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In 2023, a significant increase in the number of pertussis cases was recorded in Poland, which is consistent with the trend of a resurgence of respiratory diseases observed across Europe following the COVID-19 pandemic. This increase is related to factors such as declining population immunity, delays in vaccinations, and diagnostic difficulties, particularly in adults and adolescents. The aim of the study was to assess the epidemiological situation of pertussis in Poland in 2023 compared to the situation in previous years, with particular emphasis on assessing the impact of the COVID-19 pandemic and assessing the vaccination status of children against pertussis. The assessment of the epidemiological situation of pertussis in Poland was made based on the results of the analysis of individual reports on pertussis cases registered at the National Institute of Public Health NIH - National Research Institute in the EpiBaza system and data from the annual bulletins "Infectious diseases and poisonings in Poland" and the bulletin "Vaccinations in Poland in 2023". In 2023, 922 cases of pertussis were recorded. The incidence was 2.45/100,000, which was 150% higher than in 2022. The highest incidence of pertussis occurred in children aged 0-4 years (17.3/100,000), and high in children aged 5-9 years (7.6/100,000). Approximately 45% of cases occurred in people over 15 years of age. In 2023, the number of pertussis cases in Poland increased more than 2.5-fold compared to the previous year, which is due, among other things, to the complete lifting of pandemic restrictions and an increase in social contacts. Pertussis remains a significant public health threat, and waning post-vaccination immunity promotes transmission, especially among adolescents and adults, who can infect infants. W 2023 roku w Polsce odnotowano istotny wzrost liczby zachorowań na krztusiec, co wpisuje się w obserwowany w całej Europie trend nawrotu chorób układu oddechowego po pandemii COVID-19. Wzrost ten jest związany m.in. ze spadkiem odporności populacyjnej, opóźnieniami w szczepieniach oraz trudnościami w diagnostyce, zwłaszcza u dorosłych i młodzieży. Celem pracy była ocena sytuacji epidemiologicznej krztuśca w Polsce w 2023 r. w porównaniu z sytuacją w ubiegłych latach, ze szczególnym uwzględnieniem oceny wpływu pandemii COVID-19 oraz oceny stanu zaszczepienia dzieci przeciw krztuścowi. Ocena sytuacji epidemiologicznej krztuśca w Polsce została wykonana na podstawie wyników analizy raportów jednostkowych o zachorowaniach na krztusiec zarejestrowanych w NIZP PZH – PIB w systemie EpiBaza oraz danych z biuletynów rocznych „Choroby zakaźne i zatrucia w Polsce” oraz biuletynu „Szczepienia ochronne w Polsce w 2023 r.”. W 2023 r. zarejestrowano 922 zachorowań na krztusiec. Zapadalność wynosiła 2,45 /100 tys. i była wyższa o 150% w porównaniu z zapadalnością w roku 2022. Najwyższa zapadalność na krztusiec wystąpiła u dzieci w grupie wieku 0-4 lata (17,3/100 tys.), a wysoka u dzieci w wieku 5-9 lat (7,6/100 tys.). Około 45% zachorowań dotyczyło osób powyżej 15 r.ż. W 2023 roku w Polsce liczba zachorowań na krztusiec wzrosła ponad 2,5-krotnie w porównaniu z rokiem poprzednim, co wiąże się m.in. z całkowitym zniesieniem ograniczeń pandemicznych i wzrostem liczby kontaktów społecznych. Krztusiec pozostaje istotnym zagrożeniem zdrowia publicznego, a wygasająca odporność poszczepienna sprzyja transmisji, zwłaszcza wśród młodzieży i dorosłych, którzy mogą zakażać niemowlęta. Najwyższą zapadalność odnotowano wśród dzieci w wieku 0-4 lat. Najbardziej narażone na ciężki przebieg i zgon są niemowlęta poniżej 6 miesiąca życia.

Arboviruses constitute a major global public health concern, particularly in countries with fragile healthcare systems. However, data on arbovirus circulation remain fragmented and under-analysed. This study aimed to document the historical and current circulation of arboviruses in Guinea and propose public health strategies to enhance surveillance, prevention, and control. We compiled reports of arbovirus-related human epidemics in Guinea from 2000 to 2024, drawing information from Guinea's weekly epidemiological bulletins, as well as from the World Health Organization's Weekly Bulletin on Outbreaks and Other Emergencies, the Africa CDC's Weekly Event-Based Surveillance Report, and the Annual Global Yellow Fever Update reports. In addition, a literature review was conducted to identify studies on arboviruses involving arboviruses in humans, vectors, and animals. Between 2000 and 2024, multiple and simultaneous arboviral outbreaks were reported by surveillance systems, involving three arboviruses: yellow fever virus (YFV), dengue virus (DENV), and chikungunya virus (CHIKV). YFV outbreaks were the most recurrent, with 947 confirmed cases and 284 deaths, corresponding to a case fatality rate of 30%. Moreover, 17 studies documented the circulation of several arboviruses in humans, vectors, and animals, including DENV, YFV, CHIKV, Zika virus (ZIKV), and West Nile (WNV). Novel viruses such as Kindia virus, Forécariah virus, and Kolente virus have also been identified. Serological evidence in human reported IgM seroprevalence ranging from 1.2% to 14.7% for ZIKV, 4.3% to 12.2% for YFV, and 0.6% to 2.1% for DENV. Additionally, other studies were also reported IgM seroprevalence of 23.4% for WNV, 17.0% for CHIKV, and 10.6% for TAHV. Concerning IgG serology, the studies reported seroprevalences ranging from 12.9% to 51.7% for CHIKV, 27.0% to 34.0% for WNV, 11.8% to 25.2% for DENV, and 2.2% to 3.0% for CCHFV. Furthermore, IgG seroprevalences of 28.5% for YFV and 5.5% for BATV were reported. This study highlights the circulation of several arboviruses in Guinea across human, vector animal populations. The results suggest that public health efforts should focus on community engagement, strengthened entomological and epidemiological surveillance, and multisectoral and international collaboration, to anticipate, prevent, and control future arbovirus-related epidemics.

This study aimed to identify predictors for maternal morbidity among individuals categorized as low-risk for postpartum hemorrhage (PPH) according to American College of Obstetrics and Gynecology (ACOG) Practice Bulletin (no.: 183). A retrospective cohort study of all singleton births between March 2020 and February 2022 at a Level IV maternity center. Individuals deemed at medium- or high-risk for PPH according to the ACOG risk stratification and those with missing data were excluded from the main analysis. Individuals with the composite maternal hemorrhagic outcome (CMHO) were compared with those without. Variables previously associated with maternal morbidity yet absent from the ACOG stratification were examined as potential predictors of the CMHO. Possible predictors were identified using a multivariable logistic regression and further assessed with a receiver operating characteristic curve (ROC). Out of 8,623 deliveries, 3,472 (40.3%) met the inclusion criteria. Among them, 175 (5.0%) had a CMHO. Individuals with the composite outcome were older, had a higher body mass index, and had higher rates of Hispanic race/ethnicity, diabetes, postterm pregnancy, scheduled cesarean delivery, and neonatal birth weight ≥ 4,000 g. The combination of ≥ 2 risk factors among low-risk patients, present in 16%, was associated with a similar CMHO rate compared with those at medium PPH risk by the ACOG criteria. The combined presence of ≥ 4 factors was associated with a CMHO rate of 36% and yielded a 10.47 positive likelihood ratio (95% confidence interval [CI]: 3.55-30.90). The area under the curve for the ROC curve of the final model was 0.63 (95% CI: 0.62-0.65). Among low-risk PPH patients, several risk factors with low predictive value flagged roughly one out of six with morbidity similar to medium risk. · Five percent of individuals categorized as low-risk for PPH have hemorrhagic morbidity.. · Several predictors of morbidity were identified.. · Low-risk patients with ≥ 2 predictors had similar morbidity to patients with a moderate PPH risk..

Devraj et al. (Psychonomic Bulletin and Review. https://doi.org/10.3758/s13423-023-02448-2 ,  2024) argued that findings which suggest that memories for items become less accessible over time conflict with categorisation findings where exemplar performance improves across training. To reconcile this, they highlighted that under real-world conditions items tend to reappear less frequently over time, thus preferentially maintaining new items can improve performance. Typical categorisation experiments instead distribute exemplars uniformly across trials. However, under a power-law stimulus distribution, Devraj et al. showed worsening fit for exemplar classification models across trials. They used this as evidence that forgetting behaviour adapted to task demands, reducing exemplar accessibility and encouraging prototype use for classification decisions. By re-analysing the same data, we argue instead that this pattern can be produced with exemplar-forgetting in both conditions. By systematically increasing in the delays across which stimuli were tested, their Experimental condition exaggerated the effects of forgetting on performance in later trials compared to the Control condition. This resulted in a reversal of performance growth across trials - instead leading to a steady decline in performance. As exemplar model-fit advantage is expected to vary with performance, we suggest that trends in this advantage are not diagnostic of a shift in classification strategy. We found that a forgetting-function improved exemplar model fit to Devraj et al.'s data, and under reasonable parameters could predict the observed patterns of performance and model-fit a priori. Compared with a strategy-shifting mixture model, exemplar-forgetting provided equivalent fits despite being more theoretically parsimonious. We suggest power-law memory decay does not produce a tension between categorisation and memory findings, as increased forgetting is found across longer retention intervals, whereas the delay between exemplar learning and classification remains constant across typical categorisation experiments.

In Bangladesh, sub-district hospitals (SDHs) are the first referral point for inpatient primary healthcare (PHC) services of the public providers in both rural and municipal corporation areas. These facilities also provide both outpatient and emergency healthcare services to the population at a minimum user fee. The efficient use of resources in primary-level healthcare facilities is essential for delivering quality healthcare services. Therefore, our aim was to estimate the technical efficiency (TE) of the SDHs in Bangladesh. We used an output-oriented data envelopment analysis (DEA) method to estimate the variable returns to scale (VRS) and constant returns to scale (CRS) TE of a total of 423 SDHs using data from the Local Health Bulletin -2017. To measure TE, we used workforce and inpatient beds as inputs and the number of inpatients and outpatients served by the hospitals in a month as output. We applied the Simar and Wilson model to find how the other internal and external characteristics of these hospitals influenced estimated TE score. We compared our DEA results with stochastic frontier analysis (SFA) and performed sensitivity analysis. The average VRS and CRS TE of the SDHs were estimated to be 58.9% and 53.4%, respectively. Of the 423 SDHs, 15 were fully efficient in CRS, 30 were in VRS and 60 were scale efficient, while the rest operated below the efficiency frontier. The population density per bed, ratios of bed occupancy, ratios of beds to physicians, ratios of physicians to nurses, and administrative division had a significant positive influence, while lengths of stay and ratios of beds to nurses had a significant negative influence on the SDHs efficiency scores. The mean TE demonstrated that the SDHs, on an average, could improve their output by 42% using the existing level of input mix. The results were consistent in the sensitivity analysis. The average TE of the SDHs was half of the best score, suggesting there is scope for overall improvement among the inefficient SDHs by learning from the efficient SDHs. The Ministry of Health and Family Welfare (MOHFW) of Bangladesh allocates resources to SDHs based on the number of beds rather than based on an assessment of needs. The MOHFW could improve its monitoring system to investigate why some facilities are performing well using similar resources while others do not and adjust the allocation system to take into account the quantity and quality of care. The online version contains supplementary material available at 10.1186/s13561-026-00748-6.

Lyme disease is a vector-borne disease transmitted by ticks of the Ixodes genus, caused by a heterogeneous group of Borrelia burgdorferi sensu lato. Human infection occurs through a tick bite and its feeding on the skin. Due to the diverse symptoms, diagnosing Lyme disease is challenging and usually involves a two-step serological approach. Currently, there is still no vaccine against Lyme disease, but in 2024, data on the immunogenicity and safety of the VLA15-221 vaccine, which is in the second phase of clinical trials, was announced. The aim of the study is to discuss the epidemiological situation of Lyme disease in Poland in 2023 compared to previous years. To assess the epidemiological situation of Lyme disease in Poland, data sent to NIPH NIH - NRI by the district Sanitary-Epidemiological Stations and published in the annual bulletin: "Infectious diseases and poisonings in Poland in 2023" were used. In 2023, there were 25 285 reported cases of Lyme disease and 1 155 hospitalizations. This represents a significant increase in cases by 45.58% compared to the previous year. Seasonal variations in case occurrences are evident in distinct quarters, with the number rising from 2 466 in Q1 to 11 626 in Q3, and then declining in Q4 to 5 945. The highest incidence was recorded in the Małopolskie voivodeship (122.9 per 100,000), Podlaskie voivodeship (96 per 100,000), and Warmińsko-Mazurskie voivodeship (95.2 per 100,000). The number of borreliosis cases returned to pre-pandemic levels but also increased by 22.57% compared to 2019 (20 630 cases), and doubled (95.49%) compared to 2020 (12 934 cases). Seasonality has remained unchanged for years. Usually, eastern Poland (most often the Podlaskie voivodeship) is characterised by the highest incidence, however, in 2023, the highest incidence was recorded in the Małopolskie voivodeship at 122.9 per 100,000. Borelioza to choroba wektorowa przenoszona przez kleszcze rodzaju Ixodes, wywoływana przez niejednorodną grupę Borrelia burgdorferi sensu lato. Zakażenie człowieka odbywa się poprzez ukłucie i żerowaniu kleszcza na skórze. Z uwagi na zróżnicowane objawy, rozpoznanie choroby z Lyme jest trudne i zwykle obejmuje dwuetapowe podejście serologiczne. Obecnie, nie ma jeszcze szczepionki przeciwko boreliozie, ale w 2024 roku zostały ogłoszone dane dotyczące immunogenności i bezpieczeństwa szczepionki VLA15-221 będącej w drugiej fazie badań klinicznych. Celem pracy jest omówienie sytuacji epidemiologicznej boreliozy w Polsce w 2023 r. w porównaniu do ubiegłych lat. Do przeprowadzenia oceny sytuacji epidemiologicznej boreliozy w Polsce wykorzystano dane nadsyłane do NIZP PZH – PIB przez Wojewódzkie Stacje Sanitarno-Epidemiologiczne i publikowane w biuletynie rocznym: „Choroby zakaźne i zatrucia w Polsce w 2023 r.”. W 2023 r. zarejestrowano 25 285 zachorowań na boreliozę oraz 1 155 hospitalizacji z powodu tej choroby. Jest to znaczny wzrost zachorowań o 45,58% w stosunku do poprzedniego roku. W poszczególnych kwartałach widać sezonowość występowania przypadków tzn. wzrost ich liczby z 2 466 w Q1 do 11 626 w Q3 oraz spadek w Q4 do 5 945. Największą zapadalność odnotowano w województwie małopolskim (122,9 na 100 tys.) podlaskim (96 na 100 tys.), oraz warmińsko-mazurskim (95.2 na 100 tys.). Liczba przypadków boreliozy zgłaszanych przez lekarzy do powiatowych stacji sanitarno-epidemiologicznych nie tylko wróciła do wartości sprzed pandemii, ale uzyskała wzrost o 22,57% w porównaniu do roku 2019 (20 630 przypadków), oraz prawie dwukrotny wzrost (95,49%) w porównaniu do roku 2020 (12 934 przypadków). Sezonowość pozostaje niezmienna od lat – szczyt zachorowań jest rejestrowany w Q3, a najmniej zachorowań występuje w Q1. Zazwyczaj największą zapadalnością charakteryzuje się wschodnia część Polski (najczęściej województwo podlaskie), jednak w 2023 r. najwyższa zapadalność została odnotowana w województwie małopolskim 122,9 na 100 tys.

Output interference in recognition refers to a decrease in performance over the course of a test. The goal of the current study was to determine whether experimentally shifting the decision criterion changes the form of output interference and to identify a process account of any interaction. In two experiments, we manipulated the decision criterion via changes in the base rate of the old items at test (80%, 50%, 20%). Experiment 1 implemented this manipulation within-subjects and failed to induce criterion shifts. In contrast, when the base rate was manipulated between-subjects in Experiment 2, decision criteria differed across conditions. Qualitative patterns suggested that liberal criteria attenuated the hit rate (HR) decline and increased the false alarm rate (FAR) across blocks, whereas conservative criteria yielded steeper HR declines with relatively stable FAR. To further examine this effect, Experiment 3 employed longer test lists and a larger sample. The criterion was manipulated only via prior information about the base rates, while the actual base rate was 50% in all conditions. Experiment 3 revealed a significant interaction between response bias and output interference in HR and FAR. When we used an independent data set (Layher et al., Journal of Experimental Psychology: Learning, Memory, and Cognition, 46(11), 2075-2105, 2020), we demonstrated the same patterns. To account for these findings, we conducted simulations with the Retrieving Effectively from Memory (Shiffrin & Steyvers, Psychonomic Bulletin & Review, 4(2), 145-166, 1997) model. The results were best captured by a learning-during-test mechanism in which every test item is encoded as a new memory trace.

Restrictive interventions, including physical restraint, seclusion, chemical restraint, and segregation, continue to be used within mental health services, despite sustained policy efforts to promote least-restrictive and trauma-informed care. However, little is known about national trends affecting women, for whom restrictive interventions often carry heightened risks of re-traumatisation and stigma. We conducted a longitudinal secondary analysis of publicly available administrative data from the Mental Health Bulletin covering NHS-funded mental health services in England between 2017 and 2025. Annual counts of restrictive interventions involving women were examined relative to the number of women detained under the Mental Health Act to estimate annual rates per 1,000 detained. Regression modelling was used to assess temporal trends overall, by age group and type of restrictive intervention, and interrupted time-series analyses to examine changes following implementation of the Mental Health Units (Use of Force) Act 2018 ("Seni's Law"). Trends were also examined alongside available national data on restrictive interventions involving men. Rates of restrictive interventions involving women increased by approximately 12 percent per year over the study period, with no evidence of a reduction following the introduction of Seni's Law. Increases were most pronounced for chemical restraint, seclusion, and segregation, while physical and mechanical restraint remained stable. Restrictive interventions declined among women under 18 but increased consistently across all adult age groups, indicating a widening age-related divergence. Although overall trends broadly mirrored those observed among men, the types of restrictive interventions used and their potential impact may differ, highlighting gendered dimensions in how restrictive practices are experienced and applied. Despite extensive national initiatives, restrictive interventions involving women have continued to rise in England, highlighting a persistent gap between policy intent and practice. The findings suggest that legislative frameworks alone are insufficient to achieve meaningful reductions without operational changes in clinical practice, organisational culture, and monitoring systems. Internationally, the study contributes rare gender-disaggregated longitudinal evidence and highlights the need for comparable monitoring systems and coordinated research to inform rights-based, trauma-informed strategies to reduce restrictive interventions in mental health services.

More than half of Korean adults do not meet aerobic exercise guidelines, and participation continues to decline. In response, digital health technologies such as mobile applications, wearable devices, artificial intelligence, and the Internet of Things are being used to promote exercise. This study investigates how young adults perceive digital health technologies for exercise. This was a descriptive qualitative study. Data were collected from 24 participants in their 30 s using semi-structured interviews conducted between June 3rd and August 2nd, 2024. Participants were initially recruited through university bulletin boards and subsequently via snowball sampling. The following four main themes with corresponding subthemes emerged from the data analysis: (1) increasedneed for health management, (2) changing perceptions of exercise, (3) limited digital health experience, and (4) expectations for digital health. The use of digital technology for exercise is influenced by factors such as awareness of health changes, evolving values around health and appearance, social and economic motivations, and personal experience with the technology. Adults in their 30 s who are facing growing health concerns and real-life constraints tend to assess the usefulness of these tools based on their practical benefits. Although most participants were office workers with relatively high levels of education-factors that may have shaped their experiences-these findings offer insights into how young adults engage with digital health technologies. Nurses and other healthcare professionals should design, implement, and evaluate interventions that enhance engagement, address emotional needs and motivational factors, and promote long-term behavior change.

The COVID-19 pandemic has significantly impacted public health in Mexico. This study evaluated its impact on the frequency of vaccine-preventable diseases (VPDs) from 2020 to 2024. The analyzed information was extracted from the weekly epidemiological bulletins, which compile the suspected, probable, and confirmed cases reported to the Ministry of Health. The epidemiological behavior of VPDs was analyzed with endemic channels based on 2014-2019 data. An endemic channel is a graphical tool that is used to plot a central tendency and its limits; with this tool we can detect the presence of an epidemic and quantify it. Between 2020 and 2024, VPDs presented variable patterns due to the pandemic. Rotavirus cases exhibited an 81% negative deviation in 2020 and a final 47% negative deviation in comparison with the expected values from 2014-2019. Chickenpox declined by 91% in 2020, with a partial recovery in reports afterward. Hepatitis A and B declined initially, but hepatitis B surpassed pre-pandemic levels later. Mumps declined by 45% in 2020, with a partial recovery, remaining 35% below expected reports. Meningeal and pulmonary tuberculosis increased by 125% and 33%, respectively. Human Papilloma Virus (HPV) infection and mild cervical dysplasia showed negative deviations, with partial increases later. However, severe dysplasia and in situ cervical cancer reports exceeded expected levels. Overall, several VPDs showed negative deviations, which could increase the size of the susceptible population. In contrast, increases in tuberculosis and HPV infection present a major challenge for health systems, given their chronic and high treatment costs.

Snow avalanches pose a serious hazard in snow-covered, mountainous areas. In order to protect inhabited areas and infrastructure such as roads and railway lines, avalanche protection measures need to be taken. In addition to permanent, technical protection measures, temporary, organizational measures, which are based on risk assessments by local avalanche warning commissions, are utilized. These avalanche risk assessments rely on regional avalanche bulletins, weather forecasts, local expertise, and information on current snowpack conditions. Our research seeks to enhance knowledge of current snowpack and avalanche conditions by providing in situ monitoring of potential avalanche slopes. Therefore, we developed a novel sensor box array, peakr, consisting of multiple sensor units deployed by hand or by drone at key avalanche slope locations throughout the winter season. The sensors continuously measure temperature, humidity, position, and snowpack movement. Data are transmitted via LoRaWAN and GSM, stored locally, and accessed through a web platform. Automated analysis using a decision tree and event-detection algorithm triggers immediate alerts to responsible personnel via SMS and email. This paper presents an overview of the peakr sensor array and web platform, focusing on data analysis and avalanche events from the Arlberg ski resort in winter 2023/2024, supported by webcam time-lapse validation.

Hepatitis B remains a serious public health problem worldwide. Achievement of the goals of the global hepatitis elimination strategy has been significantly delayed, especially during the COVID-19 pandemic. Since 2022, a gradual levelling of hepatitis B epidemiological indicators has been observed in Poland. The aim of the study was to assess the epidemiological situation of hepatitis B and hepatitis B vaccination coverage in Poland in 2023 and 2024, compared to previous years. The epidemiological situation of hepatitis B was assessed based on the analysis of the national hepatitis B and HBV infections surveillance system data recorded by the local sanitary and epidemiological stations in the Epibaza system. Data published in the annual bulletins "Infectious Diseases and Poisonings in Poland" and "Vaccinations in Poland" were also used, as well as data on deaths provided by the Demographic Surveys Department of Statistics Poland (GUS). In 2023 and 2024, 36 and 32 cases of acute hepatitis B were recorded, respectively, resulting in an incidence of 0.1/100,000 and 0.09/100,000. The share of migrants among acute hepatitis B patients was 39% in 2023 and 25% in 2024, with no cases among children or young adults. Acute hepatitis B cases occurred in 14 of 16 voivodeships in 2023, and in 13 of 16 voivodeships in 2024. In 2023, 3,106 chronic and unknown stage (CHB and UNK) cases were recorded, and in 2024, 3,513, with a diagnosis rate of 8.24/100,000 and 9.35/100,000, respectively, which were higher than in the previous years. Imported cases of CHB and UNK accounted for 7% in 2023 and 9.9% in 2024, mostly acquired in Ukraine. The most frequently identified probable route of infection was medical procedures. Hepatitis B vaccination coverage HepB3 among 1-year-olds (in their second year of life) was 89.5% in 2023 and 87.3% in 2024. In 2023 and 2024, a further increase in the number of diagnosed hepatitis B cases was observed, to levels exceeding those observed before the COVID-19 pandemic. Reintroduction of testing and the increased number of migrants, particularly from Ukraine, contributed to the increase in the incidence and the diagnosis rate of HepB cases. In 2023 and 2024, further declines in hepatitis B vaccination coverage among 1-year-old children were recorded, to below 90%. Wzw B pozostaje poważnym problemem zdrowia publicznego na całym świecie. Realizacja celów zawartych w globalnej strategii zwalczania wzw uległa dużemu opóźnieniu, zwłaszcza w czasie pandemii COVID-19. Od 2022 r. w Polsce obserwuje się stopniowe wyrównywanie wskaźników epidemiologicznych wzw B. Celem pracy była ocena sytuacji epidemiologicznej wzw B oraz stanu zaszczepienia przeciw wzw B w Polsce w 2023 i 2024 r. w porównaniu z sytuacją w poprzednich latach. Dokonano ewaluacji sytuacji epidemiologicznej wzw B na podstawie analizy danych z nadzoru epidemiologicznego, w szczególności danych jednostkowych z raportów o zachorowaniach na wzw B i zakażeniach HBV rejestrowanych przez PSSE w systemie Epibaza. Wykorzystano również dane publikowane w biuletynach rocznych „Choroby zakaźne i zatrucia w Polsce” i „Szczepienia ochronne w Polsce” oraz dane o zgonach udostępnione przez Główny Urząd Statystyczny. W 2023 i 2024 r. zarejestrowano odpowiednio 36 i 32 przypadki ostrego wzw B, zapadalność wyniosła 0,1/100 000 i 0,09/100 000. Odsetek migrantów wśród pacjentów z ostrym wzw B wyniósł 39% w 2023 r. i 25% w 2024 r., nie odnotowano zachorowań wśród dzieci i młodych dorosłych. Ostre przypadki wzw B wystąpiły w 14 z 16 województw w 2023 r. i w 13 z 16 województw w 2024 r. W 2023 r. zarejestrowano 3106 zachorowań przewlekłych i nieokreślonych co do fazy (BNO), a w 2024 r. – 3513, wskaźnik rozpoznawania wynosił odpowiednio 8,24/100 tys. i 9,35/100 tys. i był wyższy od wskaźnika w roku poprzedzającym. Przypadki importowane wśród przewlekłych i BNO wzw B stanowiły 7% w 2023 r. oraz 9,9% w 2024 r., w większości z Ukrainy. Najczęściej identyfikowaną prawdopodobną drogą zakażenia były procedury medyczne. Stan zaszczepienia trzema dawkami szczepionki przeciw wzw B dzieci w drugim roku życia wynosił w 2023 r. 89,5%, a w 2024 87,3%. W 2023 i 2024 r. obserwowano dalszy wzrost liczby rozpoznawanych przypadków wzw B, do poziomów przekraczających obserwowane przed pandemią COVID-19. Na wzrost zapadalności ostrego wzw B oraz wskaźnika wykrywania CHB i BNO, poza przywracaniem testowania, miała wpływ zwiększona liczba migrantów, szczególnie z Ukrainy. W 2023 i 2024 r. odnotowano kolejne spadki stanu zaszczepienia HepB3 dzieci w drugim roku życia, do poziomu poniżej 90%.

Fetal heart rate surveillance is a standard component of intrapartum care. The fetal heart rate can be evaluated using intermittent auscultation or electronic fetal monitoring. Research that has compared these 2 strategies found them to be equivalent with respect to long-term neonatal outcomes. The purpose of this clinical bulletin by the American College of Nurse-Midwives is to review evidence for the use of intermittent auscultation and provide recommendations for intermittent auscultation technique, interpretation, and documentation.

Over the years, India has experienced numerous rainfall-triggered landslides that initiate complex multi-hazard events, resulting in substantial human loss. This study presents a graph-based risk assessment of multi-hazards for two case studies in India: The South Lhonak Lake Glacial Lake Outburst Flood which impacted North Sikkim in October 2023 and the Wayanad Landslides in July 2024, which collectively claimed over 600 lives. This is achieved through a multidimensional methodology which integrates dynamic rainfall and discharge thresholds, stakeholder-informed hazard sequences, spatiotemporal hazard progression, and elements at risk. Heterogeneous data sources including remote sensing, field surveys, hydro-meteorological observations, and gray literature such as government reports and official situation bulletins, are synthesized to construct weighted, directed hazard networks. Graph-theory metrics, including degree centrality, betweenness centrality, and cascade depth, are used to compute sub-basin-level risk scores. Results highlighted critical sequences present in both regions, particularly the transition from extreme rainfall to landslides and subsequent flooding. Also, they identified high-risk zones influenced by both topography and infrastructure exposure. The findings emphasize the need for real-time threshold monitoring and alert systems, hazard-sequence-based operational protocols, and spatiotemporally phased response planning to support coordinated evacuations and early warning. The proposed framework offers actionable guidance for dynamic risk monitoring and multi-hazard governance in vulnerable mountain ecosystems.

The number of individuals choosing to give birth at home has increased significantly in the United States over the past decade. It is essential to gain a greater understanding of the evidence regarding the provision of midwifery care to people considering this option. The safety of planned home birth continues to be debated and studied primarily through observational research both globally and within the United States. Findings from well-designed studies demonstrate that pregnant people who are essentially healthy at term with a singleton fetus and choose a planned home birth have positive outcomes and a lower rate of interventions during labor and birth; furthermore, there is no statistically significant impact on infant mortality when these births are attended by skilled health care providers. The purpose of this American College of Nurse-Midwives (ACNM) clinical bulletin is to provide information, including relevant research, ethics, informed decision-making, and quality assurance, to midwives and other birth providers to use when caring for people planning a home birth.