Integrating HIV clinical records with population-based surveillance data allows the study of health care seeking behaviours, access to care, and predictors of patient outcomes. We implemented a graph-based record linkage algorithm to deduplicate and link HIV clinical and population-based surveillance records in an HIV-endemic setting in rural South Africa. We linked four data sources to create the Africa Health Research Institute (AHRI) Unified Data Platform: AHRI's Health and Demographic Surveillance System (HDSS), AHRI Clinic and Hospital Information System (AHRILink), National Health Laboratory Service (NHLS), and Three Integrated Electronic Registers (TIER.Net) HIV care and treatment records. HDSS data were collected between January 1, 2000, and July 31, 2024, through repeated household surveys of over 140,000 individuals. Clinical and laboratory data were obtained for one hospital and 17 clinics in Hlabisa, KwaZulu-Natal, covering the HDSS surveillance area. We implemented a probabilistic record linkage algorithm trained and validated on a subset of records with national identity numbers. We assessed linkage accuracy, computed descriptive statistics for the linked database, and estimated the HIV care cascade for this population. A total of 986,832 records were successfully linked across the four databases, achieving a sensitivity of 92.7% and a positive predictive value of 96.5% (F-score=0.95). The average number of records (standard deviation (SD)) in TIER.Net, HDSS, AHRILink and NHLS were 1.18 (0.44),1.05 (0.23),1.13 (0.40), and 5.21 (4.24), respectively. The linked data indicated that 12,293 HDSS resident adults (≥15 years) were living with HIV at some point during the 2022 and 2024 surveillance rounds. Of these, 10,622 (86.4%) had ever sought HIV care in the public sector, of whom 10,492 (98.8%) had ever started ART and 7,065 (66.5%) were currently on ART, of whom 6,301 (89.2%) were virally suppressed(viral load<200 copies/mL). HIV care and population surveillance records from four data sources were deduplicated and linked with high accuracy, revealing persistent gaps in retention in care and viral suppression in an HIV-endemic region in rural South Africa. The AHRI Unified Data Platform offers the potential to deepen our understanding of HIV epidemiology in a well-described population and to improve services for HIV. Not applicable.

Introduction. Vibrio cholerae is a diverse species of bacteria that causes watery diarrhoea, vomiting and stomach cramps and is the aetiological agent of cholera.Gap statement. Despite the global upsurge in notifications of cholera and concerns over the impact of climate change, systematic analysis of national and international surveillance data describing the microbiology and epidemiology of V. cholerae is sparse.Aim. We reviewed the microbiology and epidemiology of V. cholerae isolated from travellers returning to the UK.Methodology. All human isolates of V. cholerae detected from 2004 to 2024 were extracted from UK Health Security Agency reference laboratory surveillance systems. Microbiological data were analysed and linked to available epidemiological data and genome sequences for all isolates from 2016 to 2024.Results. There were 984 notifications of V. cholerae from 2004 to 2024 (an average of 51 each year), of which 266 (27.0%) belonged to serogroup O1. There were over 180 different sequence types (STs), of which cholera toxin producing ST69 was the predominant type (n=99, 28.2%). The highest number of isolates was in 2010 (n=74), while the lowest was in 2020 (n=8) and 2021 (n=4) due to travel restrictions imposed during the COVID-19 pandemic. Children under the age of 10 and the middle-aged and elderly population were most susceptible to infection, and 51.6% of the cases were male. There was a seasonal peak in August and September. Travel was reported by 92.9% of cases, and the most frequently reported travel destinations were India, Pakistan and Kenya.Conclusion. From the UK perspective, to assess the risk to food safety and to more accurately determine the clinical burden of V. cholerae, we recommend (i) widespread molecular testing of shellfish to monitor the emergence of V. cholerae in UK waters due to climate change and (ii) comprehensive testing of faecal specimens from non-travellers with gastrointestinal symptoms. Public health surveillance and information sharing at the global level is essential to assess the impact of investment in water, sanitation and hygiene initiatives for the prevention of cholera.

Maternal evaluation during routine antenatal care visits may reduce maternal morbidity and mortality by identifying and addressing issues early on. A health recommender system could help health professionals and pregnant women monitor daily health parameters, provide tailored recommendations, and support timely antenatal care. This study aims to qualitatively analyze challenges in the preimplementation of health recommender system for maternal care in Indonesia as perceived by multiple stakeholders, including health care providers, patients, health system managers, government officers, and technology vendors. The methodology used a qualitative approach, where qualitative data were obtained from interviews of 37 respondents from multiple stakeholders, consisting of 15 health workers and 15 patients from private and government health care facilities, 4 officers from government health offices, 2 directors of health application vendors, and 1 manager from a private health clinic. These semistructured interview results were analyzed using thematic analysis. This qualitative study identifies key challenges in implementing a health recommender system for maternal care in Indonesia across the people, process, infrastructure, and policy dimensions. Intercoder reliability for the coding process demonstrated almost perfect agreement (Cohen κ=0.90), supporting the consistency of the coding process. Six major challenges were revealed, mostly regarding skill, accuracy, completeness, timeliness, cost, and standardization. These 6 major challenges were mentioned 96 times, accounting for 64.43% of all codes extracted from the interviews. These findings emphasize the value of user involvement in system design to meet health care professionals' and patients' needs, technical advancements to foster trust and support effective decision-making, as well as enhanced data accuracy, reliable and timely service delivery, cost management, and clear regulatory standards. This formative, preimplementation qualitative study highlights the importance of involving users in system design and future implementation to meet the needs of health care professionals and patients. Reducing input errors and improving system reliability are critical to building trust and supporting effective point-of-care decision-making and, in later phases, facility-level monitoring as part of public health surveillance. Adherence to regulatory standards and the establishment of standardized guidelines will be key to enabling broader implementation. Further usability, feasibility, and pilot studies are required before any evaluation of effectiveness.

Objective This study investigates the integration of different large language models (LLMs) into the Medical Cell Biology Laboratory Course (MCBLC) to enhance bioethics training for undergraduate medical students in China. It further compares the effectiveness of these LLMs in improving teaching outcomes and student learning performances. Key challenges encountered during implementation were identified, and potential strategies to address them were also explored. Methods First-year undergraduate medical students from three medical majors were assigned to five groups. The study involved three phases: instructor-led course introduction, LLM-assisted experimental practice addressing procedural, conceptual, and psychological challenges, and post-training evaluation via questionnaires and blind-graded laboratory reports. Four domestic robust LLMs (DeepSeek, Doubao, KIMI, ChatGLM) were compared to assess their impact on bioethics integration, instructional effectiveness, and student learning outcomes, while documenting students' perceptions and concerns regarding LLM use. Results The study demonstrated that all four LLMs supported first-year undergraduate medical students in consolidating foundational knowledge, enhancing bioethics proficiency during laboratory practice, and developing critical competencies for future physicians. Questionnaires from 86 students across three majors indicated generally high satisfaction. For Medical Imaging Technology students, DeepSeek (mean 4.3, SD 0.7) and KIMI (mean 4.3, SD 0.8) were rated significantly higher than Doubao (mean 3.9, SD 0.7) and ChatGLM (mean 3.3, SD 0.6). KIMI was also preferred among Health Surveillance and Quarantine (mean 4.4, SD 0.5) and Medical Prevention (mean 4.5, SD 0.5) students. Nevertheless, students expressed concerns regarding potential academic inaccuracies, bias, and possible impact on independent thinking. Conclusions This study suggested that recent LLMs, particularly KIMI and DeepSeek, may support integrating bioethics into undergraduate medical laboratory courses in a university in China. By assisting students in accessing information, reflecting on ethical issues, and navigating practical challenges, these tools can facilitate learning and foster ethical awareness, competent future physicians. These findings, as an initial exploration and context-specific, indicate that LLMs may support bioethics learning in undergraduate medical laboratory courses and help foster ethically aware, competent future physicians.

This study provides the first record of helminth prevalence associated with Magellanic penguins (Spheniscus magellanicus) at the southernmost limit of their distribution, in the Beagle Channel, Argentina. Using a noninvasive and indirect nest soil sampling approach, we detected multiple helminth morphotypes, including nematodes, cestodes, trematodes, and acanthocephalans. Nematodes were the most frequently encountered group. Helminth load was greater during chick rearing than in the postbreeding period, likely due to increased fecal deposition and favorable environmental conditions. Parasite occurrence also varied across colony erosion zones shaped by penguin activity and natural processes, suggesting that microhabitat characteristics influence helminth persistence. These findings underscore the utility of soil sampling for monitoring temporal patterns of parasite exposure, particularly in remote wildlife populations, highlighting the need for continued surveillance of penguin health. Future research integrating direct parasitological and molecular techniques will improve taxonomic resolution and advance the understanding of parasite transmission dynamics.

Background: A Malaria surveillance system is essential to achieve "Malaria-free Bangladesh" by 2030. Though the system encountered challenges, including poor data quality, this study evaluated it in Khagrachari and rated its main attributes. Materials and methods: An observational study was conducted consisting of survey, secondary data analysis, record review and mixed methods of data collection. The surveillance system was examined using the "2001 United States Centers for Disease Control's updated guidelines for Evaluating Public Health Surveillance Systems". A total of 1407 patients' data was collected from previous records (2018-2022). Purposively chosen, 22 stakeholders participated in the study, and 128 case investigation forms were assessed. Results: 15(68.18%) out of 22 respondents had 12-year experience on surveillance and 17(77.27%) had formal training. 19(86.36%) respondents reported case definitions were easy-to-use, and 14(63.64%) participants claimed data tools could accommodate changes. 731(51.95%) cases were detected through Passive Case Detection (PCD) and nearly one-fourth (26.15%) cases by Government Organizations. The results of 'Timeliness' against the number of cases investigated within day one was 64.84%. Trends of cases showed significant decline ( 2 trend = 683.03, p = 0.0001). Conclusion: The system is effective as it meets most of its objectives. JCMCTA 2025 ; 36 (2) : 99-106

Air pollution is a growing threat to environmental and human health, particularly in densely populated and industrial regions such as Baja California (Mexico) and California (USA). This narrative review, informed by a structured literature search, explores the use of honey bees (Apis mellifera) as bioindicators of air quality and their relevance for environmental and public health surveillance within a One Health framework. A systematic literature search was conducted in PubMed/PubMed Central in May 2025, with no restrictions on language or study type, using MeSH terms and relevant keywords combined with Boolean operators. A manual search of key references was also performed. The selection process included duplicate removal, title and abstract screening, and full-text review using predefined inclusion criteria. Evidence indicates that bees accumulate atmospheric contaminants, including heavy metals, pesticides, particulate matter, and microplastics, across various matrices such as wings, pollen, and honey. These exposures trigger sublethal physiological responses, including oxidative stress and enzymatic alterations, paralleling early pathophysiological mechanisms in humans (e.g., IL-6 and TNF-α–mediated inflammation). Bee-based biomonitoring represents a cost-effective, sensitive, and scalable approach for identifying pollution hotspots and potential human exposure zones. The use of honey bees as environmental bioindicators can enhance early detection of pollution-related health risks, especially in regions with limited air quality infrastructure. Implementing standardized analytical protocols and fostering binational cooperation between Mexico and the United States could strengthen One Health surveillance networks. This integrative approach provides a practical model for linking environmental monitoring with preventive public health strategies.

A patient-centered HIV care model (PCHCM) can improve antiretroviral treatment adherence and viral suppression outcomes. No studies have evaluated viral suppression among people with HIV (PWH) in carceral settings under this model. This study compares HIV virologic suppression among PWH in Washington state prisons under a PCHCM to all PWH in Washington between 2008 and 2019. We conducted three analyses of a retrospective cohort of 403 PWH in prison. Prison-wide annual viral suppression proportions among total HIV population and the HIV population tested each year were compared with Washington public health surveillance data. Average changes in viral suppression proportions at intake and release were summarized and tested for statistically significant differences. Prison-wide HIV viral suppression increased from 61.4% in 2008 to 86.0% in 2019, surpassing most annual statewide proportions. Viral suppression proportions among those with at least one yearly viral load test were even higher. Between 2015 and 2019, > 95% of incarcerated PWH achieved viral suppression. Average viral suppression proportions increased during incarceration from 59.1% at intake to 92.4% at release between 2008 and 2019 (p < 0.05). Prison populations can reach near universal viral suppression under a PCHCM, suggesting a higher threshold from which to judge the effectiveness of HIV carceral care.

Public health surveillance systems require high-quality data to represent the population. In the absence of comprehensive or random testing throughout the COVID-19 pandemic, we have developed a proxy method for synthetic random sampling to estimate the actual community-level viral incidence, based on viral testing of patients who are asymptomatic and present for elective procedures within a hospital system. The approach collects routine testing data on SARS-CoV-2 exposure among outpatients and performs statistical adjustments of sample representation using multilevel regression and poststratification (MRP), a procedure that adjusts for nonrepresentativeness of the sample and yields stable small group estimates. We extend MRP to accommodate time-varying data and granular geography. We have developed an open-source, user-friendly MRP interface for public implementation of the Bayesian analysis workflow. We illustrate the MRP interface with an application to track community-level COVID-19 viral transmission in Michigan. We present the estimated infection rate over time for the targeted population and across demographic and geographic subpopulations. The interface provides timely, substantive insights into population health trends and serves as a valuable surveillance tool for future epidemic preparedness. Beyond monitoring COVID-19, the MRP interface can analyze a wide range of health and social science data, making it broadly applicable to diverse research areas with reproducibility and scientific rigor.

Household water insecurity is associated with greater likelihood of early exclusive breastfeeding cessation and diarrhea among children aged 6-59 months in Ethiopia: Data from Haramaya University Health and Demographic Surveillance System.

The safety of plant-based family diets, particularly vegan diets, during pregnancy and infancy is debated. Large population data on infant growth are scarce. To examine whether family dietary patterns (vegan, vegetarian, and omnivorous) are associated with growth trajectories, weight, and length among infants. This retrospective cohort study used data collected from January 1, 2014, through December 31, 2023, from a national network of public family care centers in Israel providing health and developmental surveillance for infants. Singleton births of infants gestational age 32 weeks or later without congenital malformations or birth weight less than 1500 g were followed up for 24 months. The data were analyzed between November 17, 2024, and December 6, 2025. The family diet as recorded at least 6 months after delivery. The primary outcome was infant length. Secondary outcomes included weight, head circumference, stunting (length-for-age z score less than -2), underweight (weight-for-length z score less than -2), and overweight (weight-for-length z score >2). Growth trajectories were analyzed using linear mixed-effects models, and nutritional status at birth, early infancy (ie, first 60 days of life), and 24 months were analyzed using logistic regression. Among 1 198 818 infants (mean [SD] gestational age, 39.2 [1.5] weeks; 53.2% male), 98.5% were from omnivorous households; 0.3% from vegan households, and 1.2% from vegetarian households. Differences in early-infancy length and length-for-age z scores among dietary groups were small (World Health Organization z score ≤0.3), and stunting prevalence was similar across groups (from 7.0% in the vegan and vegetarian groups to 7.1% in the omnivorous group), while underweight was more common in infants in the vegan vs omnivorous groups (adjusted odds ratio, 1.37 [95% CI, 1.15-1.63]). By age 24 months, stunting prevalence declined to 3.1%, 3.4%, and 3.9% in omnivore, vegetarian, and vegan groups, respectively, with no significant differences among the groups. Underweight and overweight were also low, with no differences by dietary group at age 24 months. Mean differences for weight, length, and head circumference were clinically minor (World Health Organization z score <0.2) and diminished further in adjusted longitudinal models. In this cohort study, infants from vegan households had growth patterns similar to those from omnivorous households, with a higher odds of early underweight that decreased by age 24 months. In the context of developed countries, these findings seem reassuring. Further research should examine vegan diet quality and the impact of nutritional counseling during pregnancy and infancy in supporting optimal infant development.

Extraintestinal invasive Escherichia coli infections are a leading cause of sepsis and hospitalization, further complicated by increasing rates of antimicrobial resistance. To describe the US epidemiology of invasive E coli infections and their clinical and molecular features. This cohort study used active laboratory- and population-based surveillance data from 9 US sites with a total population of more than 7.2 million people for invasive E coli in normally sterile body sites, collected from June to August 2023 from medical records and isolate characterization. Data were analyzed from November 2023 to February 2024. Laboratory-confirmed identification of any E coli organism isolated from a normally sterile body site obtained from a resident of the surveillance area. Outcomes of interest were population-based and site-specific incidence rate estimates of E coli infections, demographic and clinical characteristics, antimicrobial susceptibility profiles, and predicted O serotypes by in silico serotyping. Among 1345 cases of E coli infection in 1334 unique case-patients, the median (IQR) age was 68 (55-79) years, and 762 case-patients (57.1%) were female; 1223 infections (90.9%) were from blood and 122 infections (9.1%) were from other sterile sites. The overall estimated annual incidence rate was 74.7 per 100 000 population (surveillance site range, 51.4-96.0 per 100 000 population). Estimated incidence rates were higher among cases in patients aged 60 years or older compared with younger patients (225.0 vs 30.6 per 100 000 population), although rates were similar for females and males aged 60 years or older (224.5 vs 224.0 per 100 000 population). The most common underlying medical condition reported was diabetes (457 patients [34.0%]). Pyelonephritis (267 infections [19.9%]) and lower urinary tract infections (495 infections [36.8%]) were the most frequently associated infection types. In total, 1279 cases (95.1%) were hospitalized for less than 30 days after isolate collection; 106 case-patients (7.9%) died. Overall, 185 infections (13.8%) were due to extended-spectrum β-lactamase-producing E coli; 275 of 1061 isolates (25.9%) were resistant to ciprofloxacin and 370 of 1286 (28.8%) were resistant to trimethoprim-sulfamethoxazole. Of 846 sequenced isolates, the most prevalent O serotypes were O25B (137 isolates [16.2%]), O2 (93 isolates [11.0%]), and O6 (84 isolates [9.9%]). This cohort study using population-based public health surveillance data identified a substantial burden of invasive E coli disease, especially in older people, with high rates of antimicrobial resistance. These results can help inform national public health prevention efforts.

Nipah virus as a pandemic threat: Current knowledge, diagnostic gaps, and future research priorities.

AI-based automated weight prediction in cattle for herd health surveillance.

Exploring biosensors: Distinctive features and emerging applications.

Enhancing One Health Through Wastewater-Based Surveillance: Development and Validation of a Multiplex ddPCR Tool to Differentiate Human and Livestock Contributions.

Field-deployable CRISPR-Cas variants for rapid on-site detection of plant pathogens.

Behavioral and Emotional Challenges in Children With Spinal Muscular Atrophy.

Background.Listeria monocytogenes is a common foodborne organism identified as a causative agent of multiple clinical conditions in unique circumstances such as pregnancy and immunocompromise. It is a Gram-positive rod and a facultative anaerobic organism. This paper presents a study over a timeline of 5 years in retrospect and explores the incidence of listeriosis amongst patients of different age groups, along with its associated risk factors and clinical outcomes.Materials and methods. This study was conducted in retrospect from June 2019 to June 2024 at Shifa International Hospital, Islamabad. Ninety-seven cases of listeriosis were identified. These cases were culture-positive listeriosis where the pathogen was isolated from various samples such as blood and cerebrospinal fluid. Important risk factors associated with the clinical presentations were also documented, which included diabetes mellitus, chronic kidney disease and malignancy. The mean±sd was calculated for the continuous variable. Frequency and percentage were calculated for categorical variables. Chi-square tests were performed to assess associations with mortality and foetal outcomes.Results. A total of 97 culture-confirmed listeriosis cases, comprising 44 (45.5%) males and 53 (54.6%) females, were obtained. Fifteen of the females were pregnant. Fever was the most common presenting symptom across all groups, with pregnant patients also reporting abdominal pain, vomiting and foetal complications, while non-pregnant patients showed a wider range, including neurological, respiratory and gastrointestinal complaints. Of the 97 patients, 86 had comorbidities – most commonly hypertension and diabetes – while 15 total adult deaths occurred. Eight pregnancies resulted in foetal losses. Descriptive trends in pregnant patients suggested worse foetal outcomes with higher C-reactive protein, total leukocyte count and maternal comorbidities. Ampicillin-based regimens were the most frequently used treatments, and all isolates were sensitive to the tested antibiotics.Conclusion. This study highlights how listeriosis poses substantial morbidity and mortality risk, especially in pregnant cases. There is also a critical data gap, emphasizing the need for better diagnostic strategies, timely and targeted interventions, awareness of the clinical team and public health surveillance to reduce the burden of this often-overlooked infection in Pakistan.

Evidence of point-of-care diagnostics in forensic death investigations: A scoping review.