This is very important to prioritize nodes for immunization in controlling infectious disease outbreaks. In this paper, we propose a new immunization strategy for multiplex networks; we specifically model two separate layers: the physical layer where infection propagates and the virtual layer where information is transmitted. We assume that each layer has a different “context” and use that to identify the most suitable centrality measure for each. For the infection layer, we choose PageRank, as it has shown certain effectiveness in determining those nodes crucial for reducing transmission. For the awareness layer, we show how closeness centrality is a better measure of quality for the passing of information along short paths. We, therefore, propose Multiplex Combined PageRank, or MCPR, combining the centralities from both layers to immunize the most important nodes. The simulations employ the extended SIR-UA model, which exploits the interaction between infection and awareness dynamics, to scenarios on measles and smallpox. Validation on both synthetic networks and the real-world Copenhagen Networks Study dataset demonstrates consistent superiority of MCPR over classical methods. In terms of epidemic size in simulations with very limited immunization budgets, MCPR indeed resulted in better outcomes than the single-layer PageRank immunization strategy and the existing Multiplex PageRank method. Real-world validation shows epidemic size reductions of 2.2% for measles and 7% for smallpox at 10% immunization coverage, with parameter optimization yielding improvements up to 9.5%. The sensitivity analysis demonstrates that increasing transmission of awareness and the quality of information can help control the infection immensely.

Consuming fruit juice/smoothies could help overcome barriers to fruit and vegetable (F&V) intake. However, their contribution towards F&V intake within a healthy diet is contentious. We investigated how F&V intake is affected by UK 5-a-day advice, with and without one portion/day of fruit juice/smoothies and explored how these interventions impacted markers of health. Healthy individuals (n=42) with low F&V intake (≤2 servings/day) completed a four-week, parallel-group randomised controlled trial (ClinicalTrials.gov ID: NCT06628401). Participants were randomised to 1) control, 2) whole F&V (FV), or 3) whole F&V plus fruit juice/smoothies (FV+FJ). All groups received weekly financial support (to remove financial barriers to F&V purchase in the intervention groups). FV and FV+FJ also received a co-designed educational booklet. We investigated the intervention effects on self-reported F&V intake (primary outcome), biomarkers of intake and metabolism, mood, gut symptoms, and acceptability. Post-intervention F&V intake differed between groups (p<0.001; ηp2=0.62). It was significantly higher in FV ((estimated marginal means [SE]); 8.9 [0.64] portions/day, p<0.001) and FV+FJ (6.6 [0.64], p<0.001) versus control (2.45 [0.64]), but there was no difference between FV and FV+FJ (p=0.051). Both interventions showed good acceptability. Depression symptoms differed between groups (p=0.01; ηp2=0.21); they were significantly lower in FV+FJ than control. There were no differences in anxiety or gut symptoms, nor in intake or metabolic biomarkers. A financial and educational intervention based on UK 5-a-day recommendations, with or without fruit juice/smoothies, significantly increased short-term F&V intake and benefited mood without adversely impacting health markers in the short-term. Funder: Fruit Juice Science Centre.

Ultra-processed foods, as classified by NOVA, provide a substantial and rising share of dietary energy worldwide. Manufactured from cheap refined ingredients and cosmetic additives, they are engineered for hyper-palatability, long shelf life and profit and are widely perceived as convenient, low-cost options. This commentary argues that such perceptions of “cheapness” are misleading once health, equity and environmental impacts are considered.

India’s Supplementary Nutrition Programme (SNP), under the Integrated Child Development Services, provides a Morning Snack and a Hot Cooked Meal to children aged 36–72 months through Anganwadis (day-care centres). This study assessed these meals against SNP standards (2012) and age-specific ICMR recommendations, when standards were unavailable, and explored the use of linear programming (LP) to improve nutrient quality of SNP meals. A cross-sectional survey documented the SNP-meals, ingredients, serving portions and other details, using questionnaires administered to Anganwadi workers and programme officials from purposively selected Anganwadis across 27 States and Union Territories. Nutrient composition was estimated using standard food composition tables, and State-specific food lists and retail prices were incorporated into the LP framework to identify foods that could improve nutrient content of SNP meals. Energy standards were met in 56% of States, while 22% fell more than 20% below recommendations. Protein standards were achieved in 74% of States; however, declined to 52% after adjusting for digestibility. Only 22% of States met the ICMR-based fat requirement. Zinc, iron and folate were largely met, whereas calcium and vitamins A, B6 and B12 were below recommendations in more than half the States. Meals were predominantly cereal-based with limited inclusion of nutrient-dense foods. LP identified foods that reduced nutrient gaps, although many improvements exceeded the per-child cost allocation. Overall, meals showed wide variability, with persistent gaps in fat and key micronutrients. LP provides a structured approach to enhance nutrient provision within the programme setting, although meeting all nutrient targets may require adjustments to cost and procurement strategies.

Defined by DSM-5-TR as a neurodevelopmental disorder Attention-Deficit/Hyperactivity Disorder (ADHD) has attracted ever-mounting attention from the public, coupled with a growing interest from clinicians, researchers, and patients. This is reflected in significantly higher demand for clinical assessments and frequent media reports of a surge in ADHD cases across the lifespan. These trends are puzzling as it is unknown what they truly reflect: an improvement in clinical detection or a concerning degree of overdiagnosis? A key reason for this uncertainty is our limited understanding of the disorder and imprecision of the diagnosis – a long-running subject of criticism. To better understand these issues, in this article we deconstruct ADHD through the lens of its DSM-5-TR diagnostic criteria – the basis upon which the diagnosis is routinely made. Our in-depth analysis reveals major problems associated with the diagnostic criteria with respect to their arbitrariness, vagueness, redundancy, and context-dependent normality, which together substantially undermine the validity and reliability of the diagnosis, and the ADHD construct itself, blunting the precision of ADHD research, clinical decisions and the effectiveness of treatment – all of which are contingent on having a robust diagnosis in the first place. Hence, our detailed deconstruction of the diagnosis of ADHD is critical as it provides the necessary groundwork for its accurate reconstruction – an essential step towards developing a valid, reliable, and clinically meaningful diagnostic foundation that will inform research and improve clinical care for patients with attentional and hyperactivity-impulsivity problems.

Food insecurity (FI), defined as unreliable access to sufficient, safe, and nutritious food, affects nearly 10 million people in the UK. However, official statistics often exclude individuals relying on informal or non-referral-based food support, rendering their experiences largely invisible. This study explores how users and volunteers experience and interpret FI in charity-run, community-based food aid settings across England, an area under-represented in UK studies which are dominated by formal, referral-based food bank models. This qualitative study employed a hermeneutic phenomenological approach to understand the lived experiences of FI. Nineteen semi-structured interviews were conducted with a purposive sample of food bank users (n = 10) and volunteers (n = 9). Interviews were transcribed verbatim and analysed using reflexive thematic analysis (TA). The socio-ecological model (SEM) was used to structure analysis across five levels: individual, interpersonal, institutional, community, and policy levels. Five interconnected themes emerged across the socio-ecological model: (1) Individual: Mental Health, Stigma and Shame; (2) Interpersonal: Caregiving Responsibilities and Sacrifice; (3) Institutional: Chronic Food Aid Reliance and Nutritional Constraints; (4) Community: Informal Networks and Support; and (5) Public Policy: Welfare Inadequacy and Political Neglect. Volunteers also played a mediating role between systems and individuals, navigating logistical burdens and emotional labour. The findings highlight the multidimensional and structured nature of FI in the UK and offer new insights into how dignity, autonomy, and nutritional adequacy are negotiated within informal food support systems. The study calls for more sustainable, community-responsive food aid models and structural policy reforms addressing poverty, inequality, and the legal right to food.

Hyperuricemia is a common metabolic disorder and has become a global health concern. This study investigated the association between DNA methylation (DNAm) and serum uric acid (SUA) by conducting an epigenomewide association study (EWAS) in Chinese monozygotic (MZ) twins. Genomewide DNAm of 50 MZ twin pairs was profiled using the Infinium MethylationEPIC v2.0 BeadChip (935K). Generalized estimating equations (GEE) were used to examine the association between DNAm and SUA. Causal relationships between DNAm and SUA were assessed using ICE FALCON approach. Associations between mRNA expression and SUA were further assessed. Finally, candidate genes identified through epigenomewide association study (EWAS), causal inference, and gene expression analyses were validated in a longitudinal twin study. We identified 70 CpGs, mapping to genes such as DOK6 and NGLY1, significantly associated with SUA (Bonferroni correction p < 5.8 × 10−8). Causal analyses revealed one CpG with a causal effect of DNAm on SUA, 22 CpGs with causal effects of SUA on DNAm, and 33 CpGs showing bidirectional causality. Eleven genes displayed expression levels associated with SUA. DOK6, NGLY1, PKM, and SLC44A1 were selected as candidate genes, all of which showed unidirectional causal effect of SUA on DNAm. In the longitudinal analysis, baseline SUA levels (2012–13) were associated with subsequent DNAm levels in DOK6 and NGLY1 genes (2023–24). In conclusion, we found that SUA levels may influence DNAm variations, particularly at CpG loci within the DOK6 and NGLY1 genes. These findings provide key clues for future investigations into the mechanisms linking SUA with its epigenetic regulatory pathways.