Search Results (473)

Background/Objectives: Antimicrobial resistance (AMR) surveillance is a cornerstone of national AMR strategies but requires sustained, cross-sectoral financing. While the need for such financing is well recognized, its quantification remains scarce in low- and middle-income countries. This study aimed to estimate the full costs of AMR surveillance across the human health, animal health, and food sectors (2021–2030) in selected facilities in Nepal and generate evidence to inform sustainable financing. Methods: A bottom-up micro-costing approach was used to analyze data from five sites. Costs were adjusted for inflation using projected gross domestic product deflators, and probabilistic sensitivity analyses were conducted to assess uncertainty in laboratory sample volumes under four scenarios. Results: The total cost of AMR surveillance in Nepal was $6.7 million: $3.4 million for human health (50.3% out of the aggregated costs), $2.7 million for animal health (39.8%), and $0.7 million for the food sector (9.9%). Laboratories accounted for >90% of total costs, with consumables and personnel as the main cost drivers. Average cost per sample was $150 (animal), $64 (food), and $6 (human). Conclusions: This study offers the first robust, multi-sectoral 10-year cost estimates of AMR surveillance in Nepal. The findings highlight that sustaining AMR surveillance requires predictable domestic financing, particularly to cover recurrent laboratory operations as donor support declines. These results provide cost evidence to support future budgeting and policy planning toward sustainable, nationally financed AMR surveillance in Nepal. Full article

Licorice (Glycyrrhiza glabra) is a perennial herb traditionally valued for its aromatic and therapeutic properties. In recent years, however, growing attention has shifted toward the technical and environmental potential of the plant’s industrial by-products, particularly the fibrous material left after extraction. This review integrates botanical knowledge with engineering and industrial perspectives, highlighting the role of licorice fiber in advancing sustainable innovation. The natural fiber obtained from licorice roots exhibits notable physical and mechanical qualities, including lightness, biodegradability, and compatibility with bio-based polymer matrices. These attributes make it a promising candidate for biocomposites used in green building and other sectors of the circular economy. Developing efficient recovery processes requires collaboration across disciplines, combining expertise in plant science, materials engineering, and industrial technology. The article also examines the economic and regulatory context driving the transition toward more circular and traceable production models. Increasing interest from companies, research institutions, and public bodies in valorizing licorice fiber and its derivatives is opening new market opportunities. Potential applications extend to agroindustry, eco-friendly cosmetics, bioeconomy, and sustainable construction. By linking botanical insights with innovative waste management strategies, licorice emerges as a resource capable of supporting integrated, competitive, and environmentally responsible industrial practices. Full article

Background/Objectives: Child undernutrition remains a major public health in Djibouti, yet conventional anthropometric indicators may underestimate its true burden by failing to capture overlapping forms of malnutrition. The Composite Index of Anthropometric Failure (CIAF) provides a more comprehensive assessment by identifying children experiencing one or multiple anthropometric deficits. This study aimed to estimate the prevalence and determinants of undernutrition among children under five years of age in Djibouti using the CIAF. Methods: This study is a secondary analysis of data from the nationally representative 2023 Multisectoral Survey conducted in Djibouti. A cross-sectional design with a two-stage stratified cluster sampling method was used to collect data on a national random sample (n = 2103) of children aged 6–59 months. Standardized anthropometric measurements were used to derive conventional indicators (stunting, wasting, and underweight) and the CIAF. Binary logistic regression analyses were performed to identify factors associated with anthropometric failures, adjusting for child, household, and contextual characteristics. Results: Based on conventional indicators, 23.4% of children were stunted, 20.0% were underweight, and 9.9% were wasted. Using the CIAF, 36.9% of children experienced at least one anthropometric failure, including 18.8% with multiple concurrent failures. Boys, children aged 6–47 months, those living in nomadic households, and those residing in specific regions had significantly higher risks of undernutrition. Socioeconomic indicators and household food security were not independently associated with undernutrition after adjustment. Conclusions: More than one-third of children under five in Djibouti experience undernutrition when assessed using the CIAF, revealing a substantial hidden burden not captured by conventional indicators alone. Incorporating the CIAF into routine nutrition surveillance could improve identification of vulnerable children and support more targeted, context-specific interventions. Full article

Child marriage remains a major threat to adolescent girls’ health, development, and rights worldwide. Despite decades of progress, recent policy backsliding and sociopolitical instability have created new risks, with examples from Iraq, Afghanistan, and The Gambia illustrating how legal and political shifts are reshaping vulnerabilities for girls. This paper presents an integrated framework linking developmental science with legal and policy advocacy, emphasizing how evolving capacities and psychosocial maturity should inform marriage laws and protection mechanisms. It reframes advocacy and rights-based action as essential components of adolescent health systems, drawing on recent policy analyses and country examples to identify actionable, multisectoral strategies. The paper highlights an urgent need for collective, evidence-informed advocacy to protect adolescent girls and advance gender equality, an issue of growing importance amid renewed global attention to legal reforms on child marriage. Full article

The COVID-19 pandemic exacerbated structural, social, economic, and racial inequalities affecting immigrant, refugee, and asylum-seeking men—vulnerable populations often overlooked in men’s health research. This study investigated the health conditions of immigrant, refugee, and asylum-seeking men during the COVID-19 pandemic. A scoping review was conducted following Joanna Briggs Institute guidance, and a qualitative lexical analysis (text-mining of standardized study syntheses) was performed in IRaMuTeQ using similarity analysis, descending hierarchical classification, and factorial correspondence analysis. We identified 93 studies published between 2020 and 2023 across 35 countries. The evidence highlighted vaccine hesitancy, high epidemiological risks (infection, hospitalization, and mortality), barriers to accessing services and information, socioeconomic vulnerabilities, psychological distress (e.g., anxiety and depression), and structural inequalities. Findings were synthesized into four integrated thematic categories emphasizing the role of gender constructs in help-seeking and gaps in governmental responses. Most studies focused on immigrants, with limited evidence on refugees and especially asylum seekers; therefore, conclusions should be interpreted cautiously for these groups. Overall, the review underscores the urgency of multisectoral interventions, universal access to healthcare regardless of migration status, culturally and linguistically appropriate outreach, and gender-sensitive primary care strategies to support inclusive and resilient health systems. Full article

The study introduces an AI-enhanced Environmental, Social, and Governance (ESG) framework that integrates explainable artificial intelligence (XAI) and bias-mitigation techniques to improve transparency and comparability of sustainability assessments across sectors. Addressing the persistent gap in standardized ESG evaluation methods, the framework combines gradient-boosting models (XGBoost) with SHAP-based explainability and a human-in-the-loop (HITL) validation layer. The approach is demonstrated using ESG indicators for 18 firms across three industries from the banking, aviation, and chemical sectors between 2021 and 2023. Results indicate an average 12.4% improvement in ESG-score consistency and a 9% reduction in inter-sector variance relative to baseline traditional ESG evaluations. Fairness metrics (Disparate-Impact Ratio = 0.81–0.86) provide preliminary evidence of improved alignment across sectors. The findings provide preliminary evidence that XAI-driven frameworks can enhance the trustworthiness and regulatory compliance of ESG analytics, particularly under the EU AI Act and Corporate Sustainability Reporting Directive (CSRD). The framework contributes to both research and practice by operationalizing explainability, fairness, and human oversight within ESG analytics, thereby supporting more reliable and comparable sustainability reporting. Full article

The One Health framework highlights the interconnectedness of human, animal, and environmental health, requiring interdisciplinary and multisectoral collaboration to address complex global health challenges. This scoping review protocol aims to guide the systematic mapping on how studies and policy initiatives have incorporated socioecological interconnections within the One Health paradigm, following the Joanna Briggs Institute guidance and the PRISMA Scr checklist. The experimental design includes searches in PubMed, Scopus, Web of Science, LILACS, Health Systems Evidence, Social Systems Evidence, and Google Scholar for the period from 2004 to 2025. The strategy, developed with librarian support and peer reviewed, includes terms in English, Portuguese, and Spanish. Pilot searches retrieved 5333 PubMed and 470 LILACS records. Eligible documents must explicitly present two or more of the six One Health dimensions: policies to strengthen health systems; antimicrobial resistance; food safety; environmental health; emerging and re-emerging zoonotic epidemics and pandemics; endemic zoonotic, neglected tropical and vector-borne diseases. A standardized tool was developed for data extraction, synthesizing in narrative, tabular, and graphical formats. The protocol’s utilization will provide comprehensive mapping of practices and policies, identifying achievements, barriers, and knowledge gaps to inform future strategies and strengthen global health governance. Full article

Using Shanghai as a case study, this paper estimates multi-sector urban carbon emissions by integrating multi-source statistical data from 2000 to 2023 with IPCC guidelines. Via rolling-window time-series validation, XGBoost is the most reliable model. To better understand the underlying drivers, explainable machine-learning approaches, including SHAP and the Friedman H-statistic, are applied to examine the nonlinear effects and interactions of population scale, industrial energy efficiency, investment structure, and infrastructure. The results suggest that Shanghai’s emission pattern has gradually shifted from a scale-driven process toward one dominated by structural change and efficiency improvement. Building on an incremental framework, four scenarios, Business-as-Usual, Green Transition, High Investment, and Population Plateau, are designed to simulate emission trajectories from 2024 to 2060. The simulations reveal a two-stage pattern, with a period of rapid growth followed by high-level stabilisation and a weakening path-dependence effect. Population agglomeration, economic growth, and urbanisation remain the main contributors to emission increases, while industrial upgrading and efficiency gains provide sustained mitigation over time. Scenario comparisons further indicate that only the Green Transition pathway supports early peaking, a steady decline, and long-term low-level stabilisation. Overall, this study offers a data-efficient framework for analysing urban carbon-emission dynamics and informing medium- to long-term mitigation strategies in megacities. Full article

Emerging and re-emerging viruses continue to pose major threats to public health. Their ability to adapt, cross species barriers, and spread rapidly can trigger severe outbreaks or even pandemics. Strengthening preparedness with comprehensive and efficient strategies is therefore essential. Here, we explore the key components of viral outbreak preparedness, including surveillance systems, diagnostic capacity, prevention and control measures, non-pharmaceutical interventions, antiviral therapeutics, and research and development. We emphasize the increasing importance of genomic surveillance, wastewater-based surveillance, real-time data sharing, and the One Health approach to better anticipate zoonotic spillovers. Current challenges and future directions are also discussed. Effective preparedness requires transparent risk communication and equitable access to diagnostics, vaccines, and therapeutics. The COVID-19 pandemic highlighted both the promise of next-generation vaccine platforms and the necessity of maintaining diagnostic capacity, as early testing delays hindered containment efforts. Countries adopted various non-pharmaceutical interventions: risk communication and social distancing proved to be the most effective, while combined workplace infection-prevention measures outperformed single strategies. These experiences highlight the importance of early detection, rapid response, and multisectoral collaboration in mitigating the impact of viral outbreaks. By applying best practices and lessons learned from recent events, global health systems can strengthen resilience and improve readiness for future viral threats. Full article

Objective: To assess the structure and regional variation in mortality among school-aged children in Kazakhstan from 2015 to 2024, and to determine its association with dietary patterns and socio-economic factors. Materials and Methods: An ecological inter-regional analysis was conducted using official statistical data of the Republic of Kazakhstan. Mortality rates among children aged 6–17 years, the distribution of death causes according to ICD-10, indicators of consumption of major food product groups, and poverty levels were examined. Linear mixed-effects regression with a random intercept for region and fixed effects for year and covariates, and spatial description of regional trends were applied. Results: Variation in school-age mortality across regions and calendar years was evident, with external causes predominating, followed by diseases of the nervous system, neoplasms, and diseases of the circulatory and respiratory systems in the mortality structure. In the multivariable linear mixed-effects model, none of the dietary or socioeconomic predictors showed statistically significant independent associations with mortality (all p > 0.05), and the calendar year was not significant (p = 0.180). Model explanatory power was very low (marginal R² = 0.017; conditional R² = 0.020; ICC = 0.005), and residuals demonstrated significant temporal autocorrelation (p < 0.001). Conclusions: The mortality structure among school-aged children is shaped by a complex interplay of medical, social, and behavioral determinants. Dietary and socioeconomic indicators showed only weak ecological associations with mortality and did not retain independent effects after multivariable adjustment, underscoring the multifactorial nature of regional mortality patterns and the need for multisectoral action, including improved access to nutritious foods, enhanced social well-being, and strengthened health system capacity. Full article

Urban resilience has emerged as a crucial objective for achieving sustainable urban development. However, its practical integration into planning remains limited. This study evaluates the extent to which resilience thinking is integrated into Chengdu’s urban planning system by combining policy-theoretical analysis with empirical evidence. Drawing on a framework of nine resilience attributes, we conduct content analysis of Chengdu’s three types of statutory plan documents (Socioeconomic Development Plan, Urban and Rural Plan, and Land Use Plan) and a questionnaire survey of 70 expert planners. The results reveal that resilience is reflected implicitly in the plans through engineering-oriented attributes such as robustness, efficiency, and connectivity. In contrast, social and ecological attributes like inclusion, redundancy, and innovation are largely absent. Planners demonstrate moderate awareness of resilience, yet associate it predominantly with rapid response and infrastructure robustness rather than long-term adaptation or community capacity-building. These findings indicate the dominant top-down, growth-centric planning logic that constrains the adoption of broader socio-ecological resilience concepts. This paper concludes with policy recommendations for institutionalizing resilience in Chinese urban planning through legal mandates; multi-sectoral coordination; and participatory, adaptive planning frameworks. Full article

One Health envisions integrated governance across human, animal, and environmental systems to prevent and respond to complex health threats. Despite its global endorsement, One Health implementation often falters due to institutional fragmentation, power asymmetries, and ethical tensions that erode trust and cooperation. This paper proposes the integration of medical-bioethics mediation within One Health governance as a structured, relational mechanism to manage conflict, foster ethical deliberation, and strengthen trust between sectors and communities. We develop a conceptual framework to apply the mediation principles of neutrality, confidentiality, respect, and shared problem-solving beyond clinical ethics toward multisectoral One Health contexts. The framework is illustrated through domain-specific examples from zoonotic disease control, antimicrobial resistance, and environmental health. Medical bioethics mediation can advance conflict transformation, ethical reflection, participatory decision-making, and policy alignment, thereby supporting transparent negotiation of values and institutionalized dialogue of different One Health actors. Future research should pilot mediation-based governance models and assess their effects on intersectoral trust, collaborative capacity, and integrated health outcomes. Full article

Accurate, high-frequency carbon emission forecasting is crucial for urban climate mitigation and achieving sustainable development goals. However, generalized models often result in lower prediction accuracy by overlooking the unique “sector specificity” of urban emission systems, namely, the different temporal patterns driven by distinct physical and economic factors across sectors. This study establishes a decision-support framework to select optimal forecasting models for distinct sectors. Using daily multi-sector carbon emission and meteorological data from Hangzhou, we evaluated 12 models across statistical, machine learning, and deep learning classes. Our three-stage design identified the best model for each sector, quantified the contribution of meteorological drivers, and assessed multi-step forecasting stability. The results indicated the lack of universality in generalized models, as no single model performed best across all sectors. A hybrid CNN-LSTM model outperformed other candidates for ground transport (R² = 0.635), while LSTM showed better performance for industry (R² = 0.866) and residential (R² = 0.978) sectors. Integrating meteorological factors only improved accuracy in weather-sensitive sectors (e.g., residential) and acted as noise in others (e.g., aviation). We conclude that a sector-specific strategy is more robust than a one-size-fits-all approach for carbon emission forecasting. By resolving the specific driving mechanisms of each sector this decision-support framework provides the granular data foundation necessary for precise urban energy dispatch and targeted emission reduction policies. Full article

Micronutrient deficiencies, also known as “hidden hunger,” remain a pervasive public health issue in low- and middle-income countries, particularly among vulnerable populations within these countries. The main drivers of these deficiencies are poverty, limited dietary diversity, weak nutritional strategies, poor health service delivery and general health access barriers. This review assesses the prevalence, drivers, and consequences of selected micronutrient deficiencies: iron, iodine, zinc, vitamin A and vitamin D, within the scope of undernutrition, food insecurity, and socioeconomic inequity. The consequences associated with these deficiencies include stunted growth, increased susceptibility to illness, poor cognitive and social functioning, and deepened poverty. The primary strategies to address these deficiencies include dietary diversification, supplement provision, biofortification, and the production of fortified foods. Barriers to progress include the high cost of food, weak healthcare infrastructure, low educational levels, and ineffective policy implementation. Integrated food systems, personalised nutrition, and innovative food technologies have the potential to address both nutritional and health inequities. Addressing barriers to safe and nutritious food and healthcare systems in order to address health inequities requires integrated, multisectoral planning and contextual policy. Improving individual health outcomes is crucial, but addressing micronutrient deficiencies has a ripple effect throughout society, enabling economic development through poverty reduction and increased productivity. Full article

Rising residential land prices push up housing prices and worsen credit misallocation. These patterns emerge amid cyclical real estate fluctuations and heavy land-based public finance. Such pressures undermine macroeconomic stability and sustainable land-use. The land price circuit breaker is widely applied with a price cap and state dependence, yet its trigger mechanism and interaction with inflation targeting remain underexplored. This study addresses three core questions. First, how does the circuit breaker’s discrete trigger and rule-switching logic differ from traditional static price ceilings? Second, can the mechanism, via the collateral channel, restrain excessive land price hikes, improve credit allocation, and, thereby, stabilize land price dynamics and long-run macroeconomic performance? Third, how does the circuit breaker interact with inflation targeting, and through which endogenous channels does a strict target dampen housing prices and raise activation probability? This study develops a multi-sector DSGE model with an embedded land price circuit breaker. The price cap is modeled as an occasionally binding constraint. A dynamic price band and trigger indicator capture the policy’s switch between slack and binding states. The framework incorporates interactions among local governments, the central bank, developers, and households. It also links firms and the secondary housing market. Under different inflation-targeting rules, this study uses impulse responses, an event study, and welfare analysis to assess trigger conditions and macroeconomic effects. The findings are threefold. First, a strict inflation target increases the probability of a circuit breaker being triggered. It channels housing-demand shocks toward land prices and creates a “nominal anchor–relative price constraint” linkage. Second, once activated, the circuit breaker narrows the gap between land price and house-price growth. It weakens the procyclicality of collateral values. It also restrains credit expansion by impatient households. These effects redirect credit toward firms, improve corporate financing, reduce the decline in investment, and accelerate output recovery. Third, the circuit breaker limits new land supply and shifts demand toward the secondary housing market. This generates a supply-side effect that releases existing stock and stabilizes prices, thereby weakening the amplification mechanism of housing cycles. This study identifies the endogenous trigger logic and cross-market transmission of the land price circuit breaker under a strict inflation target. It shows that the mechanism is not merely a price-management tool in the land market but a systemic policy variable that links the real estate, finance, and fiscal sectors. By dampening real estate procyclicality, improving credit allocation, and stabilizing macroeconomic fluctuations, the mechanism offers new insights for sustainable land-use policy and macroeconomic stabilization. Full article