Burn injuries continue to represent a substantial global health burden, not only due to their acute clinical impact but also because of their long-term physical, psychological and socioeconomic consequences. Importantly, a large proportion of these injuries occur in domestic environments and are associated with identifiable and modifiable risk factors. This makes burns uniquely positioned among traumatic injuries as highly preventable events, provided that risk patterns are correctly identified and translated into effective interventions. This study aims to characterize the epidemiological and clinical features of burn injuries within a recent cohort and, more critically, to reinterpret these findings through a prevention-oriented framework. The goal is to identify high-risk mechanisms and populations and to define targeted, evidence-based preventive strategies applicable in domestic settings. A retrospective observational analysis was conducted on 224 burn cases recorded between 2024 and 2025. Variables included demographic data, burn etiology and burn severity measured as percentage of Total Body Surface Area (%TBSA). Burn mechanisms were systematically categorized to allow meaningful comparison across groups. Statistical analyses were used not only to detect associations but also to highlight priority areas for preventive intervention. The analysis revealed a clear predominance of flame/explosion burns, which accounted for nearly half of all cases and were associated with the greatest injury severity. Scald burns emerged as the second most common mechanism but demonstrated a strong concentration in pediatric patients. The statistically significant association between age and burn etiology underscores that burn risk is structured and predictable, rather than random. Importantly, a non-negligible proportion of patients sustained severe burns, reinforcing the need for upstream prevention. The findings confirm the presence of two dominant and preventable burn profiles: pediatric scald injuries and adult flame-related burns. Effective prevention requires a targeted, stratified approach that addresses specific mechanisms of injury, environmental hazards and behavioral risk factors within the domestic setting.

Pyrethroid-induced cardiac Dysfunction: A systematic review and meta-analysis of preclinical evidence.

Epidemiology, management, and outcomes of pediatric traumatic brain injury: a prospective study from a tertiary trauma centre in North India.

Abstract We examine the social role of dogs in the Central Andes using dog remains from Middle Horizon (AD 600–1000) Tiwanaku sites in the Moquegua Valley, Peru. We describe dog remains from domestic, cemetery, and temple contexts and provide life histories of two naturally mummified young dogs that Tiwanaku inhabitants intentionally buried in domestic households at the sites of Rio Muerto and Omo. We present morphological and morphometric values for the mummified dog from Rio Muerto, along with isotopic analyses of the bones, teeth, and hair from both dogs. The strontium ( 87 Sr/ 86 Sr) isotopic analyses indicate that both dogs had local origins. Isotopic analyses of carbon (δ 13 C) and nitrogen (δ 15 N) show that the Rio Muerto dog consumed a mixed terrestrial and omnivorous diet composed of both C 3 and C 4 foods, like that of humans from that site. The Omo dog consumed less C 4 foods and more protein. Although some dog remains exhibit cut marks, there is no evidence that dogs were food animals. We interpret the intentional burial of the two dogs in domestic settings and the fragmentary remains as evidence that the Tiwanaku inhabitants of Moquegua considered dogs to be companion animals and possibly nonhuman persons worthy of respect after death.

Deconstructing the cortisol awakening response (CAR): Post-peak decline predicts health vulnerability in healthy females.

Analytical approaches for detecting biocides in aquatic environments: Advances and challenges

Hospital twinning partnerships have emerged as a strategy for health system strengthening, yet evidence on their implementation in domestic settings within low- and middle-income countries remains limited. This study examined a hospital twinning partnership between West China Hospital and Dafang County People's Hospital in western China to identify partnership components and implementation determinants, complemented by assessment of implementation outcomes. A mixed-methods implementation study was conducted using the World Health Organization health system building blocks and the Consolidated Framework for Implementation Research (CFIR). Data were collected through semi-structured interviews (n = 10), structured surveys (n = 63), and administrative records. Partnership elements were mapped to the building blocks, while CFIR constructs were rated to identify facilitators and barriers. Qualitative and quantitative findings were integrated to provide a comprehensive understanding of implementation determinants. Partnership elements spanned all six building blocks, with particular emphasis on leadership and governance, service delivery, and health workforce development. Key facilitators included source credibility and reputation of the supporting hospital, government support, and a two-way partnership philosophy. Barriers included IT infrastructure limitations, inadequate external funding, intervention complexity, sustainability pressure, and cultural inertia toward change. Implementation outcomes showed improvements in service capacity, workforce development, and organizational culture, with observable changes extending to township health centers within the County Medical Consortium. The findings from this study suggest that structured domestic hospital twinning partnerships may serve as a promising approach to rural health systems. The comprehensive approach addressing multiple health system building blocks, combined with mechanisms for extending support to primary care facilities, offers a replicable model for health system strengthening in resource-limited settings.

BackgroundBurn injuries remain a significant global public health problem, causing substantial morbidity, mortality, and economic burden, particularly in low- and middle-income countries where nearly 90% of cases occur. Despite the importance of timely and appropriate first aid in reducing complications, community responses to burn injuries in many settings continue to rely on traditional or non-evidence-based practices.ObjectiveThis qualitative phenomenological study explored community-based knowledge and responses related to the causes and first aid of burn injuries.MethodsThe study involved ten (10) purposively selected informants residing in South Mangga Dua Urban Village, Central Jakarta, Indonesia. Data collection methods included semi-structured interviews, direct observations, and focus group discussions (FGDs). Thematic analysis was used.ResultsThree (3) core domains were identified: (1) community perceptions of burn causes and classifications, (2) indigenous first aid practices used in domestic settings, and (3) sources of knowledge and information pathways related to burn first aid. Participants commonly attributed burns to incidents involving fire, hot liquids, and electrical faults. Their understanding of burn severity was limited to superficial assessments, with little awareness of clinical classifications. First aid responses were largely based on traditional practices such as the application of toothpaste, honey, or aloe vera, while evidencebased practices like using running water were rarely mentioned. Notably, most participants relied on familial teachings and informal community experiences as their primary sources of knowledge, with limited exposure to health professionals or verified media content.ConclusionCommunity knowledge is culturally rooted but misaligned with medical standards, potentially leading to unsafe practices. Culturally sensitive health education integrating traditional beliefs and accurate information is essential to improve outcomes in burn injury management.

Introduction: Poisoning is a leading cause of preventable mortality worldwide, with trends shaped by changingsocietal, environmental, and toxicological factors. This study examines poisoning-related fatalities in Patiala,Punjab, using autopsy data to identify patterns, demographic correlations, and toxicological profiles, aiming toinform preventive and intervention strategies.Aims and Hypothesis: The study hypothesizes that poisoning trends are shifting due to the increased availabilityof hazardous substances and changing socio-economic pressures. It aims to analyze these trends and exploreinnovative approaches to mitigate poisoning-related mortality.Materials and Methods: A descriptive prospective study was conducted over 1.5 years on 360 autopsy cases withalleged poisoning. Data was analyzed on parameters including demographic profiles, type of poison, route andtiming of exposure, and the socio-environmental context of incidents. Statistical analysis, including Fisher’s ExactTest, identified significant associations, with p ≤ 0.05 considered significant.Results: Among 360 cases, 301 (83.6%) were males, and 59 (16.4%) were females, with the highest incidence inthe 21–30 years age group (30.56%). Aluminum phosphide was the most commonly detected poison (21.39%),followed by alcohol (11.11%). Suicide was the predominant manner of death (37.22%), strongly associated withaluminum phosphide, while alcohol was a key factor in accidental and overdose cases.Innovative findings revealed that 29.44% of cases had pending toxicology reports, underscoring systemic delaysthat hinder timely legal and preventive interventions. Furthermore, most incidents (77.78%) involved oralingestion, with 59.17% occurring in domestic settings, highlighting the need for stricter regulation and storageof household toxins. Seasonal analysis identified a significant spike in poisoning cases during the rainy season(43.61%), suggesting the role of agricultural practices and pesticide use during this period.Conclusion: This study emphasizes the critical need for gender- and age-specific interventions, enhanced mentalhealth services, and stricter regulations on toxic substances, particularly aluminum phosphide. Innovativemeasures, such as real-time toxicological diagnostics, community-based poison control programs, and educationalcampaigns targeting rural and urban populations, are essential to reduce the burden of poisoning-related mortality

This case report follows M.K., a 31-year-old man with spastic paraplegia who sustained a second-degree skin burn after his mobile phone charger cord was trapped beneath his back while hospitalized. This led to complications that necessitated three hospitalizations, multiple surgical interventions, and treatment for a hospital-acquired infection caused by multidrug-resistant bacteria. Nearly every patient brings a mobile phone (and, often, a charger) into the hospital, and the use of these and other electronic devices carries risks. Although numerous media and medical publications have reported serious and even fatal injuries caused by mobile phones and their chargers in domestic settings, reports of such incidents in hospitals remain scarce. This case study discusses the authors' experience in addressing various patient safety and risk management issues associated with patients' use of mobile phone chargers in a general hospital setting.

Purpose Rollators are widely used in Germany, yet evidence on real-world usability and satisfaction in home environments, including contextual and service factors, remains limited. This study explored rollator use and user satisfaction in domestic settings. Methods Exploratory cross-sectional home interviews with open-ended questions were conducted (June 2024–April 2025) in Germany. Regular rollator users were recruited via outpatient care services. Use context and provision pathways were assessed; satisfaction was measured with Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0) and recommendation behaviour with the Net Promoter Score (NPS). Quantitative data were analysed descriptively; qualitative responses were thematically summarised. Results Forty-four participants (median age 85.5 years; 54.5% female) were included. More than half obtained a rollator by prescription (54.5%); medical supply stores (MPS) were key actors in procurement (63.6%), yet training was rare (11.4%) and initial handles height adjustment was inconsistent (61.4%). Rollators were used primarily outdoors and for walking (100%), transport (82%), and seating (75%). Defects were observed in 20.5% and accidents were reported by 12.7% (mainly in public transport). Device satisfaction was high (QUEST 2.0 mean 4.41, SD 0.55) and correlated with NPS (ρ = .433, p = .003), yielding an overall NPS of +49. Suggested improvements included brakes, suspension, handles, lighting, and follow-up services. Conclusions Despite high satisfaction, observed defects and reported accidents indicate relevant safety concerns, alongside barriers related to context and services. Strengthening user-centered product–service design and follow-up may improve safety and long-term usability.

Purpose This paper aims to detail the policy impact arising from a series of interlocking studies designed to reduce the risk of domestic servitude, a severe form of modern slavery, within care work conducted in private households. Design/methodology/approach Mixed methods were used including feminist participatory action research; comparative international case studies; prevalence estimation based upon respondent-driven sampling and network scale-up methods; and facilitated group problem solving techniques. Findings While this impact pathway demonstrates that it is possible to amplify the voices of marginalised communities within public policy debates, such an approach also raises questions about the ethical implications of impact work, including how to ensure that the voices of other affected communities are acknowledged. Practical implications This impact work includes the publication of modern slavery risk assessment and due diligence guidance, and a process for their local development, for commissioners and procurers of adult social care. Social implications Domestic servitude is a hidden phenomenon. Through engagement with those who deliver live-in care provision, this impact study aimed both to shed light on the risks that they face and increase their agency through direct training in research methods and community-based advocacy. Originality/value This impact paper summarises a multi-faceted research approach to a complex and urgent social problem. It highlights the role public authorities, as state procurers and commissioners of adult social care, can play in the reduction of modern slavery risk in domestic settings and extends the understanding of the role of worker voice in identifying and amplifying the views of those engaged in care work in private household settings.

ABSTRACT This study explores how music and dance functioned as embodied forms of resistance and identity formation among Converso and Morisco communities in the early modern Crown of Aragon. It argues that expressive practices such as singing, ritual dancing and festive celebration were not marginal cultural remnants but pivotal strategies for affirming communal memory, negotiating socioreligious identity and challenging hegemonic Christian norms. Focusing on rites of passage and major religious festivals, the study adopts a comparative and cross-cultural approach to demonstrate how these acts operated as counter-performances that subverted imposed religious uniformity and fostered transcultural practices. Drawing on a range of sources, including municipal decrees, royal edicts, theological treatises and inquisitorial records, the research highlights the everyday, gendered and ephemeral nature of cultural resistance. Women and musicians, in particular, emerge as key agents of ritual transmission and subaltern agency, sustaining ethnomusical performances that official discourse sought to erase. These expressive acts, often enacted in domestic or communal settings, transformed music and movement into powerful media of cultural continuity. Framing music as a cultural text embedded with dissent, the study shows how Aragonese crypto-Jewish and crypto-Muslim communities transformed embodied tradition into an instrument of resilience and defiance within a hostile religious landscape.

Gender-based violence against women and girls aged ≥15 years presenting to European emergency departments: a multinational, cross-sectional analysis.

Promoting handwashing with soap reduces risk of diarrhoea by 30% and respiratory infections by 17%. Handwashing promotion in nonhealthcare settings is widely considered cost-effective, but there is no systematic review on this topic. To inform resource allocation decisions, we reviewed the state and quality of evidence regarding cost-effectiveness and benefit-cost of interventions promoting handwashing with soap in domestic, educational, and childcare settings globally. We searched Medline, Embase, Global Health, EconLit, and Web of Science for studies published from January 1, 1980 to September 3, 2025, as well as grey literature (PROSPERO CRD42021288727). We included full economic evaluations comparing the cost of two or more interventions with their outcomes. We included interventions promoting the practice of handwashing with soap, including those providing information, motivational campaigns, and/or handwashing facilities. We scored quality of reporting using the Consolidated Health Economic Evaluation Reporting Standards. We identified 15 studies of which 3 were in high-income countries. Five used empirical data collection to evaluate interventions actually implemented and 10 modelled from secondary data only. Amongst the 3 medium- or high-quality studies reporting cost per disability-adjusted life-year averted, estimates ranged from US$ 37 to 937 (2024 prices). Of these 3 estimates, 2 were cost-effective compared to plausible thresholds for the respective country. In the only medium- or high-quality benefit-cost study, the mean benefit-cost ratio was 2.1 with "medium" levels of handwashing adoption (40% of population) and adherence (50% of those adopting). Few studies measured or modelled adoption of handwashing over time, and none which focussed on diarrhoea also valued respiratory infections. Limitations of our review include that we excluded alcohol-based handrub interventions, and that there is high uncertainty about cost-effectiveness thresholds. Promoting handwashing with soap is very likely to be cost-effective for interventions that successfully increase and sustain adoption of handwashing behaviours. More empirical studies are needed, especially those comparing multiple promotion options and valuing reductions in respiratory infections as well as diarrhoea.

Salmonella enterica and Listeria monocytogenes Inactivation Dynamics During Low-Temperature Sous Vide Cooking of Beef Steaks.

Background: Increasing demand for home care is a critical issue for the European Union (EU) and policy directions for improving the quality of care and labour conditions have been set out in the European Care Strategy. Access to collective bargaining is a key element of this. However, worker organisation in the sector is generally weak and trade union strength is in decline particularly in liberal welfare states within the EU. The European Institute for Gender Equality (2021) estimates that about 9 out of 10 paid care workers are women, with one in four having a migrant background. A high level of informality prevails in the sector. According to the European Labour Authority (2022), about half of care workers in domestic settings are undeclared workers. Funding models relying on poorly regulated use of cash transfers can encourage the employment of workers under informal contractual arrangements. Coupled with existing challenges, platform work is now a growing feature of the sector. It is evident that in the digitalised, post-pandemic world of work a new approach to organising workers is required. Approach: This paper examines the challenges and opportunities that this context presents for organising care workers needs, representing the care workforce and creating sustainable approaches to care through digital platform solutions including commercial and cooperative based approaches. Results: The paper sets out a dichotomy of approaches for with regard to representing the concerns of platform based care workers. Implications: The paper outlines the implications of the EU Directive on Platform Work, and also the possible implications associated with the transposition of the Directive on Adequate Minimum Wages and Collective Bargaining Coverage in creating a sustainable workforce in home care provision

Breast cancer is the most common malignancy among women worldwide, with its incidence continuing to rise, posing a serious threat to women's health. In recent years, with the widespread adoption of molecular subtyping in diagnosis and treatment, breast cancer therapy has entered an era of individualized precision medicine. Early-stage breast cancer is primarily managed with surgery, combined with chemotherapy, radiotherapy, endocrine therapy, and targeted therapies (such as trastuzumab and pertuzumab), significantly improving cure rates. However, for recurrent or metastatic breast cancer, particularly refractory subtypes such as triple-negative and HER2-positive breast cancer, the efficacy of traditional treatments remains limited, and patients still face a poor prognosis. Antibody-drug conjugates (ADCs), as an innovative targeted therapy strategy, combine the precise targeting of monoclonal antibodies with the potent cytotoxicity of payload drugs, delivering cytotoxic agents directly to tumors through targeted chemotherapy, achieving "precision delivery and efficient killing". ADCs represent a relatively novel class of highly targeted anticancer biologics. In the field of breast cancer treatment, ADCs have made groundbreaking progress. Agents such as T-DM1 and T-DXd have significantly prolonged progression-free survival and overall survival in HER2-positive patients, providing critical treatment options for advanced-stage patients, markedly improving survival outcomes, and are now being explored in earlier lines of therapy, reshaping the treatment landscape of breast cancer. Although ADCs are generally well-tolerated, their unique structure-comprising antibodies, cytotoxic payloads, linkers, and conjugation processes-leads to distinct adverse effects and heterogeneous safety profiles within the class. Based on the latest research advances in ADC therapy for breast cancer and incorporating clinical experience from both domestic and international settings, the Breast Cancer Professional Committee of China Anti-Cancer Association, along with Breast Cancer Prevention and Treatment Research Professional Committee of Maternal and Child Health Research Society of China have jointly developed the "Guidelines for managing adverse reactions to antibody-drug conjugates in breast cancer (2025 edition)". This guideline aims to provide healthcare professionals with practical guidance on the early identification, regular assessment, timely management, and follow-up monitoring of ADC-related adverse reactions or events.

Pemphigus vulgaris (PV) and bullous pemphigoid (BP) are rare autoimmune bullous diseases (AIBDs) of unknown etiology. Genetic and environmental factors have been described to trigger autoimmunity. The latter include exposure to pesticides and industrial pollutants. To investigate the incidence of AIBDs in Liguria (Northern Italy) and to assess the association between exposure to pesticides and working in agriculture and AIBDs. We conducted a retrospective observational study on the incidence of AIBDs in the decade 2014-2024 in the Liguria region. Moreover, we conducted a retrospective case-control study on patients in the province of Imperia, where the highest incidence of AIBDs was found, using a questionnaire to assess exposure to environmental and occupational risk factors. The mean annual incidence of AIBDs (PV 0.026/1000 inhabitants and BP 0.102/1000 inhabitants) in Liguria was higher than the European incidence values. In Imperia the incidence of BP was significantly higher than the Ligurian incidence (p=0.0015). The retrospective case-control study found that the exposure in domestic settings to pesticides and having worked in agriculture were associated to higher risk of developing PV. The present study supports and suggests the association between pesticides exposure and the development of PV.

Foodborne diseases have a high incidence and widespread occurrence, affecting a significant number of individuals, making them one of the most pressing public health issues globally. The situation regarding foodborne diseases in China is similarly concerning. This study collected data on foodborne disease outbreaks reported by 39 districts and counties in Chongqing from 2003 to 2023 and analyzed the epidemiological characteristics. The aim was to understand the patterns and trends of foodborne disease outbreaks in Chongqing, thereby providing a scientific basis for developing effective prevention and control strategies. From 2003 to 2023, a total of 767 foodborne disease outbreaks were reported in Chongqing, resulting in 10,462 individual cases and 43 fatalities. Domestic settings were identified as the primary location for these incidents, accounting for 46.4% (356/767) of the total occurrences, followed by hotel and restaurant, which contributed 25.0% (192/767). The majority of incidents occurred between May and October. The highest number of incidents was associated with the consumption of poisonous mushrooms, totaling 204 cases, which represents 26.6% (204/767) of all reported incidents. This was followed by meat and meat products, which accounted for 94 incidents, or 12.3% (94/767). Poisonous mushrooms and aconitines emerged as the leading pathogenic factors contributing to fatalities, responsible for 27.9% (12/43) and 16.3% (7/43) of the total deaths, respectively. In recent years, the epidemiological characteristics of foodborne disease outbreaks in the region have evolved. Since 2020, surveillance datum has indicated that mushroom-related events have emerged as the predominant cause of both foodborne disease incidents and associated fatalities in Chongqing. It is essential to enhance monitoring of cases and incidents, improve incident response and early warning mechanisms, conduct comprehensive analyses of the factors contributing to the high incidence of these events, and implement targeted supervision and education for critical locations, pathogenic factors, and personnel.