Global Health

The aim of this multicenter observational study is to report data from real world on the use of bimekizumab in patients aged ≥ 65 years with moderate-to-severe plaque psoriasis. Elderly patients are poorly represented in clinical trials on bimekizumab for plaque psoriasis, and real-world studies are important to guide clinical choices. A retrospective multicenter study was conducted in 33 dermatological outpatient clinics in Italy. Patients aged ≥ 65 years, with moderate-to-severe plaque psoriasis and treated with bimekizumab were enrolled. No exclusion criteria were applied. Bimekizumab was administered following the Italian Guidelines for the management of plaque psoriasis and according to the summary of product characteristics, in adult patients who were candidates for systemic treatments. Overall, 98 subjects were included, and received bimekizumab up to week 36. Clinical and demographic data were collected before the initiation of treatment with bimekizumab. At baseline and each dermatological examination (4, 16, and 36 weeks), clinical outcomes were measured by the following parameters: (1) PASI score; (2) site-specific (scalp, palmoplantar, genital, nail) Psoriasis Global Assessment (PGA). At each visit, the occurrence of any adverse events (AEs) was recorded, including serious AEs and AEs leading to bimekizumab discontinuation. The mean PASI score was 16.6 ± 9.4 at baseline and significantly decreased to 4.3 ± 5.2 after 4 weeks ( < 0.001), and 1.1 ± 1.7 after 16 week ( < 0.001). This level of improvement was maintained after 36 weeks ( < 0.001). PASI ≤2 was recorded in 36 (36.7%) at week 4, 68% and 69.4% at week 16 and 36, respectively. By week 16, 86/98 (87.8%) patients reached PASI75, 71/98 (72.4%) obtained PASI90, and 52/98 (53.1%) PASI100. Binary logistic regression tests showed a significant association of PASI100 by week 4 with lower PASI at baseline. PASI 100 at 16 or 36 weeks was not associated with baseline PASI, obesity, age, gender, previously naïve state, and presence of psoriatic arthritis. Patients naïve to biologics at baseline had similar response to bimekizumab as non-naïve subjects. Bimekizumab is a suitable option for elder patients as it is effective, tolerated and has a convenient schedule.

Despite high pediatric vaccination coverage rates (VCRs), pertussis incidence has increased worldwide, including in several countries in Latin America in the last two decades. Given the few vaccine effectiveness (VE) studies in Latin American countries, this retrospective, observational, cohort study estimated the effectiveness of hexavalent acellular (aP) primary and booster vaccination (wP) against pertussis in infants (6.5-18.5 months) and children (18.5-48.5 and 48.5-72.5 months) in Panama. Age-specific incidence rates (IRs) were calculated for the vaccine's pre-initiation (2001-2013), initiation (2014), and post-initiation (2015-2019) periods. VCRs and trends were determined, and VE was analyzed using a case coverage or screening method to compare proportions of vaccinated cases and vaccinated individuals in the population. Between 2001-2019, 868 confirmed pertussis cases were reported in Panama; 712 (82.0%; 54.8 cases/year) during the pre-initiation period, 19 (2.2%; 19 cases/year) during the initiation period, and 137 (15.8%; 27.4 cases/year) during the post-initiation period. Panama underwent cyclical increases in IRs, which varied between age groups. VCRs increased for primary and booster doses. Between 2015 and 2019, third-dose yearly vaccine coverage increased, on average, 3.3%. Specifically, during the post-initiation period, 109/137 (79.6%) of cases were unvaccinated. Relative VE was estimated at 96.2% [95% CI: 86.5%, 98.9%] with three doses; 100% with 4 and 5 booster doses. Absolute VE was estimated at 99.3% with three doses only. These results show that vaccination played an important role in maintaining a low number of pertussis cases in Panama, affirming the need for sustained investment and commitment to vaccination programs.

In this article, we provided a comprehensive overview and in-depth analysis of global patterns and temporal trends in years lived with disability (YLDs) for musculoskeletal (MSK) disorders in individuals aged ≥70. Data on YLDs for MSK disorders in individuals aged ≥70 were obtained from the Global Burden of Disease 2019. The average annual percentage change (AAPC) was calculated to assess the temporal trends in the YLDs rate of MSK disorders. A Bayesian Age-Period-Cohort model was used to predict the YLDs rate up to the year 2040. In 2019, the global rate of YLDs for MSK disorders in individuals aged ≥70 were 4819.81 (95 % UI: 3402.91 - 6550.77) per 100,000 persons. The YLDs rate of MSK disorders in female was 1.36 times higher than that in male, and was highest in high SDI regions. From 1990 to 2019, the global YLDs rate showed a slightly downward trend (AAPC = -0.04 %, 95 % CI: -0.06 % to -0.03 %), while it significantly increased in high, low-middle, low SDI regions. Tobacco and high body mass index were the primary risk factors worldwide, while in low SDI regions, occupational risks emerged as the predominant factors. Up to 2040, the global YLDs rate of MSK disorders are expected to increase by 1.78 %, with 36.39 %, 20.66 %, 18.96 % and 5.32 % growth in other MSK disorders, rheumatoid arthritis, neck pain and osteoarthritis. MSK disorders are a significant and continuously growing public health concern among older adults. Tailored interventions should be developed for older adults, taking into account the variations across distributions, trends, and risk factors in terms of sex and SDI levels.

Digital phenotyping is a promising method for advancing scalable detection and prediction methods in mental health research and practice. However, little is known about how digital phenotyping data are used to make inferences about youth mental health. We conducted a scoping review of 35 studies to better understand how passive sensing (e.g., Global Positioning System, microphone etc) and electronic usage data (e.g., social media use, device activity etc) collected via smartphones are used in detecting and predicting depression and/or anxiety in young people between 12 and 25 years-of-age. GPS and/or Wifi association logs and accelerometers were the most used sensors, although a wide variety of low-level features were extracted and computed (e.g., transition frequency, time spent in specific locations, uniformity of movement). Mobility and sociability patterns were explored in more studies compared to other behaviours such as sleep, phone use, and circadian movement. Studies used machine learning, statistical regression, and correlation analyses to examine relationships between variables. Results were mixed, but machine learning indicated that models using feature combinations (e.g., mobility, sociability, and sleep features) were better able to predict and detect symptoms of youth anxiety and/or depression when compared to models using single features (e.g., transition frequency). There was inconsistent reporting of age, gender, attrition, and phone characteristics (e.g., operating system, models), and all studies were assessed to have moderate to high risk of bias. To increase translation potential for clinical practice, we recommend the development of a standardised reporting framework to improve transparency and replicability of methodology.

This study focused on designing a WASH Index for assessing the status of WASH in Primary Healthcare Facilities (PHCs) especially for low- and middle-income countries. To assess the effectiveness of the WASH Index in evaluating the WASH in PHCs, PHCs were selected from 70 Local Government Areas (LGA) across 3 Southwestern States in Nigeria. The WASH index comprises of the five Joint Monitoring Programme service ladders as outlined in the World Health Organization Global Baseline Report for monitoring basic WASH services in health care facilities: water, sanitation, hygiene, waste management and environmental cleaning. The 5 service elements (termed as components) assessed were based on 10 indicators and 30 sub-indicators. The results of the WASH Index of the PHCs were compared statistically on LGA and State basis with emphasis on the status of WASH facilities. The study concludes that the result would further provide baseline information on the status of WASH in PHCs in the selected States in the quest to achieve the Sustainable Development Goals (SDGs). This study recommends that the WASH Index could be adopted an assessment tool for evaluating WASH in PHCs in other to ensure communication of results to policy makers and other relevant stakeholders, for effective monitoring healthcare facilities.

Obesity is a burgeoning global health problem with an escalating prevalence and severe implications for public health. New evidence indicates that long non-coding RNAs (lncRNAs) may play a pivotal role in regulating adipose tissue function and energy homeostasis across various species. However, the molecular mechanisms underlying obesity remain elusive.

A pervasive threat regarding human health, ecological balance, progress, and sustainability marks the current era. Many nations are grappling with the consequences of the overabundance of carbon emissions from a wide range of destructive human activities, which is the primary driver of air pollution, global warming, and warming. Thus, while some countries are squandering their riches, others are making great strides to keep the environment clean and green so that future generations may thrive. National governments and policymakers are now focusing a lot of energy on addressing the dangers posed by environmental concerns and the threat of climate change. A very contentious issue in recent years has been the link between environmental change and tourism and its vulnerability. This study focuses on the impact of fluctuating visitor numbers on greenhouse gas emissions, the primary gas responsible for the acceleration of global warming and other environmental changes. Therefore, we look at how the most visited countries' carbon emissions have changed due to increased tourism. The ecological effects of tourism on a regional scale are investigated using a panel data analysis spanning the years 2001-2018 in China, including the top 80 countries. The best-modified assessment methodologies determine the overall, direct, and indirect impact of tourist spending on carbon emissions. The findings demonstrate that CO2 emissions might be reduced by environmental regulation, urbanization, and tourist revenue and that they could be increased through economic expansion, population, and tourism. Due to this distinction, tourists' overall impact is much more harmful than their direct impact. In addition, a U-shape is formed by the direct effects of carbon emissions and a growing economy, and vice versa. Several factors impact environmental regulation, including population density, population growth, pollution, and GDP growth. Spending on infrastructure development and economic expansion also considerably mitigates the impacts of tourism and environmental alteration. The results reveal that a nation's emissions often rise with the expansion of its tourism industry. Still, they begin to decline after certain levels and show that the link between the two has important policy implications.

In response to the growing number of outbreaks of emerging infectious diseases, the US Administration for Strategic Preparedness and Response (ASPR) has embarked on a plan to improve and expand special pathogen patient care capabilities. To achieve this, ASPR is developing a coordinated network of Regional Emerging Special Pathogen Treatment Centers (RESPTCs) to serve as state-of-the-art facilities staffed by a highly trained workforce to care for and manage special pathogen patients across the lifespan. The RESPTC network represents the operational arm of a broader US National Special Pathogen System of care to prevent and prepare for the next infectious disease outbreak. RESPTCs are strategically located in every region across the country and form a network linking local and regional healthcare partners to enhance national preparedness through training in best practices for detection, isolation, and treatment of individuals suspected of or known to be infected with a special pathogen. This local, regional, and national network is also designed to lead a coordinated response that includes the dissemination of accurate and trustworthy information to responders and the public. The overarching goal of the RESPTCs is to serve as a valuable resource for clinical care, training, and material support to meet current and future major infectious diseases challenges. In this case study, 2 new RESPTCs, MedStar Washington Hospital Center and the University of North Carolina, describe their experiences related to designing a biocontainment unit, creating clinical teams, building staff resiliency, receiving mentoring from regional RESPTC partners, and developing opportunities for innovation.

Carbapenem-resistant (CRKP) infection has become a significant threat to global health. The application of chemical disinfectants is an effective infection control strategy to prevent the spread of CRKP in hospital environments. However, bacteria have shown reduced sensitivity to clinical disinfectants in recent years. Furthermore, bacteria can acquire antibiotic resistance due to the induction of disinfectants, posing a considerable challenge to hospital infection prevention and control. This study collected 68 CRKP strains from the Fifth Affiliated Hospital of Xinjiang Medical University in China from 2023 to 2024. These strains were isolated from the sputum, urine, and whole blood samples of patients diagnosed with CRKP infection. Antibiotic susceptibility tests were performed on CRKP strains. Concurrently, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of disinfectants (benzalkonium bromide, 1% iodophor disinfectant, alcohol, and chlorine-containing disinfectant) against the test isolates were determined by the broth microdilution method. The efflux pump genes (cepA, qacE, qacEΔ1, qacEΔ1-SUL1, oqxA, and oqxB) were detected using polymerase chain reaction. The results showed that 21 out of the 68 CRKP strains exhibited extensive drug resistance, whereas 47 were nonextensively drug-resistant. The MIC value for benzalkonium bromide disinfectants displayed statistically significant differences ( < 0.05) between extensively drug-resistant (XDR) and non-XDR strains. Additionally, the MBC values for benzalkonium bromide disinfectants and 1% iodophor disinfectants displayed statistically significant differences ( < 0.05) between XDR and non-XDR strains. The detection rates for the efflux pump genes were as follows: cepA 52.9%, qacE 39.7%, qacEΔ1 35.2%, qacEΔ1-SUL1 52.9%, oqxA 30.8%, and oqxB 32.3%. The detection rate of the qacEΔ1-SUL1 gene in XDR CRKP strains was significantly higher than in non-XDR CRKP strains ( < 0.05). This indicates a potential link between CRKP bacterial disinfectant efflux pump genes and CRKP bacterial resistance patterns. Ongoing monitoring of the declining sensitivity of XDR strains against disinfectants is essential for the effective control and prevention of superbug.

Multidisciplinary care (MDC) meetings improve the quality of cancer care by providing a space for interdisciplinary communication. The Pediatric Oncology Facility Integrated Local Evaluation (PrOFILE) tool assesses MDC meetings as part of the Service Integration module. We aimed to evaluate the characteristics of MDC meetings at institutions that completed PrOFILE.

The invasive species Aedes albopictus is a major vector of several arboviruses. The global spread of this species seriously threatens human health. Insecticide resistance is an increasing problem worldwide that limits the efficacy of mosquito control. As the major structural component of cuticles, chitin is indispensable to insects. Chitin synthase (CHS) is the enzyme that catalyzes the biosynthesis of chitin at the final step. In this study, two CHS genes of Aedes albopictus (AaCHS1 and AaCHS2) were identified and their basic characteristics were evaluated via bioinformatics analysis. The highest abundance of AaCHS1 transcripts was detected in pupae, whereas that of AaCHS2 transcripts was detected in females; the highest expression levels of AaCHS1 and AaCHS2 were found in the epidermis and the midgut of pupae, respectively. The survival and emergence rates of pupae were significantly reduced after the injection of double-stranded RNA of AaCHS1 or AaCHS2, indicating that both AaCHS1 and AaCHS2 play crucial roles in the pupal development. In addition, the chitin content of pupae was obviously decreased after the suppression of AaCHS1 expression by RNA interference (RNAi) treatment. This influence of the RNAi treatment was further supported by the reduced chitin thickness and weakened chitin fluorescence signal in the new cuticle. The midgut of pupae presented a reduced intensity of the chitin fluorescence signal along with RNAi treatment specific to AaCHS2 expression. The results of this study indicate that CHS genes may be suitable as molecular targets used for controlling mosquitoes.

Dupilumab is the first and only biologic agent approved for the treatment of atopic dermatitis (AD) in pediatric patients aged from 6 months to 17 years. The study aimed to evaluate the impact of dupilumab on the occurrence of comorbidities in pediatric patients with AD.

To explore enablers and barriers to the creation of an oral health training for care workers at specialized centres for children with disabilities in Ouagadougou.

The COVID-19 pandemic has had a major impact on global health and economy, which was significantly mitigated by the availability of COVID-19 vaccines. The levels of systemic and mucosal antibodies against SARS-CoV-2 correlated with protection. However, there is limited data on how vaccine type and booster doses affect mucosal antibody response, and how the breadth of mucosal and systemic antibodies compares. In this cross-sectional study, we compared the magnitude and breadth of mucosal and systemic antibodies in 108 individuals who received either the BNT162b2 (Pfizer) or CoronaVac (SinoVac) vaccine. We found that BNT162b2 (vs CoronaVac) or booster doses (vs two doses) were significantly associated with higher serum IgG levels, but were not significantly associated with salivary IgA levels, regardless of prior infection status. Among non-infected individuals, serum IgG, serum IgA and salivary IgG levels were significantly higher against the ancestral strain than the Omicron BA.2 sublineage, but salivary IgA levels did not differ between the strains. Salivary IgA had the weakest correlation with serum IgG (r = 0.34) compared with salivary IgG (r = 0.63) and serum IgA (r = 0.60). Our findings suggest that intramuscular COVID-19 vaccines elicit a distinct mucosal IgA response that differs from the systemic IgG response. As mucosal IgA independently correlates with protection, vaccine trials should include mucosal IgA as an outcome measure.

Esophageal cancer is increasingly recognized as a significant global malignancy. The main pathological subtype of this cancer is esophageal squamous cell carcinoma (ESCC), which displays a higher degree of malignancy and a poorer prognosis. Reactive oxygen species (ROS) play a critical role in modulating the immune response to tumors, and understanding the regulation of ROS in ESCC could lead to novel and improved therapeutic strategies for ESCC patients.

HMGXB4 (additionally known as HMG2L1) is a non-histone DNA-binding protein that contains a single HMG-box domain. HMGXB4 was originally described in Xenopus where it was seen to negatively regulate the Wnt/β-catenin signaling pathway.

There is concern regarding potential long-term cardiotoxicity with systemic distribution of metals in total joint arthroplasty (TJA) patients.

In Vietnam and other global settings, men who have sex with men (MSM) have become the population at greatest risk of HIV infection. Although HIV pre-exposure prophylaxis (PrEP) has been implemented as a prevention strategy, PrEP outcomes may be affected by low persistence and adherence among MSM with unhealthy alcohol use. MSM have a high prevalence of unhealthy alcohol use in Vietnam, which may affect PrEP outcomes.

Right ventricular (RV) dysfunction is known to impact prognosis, but its determinants in coronary artery disease are poorly understood. Stress cardiac magnetic resonance (CMR) has been used to assess ischemia and infarction in relation to the left ventricle (LV); the impact of myocardial tissue properties on RV function is unknown.

Tuberculosis (TB) remains a serious global public health problem in China. The right knowledge, attitude, and practice (KAP) towards TB are indispensable to appropriate healthcare-seeking behaviors and treatment services timely. However, there are few studies that addressed the KAP towards TB in high-risk and under-developing regions in China. This study aims to evaluate the KAP towards TB in Ningxia Northwest, China, and identify factors that influence it. The findings can guide future health education and promotion interventions.

Clinical complications of anorexia nervosa (AN) include cardiac structural and functional alterations. Available evidence on impaired myocardial deformation in AN patients without overt systolic dysfunction as assessed by left ventricular ejection fraction (LVEF) is scanty and based on a few studies. The aim of the present meta-analysis was to provide comprehensive and updated information on this issue.

This is a summary of a paper that describes the results of the SPARTAN and TITAN studies, which looked at whether a treatment called apalutamide can help treat individuals with advanced prostate cancer.The SPARTAN study included 1207 participants with nonmetastatic castration-resistant prostate cancer (or nmCRPC). The TITAN study included 1052 participants with metastatic castration-sensitive prostate cancer (or mCSPC). Treatment with apalutamide was compared with treatment with placebo. In both studies, all participants were also given androgen deprivation therapy (or ADT), which has been used for many years for the treatment of prostate cancer.The results showed that treatment with apalutamide plus ADT increased participants' survival time while their health-related quality of life stayed the same, compared with placebo plus ADT. Also, apalutamide plus ADT increased the length of time that the cancer did not spread to other parts of the body (metastasize) or did not continue to grow. In both studies, treatment with apalutamide plus ADT was associated with a deep decline in blood prostate-specific antigen (or PSA) levels (called a deep PSA decline). This additional analysis of the SPARTAN and TITAN studies was performed to understand whether the deep PSA decline in participants who received apalutamide plus ADT was linked to their overall health-related quality of life.

Infectious disease outbreaks are an ongoing public health concern, requiring extensive resources to prevent and manage. Invasive Meningococcal Disease (IMD) is a severe outcome of infection with Neisseria meningitidis bacteria, which can be carried and transmitted asymptomatically. IMD is not completely vaccine-preventable, presenting an ongoing risk of outbreak development. This review provides a retrospective assessment of public health management of IMD outbreaks.

Scabies undermines quality of life through its highly disturbing disease symptoms, by distorting self-perception, and secondary to social stigma. Knowledge of its effect on quality of life in general and on specific aspects of day-to-day life is key to addressing the health needs of individual patients and to evaluating gains from community-based disease control interventions.

Major depressive disorder (MDD) is common worldwide and can be highly disabling. People with MDD face many barriers to treatment and may not experience full symptom relief even when treated. Therefore, new treatment modalities are needed for MDD. Digital therapeutics (DTx) may provide people with MDD an additional treatment option.

ConspectusWater scarcity as a consequence of either environmental or economic actions is the most compelling global concern of the 21st century, as ∼2 billion people (26% of the total population) struggle to access safe drinking water and ∼3.6 billion (46% of the total population) lack access to clean water sanitation. In this context, groundwater pollution by toxic heavy metals and/or their oxo-pollutants, such as CrO, CrO, AsO, SeO, SeO, TcO, UO, etc., have been becoming rapidly growing global concerns. The severe toxicity upon bioaccumulation of these oxo-anions has prompted the US Environment Protection Agency (EPA) to mark these persistent and hazardous substances as priority pollutants. Additionally, the heavy-metal-based pollutants are difficult to transform into eco-friendly substances, thus presenting serious challenges toward human health and environmental preservation. To this end, the emergence of advanced functional porous materials (AFPMs), including metal-organic frameworks (MOFs), covalent organic frameworks (COFs), metal-organic polyhedrons (MOPs), porous organic polymers (POPs), etc., have presented extraordinary opportunities in material research and water treatment applications. The liberty in designing and structural tunability of AFPMs, facilitated by utilization of structure-encoded molecular building blocks, enables precise control over target-specificity and structure-property correlations. Bridging the gap between strategic material design and on-demand real-world application can facilitate the development of next-generation sorbents/ion-exchangers for efficient water treatment.In this Account, we summarize the recent advancements from our group toward the development of cutting-edge multifunctional ionic-porous sorbents, offering viable solutions toward providing clean and safe drinking water. Our vision allows us to comprehend this challenge through two strategic factors: efficient oxo-anion capture via ion-exchange and specific host-guest interactions via installation of modular functional groups. To provide an overview, we first highlight the different structural variants and coexistance of various toxic oxo-anions depending on the pH of the medium and their adverse effects. Next, we highlight the promising potential of water stable cationic MOFs toward selective remediation of toxic Cr(VI), Mn(VII), Tc(VI), Se(IV), Se(VI), U (VI), As(III), and As(V)-based toxic oxo-pollutants from water. In the subsequent sections, we summarize the target-specific design strategies and oxo-anion remediation performances of ionic porous organic polymers and hybrid functional porous materials. The key role of target-specific designability and/or structural fine-tuning of AFPMs toward preferential sorption of oxo-pollutants is systematically demonstrate. Particularly, the role of ion-exchange (anion-exchange) processes toward targeted oxo-pollutant capture by ionic AFPMs has been discussed in details. In several examples, the AFPMs were successful in reducing the toxic oxo-anion concentration levels lower than the permitted values for drinking water by the World Health Organizing Committee (WHO), showcasing their real-world applicability potency.Our contemporaneous endeavors in exploring ionic AFPMs for selective toxic oxo-anion sequestration may serve as a blueprint to researchers for future development of the next generation sorbent materials for energy-economically feasible water treatment methods.

Multicomponent interventions with carers of people with dementia demonstrate positive effects on the health and quality of life for carers and care recipients. The World Health Organization's iSupport for Dementia is an evidence-based online psychoeducation programme for carers. However, the programme was mainly implemented as a self-learning tool which might have limited its positive effects on carers and care recipients. Evidence for online multicomponent interventions with carers that incorporates the iSupport programme remains unknown.

An mHealth-based school health education platform (EduSaltS) was promoted in real-world China to reduce salt intake among children and their families. This progress evaluation explores its implementation process and influencing factors using mixed methods.

While bats are tremendously important to global ecosystems, they have been and continue to be threatened by loss of habitat, food, or roosts, pollution, bat diseases, hunting and killing. Some bat species have also been implicated in the transmission of infectious disease agents to humans. While One Health efforts have been ramped up recently to educate and protect human and bat health, such initiatives have been limited by lack of adequate data on the pathways to ensure their support. For instance, data on the role of bats in supporting different components of human welfare assets would be utilized as a stepping stone to champion conservation campaigns. Unfortunately, these data are limited and efforts to synthesize existing literature have majorly focused on few components human welfare leaving other important aspects.

Obesity is a global health issue with detrimental effects on various human organs, including the reproductive system. Observational human data and several lines of animal experimental data suggest that maternal obesity impairs ovarian function and early embryo development, but the precise pathogenesis remains unclear.

Klebsiella pneumoniae is the most commonly encountered pathogen in clinical practice. Widespread use of broad-spectrum antibiotics has led to the current global dissemination of carbapenem-resistant K. pneumoniae, which poses a significant threat to antibacterial treatment efficacy and public health. Outer membrane vesicles (OMVs) have been identified as carriers capable of facilitating the transfer of virulence and resistance genes. However, the role of OMVs in carbapenem-resistant K. pneumoniae under external pressures such as antibiotic and phage treatments remains unclear.

We examined the link between discrimination and self-rated mental health (SRMH) among immigrants and Canadian-born individuals, stratified according to an individual's identification as racialized or white. Using data from Canada's General Social Survey (2014) (weighted N = 27,575,000) with a novel oversample of immigrants, we estimated the association of perceived discrimination with SRMH separately among immigrants and Canadian-born individuals and stratified by racialized status. Among immigrants, we also investigated whether age-at-arrival attenuated or strengthened associations. The prevalence of discrimination was higher among racialized compared to white immigrants (18.9% versus 11.8%), and among racialized compared to white non-immigrants (20.0% versus 10.5%). In the adjusted model with immigrants, where white immigrants not reporting discrimination were the referent group, both white (adjusted prevalence odds ratio [aPOR] 6.11, 95% confidence interval [CI] 3.08, 12.12) and racialized immigrants (aPOR 2.28, 95% CI 1.29, 4.04) who experienced discrimination reported poorer SRMH. The associations were weaker among immigrants who immigrated in adulthood. In the adjusted model with non-immigrants, compared to unexposed white respondents, Canadian-born white respondents who experienced discrimination reported poorer SRMH (aPOR 3.62, 95% CI 2.99, 4.40) while no statistically significant association was detected among racialized respondents (aPOR 2.24, 95% CI 0.90, 5.58). Racialized respondents experienced significant levels of discrimination compared to white respondents irrespective of immigrant status. Discrimination was associated with poor SRMH among all immigrants, with some evidence of a stronger association for white immigrants and immigrants who migrated at a younger age. For Canadian-born individuals, discrimination was associated with poor SRMH among white respondents only.

Vast amounts of pathogen genomic, demographic and spatial data are transforming our understanding of SARS-CoV-2 emergence and spread. We examined the drivers of molecular evolution and spread of 291,791 SARS-CoV-2 genomes from Denmark in 2021. With a sequencing rate consistently exceeding 60%, and up to 80% of PCR-positive samples between March and November, the viral genome set is broadly whole-epidemic representative. We identify a consistent rise in viral diversity over time, with notable spikes upon the importation of novel variants (e.g., Delta and Omicron). By linking genomic data with rich individual-level demographic data from national registers, we find that individuals aged  < 15 and  > 75 years had a lower contribution to molecular change (i.e., branch lengths) compared to other age groups, but similar molecular evolutionary rates, suggesting a lower likelihood of introducing novel variants. Similarly, we find greater molecular change among vaccinated individuals, suggestive of immune evasion. We also observe evidence of transmission in rural areas to follow predictable diffusion processes. Conversely, urban areas are expectedly more complex due to their high mobility, emphasising the role of population structure in driving virus spread. Our analyses highlight the added value of integrating genomic data with detailed demographic and spatial information, particularly in the absence of structured infection surveys.

Plastic and microplastic pollution in the environment has become a significant global concern. Biodegradable plastics (BPs), as environmentally friendly alternatives to conventional plastics, have also emerged as a crucial topic of global discussion. The successful application of BPs appears to offer a solution to the potential ecological risks posed by conventional plastics. However, BPs have negative impacts on the ecological environment and human health. BPs can gradually degrade into biodegradable microplastics (BMPs) in the environment. Wastewater treatment plants (WWTPs) have become an undeniable source and sink of microplastics. With the production and application of BPs, BMPs will inevitably enter WWTPs. This paper reviews the pollution status, degradation behavior of BMPs, and their potential impact on wastewater treatment performance. The focus is on the environmental behavior of BMPs in wastewater treatment systems. The influences of BMPs on microbial communities, sludge treatment, and disposal are thoroughly discussed. The results indicate that BMPs are more easily decomposed into micro/nanoplastics and release additives compared to conventional microplastics. The effects of BMPs on microbial communities and wastewater treatment depend on their characteristics. The numerous oxygen-containing functional groups on the surface of BMPs enable them to serve a dual purpose as transport media and potential sources of environmental pollutants. Finally, in light of existing knowledge gaps, suggestions and prospects for future research on BMPs are proposed.

Uncontrolled gout can cause articular impairment but is also associated with a global and cardiovascular excess mortality, especially in dialysis population. Data documented within existing research is not conclusive regarding gout flares evolution during hemodialysis and their control by urate lowering therapy (ULT). Without clear guidelines concerning hemodialysis patients management with chronic gout, this study proposes to investigate whether gout flare incidence reduction could be observed on this population treated by urate lowering therapy versus patients without treatment.

Despite the global health risk of carbapenem-resistant Enterobacterales (CRE), especially carbapenemase-producing Enterobacterales (CPE), Japan reports a significantly low frequency of CRE with a predominance of IMP-type carbapenemases. This study aimed to investigate the prevalence and characteristics of CRE isolated from hospitals in the city of Nara, Japan.

Pneumonia is the leading cause of death among children around the world. According to WHO, a total of 740,180 lives under the age of five were lost due to pneumonia in 2019. Lung ultrasound (LUS) has been shown to be particularly useful for supporting the diagnosis of pneumonia in children and reducing mortality in resource-limited settings. The wide application of point-of-care ultrasound at the bedside is limited mainly due to a lack of training for data acquisition and interpretation. Artificial Intelligence can serve as a potential tool to automate and improve the LUS data interpretation process, which mainly involves analysis of hyper-echoic horizontal and vertical artifacts, and hypo-echoic small to large consolidations. This paper presents, Fused Lung Ultrasound Encoding-based Transformer (FLUEnT), a novel pediatric LUS video scoring framework for detecting lung consolidations using fused LUS encodings. Frame-level embeddings from a variational autoencoder, features from a spatially attentive ResNet-18, and encoded patient information as metadata combiningly form the fused encodings. These encodings are then passed on to the transformer for binary classification of the presence or absence of consolidations in the video. The video-level analysis using fused encodings resulted in a mean balanced accuracy of 89.3 %, giving an average improvement of 4.7 % points in comparison to when using these encodings individually. In conclusion, outperforming the state-of-the-art models by an average margin of 8 % points, our proposed FLUEnT framework serves as a benchmark for detecting lung consolidations in LUS videos from pediatric pneumonia patients.

Cardiovascular diseases (CVDs) are the leading causes of global mortality. Modifiable behavioural and metabolic risk factors significantly contribute to the burden of CVD. Given the vast socio-demographic and health outcome heterogeneity in Latin America, similar southern Latin American countries (Argentina, Chile, and Uruguay) were analysed as a distinct group to describe the CVD death rates related to metabolic and behavioural risk factors.

Enterobacter species are included among the normal human gut microflora and persist in a diverse range of other environmental niches. They have become important opportunistic nosocomial pathogens known to harbour plasmid-mediated multi-class antimicrobial resistance (AMR) determinants. Global AMR surveillance of Enterobacterales isolates shows the genus is second to Klebsiella in terms of frequency of carbapenem resistance. Enterobacter taxonomy is confusing and standard species identification methods are largely inaccurate or insufficient. There are currently 27 named species and a total of 46 taxa in the genus distinguishable via average nucleotide identity (ANI) calculation between pairs of genomic sequences. Here we describe an Enterobacter strain, ECC3473, isolated from the wastewater of an Australian hospital whose species could not be determined by standard methods nor by ribosomal RNA gene multi-locus typing.

Availability of high-level pediatric training for nurses in Malawi is limited. To address this gap, a novel pediatric critical care nurse preceptor program was developed and implemented by pediatric nurse specialists.

The widespread presence of antibiotics in global watershed environments poses a serious threat to public health and ecosystems. It is essential to examine the resistance of microbial communities in watershed environments in response to shifting antibiotic residues. Sediment samples were collected from seven sites across a watershed, encompassing surface sediment (0-10 cm) and bottom sediment (30-40 cm) depths. The aim was to replicate exposure scenarios to different antibiotics (oxytetracycline (OTC) and sulfadiazine (SD)) at varying concentrations (0, 10, and 100 μg/L) in sediment overlying water, within controlled laboratory settings. The study findings revealed significant variations in the microbial community structure of sediments between different treatments, with distinct differences observed in the upper stream and top sediment layers compared to the sediments located downstream and in the bottom layers. After the introduction of antibiotics, a significant decrease in microbial nodes was observed in the genus-level co-occurrence network analysis of the bottom sediment layer, particularly in the OTC treatment groups. In contrast, the downstream region displayed more robust correlations among the top 20 genera than the upstream area. There was no significant variance observed in the expression of Antibiotic resistance genes (ARGs), consisting of tetracycline resistance genes (tetC, tetG, tetM, tetW, and tetX) and sulfonamide resistance genes (sul1, sul2, and sul3), between sediments in the top and bottom layers. Nevertheless, downstream samples exhibited significantly higher levels of ARGs when compared to upstream samples. Network correlation analysis indicated notably lower correlations between ARGs and bacterial genera in sediments from upstream or surface layers compared to those in downstream or deeper layers. Moreover, correlations in the sediments from surface layers and upstream regions showed a decreasing trend with increasing SD exposure concentrations, while those in deeper layers and downstream areas remained relatively stable. The presence of antibiotics notably enhanced the correlation between sediment properties and ARGs, particularly emphasizing associations with total carbon, nitrogen, and sulfur content. However, the introduction of SD and OTC resulted in a decrease in the influence of these sediment factors on microbial community functions related to sulfur and nitrogen metabolism, as indicated by KEGG (Kyoto Encyclopedia of Genes and Genomes) annotation. The research provided empirical evidence on how microbial resistance responds to changes in antibiotics in sediment samples taken from various depths and locations within a watershed. It emphasized the urgent need for heightened awareness of the movement and alteration of antibiotic resistance patterns in watershed ecosystems.

Ochratoxin A (OTA) contamination in various agro-products poses a serious threat to the global food safety and human health, leading to enormous economic losses. Enzyme-mediated OTA degradation is an appealing strategy, and the search for more efficient enzymes is a prerequisite for achieving this goal. Here, a novel amidohydrolase, termed PwADH, was demonstrated to exhibit 7.3-fold higher activity than that of the most efficient OTA-degrading ADH3 previously reported. Cryo-electron microscopy structure analysis indicated that additional hydrogen-bond interactions among OTA and the adjacent residue H163, the more compact substrate-binding pocket, and the wider entry to the substrate-access cavity might account for the more efficient OTA-degrading activity of PwADH compared with that of ADH3. We conducted a structure-guided rational design of PwADH and obtained an upgraded variant, G88D, whose OTA-degrading activity was elevated by 1.2-fold. In addition, PwADH and the upgraded G88D were successfully expressed in the industrial yeast Pichia pastoris, and their catalytic activities were compared to those of their counterparts produced in E. coli, revealing the feasibility of producing PwADH and its variants in industrial yeast strains. These results illustrate the structural basis of a novel, efficient OTA-degrading amidohydrolase and will be beneficial for the development of high-efficiency OTA-degrading approaches.

Healing Right Way (HRW) aimed to improve health outcomes for Aboriginal Australians with stroke or traumatic brain injury by facilitating system-level access to culturally secure rehabilitation services. Using a stepped-wedge randomised controlled trial (RCT) design (ACTRN12618000139279, 30/01/2018), a two-pronged intervention was introduced in four rural and four urban hospitals, comprising 1.Cultural security training (CST) for staff and 2.Training/employment of Aboriginal Brain Injury Coordinators (ABIC) to support Aboriginal patients for 6-months post-injury. Three-quarters of recruited patients lived rurally. The main outcome measure was quality-of-life, with secondary outcomes including functional measures, minimum processes of care (MPC); number rehabilitation occasions of service received, and improved hospital experience. Assessments were undertaken at baseline, 12- and 26-weeks post-injury. Only MPCs and hospital experience were found to improve among intervention patients. We report on the process evaluation aiming to support interpretation and translation of results.

The COVID-19 global pandemic has brought unprecedented physical and mental health challenges to many, making the exploration of the spiritual dimension of suffering increasingly meaningful and relevant. Pope John Paul II's theologico-pastoral approach in Salvifici Doloris (SD) sheds light on how spiritual reflections and pastoral care anchored on the theology of Jesus Christ's sufferings can be put together to contribute to post-COVID-19 reflections. Given this context, this paper explores the perceptions and coping mechanisms of COVID-19 patients as they navigate the challenges of their illness. By examining patient experiences gleaned from medical and scientific journals, the study underscores the necessity of supporting individuals suffering from various diseases. As John Paul II thoughtfully remarks in Salvifici Doloris, there is a profound need to address patients' inquiries about "the cause, the reason, and equally, the purpose of suffering, and, in brief, a question about its meaning." Taking this into account, this paper contextualizes the theology of suffering articulated by Pope John Paul II in SD within the experiences of patients who contracted COVID-19 during the global pandemic. To embark on this discussion, the following themes about suffering are expounded: First, Insights into the Weight of Suffering Among Persons who Contracted COVID-19. Second, Understanding of Suffering in Salvifici Doloris, and Third, The Salvific Meaning of Suffering in COVID-19 and its Transformative Experience.

The brain age gap (BAG), calculated as the difference between a machine learning model-based predicted brain age and chronological age, has been increasingly investigated in psychiatric disorders. Tobacco and alcohol use are associated with increased BAG; however, no studies have compared global and regional BAG across substances other than alcohol and tobacco. This study aimed to compare global and regional estimates of brain age in individuals with substance use disorders and healthy controls.

Mosquitoes are important vectors of disease pathogens and multiple species are undergoing geographical shifts due to global changes. As such, there is a growing need for accurate distribution predictions. Ecological niche modelling (ENM) is an effective tool to assess mosquito distribution patterns and link these to underlying environmental preferences. Typically, macroclimatic variables are used as primary predictors of mosquito distributions. However, they likely undervalue local conditions and intraspecific variation in environmental preferences. This is problematic, as mosquito control takes place at the local scale. Utilising high-resolution (10 × 10 m) Maxent ENMs on the island of Bonaire as model system, we explore the influence of local environmental variables on mosquito distributions. Our results show a distinct set of environmental variables shape distribution patterns across ecologically-distinct species, with urban variables strongly associated with introduced species like Aedes aegypti and Culex quinquefasciatus, while native species show habitat preferences for either mangroves, forests, or ephemeral water habitats. These findings underscore the importance of distinct local environmental factors in shaping distributions of different mosquitoes, even on a small island. As such, these findings warrant further studies aimed at predicting high-resolution mosquito distributions, opening avenues for preventative management of vector-borne disease risks amidst ongoing global change and ecosystem degradation.

Characterize global genomic features of 86 genomes of Salmonella Gallinarum (SG) and Pullorum (SP), which are important pathogens causing systemic infections in poultry.

Non-communicable diseases (NCDs) pose a significant global health challenge, constituting over 80% of mortality and morbidity. This burden is particularly pronounced in low- and middle-income countries (LMICs), including Ethiopia. Despite this, there's limited research on this issue in Africa. This study aims to investigate the prevalence, patterns, and outcomes of NCDs in hospitalized populations across three tertiary hospitals in Ethiopia.

Early in the coronavirus disease 2019 (COVID-19) pandemic, evidence emerged that individuals with chronic and immunocompromising conditions faced increased risk of severe infection, including death. The Australian Government and public health authorities prioritised these citizens' access to vaccines, including them in phase 1b of the rollout from 22 March 2021. Given the rapidly evolving knowledge and advice, we sought to understand what people with comorbidities understood about their eligibility, where they obtained information, and their experiences interfacing with the program.

Children's health is a global public health priority and a determinant of development and sustainability. Its effective delivery and further improvements require constant and dedicated research on children, especially by child healthcare workers (HCWs). Studies have shown a high involvement of child HCWs from developed countries in child health research, with an under-representation from the global south in authorship and leadership in international collaborations. To our knowledge, there is very little literature on challenges faced by child HCWs in Malawi in conducting child health research. We sought to explore the lived experiences of child HCWs at Kamuzu Central Hospital (KCH) in Malawi by examining their perceptions of child health research and assessing the availability of child health research opportunities.

To compare serological evidence of prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with linked coronavirus disease 2019 (COVID-19) case notification data in Victoria, Australia, and to determine SARS-CoV-2 neutralisation activity based on prior infection and vaccination history.

Individual variation in the need for healthcare constitutes knowledge gaps for young atrial fibrillation (AF) patients. We aimed to estimate the prevalence and primary care burden of early-onset AF in Norway, emphasising sex differences, in a nationwide healthcare database.

Type 2 diabetes mellitus (T2DM) is a metabolic disorder associated with insulin resistance and ensuing dysglycemia, dyslipidemia, and inflammation. Owing to the putative metabolic benefits of curcumin-piperine combination, we explored the efficacy of this combination in improving cardiometabolic indices of patients with T2DM and hypertriglyceridemia. In this double-blind clinical trial, 72 patients with T2DM and hypertriglyceridemia were randomized to receive either a tablet containing 500 mg of curcuminoids plus 5 mg of piperine, or a matched placebo for 12 weeks. Anthropometric indices, blood pressure, glycemic indices, lipid profile, C-reactive protein (CRP), quality of life, and mood were evaluated at baseline and end of the study. After 12 weeks of intervention, the levels of triglycerides (p-value = 0.001) and fasting blood glucose (p-value = 0.004) were significantly reduced in the curcumin-piperine compared with the placebo group. CRP levels were marginally reduced in the curcumin-piperine compared with the placebo group (p-value = 0.081). In addition, energy/fatigue significantly increased in the curcumin-piperine group compared to the control group (p-value = 0.024). However, between-group comparisons showed no significant change in other parameters, including anthropometric indices (waist circumference and body mass index (BMI)), biochemical parameters (low-density lipoprotein (LDL-c), high-density lipoprotein (HDL-c), and insulin), HOMA-IR, blood pressure, quality of life, and DASS-21 items between the studied groups (p-value >0.05). The current study showed that curcumin-piperine supplementation can improve serum CRP, triglycerides, and glucose concentrations in patients with T2DM and hypertriglyceridemia.

This study examined whether maternal depression is related to Early Childhood Developmental (ECD) delay among children by quantifying the mediating contribution of responsive caregiving. We used data from 1235 children (Children's mean age = 50.4 months; 582 girls, 653 boys, 93.9% were Han), selected through convenience sampling, in 2021. 4.7% of children had ECD delay, 34.3% of mothers had depression. Children with depressed mothers were less likely to receive responsive caregiving (OR 4.35, 95% CI 2.60-7.27), and those who did not receive responsive caregiving were more likely to experience ECD delay (OR 3.89, 95% CI 1.89-8.02). Responsive caregiving partly mediated the relationship between maternal depression and ECD. Early intervention for children with depressed mothers is worthy of further investigation.

A number of barriers in care exist for women/girls with bleeding disorders. Little progress has been made to overcome them, particularly regarding levels of awareness of healthcare professionals (HCPs) and women/girls.

Global health partnerships are increasingly being used to improve coordination, strengthen health systems, and incentivize government commitment for public health programs. From 2012 to 2022, the Bill & Melinda Gates Foundation (BMGF) and Aliko Dangote Foundation (ADF) forged Memorandum of Understanding (MoU) partnership agreements with six northern state governments to strengthen routine immunization (RI) systems and sustainably increase immunization coverage. This mixed methods evaluation describes the RI MoUs contribution to improving program performance, strengthening capacity and government financial commitment as well as towards increasing immunization coverage.

This study explores the critical role of inhibitors targeting the mammalian target of rapamycin (mTOR) signaling pathway in breast cancer research and treatment. The mTOR pathway, a central regulator of cellular processes, has been identified as a crucial factor in the development and progression of breast cancer. The essay explains the complex molecular mechanisms through which mTOR inhibitors, such as rapamycin and its analogs, exert their anticancer effects. These inhibitors can stop cell growth, proliferation, and survival in breast cancer cells by blocking critical signaling pathways within the mTOR pathway. Furthermore, the essay discusses the implications of using mTOR inhibitors as a comprehensive therapeutic strategy. It emphasizes the potential benefits of combining mTOR inhibitors with other treatment approaches to enhance the effectiveness of breast cancer treatment. The evolving landscape of breast cancer research underscores the significance of mTOR as a therapeutic target and highlights ongoing efforts to improve and optimize mTOR inhibitors for clinical use. In conclusion, the essay asserts that inhibitors of the mTOR signaling pathway offer a promising approach in the fight against breast cancer. These inhibitors provide a focused and effective intervention targeting specific dysregulations within the mTOR pathway. As research advances, the integration of mTOR inhibitors into customized combination therapies holds excellent potential for shaping a more effective and personalized approach to breast cancer treatment, ultimately leading to improved outcomes for individuals affected by this complex and diverse disease.

Despite effective vaccination strategies, measles remains a global public health challenge. The study explored individual and contextual factors associated with measles infection in Malaysia from 2018 to 2022, informing the development of targeted public health interventions.

HIV prevention with pre-exposure prophylaxis (PrEP) constitutes a major pillar in fighting the ongoing epidemic. While daily oral PrEP adherence may be challenging, long-acting (LA-)PrEP in oral or implant formulations could overcome frequent dosing with convenient administration. The novel drug islatravir (ISL) may be suitable for LA-PrEP, but dose-dependent reductions in T cell and lymphocyte counts were observed at high doses. We developed a mathematical model to predict ISL pro-drug levels in plasma and active intracellular ISL-triphosphate concentrations after oral vs. subcutaneous implant dosing. Using phase II trial data, we simulated antiviral effects and estimated HIV risk reduction for multiple dosages and dosing frequencies. We then established exposure thresholds where no adverse effects on immune cells were observed. Our findings suggest that implants with 56-62 mg ISL offer effective HIV risk reduction without reducing lymphocyte counts. Oral 0.1 mg daily, 3-5 mg weekly, and 10 mg biweekly ISL provide comparable efficacy, but weekly and biweekly doses may affect lymphocyte counts, while daily dosing regimen offered no advantage over existing oral PrEP. Oral 0.5-1 mg on demand provided protection, while not being suitable for post-exposure prophylaxis. These findings suggest ISL could be considered for further development as a promising and safe agent for implantable PrEP.

Rapid point-of-care tests for malaria are now widely used in many countries to guide the initial clinical management of patients presenting with febrile illness. With China having recently achieved malaria elimination, better understanding regarding the identity and distribution of major non-malarial causes of febrile illnesses is of particular importance to inform evidence-based empirical treatment policy.

Intimate partner violence is a global public health problem that mainly affects women rather than men. It has been associated with negative physical and mental health outcomes, including experiences of revictimization. This systematic review describes the risk and protective factors associated with revictimization in female victims of intimate partner violence.

Bioethics plays a pivotal role in guiding ethical decision-making within the realm of medical research and healthcare. However, the influence of geopolitics on bioethical considerations, particularly regarding bioweapons research, remains an underexplored area. This study delves into the uncharted territory of how international political interests can intersect with bioethical principles, potentially shaping collaborative efforts and global health policies related to bioweapons research. Through a hypothetical scenario involving a hypothetical pathogen, a collaborative effort between unspecified countries, we examine the implications of such cooperation on global health governance, with a specific focus on bioweapons research. Ethical dilemmas surrounding responsible research, potential risks and benefits, equitable distribution of findings, and biosafety measures are explored. This analysis underscores the importance of transparent and responsible practices in bioweapons research amidst geopolitical tensions. By striking a balance between national interests and international solidarity, we advocate for robust bioethical frameworks to navigate such collaborations for the collective well-being of humanity and to mitigate potential risks associated with bioweapons research.

Repeated cocaine use produces adaptations in brain function that contribute to long-lasting behaviors associated with cocaine use disorder (CUD). In rodents, the activity-regulated cytoskeleton-associated protein (Arc) can regulate glutamatergic synaptic transmission, and cocaine regulates Arc expression and subcellular localization in multiple brain regions, including the nucleus accumbens (NAc)-a brain region linked to CUD-related behavior. We show here that repeated, non-contingent cocaine administration in global Arc KO male mice produced a dramatic hypersensitization of cocaine locomotor responses and drug experience-dependent sensitization of conditioned place preference (CPP). In contrast to the global Arc KO mice, viral-mediated reduction of Arc in the adult male, but not female, NAc (shArc) reduced both CPP and cocaine-induced locomotor activity, but without altering basal miniature or evoked glutamatergic synaptic transmission. Interestingly, cell type-specific knockdown of Arc in D1 dopamine receptor-expressing NAc neurons reduced cocaine-induced locomotor sensitization, but not cocaine CPP; whereas, Arc knockdown in D2 dopamine receptor-expressing NAc neurons reduced cocaine CPP, but not cocaine-induced locomotion. Taken together, our findings reveal that global, developmental loss of Arc produces hypersensitized cocaine responses; however, these effects cannot be explained by Arc's function in the adult mouse NAc since Arc is required in a cell type- and sex-specific manner to support cocaine-context associations and locomotor responses.

Air pollution poses a significant threat to global public health. While broad mitigation policies exist, an understanding of the economic consequences, both in terms of health benefits and mitigation costs, remains lacking. This study systematically reviewed the existing economic implications of air pollution control strategies worldwide.

This study analyzed the Quality of Life (QoL) and cost-effectiveness of laparoscopic (LDP) versus robotic distal pancreatectomy (RDP).

To investigate the relationships among communication competence, professional autonomy and clinical reasoning and to identify the factors that influence clinical reasoning competence in oncology nurses.

The mariculture industry has seen a rapid expansion in recent years due to the increasing global demand for seafood. However, the industry faces challenges from climate change and increased pathogen pressure. Additionally, the chemicals used to enhance mariculture productivity are changing ocean ecosystems. This study analyzed 36 surface-water metagenomes from South Korean mussel, oyster, scallop, and shrimp farms to expand our understanding of aquaculture microbial genetic resources and the potential impacts of these anthropogenic inputs. We recovered 240 non-redundant species-level metagenome-assembled genomes (MAGs), comprising 224 bacteria, 13 archaea, and three eukaryotes. Most MAGs were assigned to Proteobacteria, Bacteroidota, and Actinobacteriota, with 40.7% remaining unclassified at the species level. Among the three eukaryotic MAGs, one was identified as a novel lineage of green algae, highlighting the uncharacterized genetic diversity in mariculture environments. Additionally, 22 prokaryotic MAGs harbored 26 antibiotic and metal resistance genes, with MAGs carrying beta-lactamases being particularly prevalent in most farms. The obtained microbiome data from mariculture environments can be utilized in future studies to foster healthy, sustainable mariculture practices.

Africa's dual burden of rising incidence of infectious diseases and increasing prevalence of non-communicable diseases (NCDs), such as cardiovascular diseases and diabetes, demands innovative approaches to disease surveillance, response, and cross-border health management in response to growing economic integration and global connectivity. In this context, we propose a discursive framework for the development and implementation of a multi-disease digital health passport (MDDHP) in Africa. The MDDHP would serve as a secure platform for storing and sharing individual health data, offering a comprehensive solution to track and respond to infectious diseases, facilitate the management of NCDs, and improve healthcare access across borders. Empowering individuals to proactively manage their health and improve overall outcomes is a key aspect of the MDDHP. In the paper, we examine the key elements necessary to effectively implement MDDHP, focusing on minimizing risks, maintaining efficacy, and driving its adoption while also taking into consideration the unique contexts of the continent. The paper is intended to provide an understanding of the key principles involved and contribute to the discussion on the development and successful implementation of MDDHP in Africa.

Many countries have an insufficient supply of adequately skilled supply chain workers to manage health commodities, and no global standards in education or experience exist for the supply chain management (SCM) workforce managing health products. We present a professionalization framework for the health SCM workforce that provides a systematic process that countries can use to standardize and elevate the health SCM profession.

Overweight/obesity combined with depression among children and adolescents (ODCA) is a global concern. The bidirectional relationship between depression and overweight/obesity often leads to their comorbidity. Childhood and adolescence represent critical periods for physical and psychological development, during which the comorbidity of overweight/obesity and depression may increase the risk of adverse health outcomes.

This cross-sectional retrospective and prospective study implemented the 2023 International Olympic Committee Relative Energy Deficiency in Sport (REDs) Clinical Assessment Tool version 2 (CAT2) to determine the current severity of REDs (primary outcome) and future risk of bone stress injuries (BSI, exploratory outcome) in elite athletes.

The maternal and newborn health (MNH) eCohort is a new mixed-mode (in-person and phone) longitudinal survey aiming to provide data on novel and undermeasured dimensions of quality along the MNH continuum of care. We describe implementation experiences and lessons learned in Ethiopia, India, Kenya, and South Africa to inform future longitudinal mobile phone-based studies on health system quality.

Understanding how spontaneous brain activity influences the response to neurostimulation is crucial for the development of neurotherapeutics and brain-computer interfaces. Localized brain activity is suggested to influence the response to neurostimulation, but whether fast-fluctuating (i.e., tens of milliseconds) large-scale brain dynamics also have any such influence is unknown. By stimulating the prefrontal cortex using combined transcranial magnetic stimulation (TMS) and electroencephalography (EEG), we examined how dynamic global brain state patterns, as defined by microstates, influence the magnitude of the evoked brain response. TMS applied during what resembled the canonical microstate C was found to induce a greater evoked response for up to 80 milliseconds compared to other microstates. This effect was found in a repeated experimental session, was absent during sham stimulation, and was replicated in an independent dataset. Ultimately, ongoing and fast-fluctuating global brain states, as probed by microstates, may be associated with intrinsic fluctuations in connectivity and excitation-inhibition balance and influence the neurostimulation outcome. We suggest that the fast-fluctuating global brain states be considered when developing any related paradigms. Previous findings suggested local spontaneous neural oscillations can influence neurophysiological response to stimuli. However, beyond the local oscillatory activity, the brain state is rapidly fluctuating on a millisecond time resolution on a global spatial scale. We investigated whether these rapid global fluctuations influenced the evoked response to brain stimulation. We used combined transcranial magnetic stimulation and electroencephalography (TMS-EEG) to stimulate the prefrontal cortex while recording global brain states via EEG microstates. The evoked neurophysiological response was significantly larger when stimulation was applied after the occurrence of a specific global brain state (i.e., microstate C) linked to mind-wandering. The finding was selective to active stimulation, replicated for the same individuals in a repeated session, and replicated in an entirely independent dataset.

: No comprehensive analysis has yet been published regarding global trends in childhood sexual abuse (CSA) and bullying victimization (BV). The present study offers a longitudinal perspective on their prevalence worldwide.

This study aimed to explore the (1) experiences of breast cancer previvor women during genetic testing; (2) perceptions of the impact of genetic testing on their personal, social, family, and professional lives; and (3) views on breast cancer prevention and follow-up processes. This study focused on the risk of breast cancer in persons with BRCA mutations.

Substantial overuse of health care services is identified and intensified efforts are incited to reduce low-value services in general and in imaging in particular.

The behaviors and attitudes associated with event attendance and engagement in physical and sporting activities exert a significant impact on planetary health. This scoping review aims to scrutinize existing literature, elucidate concepts, investigate methodologies, and identify knowledge gaps pertaining to physical activity behavior within the context of planetary health.

Introduction Nanotechnology is the study of manipulating matter at the atomic scale involving particles smaller than 100 nm. Silver nanoparticles (AgNPs) are gaining popularity across diverse sectors including medical, food, healthcare, consumer goods, and industrial fields due to their distinctive physical and chemical characteristics. The eco-friendly synthesis of AgNPs offers a straightforward, cost-effective, and environmentally benign method devoid of hazardous chemicals. Methodology Eighty milliliters (mL) of silver nitrate mixed with 20 mL of and plant extract underwent two days of magnetic stirring for AgNP synthesis. Characterization was done via ultraviolet-visible (UV-vis)-spectroscopy (300-700 nm), and antimicrobial properties, which were checked with , were assessed using the agar-well diffusion method. Results The change in color and peak observed in the UV-vis spectrum confirmed the successful synthesis of AgNPs. Both neem and clove extract-mediated synthesis of AgNPs exhibited antibacterial activity against . However, neem extract synthesized AgNPs displayed a larger inhibitory zone diameter and lower minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values compared to those synthesized using clove extract. Conclusion Incorporating neem and clove extracts in AgNP synthesis offers a practical, eco-friendly, and cost-efficient method with notable efficacy. These AgNPs exhibit antibacterial activity against , suggesting their viability as potent antibacterial agents for addressing oral pathogens. Their sustainable synthesis underscores a promising avenue for developing effective antimicrobial solutions in oral healthcare.

Non-alcoholic fatty liver disease (NAFLD) presents a pervasive global pandemic, affecting approximately 25 % of the world's population. This grave health issue not only demands urgent attention but also stands as a significant economic concern on a global scale. The genesis of NAFLD can be primarily attributed to unhealthy dietary habits and a sedentary lifestyle, albeit certain genetic factors have also been recorded to contribute to its occurrence. NAFLD is characterized by fat accumulation in more than 5 % of hepatocytes according to histological analysis, or >5.6 % of lipid volume fraction in total liver weight in patients. The pathophysiology of NAFLD/non-alcoholic steatohepatitis (NASH) is multifactorial and the mechanisms underlying the progression to advanced forms remain unclear, thereby representing a challenge to disease therapy. Despite the substantial efforts from the scientific community and the large number of pre-clinical and clinical trials performed so far, only one drug was approved by the Food and Drug Administration (FDA) to treat NAFLD/NASH specifically. This review provides an overview of available information concerning emerging molecular targets and drug candidates tested in clinical studies for the treatment of NAFLD/NASH. Improving our understanding of NAFLD pathophysiology and pharmacotherapy is crucial not only to explore new molecular targets, but also to potentiate drug discovery programs to develop new therapeutic strategies. This knowledge endeavours scientific efforts to reduce the time for achieving a specific and effective drug for NAFLD or NASH management and improve patients' quality of life.

This study's objective was to investigate the adverse effects of atypical antipsychotics (AAPs) on the metabolic, hematological, and endocrinological systems in the inpatient environment for children and adolescents with diverse psychiatric disorders.

Leaf-associated microbial communities can promote plant health and resistance to biotic and abiotic stresses. However, the importance of environmental cues in the assembly of the leaf endo- and epi-microbiota remains elusive. Here, we aimed to investigate the impact of seasonal environmental variations, on the establishment of the leaf microbiome, focusing on long-term changes (five years) in bacterial, fungal, and nonfungal eukaryotic communities colonizing the surface and endosphere of six wild populations. While leaf-microbial communities were found to be highly stochastic, the leaf niche had a predominant importance with endophytic microbial communities consistently exhibiting a lower diversity and variability. Among environmental factors, radiation- and humidity-related factors are the most important drivers of diversity patterns in the leaf, with stronger effects on epiphytic communities. Using linear models, we identified 30 important genera whose relative abundance in leaf compartments could be modeled from environmental variables, suggesting specific niche preferences for these taxa. With the hypothesis that environmental factors could impact interactions within microbial communities, we analyzed the seasonal patterns of microbial interaction networks across leaf compartments. We showed that epiphytic networks are more complex than endophytic and that the complexity and connectivity of these networks are partially correlated with the mentioned environmental cues. Our results indicate that humidity and solar radiation function as major environmental cues shaping the phyllosphere microbiome at both micro (leaf compartment) and macro (site) scales. These findings could have practical implications for predicting and developing field-adapted microbes in the face of global change.

The adoption of sustainable agricultural practices is increasingly imperative in addressing global food security and environmental concerns, with microbial based bio-inoculums emerging as a promising approach for nurturing soil health and fostering sustainable crop production.This review article explores the potential of microbial based bio-inoculumsor biofertilizers as a transformative approach toenhance plant disease resistance and growth. It explores the commercial prospects of biofertilizers, highlighting their role in addressing environmental concerns associated with conventional fertilizers while meeting the growing demand for eco-friendly agricultural practices. Additionally, this review discusses the future prospects of biofertilizers, emphasizing the ongoing advancements in biotechnology and formulation techniques that are expected to enhance their efficacy and applicability. Furthermore, this article provides insights into strategies for the successful acceptance of biofertilizers among farmers, including the importance of quality control, assurance, and education initiatives to raise awareness about their benefits and overcome barriers to adoption. By synthesizing the current research findings and industrial developments, this review offers valuable guidance for stakeholders seeking to exploit the potential of biofertilizers or beneficial microbes to promote soil health, ensure sustainable crop production, and addressing the challenges of modern agriculture.

Hepatitis C virus (HCV) is a major global health concern, particularly in Egypt, due to historic schistosomiasis control efforts that inadvertently led to widespread HCV transmission. This study aimed to evaluate the efficacy of Egypt's national strategies in controlling and reducing the prevalence of HCV, including introducing sofosbuvir and implementing the "100 Million Healthy Lives" campaign. The approach includes a review of epidemiological data, an analysis of the national HCV control strategies implemented, and an assessment of their outcomes, focusing on the period from 2006 to 2022. Significant milestones were achieved, including a drastic reduction in new HCV infections from 300 per 100,000 in 2014 to 9 per 100,000 in 2022 and successful treatment of over 4 million people. Egypt has become the first country in the world to achieve the "gold tier" status based on World Health Organization criteria on the path to eradication of HCV. Egypt's comprehensive approach can serve as a model for similar endemic regions. Other nations with high HCV prevalence might benefit from adopting similar multidimensional strategies, emphasizing prevention and treatment.

Gastric cancer (GC) remains a major global health threat ranking as the fifth most prevalent cancer. Hypoxia, a characteristic feature of solid tumors, significantly contributes to the malignant progression of GC. Mitochondria are the major target of hypoxic injury that promotes mitochondrial dysfunction during the development of cancers including GC. However, the gene signature and prognostic model based on hypoxia- and mitochondrial dysfunction-related genes (HMDRGs) in the prediction of GC prognosis have not yet been established.

Hidradenitis suppurativa is a chronic inflammatory skin disease that usually presents in young adults with painful abscesses in intertriginous areas. We present a case of severe hidradenitis suppurativa (Hidradenitis Suppurativa Investigator Global Assessment (HS-IGA) = 5; Hurley stage III) investigated by cardiology and respirology specialists for dyspnea. The patient's symptoms required right-sided cardiac catheterization via the right femoral vein in the inguinal area. The patient was able to undergo this invasive cardiac procedure without infectious complications using multidisciplinary management (dermatology, cardiology, respirology, internal medicine, and infectious diseases specialists), intravenous ertapenem 1 g/day for 6 weeks perioperatively, biologic therapy, and treatment of diabetes with semaglutide. The administration of ertapenem preoperatively and postoperatively of an invasive procedure can be beneficial, particularly when the upcoming intervention requires access to skin areas severely affected by hidradenitis suppurativa. Comorbidities such as obesity and diabetes should be addressed as their treatment might contribute to improve hidradenitis suppurativa.

Artificial Intelligence (AI) holds transformative potential for the healthcare industry, offering innovative solutions for diagnosis, treatment planning, and improving patient outcomes. As AI continues to be integrated into healthcare systems, it promises advancements across various domains. This review explores the diverse applications of AI in healthcare, along with the challenges and limitations that need to be addressed. The aim is to provide a comprehensive overview of AI's impact on healthcare and to identify areas for further development and focus.

The alarming prevalence of teen mothers' exposure to perinatal intimate partner violence (IPV, 8.3-67%) and attachment disorders (ADs) among their children is a global concern, especially in sub-Saharan Africa with high teenage pregnancy rates. This study, therefore, aimed to examine the link between teen IPV and AD in their offspring. We sought also to explore the mediating roles of postpartum depression symptoms, maternal sensitivity, parenting stress, and perceived social support in the relationship between perinatal IPV and children's ADs. This cross-sectional study selected a random sample of 309 teen mothers from Nyanza district. This sample size was determined using Yamane's formula, with random sampling. Various instruments were used for data collection, including questionnaires on intimate partner violence, social support, maternal sensitivity, postpartum depression symptoms and parenting stress and early trauma-related disorders. The data was analysed using SPSS, with mediation analyses performed using the PROCESS macro (version 4.1). IPV was found to be significantly associated with attachment disorders. Simple mediation models showed that parenting stress completely mediated these relationships, while postpartum depression, perceived social support, and maternal sensitivity partially mediated the relationship between IPV and children's ADs. In parallel mediation model, the combined roles of all mediators fully mediated the associations between IPV and ADs. These findings offer valuable insights in designing or strengthening the appropriate interventions to prevent and mitigate the perinatal intimate partner violence and its detrimental impact on children's attachment disorders. Combating intimate partner violence in post-conflict situations is challenging in teen mothers, however, our results suggest that efforts to address maternal mental health and parenting practices may protect children from attachment disorders.

Despite substantial investment in improving healthcare among adolescents in low- and middle-income countries, barriers to access and utilization of services persist, especially to sexual and reproductive health (SRH) services. In response to adolescents' health service needs due to their vulnerability, interventions aimed at improving access and utilization of sexual and reproductive health services have been implemented in specific regions of Zambia. To highlight progress in the access and the overall delivery of services in Zambia, in the wake of a system-level funding mechanism, this paper aims to understand the accessibility, availability, acceptability and quality (AAAQ) of health services provided to young people.

Decoding pancreatic ductal adenocarcinoma heterogeneity and the consequent therapeutic selection remains a challenge. We aimed to characterize epigenetically regulated pathways involved in pancreatic ductal adenocarcinoma progression.

There is a growing interest in the use of complementary therapies for the prevention of disease and the maintenance of health. Furthermore, complementary therapies that incorporate exercise are becoming increasingly prevalent among the older adult, and thus may represent a crucial strategy for the primary and secondary prevention of cardiovascular disease (CVD). Exercise therapy, as a means to prevent and treat cardiovascular diseases, has been gradually applied in clinical practice. It has the advantages of reducing mortality, improving clinical symptoms, restoring physical function and improving quality of life. In recent years, traditional Chinese sports such as Ba Duan Jin and Qigong have developed rapidly. Therefore, a comprehensive systematic review is required to examine interventions involving Ba Duan Jin exercise in healthy adults or those at increased risk of CVD in order to determine the effectiveness of Ba Duan Jin exercise for the primary prevention of CVD.

Tuberculosis (TB) remains a leading cause of mortality worldwide. We conducted this systematic review to understand the distribution of bovine and zoonotic tuberculosis in the World Health Organization (WHO)'s Southeast Asia Region (SEAR) and Western Pacific Region (WPR) to inform our understanding of the risk posed by this disease.

This study sought to document and understand facilitators and barriers to producing, translating, and using modeled evidence in decision-making in Burkina Faso, Nigeria, India, and Kenya. We explored researcher-decision-maker engagement mechanisms as key facilitators of evidence use, with a focus on knowledge brokers and boundary organizations.

Planetary health is being or should be added to medical training curricula in accordance with association consensus. Several articles published in recent years have addressed concern on the implementation, and the challenges that can occur if not addressed properly. This scoping narrative literature review focuses on planetary health as a concept, as well as challenges and suggested solutions to address these challenges. Planetary health is an important concept and needs to be addressed in all medical training. We found that one main challenge is implementation without ensuring the right competences and resources. Medically trained teachers set out to understand and teach complex natural and social systems. At some institutions the time allocated to teach planetary health is limited or non-existent. Case studies and student led teaching are solutions suggested, while other argue that true interdisciplinarity by inviting experts are more in line with what we expect from other subjects. In conclusion, the roots of planetary health, the enormous health risks at stake and nature of the subject requires medical training to adopt a true inter/trans-disciplinary approach to succeed. It might not be expected for all students to become planetary health experts, but all need a general understanding of the most important aspects and values.

Hypertensive disorders of pregnancy are the second most common cause of maternal deaths worldwide. Metabolic syndrome is recognized as one of the risk factors for pre-eclampsia. A recent study revealed a high prevalence of metabolic syndrome in the United Arab Emirates (UAE), particularly amongst Emirati women compared with global estimates. This finding raises the possibility that the prevalence of pre-eclampsia in the region may also be higher as research is increasingly demonstrating an association between pre-eclampsia and metabolic syndrome. We therefore conducted this scoping review of the literature to investigate the nature and extent of studies evaluating the prevalence of pre-eclampsia within the Middle East region to enable subsequent comparison of these findings with the global burden of pre-eclampsia, objectively identify gaps in the literature and inform the design of future studies to address these gaps. PubMed and Scopus were used to extract studies published over the last 20 years (2003-2023). The search terms used included ("Pre-eclampsia" AND "Prevalence") OR ("Hypertension in pregnancy" AND "Prevalence") OR ("Pregnancy" AND "Pre-eclampsia") OR ("Pre-eclampsia" AND "Epidemiology"). We limited our studies to those from the Middle East (ME). A total of 556 relevant articles were identified following which 11 were shortlisted for review. There were four studies from Iran, two from Saudi Arabia, two from Qatar, one from Jordan, and one from Bahrain. The remaining study included 29 countries from Africa, Asia, Latin America, and the Middle East of which data from Jordan, Lebanon, the Occupied Palestinian Territory, and Qatar were included. There were four retrospective, two cross-sectional, and two cohort studies, one prospective study, one meta-analysis, and one descriptive-analytical study. The prevalence of pre-eclampsia in the studies ranged from 0.17 to 5%. We did not find any study investigating the prevalence of pre-eclampsia in the United Arab Emirates. Based on our findings, we conclude that there is a significant scarcity of research in this area, especially within the Middle East, and notably an absence of studies specifically pertaining to the UAE. Consequently, we assert that there is a pressing requirement for additional research to evaluate the prevalence of pre-eclampsia in the region.