Global Health

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.

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.

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.

Duggan, JD, Byrne, P, Malone, S, Cooper, S-M, and Moody, J. The physical and physiological demands of intercounty camogie during competitive match-play. J Strength Cond Res 38(9): e510-e520, 2024-The aim of this study was to determine the physical and physiological demands of intercounty camogie match-play between positions and halves of play. Data were collected from 28 players during 18 competitive games using global positioning systems (10-Hz) and heart rate monitors (2.4-GHz). The study demonstrated that intercounty camogie players covered a total distance (TD) (m ± SD) of 6,040 ± 628 m, relative distance (RD) of 83 ± 13 m·min-1, and maximum speed of 25 ± 1 km·h-1. Furthermore, the players covered a mean sprint distance of 214 ± 112 m and 14 ± 6 sprints. Players' mean heart rate (HRmean) and HRmax was 138 ± 23 b·min-1 and 164 ± 20 b·min-1, respectively. There were decrements between halves in TD (p < 0.01, ES = -0.45), RD (p < 0.01, ES = -0.45), maximum speed (p < 0.05, ES = -0.18), HRmax (p < 0.05, ES = -0.23), running (p < 0.01, ES = -0.34), high-speed running (p < 0.01, ES = 0.34), sprinting (p < 0.01, ES = -0.10), HRmax (p < 0.05, ES = -0.23), and HRmax % (p < 0.05, ES = -0.24). Midfielders covered a greater TD compared with full-forwards (p < 0.05, ES = -0.38) and half-forwards (p < 0.05, ES = -0.38). Full-backs covered a significantly lower RD than midfielders (p < 0.05, ES = -1.2), half-backs compared with full-forwards (p < 0.05, ES = 1.14), and half-forwards compared with full-forwards (p < 0.05, ES = 1.15). Full-forwards covered significantly less RD when compared with half-backs (p < 0.05, ES = -1.14), midfielders (p < 0.05, ES = -1.47), and half-forwards (p < 0.05, ES = -1.15). The findings provide physical and physiological values on the match demands of intercounty camogie match-play.

Heavy metal contamination is an alarming concern on a global scale, as drinking tainted water significantly increases human susceptibility to heavy metals. In a realistic scenario, humans are often exposed to a combination of harmful chemicals rather than a single toxicant. Phloretin (PHL), biochanin-A (BCA), and coenzyme Q10 (CoQ10) are bioactive compounds owning plentiful pharmacological properties. Henceforth, the current research explored the putative energizing effects of selected nutraceuticals in combined chromium (Cr) and arsenic (As) intoxicated Swiss albino mice. Potassium dichromate (75 ppm) and sodium meta-arsenite (100 ppm) were given in the drinking water to induce hepatotoxicity, conjugated with PHL and BCA (50 mg/kg each), and CoQ10 (10 mg/kg) intraperitoneally for 2 weeks. After the statistical evaluation, it was observed that the hepato-somatic index, metal load, and antioxidant activity (lipid peroxidation and protein carbonyl content) increased along with the concomitant decrease in the antioxidants (catalase, glutathione-S-transferase, superoxide dismutase, reduced glutathione, and total thiol) in the Cr and As intoxicated mice. Additionally, light microscopy observations, DNA breakages, decreased silent information regulator 1 (SIRT1), nuclear factor (erythroid-derived 2)-like 2 (Nrf2), heme oxygenase (HO-1), and NAD(P)H quinone dehydrogenase 1 (NQO1) gene expressions, together with stimulated apoptotic cell death manifested by the increased expressions of caspase 8 and caspase 3, thus, proved consistency with the aforementioned outcomes. Importantly, the treatment with nutraceuticals not only restored the antioxidant activity but also favorably altered the expressions of SIRT1, Nrf2, HO-1, and NQO1 signaling and apoptosis markers. These findings highlight the crucial role of the PHL, BCA, and CoQ10 combination in reducing Cr and As-induced hepatotoxicity in mice. By averting the triggered apoptosis in conjunction with oxidative stress, this combination increases the SIRT1, Nrf2, HO-1, and NQO1 signaling, thereby reassuringly maintaining the cellular equilibrium.

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.

Treating plaque psoriasis (PsO) with guselkumab (GUS) promotes skin clearance and is associated with improvements in health-related quality of life (HRQoL), anxiety, and depression. It is unclear whether improvements in patient-reported outcomes are due to resolution of skin symptoms or the direct result of GUS treatment.

The coronavirus disease-2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has had a profound global impact on individual health and well-being in adults and children. While most fully recover from COVID-19, a relatively large subgroup continues to experience persistent physical, cognitive, and emotional/behavioral symptoms beyond the initial infection period. The World Health Organization has termed this phenomenon "Post-COVID-19 Condition" (PCC), better known as "Long COVID." Due to the cognitive and psychosocial symptoms, neuropsychologists often assess and recommend treatment for individuals with Long COVID. However, guidance for neuropsychologists' involvement in clinical care, policy-making, and research has not yet been developed. The authors of this manuscript convened to address this critical gap and develop guidance for clinical neuropsychologists working with patients presenting with Long COVID. Authors include pediatric and adult neuropsychologists with expertise in Long COVID and behavioral health. All authors have been engaged in clinical and research efforts examining the impact of COVID-19. Authors summarized the literature-to-date pertinent to the neuropsychiatric sequelae of Long COVID and developed guidance for neuropsychologists working with individuals with Long COVID. Research findings regarding neuropsychiatric symptoms associated with Long COVID are mixed and limited by methodological differences. As they practice and conduct research, neuropsychologists should remain mindful of the evolving and tenuous nature of the literature.

Outdoor thermal irritation poses a serious threat to public health, with the frequent occurrence of increasingly intense heat waves. With the global goal of carbon peaking and carbon neutrality, there is an urgent need for a strategy that is efficient and can provide localized outdoor cooling without an intensive energy input. This paper demonstrated a rapidly formable polyurethane-based coating with controlled bimodal spherical micropores. Nano-AlO particles (300 nm) embedded in the polymer were used for targeted enhancement of reflectance at 0.38-0.5 wavelengths. The enhanced film reflected 93% solar irradiance and selectively transmitted 95% thermal radiation (8-13 μm), enabling rapid cooling and the creation of a comfortable thermal microclimate to avoid overheating of 6-11 °C during daytime conditions. The ultrawide material compatibility and excellent adaptive mechanical strength of polyurethane-based coatings are expected to benefit the sustainable development of society in a wide range of fields, from health to economics.

Given the vast quantity of oil and gas input to the marine environment annually, hydrocarbon degradation by marine microorganisms is an essential ecosystem service. Linkages between taxonomy and hydrocarbon degradation capabilities are largely based on cultivation studies, leaving a knowledge gap regarding the intrinsic ability of uncultured marine microbes to degrade hydrocarbons. To address this knowledge gap, metagenomic sequence data from the Deepwater Horizon (DWH) oil spill deep-sea plume was assembled to which metagenomic and metatranscriptomic reads were mapped. Assembly and binning produced new DWH metagenome-assembled genomes that were evaluated along with their close relatives, all of which are from the marine environment (38 total). These analyses revealed globally distributed hydrocarbon-degrading microbes with clade-specific substrate degradation potentials that have not been reported previously. For example, methane oxidation capabilities were identified in all . Furthermore, all encoded and expressed genes for non-gaseous -alkane degradation; however, DWH encoded alkane hydroxylase, not alkane 1-monooxygenase. All but one previously unrecognized DWH plume member in the SAR324 and UBA11654 have the capacity for aromatic hydrocarbon degradation. In contrast, were diverse in the hydrocarbon substrates they could degrade. All clades encoded nutrient acquisition strategies and response to cold temperatures, while sensory and acquisition capabilities were clade specific. These novel insights regarding hydrocarbon degradation by uncultured planktonic microbes provides missing data, allowing for better prediction of the fate of oil and gas when hydrocarbons are input to the ocean, leading to a greater understanding of the ecological consequences to the marine environment.IMPORTANCEMicrobial degradation of hydrocarbons is a critically important process promoting ecosystem health, yet much of what is known about this process is based on physiological experiments with a few hydrocarbon substrates and cultured microbes. Thus, the ability to degrade the diversity of hydrocarbons that comprise oil and gas by microbes in the environment, particularly in the ocean, is not well characterized. Therefore, this study aimed to utilize non-cultivation-based 'omics data to explore novel genomes of uncultured marine microbes involved in degradation of oil and gas. Analyses of newly assembled metagenomic data and previously existing genomes from other marine data sets, with metagenomic and metatranscriptomic read recruitment, revealed globally distributed hydrocarbon-degrading marine microbes with clade-specific substrate degradation potentials that have not been previously reported. This new understanding of oil and gas degradation by uncultured marine microbes suggested that the global ocean harbors a diversity of hydrocarbon-degrading bacteria, which can act as primary agents regulating ecosystem health.

This chapter provides a blueprint for accelerating biotech and life sciences innovation using public-private partnerships to create innovation infrastructure that become a platform for scientific breakthroughs and economic growth. Examples are provided on creating standalone co-working labs as well as through partnerships with academic and healthcare system partners both in the United States and Europe. Risks and challenges are addressed as well as the overall benefits to the broader public of investing public funds in biotech and life science infrastructure versus individual companies based on the potential impact to global public health from new treatments, therapies, devices, and diagnostics.

Rwanda is a country in East Africa, a region characterized by highly mobile populations and outbreaks of high-consequence infectious diseases occurring on a regular basis. To increase the level of outbreak preparedness in the region, the Rwandan government and the German Ministry of Health signed a joint agreement to construct a new high-level isolation unit in Rwanda, the first in East Africa, and implement a training program for Rwandan healthcare workers to equip them with the necessary skills and knowledge for medical management of patients under high-level isolation conditions, including intensive care treatment. To better understand the scope and format of the planned training program, a needs assessment was performed based on findings from a standardized survey of 4 intensive care units in Rwanda as well as observations from 2 members of a German high-level isolation unit who completed clinical internships at Rwandan hospitals. In this case study, we describe the necessary steps to promote the sustainability and capabilities of the new high-level isolation unit in Kigali and ensure the successful implementation of the training program.

Intermittent fasting, such as during Ramadan, is prevalent among pregnant women. However, the association between Ramadan during pregnancy and offspring health along the life course has not been fully established.

Substance use disorders (SUDs) represent a significant global health concern, demanding the development of effective pharmacological treatments. To address this, an investigation was conducted to examine the anti-addictive properties of two compounds, (S)-T1 and (S)-T2, which specifically target the α3β4 nicotinic acetylcholine receptor (nAChR).

Previous epidemiological studies have reported a short-term association between ambient temperature and suicide risk. To gain a clearer understanding of this association, it is essential to differentiate the risk factors for intentional self-harm (ISH) from those specifically associated with suicide deaths. Therefore, this study aims to examine whether the association between daily temperature and ISH or suicide deaths differs by age and sex. Between 2014 and 2019, cases of emergency room visits related to ISH and suicide deaths in Seoul were identified. A time-stratified case-crossover design was used to adjust for temporal trends and seasonal variation. A distributed lag nonlinear model was used to analyze the nonlinear and time-delayed effect of ambient temperature on ISH and suicide deaths. Positive associations were observed between temperature and both ISH and suicide deaths. For ISH, the relative risk (RR) was high at 1.17 (95% confidence interval (CI): 1.03, 1.34) for a temperature of 25.7 °C compared with 14.8 °C. The RR for suicide death was higher than those for ISH, at 1.43 (95% CI: 1.03, 2.00) for a temperature of 33.7 °C. These associations varied by age and sex, with males and females aged 35-64 years showing increased susceptibility to suicide deaths. This study provides detailed evidence that unusually high temperatures, both anomalous and out of season, may trigger suicidal behaviors, including both ISH and suicide deaths.

The interpretation of lung sounds plays a crucial role in the appropriate diagnosis and management of pediatric asthma. Applying artificial intelligence (AI) to this task has the potential to better standardize assessment and may even improve its predictive potential.

Globally, 1 in 3 people live with health conditions that could be improved with rehabilitation. Ideally, this is provided by trained professionals delivering evidence-based dose, intensity, and content of rehabilitation for optimal recovery. The widely acknowledged inability of global health care providers to deliver recommended levels of rehabilitation creates an opportunity for technological innovation. Design processes that lack close consideration of users' needs and budgets, however, mean that many rehabilitation technologies are neither useful nor used. To address this problem, our multidisciplinary research group have established a cocreation center for rehabilitation technology that places the end user at the center of the innovation process.

To analyze contemporary trends of dementia and dementia-related mortality in the United States between 1999 and 2020 categorized by demographic and regional attributes. A retrospective cohort analysis was conducted using mortality data from individuals aged 35 years to ≥85 years, where dementia/Alzheimer disease was recorded as a contributing or underlying cause of death. Data were extracted from the US Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database for the years 1999-2020. Mortality rates adjusted for age due to dementia (annual age-adjusted mortality rate [AAMR]) per 10,000 individuals in the United States were categorized by gender, racial and ethnic groups, and geographic regions. Results revealed 6,601,680 deaths related to dementia between 1999 and 2020. Among these, 85.5% were non-Hispanic (NH) white, 8% NH black, 4.34% Hispanic or Latino, 1.6% NH Asian or Pacific Islander, and 0.3% NH American Indian or Alaska Native adults. The overall AAMR was 17.49, with women experiencing a higher AAMR of 18.19 compared to men (16.05). Ethnic disparities were evident, with NH black adults having the highest AAMR (18.23), followed by NH white (18.09) and Hispanic adults (12.7). Over the study period, the overall AAMR increased from 10.86 in 1999 to 21.42 in 2020, with a notable 18.4% rise in the AAMR from 1999 to 2001. From 2001 to 2020, the average percent change of the AAMR was 1.0%. This upward trend in mortality was observed for both men and women and across all ethnicities. The study spanning 1999-2020 revealed concerning trends in dementia-related mortality in the United States. There is a critical need for targeted health care policy initiatives aimed at mitigating the increasing dementia burden. .

Hypertrophic cardiomyopathy (HCM), a common genetic heart condition, is characterized by thickening of the left ventricle, which can result in a range of health issues, such as arrhythmias, heart failure, and sudden death. Despite traditional cautions against exercise in HCM patients due to potential exacerbation of symptoms and risk of sudden death, recent evidence suggests a paradigm shift toward the benefits of structured exercise rehabilitation. The pathogenesis of HCM, the physical and psychological effects of the illness on patients, and changing views on exercise as a therapeutic intervention are all covered in this review. Recent research shows that modest physical activity can considerably enhance functional ability, psychological health, and overall quality of life in individuals with heart failure without increasing the risk of unfavorable cardiac events, challenging earlier recommendations. Moreover, exercise rehabilitation has been shown to induce favorable myocardial remodeling and enhance cardiovascular fitness, suggesting a revaluation of exercise prescriptions tailored to individual patient profiles. Despite the promising role of exercise in managing HCM, this review also acknowledges the complexities of implementing rehabilitation programs, including the need for comprehensive patient assessment, personalized exercise regimens, and monitoring for potential complications. Future research should focus on optimizing exercise recommendations, understanding long-term outcomes, and integrating exercise rehabilitation into standard care protocols for HCM to foster a more holistic approach to patient management. Underscoring the necessity of a multidisciplinary strategy that balances the benefits of physical activity with the unique risks associated with HCM with the aim of improving patient outcomes through evidence-based, patient-centered care.

, including Zika virus (ZIKV), are a significant global health concern, yet no licensed antivirals exist to treat disease. The small Membrane (M) protein plays well-defined roles during viral egress and remains within virion membranes following release and maturation. However, it is unclear whether M plays a functional role in this setting. Here, we show that M forms oligomeric membrane-permeabilising channels , with increased activity at acidic pH and sensitivity to the prototypic channel-blocker, rimantadine. Accordingly, rimantadine blocked an early stage of ZIKV cell culture infection. Structure-based channel models, comprising hexameric arrangements of two -membrane domain protomers were shown to comprise more stable assemblages than other oligomers using molecular dynamics (MD) simulations. Models contained a predicted lumenal rimantadine binding site, as well as a second druggable target region on the membrane-exposed periphery. screening enriched for repurposed drugs/compounds predicted to bind to either one site or the other. Hits displayed superior potency and in cell culture compared with rimantadine, with efficacy demonstrably linked to virion-resident channels. Finally, rimantadine effectively blocked ZIKV viraemia in preclinical models, supporting that M constitutes a physiologically relevant target. This could be explored by repurposing rimantadine, or development of new M-targeted-therapies.

The consequent use of malaria rapid diagnostic tests (RDTs) preceding a treatment decision has improved the global management of malaria. A combination RDT, including an inflammation marker to potentially guide antibiotic prescription, could improve the management of acute febrile illness (AFI).

Cardiovascular disease (CVD) is a global health concern, presenting significant risks to human health. Atherosclerosis is among the most prevalent CVD, impacting the medium and large arteries in the kidneys, brain, heart, and other vital organs, as well as the lower limbs. As the disease progresses, arterial obstruction can result in heart attacks and strokes. Therefore, patients with atherosclerosis should receive accurate diagnosis and timely therapeutic intervention. With the advancements in nanomedicine, researchers have proposed new research strategies and methods for atherosclerosis imaging. This paper summarizes some current research findings on the use of nanomaterials in diagnosing atherosclerosis and offers insights for optimizing the imaging applications of nanomaterials in the future.

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].

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).

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.

Building longitudinal population cohorts in Africa for coordinated research and surveillance can influence the setting of national health priorities, lead to the introduction of appropriate interventions, and provide evidence for targeted treatment, leading to better health across the continent. However, compared to cohorts from the global north, longitudinal continental African population cohorts remain scarce, are relatively small in size, and lack data complexity. As infections and noncommunicable diseases disproportionately affect Africa's approximately 1.4 billion inhabitants, African cohorts present a unique opportunity for research and surveillance. High genetic diversity in African populations and multiomic research studies, together with detailed phenotyping and clinical profiling, will be a treasure trove for discovery. The outcomes, including novel drug targets, biological pathways for disease, and gene-environment interactions, will boost precision medicine approaches, not only in Africa but across the globe.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

, 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 .

Tuberculosis (TB) is amongst the leading causes of death from an infectious disease, with an estimated 1.3 million deaths from TB in 2022. Approximately 25% of the global population is estimated to be infected with the TB bacterium, giving rise to 10.6 million episodes of TB disease in 2022. The prevalence of diabetes influences TB incidence and TB mortality. It is associated not only with an increased risk of TB disease but also death during TB treatment, TB relapse after treatment completion and multidrug-resistant TB. Since 2011, the World Health Organization (WHO) has recommended collaborative TB and diabetes activities as outlined in the Collaborative Framework for Care and Control of TB and Diabetes.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Secondary prevention of skin cancer consists in early detection of malignant lesions through patients' mole self-examination and medical examination. The objective of this study was to assess the self-reported  frequency of mole examination in a large, representative sample of the adult general population of 17 countries from all continents. Of a total of 17,001 participants, 4.8% had their moles checked by a dermatologist more than once a year, 11.3% once a year, 8.4% every 2-3 years, 12.4% once in a while, 10.3% once in lifetime, and 52.6% of participants had never performed a mole examination. Egypt was the country with the highest prevalence of people who performed a moles check more than once a year (15.9%), followed by Brazil and the USA. A higher frequency of mole checks was associated with sex (man vs woman), higher education, higher income, fair phototype, history of skin cancer, medical insurance, and sun-protective behaviours. Despite recommendations by health providers, it appears that the frequency of mole checks in the general population is still low. It is necessary for dermatologists to keep informing at-risk populations about the importance of moles check, with particular care regarding categories that less frequently adhere to secondary prevention measures.

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

 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.

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.

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.

Palliative care is essential to global health services as it improves the quality of life of patients, their families and caregivers. The ATLANTES Global Observatory of Palliative Care (University of Navarra) was created a decade ago to promote a positive attitude towards patients with advanced illness in society and medicine. To do so, and over the past 15 years, ATLANTES has mapped palliative care data worldwide using public health, macro and comparative perspectives in different atlases. These have enabled data to be contextualised and good examples to be identified concisely and graphically. Atlases have been widely employed as advocacy tools within international institutions and ministries of health. While the aim and the perspective have remained unalterable over time, the methods and design have evolved throughout the publications from sober cartography and static infographics to big interactive data visualisation web tools. By embracing technology, ATLANTES has developed an open-access web mapping tool reuniting information from regional atlases, favouring global access to data. In 2022, matching the increasingly recognised need for robust monitoring of palliative care worldwide, ATLANTES became a WHO Collaborating Centre for the Global Monitoring of Palliative Care Development. This attempt to bridge the gap and ensure equitable care information in countries with limited palliative care access has resulted today in more accessible, self-explanatory, and visually appealing palliative care data.

Global health photography has historically been commissioned and, therefore, dominated by the gaze of Western photographers on assignments in the Global South. This is changing as part of international calls to decolonise global health and stimulate 'empowerment', spawning a growing initiative to hire local photographers. This article, based on interviews with global health photographers, reflects on this paradigm shift. It highlights how behind the laudable aim of 'empowerment' of local global health photography there is a simultaneous exploitation of precarious photographer labour and the emergence of 'glocal' photography elites. The paper argues that empowerment of local photographers can become a euphemism for reducing image production costs and maintaining control over the image content, while extending the scope of mainstream global health visual culture without challenging it. Finally, the article amplifies the growing concern that uncritical engagement with institutionalised empowerment becomes a warrant for the reproduction of local inequalities behind the fashionable façade of cooperation and care.

Child healthcare services such as diphtheria-tetanus-pertussis (DPT3) vaccination are known to reduce childhood mortality and morbidity. However, inequalities in access to these services in developing countries continue to constrain global efforts aimed at improving child health. This study examines the impact and equity effect of a community-based primary healthcare programme known as the Ghana Essential Health Intervention Programme (GEHIP) on improving the uptake of childhood DPT3 immunisation coverage in a remote rural region of Ghana.

Hypertension is a silent killer disease and the global report revealed that half of the world's population lives with undiagnosed hypertension. The problem is expected to be worse in low-income countries such as in Horn of Africa countries. Thus, we planned to determine the trend, burden, and determinates of undiagnosed hypertension in this region and provide conclusive and tangible evidence for interventions.

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.

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.

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.

This review brings together a multidisciplinary, multinational team of experts to discuss the current state of knowledge in the detection and treatment of hip displacement in cerebral palsy (CP), a global public health problem with a high disease burden. Though common themes are pervasive, different views are also represented, reflecting the confluence of traditional thinking regarding the aetiology and treatment of hip displacement in CP with emerging research that challenges these tried-and-true principles. The development of hip displacement is most closely related to gross motor function, with radiographic surveillance programs based on the Gross Motor Function Classification System (GMFCS), the goal being early detection and timely treatment. These treatments may include non-operative methods such as abduction bracing and Botulinum Neurotoxin A (BoNT-A), but outcomes research in this area has been variable in quality. This has contributed to conflicting opinions and limited consensus. Soft tissue lengthening of the hip adductors and flexors has traditionally been employed for younger patients, but population-based studies have shown decreased survivorship for this treatment when performed in isolation. Concerns with the identification of hip displacement in very young children are raised, noting that early reconstructive surgery has a high recurrence rate. This has prompted consideration of viable minimally invasive alternatives that may have better success rates in very young children with CP, or may at least delay the need for osteotomies. Recent reports have implicated the role of abnormal proximal femoral growth and secondary acetabular dysplasia as a primary cause of hip displacement, related to ambulatory status and abductor function. As such, guided growth of the proximal femur has emerged as a possible treatment that addresses this purported aetiology, with promising early results.

There is widespread recognition that many transplant recipients struggle to become and remain physically active. However, some transplant recipients do undertake strenuous training and significant physical activity (PA) and participate in intensive sports.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Intimate partner violence (IPV) is a global public health crisis, with physical violence leaving IPV survivors at high risk of brain injury (BI). Both BI and IPV have significant physical, psychological, cognitive, and social impacts, including a high risk of mental health concerns, yet there is limited exploration of IPV survivors' experiences with BI and mental health. This study aimed to explore the BI- and mental health-related needs and experiences of IPV survivors from the perspectives of survivors and service providers with the objective of developing knowledge translation materials to raise awareness and support survivors and service providers in addressing these concerns.

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

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.

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).

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.

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.

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.

Road traffic accident is a leading cause of death and various life deformities worldwide. This burden is even higher among motorcycle riders in lower-to-middle-income countries. Despite the various interventions made to address the menace, the fatalities continue to be on the ascendency. One major area that has received little attention is the attitude and behaviour of motorcycle riders. The present study aimed to examine the contribution of traffic Locus of Control (LoC) and health belief on road safety attitude and behaviour. 317 motorcycle riders participated in the study. The participants completed a questionnaire comprising various sections such as motorcycle riding behaviour, road safety attitude, risk perception, the intention to use helmets, and traffic LoC. The results showed a significant positive correlation between road safety attitude and behaviour (r (295) = .33, p < .001). Drifting towards internal LoC was associated with more positive behaviour on the roads (r (295) = -.23, p < .001). Intention to use helmet, health motivation, perceived susceptibility, perceived benefits, and perceived barriers were the factors in the health belief model that were associated with road safety attitude (r (295) = .404, p < .001). Finally, the multiple linear regression model showed that road safety attitude and traffic LoC made significant contributions to road user behaviour [F(3, 293) = 13.73, p < .001]. These findings have important implications towards shaping responsible behaviour among motorcycle riders.

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.

Functional impairment can be an early indicator of cognitive decline. However, its predictive utility in cognitively normal (CN) older adults remains unclear. This study aimed to determine whether mild functional impairment (MFI) in CN older adults could predict incident dementia over 6 years, in addition to assessing its association with cognitive performance.