This study assessed the impact and cost-effectiveness of pre-exposure prophylaxis (PrEP) in reducing HIV infections and HIV-related deaths among four key populations in China: men who have sex with men (MSM). Female sex workers (FSW), people who inject drugs (PWID), and HIV-negative partners of serodiscordant couples (SDC). Decision-analytic Markov models simulated HIV transmission and progression in cohorts of 100,000 adults over 40 years under three strategies: no PrEP, daily oral PrEP, and on-demand oral PrEP evaluated nationaly and high-incidence provinces. Cost-effectiveness was measured using a willingness-to-pay threshold of US$37,653 per QALY. Across all populations, on-demand PrEP was the most cost-effective strategy. Among MSM, it was cost-effective both nationwide (ICER: $4,554/QALY) and in high-incidence provinces (ICER: $1,045-2,129/QALY), reducing new infections by 24.7%. Daily PrEP was also const-effective for MSM nationally and prevented 19.9% of infections. For FSW, on-demand PrEP was cost-effective in high-incidence provinces (ICER: $25,399-37,045/QALY), reducing infections by 21.8%-22.5%. For PWID, it was cost-effective in high-incidence provinces (ICER: $10,361-29,560/QALY), reducing infections by 15.5%-17.9%. For HIV-negative partners of SDC, on-demand PrEP was cost-effective both nationally and in high-incidence provinces, reducing infections by 24.0%. Overall, on-demand PrEP offers substantial health and economic benefits, particularly for HIV-negative partners of SDC and high-incidence regions.

Health Technology Assessment (HTA) informs resource allocation and policy decisions, particularly to achieve Universal Health Coverage (UHC). Recognizing the increasing demand for evidence-informed decision-making, the HTAsiaLink network was established in 2011 as a regional platform to strengthen individual and institutional capacity in HTA research and facilitate the integration of HTA evidence into policy decisions across the Asia-Pacific.

Over the years, HTAsiaLink has expanded to over fifty members from twenty economies. In 2024, a structured strategic planning process was undertaken to ensure its continued growth and strengthen its impact on HTA development and implementation. This process involved a targeted review of strategic plans from international networks, alongside comprehensive member engagement, to develop a data-driven and adaptable plan responsive to the evolving healthcare landscape and member needs. As a result, five strategic priorities, corresponding action items, and success indicators were identified.

This commentary outlines the needs and processes involved in developing the network’s first-ever strategic plan, emphasizing the critical role of member engagement in shaping its future direction. We believe that this experience offers transferable insights for other HTA networks, particularly those operating in low- and middle-income country contexts, on the collaborative development of strategic plans that are responsive to shared objectives, accommodate varying institutional capacities, and align with regional priorities.

Maintaining dialysis care in disaster-affected regions is challenging, especially where health care access is already limited. This case from coastal Fukushima highlights a woman in her 30s with diabetic nephropathy who required dialysis 3 times a week at a hospital 80 kilometers away due to local capacity shortages. Her visual impairment necessitated her father’s help for transportation. To ease this burden and support her return to work, she underwent a successful living donor kidney transplant, with her father as the donor. Post-transplant, her hospital visits were reduced to monthly follow-ups, significantly improving both her and her caregiver’s quality of life. This case illustrates the potential of kidney transplantation to address dialysis access issues in disaster-affected areas by reducing logistical and caregiving challenges. While not suitable for every patient, transplantation should be considered as part of health care recovery strategies in regions with limited dialysis availability.

Long-acting injectable antipsychotics (LAIs) can lead to improved outcomes for people with schizophrenia, schizoaffective disorder, and bipolar disorder, as they guarantee medication delivery during the injection interval. Contemporary guidance on the use of LAIs includes considering not only patients with poor or uncertain adherence but also patients who would prefer monthly administration (or longer) of their maintenance medication, including those in their first episode of illness. This narrative review discusses the incorporation of LAIs in treatment planning across different settings: acute inpatient units, community mental health outpatient clinics, and jails. Implementing this treatment modality requires the recognition of eligible patients, providing information to patients and their families about the benefits and drawbacks of LAIs, and educating all members of the treatment team.

Older adults aged 75 and older (75+) represent the fastest-growing demographic in the USA yet remain underrepresented in prevention-focused clinical research. This scoping review evaluated recruitment strategies used in healthy aging clinical trials targeting this population, with particular attention to technology-enabled and belonging-focused approaches.

A PubMed search initially identified only four US-based studies focused on adults aged 75+. To broaden the scope and enrich the analysis, additional studies involving adults aged 65+ and those with pre-existing conditions were included, yielding a total of 23 relevant studies. Recruitment strategies were analyzed using the Design for Belonging framework to assess how inclusion and engagement were fostered.

Findings revealed that adults aged 75+ preferred traditional methods – targeted mailings, phone calls, and in-person outreach – due to barriers related to digital access and usability. In contrast, adults aged 65+ showed greater receptivity to digital tools such as electronic health records, social media, and web-based enrollment. Community engagement and culturally tailored materials are effective across all age groups. However, few studies addressed later-stage engagement strategies like advocacy and trust repair.

These results underscore the importance of tailoring recruitment strategies to aging subgroups, combining personalized outreach with inclusive design to enhance equity and retention in clinical research.

The Interplay of Genes and Environment across Multiple Studies (IGEMS) is a consortium of 21 twin studies from 5 countries (Australia, Denmark, Finland, Sweden, and United States) established to explore the nature of gene–environment interplay in cognitive, physical, and emotional health across the adult lifespan. The combined data from over 145,000 participants (aged 18 to 108 years at intake) has supported multiple research projects over the three phases of development since its inception in 2010. Phases 1 and 2 focused on launching and growing the consortium and supported important developments in data harmonization, analyses of data pooled across multiple studies, incorporation of linkages to national registries and conscription data, and integration of molecular genetic and classical twin designs. IGEMS Phase 3 focuses on developing appropriate infrastructure to maximize utilization of this large twin consortium for aging research.

Hypertension (HTN) is the primary cause of preventable cardiovascular-related deaths globally, representing the most important modifiable risk factor for preventing such deaths. Nearly 700 million of the 1.3 billion adults with HTN worldwide remain untreated, most of whom live in low-and middle-income countries, including East Africa. Barriers to the diagnosis of HTN also impact treatment adherence after diagnosis and the initiation of treatment. This scoping review used a qualitative synthesis method to describe studies examining the cultural and contextual factors influencing HTN treatment adherence in East Africa and the lived experiences of patients with HTN to gain a better understanding of these factors in the region. A total of 34 studies, 25 qualitative and 9 mixed-methods designs from five East African nations were included in the final review. Reported influencing factors are classified into individual, structural, and social factors. Lack of HTN literacy and limited risk perception were often cited as individual barriers to adherence, along with mental health challenges, including fear of stigma, while trust and HTN literacy enhanced adherence. Inconsistent healthcare delivery, lack of access, and financial constraints were the most reported structural factors. Social norms surrounding health behaviours and attitudes towards HTN treatment were identified as key determinants of adherence at the social level. The findings underscore the complex interplay of individual, structural, and social factors associated with HTN treatment adherence in East Africa, offering practical ways to enhance adherence in the region at all three levels.

China accounts for over 90% of global alveolar echinococcosis (AE) cases caused primarily by Echinococcus multilocularis. If left untreated, AE can have a 10-year mortality rate of 94%. Understanding its epidemiological patterns is essential for targeted control strategies. Surveillance data from 2006 to 2020 were obtained from the Public Health Scientific Data Center, and spatial and temporal trends were analyzed using spatial autocorrelation, hot spot analysis, and centroid migration techniques. A total of 51,403 echinococcosis cases were reported from 2006 to 2020, with an average annual incidence of 0.25 per 100,000. Most cases (71.33%) occurred in individuals aged 20–60 years. High-incidence areas centred in western/northwestern provinces, including Qinghai, Xinjiang, Xizang, Gansu, and Ningxia. Incidence and cases increased until 2017, then declined steadily. Spatial autocorrelation revealed persistent High-High clusters in Gansu and Ningxia (2008–2018) and Xizang (2010–2020), while Low-Low clusters persisted in central/eastern China. Hotspot analysis confirmed sustained high-risk zones in western/northwestern regions. Trend surface and centroid migration showed a southward disease shift within Qinghai. Echinococcosis remains endemic in western/northwestern China, with a trend of southward expansion. Strengthened, tailored interventions are urgently needed, particularly in high-burden areas like Xizang and Qinghai.

Based on morphological and molecular data, we describe a new species of Diaphorocleidus parasitizing the nasal cavities of Tetragonopterus argenteus from the Lima Campos weir, municipality of Icó, state of Ceará, Brazil. Diaphorocleidus radius n. sp. resembles other congeners in the morphology of the accessory piece, all by having a bifurcated accessory piece (pincer-shaped), composed of two subunits articulated. However, the new species can be easily distinguished from all congeners by the morphology of the sclerotized structures of the haptor (ventral anchor with well-developed superficial root, ornamented deep root, recurved blade, elongated and lightning-shaped tip; and ventral bar robust, plate-shaped, truncated in lateral ends). Phylogenetic analyses of LSU rDNA and COI mtDNA sequences, conducted using Bayesian Inference and Maximum Likelihood, placed Diaphorocleidus radius n. sp. within Diaphorocleidus, grouping it with species parasitizing acestrorhamphid hosts. Genetic distances between Diaphorocleidus radius n. sp. and other congeneric species such as D. armillatus and D. forficata showed clear differentiation. Both molecular markers support the distinctiveness of Diaphorocleidus radius n. sp., consistent with its recognition as a new taxon.

Despite the multiple advantages of 25-hydroxyvitamin D (calcifediol or 25(OH)D) compared to cholecalciferol, it is used sparingly. This study was planned to assess the safety and efficacy of supplementing daily 25 µg of calcifediol capsules vis-a-vis 100 µg (4000 IU) of cholecalciferol sachets in apparently healthy individuals with vitamin D deficiency in Chandigarh, India (latitude 30.7° North, 76.8° East). It was a prospective, interventional study to evaluate the effects of calcifediol vis-a-vis cholecalciferol. Following initial screening of 70 subjects in each group, 62 were included in the calcifediol and 41 in the cholecalciferol group. Forty-six from calcifediol and 37 from cholecalciferol group completed the 6-month follow up. There was a significant increase in serum 25(OH)D (355% in cholecalciferol & 574% in calcifediol groups, respectively, p < 0.001) and 1,25 (OH)2D (p < 0.001) with a marked decrease in iPTH (p < 0.001) and ALP (p = 0.016) in both groups. Though serum ALP decreased significantly more in the calcifediol group than the cholecalciferol group, no appreciable difference in other biochemical parameters was noted between the groups. No episodes of hypercalcaemia or incidence of new renal stone disease were observed during follow-up. However, hypercalciuria (spot urine calcium creatinine > 0.2 mg/mg) was noted in 8/46 individuals in the calcifediol group and 5/37 individuals in the cholecalciferol group at final visit with no significant difference between two groups. This study establishes the efficacy and safety of correcting vitamin D deficiency with daily 25 µg calcifediol capsules as an alternative to 4000 IU (100 µg) cholecalciferol sachets.