Reaching and fully immunizing zero-dose (ZD) children and missed communities is at the core of the Gavi, The Vaccine Alliance 5.0/5.1 and Immunization Agenda 2030 strategies. This is critical to ensure equitable immunization coverage and access to other primary health care services and to prevent outbreaks. The diversity of settings where these children live and the complexity of vaccination barriers require a complementary set of activities embedded in national systems. Learning approaches are needed to use evidence to improve equity and reach. Gavi has helped fill this gap with the Zero-Dose Learning Hub (ZDLH) initiative, which is composed of consortia partners in four countries-Mali, Nigeria, Uganda, and Bangladesh-and a global-level consortium. This paper describes the ZDLH design, theory of change, methods, and measures of success. Then, future papers will present ZDLH results, successes and challenges, and recommendations. The ZDLH initiative is prospective and runs through 2025. It features primary evidence generation through rapid assessments, improved monitoring, implementation research in targeted sub-national areas where ZD children are located, and country-specific learning agendas and knowledge translation activities to facilitate evidence use. The global level consortium offers technical assistance to country learning hubs (CLH) and facilitates synthesis, dissemination, and improves evidence use across low- and middle-income countries. A common measurement, evaluation, and learning (MEL) plan documents whether evidence is generated and used and how the overall model works to inform future adaptation. Target audiences for evidence are the Gavi Board; Gavi strategy, programme, and country teams; countries' ministry of health and immunization programmes at national and subnational level; and other donors and implementing partners working to improve immunization equity. The ZDLH initiative is a coherent approach to evidence generation and learning, and the implementation experience informs how to better design and support learning systems embedded within national health systems.

The work is a report on the intentional use of harmful biological agents in workplaces in Poland based on National Register of Biological Agents (Krajowy Rejestr Czynników Biologicznych - KRCB) as of June 2025. The KRCB is a central database gathering notifications of the intentional use of biological agents in risk groups 2-4 in work processes in accordance with the Regulation of the Minister of Health of December 11, 2020, amending the regulation regarding biological agents. Notifications were sent by 749 enterprises for: diagnostic - 59.3%, research - 32.4% and industrial purposes - 8.1%. Notifications were most often sent by microbial laboratories (N = 438, 58.5%), scientific-research institutions (N = 229, 30.6%) and industrial enterprises (N = 82, 11.0%). In total, 7795 workers (87.6% women, 12.4% men) were exposed to biological agents intentionally used at work. Biological agents from risk groups 2 and 3 were used by 97.6% and 15.9% enterprises, respectively. The most frequently were used bacteria Escherichia coli (with the exception of non-pathogenic strains) - 4823 exposed workers (61.9%), Staphylococcus aureus - respectively 4655 (59.7%) and Pseudomonas aeruginosa - 4188 (53.7%). National Register of Biological Agents gathered 9 notifications of intentionally using of the biological agent carcinogenic to humans, including viruses (hepatitis B virus [N = 2015 workers, 25.8%], hepatitis C virus [N = 1982, 25.4%], human immunodeficiency virus type 1 [N = 1796, 22.7%], Epstein-Barr virus [N = 196, 2.5%], human papilloma virus [N = 60, 0.8%], human herpes virus type 8 [N = 16, 0.2%], human T-lymphotropic virus type 1 [N = 38, 0.5%]), bacteria (Helicobacter pylori [N = 327, 4.2%]), parasite (Schistosoma haematobium [N = 9, 0.1%]). Intentionally used biological agents most often pose a threat to workers of microbial laboratories, but a higher health risk concerns workers of scientific-research institutions. Med Pr Work Health Saf. 2026;77(1).

Fibromyalgia: the Italian survey by the ministry of health.

Liquefied Petroleum Gas (LPG) is a respirable mixture of two hydrocarbon-based gases stored as liquid under high pressure. Chronic inhalation of LPG irritates and potentiate inflammation of the bronchi. This study evaluated Pulmonary function of vendors in Calabar metropolis, Nigeria. The following spirometric parameters; forced vital capacity (FVC), forced expiratory volume per one second (FEV1), peak expiratory flow (PEF) and forced expiratory ratio (FEV1%) were assessed to determined lung function. Demographic parameters, including chest circumference and oxygen saturation were obtained to have adequate information about participants. Five hundred and ten subjects were evaluated in the investigation. The participants were divided into two groups, Group I (test) and Group II (Control). The test group comprised of two hundred and fifty-five LPG vendors, while same number of students from University of Calabar served as control group. All participants were male subjects and of same age range (20-40years), devoid of pre-existing illness and were not on medication(s). Ethical certificate (Reg no: CRS/MH/HREC/2018/610) was obtained from the state Ministry of Health, Calabar. Lung function was measured using a Vitalograph, while oxygen saturation was measured with pulse oximeter. The results showed significant reduction (P<0.001) in the lung function parameters among the LPG vendors (test group) compared to Control group. In conclusion, The LPG vendors showed reduced lung volumes, indicating a compromised lung function associated with obstructive pulmonary pattern.

Occupational skin diseases represent a significant consequence of exposure to irritant substances in the workplace, with irritant contact dermatitis (ICD) being among the most prevalent. According to 2018 data from the Indonesian Ministry of Health, the agricultural and plantation sector reported the highest prevalence of dermatological complaints (29.27%) among the working population aged 15 years and above. This study aims to analyze the relationship between the use of personal protective equipment (PPE), personal hygiene, exposure to active pesticide ingredients, and work duration with the symptoms of ICD among apple orchard workers in Tulungrejo Village, Batu City. A cross-sectional study was conducted, and the results demonstrated a statistically significant association between the completeness and proper use of PPE, personal hygiene practices, types of active pesticide ingredients, and duration of employment and the prevalence of ICD symptoms. These findings underscore the critical need for targeted workplace safety interventions in this agricultural sector.

Speech by A.S. Blagonravova, Rector of Academician Ye.A. Vagner Perm State Medical University, Federal State Budgetary Educational Institution of Higher Education of Ministry of Health of Russia, at the Ceremonial Meeting of the Academic Council Dedicated to the Opening of the University`S Anniversary Year (January 28, 2026)

Xenotransplantation has emerged as a potential solution to the critical shortage of donor organs, with recent breakthroughs demonstrating transplantation of genetically modified porcine organs into humans. In Japan, the Ministry of Health, Labour and Welfare has advanced the regulatory review framework to accelerate research and enable the nation's first clinical xenotransplantation. Unlike conventional pharmaceutical pathways, the Act on the Safety of Regenerative Medicine provides a distinctive framework that allows xenotransplantation to be delivered as a medical procedure rather than as a medicinal product. Under this law, a multi-step review process and adherence to specific guidelines, this framework may facilitate early-phase clinical research while safeguarding public health, offering an alternative model to regulatory systems in the other countries.

Understanding COVID-19 vaccination choices and development of a toolkit and training for Botswana, 2022-2023.

Type 2 diabetes accounts for over 90% of diabetes cases worldwide, underscoring the need for effective management, particularly in dietary practices. This study aimed to assess dietary practices and identify associated factors among patients with type 2 diabetes at Gabiley General Hospital, Somaliland. A cross-sectional study was conducted using a questionnaire survey at Gabiley General Hospital. A purposive sampling technique was employed to recruit 168 respondents who met the clinical inclusion criteria. Data on dietary practices, sociodemographic factors, nutritional knowledge, and clinical characteristics were collected using a pre-tested structured questionnaire. Data were analyzed using binary logistic regression using Stata version 16.0. The study revealed that most respondents (77.38%) had poor dietary practices. Factors significantly associated with dietary practice included age (OR = 3.02, p < 0.001), household income (OR = 2.98, p < 0.001), marital status (OR = 1.61, p = 0.027), residence (OR = 2.72, p = 0.05), nutritional knowledge (OR = 38.07, p < 0.001), duration of diabetes (OR = 3.65, p < 0.001), and having other comorbidities (OR = 0.17, p < 0.001). The high prevalence of poor dietary practices highlights a need for intervention. Enhancing nutritional education, establishing dedicated nutrition services at Gabiley General Hospital, and gaining policy support from Somaliland's health and agricultural ministries are recommended to improve dietary management and health outcomes for patients with type 2 diabetes.

The importance of early diagnosis of inherited metabolic diseases (IMDs) is well known, as it allows early intervention to prevent or reduce complications and improve prognosis, since many of these disorders are treatable. However, diagnosis can still be delayed, and many patients remain undiagnosed. Reducing diagnosis delays is a primary goal of the French Ministry of Health and Prevention (Rare Disease Department). This article describes a national initiative coordinated by the French network for IMD, "Filière G2m." Sixty-seven IMD experts from various reference and competence centers in France drafted one-page summaries dedicated to specific diseases or groups of diseases in the field of IMDs, covering the full spectrum of IMDs. These documents include keywords summarizing clinical signs which, when considered alongside data from routine biological or imaging tests, should suggest the diagnosis of an IMD. A total of 48 summaries have been drafted and are available on the Filière G2m website. To assess the accuracy and relevance of the diagnostic fact sheets, we selected 4 IMDs and compared their content with the clinical profiles of patients followed at Necker-Enfants Malades Hospital, using Natural Language Processing tools to automatically extract patient phenotypes from medical records (Dr Warehouse). We found a strong alignment between the fact sheets and the real-world clinical data from these patients. This tool will enable patients to recognize themselves in an IMD. General practitioners will use these documents alongside diagnostic aid software. It may also support new artificial intelligence-based technologies to identify undiagnosed patients in hospital databases.

Safety and efficacy of intensive task-specific training in people with recent spinal cord injury: a phase 3, pragmatic, randomised, assessor-blinded, superiority trial.

A proposed pathological diagnosis flowchart for adult interstitial lung disease with transbronchial lung cryobiopsy: Position paper from the Japanese research group on diffuse lung disease.

Background: Non-adherence to comprehensive management of chronic kidney disease (CKD) especially renal diet and fluid restrictions will hinder the effective management of the overall dialysis population. Long-term effects of indulging and overloading on food and drinks which are not suitable for the dialysis patient brings on a lifetime of suffering from a multitude of diseases such as cardiovascular and bone disease which eventually leads to death. The aim of this research project is to identify the dialysis regime, renal diet and fluid restriction among dialysis patients. Methods: This research is a quantitative descriptive cross-sectional design. The sample was distributed using convenience sampling method with inclusion and exclusion criteria. 80 participants were recruited. The study tool was adopted from Standard for Private Hemodialysis Centre from the Malaysian Ministry of Health for Private Dialysis Centers. Results: Of the 80 participants, most were female (62.5%) and aged 18–25 years (41.3%). Although almost all (98.8%) adhered to the prescribed thrice-weekly hemodialysis (HD) schedule, a notable proportion skipped sessions (31.3%) or ended treatments early (67.5%). Mean adherence scores indicated moderate compliance for fluid (4.123 ± 1.524) and diet (3.988 ± 1.563) management, and low compliance for the dialysis regime (1.44 ± 0.524). Overall, 38.75% had poor, 60% moderate, and only 1.75% good adherence, with no significant association between demographic variables and compliance, highlighting the need for targeted behavioural and educational interventions. Conclusion: Adherence to dialysis, fluid, and diet regimes was generally moderate to low, underscoring the urgent need for patient-centred education and behavioural interventions to improve compliance regardless of demographic background.

Health access reforms in the Caribbean Netherlands from 2010-2023.

In dental practice, claims for National Health Insurance reimbursement are an essential extension of clinical care, and dentists ultimately bear responsibility for the accuracy of insurance claims. This study analyzed dental-related cases included in the 2025 Compilation of Improper Health Insurance Claims published by the Health Insurance Review and Assessment Service and the Ministry of Health and Welfare of Korea to examine patterns of claim errors frequently occurring in routine dental practice. The findings suggest that these errors reflect structural vulnerabilities within dental clinic workflows, and that strengthening basic internal review systems may contribute to the prevention of improper insurance claims.

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.

Zambia has implemented significant health-sector decentralization since 1992, culminating in the devolution of district health services to local authorities under the 2016 Constitutional Amendment. Results-Based Financing (RBF) has been piloted as a performance incentive mechanism, but its institutionalization within devolved structures remains largely unexplored. This study explores the opportunities and challenges of embedding RBF within Zambia's devolved health system, with a focus on Northern Province. A qualitative case study design was used, involving forty-four participants from twelve districts. Purposive sampling selected health workers from provincial and district health offices, local authority representatives, and national stakeholders. Data collection included semi-structured interviews, document reviews, and observations, with thematic analysis conducted using NVivo 9. Most respondents (82%) reported involvement in RBF implementation, and fifty-three% believed that increased Constituency Development Fund (CDF) allocations improved district health services. Key benefits cited were increased accountability (81.8%) and greater community participation (77.3%). Challenges included insufficient funding (83.3%), delays in disbursing funds (91.7%), and limited understanding among local authority implementers. Infrastructure development and procurement of medical equipment were identified as primary areas for CDF improvements (56%). Respondents also agreed (53%) that the Ministry of Health and the Ministry of Local Government would support the institutionalization of RBF. Effective integration of RBF into devolved systems requires harmonizing policies between health and local government ministries, building capacity within local authorities, and aligning RBF with other domestic financing mechanisms, such as CDFs. A phased approach to integration, with clearly defined governance structures, is recommended to ensure sustainable scaling.

Japan's aging society concentrates pneumonia burden across communities, long‑term care, perioperative pathways, and hospitals. Adult pneumococcal and influenza vaccination are supported by trials and meta‑analyses and are often cost‑effective; yet, realized value depends on targeting, measurement, financing, and pairing with bedside prevention such as oral care and hospital‑acquired pneumonia bundles. This viewpoint proposes a formative, indicator‑driven architecture linking cost‑effectiveness to operations by aligning vaccination with complementary oral‑care prevention and value‑based payment under the existing policy infrastructure. Working within the Ministry of Health, Labour and Welfare/Central Social Insurance Medical Council health technology assessment framework, Center for Outcomes Research and Economic Evaluation for Health methods, and claims-electronic health record linkage via My Number insurance card, we specify a compact national indicator set: vaccination coverage and timeliness, nonventilator hospital‑acquired pneumonia, ventilator‑associated pneumonia, postoperative and stroke‑associated pneumonia, antibiotic days of therapy, and length of stay, with pragmatic risk adjustment and present‑on‑admission flags. Value levers first reward reliable reporting and adherence to evidence‑based bundles and then share verified, risk‑adjusted savings. Long‑term care facilities receive add‑ons for professional oral care in high‑risk residents; hospitals receive quality add‑ons and shared savings; perioperative pathways may incorporate oral health management; and stroke units standardize oral hygiene with dysphagia screening. A phased roadmap details the pilot co‑design, governance, risk‑adjusted reporting with equity safeguards, and iterative recalibration by using real‑world evidence. The learning loop-measure, report, improve, generate evidence, adapt cost‑effectiveness, recalibrate payment-converts modeled value into lived experience: fewer pneumonias, reduced antibiotic exposure, shorter stays, improved function, and dignity at favorable or potentially lower costs, context-depending on baseline pneumonia rates, implementation fidelity, and local unit costs.

Background. In 2025, new regulatory documents governing staffing in medical organizations providing dermatovenereological care came into force. The key regulatory act is Order No. 582n of the Ministry of Health of the Russian Federation, which revised the structure of medical units and introduced additional medical positions. The feasibility of implementing these changes depends on the actual availability of specialists. Aim: to assess the scale of changes in staffing norms for dermatovenereology and compare the normative requirements with the actual workforce availability. Methods. A comparative analysis of the previously valid and newly adopted regulatory documents was performed. The normative staffing requirement was calculated using national population data and information on hospital bed capacity. Actual workforce availability was assessed using official data on the number of physicians. Results. The updated staffing norms introduce fourteen new medical positions and revise the standards for physician availability. For the population of the Far North regions, the normative requirement was doubled. The total need amounts to 9,300 positions, whereas the current number of specialists covers only about 18% of the requirement. Conclusions. Implementation of the new regulatory framework is not feasible without a substantial expansion of workforce training. Adjustment of labor standards to regional characteristics and development of measures to attract and retain specialists are required.

Aedes aegypti is the principal vector of dengue virus. Its vector ability is related to its capacity to adapt to different environments and to lay eggs in diverse sites to ensure the success of its progeny. The species abundance can be studied by estimating the infestation level using the Breteau Index (BI) and the House Index (HI). These indices indirectly reveal the practices and habits of house dwellers, who accumulate containers that contribute to the presence and abundance of Ae. aegypti and the potential transmission of dengue virus. The objective of this work was to analyze the relationship between these indices and environmental variables in drought years (2004-2005). The data analyzed were taken from entomological surveillance spreadsheets of the National Ministry of Health of Argentina, and included 156,288 houses and 658,656 artificial containers inspected by Ministry technicians. A correlation matrix was generated between the indices and the climatic variables to analyze cross correlations. When the relationships between climatic variables and the indices were significant, they were adjusted with General Linear Models (GLMs) taking into consideration the lowest value of the Akaike Information Criterion (AIC). The models were validated by testing the normal distribution of the residuals and the lack of autocorrelation. The results showed that 8,249 houses and 15,165 artificial containers were positive for Ae. aegypti. The BI and HI were positively correlated with precipitation, minimum temperature and maximum temperature at a zero-month time lag. The best GLM found between HI, minimum temperature and precipitation at a zero-month time lag was a gamma model. The increase of HI was related to the mean temperature at a 1-month time lag by using a gamma GLM. This increase in the HI may be potentially related to the accumulation of containers by humans under drought conditions, a behavior that favors the growth of immature forms of the main dengue vector.