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The World Health Organization recommends universal preventive iron interventions for young children in anemia-prevalent areas to alleviate the effects of anemia on child neurodevelopment and other outcomes. However, the functional benefits have not been confirmed in randomized clinical trials and there are concerns that iron interventions may increase infection risk. To determine whether universal iron interventions administered with malaria chemoprevention improve child functional outcomes and are safe regarding infection risk. This randomized clinical trial enrolled 6-month-old infants at 4 centers in southern Malawi, which is a rural, malaria-endemic setting. Enrollment occurred between April 2020 and October 2021. The final assessment was completed in October 2022. Six months of (1) iron syrup and malaria chemoprevention (n = 542), (2) iron-containing micronutrient powders and malaria chemoprevention (n = 543), (3) malaria chemoprevention alone (n = 541), or (4) placebo alone (n = 542). Children were assessed after the 6-month intervention period and after 6-month follow-up. The primary outcome was the Cognitive Scale composite score at the end of the intervention period using the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III). The secondary outcomes included Bayley-III Language Scale and Motor Scale composite scores, anemia prevalence, and concentrations of hemoglobin and ferritin. The primary and secondary outcomes were measured when children were 1 year of age and when they were 18 months of age. The safety outcomes included incidence of infection (including malaria). A total of 2168 infants (mean age, 5.7 months; 49% were female; and 71% had anemia) were recruited to participate. Compared with malaria chemoprevention alone, there was no between-group difference in the Bayley-III Cognitive Scale composite score for iron syrup and malaria chemoprevention (mean difference [MD], -0.52 [95% CI, -2.52 to 1.48]). Compared with malaria chemoprevention alone, there was no between-group difference in the Bayley-III Cognitive Scale composite score for iron-containing micronutrient powders and malaria chemoprevention (MD, -0.85 [95% CI, -2.80 to 1.09]). Compared with placebo alone, there was no between-group difference in the Bayley-III Cognitive Scale composite score for malaria chemoprevention alone (MD, 1.62 [95% CI, -0.31 to 3.55]). Although the 2 iron interventions increased ferritin concentration, neither reduced anemia prevalence compared with malaria chemoprevention alone. Compared with malaria chemoprevention alone, neither iron syrup and malaria chemoprevention nor iron-containing micronutrient powders and malaria chemoprevention increased malaria risk. Compared with placebo alone, malaria chemoprevention alone reduced the incidence of malaria. Two universal, 6-month iron interventions with malaria chemoprevention did not improve cognitive outcomes among children in Malawi. anzctr.org.au Identifier: ACTRN12620000386932.

Antibiotic resistance and biofilm-associated infections represent persistent barriers to effective tissue healing, particularly in chronic and implant-associated wounds. Despite substantial advances in material design, most antibacterial wound dressings remain passive, empirically developed, and poorly adapted to the dynamic biological microenvironment of infection. Nanocellulose (NC), offers exceptional mechanical strength, high surface area, and excellent biocompatibility, positioning it as a versatile matrix for advanced therapeutic applications. Recent innovations focus on engineering NC composites through functionalization with bioactive moieties that enable the activation or localized release of antimicrobial agents selectively within pathological microenvironments. These advanced NC systems are specifically designed to overcome biofilm penetration barriers while minimizing systemic toxicity through site-specific intervention. This review delineates the evolution from fundamental material design principles, such as NC morphology control and surface chemistry modulation, to the development of NC-based platforms capable of disrupting mature biofilms and eliminating pathogenic bacteria. We highlight the breadth, versatility, and long-term potential of NC derivatives and composites as adaptable platforms for antibacterial and antibiofilm applications across multiple infected tissues, including skin, bone, diabetic foot ulcers, and dental infections. Furthermore, we emphasize the translational significance of NC-based hydrogels and scaffolds in future healthcare, positioning them as next-generation, clinically relevant platforms.

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A previous systematic review reported that general mental health and anxiety symptoms, but not depression or stress, worsened more for females or women than for males or men from before to during the COVID-19 pandemic based on 12 studies published up to August 2021. To update a systematic review on sex or gender differences in mental health symptom changes from before to during the COVID-19 pandemic. Medline, PsycINFO, CINAHL, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, medRxiv, and Open Science Framework Preprints were searched from December 31, 2019, to August 31, 2023. Eligible studies included data to calculate changes in general mental health, anxiety symptoms, depression symptoms, or stress from before to during the COVID-19 pandemic by sex or gender. Standardized mean differences (SMDs) for continuous changes and proportions for dichotomous changes were used. Two independent reviewers extracted data and evaluated risk of bias. Data were pooled via random-effects models on March 21, 2024. The main outcome was the differences in SMD changes and proportions between women or females and men or males of mental health symptoms from before the COVID-19 pandemic to during the COVID-19 pandemic. The study included 27 unique cohorts from 14 countries (n = 102-18 127; 31 155 women or females and 30 737 men or males). Differences in SMD change between men and women were minimal and not statistically significant for continuous outcomes of general mental health (0.01 [95% CI, -0.07 to 0.10 and 95% prediction interval (PI), -0.23 to 0.25]; 8 cohorts; 21 762 participants; heterogeneity [I2] = 81.4%), anxiety (0.09 [95% CI, -0.04 to 0.22 and 95% PI, -0.27 to 0.45]; 7 cohorts; 6039 participants; I2 = 68.7%), depression (0.10 [95% CI, -0.00 to 0.20 and 95% PI, -0.23 to 0.43]; 12 cohorts; 9750 participants; I2 = 65.4%), and stress (-0.08 [95% CI, -0.16 to 0.01 and 95% PI, -0.18 to 0.02]; 8 cohorts; 2994 participants; I2 = 0%). Substantial heterogeneity, high risk of bias, or both were present across analyses. No studies reported changes for gender minority groups (eg, transgender, nonbinary). In this systematic review and meta-analysis of sex or gender differences in mental health changes from before to during the COVID-19 pandemic, no significant differences were found. However, findings should be interpreted cautiously and may not apply in all settings due to heterogeneity and methodological limitations of included studies.

Global glycemic control in diabetes is suboptimal, with persistent gaps between guideline recommendations and clinical practice. To evaluate the effectiveness of a role-playing-based intensive training program for physicians in improving glycemic control among patients with type 2 diabetes. This was an open-label, 2-arm parallel, cluster randomized clinical trial conducted at 205 centers in China, with enrollment from February 13 to September 19, 2023, and 12-month follow-up completed on October 25, 2024. In phase 1, 205 physicians from qualified diabetes centers across China were enrolled from February 13 to April 29, 2023, and randomly assigned to the intensive training group (n&#x2009;=&#x2009;103) and the regular training group (n&#x2009;=&#x2009;102). In phase 2, 2017 patients with type 2 diabetes were enrolled from February 28 to September 19, 2023. Data were analyzed from January 1 to June 1, 2025. One-week on-site role-playing-based intensive training (involving simulating patient roles in experiencing diabetes-related health examinations, complication scenarios, lifestyle intervention, and face-to-face conversations) vs regular training. The proportion of patients achieving a hemoglobin A1c (HbA1c) level of less than 7.0% at 6 months. The primary analysis was based on the intention-to-treat principle. A total of 205 physicians (mean [SD] age, 36.2 [5.1] years; 155 women [75.6%]) and 2017 patients (mean [SD] age, 53.0 [7.0] years; 713 women [35.3%] and 1304 men [64.7%]) were enrolled, with 1009 patients in the intensive training group and 1008 patients in the regular training group. At 6 months, a significantly greater proportion of patients in the intensive training group achieved an HbA1c level less than 7.0% compared with the regular training group (58.0% [476 of 820] vs 42.9% [351 of 818]), with an adjusted between-group difference of 16.6% (95% CI, 7.2%-25.7%; P&#x2009;<&#x2009;.001). At 12 months, the difference between the intensive training group and the regular training group remained significant (60.9% [502 of 824] vs 44.6% [371 of 832]; adjusted between-group difference, 17.0% [95% CI, 7.0%-26.8%]; P&#x2009;<&#x2009;.001). The intensive group had greater reductions in body mass index (adjusted between-group difference, -0.3 [95% CI, -0.5 to -0.1]), waist circumference (adjusted between-group difference, -1.4 cm [95% CI, -2.1 to -0.8 cm]), fasting glucose (adjusted between-group difference, -6.3 mg/dL [95% CI, -10.7 to -1.9 mg/dL]), and systolic blood pressure (adjusted between-group difference, -1.5 mm Hg [95% CI, -2.9 to -0.1 mm Hg]). Serious adverse events were comparable between groups (intensive group, 2.6% [26 of 1009]; regular group, 2.4% [24 of 1008]). In this cluster randomized clinical trial of role-playing-based intensive training for physicians managing type 2 diabetes, the intervention significantly improved patient glycemic control. These findings suggest a feasible strategy to narrow the guideline-implementation gap in diabetes care. ClinicalTrials.gov Identifier: NCT05715307.

Heart rate variability (HRV) has remained a relatively finite and niche tool in cardiology despite decades of research supporting its physiological and clinical relevance. This limited adoption may resemble the early history of electrocardiography (ECG), which was initially regarded by many physicians as a laboratory instrument rather than a routine clinical tool. The delayed acceptance of ECG reflected technological limitations, cultural resistance and the need for clinicians to master unfamiliar concepts derived from physics and electrophysiology. HRV faces comparable barriers today. Although derived from ECG RR intervals, HRV requires interpretation of time-domain, frequency-domain, geometric and nonlinear indices that may appear mathematically complex and distant from conventional bedside reasoning. We argue that HRV should not be viewed as a replacement for ECG, but as an extension of ECG from electrical morphology to physiological dynamics. Lessons from ECG history were examined and compared with the current state of HRV adoption in clinical practice. The complementary diagnostic roles of ECG morphology and HRV analysis were considered, together with the potential contribution of wearable sensors, remote monitoring, artificial intelligence and large language models to facilitate HRV interpretation, education and clinical integration. Whereas conventional ECG morphology identifies arrhythmias, conduction disturbances, ischemic alterations and overt electrical abnormalities, HRV provides insight into autonomic modulation, cardiovascular adaptability and systemic physiological regulation. The emergence of wearable sensors, remote monitoring, artificial intelligence and large language models creates an opportunity to overcome barriers that have limited HRV adoption. Artificial intelligence may serve as an educational and interpretive bridge, translating complex HRV metrics into clinically meaningful concepts while supporting medical training, artefact awareness, case-based learning and workflow integration. HRV faces barriers comparable to those encountered during the early adoption of ECG, including technological limitations, educational challenges and resistance to incorporating unfamiliar physiological concepts into routine clinical practice. Lessons from ECG history suggest that HRV adoption will depend not only on evidence but also on standardization, education, clinical interpretation and cultural acceptance within cardiology.

Amelogenesis imperfecta (AI) is a group of inherited diseases characterized by enamel defects. Mutation in multiple genes may cause AI. The objective of this study was to investigate the specific roles of Family with sequence similarity 83 member H (FAM83H) in AI and determine its effect on ameloblasts. To investigate the impact of Fam83h on ameloblast gene expression, we utilized ameloblast line HAT-7 cells with knockdown of Fam83h gene for transcriptome sequencing. The experimental cell samples were undergone library preparation and RNA sequencing expreiments. Cell Adhesion test kit was employed to evaluate the influence of Fam83h on HAT-7 cell adhesion ability. RT-qPCR and western blot were conducted to analyze the expression levels of integrin and collagen proteins upon downregulation of Fam83h. RNA-seq analysis revealed differential expression of 572 genes in HAT-7 cells with knockdown of Fam83h gene, including 285 up-regulated genes and 287 down-regulated genes. GO and KEGG enrichment analysis indicated that Fam83h could modulate collagen synthesis in ameloblasts as well as affect the focal adhesion pathway. In the cell adhesion assay, we observed a decrease in adhesion ability due to downregulation of Fam83h in HAT-7 cell line. Furthermore, it was found that Fam83h can upregulated extracellular matrix collagen formation in ameloblasts. Fam83h may affect the adhesion ability and extracellular matrix collagen formation in ameloblasts, leading to AI.

Depression is prevalent yet frequently underdiagnosed. Although speech-based detection methods show promise, most prior studies have emphasized binary classification in nontonal languages. This study examined whether acoustic features of spontaneous Mandarin speech reflect depression as a categorical condition or a continuous, dimensional construct. A validated emotional Mandarin speech corpus paired with self-reported depression severity scores was analyzed. Acoustic features were extracted using the extended Geneva Minimalistic Acoustic Parameter Set. A multistage analytic framework was applied, including random forest classification to distinguish depressed from nondepressed clips, linear mixed-effects modeling to examine group and severity effects, and unsupervised clustering to examine latent structure in the acoustic feature space. The random forest classifier achieved an accuracy of 72.3% and an area under the receiver operating characteristic curve of 0.826 on the held-out test set. Model performance favored sensitivity over precision in identifying depressed clips. SHapley Additive exPlanations analysis identified features across multiple acoustic domains, including spectral, pitch-related, voice quality, cepstral, and intensity measures, as important contributors to model predictions. Among the Top 10 features, no acoustic features showed statistically significant group differences. In contrast, median and mean fundamental frequencies were significantly positively associated with depression severity. Clustering analysis revealed overlapping group structures and a continuous distribution of severity scores across clusters. These findings provide preliminary support for a dimensional conceptualization of depression in spontaneous Mandarin speech. While classification models can distinguish depressed from nondepressed speech with moderate accuracy, acoustic features appear to vary more consistently with symptom severity than with diagnostic group. Speech-based measures may therefore have potential for continuous monitoring of depression, although this possibility requires further longitudinal verification.

Saliva-based point-of-care testing (POCT) is critical for the early diagnosis of periodontal disease. However, current wearable platforms, such as smart mouthguards, are predominantly limited to monitoring small metabolites (e.g., glucose) and cannot detect specific macromolecular proteins essential for disease characterization. To enable precise early diagnosis, we demonstrate a novel biosensor that integrates microfluidics with organic electrochemical transistors (OECTs). Functionally, this integration enables the simultaneous, multiplexed detection of a complementary biomarker combination: interleukin-6 (IL-6) and matrix metalloproteinase-8 (MMP-8). In terms of performance, the device leverages the high transconductance of OECTs to ensure high precision even at trace levels, achieving exceptional sensitivity with distinct dynamic ranges tailored for early-stage detection (IL-6: 1-80 pg/mL; MMP-8: 10-500 ng/mL). Validating its diagnostic utility, the sensor showed precise quantification (R2 > 0.97) correlated with gold-standard laboratory measurements in a rat model. By delivering clinical-grade precision for complex biomacromolecules, this platform overcomes the limitations of existing wearables and offers a viable path for translating advanced bioelectronics into practical periodontal healthcare.

Intravenous thrombolysis (IVT) is an established therapy for acute ischemic stroke when administered within 4.5 hours of symptom onset. However, many patients present beyond this window or with unknown onset, and recent randomized clinical trials (RCTs) have evaluated whether imaging-selected patients may benefit from thrombolysis in the extended window. To evaluate the functional and safety outcomes associated with IVT administered 4.5 hours or more after stroke onset. PubMed, Embase, and Cochrane Central Register of Controlled Trials were systematically searched from database inception through March 3, 2026. RCTs enrolling adults with acute ischemic stroke treated with IVT 4.5 hours or more after symptom onset were included. Trials comparing thrombolysis with placebo or standard medical care and reporting functional or safety outcomes were eligible. Data were extracted independently by 2 reviewers following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Risk ratios (RRs) and mean differences with 95% CIs were pooled using random-effects models. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Primary outcomes were excellent functional outcome (modified Rankin scale scores of 0-1 at 90 days), good functional outcome (modified Rankin scale scores of 0-2 at 90 days), all-cause 90-day mortality, and symptomatic intracerebral hemorrhage (ICH). Fourteen RCTs including 4174 patients (2102 in the thrombolysis group and 2072 in the control group) were analyzed, 9 of which were published within the past 5 years. IVT was associated with a higher likelihood of excellent functional outcome (RR, 1.22; 95% CI, 1.14-1.31) and good functional outcome (RR, 1.12; 95% CI, 1.06-1.18) at 90 days. Mortality did not differ between groups (RR, 1.13; 95% CI, 0.93-1.38), but thrombolysis was associated with an increased the risk of symptomatic ICH (RR, 2.44; 95% CI, 1.45-4.09). Absolute treatment effects corresponded to a number needed to treat of 12&#x2009;to 16 for an additional favorable outcome and a number needed to harm of 62 for symptomatic ICH. In this systematic review and meta-analysis of 14 RCTs, IVT administered beyond 4.5 hours after stroke onset was associated with improved functional outcomes despite an increased risk of symptomatic ICH, supporting extension of thrombolytic therapy beyond the conventional treatment window in appropriately imaging-selected patients.

Hip fractures are common among residential aged care (RAC) residents and associated with a larger burden of mortality and functional impairment. RAC residents are often prioritised for early discharge back to RAC and are at risk of disjointed care and limited support in their functional recovery. To compare next-of-kin and RAC staff perspectives on the discharge care transition from hospital following hip fracture surgery, using routinely collected questionnaire data from a geriatrician-led virtual service. A secondary aim was to describe clinical outcomes including mobility, readmission and mortality rates. This prospective descriptive study was conducted between 1/5/22 and 30/4/23 in an Australian metropolitan region. Paired responses from next-of-kin and RAC staff were analysed to assess agreement on key aspects of discharge care planning, discharge processes and post-discharge outcomes. We analysed 94 paired responses (next-of-kin and RAC staff) for 47 older persons. Low levels of agreement were observed in goal-setting, timing of discharge, discharge summaries, pain management and mobility. Agreement was highest at conclusion of the virtual care service when 79% pairs felt the older person's care needs were being met at the RAC facility. Limited mobility improvements were observed, with 19% regaining baseline mobility within a median of 18.5&#x2009;days after surgery. The 30-day readmission rate was 13%, and 12-month mortality was 34%. While there was high agreement that care needs were eventually met at the RAC facility, gaps remain in pre-discharge communication and post-discharge mobility and pain management. Clinicians should address communication on discharge to enhance transition of care from the hospital.

Decapod iridovirus 1 (DIV1) is a highly lethal pathogen that infects decapod crustaceans including Litopenaeus vannamei, causing mass mortality in cultured shrimp and severe economic losses worldwide. The ATPase gene is a highly conserved region within the DIV1 genome, plays a critical role in viral replication and represents an ideal target for molecular diagnostic development. In this study, we established a rapid, sensitive and field-adaptable detection platform for DIV1 by integrating recombinase polymerase amplification (RPA) with the CRISPR/Cas12a system. RPA enables efficient isothermal amplification of target nucleic acids, achieving exponential enrichment of the target nucleic acids and exerting the function of signal amplification. While the CRISPR/Cas12a system upon crRNA-guided specific recognition of the amplicon, triggers robust trans-cleavage activity against reporter probes for signal generation and readout. After systematic optimization, the RPA reaction was performed at 38&#xb0;C for 10&#x2009;min and the CRISPR-Cas12a reaction was conducted at 37&#xb0;C for 20&#x2009;min. The integrated two-step workflow completed detection within 40&#x2009;min, with a limit of detection of 2.3&#x2009;&#xd7;&#x2009;101 copies/&#x3bc;L. Specificity evaluation confirmed that the RPA-CRISPR/Cas12a assay exclusively recognised DIV1 without cross-reaction with other major shrimp pathogens. Further validation using clinical shrimp samples demonstrated stable and reliable performance, supporting its practical utility in aquaculture settings. In conclusion, the established CRISPR/Cas12a-based detection platform provides a robust technical tool for early warning and on-site rapid screening of DIV1, facilitating timely disease control and risk management in shrimp farming.

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Adaptive therapy is an evolution-based treatment paradigm that has been shown to delay resistance in prostate cancer through treatment breaks that control, rather than minimize, tumor burden. However, patient responses are highly heterogeneous, and there is a significant unmet clinical need for biomarkers to personalize treatment scheduling. To develop and retrospectively validate mathematical biomarkers that predict time to progression (TTP), mean daily dose, and overall survival (OS) under adaptive therapy from first-cycle prostate-specific antigen (PSA) dynamics. This retrospective modeling and validation study used longitudinal, nonrandomized clinical trial data from 2 independent cohorts: 40 patients with castrate-sensitive prostate cancer (CSPC) (June 1996 to September 2006) and 13 patients with metastatic castrate-resistant prostate cancer (mCRPC) (April 2015 to January 2022). A 2-population differential equation model was used to describe the overall tumor growth through the competing dynamics of drug-sensitive and drug-resistant cells. The statistical analysis was conducted from January 2025 to May 2026. Patients received either intermittent androgen deprivation therapy (for CSPC) or adaptive abiraterone acetate (for mCRPC). The initial treatment cycle served as the exposure period to extract longitudinal PSA kinetics. Mechanism-based mathematical biomarkers (adaptive therapy score, expected TTP, and expected mean daily dose) were derived from first-cycle PSA kinetics. Outcomes included in silico benchmarking experiments and retrospective validation against clinical TTP and OS. Performance was benchmarked against standard phenomenological PSA metrics (eg, PSA nadir, time to nadir, and doubling time). Overall, data from 53 patients across 2 clinical trials were included. In the CSPC cohort of 40 patients, the adaptive therapy score derived from first-cycle data was highly prognostic for prolonged clinical TTP (univariable hazard ratio [HR], 0.49; 95% CI, 0.31-0.76; P&#x2009;=&#x2009;.002). In the mCRPC cohort of 13 patients, the adaptive therapy score exhibited a strong rank correlation with clinical TTP (Spearman &#x3c1;&#x2009;=&#x2009;0.76; P&#x2009;=&#x2009;.002) and was associated with prolonged TTP (HR, 0.41; 95% CI, 0.16-1.07; P&#x2009;=&#x2009;.07). Analysis of long-term survival data in the mCRPC cohort demonstrated that both the adaptive therapy score and expected TTP were significantly associated with prolonged OS, whereas standard empirical PSA metrics displayed no association with OS. In this modeling and validation study, mechanism-based mathematical biomarkers derived from the initial-cycle PSA dynamics accurately predicted patient-specific outcomes and survival, outperforming traditional phenomenological PSA monitoring. These accessible metrics could act as a mathematically informed decision support framework to stratify patients into personalized treatment protocols.

Soft tissue balance is crucial for the success of total knee arthroplasty (TKA), influencing joint stability, patient satisfaction, and implant longevity. However, intraoperative assessment of ligament tension is subjective and prone to error. In this study, we present a novel, low-cost, and highly sensitive force measurement system based on flexible sensors for real-time evaluation of soft tissue balance during TKA. The system integrates 24 sensor units (12 each in the medial and lateral compartments) embedded within a custom-designed spacer, enabling continuous real-time force measurements throughout the full knee motion range, including clinically relevant positions: full extension (0&#xb0;), mid-flexion (45&#xb0;), and deep flexion (90&#xb0;). The sensors, fabricated from RTV silicone rubber filled with carbon nanotubes (CNTs) and carbon black, show high sensitivity (0.117 N&#x207b;1) at low forces and stable performance across a wide detection range (0-100 N). A complete testing platform, including data acquisition circuitry and a graphical user interface (GUI), was developed to visualize pressure distribution during simulated surgery. The proposed system demonstrates rapid response (~&#x2009;0.4&#xa0;s), low hysteresis (~&#x2009;1.18%), and high repeatability (CV&#x2009;<&#x2009;3%) across 2000 loading cycles. These characteristics underscore its potential as a practical intraoperative tool to assist surgeons or robotic systems in optimizing soft tissue balance, thus enhancing TKA outcomes.

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Nearly half of all cancer diagnoses are attributable to modifiable risk factors, yet cancer prevention continues to underinvest in one of its most consequential life-course windows: early adulthood. Community college students represent a large and underserved population in this period who cluster cancer-relevant risk behaviors, including tobacco use, alcohol consumption, physical inactivity, and poor diet, while remaining largely invisible in prevention research and practice. Although community colleges enroll millions of students nationwide and disproportionately serve lower-income, racial and ethnic minority, and medically underserved populations, they are rarely treated as core prevention infrastructure. This debate paper argues that cancer prevention is missing a critical opportunity by failing to prioritize community colleges as settings for life-course intervention. We integrate epidemiologic, developmental, and prevention science evidence to advance three claims early adulthood is a uniquely malleable period for shaping trajectories of cancer risk; community colleges concentrate both modifiable risk and health inequities at population scale; and place-based prevention strategies offer a feasible pathway for intervening in under-resourced institutional environments where clinical prevention is limited. Drawing on implementation experience from the Be Well Baytown is the initiative -a community-embedded prevention program operating at Lee College is the community college, a Hispanic-Serving Institution in Baytown, Texas-we illustrate how community colleges can support multi-component, theory-driven cancer prevention efforts. We conclude that continued neglect of community colleges reflects not a lack of prevention promise but a failure of prevention prioritization. Aligning cancer prevention investment with where early-adult risk accumulates will require treating community colleges as essential components of prevention infrastructure.

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National evidence on the long-term burden of Clostridioides difficile infection (CDI) in China remains limited. We assessed CDI-related burden from 1990 to 2021 and projected rates to 2030. China-specific estimates of deaths, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) were obtained from the Global Burden of Disease Study 2021 (GBD 2021). Temporal trends were evaluated using joinpoint regression, decomposition analysis, and autoregressive integrated moving average models. From 1990 to 2021, CDI-related DALYs increased from 6,645.59 to 15,759.24, and GBD-estimated CDI-attributable deaths increased from 215 to 721. YLLs accounted for more than 99% of DALYs within the GBD estimation framework. In 2021, DALY rates were higher in males than females and increased markedly with age. The death rate had the highest average annual percentage change. Population aging contributed 57.1% of the increase in DALYs, exceeding the contributions of population growth and epidemiological change. Historical-trend-based projections suggested that all-age burden rates may continue to rise through 2030; YLD projections require additional caution because of possible residual autocorrelation. GBD-estimated CDI-related burden in China increased substantially, and age-specific DALY rates were highest among older adults. These model-based findings support strengthened CDI surveillance, diagnostic capacity, antimicrobial stewardship, infection control, and prevention among high-risk older populations.