The accumulation of potentially toxic elements (PTEs) in agricultural soils poses significant risks to food safety and ecosystem health, necessitating rapid and cost-effective monitoring approaches. While inductively coupled plasma optical emission spectroscopy (ICP-OES) provides accurate PTE quantification, its high cost, time requirements, and chemical reagent necessitate the search for green, fast, robust, and cost-effective alternatives. This study aims to evaluate the suitability of mid-infrared Fourier transform infrared (MIR-FTIR) spectroscopy combined with partial least squares regression (PLSR) as an alternative rapid method for predicting PTE concentrations and calculating pollution indices in semi-arid agricultural soils of central Morocco. A total of 67 surface soil samples (0–20 cm) were collected from three distinct soil types: Lithic Calciustolls (n=23), Typic Haplusterts (n=23), and Typic Calciustolls (n=21). Ten PTEs (As, Ba, Cd, Cu, Mn, Pb, Se, Sr, Ti, and Zn) were measured by ICP-OES and predicted using MIR-FTIR (4000–400 cm −1 ) coupled with PLSR. Mean PTE concentrations varied substantially across soil types, with Cd ranging from 0.95 to 3.91 mg·kg −1 , Sr from 56.25 to 535.14 mg·kg −1 , and Zn from 38.23 to 59.63 mg·kg −1 . PTE Pollution Index (PI) was calculated using both datasets for comparative pollution assessment. Results demonstrated strong to excellent predictive performance (R² = 0.82-0.95) with the highest correlations for Ba, Zn, and Sr. PI calculations showed exceptional concordance between methods (mean PI: 1.54 for both), with all samples classified as low pollution. FTIR spectroscopy maintains the same geochemical relationships as ICP-OES (correlation differences <0.083), confirming method equivalence for soil pollution indexation. This approach offers significant advantages for large-scale monitoring programs while maintaining classification accuracy for environmental risk assessment.

School-based caries prevention programs are clinically and cost-effective public health approaches to increase access to essential oral healthcare for high-risk children. However, approximately 1 in 4 children participating in school caries prevention fail to respond to care, remaining at risk for dental caries and related sequela. The Building Adaptive School-based Interventions for Caries study (BASICS) will develop and test adaptive preventive interventions using a Sequential, Multiple Assignment, Randomized Trial (SMART) design, reducing treatment nonresponse by incorporating personalized medicine into school caries prevention. Children will receive a first-stage treatment of either silver diamine fluoride or glass ionomer dental sealants and atraumatic restorations. At subsequent observations, the primary outcome of reoccurrence or new presentation of dental caries will be used as a tailoring variable for treatment nonresponse. Nonresponsive participants in either first-stage pathway will subsequently receive either (1) reapplication of initial treatment plus fluoride varnish and receipt of an electronic toothbrush or (2) an intensified Silver Modified Atraumatic Restorative Technique. The targeted enrollment is 1200 children from primarily low-income rural families enrolled in kindergarten through third grades in public primary schools. Primary study objectives of BASICS include determining the most effective initial treatment for caries prevention and sequence of treatments to reduce nonresponse, identifying the optimal dynamic treatment regime given patient attributes, and estimating the most cost-efficient allocation of resources for adaptive school-based caries prevention. If successful, BASICS will result in a resource-efficient approach to school dental care that optimizes resources matched to patient needs. ClinicalTrials.gov #NCT07265830, Registered on 12/4/25. https://www. gov/study/NCT07265830.

Marijuana use in the United States (U.S.) has diversified alongside expanding legalization, yet little is known about the psychosocial factors that distinguish medical from recreational use. This study examined whether psychological distress mediates the association between perceived social isolation (i.e., loneliness) and marijuana use type among U.S. adults. We analyzed cross-sectional, nationally representative data from the 2024 Health Information National Trends Survey (HINTS, cycle 7). Marijuana use was categorized as medical (including medical and both medical/recreational) versus recreational. Perceived social isolation was measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) Social Isolation t-score, and psychological distress was assessed with the Personal Health Questionnaire (PHQ)-4. Survey-weighted descriptive analyses and a weighted structural equation mediation model accounting for the complex sampling design were conducted. Medical marijuana users reported significantly higher levels of psychological distress and perceived social isolation than recreational users. Greater social isolation was strongly associated with higher psychological distress, and higher distress was associated with a greater likelihood of medical (vs. recreational) marijuana use. The indirect effect of social isolation on marijuana use type through psychological distress was statistically significant, while the direct effect of social isolation was not significant after accounting for distress. Overall, greater perceived social isolation predicted medical marijuana use primarily through elevated psychological distress. These findings suggest that medical marijuana use among U.S. adults may reflect coping with psychological distress linked to social disconnection, underscoring the importance of integrating mental health and social context into clinical and public health approaches to cannabis use.

Little is known about predictors of housing instability for young adults participating in a Boston-area rapid rehousing program over the course of 1 year. We analyzed de-identified data from young adults enrolled in a rapid rehousing program between April 2020 and March 2022. The primary outcome was housing success, defined as acquiring independent housing or securing a second-year rapid rehousing lease. Mental health, substance use, service utilization, employment, experiences of interpersonal violence, and pregnancy were collected at baseline and at 3-month intervals for 1 year. Data were analyzed for 104 young adults, comprising primarily of transition-age youth (M = 21.2 years) of color (86.5%) with histories of interpersonal violence exposure (51.9%) and high rates of past-month cannabis use (72.1%). Approximately two thirds (64.4%) of participants had a successful housing outcome at 1 year. A total of 24.5% (13/53) of participants who were female at birth became pregnant after being enrolled in rapid rehousing, and 100% of females at birth who became pregnant experienced interpersonal violence during rapid rehousing. Multiple logistic regression analyses identified days of cannabis use in the 30 days prior to baseline and the experience of interpersonal violence or becoming pregnant during rapid rehousing as independent predictors of unsuccessful housing outcome. Results suggest the value of integrating evidence-based approaches for substance use, relational trauma, and reproductive health into rapid rehousing programs for young adults. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

This article focuses on the biosocial perspective in criminology. Its purpose is to highlight public health approaches on biosocial interactions that can be drawn from to develop more theorization on the social environment and to provide new possibilities in studying how socio-environmental macro–micro characteristics interact with neurobiology in developing antisocial, violent, and criminal behaviors. Extant biosocial research in criminology examines and understands the social environment as characteristics proximal to the individual, more so than those that are distal. Examples of proximal level characteristics are family, education, or individual socioeconomic status and examples of distal level ones are income inequality and institutional racial discrimination. Although the field of criminology traces the history of the biosocial perspective to Cesare Lombroso, the concept of “biosocial” and its onto-epistemological approach is also linked to that of public health. In relinking criminological biosocial research to public health, this article highlights how trends within the latter may have shaped the former; and in relinking, the article also provides “ways of seeing” the role of distal level social factors in biosocial interactions from three public health theoretical frameworks and constructs: Nancy Krieger’s embodiment from ecosocial theory; Merrill Singer’s syndemics ; and Johan Galtung’s structural violence .

United we stand, divided we fall: Strengthening clinical alliances between human and veterinary medicine to tackle global priority antimicrobial-resistant bacterial pathogens.

Floods are among the most frequent and complex climate-related hazards, affecting health and health systems through infectious disease risks, water and chemical contamination, and disruption of essential services. Examining how international guidance reflects the operational realities of flood response, and how it supports countries in practice, is essential. While each event is unique, sharing experiences can strengthen preparedness and resilience. This paper draws lessons from an assessment of the response measures used during the 2023 floods in Greece. The coordination team rapidly adapted existing structures for infectious disease surveillance, vaccination and water quality monitoring to an emergency response of exceptional scale. To track flood-related diseases, the coordination team reconfigured syndromic surveillance tools initially designed for refugee camps, and compared proportional morbidity with baseline data to provide early warnings. The team also implemented multiplex polymerase chain reaction diagnostics and mobile vaccination campaigns targeting high-risk groups. Risk communication and community outreach combined repurposed materials with new flood-specific guidance. While there were no outbreaks of gastroenteritis, respiratory infections or mosquito-borne diseases, 45 leptospirosis cases and one fatal non-toxigenic Vibrio cholerae infection highlighted the need for sustained vigilance. The lessons learnt indicate that preparedness relies on flexible adaptation of existing systems, cross-governmental coordination and active community engagement. Gaps in global and regional guidance, especially regarding laboratory diagnosis, safe water restoration and chemical safety monitoring, complicate field decision-making. Strengthening international frameworks, embedding flood preparedness within climate adaptation strategies and applying One Health approaches are therefore critical to ensure health system resilience as flood events become increasingly frequent and severe.

One Health perspective: an integrated in-silico approach to assess the environmental fate of pesticides, the exposure of aquatic and soil organisms and the risks for human health.

Africa has significant challenges in meeting its vaccination needs, including inadequate manufacturing capacity, infrastructure deficiencies, a scarcity of experienced personnel, regulatory hurdles, restricted access to technology and intellectual property. This review evaluates African vaccine manufacturing capacity, region-specific limitations, and highlights significant innovations and policy alternatives to promote vaccine autonomy and equitable public health results. A comprehensive narrative evaluation of the literature was done. We obtained prior papers from WHO publications, CDC publications, Google Scholar, Elsevier, PubMed, and EBSCOhost. The assessment examines the current status and future prospects of vaccine manufacturing in Africa, emphasizing obstacles, innovations, and possibilities. Africa's vaccine manufacturing capacity is constrained by limited production infrastructure, a shortage of skilled personnel, and inadequate technical resources. These challenges are compounded by financial constraints, heavy reliance on donor support, and restricted access to technology transfer. In remote regions, regulatory fragmentation and weak cold chain infrastructure further hinder vaccine distribution. Promising innovations such as mRNA platforms, heat-stable formulations, and microarray patches offer potential breakthroughs, but progress in scaling up manufacturing remains slow despite international partnerships and funding support. To achieve vaccine self-sufficiency, Africa must strengthen its research ecosystem, build a skilled workforce, and expand domestic manufacturing capabilities. Africa's vaccine manufacturing capacity is at an important phase, requiring coordinated efforts to overcome long-standing barriers. Investment in local vaccine facilities, skilled personnel development, and strong regulatory framework are essential. Strengthening international partnerships while fostering local innovations will lead to self-reliance. Emphasis on One Health approaches can enhance disease surveillance and control. Adequate funding and political will are indispensable for sustained progress.

Toward Eliminating Leishmaniasis as a Public Health Problem in Yemen: Advocating for a One Health Approach

Optimizing inpatient access to oral contraceptives: A quality improvement approach in behavioral health.

A multilevel clinic- and community-based intervention to increase COVID-19 vaccination among Latinos in San Diego County: Protocol description of the vaccine promotion program.

Understanding and preventing drug-related interpersonal violence in Ireland through a public health approach.

Global burden, inequalities and projections of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis, 1990-2050: A systematic global analysis.

Zoonotic tuberculosis (zTB), predominantly caused by Mycobacterium bovis, remains an underrecognized public health threat in many low- and middle-income countries. Although global estimates suggest that zTB accounts for approximately 1–1.5% of all human tuberculosis cases, limited molecular diagnostic capacity and underreporting likely obscure its true burden. In Southeast Asia, particularly Indonesia, increasing detection of bovine tuberculosis in dairy and beef production systems—combined with high rates of raw milk consumption, informal slaughtering practices, and weak intersectoral surveillance—may amplify the risk of human exposure. Co-infections in livestock, including mastitis and respiratory pathogens, further complicate clinical detection and may enhance bacterial shedding. This review synthesises global and national epidemiological patterns of zTB, describes major transmission pathways at the human–animal interface, and examines interactions between M. bovis infection and other livestock diseases. Critical gaps in diagnostics, surveillance integration, and food-safety regulation are identified. Strengthening One Health approaches through improved laboratory capacity, coordinated public–animal health systems, and enhanced risk mitigation along dairy and beef value chains is essential to reduce the burden of zTB in Indonesia.

Antimicrobial Stewardship Programs (ASPs) are a cornerstone strategy to mitigate the global threat of antimicrobial resistance (AMR), primarily driven by inappropriate antimicrobial use. ASPs aim to optimize antimicrobial therapy by ensuring appropriate indication, agent selection, dosing, route of administration, and duration of treatment. Through these interventions, ASPs improve clinical outcomes, reduce adverse drug events, decrease selective pressure for resistant organisms, and contribute to healthcare cost containment. Effective implementation requires a multidisciplinary approach involving physicians, pharmacists, microbiologists, nurses, and information technology specialists, and must be tailored to local epidemiology and healthcare system capacity in accordance with World Health Organization (WHO) recommendations. This narrative review describes the development and evolution of the national antimicrobial stewardship policy in Chile, based on a review of publications indexed in SciELO, official documents from the Ministry of Health (MINSAL), and relevant national legislation. In Chile, antimicrobial stewardship initiatives began in the late 1990s with regulatory measures mandating prescription-only dispensing of antimicrobials and the introduction of national technical standards for rational antimicrobial use. After that, Chile adopted a comprehensive One Health approach and implemented national AMR action plans aligned with WHO strategies. Substantial progress has been achieved across hospital, primary care, veterinary, and aquaculture settings, including expanded ASP coverage, strengthened regulatory frameworks, national surveillance systems for antimicrobial consumption and resistance, and incorporation of stewardship indicators into institutional performance metrics. Despite these advances, challenges related to workforce capacity, technological infrastructure, and long-term monitoring persist and must be addressed to further consolidate national ASP implementation.

Background. Self-congruency refers to the coherence between emotional experience (internal states) and enacted behavior (outward actions). Reduced self-congruency has been linked to vulnerability in mental health, yet its physiological correlates remain poorly characterized. Heart–brain temporal coupling may provide a candidate physiological marker of this psychological coherence. Methods. Thirty-eight healthy adults underwent resting-state functional magnetic resonance imaging while cardiac activity was simultaneously recorded using photoplethysmography to derive heart rate variability (HRV). Self-congruency was assessed using a graphic rating scale based on the spatial overlap between emotional experience and enacted behavior. Heart–brain temporal coupling between HRV and regional blood-oxygen-level-dependent (BOLD) signals was quantified using cross-covariance analysis across biologically plausible temporal shifts. Results. Heart–brain temporal coupling predominantly reflected brain-to-heart temporal ordering, particularly within regions central to the neurovisceral integration model, including the ventromedial prefrontal and anterior cingulate cortices. In contrast, higher self-congruency was associated with stronger heart-to-brain temporal coupling, notably within the right rostral middle frontal gyrus and supramarginal gyrus, regions implicated in emotion regulation and socio-emotional processing. Conclusions. While global heart–brain temporal coupling is dominated by top-down neural regulation, greater alignment between emotional experience and enacted behavior is associated with enhanced bottom-up cardiac temporal ordering on neural activity. These findings seem to identify a physiological–psychological axis that may inform original prevention-oriented approaches in mental health.

Large language models (LLMs) have emerged as powerful tools for analyzing and interpreting complex datasets. Recent studies demonstrate their potential to generate useful, personalized responses when provided with patient-specific health information that encompasses lifestyle, biomarkers, and context. As LLM-driven health applications are increasingly adopted, rigorous and efficient one-sided evaluation methodologies are crucial to ensure response quality across multiple dimensions, including accuracy, personalization, relevance and safety. However, current evaluation practices, particularly for open-ended text responses, heavily rely on human experts. This approach introduces human factors (perspectives, potential biases, inconsistencies) and is often cost-prohibitive, labor-intensive, and hinders scalability, especially in complex domains like healthcare where response assessment necessitates domain expertise and considers multifaceted patient data, which is often nuanced and diverse. In this work, we introduce Adaptive Precise Boolean rubrics: an evaluation framework that aims to streamline human and automated evaluation of open-ended questions by identifying critical gaps in model responses using a minimal set of targeted rubric questions. Our approach is based on recent work in more general evaluation settings that contrasts a smaller set of complex evaluation targets with a larger set of more precise, granular targets answerable with simple Boolean responses. We validate this approach in metabolic health, a domain encompassing diabetes, cardiovascular disease, and obesity. Our results demonstrate that Adaptive Precise Boolean rubrics yield substantially higher inter-rater agreement among both expert and non-expert human evaluators, as well as in automated assessments, compared to traditional Likert scales, while requiring approximately half the evaluation time of Likert-based methods. This enhanced efficiency and scalability, particularly through automated evaluation and non-expert contributions, paves the way for more extensive and cost-effective evaluation of LLMs in health.

The escalating pace of academic pressures and social life have intensified mental health challenges among college students, including widespread anxiety and depression. Non-pharmacological interventions, such as exercise therapy, have gained prominence, with 24-Style Tai Chi emerging as a promising mind-body exercise due to its simplicity and potential mental health benefits. However, its effectiveness across various promotion approaches in higher education settings remains underexplored. This study aimed to evaluate the impact of different 24-Style Tai Chi promotion methods (on-site, online, mixed, and independent practice) on college students' mental health, assess intervention efficacy, and identify an optimal promotion strategy. A randomized controlled trial (RCT) involving 250 college students from Shandong Sport University was conducted over 8 weeks. Participants were allocated to On-Site Promotion Group (Offline-PG), Online Promotion Group (Offline-PG), Mixed Promotion Group (MPG), Independent Practice Group (IPG), or Control Group (CG). Mental health was assessed using the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and General Self-Efficacy Scale (GSES) at baseline, 4 and 8 weeks, and follow-up. Data were analyzed using one-way ANOVA, repeated measures ANOVA (RM-ANOVA), and regression analysis to evaluate intervention effects and participation impacts. Offline-PG (90% attendance) and MPG (84% attendance) showed significant reductions in anxiety (SAS: Offline-PG 34.8 ± 6.3, MPG 36.2 ± 7.0, P < 0.01) and depression (SDS: Offline-PG 33.7 ± 6.9, MPG 34.9 ± 7.2, P < 0.05) by week 8. Online-PG (72% attendance) and MPG demonstrated significant self-efficacy improvements (GSES: Online-PG 36.1 ± 5.2, MPG 35.5 ± 5.6, P < 0.01). IPG (60% attendance) showed no significant changes. ANOVA revealed inter-group differences (SAS F = 6.45, P = 0.004; SDS F = 5.32, P = 0.009; GSES F = 6.74, P = 0.003), with RM-ANOVA confirming time effects. Regression analysis indicated participation strongly correlated with anxiety and depression reductions in Offline-PG (R = 0.62, P = 0.003) and MPG (R = 0.58, P = 0.004) and self-efficacy gains in Online-PG and MPG (R = 0.67, P = 0.002). 24-Style Tai Chi effectively improves college students' mental health, with on-site and mixed approaches excelling in reducing anxiety and depression, and online and mixed approaches enhancing self-efficacy. A hybrid promotion strategy is recommended to optimize participation and outcomes. Registration number: TCTR20250306005; https://thaiclinicaltrials.org/.

A growing body of research supports the efficacy of text messaging programs to help tobacco users quit, but texting as a strategy for recruiting tobacco users into other evidence-based cessation services, such as quitline coaching, is less well understood. Texting to offer treatment could increase use of cessation resources, an important consideration for health systems trying to improve their quality metric performance on tobacco assessment and counseling. The aim of this study is to compare the effects of text messages offering free quitline coaching or free nicotine patches on engagement with quitline services by patients identified in electronic health records as unassisted tobacco users. Participants (N=4171) were adult patients of Los Angeles County Department of Health Services who had had a clinical visit in the past 12 months, were willing to receive text messages, and were identified as unassisted tobacco users (ie, those with no documented advice or assistance to quit in the past 24 months). They included 3139 English speakers and 1032 Spanish speakers. Participants were stratified by language, then randomly assigned to one of two groups. Group 1 received a text offering free quitline coaching. Group 2 received a text offering free nicotine patches. The texts were sent in April and May 2022. Outcome measures were the proportions calling the quitline and receiving evidence-based cessation treatments. Data were analyzed in 2025. Overall, 1.5% (61/4171) of participants called the quitline, including 1.3% (28/2086) in Group 1 and 1.6% (33/2085) in Group 2, and 0.5% (21/4171) received treatment, including 0.4% (8/2086) in Group 1 and 0.6% (13/2085) in Group 2. There was no significant difference either in calls (P=.52) or receiving treatment (P=.29). However, Spanish speakers were significantly more likely to call than English speakers, 2.3% (24/1032) vs 1.2% (37/3139), respectively (P=.008), and engaged in treatment at approximately twice the rate of English speakers, 0.9% (9/1032) vs 0.4% (12/3139), although the latter difference was nonsignificant (P=.07). A single text was effective in connecting unassisted tobacco users with evidence-based quitline services for both English and Spanish speakers, but especially the latter. A population health approach of reaching out to tobacco-using patients outside clinical visits can meaningfully supplement provider referral. Research is needed on ways to increase the population health impact of this strategy.