Comparing the physiques of elite Polish female and male swimmers training for short and long distances with their non-training peers – Is swimming a health-promoting sport?

by Aleksandra Stachowicz, Anna Kęska, Katarzyna Milde, Małgorzata Stachowicz

In athletes, anthropometric measures are widely used to prescribe desirable body weight, to optimize competitive performance, and to evaluate the effectiveness of various training regimens. However, it also seems interesting to find out which values of anthropometric indices showing a significant relationship with health risk characterise the top athletes, especially in popular sports. The aim of the study was to characterise the physique of female and male swimmers compared to their non-training peers and to determine to what extent it is influenced by training distance. Somatic measurements were taken in 30 female and 30 male top Polish swimmers. The subjects were divided into four groups, i.e., SDF (n = 24) and SDM (n = 24) groups comprising females and males training for short-distance, and LDF (n = 6) and LDM (n = 6) groups comprising those training for long-distance. The swimmers were compared with their non-training peers, 373 females and 155 males aged 20–30 years. BMI, WHR, BF, BAI and Slenderness index were calculated to describe the athletes’ physiques. Swimmers had significantly lower BMI (19.3 ± 1.4 in SDF and 22.1 ± 0.6 in LDF compared to 23.1 ± 3.7 in non-swimmers, p p p p 

Causes of community deaths by verbal autopsy among persons with HIV in 33 districts in Zambia, 2020–2023

by Priscilla Kapombe, Choolwe Jacobs, Mark W. Tenforde, Kashala Kamalonga, Diane Morof, Terrence Lo, Mweene Cheelo, Lloyd Mulenga, Sombo Fwoloshi, Cordilia M. Himwaze, Patrick Musonda, Mpundu Makasa, Jonas Z. Hines

Zambia has achieved improvements in life expectancy among persons living with HIV (PLHIV) because of high antiretroviral therapy (ART) coverage, which should improve survival due to reductions in AIDS-defining conditions. However, recent estimates of the most common causes of death are not widely available. We utilized mortality surveillance data to report on common causes of death among persons with HIV who died in community settings in Zambia. The Zambian Ministry of Health conducted sentinel mortality surveillance of community deaths in 45 hospitals in 33 of 116 districts from January 2020 through December 2023. Verbal autopsies (VA) were conducted through interviews with relatives or close associates of deceased persons using the 2016 World Health Organization tool. HIV status was reported. A probable cause of death was assigned by a validated computer algorithm (InterVA5). We describe the top assigned causes of death stratified by HIV status. Verbal autopsies were conducted for 67,079 community deaths, of which 11,475 (17.1%) were persons with HIV. The mean age at death was 45 years among persons with HIV and 48 years for persons without HIV (T-test p 

Real-world optimization of tunnel lengths in tunneled peripherally inserted central catheters for cancer patients: A multi-center retrospective cohort study

by Yinyin Wu, Wei Ding, Yuying Liu, Qianhong Deng, Fengqin Tao, Hanbin Chen, Chang Chen, Meng Xiao, Bilong Feng

Background

Standardized guidelines for optimal tunnel length in tunneled peripherally inserted central catheters (PICCs) are lacking.

Objectives

The objective of this study was to evaluate the real-world impact of tunnel length on clinical outcomes.

Methods

This retrospective cohort study included 207 cancer patients who received tunneled PICCs, categorized into a control group (tunnel length > 4 cm, n = 134) and an observation group (tunnel length ≤ 4 cm, n = 73). Propensity score matching (PSM) was used to address baseline heterogeneity. Cox regression analyses were used to assess the risk of complication during a 120-day follow-up.

Results

Compared to the control group (tunnel length > 4 cm), the observation group (tunnel length ≤ 4 cm) had a significantly higher adjusted overall complication risk (HR = 2.92, 95% CI: 1.07–7.94, P = 0.036) and unplanned catheter removal rate (4.4% vs. 0.0%, P = 0.027), confirming the safety of longer tunnels despite comparable comfort levels between groups. After PSM, Cox regression analysis showed results consistent with those from the unmatched cohort. Subgroup analyses revealed a reduced risk of complications with longer tunnels in patients with BMI ≤ 25 kg/m² (HR = 0.29, 95% CI: 0.11–0.82), without hypertension (HR = 0.36, 95% CI: 0.13–1.00), without diabetes (HR = 0.38, 95% CI: 0.15–0.97), and with solid tumors (HR = 0.31, 95% CI: 0.11–0.85).

Conclusion

The results show that tunnel lengths > 4 cm reduce overall complications and prolong catheter retention, supporting the implementation of standardized protocols while advocating for personalized adjustments based on BMI, comorbidities, and cancer type.

Investigating organizational resilience in a medicine and health sciences university in United Arab Emirates

by Tamara Muir, Chandra Sharma Poudyal, Romana De Lima, Farah Otaki

Introduction

COVID-19 pandemic emerged in late 2019, leading to global disruption and forcing people to adapt to a new reality. The intensity of the pandemic affected many organisations’ preparedness, response, and recovery efforts, causing numerous businesses to struggle. Although no single theory fully explains why some businesses thrived during this time, the concept of organisational resilience stands out. Organisations with a resilient culture seemed better equipped to address risks, adapt effectively, and seize opportunities for innovation. Therefore, the purpose of the current study is to critically examine the response to COVID-19 of a medicine and health sciences university in Dubai, United Arab Emirates.

Methods

The study relied on a convergent mixed methods approach to research. A tailor-made questionnaire was used to collect quantitative data using two 5-point Likert-type scales: ‘Opinions about Organizational Response’ and ‘Conducive Organizational Response Behaviours’ (where 110 current employees who were tenured during COVID-19 were selected, using purposive, non-probability sampling, and in turn invited to participate). Semi-structured interviews were conducted to collect qualitative data [where seven respondents who had completed the questionnaire and agreed to participate in follow-up interviews were selected (i.e., convenience, nonprobability sampling) and in turn invited to participate]. The quantitative data were descriptively and inferentially analysed. Qualitative data was analysed using an inductive six-step thematic approach. The quantitative findings were mapped onto the output of qualitative analysis using the iterative joint display analysis process.

Results

A total of 70 employees completed the questionnaire (63.64%), and six out of seven invitees participated in the semi-structured interviews. The percentage of the total extent of agreement of ‘Opinions about Organizational Response’ score was 90.94%. As for the percentage of the total frequency of observation of ‘Conducive Organizational Response Behaviours’ score, it was 95.08%. The qualitative analysis generated a conceptual model, namely: ‘Enablers of Organizational Resilience’, with five interlinked themes namely: Preparedness and planning for uncertainty, Adaptation and agility, Team cohesion, Social responsibility, and Learning organisation. Four meta-inferences emerged from integrating the data findings: Response characteristics, Behaviour specificities, Consistency of opinions, and the Fundamental role of organizational culture.

Conclusion

The findings reveal that organizations, in the intersect between higher education and public health, should continue on innovatively investing in agile leadership, strategic partnerships, and a robust continuous learning and development culture to better navigate future disruptions.

Patterns of symptom deterioration can support multimorbidity management in COPD: Perspectives of patients and healthcare professionals

by Sanne H. B. van Dijk, Marjolein G. J. Brusse-Keizer, Bente Rodenburg, Anke Lenferink

Introduction

Comorbidities significantly complicate COPD management. Remote monitoring could aid real-time disease and symptom management, assisting both patients with multimorbidity and healthcare professionals (HCPs). This study aimed to explore how insight in patterns of symptom deterioration, derived from remote monitoring, could enhance multimorbid COPD management as perceived by patients and HCPs.

Methods

Using daily symptom data collected via a mobile diary in the prospective RE-SAMPLE cohort study, patterns of symptom deterioration of COPD, chronic heart failure, anxiety, and depression were visualized per patient (follow-up duration of ≥4 months). Semi-structured individual interviews were conducted with Dutch patients with COPD and ≥1 comorbidity, and with HCPs from pulmonology, cardiology, and medical psychology who were involved in care for patients with multimorbidity. Interviews addressed current multimorbid COPD management, its challenges, and the way pattern visualizations of symptoms deterioration could support disease management. Transcripts were thematically analyzed using an inductive approach.

Results

7 patients (69–80 years, 4 men) and 7 HCPs were interviewed in the hospital (patients and HCPs), at home (patients) or online (HCPs). Three overarching themes were identified, representing the elements of multimorbid COPD management that could be supported by the pattern visualizations: 1) relationship between diseases, 2) decision-making, and 3) self-management. According to patients and HCPs, pattern visualizations can be an informative source to explain the relation between COPD and comorbidities, function as a conversation starter facilitating communication between patients and HCPs as well as between medical disciplines, and educate patients in adequately recognizing their care needs.

Conclusion

Three elements of personalized multimorbid COPD management were identified through qualitative analysis, which can all be supported by visualizing patterns of symptom deterioration via remote monitoring. The visualizations could enhance patients’ understanding of their diseases, improve shared decision-making, improve in-hospital multidisciplinary collaboration, and support multimorbid COPD (self-)management.

Multi-omics analysis reveals diagnostic and therapeutic biomarkers for aging phenotypes in ulcerative colitis

by Lei Guo, Jun Ge, Li Cheng, Xinyi Zhang, Zhengzheng Wu, Meili Liu, Hanmei Jiang, Wei Gong, Yi Liu

Background

The incidence of ulcerative colitis (UC) remains high, with an increasing prevalence among elderly patients. Cellular senescence has been widely recognized as a contributor to UC susceptibility; however, the underlying molecular mechanisms remain incompletely understood. This study aimed to identify senescence-associated biomarkers in UC to provide new insight for diagnosis and treatment.

Methods

By integrating transcriptomic data from UC patients with established aging-related databases, we identified aging-associated differentially expressed genes (DEGs). Using weighted gene co-expression network analysis (WGCNA) and Cytoscape, we pinpointed the core genes involved. A diagnostic model for UC was then developed based on these core genes, and their expression patterns were characterized at single-cell resolution. The roles of these genes were ultimately validated through in vitro and animal experiments.

Results

We identified 24 aging-related DEGs in UC, which were primarily implicated in inflammatory responses and cytokine-receptor interactions. Further analyses pinpointed three core genes (CXCL1, MMP9, and STAT1) that were predominantly expressed in macrophages. A diagnostic model constructed using these genes exhibited robust predictive performance. Experimental validation confirmed that the expression levels of all three core genes were significantly upregulated in both a UC mouse model and in macrophages compared to controls. Additionally, pathway analyses revealed elevated levels of CXCL12 and VEGFA in the enriched pathways.

Discussion

Our findings underscore the pivotal roles of CXCL1, MMP9, and STAT1 in UC-associated cellular senescence. The analysis positions these molecules as promising macrophage-mediated diagnostic biomarkers and therapeutic targets. Collectively, this work provides novel insights into UC pathogenesis and lays a foundation for developing precision medicine strategies that target senescence pathways.

‘Wish you were here’: Managers’ experiences of hybrid work in higher education

by Helena Tinnerholm Ljungberg, Martina Wallberg, Emmanuel Aboagye, Gunnar Bergström, Christina Björklund, Lydia Kwak, Susanna Toivanen, Irene Jensen

The prevalence of telework increased dramatically during the COVID-19 pandemic, and today it is not uncommon to refer to hybrid work as “the new normal” in work life. Leadership plays a pivotal role in hybrid work transitions, underscoring the need for research on post-pandemic managerial practices. This qualitative interview study with 15 professional service managers at a Swedish medical university, working in either central administration or a research department, provides a nuanced understanding of the experiences of implementing hybrid work in a higher education setting. The qualitative content analysis resulted in three main themes and six sub-themes: New ways of organising work (sub-themes: Hybrid work brings new opportunities and needs, and Hybrid work as an ongoing process of change); Changes for employees (sub-themes: Social interaction and sense of community, and Increased work-life balance); and Changes in leadership (sub-themes: Communication with employees and New expectations on managers). The findings of this study provide a more fine-grained understanding of how managers experienced both challenges and opportunities in implementing and managing hybrid working arrangements. Challenges included managing employee expectations and relations, while opportunities included potential improvements in work-life balance. A key conclusion of this study is that managers in hybrid work environments adjust their leadership, especially when communicating and managing relationships within teams and across the organization. Despite the identified challenges and despite managers’ wish to see their employees in person and on site, the interviewed managers are generally optimistic about hybrid work and see it as the future. To address the identified challenges, managers may benefit from networking and exchanging information with other managers in similar situations, as well as support from their organisation.

Understanding the mechanisms of infodemics: Equation-based vs. agent-based models

by Cristian Berceanu, Francesco Bertolotti, Nadia Arshad, Monica Patrascu

In an era where digital communication accelerates the global spread of false narratives, understanding how misinformation and disinformation propagate, especially during crises such as the COVID-19 pandemic, is vital to public health and policy. To delve into the diffusion mechanisms of misinformation (unintentionally false information) and disinformation (intentionally false information), we introduce a novel enhanced agent-based model (ABM) that integrates psycho-social factors and communication networks, which are elements often overlooked in traditional equation-based models (EBMs). We assess the two distinct techniques (ABMs and EBMs) through the lens of six classical SEIRS-class models (S susceptible, E exposed, I infected, R recovered). Beside the enhanced ABM, we also develop a simple ABM to emulate the EBM structure. We compare the ABMs with the EBMs over their entire parameter ranges in a total of 11110 experiments. Results show an overall weak equivalence between the two types of models, even if, under certain conditions, the outcomes of the EBMs and ABMs are similar. Furthermore, we evaluate the two model types by fitting them to real-world infodemic data on vaccine acceptance over 36 weeks using a multi-objective optimization procedure. The enhanced ABM shows an exceptionally better fit to real-world data (Pearson’s correlation coefficient ρ = 0.872 and normalized root mean of square error NRMSE  = 0.055) than the EBM (ρ=−0.067, NRMSE  = 0.418) and the simple ABM (ρ=0.391, NRMSE  = 0.103). These findings underscore the critical role of model structure in capturing infodemic dynamics, and advocate for the use of ABMs when psycho-social influences and network interactions are central to the phenomenon.

‘Thriving with bipolar disorder’: The co-design of a peer-delivered group psychoeducation program and single-arm pilot feasibility evaluation protocol

by Emma Morton, Andrew Kcomt, Erin E. Michalak

Background

Self-management strategies can be used by individuals with bipolar disorder (BD) to cope with symptoms and improve quality of life (QoL). Peer-facilitated psychoeducation has potential to diversify delivery of self-management information by capitalising on the expertise of individuals who live well with BD. This protocol describes the process of co-designing a novel peer-facilitated, QoL-focused, group psychoeducation program for people living with BD, and plans for its pilot evaluation.

Methods

Content from two web-based, self-directed psychoeducational interventions was adapted to inform a peer-facilitated group program, using a community-based participatory research (CBPR) framework. The resultant program contains eight weekly two-hour sessions on topics related to QoL in BD, and contains a combination of education, opportunities for peer-to-peer knowledge exchange, and activities that facilitate practice of self-management strategies. A single-arm pilot evaluation of this program is planned: individuals who self-identify as living with BD (~n = 40) will be recruited from the community. Four groups (~n = 10) will be delivered online by peer facilitators. The primary outcome will be feasibility (session attendance). Data will also be collected on fidelity, intervention acceptability, and impacts (QoL, mood symptoms, self-stigma, subjective recovery, self-efficacy, self-compassion, social support). A subset of participants (~n = 12) and peer facilitators (~n = 4) will be invited to participate in a feedback interview post-intervention.

Discussion

Recovery-oriented healthcare frameworks emphasise a focus on patient-valued outcomes and the development on a peer workforce. By evaluating this novel intervention, we hope to lay the groundwork for peer-facilitated programs specific to the priorities of individuals with BD, that may be embedded in clinical settings.

Trial registration

ClinicalTrials.gov NCT06878937

Risk of emergency cesarean section when giving birth in Sweden: A nationwide cohort study comparing women born in countries practicing female genital mutilation, with Swedish-born women

by Bita Eshraghi, Jonas Hermansson, Lena Marions

Introduction

The impact of female genital mutilation (FGM) on obstetric outcomes in high-income countries remains unclear and is an area of ongoing research. This nationwide study aimed to examine the risk of emergency cesarean section among primiparous women from countries where FGM is practiced, in comparison to Swedish-born women. Additionally, the study explored whether a confirmed diagnosis of FGM contributes to this potential risk.

Materials and methods

A Swedish nationwide cohort study including primiparous singleton term deliveries (≥37 + 0–  Results

Women born in FGM-practicing countries (n = 13 246) had a significantly increased risk of emergency cesarean section (aOR 1.28, 95% CI: 1.21–1.35) compared to Swedish-born women (n = 199 914). Including FGM diagnosis as a covariate did not alter the result. When excluding women born in FGM-practicing countries outside Sub-Saharan Africa the aOR was amplified (aOR 1.58, 95% CI: 1.47–1.69). To further isolate the effect of FGM itself, we restricted the analysis to women born in FGM-practicing countries and compared those with a recorded FGM diagnosis to those without. This analysis showed no significant association between FGM diagnosis and emergency cesarean section (aOR 1.05, 95% CI: 0.90–1.23).

Conclusions

Primiparous women from FGM-practicing countries have an increased risk of emergency CS compared to Swedish-born women, when giving birth in Sweden. The presence of FGM diagnosis did not contribute to this risk. Further research is needed to understand the underlying mechanisms for this to be able to improve obstetric care for migrant populations.

Can creative activities and mind-body practices help enhance well-being and mental health awareness? An exploratory qualitative study in UK higher education

by Marianna Cortesi, Federico Pendenza, Elizabeth Haddon, Andrea Schiavio

Creative arts activities and mind-body practices, such as yoga, have been shown to benefit mental health and well-being. Research in higher education highlights the mental health challenges faced by students and staff in tertiary education; however, most studies on the potential of creative arts and mind-body practices have been conducted in the United States, with limited research investigating their impact in the UK higher education context. This qualitative study seeks to examine students’ and staff members’ views on extra-curricular creative and mind-body practices provided by one UK university, exploring how engagement in such activities can impact their understanding and awareness of mental health and well-being. In addition, it intends to investigate potential barriers to engagement with such activities. Drawing on questionnaire responses from 25 students and 20 staff members, findings highlight the effectiveness of art-based interventions and mind-body practices in raising awareness and understanding of mental health and well-being, while also having the potential to positively impact individuals’ mental health and well-being. Although personal interests and time restrictions may limit engagement, such activities were found to foster community-building, a particularly relevant factor in the post-Covid era, as institutions seek to re-engage students and staff through in-person activities. These findings have therefore important implications for the implementation of similar interventions in higher education and beyond to promote mental health and well-being awareness in diverse communities.

Effect of Ab interno XEN gel stent implantation on corneal astigmatism

by Pawasoot Supasai, Kanwasee Kanjana, Kannawee Boonchuenchom, Yosanan Yospaiboon

Purpose

To assess surgically induced astigmatism (SIA) after XEN gel stent implantation over 5 visits during a 3-month follow-up. Changes in intraocular pressure (IOP), IOP-lowering medications, and best-corrected visual acuity (BCVA) were also assessed.

Methods

This prospective cohort study recruited 24 eyes from 24 glaucoma patients at KKU Eye Center, Khon Kaen University, Thailand. All eyes underwent XEN implantation, using our specific surgical technique. We evaluated both the magnitude and the axis of SIA at 1, 2 weeks, 1, 2 and 3 months after the procedure. Preoperative and postoperative intraocular pressure (IOP), IOP-lowering medications, and best-corrected visual acuity (BCVA) were also analyzed.

Results

We observed a statistically significant centroid SIA of 0.14 D. at an axis of 105° and median SIA of 0.36 D. at 1 week following XEN (p  Conclusions

Ab Interno XEN gel stent implantation induces a small SIA immediately after the surgery, but no further significant change during 3-month follow-up period. Although SIA has no significant effect on visual acuity, this should be addressed with patients preoperatively. Further studies are needed to investigate how different surgical techniques may affect refractive changes after XEN.

Assessment of allergy knowledge among the Palestinian community: A cross-sectional study

by Maha Rabayaa, Mustafa Ghanim, Malik Alqub, Mohammad Abuawad, Majdi Dwikat, Samar Alkhaldi, Haneen Badawi, Johnny Amer

Introduction

Allergy is a form of chronic illness with an increasing prevalence globally. Adequate knowledge among the community about the causes, symptoms, and treatment of allergy is crucial in preventing the associated life-threatening complications. Limited research has been conducted in Palestine regarding this health priority. The current study aimed to assess the Palestinian community’s level of knowledge regarding allergy.

Methods

An observational cross-sectional study was conducted using an online questionnaire targeting Palestinians aged 18 years and older between 1 June 2024 and 26 January 2025. The questionnaire gathered demographic information about the participants and assessed their knowledge level concerning allergy.

Results

A total of 1002 participants were included in the study. The mean age of the participants was 30.33 years. 66.1% of the participants were females, 60.2% were unmarried, 60.1% had possessed a bachelor’s degree, 63.1% had a personal history of allergy, and 82% reported knowing of someone with allergies. The mean knowledge score about allergies was 5.4 out of 10, with over half of the participants having an average level of knowledge (4–6). The knowledge score about allergies was significantly different based on the participants’ sex, marital status, place of residence, educational level, and occupation (p-value Conclusion

The Palestinians’ knowledge of allergy is considered good regarding its common causes and symptoms. However, there is still inadequate knowledge about the treatment of allergy and its less common causes. The community awareness of allergy should be improved through targeted campaigns and brochures aimed at achieving earlier diagnosis and proper management to prevent the development of life-threatening complications.

Sick Becomes Seriously Ill—Scald Injuries due to Domestic Medical Self‐Treatment: A Six‐Year Single Center Retrospective Study

ABSTRACT

Self-treatment of benign symptoms using hot water bottles, steam inhalation or hot tea is common in households and poses risks of severe scald injuries. This study aims to investigate associated hazards and identify high-risk patient groups to facilitate targeted prevention. A retrospective, single-center descriptive study was conducted on adult burn patients with scald injuries from hot water bottles, steam inhalation or hot tea. Demographic information, injury mechanism and outcomes were analysed. A total of 43 patients (mean age: 37.5 years; female:male ratio 23:20) were included. Injuries were caused by hot water/tea (37.2%), steam (34.9%) and hot water bottles (27.9%). The average burned total body surface area (TBSA) was 4%, with 79.1% of injuries being superficial partial-thickness burns. Surgical intervention was required in 13.9% of cases. Hot water bottle injuries predominantly affected young females (75%, mean age 32.6 years), with a high incidence of genital burns (58.3%). Hot tea-related injuries were more frequent in older males (62.5%, mean age 41.6 years), involving greater TBSA (6.5%) and a higher necessity for skin grafting (18.8%). Common self-treatment strategies can cause serious scalds, particularly in specific demographic groups, thereby burdening healthcare systems. Awareness of these risks is pivotal for effective education and prevention.

Prevention of Infections in Cardiac Surgery (PICS)-Prevena Study – A pilot/vanguard factorial cluster cross-over RCT

by Thomas C. Scheier, Richard Whitlock, Mark Loeb, Philip James Devereaux, Andre Lamy, Michael McGillion, MacKenzie Quantz, Ingrid Copland, Shun-Fu Lee, Dominik Mertz

Sternal surgical site infections after cardiac surgery can lead to significant morbidity, mortality, and cost. The effects of negative pressure wound management and adding vancomycin as perioperative antimicrobial prophylaxis are unknown. The PICS-PREVENA pilot/vanguard trial, a 2x2 factorial, open label, cluster-randomized crossover trial with 4 periods, was conducted at two major cardiac surgery hospitals in Ontario, Canada. Sites were randomized to one of eight sequences of the four study arms (Cefazolin or Cefazolin + Vancomycin (not analyzed) and standard wound dressing or a negative pressure 3M Prevena incision management system (Prevena). Only diabetic or obese patients were eligible for the latter comparison. This trial investigated feasability including adherence to protocol of each intervention (goal: > 90% each) and loss to follow-up (goal: 

<i>Mycobacterium tuberculosis</i> complex lineages and drug resistance patterns among tuberculosis patients with or without diabetes mellitus in southern Ghana

by Emelia Konadu Danso, Prince Asare, Amanda Yaa Tetteh, Phillip Tetteh, Augustine Asare Boadu, Ivy Naa Koshie Lamptey, Augustina Angelina Sylverken, Kwasi Obiri-Danso, Jane Sandra Afriyie-Mensah, Abraham Adjei, Dorothy Yeboah-Manu

Drug-resistant (DR) tuberculosis (TB) and diabetes mellitus (DM) are intersecting epidemics that complicate management of both diseases and worsen patient outcomes. We conducted a prospective cohort study of 758 GeneXpert-confirmed pulmonary TB patients, of whom 75 had DM. Demographic, clinical, radiographic, and anthropometric data were collected at baseline. Sputum samples were cultured for mycobacterial isolation, and the obtained isolates were characterized for Mycobacterium tuberculosis complex (MTBC) lineage and drug-susceptibility testing using spoligotyping and microplate alamar blue assay. The TB-diabetes (TB-DM) comorbid cohort was older [TB-DM: 53/75 (70.7%) vs. 241/683 (35.3%) aged 41–60 years) (p 

Biopsychosocial factors associated with symptom severity in the overlap of non-erosive reflux disease and epigastric pain syndrome: A multicenter cross-sectional study

by Mi Lv, Hui Che, Jiayan Hu, Wenxi Yu, Zhaoxia Liu, Xiaolin Zhou, Binduo Zhou, Jinyi Xie, Fengyun Wang

Background

The overlap between non-erosive reflux disease (NERD) and epigastric pain syndrome (EPS, a subtype of functional dyspepsia) is common, yet its associated factors remain poorly defined. We aimed to identify factors associated with symptom severity in NERD-EPS overlap, focusing on psychosocial and somatic factors.

Methods

In this multicenter cross-sectional study, 800 patients meeting Rome IV criteria for NERD-EPS overlap were enrolled. Standardized questionnaires assessed gastrointestinal symptoms (GSRS), somatic symptoms (PHQ-15), anxiety/depression (PHQ-4), and sleep quality (SRSS). Multivariable regression models identified factors independently associated with GSRS scores, adjusted for demographics and clinical covariates. Interaction terms were tested to assess whether the association between one factor and GSRS scores varied across different levels of another factor.

Results

Of the 800 patients, 67% were female, and the mean age was (44.50 ± 14.43) years. 67% had mild or more sleep problems, and 47% had anxiety or depression. Somatic symptoms (PHQ-15) showed the strongest association with GSRS scores (β = 0.617, P P P = 0.026). Urban residence (β = 0.071) and mixed labor type (β = −0.066) were also independently associated with symptom burden.

Conclusion

Somatic symptoms, psychological distress, and sleep disturbances were the factors most strongly associated with symptom severity in NERD-EPS overlap, with additional contributions from younger age, male sex, and urban residence. Our findings advocate for integrated biopsychosocial interventions to alleviate symptom burden in this population.

A disproportionality analysis of FDA adverse event reporting system (FAERS) events for filgotinib

by Yinli Shi, Shuang Guan, Sicun Wang, Muzhi Li, Yanan Yu, Jun Liu, Weibin Yang, Zhong Wang

Background

Although filgotinib, a selective Janus kinase 1 inhibitor, has been increasingly applied in the treatment of inflammatory diseases, its comprehensive safety profile remains insufficiently characterized. Using data from the FAERS database covering Q1 2014 to Q2 2024, this study attempts to analyze adverse event signals linked to filgotinib and provide guidance for the safe and sensible clinical usage of filgotinib.

Methods

From Q1 2014 to Q2 2024, information on adverse drug events (ADEs) associated with filgotinib was gathered. The reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and multi-item gamma Poisson shrinker (MGPS) were among the signal detection methods that were employed for analysis following data normalization.

Results

Filgotinib was shown to be the main suspected medication in ADE reports, exposing 103 preferred terms (PTs) in 17 system organ classes (SOCs). Infections, gastrointestinal disorders, and musculoskeletal and connective tissue disorders were the most commonly reported adverse effects. Additionally, atrial fibrillation, alopecia, elevated serum creatinine, blood creatinine increased, pulmonary embolism, epididymitis, respiratory failure, and osteopenia were identified as potential disproportionate reporting signals for filgotinib, although these were not listed in the official drug label. Notable significant signals included large intestine erosion (ROR 2186.05, 95%CI_(ROR): 1015.94–4703.86, PRR 2176.18, 95%CI_(PRR): 1014.64–4667.42), mesenteric arterial occlusion (ROR 1832.17, 95%CI_(ROR): 897.68–3739.48, PRR 1822.71, 95%CI_(PRR): 896.17–3707.20), repetitive strain injury (ROR 1149.27, 95%CI_(ROR): 363.16–3637.01, PRR 1147.05, 95%CI_(PRR): 363.24–3622.15), oligoarthritis (ROR 755.02, 95%CI_(ROR): 310.74–1834.54, PRR 752.59, 95%CI_(PRR): 310.60–1823.51), and periostitis (ROR 676.03, 95%CI_(ROR): 319.36–1431.06, PRR 672.98, 95%CI_(PRR): 318.97–1419.87). The subgroup analysis identified obvious sex and age-specific trends in filgotinib-related adverse reactions, emphasizing a higher risk of renal disorders in females, a preponderance of gastrointestinal events in males, and age-dependent trends involving mesenteric occlusion, increased serum creatinine, and immunoglobulin reduction.

Conclusion

While filgotinib demonstrates therapeutic efficacy, it is associated with a range of potential adverse events, underscoring the need for vigilant clinical monitoring. Particular attention should be given to gastrointestinal, cardiovascular, respiratory, and metabolic complications.

Investigating risk factors of hemorrhagic fever of renal syndrome (HFRS) in Qingdao, Shandong province, China

by Ying Li, Jing Jia, Runze Lu, Liyan Dong, Lizhu Fang, Litao Sun, Zongyi Zhang, Qing Duan, Lijie Zhang, Kunzheng Lv, Huilai Ma

Background

Qingdao, a historically high-risk area for hemorrhagic fever with renal syndrome (HFRS) in China, is undergoing agricultural mechanization and urbanization. However, the specific risk factors for HFRS in this context remain unclear. This study sought to determine the risk factors for HFRS in Qingdao.

Methods

Community-based, 1:2 case-control study. Each case was matched with two healthy neighborhood controls based on biological sex, age, and the same neighborhood or village. Univariate and multivariate conditional logistic regression analyses were performed. Furthermore, stratified analyses were performed to explore risk factor heterogeneity between the peak season for Hantaan virus (HTNV) type HFRS (October-January) and other months.

Results

93 cases (73.2%, 93/127) reported from January 2022 to September 2023 and 186 controls completed this questionnaire. Farmers accounted for the highest proportion (68.8%, 64/93). In multivariate logistic regression analysis, there were three significant risk factors for HFRS: piles of firewood and/or grain in residential yards (odds ratio [OR]=3.75, 95% CI: 2.14–6.55), mite and/or flea bites (OR=1.83, 95% CI: 1.06–3.18) and contacting with rats and/or their excreta (OR=1.73, 95% CI: 1.09–2.74); three variables represented significant protective factors for HFRS: frequency of sun exposure for quilts and bedding (OR=0.41, 95% CI: 0.19–0.90), rodent control measures at home (OR=0.50, 95% CI: 0.30–0.81) and knowing the main sources of HFRS transmission (OR=0.58, 95% CI: 0.36–0.90). Stratified analysis revealed that the influence of these factors varied by season, with rodent contact and control measures being particularly salient during the HTNV peak season.

Conclusion

This study provides the first comprehensive evidence of risk and protective factors for HFRS in Qingdao, highlighting the role of rodent control, promoting comprehensive health education, environmental management, and personal protection. However, the results should be interpreted considering the study’s limitations, including a 73.2% response rate and the potential for recall bias.

A mixed-methods study to explore the modifiable aspects of treatment burden in Parkinson’s disease and develop recommendations for improvement

by Qian Yue Tan, Kinda Ibrahim, Helen C. Roberts, Khaled Amar, Simon D.S. Fraser

Background

People with Parkinson’s (PwP) and their caregivers have to manage multiple daily healthcare tasks (treatment burden). This can be challenging and may lead to poor health outcomes.

Objective

To assess the extent of treatment burden in Parkinson’s disease(PD), identify key modifiable factors, and develop recommendations to improve treatment burden.

Methods

A mixed-methods study was conducted consisting of: 1) a UK-wide cross-sectional survey for PwP and caregivers using the Multimorbidity Treatment Burden Questionnaire (MTBQ) to measure treatment burden levels and associated factors and 2) focus groups with key stakeholders to discuss survey findings and develop recommendations.

Results

160 PwP (mean age = 68 years) and 30 caregivers (mean age = 69 years) completed the surveys. High treatment burden was reported by 21% (N = 34) of PwP and 50% (N = 15) of caregivers using the MTBQ. Amongst PwP, higher treatment burden was significantly associated with advancing PD severity, frailty, a higher number of non-motor symptoms, and more frequent medication timings (>3 times/day). Caregivers reporting higher treatment burden were more likely to care for someone with memory issues, had lower mental well-being scores and higher caregiver burden. Three online focus groups involved 11 participants (3 PwP, 1 caregiver and 7 healthcare professionals) recruited from the South of England. Recommendations to reduce treatment burden that were discussed in the focus groups include improving communication. clear expectation setting, and better signposting from healthcare professionals, increasing education and awareness of PD complexity, flexibility of appointment structures, increasing access to healthcare professionals, and embracing the supportive role of technology.

Conclusions

Treatment burden is common amongst PwP and caregivers and could be identified in clinical practice using the MTBQ. There is a need for change at individual provider and system levels to recognise and minimise treatment burden to improve health outcomes in PD.