Search Results (3,956)

Per- and polyfluoroalkyl substances (PFAS) are widespread environmental contaminants associated with adverse health effects, yet dermal exposure remains poorly characterized. This study evaluated the influence of vehicle and chemical structure on dermal absorption and skin barrier integrity using a reconstructed human epidermis model (EpiDermFT). Two C6 PFAS, perfluorohexane sulfonate (PFHxS) and perfluorohexanoic acid (PFHxA), were applied in three vehicles (acetone, water, and diethylene glycol monobutyl ether [DEGME]) at concentrations of 0–0.015% for 4 or 24 h. PFAS concentrations were quantified in tissue and receptor media, and skin barrier integrity was assessed using histological and immunological endpoints. Increasing exposure resulted in higher concentrations of PFHxS and PFHxA in both tissue and media across all vehicles, indicating dermal penetration and absorption. PFHxS exhibited greater tissue retention but only a few small, isolated changes in cytokine and gene expression and no significant effect on barrier integrity. In contrast, PFHxA induced increased expression of inflammatory mediators and alterations in skin barrier function. These findings indicate a divergence between dermal retention and biological activity. Overall, while the vehicle influenced PFAS transport, biological responses were more strongly associated with functional group. These results suggest that functional group-dependent toxicity is an important determinant of dermal PFAS effects and should be considered when characterizing PFAS dermal hazard and grouping structurally related compounds for assessment. Full article

Microplastics have emerged as a persistent and prevalent threat to human health and the marine environment due to their widespread use and poor management, including low recycling rates, inadequate waste management, improper disposal, and inadequate control of plastic leakage into the environment. Plastic pollution is transported to the marine ecosystem through both ocean-based and land-based pathways and can be fragmented into microplastics (<5 mm) and nanoplastics (<1 µm). The study explains the sources, distribution, mechanisms of degradation, and transport pathways to the marine environment. Land-based activities are recognized as the dominant source, causing approximately 70–80% of marine plastic pollution. Domestic greywater is highlighted as a significant and common source of microplastics due to the release of microbeads and synthetic fibers from different sources, such as laundry, washbasins, and personal care products (PCPs). Similarly, greywater release from maritime vessels and cruise ships significantly contributes to marine microplastic pollution. The study discusses the biotic and abiotic degradation mechanisms. The health and environmental effects of microplastics are measured across different trophic levels. Ingestion and bioaccumulation of microplastics can cause physiological and reproductive disturbances. Human exposure through seafood consumption and inhalation may result in skin infections, cardiovascular complications, gastrointestinal disorders, and respiratory problems. The mitigation and control measures include improvements in wastewater treatment, public awareness, policy regulations, and biodegradable alternatives to support sustainable protection of the marine environment. Full article

Flexible pressure sensors serve as core sensing components for wearable health monitoring systems, electronic skins for soft robots, and flexible human–machine interaction devices. Benefiting from the interfacial electric double-layer polarization effect, iontronic sensing delivers far higher pressure response sensitivity than conventional parallel-plate capacitive sensors, endowing it with distinctive advantages in the detection of weak physiological signals. Nevertheless, current dense ionic thin-film dielectric layers suffer from limited deformation space under compression and poor low-pressure sensing capability. Mainstream high-precision micropillar arrays are fabricated via photolithography, 3D printing, and metal etching molds, which require costly equipment and complicated fabrication procedures, making large-area mass production unfeasible. Random frosted concave-convex microstructures feature disordered dimensions, leading to severe device hysteresis and narrow linear ranges, which fail to achieve ultrahigh sensitivity alongside a wide pressure detection range simultaneously. To address the aforementioned multiple bottlenecks, this paper proposes a low-cost resin template replication process to fabricate TPU-based ionic thin-film dielectric layers with ordered micropillar array microstructures. Combined with inkjet-printed silver conductive PI flexible electrodes, an iontronic flexible pressure sensor with a sandwich layered structure is constructed. Multi-dimensional investigations including microscopic morphology characterization, electromechanical sensing performance calibration, and human wearable application tests are systematically implemented to thoroughly elucidate the synergistic enhancement mechanism of the arrayed micropillars. Test results demonstrate that the effective pressure detection range of the sensor spans 0–1038 kPa, accommodating ultra-low pressures such as pulse signals as well as medium-to-high-pressure loads including joint bending. The sensitivity reaches 23.27 kPa⁻¹ within the low-pressure range of 0–200 kPa and remains stable at 3.52 kPa⁻¹ in the high-pressure range of 200–1038 kPa, with piecewise linear fitting correlation coefficients of 0.93 and 0.96 respectively. Both the response time and recovery time of the device are 40 ms, and the hysteresis error throughout the loading-unloading cycle is merely 2.62%. After 20,000 consecutive cyclic loading-unloading tests, the peak capacitance output only decays by 5.1%, verifying outstanding mechanical fatigue resistance and electrical stability. Validations in multi-scenario applications prove that the sensor can accurately capture human physiological and motion signals including radial artery pulses, laryngeal deformation induced by multi-syllable vocalization, and multi-angle bending of fingers and elbow joints, suitable for home-based health monitoring, quantitative rehabilitation training, flexible tactile interaction and other scenarios. The entire fabrication process eliminates high-precision micro-nano processing equipment such as photolithography systems, plasma etchers and 3D printers; only general chemical raw materials and conventional laboratory instruments are adopted. The reusable templates enable low manufacturing costs and large-area coating forming, offering a novel low-cost technical solution for the engineering implementation and industrialization of high-performance iontronic flexible pressure sensors. Full article

Rising temperatures and the occurrence of heat waves due to climate change can increase the risk of various skin disorders. Moreover, elevated temperatures worsen oxidative damage and inflammation caused by other climate change stressors, such as UV exposure. Consequently, there is growing interest in innovative solutions to protect skin health from the effects of pollution and climate change stressors. Among natural cosmeceuticals, carotenoids are recognized for their antioxidant and anti-inflammatory properties. This study evaluated the thermoprotective effects of Hematococcus lacustris (the microalga formerly called Hematococcus pluvialis) extract (HLE), which is considered the richest natural source of carotenoid astaxanthin, against acute hyperthermia, which mimics the conditions of heat waves. In addition, we separately assessed the effects of HLE against UVA and hydrogen peroxide stress, complementing the antioxidant profile of the extract under study. The evaluation was conducted using in vitro tests on human HaCaT keratinocytes and the nematode Caenorhabditis elegans, which is a model organism sensitive to environmental stressors. The treatment of HaCaT keratinocytes with HLE counteracted the intracellular formation of reactive oxygen species and cytotoxicity induced by hyperthermia, UVA, and hydrogen peroxide exposure. Under the same experimental conditions, HLE also restored the impaired expression of stress-sensitive genes, such as matrix metalloproteinase-1, in HaCaT keratinocytes and promoted wound closure mimicking the process of re-epithelization. Lastly, experiments in C. elegans confirm that HLE reduces heat stress-induced oxidative damage and preserves motility, supporting a systemic protective effect consistent with dietary uptake of the extract. These findings suggest that HLE, rich in carotenoid astaxanthin, can protect keratinocytes against oxidative damage and cytotoxicity induced by thermal stress, indicating its potential role in mitigating thermal aging. Full article

Skin cancer represents a growing global health burden. Current diagnostic pathways combine clinical examination and dermoscopy with histopathological confirmation; however, overlap between benign and malignant lesions can create diagnostic uncertainty and lead to potentially avoidable biopsies. Electrical impedance spectroscopy (EIS) has emerged as a non-invasive technique with potential for portable and cost-efficient implementation that quantifies the dielectric contrast between malignant and healthy tissue, providing objective information that may support clinical decision-making. This review synthesizes the field across four levels. First, we describe the biophysical origins of the impedance contrast in skin cancer, spanning the cellular, tissue architecture, and molecular scales, together with the equivalent circuit and Cole–Cole frameworks used to interpret it. Second, we examine hardware advances, including electrode–skin interface strategies, flexible and wearable architectures, computational electrode design, and the translation from laboratory prototypes to commercial systems such as Nevisense. Third, we critically appraise clinical evidence from large multicenter trials, focusing on the sensitivity–specificity trade-off and the demonstrated reduction in the number needed to excise. Finally, we discuss emerging frontiers, including artificial intelligence-driven analysis and multimodal fusion with dermoscopy, reflectance confocal microscopy, optical coherence tomography, and near-infrared spectroscopy. We conclude that EIS is most valuable as a complementary component within an integrated, AI-supported multimodal diagnostic framework. Full article

Background/Objectives: Vitis vinifera is a rich source of polyphenolic compounds that are known for their benefits on skin health, including antioxidant, anti-inflammatory, and photoprotective effects. Red wines have shown a positive impact on cardiovascular disease, diabetes, and cancer prevention; however, evidence regarding their effects on skin biology remains scarce. This study evaluated red wine concentrates obtained from Cabernet Sauvignon and Merlot varieties, selected based on their previously demonstrated biological activities, to identify the samples with the highest potential for skin health applications by assessing their inhibitory activity against skin-related enzymes (tyrosinase, elastase, and collagenase), along with their effects on HaCaT cells, including cytotoxic, antioxidant, anti-inflammatory, and wound healing activities. Methods: Enzyme inhibition studies were based on spectrophotometric methods; the MTT and CV assays were carried out to test the cytotoxicity, and the DCFH-DA assay was employed to evaluate the antioxidant activity of the wine concentrates; wound healing potential was examined by the cell scratch assay, and anti-inflammatory activity was investigated using ELISA and qPCR analyses. PCA of the samples and their biological activity was performed as well. Results: Examined red wine concentrates exhibited significant enzyme inhibitory activity and showed no cytotoxicity on HaCaT cells up to the concentration of 50 μg/mL; the samples stimulated cell migration, inhibited intracellular ROS production in AAPH-stressed keratinocytes, and selectively modulated TNF-α-induced inflammatory responses, reducing IL-8 secretion while enhancing certain cytokine transcripts, underscoring the complexity of their bioactive effects. Conclusions: Red wine concentrates showed significant potential as skin-beneficial agents, demonstrating strong antiaging, marked cellular antioxidant effects and wound healing activity when applied at non-cytotoxic concentrations. Multivariate analysis revealed distinct bioactivity profiles among the wine concentrates. Full article

Flexible pressure sensors featuring high sensitivity, a broad detection range, and excellent stability are pivotal components for high-precision electronic skins and human health monitoring. To circumvent the limitations of existing sensors in maintaining high responsiveness across extensive pressure ranges, herein, a novel flexible capacitive pressure sensor is developed based on a 3D porous ionogel foam composite (IL/EG/PVA@MF) coupled with a planar electrode array. This device leverages the synergistic structural engineering of the 3D hyperelastic melamine foam (MF) skeleton and the pressure-regulated fringe-field distribution and iontronic interfacial polarization of the porous ionogel. Experimental evaluations demonstrate that the sensor achieves a high normalized sensitivity of 62.45 kPa⁻¹ (2–10 kPa) and maintains reliable piecewise linear sensing performance across a broad working range of 0–50 kPa, accompanied by a rapid response time of within 8 ms. Furthermore, the sensor exhibits outstanding performance consistency after 6000 compression-release cycles at 50 kPa, verifying its good mechanical durability. In practical applications, the device can monitor diverse physiological signals with high fidelity, ranging from subtle radial artery pulses to large-scale joint movements and specific coughing patterns, underscoring its broad potential for integrated wearable systems and intelligent healthcare. Full article

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease with a relapsing course and a substantial multidimensional burden. Conventional clinical and patient-reported outcome measures mainly provide cross-sectional evaluations and may not fully capture the long-term impact of the disease. The concept of cumulative life course impairment (CLCI) has been proposed to describe the progressive and lifelong consequences of chronic dermatologic conditions. Methods: This narrative review is based on a non-systematic literature search conducted in PubMed/MEDLINE and Embase up to July 2026. Relevant studies addressing quality of life, mental health, comorbidities, and economic burden in AD were identified and narratively synthesized, with particular focus on evidence supporting the CLCI framework. Results: AD exerts a cumulative burden across multiple domains. Pruritus and sleep disturbance emerge as key drivers, contributing to a self-reinforcing cycle involving psychological distress and impaired daily functioning. Increased rates of anxiety and depression, along with social stigmatization, negatively affect interpersonal relationships, educational attainment, and work productivity. Comorbidities and the chronic relapsing nature of AD further amplify long-term impairment. Economic burden, including both direct and indirect costs, acts as both a consequence and a driver of cumulative disadvantage. Recurrent disease flares play a central role in sustaining and amplifying this trajectory over time. Conclusions: AD should be considered a life-course disease in which interacting biological, psychological, and social factors shape long-term outcomes. A CLCI-oriented approach may improve patient stratification and support earlier, multidisciplinary, and proactive management strategies aimed at reducing long-term burden and improving overall outcomes. Full article

Background: Skin cancer encompasses a diverse range of malignancies and remains a significant global health challenge. Accurate machine-learning-assisted diagnosis can substantially improve patient outcomes through early detection and timely clinical intervention. Federated Learning (FL) enables privacy-preserving collaborative model training across multiple healthcare institutions while ensuring that sensitive patient data remain decentralized. However, deploying advanced architectures such as Vision Transformers (ViTs) in clinical environments is challenging due to the high computational demands of self-attention mechanisms. Methods: This work proposes FedSwin-LHTP, an efficient federated learning framework for skin lesion classification that integrates a Swin Transformer backbone with a Lightweight Hessian-Inspired Token Pruning (LHTP) mechanism. LHTP estimates token importance using a second-order Taylor approximation around converged local model parameters to identify less informative patch tokens, enabling the early pruning of redundant representations without explicitly computing the Hessian matrix. Furthermore, the framework incorporates the FedProx optimization objective to mitigate client drift under heterogeneous non-IID data distributions. The proposed framework is evaluated on the HAM10000 and ISIC datasets under realistic non-IID federated settings. Results: Experimental results demonstrate stable convergence, effective knowledge aggregation, and robust diagnostic discrimination across distributed clients. By adaptively pruning approximately 60% of Stage-1 tokens, the proposed framework substantially reduces the computational burden of local transformer processing while maintaining high multiclass classification performance, achieving an accuracy of up to 96.1% on the evaluated datasets. Conclusions: These results highlight the potential of FedSwin-LHTP as a practical, privacy-preserving, and resource-efficient solution for collaborative healthcare intelligence. Full article

Background/Objectives: Rosacea is a chronic inflammatory skin disease that requires long-term management and continuous patient education regarding triggers, skincare practices, and treatment adherence. In recent years, patients have increasingly turned to online platforms and artificial intelligence (AI)-based chatbots for health-related information. Although ChatGPT has been evaluated in the context of rosacea, evidence regarding the performance of other AI chatbots remains limited. This study aimed to evaluate the accuracy, reliability, quality, readability, and diagnostic relevance of AI-generated responses to common rosacea-related patient questions and to assess their potential role as sources of health-related information. Methods: Between 21 December 2025 and 22 February 2026, rosacea-related questions were collected from the publicly accessible Quora platform using a systematic screening process. Twenty clinically relevant and representative questions covering diagnosis, triggers, treatment options, skincare practices, and disease manifestations were selected. Each question was independently submitted to three AI chatbots (Claude Sonnet 4.5, ChatGPT-5.2, and DeepSeek-V3.2). Responses were evaluated by domain experts using the modified DISCERN (mDISCERN) for reliability, the Global Quality Scale (GQS) for overall quality, the Flesch Reading Ease Score (FRES) for readability, and a 5-point Likert scale for accuracy. Reference hallucinations were assessed through manual verification of cited sources. Statistical comparisons were performed using the Friedman test with Bonferroni-adjusted post hoc analyses, and effect sizes were calculated using Kendall’s coefficient of concordance (Kendall’s W). Results: Significant differences were observed among the AI chatbots across all evaluation domains (p < 0.05), with moderate to large effect sizes (Kendall’s W = 0.272–0.683). ChatGPT-5.2 and DeepSeek-V3.2 demonstrated significantly higher reliability and accuracy scores than Claude Sonnet 4.5. DeepSeek-V3.2 achieved the highest overall quality scores, whereas ChatGPT-5.2 produced the most readable responses. Reference analysis revealed variable hallucination rates among the evaluated models. Conclusions: Generative AI chatbots demonstrate considerable potential as sources of health-related information for rosacea-related queries. However, variability in performance and reference hallucination rates highlights the need for careful validation before their widespread use as complementary sources of patient health information. Full article

Athletic environments—ranging from natural grass pitches and synthetic crumb–rubber turf to indoor mats and hardwood courts—are increasingly recognized as dynamic built-environment microbiomes rather than inert platforms. These surfaces are continuously exposed to human skin contact, perspiration and environmental debris, and may act as reservoirs for both beneficial commensals and opportunistic pathogens. The present study characterized and compared the taxonomic diversity of bacterial communities across four distinct sports surfaces and tested whether surface material or intensity of human use is the stronger determinant of community structure. Environmental swabs were collected from natural grass pitches, synthetic crumb–rubber turf, polyvinyl chloride (PVC) karate mats and hardwood squash courts, before and after sporting activity. Bacterial communities were profiled by 16S rRNA gene amplicon sequencing, with taxonomic assignment against the SILVA reference database. Alpha diversity was quantified using the Shannon and Simpson indices, and community structure (beta diversity) was visualized by Principal Coordinates Analysis (PCoA) on Bray–Curtis dissimilarities. Surface material was the strongest predictor of microbial composition. Natural grass exhibited high alpha diversity dominated by soil-dwelling Proteobacteria and Actinobacteria, whereas synthetic surfaces showed reduced diversity but a markedly higher prevalence of human skin-associated taxa (Staphylococcus, Corynebacterium and Streptococcus). High-contact PVC mats underwent a significant relative enrichment in these skin-associated genera following active training. PCoA revealed clear spatial segregation by material. A multivariate PERMANOVA confirmed surface material as the primary driver of microbial structure, explaining 52.2% of the total variance (p < 0.001), whereas the intensity of human use (pre- vs. post-activity) explained only 2.8% of the variance (p = 0.035), with a non-significant interaction term (p = 0.178). These findings demonstrate that sports surfaces are living biological landscapes whose microbial fingerprint is strongly associated with specific surface types. This provides a molecular baseline for targeted hygiene interventions and future antimicrobial-material design tailored to specific athletic disciplines. Full article

Background/Objectives: Occupational contact dermatitis (OCD) is the most common work-related skin disease, accounting for roughly 90–95% of occupational dermatoses and falling predominantly on the hands. It is rarely dangerous yet imposes a substantial burden through impaired quality of life, lost productivity, and premature exit from affected trades. The COVID-19 pandemic intensified this burden among healthcare workers, in whom the pooled one-year prevalence of self-reported hand eczema reaches around 27%; meta-analytic data link the increased risk principally to frequent handwashing and wet work rather than to alcohol-based hand rub. Methods: This narrative review, which follows a non-systematic, thematically organised search strategy rather than PRISMA methodology, integrates current evidence on the epidemiology, pathophysiology, diagnosis, prevention, and management of OCD, with particular emphasis on the self-reinforcing cycle linking skin barrier disruption, microbiome dysbiosis, and antimicrobial-peptide dysregulation to inflammation. Results: We critically appraise the prevention evidence, foregrounding the low certainty of the existing trial base and the tension between the randomised trials of primary and secondary prevention, which have been null, and the encouraging but uncontrolled results of structured tertiary-prevention programmes. We summarise recent therapeutic advances, including topical delgocitinib, and situate the field within the World Health Organisation’s 2025 recognition of skin diseases as a global public health priority. Established evidence and hypotheses are kept separate throughout: we additionally advance, explicitly as a conjecture rather than as a demonstrated mechanism, a conceptual trans-kingdom dialogue model in which protease-generated LL-37 fragments may modulate staphylococcal quorum sensing, and each step of that model is labelled according to whether the supporting evidence is direct, extrapolated, or as yet untested. Conclusions: We argue that the prevention failure is less one of biology than of trial design and measurement, and outline the research needed to close the gap. Full article

Sweet cherry (Prunus avium L.) is a non-climacteric fruit that reaches its optimal organoleptic and nutraceutical quality only when fully ripened on the tree. However, growers often harvest prematurely to avoid weather-related losses or to capture early-market premiums. This study evaluated the impact of harvest timing on the pomological and nutraceutical profiles of nine red-skinned sweet cherry cultivars (Black Star, Burlat, Cashmere, Ferrovia, Giorgia, Grace Star, Lapins, Regina, Sandra Rose) grown in the Puglia region of Southeastern Italy, a major Mediterranean production area. Fruits were collected at two maturity stages: light-red skin (Stage 1) and dark-red skin (Stage 2). Pomological parameters, i.e., fruit weight, equatorial diameter, CIELAB color parameters, soluble solids content (SSC), titratable acidity (TA) and nutraceutical metrics (total polyphenols, total anthocyanins, FRAP antioxidant activity) were measured. Delaying harvest significantly increased fruit weight (5.7–24.5%), equatorial diameter (up to 9.8%), and SSC (14.0% average, up to 26.4% in early ripening cultivars), while decreasing TA in most cultivars (non-significant in some). The SSC/TA ratio, a key driver of consumer preference, improved substantially across all genotypes. CIELAB parameters h° and C* decreased sharply, and L* generally decreased, reflecting intense anthocyanin accumulation. Total polyphenols increased by 20.7–68.8%, total anthocyanin content (TAC) by 203–1053% and FRAP antioxidant capacity by 20.7–111.7%. Two-way ANOVA revealed significant (p < 0.01), cultivar × stage, interactions for all parameters, confirming genotype-dependent ripening kinetics. Principal component analysis using all quality parameters clearly separated Stage 1 from Stage 2 fruits, with SSC, TAC, and FRAP as primary discriminators. These results demonstrate that delaying harvest until a uniform dark-red skin consistently enhanced fruit size, SSC, and health-promoting bioactive compounds across all evaluated genotypes. We provide cultivar-specific harvest calendars, colorimetric targets (hue angle ≤ 10° for optimal maturity), and a quantitative framework to help growers balance quality improvement against agronomic risks. Full article

Non-tuberculous mycobacteria are recognized as pathogens affecting aquatic animals and humans. Although Mycobacterium marinum is traditionally considered the principal etiological agent of fish mycobacteriosis and fish-tank granuloma in humans, the contribution of Mycobacterium chelonae in fish as well as in humans remains underestimated, particularly in Ziehl–Neelsen (ZN)-negative lesions. In this study, granulomatous lesions of marine fish species and human skin biopsies were investigated using histopathology and molecular diagnostics. Following histological evaluation, all samples were analysed by PCR amplification and sequencing of the hsp65 gene to identify the causative agent. Fish and human tissues showed similar chronic granulomatous lesions, with all cases negative for acid-fast bacilli by ZN staining. Molecular analysis consistently identified M. chelonae in both marine fish organs and human skin lesions exhibiting clinicopathological features traditionally attributed to M. marinum. Phylogenetic analysis revealed high genetic similarity between fish- and human-derived sequences, suggesting shared environmental reservoirs rather than host-specific lineages. These findings identify M. chelonae as an underrecognized cause of granulomatous disease in fish and humans and demonstrate the limitations of histochemical methods in these infections. Incorporating molecular diagnostics into routine investigations of granulomatous disease supports more accurate diagnosis across veterinary and human medicine and strengthens One Health surveillance of aquatic non-tuberculous mycobacterial infections. Full article

Extreme heat events are associated with increased morbidity and mortality, disproportionately affecting vulnerable populations. However, evidence from disadvantaged urban settings in Africa remains scarce. This systematic review aimed to synthesize existing research on the health impacts of extreme heat in Africa’s disadvantaged urban communities. A systematic literature search was conducted in accordance with PRISMA guidelines across eleven databases (PubMed, Cochrane, VHL, Google Scholar, ScienceDirect, Research4Life, DOAJ, Emerald, Taylor & Francis, Annual Reviews, and IRIS), carried out over two search periods (December 2023–March 2024 and December 2024–February 2025). Eligible studies were published between 2010 and 2024 in English, French, or Portuguese, and examined direct or indirect heat-health effects in disadvantaged urban settings. Screening of 96,608 titles and 59 abstracts yielded 21 eligible studies. Geographically, the evidence was concentrated in South Africa (n = 7), Kenya (n = 6), and Tanzania (n = 4), with single studies from Cameroon, Egypt, Nigeria, and Ghana. Heat-related morbidity was examined in 17 studies and mortality in four. Commonly reported conditions included dehydration, heat exhaustion, skin rashes, heatstroke, and cardiovascular and respiratory diseases. Extreme heat was further associated with mortality from non-communicable diseases, pneumonia, and acute respiratory infections. Children, older adults, and the most economically deprived communities exhibited heightened vulnerability, driven by adverse socioeconomic and environmental conditions. The available evidence confirms substantial heat-health impacts on disadvantaged urban populations across Africa, while revealing a notable research gap in French- and Portuguese-language literature. These findings underscore the urgent need for expanded, geographically and linguistically diverse research to inform climate adaptation strategies and health protection policies. Full article