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Tanzania carries a dual burden of communicable and non-communicable diseases while remaining vulnerable to emerging pandemics of public health concern. Since its independence in 1961, Tanzania has implemented successive health reforms aimed at expanding access and moving towards universal health coverage (UHC). Despite notable progress, inequities in access, quality and financial protection persist. This review examined how policy evolution (1961-2025) addressed or reinforced inequities and the lessons for building resilience and equity in UHC. We conducted a scoping review of national health policies, strategies, legislation and the related literature (1961-2025), following Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Eligible sources included government reports, strategic plans, evaluation reports and peer-reviewed or grey literature. Data were analysed using the Walt and Gilson Policy Triangle and mapped against the WHO Health Systems Building Blocks. Out of 10 435 records identified, 60 documents met the inclusion criteria. Policy evolution reflected five broad reform episodes, ranging from postindependence centralisation to primary healthcare, structural adjustment and cost-sharing, sector-wide reforms and recent UHC-focused financing strategies. Reforms shifted from politically driven, top-down policies to participatory and evidence-informed approaches. Mapping showed progressive but uneven gains across service delivery, workforce, financing, governance, medicines and information systems. Six thematic shifts towards UHC were identified: fragmented to pooled financing, routine delivery to resilient systems, paper to digital systems, workforce numbers to distribution and skills-mix, state-only to mixed providers and expansion to effective coverage. Tanzania's reform trajectory illustrates adaptive progress, but persistent inequities in financing, workforce distribution and service access remain. Achieving equitable and resilient UHC will require stronger domestic financing, governance and primary care, with transferable lessons for other low- and middle-income countries.

While video generation models excel at producing high-quality monocular videos, generating 3D stereoscopic and spatial videos for immersive applications remains an underexplored challenge. We present a pose-free and training-free method that leverages an off-the-shelf monocular video generation model to produce immersive 3D videos. Our approach first warps the generated monocular video into pre-defined camera viewpoints using estimated depth information, then applies a novel frame matrix inpainting framework. This framework utilizes the original video generation model to synthesize missing content across different viewpoints and timestamps, ensuring spatial and temporal consistency without requiring additional model fine-tuning. Moreover, we develop a disocclusion boundary re-injection scheme that further improves the quality of video inpainting by alleviating the negative effects propagated from disoccluded areas in the latent space. The resulting multi-view videos are then adapted into stereoscopic pairs or optimized into 4D Gaussians for spatial video synthesis. We validate the efficacy of our proposed method by conducting experiments on videos from various generative models, such as Sora, Lumiere, WALT, and Zeroscope. The experiments demonstrate that our method has a significant improvement over previous methods. Project page at: https://daipengwa.github.io/S-2VG_ProjectPage/.

This study examines how China's "Healthy China 2030" policy influences community health curriculum reform in higher vocational medical education through systemic policy transmission mechanisms across governance levels. Employing a qualitative document analysis design with cross-sectional data collection guided by Walt and Gilson's policy triangle model, this study analyzed 13 national, provincial, and institutional policy documents produced between 2016 and 2025 to map policy development from strategic planning to operational deployment. Based on descriptive document analysis, the findings suggest that the observed policy transmission pattern involves three main mechanisms of content adaptation, language simplification, and contextual integration, facilitating the translation of national health goals into institutional implementation while maintaining long-term strategic consistency. The research identifies an adaptive pattern of transmission beyond sequential assumption of implementation, and a consistent linguistic evolution from strategic abstract direction through to operational activity in the structures of governance. Institutional response reporting indicates varying implementation strategies by organizational context and capacity, where institutions interpret policy objectives into varying mechanisms such as curriculum alignment, faculty development, and building of community partnerships. Preliminary analysis of follow-up reporting indicates institutional development in aligning education practice with policy objectives, although measurement of overall effectiveness is constrained by heterogeneous assessment practice. The analysis provides empirical support for the observation that policy implementation appears associated with active content adjustment rather than stereotypical compliance, suggesting that policymakers should consider flexible models of implementation that accommodate institutional diversity while maintaining strategic integration. The findings offer preliminary insights into adaptive implementation processes in health education policy transmission as identified through document-based policy analysis.

To analyse why rural health workforce initiatives have not delivered sustainable surgical services in rural and regional Australia, and to identify system-level policy changes that could improve access. Nearly one-third of Australians live in rural or remote areas, however rural hospitals face shortages of general and specialist surgeons, have dependence on locums, and frequently use inter-hospital transfers. Despite national strategies aimed at rural workforce equity, surgical services remain highly variable by location and face difficulty in sustaining them. This analysis draws on federal and state workforce strategies, national policy documents including the National Medical Workforce Strategy and Stronger Rural Health Strategy, accreditation and workforce governance reviews from the Australian Government, published statements from professional bodies including the Royal Australasian College of Surgeons and the Australian Medical Association, and peer-reviewed literature on rural surgery, training pathways, and service delivery. We applied Walt and Gilson's health policy triangle (actors, content, context and process) to map power, accountability, and implementation pathways relevant to the rural surgical workforce. Actor influence and interest were further examined using a power-interest matrix. Responsibility for training, accreditation, funding, and service delivery is fragmented across federal, state, and professional actors, with no mechanism to enforce or coordinate rural surgical service provision. Current reforms rely on voluntary uptake by local champions. We propose three policy shifts: reframing rural surgical access around service delivery, a national rural surgical workforce authority, and a rural surgical data and accountability framework.

Health policy analysis frameworks play a central role in understanding how reforms are designed, implemented, and experienced in practice. Walt and Gilson's Health Policy Analysis Triangle has been widely used to examine the interaction between policy content, context, actors, and processes, particularly in settings where implementation is shaped by political and organizational dynamics. However, many contemporary health reforms are increasingly digitally mediated and culturally embedded, raising questions about whether existing frameworks sufficiently capture the conditions that structure implementation. This paper proposes a conceptual extension of the Health Policy Analysis Triangle by theorizing Technology and Culture as cross-cutting dimensions that shape how policy content is enacted through actors and processes within specific contexts. The extension is grounded in secondary analysis and theoretical interpretation of empirical patterns previously identified in an evaluation of Saudi Arabia's Health Sector Transformation Program, a large-scale reform initiative implemented under Vision 2030. Drawing on previously collected policy documents and qualitative interview data from the doctoral study [6] SHSTP evaluation, the paper illustrates how digital infrastructure and sociocultural norms operate as structuring influences on coordination, accountability, participation, and patient-centred care. The proposed framework does not replace the original triangle but enhances its analytical adequacy for reforms unfolding in digitally mediated and culturally complex systems. By making Technology and Culture explicit, the extended model provides a pragmatic analytical framework for analyzing implementation variation and reform learning in Saudi Arabia, with potential relevance for other health systems undergoing rapid transformation when adapted to local contexts.

Forcibly displaced populations face persistent barriers to accessing equitable healthcare, yet qualitative evidence on how policy and health system factors shape these experiences remains fragmented, particularly across underrepresented domains. This scoping review synthesised qualitative and mixed-methods evidence on healthcare experiences among refugees, asylum seekers and internally displaced persons. PubMed, Web of Science and Scopus were searched for studies published between January 2010 and April 2025, alongside grey literature from Google Scholar and institutional repositories. Eligible studies reported primary qualitative data across four domains: mental health, disability inclusion, women's health and palliative and end-of-life care. Data were charted using a structured framework and synthesised thematically, guided by the Policy Triangle Framework developed by Walt and Gilson, the Consolidated Framework for Implementation Research and Proctor's implementation outcomes taxonomy. Of 2522 records identified, 42 studies met inclusion criteria. Across settings, participants reported restrictive entitlement policies, documentation barriers, limited interpreter services and fragmented referral systems. Weak coordination between humanitarian and national systems and limited participation in governance constrained access. These factors resulted in delayed care, unmet needs, communication challenges and exclusion from decision-making. Findings clustered into six domains: entitlement frameworks, service integration, community-based and home-based care, workforce governance, participatory mechanisms and system alignment. Disability inclusion and palliative care were underrepresented in low- and middle-income settings. Inequities in healthcare experiences among displaced populations are shaped by policy design, governance structures and implementation processes. Strengthening entitlement coherence, service integration and participatory governance is critical to improving equity and responsiveness across underrepresented domains.

Despite measurable national gains in child health, Ethiopia continues to face stark spatial inequalities-particularly in pastoralist and peripheral regions like Afar. These disparities are often attributed to logistical or behavioural challenges, yet such framings obscure the deeper political, institutional, and ideological drivers that sustain inequity. This study employs a political economy lens to critically examine how policy structures, actor dynamics, and dominant narratives contribute to the persistence of child health inequalities in Ethiopia. Using an embedded single-case study design, this research draws on 23 semi-structured interviews with national and regional policymakers, development partners, and civil society actors, as well as a review of 53 national and sectoral policy documents. Data were analysed thematically, guided by Walt and Gilson's Policy Triangle and Moncrieffe and Luttrell's political economy framework. Four interrelated drivers of inequality were identified: (1) historical legacies of exclusion and underinvestment in Afar; (2) institutional fragmentation and symbolic decentralisation that limit regional policy autonomy; (3) efficiency-centred policy design that marginalises mobile and hard-to-reach populations; and (4) global donor practices that reinforce centralised, metric-driven planning. These dynamics interact to produce and legitimise structural inequality across space. Child health inequalities in Ethiopia are not technical anomalies but structural outcomes of how public policy is historically framed, institutionally governed, and ideologically justified. Addressing these disparities requires reframing equity as a political and ethical priority-supported by redistributive policy logic, inclusive planning processes, and donor strategies attuned to the needs of marginalised regions. The findings contribute to a growing body of equity-focused health policy literature and offer lessons for other low- and middle-income countries grappling with spatial and structural health inequities.

To conduct a comprehensive health systems policy analysis of the Sindh Telemedicine and Telehealth Act 2021 by examining its contextual drivers, governance and stakeholder dynamics, implementation barriers and facilitators, and policy content, and by comparing it with telemedicine policies in neighboring low- and middle-income countries (LMICs). Our study applied Walt and Gilson's policy triangle to examine context, content, process, and actors. A desk review of relevant policy documents from Sindh and other LMICs (India, Bangladesh, and Nepal) was conducted, followed by in-depth interviews with 28 stakeholders (July-October 2023) until data saturation was reached. Participants were recruited using purposive and snowball sampling strategies. Thematic analysis was done using Qualitative Data Analysis Software (QSR NVivo v12) to identify barriers and facilitators to policy implementation. The contextual drivers behind the formulation of the Act included the coronavirus disease 2019 pandemic, limited healthcare access, and the growth of telehealth providers in private sector. The Act provides a regulatory framework for healthcare providers registration and training requirements, guidelines for patient consent, emergency care, and data privacy. However, it lacks clarity on the cost of telemedicine services and measures for cross-border telemedicine. Stakeholder analysis showed government bodies hold the highest power in telemedicine policymaking. Telemedicine service providers and healthcare providers expressed support for the Act but were excluded from policymaking process. Service users also had minimal involvement in the policymaking process. Policy implementation varies, facing financial and technological barriers, while strategic financial planning and public-private partnerships, identified as facilitators in overcoming these challenges. The study may be subject to limitations, including potential selection bias while identifying stakeholders and the constraints of desk review in capturing details. The Act is an important step towards addressing healthcare disparities, with its success contingent on overcoming implementation barriers through inclusive and strategic policymaking and investment in digital infrastructure.

Evidence on sociodemographic disparities in COVID-19 booster vaccine uptake remains limited. We examined disparities in COVID-19 vaccine uptake among the Arab, ultraorthodox Jewish, and general Jewish populations in Israel (January 2021-August 2022), focusing on vaccine dose, community characteristics, and policy analysis. Publicly available COVID-19 data from 135 cities (≥ 10,000 residents) were analyzed. Cumulative vaccine uptake by dose was assessed by age and population group across 3 periods (period-1: to June 2021, period-2: to December 2021, period-3: to August 2022). Policy analysis was conducted using Walt and Gilson's Policy Triangle framework, drawing on the literature, government reports, official websites, and media coverage. Data from 76 predominantly non-ultraorthodox Jewish cities, 10 ultraorthodox Jewish cities, and 49 Arab cities were included. Compared to the general Jewish population, dose 1 uptake was lower in ultraorthodox (incidence rate ratio (IRR) = 0.51, 95% CI 0.26-0.99) and Arab cities: IRR = 0.76, 0.53-1.09), with similar gaps for dose 2. Disparities widened with boosters: for dose 3, uptake was significantly lower in ultraorthodox cities (period-2 IRR = 0.38 [0.20-0.74], period-3: IRR = 0.39 [0.20-0.75]); and Arab cities (period-2 IRR = 0.55 [0.38-0.79], period-3 IRR = 0.56 [0.39-0.81]). For dose 4, gaps were largest in adults aged ≥ 60 years (ultraorthodox: IRR = 0.24 [0.12-0.47]; Arab: IRR = 0.15 [0.10-0.22]). Higher socioeconomic status was consistently associated with uptake, particularly for boosters. The peripherality index was associated with lower dose 4 uptake, suggesting geographic disparities and access barriers. Policy analysis highlighted Israel's rapid mass vaccination rollout and evidence-based booster adoption, but also declining booster uptake and widening sociodemographic inequities. The primary campaign relied on centralized mass vaccination efforts and intensive public messaging, achieving high coverage, while the booster phase was mainly integrated into existing infrastructure, with more targeted outreach and reduced media emphasis, shifting from infection prevention to severe-disease prevention policy. Persistent disparities in COVID-19 vaccine uptake widened during the booster phase in Israel. While rapid, centralized rollout achieved high initial coverage, sustaining equitable uptake proved challenging. These findings highlight the need for ongoing, equity-focused strategies, including targeted outreach and culturally tailored interventions throughout all phases of public health emergencies, particularly in the long-term phase, to strengthen existing healthcare infrastructure.

BACKGROUND: The COVID-19 pandemic has posed unprecedented challenges to healthcare systems worldwide, necessitating rapid adaptation and strategic responses. This article aims to explore the structural factors, challenges, and strategies in Iran’s COVID-19 response, from the opinion of health experts. By examining the multifaceted dimensions of Iran’s response, this study seeks to contribute to the understanding of how structural factors influence pandemic management and to identify potential strategies for improving health policy responses in similar contexts. METHODS: This qualitative study employed a framework analysis approach. Interviewees were purposefully selected with a maximum variation strategy in one of the biggest provinces of Iran, and Walt and Gilson policy triangle framework was applied to inform our data analysis. RESULTS: Key structural challenges emerged across three domains. (1) Management system infrastructure: Experts identified a lack of integrated decision-making, an organizational structure prioritizing treatment over prevention, and conflicting levels of autonomy for regional universities. (2) Economic factors: Severe financial constraints on both the government and society hindered the implementation of effective lockdowns and undermined public adherence to health protocols. (3) Political factors: The response was shaped by a dual influence of perceived political unity under a centralized task force and disruptive divergence from inter-ministerial conflicts and shadow power groups, which occasionally led to policy sabotage. CONCLUSION: This study contributes valuable insights for future health policy responses in similar contexts. The findings underscore the critical role of integrated management, economic support, and political unity in shaping a successful pandemic response. The lessons learned from Iran’s experience emphasize that addressing structural factors is not only crucial for immediate crisis response, but also for building more resilient health systems capable of responding effectively to future crises.

Despite known linkages between family planning (FP) and nutrition, there is little evidence on whether and how these services are integrated for women of reproductive age (WRA; aged 15-49 years) in Burkina Faso. This study aimed to obtain an overview of FP and nutrition policies and programmes in Burkina Faso to understand the value, current efforts, gaps and opportunities for integration. In this mixed-methods study, we analysed recent Demographic and Health Survey Demographic and Health Survey (2021) data using survey-adjusted tabulation and Poisson regression models to assess population-level FP and nutrition needs and inter-relationships. We also conducted a desk review of 27 policies and programmes targeting nutrition and/or FP and their integration, analysed using Walt and Gilson's triangular framework. Finally, we conducted a series of in-depth interviews with policy and programme leaders and focus group discussions with WRA and other community members to determine perspectives and experiences on FP and nutrition service integration (n=144), with data analysed using thematic analysis. We found a high prevalence of unmet need for FP (18.3%, 95% CI 17.3 to 19.3) and of indicators of poor nutrition (moderate anaemia: 29.3%, 95%&#x2009;CI 28.0 to 30.7) among WRA. Use of hormonal contraceptives was associated with reduced anaemia risk (risk ratio for injections: 0.72, 95%&#x2009;CI 0.65 to 0.80, p<0.001). Alignment of FP and nutrition was noted in 9/27 policy and programme documents, especially within the context of maternal and child healthcare services. Interviewees recognised the health-related, resource-related and logistical (to WRA) benefits of integrating FP and nutrition services particularly for maternal and child well-being, but financial, logistical and cultural barriers were emphasised. Integrating FP and nutrition services is a potentially valuable and impactful approach to improve health in WRA in Burkina Faso. However, this view is not universal, and effectively consolidating integration will require targeted efforts to address barriers at multiple levels.

Iran was heavily affected by COVID-19 and faced a delayed, uneven vaccine rollout. While global vaccine hoarding constrained access, the delay also reflected an immunitarian decision by the Supreme Leader to ban US- and UK-produced vaccines. Using Walt and Gilson's Health Policy Analysis (HPA), I examine Iran's early COVID-19 response, tracing how context, content, process, and actors shaped vaccine governance and outcomes. I compare deaths per 100,000 from the World Health Organization (WHO) with eight peer countries benchmarked by income group and vaccine portfolio. Adjusting for GDP per capita, the share aged 65 and over, and a Health Resources score, I identify excess mortality beyond expectations. Drawing on Esposito's immunity and Agamben's homo sacer, I read Iran alongside Global North policies prioritizing economic continuity and invoking 'natural herd immunity.' In both settings, protection is pursued through selective exposure, edging toward autoimmunity. In the Global North, sacrifice fell along the lines of unequal welfare and labour regimes and unequal vaccine markets; in Iran, martyrdom and purification moralized immunitary sovereignty as resistance to 'Western arrogance,' casting dissent as impurity and tending toward 'disinfestation,' where defence turns against the life it claims to secure.

Through the combined lenses of ecofeminism, masculinity studies, and critical animal studies, this article examines the cultural functions of animal metamorphosis in two Walt Disney animated feature films, Beauty and the Beast and The Princess and the Frog. It argues that animality operates as a narrative and symbolic space in which dominant gender norms and human-animal hierarchies are temporarily destabilized and reconfigured. Drawing on film analysis, this study shows how the animal figure enables the emergence of alternative masculinities-sensitive, relational, and ecologically attuned-while simultaneously exposing the structural limits of this apparent subversion. Although these films challenge toxic masculinity and propose more egalitarian interspecific relationships, their narrative resolutions ultimately reinstate anthropocentric and heteronormative frameworks by reasserting human centrality and normative romantic closure. By situating Disney's representations within broader Western dualistic logics of domination (culture/nature, masculine/feminine, human/animal), I demonstrate that animality functions less as an autonomous mode of existence than as a transitional narrative device facilitating human self-transformation. In doing so, this article contributes to current discussions on how culturally mediated representations of animals shape human social imaginaries, ethical frameworks, and understandings of interspecies relationships.

Integration of family planning (FP) and nutrition is critical for improving maternal and child health, yet evidence on effective integration remains limited in Tanzania. This study explored challenges and opportunities for integrated service delivery in Tanzania. A mixed-methods approach was used, combining analysis of the 2022 Tanzania Demographic and Health Survey (n=15,&#x2009;254&#x2009;women), a desk review of 25 national documents, and qualitative data from 18 focus group discussions and 14 key informant interviews in urban and rural areas. Thematic analysis and the Walt and Gilson framework guided qualitative and policy reviews, while Poisson regression assessed quantitative associations. Unmet FP needs were high (25%). Anaemia affected 40% of women, with 6% underweight and 30% overweight/obese. Our novel quantitative analysis revealed that hormonal contraceptive use was associated with 30%-40%&#x2009;reduction in anaemia risk, while short birth intervals doubled the risk of being underweight. Urban women faced higher obesity rates (24%) than rural women (12%). While national policies conceptually support integration, gaps in implementation, monitoring and cross-sectoral coordination persist, including siloed programme design, fragmented governance and a lack of joint operational guidance and monitoring frameworks. Stakeholders highlighted challenges to service integration, including fragmentation between FP and nutrition services, frequent stockouts, long wait times, stigma and limited male engagement. Key opportunities identified include strong community preference for bundled services, advocacy from faith leaders for mosque-based and church-based outreach, and the potential of digital platforms and private-sector partnerships to expand access. Addressing integration gaps requires policies that prioritise underserved groups (eg, rural women, adolescents) and delivery models tailored to local contexts (urban vs rural), as well as strengthened implementation. Unified governance and community-based platforms, with integrated service delivery at health facilities and in the community, can enhance impact in Tanzania and similar settings.

Understanding the tripartite interaction between diet, the microbiome, and host physiology is essential for optimizing the bioconversion efficiency of black soldier fly larvae (Hermetia illucens). These interactions were investigated by analyzing life-history traits and metatranscriptomes of larvae fed carbohydrate-rich (1P:5C), protein-rich (5P:1C), and balanced ratio macronutrient (1P:1C) diets. The results showed that dietary macronutrients correlated with shifts in the microbial community and gene expression. In particular, optimal larval performance, characterized by the highest weight and survivorship, was achieved on the balanced ratio diet. While the carbohydrate-rich diet increased microbial alpha diversity and enriched microbial transcripts for carbohydrate metabolism and transport, it significantly delayed pupation, reduced larval weight, and induced host immune genes related to pathogen recognition. Larval guts were predominantly composed of the fungal genus Magnusiomyces, no matter the diet, whereas the frass microbiome was primarily bacterial. In the frass, Klebsiella dominated the carbohydrate-rich diet, while Streptococcus, Lactobacillus, and Klebsiella were the most prevalent taxa in the balanced and protein-rich treatments. Significant correlations were identified between host gene expression and microbial alpha diversity and transcript expression, suggesting host-microbe crosstalk in response to nutritional stress. Ultimately, these findings demonstrate that balanced macronutrient ratios are required to synchronize host-microbiota metabolic synergy and mitigate physiological stress, providing a definitive mechanistic framework for optimizing industrial black soldier fly rearing outcomes.

The gut modulates systemic health, influencing immune, neurological, and cardiovascular processes. While fecal sequencing of microbial nucleic acids provides a non-invasive view of microbial composition, sensitive measurement of host-derived signals in stool remains limited. Here we introduce DIGEST (Digital Immunoassay for Gut-Environment Single-molecule Targets), an ultrasensitive digital immunoassay that quantifies proteins in fecal extracts to attomolar levels. In mice, longitudinal profiling during a high-fat diet perturbation revealed coordinated host cytokine responses that occurred within 24 hours, with sustained elevation after diet withdrawal, enabling non-invasive tracking of within-subject immune dynamics. Application of DIGEST to quantify a panel of host inflammatory cytokines in patients with inflammatory bowel disease distinguished active ulcerative colitis from quiescent disease and non-IBD controls (AUC=0.98). In advanced melanoma patients receiving PD-1 blockade, pretreatment fecal IL-23 concentrations discriminated responders from non-responders with an AUC of 0.87. Together, these results establish DIGEST as a generalizable platform for sensitive, non-invasive quantification of host protein activity at the gut interface, with broad applications in basic science discovery, disease surveillance, and therapy response prediction.

Chimeric antigen receptor T-cell (CAR-T) therapy is associated with immune effector cell-associated neurotoxicity syndrome (ICANS), which can manifest as acute and sub-acute cognitive dysfunction. Few studies have investigated cognitive recovery post-CAR-T therapy. In this prospective longitudinal study, patients treated with CAR-T therapy at The Alfred Hospital, Melbourne, underwent cognitive testing at preinfusion and 3- and 6-months postinfusion. Psychometric tests measured attention, processing speed, visuospatial function, language, memory, and executive function. 197 cognitive evaluations were conducted on 91 participants (62% male, mean age at infusion was 66.1 yr [SD = 10.6 yr]). Thirty-two (35%) patients developed ICANS. General linear mixed-effects models found no evidence for an interaction between time and ICANS group for most psychometric test Z-scores, except for a single test of visuospatial function (P = .007). Patients in the ICANS group demonstrated a decline on this test relative to the non-ICANS group, but the magnitude of this effect was small. Patients who develop ICANS demonstrate no strong evidence of significant cognitive decline in 6 months post-CAR-T therapy. Our data are reassuring, revealing that ICANS-related cognitive impairment resolves sometime in the first 3 months post-CAR-T therapy in most cases.

Extracellular vesicles (EVs) are nanoscale particles secreted by cells that carry diverse biomolecules reflecting their cell of origin. Single-EV imaging approaches have enabled precise characterization of heterogeneous EV populations; however, their broader application is limited by low-throughput workflows and cumbersome EV isolation procedures. Here, we introduce a streamlined, high-throughput imaging platform capable of analyzing protein expression of individual intact EVs directly from unprocessed biological samples at the single-vesicle level. Our approach employs a functionalized glass surface optimized for high-throughput single-EV imaging, facilitating specific capture of EVs and enabling integration with existing automation technologies. We evaluate the platform's analytical capabilities by characterizing various recombinant EV samples and demonstrate its clinical utility by analyzing EVs in a total of 191 human plasma samples with high-throughput efficiency. This technology will offer a pathway for high-precision and large-scale characterization of EVs in clinical samples.

Idiopathic intracranial hypertension (IIH) is characterised by raised intracranial pressure in the absence of structural pathology and with normal cerebrospinal fluid composition. IIH is strongly associated with obesity and rising incidence has been reported in northern hemisphere countries. However, paediatric and Southern Hemisphere populations, including Australia, are under-represented in the existing literature. We conducted a multicentre retrospective study of adults (&#x2265;&#x2009;18&#xa0;years) and children (<&#x2009;18&#xa0;years) diagnosed with definite IIH (Revised Friedman criteria 2013) between 2010 and 2023 at two Melbourne-based quaternary hospitals, capturing the majority of cases in Victoria, Australia. Demographic and clinical data were collected at diagnosis. Annual crude and age-standardised incidence rates per 100,000 population were calculated overall and by age group across predefined periods (2010-2014, 2015-2019, and 2020-2023). Temporal trends were assessed using negative-binomial regression. A total of 612 incident IIH cases were identified, including 504 adults and 108 children. Adults were predominantly female (94%), with mean age 28.0&#x2009;&#xb1;&#x2009;6.5&#xa0;years and mean BMI 37.6&#x2009;&#xb1;&#x2009;8.4&#xa0;kg/m2. Children showed lower female predominance (76%), younger mean age (12.4&#x2009;&#xb1;&#x2009;3.5&#xa0;years), and lower mean BMI (31.9&#x2009;&#xb1;&#x2009;8.4&#xa0;kg/m2). Headache was the most common presenting symptom in both groups (adults 84% and children 86%). Diplopia and sixth nerve palsy were more frequent in children. Age-standardised IIH incidence increased from 0.86/100,000 person-years in 2010-2014 to 6.53/100,000 in 2020-2023. In adults, incidence rose from 0.07/100,000 in 2010 to 2.30/100,000 in 2023 (32-fold); in children, from 0.33/100,000 to 1.01/100,000 (threefold). The highest incidence rates were seen among females aged 18-39&#xa0;years, in whom incidence rose from 0.11/100,000 to 6.79/100,000 between 2010 and 2023. IIH incidence in Victoria increased substantially over 14&#xa0;years, with the greatest burden among young adult females, mirroring international trends and highlighting the need for ongoing surveillance and mechanistic research.