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Interventions such as vaccinations, treatment et cetera are usually the gold standard of disease control, as measured by reducing the reproduction number below unity. However, in practice, few diseases are reduced below this eradication threshold and instead persist despite active intervention campaigns. We propose an epidemic model of rabies with a saturated incidence rate that represents "soft" interventions such as public-awareness campaigns, animal curfews, fences etc. We prove local and global stability results based on the reproduction number. However, numerical simulations suggest that eradication is unlikely to occur using current practices. We thus investigate the effect of altering the saturated incidence term using "soft" interventions and show that near-eradication can be achieved even when the reproduction number exceeds unity. Soft interventions such as public-awareness campaigns, reducing contacts, animal curfews and fences can have a greater effect on eradicating rabies than current vaccination programs.

Background In Uganda, village health workers (VHWs) use the integrated community case management (iCCM) strategy to treat malaria, pneumonia, and diarrhea in the community. It is very important for children to get treatment within 24 hours of getting sick to lower their risk of death and illness. In March 2020, Uganda imposed nationwide COVID-19 lockdown measures, encompassing transport restrictions and curfews, potentially impacting healthcare accessibility. This study evaluated the impact of the lockdown on the timeliness of treatment-seeking from VHWs for children under five years in southwestern Uganda. Methods We conducted a retrospective review of VHW patient registers from 22 villages in Bugoye sub-county, Kasese district, for the time between December 1, 2019, and May 31, 2020. The time before the lockdown was from December 1, 2019, to March 22, 2020, and the time during the lockdown was from March 23 to May 31, 2020. There were 4,024 child records in total, and 3,822 of them were used in regression models because they had all the information needed. Timeliness was defined as seeking care within 24 hours of the onset of illness. We used logistic regression to find crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Results Overall, a total of 2,428 out of 3,822 (63.5%) children sought care within 24 hours. In the pre-lockdown period, 823 out of 1,330 people (61.9%) sought care on time. During the lockdown, 1,605 out of 2,492 people (64.4%) (p = 0.131) sought care on time. In multivariable logistic regression, the lockdown period was not significantly associated with timely care-seeking (adjusted OR (aOR) = 1.13, 95% CI: 0.99-1.30; p = 0.079). Fever was independently correlated with increased likelihood of timely care-seeking (aOR = 1.18, 95% CI: 1.02-1.37; p = 0.023), and increasing age in months was similarly associated with slightly higher odds (aOR = 1.01 per month increase, 95% CI: 1.00-1.01; p = 0.024). There was no significant association between sex, rapid breathing, diarrhea, and danger signs and timeliness. Conclusion The nationwide COVID-19 lockdown period was associated with a modest but non-significant increase in timely care-seeking. These results indicate that community-based health services delivered by VHWs remained accessible and robust despite mobility restrictions. Improving VHW programs could help make sure that important child health services are still available during future public health emergencies.

During the COVID-19 pandemic many people experienced psycho-social stress which affected their sleep. This study was conducted during the third and fourth epidemic wave when international borders of Serbia and Bosnia-Herzegovina were entirely open, no curfew or wearing face masks were imposed, but the highest rates of COVID-19-related fatalities were reported. The aim of this study was to examine sleep patterns with COVID-related stress during the pandemic. Anonymous paper questionnaires were distributed from September 2020 to October 2021 across 8 cities in Serbia and Republic of Srpska (Bosnia and Herzegovina). Socio-epidemiologic characteristics, the COVID Stress Scales-CSS and the Perceived Stress Scale were administered. Sleeping patterns before and during the COVID-19 pandemic (bedtime, time spent sleeping and sleep quality) were recorded. Responses of 2,301 participants suggested that bedtime after midnight before and during the pandemic did not differ (13.4% vs. 14.8%, respectively). Most participants reported similar length of sleep before and during the pandemic (around 7 h), although 11% of them reported that during the pandemic they slept more often compared to pre-pandemic sleeping schedule. There was an increase in prevalence of poor sleep quality during the pandemic (4.5% vs. 9.4%, respectively). Sleeping more often compared to pre-pandemic sleeping schedule and poor sleep quality during the pandemic were independently associated with a higher CSS. Proportion of people who reported poor sleep quality doubled in the pandemic. Optimizing sleep quality in crises among people who experience poor sleep quality should be prioritized when managing public health emergencies.

Night-time light (NTL) composites offer a unique spatiotemporal view of urban growth by capturing electricity consumption, infrastructure density, and economic activity patterns that traditional land-cover surveys cannot fully reveal, yet inland China's megaregions remain understudied from this perspective. Using a 23-year (2000-2022) cross-calibrated NTL product integrated with land-cover, population, and topographic data, we analysed illumination dynamics in the Chengdu-Chongqing economic circle. Mean radiance rose by 78% while the lit area expanded from 0.53% to almost 12%. About three-quarters of this growth is confined to a 4-6 km peri-urban "neon ring" created chiefly by cropland conversion to high-rise housing and logistics estates, now ~ 40% brighter than historic cores. Targeted LED retrofits and façade-lighting curfews produced persistent downtown "dark hollows", proving that local policy can dampen sky-glow. Cropland-to-urban parcels emitted roughly 6 nW cm⁻² sr⁻¹ more light than other transitions, and protected wetlands brightened threefold, flagging covert development. Spatial autocorrelation analysis revealed extremely high global Moran's I values (> 0.92 after 2013), indicating strong spatial clustering patterns of illumination changes, with local LISA analysis identifying hotspots predominantly concentrated in the core areas of both cities. Projections indicate ~ 1,000 km² of additional luminous sprawl by 2042 as radiance continues to climb despite a 1.6% population decline, underscoring a widening decoupling between light and headcount.

To evaluate the relative effectiveness of voluntary social distancing appeals versus mandated lockdowns in reducing population mobility during the COVID-19 pandemic, using India as a developing country case study. This study analyzed daily mobility data from Google's Community Mobility Reports across six location categories between February 16 and May 31, 2020. A geographic-level regression model was employed to isolate voluntary mobility changes during India's 14-hour voluntary Janta Curfew prior to the mandatory nationwide lockdown. The model controlled for pandemic severity, health infrastructure, and socioeconomic factors. Conservative estimates indicate that voluntary measures accounted for a substantial proportion of overall mobility declines, ranging from 27% to 71% depending on the location. The most pronounced voluntary reductions occurred in retail and recreational centers, parks, and transit stations. Timely and targeted non-mandated appeals can achieve meaningful behavioral change, complementing formal restrictions. These findings offer critical guidance for health promotion policy, demonstrating that voluntary public compliance can be a viable, flexible strategy for pandemic management, particularly in resource-limited settings where strict mandates may cause severe socioeconomic strain.

Harm reduction can decrease negative consequences of substance use, but the extent to which harm reduction practices are implemented in emergency shelter settings is unknown. We conducted 55 semi-structured interviews at four shelters across Massachusetts to understand guest (40) and staff (15) experiences with harm reduction practices. We conducted thematic analysis rooted in the Social Ecological Model (SEM). Well-established harm reduction practices include naloxone distribution, bathroom checks, and safe-sex supplies. Less established practices include wound care supplies, bad-date lists for people engaging in survival sex work, "no questions asked" lockers, amnesty beds, and abolishing curfews. Recommended future practices include safer consumption spaces, drug checking, and a full suite of harm reduction supplies. Key findings at each SEM level were: At the individual level: guest and staff attitudes toward harm reduction were mixed and influenced by personal experience, or gender identity. At the interpersonal level: tensions between people who use drugs (PWUD) and others who are abstinent; stigma prevents guests from being candid with staff about substance use, and fuels tension between staff and guests. At the community level: Guests and staff have access to naloxone at shelters, carry it, and use it regularly; communication around the presence and availability of naloxone is essential; women innovate distinct interventions for themselves. Last, at the societal level: prohibitory policies do not stop people from using drugs but make people less safe; shelters can collaborate with community organizations to provide necessary harm reduction services. Shelters are implementing increasingly creative programs of harm reduction practices.

Juvenile cybercrime is a salient governance challenge in digitalizing societies, yet scholarship concentrates on ex post sanction and under-theorizes the interaction among platform design, the digital risk environment, and minors' developmental vulnerability. Drawing on K.G.M. v. Meta Platforms, this study develops a "front-end governance" framework anchored in the best-interests-of-the-child principle and articulated through three doctrinal pillars, the platform duty of risk mitigation, the regulation of harmful design and risky digital environments, and the foreseeability of risk. An empirical component, based on a cross-sectional survey in China, examines institutional support for prevention. Endorsement is broad, 92% for strengthened market regulation, 91% for cyber-law education, 84% for technical firewalls, and 83% for internet classification and digital curfews. On responsibility allocation, 76% prioritize tri-partite collaborative governance involving families, schools, and society. Multinomial logistic regression indicates occupational positioning is the only significant predictor of priority orientation; regional, income, and educational variation are non-significant once controls are applied, a null pattern we read as suggestive rather than confirmatory. The findings support a shift from ex post sanction to ex ante risk governance, organized around platform accountability, age-appropriate design, rule-of-law education, and graded content ecosystems.

Alcohol and cannabis are psychotropic substances most used by adolescents. Psychological, behavioral, social, and cognitive factors linked to substance use in adolescents with chronic pain (ACP) are unclear. We examined these factors among four groups: those reporting Only Alcohol Use (AU), Only Cannabis Use (CU), Co-use of Alcohol and Cannabis (CAM), and No Substance Use (No-SU). From September 2021 to May 2024, we surveyed 243 patients from a pediatric pain clinic in the Northeastern U.S. Kruskal Wallis, Mann-Whitney U, and Monte Carlo Chi-Square tests assessed group differences. Among 243 (Mage&#xa0;=&#xa0;16.9, SD&#xa0;=&#xa0;1.42&#xa0;years, 68% female), 12.3% reported AU, 5.3% CU, 19.8% CAM, and 62.6% No-SU in their lifetime. Groups differed by age, functional disability, depressive symptoms, and behavior avoidance in drive and fun-seeking domains (ps&#xa0;<&#xa0;0.05). CAM group was older (p&#xa0;<&#xa0;0.001), more depressed (p&#xa0;=&#xa0;0.003), stressed (p&#xa0;=&#xa0;0.03), and had more school-related anxious anticipation (p&#xa0;=&#xa0;0.03) than No-SU, reporting more drinking and drunkenness (ps&#xa0;<&#xa0;0.05) than AU. CU group reported greater pain interference (p&#xa0;=&#xa0;0.04) and functional disability (p&#xa0;=&#xa0;0.01) than AU, with 100% using for symptom relief and 85.6% for pain. Increased drunkenness past-year was positively associated with stricter curfew times and increased parental supervision in the CAM group (p&#xa0;<&#xa0;0.006). CAM group reported more stress, depression, and alcohol consumption, complicating pain management. CU is frequently used for pain relief and is associated with greater functional disability. Interventions targeting substance use and mental, physical, and social wellbeing in ACP are limited, underscoring the need for multidisciplinary strategies addressing pain and substance use in parallel.

This ecological study aimed to investigate changes in the time-varying reproduction number (Rt) of SARS-CoV-2 across six regions of Massachusetts from 2020 to 2022 and to evaluate the impact of various nonpharmaceutical interventions (NPIs) implemented in 2020 by examining associated changes in the Rt. COVID-19 incident case data from the Johns Hopkins University database were adjusted for reporting delays using deconvolution and for underreporting via a Poisson-distributed multiplier of 4. Negative and zero counts were corrected using imputation. Rt was estimated using R package EpiEstim (Version 2.2-4) with a 7-day sliding window from 2020 to 2022 and with non-overlapping time windows between policy changes in 2020. From 2020 to 2022, Massachusetts experienced five COVID-19 surges, linked to the wild-type strain and emerging variants, with Rt exceeding 1 during each wave and stabilizing at or dropping below 1 during low-incidence phases. School closure and gathering restrictions, the first major intervention, were associated with a 14.7% statewide reduction in Rt (95% credible interval (CrI): -23.6%, -5.6%), with greater reductions in high-density areas such as Boston (-16.9%; 95% CrI: -26.9%, -7.5%). No statistically significant changes in Rt were found to be associated with other NPIs in 2020, including the mask mandate, reopening phases, travel restrictions and quarantine requirements, and curfews. Our findings highlight the different NPIs' varying impacts on COVID-19 transmission dynamics across regions in Massachusetts in 2020 and underscore the importance of early interventions for future pandemic preparedness.

Non-pharmaceutical interventions (NPIs) such as city-level curfews and local lockdowns were implemented to control SARS-CoV-2 transmission, yet their effectiveness at fine spatial scales remains uncertain. We evaluated a rotational lockdown policy in Bogot&#xe1;, Colombia, applied at the locality level-an administrative aggregation of neighborhoods. Mobility patterns derived from mobile phone data were analyzed to quantify commuting changes, defined as relative variations in movement compared to a pre-intervention baseline (one month before restrictions). We distinguished between external mobility (between localities) and internal mobility (within localities). Using epidemiological surveillance data, we estimated the effective reproductive number ([Formula: see text]) and assessed its association with mobility reductions. A compartmental transmission model simulated counterfactual epidemic trajectories without NPIs, comparing predicted and observed infections, mortality, and [Formula: see text]. The intervention reduced inter-locality mobility by up to 40% but only minimally affected within-locality movement (median change&#x2009;<&#x2009;5%), a descriptive result based on mobility data. Early lockdown cycles produced the largest declines in transmission (up to 27% reduction in cases), while subsequent rounds showed diminishing effects. Socioeconomic heterogeneity explained substantial spatial variability in transmission dynamics, revealing stronger associations between mobility and [Formula: see text] in localities with lower socioeconomic status. Our findings demonstrate that fine-scale NPIs can transiently reduce community transmission, but their impact depends on the spatial distribution of mobility and socioeconomic inequalities across the urban landscape.

Japanese elementary school children experience short weekday sleep because of academic demands and increasing digital media use. This study examined lifestyle factors associated with children's weekday sleep duration and social sleep restriction (SSR: weekend minus weekday sleep duration) within a sociocultural context. Caregivers of 4273 children aged 6-12 years from 125 Japanese schools (response rate: 8.8%) completed online questionnaires between November 2023 and March 2024. Multivariable regression analysis was used to identify correlates, and structural equation modeling (SEM) examined pathways among them. Weekday sleep duration was the primary outcome and SSR was the secondary outcome. Mean weekday sleep duration was 9&#x202f;h 16&#x202f;min (SD&#x202f;=&#x202f;112&#x202f;min); SSR was 30&#x202f;min (SD&#x202f;=&#x202f;52&#x202f;min). Female, older age, homework/extracurriculars, pre-bedtime media use, and absent bedtime rules were associated with shorter weekday sleep duration, whereas bedtime reading and outdoor play were associated with longer sleep. Room-sharing, a characteristic of the sleep environment for Japanese children, was also associated with shorter weekday sleep duration. SEM showed the strongest total effect of age (&#x3b2;&#x202f;=&#x202f;-0.389), followed by pre-bedtime media use (&#x3b2;&#x202f;=&#x202f;-0.194), and household rules (&#x3b2;&#x202f;=&#x202f;0.154) on weekday sleep duration. Family-based sleep rules, especially media curfews and fixed bedtimes, may help protect weekday sleep duration and reduce SSR among Japanese children despite academic and digital pressures. Findings propose culturally adapted, family-centered interventions for Japanese children's sleep.

Global obesity rates are rising sharply, prompting interest in environmental drivers beyond diet and activity. Widespread artificial light at night disrupts circadian rhythms and metabolism. potentially elevating obesity risk, but evidence syntheses are outdated and limited. We conducted a systematic search of databases including PubMed, EMbase, Cochrane Library, and Web of Science. Eligible observational studies (cohort or cross-sectional) were required to report adjusted risk estimates (odds ratio [OR], relative risk [RR], or hazard ratio [HR] with 95% confidence intervals [95% CI]) for obesity or overweight, with quantifiable LAN exposure. Study quality was evaluated using the Newcastle-Ottawa Scale (NOS) for cohort studies and the AHRQ criteria for cross-sectional studies. A random-effects model was applied for effect size pooling, alongside subgroup analyses stratified by geographic region, age, and sex, supported by sensitivity analyses and Egger's test for publication bias assessment. Our analysis included 13 studies involving 867,647 participants (9 cross-sectional and 4 cohort studies). A significant 14% increased risk of obesity was observed in the highest LAN exposure group compared to the lowest (OR&#x2009;=&#x2009;1.14, 95% CI: 1.07-1.22; I&#xb2; = 92.5%, P&#x2009;<&#x2009;0.001). For overweight risk, a 7% increase was noted (OR&#x2009;=&#x2009;1.07, 95% CI: 1.00-1.15; I&#xb2; = 92.5%, P&#x2009;<&#x2009;0.001). Regionally, the strongest association was in North America (OR&#x2009;=&#x2009;1.21, 95% CI: 1.10-1.32; I&#xb2; = 46.6%, P&#x2009;=&#x2009;0.132) and significant in Asia (OR&#x2009;=&#x2009;1.14, 95% CI: 1.06-1.21; I&#xb2; = 85.5%, P&#x2009;<&#x2009;0.001), but not in Europe. Age-wise, both adults (OR&#x2009;=&#x2009;1.16) and adolescents (OR&#x2009;=&#x2009;1.17) exhibited significant associations (P&#x2009;<&#x2009;0.05), with no notable differences between sexes. All studies were deemed high quality (mean NOS score: 7.50; mean AHRQ score: 7.56), and sensitivity analyses confirmed the findings with no evidence of publication bias (P&#x2009;>&#x2009;0.05). Exposure to LAN significantly correlates with increased obesity and overweight risks, influenced by geographic and age-specific factors. These results highlight LAN as a noteworthy environmental risk factor for metabolic health, advocating for informed public health strategies, including region-specific lighting regulations and "screen curfews" for adolescents.

The COVID-19 pandemic and various consequent isolation, quarantine and curfew measures to curb the spread of the virus caused an increase in anxiety, depression, and loneliness among university students. The aim of this study was to assess the association between psychological distress and loneliness among university students in Europe during the COVID-19 pandemic. This cross-sectional study was part of the COVIDiSTRESS global survey conducted during the first wave of COVID-19 pandemic in 2020. We evaluated for psychological stress and loneliness among university students in Europe (n&#x2009;=&#x2009;11 231) using the Perceived Stress Scale (PSS-10) and the Loneliness Scale (SLON-3). The associations between the students' psychological stress levels, loneliness, and perceived helplessness were analysed using chi-square test, ANOVA, t-test, and regression models. In total, 9737 university students (69.9% female) between 18 and 34 years (mean: 25.3 years from 13 European countries were included in the analyses. Most (89.6%) of the university students experienced moderate stress levels, with women reporting significantly more stress than men (p&#x2009;<&#x2009;0.001). Differences in stress levels were also associated with geographic region, marital status, and age. Higher levels of psychological stress were associated with the students' loneliness levels; loneliness accounted for 12.9% of the variance in stress. Perceived helplessness was associated with loneliness and gender and country of residence. Majority of the university students in Europe experienced increased level of stress and loneliness during the first wave of COVID-19. Perceived helplessness was significantly associated with stress and correlated with gender, various loneliness factors and country of origin.