Global Health

There is inadequate evidence about the influence of digital and cash payment modalities on the performance of Community Health Workers (CHWs) in underserved communities, such as refugee settlements.

Decades of conflict, political instability, and limited infrastructure left Somalia facing significant challenges to offer consistent and equitable health services, especially for child vaccination. Recent data reveals alarming vaccination gaps, with 60% of children receiving no vaccinations, and only 11% completing required vaccines. Despite global support, an estimated 1.15 million children remain unvaccinated, half of them reside in inaccessible areas controlled by non-state armed actors. In this context, the Far-Reaching Integrated Delivery (FARID) project was initiated since October 2022 across 10 districts of Galmudug and Hirshabelle state in Somalia. Employing the 'Health Camp' model, FARID addresses social, structural, and gender barriers, adapting to ever-changing context of inaccessible regions by providing mobile health facilities and outreach health and nutrition services, including child vaccination. This approach effectively reached previously unreached population in Somalia's most difficult-to-reach areas. Implemented in phases, the project immunized 51,168 children (0-23 months) who had not received any prior vaccinations (23,753 boys and 27,415 girls), screened and treated 14,158 malnourished children (0-59 months) and vaccinated 11,672 pregnant women during March-December 2023. The project's success hinges on intensive community engagement, local partnerships, innovation in mapping and data management, and delivery of integrated services tailored to population needs. The project underscores the critical role of local community-based organizations and clan elders in reaching inaccessible populations through humanitarian negotiation amidst security challenges. The project has achieved significant milestones aligned with national health strategic plans, including progress towards universal health coverage and improved immunization access in Somalia's most challenging regions.

In this contribution, we applied a multi-stage machine learning (ML) framework to map daily values of nitrogen dioxide (NO) and particulate matter (PM and PM) at a 1 km resolution over Great Britain for the period 2003-2021. The process combined ground monitoring observations, satellite-derived products, climate reanalyses and chemical transport model datasets, and traffic and land-use data. Each feature was harmonized to 1 km resolution and extracted at monitoring sites. Models used single and ensemble-based algorithms featuring random forests (RF), extreme gradient boosting (XGB), light gradient boosting machine (LGBM), as well as lasso and ridge regression. The various stages focused on augmenting PM using co-occurring PM values, gap-filling aerosol optical depth and columnar NO data obtained from satellite instruments, and finally the training of an ensemble model and the prediction of daily values across the whole geographical domain (2003-2021). Results show a good ensemble model performance, calculated through a ten-fold monitor-based cross-validation procedure, with an average R of 0.690 (range 0.611-0.792) for NO, 0.704 (0.609-0.786) for PM, and 0.802 (0.746-0.888) for PM. Reconstructed pollution levels decreased markedly within the study period, with a stronger reduction in the latter eight years. The pollutants exhibited different spatial patterns, while NO rose in close proximity to high-traffic areas, PM demonstrated variation at a larger scale. The resulting 1 km spatially resolved daily datasets allow for linkage with health data across Great Britain over nearly two decades, thus contributing to extensive, extended, and detailed research on the long-and short-term health effects of air pollution.

In the changing global landscape, education programs for radiation therapists (RTTs), also known as therapeutic radiographers or radiation therapy technologists, at higher education institutions (HEIs) are non-existent in many African countries. In countries with local RTT education programs, there is evidence of a wide variety of qualification types, including in-house training, diploma and degree offerings. However, what is consistent is the integrated curriculum approach to classroom theory and clinical work-based learning that across the continent follows the general structure of a work-integrated learning (WIL) approach, to enhance clinical competence and meet the needs of the health sector. This study used a qualitative approach with thematic analysis of publicly available documents and reflective writings followed by further analysis through application of the Cultural Historical Activity Theory (CHAT) to explore the changing landscape of oncology in Africa and the impact of this on the education of RTTs. The study was guided by the reflective research question: How can the systemic understanding of RTT training in a changing landscape enable competent and caring practice? The study extends prior research on RTT education in Africa and contributes to debates on the changing role of RTTs in a rapidly changing environment.

To assess the impact of a multi-pronged educational approach on the knowledge, attitudes, and behaviors regarding Familial Hypercholesterolemia (FH) management at a large academic medical center with the aim of empowering primary care clinicians (PCC) to diagnose and treat FH.

Thailand has consistently held the highest global ranking in traffic accidents since 2017, with Khon Kaen displaying the highest mortality rate in the Department of Disease Control Region 7.

Dementia is a global public health concern. This study focuses on the genetic factors underlying dementia. We analyzed electronic medical records (EMR) from Taichung Veterans General Hospital, Taiwan, to confirm differences between dementia and non-dementia patients. This work was supported by Taipei Medical University [TMU111-AE1-B45].

In light of the global increase in breast cancer cases and the crucial importance of the density of fibroglandular tissue (FGT) in assessing risk and predicting the course of the disease, the accurate measurement of FGT emerges as a significant challenge in diagnostic imaging. The current study focuses on the automatic segmentation of breast glandular tissue in MRI scans using a deep learning model. The aim is to establish a solid foundation for the development of methods for the precise quantification of fibroglandular tissue. For this purpose, the publicly available 'Duke Breast Cancer MRI' dataset was systematically processed to train a deep neural network model utilizing the nnU-Net ('no-new-Net') framework, which was then subjected to a quantitative evaluation. The results show the following macro-averaged metrics with standard deviation: Dice Similarity Coefficient 0.827 ± 0.152, accuracy 0.997 ± 0.003, sensitivity 0.825 ± 0.158, and specificity 0.999 ± 0.001. The effectiveness of our model in segmenting FGT is underscored by the high values of the Dice coefficient, Accuracy, Sensitivity, and Specificity, which reflect the precision and reliability of our results. The findings of this study lay a solid foundation for developing automated methods to quantify FGT. Our research efforts, especially driven by clinical studies at the University Hospital Augsburg, are focused on further exploring and validating these potentials.

This article addresses critical health data integrity by proposing an HF (Hyperledger Fabric)-based architecture with integration into the global health data architecture based on distributed content-addressable storage networks.

Adherence to recombinant human growth hormone (r-hGH; somatropin, [Saizen®], Merck Healthcare KGaA, Darmstadt, Germany) treatment is important to achieve positive growth and other outcomes in children with growth disorders. Automated injection devices can facilitate the delivery of r-hGH, injections of which are required daily for a number of years. The ability to adjust injection device settings may improve patient comfort and needle anxiety, influencing adoption and acceptance of such devices, thereby improving treatment adherence. Here, we present the results of a retrospective observational study which investigated the association between injection device settings and adherence in the first 3 months of treatment in patients with growth disorders. Patients aged ≥2 and <18.75 years of age at treatment start, with ≥3 months of adherence data from start of treatment with the third generation of the easypod® device (EP3; Merck Healthcare KGaA, Darmstadt, Germany) were selected (N=832). The two most chosen combinations of device settings at treatment start were the default settings for injection speed, depth and time, or a slow injection speed and default depth and time. These combinations also demonstrated the highest adherence rates (94% and 95%, respectively) compared to other device settings (89%). A higher proportion of patients with intermediate/low adherence in the first month of treatment (31%, n=18/59) changed the device settings during treatment compared with those with high adherence (16%, n=128/803) (p=0.005). The ability to adjust injection device settings offers a valuable opportunity for personalizing treatment, improving patient comfort and treatment adherence.

Submitted genomic data for respiratory viruses reflect the emergence and spread of new variants. Although delays in submission limit the utility of these data for prospective surveillance, they may be useful for evaluating other surveillance sources. However, few studies have investigated the use of these data for evaluating aberration detection in surveillance systems. Our study used a Bayesian online change point detection algorithm (BOCP) to detect increases in the number of submitted genome samples as a means of establishing 'gold standard' dates of outbreak onset in multiple countries. We compared models using different data transformations and parameter values. BOCP detected change points that were not sensitive to different parameter settings. We also found data transformations were essential prior to change point detection. Our study presents a framework for using global genomic submission data to develop 'gold standard' dates about the onset of outbreaks due to new viral variants.

The objective of this study was to develop explainable AI modeling in the prediction of cardiovascular disease. The XGBoost algorithm was used followed by rule extraction and argumentation theory that provides interpretability, explainability and accuracy in scenarios with low confidence results or dilemmas. Our findings are in agreement with previous research utilizing the XGBoost machine learning algorithm for prediction of cardiovascular risk, however it is supported by rule based explainability, offering significant advantages in terms of providing both global and local explainability. Further work is needed to enhance the argumentation-based rule interpretability, explainability and accuracy in scenarios with low confidence results or dilemmas.

Heart failure poses a significant global health burden with high prevalence and mortality rates. A promising possibility in this context is the constant monitoring of the patients through telemedicine. The aim of this work is to present a digital twin of a patient at risk of heart failure. Applying machine learning to the recorded data of the patient, the system is able to early detect potential issues and improve the outcome.

This study explores the critical success factors and barriers to mHealth implementation in South Africa and Tanzania. Through an unstructured literature review and semi-structured interviews with eight mHealth experts, the study uncovers common challenges, including lack of alignment with user needs, inadequate government support, and sustainability issues. Critical success factors identified include user-friendly design and adaptable tools offered at low or no cost. The findings offer insights for organizations and startups in the mHealth sector, highlighting essential considerations for success and barriers alongside strategies for overcoming obstacles and fostering an environment conducive to mHealth integration.

With the rise in global life expectancy, ensuring healthier aging experiences for the older population becomes paramount. This scoping review delves into the technologies employed in the remote health monitoring of the elderly over the past 15 years. Exploring the concept of "Healthy Ageing" as proposed by the World Health Organization, this paper attempts to highlight the techniques and technologies used in health monitoring of the elderly population. The integration of wearable sensors in health monitoring presents promising avenues for enhancing healthcare delivery to older adults. However, challenges such as limited digital literacy and privacy concerns persist, necessitating innovative solutions for unobtrusive monitoring. This paper discusses the potential of passive and ambient sensors to address these challenges, offering insights into enhancing the well-being of the older population while preserving their independence and privacy.

Secure extraction of Personally Identifiable Information (PII) from Electronic Health Records (EHRs) presents significant privacy and security challenges. This study explores the application of Federated Learning (FL) to overcome these challenges within the context of French EHRs. By utilizing a multilingual BERT model in an FL simulation involving 20 hospitals, each represented by a unique medical department or pole, we compared the performance of two setups: individual models, where each hospital uses only its own training and validation data without engaging in the FL process, and federated models, where multiple hospitals collaborate to train a global FL model. Our findings demonstrate that FL models not only preserve data confidentiality but also outperform the individual models. In fact, the Global FL model achieved an F1 score of 75,7%, slightly comparable to that of the Centralized approach at 78,5%. This research underscores the potential of FL in extracting PIIs from EHRs, encouraging its broader adoption in health data analysis.

Feature attribution methods stand as a popular approach for explaining the decisions made by convolutional neural networks. Given their nature as local explainability tools, these methods fall short in providing a systematic evaluation of their global meaningfulness. This limitation often gives rise to confirmation bias, where explanations are crafted after the fact. Consequently, we conducted a systematic investigation of feature attribution methods within the realm of electrocardiogram time series, focusing on R-peak, T-wave, and P-wave. Using a simulated dataset with modifications limited to the R-peak and T-wave, we evaluated the performance of various feature attribution techniques across two CNN architectures and explainability frameworks. Extending our analysis to real-world data revealed that, while feature attribution maps effectively highlight significant regions, their clarity is lacking, even under the simulated ideal conditions, resulting in blurry representations.

Korean National Institute of Health initiated data harmonization across cohorts with the aim to ensure semantic interoperability of data and to create a common database of standardized data elements for future collaborative research. With this aim, we reviewed code books of cohorts and identified common data items and values which can be combined for data analyses. We then mapped data items and values to standard health terminologies such as SNOMED CT. Preliminary results of this ongoing data harmonization work will be presented.

At the core of the child's medical, social, and educational pathway, coordination and referral platforms (CRPs) for neurodevelopmental disorders (NDDs) have been gradually deployed in France since 2018 and support the early detection of NDDs in children. The 112 nationwide CRPs do not benefit from a common electronic health record system. Our aim was to propose an HER model for CRP to enable real-life data reuse, optimize care pathway management and conduct pre-screening for research. CRP data were collected (n=34) into an application enriched by a NLP tool extracting standardized scales for NDDs assessments from medical and paramedical professionals. NLP tool evaluation presented a precision of 86.4% and recall of 90.5%. CRP support was provided to 195 children included between 1 September 2022 and 31 August 2023, aged 4 years, with a sex ratio of 2.8, with delays reported in language (75%) and concerned by global developmental delays (16%). Children's ND phenotype and care pathway description could be automated by a harmonized and structured EHR. While many clinical situations are at an impasse, real-life data-driven evidence is particularly relevant in the context of NDDs, where early intervention plays such a key role in children's development and prognosis. A harmonized and enriched CRP database could benefit both individual and public health levels with pathway monitoring, intervention proposals and research pre-screenings.

The World Health Organization's Operational Framework for Climate Resilient and Low Carbon Health Systems outlines 10 broad components for the development and maintenance of health systems that respond effectively to climate-related challenges. This work analyses the WHO framework from a participatory health informatics perspective and identifies specific initiatives involving non-professionals that align with the framework. Citizen and patient participation in the development of climate-resilient health systems is not only possible but also necessary to maximize climate resiliency at the community and global levels.

Bacterial biofilms represent an escalating global health concern with the proliferation of drug resistance and hospital-acquired infections annually. Numerous strategies are under exploration to combat biofilms and preempt the development of antibacterial resistance. Among these, mechanical disruption of biofilms and enclosed bacteria presents a promising avenue, aiming to induce membrane permeabilization and consequent lethal damage. Herein, we introduce a hemithioindigo (HTI) motor activated by visible light, capable of disrupting sessile bacteria when integrated into a polymeric vesicle carrier. Under visible light, bacteria exhibited a notable outer membrane permeability, reduced membrane fluidity, and diminished viability following mechanical drilling. Moreover, various genetic responses pertaining to the cell envelope were examined via qRT-PCR, alongside the activation of a self-lysis mechanism associated with phage stress, which was coupled with increases in quorum sensing, demonstrating a potential self-lysis cascade from within. The multifaceted mechanisms of action, coupled with the energy efficiency of mechanical damage, underscore the potential of this system in addressing the challenges posed by pathogenic biofilms.

Dementia poses a significant global health problem, necessitating early detection for effective intervention. A literary review was conducted to examine current mobile-based cognitive tests. The limitations of the reviewed applications varied from accessibility to reliability. The paper addresses these limitations by proposing a digital, self-administered version of the Montreal Cognitive Assessment (MoCA) test, with future research focusing on validating the effectiveness of the proposed mobile application in early detection.

Montenegrin Digital Academic Innovation Hub established within Erasmus+ project DigNEST is essential institutional support for developing innovations in the field of health in academic-business cooperation and partnership. Experience of 18 months in running Hub service provides preliminary results in analysis received innovation ideas, provided support and potentials/capacities in medical informatics advancements at national, regional and global level.

The growing challenges of healthcare systems pose a unique opportunity to leverage evidence-based digital health interventions. The WHO's SMART (Standards-based, Machine-readable, Adaptive, Requirements-based, and Testable) guidelines represent a significant advancement in this domain. This paper aims to summarize SMART guidelines authoring and implementation process, drawing on a comprehensive literature analysis. Our findings highlight critical success factors for national implementation, including stakeholder engagement, customization to local contexts, and leveraging international standards and digital technologies. We conclude with recommendations for countries aiming to implement WHO SMART guidelines, underscoring the need for a multi-disciplinary approach and the potential challenges to be navigated.

The integration of data from various healthcare centers into disease registries is pivotal for facilitating collaborative research and enhancing clinical insights. In this study, we investigate the integration process of existing registries into the PVRI GoDeep meta-registry, focusing on the complexities and challenges encountered. We detail the integration process, including data transformation, mapping updates, and feedback mechanisms. Our findings underscore the importance of standardized processes and proactive communication in addressing data quality issues, ultimately enhancing the reliability and trustworthiness of meta-registry data. Through careful harmonization of the data and transparent documentation of data processing, we pave the way for leveraging registry data to drive advancements in pulmonary hypertension research and patient care.

Chronic kidney disease (CKD) raises major concerns for global public health as it is characterized by high prevalence, low awareness, high healthcare costs, and poor prognosis. Therefore, our study prospectively established and validated native T mapping-based radiomics models for the prediction of renal fibrosis and renal function in patients with CKD. Moreover, the area under the receiver operating characteristic curve (AUC) and diagnostic sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were used to evaluate its performance. Thus, our results show that radiomics based on native T mapping images can better identify renal function and renal fibrosis in patients with CKD and outperform conventional T mapping parameters of ΔT and T%, thus providing more information for CKD management and clinical decision-making.

The use of cigarettes and electronic nicotine delivery system (ENDS) has likely changed since 2019 with the rise of pods and disposables, the lung injuries outbreak, flavour bans, Tobacco 21 and the COVID-19 pandemic.

L-lysine is an essential amino acid with broad applications in the animal feed, human food, and pharmaceutical industries. The fermentation production of L-lysine by has limitations such as poor substrate utilization efficiency and low saccharide conversion rates. We deleted the global regulatory factor gene and introduced heterologous genes, including the maltose phosphotransferase genes () from , to enhance the use efficiency of disaccharides and trisaccharides. The engineered strain . XC3 demonstrated improved L-lysine production, yield, and productivity, which reached 160.00 g/L, 63.78%, and 4.44 g/(L‧h), respectively. Furthermore, we overexpressed the glutamate dehydrogenase gene () and assimilated nitrate reductase genes () from . , along with nitrite reductase genes () from . , in strain . XC3. This allowed the construction of . XC4 with a nitrate assimilation pathway. The L-lysine production, yield, and productivity of . XC4 were elevated to 188.00 g/L, 69.44%, and 5.22 g/(L‧h), respectively. After optimization of the residual sugar concentration and carbon to nitrogen ratio, the L-lysine production, yield, and productivity were increased to 204.00 g/L, 72.32%, and 5.67 g/(L‧h), respectively, in a 5 L fermenter. These values represented the increases of 40.69%, 20.03%, and 40.69%, respectively, compared with those of the starting strain XC1. By engineering the substrate utilization pathway, we successfully constructed a high-yield L-lysine producing strain, laying a solid foundation for the industrial production of L-lysine.

An increased risk of cardiovascular disease (CVD) has been reported in patients with diverticular disease (DD). However, there are knowledge gaps about specific risks of each major adverse cardiovascular event (MACE) component.

Novel supportive care interventions designed for an aging population with lung cancer are urgently needed. We aimed to determine the feasibility of a novel supportive care physical therapy (PT) plus progressive muscle relaxation (PMR) intervention delivered to older adults with advanced lung cancer in the United States (US).

There is a notable absence of robust evidence on the efficacy of ultrasound-based breast cancer screening strategies, particularly in populations with a high prevalence of dense breasts. Our study addresses this gap by evaluating the effectiveness of such strategies in Chinese women, thereby enriching the evidence base for identifying the most efficacious screening approaches for women with dense breast tissue.

Children who have respiratory allergies are more likely to experience sleep disturbances. Persistent sleep-disordered breathing directly contributes to poor symptom control for asthma and allergic rhinitis, including deterioration in quality of life. This study aimed to investigate the prevalence, risk factors of habitual snoring, and the correlation between 18-item obstructive sleep apnea (OSA-18) scores and the level of asthma and allergic rhinitis (AR) symptoms control for habitual snorers with respiratory allergies.

This systematic review was aimed to assess the prevalence of apical periodontitis (AP) in Saudi Arabia, focusing on individual-level prevalence and the frequency of AP in endodontically versus untreated teeth.

Noncommunicable diseases (NCDs) account for a substantial number of deaths in Afghanistan. Understanding the prevalence and correlates of major NCD risk factors could provide a benchmark for future public health policies and programs to prevent and control NCDs. Therefore, this study aimed to examine the prevalence and correlates of NCD risk factors among adults aged 18-69 years in Afghanistan.

Liver cancers, including hepatocellular carcinoma (HCC), are the sixth most common cancer and the third leading cause of cancer-related death worldwide, representing a global public health problem. This study evaluated nine patients with HCC. Six of the cases involved hepatic explants, and three involved hepatic segmentectomy for tumor resection. Eight out of nine tumors were HCC, with one being a combined hepatocellular-cholangiocarcinoma tumor. Conventional markers of hepatocellular differentiation (Hep Par-1, arginase, pCEA, and glutamine synthetase) were positive in all patients, while markers of hepatic precursor cells (CK19, CK7, EpCAM, and CD56) were negative in most patients, and when positive, they were detected in small, isolated foci. Based on in silico analysis of HCC tumors from The Cancer Genome Atlas database, we found that Hedgehog (HH) pathway components (GLI1, GLI2, GLI3 and GAS1) have high connectivity values (module membership > 0.7) and are strongly correlated with each other and with other genes in biologically relevant modules for HCC. We further validated this finding by analyzing the gene expression of HH components (PTCH1, GLI1, GLI2 and GLI3) in our samples through qPCR, as well as by immunohistochemical analysis. Additionally, we conducted a chemosensitivity analysis using primary HCC cultures treated with a panel of 18 drugs that affect the HH pathway and/or HCC. Most HCC samples were sensitive to sunitinib. Our results offer a comprehensive view of the molecular landscape of HCC, highlighting the significance of the HH pathway and providing insight into focused treatments for HCC.

Mosquito-borne diseases kill millions of people each year. Therefore, many innovative research and population control strategies are being implemented but, most of them require large-scale production of mosquitoes. Mosquito rearing depends on fresh blood from human donors, experimentation animals or slaughterhouses, which constitutes a strong drawback since high blood quantities are needed, raising ethical and financial constraints. To eliminate blood dependency and the use of experimentation animals, we previously developed BLOODless, a patented diet that represents an important advance towards sustainable mosquito breeding in captivity. BLOODless diet was used to maintain a colony of Anopheles stephensi for 40 generations. Bloodmeal appetite, fitness, Plasmodium berghei infectivity, whole genome sequencing and microbiota were evaluated over time. Here we show that BLOODless can be implemented in Anopheles insectaries since it allows long-term rearing of mosquitoes in captivity, without a detectable effect on their fitness, infectivity, nor on their midgut and salivary microbiota composition.

Alzheimer's disease (AD) stands as the predominant form of dementia, presenting significant and escalating global challenges. Its etiology is intricate and diverse, stemming from a combination of factors such as aging, genetics, and environment. Our current understanding of AD pathologies involves various hypotheses, such as the cholinergic, amyloid, tau protein, inflammatory, oxidative stress, metal ion, glutamate excitotoxicity, microbiota-gut-brain axis, and abnormal autophagy. Nonetheless, unraveling the interplay among these pathological aspects and pinpointing the primary initiators of AD require further elucidation and validation. In the past decades, most clinical drugs have been discontinued due to limited effectiveness or adverse effects. Presently, available drugs primarily offer symptomatic relief and often accompanied by undesirable side effects. However, recent approvals of aducanumab (1) and lecanemab (2) by the Food and Drug Administration (FDA) present the potential in disrease-modifying effects. Nevertheless, the long-term efficacy and safety of these drugs need further validation. Consequently, the quest for safer and more effective AD drugs persists as a formidable and pressing task. This review discusses the current understanding of AD pathogenesis, advances in diagnostic biomarkers, the latest updates of clinical trials, and emerging technologies for AD drug development. We highlight recent progress in the discovery of selective inhibitors, dual-target inhibitors, allosteric modulators, covalent inhibitors, proteolysis-targeting chimeras (PROTACs), and protein-protein interaction (PPI) modulators. Our goal is to provide insights into the prospective development and clinical application of novel AD drugs.

Few panel studies have investigated how different types of mental health (MH) and socio-emotional wellbeing (SEW) outcomes have changed during the pandemic and if their burden has been equally distributed at the population-level. We aimed to examine temporal changes in these outcomes and their socio-ecological predictors using panel data.

, a curved bacterial rod and causative agent of peptic ulcer and gastric adenocarcinoma, is found as an infectious agent in the stomach of over half of the global population. has been identified in oral biofilms and its presence in adenotonsillar tissues has been suggested, with variations in testing methodology both proving and disproving its presence. The current study employed 119 formalin-fixed paraffin-embedded tonsillar tissues from an adult population (n=86) in a major metropolitan city with immunohistochemistry procedures using a monoclonal antibody to determine the incidence of in the tonsils. was identified in 72.1% of the patients and was associated with . in 92.0% of those cases. The high incidence of in patients undergoing tonsillectomy suggests that may be a contributing factor for tonsillitis and tonsillar hypertrophy. Furthermore, the reservoir for in the tonsils may explain why some persons remain refractory to antibiotic treatment for gastric .

Tuberculous meningitis (TBM)-the extrapulmonary form of tuberculosis, is the most severe complication associated with tuberculosis, particularly in infants and children. The gold standard for the diagnosis of TBM requires cerebrospinal fluid (CSF) through lumbar puncture-an invasive sample collection method, and currently available CSF assays are often not sufficient for a definitive TBM diagnosis. Urine is metabolite-rich and relatively unexplored in terms of its potential to diagnose neuroinfectious diseases. We used an untargeted proton magnetic resonance (H-NMR) metabolomics approach to compare the urine from 32 patients with TBM (stratified into stages 1, 2 and 3) against that from 39 controls in a South African paediatric cohort. Significant spectral bins had to satisfy three of our four strict cut-off quantitative statistical criteria. Five significant biological metabolites were identified-1-methylnicotinamide, 3-hydroxyisovaleric acid, 5-aminolevulinic acid, N-acetylglutamine and methanol-which had no correlation with medication metabolites. ROC analysis revealed that methanol lacked diagnostic sensitivity, but the other four metabolites showed good diagnostic potential. Furthermore, we compared mild (stage 1) TBM and severe (stages 2 and 3) TBM, and our multivariate metabolic model could successfully classify severe but not mild TBM. Our results show that urine can potentially be used to diagnose severe TBM.

Antibiotic resistance is an urgent global health challenge, necessitating rapid diagnostic tools to combat its threat. This study uses citizen science and image feature analysis to profile the cellular features associated with antibiotic resistance in Escherichia coli. Between February and April 2023, we conducted the Infection Inspection project, in which 5273 volunteers made 1,045,199 classifications of single-cell images from five E. coli strains, labelling them as antibiotic-sensitive or antibiotic-resistant based on their response to the antibiotic ciprofloxacin. User accuracy in image classification reached 66.8 ± 0.1%, lower than our deep learning model's performance at 75.3 ± 0.4%, but both users and the model were more accurate when classifying cells treated at a concentration greater than the strain's own minimum inhibitory concentration. We used the users' classifications to elucidate which visual features influence classification decisions, most importantly the degree of DNA compaction and heterogeneity. We paired our classification data with an image feature analysis which showed that most of the incorrect classifications happened when cellular features varied from the expected response. This understanding informs ongoing efforts to enhance the robustness of our diagnostic methodology. Infection Inspection is another demonstration of the potential for public participation in research, specifically increasing public awareness of antibiotic resistance.

Buruli ulcer, caused by , is a neglected tropical disease (NTD) characterized by necrosis of the cutaneous tissue, predominantly affecting the limbs. The pathogenesis of this disease is mainly attributed to mycolactone, a lipid toxin produced by . Here, we report the case of a 7-year-old Japanese girl who presented with worsening ulceration on her left forearm, extending to the elbow, following antimicrobial treatment. To evaluate disease progression, we used a mycolactone-specific lateral flow assay. The test yielded positive results in the advancing necrotic area, aiding in determining the extent of necessary debridement. After undergoing two debridement surgeries and receiving 38 weeks of antimicrobial treatment followed by skin grafting, the patient achieved cure. Timely diagnosis is imperative in avoiding prolonged treatment, highlighting the importance of readily available diagnostic point-of-care tests for Buruli ulcer. Moreover, detection of mycolactone not only can serve as a diagnostic tool for Buruli ulcer but also enables prediction of lesion spread and assessment of cure.

Primary liver cancer is the third leading cause of cancer-related mortality. The increasing prevalence of metabolic syndrome and alcohol consumption, along with the existing burden of viral hepatitis, could significantly heighten the impact of primary liver cancer. However, the specific effects of these factors in the Asia-Pacific region, which comprises more than half of the global population, remain largely unexplored. This study aims to analyze the epidemiology of primary liver cancer in the Asia-Pacific region. We evaluated regional and national data from the Global Burden of Disease study spanning 2010 to 2019 to assess the age-standardized incidence, mortality, and disability-adjusted life years associated with primary liver cancer in the Asia-Pacific region. During the study period, there were an estimated 364,700 new cases of primary liver cancer and 324,100 deaths, accounting for 68 and 67% of the global totals, respectively. Upward trends were observed in the age-standardized incidence rates of primary liver cancer due to metabolic dysfunction-associated fatty liver disease (MASLD) and alcohol-associated liver disease (ALD) in the Asia-Pacific region, as well as an increase in primary liver cancer from Hepatitis B virus infection in the Western Pacific region. Notably, approximately 17% of new cases occurred in individuals aged 15-49 years. Despite an overall decline in the burden of primary liver cancer in the Asia-Pacific region over the past decade, increases in incidence were noted for several etiologies, including MASLD and ALD. However, viral hepatitis remains the leading cause, responsible for over 60% of the total burden. These findings underscore the urgent need for comprehensive strategies to address the rising burden of primary liver cancer in the Asia-Pacific region.

Fibroblast Activation Protein (FAP)-targeted nanoparticles (NPs) are designed to accumulate in cancerous stroma. These NPs hold promise for imaging applications in cancer therapy.

Environmental air pollution presents a considerable risk to global respiratory health. If critical levels are exceeded, inhaled pollutants can lead to the development of respiratory dysfunction and provoke exacerbation in those with pre-existing chronic respiratory disease. Over 90% of the global population currently reside in areas where environmental air pollution is considered excessive-with adverse effects ranging from acute airway irritation to complex immunomodulatory alterations. This narrative review provides an up-to-date perspective concerning the impact of environmental air pollution on respiratory health and function and describes the underpinning mechanisms that contribute to the development and progression of chronic respiratory disease.

VESTED (NCT03048422) compared the safety and efficacy of three antiretroviral treatment () regimens in pregnant and postpartum women: dolutegravir+emtricitabine/tenofovir alafenamide fumarate; dolutegravir+emtricitabine/tenofovir disoproxil fumarate (); efavirenz/emtricitabine/TDF. Vertical HIV transmission () occurred to 4/617 (0.60%) live-born infants, who were evaluated for HIV drug resistance () and other risk factors.

The objective of this review was to map the literature about the concept of capability in advanced practice nursing education and practice to achieve greater clarity on the concept and its application.

Anaemia is a global public health issue that impacts individuals of all ages in both developed and developing countries. Anaemia is common in patients with diabetes mellitus; however, it is often undiagnosed and untreated. The main aim of this study was to assess the prevalence and associated factors of anaemia in patients with type 2 diabetes mellitus admitting to a medical unit at National Hospital Kandy.

The Swedish Primary Health Care (PHC) system has, like in other European countries, undergone a gradual transition towards marketization and privatization, most distinctly through a 2010 choice reform. The reform led to an overall but regionally heterogenous expansion of private PHC providers in Sweden, and with evidence also pointing to possible inequities in various aspects of PHC provision. Evidence on the reform's impact on population-level primary health care performance and equity in performance remains scarce. The present study therefore aimed to examine whether the increase in private provision after the reform impacted on population-average rates of avoidable hospitalizations, as well as on corresponding socioeconomic inequities.

In Kyrgyzstan, drug-resistant tuberculosis poses a significant challenge. Recognizing the potential of the BPaL regimen, the World Health Organization recommended its use for selected drug-resistant TB cases under operational research conditions in 2020.

Over the years, low-and middle-income countries have adopted several policy initiatives to strengthen community health systems as means to attain Universal Health Coverage (UHC). In this regard, Zambia passed a Community Health Strategy in 2017 that was later halted in 2019. This paper explores the processes that led to the halting and re-issuing of this strategy with the view of drawing lessons to inform the development of such strategies in Zambia and other similar settings.

Obesity is a global issue that warrants the identification of more effective therapeutic targets and a better understanding of the pivotal molecular pathogenesis. Annexin A1 (ANXA1) is known to inhibit phospholipase A2, exhibiting anti-inflammatory activity. However, the specific effects of ANXA1 in obesity and the underlying mechanisms of action remain unclear. Our study reveals that ANXA1 levels are elevated in the adipose tissue of individuals with obesity. Whole-body or adipocyte-specific ANXA1 deletion aggravates obesity and metabolic disorders. ANXA1 levels are higher in stromal vascular fractions (SVFs) than in mature adipocytes. Further investigation into the role of ANXA1 in SVFs reveals that ANXA1 overexpression induces lower numbers of mature adipocytes, while ANXA1-knockout SVFs exhibit the opposite effect. This suggests that ANXA1 plays an important role in adipogenesis. Mechanistically, ANXA1 competes with MYC binding protein 2 (MYCBP2) for interaction with PDZ and LIM domain 7 (PDLIM7). This exposes the MYCBP2-binding site, allowing it to bind more readily to the SMAD family member 4 (SMAD4) and promoting its ubiquitination and degradation. SMAD4 degradation downregulates peroxisome proliferator-activated receptor gamma (PPARγ) transcription and reduces adipogenesis. Treatment with Ac2-26, an active peptide derived from ANXA1, inhibits both adipogenesis and obesity through the mechanism. In conclusion, the molecular mechanism of ANXA1 inhibiting adipogenesis was first uncovered in our study, which is a potential target for obesity prevention and treatment.

The rise of drug resistance has become a global crisis, with >1 million deaths due to resistant bacterial infections each year. Pseudomonas aeruginosa, in particular, remains a serious problem with limited solutions due to complex resistance mechanisms that now lead to more than 32,000 multidrug-resistant (MDR) infections and over 2000 deaths in the U.S. annually. While the emergence of resistant bacteria has become ominously common, identification of useful new drug classes has been limited over the past over 40 years. We found that a potential novel therapeutic, the peptide-mimetic TM5, is effective at killing P. aeruginosa and displays sufficiently low toxicity in mammalian cells to allow for use in treatment of infections. Interestingly, TM5 kills P. aeruginosa more rapidly than traditional antibiotics, within 30-60 min in vitro, and is effective against a range of clinical isolates, including extensively drug resistant strains. In vivo, TM5 significantly reduced bacterial load in the lungs within 24 h compared to untreated mice and demonstrated few adverse effects. Taken together, these observations suggest that TM5 shows promise as an alternative therapy for MDR P. aeruginosa respiratory infections.

Hepatocellular carcinoma (HCC) poses a significant global health burden and ranks as the fifth most prevalent cancer on a global scale. Hepatitis C virus (HCV) infection remains one of the major risk factors for HCC development. HCC is a heterogeneous disease, and the development of HCC caused by HCV is intricate and involves various factors, including genetic susceptibility, viral factors, immune response due to chronic inflammation, alcohol abuse, and metabolic dysfunction associated with fatty liver disease. In this review, we provide a comprehensive and updated review of research on the genetics and epigenetic mechanisms implicated in developing HCC associated with HCV infection. We also discuss the potential translational implications, including novel biomarkers and drugs for treatment.

Non-pharmacological interventions have proven effective at alleviating depression and anxiety symptoms in older adults. Methodological refinement and testing of these interventions in new contexts are needed on a small scale before their effectiveness and implementation can be evaluated. The purpose of this pilot study is to assess the feasibility of a future large-scale trial comparing an adapted mental health multi-component evidence-based intervention (VIDACTIVA) versus standard care for older adults experiencing depression symptoms in urban, resource-limited settings in Lima, Peru. Furthermore, this study will explore the acceptability, feasibility, and fidelity of implementing the intervention.

BackgroundIn 2022, a global monkeypox virus (MPXV) clade II epidemic occurred mainly among men who have sex with men. Until early 1980s, European smallpox vaccination programmes were part of worldwide smallpox eradication efforts. Having received smallpox vaccine > 20 years ago may provide some cross-protection against MPXV.AimTo assess the effectiveness of historical smallpox vaccination against laboratory-confirmed mpox in 2022 in Europe.MethodsEuropean countries with sufficient data on case vaccination status and historical smallpox vaccination coverage were included. We selected mpox cases born in these countries during the height of the national smallpox vaccination campaigns (latest 1971), male, with date of onset before 1 August 2022. We estimated vaccine effectiveness (VE) and corresponding 95% CI for each country using logistic regression as per the Farrington screening method. We calculated a pooled estimate using a random effects model.ResultsIn Denmark, France, the Netherlands and Spain, historical smallpox vaccination coverage was high (80-90%) until the end of the 1960s. VE estimates varied widely (40-80%, I2 = 82%), possibly reflecting different booster strategies. The pooled VE estimate was 70% (95% CI: 23-89%).ConclusionOur findings suggest residual cross-protection by historical smallpox vaccination against mpox caused by MPXV clade II in men with high uncertainty and heterogeneity. Individuals at high-risk of exposure should be offered mpox vaccination, following national recommendations, regardless of prior smallpox vaccine history, until further evidence becomes available. There is an urgent need to conduct similar studies in sub-Saharan countries currently affected by the MPXV clade I outbreak.

Dementia represents a significant global health challenge, with early screening during the preclinical stage being crucial for effective management. Traditional diagnostic biomarkers for Alzheimer's Disease, the most common form of dementia, are limited by cost and invasiveness. Mild cognitive impairment (MCI), a precursor to dementia, is currently identified through neuropsychological tests like the Montreal Cognitive Assessment (MoCA), which are not suitable for large-scale screening. Eye-tracking technology, capturing and quantifying eye movements related to cognitive behavior, has emerged as a promising tool for cognitive assessment. Subtle changes in eye movements could serve as early indicators of MCI. However, the interpretation of eye-tracking data is challenging. This study introduced a dementia screening tool, VR Eye-tracking Cognitive Assessment (VECA), using eye-tracking technology, machine learning, and virtual reality (VR) to offer a non-invasive, efficient alternative capable of large-scale deployment. VECA was conducted with 201 participants from Shenzhen Baoan Chronic Hospital, utilizing eye-tracking data captured via VR headsets to predict MoCA scores and classify cognitive impairment across different educational backgrounds. The support vector regression model employed demonstrated a high correlation (0.9) with MoCA scores, significantly outperforming baseline models. Furthermore, it established optimal cut-off scores for identifying cognitive impairment with notable sensitivity (88.5%) and specificity (83%). This study underscores VECA's potential as a portable, efficient tool for early dementia screening, highlighting the benefits of integrating eye-tracking technology, machine learning, and VR in cognitive health assessments.

Physical activities performed under free-living conditions that are unsupervised in the home or community have the potential to modulate non-motor symptoms in people with Parkinson's disease.

Hypertension is highly prevalent in India, but the proportion of patients achieving blood pressure control remains low. Efforts have been made to expand health insurance coverage nationwide with the aim of improving overall healthcare access. It is critical to understand the role of health insurance coverage in improving hypertension care.

Chronic obstructive pulmonary disease (COPD) stands as a significant global health challenge, with its intricate pathophysiological manifestations often demanding advanced diagnostic strategies. The recent applications of artificial intelligence (AI) within the realm of medical imaging, especially in computed tomography, present a promising avenue for transformative changes in COPD diagnosis and management. This review delves deep into the capabilities and advancements of AI, particularly focusing on machine learning and deep learning, and their applications in COPD identification, staging, and imaging phenotypes. Emphasis is laid on the AI-powered insights into emphysema, airway dynamics, and vascular structures. The challenges linked with data intricacies and the integration of AI in the clinical landscape are discussed. Lastly, the review casts a forward-looking perspective, highlighting emerging innovations in AI for COPD imaging and the potential of interdisciplinary collaborations, hinting at a future where AI doesn't just support but pioneers breakthroughs in COPD care. Through this review, we aim to provide a comprehensive understanding of the current state and future potential of AI in shaping the landscape of COPD diagnosis and management.

Hearing loss frequently goes undiagnosed and untreated, with serious sequelae. Hearing screening facilitates diagnosis and treatment but is not routinely conducted in primary care. This study addresses attitudes and insights of patients and primary care clinic personnel relative to routinization of hearing screening in primary care for older adults.

Although previous reviews have examined the relationship between heritage cultural maintenance and mental health outcomes among migrants, none have focussed specifically on migrant adolescents (i.e. those aged 10-24 years).

This study assessed the feasibility of smartphone-based colposcopy (SBC) for visual inspection of the cervix by community healthcare workers in low-resource areas.

The disturbance of the inflammatory microenvironment is a frequent pathological trait of diabetic wounds, contributing to the emergence of numerous chronic illnesses. This is crucial in both the development and recovery of wounds caused by diabetes. This study aims to perform a bibliometric analysis of research on the inflammatory microenvironment within the domain of diabetic wounds (DW) over the past 10 years. The objective is to map out the current global research landscape, pinpoint the most significant areas of study and offer guidance for future research avenues. Our research involved querying the Web of Science Core Collection (WoSCC) database for all pertinent studies on the inflammatory microenvironment in diabetic wounds (DW). We utilized bibliometric tools such as CiteSpace, VOSviewer and R (version 4.3.1) to identify and highlight the most impactful studies in the field. The study encompassed a review of 1454 articles published from 2014 to 2023, highlighting China and the United States as pivotal nations in the research of the inflammatory microenvironment in diabetic wounds (DW). Within this sphere, the University of Michigan and Harvard University in the United States, along with Shanghai Jiaotong University in China, emerged as the most prolific institutions. WANG Y from China was identified as the most productive author, while KUNKEL SL from the United States received the most citations. The research primarily focuses on topics such as wound healing, repair processes, angiogenesis, oxidative stress and macrophage activity. Additionally, "macrophage" and "delivery" were pinpointed as the leading subjects with promising research potential in this area. Research on the inflammatory microenvironment of diabetic wounds is rapidly advancing through active international collaboration. The study of new mechanisms related to the inflammatory microenvironment and the development of novel materials for repair based on this microenvironment represent emerging fields of future research, particularly in terms of translational applications. This may offer guidance and novel perspectives for further research in the area of the diabetic wound inflammatory microenvironment.

A recent name change of nonalcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated fatty liver disease (MAFLD) to metabolic dysfunction-associated steatotic liver disease was primarily driven by potential stigma associated with the terminology. This stigma can be different between patients and healthcare providers and differ according to geographic regions of the world. Our aim was to better understand stigma and disease burden among patients with NAFLD enrolled in the global survey from Saudi Arabia (SA).

Adolescent contraceptive decision-making is influenced by a number of patient and clinician-driven factors. Although the AAP continues to endorse an efficacy-based model of contraceptive counseling, many professional organizations are shifting to a shared decision-making model as the optimal approach for providing unbiased and patient-driven contraceptive counseling. While SDM is intended to reduce the influence of clinician bias, it can exacerbate inequity if a clinician tailors a conversation based on their assumptions of a patient's goals or preferences. In this qualitative study, we explored self-reported contraceptive counseling practices among US-based clinicians who see adolescent patients to assess how these practices create barriers or facilitators to SDM and person-centered contraceptive care.

Water, sanitation, and hygiene (WaSH) are crucial determinants of human health. However, the spatio-temporal trends in the global burden of disease attributable to unsafe WaSH remain poorly understood. This study aimed to estimate the disease burden attributable to unsafe WaSH from 1990 to 2019 using data from the Global Burden of Disease (GBD) Study 2019, providing new insights into the associated health conditions.

Cardiovascular diseases (CVD) affect over half a billion people worldwide and are the leading cause of global deaths. In particular, due to population aging and worldwide spreading of risk factors, the prevalence of heart failure (HF) is also increasing. HF accounts for approximately 36% of all CVD-related deaths and stands as the foremost cause of hospitalization. Patients affected by CVD or HF experience a substantial decrease in health-related quality of life compared to healthy subjects or affected by other diffused chronic diseases.

Recent evidence from randomized trials demonstrates that colchicine can reduce the risk of major adverse cardiovascular events (MACE) in patients with coronary artery disease. Colchicine's effect on lower-extremity peripheral artery disease (PAD) is not known.

Introduction Dengue, a viral infection transmitted by mosquitoes, has become a significant global health concern. Its incidence has surged dramatically over the past decades, with severe cases potentially leading to life-threatening conditions such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Despite its prevalence in tropical regions, including India, the clinical manifestations of dengue can vary widely, sometimes presenting atypically. Recent outbreaks, particularly in Northern India, underscore the urgency of understanding and managing this disease. This study focuses on the clinical and laboratory findings of hospitalized dengue fever patients from January 2022 to January 2023, aiming to provide insights for effective patient care and mortality reduction. Methods This was a prospective study at JSS (Jagadguru Sri Shivarathreeshwara) Medical College and Hospital, Mysuru, Karnataka, India (January 2022-January 2023). Blood samples from suspected dengue patients presenting acute febrile symptoms were collected. NS1 antigen and IgM antibody were detected using enzyme-linked immunosorbent assay (ELISA). Patients positive for dengue NS1 antigen and IgM antibodies were included in the study, excluding those with co-infections or comorbidities. Results A nine-month study at JSS Hospital (January 2022-January 2023) screened 1019 samples, identifying 316 dengue cases. Among these, 84.8% were dengue fever and 15.1% were DHF/DSS. Male predominance (60.1%) was noted, with peak incidence in the age groups of 11-20 years (29.11%) and 0-10 years (27.53%). Common symptoms included fever (98.1%), headache (32.91%), myalgia (40.87%), and vomiting (42.7%). Thrombocytopenia was found in 60.6% of cases. NS1 was detected in 56% of patients and IgM was positive in 20.8% of the patients. Comorbidities like type 2 diabetes mellitus (T2DM) (7.59%) and hypertension (7.27%) were observed. Among severe cases, 43.6% had platelet counts <1 lakh/cumm, and 27.5% required intravenous fluids. Seven deaths occurred, primarily in patients with comorbidities and severe dengue. Discussion and conclusion High dengue seropositivity among males (60.12%) compared to females (39.87%) was noted, possibly due to varied exposures. Patients aged 11-20 years had the highest dengue infection, with a peak in admissions during the rainy season. Thrombocytopenia (60.6%) and comorbidities like T2DM and HTN were common, with seven fatalities linked to severe dengue and comorbidities, emphasizing the need for early recognition and management to reduce mortality.

 According to reports on cancer incidence in 2020, breast cancer became the leading malignancy among women worldwide. This multistep disease involves genetic and environmental factors. Paclitaxel, a naturally occurring antimitotic substance, is a widely used chemotherapeutic drug for treating various human malignancies, including breast cancer. However, its major drawback is its extensive toxicity. This limitation can be mitigated through combination therapy with natural products like luteolin. Studies suggest that luteolin has anticancer properties, as it inhibits cancer cell growth and induces apoptosis in breast, lung, and colon cancers. This study aims to investigate the synergistic anticancer effects of combining luteolin and paclitaxel on breast cancer cells.

Obstructive sleep apnoea (OSA) poses a significant health burden globally, necessitating effective intervention strategies to mitigate its adverse consequences. Orthodontic treatment modalities offer promising avenues for addressing OSA by targeting the underlying anatomical abnormalities and restoring unobstructed airflow during sleep. This systematic search was conducted across multiple electronic databases using predefined search terms and inclusion criteria. Studies eligible for inclusion encompassed a range of study designs, including randomized controlled trials, prospective and retrospective studies, clinical trials, and observational studies. Outcome measures included changes in apnoea-hypopnoea index (AHI), oxygen saturation levels, polysomnographic variables, skeletal/cephalometric changes, nasal parameters, upper airway morphology, and clinical symptoms. Initially, 756 records were identified through database searches, with 21 studies meeting the inclusion criteria after meticulous screening and selection. Orthodontic interventions, including rapid maxillary expansion (RME), personalized oral appliances, mandibular positioning devices, and comprehensive orthodontic protocols, demonstrated significant promise in ameliorating OSA symptoms among paediatric populations. Improvements in AHI, nasal resistance, sleep parameters, and upper airway dimensions were consistently observed across various studies, highlighting the potential of orthodontic treatments in mitigating OSA severity. This systematic review underscores the efficacy of orthodontic treatment modalities in addressing OSA among paediatric populations. Despite certain limitations in study design and outcome measures, the review emphasizes the need for further well-designed randomized controlled trials to validate and optimize these interventions for paediatric patients with OSA. Enhanced understanding and implementation of orthodontic treatments hold promise for alleviating the burden of OSA on global health and well-being.

Heart failure (HF) epidemiology, patient characteristics, and clinical outcomes exhibit substantial regional variations, reflecting diverse etiologies and health system capacities. This review comprehensively analyses these variations, drawing on data from recent global registries and clinical trials. Our review indicates that ischemic and hypertensive heart diseases are prevalent globally but differ in dominance depending on the region. Notably, regions such as Africa and Latin America show higher instances of HF from hypertensive heart disease and Chagas cardiomyopathy, respectively. Moreover, disparities in age and comorbidity profiles across regions highlight younger populations with HF in lower-income countries compared to older populations in high-income regions. This review also highlights the global disparity in guideline-directed medical and device therapy, underscoring significant underuse in lower-income regions. These insights emphasize the need for targeted HF management strategies considering regional clinical and demographic characteristics to enhance global HF care and outcomes.

The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) encompasses various autoimmune conditions triggered by exposure to substances with adjuvant activity. Despite its potential relevance to public health, global scientific production on ASIA syndrome is significantly limited. This knowledge gap underscores the need for a comprehensive bibliometric assessment to understand global research in this field. Therefore, this article aims to conduct a bibliometric analysis to identify and evaluate research trends related to ASIA syndrome worldwide. A Scopus search identified scientific documents published between 2010 and 2022. A total of 2,133 articles meeting inclusion criteria were selected and analyzed for scientific production, authors, and institutions. Two-hundred fifty six documents were analyzed, mostly journal articles with multiple authors. The year with the highest publications was 2023, marking a notable increase since 2021. Italy and Israel had the most documents and citations, correlating with authors Yehuda Shoenfeld (Israel) and Carlo Perricone (Italy). Standout journals are "The Journal of Immunologic Research" and "Lupus." Relevant affiliations include Tel-Aviv University and the National Autonomous University of Mexico. This article identifies and analyzes scientific trends associated with ASIA syndrome. Despite increased publications, this field remains controversial and lacks full acceptance within the medical and scientific community, as evidenced by limited scientific production compared to other pathologies. These findings may motivate researchers to generate impactful publications, contributing to the global knowledge expansion on this syndrome.

There are limited national data on the trends and outcomes of patients hospitalized with acute myocardial infarction (AMI) during the coronavirus disease 2019 (COVID-19) pandemic. We aimed to evaluate the impact of early COVID-19 pandemic on the trends and outcomes of AMI using the National Inpatient Sample (NIS) database.

The pursuit of effective vaccination strategies against COVID-19 remains a critical endeavour in global public health, particularly amidst challenges posed by immunity loss and evolving epidemiological dynamics. This study investigated optimal vaccination strategies by considering age structure, immunity dynamics, and varying maximal vaccination rates. To this end, we formulated an SEIR model stratified into $ n $ age classes, with the vaccination rate as an age-dependent control variable in an optimal control problem. We developed an objective function aimed at minimising critical infections while optimising vaccination efforts and then conducted rigorous mathematical analyses to ensure the existence and characterization of the optimal control. Using data from three countries with diverse age distributions, in expansive, constrictive, and stationary pyramids, we performed numerical simulations to evaluate the optimal age-dependent vaccination strategy, number of critical infections, and vaccination frequency. Our findings highlight the significant influence of maximal vaccination rates on shaping optimal vaccination strategies. Under constant maximal vaccination rates, prioritising age groups based on population demographics proves effective, with higher rates resulting in fewer critically infected individuals across all age distributions. Conversely, adopting age-dependent maximal vaccination rates, akin to the WHO strategy, may not always lead to the lowest critical infection peaks but offers a viable alternative in resource-constrained settings.

Obesity and metabolic abnormalities were associated with an increased risk of cardiovascular disease. However, it is unclear how metabolic weight phenotypes relate to cardiovascular diseases in postmenopausal women. This study aimed to explore the relationships in postmenopausal women.

In the face of escalating global aridification, this study examines the complex relationship between climate variability, air pollution, natural disasters, and the prevalence of cardiovascular disease (CVD) and diabetes mellitus (DM) in arid regions.

[This corrects the article DOI: 10.3389/fimmu.2022.967040.].

Suicide attempts and anxiety are common commodities in patients with major depressive disorder (MDD), and suicide attempts are often associated with anxiety symptoms. Studies have found gender differences in several aspects of MDD; however, gender differences in suicide attempts in young first-episode and drug-naive (FEDN) MDD patients with anxiety remain unknown. This study aimed to investigate potential gender differences in the prevalence of suicide attempts and associated risk factors among young FEDN MDD patients with anxiety in a Chinese Han population.

Human Papillomavirus (HPV), an extensive family of DNA viruses, manifests as a persistent global health challenge. Persistent HPV infection is now firmly established as a significant aetiological factor for a spectrum of malignancies. In this review, we examine the latest insights into HPV biology and its intricate relationship with the host. We delve into the complex dynamics of co-infections involving HPV alongside other viruses, such as HIV, EBV, and HSV, as well as the burgeoning role of the microbiome in cancer development. We also explore recent advancements in understanding the specific contributions of HPV in the development of various cancers, encompassing cancers of the anogenital region, head and neck, as well as breast, lung, and prostate. Moreover, we focus on the current preventive strategies, including vaccination and screening methods, and therapeutic interventions that range from traditional approaches like surgery and chemotherapy to emerging modalities such as targeted therapies and immunotherapies. Additionally, we provide a forward-looking view on the future directions of HPV research, highlighting potential areas of exploration to further our understanding and management of HPV and its associated cancers. Collectively, this review is positioned to deepen readers' understanding of HPV biology and its complex interplay with cancer biology. It presents innovative strategies for the prevention, management, and therapeutic intervention of HPV-associated malignancies.

B cells are adaptive immune cells in the tumor microenvironment and play an important role in tumor development and metastasis. However, the roles of genetic variants of the immunity B cell-related genes in the survival of patients with non-small cell lung cancer (NSCLC) remain unknown. In the present study, we first evaluated associations between 10,776 single nucleotide polymorphisms (SNPs) in 220 immunity B cell-related genes and survival of NSCLC in a discovery dataset of 1,185 patients from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. We found that 369 SNPs were significantly associated with overall survival (OS) of NSCLC in multivariable Cox proportional hazards regression analysis ( ≤ 0.05, Bayesian false discovery probability ≤ 0.80), of which 18 SNPs were validated in another independent genotyping dataset of 984 patients from the Harvard Lung Cancer Susceptibility (HLCS) Study. We then performed linkage disequilibrium (LD) analysis, followed by stepwise analysis with a multivariable Cox regression model. Finally, two independent SNPs, inositol polyphosphate-5-phosphatase D () rs13385922 C>T and exosome component 3 () rs3208406 A>G, remained significantly associated withNSCLC OS with a combined hazards ratio (HR) of 1.14 (95% confidence interval = 1.06-1.23, = 2.41×10) and 1.20 (95% confidence interval = 1.14-1.28, = 3.41×10), respectively. Furthermore, NSCLC patients with the combination of unfavorable genotypes for these two SNPs were associated with a poor OS ( = 0.0002) and disease-specific survival (DSS, < 0.0001) in the PLCO dataset. Expression quantitative trait loci (eQTL) analysis suggested that the rs6782875 T allele was significantly correlated with elevated mRNA expression levels in normal lung tissues and whole blood samples, while the rs3208406 G allele was significantly correlated with increased mRNA expression levels in normal lung tissues. Our data indicated that genetic variants in these immunity B cell-related genes may predict NSCLC survival possibly by influencing the gene expression.

The global recognition of the importance of physical exercise (PE) for human health has resulted in increased research on its effects on cortical activity. Neural oscillations, which are prominent features of brain activity, serve as crucial indicators for studying the effects of PE on brain function. Existing studies support the idea that PE modifies various types of neural oscillations. While EEG-related literature in exercise science exists, a comprehensive review of the effects of exercise specifically in healthy populations has not yet been conducted. Given the demonstrated influence of exercise on neural plasticity, particularly cortical oscillatory activity, it is imperative to consolidate research on this phenomenon. Therefore, this review aims to summarize numerous PE studies on neuromodulatory mechanisms in the brain over the past decade, covering (1) effects of resistance and aerobic training on brain health via neural oscillations; (2) how mind-body exercise affects human neural activity and cognitive functioning; (3) age-Related effects of PE on brain health and neurodegenerative disease rehabilitation via neural oscillation mechanisms; and (4) conclusion and future direction. In conclusion, the effect of PE on cortical activity is a multifaceted process, and this review seeks to comprehensively examine and summarize existing studies' understanding of how PE regulates neural activity in the brain, providing a more scientific theoretical foundation for the development of personalized PE programs and further research.

The Dengue virus (DENV), primarily spread by and also by in some regions, poses significant global health risks. Alternative techniques are urgently needed because the current control mechanisms are insufficient to reduce the transmission of DENV. Introducing into inhibits DENV transmission, however, the underlying mechanisms are still poorly understood. Innate immune effector upregulation, the regulation of autophagy, and intracellular competition between and DENV for lipids are among the theories for the mechanism of inhibition. Furthermore, mainly three immune pathways Toll, IMD, and JAK/STAT are involved in the host for the suppression of the virus. These pathways are activated by and DENV in the host and are responsible for the upregulation and downregulation of many genes in mosquitoes, which ultimately reduces the titer of the DENV in the host. The functioning of these immune pathways depends upon the , host, and virus interaction. Here, we summarize the current understanding of DENV recognition by the 's immune system, aiming to create a comprehensive picture of our knowledge. Additionally, we investigated how regulates the activation of multiple genes associated with immune priming for the reduction of DENV.

System learning from major incidents is essential for enhancing preparedness for responding to future adverse events. Sharing learning not only stimulates further improvements, preventing the repetition of mistakes, but may also promote collaboration and the adoption of evidenced-based best practises. As part of a qualitative interview study designed to explore lessons learned, this paper describes the experiences and perspectives of 30 staff from the public health agency responsible for the national COVID-19 response in the United Kingdom. The focus of the interviews was on enabling factors and practises that worked well, as well as those that were more challenging, and which, if addressed, could improve responses to future infectious disease incidents. The interviews elicited valuable insights across various thematic areas that could inform emergency preparedness activities for future infectious disease outbreaks. The outcomes of this study, while integral for the UK agency responsible for public health, extend beyond organisational boundaries and contribute to a broader spectrum of activities aimed at facilitating global learning from the COVID-19 response.

Saline soils pose significant challenges to global agricultural productivity, hindering crop growth and efficiency. Despite various mitigation strategies, the issue persists, underscoring the need for innovative and sustainable solutions. One promising approach involves leveraging microorganisms and their plant interactions to reclaim saline soils and bolster crop yields. This review highlights pioneering and recent advancements in utilizing multi-traits and species as potent promoters of plant growth and health. It examines the multifaceted impacts of saline stress on plants and microbes, elucidating their physiological and molecular responses. Additionally, it delves into the role of ACC deaminase in mitigating plant ethylene levels by and species. Although there are several studies on , much remains to be understood about their synergistic relationships and their potential as auxiliaries in the phytoremediation of saline soils, which is why this work addresses these challenges.

Nearly one in six children lived in war zones in 2023. Evidence-based psychosocial and parenting support has potential to mitigate negative impacts for parents and children co-exposed to war and displacement, especially in relation to mental health and harsh parenting reactions. In the current war in Ukraine, local mental health experts co-created and evaluated, with global experts, the effectiveness of psychosocial and parenting support groups, called on improvements in mental health, positive parenting, and violence against children. This paper aimed to assess the effectiveness of psychosocial and parenting support groups, called 'Hope Groups,' on improvements in caregiver mental health, positive parenting, and prevention of violence against children, for families affected by the war in Ukraine, using a pre/post study design.

Cardiovascular disease remains a major global health concern, with atherosclerosis (AS) being a significant contributor. Vulnerable plaques play a critical role in acute cardiovascular events. Syndecan-1 (SDC-1), a vital membrane proteoglycan in the vascular endothelial glycocalyx, is believed to be associated with plaque progression. However, its precise relationship with severity and vulnerability of atherosclerotic plaque remains unclear. This study aimed to investigate SDC-1 expression and its potential correlation with plaque vulnerability in ApoE atherosclerosis mouse model.

Telerehabilitation (TR) offers a valuable opportunity to improve access to care and has shown results comparable to onsite rehabilitation (SR) across different conditions. The present study aimed to explore the efficacy of TR and SR in improving clinically meaningful outcomes in people with multiple sclerosis (pwMS).

Post-acute COVID-19 syndrome (long COVID) refers to the persistence of COVID-19 symptoms or exceptional symptoms following recovery. Even without conferring fatality, it represents a significant global public health burden. Despite many reports on long COVID, the prevalence and data on associated biological factors remain unclear and limited. This research aimed to determine the prevalence of long COVID during the two distinct epidemic periods in Thailand, due to the Delta and Omicron variants of SARS-CoV-2, and to investigate the biological factors associated with long COVID. In addition, the spike protein amino acid sequences of the Delta and Omicron variants were compared to determine the frequency of mutations and their potential biological implications.

The use rate of electronic cigarettes (e-cigarettes) among adolescents is continuously rising globally, posing new challenges to public health and negatively impacting adolescent health. This study employs bibliometric methods to systematically present the current state and evolving trends in global research on adolescent e-cigarette use.

Tuberculosis (TB) is a global threat, affecting one-quarter of the world's population. The World Health Organization (WHO) reports that 6 million people die annually due to chronic illnesses, a statistic that includes TB-related deaths. This high mortality is attributed to factors such as the emergence of drug-resistant strains and the exceptional survival mechanisms of (MTB). Recently, microRNAs (miRNAs) have garnered attention for their crucial role in TB pathogenesis, surpassing typical small RNAs (sRNA) in their ability to alter the host's immune response. For instance, miR-155, miR-125b, and miR-29a have been identified as key players in the immune response to MTB, particularly in modulating macrophages, T cells, and cytokine production. While sRNAs are restricted to within cells, exo-miRNAs are secreted from MTB-infected macrophages. These exo-miRNAs modify the function of surrounding cells to favor the bacterium, perpetuating the infection cycle. Another significant aspect is that the expression of these miRNAs affects specific genes and pathways involved in immune functions, suggesting their potential use in diagnosing TB and as therapeutic targets. This review compiles existing information on the immunomodulatory function of exosomal miRNAs from MTB, particularly focusing on disease progression and the scientific potential of this approach compared to existing diagnostic techniques. Thus, the aim of the study is to understand the role of exosomal miRNAs in TB and to explore their potential for developing novel diagnostic and therapeutic methods.

Orthopaedic systems are facing an impending wave of increased pressures as a result of global ageing populations. This is compounded by the current stresses these services face, as a result of the COVID-19 pandemic, and increasing burden of musculoskeletal conditions. It is vital that measures are taken to alleviate the pressures on these systems, to ensure timely and quality access to care for patients. This literature review presents a taxonomic classification of the applications of Operational Research and Management Science (OR/MS) methodologies to orthopaedic care settings and treatments, covering the general, medical, and methodological context of each paper. Our structured search identified 492 relevant publications that have been included in our analysis. The results found a literature largely dominated by cost analysis applications, typically utilising Markov models or decision trees. Key gaps identified in this review include the lack of holistic modelling of orthopaedic systems and pathways, and limited applications to resource and capacity planning. The implications of our review are that researchers, healthcare professionals and managers can develop a research agenda to address these gaps, and enhance decision support in orthopaedics.

The messenger RNA (mRNA) platform emerged at the forefront of vaccine development during the COVID-19 pandemic, with two mRNA COVID-19 vaccines being among the first authorized globally. These vaccines were developed rapidly. Informed by decades of laboratory research, and proved to be safe and efficacious tools for mitigating the global impact of the COVID-19 pandemic. The mRNA platform holds promise for a broader medical application beyond COVID-19. Herein, we provide an overview of this platform and describe lessons learned from the COVID-19 pandemic to help formulate strategies toward enhancing uptake of future mRNA-based interventions. We identify several strategies as vital for acceptance of an expanding array of mRNA-based vaccines and therapeutics, including education, accurate and transparent information sharing, targeted engagement campaigns, continued investment in vaccine safety surveillance, inclusion of diverse participant pools in clinical trials, and addressing deep-rooted inequalities in access to healthcare. We present findings from the Global Listening Project (GLP) initiative, which draws on quantitative and qualitative approaches to capture perceptions and experiences during the COVID-19 pandemic to help design concrete action plans for improving societal preparedness for future emergencies. The GLP survey (>70,000 respondents in 70 countries) revealed tremendous disparities across countries and sociodemographic groups regarding willingness to accept novel mRNA vaccines and medicines. The comfort in innovations in mRNA medicines was generally low (35%) and was marginally lower among women (33%). The GLP survey and lessons learnt from the COVID-19 pandemic provide actionable insights into designing effective strategies to enhance uptake of future mRNA-based medicines.

Chronic pain significantly impacts quality of life and poses substantial public health challenges. Buprenorphine, a synthetic analog of thebaine, is recognized for its potential in managing moderate to severe chronic pain with fewer side effects and a lower incidence of tolerance compared to traditional opioids.

Telehealth is a great tool that makes accessing healthcare easier for those incarcerated and can help with reentry into the the community. Justice impacted individuals face many hardships including adverse health outcomes which can be mitigated through access to telehealth services and providers. During the federally recognized COVID-19 pandemic the need for accessible healthcare was exacerbated and telehealth use surged. While access to telehealth should be considered a necessity, there are many challenges and barriers for justice impacted individuals to be able to utilize this service. This perspective examines aspects of accessibility, pandemic, policy, digital tools, and ethical and social considerations of telehealth in correctional facilities. Carceral facilities should continue to innovate and invest in telehealth to revolutionize healthcare delivery, and improve health outcomes for justice impacted individuals.

Antibiotics, often hailed as 'miracle drugs' in the 20th century, have revolutionised medicine by saving millions of lives in human and veterinary medicine, effectively combatting bacterial infections. However, the escalating global challenge of antimicrobial resistance and the appearance and spread of multidrug-resistant pathogens necessitates research into alternatives. One such alternative could be lactoferrin. Lactoferrin, an iron-binding multifunctional protein, is abundantly present in mammalian secretions and exhibits antimicrobial and immunomodulatory activities. An often overlooked aspect of lactoferrin is its proteolytic activity, which could contribute to its antibacterial activity. The proteolytic activity of lactoferrin has been linked to the degradation of virulence factors from several bacterial pathogens, impeding their colonisation and potentially limiting their pathogenicity. Despite numerous studies, the exact proteolytically active site of lactoferrin, the specific bacterial virulence factors it degrades and the underlying mechanism remain incompletely understood. This review gives an overview of the current knowledge concerning the proteolytic activity of lactoferrins and summarises the bacterial virulence factors degraded by lactoferrins. We further detail how a deeper understanding of the proteolytic activity of lactoferrin might position it as a viable alternative for antibiotics, being crucial to halt the spread of multi-drug resistant bacteria.