Context Of Global Health Research Articles

Perspectives of Digital Health Innovations in Low- and Middle-Income Health Care Systems From South and Southeast Asia.

Digital health innovations have emerged globally as a transformative force for addressing health system challenges, particularly in resource-constrained settings. The COVID-19 pandemic underscored the critical importance of these innovations for enhancing public health. In South and Southeast Asia, a region known for its cultural diversity and complex health care landscape, digital health innovations present a dynamic interplay of challenges and opportunities. We advocate for ongoing research built into system development and an evidence-based strategy focusing on designing and scaling national digital health infrastructures combined with a vibrant ecosystem or "marketplace" of local experiments generating shared experience about what works in which settings. As the global digital health revolution unfolds, the perspectives drawn from South and Southeast Asia-including the importance of local partnerships-may provide valuable insights for shaping future strategies and informing similar initiatives in low- and middle-income countries, contributing to effective digital health strategies across diverse global health contexts.

India’s Vaccine Diplomacy and Global Health Governance: A Soft Power Approach in the Context of Public Policy and Religious Values

Research Problem: India's vaccine diplomacy during the Covid-19 pandemic has not only emerged as a significant tool of soft power but also involves moral and ethical dimensions closely tied to religious values and public policy. In the midst of a global crisis, the interaction between India’s vaccine diplomacy and the religious and public policy frameworks of recipient nations requires deeper exploration. Research purposes: This article aims to analyze the role of India’s vaccine diplomacy in relation to public policy and religious values in recipient countries, examining how India’s global health initiatives influence moral and ethical perceptions of vaccine distribution, fairness, and international solidarity. Research methods: The study employs policy analysis through a comprehensive literature review, focusing on the relationship between vaccine diplomacy, public policy, and responses from religious communities in the recipient countries. It also explores the ethical and spiritual dimensions of India’s health diplomacy approach and its impact on public health policies. Results and Discussion: The findings reveal that India’s vaccine diplomacy, through initiatives like "Vaccine Maitri," not only strengthens political ties with neighboring and global countries but also interacts with religious value systems, influencing public acceptance of vaccines. Moral values such as solidarity and justice, integral to many religious traditions, reinforce positive responses to the vaccine initiatives. Additionally, in some nations, religious communities have played a significant role in promoting vaccine acceptance by framing the health response in moral terms. Research Implications and Contributions: This research highlights the importance of integrating religious values into public health policy, particularly in global health contexts. Vaccine diplomacy rooted in moral solidarity and universal ethical principles, aligned with religious values, has the potential to enhance international cooperation and reduce vaccine hesitancy. Thus, this study contributes to understanding how religion and public policy can collaborate effectively in addressing global health challenges.

Speech-language pathology telementoring projects in global health contexts: Partnerships, payoffs and progression

Speech-language pathology telementoring projects in global health contexts: Partnerships, payoffs and progression

The Role of Artificial Intelligence in the Primary Prevention of Common Musculoskeletal Diseases.

Musculoskeletal disorders (MSDs) are a leading cause of disability worldwide, with a growing burden across all demographics. With advancements in technology, conversational artificial intelligence (AI) platforms such as ChatGPT (OpenAI, San Francisco, CA)have become instrumental in disseminating health information.This study evaluated the effectiveness of ChatGPT versions 3.5 and 4 in delivering primary prevention information for common MSDs, emphasizing that the study is focused on prevention and not on diagnosis. This mixed-methods study employed the CLEAR tool to assess the quality of responses from ChatGPT versions in terms of completeness, lack of false information, evidence support, appropriateness, and relevance. Responses were evaluated independently by two expert raters in a blinded manner. Statistical analyses included Wilcoxon signed-rank tests and paired samples t-tests to compare the performance across versions. ChatGPT-3.5 and ChatGPT-4 effectively provided primary prevention information, with overall performance ranging from satisfactory to excellent. Responses for low back pain, fractures, knee osteoarthritis, neck pain, and gout received excellent scores from both versions. Additionally, ChatGPT-4 was better than ChatGPT-3.5 in terms of completeness (p = 0.015), appropriateness (p = 0.007), and relevance (p = 0.036), and ChatGPT-4 performed better across most medical conditions (p = 0.010). ChatGPT versions 3.5 and 4 are effective tools for disseminating primary prevention information for common MSDs, with ChatGPT-4 showing superior performance. This study underscores the potential of AI in enhancing public health strategies through reliable and accessible health communication. Advanced models such as ChatGPT-4 can effectively contribute to the primary prevention of MSDs by delivering high-quality health information, highlighting the role of AIs in addressing the global burden of chronic diseases. It is important to note that these AI tools are intended for preventive education purposes only and not for diagnostic use. Continuous improvements are necessary to fully harness the potential of AI in preventive medicine. Future studies should explore other AI platforms, languages, and secondary and tertiary prevention measures to maximize the utility of AIs in global health contexts.

A Holistic In Silico and In Vivo Approach to Exploring the Antidiabetic, Antioxidant, and Hepatoprotective Properties of Rose of Sharon.

Diabetes mellitus (DM) is a significant global health burden that necessitates the exploration of effective and accessible therapeutic options. Phytotherapy has played a vital role in healthcare, with plant extracts being integral to traditional medicinal practices. The therapeutic potential of Hibiscus syriacus (Rose of Sharon), a plant with a rich ethnobotanical history, in the management of DM and its associated complications was investigated. In this study, the therapeutic potential of Hibiscus syriacus L. extract (HSE) against DM in streptozotocin (STZ)-induced diabetic rats was assessed, focusing on its effects on glucose regulation, antioxidative defense, and liver protection. The administration of the HSE extract substantially reduced hyperglycemia and increased insulin production, with concurrent improvements in body weight and hydration. The enhanced activity of antioxidant enzymes, such as superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), suggests reduced oxidative stress, which is further supported by molecular docking results with the 3GTV superoxide dismutase enzyme, showing a binding energy of -6.3 kcal/mol. A decrease in MDA levels also indicates a reduction in oxidative stress. Notably, HSE treatment led to decreased aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels and improved lipid profiles, indicating its hepatoprotective and lipid-modifying benefits. These findings support the inclusion of HSE as an adjunctive therapy in DM management strategies. This study promotes the consideration of Hibiscus syriacus L. therapeutic properties in global health contexts.

Do No Harm in Global Health Engagement.

This manuscript examines the principle of "Do No Harm" in DoD Global Health Engagement (GHE) efforts. It highlights the potential positive and negative consequences of health investments and explores how unintentional harm is addressed in a global health context. The manuscript also discusses the involvement of the U.S. military in global health and the concept of dual loyalty faced by military GHE practitioners. The goal is to understand the challenges of doing no harm and identify methods to mitigate or avoid unintended negative consequences in DoD GHE activities.

Neglected Tropical Diseases and Long-Term Captive Animals: Ethical Considerations with Venom Lab Snakes

Abstract Venomous snakebite is a neglected tropical disease and disease of poverty, affecting hundreds of thousands of people annually. The only effective medical intervention for snakebite is antivenom, produced primarily using captive venomous snakes as a source of venom. This paper analyzes snakes’ welfare at venom labs within this global health context. I recommend significant changes to improve the welfare of captive snakes, particularly in light of recent ethological research and attention on snakes. These recommendations are broadly consequentialist, aiming to improve the lives of the snakes and ensure that people have increased access to affordable antivenom.

LEADERSHIP IN GLOBAL HEALTH: NAVIGATING CHALLENGES AND OPPORTUNITIES FOR IMPACTFUL OUTCOMES IN AFRICA AND SRI LANKA

Effective leadership is paramount in addressing the complex challenges and harnessing the opportunities in global health, particularly in regions such as Africa and Sri Lanka. This review explores the multifaceted dimensions of leadership within the context of global health, highlighting the unique challenges and opportunities faced by these regions. In Africa, leadership in global health is confronted with a myriad of challenges including limited resources, political instability, and infrastructural deficiencies. The burden of infectious diseases, inadequate healthcare access, and socio-economic disparities further exacerbate the complexities. However, amidst these challenges lie opportunities for transformative leadership. Visionary leaders can leverage partnerships, innovative technologies, and community engagement to strengthen health systems, promote preventive healthcare, and address the root causes of health inequities. Similarly, in Sri Lanka, leadership in global health faces its own set of challenges and opportunities. Despite notable achievements in healthcare infrastructure and disease control, the country grapples with emerging health threats, non-communicable diseases, and disparities in healthcare access. Effective leadership is essential in mobilizing resources, fostering intersectoral collaboration, and implementing evidence-based interventions to ensure equitable health outcomes for all segments of the population. In both regions, transformative leadership in global health necessitates a multidisciplinary approach that integrates political commitment, scientific innovation, and community participation. Leaders must possess strong communication skills, cultural competence, and a deep understanding of local contexts to navigate the intricate socio-political landscapes. Furthermore, fostering leadership capacity at all levels of the healthcare system is crucial for sustainability and resilience in the face of evolving health challenges. By examining the challenges and opportunities for leadership in global health within the contexts of Africa and Sri Lanka, this review underscores the importance of visionary leadership in driving impactful outcomes. Empowering leaders to navigate complexities, foster collaboration, and innovate solutions is essential for advancing the global health agenda and achieving health equity on a global scale.
 Keywords: Leadership, Global Health, Africa, Sri Lanka, Healthcare, Review

Breast cancer prediction: a CNN approach

Detecting breast cancer promptly holds utmost importance in ensuring effective treatment, as it is a matter of great concern in the global health context. The primary objective of this research endeavor is to enhance the process of breast cancer identification through the utilization of a Convolutional Neural Network (CNN). The purpose of this study is to mitigate potential errors in human interpretation of mammograms by comparing this approach to conventional machine-learning techniques. In our present investigation on breast imaging, we have leveraged the well-established mammographic dataset, CBIS-DDSM. This dataset effectively categorizes the images into three distinct classes: normal, benign, or malignant. This compilation encompasses a grand sum of 10,239 images. A myriad of approaches were employed to arrange the content, including the manipulation of the image dimensions to a size of 256x256 pixels. A CNN architecture that was specifically crafted was educated through the fusion of backpropagation and angle plunge techniques. Numerous measures, such as sensitivity, specificity, F1 score, and accuracy, were deftly utilized to thoroughly assess the model's effectiveness. It is truly awe-inspiring to witness the outstanding exhibition of performance showcased by the CNN model, as evidenced by the extraordinary values attained for sensitivity, specificity, F1 score, total precision, and accuracy, all of which are undeniably remarkable. These evaluations undeniably serve as irrefutable evidence that the model possesses exceptional diagnostic capabilities, surpassing even the most advanced techniques currently in use. In truth, the model's performance is so exceptional that it has firmly established itself as a pioneering force in the field, leaving other techniques astounded and trailing far behind, in utter admiration of its immense potential and resounding success. This research elucidates the ability of Convolutional Neural Networks (CNNs) to mechanize and enhance the identification of breast cancer in mammographic images. The findings bring to light a captivating realm for forthcoming exploration, potentially fostering advancements in screen layout and the integration of more easily navigable diagnostic functionalities.

Key strategies for improving physical activity of the population within a global dimension

Topicality. As a result of the war before Ukraine has faced extremely difficult challenges. General situation remains dynamic and unstable. Based on research results it is determined that a lot of things, in particular, direction and pace of further transformations in Ukraine in the post-war period, depend on the level and quality of life of the population. The quality of life in the human health context is determined by certain factors, among which the physical activity is as the leading one. Its lack is considered as the fourth leading factor risk of global mortality. The purpose of the study is to carry out an analysis of the international key strategies experience for improving physical activity of the working-age population. Methodology. A semantic bibliography method followed by content analysis of research papers and e-resources have been used. The research novelty. Investigating the negative impact of physical activity lack on public health, World Health Organization (WHO) and the European Union (EU) reported global efforts to improve the situation by developing national programs and recommendations on the issue of increasing the levels of physical activity and reducing a sedentary lifestyle. Most of the member states already have, or currently have, physical activity recommendations, or some of them are being at the development stage. Key findings. There is a general trend the use of the WHO Global Recommendations, which indicates a common scientific consensus on the importance of physical activity and sustainable nature of these recommendations in the global health context. In addition, coordination of national health monitoring programs will allow monitor progress towards both national and global goals of physical activity and reduction of the sedentary lifestyle. It a significant component of assessment the effectiveness of national view and programs on solving issues related to the health of the nation.

New Picture Stimuli for the NIH Stroke Scale: A Validation Study.

The National Institutes of Health Stroke Scale is a widely accepted tool for structured graded neurological examination of stroke or suspected stroke in the hyperacute setting. Concerns have arisen about the use of its picture stimuli in a contemporary and global health context. Here, we present new stimuli prepared to serve the needs of stroke providers worldwide: the precarious painter image description and updated objects for naming. This was a validation study of 101 healthy fluent English speakers. Participants were reached by the Johns Hopkins Outpatient Center, the University of South Carolina, and Prisma Health from 2022 to 2023 and included residents of the United States, Germany, Canada, the United Kingdom, Australia, and Zambia. Participants were recorded in person or via video conferencing when asked to describe the new picture, while a subset named seven illustrations. Multivariate analyses of variance were used for primary analyses. In a complementary investigation, 299 attendees of the 2023 International Stroke Conference were asked about their preference for the existing or new stimuli and why. Each of the 44 content units from the picture description was included by at least 5% of respondents in the demographically representative subsample. Performance was similar across healthy participants irrespective of age, sex, race, ethnicity, or education. Typical descriptions were characterized by an average of 23 content units (SD=5) conveyed with 167 syllables (SD=79). The new naming stimuli were recognized by 100% of participants from many countries as being familiar and identifiable, and names provided in response to the task were highly convergent. The majority of stroke health care providers preferred both the precarious painter and naming stimuli. The description of the new National Institutes of Health Stroke Scale picture, the precarious painter, results in rich samples among healthy speakers that will provide an appropriate basis for the detection of language deficits.

Ethical Frameworks and Global Health: A Narrative Review of the "Leave No One Behind" Principle.

The "Leave No One Behind" (LNOB) principle, a fundamental commitment of the United Nations' Sustainable Development Goals, emphasizes the urgent need to address and reduce global health inequalities. As global health initiatives strive to uphold this principle, they face significant ethical challenges in balancing equity, resource allocation, and diverse health priorities. This narrative review critically examines these ethical dilemmas and their implications for translating LNOB into actionable global health strategies. A comprehensive literature search was conducted using PubMed, Scopus, Web of Science, and Semantic Scholar, covering publications from January 1990 to April 2024. The review included peer-reviewed articles, gray literature, and official reports that addressed the ethical dimensions of LNOB in global health contexts. A thematic analysis was employed to identify and synthesize recurring ethical issues, dilemmas, and proposed solutions. The thematic analysis identified 4 primary ethical tensions that complicate the operationalization of LNOB: (1) Universalism versus Targeting, where the challenge lies in balancing broad health improvements with targeted interventions for the most disadvantaged; (2) Resource Scarcity versus Equity; highlighting the ethical conflicts between maximizing efficiency and ensuring fairness; (3) Top-down versus Bottom-up Approaches, reflecting the tension between externally driven initiatives and local community needs; and (4) Short-term versus Long-term Sustainability, addressing the balance between immediate health interventions and sustainable systemic changes. To navigate these ethical challenges effectively, global health strategies must adopt a nuanced, context-sensitive approach incorporating structured decision-making processes and authentic community participation. The review advocates for systemic reforms that address the root causes of health disparities, promote equitable collaboration between health practitioners and marginalized communities, and align global health interventions with ethical imperatives. Such an approach is essential to truly operationalize the LNOB principle and foster sustainable health equity.

Social Dimensions of Antimicrobial Resistance and an Anthropological Approach: Analytic Review

Purpose: The objective of this paper is to devise a comprehensive and layered framework to tackle antimicrobial resistance (AMR). It aims to weave together the strands of ethnomedicine, healthcare system analysis, and anthropological perspectives on illness, aligning with universal healthcare principles to encourage community participation and address the societal roots of health inequalities. The framework seeks to address AMR through a lens that views health disparities not merely as medical issues, but as complex phenomena shaped by cultural, social, and structural factors.
 Methodology: The research employs a single-case study design to synthesize and analyse interdisciplinary insights into AMR. This approach facilitates an in-depth understanding of how various elements, such as cultural beliefs, healthcare practices, and community dynamics, interact and influence the spread and management of AMR. By focusing on a single case, the study intends to meticulously document and interpret the nuanced interactions between these factors, providing a detailed narrative that captures the essence of the AMR challenge in a global health context. The study utilizes 66 varied references, such as journal articles, book excerpts, theses, reports, and websites, sourced from academic venues and the internet, published between 1946 and 2023.
 Findings: Through its investigation, the study presents a healthcare approach that marries the traditional wisdom of ethnomedicine with the precision of biomedicine, underscoring the significance of cultural competence in formulating AMR mitigation strategies. It dissects the intricate relationship between the three primary health sectors—popular, professional, and folk—and disentangles the sociocultural concepts of 'disease' and 'illness' as distinguished by medical anthropologists. The research calls for a reconceptualization of healthcare systems that goes beyond the biomedical model, advocating for an integration of the sociocultural, economic, and political dimensions that influence health and illness manifestations.
 Unique contribution to theory: This study's unique theoretical contribution lies in its interdisciplinary approach to health disparities and AMR. It proposes a model that balances the rigor of scientific research with the insights gleaned from traditional health practices, placing a premium on the dynamics of community involvement and the myriad influences on health. By doing so, it offers a more equitable, sustainable, and contextually relevant paradigm for health practices and policies. This paradigm shift is intended to provide actionable insights for policymakers and health practitioners, enabling them to devise strategies that are not only scientifically sound but also culturally sensitive and broadly applicable. The framework envisages a future where health interventions are tailored to the lived experiences of diverse populations, potentially transforming the landscape of global health and AMR strategy.

Spina Bifida Global Learning Collaborative: Educating the next generation of clinicians, researchers, and advocates.

This project aimed to launch an international learning community to guide the development of a spina bifida (SB) curriculum for global health trainees. Using a descriptive study design, a convenience sample of SB curricula were identified in 2022-23 by members of the Spina Bifida World Congress Outreach Committee and evaluated during a series of monthly Zoom calls to discuss SB education in a global health context. Participants included (1) leadership from the ReachAnother Foundation, (2) invited panelists from the Spina Bifida World Congress Global Health Symposium, and (3) global health students and preceptors. Education initiatives in Ethiopia, Sweden, Argentina, Ecuador, and the United States were evaluated vis-à-vis format and content. All of the education initiatives referenced the framework of the World Health Organization International Classification of Functioning, Disability and Health. Formats varied and included both virtual and interactive workshops, print materials, videos, and guides for small group discussion. Content addressed four domains: Folate Prevention, Neurosurgical Training, After Care, and Data Collection. A multidisciplinary approach, partnerships with families, and workforce pipeline training were identified as guiding themes for educating the next generation of SB researchers and clinicians in global health settings. The Spina Bifida Global Learning Collaborative is a transnational group of advocates, clinicians, and investigators whose mission is the advancement of SB-related global health education. Lessons learned from the collaborative are being leveraged to develop a global health curriculum for learners, which may improve services for individuals with SB around the globe.

Hypertensive supratentorial intracerebral hemorrhage: clinical picture, diagnosis, treatment

Background. The paper analyzed the severity and prevalence of hypertensive supratentorial intracerebral hemorrhages (ICH). This pathology is an urgent problem in the global health context, as it leads to severe consequences, including disability and death of patients. Recent discoveries and clinical guidelines provide physicians and researchers with new opportunities to improve clinical practice and improve the effectiveness of treatment for these complications. An increase in the number of cases of hypertensive supratentorial intracerebral hemorrhages and their impact on public health makes this problem extremely relevant in the field of medicine. Materials and methods. Two hundred and thirty-two patients with supratentorial intracerebral hemorrhages caused by hypertension were examined and treated in 2019–2020 at the Kyiv City Clinical Emergency Hospital. The average age of patients was 60 years: for men, it was 56 years, for women 69 years. They were observed during treatment in the hospital for up to 21 days. On the 21st day, the degree of disability was assessed. All patients underwent a neurological examination with an assessment of consciousness according to the Glasgow Coma Scale, Intracerebral Hemorrhage Score, Barthel index, modified Rankin scale, National Institutes of Health Stroke Scale (NIHSS). We have used neuroimaging methods (computed tomography, magnetic resonance angiography, if necessary). Clinical and laboratory studies were conducted. Results. It was found that 127 (57 %) patients had putaminal supratentorial hemorrhage, 24 (10 %) — thalamic, 34 (15 %) — subcortical (in the white matter of the cerebral hemispheres), 47 (20 %) — mixed. Seventy-seven (33 %) patients were hospitalized in a coma (Glasgow Coma Scale ≤ 8 points), 36 (16 %) in a sopor, 81 (35 %) in a stunned state, and 31 (13 %) patients were conscious. Patients over 60 years of age had ICH of deep localization, while young patients had cortical ones. Ninety-four surgical interventions were performed in 84 patients with lobar and lateral hematomas, as well as with breakthrough into the ventricular system (liquid drainage surgery). General mortality was 39.5 %, surgical — 46.4 %. Contraindications for surgical interventions were as follows: an existing severe coma, unstable hemodynamics, the need for constant administration of vasopressors, as well as severe comorbid conditions. Conclusions. It was found that the clinical picture of acute supratentorial intracerebral hemorrhages against the background of hypertension is characterized by polymorphic neurological symptoms according to the localization of the hematoma, its volume, cerebral edema, and intracranial hypertension. The results of the treatment of patients with hypertensive ICH indicate the need for early hospitalization, early computed tomography scan, and a differentiated approach to surgical removal of the hematoma. The favorable outcome of supratentorial ICH is more typical for patients with initial mild and moderate neurological symptoms in case of a hemorrhage volume of less than 30 cm3. The presence of blood breakthrough into the ventricular system increases the risk of death by 35 times.

Advancements in Rapid and Affordable Diagnostic Testing for Respiratory Infectious Diseases: Evaluation of Aptamer Beacon Technology for Rapid and Sensitive Detection of SAR-CoV-2 in Breath Condensate.

The demand for rapid and efficient diagnostic point-of-care tests for respiratory infectious diseases has become increasingly critical in the current landscape. The emphasis on accessibility has been underscored over the past year, making it crucial to have biological components that exhibit fast and accurate kinetics. The foundation for precise, swift, and effective testing relies on the availability of highly responsive biological agents. Two published aptamer DNA sequences designated Song and MSA52 and their truncated internal stem-loop structures were studied for their potential to serve as aptamer beacons for rapid COVID detection. The candidate beacons were covalently labeled with Atto 633 dye attached to their 5' ends and Iowa Black quencher attached to their 3' ends. The whole aptamer structures exhibited the greatest fluorescence signal intensities and higher fluorescence background than their truncated internal stem-loop beacon structures suggesting that the distance between fluorophores and quenchers was greater for the whole aptamer beacon candidates versus the isolated stem-loop structures. Beacon candidates were tested against two heat- or gamma radiation-killed SARS-CoV-2 Washington 1/2020 virus samples and three different COVID spike (S) proteins to test their effectiveness. Despite the higher background fluorescence, the whole aptamer beacons showed better signal-to-noise ratios and were selected for further investigation. Limit of detection (LOD) studies revealed that both the whole Song and whole MSA52 aptamer beacon candidates had a LOD of 9.61 × 103 genome equivalents in phosphate-buffered saline using the red channel of a Promega Quantus™ fluorometer which correlated well with confirmatory spectrofluorometry. Cross-reactivity studies using numerous COVID variants, related coronaviruses, and other common respiratory pathogens suggested greater COVID selectivity for the whole MSA52 versus the whole Song aptamer beacon candidate, indicating promise for specific COVID detection. Importantly, both whole aptamer beacon candidates exhibited very rapid "bind and detect" fluorescence increases within the first 1-2min of mixing the beacons with killed SARS-CoV-2 viruses in 100µl samples. Overall, this work illustrates the strong potential for aptamer beacons for rapid, on-site detection and presumptive diagnosis of COVID in breath condensates or other small liquid samples. This research highlights the strong potential of aptamer beacons for addressing the need for fast and convenient diagnostic tools in global health contexts, especially in resource-limited settings.

From Reward to Anhedonia-Dopamine Function in the Global Mental Health Context.

When "hijacked" by compulsive behaviors that affect the reward and stress centers of the brain, functional changes in the dopamine circuitry occur as the consequence of pathological brain adaptation. As a brain correlate of mental health, dopamine has a central functional role in behavioral regulation from healthy reward-seeking to pathological adaptation to stress in response to adversity. This narrative review offers a spotlight view of the transition from healthy reward function, under the control of dopamine, to the progressive deregulation of this function in interactions with other brain centers and circuits, producing what may be called an anti-reward brain state. How such deregulation is linked to specific health-relevant behaviors is then explained and linked to pandemic-related adversities and the stresses they engendered. The long lockdown periods where people in social isolation had to rely on drink, food, and digital rewards via the internet may be seen as the major triggers of changes in motivation and reward-seeking behavior worldwide. The pathological adaptation of dopamine-mediated reward circuitry in the brain is discussed. It is argued that, when pushed by fate and circumstance into a physiological brain state of anti-reward, human behavior changes and mental health is affected, depending on individual vulnerabilities. A unified conceptual account that places dopamine function at the centre of the current global mental health context is proposed.

Artificial intelligence-based computer aided detection (AI-CAD) in the fight against tuberculosis: Effects of moving health technologies in global health

Computer Aided Detection software based on Artificial Intelligence (AI-CAD), combined with chest X-rays have recently been promoted as an easy fix for a complex problem: ending TB by 2030. WHO has recommended the use of such imaging devices in 2021 and many partnerships have helped propose benchmark analysis and technology comparisons to facilitate their “market access”.Our aim is to examine the socio-political and health issues that stem from using AI-CAD technology in a global health context conceptualized as a set of practice and ideas organizing global intervention “in the life of others”. We also question how this technology, which is not yet fully implemented in routine use, may limit or amplify some inequalities in the care of tuberculosis. We describe AI-CAD through Actor-Network-Theory framework to understand the global assemblage and composite activities associated with detection through AI-CAD, and interrogate how the technology itself may consolidate a specific configuration of “global health”.We explore the various dimensions of AI-CAD “health effects model”: technology design, development, regulation, institutional competition, social interaction and health cultures. On a broader level, AI-CAD represents a new version of global health's accelerationist model centered on “moving and autonomous-presumed technologies”.We finally present key aspects in our research which help discuss the theories mobilized: AI-CAD ambivalent insertion in global health, the social lives of its data: from efficacy to markets and AI-CAD human care and maintenance it requires. We reflect on the conditions that will affect AI-CAD use and its promises. In the end, the risk of new detection technologies such as AI-CAD is indeed that the fight against TB could be reduced to one that is purely technical and technological, with neglect to its social determinants and effects.

Antimicrobial Resistance in the Global Health Network: Known Unknowns and Challenges for Efficient Responses in the 21st Century.

Antimicrobial resistance (AMR) is one of the Global Health challenges of the 21st century. The inclusion of AMR on the global map parallels the scientific, technological, and organizational progress of the healthcare system and the socioeconomic changes of the last 100 years. Available knowledge about AMR has mostly come from large healthcare institutions in high-income countries and is scattered in studies across various fields, focused on patient safety (infectious diseases), transmission pathways and pathogen reservoirs (molecular epidemiology), the extent of the problem at a population level (public health), their management and cost (health economics), cultural issues (community psychology), and events associated with historical periods (history of science). However, there is little dialogue between the aspects that facilitate the development, spread, and evolution of AMR and various stakeholders (patients, clinicians, public health professionals, scientists, economic sectors, and funding agencies). This study consists of four complementary sections. The first reviews the socioeconomic factors that have contributed to building the current Global Healthcare system, the scientific framework in which AMR has traditionally been approached in such a system, and the novel scientific and organizational challenges of approaching AMR in the fourth globalization scenario. The second discusses the need to reframe AMR in the current public health and global health contexts. Given that the implementation of policies and guidelines are greatly influenced by AMR information from surveillance systems, in the third section, we review the unit of analysis ("the what" and "the who") and the indicators (the "operational units of surveillance") used in AMR and discuss the factors that affect the validity, reliability, and comparability of the information to be applied in various healthcare (primary, secondary, and tertiary), demographic, and economic contexts (local, regional, global, and inter-sectorial levels). Finally, we discuss the disparities and similarities between distinct stakeholders' objectives and the gaps and challenges of combatting AMR at various levels. In summary, this is a comprehensive but not exhaustive revision of the known unknowns about how to analyze the heterogeneities of hosts, microbes, and hospital patches, the role of surrounding ecosystems, and the challenges they represent for surveillance, antimicrobial stewardship, and infection control programs, which are the traditional cornerstones for controlling AMR in human health.

Using functional near-infrared spectroscopy to study the early developing brain: future directions and new challenges.

Functional near-infrared spectroscopy (fNIRS) is a frequently used neuroimaging tool to explore the developing brain, particularly in infancy, with studies spanning from birth to toddlerhood (0 to 2 years). We provide an overview of the challenges and opportunities that the developmental fNIRS field faces, after almost 25 years of research. We discuss the most recent advances in fNIRS brain imaging with infants and outlines the trends and perspectives that will likely influence progress in the field in the near future. We discuss recent progress and future challenges in various areas and applications of developmental fNIRS from methodological and technological innovations to data processing and statistical approaches. The major trends identified include uses of fNIRS "in the wild," such as global health contexts, home and community testing, and hyperscanning; advances in hardware, such as wearable technology; assessment of individual variation and developmental trajectories particularly while embedded in studies examining other environmental, health, and context specific factors and longitudinal designs; statistical advances including resting-state network and connectivity, machine learning and reproducibility, and collaborative studies. Standardization and larger studies have been, and will likely continue to be, a major goal in the field, and new data analysis techniques, statistical methods, and collaborative cross-site projects are emerging.