Multi-model large-scale AI framework for avian influenza surveillance and preparedness: Harnessing large language models to enhance risk communication, real-time decision support, and public health response strategies.

A Critical Perspective on the Dietary Guidelines for Americans 2025-2030: Methodological, Conceptual, and Communication Challenges.

The 2023 Marburg virus disease (MVD) outbreak in Tanzania, which resulted in nine confirmed cases and six deaths (case fatality rate [CFR]: 66.7%), served as a critical stress test of the national health system, revealing significant gaps in outbreak preparedness across surveillance, laboratory capacity, and infection prevention and control (IPC). This narrative review examines how Tanzania's public health response evolved between the 2023 and subsequent 2025 outbreak and assesses how response strategies changed between the two outbreaks. The 2025 outbreak was limited to two confirmed cases with no further transmission, a marked contrast to the 2023 outbreak. Between the two outbreaks, Tanzania implemented several critical interventions, including expansions of PCR diagnostic capacity, integration of electronic tracing modules, and public health communication strategies. This review synthesizes publicly available reports from the World Health Organization (WHO), Africa Centers for Disease Control and Prevention (Africa CDC), the Tanzanian Ministry of Health, and peer-reviewed literature, and analysis focuses on three major response domains: infectious disease surveillance, IPC, and public health education as key factors associated with Tanzania's progress. The rapid containment of the 2025 outbreak suggests meaningful progress in Tanzania's public health capabilities and the need for continued, sustained investment in integrated surveillance systems and IPC infrastructure to maintain resilience against future outbreaks. Tanzania's adaptation and multi-level interventions between 2023 and 2025 provide a model for regional health security in Africa.

Molecular characteristics, epidemiological trends, and public health implications of human metapneumovirus (hMPV): a review.

Expert to novice: Understanding the challenges of transition to the specialist community public health nurse - health visitor role and its implications for role retention. A constructivist grounded theory.

Drug mixture composition and compound identifications provide public health, first responder, and law enforcement communities with critical and actionable data, guiding emergency response and interdiction, informing the public, and targeting overdose prevention. The advent of novel synthetic opioids, nitazenes, and benzodiazepines, along with the spread of strong veterinary tranquilizer adulterants (e.g., xylazine and medetomidine), have created an ever-changing drug landscape. The Testing, Rapid Analysis, and Narcotic Quality (TRANQ) Research Act of 2023 directs research, method development, measurement science, and standards to address these hurdles. In conjunction with the National Institute of Standards and Technology (NIST) Rapid Drug Analysis and Research (RaDAR) program, aimed at monitoring the chemical makeup of the drug landscape, we are investigating analytical instrumentation to enable drug screening to move from the laboratory to an agile point-of-need setting. We explored compound identification with a direct analysis in real time triple quadrupole mass spectrometer (DART-TQ-MS) and the NIST/NIJ DART-MS Data Interpretation Tool with Forensics Database. Full scan analysis of single-component standards demonstrated limits of detection generally in the tens to hundreds of picograms with a few in the single nanogram range (i.e., compounds with extremes in volatility). Single-component, mixtures, and real-world street drug samples were investigated with potential identifications made matching against the high-resolution mass spectral library, using both full scan and product ion scan spectra. The development of a compact TQ-MS system enables the future potential for rapid on-site analysis, supporting public health, law enforcement, and forensic applications. This innovation paves the way for mobile, point-of-need drug testing and identification, enhancing our ability to respond to emerging drug threats.

Background:Measuring the impact of nonfatal injuries and violence is essential for informed public health policymaking and communications. This study aimed to generate new health-related quality of life data for a prominent United States nonfatal injury surveillance source using disability weights derived from general population survey estimates.Methods:Disability weights reflecting severity as measured on a 0 (no disability) to 1 (death) scale, for 47 natures of injury from the Global Burden of Diseases, Risk Factors, and Injuries Study (GBD) were mapped to 492 injury types in the US National Electronic Injury Surveillance System - All Injury Program (NEISS-AIP). The matching of GBD natures of injury to NEISS-AIP injury types was based on the underlying definitions for each injury diagnosis.Results:The average disability value weighted by incidence for all NEISS-AIP types was 0.073 (95% uncertainty interval [UI]: 0.050–0.097), and the range by injured body part and diagnosis was 0.006–0.408. Injuries that impacted large or critical body parts (lower trunk, upper trunk, head, neck) had the highest disability weights. Internal injuries, crushing, burns, nerve damage, and fractures had higher disability weight values than lacerations, avulsions, and contusions. The three most common NEISS-AIP nonfatal injury types during 2015–2020 were poisoning, internal injuries of the head, and face lacerations, with disability weights of 0.163 (0.109–0.227), 0.168 (0.112–0.232), and 0.018 (0.010–0.029), respectively.Conclusion:Mapping of publicly available disability weights data to a prominent nonfatal injury surveillance source can improve opportunities to measure and communicate the health and economic impact of injuries and violence.

Willingness to adopt preventive measures among international travellers attending a vaccination centre during COVID-19: A cross-sectional study.

Chikungunya continues to expand geographically, driving demand for trustworthy, easy-to-read public guidance. Conversational AI systems are increasingly used for health information, yet their medical validity, reliability, and readability remain uneven. We evaluated four widely used chatbots (ChatGPT, Claude, DeepSeek, Gemini) on two task sets: (1) validity on a 50-item single-answer MCQ dataset about Chikungunya; and (2) reliability and readability on 13 core public-education questions derived from Google Trends "topics" and clinician. Reliability was scored with DISCERN, EQIP, GQS, and JAMA benchmarks by clinician raters; readability used ARI, CL, FKGL, FRES, GFI, and SMOG. Across three independent runs, Deepseek-V3.2 achieved the highest MCQ accuracy (86.7%); other models ranged near 72-78% accuracy. In paired brand-line comparisons, newer iterations outperformed predecessors: ChatGPT-5 vs. ChatGPT-4o showed a 5.3-percentage-point gain, and Deepseek-V3.2 vs. Deepseek-R1 showed an 8.7-point gain in accuracy. Reliability (DISCERN, EQIP, GQS, and JAMA) differed significantly across models (p < 0.05). Pairwise tests favored Deepseek-V3.2 on most instruments, though absolute JAMA scores were low for all systems, indicating limited transparency signals. Readability (ARI, CL, FKGL, FRES, GFI, and SMOG) also differed significantly (p < 0.05). Deepseek-V3.2 produced the easiest text on average, Gemini the most complex, and no model met the sixth-grade benchmark. Under the benchmark conditions of this study, newer chatbot iterations showed higher factual performance, and DeepSeek-V3.2 achieved the strongest task-specific answer-quality metrics. However, these findings should not be interpreted as evidence of readiness for public-health deployment or as an endorsement of any platform. Transparency remained limited, readability exceeded recommended public-facing levels, and platform-level concerns (including privacy, data governance, content moderation, and sociopolitical acceptability) remain essential considerations. Chatbots should therefore be treated as supervised adjuncts to, not substitutes for, authoritative public-health communication.

Genital ulcer disease (GUD), a common clinical presentation at health facilities in Uganda, is often caused by sexually transmitted infections (STIs) and increases the risk of HIV. Family planning (FP) methods are effective for preventing unintended pregnancies, while some methods, namely male and female condoms, also reduce the risk of STI transmission. However, little has been documented about FP use among individuals with GUD in Uganda. Patients with clinician-confirmed genital ulcers were enrolled for a GUD study at six sites across government clinics and community outreaches in Kampala, Wakiso, and Kalangala, Uganda, between July/2023 and June/2024. Demographic, behavioral, and family planning use data were collected in English and Luganda using prespecified questionnaires. Urine and genital swabs were collected for gonorrhea and chlamydia testing and blood for HIV and syphilis antibodies using rapid diagnostic tests (RDT). Pregnant women were excluded from the analysis. Associations with FP use were explored using rank sum tests, chi-square, and Fisher's exact tests as appropriate. Of 104 participants with confirmed genital ulceration, 75(72.1%) were women, 12(16.0%) of whom were pregnant. Overall, of 92 non-pregnant participants, 36(39.1%) had a reactive HIV RDT; 10(27.8%) were new diagnoses. Nine (9.8%) had positive tests for gonorrhea, chlamydia, or syphilis. No men reported condom use. Of the 63 non-pregnant female participants analyzed, 29(46.0%) reported current FP use. Subdermal implants were the most used method in 15/29(51.7%). Twenty-one (33.3%) reported ≥ 2 sexual partners in the past 3 months. FP use was significantly associated with younger age, being married, transactional sex, ≥ 2 sexual partners in the past 3 months, and being sexually active in the past month. More than one-sixth of women with GUD were pregnant. The uptake of FP among individuals with GUD was low, and HIV/STI prevalence was high. Effective FP has a key role in preventing unintended pregnancies and mother-to-child transmission of STIs. These findings highlight the need for educational and policy strategies to increase sensitization on sexual health, including increasing uptake of FP and encouraging male condom use in a population at high risk of STIs.

To examine secular trends in the incidence of early- (ages 45-64) and late-onset (ages 65+) dementia in Israel from 2011 to 2019 and to assess sex-specific patterns. A nationwide, population-based study using electronic health records from all four Israeli health maintenance organizations, which provide universal healthcare coverage. Incident cases were identified by International Classification of Diseases (ICD-9/10) codes and/or purchases of anti-dementia medications. Age- and sex-specific incidence rates were calculated, and joinpoint regression models were used to assess trends over time. Over the 9-year period, dementia incidence declined significantly in both early- and late-onset groups. Mean annual incidence per 100 individuals was 0.04 for early-onset dementia overall (0.05 in men, 0.04 in women), and 1.55 for late-onset dementia (1.35 in men, 1.72 in women). Statistically significant annual percentage changes (APCs) were observed across most age groups, with the sharpest declines in those aged 65-74 (-4.0% per year) and 75-84 (-4.1% per year). Among adults aged 85+, incidence was stable from 2011-2015, followed by a significant decline from 2015-2019 (-6.6% per year). These trends were consistent across sexes. These findings highlight important public health and community health implications, underscoring the need for continued dementia surveillance, early detection, and evidence-based policy to support healthy aging.

The role of community-based blood pressure screening in improving hypertension care.

The Implementation Leadership Scale (ILS) is widely used to measure implementation leadership for health innovations. While used often in behavioral health and other clinical settings, it remains untested in community public health contexts such as food retail. Healthy food retail strategies, including nutrition incentive programs, could benefit from measuring and subsequently strengthening leadership support to facilitate effective implementation. The objective of this study was to test the suitability of an adapted ILS to measure leadership support for a nutrition incentive program implemented in a brick-and-mortar food retail setting. As part of a larger evaluation, a multidisciplinary team of practitioners, evaluators, and food retail representatives created a modified version of the ILS suitable for the food retail context. Food retailer staff and management from one privately-owned grocery chain who participated in implementing a nutrition incentive program for Supplemental Nutrition Assistance Program (SNAP) shoppers in Southern California completed a survey that included the adapted ILS. Of the 522 survey respondents from the larger evaluation, 473 retailers including management and staff provided complete responses for the ILS. We assessed construct validity, internal consistency reliability, and measurement invariance using differential item functioning (DIF) analyses, Cronbach's alpha, confirmatory factor analysis (CFA), and multiple-group CFA for the adapted ILS. DIF analyses indicated minimal evidence of measurement bias. The CFA supported the original four-factor ILS structure, with excellent internal consistency for the knowledgeable, supportive, and perseverant subscales and fair consistency for the proactive subscale. Further, the demonstrated measurement invariance between management and staff highlights the robustness of the ILS and its potential for assessing alignment or discrepancies in perceptions of implementation leadership between management and staff within food retail organizations. Findings suggest that the adapted ILS is a valid and reliable tool for measuring implementation leadership support for nutrition incentive programs in a food retail setting in the US. Future research should examine the adapted ILS across diverse food retail environments and healthy food retail strategies to improve its generalizability and applicability.

Air Quality Health Indices (AQHIs) translate epidemiological concentration–response functions into composite risk metrics for public health communication. Recent proposals grounded in meta-analytic evidence have advanced the construction of globally harmonized indices by deriving pollutant weights from excess mortality risks at World Health Organization guideline concentrations. However, these approaches implicitly treat point estimates as exact quantities, overlooking the evidential uncertainty surrounding concentration–response parameters. In this commentary, we examine the implications of this assumption using the severity framework of Mayo and Spanos. We show that conventional point-estimate–based weighting structures embed a form of false precision that systematically exaggerates inter-pollutant risk differentials. By deriving severity-informed minimum warranted excess risks, we construct alternative weight ratios that reflect the magnitude of differences supported by the data rather than their nominal estimates. Numerical application to WHO guideline concentrations demonstrates that gaseous pollutant contributions are consistently underweighted when uncertainty is ignored. Importantly, this critique does not challenge the underlying epidemiological associations but distinguishes statistical significance from evidentially warranted magnitude. Incorporating severity-based reasoning into AQHI construction yields weighting schemes that are more conservative, epistemically defensible, and better aligned with the inferential limits of meta-analytic evidence. These findings suggest that future composite health indices should explicitly propagate parameter uncertainty to avoid overstating pollutant risk contrasts in public-facing tools.

Background Vaccine hesitancy and public adherence to health measures remain critical challenges in Slovakia, where coverage of COVID-19 vaccination has been low, and parents’ decisions regarding vaccination of their children further illustrate variability in immunization uptake. Methods This study investigates how Slovak adults (N = 505) differ in their perceptions of vaccination, compliance with restrictions, and health literacy. Using Latent Class Analysis, we identified three distinct population segments that reflect both internationally recognized typologies and the unique sociocultural context of Slovakia. Results Our findings indicate that health literacy is an important characteristic distinguishing population segments with different vaccine-related beliefs and behaviours. Individuals with higher health literacy demonstrated greater confidence in vaccination and more autonomous, informed decision-making, whereas those with lower literacy relied more on external authority and restrictive measures. Conclusions These results highlight the importance of tailored public health communication strategies that prioritize clarity, accessibility, and credibility, alongside interventions that combine education and community engagement. By targeting health literacy, policymakers can potentially reduce vaccine hesitancy and foster sustainable trust in health systems. Future research should explore longitudinal and mixed-method approaches to examine causal mechanisms and the dynamic interplay of literacy, trust, and social influence over time.

Dogs are key reservoirs of zoonotic infections, including Toxocara canis, a widely distributed parasite of major public health concern. In Vietnam, the parasite is highly prevalent in dog populations and humans. Epidemiological studies assessing infection and associated factors are essential to better understand transmission and to inform effective control strategies. We conducted a cross-sectional baseline survey to assess Toxocara infection in dogs in rural Vietnam. Fecal samples from 371 dogs were examined using centrifugal flotation (Sheather's solution, specific gravity 1.2) and conventional polymerase chain reaction (PCR), alongside structured questionnaires on dog demographics and management. Using combined copromicroscopic and molecular methods, the overall prevalence of Toxocara infection was 44.7% (95% CI: 39.6-50.0). By microscopy alone, 29.9% (95% CI: 25.4-34.9) of samples were positive, while PCR detected Toxocara DNA in 41.2% (95% CI: 36.2-46.5) of dogs. Molecular analysis identified T. canis in 35.9% (95% CI: 31.0-41.0) and T. cati in 10.5% (95% CI: 7.7-14.2) of tested dogs. Dog age and deworming status were independently associated with PCR-detected T. canis infection. The elevated likelihood of infection among dogs that have never been dewormed highlights the importance of canine deworming. Questionnaire findings indicating suboptimal dog care and management highlight the need for community public health education to promote responsible ownership and reduce transmission risk. This baseline assessment provides essential evidence to inform targeted interventions and improve understanding of Toxocara transmission in endemic settings.

Exploring consumer motivations to increase pulse protein in Portuguese family meals using means-end chain theory and novel recipes.

The stress test the COVID-19 pandemic imposed on the US public health system illuminated predictable yet surprisingly unplanned for fault lines. A perceived lack of choice associated with nonpharmaceutical and pharmaceutical interventions led many Americans to question both measures and processes for mitigating disease consequences, such as masking and mass vaccination. A cultural-historical examination shows that a central impediment for US efforts to control the pandemic was the limited sense of common good. Many factors and beliefs, including also that the scientific-biotechnological innovation system did not serve the interests of all people equally, and the public health community's equating disease with how people perceived illness, weakened vaccination acceptance and disease control efforts. We conclude that US public health must renegotiate the social contract with the American people to recover a shared understanding of its relevance and to effectively respond to future health challenges and pandemics.

Hierarchical alginate-bentonite beads enable instrument-free pre-analytic enrichment of liter-scale wastewater.

Effects of Dance Interventions on Physical Function in Healthy Older Adults: A Systematic Review and 3-Level Meta-Analysis.