Tag: pubmed

Chem Biodivers. 2025 Jun 13:e00956. doi: 10.1002/cbdv.202500956. Online ahead of print.

ABSTRACT

One previously undescribed rosane diterpenoid (1) and 13 known ones (2-14) were isolated from the whole plant of Jatropha curcas L. The relative configuration 1 was determined by NMR calculation combined with DP4+ probability analysis, and its absolute configuration (AC) was further determined by ECD calculation. The final structure was further confirmed by single crystal x-ray diffraction. The biological testing revealed that compounds 5 and 14 possessed inhibitory effects on NLRP3 inflammasome with IC₅₀ values of 8.1 ± 0.3 and 9.7 ± 0.4 µM. Further investigation exhibited that compound 5 has an obvious effect on inhibiting pyroptosis.

PMID:40512504 | DOI:10.1002/cbdv.202500956

Environ Health Perspect. 2025 Jun 13. doi: 10.1289/EHP16515. Online ahead of print.

ABSTRACT

BACKGROUND: Growing evidence links air pollution to cognitive dysfunction in older adults. The gut microbiome and circulating metabolites present an important yet unexplored pathway, given their crucial role in the gut-brain axis.

OBJECTIVES: We aimed to explore the potential roles of gut bacteria, fungi, microbial functional potentials, and circuiting metabolites in the association of residential PM_2.5 and O₃ exposures with cognitive dysfunction.

METHODS: We analyzed gut microbiome data from 1,027 older adults using metagenome and internal transcribed spacer sequencing to profile bacterial and fungal taxa, functional pathways, and enzyme abundances. Targeted metabolomics quantified 195 circulating metabolites, such as amino acids and organic acids. Annual average ambient PM_2.5 and O₃ exposures were estimated using satellite-based models. Cognitive outcomes, including mild cognitive impairment and cognitive decline, were assessed using the Mini-mental State Examination and Hasegawa dementia scale. Statistical analyses included Microbiome Multivariable Association with Linear Models (with a false discovery rate threshold of 0.25) for microbial associations and multivariate regression for metabolites and cognitive outcomes.

RESULTS: Higher PM_2.5 and O₃ exposures were associated with disturbances in microbial composition, altered taxonomic profiles (e.g., decreased abundances of Blautia obeum and Gordonibacter pamelaeae), and disrupted functional pathways, particularly those regulating 2-oxoglutarate. These findings were partially replicated in an independent population. Higher air pollution levels were associated with increased circulating levels of 2-oxoglutarate and L-glutamine (key metabolites in neurodegenerative progression), which were further linked to higher odds of concurrent mild cognitive impairment (OR: 1.39-1.56) and an increased 2-year risk of cognitive decline (OR: 1.26-1.37). These associations were partially mediated by air pollution-related changes in microbial anaerobic energy metabolism pathways, especially involving 2-oxoglutarate metabolism and the enzyme aspartate transaminase.

CONCLUSIONS: Our findings highlight the role of the gut microbiome and microbial metabolites in mediating the detrimental impact of air pollution on cognitive health in older adults, providing new insights into the underlying etiology for future hypothesis generation. https://doi.org/10.1289/EHP16515.

PMID:40512497 | DOI:10.1289/EHP16515

JAMA Netw Open. 2025 Jun 2;8(6):e2515526. doi: 10.1001/jamanetworkopen.2025.15526.

ABSTRACT

IMPORTANCE: The efficacy and safety of endovascular thrombectomy (EVT) plus best medical treatment (BMT) for vertebrobasilar artery occlusion beyond 24 hours remain uncertain.

OBJECTIVE: To evaluate outcomes associated with EVT in patients treated beyond 24 hours after last known well time due to vertebrobasilar artery occlusion.

DESIGN, SETTING, AND PARTICIPANTS: This multicenter, prospective cohort study enrolled patients between 2019 and 2024 from 11 comprehensive stroke centers across China. Eligible patients with vertebrobasilar artery occlusions treated beyond 24 hours after the estimated onset were included.

EXPOSURES: Patients were categorized into 2 groups: those who underwent EVT plus BMT and those who received BMT alone.

MAIN OUTCOMES AND MEASURES: The primary outcome was good functional status (modified Rankin Scale score, 0-3) at 90 days. Safety outcomes included symptomatic intracranial hemorrhage within 24 hours and 90-day mortality.

RESULTS: Among 202 patients with vertebrobasilar occlusion (158 male [78.2%]; median [IQR] age, 64.0 [56.2-70.0] years), 101 patients received EVT plus BMT and 101 patients received only BMT. The median (IQR) posterior circulation Acute Stroke Prognosis Early Computed Tomography Score was 8 (8-9), and the median (IQR) of time of onset to admission was 48 (24-96) hours. In the primary analysis using propensity score matching, 71 patients with EVT plus BMT had a higher rate of a good functional outcome at 90 days compared with 71 patients receiving BMT alone (41 patients [57.7%] vs 32 patients [45.1%]; adjusted risk ratio [aRR], 1.35 [95% CI, 1.02-1.79]). EVT plus BMT compared with BMT alone showed lower mortality (9 patients [12.7%] vs 20 patients [28.2%]; aRR, 0.27 [95% CI, 0.08-0.81]); differences in rates of symptomatic intracranial hemorrhage were not statistically significant (4 patients [5.6%] vs 0 patients; P = .13). A similar advantage in functional outcome for EVT plus BMT (aRR, 1.33 [95% CI, 1.04-1.71]) was observed in the inverse probability of treatment weighting analysis.

CONCLUSIONS AND RELEVANCE: In this study, EVT plus BMT was associated with improved functional outcomes and survival rates at 90 days and a nonsignificant but numerically higher frequency of symptomatic intracranial hemorrhage than BMT alone in patients treated beyond 24 hours after last known well time. These findings suggest that randomized clinical trials comparing EVT with BMT in patients with acute vertebrobasilar artery occlusion are warranted.

PMID:40512496 | DOI:10.1001/jamanetworkopen.2025.15526

JAMA Netw Open. 2025 Jun 2;8(6):e2515534. doi: 10.1001/jamanetworkopen.2025.15534.

ABSTRACT

IMPORTANCE: With shifting epidemiology and changes in the vaccine funding landscape, resource use considerations for COVID-19 vaccination programs are increasingly important.

OBJECTIVE: To assess the cost effectiveness of COVID-19 vaccination programs, where eligibility is defined by combinations of age and chronic medical conditions, including a strategy similar to current Canadian recommendations.

DESIGN, SETTING, AND PARTICIPANTS: Static, individual-based, probabilistic cost-utility model economic evaluation parameterized with recent data describing COVID-19 epidemiology, vaccine characteristics, and costs. The analysis used a 15-month time horizon from July 2024 to September 2025 and a modeled cohort of 1 million people with characteristics based on the Canadian population, stratified by age group and presence or absence of at least 1 chronic medical condition.

EXPOSURE: Annual or biannual COVID-19 vaccination strategies offered to different age and medical risk groups, with annual vaccination occurring in October and November in the primary analysis.

MAIN OUTCOMES AND MEASURES: Medically attended SARS-CoV-2 infections treated in outpatient and inpatient settings, including post-COVID condition cases and deaths. Costs in 2023 Canadian dollars, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs), discounted at 1.5% for the health system and societal perspectives.

RESULTS: Among 1 million simulated individuals, annual vaccination for adults aged 65 years and older consistently emerged as a cost-effective intervention, with ICERs less than CAD $50 000 per QALY compared with no vaccination for a range of model assumptions. Adding a second dose for adults aged 65 years and older or expanding programs to include vaccination for younger age groups, including those at higher risk of COVID-19 due to chronic medical conditions, generally resulted in ICERs greater than $50 000 per QALY. Shifting timing of vaccination programs to better align with periods of high COVID-19 case occurrence resulted in biannual vaccination for those aged 65 years and older being cost effective.

CONCLUSIONS AND RELEVANCE: In this economic evaluation of COVID-19 vaccination strategies, programs were observed to be cost effective when focused on groups at higher risk of disease. Optimal timing of programs improved the cost effectiveness of vaccination strategies. As COVID-19 transitioned to an endemic disease with high levels of population immunity, many jurisdictions revisited COVID-19 vaccination recommendations; these results identified COVID-19 vaccination programs that may provide good value for money.

PMID:40512495 | DOI:10.1001/jamanetworkopen.2025.15534

JAMA Netw Open. 2025 Jun 2;8(6):e2515592. doi: 10.1001/jamanetworkopen.2025.15592.

ABSTRACT

IMPORTANCE: Chronic low back pain (LBP) is a prevalent and costly condition, and regular physical activity may reduce its risk. Walking is a common and accessible form of physical activity, but its association with the risk of chronic LBP is unclear.

OBJECTIVE: To examine whether accelerometer-derived daily walking volume and walking intensity are associated with the risk of chronic LBP.

DESIGN, SETTING, AND PARTICIPANTS: This prospective population-based cohort study used data from the Trøndelag Health (HUNT) Study in Norway, with a baseline in 2017 to 2019 and follow-up in 2021 to 2023. The study included individuals without chronic LBP at baseline and with at least 1 valid day of device-measured walking.

EXPOSURE: Daily walking volume (minutes per day) and walking intensity, expressed as metabolic equivalent of task (MET) per minute.

MAIN OUTCOMES AND MEASURES: The primary outcome was self-reported chronic LBP at follow-up, defined as pain lasting 3 months or longer in the past 12 months. Poisson regression was used to estimate adjusted risk ratios (RRs) with 95% CIs of chronic LBP according to daily walking volume and mean walking intensity.

RESULTS: A total of 11 194 participants aged 20 years or older (mean [SD] age, 55.3 [15.1] years; 6564 women [58.6%]) were included in the analysis. At follow-up (mean [SD] follow-up time, 4.2 [0.3] years), 1659 participants (14.8%) reported chronic LBP. Continuous measures of both walking volume and walking intensity were inversely associated with the risk of chronic LBP using restricted cubic splines models. Compared with participants walking less than 78 minutes per day, those walking 78 to 100 minutes per day had an RR for chronic LBP of 0.87 (95% CI, 0.77-0.98), those walking 101 to 124 minutes per day had an RR of 0.77 (95% CI, 0.68-0.87), and those walking 125 minutes or more per day had an RR of 0.76 (95% CI, 0.67-0.87). Compared with a mean walking intensity of less than 3.00 MET per minute, participants with walking intensity of 3.00 to 3.11 MET per minute had an RR for chronic LBP of 0.85 (95% CI, 0.75-0.96), those with walking intensity of 3.12 to 3.26 MET per minute had an RR of 0.82 (95% CI, 0.72-0.93), and those with walking intensity greater than or equal to 3.27 MET per minute had an RR of 0.82 (95% CI, 0.72-0.93). After mutual adjustment, the association remained largely similar for walking volume but was attenuated for walking intensity.

CONCLUSIONS AND RELEVANCE: In this cohort study, daily walking volume and walking intensity were inversely associated with the risk of chronic LBP. The findings suggest that walking volume may have a more pronounced benefit than walking intensity.

PMID:40512494 | DOI:10.1001/jamanetworkopen.2025.15592

JAMA Netw Open. 2025 Jun 2;8(6):e2515894. doi: 10.1001/jamanetworkopen.2025.15894.

ABSTRACT

IMPORTANCE: Many conditions, including neurodegenerative diseases and psychiatric disorders, can impair financial decision-making in older age. Although banking data offer rich insights, they have not yet been leveraged to understand how the loss of financial capacity is associated with financial behaviors.

OBJECTIVE: To describe the behavioral indicators of financial capacity loss and the association of financial capacity loss with financial vulnerability.

DESIGN, SETTING, AND PARTICIPANTS: In this case-control study, banking data recorded by a major UK bank between January 1, 2009, and April 21, 2023, were used to compare the financial outcomes of a group of 16 742 donors of power of attorney (PoA) registrations with a “loss of financial capacity” marker and a control group of 50 226 individuals with no reported financial capacity loss that matched the demographic and socioeconomic characteristics of the donor group 10 years prior to their PoA registration. Group differences in financial outcomes were examined in the 10-year period leading up to the PoA registration. Analysis took place between December 2023 and December 2024.

EXPOSURES: Bank registrations of PoAs recorded between 2019 and 2023 for which the attorney reported that the donor lost financial capacity.

MAIN OUTCOME MEASURES: A broad range of 344 financial measures capturing day-to-day transactional activity (eg, spending on travel and hobbies) and other financial behaviors (eg, online banking logins).

RESULTS: The group of donors of PoA registrations with a “loss of financial capacity” marker comprised 16 742 individuals (mean [SD] age, 72.8 [8.5] years; 10 285 women [61.4%]), and the control group comprised 50 226 individuals (mean [SD] age, 72.7 [8.2] years; 30 657 women [61.0%]). During the 5 years prior to PoA registration, compared with the control group, donors were increasingly less likely to spend on everyday activities (clothing [difference, -9.1 percentage points (pp); 95% CI, -10.0 to -8.3 pp], travel [eg, hotels; difference, -9.6 pp; 95% CI, -10.5 to -8.8 pp], hobbies [eg, gardening; difference, -7.9 pp; 95% CI, -8.8 to -7.1 pp]) and more likely to spend on items associated with increased time at home (eg, household gas and electricity bills [difference, 5.1 pp; 95% CI, 4.6-5.7 pp]). Signs of heightened financial vulnerability in the donor group compared with the control group included an increase in the frequencies of PIN (personal identification number) reset requests (difference, 0.002 [95% CI, 0.002-0.003]), fraud cases (eg, animal charity difference, 0.0003 [95% CI, 0.0002-0.0003]), and lost or stolen credit or debit cards reported (difference, 0.005 [95% CI, 0.004-0.006]) and increased spending on charity (difference, 1.1 pp [95% CI, 0.5-1.7 pp]). In addition, the donor group exhibited reduced attention to finances compared with the control group via decreased online banking activity (difference in number of monthly online banking logins, -1.0 [95% CI, -1.1 to -0.8]).

CONCLUSIONS AND RELEVANCE: This study highlighted the financial behaviors and vulnerabilities associated with declining financial capacity, such as a decrease in activity across multiple domains of daily life. These findings illustrate how banking data can reveal early behavioral signs and financial harms associated with financial capacity loss.

PMID:40512491 | DOI:10.1001/jamanetworkopen.2025.15894

Public Health Nurs. 2025 Jun 13. doi: 10.1111/phn.13580. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this study is to examine the relationship between nursing students’ worry about climate change and their environmental sensitivity.

DESIGN AND METHOD: This research is a descriptive and correlational study. It was conducted with 432 nursing students. The data were collected using a Personal Information Form, the Climate Change Worry Scale, and the Environmental Sensitivity Scale. Descriptive statistics (frequency, percentage, mean, standard deviation), independent groups t-test, Mann-Whitney U test, one-way ANOVA, and multiple regression analysis were used to analyze the data.

RESULTS: The mean score of nursing students on Climate Change Worry Scale was 30.74 ± 6.92, and the mean score on the Environmental Sensitivity Scale was 4.24 ± 0.44. A statistically significant moderate negative correlation was found between nursing students’ worry about climate change and their level of environmental sensitivity (r = -0.694, p < 0.01).

CONCLUSIONS: The study revealed a moderate negative correlation between climate change worry and environmental sensitivity among nursing students. Reducing worry about climate change and enhancing environmental sensitivity may enable the students to take an active role in protecting public health in their professional careers.

PMID:40512470 | DOI:10.1111/phn.13580

Clin Exp Med. 2025 Jun 13;25(1):201. doi: 10.1007/s10238-025-01746-4.

ABSTRACT

The neutrophil-to-lymphocyte ratio (NLR) has been suggested as a potential biomarker for the prediction and risk stratification of acute kidney injury (AKI), but conflicting results were reported by literature. We therefore conducted a pooled analysis to consolidate available evidence regarding the predictive and prognostic value of NLR in AKI patients. A systematic search was performed in the PubMed/Medline, Embase, and Cochrane Central Register of Controlled Trials (Central) databases from inception to March 2025 for cohort studies investigating the association between NLR and AKI. Quality assessment was performed via the Quality Assessment for Studies of Diagnostic Accuracy (QUADAS-2) tool. The predictive and prognostic value of the NLR for AKI was evaluated via pooled estimates of odds ratio (OR), sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NeLR), diagnostic score (DS), diagnostic odds ratio (DOR), summary receiver operating characteristic (SROC) curves, and the Fagan nomogram. Twenty-nine studies with 102,870 patients were pooled in this meta-analysis. Higher NLR was associated an increased risk of AKI (OR 1.52, 95% CI 1.29-1.79; p < 0.001). The pooled sensitivity and specificity were 0.70 (95% CI 0.65-0.74) and 0.67 (95% CI 0.60-0.74). The combined values of the PLR, NeLR, DS, and DOR were 2.13 (1.74-2.60), 0.45 (0.38-0.52), 1.56 (1.24-1.89), and 4.78 (3.46-6.60), respectively, with a pooled area under the curve (AUC) for the SROC being 0.74 (95% CI 0.70-0.78). Subgroup analysis suggested that the associations remained statistically significant in contrast-associated AKI (p < 0.001) and surgery-associated AKI (p < 0.001), but of boarder line significance in sepsis-associated AKI (p = 0.082). In addition, higher NLR was also found to be related to 1.47-fold increase in mortality among AKI patients (OR 1.47, 95% CI 1.13-1.91, p = 0.004). NLR is not only an effective marker for predicting AKI event, but also a prognostic tool to identify AKI patients with higher risk of death. Future studies are needed to justify its value in different AKI subtypes.

PMID:40512416 | DOI:10.1007/s10238-025-01746-4

Environ Sci Pollut Res Int. 2025 Jun 13. doi: 10.1007/s11356-025-36603-0. Online ahead of print.

ABSTRACT

Black carbon (BC) consists of partially combusted organic matter deriving from biomass and fuels burning. According to the IPCC’s reports, BC emissions are the second-largest contributor to global warming after CO₂. BC enters the marine system via dry deposition or river run-off. Once in the sea, BC has the potential to affect nutrient biogeochemical cycles. In a series of four incubation experiments (Adriatic Sea and Ligurian Sea) and a pilot study, we have challenged the microbes with heavy loads of BC (24 mg L^-1) in order to study the short-term BC effect on microbial dynamics and activities. Upon BC amendment, heterotrophic prokaryotes increased in abundance while viruses decreased. At the microscale, microbes became attached to BC particles, very heterogeneous in shape and size and enriched in proteins over time; these findings were confirmed by Fourier transform-IR spectroscopy and atomic force microscopy. Enzymatic degradative activities, proteases, and alkaline phosphatases were suppressed in the BC treatments despite an enhancement in prokaryotic carbon production. The 16S rRNA gene amplicon sequencing analysis did not show a significant shift in the microbial communities. Despite this, indicator species analysis revealed that Arcobacter and Pseudoalteromonas genera were statistically associated with the BC treatment at 48 h, thus suggesting their adaptive strategies to utilize BC. Our findings reveal that BC has the potential to stimulate intense carbon flow through microbial activity in the sea. Future studies should take account of the contribution of anthropogenic carbon, BC, into the marine biogeochemical C cycle.

PMID:40512408 | DOI:10.1007/s11356-025-36603-0

J Patient Rep Outcomes. 2025 Jun 13;9(1):67. doi: 10.1186/s41687-025-00897-y.

ABSTRACT

BACKGROUND: This study is an external evaluation of the Patient Reported Outcome Measure (PROM) EFAS-DK developed by the European Foot and Ankle Society (EFAS). The evaluation included a test of the psychometric properties.

METHODOLOGY: From October 2019 to September 2022, 101 patients undergoing elective foot or ankle surgery completed questionnaires (EFAS-DK, SEFAS-DK, EQ-5D-5L) prior to surgery and 6 months post-surgery. A subgroup of patients completed a retest. A foot-healthy group control group was added. Testing covered construct validity with hypothesis testing, floor and ceiling effects, internal consistency (Cronbach’s Alpha), test-retest reliability (ICC 2.1), effect size (ES), Standardized Response Mean (SRM), Smallest Detectable Change (SDC) and Minimal Important Change (MIC).

RESULTS: Moderate construct validity with 59% confirmed hypothesis. High content validity, no floor ceiling effects. Cronbach’s alpha 0.88, ICC 0.93. ES and SRM were both 1.06. SDC 4 and MIC 6. Control group score changes was insignificant.

CONCLUSION: EFAS-DK is a valid, reliable, and responsive foot and ankle PROM score. EFAS-DK can detect a clinically subjective relevant change score of 6 (25% of the total scale), which makes it useful for implementation in the clinic when evaluating patients undergoing foot and ankle surgery. Comparison with a control group showed results that significantly differ from the patients.

LEVEL OF EVIDENCE: IIa prospective observational analytic cohort study.

PMID:40512400 | DOI:10.1186/s41687-025-00897-y