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Abstract Background Breast and cervical cancers pose significant health challenges for women globally, emphasizing the critical importance of effective screening programs for early detection. In Canada, despite the implementation of accessible healthcare systems, ethnic and racialized disparities in cancer screening persist. This study aims to assess ethnic and racialized disparities in breast and cervical cancer screening in Canada. Methods Using 2015–2019 data from the Canadian Community Health Survey, we analyzed women aged 18–70 in distinct ethnic and racial groups. The primary outcome was mammography or Papanicolaou test (pap smear). The secondary outcome was time since the last screening. We used weighted multivariable logistic regression to estimate the odds of having a pap smear or mammography across the ethnic and racialized groups, adjusted for relevant covariates. Results were reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results We included 14,628,067 women of which 72.5% were White, 8.4% Southeast Asian, 4.7% South Asian, 3.4% Indigenous, 2.7% Black, 2.0% West Asian, and 1.6% Latin American. In comparison with the White reference group, a higher odds ratio of not having a pap smear was estimated for the West Asian (5.63; CI 3.85, 8.23), South Asian (5.19; CI 3.79, 7.12), Southeast Asian (4.35; CI 3.46, 5.46), and Black groups (2.62; CI 1.82, 3.78). Disparities in mammography screening were found only for the Southeast Asian group with higher odds of not having screening (1.85; CI 1.15, 2.98) compared to the White reference group. Conclusion This study reveals significant disparities in pap smear and mammography screenings affecting various ethnic groups, particularly in West Asia, South Asian, and Black communities. These findings underscore the urgent need for targeted interventions, policies, and healthcare strategies to address these gaps and ensure equitable access to essential breast and cervical cancer prevention across all ethnicity.

Background Climate change and extreme weather events significantly threaten neonatal and child health. This review aims to provide a comprehensive overview of the current evidence on the impact of climate change on child health, using the evidence gap map (EGM) to address knowledge gaps and establish a foundation for evidence-based interventions and future research.Method From inception, academic databases (such as MEDLINE, EMBASE, Global Health, CINAHL and Scopus) and grey literature were systematically searched. We included climate change-related studies involving children aged 0–5 worldwide. Covidence facilitated a rigorous screening process, and we conducted a critical appraisal. Two independent reviewers handled screening and data extraction. Eligible studies underwent coding and extraction using Evidence for Policy and Practice Information (EPPI) reviewer software. The EGM was constructed using EPPI Mapper, and comprehensive findings were presented through live links and figures.Result We identified 196 studies, comprising 59.2% children and 40.8% neonates, with diverse research approaches, including 94% quantitative studies. There has been a notable increase in research publications over the past 5 years. Evidence is heavily concentrated in Asia (93 studies) and Africa (47 studies). The most frequently studied exposures are those related to extreme climate events, followed by drought and floods. However, there are gaps in the study of extreme cold and storms. The significant outcomes comprised preterm birth (55 studies), low birth weight (27 studies), malnutrition (59 studies) and diarrhoeal diseases (28 studies). Evidence on mental health problems and congenital disabilities receives relatively less attention.Conclusion This EGM is crucial for researchers, policymakers and practitioners. It highlights knowledge gaps and guides future research to address the evolving threats of climate change to global child health.Trial registration number INPLASY202370086

Objective: Glucose-1,6-bisphosphate (G-1,6-BP), a byproduct of glycolysis that is synthesized by phosphoglucomutase 2 like 1 (PGM2L1), is particularly abundant in neurons. G-1,6-BP is sensitive to the glycolytic flux, due to its dependence on 1,3-bisphosphoglycerate as phosphate donor, and the energy state, due to its degradation by inosine monophosphate-activated phosphomannomutase 1. Since the exact role of this metabolite remains unclear, our aim was to elucidate the specific function of G-1,6-BP in the brain. Methods: The effect of PGM2L1 on neuronal post-ischemic viability was assessed by siRNA-mediated knockdown of PGM2L1 in primary mouse neurons. Acute mouse brain slices were used to correlate the reduction in G-1,6-BP upon ischemia to changes in carbon metabolism by 13C6-glucose tracing. A drug affinity responsive target stability assay was used to test if G-1,6-BP interacts with the mitochondrial pyruvate carrier (MPC) subunits in mouse brain protein extracts. Human embryonic kidney cells expressing a MPC bioluminescence resonance energy transfer sensor were used to analyze how PGM2L1 overexpression affects MPC activity. The effect of G-1,6-BP on mitochondrial pyruvate uptake and oxygen consumption rates was analyzed in isolated mouse brain mitochondria. PGM2L1 and a predicted upstream kinase were overexpressed in a human neuroblastoma cell line and G-1,6-BP levels were measured. Results: We found that G-1,6-BP in mouse brain slices was quickly degraded upon ischemia and reperfusion. Knockdown of PGM2L1 in mouse neurons reduced post-ischemic viability, indicating that PGM2L1 plays a neuroprotective role. The reduction in G-1,6-BP upon ischemia was not accompanied by alterations in glycolytic rates but we did see a reduced 13C6-glucose incorporation into citrate, suggesting a potential role in mitochondrial pyruvate uptake or metabolism. Indeed, G-1,6-BP interacted with both MPC subunits and overexpression of PGM2L1 increased MPC activity. G-1,6-BP, at concentrations found in the brain, enhanced mitochondrial pyruvate uptake and pyruvate-induced oxygen consumption rates. Overexpression of a predicted upstream kinase inhibited PGM2L1 activity, showing that besides metabolism, also signaling pathways can regulate G-1,6-BP levels. Conclusions: We provide evidence that G-1,6-BP positively regulates mitochondrial pyruvate uptake and post-ischemic neuronal viability. These compelling data reveal a novel mechanism by which neurons can couple glycolysis-derived pyruvate to the tricarboxylic acid cycle. This process is sensitive to the glycolytic flux, the cell's energetic state, and upstream signaling cascades, offering many regulatory means to fine-tune this critical metabolic step.

Recent major disruptions such as natural disasters, geopolitical tensions, Covid-19 pandemic have led supply chain managers to rethink strategies for achieving significant levels of sustainability and resilience. At the same time, new digital technologies are offering significant opportunities to increase company performance, while maintaining a high level of customer service. In this challenging context, the Supply Chain Digital Twin (SCDT) represents an emerging and promising concept, which deserves to be explored. In this paper, a holistic and cyclical methodology, based on simulation, is proposed to enable and exploit the SCDT Paradigm, with the main aim to increase sustainability and resilience of the chains. The proposed methodology is successfully tested and validated on a real case study in the agri-food sector, through the use of the anyLogistix software. The results return valuable information on the level of resilience of the supply chain in the face of any considered disruption and provide useful managerial insights on the actions to be taken to improve some performance indicators.

Climate change poses unique challenges to maternal well-being and increases complications during pregnancy and childbirth globally. This evidence gap map (EGM) aims to identify gaps in existing knowledge and areas where further research related to climate change and its impact on maternal health is required. The following databases were searched individually from inception to present: Medline, EMBASE, and Global Health via OVID; Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCOhost; Scopus; and organizational websites. In this EGM, we integrated 133 studies published in English, including qualitative, quantitative, reviews and grey literature that examined the impact of climate change on maternal health (women aged 15-45). We used Covidence to screen studies and Evidence for Policy and Practice Information (Eppi reviewer)/Eppi Mapper software to generate the EGM. Data extraction and qualitative appraisal of the studies was done using critical appraisal tools. The study protocol was registered in International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) # INPLASY202370085. Out of 133 included studies, forty seven studies were of high quality, seventy nine moderate equality and seven low quality. This EGM found notable gaps in the literature regarding the distribution of research across regions. We found significant research in North America (51) and Asia (40 studies). However, Africa and the Caribbean had fewer studies, highlighting potential disparities in research attention and resources. Moreover, while the impact of extreme heat emerged as a prominent factor impacting maternal well-being, there is a need for further investigation into other climate-related factors such as drought. Additionally, while preterm stillbirth and maternal mortality have gained attention, there is an overlook of malnutrition and food insecurity indicators that require attention in future research. The EGM identifies existing research gaps in climate change and maternal health. It emphasizes the need for global collaboration and targeted interventions to address disparities and inform climate-responsive policies.

Abstract Aim The aim of the study was to explore and describe the mothers' perspectives on issues associated with caring for Ghanaian children aged 0–14 years living with tuberculosis. Design Exploratory descriptive qualitative design. Methods Semi‐structured individual interviews were conducted face to face with 15 purposively sampled mothers from two health facilities in the Greater Accra area. Transcribed data were analysed using computer‐enhanced thematic analysis. Results Findings were grouped into (1) physical burden on the mothers and (2) psychological burden on mothers. The eight subthemes indicate that mothers of children living with tuberculosis experienced tiredness, sleeplessness, body pains, weight loss and sicknesses as they cared for their children. In addition to worrying, mothers experienced stigma and negative emotions such as sadness, guilt, fear and loneliness. Conclusion Mothers of children diagnosed with tuberculosis in Ghana experience physical and psychological health problems related to their caregiving roles. Nurses and other healthcare providers should identify specific problems and offer broad‐based emotional and other support for these women.

Abstract Objective African newborns undergo numerous traditional and religious practices ranging from fontanelle fomentation to total head shaving, scalp molding, skin scarification and ano-genital irrigation which can negatively impact the health of neonates. Hot fomentation of fontanelles has been a predominant indigenous home-based postnatal practice in Ghana and among Africans in the diaspora. Mobility restrictions during the Covid-19 pandemic has impacted direct access to facility-based care as well as home care. The flourishing of newborn traditional practices among African populations during this Covid-19 pandemic offers opportunities to rethink the provision of family healthcare support for newborns during the ongoing pandemic and beyond. Hence, the aim of this critical review was to examine and describe a common indigenous practice—hot fontanelle fomentation to inform home birth support, discharge planning, and the delivery of optimal home-based care support. Study design This study is a review of literature on hot fomentation of newborn fontanelles. Methods Literature search in CINAHL, PubMed, African Index Medicus and Scopus, was conducted and evidence synthesised from articles ranging from 1983–2022. Sixty articles were reviewed; however, 10 manuscripts were excluded prior to screening. The other 19 were exempted because they were either below 1983 or were not the best fit for the study purpose. In all, 31 studies were included in the study. The study was guided by Madeleine Leininger’s Culture Care Diversity and Universality care theory. Results The current study identifies hot fomentation of newborn fontanelles practices in Ghana, the description of hot fomentation practices and the dangers associated with it. The findings and suggested ways to help overcome this challenge. Conclusion There are several neonatal indigenous practices including fontanelle fomentation which pose threat to the health of the neonate as discussed in this study. Future research needs to investigate innovative ways of fontanelle fomentation where necessary instead of the use of hot water by mothers, especially in this Covid-19 pandemic where health and mobility restrictions impact physical access to timely health care. This research will help educate mothers about the dangers of fontanel fomentation and reduce the practice, especially in rural areas of developing countries. This could help reduce neonatal mortality and unnecessary healthcare costs.

The electronic form of democracy carries the potential to resolve the crisis of the systems of the modern democratic structure, but recently its concept has been increasingly criticized. In this regard, researchers are interested in identifying the causes of this trend. The author suggests that the essence of the problem of e-democracy is in its internal contradictions: a) the convergence of the concept with other theories of democracy; b) ethical issues of the ICT exploitation within the political sphere. The former includes the combination in a single construction of fundamental features of both direct, deliberative and representative democracy in a single construction; substitution of the principles of direct democracy by the principles of plebiscite democracy; multidirectional aspirations expressed in involvement with the simultaneously existing internal apathy to the political sphere. Ethical contradictions: maximizing transparency with high manipulability; independence of decisions with controversial anonymity; reducing bureaucratic procedures as fraud acts increase; reduced number of absentists with persisting distrust of the system. Also, the methods of e-democracy within one society can create premises for both digital authoritarization and the strengthening of the role of civil society.