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Background: There is a lack of evidence regarding 24-hour movement behaviors of young children from low- and middle-income countries. This study examined Mongolian preschoolers' adherence to the World Health Organization's guidelines for physical activity, sedentary behavior, and sleep; their associations with health indicators, and the feasibility of the SUNRISE International study in Mongolia. Methods: Preschool-aged children were recruited from 5 kindergartens in urban and rural areas of Ulaanbaatar city and Tuv province in Mongolia. Physical activity and sedentary behavior were measured by an ActiGraph accelerometer worn for 5 consecutive days. Screen time and sleep were reported by parents. The National Institute of Health and Early Years Toolboxes were used to assess motor skills and executive function, respectively. Results: One hundred and one children participated in the study (mean age = 4.82 y, boys = 58), with 88% (n = 89) having complete data for analysis. The proportion of children who met the recommendations for physical activity, sedentary screen time, and sleep was 61%, 23%, and 82%, respectively. Only 7% met all recommendations. Meeting the sleep recommendation individually (P =.032) and in combination with the physical activity recommendation was associated with better gross (P =.019) and fine (P =.042) motor skills. Spending more time in physical activity was positively correlated with motor development. Results confirmed that the SUNRISE study protocol was feasible, age-appropriate, and enjoyable for children. Conclusions: The results of the SUNRISE pilot study will help inform the SUNRISE Mongolia main study and lay the groundwork for future research into children's 24-hour movement behaviors in Mongolia. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to comprehensively investigate the global implementation of flywheel training (FT) by basketball strength and conditioning (S&C) coaches in various contexts, encompassing daily practice, games, and sessions. Methods: Survey data were collected from 117 basketball S&C coaches who participated in a 24-question online survey. The survey was structured into 6 key areas, including country and competition, S&C coach context, training methodology, flywheel and competition, postactivation performance enhancement, and recovery. Results: Notably, all respondents emphasized the necessity of a familiarization period with flywheel technology, with a substantial 96% indicating that FT yielded improved player performance on the court. The predominant mention was the conical pulley system. During the season, the prevalent approach involved integrating FT into training twice a week, allocating <15 minutes per session, often in conjunction with traditional strength training. A diverse array of lower-body closed kinetic chain exercises were reported, encompassing squats, decelerations, and backward lunges. Intriguingly, FT implementation on match days was unlikely (77%), with the primary aims cited as injury prevention (34%) and enhancing players' strength levels during various phases of the regular season (27%). Conclusions: Recognizing its inherent limitations, this descriptive study provides valuable contextual insights and practical applications for professional basketball practitioners grappling with the utilization of FT. [ABSTRACT FROM AUTHOR]

Objective To describe the scale-up of cervical cancer screening and treatment for women living with human immunodeficiency virus (HIV), aged 25-49 years in Uganda, and to analyse the programme data. Methods The health ministry targeted existing HIV clinics in a 2-year scale-up of cervical cancer screening services from October 2020. In preparation, we trained health workers to assess women attending HIV clinics for screening eligibility, provided either by human papillomavirus (HPV) testing and/or visual inspection with acetic acid. Clinic staff treated women with precancerous cervical lesions with thermocoagulation or referred women with suspected cancer to external services. We analysed data reported every 6 months for the number of clinics offering screening, screening uptake, the number of positive diagnoses and the number of women who received treatment. Findings The number of HIV clinics offering cervical cancer screening services increased from 11, before the programme launch, to 1571. During the programme, screening uptake increased from 5.0% (6506/130 293) to 107.3% (151872/141 527) of targets. The cumulative proportion of positive diagnoses was 5.9% (23 970/407 323) overall, but was much lower for screening offering visual inspection only compared with clinics offering HPV testing. Although the proportion of women receiving treatment if positive increased from 12.8% (53/413) to 84.3% (8087/9592), the World Health Organization target of 90% was not reached. Conclusion We demonstrated marked increases, potentially replicable by other countries, in screening and treatment. These increases could be improved further by expanding HPV testing and same-day treatment of precancerous lesions. Objectif Decrire Intensification du depistage et du traitement du cancer du col de l'uterus chez les femmes vivant avec le virus de l'immunodeficience humaine (VIH) et agees de 25 a 49 ans en Ouganda, puis analyser les donnees du programme. Methodes Le Ministere de la Sante a cible les cliniques de prise en charge du VIH existantes dans le cadre d'un renforcement des services lies au cancer du col de l'uterus sur une periode de deux ans, a partir d'octobre 2020. En amont, nous avons forme des professionnels de la sante a examiner les femmes frequentant les cliniques du VIH afin de determiner leur admissibility au depistage, par un test de detection du papillomavirus humain (HPV) et/ou une inspection visuelle apres application d'acide acetique. Le personnel des cliniques a traite les femmes presentant des lesions precancereuses du col de l'uterus par thermocoagulation, ou les ont renvoyees vers des services externes lorsqu'elles etaient susceptibles d'etre atteintes d'un cancer. Nous avons analyse les donnees transmises tous les six mois concernant le nombre de cliniques proposant un depistage, la participation au depistage, le nombre de diagnostics positifs et le nombre de femmes ayant repu un traitement. Resultats Le nombre de cliniques du VIH disposant de services de depistage du cancer du col de l'uterus a augmente: 11 avant le lancement du programme, 1571 apres. Au cours de ce programme, la participation au depistage est passee de 5,0% (6506/130 293) a 107,3% (151 872/141 527) des cibles. Le pourcentage cumule de diagnostics positifs s'elevait a 5,9% (23 970/407 323) au total; cependant, il etait nettement moins important dans des cliniques effectuant uniquement des inspections visuelles que dans celles proposant un test de detection du HPV. Bien que le pourcentage de femmes ayant regu un traitement en cas de diagnostic positif ait progresse de 12,8% (53/413) a 84,3% (8087/9592), l'objectif de l'Organisation mondiale de la Sante, fixe a 90%, n'a pas ete atteint. Conclusion Nous avons observe des hausses considerables, susceptibles de se reproduire dans d'autres pays, en matiere de depistage et de prise en charge. Ces hausses pourraient etre accentuees par le developpement des tests de detection du HPV et de traitement des lesions precancereuses le jour meme. Objetivo Describir la ampliacion del cribado y tratamiento del cancer de cuello uterino para mujeres con el virus de la inmunodeficiencia humana (VIH) de entre 25 y 49 anos en Uganda, y analizar los datos del programa. Metodos El Ministerio de Salud se centro en las clinicas de VIH existentes en una ampliacion de dos anos de los servicios de cribado del cancer de cuello uterino a partir de octubre de 2020. Como preparacion, formamos a profesionales sanitarios para que evaluaran a las mujeres que acudian a las clinicas de VIH para determinar si cumplian los requisitos para someterse al cribado, mediante pruebas del virus del papiloma humano (VPH) o inspeccion visual con acido acetico. El personal clinico trato a las mujeres que presentaban lesiones cervicales precancerosas con termocoagulacion o derivo a las mujeres con sospecha de cancer a servicios externos. Se analizaron los datos comunicados cada seis meses sobre el numero de clinicas que ofrecian el cribado, la aceptacion del cribado, el numero de diagnosticos positivos y el numero de mujeres que recibieron tratamiento. Resultados El numero de clinicas de VIH que ofrecen servicios de cribado del cancer de cuello uterino aumento de 11, antes del lanzamiento del programa, a 1571. Durante el programa, la aceptacion del cribado aumento del 5,0% (6506/130 293) al 107,3% (151 872/141 527) de los objetivos. El porcentaje acumulado de diagnosticos positivos fue del 5,9% (23 970/407 323) en general, pero fue mucho menor en el caso de los diagnosticos en clinicas que solo ofrecian inspeccion visual en comparacion con las clinicas que ofrecian pruebas del VPH. Aunque el porcentaje de mujeres que recibieron tratamiento en caso positivo aumento del 12,8% (53/413) al 84,3% (8087/9592), no se alcanzo el objetivo del 90% que habia fijado la Organizacion Mundial de la Salud. Conclusion Se registraron aumentos notables, potencialmente reproducibles en otros paises, en el cribado y el tratamiento. Estos aumentos podrian mejorarse aun mas ampliando las pruebas del VPH y el tratamiento en el mismo dia de las lesiones precancerosas. [phrase omitted], Introduction Cervical cancer is a disease of the female reproductive tract caused primarily by oncogenic types of human papillomavirus (HPV). In 2020, it was the fourth most common cancer among [...]

ABSTRACT Objective Design Results Conclusion Despite a brief decline during the COVID‐19 pandemic, vaping behaviors among adolescents continue to be an international public health concern because of associated health risks and harms. A thorough investigation of existing interventions preventing adolescent vaping is needed to help address this public health crisis and reduce serious and avoidable vaping‐related health risks. We reviewed the literature to identify public health interventions aimed at preventing adolescent vaping and summarized their key components and outcome measures.We conducted a scoping review of the literature using the Joanna Briggs Institute methodology searching in MEDLINE, CINAHL, Embase, PubMed, PsycINFO, ProQuest, and Web of Science. Two reviewers screened 589 records for relevance. Studies from any location, reported in English, and described vaping prevention interventions targeting adolescents were included. Records were excluded if they were reported in other languages, published outside the review timeframe, lacked an evaluation, focused on cessation‐based interventions, or were review articles. Data extracted included intervention type, key components, and outcome measures.Thirty‐eight included articles were identified and categorized into three intervention categories: school‐based, public education/risk communication campaigns, and public policies/government regulations. Key components of the interventions included format, duration, and topics. Formats varied from single to multi‐sessions. Prominent topics covered included risks and harms associated with vaping, and the most frequently reported outcome measures used were knowledge, attitudes, and beliefs.Our findings summarize existing public health interventions found in the literature and insights into approaches used to address the global adolescent vaping crisis. [ABSTRACT FROM AUTHOR]

In recent decades, global rates of overweight and obesity have surged, posing significant health challenges, Maternal obesity is particularly concerning because of its potential adverse effects on women, foetuses, and children. The intrauterine environment plays a crucial role in shaping long-term health outcomes, with maternal factors significantly influencing childhood obesity and related health markers. This review synthesises current evidence on the associations between macrosomia, maternal weight, pregnancy weight gain, and offspring obesity risk. It explores how maternal weight status during pregnancy may impact a child’s susceptibility to obesity later in life, examining potential underlying mechanisms. By consolidating these findings, the review aims to deepen our understanding of the complex relationships between maternal health, prenatal factors, and childhood obesity. This knowledge can inform future research and public health strategies aimed at addressing this global health issue effectively. [ABSTRACT FROM AUTHOR]

Background and purpose Methods Results Conclusions The European Academy of Neurology (EAN) has adhered to the global plan for reducing the burden of neurological disorders and promoting brain health launched by the World Health Organisation (WHO), the WHO Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders. This study reports the results of an EAN survey among national neurological societies (NNSs) on their awareness of brain health policies.The EAN survey on the current state of national brain health policies was conducted among the 47 presidents of the NNSs affiliated with the EAN, with the aim of developing the best strategy for close collaboration among stakeholders.From June 2023 to February 2024, 36/47 responses (77%) were collected. Among respondents, 67% were in contact with their Ministry of Health and 78% were aware of and in contact with one or more national neurological patient organisation, while 17% had no contacts with any association. Ninety‐two percent declared a high to medium degree of awareness of the need to support brain health and of brain health plans and strategies in their country.Our findings suggest good awareness of the importance of brain health and of the strategies implemented at the national level among the EAN‐affiliated NNSs and representatives. Efforts towards improvement may be directed towards cooperation between NNSs and political institutions, as well as patient organisations, to optimise brain and global public health and neurological care in each country. [ABSTRACT FROM AUTHOR]

Background: The viability of community-based health insurance programs depends on beneficiary satisfaction, and healthcare systems evaluate performance through patient reports and ratings to ensure effectiveness and service quality. To our knowledge, Ethiopia lacks national pooled data on the satisfaction of community-based health insurance beneficiaries and related factors. As a result, this review aimed to evaluate the level of beneficiaries' satisfaction with the scheme's services and associated factors in Ethiopia. Methods: Database searches on Scopus, Hinari, PubMed, Google Scholar, and Semantic Scholar were conducted on September 1st, 2022. Thirteen studies were chosen for review from the search results. Checklists from the Joan Briggs Institute were used to evaluate the risk of bias for the included studies. The data were extracted using a 2019 Microsoft Excel spreadsheet and analyzed using Stata 17. The odds ratios at p-values less than 0.05 with a 95% confidence interval were used to evaluate the effect estimates. Results: The pooled satisfaction of beneficiaries with community-based health insurance was found to be 66.0% (95% CI = 57-76%) and was found to be influenced by socio-demographic, health service-related, the scheme's related factors, and the beneficiaries' knowledge of it. The beneficiary satisfaction levels were highest in the Amhara region, at 69.0% (95% CI = 59-79%), followed by Southern Nations Nationalities and Peoples' Region (SNNPR) at 67.0% (95% CI = 40-94%), Oromia at 63.0% (95% CI = 58-68%), and Addis Ababa at 53.0% (95% CI = 45-62%). Conclusion: Even though there was a moderate level of satisfaction, there are indications that the quality of health services and the coverage of the entire population lag behind, necessitating greater efforts to achieve universal health coverage. [ABSTRACT FROM AUTHOR]

Solid fuel combustion exposure is a leading global health risk factor, yet evidence on its effects, especially on vulnerable children, is sparse. This large-scale, multi-center prospective study aimed to address this gap by involving 9997 schoolchildren across China between 2013 and 2015. Here we show that lung function levels exhibited a marginally significant decline among children exposed to solid fuel usage. Specifically, FVC and FEV1 decreased by 21.2 mL (95% CI: −15.7, 58.1) and 24.1 mL (−8.4, 56.6), respectively. Additionally, PEF, FEF25 and FEF75 decreased by 25.7 mL/s (−46.5, 98.0), 32.7 mL/s (−42.7, 108.2), and 35.4 mL/s (−5.9, 76.7), respectively. Persistent exposure to solid fuel usage in children led to greater lung damage. Children with allergy history were more susceptible to solid fuel exposure. Our study highlights the adverse impact of solid fuel usage on children and the need to promote clean fuel usage for this vulnerable population. This study of 9,997 Chinese children (2013–2015) found that solid fuel exposure led to marginally significant declines in lung function, with higher risk for children with persistent exposure or allergies, highlighting the need for clean fuel use. [ABSTRACT FROM AUTHOR]

The emergence of antimicrobial resistance (AMR) across bacterial pathogens presents a serious threat to global health. This threat is further exacerbated in tuberculosis (TB), mainly due to a protracted treatment regimen involving a combination of drugs. A diversity of factors contributes to the emergence of drug resistance in TB, which is caused by the pathogen Mycobacterium tuberculosis (Mtb). While the traditional genetic mutation‐driven drug resistance mechanisms operate in Mtb, there are also several additional unique features of drug resistance in this pathogen. Research in the past decade has enriched our understanding of such unconventional factors as efflux pumps, bacterial heterogeneity, metabolic states, and host microenvironment. Given that the discovery of new antibiotics is outpaced by the emergence of drug resistance patterns displayed by the pathogen, newer strategies for combating drug resistance are desperately needed. In the context of TB, such approaches include targeting the efflux capability of the pathogen, modulating the host environment to prevent bacterial drug tolerance, and activating the host anti‐mycobacterial pathways. In this review, we discuss the traditional mechanisms of drug resistance in Mtb, newer understandings and the shaping of a set of unconventional approaches to target both the emergence and treatment of drug resistance in TB. [ABSTRACT FROM AUTHOR]

Total Knee Arthroplasty (TKA) is a surgery that is commonly performed on older adults to improve their quality of life. However, the increasing use of knee joint prostheses has led to a rise in the incidence of Prosthetic Joint Infections (PJI) in patients after TKA. Different clinical studies have looked at the occurrence of PJI after TKA in different regions, but they have drawn varying conclusions. To better understand this topic, we conducted a meta-analysis and bibliometric study using data from multiple databases. Our research found that the estimated prevalence of PJI after TKA is approximately 1.08% across different regions, but there is still considerable variation. Additionally, our regression analysis of sub-groups shows significant differences in follow-up periods. Furthermore, our comprehensive bibliometric analysis identifies current research trends, "hotspots" related to TKA-related PJI, influential nations, organizations, and noteworthy publications. Our analysis provides valuable insights to guide future research in this area. [ABSTRACT FROM AUTHOR]

Robust data privacy regulations hinder the exchange of healthcare data among institutions, crucial for global insights and developing generalised clinical models. Federated learning (FL) is ideal for training global models using datasets from different institutions without compromising privacy. However, disparities in electronic healthcare records (EHRs) lead to inconsistencies in ML-ready data views, making FL challenging without extensive preprocessing and information loss. These differences arise from variations in services, care standards, and record-keeping practices. This paper addresses data view heterogeneity by introducing a knowledge abstraction and filtering-based FL framework that allows FL over heterogeneous data views without manual alignment or information loss. The knowledge abstraction and filtering mechanism maps raw input representations to a unified, semantically rich shared space for effective global model training. Experiments on three healthcare datasets demonstrate the framework's effectiveness in overcoming data view heterogeneity and facilitating information sharing in a federated setup. [ABSTRACT FROM AUTHOR]

Objective: Uterine cancer (UC) is one of the prevalent malignancies in the female reproductive system. Estimating the burden trends of UC is crucial for developing effective prevention strategies at the national level. However, there has been no comprehensive analysis of the UC burden in China. We focused on the evaluation of the burden trends of UC in China over the past 32 years to provide a 15-year projection, comparing it with global levels. Methods: Data on incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were extracted from Global Burden of Disease (GBD) 2021 to describe the burden of UC in China. Joinpoint regression analysis was employed to describe the temporal trends of UC in China and globally over the past 32 years. A Bayesian age-period-cohort model was utilized to predict the trends of UC in the next 15 years. Spearman correlation analysis was used to compare the relationship between ASIR, ASPR, ASMR, ASDR, and SDI in UC in China and globally. Changes in ASMR and ASDR in UC caused by high BMI in China and globally from 1990 to 2021 were explored. Results: In 2021, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) of UC in China were 6.65, 46.52, 1.24, and 37.86 (per 100,000 population) respectively. Compared to 1990, the ASMR and ASDR decreased by 48.63% and 48.15% respectively, while the ASIR and ASPR increased by 17.79% and 37.67% respectively. Globally, the burden of UC followed a similar trend in China, with increasing ASIR and ASPR, and decreasing ASMR and ASDR, although the magnitude of increase and decrease was smaller than in China. Joinpoint regression analysis results showed an overall upward trend in ASIR and ASPR for both China and global UC, while an overall downward trend was observed in ASMR and ASDR. Age-specific analysis revealed that during the period from 1990 to 2021, the age groups with the highest incidence, prevalence, mortality, and DALYs for UC in China generally occurred at earlier ages compared to the global pattern. It is projected that over the next 15 years, the burden of UC in China will continue to increase at a higher rate than the global level. Spearman correlation analysis showed that ASIR and ASPR of UC in China and the world were significantly positively correlated with SDI (p < 0.05), and ASMR and ASDR were significantly negatively correlated with SDI (p < 0.001). High BMI is a risk factor affecting the mortality rate and DALYs of UC in both China and globally, with the increase in ASMR and ASDR due to high BMI being greater in China than globally. Conclusion: The incidence and prevalence burden of UC among Chinese and global women have shown an increasing trend over the past 32 years, while the mortality and DALYs have decreased. The projected burden of UC in China is anticipated to continue rising at a higher rate than the global level over the next 15 years. Given the large population in China, the government needs to strengthen screening and prevention strategies to mitigate the burden of UC. [ABSTRACT FROM AUTHOR]

Addressing health inequity is a central component of the Sustainable Development Goals and a priority of the World Health Organization (WHO). WHO supports countries in strengthening their health information systems in order to better collect, analyze and report health inequality data. Improving information and research about health inequality is crucial to identify and address the inequalities that lead to poorer health outcomes. Building analytical capacities of individuals, particularly in low-resource areas, empowers them to build a stronger evidence-base, leading to more informed policy and programme decision-making. However, health inequality analysis requires a unique set of skills and knowledge. This paper describes three resources developed by WHO to support the analysis of inequality data by non-statistical users using Microsoft Excel, a widely used and accessible software programme. The resources include a practical eLearning course, which trains learners in the preparation and reporting of disaggregated data using Excel, an Excel workbook that takes users step-by-step through the calculation of 21 summary measures of health inequality, and a workbook that automatically calculates these measures with the user's disaggregated dataset. The utility of the resources is demonstrated through an empirical example. [ABSTRACT FROM AUTHOR]

Despite recognized need and reasonable demand, health systems and rehabilitation communities keep working in silos, independently with minimal recognition to the issues of those who require rehabilitation services. Consolidated effort by health systems and rehabilitation parties, recognizing the value, power and promise of each other, is a need of the hour to address this growing issue of public health importance. In this paper, the importance and the need for integration of rehabilitation into health system is emphasized. The efforts being made to integrate rehabilitation into health systems and the potential challenges in integration of these efforts were discussed. Finally, the strategies and benefits of integrating rehabilitation in health systems worldwide is proposed. Health policy and systems research (HPSR) brings a number of assets that may assist in addressing the obstacles discussed above to universal coverage of rehabilitation. It seeks to understand and improve how societies organize themselves to achieve collective health goals; considers links between health systems and social determinants of health; and how different actors interact in policy and implementation processes. This multidisciplinary lens is essential for evidence and learning that might overcome the obstacles to the provision of rehabilitation services, including integration into health systems. Health systems around the world can no longer afford to ignore rehabilitation needs of their populations and the World Health Assembly (WHA) resolution marked a global call to this effect. Therefore, national governments and global health community must invest in setting a priority research agenda and promote the integration of rehabilitation into health systems. The context-specific, need-based and policy-relevant knowledge about this must be made available globally, especially in low- and middle-income countries. This could help integrate and implement rehabilitation in health systems of countries worldwide and also help achieve the targets of Rehabilitation 2030, universal health coverage and Sustainable Development Goals. [ABSTRACT FROM AUTHOR]

Dengue is a vector-borne disease that has increased over the past two decades, becoming a global public health emergency. The transmission of dengue is contingent upon various factors, among which climate variability plays a significant role. However, there remains substantial uncertainty regarding the underlying mechanisms. This study aims to investigate the spatial and temporal patterns of dengue risk and to quantify the associated risk factors in Valle del Cauca, Colombia, from 2001 to 2019. To achieve this, a spatio-temporal Bayesian hierarchical model was developed, integrating delayed and non-linear effects of climate variables, socio-economic factors, along with spatio-temporal random effects to account for unexplained variability. The results indicate that average temperature is positively associated with dengue risk 0-2 months later, showing a 35% increase in the risk. Similarly, high precipitation levels lead to increased risk approximately 2-3 months later, while relative humidity showed a constant risk within a 6 months-lag. These findings could be valuable for local health authorities interested in developing early warning systems to predict future risks in advance. [ABSTRACT FROM AUTHOR]

The G20 summit is a unique opportunity for India to reinvigorate and realign its public health policies and enhance its role and influence in global health governance. India, as the world's most populous country and the fifth largest economy, has a vital stake and responsibility in addressing the health challenges and opportunities globally. The COVID-19 pandemic has exposed the vulnerabilities and interdependencies of the global health system and highlighted the need for stronger cooperation and solidarity among countries. The G20 summit provides a platform for India to showcase its public health achievements, such as its remarkable vaccination drive, its universal health coverage scheme, its digital health initiatives, and its leadership in health diplomacy and research. It enables India to seek cooperation and support from other countries on health issues of common concern, such as ensuring equitable access to vaccines and therapeutics, strengthening health systems resilience and preparedness, promoting health innovation and research, and fostering health diplomacy and leadership. At the G20 summit, India recommends to take concrete actions such as advocating for a global treaty on pandemic preparedness, supporting a global health financing mechanism, enhancing W.H.O.'s role, and strengthening the G20's health agenda and governance. Key Messages: This article provides a comprehensive and timely analysis of India's public health situation and priorities in the context of the G20 summit and offers practical and strategic advice for India's engagement and influence at the global health stage. It argues that the G20 summit is a critical platform for India to showcase its public health achievements and aspirations and to seek cooperation and support from other countries on health issues of common concern, such as the COVID-19 pandemic, universal health coverage agenda, health workforce crisis and digital health revolution. It also suggests some concrete actions and recommendations for India to take at the G20 summit, such as advocating for equitable access to vaccines and therapeutics, strengthening health systems resilience and preparedness, promoting health innovation and research, and fostering health diplomacy and leadership. This article can help inform and inspire policymakers, practitioners, researchers and advocates who are interested in India's public health development and its role in global health governance. It can also stimulate further dialogue and debate on how India can leverage the G20 summit to advance its public health goals and collaborate with global partners on health challenges. [ABSTRACT FROM AUTHOR]

Introduction: Stroke is a life-threatening condition that increasingly damages cerebral tissue over time and can lead to serious post-effects, including depression, which can hinder a patient's recovery from stroke and reduce quality of life. This paper aims to analyze the global research landscape of post-stroke depression (PSD) between the years 1900 to 2024 using bibliometric analysis. Methods: The data used in this analysis was collected from the Web of Science Core Collection (WoSCC). An advanced search was performed using the keywords, "stroke" and "depression," on July 8th, 2024. From the Web of Science, bibliometric data was then extracted and analyzed in VOSviewer through four categories: countries, number of publications, keywords, and journals. Results: The bibliometric analysis resulted in 2,289 publications from the year 1900 to 2024. A gradual increase in the number of publications on post-stroke depression over the study period was observed. China was found to be the leading country for publications and funding on PSD, with the United States following in second. The top keywords included: "stroke," "depression," and "poststroke depression." The Journal of Stroke had the highest number of publications on depression in post-stroke patients. Conclusion: This study provides an overview of the current trends in articles published on PSD. Depression is an important topic to be considered in post-stroke patients due to its negative effects on post-stroke recovery and reduced quality of life, necessitating a call to attention and support for future research in this field. With continued research efforts led by the United States and China, improved treatments for patients with post-stroke depression can be implemented. [ABSTRACT FROM AUTHOR]

Objectives: To assess the global burden of atrial fibrillation (AF) attributable to high body mass index (BMI) from 1990 to 2021 and analyze its spatiotemporal distribution characteristics. Study design: An observational study based on GBD 2021 data. Methods: Data on AF burden due to high BMI were obtained from the Global Burden of Disease Study (GBD) 2021. Estimated annual percentage change (EAPC) was calculated to evaluate temporal trends in age-standardized rates of deaths and disability-adjusted life years (DALYs) over 30 years. Results: In 2021, high BMI-related AF caused 27,000 deaths and 725,000 DALYs globally, a 376% increase since 1990. Females and the elderly (aged 70+) bore a higher burden. Upper-middle-income regions surpassed high-income regions in AF burden. Australasia had the highest age-standardized rates, while High-income Asia Pacific and South Asia had the lowest. South Asia showed rapid growth in age-standardized death rates. Conclusion: The global burden of high BMI-related AF varies across regions and time, threatening global health, especially for females and the elderly. Targeted strategies are needed to reduce AF and obesity. [ABSTRACT FROM AUTHOR]

Several epidemiologic studies have investigated the circulating levels of albumin, bilirubin, and uric acid (UA) in relation to cancer risk; however, they have provided equivocal evidence. In this prospective case-cohort study, we measured the plasma levels of albumin, bilirubin, and UA and investigated their association with cancer incidence in 3584 case patients and 4270 randomly selected participants with a median follow-up of 15.8 years. The adjusted hazard ratios (HRs) and 95% CIs of total cancer for the highest quartile (Q4) versus lowest quartile (Q1) was 0.77 (95% CI, 0.67-0.90; P <.001 for trend) for albumin. This association was attenuated after excluding liver cancer cases with lower plasma albumin levels. Plasma bilirubin levels were positively related to liver cancer but inversely to total cancer after excluding liver cancer with, for Q4 versus Q1, an adjusted HR of 0.86 (95% CI, 0.74-0.99; P  = .015 for trend). Plasma UA levels were not dose-responsively associated with total cancer risk. Higher plasma bilirubin levels were associated with a decreased risk of total cancer after excluding liver cancer, which is likely attributed to the antioxidant properties of bilirubin. [ABSTRACT FROM AUTHOR]

Simple Summary: Pathogenic variants in the PALB2 gene significantly increase the risk of developing breast, ovarian, and pancreatic cancers. However, the prevalence of these mutations in East Asian populations, particularly Koreans, has not been well studied. This research aims to estimate the prevalence of PALB2 variants in these populations by analyzing large-scale genomic databases. Understanding the frequency of PALB2 variants can help in identifying individuals at higher risk for these cancers and guide the development of targeted screening and prevention strategies. The findings from this study provide valuable reference data that can enhance genetic counseling and improve cancer risk management in East Asian populations, ultimately contributing to better health outcomes in these communities. PALB2 is a tumor suppressor gene. Heterozygous germline pathogenic variants of PALB2 significantly increase the lifetime risk of breast cancer and moderately increase the risk of ovarian and pancreatic cancers. This study analyzed the estimated prevalence of PALB2 variants globally, focusing on East Asian and Korean populations, where limited data were previously available. We examined 125,748 exomes from the Genome Aggregation Database (gnomAD), including 9197 East Asians, and additional data from 5305 individuals in the Korean Variant Archive and 1722 in the Korean Reference Genome Database. All PALB2 variants were interpreted according to guidelines from the American College of Medical Genetics and Genomics and the Clinical Genome Resource. The global prevalence of PALB2 variants was 0.18%, with the highest prevalence in Finnish populations (0.41%) and the lowest in Ashkenazi Jewish populations (0.04%). East Asians had a prevalence of 0.09%. By combining data from Korean genome databases and gnomAD totaling 8936 individuals, the overall prevalence of PALB2 variants in the Korean population was determined to be 0.13%. This study is the first comprehensive investigation of PALB2 variant prevalence in East Asians and Koreans using gnomAD and Korean genome databases. These findings provide essential reference data for future research and highlight the importance of region-specific genetic studies that will inform genetic counseling and hereditary cancer risk management. [ABSTRACT FROM AUTHOR]

Technological advances in analytics, as well as scientific and regulatory knowledge and experience gained from biosimilar development/approvals over the last decade, enabled the World Health Organization (WHO) in 2022 to revise its guidelines on the evaluation of biosimilars. Among the revisions, there is more reliance on analytical and functional aspects to prove similarity (and likely fewer clinical requirements). WHO international reference standards for biosimilars provide additional confidence to regulators looking for evidence‐ and data‐based regulatory convergence in scientific and technical measures of quality attributes. These standards serve as a benchmark for harmonizing the bioactivity or potency of biosimilars, ensuring their future sustainability. This article discusses the availability and role of WHO international reference standards throughout the product life cycle of biosimilars. [ABSTRACT FROM AUTHOR]

The discourse surrounding China's influence in the Middle East and North Africa tends to oscillate between extremes, in some instances portraying China as a burgeoning hegemon poised to displace America's regional primacy, while in others describing its influence as insufficient to effect meaningful change. China has made significant inroads in the region through diplomacy, trade, investment and infrastructure projects, enhancing its economic presence and raising Beijing's profile in regional geopolitics. However, examining the nature of interdependence between China and Middle Eastern nations reveals that China's capabilities, while increasingly formidable, are tempered by equally formidable constraints. Mutual dependencies, regional dynamics, limited hard power, domestic priorities, geography and the agency of regional states all modulate the extent to which China can exercise influence and impose its will. While Beijing's strategy of gradually shifting asymmetries in China's favour certainly warrants scrutiny, undue alarmism and complacency alike could increase the likelihood of faulty assessments and misguided policymaking. [ABSTRACT FROM AUTHOR]

Moscow is actively using the conflict in Ukraine to advance its vision of a different international order. This vision emphasises a world fragmented into spheres of influence centred on a handful of 'civilisational states' embodying distinct political cultures not necessarily compatible with liberalism and democracy. Russia uses its own sphere of influence in Eurasia as the incubator of an alternative set of norms and institutions that it seeks to socialise globally. This Russian vision appeals to other revisionist powers, notably China and Iran, which support Russia's war in Ukraine largely out of a desire to diminish US influence and consolidate their own regional spheres. Elements of it also appeal across the Global South, now a key arena for competition over the future global order. The outcome of Russia's war in Ukraine is perhaps the most important determinant of what the coming world order will look like. [ABSTRACT FROM AUTHOR]

Atrial fibrillation (AF) has been receiving a lot of attention from scientists and clinicians because it is an extremely common clinical condition. Due to its special hemodynamic changes, AF has a high rate of disability and mortality. So far, although AF has some therapeutic means, it is still an incurable disease because of its complex risk factors and pathophysiologic mechanisms, which is a difficult problem for global public health. Age is an important independent risk factor for AF, and the incidence of AF increases with age. To date, there is no comprehensive review on aging‐associated AF. In this review, we systematically discuss the pathophysiologic evidence for aging‐associated AF, and in particular explore the pathophysiologic mechanisms of mitochondrial dysfunction, telomere attrition, cellular senescence, disabled macroautophagy, and gut dysbiosis involved in recent studies with aging‐associated AF. We hope that by exploring the various dimensions of aging‐associated AF, we can better understand the specific relationship between age and AF, which may be crucial for innovative treatments of aging‐associated AF. [ABSTRACT FROM AUTHOR]

Global health emergencies often lead to a proliferation of health-related research and resultant data, which is shared across borders to help control the outbreak of disease and support decision-making regarding public health interventions. However, efforts to share data can be hindered by diverse international ethical and legal frameworks. The frameworks aim to govern coordinated processing, sharing and transfer of health data across borders thus placing burdens on researchers who are willing or obligated to share data. In this paper, we investigate ethical values and legal principles that can be applied to ensure a more streamlined approach in the governance of cross-border health data sharing during global health emergencies. A scoping review approach was used to better understand emerging evidence about issues related to the ethical and legal governance of cross-border health data sharing. We first highlight the challenges of sharing health data across borders. We then discuss how the challenges might be overcome through the application of ethical values and legal principles that have been identified in literature. This is followed by a proposal for possible ways of streamlining the governance of health data sharing from ethical and legal perspectives in a bid to better prepare for future global health emergencies and promote the responsible sharing of health data. [ABSTRACT FROM AUTHOR]

Research represents an essential component of the response to infectious disease outbreaks and to other public health emergencies, whether they are localised, of international concern, or global. Research conducted in such contexts also comes with particular ethics challenges, the awareness of which has significantly grown following the Ebola outbreak in West Africa, the Zika outbreak in Latin America and the COVID-19 pandemic. These challenges include the need for implementing meaningful community engagement with the researched communities, not just to build unidirectional trust towards the research team, but to achieve a genuine and mutually respectful partnership before, during and after the research. Here, we describe the real-life experience of 10 well-established research clinics in Nairobi, where a successful experience of community engagement linking prevention and care to research was interrupted during the COVID19 pandemic. We contrast this experience with the concept and processes of community engagement as described in selected scientific manuscripts and guidelines, to formulate some conclusions and recommendations. We contend that more action is needed, from research ethics committees and other key-research stakeholders, to align policies and practices with ethics guidance and with evidence-based recommendations from the academic literature, to achieve meaningful community engagement during emergency research, irrespective of the scale and location of an outbreak or public health crisis. Failure to do so, will aggravate the (postcolonial) asymmetries of power in global health and local systems. [ABSTRACT FROM AUTHOR]

Stress-related disorders constitute a fast-progressing worldwide societal problem that needs urgent attention and new solutions. Recent neuroscientific research has shown that stress-related disorders are characterized by maladaptive dynamic changes in large-scale brain networks in response to stressors, raising the possibility of modulating these networks as a promising target for intervention. Neurofeedback can be used to train individuals to endogenously modulate brain network dynamics. Once learned, this skill is transferrable to ecologically relevant scenarios outside of a laboratory or treatment facility, and individuals can be trained to explicitly apply it at the right moments as part of a just-in-time adaptive intervention in response to actual stressors in daily life. We argue that these characteristics position neurofeedback as a prime candidate for a personalized preventive neuroscience-based intervention strategy. Stress-related disorders are among the biggest global health challenges. Despite significant progress in understanding their neurocognitive basis, the promise of applying insights from fundamental research to prevention and treatment remains largely unfulfilled. We argue that neurofeedback – a method for training voluntary control over brain activity – has the potential to fill this translational gap. We provide a contemporary perspective on neurofeedback as endogenous neuromodulation that can target complex brain network dynamics, is transferable to real-world scenarios outside a laboratory or treatment facility, can be trained prospectively, and is individually adaptable. This makes neurofeedback a prime candidate for a personalized preventive neuroscience-based intervention strategy that focuses on the ecological momentary neuromodulation of stress-related brain networks in response to actual stressors in real life. [ABSTRACT FROM AUTHOR]

Recently, there has been worldwide growing interest on profiling the human fertility of populations because there has been a noticeable global decline in fertility rate, leading to increased attention toward reproductive health and fertility. The decline in fertility of population of the Arab World was investigated for the 10 years period between 2011–2021. The Arab World was classified into three regional blocks; Block-1 Arabian Peninsula countries: Bahrain, Kuwait, Saudi Arabia, Oman, Qatar, United Arab Emirates (UAE), Yemen. Block-2 Fertile Crescent Arab countries: Iraq, Jordan, Lebanon, Syria, West Bank and Gaza. Block-3 African Arab countries: Algeria, Comoros, Djibouti, Egypt, Libya, Mauritania, Morocco, Somalia, Sudan, Tunisia. Data on fertility rates for the 10 years period between 2011–2021 were collected from the World Bank for Arab countries. Statistical analysis along with decline in the fertility rates were determined. Results: Fertility rates varied across Arab countries in 2011 and 2021, with notable decline ranging from 24.3% to 3.8%, except for Algeria, with zero decline. Countries that exhibited significant decline were Jordan (24.3%) followed by Iraq (22.2%) then Yemen (19.1%); Whereas, countries that exhibited slight fertility decline were Libya (3.8%), followed by Tunisia (4.5%), Lebanon (4.5%) and Kuwait (4.5%). On another note, lowest fertility rate was observed in UAE as maintained between 1.7% and 1.5% and the highest fertility rate was observed in Somalia as maintained between 7.3% and 6.3% for 2011 and 2021 respectively. Conclusion: The present study reveals the declining-trend in fertility rate across Arab countries, influenced by variable factors. Therefore, we recommend to the Council of the Health Ministries in the Arab-League to focus on investigating the fertility decline as an important parameter for public health in the Arab world to maintain natural balanced fertility rate. As some non-biological factors surrounding the Arabian region, such as instability, war, migration, the present study did not aim to include the influence of war and migration on fertility because both war and migration are non-biological external factors and both are not among the WHO criteria for fertility determination which based of the population growth rate of population under normal living conditions. [ABSTRACT FROM AUTHOR]

Background: After the establishment of the public health emergency of international concern in 2020, health systems worldwide and in Brazil observed the need to apply more extraordinary logistical efforts and possibly resources to combat the imminent pandemic. Methods: Using the historical series of public expenditures of the National Health Fund (FNS), 2015 to 2021, the number of confirmed cases of COVID-19, and a seasonal ARIMAX model, we sought to assess how the increase in the new virus infections affected the systematic financing of the SUS in Brazil. Results: There were signs of seasonality and an increasing trend in the expenditure variable, which in practical terms, only indicated that the resource contributions followed an increasing trajectory already underway before the advent of the pandemic. The 1% increase in COVID-19 cases, with a one-month lag, contributes to the 0.062% increase in the variation in FNS expenditures but a decrease of 0.058% with a two-month lag. Conclusion: The tests showed no evidence to confirm a positive shift on FNS spending growth trajectory due to the increase of COVID-19 cases, only observing a significant increase one month after the occurrence of COVID cases, probably due to their worsening after this period, which was followed by a similar and comparable decrease in percentage of growth in the following month. [ABSTRACT FROM AUTHOR]

Disordered eating refers to a range of eating behaviours and attitudes towards weight and food that can negatively influence physical and psychosocial well-being. The menopausal transition could be a vulnerable period for disordered eating due to major hormonal fluctuations, menopausal symptoms, common body composition shifts, and an increased risk of psychological challenges. This systematic review aimed to summarize evidence on the associations between the menopausal transition and disordered eating. Records published before October 2023 were identified through MEDLINE, PsycINFO, Scopus, Embase, and CINAHL. Studies investigating associations between menopausal status, menopausal symptoms, or reproductive hormone levels, and disordered eating during the menopausal transition were sought. A total of 1301 non-duplicate records were screened, with 10 studies deemed eligible for inclusion. Most included studies used a cross-sectional design (n = 9). Findings include potentially higher levels of binge eating during the perimenopausal stage, whereas restrictive eating behaviours appeared more common during postmenopause compared to premenopause. Both studies investigating menopausal symptoms found strong positive associations with disordered eating. Nonetheless, findings are equivocal with contrasting results and limited methodological quality across studies. Further research is needed to verify these findings and better assist health professionals in supporting healthy eating behaviours in menopausal women during this complex transition. (PROSPERO ID: CRD42021290736) [ABSTRACT FROM AUTHOR]

Traumatic injury remains a significant public health problem, with the burden highest in low-middle income countries (LMICs) and rural areas.1,2 The far-western region of Nepal, which has the lowest human development index in the country, has a high burden of traumatic injuries.3-5 One hospital in the far-western district of Achham, Bayalpata Hospital, cares for the majority of patients with traumatic injuries – most of whom arrive without any pre-hospital care. The absence of a professionalized pre-hospital program, such as an established Emergency Medical Services (EMS) system, necessitates creative strategies to address this gap.6,7 In this context, implementing a trauma-training program for community health responders (CHRs) offers a promising solution, leveraging local resources to improve early-stage trauma care. [ABSTRACT FROM AUTHOR]

Background: Nurses contribute to the largest demographic of the healthcare workforce. However, given current global shortages of workforce capacity, this often leads to limited capacity to engage in extracurricular educational developments beyond their immediate role. Consequently, this significantly limits the range of workforce training and development opportunities that are available to them, which could enhance the variety of skills that are brought to the National Health Service (NHS). Objective: We aimed to understand prior, current, and future participation in global health activities such as global health conferences, networks, and placements, among National Health Service (NHS) staff. Furthermore, we investigated the barriers and facilitators to participation in global health activities for nurses in our sample. Method: Qualitative and quantitative data was gathered from an online survey conducted in England from July to November 2021. Thematic analysis was used to examine the qualitative data collected from one open-ended question, whereas statistical analysis was used to examine the remaining quantitative data. Results: Most (84%) nurses in our sample had not participated in a global health activity. Our results highlighted three barriers to participation, including insufficient communication, a lack of awareness, and capacity issues. Conclusion: This study showed that, despite low levels of prior participation, there is a strong desire among surveyed nurses to be involved in global health activities and education. Our findings also suggest that enhanced communication of opportunities available is needed, in addition to organisational support which incorporates strategies to overcome capacity constraints. [ABSTRACT FROM AUTHOR]

In the past decade, there has been an increasing focus within scientific research on how to assist people affected by the negative consequences of trauma and crises around the globe. As many countries struggle with a lack of resources to deliver mental health interventions, scalable strategies have been developed to help more people in need. These scalable strategies were the theme of the 39th annual meeting of the International Society for Traumatic Stress Studies (ISTSS). The presidential panel, chaired by Marit Sijbrandij during her ISTSS presidency, brought together a group of experts in the field of scalable interventions: Kenneth Carswell, Syed Usman Hamdani, Judy Bass, and Eirini Karyotaki. The panel highlighted the current state of the evidence on scalable interventions for adults and children and outlined important next steps for research and implementation. These recommendations include further improving the availability of, and evidence for, scalable interventions through increased training and sustained funding; conducting more studies in underrepresented samples, such as children and adolescents; and promoting open access availability of research findings worldwide. In this paper, we provide an overview of the topics discussed in the panel as well as the key takeaways. [ABSTRACT FROM AUTHOR]

Introduction Article 11 of the World Health Organization's Framework Convention on Tobacco Control (WHO FCTC) requires Parties to adopt and implement effective tobacco packaging and labeling policies to communicate health risks and reduce tobacco consumption. Aims and Methods The goal of this study was to assess adoption of these policies in the WHO African Region (AFRO). We reviewed tobacco packaging and labeling policies adopted in AFRO from the Campaign for Tobacco-Free Kids' Tobacco Control Laws database (www.tobaccocontrollaws.org). We assessed these policies based on WHO FCTC Article 11 and its Implementation Guidelines examining three subpolicy areas (health warning labels [HWLs], descriptive constituents and emissions information, and misleading packaging and labeling). We developed a scoring system to rank AFRO countries individually and by the World Bank's income-level groups, and documented the progress during 1985–2023. Results Forty (of 47) AFRO countries adopted national laws, of which a majority adopted large rotating pictorial HWLs and banned misleading descriptors; only Cote d'Ivoire and Mauritius adopted standardized packaging. The higher a country is in the World Bank's income-level group, the stronger their packaging and labeling policies. This observation was not present in the HWLs subpolicy area. Prior to approving the WHO FCTC Article 11 Implementation Guidelines, only 23 countries adopted text-only HWLs, whereas 26 countries adopted pictorial HWLs after the approval. Conclusions Several AFRO countries have adopted tobacco packaging and labeling policies that align with the WHO FCTC Article 11 Implementation Guidelines. More efforts could be directed toward the low-income group and disseminating standardized packaging throughout AFRO. Implications In the AFRO, the number of tobacco users is increasing, highlighting the need for tobacco packaging and labeling policies aligned with WHO FCTC Article 11 and its Implementation Guidelines as these are proven tobacco control strategies. This study provides a country- and income-level group ranking of tobacco packaging and labeling policies, and documents the evolution of HWLs adopted in AFRO. It also identifies regional and income-level group successes and gaps in tobacco product packaging and labeling policies and provides recommendations to further align with WHO FCTC Article 11 and its Implementation Guidelines. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the clinical significance of subtyping (type 1 vs 2) of papillary renal cell carcinoma (PRCC) in patients treated with targeted therapy, as well as the concordance, sensitivity and positive predictive value (PPV) of local review pathology review. Methods: Patients with advanced refractory PRCC were randomised to receive sunitinib or cabozantinib, crizotinib or savolitinib, stratified by PRCC subtype (type 1, type 2, or not otherwise specified [NOS]/mixed) by local review. Central review was retrospectively conducted by three expert genitourinary pathologists who independently reviewed cases. The sensitivity and PPV of local review were estimated and outcomes [objective response rate (ORR), progression‐free survival (PFS)] were summarised for treatment groups stratified by subtypes by central review. Results: Amongst the 147 patients reviewed, the prevalence of individual subtypes varied by local or central review (type 1: 17.7% vs 29.3%; type 2: 53.1% vs 45.6%; NOS/mixed: 29.3% vs 25.2%), respectively. Individual cases were frequently reclassified and local pathology review demonstrated low sensitivity (type 1: 48%, 95% confidence interval [CI] 33, 65; type 2: 67%, 95% CI 55, 78; NOS/mixed: 43%, 95% CI 27, 61). The PPVs of local review were 80%, 57.7% and 37% for type 1, 2 and NOS/mixed, respectively. Compared to sunitinib, cabozantinib demonstrated improved PFS for both type 1 and type 2 PRCC subgroups (7.4 vs 9.0 and 2.9 vs 5.6 months, respectfully) as well as higher ORR. Conclusions: The PRCC subtype assignment did not identify a subset of patients with greater clinical benefit from cabozantinib, with significant discordance between local and central review. Our findings confirm the limited clinical value of pathological subtyping of metastatic PRCC, in line with the recent World Health Organisation 2022 guidelines. Patient summary: In this study, categorising papillary renal cell carcinoma into type 1 or 2 subtypes showed limited concordance between central and local pathological review and did not enrich for patients more likely to benefit from cabozantinib in the S1500 PAPMET trial. [ABSTRACT FROM AUTHOR]

Purpose: To estimate the incidence of Optic Neuritis (ON) in Colombia using data from the national health registry between January 1, 2015, and December 31, 2020. Methods: A population-based study was conducted using the Integrated Social Protection Information System from the Colombian Ministry of Health and the International Classification of Diseases-10 code for ON to estimate the incidence of ON from 2015 to 2020. We also evaluated the impact of the COVID-19 lockdown on the epidemiology of the disease in 2020. Finally, a standardized morbidity rate map was created to assess a country's ON geographic distribution. Results: From 2015 to 2019, 2,463 new cases of ON were reported. The overall 5-year incidence rate was 1.56 cases per 100,000 inhabitants per year, 66% of the patients were females. The peak of presentation in males was the quinquennium of 50–54 years, and in females, it was 45–49 years. In 2020, coinciding with the COVID-19 pandemic, there was a reduction in the incidence of ON by approximately 0.15 cases per 100,000 inhabitants. The regions with a high number of cases and an increasing risk of new cases were Bogotá, Antioquia, and Valle del Cauca. Conclusions: The incidence of ON in Colombia is lower compared to countries in the northern hemisphere, with women under 50 years being predominantly affected. The onset of the COVID-19 pandemic corresponded with a reduction in identifying new ON cases. This underscores governments' need to implement effective diagnostic strategies in the future. [ABSTRACT FROM AUTHOR]

Objective: To identify and describe differences in demographics, injury characteristics, and outcomes between rural and urban patients suffering brain injury. Data Sources: CINAHL, Emcare, MEDLINE, and Scopus. Review Methods: A systematic review and meta-analysis of studies comparing epidemiology and outcomes of rural and urban brain trauma was conducted in accordance with PRISMA and MOOSE guidelines. Results: 36 studies with ~ 2.5-million patients were included. Incidence of brain injury was higher in males, regardless of location. Rates of transport-related brain injuries, particularly involving motorized vehicles other than cars, were significantly higher in rural populations (OR:3.63, 95% CI[1.58,8.35], p = 0.002), whereas urban residents had more fall-induced brain trauma (OR:0.73, 95% CI[0.66,0.81], p < 0.00001). Rural patients were 28% more likely to suffer severe injury, indicated by Glasgow Coma Scale (GCS)≤8 (OR:1.28, 95% CI[1.04,1.58], p = 0.02). There was no difference in mortality (OR:1.09, 95% CI[0.73,1.61], p = 0.067), however, urban patients were twice as likely to be discharged with a good outcome (OR:0.52, 95% CI[0.41,0.67], p < 0.00001). Conclusions: Rurality is associated with greater severity and poorer outcomes of traumatic brain injury. Transport accidents disproportionally affect those traveling on rural roads. Future research recommendations include addition of prehospital data, adequate follow-up, standardized measures, and sub-group analyses of high-risk groups, e.g. Indigenous populations. [ABSTRACT FROM AUTHOR]

In this paper, as Black scholars, we address ways that interventions designed to promote equity in health can create pathways for coupling decolonization with antiracism by drawing on the intersection of the health of Africans and African Americans. To frame this intersection, we offer the Public Health Critical Race Praxis (PHCRP) and the PEN-3 Cultural Model as antiracism and decolonization tools that can jointly advance research on colonization and racism globally. We argue that racism is a global reality; PHCRP, an antiracism framework, and PEN-3, a decolonizing framework, can guide interventions to promote equity for Africans and African Americans. [ABSTRACT FROM AUTHOR]

International Organisations (IOs) can expand their mandate by employing deliberately chosen strategies. I propose that IOs' mandate expansion follows a two-step sequence: First, IOs branch out into a domain that lies outside of their initial mandate area. Second, IOs further increase their relevance within the domain and move their position from a marginal to a more focal one. To accomplish the two-step expansion, individual IOs use a particular mix of strategies, reflecting their organisation-specific contexts as well as external environments. The two-step sequence is explored in the case of the OECD's growing involvement in the health policy field from the organisation's establishment in 1961 until 2022. I employ a mixed-method approach, combining structural topic modeling and qualitative document analysis. This article highlights the different stages of IOs' mandate expansion and contributes to enriching the research streams of IOs' institutional changes and dynamics in global health governance. [ABSTRACT FROM AUTHOR]

The differential diagnosis of multiple sclerosis can present specific challenges in patients from Latin America, Africa, the Middle East, eastern Europe, southeast Asia, and the Western Pacific. In these areas, environmental factors, genetic background, and access to medical care can differ substantially from those in North America and western Europe, where multiple sclerosis is most common. Furthermore, multiple sclerosis diagnostic criteria have been developed primarily using data from North America and western Europe. Although some diagnoses mistaken for multiple sclerosis are common regardless of location, a comprehensive approach to the differential diagnosis of multiple sclerosis in Latin America, Africa, the Middle East, eastern Europe, southeast Asia, and the Western Pacific regions requires special consideration of diseases that are prevalent in those locations. A collaborative effort has therefore assessed global differences in multiple sclerosis differential diagnoses and proposed recommendations for evaluating patients with suspected multiple sclerosis in regions beyond North America and western Europe. [ABSTRACT FROM AUTHOR]

Globally, billions of people do not have access to safely managed drinking water and sanitation services. Interventions to improve drinking water, sanitation and hygiene could reduce the incidence of diarrhoea in low- and middle-income countries. This study aimed to investigate the association between these services and the incidence of diarrhoea. Worldwide, ecological observational study, utilising cross-sectional data. Data from the Global Burden of Disease Study 2019 and World Bank were used in this study. Diarrhoeal disease episodes were defined as three or more loose bowel movements within 24 h. Estimated Annual Percentage Change was used to quantify trends in disease incidence over a specific time interval. Quasi-Poisson Generalised Linear Model was introduced to analyse the influence of basic drinking water and sanitation services on the incidence of diarrhoea. Subgroup analyses were carried out to determine potential variations in the incidence of diarrhoeal diseases according to sex, age and sociodemographic index (SDI) region. Between 2000 and 2019, the incidence rate of global diarrhoea remained consistent, with regional variations linked to SDIs. A 1% increase in access to basic drinking water was associated with a 0.41% (95% confidence interval [CI], 0.33%–0.50%) increase in the age-standardised incidence rate of diarrhoea; meanwhile, a 1% increase in sanitation service usage was associated with a 0.47% (95% CI, 0.40%–0.54%) reduction in the age-standardised incidence rate of diarrhoea. The correlation differed across SDI regions. The use of safely managed drinking water was associated with a reduction in diarrhoeal disease rates, but the effect was non-significant in High SDI regions. Higher diarrhoeal disease incidence was seen in younger and older populations. Individuals in the age groups 55–59 years and 10–14 years showed the greatest association of water service usage with diarrhoea, while an increase in sanitation service usage was related to decreased diarrhoea rates in most age groups, excluding children aged 5–14 years. Emphasising initiatives to enhance water quality, elevate the standards of drinking water safety management, and strengthening related infrastructure development in global health policies and development plans could have a positive impact on overall global health. Such comprehensive interventions have the potential to not only prevent waterborne diseases but also elevate the general health status of societies worldwide. [ABSTRACT FROM AUTHOR]

Depression is a global health challenge, but only a few studies have fully assessed and predicted the disease burden. This study described the trend of global depression burden from 1990 to 2019 through age-standardized incidence rate (ASIR), age-standardized disability-adjusted life rate (ASDR), and predicted the number of cases of depression during 2020–2030. Linear regression analysis was used to calculate the estimated annual percentage change (EAPC) in the age-standardized rates. The trends of global depression burden from 1990 to 2019 were analyzed by age, sex, and socio-demographic index (SDI) across various regions. Finally, we used the Bayesian age-period-cohort (BAPC) model to predict the disease burden in the coming 10 years. Globally, the ASIR of depression decreased from 3681.24 per 100,000 population in 1990 to 3588.25 per 100,000 population in 2019 and the EAPC was −0.29%. ASDR also decreased, following a similar trend as the ASIR. The highest ASDR was observed in adults aged 60–64 years. The burden of depressive illness was higher in women, with the greatest increase in incidence in low SDI areas. BAPC predicted that the worldwide ASIR and ASDR of depression would stabilize from 2020 to 2030, with an increasing number of cases. By 2030, the ASIR was estimated to be 2519.88 per 100,000 men and 3835.11 per 100,000 women. From 1990 to 2019, the global burden of depression remained significant, especially among women. It is important to address depression in older people, and it is therefore necessary to develop measures for prevention. [ABSTRACT FROM AUTHOR]

Purpose: Low- and middle-income countries (LMICs) are underrepresented in ophthalmic research, despite carrying the highest burden of visual impairment. To assess the representation of local authors in global ophthalmic research, this cross-sectional, bibliometric analysis measured the proportion of LMIC-affiliated authorship in LMIC-based ophthalmic research. Methods: We sampled original, primary research conducted in LMICs and published in 1 of 7 high-impact ophthalmic journals between 2017 and 2021. For each article, we extracted the number and name of country study site(s), country affiliation(s) of first and last author, proportion of LMIC-affiliated authors, funding sources, and study design. Results: Of the 1,333 studies exclusively conducted in LMICs, 89.4% of first authors and 80.6% of last authors were exclusively LMIC-affiliated. Representation of LMIC-affiliated first authors were lower in studies based in low-income countries (25.0%) or in sub-Saharan Africa (26.5%), published in journals with higher impact factors (68.0% in Ophthalmology), funded by high-income countries (HICs) (41.4%), or conducted in both LMICs and HICs (27.1%). The United States, United Kingdom, and Australia had the 3rd, 6th, and 8th largest shares of last authors. There were only 12 single-country studies conducted in low-income countries, namely Ethiopia, the Gambia, Guinea, Liberia, the Niger, and Sierra Leone. Of these countries, only three held first authorship and one held last authorship. Conclusions: Although LMIC-based ophthalmic research has demonstrated higher local authorship representation compared to other fields, underrepresentation can be exacerbated by country income level, journal "prestige," and degree of HIC involvement. These discrepancies highlight the need for more equitable data ownership in global ophthalmic research. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is a significant global health concern, ranking as the third most common cancer and the second leading cause of cancer-related deaths. However, in Africa, CRC is the fifth most common invasive malignancy. Limited data hinder our understanding of the evolving burden of CRC in sub-Saharan Africa. This study explores CRC trends in Mozambique, utilising data from population-based oncological registries. Methods: CRC data were gathered from Beira and Maputo population-based cancer registries, along with supplementary information from pathology-based and hospital-based registries. Comparative analyses were performed across different time periods, focusing on trends and epidemiological characteristics. Results: Incidence rates of CRC in Maputo and Beira were relatively low historically. However, data from recent years showed an increase, especially in age groups above 50. Analyses from pathology-based and hospital-based registries affirmed the rising trend. The age-standardised incidence rate in Maputo (2015-2017) was 3.17 for males and 2.55 for females. Beira exhibited increasing rates between 2009 and 2020, particularly in individuals aged 50 and above. Conclusion: The study reveals an emerging burden of CRC in Mozambique, challenging the perception of low incidence. The rising trend underscores the necessity for tailored interventions, emphasizing early diagnosis, preventive strategies, and investments in healthcare infrastructure to address the increasing CRC burden in the region. [ABSTRACT FROM AUTHOR]

Context: The European Union (EU) governs global health through its constituent laws, institutions, actors, and policies. However, it is unclear whether or how these political factors interact to position the EU as a political determinant of global health. Methods: The authors conduct a case study of the political factors influencing the adoption of the EU's Biotechnology Directive 98/44/EC and Orphan Medicines Regulation 141/2000. Findings: The European Commission (EC) generally framed both of its proposals around economical and biomedical paradigms aligned with the needs of the EU's industry and patients, whereas the European Parliament (EP) contested some of these frames and proposed amendments supporting global access to medical products. The political factors influencing the adoption (in the Biotechnology Directive) or rejection (in the Orphan Regulation) of the EP's amendments include the complementarity between the EP and EC proposals, the EP's power in the intra- and interinstitutional negotiating process, the existence and support of civil society, and the alignment with member state priorities in the Council. Conclusions: In the late 1990s, the EU was an internally fragmented and politicized player concerning global health matters. These political factors should be considered for a coherent post-2022 EU strategy on global health. [ABSTRACT FROM AUTHOR]

In 2020, the COVID-19 pandemic thrust the world's population into a crisis. Social workers and other professionals working with youth have been front-line witnesses to the accentuated negative impact of this public health emergency on youth and their families as well as to the creative adaptive strategies of youth and their families. Purpose: Because youth workers are often the first to identify and respond to the needs and desires of children and youth, it is critical to better understand the ways in which youth workers adapted, coped, and intervened within the context of this global health, social, and economic crisis. Youth workers play a central role in the lives of children and youth. Their perspective is key to recognizing both practice innovation and organizational impediments. Method: 31 youth workers in mental health, housing, primary care, and child protection participated in focus groups discussing the impact of the pandemic during waves 1 and 2 on the youth and families they work with and, consequently, on their own practice. Results: include two central domains that organize findings around adapting professional practice to crisis situations: (1) the first-person experience of working with youth during the pandemic; (2) the changing needs and risks faced by youth and their families. Discussion: These domains include discussions around participant emotions and feelings of isolation, helplessness, and fear as well as adaptability. The article concludes with recommendations to support youth workers and adapt organizational structures to help protect youth from increased risk and vulnerability during a pandemic or other crises. [ABSTRACT FROM AUTHOR]