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Given the academic and clinical demands faced by nursing students, mental health is a critical component of their well-being. To promote a culture of wellness, Mental Health Bulletin Boards were implemented at a large, multicampus nursing college to provide an interactive space for students to share mental health strategies. A thematic analysis of 339 individually posted bulletin board notes revealed five overarching categories: physical health, connectedness, mental and emotional health, leisure and creative outlets, and personal management strategies. The findings inform nursing education wellness initiatives, including curriculum integration, faculty messaging, and community outreach.
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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.
The objective is to determine the prevalence and types of drug-related problems (DRPs), identify associated factors, and evaluate the impact of a structured pharmacist-led intervention on prescribing quality in pediatric outpatient care in a resource-limited health system with limited advanced prescribing decision-support. A pre-post intervention study was conducted from July 2023 to June 2024 at a secondary-level hospital in a lower-middle-income country setting (Vietnam). Two independent cross-sectional prescription samples were obtained using systematic random sampling (323 prescriptions preintervention and 323 postintervention). DRPs were identified using national prescribing frameworks and mapped to the Pharmaceutical Care Network Europe DRP Classification (v9.1). The intervention comprised pharmacist-led educational sessions and the dissemination of drug information bulletins, with ongoing reminders, targeting the most frequent baseline DRPs. Factors associated with DRP occurrence (≥1 DRP per prescription) were examined using logistic regression; pre-post comparisons used Chi-square tests. At baseline, 57.9% of prescriptions contained at least one DRP, predominantly dosage regimen-related problems, with incorrect timing of administration being the most frequent (32.20%). In multivariable analysis, prescriptions issued by male prescribers had higher odds of DRPs (odds ratio 2.51, 95% confidence interval 1.51-4.18), whereas prescriptions for children aged 2-6 years and 6-12 years had lower odds than those for children aged ≤2 years. Following the intervention, DRP prevalence decreased significantly to 40.2% (P < 0.001), with marked reductions in timing- and dosing-related DRPs. A structured, low-cost pharmacist-led intervention integrated into routine outpatient practice was associated with a clinically meaningful reduction in DRPs. Strengthening clinical pharmacy services is a feasible and scalable strategy to improve pediatric prescribing safety in resource-limited settings where systematic medication review and electronic decision support are constrained.
Background and Objectives: Menopausal hormone therapy (MHT) is the most efficacious treatment for vasomotor symptoms and genitourinary conditions associated with menopause. Modern menopause care increasingly encompasses women with multimorbidity, renal or hepatic impairment, previous malignancies or thromboembolic disorders, advanced age, and polypharmacy-groups frequently underrepresented in randomized clinical trials. This evidence gap prompts significant inquiries about the relevance of trial-based recommendations to actual clinical practice. Materials and Methods: This narrative review offers a concentrated assessment of prominent worldwide clinical guidelines regarding menopausal hormone therapy through thematic synthesis. We examined position statements from the North American Menopause Society (NAMS), the European Menopause and Andropause Society (EMAS), NICE clinical guidelines, the ACOG Practice Bulletin on menopausal symptom management, the Endocrine Society clinical practice guideline, and pertinent UK guidance from RCOG, BMS, and BGCS. Data from systematic reviews, meta-analyses, and extensive observational studies were analyzed to contextualize guideline recommendations for populations often underrepresented in clinical trials, including women aged ≥65 years and individuals with multimorbidity or polypharmacy. Results: Only the NICE and EMAS recommendations expressly acknowledge clinical vulnerability or complexity (multimorbidity, frailty, and cancer survivorship) as foundational principles. NAMS and ACOG delineate risk categories but fail to offer a cohesive taxonomy of vulnerability. Polypharmacy and drug-drug interactions are inconsistently addressed across guidelines, and there is a deficiency of standardized prescribing algorithms. While routine safety monitoring is universally advocated, the intervals for follow-up and methods for risk categorization differ. Observational evidence consistently indicates route-dependent variations in cardiovascular and thromboembolic risk, with transdermal estrogen linked to a more advantageous safety profile in higher-risk individuals. Conclusions: Present menopausal therapy guidelines are methodologically sound; however, they insufficiently address the complexities of multimorbidity, polypharmacy, and organ dysfunction. A systematic conceptual framework that incorporates areas of clinical vulnerability may facilitate personalized benefit-risk evaluation in practical applications. Future guideline revisions should enhance clarity by incorporating polypharmacy concerns, monitoring strategies, and systematic risk stratification methods for clinically complicated patients.
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..
The 2025 measles outbreak in Mexico (5741 cases) marked a severe decline in immunization resilience. We aimed to measure this systemic vulnerability and project 2026 coverage. A Bayesian Ridge Regression model was built using a high-resolution (2015-2025) dataset (WHO indicator WHS8_110 and national bulletins). To validate the model, Leave-One-Out Cross Validation and Bootstrap (n = 5000) methods were used. Our results project a MCV1 vaccine coverage of 85.41% (95% confidence interval: 64.45-100.00%) for 2026, which remains below the 95% herd immunity threshold. High postpandemic volatility limited the model's predictive performance (R² = -0.36), reflecting an atypical deviation from historical trends. Prior coverage (89.59%) is the primary driver, while outbreak load and crisis status (10.41% combined) trigger the projected downturn. This indicates a delayed immunization recovery where past performance no longer reliably dictates the future due to logistical saturation. The immunization system of Mexico has reached a state of prolonged vulnerability, and there is an urgent need for structural reinvestments and catch-up campaigns to prevent the re-establishment of endemic measles transmission.
Enrolled medical undergraduates face high exam competition and stress, reducing life quality, well-being, learning abilities and health; supporting their exam stress management is critical. This study used a 2-h forest bathing intervention to alleviate their exam-related stress. One week prior to the intervention, 160 students were recruited via university bulletin boards; eligibility screening, defined by a State-Trait Anxiety Inventory-State score >40, was administered 1 day before the 2-h sensory exposure. Ultimately, 60 final-examination-preparing medical undergraduates (male:female = 7:53) were randomly assigned to two groups (n = 30 per group). Analyses focused on oxygenated hemoglobin (oxy-Hb) levels in the prefrontal cortex (PFC), physiological functions, and psychological changes under specific tasks. Forest environments characterized by lower noise levels, and higher negative air ion concentrations-with a comfort index of 0.971-1.368 (vs. 2.221-3.647 in urban areas) and negative oxygen ion concentrations of 1,000-1,200 ions/cm3 (vs. 400-500 ions/cm3 in urban areas). For the PFC region, forest group had significantly greater oxy-Hb reduction during the Trier Social Stress Test (TSST) [t(29) = 3.038, p = 0.005]. At the channel-specific level, forest group had decreased oxy-Hb in the left PFC and bilateral Frontopolar Area during the TSST, while the urban group exhibited increased oxy-Hb in the right PFC during the MT. No between-group oxy-Hb differences were observed in the Stroop task or rumination task. Forest group showed lower heart rate [F(1,57) = 4.227, p = 0.044], salivary cortisol [F(1,57) = 4.590, p = 0.036], higher Nature Connection Scale [F(1,57) = 4.822, p = 0.032], Digit Span Backward Test [F(1,57) = 6.164, p = 0.016], Montreal Cognitive Assessment scores [F(1,57) = 12.040, p < 0.001], lower Rumination-Reflection Questionnaire [F(1,57) = 11.318, p = 0.001]/Perceived Stress Scale scores [F(1,57) = 6.076, p = 0.017], 56.7% positive facial expressions (U = 263.000, n = 60, p = 0.002), and elevated positive affect [Profile of Mood States: F(1,57) = 17.063, p < 0.001]. Short-term forest bathing reduces physiological stress markers, enhances nature connectedness/positive emotions, alleviates stress via modified cerebral blood flow, and improves memory and reduce cognitive fatigue to a certain extent. As a low-cost, easy-to-implement strategy, it is may recommended for enrolled medical undergraduates' mental health curricula to build sustainable stress management.
Salmonellosis is a foodborne bacterial disease caused by Salmonella spp. (excluding S. Typhi and S. Paratyphi) and remains a significant public health concern in Poland and worldwide. According to the CDC, the true burden of infection may be substantially underestimated. In 2023, the epidemiological situation in Poland returned to pre-COVID-19 levels, reaching some of the highest values observed in recent years. The aim of this article is to present and compare the epidemiological situation of salmonellosis in Poland in 2023 with that observed in previous years. The analysis was based on individual case data on salmonellosis, data on foodborne disease outbreaks reported to the EpiBaza and ROE systems, bulletins and articles published by the National Institute of Public Health NIH NIPH - PIB, scientific publications, data from the ECDC website, and data from the Central Statistical Office (GUS). In 2023, 10,348 cases of salmonellosis were reported in Poland, with an incidence rate of 27.4 per 100,000 population; 61.7% of cases required hospitalization. The predominant serotype was Salmonella Enteritidis (71%). A total of 1,220 foodborne outbreaks were recorded, including 396 salmonellosis outbreaks, with 147 imported cases. Nineteen deaths due to Salmonella infection were reported. In 2023, Poland accounted for 13% of all reported salmonellosis cases in the EU, with an incidence rate higher than the EU average and comparable to pre-COVID-19 levels. The proportion of imported infections remained low, with Turkey most frequently identified as the country of origin in both Poland and the EU. Monitoring imported cases is important due to the risk of introducing rarely isolated serotypes. Notably, an outbreak caused by the rare serotype Salmonella Agama, affecting over 30 individuals, was identified against the background of dominant Salmonella Enteritidis infections in Poland. Salmoneloza to bakteryjna choroba zakaźna wywoływana przez pałeczki z rodzaju Salmonella (inne niż S. Typhi i S. Paratyphi), przenoszona drogą pokarmową lub przez kontakt z zakażonymi osobami, zwierzętami lub ich odchodami. Choroba od lat istotnie wpływa na zdrowie publiczne w Polsce i na świecie. Według CDC rzeczywista liczba zakażeń może być nawet 30-krotnie wyższa niż liczba zgłoszona w systemach nadzoru. W 2023 r. sytuacja epidemiologiczna salmoneloz w Polsce powróciła do poziomów sprzed pandemii COVID-19, osiągając jedne z najwyższych wartości w ostatnich kilkunastu latach. Artykuł ma na celu przedstawienie i porównanie sytuacji epidemiologicznej salmoneloz w Polsce w 2023 roku z latami wcześniejszymi. Analizę przeprowadzono na podstawie jednostkowych danych o zachorowaniach na salmonelozy, danych dotyczących ognisk chorób przenoszonych drogą pokarmową wprowadzonych do systemu EpiBaza i ROE, biuletynów i artykułów NIZP PZH – PIB, artykułów naukowych, danych ze strony ECDC i danych GUS. W 2023 r. w Polsce zarejestrowano 10 348 przypadków salmoneloz, w tym 9 856 jelitowych i 492 pozajelitowe; hospitalizacji wymagało 61,7% chorych. Wskaźnik zapadalności wyniósł 27,4/100 tys. ludności, najwyższy w woj. podkarpackim (52,5/100 tys.), najniższy w zachodniopomorskim (12,2/100 tys.). Dominującym serotypem była Salmonella Enteritidis (71%). Odnotowano 1 220 ognisk zatruć pokarmowych, w tym 396 salmonelozowych; zakażenia importowane stanowiły 147 przypadków. W wyniku zakażenia pałeczkami z rodzaju Salmonella zmarło 19 osób. W 2023 r. Polska odpowiadała za 13% wszystkich zgłoszonych przypadków salmonelozy w UE, a wskaźnik zapadalności był wyraźnie wyższy od średniej unijnej, powracając do poziomów sprzed pandemii COVID-19 i osiągając jedne z najwyższych wartości w ostatnich kilkunastu latach. Odsetek zakażeń importowanych pozostawał niski, a Turcja była najczęściej wskazywanym krajem źródłowym także w UE. Monitorowanie przypadków importowanych jest istotne ze względu na możliwość zawlekania rzadko izolowanych serotypów. Na tle dominującego serotypu Salmonella Enteritidis w Polsce uwagę zwracało ognisko wywołane przez rzadko izolowany serotyp Salmonella Agama, obejmujące ponad 30 osób.
In 2023 there was a significant increase in the number of syphilis cases in Poland, more than 50% new cases were reported compare to previous year. There is still a problem with the clinical differentiation of reported cases, i.e. new infections, reinfections, and residual positive serological tests confirming the presence of antibodies against Treponema pallidum in previously successfully treated individuals. The aim of the study was to assess the epidemiological situation of syphilis cases in Poland in 2023 in comparison to previous years. Analysis of the epidemiological situation was based on case-based data from reports of newly detected syphilis cases received from doctors and laboratories and registered in 2023 year. Additionally aggregated data from MZ-56 reports on infectious diseases, infections and poisoning from 2017 to 2019 sent from Sanitary Inspections to NIPH NIH - NRI was used. Also, data about treatment patients in dermatology/venereology clinics in 2020-2023 reported on MZ-14 forms and published in the NIPH NIH - NRI bulletins were used. In 2023, in Poland, 2,968 syphilis cases were reported (diagnosis rate was 7.89 per 100,000 population), including 130 cases among non-Polish citizens. The most often syphilis cases were detected among people below 30 years old (37.1%) and among men (88.1%). In 2023, early syphilis (ICD-10 code: A51) consisted 36.0% of all cases reported to surveillance (1,068 cases) and other syphilis and undetermined (ICD-10 code: A53) consisted 60.6% (1,799 cases). In 2023, the number of reported syphilis cases increased more than by half compared to the previous year. The percentage of cases of early syphilis (the most infectious), which probably occurred in a short period of time, also remains high, what can influence on transmission this infection in population and lead to increase in the number of new cases. W 2023 roku nastąpił znaczny wzrost liczby przypadków kiły w Polsce, zgłoszono o ponad 50% więcej przypadków niż w roku poprzednim. Nadal pozostaje problemem rozróżnienie kliniczne zgłaszanych przypadków tj. nowych zakażeń, reinfekcji, oraz pozostałości dodatnich testów serologicznych potwierdzających obecność przeciwciał w kierunku Treponema pallidum u osób wcześniej skutecznie leczonych. Celem pracy była ocena sytuacji epidemiologicznej kiły w Polsce w roku 2023 w porównaniu z poprzednimi latami. Ocenę sytuacji epidemiologicznej przeprowadzono na podstawie zgłoszeń przypadków kiły zarejestrowanych w roku 2023 pochodzących od lekarzy i z laboratoriów. Wykorzystano również zagregowane dane ze sprawozdań o zachorowaniach na choroby zakaźne, zakażeniach i zatruciach MZ-56 (meldunki dwutygodniowe, kwartalne, roczne) za lata 2017-2019 przekazane przez Państwową Inspekcję Sanitarną do NIZP PZH – PIB oraz dane ze sprawozdań MZ-14 o leczonych w poradniach skórno-wenerologicznych, publikowane w biuletynach NIZP PZH – PIB za lata 2020-2023. W 2023 roku w Polsce zgłoszono 2 968 przypadków kiły (wskaźnik rozpoznań 7,89 na 100 000 mieszkańców), w tym 130 u obcokrajowców. Najwięcej przypadków stwierdzono u osób poniżej 30 r.ż. (37,1%) oraz mężczyzn (88,1%). W 2023 roku kiła wczesna (ICD-10: A51) stanowiła 36,0% wszystkich rozpoznań kiły zgłoszonych do nadzoru (1 068 przypadków), a kiła inna i nieokreślona (ICD-10: A53) 60,6% (1 799 przypadków). W 2023 roku liczba zgłoszeń przypadków kiły zwiększyła się o ponad połowę w porównaniu z poprzednim rokiem. Na wysokim poziomie pozostawał również odsetek przypadków kiły wczesnej (najbardziej zakaźnej), co może mieć wpływ na rozprzestrzenianie się zakażeń w populacji i wzrost liczby nowych przypadków.
Developmental theories of ethnocultural socialization (Incorporating the cultural value of respeto into a framework of Latino parenting. Cultural Diversity and Ethnic Minority Psychology, 16(1), 77-86; Traditional and culture-specific parenting of prosociality in U.S. Latino/as. Oxford handbook of parenting and moral development, Oxford University Press.) emphasize the importance of understanding how caregivers instill culturally grounded values adapted to specific cultural and environmental contexts to support positive youth development. Caregivers are deemed to transmit these cultural values to their youth via ethnic heritage practices, customs, rituals, and cultural experiences. Importantly, work based on these models has shown that specific cultural values significantly predict the health and well-being of Latine youth (Cultural values, empathy, and prosocial behavior among U.S. Latino/a youth: A mediation model. Journal of Social and Personal Relationships, 38(2), 521-540; Familism values and adjustment among Hispanic/Latino individuals: A systematic review and meta-analysis. Psychological Bulletin, 147(9), 947-985). Among the cultural values instilled by many Latine parents is bien educado, a concept that emphasizes the importance that youth be well-mannered, display positive social behaviors, and exhibit a strong moral character (Familismo, respeto, and bien educado: Traditional/cultural models and values in Latinos. Critical Cultural Studies of Childhood. Springer). While much of the prior research has focused on cultural values such as familismo and respeto, relatively little is known about the cultural value of bien educado. Indeed, no studies exist on how bien educado is conceptualized and taught by Latine mothers. To address this gap, focus group interviews were conducted to explore how Latine mothers of adolescents define and teach bien educado to their adolescents. Seventeen Latine mothers (Mage = 41.88 years, SD = 6.23) reporting on their adolescents (Mage = 14.97 years, SD = 3.55) participated. On average, mothers had two children and lived in the United States for approximately 21.6 years. The majority were of Mexican origin and predominantly Spanish-speaking (88%). Focus group interviews were conducted in Spanish and English using semi-structured questions designed to explore mothers' definitions, beliefs, and practices related to bien educado. The questions included: "What is your own definition of bien educado?" and "What are some things you do to teach your child to be bien educado?" All focus groups were audio-recorded, transcribed verbatim, and trained; bilingual coders analyzed the transcripts using inductive thematic analysis (Qualitative inquiry and research design: Choosing among five approaches. SAGE Publications). Mothers conceptualized bien educado as encompassing four main aspects: respect, consideration for others, humility, and being well-mannered. Furthermore, mothers emphasized their intentionality to foster these traits in their youth and viewed the concept as a strength-based approach that contributed positively to their youth's moral development. The findings reveal that bien educado is a multidimensional cultural value construct and a Latine culturally-relevant parenting goal. Specifically, the findings highlight the central elements of bien educado as respect, consideration for others, being well-mannered, and humility. Given the centrality of these four elements in prosocial and moral development (The development and correlates of prosocial moral behaviors. Handbook of moral development. Psychology Press.), the present findings situate bien educado as a Latine-grounded value that can further our understanding of U.S. Latine youth prosocial and moral development. Moreover, the findings demonstrate the need to incorporate this understudied core Latine cultural value into sociocultural- and ecological-grounded parental socialization models and future research in U.S. Latine youth.
In a highly influential study across a wide breadth of literature, Kornell and Bjork (Psychological Science, 19[6], 585-592, 2008) showed that learning is enhanced by presenting exemplars (paintings) of to-be-learned categories (artists) in an interleaved sequence (e.g., A1, B1, C1 … A2, B2,, C2 …) rather than a blocked sequence (e.g., A1, A2, A3 … B1, B2, B3 …). However, this study, and nearly all direct replications, used an identification procedure that confounds memory abilities with response biases (i.e., one's criteria for using certain response choices); any interleaving effect assessed through an identification task may be an overestimate or, indeed, an underestimate of the effect (Hautus et al., Detection Theory, 2021). To address this, we conducted a direct replication: online, N = 288; t(287) = 8.08, p < 0.001, dz = 0.48, 96% CI [0.36, 0.59]-for the first time to our knowledge-accompanied by measures of differential learning and response biases across learned categories (which were substantial, with participants using some response categories at a rate several times higher than others). We then conducted a critical conceptual replication, changing the task from identification ("Which artist painted this?") to n-alternative forced-choice ("Which of these was painted by [e.g.] Seurat?"), the gold standard of memory tests (Brady et al., Psychonomic Bulletin & Review, 30, 2023). Reassuringly, the 2AFC experiment showed an interleaving effect comparable to our direct replication: online, N = 276; t(275) = 7.19, p < .001, dz = 0.43, 95% CI [0.32, 0.55]. Put together, this study showcases the challenges of interpretation facing any identification paradigm, illustrates a straightforward method to address them, and puts the interleaving effect on firmer footing.
The Stroop interference effect - slower color naming on incongruent trials (e.g., GREEN printed in red) compared to neutral trials (e.g., PRESS printed in red) - is widely regarded as a hallmark of selective attention failure. We (Curtis et al., Psychonomic Bulletin & Review, 32, 1328-1336, 2025) have previously argued that the integrated nature of the Stroop stimulus is a main factor contributing towards the robustness of this interference, which shows a characteristic positively sloped delta plot pattern. Here, we tested this claim by directly comparing the standard, integrated Stroop task with the primed Stroop task, in which the word and color are separated temporally (e.g., GREEN in monochrome followed by XXXX in red). Participants completed randomly intermixed standard (integrated) and primed Stroop trials: In Experiment 1, the prime-target stimulus-onset asynchrony (SOA) was 550 ms; and in Experiment 2, it was 250 ms. In the standard task, interference was large and increased across quantiles, replicating the classic delta plot pattern. In contrast, interference in the primed Stroop task was smaller and remained constant across the RT distribution - producing a flat delta slope, with both long and short SOAs. We take these results as support for our claim that the robustness of Stroop interference stems from the perceptual integration of word and color into a single visual object, and when this integration is broken as in the primed Stroop task, the resulting interference effect reflects a qualitatively different mechanism; thus, the effect in the primed Stroop task is not a "Stroop effect."
Background From mid-June into late December 2025, China experienced its largest-ever Chikungunya virus (CHIKV) outbreak across Guangdong Province, a densely populated region of southeast China with extensive international travel and established Aedes mosquito populations. CHIKV, dengue virus (DENV), and Zika virus (ZIKV) share the same Aedes vectors, overlap in clinical presentation, and exhibit serologic cross-reactivity. We describe the epidemiology and integrated public health response to this outbreak, as well as future arboviral risks and mitigation strategies. Materials and methods We synthesized weekly surveillance data from the Guangdong Provincial Center for Disease Control and Prevention, national epidemiological and genomic data from the China CDC and World Health Organization, Hong Kong Observatory climate records, published literature, and government bulletins. Outbreak dynamics were analyzed using confirmed-case counts disaggregated by prefecture-level city and reporting week. Results Guangdong reported over 25,800 locally transmitted CHIKV cases across all 21 prefecture-level cities, with nationwide cases exceeding 29,500. The outbreak occurred in two distinct waves: an initial wave centered on Foshan City (July-August; 8,948 cases) that was successfully contained through a rapid, multi-level public health response; and a second, larger wave in Jiangmen City (September-October; 10,035 cases) temporally coincident with three tropical cyclones that made landfall within a 16-day span, creating widespread Aedes breeding habitat. No deaths were reported in Guangdong. The causative lineage was the Middle African Lineage within the East/Central/South African genotype, carrying Aedes albopictus-adaptive mutations (E1-A226V, E2-L210Q, E2-I211T) independently acquired through convergent evolution with the Indian Ocean Lineage. The persistence of cases into mid-December, combined with the warmest winter on record in the Pearl River Delta, raises concerns about overwintering mosquitoes and an early resurgence in 2026. Conclusions The 2025 Guangdong outbreak suggests that extreme weather events can overwhelm even well-executed arboviral responses and that the climate-vector-arbovirus interface represents a systems-level vulnerability requiring anticipatory preparedness. We advocate for typhoon-landfall-triggered vector control deployment, intensified genomic and entomological surveillance beginning in spring 2026, multiplex molecular diagnostics for concurrent CHIKV/DENV/ZIKV detection, obstetric and neonatal arboviral screening, and cross-jurisdictional coordination across the Pearl River Delta and beyond.
Disasters can strike anywhere in Japan at any time. For patients who rely on life-sustaining equipment such as ventilators, disruption of essential services, including electricity, directly threatens their lives. Many patients with neurological disorders require specialized evacuation support during disasters, making preparedness during peacetime critical. It is desirable for relevant stakeholders to collaborate in developing individualized evacuation plans that address the securing of evacuation support personnel, evacuation methods, and post-evacuation living arrangements. The Japanese Society of Neurology has developed a disaster response manual, utilizes a disaster support network bulletin board, and has appointed network leaders and liaisons for intractable neurological diseases.
The endemic channel is a surveillance method that presents statistical indicators and visual representations of a disease's historical dynamics. Its epidemic curve defines the central tendency of cases and their expected variation, providing 3 levels (ie, "safety," "warning," and "epidemic") to assess the epidemiological status of a region. Parameters include the central tendency used as the epidemiological warning threshold (EWT), the size of the retrospective window, and the handling of previous outbreaks and zero values in data. The absence of clear guidelines for the selection of these parameters may compromise reproducibility and hinder outbreak definitions and responses for endemic diseases such as dengue. This study aimed to review the parameters of the endemic channel used for the definition and monitoring of dengue outbreaks in Colombia while quantitatively assessing the performance of the method. We reviewed institutional epidemiological bulletins in Colombia and quantitatively assessed the endemic channel in two main aspects: (1) the impact on the EWT of parameter selection regarding the retrospective data window, previous epidemic years handling, and zero-value handling, using a statistical framework; and (2) the endemic channel's performance based on the windows of opportunity, outbreak detection capacity, and the ratio of warnings that correspond to actual outbreaks. The endemic channel's performance is higher as transmission increases due to more robust data that facilitate a timely detection of outliers, while lower-transmission areas show a sharper rise in cases when outbreaks are missed, indicating limited detection capacity. Reducing the retrospective data window improved metrics across all transmission profiles by 6.34% on average, while extending it decreased performance due to changes in detection capacity. There was no significant difference (P value >.01) in performance when data from epidemic years were included or excluded for municipalities with high or very high transmission levels. Instead of adding an entire unit, shifting the data by 0.001 prevents the estimation of null values for the EWT and thresholds and significantly improves performance across all transmission levels (P value <.01) by 23.07% on average. The endemic channel's performance varies with the outbreak definition and the municipality's transmission level. Encouraging an optimal retrospective window is challenging, as data are computed over the years. Nevertheless, the improved performance with shorter retrospective windows is likely due to reduced overlap in seasonal outbreaks. Shifting data by a limiting-to-zero value, instead of adding a complete unit, improves performance and can be easily integrated into existing surveillance templates. Windows of opportunity should be considered when selecting the parameter combination. Finally, reassessing outbreak definitions and method parameters underpinning surveillance tools is essential to ensure their validity and effectiveness, especially when used to inform early warning systems and public policies.
Artificial intelligence (AI) has been increasingly applied in schizophrenia research, yet a bibliometric overview of its global development and evolutionary trends remains lacking. Based on the Web of Science Core Collection (WoSCC), a bibliometric analysis was conducted on AI‑related schizophrenia studies published from 2005 to 2025. A total of 1,839 publications were included, and trends, countries, institutions, authors, journals, and research hotspots were analysed. Annual publications grew rapidly from 2 in 2005 to 374 in 2025, consistent with the expansion of AI research. The U.S., China, and England were the most productive and influential countries. The U.S. dominated global collaboration, while Chinese institutions showed strong domestic links but limited international partnerships. Leading institutions included the University of London, King's College London, and Harvard University. Nikolaos Koutsouleris and Vince D. Calhoun were the top authors. Key journals included Frontiers in Psychiatry, Schizophrenia Research, and Schizophrenia Bulletin, with NeuroImage as the top co-cited journal. Keyword analysis showed early focus on machine learning, risk assessment, and brain biomarkers based on functional magnetic resonance imaging (fMRI) and electroencephalogram (EEG). After 2016, deep learning became dominant in diagnosis. Recently, natural language processing has emerged for risk prediction, indicating a shift toward multimodal AI applications. AI applications in schizophrenia have expanded exponentially with a clear evolution from machine learning to deep learning. The global collaboration pattern is imbalanced, and future research will advance toward multi‑modal, predictive, and precise intelligence.
Point of Care Ultrasound (POCUS) is increasing utilised in respiratory medicine as it enables immediate detection of pathologic processes without radiation, and it increases safety for pleural procedures. With increasing use of thoracic ultrasound, its potential as a vector for transmission of pathogens must be considered. Anecdotally, there is a relative dearth of education regarding appropriate cleaning practices in many short POCUS curricula. Using a previously accepted survey instrument with adjustment to reflect up to date guidelines, we surveyed a range of respiratory medicine practitioners from 01 August 2024 to 30 November 2024 regarding their use of POCUS and their knowledge and practice regarding appropriate cleaning procedures. The survey instrument was distributed electronically to the majority of Australian teaching hospitals and advertised in national society bulletins, and included a combination of yes/no, Likert Scale and free text questions. Data collection was anonymous through the Research Electronic Data Capture (REDCap) Platform. There were 66 respondents, with the majority being respiratory medicine trainees or specialists (19 and 41 respectively). Most practitioners have been using POCUS for at least 1-2 years, and respondents are generally using it from 2 to 3 times/week to 2-3 times/month. 81 % have participated in a formal education program regarding POCUS. Approximately two thirds (62 %) have never received education regarding how to clean an ultrasound machine. There was a broad range of answers regarding which parts of a machine to clean after a simple POCUS scan, with most identifying an appropriate cleaning product. Concerningly, 21 % and 3 % believe that high concentration alcohol solutions or high temperature sterilisation is appropriate for cleaning ultrasound probes. Lack of knowledge and inability to find the right materials were the most commonly cited reasons for failure to clean a POCUS device after a scan. Whilst many receive formal training on the use of ultrasound, education and knowledge of appropriate procedures for ultrasound machine cleaning appears to be lacking. There is a need for greater awareness of available machine cleaning guidelines to reduce the risk of ultrasonography as a vector for healthcare-associated pathogen transmission.