95038 research outputs found
Sort by
Prepandemic levels of cytokines and immunoglobulins and risk of SARS-CoV-2 infection and COVID-19 in the general population of Barcelona
Get PDFFrom a public health perspective it is remarkable that there are yet no longitudinal studies in the general population investigating the influence of the basal immune state, measured before the pandemic, on the risk of SARS-CoV-2 infection and COVID-19. To investigate the specific and combined effects of personal levels of cytokines and immunoglobulins—measured in individuals’ blood 4 years before the pandemic—on the risk of SARS-CoV-2 infection and COVID-19 in a general population. We conducted a prospective cohort study in 240 individuals from the general population of Barcelona. Thirty cytokines and 31 immunoglobulins were quantified in prepandemic serum samples (collected in 2016–17) by high-throughput multiplex quantitative suspension array technology. Higher concentrations in 2016–17 of IL-8 and TNF-α significantly decreased the risk of SARS-CoV-2 seropositivity in 2020–21, whereas higher concentrations of MIP-1α were a risk factor for seropositivity. Most cytokines in mixtures with IL-8, MIP-1α, TNF-α or G-CSF were associated with SARS-CoV-2 seropositivity (all OR ≥2.0 or OR≤0.4 and p < 0.05). The five individual isotype-antigen pairs more clearly associated with seropositivity were: protectively, IgG to CMV pp150, IgG to CMV pp65, and IgG to N OC43; and, increasing risk of seropositivity, IgM to CMV pp65 and IgM to EBV EA-D. The four cytokines most consistently associated with the risk of COVID-19 were also G-CSF, IL-8, TNF-α, and MIP-1α. The four isotype-antigen pairs more strongly associated with risk of COVID-19 (all protective) were IgA to CMV pp65 and N 229E, and IgG to EBV EAD and VCAp18. The unique longitudinal design of this study, with measurements before and during the pandemic in a general population, provides novel knowledge on the protective and detrimental effects of specific individual cytokines and immunoglobulins, and their mixtures, on the risk of SARS-CoV-2 seropositivity and COVID-19. If confirmed, findings would be significantly relevant for medicine and public health
Exploring the influence factors and operating mechanisms of age-friendly communities in urban fringe areas from the resilience perspective: a case study in Shangjie Township, Southeast China
Get PDFThe development of age-friendly communities (AFC) is a key initiative in response to the active ageing strategy proposed by World Health Organization. Urban fringe communities (UFC) are characterized by distinctive features such as intricate built environments and heterogeneous resident populations, and these characteristics pose a great challenge to the promotion of age-friendliness in these areas. This study combines field surveys and spatial analysis to reveal the age-friendliness in different types of UFC in Shangjie Township, southeastern China. And we employ structural equation model to quantitatively analyze the factors influencing age-friendliness in these communities. Then, this study proposes a mechanism for the operation of AFC in UFA based on the DPSIR model. Over 50% of the UFC in the study area exhibit satisfactory age-friendliness, while the age-friendliness in some communities still requires urgent improvement. Furthermore, community space, facilities and services, social interactions, and social participation all positively influence the age-friendliness of UFC, with effect sizes ranked in descending order as follows: facilities and services, social interactions, social participation, and community space. This study develops a systematic framework for enhancing the age-friendliness of UFC, providing a viable strategy for addressing the challenges of population ageing. The findings of this study make both theoretical and practical contribution to the development of AFC in UFA
Seasonal Sea Surface Temperatures from Mercenaria spp. During the Plio-Pleistocene: Oxygen Isotope Versus Clumped Isotope Paleothermometers
Get PDFThe Mid-Piacenzian Warm Interval (MPWI) is marked by warmer temperatures and higher atmospheric CO2 levels than today, making it an analogue for late-21st-century-warming, whereas the early Pleistocene cooling is more like today. We compare seasonal growth temperatures derived from oxygen isotope ratios (δ18O) and clumped isotopes (∆47) in Mercenaria. Modern shells were previously collected from coastal NC. The fossil shells are from the Duplin (MPWI) and Waccamaw Formations (early Pleistocene), NC. Oxygen isotope ratios range from −2.2‰ to 2.3‰ (modern), −0.9‰ to 2.4‰ (MPWI), and −0.9‰ to 2.9‰ (early Pleistocene). The values of Δ47 range from 0.576‰ to 0.639‰ (modern), 0.566‰ to 0.621‰ (MPWI), and 0.581‰ to 0.615‰ (early Pleistocene). We show that Mercenaria do not require a species-specific ∆47 calibration. Modern and MPWI ∆47-derived summer/winter temperatures (SST∆47) and seasonal amplitudes are indistinguishable from δ18O-derived temperatures. The early Pleistocene summer SST∆47 is indistinguishable from δ18O-derived temperatures, but the winter SST∆47 is warmer by 5 °C and may reflect within-shell time averaging. The modern summer/winter SST∆47 are indistinguishable from the MPWI, but the MPWI has a lower seasonal amplitude by 5 °C. Compared to our calculated δ18Osw values, modeled values for the MPWI are within error but are much lower, and they are not within error for the early Pleistocene
On Polymathism in 2025
Get PDFPolymathism – the practice of integrating knowledge across multiple fields – is making a timely comeback in the 21st century. As hyper-specialization becomes the norm in education and careers, we risk losing the big-picture perspective and adaptability that broad knowledge provides[1][2]. This paper explores the value of being a generalist “polymath” in an era of rapid change and artificial intelligence (AI). Recent studies indicate that breadth of expertise can enhance creativity, innovation, and career resilience[3][4]. Generalists often receive more job offers and adapt better to new challenges, partly because their diverse skillsets are less easily automated or commodified[5][6]. We draw on literature from 2018 onwards to review how interdisciplinary knowledge benefits individuals and society, and why educational and professional systems should foster polymathic skills. An informal analogy is made to AI image upscaling – just as AI can sharpen a low-resolution image[7], a broad-thinking person can leverage AI tools to “upscale” their capabilities in any niche. In a world where narrow AI excels at specific tasks but lacks general adaptability[8][9], humans can thrive by being versatile integrators of knowledge. Polymathism in 2025 is not about knowing everything, but about cultivating the curiosity, analogical thinking, and interdisciplinary fluency to connect the dots across domains. This paper argues that the future belongs not to the specialist alone, but to those who can learn widely, adapt quickly, and collaborate across disciplines. Limitations of the generalist approach and the continuing importance of deep expertise in certain contexts are also discussed
Protocol for a scoping review of time to treatment in adults with newly diagnosed multiple myeloma
Get PDFBackground Delays in cancer treatment can result in tumor growth, increased clonal heterogeneity, upstaging, increased symptoms, organ damage, increased psychological distress, and worse clinical outcomes. Evidence supported guidelines for treatment timeliness exist in many cancers, but not for multiple myeloma (MM) though there is reason to believe delays in treatment would be detrimental. Aims This scoping review aims to explore what is known about the impacts of the time from diagnosis to treatment among patients with MM. Methods Our review will be guided by the Joanna Briggs Institute scoping review methodology. Our search strategy was developed to identify sources published in or after the year 2000 related to time to treatment for adults with newly diagnosed multiple myeloma in PubMed, CINAHL, Scopus and Embase. Sources will be screened by two independent reviewers after exclusion/inclusion criteria are pilot tested and refined. A data extraction form was developed and will be refined by the study team for use during the scoping review. Discussion This review will summarize the landscape of research related to time to treatment among newly diagnosed adults with multiple myeloma. Raising awareness of the available evidence on this topic, within the MM clinical and research community, will guide future research to address identified knowledge gaps
Safety of Combination TARE and SBRT in Hepatocellular Carcinoma: A Review of Literature & Single-Center Case Series
Get PDFHepatocellular carcinoma (HCC) is the most common primary liver cancer. At the time of diagnosis, many HCC patients are not candidates for surgical resection and are considered for other locoregional therapies, including transarterial radioembolization (TARE) and stereotactic body radiation therapy (SBRT). To date only a few studies have explored the safety and efficacy of combining TARE and SBRT. Therefore, we aimed to evaluate it. Patients who received both SBRT and TARE from 2016 to 2024 were retrospectively evaluated for treatment-related toxicity based on criteria for adverse events (CTCAE v4.0). Treatment response was evaluated by modified response evaluation criteria for solid tumors (m-RECIST). We identified 12 patients with median age of 66.5 (range: 40, 87) and median follow up of 12 months. The median time between TARE and SBRT was 6.5 months (range: 1.5 to 24). Following the second treatment, ALBI grade remined the same among all patients at 3-month post treatment compared to baseline. Baseline CP was A among all patients and remained unchanged during follow-up and no higher than grade 3 clinical or biochemical toxicity was seen. The objective response rate (ORR) among patients receiving treatment to the same lesion was 100%. The combination treatment was consistent with prior studies in which the combination of TARE and SBRT has been shown to have good local control with few cases of grade 3 toxicity. Our study demonstrates that treatment with TARE and SBRT was safe and effective among our small sample of patients
The structure of informal water markets: Insights from spatial monitoring in Lodwar, Kenya
Get PDFPublic water utilities have struggled to keep pace with rapid urbanization, particularly in towns and small to medium-sized cities of low-income regions. Informal water markets have proliferated to fill gaps in piped water coverage and service delivery through a wide range of water vending activities (from private water sources to tanker trucks and handcart operators that distribute water). Despite the prevalence and persistence of water vending, the structure, impacts, and evolution of informal water markets in these settings remain poorly understood, especially the interaction between private vendors and public utilities. We seek to improve our understanding of mobile, distributing vendors (tankers, motorcycles) by advancing high-frequency, spatially explicit monitoring of water vendor transactions in Lodwar, Kenya. We examine both the market and spatial structure of the informal water supply system and then draw inferences about their impacts and evolution. We find that vendors that use motorcycles are not making profits from transporting water. We also identify many linkages between the formal and informal systems. For example, purchases of bulk water by water vendors account for 28% of the public water utility’s revenue. We also find that while most consumers of vended water are located outside of the piped water service area, many households and institutions inside the service area still purchase from private water vendors due to concerns about reliability and quality. These results highlight the complementarities between public utilities and private water vending and the corresponding importance of mapping water vending networks to support planning, policy, and investment and to protect consumers
Community Health Worker Support for Hispanic and Latino Individuals Receiving Hemodialysis
Get PDFThis randomized clinical trial evaluates if community health worker support reduces interdialytic weight gain among Hispanic and Latino individuals receiving hemodialysis.
Key Points
Question Does providing a community health worker (CHW)–based intervention for dietary education and self-efficacy improve interdialytic weight gain (IDWG) among Hispanic and Latino individuals with hemodialysis-dependent kidney failure?
Findings In this randomized clinical trial that included 139 patients at 5 dialysis centers in Denver, Colorado, from 2020 to 2022, a CHW intervention modestly reduced IDWG compared to standard care. There were fewer shortened dialysis sessions with the intervention and greater improvement in patient activation.
Meaning Providing CHW support for Hispanic and Latino individuals receiving hemodialysis is a practical and meaningful approach to improving patient outcomes, including lowering IDWG.
Importance Hispanic and Latino individuals with hemodialysis-dependent kidney failure experience social barriers that may increase their risk for volume-related complications, including fluid accumulation between dialysis sessions or interdialytic weight gain (IDWG). Higher IDWG contributes to cardiovascular complications, hospitalizations, and poor quality of life. Minimizing IDWG is prioritized by patients, clinicians, and payers; yet, high IDWG remains common despite dietary education.
ObjectiveT o determine if community health worker (CHW) support reduces IDWG among Hispanic and Latino individuals receiving hemodialysis.
Design, Setting, and Participants This parallel group, unblinded, multicenter, community-partnered, randomized clinical trial was conducted at 5 dialysis centers in Denver, Colorado, between November 2020 and August 2022. Self-identified Latino or Hispanic adults receiving in-center hemodialysis were eligible. Data were analyzed from August 2024 to July 2025.
Intervention Participants were randomized 1:1 to the Navigate-Kidney intervention or standard care. In Navigate-Kidney, CHWs followed a framework-driven, patient-centered protocol to support patient social needs and provide health navigation and culturally responsive kidney care education, including dietary modification and fluid restriction education. CHWs met participants biweekly for at least 6 visits. Standard care had no trial-driven culturally responsive components.
Main Outcomes and Measures The primary outcome was change in IDWG from 90 days prior to intervention to 180 days postintervention, calculated as a percentage of estimated dry weight. Secondary outcomes included missed and shortened dialysis sessions, health care utilization, and patient activation. Between-group IDWG differences were estimated with piecewise linear mixed models.
Results Of 139 participants (mean [SD] age, 56.8 [12.9] years; 68 [49%] female), 68 were randomly assigned to Navigate-Kidney and 71 to standard care. Postintervention trends in percentage of estimated dry weight differed between Navigate-Kidney and standard care, which corresponded to a difference between groups of −0.46 percentage points (95% CI, −0.78 to −0.14 percentage points) in IDWG after 180 days of follow-up (P = .01). Mean IDWG was 3.26% (95% CI, 2.83%-3.68%) and 3.72% (95% CI, 3.30%-4.14%) in Navigate-Kidney and standard care, respectively. There were fewer shortened dialysis sessions with Navigate-Kidney vs SC (median [IQR], 0.1 [−1.2 to 1.1] vs 0.6 [−0.5 to 1.8]; P = .02), as well as greater improvement in the Patient Activation Measure (median [IQR], 1.8 [−2.2 to 5.2] points vs −2.2 [−7.4 to 2.5] points; P = .005).
Conclusions and Relevance In this randomized clinical trial, a culturally tailored CHW intervention modestly lowered IDWG and improved dialysis adherence and patient activation among Hispanic and Latino patients with hemodialysis-dependent kidney failure.
Trial Registration ClinicalTrials.gov Identifier: NCT0397880
Systematic review and meta-analysis of family-based interventions for early psychosis: Carer and patient outcomes
Get PDFBACKGROUND: Previous reviews have indicated that family interventions in early psychosis are beneficial for patients and family caregivers. Given recent developments in research and service provision an updated review is warranted. METHODS: We conducted a systematic review and meta-analysis of family intervention trials in the first 5 years after psychosis onset. We identified randomized controlled trials that reported outcomes for family members and extracted available outcomes in relation to identified patients. RESULTS: We screened 8737 abstracts and 177 full text papers, resulting in 36 for extraction. We found significant pooled treatment effects for family interventions for carer psychological distress (Hedges g = 0.35), carer burden (Hedges g = -0.68), positive and negative carer appraisals (Hedges g = 0.20, g = -0.21), and components of expressed emotion (critical comments and emotional overinvolement) compared with care as usual (Hedges g = -0.81, -0.92). For patients we found a moderate pooled effect for reduced rates of hospitalization compared with care as usual (Hedges g = -0.52). The effects for carer burden were maintained for studies in China, but not in other settings combined. The effects for hospitalization were maintained for multicomponent interventions but not when psychoeducation was the sole component. There was evidence of significant study heterogeneity. Risk of bias assessment indicated that deviations from intended treatment were most frequently rated as the weakest domain. CONCLUSIONS: Family interventions for early psychosis benefit both family carers and their relatives diagnosed with psychosis when compared with usual care. Future research should further clarify the effective components and investigate innovations in cultural sensitivity, peer support and digital modes
A Housing and Health Equity Collaboration for Granville and Vance Counties, North Carolina
Get PDF Abstract Julia Granitto, Jasmine Johnson, Keith Newby, and Beatrice Siaw: A Housing and Health Equity Collaboration for Granville and Vance Counties, NC (Under the direction of Dr. Heba Athar, 1st reader, and Dr. Karl Johnson, 2nd reader) This thesis explores humane housing as a vital condition for health equity in Vance and Granville Counties, North Carolina. Using the Vital Conditions for Well-Being framework, it examines how housing affordability, safety, stability, and dignity influence health outcomes. Adopting a systems-level approach beyond traditional Social Determinants of Health, the study integrates demographic, housing, and eviction data with community mapping and policy review. Findings reveal persistent inequities tied to historic redlining, economic disinvestment, and weak governance linking health and housing. These structural barriers heighten eviction, environmental exposure, and chronic disease among low-income and minority residents. Grounded in public health leadership and policy frameworks, the thesis proposes an integrated governance model that positions housing as essential health infrastructure. Recommendations include forming a Humane Housing Steering Committee for oversight, strengthening code enforcement, expanding community land trusts, and embedding housing metrics in public health plans. Keywords: humane housing, Vital Conditions, health equity, social determinants of health, community engagement, policy integration, Master of Public Healt