Search Results (3,126)

Background: Prostate cancer substantially affects patients’ quality of life (QoL). However, whether distinct QoL profiles exist among patients remains unclear. Objective: This study aimed to identify latent QoL profiles among patients with prostate cancer and explore factors associated with profile membership. Methods: A cross-sectional study included 200 patients with prostate cancer recruited from a tertiary hospital in China between May and December 2024. QoL was assessed using the Functional Assessment of Cancer Therapy–Prostate (FACT-P). Latent profile analysis was performed using Mplus 8.3, and the optimal model was selected according to information criteria, entropy, and likelihood ratio tests. Multivariable logistic regression was used to examine factors associated with profile membership. Results: LPA identified two distinct subgroups: low QoL (32.5%) and high QoL (67.5%). Medium and heavy economic burden significantly increased odds of low QoL (OR = 4.13, 95% CI: 1.13–15.02, p = 0.032; OR = 11.12, 95% CI:1.55–79.86, p = 0.017). Urinary continence markedly reduced odds of low QoL (OR = 0.08, 95% CI: 0.02–0.25, p < 0.001). Longer diagnosis-to-treatment intervals were associated with membership in the low-QoL profile (1–3 months: OR = 2.99, 95% CI: 1.26–7.08, p = 0.013; >3 months: OR = 3.36, 95% CI: 1.02–11.07, p = 0.046). Conclusions: This study identified two QoL profiles among patients with prostate cancer. The findings suggest that person-centered QoL assessment may facilitate early identification of patients with greater supportive care needs and contribute to more individualized survivorship care. Full article

Objectives: To establish a global academic ranking of Schools of Public Health based on bibliometric data. Methods: Data were extracted and analyzed using InCites Benchmarking and Analytics™ and the Web of Science™ Core Collection database. Bibliometric data were collected on a selection of 145 Schools of Public Health from all continents between June and September 2025. Ten research indicators were included for the period 2019–2023. Both global and continental rankings were established. Results: The leading institutions were the Harvard T.H. Chan School of Public Health in North America, also ranked first globally; the London School of Hygiene & Tropical Medicine in Europe; the Department of Public Health at the National Autonomous University of Mexico in Latin America; the Saw Swee Hock School of Public Health in Asia; the School of Public Health at the University of Cape Town in Africa; and the School of Public Health and Preventive Medicine at Monash University in Oceania. Conclusions: PHAR 2025 provides the first global bibliometric ranking of a selection of 145 Schools of Public Health. It is a measure of research activity and bibliometric impact, rather than an assessment of the overall quality or public health contribution of each school. Full article

Background/Objectives: Fecal incontinence (FI) is an underrecognized complication of inflammatory bowel disease (IBD) and colorectal neoplasia that substantially impairs quality of life. This study translated, culturally adapted, and validated the Arabic Vaizey Incontinence Score while evaluating the burden of FI among Egyptian patients. Methods: In this multicenter cross-sectional study, 287 adults with histopathologically confirmed diagnoses were enrolled, including colorectal cancer/precancerous lesions (n = 54), IBD (n = 55), and other/no significant colorectal pathology (n = 178). The questionnaire underwent standardized translation and cultural adaptation. Internal consistency was assessed using McDonald’s omega. Structural validity was evaluated using exploratory factor analysis (EFA; n = 143) and confirmatory factor analysis (CFA; n = 144). Results: Patients with IBD had the greatest fecal incontinence burden, with the highest mean Vaizey score (9.24 ± 6.77) compared with patients with colorectal neoplasia (7.28 ± 6.03) and those with other or no significant colorectal pathology (6.68 ± 4.79). Continence-related quality of life was also poorest in IBD (median 8.0 [IQR 4–10] vs. 2.0 [IQR 1–3] and 2.5 [IQR 1–6]). EFA supported a two-factor solution explaining 48.1% of the variance (KMO = 0.691; Bartlett’s χ² = 298.61, p < 0.001). The inability-to-defer-defecation item showed negligible loading and was excluded. CFA confirmed a refined six-item model with excellent fit (CFI = 0.992, TLI = 0.985, RMSEA = 0.088, SRMR = 0.087). McDonald’s omega was 0.825 for Leakage Severity and Management and 0.869 for Functional Impact, with average variance exceeding 0.50 for both domains. Conclusions: The refined six-item Arabic Vaizey Incontinence Score demonstrated good reliability and construct validity. FI score was significantly higher among patients with IBD, supporting routine assessment using this validated instrument across Egyptian patients with colorectal diseases. Full article

Digital governance has increasingly emerged as a critical institutional mechanism for strengthening public administration, enhancing accountability, improving service delivery, and advancing inclusive development across Africa. Governments across the continent have expanded investments in e-governance systems, digital public infrastructure, artificial intelligence (AI)-enabled administrative systems, interoperable service platforms, and data-driven governance reforms as part of broader modernization and Sustainable Development Goal (SDG) agendas. Despite these developments, digital governance outcomes remain uneven and are frequently constrained by fragmented governance architectures, weak institutional coordination, administrative capacity deficits, regulatory limitations, and persistent socio-economic inequalities. To address these challenges, this study conducts a qualitative Systematic Literature Review (SLR) guided by PRISMA 2020 reporting standards to examine how digital technologies interact with governance systems, institutional structures, administrative capability, and socio-technical inequalities across African public sectors. The review synthesized 42 included studies published between 2015 and 2025 using structured Boolean search strategies, predefined inclusion and exclusion criteria, abductive thematic synthesis, and framework-oriented analytical procedures. The findings identify three interconnected governance constraints shaping digital transformation outcomes across African public sectors: fragmented and centralized governance arrangements; institutional and administrative capability deficits; and persistent digital inequalities and exclusionary governance systems. Although digital governance reforms demonstrate important potential for improving transparency, interoperability, citizen participation, financial inclusion, and administrative efficiency, sustainable transformation outcomes depend heavily on institutional coordination, adaptive governance systems, digital inclusion, regulatory effectiveness, and accountable AI governance arrangements. Building on the synthesized evidence, the study develops a decentralized AI-enabled digital public governance framework linking decentralization, interoperability, institutional coordination, digital inclusion, adaptive governance, and ethical AI governance to sustainable public-sector transformation outcomes. The study contributes theoretically by reconceptualizing digital governance as an institutionally embedded governance transformation process rather than merely a technological modernization agenda. The findings further contribute to sustainability debates by demonstrating how inclusive and decentralized digital governance systems can strengthen institutional resilience, public-sector innovation, and sustainable development outcomes across diverse African governance contexts. Full article

Megaconstruction projects, including high-speed rail networks, airports, seaports, and large urban infrastructure programmes, rank among the most resource-intensive activities in the built environment, generating substantial carbon emissions and persistent environmental degradation. These projects face compounding operational challenges: extended construction periods, supply chains that cross multiple continents, and governance structures that involve dozens of contracting organisations, producing data volumes that conventional static Life Cycle Assessment (LCA) cannot accommodate. LCA offers a robust framework for evaluating environmental performance across infrastructure lifecycles, but traditional approaches remain static and retrospective, which limits their use in dynamic, large-scale construction environments. This paper proposes a conceptual framework that integrates predictive machine learning and Digital Twin (DT) technologies within an AI-enabled digital platform, turning LCA into a continuous, real-time decision support process for megaconstruction projects. The framework was developed through a systematic literature review across the LCA, Digital Twin, and machine learning domains, and a structured four-layer design process covering data ingestion, AI predictive modelling, DT synchronisation, and interactive reporting, translated into a six-panel governance dashboard for project managers. Its completeness, coherence, and practical feasibility were then assessed through an Expert Validation Questionnaire. The framework is presented as a pre-empirical, expert-validated design; live deployment and performance testing on an operating megaconstruction project form the next stage of this research. Full article

High-resolution air pollutant measurement in Antarctica remains limited, particularly for short-term variability and episodic enhancements associated with local field activities, atmospheric processes, and long-range transport. This study presents minute-scale observations of trace gases and particulate matter collected during a short Antarctic field campaign from May to June 2023. The dataset includes NO₂, O₃, CO, SO₂, PM_2.5, and PM₁₀, with supplementary total volatile organic compound (TVOC) measurements available for May. Raw observations were quality-organized, aggregated to hourly and daily means, and examined for temporal variability, diurnal behavior, pollutant relationships, and short-duration pollution events. Across 58,652 valid observations, surface O₃ showed relatively stable concentrations compared with the other pollutants, while NO₂, CO, SO₂, PM_2.5, and PM₁₀ displayed episodic enhancements. Median concentrations were 11.05 ppb for NO₂, 38.17 ppb for O₃, 30.61 ppb for CO, 0.01 ppb for SO₂, 6.29 µg m⁻³ for PM_2.5, and 7.29 µg m⁻³ for PM10. PM2.5 and PM10 were strongly correlated, with a median PM_2.5/PM₁₀ ratio of approximately 0.96, suggesting that fine particles contributed substantially to particulate mass during much of the campaign. Event detection based on pollutant-specific hourly 95th percentile thresholds identified 142 single-pollutant enhancement events and 30 multi-pollutant concurrent events. TVOC observations were highly zero-inflated, with only about 1.9% nonzero readings and a short-lived elevated episode around 9 to 10 May; therefore, TVOC was treated as ancillary and interpreted cautiously. These results demonstrate that even short Antarctic field campaigns can capture meaningful high-resolution pollutant variability and episodic enhancements. Because reference-grade co-location was not available under Antarctic conditions, the reported concentrations are interpreted as calibrated sensor estimates, with emphasis placed on temporal variability rather than reference-equivalent absolute concentrations. The results apply only to the May–June 2023 campaign and are not intended to represent seasonal, annual, continent-wide, or long-term Antarctic air quality; they provide useful observational evidence of short-term atmospheric variability in a remote polar environment and highlight the importance of transparent event detection and cautious interpretation of short-duration sensor records. Full article

Fascioliasis, caused by Fasciola hepatica and Fasciola gigantica, is a major veterinary and zoonotic disease affecting cattle production systems worldwide. Despite extensive research, prevalence estimates vary considerably across geographic regions and study methodologies, necessitating a systematic synthesis to inform evidence-based control strategies and public health interventions. A systematic review and meta-analysis were conducted of studies reporting Fasciola prevalence in cattle from 1996 to 2024. A random-effects meta-analysis was performed on 338 studies encompassing approximately 49 million cattle samples. Subgroup analyses were performed to examine variations by continent, diagnostic method, Fasciola species, study period, sample size, and climate zone. Meta-regression identified sources of heterogeneity, and publication bias was assessed using Egger’s test. Certainty of evidence for the principal pooled outcomes was assessed using the GRADE framework. The global pooled prevalence of Fasciola infection in cattle was 26.5% (95% CI: 24.0–29.1), with very high heterogeneity (I² = 99.5%). Significant geographic variation was observed, with Europe showing the highest prevalence (42.1%, 95% CI: 33.1–51.1), followed by Oceania (38.9%, 95% CI: 24.3–53.6), America (31.4%, 95% CI: 24.5–38.4), and Africa (24.3%, 95% CI: 21.1–27.5), and Asia showed the lowest (18.3%, 95% CI: 13.9–22.8). The diagnostic method emerged as the most important source of heterogeneity (R² = 26.3%), with ELISA detecting a substantially higher prevalence (49.0%, 95% CI: 41.8–56.2) than post-mortem examination (19.2%, 95% CI: 16.2–22.3). F. hepatica exhibited a higher prevalence (33.1%, 95% CI: 27.9–38.2) than other species. No temporal trends were detected between the study periods. The climate zone explained 3.1% of the heterogeneity. Publication bias was not significant (Egger’s p = 0.157). Fasciolosis represents a substantial global burden in cattle populations, with its prevalence strongly influenced by diagnostic methodology and geographic location. The critical role of the choice of diagnostic method in prevalence estimation underscores the urgent need for standardized surveillance protocols. These findings have important implications for veterinary disease control programs and zoonotic disease prevention strategies in both endemic and emerging regions worldwide. Full article

Pantanal is the largest wetland on the American continent. This biome contains several plant species of interest for the development of medicines and cosmetics. Hence, this work aimed to review technologies described in patents concerning highly published plants from the Pantanal and their pharmacological and cosmetic applications. This research surveyed species in the Brazilian Pantanal and identified those with relevant scientific data. Patent searches for the selected species were conducted covering the past 10 years. Overall, 1859 plant and fungal species from the Pantanal were identified. Anacardium occidentale L., Annona montana Macfad., Annona muricata L., Annona squamosa L., and Calotropis procera (Aiton) W.T. Aiton presented the highest number of scientific publications. The patent search yielded 58 patents, mostly filed by private companies and in South Korea. Additionally, extracts were the primary products examined. The main pharmacological activities exploited were antitumoral, anti-inflammatory, and antidiabetic. For cosmetic compositions, the main activities were anti-aging, anti-acne, hair loss, and skin whitening. Despite strong scientific evidence for the included plant species, their claimed activities, and filings from Countries with a strong history of technology development, most studies focused on extracts. Therefore, the development of formulations to deliver these plant extracts is encouraged to improve technology transfer. Full article

Behavioural management strategies used in paediatric dentistry have neurobiological effects. This scoping review aimed to map the existing literature on the neurobiological effects of non-invasive behavioural management strategies used in paediatric dentistry. The study protocol was registered on the Open Science Framework (registration number: OSF.IO/9EZVT). A search was conducted on PubMed, Web of Science, Scopus, Google Scholar, and African Journals Online (AJOL) for studies published up to May 2025. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Studies were included if they assessed non-invasive behavioural strategies in children aged 0–17 years undergoing dental procedures and reported at least one neurobiological or physiological outcome. The data were summarised descriptively, and key findings were thematically synthesised to identify trends in behavioural strategy types and neurobiological outcomes measured. Out of 1720 records retrieved, 35 studies met the inclusion criteria. These included randomised and non-randomised controlled trials and observational studies conducted in 13 countries on five continents involving 2919 children. The behaviour management strategies identified were 18 in number, with distraction (n = 19) and tell–show–do (n = 17) being the most frequently applied. The neurobiological outcomes assessed included anxiety (n = 36), pain perception (n = 8), fear (n = 7), and stress response (n = 1). Their physiological regulation was assessed using heart rate (n = 26), oxygen saturation (n = 10), blood pressure (n = 8), pulse rate (n = 6), cortisol (n = 4), respiratory rate (n = 1), and oxytocin (n = 1). Behavioural assessment tools used were classified into Child-Reported Anxiety and Fear Instruments (n = 23), Pain Perception Instruments (n = 9), Clinician/Observer-Rated Behavioural and Anxiety Scales (n = 18), and Parental and Proxy Reports (n = 2). This review underscores the emerging evidence that non-invasive behavioural strategies may be linked to neurobiology in paediatric dentistry. More studies are needed in new countries to be able to map the possible impact of context and culture on study findings. Full article

Cross-cultural reasoning and alignment have been identified as key weaknesses of large language models (LLMs), but the architectural or cognitive features underlying these failures have not been adequately examined. In addition, previous studies rely almost exclusively on datasets and benchmarks constructed under the WEIRD (Western, Educated, Industrialized, Rich, and Democratic) bias. To address this data bias issue, we prepare a dataset with substantial coverage of non-WEIRD cultures and five-dimensional (W, E, I, R, and D) annotations. This dataset supports an interpretable approach to examining weaknesses in LLMs’ cross-cultural alignment. We adopt the Chinese–Foreign Cultural Differences Case Repository at Xiamen University, which contains 9342 cases across 151 countries, 6 continents, and 10 cultural domains. These cases are processed and transformed into benchmark-ready structured data through topic normalization, structured metadata cleaning, continent correction, and country-level WEIRD annotation along five dimensions. Each case is converted into a six-option cultural attribution question with five cognitive-trap distractors grounded in cognitive reasoning and pragmatic interpretation. Evaluation of 6 mainstream large language models shows that their dominant failures do not involve explicit stereotypes. Instead, 61% of all errors arise from oversimplifying complex cultural phenomena or applying familiar cultural frames. The proportion of errors that explain specific cultural conflicts through seemingly universal value frames increases from 11% at the low-WEIRD end to 20% at the high-WEIRD end of the dataset. These results suggest that WEIRD data bias reflects both the underrepresentation of low-WEIRD cultures and the overactivation of dominant value frames in high-WEIRD contexts. Full article

Background: Stress urinary incontinence is one of the most common and debilitating complications following radical prostatectomy. Artificial urinary sphincter (AUS) implantation is the gold standard treatment for moderate to severe post-prostatectomy incontinence. Common complications include device infection, mechanical failure, component migration, urethral erosion, and urethral atrophy, which often require device removal and subsequent reimplantation. To our knowledge, erosion or migration of orthopedic osteosynthesis screws into the lower urinary tract causing new-onset urinary symptoms after AUS implantation has not previously been reported. Case Presentation: A 57-year-old man with an implanted AUS presented to the emergency department with fever, dysuria, and de novo urge incontinence. Intravenous antibiotic therapy was initiated, resulting in resolution of the fever, after which further diagnostic evaluation was performed. Cystoscopy demonstrated normal urethral coaptation and intact urethral mucosa at the cuff site. However, three orthopedic osteosynthesis screws from previous pelvic fracture fixation were identified protruding immediately below the bladder neck. The screws were removed by open surgery during ongoing empirical antimicrobial therapy. Four weeks later, the AUS was reactivated. At 8-month follow-up, the patient remained asymptomatic and maintained the same continence status as following AUS implantation. Conclusions: A detailed history of previous pelvic surgery and orthopedic fixation, together with review of available imaging, is important in candidates for AUS implantation. In patients presenting with new-onset urinary symptoms after AUS implantation, alternative etiologies should be considered, with cross-sectional imaging and cystoscopy used selectively according to the clinical presentation. Full article

Clade A Middle East respiratory syndrome coronavirus (MERS-CoV) spilled over from camels into humans in Saudi Arabia in 2012 and caused pneumonia and severe respiratory disease, with a 37% case fatality rate. While clade A and B viruses are closely related phylogenetically, clade B MERS-CoV strains have since outcompeted clade A strains and continue to circulate in camels and humans in the Middle East and cause outbreaks in humans. Clade C strains circulate in camels across the African continent but have not been reported to cause disease in humans. We have shown that a number of East African clade C isolates are less able to utilize the TMPRSS2-mediated pathway for viral entry in both cell lines and primary nasal epithelial cultures, which may underlie the reduced replication of East African clade C strains in humans. However, the reduced replicative capacity of West African strains in human cells appears to be independent of viral entry, suggesting an alternative basis for their attenuation. Here, we report that West African clade C MERS-CoV isolates with deletions in ORF4b encoding a key accessory protein, NS4b, induced significantly more robust interferon and inflammatory responses than clade A MERS in human respiratory cell lines and primary bronchial air–liquid interface cultures. The replication deficit for the West African strain BF785, which has a complete deletion of ORF4b, was partially rescued when RNASEL was knocked out in A549 cells. These findings demonstrate that complete loss of NS4b results in stronger innate immune activation than partial truncation and suggests that differential selection on NS4b may contribute to the varying phenotypes of clade C MERS-CoV strains circulating in African camels. Full article

Background/Objectives: Perioperative androgen-deprivation therapy (ADT) and androgen-receptor pathway inhibitors (ARPIs) are increasingly used in high-risk prostate cancer, yet patient-centred functional-recovery data after radical prostatectomy are scarce and rarely standardized. We assessed whether a smartphone-based digital monitoring pathway could characterize social-continence recovery and capture differences associated with a perioperative hormonal therapy (PHT) strategy after robot-assisted radical prostatectomy with pelvic lymph-node dissection (RARP + LND). Methods: In a two-centre consecutive cohort (n = 98) of men with high-risk, non-metastatic prostate cancer aligned with SUGAR and PROTEUS criteria, we compared upfront surgery (standard of care [SOC], n = 72) with a planned PHT strategy (ADT or ARPI, n = 26); all patients were urinary-continent preoperatively. Clinical data were prospective; patient-reported and patient-experience measures were captured through a routine-care digital platform (Betty Coaching application) delivering an identical prehabilitation/rehabilitation pathway to both groups, with pre- and postoperative pelvic-floor muscle training performed by all patients. The primary endpoint was 6-month social continence (0–1 pad/day), assessed by clinician and patient reports as co-primary sources. Differences are reported as risk differences with 95% confidence intervals (CIs). Results: At 6 weeks, no statistically clear difference was observed (clinician 66.2% vs. 56.5%; risk difference 9.7 percentage points, 95% CI −12 to 32). At 6 months, social continence was lower with PHT (clinician 87.1% vs. 65.0%, difference 22.1 points, 95% CI 2.6 to 44.7; patient 81.3% vs. 58.3%, 22.9 points, 95% CI 2.4 to 43.9), converging by 12 months (96.9% vs. 95.0%). Analgesic-free rates were lower with PHT on postoperative days (POD) 7 and 10. Conclusions: Digital monitoring captured granular recovery trajectories and identified a mid-term social-continence signal associated with PHT, compatible with a transient delay in recovery. These hypothesis-generating findings support embedding standardized digital functional-outcome monitoring in perioperative trials. Full article

Antimicrobial resistance (AMR) in Salmonella enterica from aquatic animals represents an emerging food safety and public health concern, yet the global distribution patterns and trends remain insufficiently understood. Here, we performed a global genomic survey of Salmonella from aquatic animals using 2911 genomes collected from 67 countries across six continents between 1974 and 2025. These genomes represented 194 serovars and 364 sequence types. Notably, the dataset exhibited unbalanced geographical sampling, with Asian isolates accounting for 69.98% of all strains, which may limit the generalizability of our global trends. Globally, resistance to WHO-recommended clinically important antimicrobials showed substantial variation among antibiotic classes, with resistance rates for azithromycin (2.10%), cefepime (2.89%), cefotaxime (2.71%), ceftazidime (2.71%), and ceftriaxone (0.62%). Geographical differences were observed, with isolates from Asia exhibiting higher resistance levels, particularly for ciprofloxacin (13.50%) and doxycycline (18.02%). AMR temporal trends differed across geographical regions. A total of 111 acquired ARGs and 10 resistance-associated chromosomal mutations were identified, accompanied by changes in the distribution of resistance determinants. Collectively, this study provides a global genomic perspective on priority AMR in Salmonella from aquatic animals and highlights the importance of integrating aquaculture, environmental, and public health surveillance to monitor and mitigate AMR risks within the One Health framework. Full article

Large-scale administrative hospital discharge data is a key resource for secondary health systems research, yet reuse is constrained by barriers of access, quality, interoperability, and semantic comparability. This paper presents and validates a reproducible, declarative, loss-aware harmonization framework for public discharge data that avoids full migration to a comprehensive common data model. The framework comprises a lightweight 14-field canonical model, versioned JSON crosswalks, a shared execution engine, a resilient file reader, schema validation, idempotency tests, value-domain checks, and an information-loss map. It was evaluated on public record-level discharge data from five jurisdictions on three continents (Korea, Brazil, Mexico, Chile, and New York State), comprising 561,966,231 harmonized records from 2001 to 2025. Validation demonstrated conformance to the declared source profiles for 82 of 99 files and full canonical conformance for 39, idempotency across all 99 files, 99.99% conformance with permitted value domains under an explicitly stated aggregation, and detection of source-level defects such as truncated files, malformed rows, and completeness anomalies. A marker-condition query for ischemic stroke (ICD-10 I63) showed that a single case definition executes consistently on the four sources retaining raw ICD-10 codes. The results show that, for heterogeneous administrative data, the key value lies not in scale alone but in the auditability of transformations, explicit loss documentation, and reproducibility of the harmonization process. Full article