Search Results (5,741)

Background: Influenza A(H3N2) viruses remain a major public health concern due to their rapid antigenic evolution and association with severe disease, particularly among high-risk populations. During the 2025–2026 influenza season, a marked epidemiological shift was observed in Europe, with the emergence and predominance of the A(H3N2) subclade K (J.2.4.1). Objectives: This narrative review aims to provide an integrated overview of the epidemiology, evolutionary dynamics, and public health implications of subclade K, with a particular focus on its impact on vaccine effectiveness, in comparison with the 2024–2025 influenza season. Methods: A non-systematic literature review was conducted using major scientific databases and official public health sources, including WHO and ECDC reports. Recent surveillance data, genomic analyses, and epidemiological updates were included. Given the rapidly evolving evidence base, selected preprint studies were also considered and interpreted with caution. Results: The 2025–2026 influenza season in Europe was characterized by a relative genetic convergence, with subclade K accounting for the majority of A(H3N2) sequences. This variant demonstrated a clear selective advantage and was associated with an earlier and more intense epidemic peak. Molecular analyses indicate the accumulation of multiple mutations in the hemagglutinin protein, particularly within key antigenic sites, contributing to immune escape. These evolutionary changes have important implications for vaccine effectiveness, with current estimates suggesting moderate protection against infection but preserved effectiveness against severe outcomes. Antigenic mismatch, manufacturing constraints, and host-related factors further contribute to reduced vaccine performance. Conclusions: The emergence and rapid spread of subclade K highlight the dynamic nature of influenza virus evolution and its impact on public health. Continuous genomic surveillance and timely vaccine updates remain essential. Despite suboptimal effectiveness against infection, influenza vaccination continues to provide significant protection against severe disease and should remain a cornerstone of prevention strategies. Full article

Microgrid sizing has traditionally been driven by economic, technical, environmental, and social criteria, while safety has often been treated implicitly or addressed at later stages of design and operation. In this context, safety refers to the prevention of unacceptable harm to people, assets, and the environment through appropriate design margins, protection coordination, operational limits, and risk-aware system configuration. However, the increasing penetration of distributed energy resources, battery energy storage systems, power electronics, and advanced digital control architectures has elevated safety to a critical design dimension that directly influences sizing decisions. Despite its importance, safety remains fragmented across the microgrid literature and lacks unified treatment within sizing-oriented studies. This paper presents a systematic review of microgrid sizing methodologies with a specific focus on safety-related indicators. The review critically examines how distinct safety dimensions—namely energy storage safety, protection and fault tolerance, operational margins and redundancy, grid interaction, cybersecurity, human and environmental safety—are addressed within traditional, artificial-intelligence-based, software-driven, and hybrid sizing approaches. Safety is conceptualized as a cross-cutting design constraint that shapes sizing variables and feasibility boundaries rather than as an independent optimization objective. By synthesizing the existing literature, this work identifies the safety dimensions most strongly coupled with sizing decisions. The paper further analyses how safety-related constraints can be incorporated into sizing frameworks and highlights key research gaps that hinder their systematic integration. The findings aim to provide a structured reference for researchers and practitioners seeking to embed safety considerations into microgrid sizing methodologies. Full article

Geological hazards induced by large-scale and high-intensity mining activities worldwide are primary drivers of regional ecological degradation and pose significant threats to human safety and property. To construct efficient monitoring systems and enhance early warning capabilities, it is essential to clarify the formation mechanisms of various hazards and the suitability of corresponding technologies. Focusing on four typical geological hazards prevalent in mining areas (surface subsidence, ground fissures, landslides, collapses, and sinkholes), this paper characterizes their specific features and monitoring requirements. It systematically analyzes the physical principles, accuracy levels, and technical advantages and limitations of ground-based, aerial, and spaceborne monitoring, as well as multi-source remote sensing data fusion and emerging technologies (e.g., distributed optical fiber, light detection and range, microseismical monitoring, and deep learning). Utilizing case studies from an open-pit coal mine in Turkey and a loess gully mining area in China, the paper evaluates the effectiveness of methods like multi-temporal InSAR and UAV photogrammetry in identifying the evolution of these hazards. The findings indicate that the technological framework for mining area monitoring is transitioning from single-method approaches to integrated systems. However, given the complex mining environment, several bottleneck challenges remain, including single data dimensions, the limited environmental adaptability of aerospace remote sensing, insufficient stability of deep monitoring equipment, and weak anti-interference capabilities under extreme operating conditions. Consequently, this paper proposes that future innovations in geological hazard monitoring in mining areas will focus on multi-platform hierarchical collaboration, the development of multi-parameter fusion early warning criteria, and the construction of digital and visual platforms. Constructing a comprehensive monitoring system characterized by multi-scale collaboration and dynamic prediction capabilities is vital for improving safety standards in mining areas and achieving coordinated development between resource exploitation and environmental protection. The findings provide a theoretical foundation for the precise prevention and control of mining hazards, as well as for land ecological restoration. Full article

Rheumatoid arthritis (RA) has traditionally been managed after the onset of clinically apparent synovitis; however, accumulating evidence indicates that disease-related immune abnormalities precede clinical diagnosis by several years. This preclinical phase is characterized by systemic autoimmunity, early musculoskeletal symptoms, and subclinical inflammation in genetically and environmentally susceptible individuals. In this review, we summarize current concepts regarding the pathogenesis, risk stratification, and therapeutic interception of preclinical RA. Particular attention is given to the mucosal origin hypothesis and to the roles of immunosenescence, peripheral helper T cells, and fibroblast-like synoviocytes in early disease evolution. Recent advances in clinical, serological, and imaging-based risk stratification have improved the identification of individuals at high risk of progression to clinical RA, and emerging intervention trials have shown that selected therapies may delay disease onset or reduce early inflammatory burden. Although complete prevention of RA has not yet been achieved, these findings support a paradigm shift from the treatment of established RA toward earlier, risk-adapted intervention before irreversible joint damage occurs. Future efforts should focus on refining predictive biomarkers, optimizing the timing and intensity of intervention, and establishing safe, individualized preventive strategies. Full article

Background: Burnout is an occupational phenomenon that has adverse effects on the health and work outcomes of employees. In this sense, there is greater emphasis on understanding and addressing this problem. In this regard, organizations play a significant role in preventing burnout, and organizational interventions have been shown to be more effective at reducing burnout than individual-focused interventions. This study aims to systematically review organizational interventions to prevent burnout in the workplace. Methods: A search was conducted in three databases: Scopus, Web of Science, and PubMed, reviewing studies published from 2013 to 2025. Following the PRISMA model, 11 studies meeting eligibility criteria were selected. The methodological quality of included studies was assessed using the Joanna Briggs Institute (JBI) checklist. Results: Of the eligible articles, 1669 participants were identified, predominantly female healthcare professionals. Some strategies that proved to be effective in preventing burnout in the workplace were workshops, discussion groups, psychoeducation and training programs. Concerning psychotherapeutic interventions, third-generation therapies are the most used, such as ACT or mindfulness. Conclusions: These findings suggest that organizational-level interventions, particularly those combining psychoeducational strategies with third-generation therapeutic approaches, represent promising avenues for burnout prevention in the workplace, although effectiveness varies across interventions and contexts, and the most positive effects were limited to the short term. Future research should focus on evaluating long-term outcomes, exploring understudied occupational sectors beyond healthcare, and examining the role of organizational culture and leadership in sustaining intervention effects. Full article

Background/Objectives: Adults with intellectual disability are known to experience complex health needs, including an elevated presence of chronic conditions. Cardiovascular risk factors are a concern, yet the evidence base is fragmented, and the scope and focus of current research are not well understood. Methods: We conducted a scoping review to map the existing evidence on cardiovascular risk factors among adults with intellectual disability. The review included studies reporting on risk factor prevalence as well as participant characteristics (ethnicity, living arrangements, age, sex, and type of disability). Cardiovascular-related outcomes were extracted to clarify the health disparities documented in this population. Results: Searches of seven databases for studies published from 2013 onward yielded 15,598records, of which 85 met the inclusion criteria. Evidence was dominated by cross-sectional studies, with a few randomized controlled trials. Hypertension, Type 2 diabetes and obesity were commonly reported. Patterns appeared to reflect lifestyle, medication effects, genetic syndromes—particularly Down syndrome and Prader–Willi syndrome—and the severity of the disability. A notable share of the studies originated from the United Kingdom and the United States. Findings reveal a complex cardiovascular risk profile, emphasizing the need for tailored prevention and management. Conclusions: Adults with intellectual disability face a substantial burden of cardiovascular risk factors. Evidence on effective interventions remains limited, highlighting a need for targeted, evidence-informed approaches to improve cardiovascular health and long-term outcomes. Full article

The need for reliable preventive medicine tools is growing, especially for diseases with long diagnostic delays, such as endometriosis, which can take several years to diagnose. In this context, cellulose acetate nanofibrous membranes were prepared via electrospinning, to create the absorbent core of a smart wearable in the form of a sanitary pad, intended to support electronic diagnostic devices. A multi-layered structure was opted for, with each layer acting in a specific way according to its position within the pad, regarding mainly absorbency and porosity. The membranes were ultralight and highly absorbent, with single membranes showing an absorbency of 20–70 times their initial weight, and multi-layered membranes 15–30 times. Morphological evaluation of the pad was used as the basis for the optimization of the fabrication parameters, while liquid absorption capacity confirmed the pad’s high absorbency. Additionally, chemical and toxicological assessments indicated in vitro biocompatibility of the pad. The potential of the electrospinning process in the fabrication of menstrual hygiene pads is shown by these results. Future studies should focus on the integration of smart devices within the pad, as well as their functionality and effectiveness. Full article

Background: Overweight and obesity remain major public health challenges in Puerto Rico, affecting over 70% of adults and contributing to cardiovascular, metabolic, and mental health disorders. This study explores the psychosocial and behavioral factors influencing obesity within low-income Puerto Rican communities, emphasizing both biological sex differences and socially defined sex-role influences, along with their respective mental health dimensions. Method: Using a qualitative approach, Community-Based Participatory Research (CBPR), ten focus groups were conducted with 71 participants (37 women and 34 men) from two municipalities in southern Puerto Rico. Discussions were analyzed thematically with the Socioecological and Health Belief Models to identify key determinants. Results: The data collected revealed that women expressed greater emotional vulnerability, frequently citing anxiety, depression, body image concerns, and stress-related eating as contributors to obesity. Men, meanwhile, reported frustration with diet adherence, economic limitations, and healthcare inaccessibility. Across participants, economic hardship, cultural norms, and limited health education emerged as major obstacles. Conclusions: Findings underscore the need for holistic, sex-informed and socially responsive interventions that integrate mental health support with nutritional and physical health strategies. Addressing self-esteem, emotional regulation, and stress management alongside behavioral modification can promote sustainable, culturally tailored obesity prevention in Puerto Rico. Full article

As a chronic flood and erosion-prone region in India, Assam faces perpetual challenges in managing and mitigating the impacts of natural hazards every year. Despite participatory policy and communication approaches, communities in the region do not feel included in the planning and decision-making processes of mitigation and prevention. The study conducts a stakeholder perception analysis using a qualitative approach through Focus Group Discussions (FGDs) and semi-structured and structured interviews with flood-prone communities of Barpeta, Dibrugarh, and Majuli districts in Assam. The thematic analysis revealed multiple gaps in the policy planning and implementation stages where the traditional knowledge of communities has been ignored, while also revealing gendered silences and communication fallouts. The increasing frequency and intensity of floods, along with untimely modern interventions, have convinced communities to combine modern mitigation strategies with their traditional mitigation strategies like stilt houses, but engineers and policymakers often bypass the traditional knowledge of communities. The study calls for a multi-faceted approach to flood and erosion management by addressing the infrastructural and socio-cultural challenges, and involving communities more actively in the planning and decision-making processes, re-emphasizing the importance of SDG 13 and SDG 17. Full article

Ototoxicity represents a clinically significant complication of anticancer therapy in pediatric patients. Cytotoxic agents used in oncology, particularly platinum-based chemotherapy, may induce damage to the auditory and vestibular systems, resulting in hearing loss, tinnitus, and balance disturbances. Even mild hearing impairment during childhood may negatively affect speech perception, language development, communication abilities, and subsequent educational and psychosocial functioning. This narrative review aims to synthesize current evidence on treatment-related ototoxicity in children, with particular focus on commonly implicated therapies, clinical consequences, diagnostic approaches, and potential preventive strategies. A focused literature search was conducted in PubMed for publications from 2019 to 2025 addressing ototoxicity associated with pediatric anticancer treatment and audiological monitoring methods. The analysis indicates that platinum-based compounds, especially cisplatin and carboplatin, remain the primary agents associated with ototoxicity, with reported incidence ranging from approximately 20–70% for cisplatin and 10–30% for carboplatin. Additional risk factors include young age, baseline hearing status, renal function, and exposure to other ototoxic agents such as aminoglycoside antibiotics. Early detection relies on comprehensive audiological monitoring combining behavioral and objective methods, including pure-tone audiometry, extended high-frequency audiometry, otoacoustic emissions, and auditory brainstem response testing. Standardized grading systems such as ASHA, Brock, Chang, and SIOP Boston criteria play a key role in identifying and classifying ototoxic changes. Emerging research focuses on improved monitoring protocols, biomarker identification, and the development of otoprotective strategies, including sodium thiosulfate and experimental molecular therapies. Implementing systematic hearing monitoring and preventive strategies is essential to reduce long-term auditory complications and improve quality of life in pediatric cancer survivors. Full article

Gender-based violence in dating relationships is a multifaceted issue that encompasses diverse forms. In university settings, high prevalence rates have been reported, with psychological violence being the most common. New forms of digital violence, such as cyberbullying, control through social media, and digital aesthetic pressure, further complicate the phenomenon. Purpose: This study aimed to explore Health Sciences students’ perceptions of gender-based violence in dating relationships to identify key dimensions for understanding and intervention. Methods: A qualitative design was employed using focus groups with ten participants, analyzed through Interpretative Phenomenological Analysis (IPA). Results: Four main themes emerged: characteristics of gender-based violence in dating relationships, types of violence identified, aesthetic pressure within affective relationships, and strategies for detecting and responding to violence. Conclusions: Findings emphasize the importance of incorporating students’ voices into prevention strategies and propose educational interventions that address both offline and online dynamics of gender-based violence in dating relationships. Full article

Introduction: Healthcare-associated infections are a significant public health challenge, particularly in resource-limited settings. While hand hygiene is critical for infection prevention, contaminated water from hand hygiene stations (HHSs) in healthcare facilities (HCFs) may undermine infection control efforts. Chlorination can reduce microbial contamination in HHSs, ensuring that water intended for hygiene does not become an infection source. Methods: Water quality was monitored before and after the installation of on-site chlorine dispensers (CDs) in water tanks and HHSs of HCFs in Quetzaltenango, Guatemala, to evaluate their effectiveness in improving water quality. Focus groups were conducted to develop action plan proposals to ensure the intervention’s sustainability. Results: Before the intervention, 75% of HHS water samples tested positive for total coliforms, with 50% testing positive for presumptive extended-spectrum beta-lactamase (ESBL)-producing total coliforms, while 20% were E. coli-positive, with 50% presumptive ESBL-producing E. coli. After installing CD, 1% of samples were coliform-positive over a six-month period. Focus groups identified resource limitations and political barriers and proposed solutions such as developing operational manuals, strengthening inter-institutional relationships, and forming alliances with external organizations. Conclusion: Localized chlorination was successfully implemented using a community participatory approach to improve water quality in resource-limited HCFs. These findings have important implications for infection prevention and control. Full article

Serious youth violence is a public health issue nationally in the UK and internationally. The Youth Endowment Fund (YEF) was established in March 2019, with a £200 million endowment and a ten-year mandate, with a mission to prevent children and young people from becoming involved in violence. This article gives an overview of YEF’s successes and challenges to date, focusing specifically on the experience of evaluating tertiary interventions. After providing an overview of YEF’s approach to funding and evaluation, the article summarises YEF’s work focused on tertiary prevention, including: work to test interventions already being implemented in the UK; adapting and evaluating evidence-based interventions from other jurisdictions in the UK; innovations in a group approach to carrying out evaluations; and embedding a focus on racial equity in tertiary prevention. Next, the article discusses the design issues involved in high-quality evaluation of tertiary prevention, including the scale required and the processes for obtaining consent from young people to participate in evaluations. The article then documents the many challenges and lessons learned from implementing tertiary prevention evaluations, especially focusing on the recruitment and retention of young people. Finally, the article discusses the lessons and places them in a wider context. Full article

This study examines the evolution of the scientific literature on mining and heavy metals, with a particular focus on biosanitary risks associated with childhood exposure. The research integrates a systematic literature review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology, combined with a bibliometric analysis of Scopus-indexed publications, international epidemiological data, and an evaluation of the socio-environmental context in Ecuadorian mining regions. The PRISMA-based screening process was applied to identify, filter, and select relevant peer-reviewed studies, enabling the delimitation of a focused corpus of literature, with particular attention given to scientific contributions produced by Latin American researchers and institutions. The results reveal a significant concentration of knowledge production among a limited number of countries and institutions, the dominance of English as the main language of scientific communication, and the centrality of journals in environmental sciences and toxicology. While notable progress has been made in identifying contaminants and exposure pathways, governance structures, territorial disparities, and policy implementation processes remain insufficiently explored. In Ecuador, the rapid growth of mining concessions in ecologically sensitive zones presents potential threats to children’s neurocognitive development, highlighting the urgent need for ongoing surveillance, biomonitoring programs, and preventive public health measures. The study emphasizes the importance of strengthening regional research capacity and fostering more equitable international scientific collaborations to ensure that knowledge production is responsive to local contexts and effectively safeguards vulnerable populations. Full article

The increase in older adults and active lifestyles has made chondral and osteochondral lesions common in the population, making them one of the central challenges in orthopedics. Although hydrogel-based regenerative medicine offers an encouraging therapeutic option for these lesions, important obstacles still prevent these therapies from reaching the clinic. In view of these factors, we adopted a risk-based approach for this review, in line with the current legislative requirements in clinical translation and clinical trials. We identified the factors that could undermine patient safety or lead to poor outcomes. Then, we outlined solutions to remedy these problems that integrate hydrogel technology, clinical/pharmaceutical/surgical protocols, and post-operative follow-up. Upcoming studies should give priority to the development of hydrogel scaffolds modified to mimic cartilage’s mechanical and physicochemical properties, together with patient-specific features. Other crucial characteristics are host-tissue integration, long-lasting cartilage tissue regeneration, and a positive outcome. In parallel, to scale complex and costly innovations, efforts should focus on a harmonized, simplified legislative landscape, optimized standards, and established follow-up protocols. Getting through this “valley of death” between research and innovation is strategic for reaching the clinics and the largest number of patients. Full article