Vaccination strategies to achieve outbreak control for MPXV Clade I with a one-time mass campaign in sub-Saharan Africa: A scenario-based modelling study.

Background: Limited mpox vaccination coverage, declining cross-protection from historical smallpox vaccination campaigns, and persistent zoonotic reservoirs leave many sub-Saharan countries susceptible to mpox outbreaks. With millions of vaccine doses made available to the region since late 2024 and the absence of country-specific guidelines for allocation, estimating the country-specific impact of one-time mass vaccination strategies is necessary for ongoing outbreaks and other countries at future risk.

Methods And Findings: We adapted a next generation matrix model to project disease transmission potential for 47 sub-Saharan countries from 2025 to 2050 under four transmission scenarios with different contributions of community versus sexual contacts.

Network Meta-Analysis of Quality of Life in Heart Failure With Reduced Ejection Fraction.

Background: Although the effects of various combinations of treatments on mortality and morbidity outcomes in heart failure with reduced ejection fraction (HFrEF) have been evaluated, the impact on quality of life is unknown. This study evaluated and compared the composite impact of pharmacological therapies on quality of life in HFrEF using a frequentist network meta-analysis and systematic review methodology.

Methods: We searched MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials for randomized controlled trials published between January 1, 2021 and August 10, 2024.

Extreme weather events and dengue in Southeast Asia: A regionally-representative analysis of 291 locations from 1998 to 2021.

Background: Climate change, leading to more frequent and intense extreme weather events (EWEs), could significantly impact dengue transmission. However, the associations between EWEs and dengue remains underexplored in the Southeast Asia (SEA) region. We investigated the association between selected EWEs (i.

Factors affecting disease progression in early-stage chronic kidney disease in a multi-ethnic, southeast Asian primary care population.

Background: While effective risk factor control and medication optimization in early-stage CKD can significantly slow disease progression, a paucity of studies hinders comprehensive understanding. This study aims to identify factors associated with progression of early-stage CKD in primary care.

Methods: We retrospectively analyzed data of CKD G1-G2 patients with type 2 diabetes or hypertension, recruited from an ongoing cohort between 2017 and 2023 from six polyclinics in Singapore.

Progress and challenges in tuberculosis preventive treatment in the Western Pacific Region: a situational analysis of seven high tuberculosis burden countries.

Background: Tuberculosis preventive treatment (TPT) can avert progression from infection to disease, yet scale-up across the World Health Organization Western Pacific Region is patchy. To guide acceleration, we assessed progress, challenges and responses in seven high-burden countries-Cambodia, China, Lao People's Democratic Republic (PDR), Mongolia, Papua New Guinea, the Philippines and Viet Nam-drawing on 2015-2023 programme data, structured questionnaires, follow-up interviews and a regional validation workshop.

Main Body: Six of the seven countries have issued national TPT guidelines and five now offer shorter rifapentine- or rifampicin-based regimens.

Maternal Experiences and Perspectives of Marketing and Regulation of Commercial Milk Formula in Thailand: A Qualitative Study.

Commercial milk formula (CMF) marketing adversely influences breastfeeding practices globally. Thailand enacted the Control of Marketing Promotion of Infant and Young Child Food Act ('Thai Code') in 2017 to restrict the marketing of CMF for infants aged 0-12 months. This qualitative study aimed to explore mothers' experiences and perspectives of CMF marketing and its regulation by the Thai Code through semistructured interviews with 15 mothers across Thailand between July 2023 and March 2024.

Rethinking reflexivity, replicability and rigour in qualitative research.

This commentary re-examines recent proposals to define quality in qualitative research through a singular unifying framework, situating them alongside historical and ongoing debates in qualitative methodology. By juxtaposing different traditions, this piece highlights areas of tension between procedural notions of rigour and interpretive approaches that emphasise the co-constructed, context-bound nature of meaning. The discussion argues that quality in qualitative research cannot be captured by a single metric or universal rule.

Adolescent Dietary Intake and Breast Cancer in Adulthood: A Systematic Review and Meta-Analysis.

Adolescence represents a key opportunity for breast cancer prevention, as the rapid proliferation of breast tissue during puberty creates a critical window of vulnerability for the development of cancerous cells. With increasing research on adolescent dietary factors and breast cancer risk, we conducted a systematic review and meta-analysis to summarize the associations between adolescent diet and risk of breast cancer in adulthood, as well as benign breast disease (BBD) and high mammographic breast density, which are markers for breast cancer. We searched Web of Science, Ovid MEDLINE, Cochrane CENTRAL and Embase for epidemiological studies assessing dietary intakes in adolescent girls (aged 10-18 years), published through 16 October 2024, with no language or time restrictions.

Validation of the consumer health activation index (CHAI) among community-dwelling adults in primary care clinics in Singapore.

Background: Health activation is an individual's knowledge, skills, and confidence in managing personal health and healthcare. The Consumer Health Activation Index (CHAI) is a freely available, 10-item measure originally developed in the United States. This study aimed to validate CHAI among community-dwelling adults in Singapore, examining its content validity, construct validity and test-retest reliability.

High CD4⁺ T-cell Responses in Seronegative Individuals Following SARS-CoV-2 Exposure during a Dormitory Outbreak.

Objectives: We studied individuals who remained uninfected by SARS-CoV-2 despite repeated exposures during a May-July 2020 dormitory outbreak in Singapore.

Methods: We compared immune profiles of those with exposed seronegative (ESN) (negative PCR and serology), with non-infected and infected groups. Following the lifting of quarantine, incident infection rates were compared between the ESN and non-infected cohorts.

Healthy Lifestyle Mitigates the Adverse Association of Particulate Matter with Cognitive Function: A 10-year Longitudinal Analysis of Older Adults in China.

Background: Both air pollution and lifestyle are associated with cognitive function, with air pollution being detrimental and positive lifestyles being beneficial. The extent to which a favorable lifestyle can mitigate the harmful effects of air pollution on cognitive function in later life warrants further investigation.

Methods: 7,651 individuals aged 65 years and above from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were followed up between 2008 and 2018.

Signature White Matter Hyperintensity Locations Associated With Vascular Risk Factors Derived From 15 653 Individuals.

Background: White matter hyperintensities (WMHs) of presumed vascular origin are common in the elderly and are associated with vascular risk factors. There is evidence that vascular risk factors, in particular hypertension, are associated with WMH in particular locations of the white matter. However, it remains unclear whether this is true for all risk factors and whether signature WMH locations differ between risk factors.

Organizational Position and Structural Empowerment in Chinese Community Nursing: An Interpretive Case Study.

Nurse empowerment is widely recognized for advancing professional development and job satisfaction, yet its structural dimensions remain underexplored in China's community nursing sector. Guided by Kanter's structural empowerment theory, this interpretive case study examines how formal hierarchies and informal organizational dynamics converge to shape community nurses' access to power in nonward settings. Drawing on 24 semistructured remote interviews and unstructured observations in Shenzhen, four interrelated themes were identified: (1) dual-function caregiving roles, (2) entitlement to formal power, (3) variation in informal roles, and (4) inequities in informal power.

A Qualitative Analysis of Human-Animal Interactions with Respect to Zoonoses in Nepal.

Infectious diseases of zoonotic origin are a serious threat to human health and livelihoods globally. Habitat encroachment and deforestation bring humans and animals into contact, increase potential for disease spread, and foster human-animal conflict. Our aim, using thematic analysis, was to qualitatively examine the zoonotic disease landscape in Nepal from public, policymaker, and healthcare practitioner perspectives, and to describe key human-animal interactions.

Evaluating the effectiveness of international travel controls to identify MPXV-infected travelers: a simulation study.

Background: In August 2024, the World Health Organization (WHO) declared a public health emergency due to the rapid spread of mpox in Africa and beyond. International travel controls (ITCs), such as health screening and viral testing, could help avoid/delay the global spread of MPXV, fostering preparedness and response efforts. However, it is not clear whether the viral tests at immigration are sufficient to avoid introduction of MPXV and which samples should be used on the viral tests.

Synergistic effect between cortical cerebral microinfarcts and brain atrophy on cognitive decline.

Cortical cerebral microinfarcts are associated with brain atrophy in cross-sectional studies, while further investigation using longitudinal datasets is warranted. Moreover, little is known about their combined impact on cognition. This study aims to establish the association between cortical cerebral microinfarcts and brain volume loss over time and to explore whether they synergistically contribute to cognitive decline.

Telemedicine Public Reimbursement Models for National and Subnational Jurisdictions: Scoping Review.

Background: Telemedicine has transformed health care delivery, offering improved access, efficiency, and potentially cost-effectiveness. However, wide-scale implementation is challenged due to multiple factors. Among these, reimbursements were reported to influence the scalability and sustainability of telemedicine.

Multi-Comparison of Different Ocular Imaging Modality-based Deep Learning Models for Visually Significant Cataract Detection.

Purpose: Age-related cataract is the leading cause of vision impairment. Researchers have utilized various imaging modalities, including slit beam, diffuse anterior segment, and retinal imaging, to develop deep learning (DL) algorithms for automated cataract analysis. However, the comparative performance of these algorithms across different ocular imaging modalities remains unevaluated, mainly due to the absence of standardized test sets across studies.

Role and experiences of youth community health volunteers in a community health coaching programme for older adults in Singapore: a qualitative study.

Introduction: Older adults are often faced with a multitude of physical and social challenges that impede their ability to age healthily. To tackle this issue, the use of trained lay volunteers as health advocates has become increasingly popular; however, their perceptions and experiences remain to be explored. This study aimed to explore the experiences of youth community health volunteers (YCHVs) who participated in HealthStart, a community health coaching programme for older adults in Singapore.

Facilitators and barriers for use of digital technology in chronic disease management.

Despite increased screening efforts and accessibility of healthcare services, the prevalence of chronic disease is on the rise in Singapore. Digital technology has become a valuable tool to aid management of chronic diseases. However, its utilisation remains challenging among older Singaporeans.

Effect of metabolic syndrome severity on cerebral haemodynamics and cognition in community-based cohort.

Background And Aims: Metabolic syndrome (METS) increases the risk of cognitive decline, but its impact on cerebral haemodynamics remains unclear. This study investigated relationships between continuous metabolic syndrome severity score (cMETS), cerebral haemodynamics, and cognition.

Methods: In this cross-sectional study from the Epidemiology of Dementia in Singapore (EDIS) cohort, participants underwent neuropsychological assessments and arterial spin labelling MRI to evaluate cerebral haemodynamics, cognitive function, and composite metabolic syndrome severity (cMETS).

Confronting "Socio-Political Inertia" on the Long and Winding Road to "Healthy Societies" Comment on "How to Build Healthy Societies: A Thematic Analysis of Relevant Conceptual Frameworks".

The vision to create "Healthy Societies" is a reiteration of "Health for All" first made in the Declaration of Alma-Ata almost half a century ago. We contend that this long journey is due to "Socio-Political Inertia" that has prevented societies from transforming even in the presence of enabling policies. The analysis of policy documents by Nambiar et al could help set the stage for understanding how best to advance healthy societies, but the aspirations expressed in documents require active engagement and implementation to enable societal change.

How Do People Perceive Media-Reported Risks: Risk Networks and Profiles of Segments.

Individuals' perceptions of and responses to different risk sources are often intercorrelated, particularly for risks belonging to the same domain such as health or finance. However, less is known about the nature of the interconnections of risk perceptions across domains and individual differences in the interconnection patterns. This study examined the perceptions of 13 major media-reported risks and their interconnection patterns across demographic groups.

A Reliability Generalization Meta-Analysis of the Antisocial Process Screening Device.

Although the Antisocial Process Screening Device (APSD) is one of the most widely used instruments for assessing psychopathic traits, the reliability estimates of the APSD show great heterogeneity across different studies. This investigation evaluated the reliability of the APSD using a reliability generalization meta-analytic technique across 158 studies ( = 75,749). The APSD demonstrated marginal to acceptable coefficient alphas ranging from 0.