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While human augmentation (HA) technologies offer significant potential for addressing societal challenges, their specific application towards social goals like sustainability, quality of life, and well-being remains understudied. This study addresses this gap by investigating the central research question: How do current HA research landscapes align with global social targets, and what are the comparative advantages of these technologies across individual, organizational and societal levels? To answer this, we employ a comprehensive bibliometric analysis of 6,284 papers across 60 specific research topics. Using citation network analysis and text similarity mapping, we reveal that although HA literature is smaller in volume, it exhibits high topical diversity and distinct specialization. Semantic mapping identifies selective but significant intersections between HA research and social domains, particularly through three influential subclusters: Industrial Worker Augmentation Systems, Human-Building Interface Assessment Technologies, and Assistive Augmentation Technologies. Based on these findings, we developed a novel nine-dimensional performance framework for multi-level evaluation of HA's societal value. The practical applicability of this framework is validated through real-world case studies, including industrial exoskeleton deployments at Ford and VR training at Walmart, demonstrating tangible gains in productivity, safety, and learning acceleration. This framework offers actionable insights for assessing HA's social impact, guiding responsible innovation, and identifying commercialization opportunities aligned with well-being, productivity, and sustainability.

Globally, and particularly in California, the scale, intensity, and frequency of wildfires are increasing as climate change worsens. The gravity of this issue was recently made clear in Los Angeles County, California, where 29 people were killed and over 16,000 structures were destroyed by a series of seven wildfires in January 2025. Researchers across scientific disciplines have responded to recent wildfire disasters in California and elsewhere to fill in key knowledge gaps relating to wildfire impacts on the environment and human health. However, there remains a lack of understanding regarding how these health impacts disproportionately affect marginalized communities, which is crucial for developing equitable health policies and interventions. California is an important setting to consider wildfire impacts on Latines, as community leaders and policymakers in the state have advocated for and implemented innovative climate justice policies, and much of the recent literature examining wildfire health impacts has leveraged California-based datasets. In this paper, we explore wildfire health equity issues among Latines in California, with particular attention to linguistically isolated people, outdoor workers, and immigrants. We explore socio-structural factors that drive disparities and propose a path forward to advance understanding and address underlying inequities.

Parents play a pivotal role in shaping their children's food environment and eating behaviours. Involving parents in interventions designed to promote nutritional outcomes such as dietary intake in children has been shown to improve parental feeding practices. However, it remains unclear how such interventions influence children's eating behaviour outcomes. This protocol describes the methods of a systematic review evaluating the effectiveness of interventions involving parents in improving the eating behaviours of healthy children aged 0-12 years. Electronic databases including MEDLINE, EMBASE, CENTRAL, APA PsycINFO, CINAHL, Scopus and Web of Science will be searched from inception to September 2025. A search strategy is developed to identify randomised controlled trials directly involving parents and reporting eating behaviours in children as either primary or secondary outcomes. Two independent reviewers will screen identified records and extract data on study, participant and intervention characteristics. Study results relevant to our primary and secondary outcomes will also be extracted using a prepiloted standardised data extraction form. We will use the Revised Cochrane Risk of Bias tool (RoB2) and Grading of Recommendations Assessment, Development and Evaluation approach to assess risk of bias and certainty of evidence, respectively. Where possible, meta-analysis using random-effects models will be performed; otherwise a qualitative summary will be provided. Ethics approval is not required for this study as no primary data will be collected. The findings will provide valuable insights for stakeholders to inform and optimise public health policies and practices aimed at empowering families to promote healthy eating behaviours early in childhood. The results will be submitted for publication in a peer-reviewed journal. CRD420251076540.

Extreme heat is the most significant climate threat to public health, disproportionately impacting marginalized groups, including outdoor workers, older adults, and low-income rural populations. While the physiological consequences of heat-related illness-ranging from cardiovascular strain to acute kidney injury-are well-documented, a critical gap remains in the equitable implementation of mitigation strategies. This paper examines North Carolina as a case study due to its proactive leadership in heat-health mitigation, examining the evolution of the state's Heat Health Alert System and the NC DETECT surveillance platform. North Carolina is well-positioned to pioneer a multi-modal "push" communication strategy, leveraging the ubiquity of smartphone technology and Wireless Emergency Alerts to provide "just-in-time" guidance to high-risk outdoor workers and rural residents. Simultaneously, the state can strengthen its robust surveillance infrastructure by integrating data from non-traditional care sites, such as farmworker clinics, and standardizing occupational data collection. These advancements would transform existing systems into a comprehensive, community-informed model of resilience. By expanding communication modalities and data inclusivity, North Carolina offers a scalable framework for translating meteorological risk into actionable, equitable policy-ensuring that advancements in climate preparedness protect and empower the most vulnerable populations.

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Type 2 diabetes (DM2) currently lacks a standardized staging system that can be used to predict survival and guide providers towards guideline concordant care much like TNM staging does for cancer. We conducted a pilot study to assess the feasibility, provider engagement and implementation challenges of the DSS and examined if guideline concordant care improved especially SGLT2i/GLP-1a use in Veterans DM2 patients with cardiorenal disease. A 6-month pilot study implemented DSS in VA primary care clinics between December 2023-September 2024. Study visits were at baseline and 6 months. Primary outcome: the initiation of SGLT2i/GLP-1a in Veteran DM2 patients with CVD/CKD compared to baseline. Secondary outcomes: weight, blood pressure, hemoglobin A1C, glomerular filtration rate (GFR), and medication adherence compared to baseline. Inclusion criteria: Male or female Veterans between the ages of 18-75 years with DM2 and ≥1 CV event and/or CKD and not on SGLT2i/GLP-1a. Exclusion criteria: Veterans with contraindications to SGLT2i/GLP-1 and/or a serious mental health disorder. After baseline visit, all providers prescribed to 14/14 patients at least one of the medications with 12/14 prescribed SGLT2i and 2/14 prescribed GLP-1a. We found 13/14 (93%) patients to still be on at least one of the medications at 6 months. At 6 months compared to baseline, weight (216 lbs. ± 41 → 213 lbs. ± 39), blood pressure (141/76 ± 20/10 → 132/73 ± 17/10), A1C (7.7% ± 1.5% → 7.4% ± 0.8%) modestly decreased but GFR remained stable (64 mL/min ± 17 → 64 mL/min ± 19). Medication adherence was continued for all 13 patients (Medication possession ratio was ≥80%). DSS use was associated with increased SGLT2i/GLP-1a prescribing by VA primary care providers and medication adherence in Veterans DM2 patients with CVD/CKD. The DSS could help improve cardiorenal outcomes and guideline concordant in their DM2 patients in the future if larger studies can validate these findings. NCT06142006.

Although artificial intelligence-based cancer diagnostic models have demonstrated strong predictive performance, their lack of transparency and reliance on single-modality data continue to limit clinical trust and adoption. Effectively integrating multi-modal data with interpret-able decision-making remains a key challenge. We propose an explainable multi-modal deep learning framework that integrates radiological imaging and structured clinical features using attention-based fusion. Image-level explanations are generated using Grad-CAM++, while SHAP is employed to quantify clinical feature contributions, enabling unified and cross-modal aligned interpretation rather than independent uni-modal explanations. The framework was evaluated on publicly available datasets, including CBIS-DDSM mammography, Duke Breast Cancer MRI, and TCGA cohorts (BRCA, LUAD, and GBM), comprising a total of 3,842 images from 2,917 patients. The proposed model consistently outperformed uni-modal approaches and simple fusion baselines, achieving an improved balance between sensitivity and specificity. Attention-based fusion demonstrated superior performance compared with feature concatenation, and the integration of explainability did not compromise predictive accuracy. Visual and clinical explanations highlighted diagnostically relevant tumor regions and established oncological risk factors. Stable performance across datasets indicates strong generalization capability. These results demonstrate that explainable multi-modal learning can effectively combine accuracy, interpret-ability, and robustness, supporting the development of reliable AI-based decision-support systems for cancer diagnosis.

Nutrition plays a pivotal role in cancer prevention, management, and treatment. To address cancer disparities, reduce risk, and improve outcomes for patients, it is critical to implement Food is Medicine interventions across the care continuum, supported by robust, evidence‐based research, strong community clinical partnerships, and effective policy design that successfully integrates nutrition into oncology practice.

Military veterans are at risk for long-term neurobehavioral symptoms who may hinder participation in productive activities following their transition out of military service. This study examined the association between injury-related neurobehavioral symptoms and engagement in paid and unpaid productive activities among post-9/11 veterans. This secondary cross-sectional analysis utilized data from the Veterans Metrics Initiative (TVMI) Study. Veterans who served in the U.S. military after September 11, 2001, and were within 90 days of separation from active duty-or from activated status in the National Guard or Reserve-were identified in Fall 2016 through records from the Department of Veterans Affairs/Department of Defense Identity Repository. Independent variables included self-reported vestibular, somatosensory, cognitive, and affective symptoms from the Defense and Veterans Brain Injury Center (DVBIC) survey. The dependent variable was engagement in productive activity, classified as: neither paid nor unpaid labor (reference), paid labor only, paid and unpaid labor, and unpaid labor only.The relationship between neurobehavioral symptoms and productive activity status was assessed using multinomial logistic regression. In Model 1, we adjusted for pre-military traumatic brain injury (TBI) history, probable deployment TBI status, and demographic characteristics. Model 2 added a positive screen for possible post-traumatic stress disorder (PTSD). Results are presented as relative risk ratios (RR), which represent the ratio of the probability of an outcome occurring in an exposed group to the probability of it occurring in a reference group. Among 8,945 veterans (mean age&#x2009;=&#x2009;35.7 years), 37.0% engaged in paid labor only, 21.4% in both paid and unpaid labor, 27.0% in unpaid labor only, and 14.6% in neither. Symptom prevalence was somatosensory (18.0%), affective (16.9%), cognitive (11.5%), and vestibular (7.2%). In Model 1, vestibular symptoms were linked to lower likelihood of engaging in paid labor only (RR&#x2009;=&#x2009;0.54, 95% CI [0.40-0.74], P&#x2009;<&#x2009;.001) and both paid and unpaid labor (RR&#x2009;=&#x2009;0.69, 95% CI [0.49-0.96], P&#x2009;=&#x2009;.027). Cognitive symptoms were also associated with a lower likelihood of paid labor only (RR&#x2009;=&#x2009;0.67, 95% CI [0.49-0.91], P&#x2009;=&#x2009;.011). In Model 2 (adjusting for demographics and probable PTSD), vestibular symptoms remained significant (RR&#x2009;=&#x2009;0.59, 95% CI [0.43-0.81], P&#x2009;=&#x2009;.001), although cognitive symptoms were no longer associated. Post-traumatic stress disorder emerged as a strong predictor with veterans screening positive being 53% less likely to engage in paid labor only (RR&#x2009;=&#x2009;0.47, 95% CI [0.39-0.56], P&#x2009;<&#x2009;.001) and 37% less likely to engage in both paid and unpaid labor (RR&#x2009;=&#x2009;0.63, 95% CI [0.52-0.76], P&#x2009;<&#x2009;.001). Vestibular and cognitive symptoms were related to less engagement in productive activities post-service for Veterans, with an emphasis on activities that included paid employment. Participation may improve with the treatment of neurobehavioral symptoms.

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With the recent publication of an updated clinical practice guideline for managing pediatric obesity in Canada, pediatricians, healthcare providers, and families have access to up-to-date, evidence-based recommendations to support shared decision making for children and adolescents living with obesity. This commentary provides a brief overview of the new guidelines including new methods and approaches used, recommendations regarding intervention effectiveness for behavioural and psychological interventions, pharmacological and surgical interventions, practical guidance to assist providers in implementing the guidelines in clinical practice, and a summary of areas in obesity management that need more attention.

Our objective was to understand the out-of-pocket (OOP) annual costs of phosphodiesterase 5 inhibitors to treat erectile dysfunction through drug coverage programs in the United States. We compared the annual OOP costs of the lowest and highest routinely prescribed dosage of medications for sildenafil, tadalafil, and vardenafil across widely used pharmaceutical sources. We examined the cost of phosphodiesterase 5 inhibitors under Medicare Part D at (1) hospital retail pharmacies and (2) 3 commercial retail pharmacies (CVS, Walgreens, and Walmart). These findings were compared with discount platforms GoodRx (through CVS, Walgreens, and Walmart), Mark Cuban Cost Plus, and Amazon Pharmacy. For sildenafil 20 mg, the Part D annual OOP costs including hospitals and retail pharmacies were comparable ranging from $1024 to $1098. The cost at discount platforms was cheaper, ranging from $82 to $275. For sildenafil 100 mg, the hospital-based pharmacies had a median price of $1446, whereas retail pharmacies under Part D ranged from $22,528 to $22,542. Discount platforms were preferred at $89 to $324. For tadalafil 2.5 mg, the Part D groups ranged from $4721 to $4759. The cost of this drug through discount platforms was much lower, ranging from $82 to $312. For tadalafil 20 mg, the cost through Part D ranged from $25,210 to $25,235. The discount platforms were reported to have lower costs ranging from $103 to $496. Vardenafil ranged from $19,015 to $19,039 from Part D groups and $86 to $418 from discount platforms. There are significant cost savings when using discount platforms, which should be discussed to help patients improve accessibility and compliance with erectile dysfunction medications.

RFID technology is mainstream in retail where apparel is tracked and inventory is managed with digital reader systems. All items at e.g. Walmart, Nordstrom and H&M are equipped with an RFID tag. Thus, warehouse managers and sales staff have full visibility on the movement and availability of items. The pharma industry is starting to follow this trend.

Gentle skin care is key to atopic dermatitis (AD) treatment, yet products are often expensive. Pharmacy deserts may exacerbate socioeconomic disparities in AD. To compare the price of dermatologist-recommended skin care to popularly purchased products, and to assess the prevalence and accessibility of pharmacy retailers selling these products in low- versus high-income zip codes. National Eczema Association (NEA)-recommended products were more expensive than popularly purchased products for moisturizing lotions ($2.72/oz vs $1.13/oz, P<0.0001) and liquid body soaps ($1.30/oz vs $0.35/oz, P<0.0001) across all retailers (Amazon, Walmart, Walgreens, CVS, Target, and Meijer). Lower-income zip codes had significantly lower densities of retail stores than higher-income zip codes in both Chicago (0.26 vs 3.20 stores/10,000 pop, P=0.0007) and New York (0.26 vs 2.90 stores/10,000 pop, P=0.02). Stores in low-income zip codes had fewer hours of operation in both Chicago (14.9 vs 19.2 hours/day, P=0.02) and New York (13.3 vs 21.0 hour/day, P=0.0002) and lower stock in both Chicago (2.0 vs 5.1 units, P=0.05) and New York (1.4 vs 4.8 units, P=0.03). Recommended products are more expensive than popular products. Retail pharmacies selling these products are less prevalent in low-income neighborhoods, have fewer hours of operation, and have lower average stock, exacerbating AD disparities.

Telemedicine has strong potential to improve hypertension management, yet its uptake into routine care remains limited. Implementation strategies (IS) enhance evidence-based intervention (EBI) use. Identifying IS used in pre-implementation trials and understanding whether these trials are explanatory or pragmatic can inform the expedited translation of EBI. Despite the availability of tools to evaluate trial design and report IS, clinical researchers often face challenges in systematically describing IS from pre-implementation studies. Using the Pragmatic Implementation Strategy Reporting tool (PISRT), we describe a step-by-step approach to retrospectively report IS from 13 telemedicine trials of hypertension management identified from a systematic review. For each trial, we also mapped nine trial design domains along efficacy to effectiveness spectrum using the PRagmatic Explanatory Continuum Indicator Summary-2 (PRECIS-2) tool. Three clinical researchers new to implementation science underwent short training on implementation science methods including the Expert Recommendation for Implementation Change (ERIC) project, supervised by a fourth clinical researcher with working implementation science knowledge. The clinical researchers clarified important implementation science concepts, terminologies, PRECIS-2 domains and data harmonizing approaches across trials guided by published literature, lectures and group discussions during pilot coding sessions. After individual data extraction, the clinical researchers met to select and operationalize IS and trial design domains along the efficacy to effectiveness spectrum using consensus achieved through group discussions. We partnered with two implementation science experts to refine our approach and elaborated each ERIC IS by providing relevant examples in implementing IS in telemedicine management of hypertension intervention. We also defined intervention components for each trial to help distinguish EBI from IS. We describe a practical manual for systematically reporting IS and attributes of trial designs from efficacy and effectiveness telemedicine trials for hypertension management. We provide a step-by-step approach to support clinical researchers in reporting IS and assessing the readiness of trials evaluating an EBI for real-world use. Future work should evaluate the effectiveness of our methods, including implementation science experts evaluating any discordance with our IS reporting.

The adoption of telehealth services surged after the coronavirus disease 2019 pandemic, revolutionizing traditional healthcare delivery models. Amazon Clinic's recent nationwide launch marks a significant milestone in this trend. This study aims to offer a strengths, weaknesses, opportunities, and threats (SWOT) analysis of Amazon Clinic and compare its features with leading virtual healthcare platforms. To evaluate Amazon Clinic's telehealth services through a SWOT analysis and compare its features with other leading virtual healthcare platforms. The initial search terms included were, amazon clinic odds ratio (OR) amwell OR Teladoc OR Walmart virtual health service OR CVS minute clinic OR CirrusMD OR brightside health, from 2000 to 2023. This search yielded 111 articles, from which duplicates were removed, and unrelated titles were filtered out. Eight articles were retained for a final review, including comparative studies, usability research, retrospective analyses, observational studies, and review articles. The data was organized and analyzed using Rayyan software and summarized in a table and PRISMA flowcharts. The review included eight articles focusing on various aspects of telehealth. Comparative studies highlighted differences between Teladoc and traditional physician offices, noting lower diagnostic imaging orders and antibiotic prescriptions for Teladoc. User demographics for Teladoc showed younger, less engaged patients. Usability studies emphasized the importance of website design for telemedicine adoption. Tele-mental health platforms like Brightside showed superior outcomes in treating depression compared to traditional methods. Telemedicine for specialized fields like skin reconstruction demonstrated cost efficiency and reduced waiting times. The SWOT analysis identified Amazon Clinic's strengths, such as its vast consumer base and transparent pricing, and weaknesses like the lack of pediatric care. Opportunities included potential partnerships and service expansions, while threats involved competition and regulatory challenges. Amazon Clinic's entry into the telehealth sector represents a significant development with various strengths and opportunities. However, it faces challenges from established healthcare providers and regulatory landscapes. The future success of Amazon Clinic will depend on strategic collaborations, addressing service gaps, and navigating competition and regulations. Telemedicine's impact will hinge on its ability to effectively leverage these opportunities and overcome inherent challenges in the ever-evolving healthcare landscape.

Primary care physicians advise patients to select and consume healthy foods. But as patients shop their grocery aisles, will food packaging health claims direct them to healthy foods? The argument has been made that such claims might predominantly appear on unhealthy foods. This study investigated whether health claims on front packaging reliably indicated healthier food choices and thus could be used by physicians to guide their patients' shopping choices. From Walmart.com, we sampled 597 items spanning 122 categories of the most commonly consumed foods and beverages in America according to the National Health and Nutrition Examination Survey 2017-2020 database. Two researchers analyzed each product's front packaging to identify US Food and Drug Administration-approved health claims, nutritional content claims, and functional claims. We evaluated each product's nutritional facts box to derive an overall numerical nutritional score using the Nutri-Score scheme, representing healthiness. The number of packaging health claims was not associated with healthiness of foods either in aggregate or within any of the 11 standard food and beverage categories. Food categories traditionally perceived as healthy (eg, fruits, vegetables, grains) generally scored higher in healthfulness compared to categories associated with less healthy choices (eg, snacks, sweets, fats, and oils). We cannot recommend that patients rely on food packaging health claims to identify healthy or unhealthy foods. Instead, we encourage physicians to advise patients to choose foods from known healthy categories and ignore front-of-package health claims.

The offering of grocery stores is a strong driver of consumer decisions. While highly processed foods such as packaged products, processed meat and sweetened soft drinks have been increasingly associated with unhealthy diets, information on the degree of processing characterizing an item in a store is not straightforward to obtain, limiting the ability of individuals to make informed choices. GroceryDB, a database with over 50,000 food items sold by Walmart, Target and Whole Foods, shows the degree of processing of food items and potential alternatives in the surrounding food environment. The extensive data gathered on ingredient lists and nutrition facts enables a large-scale analysis of ingredient patterns and degrees of processing, categorized by store, food category and price range. Furthermore, it allows the quantification of the individual contribution of over 1,000 ingredients to ultra-processing. GroceryDB makes this information accessible, guiding consumers toward less processed food choices.

To understand how food prices differed between physical and online grocery stores and a well-established mobile market in a Midwest metropolitan area of the US. Four major grocery retailers nearest to 8 subsidized apartments were identified. Two stores from each retailer were randomly selected (n = 8), and prices for 67 size-standardized foods were collected in person and online. An analysis of variance test assessed mean differences in cart prices across stores relative to the Twin Cities Mobile Market (TCMM). Relative to TCMM cart prices, cart prices were significantly higher at physical and online Walmart (21% to 22% higher, P < 0.001), Target (29% to 30%, P < 0.001), and Cub Foods (62% to 63%, P < 0.001) stores and online Aldi stores (14%, P = 0.02). Aldi physical store prices were not statistically significantly different (P = 0.72). Results require cautious interpretation given the low number of observations per retailer; however, findings suggest TCMM provides foods at a lower cost than most nearby grocery stores, providing 1 example of full-service mobile market pricing. Future research is needed to assess mobile market pricing structures in other locations across the US.