Search Results (5,849)

Background: Transparent measurement is essential when organizational capacity is compared across public health institutions. The supplied analytic dataset did not contain repeated annual scores or indicator-level evidence for the previously proposed five-domain maturity model. We therefore conducted a reproducible cross-sectional analysis limited to the variables available in the dataset. Methods: Twenty Romanian public health directorates (PHDs)—10 in counties with a university medical center (CU) and 10 in counties without one (FU)—were compared using structural indicators, eight binary COVID-19 re-sponse measures, and a composite capacity–response index. The index was the equally weighted arithmetic mean of four sample-normalized components: employees per 100,000 inhabitants, budget per capita, previous-crisis experience, and the number of documented COVID-19 measures. Results are presented as medians and interquartile ranges. Mann–Whitney U and Fisher exact tests were used, with Holm correction within comparison families. Results: The composite index was higher in CU than FU institutions (55.0 [38.0–66.3] vs. 22.0 [19.3–31.3]; U = 93.0; p = 0.0013; Holm-adjusted p = 0.0077; rank-biserial r = 0.86). CU institutions also had larger populations, more employees, larger total budgets, higher per capita budgets, more previous-crisis experience, and more documented response measures. Employees per 100,000 inhabitants did not differ significantly. After multiplicity correction, vaccination-center involvement and communication/education were more frequently documented in the CU group. Digital platforms were recorded for only two institutions and cannot be interpreted as a digital-maturity domain. Conclusions: The available data support descriptive evidence of institutional disparities associated with the university-center context, but they do not support causal inference or validation of a maturity model. The composite index should be treated as an exploratory, sample-dependent benchmarking measure pending prospective instrument development, documented scoring rules, independent assessment, and external criterion validation. Its group difference largely reflects the four constituent components, which should remain the primary basis for interpretation. Full article

Background/Objectives: Probiotic preparations have attracted increasing attention because of their potential to modulate the gut microbiota and improve health outcomes in a wide range of gastrointestinal and extraintestinal diseases. However, their efficacy and safety are strain-specific and remain inconsistent across many clinical indications. The aim of this review was to evaluate current evidence regarding the efficacy, safety, mechanisms of action, and clinical applications of probiotic preparations. Methods: A narrative literature review was conducted using the PubMed, Scopus, and Web of Science databases to identify publications addressing the efficacy, safety, and clinical applications of probiotic preparations. The literature search was last updated in July 2026. No publication-year restrictions were applied; the studies included in this review were published between 2000 and 2026. Priority was given to systematic reviews, meta-analyses, randomized controlled trials, international clinical practice guidelines, and mechanistic studies. Results: The reviewed evidence indicates that probiotics may contribute to intestinal homeostasis through modulation of the gut microbiota, enhancement of intestinal barrier function, and regulation of immune responses. The strongest evidence supports the use of selected probiotic strains for the prevention of antibiotic-associated diarrhea, whereas evidence for the prevention of necrotizing enterocolitis is generally favorable but depends on the specific probiotic preparation, product quality, and clinical setting. Evidence for most other gastrointestinal and extraintestinal disorders remains heterogeneous and strain-specific. Although probiotics generally exhibit a favorable safety profile, rare infectious complications have been reported in high-risk patients. Conclusions: Current evidence indicates that the efficacy and safety of probiotics depend on the specific strain, clinical indication, and patient characteristics. Further high-quality, strain-specific clinical studies are needed to optimize their use in medical practice. Full article

Ebola virus disease (EVD) remains one of the most severe viral hemorrhagic fevers, with recurrent outbreaks challenging global healthcare systems. This narrative review traces the evolving epidemiology of EVD from the first recognized outbreaks in 1976 to the ongoing 2026 Bundibugyo virus public health emergency in the Democratic Republic of the Congo (DRC) and Uganda. Over nearly five decades, the recognized range of Ebola outbreak contexts and amplification mechanisms has broadened considerably: rural zoonotic spillovers remain the predominant mode of emergence, but the scale and reach of subsequent transmission increasingly depend on where introductions occur, on delays in detection, on population mobility, on ecological disruption, on armed conflict, on healthcare-associated transmission, and on viral persistence in survivors. Major advances in molecular epidemiology and genomic surveillance have improved outbreak investigation, enabling real-time transmission reconstruction and detection of survivor-linked resurgence. Vaccination, particularly ring vaccination with rVSV-ZEBOV, has shown high effectiveness against Zaire ebolavirus, yet vaccine equity gaps and the absence of licensed vaccines for Sudan virus and Bundibugyo virus remain critical vulnerabilities, though new candidate vaccines and therapeutics for Bundibugyo virus entered clinical evaluation in mid-2026. Artificial intelligence and digital technologies, including AI-assisted early warning systems, portable sequencing, drones, blockchain, and mobile health platforms, offer promising tools for outbreak preparedness, but robust evidence of their real-world operational impact during filovirus outbreaks remains limited, and their deployment in low-resource settings faces substantial barriers related to infrastructure, literacy, data costs, and governance. Integrated preparedness frameworks that combine ecological surveillance, resilient healthcare systems, community engagement, and international coordination under a One Health umbrella are increasingly viewed as a strategic necessity. The 2026 Bundibugyo outbreak reaffirms that despite decades of lessons, structural weaknesses in surveillance, response timeliness, and community trust continue to recur. Sustainable, multi-year financing, diversified vaccine platforms, regional manufacturing, and local co-design of digital tools are essential to translate lessons into lasting change. Preparedness is best understood as a continuous process rather than a reactive state. Full article

Bacterial self-healing concrete has emerged as a bio-based strategy to enhance the durability of cementitious materials and reduce the environmental impact associated with premature infrastructure deterioration. Its functional principle relies on microbially induced calcium carbonate precipitation (MICP), through which bacterial metabolism promotes CaCO₃ deposition within cracks. However, self-healing efficiency cannot be explained solely by mineral precipitation capacity. Concrete is a restrictive microbial environment characterized by alkalinity, desiccation, osmotic stress, nutrient limitation and physical confinement. Therefore, effective crack sealing requires a coordinated sequence involving bacterial survival, sporulation, germination, metabolic reactivation, biofilm-associated mineral nucleation and localized biomineralization. This integrative narrative review synthesizes mechanistic, material and biosafety evidence on bacterial self-healing concrete, focusing on spore-forming bacteria such as Bacillus subtilis and related taxa, including Paenibacillus. The evidence indicates that stress tolerance, germination signaling, calcium handling, biofilm establishment and stability, and encapsulation-mediated microenvironmental control are key determinants of performance, but remain insufficiently integrated into materials-oriented studies. Large-scale implementation also requires preventive assessment of strain persistence, genetic stability, horizontal gene transfer, environmental microbiome interactions and life-cycle exposure scenarios. Bacterial self-healing concrete should therefore be understood as a living or bioactive material system whose responsible development depends on the integration of microbiology, molecular biology, materials science, civil engineering, environmental risk assessment, occupational health, and public health. Full article

Background/Objectives: School-based food and nutrition education is an important public health strategy for developing healthy dietary behaviors during childhood and adolescence. However, limited qualitative evidence describes how nutrition teachers, who are simultaneously responsible for school meals, perceive established educational priorities and emerging needs. This study explored current and future priorities for school-based food and nutrition education in South Korea. Methods: Two online focus group interviews were conducted with eight nutrition teachers working in elementary, middle, and high schools. The interviews were transcribed and analyzed using qualitative content analysis procedures. Results: Current priorities included foundational nutrition and food-related knowledge, balanced eating, environmental issues, low-sodium and low-sugar diets, understanding school meals, prevention of eating disorders and chronic diseases, and table manners and picky eating. Future needs centered on food choice and food literacy, sustainable diets, interdisciplinary education, and understanding diverse food cultures. Across themes, participants described a shift from primarily knowledge-focused instruction toward applied dietary competence, a broadening from individual disease prevention toward health and sustainability, and stronger integration of classroom education with school meals and other subjects. Conclusions: From the perspectives of the participating nutrition teachers, the findings provide formative evidence for curricula and interventions that combine foundational nutrition science with food-choice skills, age-appropriate preventive messages, sustainable dietary practices, and opportunities for behavioral application in the school meal setting. Future quantitative and intervention studies, including nationally representative samples, are needed before robust national priorities can be established. Full article

To assess the prevalence of molar–incisor hypomineralization (MIH) and identify the associated factors in Brazilian schoolchildren, a representative cross-sectional study was conducted Diamantina, Brazil, with a random sample of 316 (80.8% response rate) children aged 7 to 10 from public and private schools. The presence of MIH was assessed according to the criteria of the European Academy of Pediatric Dentistry (EAPD). Sociodemographic data and data related to the prenatal, perinatal, and postnatal periods, as well as child health, were obtained through a questionnaire sent to caregivers. Descriptive analyses and adjusted and unadjusted Poisson regression were performed, accounting for the sample weights, using Stata software (version 16.1). The prevalence of MIH was 21.2%. The adjusted model showed that children admitted to the neonatal intensive care unit (NICU) were 2.28 times more likely to have MIH (95% CI: 1.34–3.90). The present study identified a high prevalence of MIH among children aged 7 to 10 years in Brazilian schoolchildren. Children who were admitted to the NICU had a higher prevalence of MIH than those who did not. Given the cross-sectional design, study sample and regional context, these findings should be interpreted as associations rather than evidence of causal relationships. Full article

Background: Maternal anemia remains a major public health concern in low- and middle-income countries, including Indonesia, where access to hemoglobin and iron-status measurements remains uneven. Although non-laboratory screening cannot confirm anemia or iron deficiency, digital collection of anemia-related symptoms, clinical signs, nutritional indicators, and reproductive risk factors may support preliminary risk identification in settings with limited diagnostic capacity. This study aimed to describe the nationwide implementation of a digital composite anemia-risk checklist and to examine maternal, reproductive, and regional factors associated with screening-positive status among pregnant women in Indonesia. Methods: A retrospective cross-sectional study was conducted using secondary data recorded through the e-Nutri mobile application during routine antenatal care from February to April 2025. The analysis included 205,822 pregnant women recorded across all 34 Indonesian provinces. Screening-positive anemia-related risk was defined operationally as at least one positive response among ten checklist indicators. Associations between maternal age, gestational age, parity, birth spacing, geographic region, and screening-positive status were examined using Poisson regression with robust variance estimation to obtain adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs). Results: Overall, 65.3% of participants met the operational criterion for screening-positive anemia-related risk. Multiparity was associated with a higher prevalence of screening-positive status (aPR 1.20; 95% CI 1.19–1.21), as was a birth interval of less than two years (aPR 1.10; 95% CI 1.09–1.11). Screening-positive status was slightly less prevalent during the second and third trimesters than during the first trimester. Compared with Sulawesi, the adjusted prevalence was higher in Kalimantan and lower in Sumatra and Maluku–Papua. Although 91.6% of participants reported iron supplementation use, the available data did not measure dosage, duration, adherence, or biochemical response. Conclusions: Nearly 7 of 10 pregnant women are at risk of anemia. Digital symptom-based screening conducted at a national scale identified widespread maternal anemia risk and consistent associations with cumulative reproductive burden and regional context. This approach potentially offers an alternative complement to laboratory-based surveillance in resource-limited settings. Full article

Background/Objectives: While Lebanon’s Vision 2030 prioritizes strengthening Lebanon’s chronically constrained, fragmented, and shocked primary healthcare system, implementation is hindered by weak sensing mechanisms, misaligned spatial distribution, and poorly integrated referral pathways. This study develops a preliminary, context-specific, systems-level healthcare policy assessment and framework for primary healthcare reform by applying biomimicry principles derived from the drought-resistant root architecture of grapevine (Vitis vinifera). Methods: Publicly available data from the Lebanese Ministry of Public Health, national assessments, and non-governmental organization registries were synthesized to examine mismatches between healthcare need and service capacity. We developed a preliminary healthcare Need Score for Lebanon’s eight governorates based on clinical demand, capacity strain, and socioeconomic vulnerability. An Agent-Based Approach within a biomimicry framework was used to translate grapevines’ biological strategies into healthcare policy design principles. Results: Structural deficiencies were identified in Lebanon’s primary healthcare system, including absence of standardized need-based sensing, uneven geographic service distribution, weak-referral integration, and limited adaptive feedback. Our preliminary Need Score was used four clinical demand indicators for iron deficiency, neonatal and maternal deaths, pre-mature births and birth defects, and disease incidence. Service-capacity strain indicators were primary healthcare center density and staffing. Finally, socioeconomic vulnerability indicators were percentages for non-Lebanese population and food insecurity. The proposed policy framework can translate frontline stress signals to rule-based responses, guide adaptive redistribution of capacity, and structurally anchor primary healthcare centers to referral hubs through defined catchments and electronic referral loops. Conclusions: Biomimicry can shed insight into how to improve primary healthcare governance under chronic scarcity. Need Scores and biological resilience principles can strengthen primary healthcare systems in low-resource settings while aligning with healthcare policy objectives like those in Lebanon’s Vision 2030. Full article

Endemic and (re)emerging infectious diseases pose a major threat to public health and military readiness in Central and South America. The high biodiversity and the differing transmission pathways require the use of highly sensitive methods to track the emergence and spread of these diseases. High-throughput sequencing technologies have become a critical resource for the field of infectious disease monitoring, specifically for tracking pathogen evolution, antimicrobial resistance, and transmission. This review provides an overview of the implementation of genomics-informed infectious disease surveillance conducted by the U.S. Naval Medical Research Unit SOUTH, focusing on operational, infrastructural, and logistical challenges in resource-limited settings and outlining strategies for building sustainable regional capacity. Selected case studies focused on prominent biothreats including dengue, Oropouche, malaria, and antimicrobial resistance demonstrate the significance and applicability of targeted and agnostic sequencing approaches to elucidate transmission pathways, pathogen discovery, and guide public health responses and field-deployable applications. Full article

Background: Carbon-based energy systems drive climate change with growing pressure on public health, yet research on mental health, climate change, and carbon-intensive industries remains fragmented. Objective: This scoping review mapped how mental health outcomes of climate change relate to the carbon-based matrix, identifying conceptual approaches, methodological trends, and research gaps aligned with planetary health and the SDGs. Methods: This review was conducted following the Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, with searches in PubMed, Web of Science, and PsycINFO. Results: From 232 records, 38 studies (2015–2025) were included across six clusters: eco-anxiety and distress (n = 14); extreme events and mental disorders (n = 9); air pollution and neuropsychological outcomes (n = 7); environmental justice and vulnerable populations (n = 10); green spaces and resilience (n = 6); and public policy and sustainable responses (n = 7). The carbon-based matrix was proximally linked to mental health in studies on air pollution and extractivism, and served as context in studies on extreme climate events, food insecurity, and climate uncertainty. Conclusions: An equitable transition away from carbon-intensive systems is a public health priority, with co-benefits for mental well-being aligned with the SDGs. Full article

Mpox has emerged as a global public health concern, highlighting the limitations of traditional vaccinia-based vaccination strategies and the urgent need for precision vaccinology approaches. Advances in structural virology and immunoinformatics have enabled the identification of conserved immunodominant antigens from both mature virion and extracellular virion forms, supporting the development of multivalent antigen combinations capable of inducing broad neutralizing antibody (nAb) responses. Emerging delivery technologies including mRNA-lipid nanoparticles, viral vectors, and self-assembling protein nanoparticles offer rapid scalability, enhanced immunogenicity, and improved safety compared with conventional live-attenuated vaccines. Addressing antigenic evolution, vaccine supply limitations, and population-specific immune variability will be crucial for optimizing vaccine effectiveness. This review synthesizes current evidence on antigen design, vaccine delivery platforms, and immunological correlates of protection to outline a framework for next-generation mpox vaccines. Precision vaccinology therefore represents a transformative strategy for developing durable, clade-specific mpox vaccines and strengthening preparedness against future orthopoxvirus outbreaks worldwide. Full article

Lead contamination remains a significant environmental and public health concern, creating a demand for analytical platforms that combine sensitivity, simplicity, and long-term stability. In this work, a graphene-containing molecular membrane matrix was developed for the fabrication of single-piece all-solid-state potentiometric sensors for Pb(II) detection. The sensing membrane consisted of poly(vinyl chloride), plasticizers, a Pb(II)-selective ionophore, lipophilic ionic sites, and dispersed graphene nanostructures, forming an integrated molecular sensing interface. Within the membrane phase, selective complexation of Pb(II) ions by the ionophore was coupled with graphene-assisted ion-to-electron transduction, enabling efficient signal generation without the need for a separate solid-contact layer. The influence of graphene incorporation and membrane thickness on sensor performance was systematically investigated. Among the tested configurations, a membrane prepared from 40 µL of sensing cocktail provided the best overall performance, combining high electrical capacitance, favorable surface properties, and superior potential stability. SEM imaging revealed a homogeneous membrane morphology without large graphene agglomerates, indicating effective dispersion of graphene within the polymer matrix. The optimized sensor exhibited a near-Nernstian slope of 30.3 mV dec⁻¹, a linear response range from 1.0 × 10⁻⁷ to 1.0 × 10⁻² M, a detection limit of 6.3 × 10⁻⁸ M, and a potential drift of only 0.35 mV h⁻¹. These results demonstrate that direct incorporation of graphene into an ion-selective membrane is an effective strategy for constructing robust and scalable single-piece potentiometric sensors for Pb(II) monitoring and highlight the potential of developed membrane materials for electrochemical sensing applications. Full article

Substance use disorders (SUDs) represent a major psychiatric and public health burden. Although integrated biopsychosocial approaches combining pharmacotherapy with psychosocial and behavioral interventions are recommended by international guidelines, real-world evidence on their effectiveness in acute emergency settings remains scarce, particularly in Eastern European healthcare contexts. This single-center, retrospective, observational study examined behavioral and psychosocial predictors of clinical response and compared an integrated therapeutic strategy (pharmacotherapy combined with psychosocial and behavioral interventions) with pharmacotherapy alone among all emergency psychiatric admissions for SUDs (ICD-10 F10–F19) at the Clinical Psychiatric Hospital “Elisabeta Doamna,” Galați, Romania, between January 2020 and December 2024 (N = 331; census sampling). The primary outcome was clinical status at discharge (improved/stationary/worsened). Patients receiving the integrated strategy showed a significantly higher improvement rate at discharge than those receiving pharmacotherapy alone (98.3% vs. 76.3%; OR = 17.88; 95% CI: 5.62–56.91; p < 0.001). A hospitalization window of 4–14 days was associated with optimal outcomes. In an exploratory logistic regression analysis, older age (≥51 years) and unemployment emerged as independent psychosocial predictors of suboptimal response. These findings suggest that integrating behavioral and psychosocial interventions with pharmacotherapy is associated with superior discharge outcomes in acute SUD management; given the observational, non-randomized design, these results should be regarded as hypothesis-generating rather than causal, pending confirmation in prospective multicenter studies before informing behaviorally informed triage and risk stratification in emergency psychiatry. Full article

Fusarium species are significant phytopathogens responsible for major crop losses and contamination of food products with harmful mycotoxins, posing serious risks to food security and public health. In response to the limitations of conventional agrochemicals, this study explores sustainable antifungal strategies based on plant-derived products and nanotechnology. The aqueous extract of Ocimum basilicum was investigated as a bioresource for both direct antifungal activity and the green synthesis of silver nanoparticles (OB-AgNPs). Liquid chromatography–mass spectrometry (LC-MS) analysis of the O. basilicum aqueous extract revealed the presence of key compounds, including rosmarinic and chicoric acids, which can reduce and stabilize AgNPs. The biosynthesized nanoparticles were characterized using standard analytical techniques, including UV–visible spectroscopy (UV-Vis), Fourier-transform infrared spectroscopy (FTIR), dynamic light scattering (DLS), high-resolution transmission electron microscopy (HRTEM), and powder X-ray diffraction (PXRD). The OB-AgNPs exhibited a surface plasmon resonance (SPR) peak at 437 nm, a zeta potential of ~–16.3 mV, an average size of 28 nm (TEM) while the average hydrodynamic size is ≈57 nm (DLS). The synthesized AgNPs demonstrated stability in potato dextrose broth (PDB) for up to 24 h. The nanoparticles alongside the aqueous extract were evaluated against selected mycotoxigenic Fusarium species including F. verticillioides, F. proliferatum, F. subglutinans, F. graminearum, and F. globosum, following 96 h of exposure. Results showed that the aqueous O. basilicum extract exhibited limited antifungal activity, with significant inhibition observed only against F. globosum MRC 6122 at the highest concentration tested (400 ng/µL). In contrast, the biosynthesized OB-AgNPs demonstrated potent antifungal activity against most of the tested Fusarium strains, except for F. proliferatum MRC 8549 and MRC 8550, indicating substantially greater efficacy than the crude extract. These findings highlight the potential of O. basilicum-mediated AgNPs as effective and eco-friendly antifungal agents. The study underscores the value of integrating plant-based phytochemicals with nanotechnology for controlling Fusarium pathogens, while emphasizing the need for future studies to determine their effects on mycotoxin production, as well as their safety and phytotoxicity for agricultural applications. Full article

The rapid digitalisation of healthcare has accelerated the adoption of telemedicine, Electronic Health Records (EHRs), and the Internet of Medical Things (IoMT), transforming healthcare delivery into a highly interconnected and patient-centric ecosystem. In response to growing concerns about data security, privacy, and interoperability, blockchain technology has emerged as a promising solution for its decentralization, immutability, auditability, and secure access control. However, many existing blockchain infrastructures rely on classical cryptographic primitives, including RSA- or elliptic-curve-based public-key mechanisms and cryptographic hash functions such as SHA-256, whose relevant security properties may be affected by sufficiently powerful quantum attacks. This review investigates the convergence of blockchain and quantum technologies to address emerging security threats in e-health systems. A structured literature review was conducted in accordance with the PRISMA 2020 guidelines using the IEEE Xplore, PubMed, ACM Digital Library, Google Scholar, and Crossref databases, covering studies published between January 2018 and June 2025. Following a systematic screening and eligibility-verification process, 57 relevant studies were selected and analyzed. The review evaluates quantum-resilient security mechanisms, including Quantum Key Distribution (QKD), Quantum Random Number Generation (QRNG), and NIST-standardized Post-Quantum Cryptography (PQC) algorithms specified in FIPS 203, FIPS 204, and FIPS 205. Based on the identified research gaps in the state of the art, this study also proposes a novel four-layer Quantum-Blockchain Security Architecture (QBSA) designed for secure healthcare environments. The analysis further reveals significant challenges associated with lightweight PQC deployment for IoMT devices, interoperability standardization, quantum hardware limitations, and regulatory compliance in cross-institutional healthcare systems. The findings highlight the necessity of integrating quantum-resilient cryptographic frameworks with blockchain infrastructures to support the development of secure, scalable, and patient-centric next-generation e-health ecosystems. Full article