Search Results (3,068)

Background: Varicella remains a prevalent vaccine-preventable disease, but breakthrough infections are increasingly reported. However, long-term, population-based studies investigating the temporal and demographic characteristics of breakthrough varicella remain limited. Methods: This retrospective study analyzed surveillance data from Jinhua City, China, from 2016 to 2024. Varicella case records were obtained from the China Information System for Disease Control and Prevention (CISDCP), while vaccination data were retrieved from the Zhejiang Provincial Immunization Program Information System (ISIS). Breakthrough cases were defined as infections occurring more than 42 days after administration of the varicella vaccine. Differences in breakthrough interval were analyzed across subgroups defined by dose, sex, age, population category, and vaccination type. A bivariate cubic regression model was used to assess the combined effect of initial vaccination age and dose interval on the breakthrough interval. Results: Among 28,778 reported varicella cases, 7373 (25.62%) were classified as breakthrough infections, with a significant upward trend over the 9-year period (p < 0.001). Most cases occurred in school-aged children, especially those aged 6–15 years. One-dose recipients consistently showed shorter breakthrough intervals than two-dose recipients (M = 62.10 vs. 120.10 months, p < 0.001). Breakthrough intervals also differed significantly by sex, age group, population category, and vaccination type (p < 0.05). Regression analysis revealed a negative correlation between the initial vaccination age, the dose interval, and the breakthrough interval (R² = 0.964, p < 0.001), with earlier and closely spaced vaccinations associated with longer protection. Conclusions: The present study demonstrates that a two-dose varicella vaccination schedule, when initiated at an earlier age and administered with a shorter interval between doses, provides more robust and longer-lasting protection. These results offer strong support for incorporating varicella vaccination into China’s National Immunization Program to enhance vaccine coverage and reduce the public health burden associated with breakthrough infections. Full article

Background/Objectives: The COVID-19 pandemic caused pronounced disorder in healthcare delivery globally, including ophthalmology. Our study explores how ophthalmologists in Puerto Rico (PR) altered their practices during the pandemic, confronting obstacles such as resource shortages, evolving public health mandates, and unique socio-economic and geographic constraints. The study aims to enhance preparedness for future public health crises. Methods: We conducted descriptive analyses on four online surveys distributed at crucial time points of the pandemic (March 2020, May 2020, August 2020, August 2021) to all practicing ophthalmologists in PR (N ≈ 200), capturing data on closures, patient volume, personal protective equipment (PPE) access, telemedicine use, and financial relief. Results: Survey responses ranged from 41% (n = 81) to 56% (n = 111). By March 2020, 22% (24/111) of respondents closed their offices. By May 2020, 20% (19/93) of respondents maintained a closed office, while 89% (64/72) of open offices reported seeing less than 25% of their usual patient volume. Access to PPE was a challenge, with 59% (65/111) reporting difficulty obtaining N95 masks in March 2020. Telemedicine usage increased initially, peaking in May 2020 and declining in July 2020. By August 2021, all respondents were fully vaccinated and most practices returned to pre-pandemic levels. Overall, 86% (70/81) of respondents found the surveys to be useful for navigating practice changes during the pandemic. Conclusions: PR ophthalmologists showed adaptability during the COVID-19 pandemic to maintain care given limited resources. Guidelines from professional organizations and real time surveys play an important role in future crisis preparedness. Full article

This study investigates personal exposure to fine particulate matter (PM_2.5) during walking commutes in Gliwice, Poland—a city characterized by elevated levels of air pollution. Data from a low-cost air quality sensor were compared with a municipal monitoring station and the Silesian University of Technology laboratory. PM_2.5 concentrations recorded by the low-cost sensor (7.3 µg/m³) were lower than those reported by the stationary monitoring sites. The findings suggest that low-cost sensors may offer valuable insights into short-term peaks in PM_2.5 exposure to serve as a practical tool for increasing public awareness of personal exposure risks to protect respiratory health. Full article

Highly pathogenic avian influenza (HPAI) remains a persistent threat to global poultry production and public health. Current vaccine platforms show limited cross-clade efficacy and often fail to induce mucosal immunity. Recent advances in microbiome research reveal critical roles for gut commensals in modulating vaccine-induced immunity, including enhancement of mucosal IgA production, CD8⁺ T-cell activation, and modulation of systemic immune responses. Engineered commensal bacteria such as Lactococcus lactis, Bacteroides ovatus, Bacillus subtilis, and Staphylococcus epidermidis have emerged as promising live vectors for antigen delivery. Postbiotic and synbiotic strategies further enhance protective efficacy through targeted modulation of the gut microbiota. Additionally, artificial intelligence (AI)-driven tools enable predictive modeling of host–microbiome interactions, antigen design optimization, and early detection of viral antigenic drift. These integrative technologies offer a new framework for mucosal, broadly protective, and field-deployable vaccines for HPAI control. However, species-specific microbiome variation, ecological safety concerns, and scalable manufacturing remain critical challenges. This review synthesizes emerging evidence on microbiome–immune crosstalk, commensal vector platforms, and AI-enhanced vaccine development, emphasizing the urgent need for One Health integration to mitigate zoonotic adaptation and pandemic emergence. Full article

Despite the widespread accessibility of vaccines and antivirals, seasonal influenza virus epidemics continue to pose a threat to public health. In this study, we constructed a recombinant replication-deficient simian adenovirus type 25 vector carrying the full-length hemagglutinin (HA) of the H1N1 influenza virus, named rSAd25-H1. Both systemic and mucosal humoral immune responses, as well as the protective efficacy, were assessed in mice immunized via the intramuscular (IM) or intranasal (IN) route. A single-dose IM or IN administration of rSAd25-H1 elicited a robust systemic IgG antibody response, including hemagglutination inhibition antibodies. As expected, only IN immunization was able to induce IgA production in serum and respiratory mucosa. Notably, a single dose of rSAd25-H1 at the highest dose (10¹⁰ viral particles) conferred complete protection against lethal homologous H1N1 challenge in mice despite the route of administration. These findings demonstrate the potential of simian adenovirus type 25-based vectors as a promising candidate for intranasal vaccine development targeting respiratory pathogens. Full article

Background: Moral harassment (mobbing) in healthcare, particularly among nurses, remains a persistent issue with detrimental effects on mental health, resilience, and quality of life. Aim: We examine the relationship between the resilience of nurses working in Emergency Departments (EDs) and how these factors influence experiences of workplace mobbing. Methods: This cross-sectional study included 90 nurses from four public hospitals in Greece’s 5th Health District. Data were collected between October 2023 and March 2024 using the WHOQOL-BREF, Workplace Psychologically Violent Behaviors (WPVB) scale and the Connor–Davidson Resilience Scale (CD-RISC). The sample consisted primarily of full-time nurses (84.3% female; mean age = 43.1 years), with 21.1% reporting chronic conditions. Most participants were married (80.0%) and had children (74.4%), typically two (56.1%). Statistical analyses—conducted using SPSS version 27.0—included descriptive statistics, Pearson and Spearman correlations, multiple linear regression, and mediation analysis, with significance set at p < 0.05. Results: Resilience was moderate (mean = 66.38%; Cronbach’s α = 0.93) and positively correlated with all WHOQOL-BREF domains—physical, psychological, social, and environmental (r = 0.30–0.40)—but not with the overall WHOQOL-BREF. The mean overall WHOQOL-BREF score was 68.4%, with the lowest scores observed in the environmental domain (mean = 53.76%). Workplace mobbing levels were low to moderate (mean WPVB score = 17.87), with subscale reliabilities ranging from α = 0.78 to 0.95. Mobbing was negatively associated with social relationships and the environmental WHOQOL-BREF (ρ = –0.23 to –0.33). Regression analysis showed that cohabitation and higher resilience significantly predicted better WHOQOL-BREF outcomes, whereas mobbing was not a significant predictor. Mediation analysis (bootstrap N = 5000) indicated no significant indirect effect of resilience in the relationship between mobbing and WHOQOL-BREF. Conclusions: Resilience was identified as a key protective factor for nurses’ quality of life in emergency care settings. Although workplace mobbing was present at low-to-moderate levels, it was negatively associated with specific WHOQOL-BREF domains. Enhancing mental resilience among nurses may serve as a valuable strategy to mitigate the psychological effects of moral harassment in healthcare environments. Full article

Effective management of fecal pollutants in rural sanitation is crucial for environmental health and public safety, especially in developing regions. In this study, temporal and regional variations in nutrient elements, heavy metals, pathogenic microorganisms (PMs), and antibiotic resistance genes (ARGs) of fecal samples from rural toilets in China were investigated. The moisture contents of the fecal samples average 92.7%, decreasing seasonally from 97.4% in summer to 90.6% in winter. The samples’ pH values range from 6.5 to 7.5, with a slight decrease in winter (6.8), while their electrical conductivity varies from 128.1 to 2150 μs/cm, influenced by regional diets. Chromium (9.0–49.7 mg/kg) and copper (31.9–784.4 mg/kg) levels vary regionally, with higher concentrations in Anhui and Guangxi Provinces due to dietary and industrial factors. Zinc contents range from 108.5 to 1648.9 mg/kg, with higher levels in autumn and winter, resulting from agricultural practices and Zn-containing fungicides, posing potential health and phytotoxicity risks. Seasonal and regional variations in PMs and ARGs were observed. Guangxi Province shows the high PM diversity in summer samples, while Jiangsu Province exhibits the high ARGs types in autumn samples. These findings highlight the need for improved waste management and sanitation solutions in rural areas to mitigate environmental risks and protect public health. Continued research in these regions is essential to inform effective sanitation strategies. Full article

This study presents the scientific and methodological foundation of Spain’s first national framework for the ethical management of community cat populations: the Action Plan for the Management of Community Cat Colonies (PACF), launched in 2025 under the mandate of Law 7/2023. This pioneering legislation introduces a standardized, nationwide obligation for trap–neuter–return (TNR)-based management of free-roaming cats, defined as animals living freely, territorially attached, and with limited socialization toward humans. The PACF aims to support municipalities in implementing this mandate through evidence-based strategies that integrate animal welfare, biodiversity protection, and public health objectives. Using standardized data submitted by 1128 municipalities (13.9% of Spain’s total), we estimated a baseline population of 1.81 million community cats distributed across 125,000 colonies. These data were stratified by municipal population size and applied to national census figures to generate a model-ready demographic structure. We then implemented a stochastic simulation using Vortex software to project long-term population dynamics over a 25-year horizon. The model integrated eight demographic–environmental scenarios defined by a combination of urban–rural classification and ecological reproductive potential based on photoperiod and winter temperature. Parameters included reproductive output, mortality, sterilization coverage, abandonment and adoption rates, stochastic catastrophic events, and territorial carrying capacity. Under current sterilization rates (~20%), our projections indicate that Spain’s community cat population could surpass 5 million individuals by 2050, saturating ecological and social thresholds within a decade. In contrast, a differentiated sterilization strategy aligned with territorial reproductive intensity (50% in most areas, 60–70% in high-pressure zones) achieves population stabilization by 2030 at approximately 1.5 million cats, followed by a gradual long-term decline. This scenario prioritizes feasibility while substantially reducing reproductive output, particularly in rural and high-intensity contexts. The PACF combines stratified demographic modeling with spatial sensitivity, offering a flexible framework adaptable to local conditions. It incorporates One Health principles and introduces tools for adaptive management, including digital monitoring platforms and standardized welfare protocols. While ecological impacts were not directly assessed, the proposed demographic stabilization is designed to mitigate population-driven risks to biodiversity and public health without relying on lethal control. By integrating legal mandates, stratified modeling, and realistic intervention goals, this study outlines a replicable and scalable framework for coordinated action across administrative levels. It exemplifies how national policy can be operationalized through data-driven, territorially sensitive planning tools. The findings support the strategic deployment of TNR-based programs across diverse municipal contexts, providing a model for other countries seeking to align animal welfare policy with ecological planning under a multi-level governance perspective. Full article

Incineration at sea is a significant source of marine pollution, threatening biodiversity and public health. Although Peru ratified the 1996 London Protocol in 2018, key deficiencies persist in its domestic legal framework, particularly the absence of clear and internationally aligned definitions for “incineration” and “incinerator.” These gaps hinder effective enforcement by the National Maritime Authority (NMA-DICAPI) and limit regulatory compliance with international obligations. This study analyzes Peru’s current legislation in light of the London Protocol and includes a comparative overview of regional regulatory approaches in Latin America. Based on this analysis, the study identifies regulatory inconsistencies that compromise environmental protection and proposes three key legal reforms: (1) refining the definition of “incineration” to reflect international standards; (2) formally incorporating a definition for “incinerator”; and (3) establishing specific administrative and economic sanctions for related infractions. Through comparative analysis with Mexico and Colombia’s approaches, we propose targeted amendments including refined definitions aligned with IMO standards and explicit administrative/economic sanctions. Implementing these recommendations would enhance Peru’s legal clarity, enforcement capacity, and compliance with international maritime law, reinforcing its role as a responsible actor in marine environmental governance. Full article

Heavy metal pollution represents a pervasive environmental challenge that significantly exacerbates the ever-increasing crisis of antimicrobial resistance and the capacity of microorganisms to endure and proliferate despite antibiotic interventions. This review examines the intricate relationship between heavy metals and AMR, with an emphasis on the underlying molecular mechanisms and ecological ramifications. Common environmental metals, including arsenic, mercury, cadmium, and lead, exert substantial selective pressures on microbial communities. These induce oxidative stress and DNA damage, potentially leading to mutations that enhance antibiotic resistance. Key microbial responses include the overexpression of efflux pumps that expel both metals and antibiotics, production of detoxifying enzymes, and formation of protective biofilms, all of which contribute to the emergence of multidrug-resistant strains. In the soil environment, particularly the rhizosphere, heavy metals disrupt plant–microbe interactions by inhibiting beneficial organisms, such as rhizobacteria, mycorrhizal fungi, and actinomycetes, thereby impairing nutrient cycling and plant health. Nonetheless, certain microbial consortia can tolerate and detoxify heavy metals through sequestration and biotransformation, rendering them valuable for bioremediation. Advances in biotechnology, including gene editing and the development of engineered metal-resistant microbes, offer promising solutions for mitigating the spread of metal-driven AMR and restoring ecological balance. By understanding the interplay between metal pollution and microbial resistance, we can more effectively devise strategies for environmental protection and public health. Full article

Background: Brain health is a growing public health priority due to the high global burden of neurological and mental disorders. Promoting brain health across the lifespan supports individual and societal well-being, creativity, and productivity. Objective: To address the need for specialized education in this field, the University of Bern developed a Certificate of Advanced Studies (CAS) in Brain Health. This article outlines the program’s rationale, structure, and goals. Program Description: The one-year, 15 ECTS-credit program is primarily online and consists of four modules: (1) Introduction to Brain Health, (2) Brain Disorders, (3) Risk Factors, Protective Factors and Interventions, and (4) Brain Health Implementation. It offers a multidisciplinary, interprofessional, life-course approach, integrating theory with practice through case studies and interactive sessions. Designed for healthcare and allied professionals, the CAS equips participants with skills to promote brain health in clinical, research, and public health contexts. Given the shortage of trained professionals in Europe and globally, the program seeks to build a new generation of brain health advocates. It aims to inspire action and initiatives that support the prevention, early detection, and management of brain disorders. Conclusions: The CAS in Brain Health is an innovative educational response to a pressing global need. By fostering interdisciplinary expertise and practical skills, it enhances professional development and supports improved brain health outcomes at individual and population levels. Full article

(1) The beach areas of Galveston, Texas, USA are heavily used for recreational activities and often experience elevated fecal indicator bacteria levels, representing a potential threat to ecosystem services, human health, and tourism-based economies that rely on suitable water quality. (2) During the span of 15 months (March 2022–May 2023), water samples that exceeded the U.S. Environmental Protection Agency-accepted alternative Beach Action Value (BAV) for enterococci of 104 MPN/100 mL were analyzed via microbial source tracking (MST) through quantitative polymerase chain reaction (qPCR) assays. The Bacteroides HF183 and DogBact as well as the Catellicoccus LeeSeaGull markers were used to detect human, dog, and gull fecal sources, respectively. The qPCR MST data were then utilized in a quantitative microbial risk assessment (QMRA) to assess human health risks. Additionally, samples collected in July and August 2022 were sequenced for 16S rRNA and matched with fecal sources through the Bayesian SourceTracker2 program. (3) Overall, 26% of the 110 samples with enterococci exceedances were positive for at least one of the MST markers. Gull was revealed to be the primary source of identified fecal contamination through qPCR and SourceTracker2. Human contamination was detected at very low levels (<1%), whereas dog contamination was found to co-occur with human contamination through qPCR. QMRA identified Campylobacter from canine sources as being the primary driver for human health risks for contact recreation for both adults and children. (4) These MST results coupled with QMRA provide important insight into water quality in Galveston that can inform future water quality and beach management decisions that prioritize public health risks. Full article

The extensive use of conventional pesticides has been a fundamental strategy in modern agriculture for controlling pests and increasing crop productivity; however, their improper application poses significant risks to human health and environmental sustainability. This review compiles scientific evidence linking pesticide exposure to oxidative stress and genotoxic damage, particularly affecting rural populations and commonly consumed foods, even at levels exceeding the maximum permissible limits in fruits, vegetables, and animal products. Additionally, excessive pesticide use has been shown to alter soil microbiota, negatively compromising long-term agricultural fertility. In response to these challenges, recent advances in nanotechnology offer promising alternatives. This review highlights the development of nanopesticides designed for controlled release, improved stability, and targeted delivery of active ingredients, thereby reducing environmental contamination and increasing efficacy. Moreover, emerging nanobiosensor technologies, such as e-nose and e-tongue systems, have shown potential for real-time monitoring of pesticide residues and soil health. Although pesticides are still necessary, it is crucial to implement stricter laws and promote sustainable solutions that ensure safe and responsible agricultural practices. The need for evidence-based public policy is emphasized to regulate pesticide use and protect both human health and agricultural resources. Full article

The search for sustainable, economically viable, and effective plant protection strategies against pathogenic bacteria, fungi, and viruses is a major challenge in modern agricultural practices. Chitosan (CS) is an abundant cationic natural biopolymer known for its biocompatibility, low toxicity, and antimicrobial properties. Its potential use in agriculture for pathogen control is a promising alternative to traditional chemical fertilisers and pesticides, which raise concerns regarding public health, environmental protection, and pesticide resistance. This study focused on the preparation of chitosan nanoparticles (CS-NPs) through cross-linking with organic molecules, such as tannic acid (TA). Various formulations were explored for the development of stable nanoscale particles having encapsulation capabilities towards low compounds of varying polarity and with potential agricultural applications relevant to plant health and growth. The solution properties of the NPs were assessed using dynamic and electrophoretic light scattering (DLS and ELS); their morphology was observed through atomic force microscopy (AFM), while analytical ultracentrifugation (AUC) measurements provided insights into their molar mass. Their properties proved to be primarily influenced by the concentration of CS, which significantly affected its intrinsic conformation. Additional structural insights were obtained via infrared and UV–Vis spectroscopic measurements, while detailed fluorescence analysis with the use of three different probes, as model cargo molecules, provided information regarding the hydrophobic and hydrophilic microdomains within the particles. Full article

Social trust has been linked to the development and severity of depression, but trust is a complex, multidimensional construct. This study examines the extent to which two distinct forms of trust, general trust and specific trust, predict depressive symptoms. Drawing on longitudinal data from the Directorate of Health’s national surveys conducted in 2007 and 2009, the analysis includes responses from 3211 Icelanders selected through a stratified random sample. Depressive symptoms were assessed using the Depression, Anxiety, and Stress Scale (DASS), while specific trust captured trust in close relationships, and general trust measured broader perceptions of trustworthiness in others. The two forms of trust together explained 7.6% of the variance in depressive symptoms, with specific trust contributing a substantially greater share. Both remained significant predictors after controlling for prior depression and physical health. These findings highlight the protective role of specific trust and suggest that general trust, an indicator of broader social capital, may also help buffer against depression. The results underscore the relevance of trust as a public health resource and support continued research into social determinants of mental health in Iceland. Full article