Restricting choice of e-cigarette flavor and device type increases choices to use combusted cigarettes among adults who dual use both products: Results from a within-subjects randomized trial.

Mapping visceral leishmaniasis and examining environmental influences in Baringo County, Kenya.

A WHO panel previously recommended the use of hematopoietic cytokines to manage H-ARS within 24 hours of exposure to ≥ 2 Gy radiation dose, a recommendation that has been endorsed by hematologists and oncologists with expertise in radiation management. Nevertheless, no state-of-the-art consensus has been reached regarding categorical selection of cytokines for emergency scenarios involving accidental exposures where implementation of planned and/or extended countermeasures is certain or likely (INES levels 5, 6 and 7) or an exposure from a detonated nuclear weapon. A systematic review of the published literature was conducted (422 citations identified, 391 of which were screened) in non-human primates (NHPs) (9 meeting inclusion criteria), and in reviews of human cases treated with cytokines in a search of the MEDLINE database (1970-present), websites/official publications of major national and international organizations and radiation societies, cytokine reviews and Full Prescribing Information. In contrast to filgrastim, pegfilgrastim and romiplostim, sargramostim augments the differentiation and proliferation of multiple lymphohematopoietic lineages. NHP survival benefits without the support of blood products was reported with sargramostim or pegfilgrastim plus romiplostim. Four cytokine reviews met criteria for summarizing published reports of 63 human cases that included at least one case meeting inclusion criteria. Cytokine efficacy was documented when administered at up to 96 hours after NHP exposure for sargramostim and at 24 hours but not 48 hours after exposure for filgrastim, pegfilgrstim or pegfilgrastim plus romiplostim. Ease of use favored pegfilgrastim (administered weekly x2) and romiplostim (administered once), compared to filgrastim and sargramostim (administered daily x5 and x14, respectively). Formal assessment of the published evidence is urgently needed to provide categorical guidance regarding cytokine use for patient management, and to public health officials involved in establishing a national or shared regional radiation stockpile for immediate use in a mass casualty radiological/nuclear (R/N) emergency.

Several researchers have documented the occurrence of the unfamiliar severe acute respiratory syndrome coronavirus 2 ribonucleic acid (also known as SARS-CoV-2 RNA) in various raw wastewater (WW) samples analyzed globally. The efficiency of strategic WW-based epidemiology (WBE) approach as a timely cautioning tool for human coronavirus disease-2019 (COVID) and other similar outbreaks is highly promising. This strategy offers a cost-effective, population-wide surveillance tool that can detect rising case trends, from days to weeks before clinical reports, thus enabling proactive public health interventions. This study aimed to detect the occurrence of the viral genome in WW over four seasons, which contributes to the database for multi-plant surveillance research in South Africa. About 480 WW influent samples were amassed from ten sampling points situated in nine wastewater treatment facilities (WWTFs) in Amathole District Municipality (ADM) located in the Province of Eastern Cape (EC), South Africa (SA). The study was carried out for a period of one year. Quantitative real-time polymerase chain reaction (i.e., RT-PCR) was operated to identify the viral genomes in the respective total RNA samples. Of the 480 extracted RNA samples, 210 (44%) were positive with viral genome copies (gc) that ranged from 700 to 40,000 GC/mL. Our results were contrasted with existing COVID-19-positive cases throughout the COVID omicron wave in the ECP. Variations in gc were observed across different seasons, with the highest GC observed in winter. In contrast, there were significant inconsistencies in the existing data of COVID-19 clinical cases, thus indicating no connection between both data. However, with more similar studies, advanced innovative WBE strategies could possibly act as prompt warning tools to signal public health officials about potential future outbreaks.

The proliferation of antibiotic resistance genes (ARGs) in environmental microbiomes represents a major and growing threat to public health, creating a critical demand for precise and efficient tools to monitor resistance risk. Current approaches often depend on contig-based quantification or lack comprehensive risk indices, which compromises their accuracy and utility. To address this, we developed MetaRanker (https://github.com/SteamedFish6/MetaRanker), a computational pipeline that assesses resistome risk by integrating the abundance of ARGs, mobile genetic elements (MGEs), and virulence factors (VFs)-calculated directly from sequencing reads-with their genetic co-occurrence on contigs into a unified risk index (RI). This index reflects the potential for horizontal transfer and pathogen emergence. Evaluated using in silico and diverse real-world metagenomes (n = 353), MetaRanker demonstrated superior accuracy and stronger discriminatory power than existing methods. Its optimized compact database (29.6 MB) and alignment strategy reduced runtime by over 50% in comparison to MetaCompare 2.0 under identical hardware configurations (32 CPU cores, 128 GB RAM). Practical applications confirmed that MetaRanker effectively discriminates risk levels across environments (e.g., hospital wastewater versus natural soil) and quantifies risk mitigation through wastewater treatment. As a robust, lightweight, and sequencing-platform-agnostic tool, MetaRanker offers a powerful solution for comprehensive environmental resistome surveillance and evidence-based risk management.IMPORTANCEThe environmental reservoir of antibiotic resistance is a key contributor to the global health crisis of antimicrobial resistance. Effective surveillance and risk assessment of complex microbial communities are essential for prioritizing interventions and safeguarding public health. However, existing methods often provide fragmented or computationally demanding analyses, limiting their practical application for large-scale environmental monitoring. The significance of our work lies in developing MetaRanker, which overcomes these barriers by delivering a fast, accurate, and integrated metric of resistome risk. By simultaneously accounting for the abundance, mobility potential, and pathogenicity linkage of resistance determinants, MetaRanker enables a more realistic threat assessment. This tool empowers researchers and public health officials to track resistance hotspots, evaluate the impact of human activities such as waste disposal, and monitor the effectiveness of mitigation strategies, ultimately supporting data-driven decisions to curb the environmental spread of resistance.

Hearing loss (HL) is a prevalent condition that can substantially impact quality of life. Hearing aids can benefit people living with HL, yet many delay seeking treatment. This may be due to limited public awareness of HL and the stigma surrounding HL and hearing aids. The media can significantly shape public perceptions of HL and D/deafness, and there have been calls for improved media portrayals of HL and D/deafness. This study examined how British newspapers represent HL and D/deafness both visually and textually, and whether these representations reiterate and/or challenge stigma. This qualitative study used multimodal critical discourse analysis (MCDA) guided by stigma theory and the Visual Discourses of Disability framework. Public contributors living with HL or D/deafness were consulted. A Nexis database search retrieved 7,173 articles about HL or D/deafness from 2022-2023. A random sample, extracted from the 200 most relevant articles, was screened. Three key themes were identified: (1) representing social progress, including technological advancements and societal roles for people with HL or D/deaf people, (2) the lack of diverse narratives and perspectives, including the absence of older adults, and (3) the stigma and social barriers associated with living in a hearing-orientated world, including tensions regarding whether HL should be (in)visible. Combined, this suggests that the overall social progress narrative is challenged by continued stigmatisation and inadequate diversity. This research was a novel application of MCDA to representations of HL and D/deafness, which focused on British newspapers. Further efforts are needed to improve these representations, particularly representations of older adults. Future research should apply MCDA to representations of HL and D/deafness in other contexts. The findings have important implications for academics in discourse and disability studies, and for all those who communicate with the public about hearing loss, including researchers, clinicians, public health officials, charities, and the media.

This article examines novel approaches to the initial Covid-19 vaccination campaign in the Republic of Moldova, a developing nation in Eastern Europe. Moldova’s vaccination initiatives displayed tenacity and creativity in the rapid creation of a vaccination campaign that attempted to overcome barriers related to available resources, public access to vaccination sites, and anti-vaccination sentiment. This article focuses on highlighting Moldova’s interesting approaches to vaccination as well as the implementation strategies that proved most effective. Examples of Moldova’s initiatives include those aimed at 1) flexible use of resources, 2) meeting people where they are at, 3) ensuring equal accessibility of public health offerings, and 4) engaging with local community leaders. Information was primarily obtained via interviews with local public health officials from June to August 2024. The takeaways and solutions presented in this article may provide insight and inspiration in implementing similar, rapid public health campaigns, including those in resource-limited settings.

Utilizing perceptions of public health officials in Cali, Colombia to support the surveillance of co-circulating vector-borne diseases.

Infection prevention processes implemented at a children's hospital during a community measles outbreak, 2025.

Microbiological analysis and whole-genome sequencing of Neisseria gonorrhoeae from the microbiological failures in the international, zoliflodacin, phase 3, clinical trial for treatment of uncomplicated urogenital gonorrhoea: a retrospective, genomic, observational study.

Abstract Can international organizations (IOs) effectively shape attitudes held by individuals? Under what conditions does the public perceive information supplied by IOs as more trustworthy than information provided by other authorities? With the exponential growth of social network platforms, many IOs utilize them to engage individuals directly. Building on the growing literature on IOs’ engagement with the public, we examine if and under what conditions such effort is effective. We adopt insights from the literature on information source effect to theorize that the information disseminated by IOs is more effective than that by domestic health officials in shaping individuals’ attitudes when the IOs are portrayed as impartial and equipped with expertise in the relevant issue area. We test the hypotheses in the context of the World Health Organization (WHO) and the COVID-19-related measures. Our analysis of the survey experiment with a sample of 2865 Americans shows that political independents trust COVID-19-related information provided by the WHO more than information supplied by domestic public health officials, especially when the professional expertise the WHO staff commands is highlighted. In comparison, our analysis indicates that the information source effect is muted when information is delivered to individuals with strongly held existing attitudes, Democrats and Republicans in the case of COVID-19-related information in the United States.

Introduction: Public health challenges are increasingly complex and driven by the interaction of biomedical, social, economic, environmental, and behavioral determinants. Addressing these challenges requires integrated responses that transcend single-discipline approaches. Interdisciplinary strategies have been widely promoted; however, quantitative evidence demonstrating their effectiveness in improving public health outcomes remains limited. This study aimed to quantitatively examine the effectiveness of interdisciplinary strategies in addressing public health challenges and to analyze the relationship between interdisciplinary collaboration and public health program effectiveness. Methods: A quantitative cross-sectional analytical design was employed. The study involved a total population of 50 health professionals and program managers from primary health care centers, hospitals, and public health offices engaged in interdisciplinary public health activities. Data were collected using a structured questionnaire measuring interdisciplinary strategy implementation, including interprofessional communication, shared decision-making, and coordination across disciplines. Public health program effectiveness was assessed through indicators of program performance, service delivery efficiency, and perceived outcome improvement. Data were analyzed using descriptive statistics and Pearson correlation analysis, with statistical significance set at p < 0.05. Results: he findings indicated that the mean scores for all dimensions of interdisciplinary strategies and public health effectiveness were above the midpoint of the scale, reflecting positive implementation levels. Bivariate analysis demonstrated statistically significant positive correlations between interdisciplinary strategy implementation and public health program effectiveness (r = 0.62, p < 0.001). Interprofessional communication and coordination across disciplines showed the strongest associations with public health effectiveness. Conclusion: Interdisciplinary strategies are significantly associated with improved public health program effectiveness. Strengthening structured collaboration, communication, and coordination across disciplines is essential for addressing complex public health challenges and enhancing sustainable public health outcomes

Purpose: Physical inactivity is a public health challenge. Almost half of its associated health costs are related to mental health problems, for which walking and cycling are often more feasible forms of physical activity than sports. This study presents the first umbrella review to date on walking, cycling, and mental health. Methods: A systematic literature search was carried out in Scopus and PubMed, complemented by Semantic Scholar and Research Rabbit. Systematic, narrative, or scoping reviews, and selected studies in age groups with scarce evidence, were included if they specifically addressed mental health aspects and cycling or walking. Through a deductive and inductive iterative process, mental health outcomes were grouped. Data is being charted and summarised, distinguishing active mobility/cycling/walking, age groups, interventions, and nature-based approaches. Results: Titles of 1,277 and abstracts of 219 publications were screened, and 53 were included for inspection. Of those, 27 did not meet inclusion criteria. Eleven reviews on adults, one review and two cross-country cross-sectional studies on children and young people, one review on older adults, two on interventions and nine on nature-based approaches were included. Active travel, cycling and walking, are positively associated with mental health. Walking is beneficial for depressive symptoms, and those already depressed could benefit more. In RCTs, walking interventions significantly reduce depressive symptoms, and ≥0.25 miles (0.4 km) of walking per day seems protective against developing depressive symptoms. Walking also reduces anxiety symptoms in adults in RCTs. However, in both cases, for real-life active mobility, current evidence is insufficient to draw conclusions. Emerging evidence from low-and middle-income countries shows adolescents who actively travel to school have 12% lower odds for depressive symptoms than their peers. Walking is associated with lower psychological stress in adults. In people with disabilities, adaptive cycling is associated with increased wellbeing. Initial evidence suggests nature-based walking provides additional mental health benefits. Conclusion: The results support investments to promote safe active mobility as feasible, low-cost options to enhance mental health across large parts of the population. Support/Funding Source: Under the coordination of WHO European Centre for Environment and Health and supported by the Swiss Office of Public Health.

Public health has become politicized in the U.S. Though research shows that limiting public health authority during emergency response puts community wellbeing and health outcomes at risk, during the COVID-19 emergency (2020-2021), some U.S. state policymakers limited the disease-preventing actions local public health agencies could take. This conflicts with public health agencies' mandate to protect lives. Using COVID-19 as a case study, we explored how local public health agencies upheld their mandate when faced with limited public health authority. We conducted qualitative semi-structured focus groups (October 2023) with a purposive sample of U.S. public health officials (n=14) from seven U.S. states which experienced four types of restrictions on local public health actions (limits on the emergency authority of governor, chief executive, state health officer, and local government health officers). Participants discussed barriers and challenges faced, adaptations made, actions taken, and perspectives for the future. Emergent themes suggest that while limited resources and restricted public health authority caused strain, public health efforts were upheld through cross agency collaboration at the local level which supported innovation. To achieve this, trust-building and communication were vital. Limitations on local public health authority may increase in the U.S. in the coming years. To mitigate risks amidst future public health emergencies, public health leaders must focus on building trust, clear and consistent communication, and bolstering collaborative networks at the local level. The politicization of health policy at the state and federal level also needs to be addressed, as local action can only go so far.

Eye disease has evolved into a global health issue and has become widespread. Nowadays, ocular diseases spread all over the world and cause dangerous effects in humans. A wide range of eye diseases can significantly affect visual clarity, which can lead to permanent vision loss. Among these, glaucoma affects the optic nerve due to the increased eye pressure, often leading to vision loss. Thus, it requires an effective strategy that includes healthcare providers, public health officials and community education to prevent these diseases. One of the most effective measures for reducing the consequences of ocular disease among the population is periodic check-ups and early recognition of particular diseases. By extracting enriched features in the fundus and ocular computed tomography images, the multiple layers in the deep learning architectures help in accurate image classification and segmentation of specific areas in images. In this research, ocular disease detection with a severity classification model is proposed to prevent early vision loss. The process is started by gathering input images needed for the detection task. Then, the segmentation process is done on the input images using the developed Trans-EfficientUnet[Formula: see text] (TEUNet[Formula: see text] model. This segmentation process is helpful for faster analysis of the affected regions. Then, the ocular disease classification into the normal case and abnormal case will be performed via Adaptive and Region Attention-based Pyramid Dilated EfficientNetB7 (ARA-PDEB7). Here, an Enhanced Magnificent Frigatebird Optimization with Random Number Amendment (EMFO-RNA) was introduced for optimizing the performance of the classification model to obtain accurate outcomes. If the disease is detected, then severity assessments are done to take appropriate treatments. The features in segmented images are retrieved using the Pyramid Dilated EfficientNetB7 (PDEB7). The ocular disease classification performance of the presented model was analyzed among existing models to verify its efficiency.

The outbreak of the COVID-19 pandemic led policy makers and public health officials around the world to implement non-pharmaceutical interventions to suppress the spread of the virus. The goal was to reduce human mobility and social contacts, considered as the main factors of virus diffusion. However, these containment measures needed to be revised on a frequent basis to avoid serious economic and social costs. Moreover, spatial disparities needed to be taken into consideration, since the behavior of the virus was different according to the geographical context. Therefore, a frequent update on the short-term forecasts of the epidemic course, which considered spatial heterogeneities, was crucial for planning appropriate mitigation strategies. In this paper, we present a simple epidemiological model based on Cellular Automata, that takes into account human mobility and produces short-term forecasts of daily virus infections. Cellular Automata allow the discretization of time and space and thus, the spatio-temporal dynamics of the disease can be explored at the desired scale. We apply our model on real daily infection and mobility data from Spain and show that it is reliable in predicting the short-term daily infections trajectory both at the country level, as well as at the regional level of Autonomous Communities. Furthermore, compared against four state-of-the-art methods, the proposed method achieves comparable forecasting performance with significantly lower computational resources.

Abstract Climate change directly affects public health as it significantly influences the emergence and spread of epidemics. Factors such as temperature, precipitation have a major impact on and promote the growth of prevalent epidemics transmitted by vectors and waterborne epidemics, as seen from historical and contemporary evidence. The collection of high-quality data has become a must to be able to foster the growth of climate health models to understand and predict epidemic outbreaks due to climate variability. Innovative developments in weather and climate science, especially through artificial intelligence-enabled numerical weather prediction, boost confidence in forecasting key variables such as temperature and precipitation. However, a major obstacle to the integration of climate models with health prediction systems lies in the inaccessibility of comprehensive, publicly accessible health datasets for various epidemics. Such data sets, especially on granular spatial and temporal scales, are crucial to advance climate health research and model development. In this paper we present the first weekly district-wise dataset for major epidemics spanning across India from 2009 to 2022. The data utilized in this study has been sourced from the Integrated Disease Surveillance Program, a publically available database maintained by the Government of India. This dataset, named ‘EpiClim: India’s Epidemic-Climate Dataset’, bridges the gap by providing detailed insights into health data tailored for climate-health modeling. The data set offers insight into the temporal and spatial dynamics of epidemics such as dengue, malaria, and acute-diarrheal disease (ADD). We will see in this research work the correlation of various epidemics such as dengue, cholera, ADD, and malaria with temperature For example, dengue and malaria have a good correlation with temperature and cholera, on the other hand, usually outbreaks with anomalies with precipitation showing a good correlation with the precipitation factor. Such datasets open the gates to integrate climate forecasts with epidemic prediction models and create actionable insights for policymakers, public health officials, and researchers. This work lays the foundation for coupling predictive climate health models with numerical weather and climate models, driving an innovation that seeks to understand and mitigate public health crises caused by climate.

To evaluate the clinical performance of two-piece zirconia implants with screw-retained abutments compared to titanium implants after 1 year of loading. In this multicenter, prospective, randomized clinical trial, 61 two-piece zirconia and 61 titanium implants were placed and restored with single crowns. Evaluations were performed at implant placement, crown delivery, and 1-year post-loading. Peri-implant Marginal Bone Loss (MBL), survival rate, early wound healing index, and soft tissue parameters were assessed. Intergroup comparisons of continuous outcomes were performed using Linear Mixed-Effects Models accounting for center and potential confounders. Categorical variables were analyzed using the chi-square or Fisher's exact test. Survival was analyzed using Kaplan-Meier estimates. Significance was set at p < 0.05. No significant differences were found between the two implant types. Mean MBL from implantation to crown insertion was 1.10 ± 0.78 mm for titanium and 0.94 ± 0.67 mm for zirconia implants. No significant additional bone loss occurred over the subsequent year, with changes of 0.07 ± 0.55 mm and 0.08 ± 0.51 mm for titanium and zirconia, respectively. After 1 year, zirconia implants showed a 100% survival rate, while titanium implants showed 96.5% with two failures. At 1 year, differences in probing depths, plaque accumulation, and Papilla Bleeding Index were not statistically significant. After 1 year of loading, no statistically significant differences in MBL, implant survival, or peri-implant health were found between zirconia and titanium implants, indicating no clinical superiority. Zirconia implants may therefore be considered a viable alternative in single-tooth implant restorations. The study is registered at the German Clinical Trial Register (No. DRKS 00013209) as well as at the Federal Office of Public Health's (FOPH) portal for human research in Switzerland (kofam.ch).

Patients who have received a diagnosis of tuberculosis (TB) disease face barriers to continuing and completing TB treatment when they relocate between countries, potentially resulting in lower treatment completion rates. Treatment for TB disease can range from 6 months to more than 2 years in duration; failure to complete treatment increases the risk for TB transmission and emergence of drug resistance. CDC's CureTB program makes follow-up TB care referrals for persons relocating to or from the United States, either as temporary visitors or when returning to their home countries, by providing information directly to public health authorities at patients' destinations. To evaluate program performance, public health officials examined 2016-2023 CureTB referral outcomes and treatment completion rates. Among 6,944 referral requests received from U.S. or foreign authorities during 2016-2023, approximately one half (3,912; 56%) were for patients with suspected TB, and approximately one third (2,404; 35%) were for patients with confirmed TB. Among patients who had received a diagnosis of TB for whom a request for a referral was made, CureTB made referrals for 1,741 (72%), including 1,622 (93%) persons relocating to other countries and 119 (7%) relocating to U.S. destinations. Referrals were not required for 522 (22%) persons, and referrals could not be completed for 141 (6%) because information needed to contact the patient was insufficient. Overall, within 12 months of referral, 1,379 (79%) of 1,741 referred patients completed treatment. Among 1,287 (74%) referred patients for whom data on timing of initiation of care were available, treatment completion rates were highest (91%) for 637 patients linked to treatment ≤30 days after departure, followed by 89% for 505 patients linked within 1-3 months, and 85% for 145 linked within 3-12 months. Timely initiation of care can facilitate continuity of care and support completion of TB treatment. CureTB supports the global goals of reducing TB transmission, improving treatment completion rates, and enhancing progress toward TB elimination in the United States; the program can serve as a model for other countries.

The work Una pandemia olvidada en Chiapas: la influenza «española» de 1918-1919, by Miguel Lisbona Guillén, stands out for addressing the so-called «Spanish» influenza in Chiapas, between 1918 and 1919. It describes the public health policies adopted by the governments of Mexico and Chiapas, the deaths it caused, and the conception of the disease, based on information recorded in national, state, and municipal archives. Throughout its chapters, the author reflects on hygienization from the perspective of the International Office of Public Health (now WHO), the ministries of health, and the population, considering the popular knowledge used to combat the disease as well as its treatment and management. The author also analyzes how the State confronted the disease within the framework of public health, considering the economic repercussions. He further examines the evolution of the disease alongside health policies, the enforcement of sanitary codes, and their effectiveness for the benefit of the population. Finally, the book addresses the lack of knowledge about the disease and its mutations, which gave rise to speculation and to popular approaches in health practices aimed at counteracting the pandemic’s effects.