Search Results (83)

Lymphomas are broadly categorized into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Despite treatment advances, they remain a major cause of cancer-related morbidity and mortality in Canada. This study examined temporal trends in socioeconomic inequalities in lymphoma mortality in Canada from 2000 to 2019. Using a unique census division level dataset (n = 280) constructed by pooling information from the Canadian Vital Statistics Death Database, the Canadian Census of Population and the National Household Survey, we measured mortality in HL and NHL in Canada. The age-standardized Concentration index (C) was used to quantify income and education inequalities in lymphoma. Time trend analyses were conducted to examine the changes in the observed socioeconomic inequalities. Crude HL mortality declined significantly over the study period. Crude NHL mortality remained largely unchanged in Canada overall, although modest declines were observed in the Prairies. The age-standardized C indicated persistent income and education inequalities for both lymphoma types. For NHL, mortality became increasingly concentrated among lower-income and lower-education populations over time. The persistent and widening socioeconomic inequalities observed in HL and NHL mortality, respectively, in Canada underscore the need for targeted public health interventions and more equitable distribution of resources to address systematic and avoidable differences in cancer outcomes associated with socioeconomic disadvantage. Full article

This comprehensive meta-analysis reviews 45 studies published from 2000 to 2024 that use quantitative methods to examine how educational poverty—limited resources, poor-quality teaching, and disadvantaged school settings—affects students’ academic outcomes. Following PRISMA guidelines, effect sizes were calculated using random-effects models to account for variability across studies. Educational poverty was associated with a moderate, significant negative impact on achievement (Hedges’ g = −0.45, 95% CI: −0.50 to −0.40); this likely reflects a performance gap of about 10–15% between disadvantaged and non-disadvantaged students. Variability across studies led to subgroup and meta-regression analyses. The negative effects were more pronounced for primary students (g = −0.50) than secondary students, especially in high-inequality regions like North America (g = −0.55), and were largest for cognitive outcomes such as standardized test scores (g = −0.50), compared to non-cognitive metrics like attendance and graduation. Meta-regression showed that location, age group, and outcome type significantly affected effect sizes. Sensitivity tests and bias assessments confirmed consistent results. Overall, the studies highlight that educational poverty remains a major barrier to academic success, with the strongest effects seen early in education. These findings underscore the importance of early, targeted, and context-specific policies to reduce inequalities and improve learning conditions for underprivileged students. Full article

Background/Objectives: Genitourinary cancers represent a major and growing source of cancer burden worldwide; however, important disparities persist across the Americas. This study aimed to evaluate the incidence, mortality, and disability burden of prostate, testicular, bladder, and kidney cancers across 38 countries and territories using Global Burden of Disease (GBD) 2023 estimates, with emphasis on temporal trends and sociodemographic inequalities. Methods: A descriptive ecological study was conducted using Global Burden of Disease (GBD) 2023 estimates. Age-standardized incidence, mortality, and disability-adjusted life year (DALY) rates per 100,000 population were analyzed for prostate, bladder, kidney, and testicular cancers. Burden estimates were obtained from GBD 2023 data, and temporal trend analyses were conducted using age-standardized rates from 2000–2023. Temporal trends were assessed using weighted log-linear regression to estimate annual percentage changes (APCs) based on age-standardized rates from 2000–2023. Results: In 2023, prostate cancer accounted for the greatest genitourinary cancer burden across the Americas, with high incidence concentrated in high-income North America, whereas mortality and DALY rates were disproportionately elevated in Latin America and the Caribbean. Across all cancer types, high-SDI regions consistently exhibited higher incidence but more favorable mortality and disability profiles. Testicular cancer incidence increased across all SDI quintiles, although mortality reductions were mainly observed in high-SDI settings. Bladder and kidney cancers demonstrated similar epidemiological patterns, with declining mortality trends in high-income regions but persistent or increasing burden in lower-SDI countries. Mortality-to-incidence disparities remained substantial across Latin America and the Caribbean, which may reflect differences in healthcare resources, early detection, treatment availability, or other contextual factors not directly captured in the GBD database. National extremes included Bermuda prostate ASIR 170.63 and Dominica DALYs 1423.30 per 100,000. Conclusions: The burden of genitourinary cancers across the Americas remains strongly associated with socioeconomic inequalities. Although higher-resource settings have achieved important reductions in mortality and disability, these gains have not been equitably distributed across the region. Strengthening health system capacity, improving early diagnosis, and ensuring equitable access to evidence-based cancer care are essential to reduce avoidable mortality and improve long-term outcomes throughout the Americas. Full article

This paper investigates explicit coefficient-based estimates for a class of fractional Hermite functions defined through finite power series with Gamma-function coefficients. These functions may be viewed as a fractional Hermite-type family associated with the Caputo fractional derivative of order $\alpha \in (0,1]$. An explicit representation of the fractional derivative is obtained as a finite sum of monomials with computable Gamma coefficients. This representation is used to derive a preliminary uniform estimate on bounded intervals $[0,R]$ with an explicit constant depending on $\alpha$, n, and R. Consistency with the integer-order setting is established by showing that, when $\alpha =1$, the construction reduces to a Hermite-type polynomial family and the Caputo derivative coincides with the ordinary derivative. Explicit asymptotic formulas are obtained for the associated coefficient envelope as $R\to 0^{+}$ and $R\to \infty$. Numerical experiments up to degree $n=7$ show that the ratio between the coefficient envelope and the computed supremum norm remains below approximately $1.45$ for the tested parameter range. In addition, a weighted $L^2$ estimate is derived with respect to a fractional Gaussian-type weight, yielding an explicit coefficient-based bound. The estimates obtained in this work are preliminary in nature, being based on coefficient-wise majorization, and are not claimed to be optimal. Determining sharp constants and establishing genuine norm-comparison inequalities remain open problems. The results presented here provide a rigorous starting point for the study of explicit coefficient-based estimates for fractional Hermite functions and suggest several directions for future research in fractional approximation theory. Full article

Background: Dementia and Type 2 diabetes (T2D) represent two of the most pressing global public health challenges of our time, both exacerbated by physical inactivity. These conditions disproportionately affect Global Majority populations, who experience earlier onset, higher prevalence, and poorer access to culturally appropriate preventive care. However, conventional research and interventions often overlook the sociocultural and structural factors that underpin this disparity. This study synthesises current evidence to understand how these three conditions intersect and to identify equitable pathways for prevention and support. Methods: A meta-narrative review approach was employed to integrate evidence from diverse biomedical, public health, sociocultural and intervention science traditions. Searches were undertaken across MEDLINE/PubMed-adapted searches, CINAHL, PsycINFO, Web of Science Core Collection, AMED and ASSIA, supplemented by grey literature searching and citation chasing. Five meta-narratives were identified: biomedical and epidemiological, public health, health disparities, sociocultural and behavioural, and intervention science. Cross-narrative synthesis produced a conceptual framework linking upstream determinants, lifestyle factors, and disease outcomes. Results: The review revealed that structural inequities such as deprivation, environmental barriers and sociocultural factors including stigma, gendered norms, limited access to culturally appropriate facilities that restrict physical activity (PA) opportunities within Global Majority communities. These constraints elevate T2D and dementia risk through biological pathways involving insulin resistance, vascular injury, and neuroinflammation. Community-based participatory research (CBPR) interventions particularly those delivered in trusted cultural or faith settings emerged as effective strategies to improve PA, glycaemic control, and cognitive well-being. Conclusions: This synthesis reframes dementia and diabetes as interlinked within a wider syndemic driven by structural and sociocultural inequities. The proposed framework underscores the importance of culturally grounded, community-led approaches to promote brain health, reduce risk, and achieve equitable healthy ageing among Global Majority populations. Full article

Sparse tensors have been widely applied in hypergraph representation, complex network analysis, and high-dimensional data processing, where eigenvalue inclusion sets play a fundamental role in analyzing the properties of such tensors. For sparse tensors, two new eigenvalue inclusion sets are proposed in this paper via the matrix’s digraph. Specifically, we employ the digraphs of the majorization matrix and the representation matrix to establish two new S-type inclusion sets and theoretically prove that these sets are tighter than the existing ones. By applying these inclusion sets, some inequalities for the spectral radius of weakly irreducible nonnegative tensors are derived. Moreover, several criteria for verifying the positive (semi-)definiteness of symmetric sparse tensors are also obtained. Numerical examples are provided to illustrate the effectiveness of the proposed spectral radius bounds and positive definiteness criteria. Full article

Between 2020 and 2025, Europe has faced multiple interacting public health threats shaped by and following the COVID-19 pandemic. Alongside COVID-19, the region experienced other infectious disease events, including monkeypox, measles resurgence, legionellosis and acute hepatitis of unknown origin in children. At the same time, non-communicable disease burdens, including obesity, type II diabetes mellitus, disruption of chronic disease care, mental health disorders and increased problematic digital use, intensified during and after the pandemic period. Antimicrobial resistance (AMR) remained a major cross-cutting threat because it undermines the effective treatment of infections and weakens emergency preparedness. This narrative review synthesizes peer-reviewed articles and selected reports from international organizations for the 2020–2025 period, using COVID-19 as the organizing context for examining interconnected infectious, chronic and system-level threats. Across these topics, recurring themes included vaccination gaps, fragmented surveillance, disruption of routine care, health system inequities, misinformation and insufficient preparedness for cross-border threats. The review supports integrated surveillance, continuity plans for essential services, stronger vaccination and risk-communication strategies and sustained AMR stewardship within a One Health framework. Coordinated action across public health, primary care, mental health and chronic disease policy is essential for future resilience. Full article

Pneumocystis jirovecii is an opportunistic fungal pathogen responsible for Pneumocystis pneumonia (PCP), a severe infection that remains a major cause of morbidity and mortality among immunocompromised patients, particularly in non-HIV immunosuppressed populations. Despite its recognized clinical relevance and inclusion in the World Health Organization’s Fungal Priority Pathogens List, important gaps persist in its diagnosis, epidemiology, and therapeutic management. This study provides a comprehensive bibliometric analysis of global scientific production on P. jirovecii using Scopus as the primary data source. Publications were evaluated for temporal trends, document types, authorship patterns, institutional productivity, collaboration networks, funding sources, thematic evolution, and journal distribution, with additional comparison against other major pneumonia-associated pathogens. A total of 27,396 articles published between 1916 and 2025 were identified. Over the last 50 years, scientific output increased from 10,382 publications in 1975–2000 to 16,496 in 2001–2025, representing an overall growth of 58.9%. Early research expansion was strongly shaped by the HIV/AIDS epidemic, whereas the post-2000 period reflected advances in molecular diagnostics, taxonomic clarification, and broader attention to non-HIV immunosuppressed populations. Although the field has become more diversified and clinically integrated, persistent structural inequities and underinvestment continue to limit progress, particularly in low- and middle-income settings. Full article

Background: Artificial intelligence (AI) is reshaping oncology at every stage of the cancer care pathway, from population-level screening through molecular diagnosis, treatment planning, and post-treatment surveillance. Despite an exponential growth in AI oncology publications exceeding 5000 peer-reviewed studies annually, a critical and persistent gap separates demonstrated algorithmic performance from genuine patient benefit. Most published evidence derives from retrospective, single-institution studies conducted in curated dataset environments that systematically differ from real-world clinical deployment conditions. This comprehensive review examines the translational maturity of AI applications across 18 major malignancies, providing an evidence-stratified, cross-cancer assessment of where AI has fulfilled, approaches, or remains far from fulfilling its transformative potential in oncological care. Methods: A structured narrative review was conducted across PubMed/MEDLINE, Embase, IEEE Xplore, and the Cochrane Library, supplemented by regulatory grey literature including FDA 510(k) decision summaries, CE Technical Files, and ClinicalTrials.gov. Search terms combined cancer site-specific terminology with AI methodology terms and translational outcome descriptors. Studies were only included if they applied an AI or machine learning methodology to a defined clinical oncological task, reported a clearly specified performance evaluation, and involved human subjects or human-derived clinical data. Evidence quality was assessed using QUADAS-2, PROBAST, and Cochrane RoB 2. A five-tier translational readiness framework, grounded in the NIH T0–T4 translational spectrum and CONSORT-AI/SPIRIT-AI guidelines, was applied a priori to enable cross-cancer comparison. A rigorous distinction was maintained between diagnostic accuracy and clinical utility, defined as demonstrated impact on clinical decision-making or patient-centered outcomes. Results: Across all 18 malignancies, AI development varied profoundly by cancer type. Breast cancer and prostate cancer (Tier 1) represent the most mature AI ecosystems, with multiple FDA-cleared tools for mammographic screening and digital pathology achieving prospective multi-institutional validation; however, randomized evidence demonstrating reduced cancer-specific mortality remains absent. Lung, hepatocellular, and melanoma AI (Tier 2) have achieved regulatory milestones but face documented performance disparities across demographic subgroups, including DermaSensor’s 20.7% specificity in primary care settings and HCC model failures in non-viral disease etiologies. Colorectal, glioma, pancreatic, and ovarian cancers (Tier 3) exhibit technical maturity without clinical clarity: colorectal CADe systems increase adenoma detection but meta-analyses of 18,232 patients across 21 RCTs fail to demonstrate improvement in advanced neoplasia detection or cancer incidence reduction. A full study-level presentation of pooled estimates, confidence intervals, and heterogeneity statistics for each cited randomized evidence base across all cancer types would extend beyond the intended scope and format of this cross-cancer narrative review. Gastric, esophageal, cervical, bladder, head and neck, and endometrial cancers (Tier 4) demonstrate promising single-institutional or geographically restricted results without multi-institutional external validation, particularly notable for cervical cancer AI’s transformative potential in low- and middle-income countries constrained by absent regulatory frameworks. Hematologic malignancies, sarcoma, and pediatric solid tumors (Tier 5) face structural barriers, workflow incompatibility in hematopathology, extreme rarity in sarcoma (>70 subtypes, <15,000 US cases annually), and irreducible ethical constraints in pediatric data governance, that cannot be resolved through algorithmic refinement alone. Conclusions: Oncological AI has not yet fulfilled its clinical promise. Across all five translational tiers, a single finding is consistent: diagnostic accuracy is not a surrogate for patient benefit. AI tools with high sensitivity and specificity have repeatedly failed to demonstrate equivalent reductions in cancer-specific mortality, overdiagnosis, or procedural harm under real-world outcome scrutiny. Simultaneously, documented performance disparities across races, ethnicity, disease etiology, and geographic setting reveal that current AI systems risk amplifying the very health inequities they are positioned to resolve. Bridging this translational gap requires three coordinated systemic shifts: regulatory frameworks mandating post-market outcome surveillance as a condition of clinical clearance; prospective trial designs measuring patient-centered endpoints rather than diagnostic concordance alone; and sustained infrastructure investment in federated data governance, demographically inclusive training datasets, and LMIC-accessible regulatory pathways. AI holds genuine potential to reduce cancer mortality on a global scale—but only if held to the evidentiary and equity standards that the stakes of oncological care demand. Full article

Indigenous peoples in Amazonia face major mental health inequities, including high rates of suicidal behaviour among adolescents and young adults in some settings. We conducted a scoping review of the peer-reviewed literature on community health workers (CHWs) and equivalent cadres involved in Indigenous and remote contexts, with a focus on their roles in relation to mental health, psychosocial support, and suicide prevention among Indigenous populations in Amazonia and the Guiana Shield. We reported this review in line with PRISMA-ScR. Searches (September–November 2025) were conducted in PubMed/MEDLINE, Scopus, Web of Science and SciELO, complemented by targeted searches in major publisher platforms and JSTOR. We included English, French, Spanish and Portuguese publications that (i) described CHWs or functionally equivalent cadres in Indigenous/remote contexts and/or (ii) reported CHW-related roles, models, or experiences relevant to mental health, psychosocial support or suicide prevention in Amazonian settings. Global documentation of CHW designations used in Indigenous/remote contexts was compiled; we compiled evidence from Amazonia and the Guiana Shield on CHW roles, programme models, implementation conditions and reported outcomes. Data were charted into a structured template (cadre designation, setting, population, study type, functions, programme features and reported mental health/suicide-related outcomes) and synthesised descriptively and thematically. CHWs commonly function as cultural and linguistic brokers between Indigenous communities and biomedical systems, supporting early detection of distress, psychosocial accompaniment, referral navigation and dialogue with local healing practices. Reported programme models differ markedly: Brazil’s institutionalised Indigenous Health Agents (AIS) offer stability and formal recognition, whereas French Guiana relies more heavily on project-based mediation with innovative practices but greater funding fragility. The available literature remains heterogeneous and uneven across countries, with limited evaluative designs and substantial reliance on descriptive reports. Future work should prioritise stronger implementation and impact evaluation, alongside Indigenous-led governance and sustainable support for CHW cadres. Full article

Background: Transgender and gender expansive (TGE) people experience high rates of interpersonal victimization, which has been linked to high rates of post-traumatic stress disorder (PTSD, a highly disabling and under-studied mental illness among TGE people). This systematic review identifies, classifies, critically appraises, and synthesizes the peer-reviewed literature describing the association between interpersonal victimization and post-traumatic stress among TGE people. This review collates what is known about the associations between victimization and PTSD among TGE people and makes recommendations to guide future research and intervention development. Methods: Searches were conducted across five databases (PubMed, Embase, Web of Science, PsycInfo, and CINAHL) following PRISMA guidelines. Inclusion criteria were: English language; peer-reviewed original research; articles describing the association between victimization and PTSD among TGE youth or adults; reporting TGE-specific data. Exclusion criteria were: reviews, commentaries without original data, dissertations or theses, conference abstracts, animal studies, studies without TGE-specific findings, and case studies. Quality appraisal was completed for all studies, which included a discussion of bias. Data extraction was completed by two independent authors, and conflicts were resolved by a third. Data were stratified by gender identity, race or ethnicity, and type of violence for further synthesis. Results: 25 studies were evaluated for design, measure quality, and key findings. Findings were highly consistent across studies: multiple forms of interpersonal violence (e.g., childhood maltreatment, sexual violence, intimate partner violence, and transgender-specific victimization) were significantly associated with PTSD symptom severity or diagnosis across diverse identities and geographic contexts. All studies examining childhood sexual abuse reported significant associations with PTSD outcomes, highlighting early life as a critical period of vulnerability. Samples were disproportionately White and adult, with limited examination of intersectional experiences shaped by race, ethnicity, and socioeconomic status. Discussion: Interpersonal violence-related PTSD among TGE populations reflects a pervasive and systemic pattern of trauma rooted in structural discrimination rather than isolated individual risk. Addressing this inequity requires multilevel prevention and intervention strategies. Future research should prioritize longitudinal designs, culturally responsive measurement tools, and intersectional analyses to inform prevention, clinical care, and policy responses. The majority of studies were cross-sectional designs, so causality cannot be inferred. Additionally, the samples were disproportionately White and adult, which may bias the magnitude of associations reported and limit generalizability to racially and ethnically diverse TGE populations. Although many studies reported race and ethnicity descriptively, none disaggregated violence-related PTSD outcomes by racial or ethnic group within TGE samples, representing a critical limitation for intersectional analysis. Full article

Background/Objectives: Type 2 diabetes mellitus (T2DM) is a major public health challenge, and several lifestyle-related factors associated with later T2DM may already emerge during the secondary school years. Socioeconomic status (SES), nutrition-related behaviors, physical activity, and basic diabetes-related knowledge may shape these early risk-related patterns. This study examined the relationships between SES, adapted FINDRISC-based T2DM-related risk patterns, and diabetes-related knowledge among Hungarian secondary school students aged 16–20 years. Methods: A nationwide, cross-sectional questionnaire survey was conducted among students attending Hungarian Baptist secondary schools (N = 1585). SES was classified by Two-Step cluster analysis based on parental education, parental occupation, number of books in the household, and frequency of travel abroad. Relative T2DM-related risk patterns were described using an age-adapted FINDRISC-based screening approach, and basic diabetes-related knowledge was assessed using a 12-item questionnaire. Associations were examined using cross-tabulation and regression analyses in SPSS version 27.0. Results: Most respondents fell into the lower categories of the adapted FINDRISC-based screening framework, whereas 7.4% were classified into the moderate or high adapted FINDRISC-based screening categories. SES was significantly associated with adapted FINDRISC-based screening categories (p < 0.001). Compared with the medium-SES group, students in the low-SES group had higher odds of belonging to a higher adapted FINDRISC-based screening category (OR = 1.81; 95% CI: 1.27–2.57; p = 0.001). SES was also significantly associated with basic diabetes-related knowledge profiles (p = 0.015); students with high SES were less likely to be in the low-knowledge group than in the high-knowledge group (OR = 0.62; p = 0.039). Conclusions: Social inequalities in T2DM-related risk patterns and diabetes-related knowledge are already visible among secondary school students aged 16–20 years. The adapted FINDRISC-based approach may be useful as a school-based, non-invasive descriptive screening framework for characterizing relative T2DM-related risk patterns, but it is not a validated risk prediction instrument for this age group. Full article

Background: Sub-Saharan Africa is undergoing a rapid epidemiological transition marked by a growing burden of non-communicable diseases, including breast, cervical, ovarian, and uterine cancers, which constitute major causes of morbidity and mortality among women in the region; however, comprehensive assessments of long-term trends and regional heterogeneity remain limited. This study examines the burden and temporal trends of breast, cervical, ovarian, and uterine cancers across sub-Saharan Africa from 1990 to 2023. Methods: A retrospective ecological analysis was conducted using data from the latest Global Burden of Disease 2023 study. Age-standardised incidence rates, mortality rates, and disability-adjusted life year rates were estimated for breast, cervical, ovarian, and uterine cancers across 48 sub-Saharan African countries and four sub-regions. Temporal trends were assessed from 1990 to 2023, with percentage changes calculated to characterise epidemiological transitions. Geographic variation and age-specific patterns were examined to identify high-burden settings and priority populations. Results: Between 1990 and 2023, the burden of all four cancers increased substantially across sub-Saharan Africa, with significant regional and country-level heterogeneity. Breast cancer exhibited the largest absolute burden, with incidence increasing by over 120 percent and mortality by more than 80 percent, particularly in Central and Western Africa. Cervical cancer remained the leading cause of cancer-related mortality among women in Eastern and Southern Africa, despite evidence of stabilisation or decline in selected countries. Ovarian and uterine cancers demonstrated sustained upward trends, especially in Central Africa, with high mortality-to-incidence ratios indicating late diagnosis and limited treatment access. Across all cancer types, Central and Eastern sub-Saharan Africa consistently experienced the highest disability-adjusted life year burdens. Conclusions: The burden of the selected cancers in sub-Saharan Africa has increased markedly over the past three decades, with persistent regional inequities reflecting gaps in prevention, early detection, and treatment capacity. Strengthening cancer surveillance systems, expanding equitable access to screening and vaccination programmes, and improving diagnostic and treatment infrastructure are critical to reversing current trends. These findings provide region-specific evidence to guide cancer control priorities and resource allocation across sub-Saharan Africa. Full article

Persistent urban–rural disparities remain a major challenge to inclusive and sustainable development in many developing economies. The digital economy is widely viewed as a potential mechanism for alleviating such inequalities, yet empirical evidence for its effectiveness across heterogeneous regional conditions remains limited. Using panel data from 30 Chinese provinces over the period 2013–2022, this study constructs composite indices of digital economy development and urban–rural integration based on the entropy weight method. Fixed-effects models, panel threshold regressions, and moderation analyses are employed to examine average and nonlinear effects, while instrumental variable approaches, including a Bartik-type instrument, are used to address potential endogeneity. The results indicate that the digital economy significantly promotes urban–rural integration, but the effect is highly conditional rather than uniform. Specifically, the positive impact becomes substantially stronger only after rationalization of industrial structure and education levels exceed critical threshold values. Government support and financial development further amplify this effect, and pronounced regional heterogeneity is observed, with stronger effects in eastern regions and clear late-mover advantages in western regions. These findings highlight the conditions under which digital transformation can effectively support inclusive urban–rural integration and offer policy-relevant insights for developing economies. Full article

Retirement wealth is a core indicator of financial security, autonomy, and inequality in later life. This paper examines how cohort, institutional context, and social class interact to shape retirement wealth, focusing on Generation X. Gen X occupies a critical but understudied position in the life course between peak earning years and full retirement; they also came of age during a major restructuring of the U.S. economy that shifted financial risk from institutions to individuals. I compare Gen X retirement wealth to that of adjacent cohorts, evaluating how different asset and debt types contribute to cohort differences in retirement readiness. I also examine intra-cohort inequality by wealth class. Findings suggest that retirement wealth inequality is especially severe among those nearing and exiting the labor force. The analyses highlight how long-term economic security is socially structured and historically contingent—making retirement wealth a powerful lens for understanding inequality across time and class. Full article