Despite expansion of ART under universal test-and-treat strategies, lost to follow-up remains a major barrier to effective HIV care, leading to treatment interruption, drug resistance, and poor clinical outcomes. Evidence on lost to follow-up in Eastern Ethiopia during the test-and-treat era remains limited. Therefore, this study aimed to assess the incidence and predictors of lost to follow-up in "test and treat era" among adults on Anti-Retroviral Treatment at Public Hospitals in Eastern Ethiopia. A retrospective follow-up study was conducted among 863 randomly selected adults newly enrolled in ART after the implementation of the Universal test and treat strategy from November 15, 2016 to March 30, 2024. LTFU was defined as failure to return for ART refill for ≥90 days after the last missed appointment without documented death, transfer-out, or treatment discontinuation. Data were extracted from patient charts using koboTool, and analyzed using STATA (V17.0). Kaplan-Meier survival curve with log-rank test used to compare survival differences, and Cox regression was used to identify predictors of lost to follow-up. Proportional hazard assumptions were checked. The median follow-up time was 2.1 years. A total of 229 study participants (26.54%) were lost to follow-up, yielding an incidence rate of 9.9 (95% CI:8.72-11.30) per 100 person-years. Higher hazard of lost to follow-up was observed among those without a contact person (AHR = 1.47;95% CI:1.01-2.12), who had not disclosed HIV status (AHR = 1.51;95% CI:1.03-2.20), presented with WHO clinical stage IV (AHR = 2.86;95% CI:1.57-5.18), baseline CD4 < 200 cells/mm3 (AHR = 1.61;95% CI:1.03-2.51), opportunistic infection (AHR = 1.44;95% CI:1.02-2.04), no isoniazid preventive therapy (AHR = 1.60;95% CI:1.18-2.18) and poor adherence (AHR = 2.51;95% CI:1.81-3.47). Conversely, BMI < 18.5 kg/m2 was linked to lower hazard of LTFU (AHR = 0.65;95% CI:0.45-0.92). LTFU was relatively high and remains a substantial challenge among adults receiving ART in Eastern Ethiopia during the UTT era. Clinical severity, poor adherence, and limited social support were important predictors of LTFU. Strengthening patient monitoring, adherence counseling, and targeted support for high-risk patients is essential to improve retention in HIV care and progress toward the UNAIDS 95-95-95 targets.
Background and objectives: Stenotrophomonas maltophilia (S. maltophilia) is an emerging pathogen causing hospital-acquired infections, particularly in critically ill and immunocompromised patients. Limited therapeutic options are available due to its multidrug resistance (MDR) nature. Despite the availability of advanced automated diagnostic methods in Eastern India, data describing its prevalence and antibiotic susceptibility patterns are limited. The present study was conducted to evaluate the prevalence, antimicrobial susceptibility patterns, and resistance trends of S. maltophilia over five years in a tertiary care hospital in Eastern India. Materials and methods: A retrospective laboratory-based observational study was conducted in the Department of Microbiology at Kalinga Institute of Medical Sciences (KIMS), a tertiary care hospital in Eastern India. Records of patients with positive culture reports for S. maltophilia isolates between January 2021 and December 2025 were analyzed after Institutional Ethics Committee approval (KIIT/KIMS/IEC/2616/2026). Clinically significant S. maltophilia isolates from various clinical specimens of hospitalized patients aged >18 years were included in the study. Samples were processed using standard microbiological procedures. Isolate identification was performed by VITEK 2 compact automated system (bioMérieux, Marcy-l'Étoile, France) and/or MALDI-TOF MS (VITEK MS PRIME system -bioMérieux, Marcy-l'Étoile, France). Antimicrobial susceptibility testing for trimethoprim-sulfamethoxazole, levofloxacin, and minocycline was performed by automated systems and interpreted according to CLSI M100, 34th edition (2024). Demographic, clinical, and laboratory data were retrieved from the laboratory information system and analyzed using R software Version 4.4.3 (R Foundation for Statistical Computing, Vienna, Austria). Categorical data were described with frequencies and percentages. A p-value of <0.05 was considered statistically significant. Results: During the five-year period, a total of 415 clinically significant S. maltophilia isolates were identified from 88,315 culture-positive samples, with an overall prevalence of S. maltophilia infection of 0.5%. The annual prevalence of isolates increased considerably from 38/10,239 (0.37%) in 2021 to 131/20,529 (0.6%) in 2025. The majority of the isolates were from ICUs (272/415; 65.5%), and males were 281/415 (67.7%), with a median age of 54 years. Blood was the most common specimen source (138/415; 33.3%), followed by pus/tissue/wound swabs (113/415; 27.2%). During the five years, minocycline had the highest susceptibility (73.7-83.2%), followed by trimethoprim-sulfamethoxazole (66.7-74.0 %) and levofloxacin (60.5-71.4%). Most isolates remained susceptible, while resistance phenotypes persisted, especially to levofloxacin and trimethoprim-sulfamethoxazole.  Conclusions: The rising isolation rate of S. maltophilia from clinical specimens, particularly from bloodstream infections, is an emerging epidemiological and clinical concern. There was an observed stable but notable resistance pattern to the antibiotics, such as fluoroquinolones and trimethoprim-sulfamethoxazole, highlighting the need for continuous surveillance and prudent antibiotic use, while minocycline remained the most effective antimicrobial during the study period.
Permanent pacemaker (PPM) implantation data and sex-based differences have not been well described in North Eastern India. This study aimed to evaluate the demographic profile, clinical characteristics and sex-based differences among patients undergoing PPM implantation at our center. We prospectively collected data on all patients undergoing PPM implantation between January 2014 and December 2019. The collected data were retrospectively analyzed for demographic characteristics, clinical indications and sex-based differences. A total of 1771 patients were included with a male to female ratio of 2.7:1. Mean age of the study population was 62.66 ± 12.46 years. The commonest conduction abnormality was complete heart block observed in 935 (52.80%) followed by sick sinus syndrome in 208 (11.74%) patients. Sick sinus syndrome (19.21% vs 8.98%; p < 0.001) and junctional bradycardia (1.25% vs 0.31%; p = 0.046) were more common in females. On multivariable logistic regression, female sex was an independent predictor of sick sinus syndrome (OR 2.35, 95% CI 1.74-3.17; p <0.001). Atrial capture threshold was higher (0.62 ± 0.21 vs 0.58 ± 0.21; p < 0.05) and sensed P-wave amplitudes were significantly lower in females compared to males (2.52 ± 0.64 vs 2.74 ± 0.71; p <0.001). This study represents one of the first comprehensive regional studies on demographic patterns and sex-based differences of patients undergoing PPM implantation in North Eastern India. Complete heart block was the leading indication, followed by sick sinus syndrome. Females more often received implants for sick sinus syndrome and showed higher atrial pacing thresholds with lower P-wave amplitudes.
Sexual and gender minority (SGM) individuals in South Africa's Eastern Cape face dual challenges navigating progressive constitutional protections alongside persistent cultural conservatism. Traditional Xhosa practices, including initiation schools (Ulwaluko) and ceremonial rituals, enforce rigid gender roles that conflict with SGM identities. With HIV prevalence reaching 49.5 % among men who have sex with men yet only 25.7 % achieving viral suppression, understanding how SGM individuals negotiate cultural traditions while managing HIV remains critically understudied. This qualitative study explored post-intervention experiences of 31 SGM individuals living with HIV in the Eastern Cape following participation in the SOAR (Speaking Out & Allying Relationships) intervention. Semi-structured interviews, guided by Social Cognitive Theory, were conducted in participants' preferred language by trained local interviewers. Thematic analysis through the Minority Stress Model examined four domains: traditional practices, family dynamics, community perceptions, and intervention impact. Participants demonstrated resilience through selective participation in cultural practices, balancing ancestral reverence with identity authenticity. Family acceptance was often conditional, tied to economic contributions or heteronormative expectations. Health communication barriers persisted due to stigma and traditional beliefs linking HIV to moral failing. SOAR enhanced participants' status-sharing confidence, treatment adherence, and skills for navigating cultural tensions, though community stigma remained pronounced in rural areas. SGM individuals exhibit remarkable adaptability in negotiating intersecting cultural, familial, and health challenges. While SOAR effectively builds individual resilience and HIV management skills, findings underscore the need for multi-level interventions combining skill-building with community mobilization and cultural sensitization to address structural barriers in traditional contexts.
Consumption of contaminated shellfish can be a pathway of human exposure to microplastics (MPs). Depuration is a treatment step that can effectively reduce the particle content of bivalves; however, this technique is not yet employed for mussels sold in the Eastern Amazon coast, in Brazil. Hence, this study aimed to verify the efficacy of 24 h, 48 h, and 72 h depurations in reducing the MP concentrations of the native mussel Mytella guyanensis. A total of 176 MPs were observed among fibers, fragments, and pellets, with black and blue fibers being predominant, followed by blue fragments. Non-depurated mussels had a significantly higher concentration of MPs per gram of edible weight than mussels from all depuration periods (1.31 ± 1.19 MPs/g). Meanwhile, in the concentration per individual non-depurated mussels (2.17 ± 1.04 MPs/ind) had a significantly higher contamination than mussels depurated for 48 h (1.33 ± 0.67 MPs/ind) and 72 h (0.90 ± 0.78 MPs/ind). Dyed fibers and fragments represented most of the observed MPs (58%), followed by microplastics of different polymers (25%), and cellulose (16%). Among dyes, the textile pigment Indigo and general use phthalocyanines were the most common findings, while PP was the most common microplastic. Our results reveal ample contamination by MPs in mussels that supply markets in the region. Therefore, we infer that depuration is an effective way of reducing the particle content of M. guyanensis, with the potential to reduce the human MP intake by 55-58%, considering a 72-h depuration.
To investigate the application effect of ultrasound-guided combined with Accelerated Seldinger Technique (AST) for mini midline catheter placement in patients in the neurology department undergoing short- to mid-term intravenous therapy, and to analyze its safety, feasibility, and influencing factors. A convenience sampling method was used to select 136 patients admitted to the Neurology Department of the First Affiliated Hospital of Soochow University from May to November 2025, who underwent mini midline catheter placement. Patient general information, intravenous therapy details, catheterization operation indicators, catheter indwelling outcomes, and complication occurrences were recorded. Statistical analysis was performed using SPSS 27.0. All 136 patients were successfully catheterized. The one-time puncture success rate was 77.2%, the mean operation time was (9.15 ± 4.11) min, and the pain score during placement was low (1.74 ± 1.08 points). The mean catheter indwelling time was (12.44 ± 6.66) days. The overall complication rate was 11.0%, with catheter blockage being the most common (5.1%). A higher daily average infusion volume was associated with a higher incidence of complications (P < 0.05) and with a longer indwelling time (r = 0.351, P < 0.001). Patient satisfaction reached 89.7%. The ultrasound-guided mini midline catheter is safe and feasible for application in neurology department patients. It offers advantages including a high success rate of catheterization, low complication rate, and high patient satisfaction, making it particularly suitable for short- to mid-term intravenous therapy with a relatively high daily infusion volume. Future multicenter, large-sample studies are needed to further validate its clinical benefits.
Despite intensive international efforts and broad implementation of control and prevention efforts, malaria continues to take a devastating toll on the most vulnerable populations, especially infants and young children. Emerging data support an important role for gut microbiome disruption in exacerbating, and potentially contributing to, adverse outcomes in malaria in young children. Less well understood are the role of the gut microbiome in early infancy in determining malaria susceptibility and how malaria exposure may impact gut microbial communities during this highly dynamic and sensitive period of microbiome development. To address these gaps, we recruited mother-infant dyads at birth in malaria-endemic eastern Democratic Republic of Congo. Infant fecal samples collected at six weeks, and at three, six and 12 months of age, as well as at passive malaria sick and post-treatment visits, were subjected to full length 16S rRNA sequencing. Significant differences in relative abundance of a number of bacterial species distinguished those infants who never had a malaria visit from those who did, and those malaria episodes resulted in gut dysbiosis. Classifier analysis with Boruta selection revealed preliminary predictive capacity of the six-week fecal microbiome for malaria susceptibility through the first year of life, with a modest signal partially intertwined with bednet use. Healthy gut-associated Bifidobacterium breve and its metabolic partner Cutibacterium avidum, along with Megasphaera micronuciformis were associated with malaria resistance, whereas bacteria previously associated with pathogenic processes, including Streptococcus salivarius, Klebsiella pneumoniae, and Rothia mucilaginosa, associated with malaria susceptibility. These results provide the first evidence that gut microbial composition in early infancy is associated with subsequent malaria susceptibility. These associations, if confirmed in larger cohorts, may inform future investigation of microbiome-targeted strategies to support resistance to malaria in early life.
Poverty is extensively acknowledged as a multidimensional phenomenon and has been the subject of extensive research all over the world. When it comes to child poverty, the impacts differ significantly due to the critical stages of physical, cognitive and socioemotional growth which make them vulnerable to the negative impacts of poverty. This paper analysed the impact of households' income sources on child's (0-17 years) fuzzy multidimensional poverty indicators in South Africa. The South African General Household Survey (GHS) datasets for the years 2017, 2018 and 2019 were used. The data were collected using the stratified two-stage sampling method with sampled households comprising 25,915, 25,224, and 20,083 children in 2017, 2018 and 2019, respectively. The fuzzy set methodology was used to compute child's multidimensional poverty indicator (MPI), which was later analysed with the Tobit regression model and treatment effects potential outcome framework using regression adjustment estimator. The results of the Tobit regression indicate that geography type, residence in Eastern Cape, North-West and Limpopo provinces, parental presence and income sources significantly (p < 0.01) influenced child's fuzzy multidimensional poverty. Additionally, children identified as Coloured, Indian/Asian and White and those who were biological children of household heads had significantly lower (p < 0.01) poverty. With respect to the Average Treatment Effect (ATE) and the Average Treatment Effect on the Treated (ATET), the results showed that children from households that were receiving social grants, salaries, income from business, remittances, pensions and other sources of income had significantly lower (p < 0.01) fuzzy MPI, when compared to the control group. In contrast, children from households that were receiving once off grants had significantly higher fuzzy MPI significantly (p < 0.01) higher compared to the control group. It was concluded that some income sources possess MPI reducing tendency. Therefore, development programmes to enhance households' access to them are recommended.
 Medicine shortages and governance failures in low- and middle-income countries continue to hinder progress towards universal health coverage.  To explore healthcare professionals' perceptions and experiences of medicines governance in South African healthcare facilities.  The study was conducted at the public healthcare sectors in Eastern Cape province, South Africa.  A qualitative exploratory cross-sectional design was used. Twenty healthcare professionals were purposively selected. Semi-structured interviews were conducted, audio-recorded, transcribed verbatim and thematically analysed using Braun and Clarke's framework.  Four major themes emerged: systemic governance constraints; pharmaceutical supply chain vulnerabilities; weak accountability mechanisms; and gaps in protocol implementation. Key determinants of medicine shortages included weak budget governance, supplier payment delays, limited pharmacy support staff and inconsistent implementation of standard treatment guidelines (STG) and limited functionality of Pharmacy and Therapeutics Committees (PTCs).  Medicine shortages result from systemic governance failures rather than isolated logistical issues. Strengthening pharmaceutical governance requires transparent budgeting, timely supplier payment systems, functional PTCs, and STG training to improve equitable access to essential medicines.Contribution: This study deepens the understanding of pharmaceutical governance, revealing systemic, interrelated factors that collectively lead to the shortage of pharmaceuticals in South Africa. Unlike previous research that focused primarily on supply chain logistics, the study showed that stock-outs were rooted not simply in operational inefficiency, but also in structural governance weaknesses. This study presents practical insights to strengthen pharmaceutical governance and supports national efforts to achieve universal health coverage by identifying specific governance obstacles and proposing system-level reforms.
CPRSS1-associated hereditary pancreatitis in children is characterized by early onset and rapid progression to chronic disease; however, data from Eastern European populations remain limited. This study aimed to evaluate disease severity, recurrence burden and progression to chronic pancreatitis in a Romanian pediatric cohort with PRSS1-associated hereditary pancreatitis. We conducted a retrospective observational study that included pediatric patients with pathogenic or likely pathogenic PRSS1 mutations. Clinical variables analyzed comprised age at onset, number of acute pancreatitis episodes, disease severity, complications and progression to chronic pancreatitis. Descriptive statistics were used. Five pediatric patients were included. All subjects developed recurrent acute pancreatitis. Patients with severe disease exhibited a higher recurrence burden compared to those with mild disease. Progression to chronic pancreatitis occurred in 80% of cases. Structural pancreatic changes and local complications were frequently observed. PRSS1-associated hereditary pancreatitis in children is characterized by early onset, high recurrence burden and frequent progression to chronic disease. Disease severity appears to be associated with recurrence burden, suggesting a more aggressive clinical phenotype in affected patients.
The World Health Organization (WHO) Global Breast Cancer Initiative aims to attain meaningful global breast cancer mortality reductions by 2040-a target that hinges on improvements in patient outcomes and survival. So far, however, data on cancer survival remain limited in low- and middle-income countries. The WHO estimated population-based age-standardized 5-year net survival for women diagnosed with breast cancer between 2017 and 2021 across all 194 Member States, providing a global benchmark for monitoring breast cancer outcomes. Here we found that median 5-year net survival varied widely across WHO regions during 2017-2021: 39.1% (95% uncertainty interval 34.1-44.7%) in the African Region, 61.0% (51.4-69.8%) in the Eastern Mediterranean Region, 66.3% (57.7-73.7%) in the South-East Asia Region, 81.1% (78.6-83.5%) in the Western Pacific Region, 84.0% (82.8-85.1%) in the European Region and 88.5% (86.7-90.1%) in the Region of the Americas. Persisting disparities in survival reflect profound global inequities; sustained initiatives to narrow gaps in access to diagnosis and treatment for breast cancer are crucial to strengthening health systems. This will enable all countries to ensure optimal outcomes for their patients with breast cancer and achieve Global Breast Cancer Initiative and Sustainable Development Goals targets.
The prevalence of hepatic neoplasms (carcinogenesis) in the common dab (Limanda limanda) flatfish was investigated using data collected between 2004 and 2020 from five biogeographic UK marine regions including the Northern North Sea, Southern North Sea, Irish Sea, Eastern Channel, and Western Channel and Celtic Sea. Our assessment considered age-related confounding effects, providing an improved estimation of how hepatic neoplasm prevalence differs between regions and over time. The data indicated a significant decline in prevalence in both the Irish Sea and Southern North Sea regions, with a similar decreasing trend observed when all marine regions were analysed collectively. However, a higher prevalence was noted in dab from the Irish Sea compared to other regions, indicating additional environmental pressures. We explored potential correlations between hepatic neoplasms and concentrations of hazardous substances in biota and sediment including polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), and metals. Concentrations of PCBs in biota were positively associated with hepatic neoplasm prevalence overall, although was primarily influenced by the Irish Sea region containing a disproportionately higher number of fishing locations compared to other regions. Cadmium, iron, manganese, and lead concentrations in sediments had a statistically significant effect on neoplasm prevalence, although this was believed to be correlation, not causation. The results are discussed within the context of monitoring the biological effects of contaminants and the associated challenges of long-term monitoring strategies.
Curable sexually transmitted infections (STIs), including Treponema pallidum (syphilis), Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis, remain a major global health concern; yet their epidemiology among forcibly displaced populations is poorly understood. Limited access to healthcare, high-risk exposures and structural vulnerabilities may contribute to a heightened burden of STIs in these populations. A systematic review conducted up to 12 July 2024 assessed the prevalence of syphilis, C. trachomatis, N. gonorrhoeae and T. vaginalis infections among refugees, asylum seekers and internally displaced populations globally. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Pooled mean prevalence of current and/or lifetime infection for each STI was estimated through random-effects meta-analyses. Random-effects meta-regression analysis was feasible for syphilis and investigated sources of heterogeneity, associated factors and temporal trends in prevalence. The review identified 82 reports contributing 232 prevalence measures based on over 1.1 million test results, with syphilis being the most frequently studied STI. The estimated pooled mean prevalence of current infection was 0.94% (95% CI 0.53% to 1.45%) for syphilis, 0.87% (95% CI 0.33% to 1.61%) for C. trachomatis, 0.14% (95% CI 0.06% to 0.32%) for N. gonorrhoeae and 17.07% (95% CI 0.07% to 51.37%) for T. vaginalis. The prevalence of lifetime syphilis was 2.78% (95% CI 1.54% to 4.31%). Meta-regression analyses explained 64% of the variation in syphilis prevalence. Populations displaced from the African region had a 2.90-fold higher prevalence of syphilis compared with those from the Eastern Mediterranean region (95% CI 1.58 to 5.33), and those hosted in low-income countries had a 5.20-fold higher prevalence than those in high-income countries (95% CI 1.47 to 18.38). Syphilis prevalence declined over time at a relative annual rate of 6%. This review highlights a substantial burden of syphilis among forcibly displaced populations, suggesting active transmission. Evidence for the other curable STIs is more limited, hindering a comprehensive understanding of their epidemiology in humanitarian settings. Systematic screening campaigns and effective STI surveillance are urgently needed, particularly in low-resource settings.
Existing studies highlight the potential of yoga practice techniques in reducing stress, anxiety, depressive symptoms, and somatic pain; however, a structured and validated Yoga-Based Counselling Program (YBCP) grounded in yoga philosophy remains unexplored for common mental disorders. This study aimed to develop a YBCP for CMD, validate it with yoga and mental health experts, and test its feasibility. We conducted a three-phase, sequential mixed-methods feasibility study (Development, Validation, Feasibility Testing) following an established feasibility framework. Development involved interviews with CMD patients (n = 18), literature reviews, traditional yogic texts, and yoga expert interviews. Validation used the Delphi method with experts (n = 17), thematic analysis, and the Content Validation Ratio (CVR). Feasibility testing assessed 30 patients (depression, anxiety, and somatoform pain disorder, n = 10 each) aged 18-45 years undergoing tailored yoga practices, yogic counselling (the principal component), and lifestyle modifications, with symptom, functioning, quality of life, and personality measures at baseline and post-intervention. All retained items met the CVR thresholds across Relevance (0.53), Essentiality (0.62), Clarity (0.36), and Clinical Applicability (0.31). Among 24 completers of six sessions, depression and anxiety scores fell significantly across all domains (p < 0.001), with improvements in symptom subscales and functioning (p < 0.001). Clarity and equanimity (Sattva) rose significantly (p < 0.001), with decreases in passion (Rajas) and inertia (Tamas). This preliminary work demonstrates that yogic philosophy can be integrated into psychotherapy approaches for CMD, offering a culturally relevant, novel approach to personalized mental health care. Controlled trials are warranted to establish efficacy and scalability. This work is part of an ongoing series exploring psychotherapeutic insights from eastern traditions.
This article provides updated global cancer statistics for the year 2024 based on the GLOBOCAN estimates of the International Agency for Research on Cancer. The authors describe national cancer incidence and mortality by world region and the Human Development Index and predict the burden in 2050 based on demographic trends. In 2024, an estimated 20.6 million new cancer cases (19.5 million excluding nonmelanoma skin cancer) and 9.8 million deaths (9.7 million excluding nonmelanoma skin cancer) occurred worldwide, equivalent to one in five people developing cancer during their lifetime and one in nine men and one in 13 women dying from the disease. Lung cancer is the most frequently diagnosed cancer, responsible for almost 2.6 million new cases (12.8%), followed by female breast (11.8%), colorectal (9.9%), prostate (7.5%), and stomach (4.7%) cancer. Lung cancer is also the leading cause of cancer death, with an estimated 1.9 million deaths (19.1%), followed by colorectal (9.4%), liver (7.5%), female breast (7.1%), and stomach (6.6%) cancer. Incidence rates vary four- to five-fold across regions, with the highest rates found in Australia/New Zealand (men, 477 per 100,000; women, 396 per 100,000), whereas mortality rates differ two-fold, with elevated rates in Eastern Europe for men (158 per 100,000) and Melanesia for women (108 per 100,000). The incidence burden is predicted to reach 34.4 million by 2050, up 67% from 2024, with the largest proportional increases in lower Human Development Index countries. Although global variation in cancer profiles demands a nuanced approach to cancer control at national and regional levels, primary prevention must be at the forefront, including intensified efforts to reduce tobacco use, prevent infections, lower alcohol consumption and excess body weight, and increase physical activity.
Ultrafine particles (UFPs) smaller than 100 nm are ubiquitous in polluted air. Although they carry little mass, UFPs have a large exposure surface area, can bypass respiratory defences, translocate into the brain and bloodstream, and impact the heart and other organs. Here, we assess the role of UFPs in air quality and the health burden they impose. We integrated Earth observations with machine learning to estimate long-term UFP exposure at 1 km resolution, demonstrating that they pose a major air quality concern in urban environments, with annual mean concentrations typically ranging between 10,000 and 30,000 particles/cm-3. Model calculations suggest that black and organic carbon are primary components of pollution UFPs. Based on a meta-analysis of epidemiological cohort studies in Europe and North America, we derived a pooled hazard ratio for mortality and combined it with our UFP data. We estimate a mortality density of 35.7 (15.8-65.5) per 100,000 people annually in Europe, and 27.4 (12.9-47.4) per 100,000 in North America, the latter being close to the global mean. We find that UFP exposure and mortality densities are particularly high in South and Eastern Europe. Since observational data for other regions are limited, global calculations primarily depend on modelling. We indicatively estimate that 1.99 (0.81-3.89) million excess deaths per year are attributable to UFP exposure. This could account for approximately 5% of total mortality from non-communicable diseases, to a large degree (about half) due to cardiovascular conditions. Globally, about 91% of UFP-related excess mortality occurs in urban and suburban environments, and much of that (78%) in densely populated urban areas. Health-improving interventions should target combustion sources in cities, particularly those related to energy consumption, industry, and traffic. An annual air quality limit of 5,000 cm-3 could reduce global excess mortality by about 45%.
Oropouche virus (OROV) was reported in Cuba in May 2024 and rapidly spread throughout the country. Here, among 147 reverse-transcription polymerase chain reaction-positive cases identified from May to July 2024, we sequenced 39 whole genomes of OROV. Phylogenetic analysis revealed that all sequences formed a monophyletic cluster nested within the reassortant lineage, named OROVBR-2015-2025, which has been circulating extensively in Brazil since 2023. Additional phylogeographic analyses demonstrated that the Cuban subclade probably originated from a single viral introduction from the Brazilian state of Acre in early February 2024, followed by cryptic circulation until its identification in May. The introduction probably occurred in the central region of the country, from which the virus spread and established secondary transmission hubs in the western and eastern regions. These findings underscore the capacity of OROV to spread well beyond South America, which was considered its endemic area of circulation.
Among various modifiable risk factors, dietary patterns (DPs), as a holistic lifestyle intervention, have become a focus of current research due to their protective effects on cognitive health. Classic Western DPs, such as the Mediterranean diet (MedDiet), have been widely confirmed to effectively improve cognitive function, thereby reducing the risk of Alzheimer's disease (AD). However, existing evidence mainly concentrates on Western populations and their DPs, including the MODERN (Machine learning-assisted Optimizing Dietary intERvention against demeNtia risk) diet optimized using machine learning. Given the significant differences in food types, dietary habits, and cooking methods among Asian populations, research on localized DPs optimized for cognitive health in Asian populations remains insufficient. In this context, the team at the Department of Geriatrics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine has taken the lead in systematically defining the Shanghai Cognitive Diet Pattern (SCDP). This review aims to comprehensively outline the core features and potential biological mechanisms relevant to AD in both classic Western DPs and the emerging East Asian DP. Subsequently, this review will systematically compare Eastern and Western DPs. In conclusion, this review proposes shifting​ dietary strategies from population-level adaptation to individual precision, in conjunction with multimodal lifestyle management, and offers novel strategies for the prevention and management of AD.
Air pollution, especially particulate matter (PM), poses significant environmental and health risks to humans. This study examines the toxicological effects of atmospheric PM collected over Rourkela, an industrial city in eastern India, using Drosophila melanogaster as an in-vivo model. The PM samples, evaluated using a Field Emission Scanning Electron Microscope (FE-SEM) and Energy Dispersive X-ray (EDX) Spectroscopy, revealed a complex composition of heavy metals and rare-earth elements, suggesting potential contributions from industrial and other anthropogenic sources. Food consumption exposed flies in the larval stage to varying PM exposure volumes. Histochemical staining, locomotor tests, and adult phenotypic screening were used to evaluate the effects. The results indicated volume-based PM genotoxicity, cytotoxicity, membrane damage, altered lipid metabolism, reduced climbing behaviour, and morphological abnormalities, particularly in the compound eyes. These results offer experimental evidence of the biological impacts of atmospheric PM exposure in a Drosophila model, shedding light on potential mechanisms relevant to human health.
Somatic symptom and related disorders are characterized by persistent physical symptoms accompanied by psychological distress, functional impairment, and complex patterns of emotional and cognitive vulnerability. Although these disorders are clinically important, multidimensional psychopathological profiling with contemporary instruments remains limited in Middle Eastern populations. This study aimed to characterize the MMPI-3 psychopathological profile of Iranian patients with somatic symptom and related disorders. Using convenience sampling, this cross-sectional study included 120 patients diagnosed with somatic symptom and related disorders according to DSM-5 criteria at Imam Khomeini Hospital, Sari, Iran, between May and September 2024. Participants completed the Minnesota Multiphasic Personality Inventory-3. MMPI-3 T-scores were compared with the normative mean of 50 using one-sample t-tests. Cohen's d effect sizes were calculated, and domain-wise Bonferroni correction was applied. Patients showed the largest elevations in Anxiety (mean T-score = 62.71, d = 0.99), Anger Proneness (mean T-score = 58.63, d = 0.96), Low Positive Emotions (mean T-score = 59.26, d = 0.87), Somatic Complaints (mean T-score = 61.03, d = 0.86), Fearfulness (mean T-score = 63.66, d = 0.85), Dysfunctional Negative Emotions (mean T-score = 59.48, d = 0.84), and Negative Emotionality/Neuroticism (mean T-score = 58.94, d = 0.82). In contrast, Juvenile Conduct Problems, Antisocial Behavior, Aggressiveness, and Disconstraint were lower than normative values. The overall profile indicated a predominantly internalizing pattern rather than an externalizing behavioral profile. Iranian patients with somatic symptom and related disorders showed a distinctive MMPI-3 profile marked by internalized emotional distress, somatic-cognitive preoccupation, and reduced externalizing pathology. These findings support the clinical value of structured psychological assessment in this population and highlight treatment-relevant targets, including anxiety, hopelessness, body-focused preoccupation, emotion regulation difficulties, and suicide-risk monitoring.