARTICIPANTS: This population-based study used data from the UK Biobank cohort and followed up the participants from January 1, 2015, to December 31, 2019. All participants were 60 years or older and had no history of hospitalization with a primary diagnosis of a specific CVD at baseline. Data were analyzed from August 1, 2022, to August 25, 2025.

EXPOSURES: Annual mean PM2.5 exposure was assigned based on a 1 × 1-km2 resolution PM2.5 model linked to participants’ residential locations.

MAIN OUTCOMES AND MEASURES: The main outcomes were the first hospitalization with a primary diagnosis of stroke, myocardial infarction, heart failure, or arrhythmia. Longitudinal targeted maximum likelihood estimation was used to estimate 5-year hospitalization risks under hypothetical PM2.5 interventions.

RESULTS: Among the 502 133 UK Biobank participants recruited from 2006 to 2010 (273 158 [54.4%] female), 307 202 participants met the eligibility criteria for stroke, 304 212 for myocardial infarction, 310 100 for heart failure, and 302 255 for arrhythmia. The median age was 68.0 (IQR, 64.6-71.5) years for stroke, myocardial infarction, and arrhythmia, 68.0 (IQR, 64.7-71.5) years for heart failure, with female participants ranging from 54.4% to 55.0% across cohorts. Compared with no intervention on PM2.5, implementing a stricter ambient PM2.5 standard would reduce the absolute risk of hospitalization for major CVD. It was estimated that for the hypothetical PM2.5 intervention of reducing PM2.5 exposure by 5% if it is above the threshold of 9 µg/m3, the estimated 5-year risk difference of hospitalization for stroke was -2.26 per mille (95% CI, -8.97 to -20.64 per mille); for myocardial infarction, -8.64 per mille (95% CI, -9.16 to -6.38 per mille); for heart failure, -3.20 per mille (95% CI, -4.16 to -1.25 per mille); and for arrythmia, -4.16 per mille (95% CI, -12.70 to 12.93 per mille). For the hypothetical PM2.5 intervention of reducing PM2.5 exposure by 5% if it is above the threshold of 12 µg/m3, the estimated 5-year risk difference of hospitalization for stroke was -1.54 per mille (95% CI, -2.21 to 0.73 per mille). However, the reduction in risk for arrhythmia was not statistically significant (-2.06 per mille [95% CI, -4.79 to 3.12 per mille]).

CONCLUSIONS AND RELEVANCE: In this cohort study using data from the UK Biobank, the absolute risk reduction of hospitalization for stroke, myocardial infarction, heart failure, and arrhythmia due to hypothetical ambient PM2.5 interventions was quantified. The findings suggest the beneficial cardiovascular health impacts of further strengthening the current PM2.5 regulations in the United Kingdom.

PMID:41148138 | DOI:10.1001/jamanetworkopen.2025.39862

JAMA Netw Open. 2025 Oct 1;8(10):e2539870. doi: 10.1001/jamanetworkopen.2025.39870.

ABSTRACT

IMPORTANCE: Incomplete electronic health record (EHR) documentation may limit the effectiveness of clinical decision support (CDS) algorithms designed to identify patients eligible for hereditary cancer genetic evaluation.

OBJECTIVES: To determine whether a CDS algorithm can identify patients who meet criteria for hereditary cancer genetic evaluation when family history data are incompletely documented in the EHR, and to examine whether data missingness is associated with identification patterns across patient subgroups.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study analyzed EHR data extracted in December 2020 from 2 large US health care systems: University of Utah Health (UHealth) and NYU Langone Health (NYULH). Eligible patients were adults aged 25 to 60 years who visited a primary care clinic within the previous 3 years and had some EHR documentation of cancer family history. Data analysis was conducted in August 2024.

EXPOSURES: Patient demographic factors (age, sex, race and ethnicity, and language preference) and cancer family history characteristics (number of cancer history records, number of affected first- and second-degree relatives, relatives with rising mortality cancers, presence of hereditary cancer-related terms in comments, and completeness of documentation).

MAIN OUTCOMES AND MEASURES: The primary outcome was meeting at least 1 CDS algorithm criterion for genetic evaluation of hereditary cancer risk based on National Comprehensive Cancer Network guidelines. Missing data patterns were assessed using the Little missing completely at random test, with analyses conducted using complete case analysis and multiple imputation.

RESULTS: This study included 157 207 patients: 55 918 from UHealth and 101 289 from NYULH. Their mean (SD) age was 43.5 (9.8) years, and most (65.7%) were female. A total of 5607 UHealth patients (10.0%) and 10 375 NYULH patients (10.2%) met CDS criteria for genetic evaluation. At UHealth, data appeared to be missing completely at random (χ239 = 39.09; P = .47), and complete case compared with multiple imputation analyses yielded similar results. At NYULH, data were not missing completely at random (χ255 = 914.89; P < .001). Compared with multiple imputation, complete case analysis produced different association magnitudes for older age and having relatives with rising mortality cancers, suggesting bias when excluding incomplete records.

CONCLUSIONS AND RELEVANCE: In this cross-sectional study, the magnitude of the association between incomplete family history documentation and identification of patients eligible for hereditary cancer genetic evaluation depended on whether data were missing randomly or systematically. These findings suggest that health care organizations implementing CDS algorithms should assess their specific missing data patterns and consider tailored approaches to handling incomplete family history information to ensure equitable identification of all patients who could benefit from genetic evaluation services.

PMID:41148137 | DOI:10.1001/jamanetworkopen.2025.39870