Adequate protein intake is crucial for preventing frailty and sarcopenia in older adults, but conventional dietary assessments are time-consuming. Developing a rapid screening tool for identifying those at risk of low protein intake is essential; however, no such tool exists for Asian populations. This study developed a prediction model to identify older adults in Japan at risk of low protein intake using a simple food intake questionnaire. The model was developed using data from 4,085 older adults aged ≥65 years from the 2013 and 2017 National Health and Nutrition Surveys. Protein intake was assessed using a one-day dietary record with a semi-weighted method. A multivariable logistic regression model was developed to predict low protein intake (<1.0 g/kg adjusted body weight/day), incorporating sex, age, adjusted body weight, and food intake frequency of nine food groups. Model performance was evaluated using the area under the receiver operator characteristic (ROC) curve and a calibration plot, both adjusted for optimism through bootstrap resampling. Participants had a mean age of 74.1 years (standard deviation = 6.6), and 55.5% of all participants were female. The prevalence of low protein intake was 21.8%. Internal validation showed a bootstrap optimism-corrected ROC area of 0.695 and a calibration slope of 0.921. We developed a 12-item prediction model for identifying older adults at risk of low protein intake. The model provides a practical tool to identify older adults at high risk of low protein intake and is expected to be used in public health settings.

Myopia is a critical public health issue, particularly among adolescents. This study investigates the association between adherence to a Mediterranean-style diet and the odds of myopia in US adolescents. A cross-sectional analysis was conducted using National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2008, involving 2473 participants aged 12–18 years. Adherence to the diet was assessed using the alternate Mediterranean diet (aMED) score. Myopia was defined as a spherical equivalent of ≤–0·50 dioptres (D). Multivariable logistic regression models adjusted for age, sex, race, education level, BMI, poverty income ratio and total energy intake were used to examine the association between aMED and myopia. Additionally, restricted cubic spline regression was used to explore non-linear relationships, and mediation analysis was conducted to identify potential biological pathways. Of the participants (median age: 15 years; 50·5 % male), 41 % were identified as having myopia. Participants with myopia had significantly lower aMED scores compared with non-myopic individuals (P < 0·05). Higher adherence to the aMED was associated with lower odds of myopia (OR: 0·830, 95 % CI 0·712, 0·968). A significant dose–response relationship was observed, with adolescents in the highest aMED quintile having a 41 % lower odds of myopia compared with the lowest quintile (OR: 0·592, 95 % CI 0·368, 0·952). The association was partially mediated by dietary cholesterol and eicosatetraenoic acid. In conclusion, adherence to a Mediterranean-style diet in adolescents is associated with a lower odds of myopia. Addressing diet quality may mitigate health risks related to myopia development.

This study examined whether coronavirus disease 2019 (COVID-19) infection experience enhances preventive behaviour (i.e., hand disinfection and mask-wearing), with risk perception acting as a mediating factor. The study included participants aged ≥18 years residing in Japan, enrolled in a 30-wave cohort study conducted from January 2020 to March 2024. Using propensity score matching, 135 pairs of participants with and without infection were extracted, adjusting for dread and unknown risk perception, preventive behaviours, sociopsychological variables, and individual attributes. Comparisons of risk perception and preventive behaviour were made between groups post-infection experience, and mediation analysis was conducted to test whether risk perception mediated the effect of infection experience on preventive behaviour. Following the infection experience, participants in the infection group reported significantly higher scores for one item of unknown risk perception and a greater proportion of mask-wearing. The indirect effect of infection experience on mask-wearing, mediated by the unknown risk perception item, was significant. COVID-19 infection experience increased perceptions of unknowable exposure, which in turn promoted mask-wearing behaviour. Incorporating insights from personal infection experiences into public health messaging may enhance risk perception and promote preventive behaviour among non-infected individuals, offering a novel approach to infection control at the population level.

Cyclone Alfred disrupted dialysis services across South-East Queensland. Digital tools, including real-time surveys and AI-assisted analysis, were used to evaluate impact and guide immediate improvements. This low-cost, tech-enabled response demonstrated how agile methods can support disaster resilience and inform planning for vulnerable patient groups during extreme weather events.

The genus Alloophistolecithum was recently created and comprises species that were previously included in the genus Lecithaster. The two genera form the subfamily Lecithasterinae. The genera includes species that predominantly parasitize marine fish, and occasionally those inhabiting fresh or brackish water. This study describes a new species of Alloophistolecithum, which is a parasite of the Argentinian silverside (Odontesthes bonariensis), a fish species that inhabits brackish waters. Alloophistolecithum magaliae n. sp. is characterized by smooth, unnotched testes; a uterus extending to the posterior end of the body; and short caeca that do not reach the anterior edge of the vitellary. As genetic analyses are currently limited to a few species within the genus, it is premature to establish clear relationships between them. The Argentinian silverside is considered to be of great economic importance, having spread not only within Argentina but also to other countries for commercial exploitation. The anthropogenic spread of silversides outside their natural range could pose a risk of biological invasion, so studying their parasitological fauna is important.

Accidental escapes of pathogens from laboratories continue to cause outbreaks in the community today, posing significant risks to the general public, animal communities and the environment. These incidents, as well as the uncertainties surrounding the origins of the COVID-19 pandemic, highlight the need to consider unnatural origins as part of emerging outbreak surveillance and detection. Identifying recurring patterns and distinctive factors of laboratory-associated disease outbreaks can aid in successfully preventing and mitigating these occurrences. Seventy incidents of laboratory-associated leaks that led to outbreaks in the wider public have been reported (Supplementary Appendix S1). Seven renowned cases that have been comprehensively studied were selected for review: (i) 1955 Polio vaccine incident in western USA, (ii) 1977 H1N1 influenza virus re-emergence in China and the Soviet Union, (iii) 1979 Anthrax release in Sverdlovsk, Soviet Union, (iv) 1995 Venezuelan equine encephalitis epidemics in Venezuela and Colombia, (v) 2003–4 SARS-CoV-1 escapes from Singapore, Taiwan and China, (vi) 2007 Foot-and-Mouth disease virus outbreak in Pirbright, England and (vii) 2019 Brucella leak in Lanzhou, China. These outbreaks were selected because data on their geographical spread, genetics, phylogeny, epidemiological factors (including attack rates, infectious dose, time, location and season of spread) and governmental and institutional responses to the incidents had been previously analysed and published. Thematic analysis of these lines of evidence revealed seven recurring insights described in historically confirmed laboratory-associated outbreaks: unusual strain characteristics, peculiar clinical manifestations or affected demographics, unusual geographical features, atypical epidemiological patterns, delayed government action and communication to the public, misinformation and disinformation spread to the public and biosafety concerns/incidents predating the event. The outbreaks exhibited between 13 and 19 retrospectively identified indicators. These indicators were used to develop preliminary risk criteria intended to support structured, hypothesis-generating assessment of outbreaks, rather than to establish origin.

The activity of respiratory viruses (RVs) displays large variability in tropical regions, posing challenges for public health response strategies. Data from most RVs in south-eastern Mexico remain limited, particularly in the Yucatan Peninsula, the largest tourism hub in the country. This retrospective study analyses the regional epidemiology of RVs in Merida, the largest city in the region, using laboratory test data from a local hospital (January 2018–April 2024). Test results of 143292 RVs were collected, including 121976 for SARS-CoV-2, 19355 for influenza A and B viruses, and 1961 for 17 distinct RVs. We found that non-SARS-CoV-2 RVs circulated year-round, with higher activity in autumn and spring, while SARS-CoV-2 peaked in summer and winter. Influenza A virus, respiratory syncytial virus, and influenza B virus reached their highest activity in autumn, earlier than in other regions of Mexico. Human metapneumovirus peaked during autumn-winter. Rhinovirus/enterovirus and parainfluenza showed year-round activity, with peaks in autumn and spring. Other coronaviruses were more frequent during winter-spring. In post-pandemic years (2022–2023), adenovirus outbreaks emerged, as well as an increased prevalence of non-SARS-CoV-2 RV co-infections. This study highlights the need for region-specific public health strategies, including optimized vaccination schedules, such as for influenza A virus, and enhanced diagnostic surveillance.

The FIND Integrated Biobank (FIB) network was established to address long-standing barriers in translational research, diagnostic development, and pandemic preparedness, particularly in low- and middle-income countries (LMICs). This article presents the FIB network as an innovative, contract-based model for equitable biobanking partnerships that support rapid, quality-assured access to clinical biospecimens for translational research and diagnostic evaluations. The FIB model offers a replicable and scalable approach to global diagnostic research and preparedness, anchored in equitable, legally binding partnerships. It advances the goals of the WHO Pandemic Agreement and provides a practical pathway for integrating LMIC institutions into global translational research ecosystems.

Nationwide screening for parvovirus B19 among blood donors in Hungary has been conducted since 2019. Although B19 is primarily transmitted via the respiratory route, transfusion-related transmission also occurs. This study investigated the impact of COVID-19–related restrictions on B19 incidence. Between January 1 2019 and December 31 2024, a total of 2,043,119 blood donations were screened for B19 DNA using PCR, and the study period was divided into six epidemiological phases.

During the pre-restriction period (Phase I), B19 incidence was relatively low (0.87/10,000 donations). Following the introduction of COVID-19 restrictions (Phase II), highly viremic donations were not detected. Incidence gradually returned in Phase III (0.22/10000) and increased in Phase IV (1.96/10000), suggesting a minor outbreak. A marked surge in December 2023 (23.03/10000) initiated a nationwide epidemic, peaking in March–April 2024 (46.01/10000), before declining by August (Phase VI; 0.54/10000).

COVID-19 restrictions substantially reduced B19 transmission and may have led to increased population susceptibility. This likely contributed to the unusually intense B19 epidemic observed in 2024, which was considerably more severe than contemporaneous outbreaks reported in other countries.

The recent publication by the Mental Health Commission (MHC) constitutes a welcome acknowledgement of the unique challenges within mental health care delivery for LGBTQIA+ populations in Ireland. This timely guidance illustrates a comprehensive framework to tackle the entrenched disparities in mental health outcomes and service access challenges experienced by sexual and gender minorities in Ireland, aiming to align with international best practices of affirming and inclusive mental health care. The purpose of this critique is to situate the MHC guidance within the broader multimodal context of societal change and service provision, rather than to provide procedural or implementation instructions. For clinicians, this is an opportunity to reflect on the landscape in Ireland.

Trichostrongylus spp. are globally distributed gastrointestinal nematodes that affect ruminants and humans, posing significant veterinary and public health challenges. Despite their zoonotic potential, the temporal dynamics of Trichostrongylus infection remain poorly understood globally. This study aimed to estimate long-term trends in Trichostrongylus prevalence in humans, ovines, and bovines using time series modelling. A systematic review identified 240 eligible studies with annual prevalence data across 60 countries. Following Kalman smoothing, annual prevalence time series were constructed for each host species covering 1947–2024 for humans, 1966–2024 for ovines, and 1962–2024 for bovines. ARIMA models were fitted separately: ARIMA(0,1,1) for humans, ARIMA(3,0,0) for ovines, and ARIMA(0,1,1) for bovines. Model selection was based on Stationary R2, RMSE, MAPE, and the Ljung-Box Q test for residual independence. Forecast 95% confidence intervals were reported to convey uncertainty in the projected trends. All three models demonstrated good in-sample fit and adequate residual diagnostics. Infection rates in humans and bovines are projected to decline, from 4.64% to 3.73% in humans and from 20.11% to 11.76% in bovines by 2034. In contrast, the ovine model forecasts an increase in infection rates, from 6.50% to 15.56%. This increase in ovines may reflect greater pasture exposure and environmental persistence of infective larvae, while improvements in hygiene and livestock management likely contribute to the declining trends observed in humans and bovines. The rising infection rate in ovines, coupled with sustained zoonotic risk, underscores the need for integrated One Health surveillance and control efforts.

In 2013, the National Institute of Neurological Disorders and Stroke established National Institutes of Health (NIH) StrokeNet to support multi-site clinical trials focused on stroke prevention, treatment, and recovery. The University of Cincinnati (UC) serves as the National Coordinating Center for StrokeNet. As part of the initiative, the UC StrokeNet Central IRB (SN-CIRB) was established at UC to serve as a single IRB to oversee StrokeNet trials. Since the SN-CIRB approved the first StrokeNet study in 2014, it has reviewed and approved 16 additional studies. Over this period, the UC Human Research Protection Program refined its review processes based on insights from earlier reviews. These improvements have improved efficiency while still ensuring the protection of study participants. The successful implementation and ongoing conduct of the SN-CIRB at UC demonstrate that an academic-based IRB can effectively serve as a Central IRB for a large clinical trial network.

Hyderabad, the fourth-most populous city in India, accounts for the majority of people living with human immunodeficiency virus (HIV) (PLWH) in Telangana, likely comprised of two populations with a disproportionately high national HIV prevalence: gay, bisexual, and other men who have sex with men (MSM) and those who engage in sex work (SW). Research has shown that engaging in SW increases vulnerability to HIV transmission risk for both women and MSM, but less is known about contributors to non-optimal (ART) adherence. We analyzed data from 45 MSM and 49 women living with HIV who were enrolled in the first year of data collection from an mHealth education study in Hyderabad. Modified Poisson regression was used to measure factors associated with ART adherence measured with a visual analogue scale (VAS) (model 1) and pill count (model 2). Less than half (40.9%) reported ever engaging in SW, including 13 women and 25 MSM. The prevalence of non-optimal ART adherence was 14.9% with VAS and 42.4% with pill count. Engaging in SW was not associated with non-optimal ART adherence. Differences in non-optimal ART adherence measured by VAS and pill count suggest that future studies should utilize both methods to better distinguish the measures.