BackgroundCeftriaxone is currently the most frequently recommended first-line therapy for gonorrhoea globally. The emergence of ceftriaxone-resistant Neisseria gonorrhoeae threatens effective control, yet longitudinal surveillance data remain limited in many settings. Sentinel gonococcal antimicrobial resistance surveillance has been conducted at the Department of STI Control (DSC), Singapore, since 2014. We report findings on the emergence of ceftriaxone-resistant Neisseria gonorrhoeae detected between 2018 and 2025.MethodsWe conducted an analysis of longitudinal sentinel laboratory surveillance data from January 2018 to October 2025. Neisseria gonorrhoeae isolates underwent culture and antimicrobial susceptibility testing using gradient diffusion method (Etest) at the Department of Microbiology, Singapore General Hospital. Isolates with ceftriaxone minimum inhibitory concentrations ≥0.25mg/L were identified using European Committee on Antimicrobial Susceptibility Testing criteria. Clinical, behavioural and treatment outcome data were extracted from electronic medical records.ResultsAmong 2695 Neisseria gonorrhoeae isolates tested, 23 (0.85%) ceftriaxone-resistant isolates were identified. No ceftriaxone-resistant isolates were detected prior to 2018, and annual detection varied without a consistent upward trend. Median patient age was 35years (IQR 24-48). The earliest case was a female patient involved in transactional sex work with pharyngeal infection; subsequent cases occurred exclusively among heterosexual individuals, predominantly men with urethral infection. Exposure through encounters involving paid sex as well as the absence of condom use during oral sex, were common. Most infections resolved following treatment with ceftriaxone 500mg intramuscularly, although persistent pharyngeal infection was observed in one case.ConclusionCeftriaxone-resistant Neisseria gonorrhoeae has been detected in Singapore since 2018 through sentinel surveillance. Continued culture-based antimicrobial resistance surveillance, incorporation of extragenital testing, and prioritisation of test-of-cure for pharyngeal infection are essential to support early detection, guide empirical therapy and inform clinical and public health responses.

Using Machine Learning to Design Effective Antimicrobial Dosing Regimens.

Socioeconomic position and type 2 diabetes: The mediating role of physical work environment - the Maastricht study.

Maternal depressive symptoms (MDS) are common in low-income Brazilian settings, yet longitudinal evidence on their links to parenting is limited. We examined whether MDS measured in infancy and early school age are associated with parenting practices at child school entry (∼5.5years). We used longitudinal data from the Impact Evaluation of Brazil's Happy Child Program (PCF), implemented in municipalities across four Brazilian macro-regions. The cohort included 3242 families at baseline (T0, 2018) and 1014 mother-child dyads with complete data at the fourth follow-up (T4, 2024). MDS was assessed at T0 and T4 using the Edinburgh Postnatal Depression Scale (EPDS). Parenting practices were assessed at T4 using the Parenting and Family Adjustment Scales (PAFAS). Associations were estimated using multivariable linear regression with municipality-level cluster-robust standard errors, adjusted for child sex and maternal sociodemographic characteristics. Sensitivity analyses used mixed-effects models (municipality random intercept) with BH-FDR adjustment and continuous EPDS scores. Maternal depression point prevalence was 26.5% at baseline (T0) and 31.5% at child school entry (T4). Maternal depression at both T0 and T4 was associated with higher (worse) overall PAFAS scores and higher scores for coercive practices, parental consistency, and parent-child relationship at T4. Associations for positive encouragement were smaller, with weaker evidence at T0 and clearer associations at T4. Findings were robust across sensitivity analyses. Maternal depressive symptoms in infancy and at child school entry are associated with less favorable parenting practices at early school age in low-income families. Integrating depression care with parenting supports may improve child development in resource-constrained settings.

Sleep disturbances have been linked to an increased risk of neurological disease, but it remains unclear whether they represent modifiable risk factors or early signs of disease. We investigated how multiple dimensions of sleep relate to the onset of neurological disease, and whether sleep patterns change before and after diagnosis. We used longitudinal data from 24,033 participants in the Swedish Longitudinal Occupational Survey of Health, followed biennially from 2010 to 2018. Incident neurological disease was identified via national registers. Associations were analyzed using Cox proportional hazards models and longitudinal trajectories of sleep variables were examined using linear mixed-effects models on a backward timescale. During a median follow-up of 4 years, 1382 participants developed a neurological disease. Several sleep-related symptoms were associated with increased risk, including persistent fatigue (HR 1.58, 95% CI 1.38-1.80), non-refreshing sleep (HR 1.40, 95% CI 1.22-1.62), and sleep-disordered breathing (HR 2.27, 95% CI 1.75-2.93). Insomnia alone was not associated with increased risk (HR 1.06, 95% CI 0.84-1.33), unless accompanied by daytime symptoms (HR 1.51, 95% CI 1.28-1.78). Longitudinal analyses showed that individuals who developed neurological disease experienced a gradual shift toward later bed- and wake-up times, along with increasing insomnia symptoms, fatigue, and sleep-disordered breathing in the years preceding diagnosis. Sleep symptoms and changes in sleep-wake timing precede the diagnosis of neurological disease by several years. These patterns may reflect early prodromal alterations in brain function and support the potential of sleep-related complaints as early indicators in neurological health surveillance.

Progressive short stature in Pearson syndrome and the impact of organ failure.

Longitudinal patterns of threat- and deprivation-based childhood adversity and their impact on adolescent drinking, smoking, and depression.

To investigate changes in income, employment, and welfare utilization among individuals receiving addiction treatment in Greenland. We conducted a nationwide register based study using longitudinal data from the Allorfik treatment database linked with national socioeconomic registers. We included 1157 individuals aged 18-60 who had a recorded treatment episode between 2017 and 2021, retaining the first eligible episode per person. We examined annual income, employment status, and welfare utilization at four time points: the year before treatment cessation (Year -1), the year of cessation (Year 0), and the first two years after cessation (Years 1 and 2). We used generalized estimating equations to estimate changes in outcomes over time. Increases in income (13.03% in Year 1, p<0.008; 17.21% in Year 2, p=0.005) and odds of employment (Year 1: OR=1.20, p=0.033; Year 2: OR=1.25, p=0.018) were observed after treatment cessation, along with decreases in odds of welfare utilization (Year 1: OR=0.66, p≤0.001; Year 2: OR=0.57, p<0.001). This first nationwide register-based study of addiction treatment in Greenland shows small yet consistent socioeconomic improvements following treatment. While causality cannot be inferred, the findings provide important descriptive evidence from an Indigenous Arctic population and highlight the need for future studies with comparison groups.

Brain lateralization, the hemispheric specialization of functional networks, is essential for motor and cognitive functions. However, how intensive athletic training shapes hemispheric organization remains poorly understood. This study investigated the formation of functional lateralization in elite athletes through long-term intensive training and its potential alteration by external factors, specifically sport-related concussions. Resting-state functional magnetic resonance imaging data were collected from 13 world class gymnasts (WCGs) and 14 nonathletic controls. Longitudinal data were collected from 18 soccer players and eight golfers before and after one season, with concussions monitored in the soccer players. Laterality indices of hemispheric integration and segregation (LI int and LI seg ) were calculated to quantify hemispheric differences in information processing for each brain region, and the standard laterality index (LI) was employed to measure hemispheric asymmetry. Associations between laterality indices and neurotransmitter receptor/transporter densities were examined. Postseason changes in these indices were assessed to evaluate the effects of concussion on brain lateralization. The WCGs showed significantly increased LI int in several left-hemispheric regions, including the precentral gyrus, cingulate gyrus, thalamus, superior parietal lobule, and lateral occipital cortex compared with the healthy controls, although no significant differences were found in LI seg . Furthermore, the LI analysis revealed that the WCGs showed higher hemispheric asymmetry in the left precentral gyrus, cingulate gyrus, and thalamus. These laterality indices also were positively correlated with certain neurotransmitters. Similar patterns of enhanced lateralization and neurotransmitter associations were observed in soccer players and golfers. However, no significant changes in laterality indices were observed as a result of concussions sustained during the season. Long-term intensive training enhances functional integration in the left hemisphere, leading to stable brain lateralization patterns resilient to sport-related concussions.

Evidence suggests loss of control eating (LOC) during pregnancy is prevalent and linked to adverse health consequences for birthing individuals and their offspring; however, factors underlying risk for prenatal LOC remain unclear. This systematic scoping review assessed empirical literature on factors related to the development/maintenance of prenatal LOC. Eligibility criteria for studies required inclusion of participants endorsing prenatal LOC and concurrent or prospective examination of factors in relation to prenatal LOC. Data on study location/design, sample composition, LOC measurement, and associations between factors and LOC were extracted and synthesised. Most of the 36 included studies were conducted in Western, industrialised nations; with predominantly White-identifying, highly educated samples; cross-sectionally; using single items or binge-spectrum disorder diagnostic criteria. Most demonstrated that transdiagnostic factors found to contribute risk for mental/physical health outcomes among non-pregnant individuals are similarly associated with risk for LOC among pregnant individuals; investigation of factors specific to the prenatal context was comparatively lacking. Inclusion of marginalised populations, use of validated measures that capture prenatal LOC frequency/severity, prospective and longitudinal data, and more sophisticated analytic approaches are crucial next steps in moving the field towards clarifying the course and mechanisms underlying prenatal LOC.

Objectives. To evaluate the change in the US foodscape from 2003 to 2023 overall and by area rurality, considering various modes of transportation. Methods. We conducted this study using longitudinal data on all licensed food retailers, geocoded to census-tract level, and examined changes in the foodscape by estimating the percentages of tracts defined as food deserts (no grocery stores) and food swamps (mostly restaurants or fast-food locations). Results. We found a considerable increase in the percentage of food swamps and no substantial progress in reducing food deserts. For example, using distance-based foodscape measure (one half of a mile from tract borders), between 2003 and 2023, the percentage of tracts categorized as food swamps increased from 80.2% to 88.5%, while the percentage of food deserts decreased minimally from 6.1% to 5.5%. Across all years, the percentage of food deserts was substantially higher in rural areas, and when people used public transit as a mode of transportation. Conclusions. The findings underscore the need for improving accessibility to healthy foods across the United States, particularly in rural areas. Public Health Implications. Expanding public-private partnerships to establish healthy food retailers in food deserts may improve the foodscape quality. (Am J Public Health. 2026;116(7):1004-1014. https://doi.org/10.2105/AJPH.2026.308495).

Patterns of contextually sensitive adverse childhood experiences and associations with adult mental health outcomes in a longitudinal South African community sample: a latent class analysis.

Testing the temporal stability and longitudinal measurement invariance of the Patient Health Questionnaire-4 across six years with the Socioeconomic Panel-Innovation Sample.

All-cause mortality risk associated with leisure activities in China: A cohort study.

Development of an interpretable machine learning model-based online tool for risk identification of anxiety symptoms in Chinese older adults.

From expansion to optimization: Government health expenditure and chronic disease burden among older adults in China.

Ergothioneine as a potential geroprotector: Targeting molecular hallmarks of ageing and age-related diseases.

Injectable anticipatory medications are routinely prescribed ahead of need in many countries to help manage distressing end-of-life symptoms. However, little is known about the lived experience of patients and informal caregivers as they navigate their prescription, supply and use. To explore and map patient journeys in navigating anticipatory medication care, and to identify healthcare interactions with the greatest potential for enhancing patient and informal caregiver experiences of care. Qualitative secondary analysis of longitudinal interview data using framework analysis and patient journey mapping techniques. Adults (18+) prescribed anticipatory medications (n = 6), informal caregivers (n = 9) and health care professionals involved in their care (n = 5). Visually mapping journeys highlighted that patients and informal caregivers' experiences of anticipatory medication processes varied greatly and were influenced by the context of care. All participants appreciated access to injectable medications for future symptom control. However, journeys repeatedly highlighted suboptimal information exchange between patients, informal caregivers and healthcare professionals, regarding their purpose and threshold for use. Navigating unfamiliar and complex end-of-life medication support systems was more challenging when patients lived alone or experienced communication difficulties. Patient and informal caregiver experiences of timely symptom control could be improved by healthcare professionals having open and ongoing conversations about the role of anticipatory medications. Simplified and well-signposted routes for accessing healthcare professional advice and medication input are needed. Using journey mapping offers a novel way to visually illustrate different patient and informal caregivers lived experience and can be adapted for researching experiences of various care pathways.

Patient-derived ovarian cancer organoids as platforms for predicting platinum resistance and screening tumor stem cell inhibitors.

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an inflammatory demyelinating disorder that overlaps clinically with multiple sclerosis (MS) but immunopathologically distinct. Although often considered an acute inflammatory disease, recurrent attacks in MOGAD can lead to demyelination, axonal injury, and secondary neurodegeneration. Reliable biomarkers associated with relapse risk and disease subphenotypes, including optic neuritis, remain limited. Here, we aimed to define molecular and cellular signatures that distinguish MOGAD from MS as a prototypical neuroinflammatory disease and from Alzheimer disease (AD) as a proxy of neurodegeneration and to identify candidate immune-proteomic features associated with relapse frequency and clinical phenotype in MOGAD. CSF, serum, and whole-blood samples from patients with MOGAD (n = 67), MS (n = 49), and AD (n = 36) were profiled using NULISAseq™ CSF proteomics, Olink Explore 3072 CSF and serum proteomics, and high-dimensional mass cytometry for immune cell characterization. In MOGAD, longitudinal clinical data, including total attack counts from the earliest documented attack through follow-up, were integrated with immune and proteomic profiles to assess associations with disease course and clinical phenotype. CSF and blood proteomic profiling revealed distinct inflammatory and cardiometabolic proteomic profiles in MOGAD, differentiating it from both MS and AD. Compared with MS, MOGAD showed relative reductions in lymphocyte populations with regulatory phenotypes. Within MOGAD, relapsing disease was associated with reduced frequencies of CD8+CCR7+CD31+CTLA4+ T cells and concurrent expansion of double-negative γδ T-cell subsets. IL-13 correlated positively with relapse frequency and inversely with circulating regulatory T cells, whereas IL-32 and CASP4 showed opposite associations, correlating negatively with relapse count and positively with Treg frequency. IL-13 was also inversely associated with CD31-expressing CD8+ T cells. Phenotype-stratified analyses suggested that these immune-proteomic relationships differed according to clinical presentation, including optic neuritis vs nonoptic neuritis phenotypes. This integrative immune-proteomic analysis identifies cellular and molecular features associated with relapsing vs monophasic MOGAD, suggesting a model of impaired peripheral immune regulation in relapsing disease. While exploratory, these findings generate a concrete hypothesis for future longitudinal and functional studies aimed at refining biomarker-based monitoring and informing individualized therapeutic strategies in MOGAD.