搜索结果：Science in One Health

Telehealth was essential for maintaining care continuity during the COVID-19 pandemic, leading to its rapid adoption across the United States. Telehealth has been heralded as a strategy for improving health care access and reducing health disparities, especially for community-dwelling older adults who face significant barriers to in-person care. However, data on telehealth use among socially and financially vulnerable older adults are limited, and little is known about characteristics associated with telehealth use in this population. Guided by the Systems Engineering Initiative for Patient Safety (SEIPS) 3.0 framework, this study examined factors associated with postpandemic telehealth use among older adults living at home and receiving publicly funded home- and community-based services (HCBS), considering HCBS receipt as an indicator of social and financial vulnerability. This cross-sectional study included older adults aged 65 years or older living at home with available telehealth use data who participated in the 2021-2022 survey wave of the National Core Indicators-Aging and Disabilities Adult Consumer Survey. We used complete-case multivariable logistic regression, adjusting for sociodemographic and health-related factors with state-level random intercepts, to examine associations between telehealth use and covariates of interest (age, sex, race/ethnicity, zip code, rural-urban commuting area code, internet access, self-perceived overall health, medical transportation access, living alone, number of known non-Alzheimer disease and related dementias [ADRD] diagnoses, known ADRD diagnosis, and HCBS program/payer type). Based on the regression results, we estimated bivariate associations between internet access and key sociodemographic variables (age, sex, race/ethnicity, and zip code rural-urban commuting area) using the Pearson chi-square test. Findings were organized and interpreted through the SEIPS 3.0 framework. Of the 3680 participants, 1467 (40%) were telehealth users and 2213 (60%) were nonusers. Significantly lower odds of telehealth were observed for older adults in older age groups, males, Black individuals, those living in nonmetropolitan areas, and recipients of Older Americans Act services (odds ratios [OR] between 0.66 and 0.80). Individuals with more than one known non-ADRD diagnosis (OR 1.49, 95% CI 1.02-2.17) and those with an ADRD diagnosis (OR 1.33, 95% CI 1.07-1.66) had higher odds of telehealth use. Internet access was strongly associated with telehealth use (OR 2.51, 95% CI 2.15-2.92). Follow-up bivariate analyses between internet access and sociodemographic characteristics revealed that those of younger age, females, and White individuals had higher levels of internet access. Differences in telehealth use among older HCBS recipients are associated with multiple individual, technological, and organizational factors. Interpreted through the SEIPS 3.0 framework, these findings underscore the importance of viewing telehealth use as the outcome of multiple features of the health care system. Future research should clarify the mechanisms driving variation in telehealth use to identify and address barriers to telehealth adoption among vulnerable older adults.

Recurrent outbreaks of the highly pathogenic avian influenza (HPAI) A (H5N1) virus in farmed poultry, and reports of infections in dairy cattle herds in the United States since March 2024, have triggered concerns about the spillover threat to human populations and a subsequent influenza pandemic. The increasing threat that H5N1 poses to human health has led to more vigilant public health monitoring of these developments. In addition to intensifying surveillance, preventative strategies-like vaccinating those at higher risk-are being evaluated to help minimize infection and spread. Efforts to mitigate and respond to such an event will entail broad public health interventions including vaccination. However, analysis of the COVID-19 pandemic suggests that information quality can significantly impact the effectiveness of such measures by influencing public understanding and trust. Misinformation about H5N1 and other viruses circulating online often includes inaccurate information about transmission, prevention, and the severity of the viruses. By systematically analyzing these false narratives, public health authorities can better tailor their pandemic prevention, preparedness, and response strategies. In light of the emerging threat of H5N1, we analyzed the content of social media posts from Facebook (approximately 350,000) and Instagram (n=69,551) related to HPAI. Using 40 keywords associated with misinformation, we identified over 500 posts explicitly mentioning H5N1 and related terms for further systematic analysis. Posts were coded to identify targets and topics in the social media narratives. The "target" refers to the organization or person mentioned in the post, while the "topic" refers to the primary issue or subject being addressed. Our content analysis identifies 7 main targets of misinformation, including government (149/544, 27%), health authorities (108/544, 20%), and international organizations (74/544, 14%). Also, from the 6 topics that have been identified, we found that the most widespread one was that authority figures purposefully engineer pandemics to achieve multiple political, economic, and other objectives (362/544, 67%) followed by societal destruction (121/544, 22%), and anti-vaccination (84/544, 15%). Other themes include societal destruction and religious allusions and prophecies. Our analysis of online content showed that H5N1 misinformation was primarily aimed at individuals or groups with differing degrees of political or institutional authority, such as government leaders and public health officials. These figures were often the focus due to their involvement in making health policy decisions and implementing public health measures. Decision-making entities and individuals were the target of various misinformation narratives. Results demonstrate the ongoing need for monitoring health misinformation to inform evolving public health responses to HPAI.

Enteric infectious diseases claim more than 1 million lives annually and are among the top ten causes of death in children younger than 5 years. Remarkable global investment has been dedicated to enteric infectious disease prevention and control; however, the shifting global health landscape is testing the continuance of progress. To evaluate the current status and guide future interventions, we present the latest epidemiological estimates of enteric infectious diseases from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 and assess progress towards the Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPPD) mortality target of fewer than 20 deaths per 100 000 children younger than 5 years by 2025. We quantified the incidence, mortality, and disability-adjusted life-years (DALYs) of enteric infectious diseases by age, sex, and year across 204 countries and territories from 1990 to 2023. In GBD 2023, the following were considered under the category of enteric infectious diseases: diarrhoeal diseases, enteric fever (typhoid and paratyphoid), invasive non-typhoidal Salmonella spp (iNTS) infections, and other intestinal infectious diseases. We also examined 15 aetiologies contributing to diarrhoeal diseases. Incidence and prevalence were estimated with DisMod-MR (version 2.1), a Bayesian meta-regression tool, drawing on data from systematic reviews, population-based surveys, claims data, and hospital sources. Cause-specific mortality was modelled with Cause of Death Ensemble Modelling based on data from sources including vital registration, mortality surveillance, verbal autopsy, and minimally invasive tissue sampling. Years of life lost and years lived with disability were computed and combined to derive DALYs. For aetiology-specific estimation, population-attributable fractions (PAFs) for 15 pathogens were derived with a counterfactual framework. Point estimates and 95% uncertainty intervals (UIs) were generated from 250 draws from the posterior distribution. In 2023, enteric infectious diseases resulted in an estimated 1·27 million (95% UI 0·963-1·68) deaths globally, declining from 3·69 million (3·04-4·56) in 1990. The global age-standardised mortality rate (ASMR) decreased from 74·1 (62·0-92·9) per 100 000 population to 16·4 (12·6-21·3) per 100 000 population during the same period. Diarrhoeal diseases accounted for most deaths in 2023 (1·11 million [0·811-1·54]), followed by enteric fever and iNTS. South Asia and sub-Saharan Africa remained the most affected regions in 2023, with 599 000 (441 000-882 000) and 501 000 (373 000-648 000) deaths due to enteric infectious diseases, respectively, predominantly from diarrhoeal disease. Rotavirus was the leading cause of all-age diarrhoeal disease deaths (PAF 16·3% [12·0-21·5]), followed by norovirus (10·2% [2·4-17·0]) and Shigella spp (9·3% [5·4-15·2]). Among children younger than 5 years, PAFs of deaths due to diarrhoeal diseases were 40·2% (32·5-48·5) for rotavirus, 24·0% (15·1-36·7) for Shigella spp, and 23·4% (13·7-34·3) for adenovirus. Across 204 countries and territories, 141 met the GAPPD mortality target in 2023. The driving aetiologies among countries that did not meet the target in 2023 varied slightly by GBD super-region, but the highest or second-highest number of deaths in children younger than 5 years were consistently attributed to rotavirus. Astrovirus and sapovirus, newly included in GBD 2023, were responsible for 24 600 (6290-49 000) and 18 800 (4650-44 400) deaths, respectively, in 2023, mainly in children younger than 5 years. Our findings show that mortality and ASMRs of enteric infectious diseases declined substantially between 1990 and 2023. This decline is consistent with the expansion of public health measures and broader socioeconomic development. However, the burden in 2023 remains considerably high, with the highest mortality concentrated in sub-Saharan Africa and south Asia. Considering that more than a quarter of all countries had yet to meet the GAPPD mortality target in 2023, sustained efforts are needed to address the persistent burden in affected countries and to adapt to the changing global health landscape. Gates Foundation.

Integrated, evidence-based interventions across health, education, and social systems are needed to support child and adolescent development, especially for pregnant adolescents. While youth mentoring interventions show promise in improving health and well-being outcomes, existing studies largely exclude this population group. To address this gap, we conducted a global scoping review of community-based mentoring interventions for adolescent girls during pregnancy and after birth. We performed a scoping review using the Joanna Briggs Institute scoping review methodology. First, we searched (Embase, MEDLINE, CENTRAL, CINAHL, PsycINFO, Web of Science, IBSS, and Global Health), grey literature, and international registers from inception until July 2025 (no language, setting, or time limitations) for studies that reported on a mentoring intervention for adolescent girls (aged 10-19 years old) during pregnancy and after birth that were delivered in any community settings by local members. To be included, the studies had to report on the intervention theory, methods, and components; any health, social, educational outcomes; and key challenges and lessons learnt. Following screening, we extracted and narratively synthesized the data from the included studies. We screened 1085 titles and abstracts and 97 full text records and included 13 studies (25 records) on community-based mentoring interventions for adolescent girls during pregnancy and after birth. These studies came mostly from the USA, with one delivered in Malawi and Sierra Leone each. They were conducted between 1991 and 2024 and used varied designs, including randomised trials or qualitative and mixed-methods research. Interventions were home-, school-, or community-based and aimed to reduce mortality and improve maternal, perinatal and infant health; reduce repeat pregnancies; support education and employment; and enhance well-being. Mentors, often local volunteers, provided emotional support, practical guidance, and links to services. The included studies reported on improved health practices and outcomes, reduced rapid repeat pregnancies, increased school engagement, and greater self-esteem and well-being. Key challenges were recruitment and retention, role clarity, limited resources, and structural barriers like poverty and stigma. Strong, culturally sensitive mentor-mentee relationships and integration with existing services were critical for success. Community-based mentoring interventions for adolescent girls during pregnancy and after birth were reported to provide crucial support in improving health and enhancing educational attainment, economic stability, and overall psychosocial well-being, especially when relationships were sustained and culturally sensitive. The strength of evidence, however, varied across different outcomes and contexts. Further research is needed to fully understand efficacy, generalisability and mechanisms, particularly for specific outcomes and adolescent populations in low- and middle-income countries.

Multimorbidity-the co-occurrence of two or more chronic health conditions-has become a major public health challenge in ageing societies. However, most research continues to frame it as a clinical or epidemiological issue, overlooking the role of social determinants and healthcare system dynamics. This study investigates the patterns, experiences, and structural implications of multimorbidity in southern Spain, aiming to uncover how health inequalities shape disease profiles and care experiences in one of the most deprived regions of the country. We employed a mixed-methods sequential explanatory design. The quantitative phase was based on a cross-sectional telephone survey of 1,592 individuals aged 50 and over with multimorbidity. Latent Class Analysis (LCA) was used to identify multimorbidity patterns based on 33 chronic conditions. Associations with sociodemographic factors and healthcare utilisation were analysed using chi-square tests. The qualitative phase consisted of 18 semi-structured interviews with healthcare professionals and patients, analysed thematically to explore lived experiences, care trajectories, and institutional barriers. Five multimorbidity patterns were identified: unspecific, cardiometabolic, musculoskeletal, musculoskeletal-mental, and complex multimorbidity. These patterns showed clear social stratification: complex and musculoskeletal-mental profiles were more prevalent among low-income individuals, women, and residents in deprived areas. Healthcare utilisation also varied across patterns, with higher service use in more complex profiles. Qualitative findings revealed that multimorbidity was experienced as a cycle of physical decline, emotional vulnerability, and systemic neglect. Patients faced difficulties in treatment adherence, experienced long waiting times, and often relied on informal caregiving, predominantly by women. Healthcare professionals highlighted systemic fragmentation, lack of coordination, and the inadequacy of clinical guidelines for complex cases. Multimorbidity in this context is not merely a clinical challenge but a socially embedded condition shaped by structural inequality and institutional failures. Health systems must move beyond single-disease logic and adopt integrated, equity-oriented models of care that consider the syndemic nature of multimorbidity. This study highlights the need to incorporate social determinants into chronic care strategies and to prioritise the lived experiences of patients and caregivers in future health policy and planning.

Food and nutrition insecurity are linked to poor health outcomes and disparities, yet how health care systems implement screening and referrals remains poorly understood. We searched for studies evaluating screening and referral processes for food and nutrition insecurity for patients of all ages in US health care settings. Searches were performed through May 2025 in MEDLINE (via PubMed), Cochrane (via Ovid), Cumulative Index of Nursing and Allied Health (EBSCO), and Social Interventions Research and Evaluation Network Evidence and Resource Library. Studies were included if they reported both a screening process and referral mechanism. Findings were synthesized narratively. Of 11 406 records identified, 136 studies met the inclusion criteria; all screened for food insecurity, and none screened for nutrition insecurity. Most studies screened general populations across age, sex, race, and ethnicity, with few restricting by socioeconomic status or clinical conditions. Screening primarily used tools embedded within broader social determinants of health screenings (46%) and integrated into electronic health records (48%), typically in outpatient settings (49%). Screening methods varied, most commonly self-administered by patients (21%) or by clinic staff (20%) and were unspecified in one fifth of studies (21%). A total of 129 studies described 39 unique referral strategies across 4 categories: community-based resources (46%), health care-embedded services (35%), federal nutrition programs (12%), and Food Is Medicine interventions (7%), with 46% spanning multiple categories. While about half of studies (46%) reported referral rates, only about one third (37%) reported referral completion. These findings highlight current practices and evidence gaps, informing priorities to strengthen screening and referral systems that advance food security, nutrition, health, and health equity.

Psittacosis caused by Chlamydia psittaci has re-emerged in China as sporadic cases and localized outbreaks. However, current knowledge remains fragmented across the clinical, veterinary, epidemiological, and public health fields. This scoping review mapped studies on psittacosis in China, identified major knowledge gaps, and defined priorities for research, clinical management, and prevention and control. Following the Arksey and O'Malley framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), China National Knowledge Infrastructure (CNKI), Wanfang, PubMed, Web of Science, and Embase were searched for studies published between 1 January 1985 and 31 December 2025 and synthesized eligible studies with descriptive statistics and thematic analysis. A total of 424 studies were included. Research interest showed recent sharp increases and was concentrated in Eastern and Central China. Case reports and series dominated the literature, whereas analytic epidemiology, standardized surveillance, and high-resolution molecular studies remained limited. Reported cases were most often documented in middle-aged and older adults with avian exposure, including pet birds and poultry, and the reported occurrence showed a winter-spring pattern. Pneumonia was the predominant clinical presentation, and severe cases could progress to acute respiratory distress syndrome and multi-organ dysfunction. Metagenomic next-generation sequencing (mNGS) was the most frequently reported diagnostic method in recent studies, while PCR and serology remained important complementary tools. Overall, the literature is growing rapidly, but remains uneven in geographic coverage, study design, and integration across human, animal, and environmental sectors. These findings support broader One Health surveillance, stronger analytic and molecular epidemiology, and more standardized approaches to diagnosis, source investigation, and prevention in China.

Preventing potentially avoidable hospitalisation (PAH) and reducing its duration are crucial to allow community-dwelling older people to age at home. In Japan, homecare services, which include a variety of services such as home help, home-based rehabilitation and home-visit nursing, are covered by medical and long-term care insurance and coordinated by care managers. Although home-visit nursing is essential in homecare, studies investigating the association between the use of home-visit nursing and the incidence and duration of PAH remain limited. To examine the association between home-visit nursing use and the incidence and duration of PAH among community-dwelling older people. This was a 12-month prospective cohort study. 47 home-visit nursing agencies and 73 care management offices across Japan. Older people (≥ 75 years) receiving homecare services. Using online questionnaires, home-visit nurses and care managers reported older people's demographics, health status and PAH events over 12 months, as well as the state of using home-visit nursing (users or non-users). The incidence of PAH was dichotomised as either 'none' or 'one and more', due to heavy skewing. To examine PAH days, the rate of observed days was used due to the variability in the total observation period. Poisson regression and multivariate linear regression analyses were applied. Of the 1450 participants initially recruited, 781 with complete dataset were included in the PAH incidence analysis. Of these, 81.0% were home-visit nursing users. Mean participant age was 85.3 years (standard deviation: 6.1; range: 75-103), and 58.8% were female. The incidence rate ratio (IRR) of PAH was lower among home-visit nursing users compared with non-users (IRR, 0.63; 95% confidence interval [CI]: 0.41-0.95). Among 110 participants with PAH, there was no statistically significant difference in the rate of PAH days between home-visit nursing users and non-users (β = -0.65, 95% CI: -8.35-4.50). These results suggest that home-visit nursing is associated with a lower incidence of PAH among older people; however, it is not associated with the duration of hospital stay once PAH occurs. For community-dwelling older people with homecare services, home-visit nursing may contribute to sustaining lives at home without PAH. Home-visit nursing may help support community-dwelling older people in remaining at home by minimizing the occurrence of PAH.

Access to healthcare services remains a persistent challenge, disproportionately affecting vulnerable populations. Limited access results in lower service utilisation and worse health outcomes, hindering progress toward inclusive and sustainable cities. This study developed a novel methodological framework integrating high-resolution (1-km2) socio-demographic data from the 2021 Canadian Census with an advanced multimodal transport routing engine (R5) to assess healthcare access via public transit in Surrey, British Columbia - a fast-growing, diverse city. Using a 30-min travel time threshold, we computed destination-oriented ('passive') and origin-oriented ('active') accessibility to walk-in clinics, urgent care centres, and hospitals. Eco-intersectional multilevel modelling was applied to examine accessibility inequalities across intersectional strata, defined as areas with a high concentration of vulnerable populations based on age, sex, race/ethnicity, education, income, and urbanicity (>vs. ≤ 400 people/km2). Overall, 319,402 (56.2%) residents could reach at least one healthcare facility within 30 min via public transit. Walk-in clinics were the most accessible, followed by urgent care centres and hospitals. Many vulnerable populations were concentrated near major urban centres, which generally had access to more facilities than the city's periphery and outer suburbs. Strata with a high concentration of females had higher odds of accessibility, while seniors and non-urban areas had lower odds. Access inequalities were most pronounced among senior visible minority communities living in non-urban areas. Equity-oriented planning and investments in sustainable transportation and healthcare infrastructure are required to close accessibility gaps. This scalable, open-data framework can inform inclusive urban policy and improve access to essential services for underserved communities.

In the context of the recent coronavirus pandemic, we wanted to highlight the importance of vaccination as one of the greatest medical achievements and the most effective preventive measure for protecting the population from infectious diseases. Over 200 years ago, the pioneer of vaccination in Dubrovnik, Luko Stulli, one of the most renowned physicians of the early 19th century, proudly and enthusiastically wrote about it. Immediately after the discovery of vaccination and inspired by this new medical method, he wrote a Latin poem in 1804 titled “Vaccinatio, carmen elegiacum” (Vaccination, an elegiac poem). This is probably one of the few poems in Croatian literature dedicated to a medical theme, and one of the last written in Latin. So far, three original printed copies have been found, and recently a fourth, printed in 1828, was discovered. Recent events related to the COVID-19 pandemic have once again sparked interest in Stulli’s Elegy, brought it into focus in discussions of vaccination and quarantine, and reaffirmed the value and universality of the views and messages expressed in this Latin poem, written in the spirit of classical poetics and the canon. Exactly 220 years have passed since the printing of the Elegy, yet doubts about the value and usefulness of scientific discoveries have not disappeared, nor has the distrust in medical science and vaccination as a civilizational achievement. U kontekstu recentne pandemije koronavirusom htjeli smo istaknuti važnost cijepljenja kao jedno od najvećih medicinskih dostignuća i najučinkovitiju preventivnu mjeru u zaštiti populacije od zaraznih bolesti. O tome je prije više od dvjesto godina s ponosom i oduševljenjem pisao dubrovački pionir cijepljenja Luko Stulli, jedan od najpoznatijih liječnika u Dubrovniku početkom 19. stoljeća. Neposredno nakon otkrića vakcinacije i pod dojmom nove liječničke metode, napisao je 1804. latinsku poemu Vaccinatio, carmen elegiacum (Vakcinacija, elegijska pjesma). Riječ je vjerojatno o jednoj od rijetkih pjesama posvećenoj medicinskoj temi u hrvatskoj književnosti i jednoj od posljednjih pisanih na latinskom jeziku. Do sada su bila pronađena tri originalna tiskana primjerka, a nedavno je pronađen i četvrti primjerak tiskan 1828. Recentna događanja vezana uz pandemiju COVID-19 ponovno su pobudila i usmjerila zanimanje na Stullijevu Elegiju, stavila u fokus rasprave i mišljenja o cijepljenju i karanteni te iznova potvrdila vrijednost i univerzalnost Stullijevih stavova i poruka iskazanih u ovoj latinskoj poemi u duhu klasicističke poetike i kanona. Prošlo je točno 220 godina od tiskanja Elegije, a sumnje u vrijednosti i korisnost znanstvenih otkrića nisu nestale, kao ni nepovjerenje u medicinsku znanost i cijepljene kao civilizacijski doseg.

Higher planetary health diet score was related to improved kidney function, reduced prevalence and incidence of CKD, and lower all-cause mortality. Higher planetary health diet score was correlated with lower greenhouse gas emission and land use, but with higher water use. Socioeconomic deprivation linked to lower planetary health diet adherence and weakened planetary health diet benefits on cystatin C and all-cause mortality. While planetary health diet (PHD) benefits human and environmental health, its effect on CKD under socioeconomic deprivation remains unclear. We investigated the associations between PHD and kidney function, CKD, mortality, and environmental effects, while evaluating the moderating role of socioeconomic deprivation. We included 125,581 UK Biobank and 35,021 National Health and Nutrition Examination Surveys (NHANES) participants. The associations between PHD score, kidney function, CKD, mortality, and environmental impacts were assessed using Cox proportional-hazards model, logistic regression, or multiple linear regression models. Multiplicative interactions between PHD scores and index of multiple deprivation and its domains on these associations were evaluated. In the UK Biobank and NHANES, median PHD score was 62.34 (53.74-70.97) and 40.45 (31.38-50.21), respectively. In UK biobank, each one-point higher PHD score was associated with greater eGFR ( &#x3b2; [95% confidence interval], 0.05 [0.04 to 0.05]). Compared with the lowest quartile (Q1) of PHD score, the highest quartile (Q4) was associated with lower CKD (hazard ratio [95% confidence interval], 0.75 [0.69 to 0.81]) and all-cause mortality (0.83 [0.78-0.89]). Similarly, in NHANES participants each one-point higher PHD adherence was associated with greater eGFR (0.06 [0.05-0.08]), lower CKD prevalence (OR Q4 versus Q1 : 0.80 [0.73-0.88]), and lower risk of all-cause mortality (hazard ratio Q4 versus Q1 : 0.85 [0.77-0.93]). Higher PHD score was correlated with lower greenhouse gas emission and land use, but with higher water use. Stronger inverse associations of PHD with cystatin C were observed among individuals with higher health deprivation ( P < 0.01), while stronger inverse associations with all-cause mortality were observed among those with higher employment and living environment deprivation ( P = 0.01). PHD was associated with improved kidney health, lower all-cause mortality, greenhouse gas emission, and land use, with strongest health benefits in socioeconomically deprived populations. Our study supports PHD as a strategy for concurrent human and planetary health, highlighting its potential to address health inequities.

Zoonotic diseases continue to present health, social, and economic challenges in China. While the country has demonstrated strong outbreak response capabilities, current efforts remain reactive and top-down. Shifting toward primary prevention at the human-animal-environment interface with enhanced risk communication offers a more sustainable approach to reducing zoonotic disease risks. This review synthesized peer-reviewed and gray literature in English and Chinese to characterize human-animal contact behaviors associated with 93 zoonotic diseases monitored by China's public health, agricultural, and forestry sectors. It examined contact pathways across key animal groups known to carry zoonotic pathogens, identified human populations at risk, and analyzed the demographic, socio-cultural, and ecological factors shaping these contacts. Focusing on four major human-animal interfaces, the review further identified lessons and best practices for effective risk communications. Findings reveal that human-animal contact in China is diverse and embedded in daily routines, cultural practices, and economic activities, with distinct risk profiles presented across animal groups and socio-ecological settings. Populations such as smallholder farmers, herders, rural residents, market vendors, and workers in informal sectors face higher exposure risk, influenced by socio-economic conditions and ecological changes. Gaps remain in surveillance of informal practices, emerging pathogens, and behavioral data. Evidence from global and local experiences highlights the value of behavior-centered, community-engaged communication grounded in One Health principles, emphasizing participatory design, culturally relevant education, local leadership, and integration with public service systems. Overall, this review provides an integrated understanding of zoonotic disease risks and prevention opportunities from social-behavioral and communication perspectives. It identified priority populations, settings, and best practices for targeted and effective strategies, underscoring the need for coordinated One Health efforts to address complex human-animal-environment interactions and promote proactive zoonotic disease prevention in China and beyond.

H9N2 avian influenza virus (AIV) is one of the major pathogens causing respiratory disease in chickens and poses a threat to public health by serving as a gene donor for zoonotic avian influenza strains. The DEAD-box RNA helicase DDX21 is known to play a critical role in innate immunity in mammals during influenza virus infection. However, the function role and regulatory mechanisms of its avian ortholog, chicken DDX21 (chDDX21), remain poorly understood. In this study, the chicken DDX21 (chDDX21) gene was cloned and analyzed using bioinformatics tools. Phylogenetic analysis revealed that chDDX21 clustered within the avian lineage and shared a close relationship with DDX21 from other avian species. Notably, a widespread distribution of chDDX21 was observed in various tissues in healthy chickens. Following infection with H9N2 AIV, chDDX21 mRNA expression was significantly upregulated in tissues of chickens compared to the control group. Similarly, in CEF cells, chDDX21 transcript levels increased post-infection, peaking at 24&#xa0;h, a trend that corresponded with the kinetics of viral replication. Furthermore, overexpression of chDDX21 activated the IFN-&#x3b2; promoter, and its DEXDc and HELICc domains were identified as critical for this activity. Co-transfection of chDDX21 with chTLR3 or chTRIF in CEFs resulted in significant upregulation of immune-related gene expression, suggesting that chDDX21 acted as a modulator of the chicken TLR3-mediated type I interferon (IFN) signaling pathway. Additionally, overexpression of chDDX21 significantly increased the expression of antiviral immune factors and concurrently suppressed H9N2 AIV replication. Consequently, these results demonstrated that chDDX21 inhibited H9N2 AIV replication by positively regulating the TLR3-mediated type I IFN signaling pathway. This study provides mechanistic insights into the interaction between the avian innate immune system and H9N2 AIV, highlighting chDDX21 as a key regulator of antiviral response in chickens.

The success of root canal treatment largely depends on the canal shaping procedure, which influences subsequent steps, such as cleaning, obturation, and sealing. The present study aimed to evaluate the canal-centering ability, dentin removal, and dentinal crack incidence following root canal preparation with different rotary and reciprocating nickel-titanium file systems using cone beam computed tomography (CBCT) and a stereomicroscope. Forty freshly extracted single-rooted human mandibular premolars were selected and scanned preoperatively by CBCT (KAVO OP 3D Pro, Germany) to evaluate canal curvature. The samples were then randomly distributed into 4 groups (n&#x2005;=&#x2005;10): Group 1 - ProTaper Next (continuous rotary), Group 2 - MicroMega One RECI (reciprocating), Group 3 - Race Evo (continuous rotary), and Group 4 - R-Motion (reciprocating). Root canals were prepared in accordance with the respective manufacturer's recommendations. Post-instrumentation CBCT scans were obtained to assess canal centering and remaining dentin thickness at 3, 6, and 9&#x2009;mm from the apex. Root sections were also examined under a stereomicroscope to assess dentinal cracks. The MicroMega One RECI (Group 2) demonstrated superior canal centering, with mean ratios of 0.20&#x2005;&#xb1;&#x2005;0.05, 0.18&#x2005;&#xb1;&#x2005;0.04, and 0.17&#x2005;&#xb1;&#x2005;0.03 in the apical, middle, and coronal thirds, respectively. In contrast, ProTaper Next (Group 1) showed the highest centering ratio (0.35&#x2005;&#xb1;&#x2005;0.08 at 3&#x2009;mm), indicating greater deviation from the canal axis. Reciprocating systems exhibited better dentin preservation and fewer dentinal cracks compared with continuous rotary systems. Based on observations from this in vitro study, it can be concluded that the variations in design of file systems and motion patterns critically determine the efficiency and safety of root canal shaping. Reciprocating and rotary motions show different effects on canal centering, dentin removal, crack propagation, and the preservation of root integrity.

Legacy lead (Pb) contamination from a century-long Pb-Zn mining operation (1906-1994) continues to pose severe environmental health threats in Kabwe, Zambia, one of the world's most polluted sites. While elevated blood lead levels (BLLs) in children are well-documented, maternal exposure remains understudied despite its critical implications for fetal development. We conducted a cross-sectional biomonitoring study among 510 pregnant women across four townships in Kabwe (Makululu, Kasanda, Katondo, and Mahatma Gandhi), stratified by proximity to the former mine (1.5-4.5&#xa0;km). Sociodemographic and clinical data were collected utilizing a structured questionnaire. Venous blood samples were analyzed for Pb using graphite furnace atomic absorption spectrophotometry (GFAAS), with rigorous quality control (recovery: 92.3-95.1%; MDL: 0.012&#xa0;&#xb5;g/dL). Maternal BLLs varied significantly by township (p&#x2009;<&#x2009;0.001): median BLLs were highest in Makululu (6.5&#xa0;&#xb5;g/dL; 84.4% elevated), followed by Kasanda (3.4&#xa0;&#xb5;g/dL; 48.1%), and lowest in Katondo (1.8&#xa0;&#xb5;g/dL; 10.0%) and Mahatma Gandhi (1.6&#xa0;&#xb5;g/dL; 8.8%). Overall, 43.7% of women exceeded the reference level of 3.5&#xa0;&#xb5;g/dL, disproportionately affecting those in the informal settlements near the mine waste. Elevated BLLs were significantly associated with longer years of stay in the area (p&#x2009;=&#x2009;0.007), unemployment (p&#x2009;<&#x2009;0.001), smoking (p&#x2009;=&#x2009;0.021), lower BMI (p&#x2009;=&#x2009;0.023), and higher gravidity (p&#x2009;<&#x2009;0.001), reflecting intersecting environmental, biological and socioeconomic vulnerabilities. Maternal Pb exposure in Kabwe remains alarmingly high, especially in mining-proximal, low-resource communities, underscoring a critical environmental injustice. Given potential for Pb to cross the placenta and documented links to negative birth outcomes, urgent interventions, including regular maternal screening and policy reform, are needed to potentially protect the health of the unborn baby and break cycles of intergenerational toxicity.

Neighborhood socioeconomic status (nSES) can complement individual SES to better assess health-behavior inequalities. The aim of this study was to investigate the relationship between the nSES of defined areas in Berlin with healthy lifestyle. This cross-sectional analysis used baseline data from the three Berlin study centers of the German National Cohort (NAKO). We assessed body mass index (BMI), smoking, alcohol consumption, and objectively measured physical activity and combined them to a healthy lifestyle index (HLI; range:0-12 points; 12&#x2009;=&#x2009;best score). To assess nSES, the Social Index from Berlin's Social Structure Atlas (1&#x2009;=&#x2009;best; 7&#x2009;=&#x2009;worst) was assigned to the participants' residential locations. We used multivariable regression analyses to examine the association between nSES and the HLI (mean difference with 95% confidence interval, CI) as well as the four individual lifestyle factors (odds ratios (OR) with 95% CI). In sensitivity analyses, nSES was modelled using all seven Social Index categories and as a dichotomy (categories 1-4 vs. 5-7). Of 204,801 NAKO participants, 31,075 were recruited in Berlin, of those 11,922 with complete accelerometry data were included (mean&#x2009;&#xb1;&#x2009;SD age 50.6&#x2009;&#xb1;&#x2009;12.9&#xa0;years; 52.8% women). The mean HLI was 8.3&#x2009;&#xb1;&#x2009;2.0 points. Worsening of nSES by one point was associated with a 0.08-point lower HLI (-0.08 (95%-CI -0.10; -0.06)), with a reduced odds of normal weight (0.95; 0.93-0.97) and being a never-smoker (0.96; 0.94-0.98), while it was neither associated with alcohol consumption (1.01; 0.99-1.04)) nor physical activity (0.99; 0.97-1.02)). Sensitivity analyses suggested that differences were mainly driven by a contrast between categories 1-4 and the more disadvantaged categories 5-7. However, the overall pattern of results did not change. Our analyses suggest a rather small association between Berlin's nSES and HLI, and slightly stronger associations with BMI and smoking. Future studies using longitudinal data and more neighbourhood measures are needed to better disentangle contextual influences from residential selection and to inform targeted prevention strategies.

Avian influenza (AI), particularly highly pathogenic avian influenza (HPAI), represents a serious and growing threat to global poultry production, international trade, and human health security. Control of AI is complicated by the high evolutionary rate of influenza A viruses, which drives antigenic diversity and ongoing emergence of novel strains. Effective surveillance and disease management therefore depend on timely and accurate diagnostics. While conventional methods-including virus isolation, reverse transcription-quantitative polymerase chain reaction (RT-qPCR), and enzyme-linked immunosorbent assays (ELISAs)-remain effective and widely used, they are limited by long turnaround times, the need for specialized equipment, and reliance on highly trained personnel. In addition, strict state and federal regulatory requirements restrict testing to a limited number of authorized laboratories. Although these regulations are essential for maintaining diagnostic accuracy and quality assurance, they place substantial strain on laboratory capacity during outbreaks and delay actionable results. The need for rapid, on-site decision making has driven interest in alternative diagnostic approaches, including biosensor technologies. A major limitation of current diagnostic strategies is the lack of robust DIVA (Differentiating Infected from Vaccinated Animals) capability. In countries such as the United States, where poultry vaccination against AI is not routinely practiced, the absence of DIVA-compatible diagnostics has hindered adoption of vaccination as a disease management tool, as seropositive birds and products face significant trade restrictions. Biosensor platforms capable of enabling DIVA strategies offer a potential pathway to support vaccination while preserving surveillance integrity. This review examines the current landscape of AI and HPAI diagnostics, emphasizing the limitations of traditional approaches and the opportunities presented by biosensor platforms. We evaluate electrochemical, optical, piezoelectric, and nucleic-acid-based biosensors, with particular attention to biorecognition strategies, performance metrics, field deployability, and applications supporting subtype discrimination, DIVA implementation, and One Health surveillance.

Infections with liver flukes (Clonorchis sinensis, Opisthorchis viverrini, and O. felineus) cause high burden. Mechanistic models have been employed to disentangle their transmission dynamics and guide the design of control strategies. However, no comprehensive review of these mechanistic models has yet been undertaken. In this systematic review, we searched six major databases (PubMed, Web of Science, Korea Med, Cochrane, China National Knowledge Infrastructure [CNKI], and Wanfang Data) for studies published up to 14 May 2025, to identify and evaluate mechanistic models of liver fluke infections. We included all mechanistic transmission models for human liver flukes regardless of language or setting, while excluded non-mechanistic models, reviews, and empirical studies. Of the 533 records identified, 18 studies were eligible for analysis. Most studies focused on C. sinensis in China and O. viverrini in Lao People's Democratic Republic, primarily employing population-based model with ordinary differential equations. Findings consistently identified humans as the central reservoir sustaining transmission, while the role of animal reservoir hosts (e.g. cats and dogs) in transmission was less explored (in 6 out of 18 studies) and divergent in different models. Models incorporating host heterogeneity demonstrated the superiority of integrated control strategies-combining mass drug administration, health education, and environmental improvements over single intervention. High frequency, coverage and adherence of measures were shown to be critical for achieving control or even elimination targets. Results from mechanistic models support the implementation of One Health strategies to improve liver fluke control. This review identifies the need for integrative, data-driven One Health modeling frameworks that incorporate human, animal, and environmental transmission parameters, and address key sources of heterogeneity in host behavior, exposure, and transmission dynamics to support control targets.

Cervical cancer remains a major global health challenge, as persistent high-risk human papillomavirus (HPV) infection along with chronic inflammation is one of the primary drivers that allows progression of cervical cancer. Despite recent advances in treatment strategies, there are still a lack of effective multi-target therapies that will modulate inflammatory, apoptotic and immune-regulatory pathways simultaneously. The originality of this study lies in conducting a comprehensive evaluation of piceid, as a multi-target immune-modulatory agent for cervical cancer focusing on molecular networks associated with inflammation. An integrated computational and experimental system was utilized to evaluate the potential therapeutic activity of piceid against molecular targets associated with cervical cancer. Molecular docking, MM-GBSA binding free energy calculations, molecular dynamics simulation for stability assessment of the complexes, ADMET profiling for estimating pharmacokinetic and toxic properties, and density functional theory (DFT) to assess electronic and chemical reactivity properties were all conducted in silico. In vitro validation of results was conducted using an MTT cell viability assay. Molecular docking revealed favorable binding of piceid to all five cervical cancer associated targets, with strongest affinity toward TGFBR2 (-&#x2009;6.530&#xa0;kcal/mol) and CASP8 (-&#x2009;5.873&#xa0;kcal/mol) which was further confirmed using MM-GBSA analysis. Molecular dynamics simulations (200 ns) demonstrated stable and flexible piceid-CASP8 and piceid-TGFBR2 complexes, with RMSD stabilization and minimal RMSF fluctuations in binding regions. Density functional theory analysis revealed favorable electronic properties supporting hydrogen bonding and electrostatic interactions. ADMET profiling predicted an overall favorable pharmacokinetic profile. Piceid exhibited dose-dependent cytotoxicity against HeLa cervical cancer cells, inducing marked morphological alterations, although with a higher IC&#x2085;&#x2080; than doxorubicin. These findings suggest that piceid may serve as a promising candidate for multi-target immune-modulatory activity to prevent the progress of Cervical Cancer.