Search Results (957)

A suicide epidemic exists among young U.S. veterans, with risk especially elevated in the first year of transition for the 200,000 servicemembers exiting the military annually. The VA Veteran Sponsorship Initiative (VSI) is a public–private-partnership between federal and community partners that aims to decrease suicides by providing a VA-certified volunteer peer sponsor and connection to community services. Onward Ops is a key community-based national program that enrolls, matches and manages the relationship between servicemembers and sponsors. A prior randomized controlled trial showed that the effectiveness of community interventions can be enhanced when augmented by an Onward Ops sponsor. In preparation for national implementation, we conducted a quasi-experimental, matched-cohort pilot to evaluate the feasibility of an adapted VSI protocol and then assessed effectiveness. The adaptations were executed using the Framework for Reporting Adaptations and Modifications-Enhanced between April 2021 and April 2023. The formative results supported the feasibility of the adaptations to enable proactive enrollment on military installations and expand data infrastructure, partnerships, peer sponsors, and VA clinical services. We then assessed the effectiveness for outcomes not studied in the original VSI trial for active-duty soldiers who enrolled between April and December 2023. After nearest-neighbor matching, the sample included 551 VSI participants and 551 soldiers transitioning as usual. The point-probability contrast or risk differences from the conditional logistic regression model indicated that the VSI caused a statistically significant increase in VA primary care utilization of 0.198 and a statistically significant decrease in suicide attempts of −0.019, both assessed 10 months post-military discharge. The study demonstrated the utility of public–private-partnerships, peer-sponsorship programs and enhanced VA services to support servicemembers during transition. Full article

Background and Objectives: Diabetes is one of the most common chronic non-communicable diseases and represents a major public health problem. At the global level, the epidemic character of diabetes mellitus can be attributed to an extended life expectancy but also to lifestyle. The aim of this study was to examine the sociodemographic, health, and lifestyle characteristics of adults with type 2 diabetes mellitus in Serbia. Materials and Methods: The research is part of the Serbian Population Health Survey conducted in the period from October to December 2019 by the Republic Statistical Office, in cooperation with the Institute of Public Health of Serbia “Dr Milan Jovanović Batut” and the Ministry of Health of the Republic of Serbia. The research instrument was standardized questionnaires constructed in accordance with the European Health Interview Survey (EHIS—European Health Interview Survey, wave 3) questionnaire, which were adapted to the specifics of our area. The research was conducted as a cross-sectional study on a representative sample of the adult population of Serbia. Results: Among 1138 adults with type 2 diabetes in Serbia (52.8% female; mean age 66.0 ± 11.9 years), overweight and obesity were highly prevalent (40.1% and 34.4%, respectively), with Obesity I predominating. Significant gender differences were observed: female more often reported obesity, multimorbidity, and depressive symptoms, whereas men were more physically active and more frequently overweight. Most participants were physically inactive, consumed breakfast and bread daily, and had low engagement in cycling and sports. Alcohol consumption was significantly higher in men, while dietary habits differed by gender for bread intake. These findings highlight substantial gender- and lifestyle-related disparities among adults with type 2 diabetes in Serbia. Conclusions: Targeted interventions promoting healthy lifestyle, physical activity, psychosocial support, and chronic disease management are urgently needed to address gender- and lifestyle-related disparities in adults with type 2 diabetes in Serbia. Full article

Infections caused by arboviruses, a diverse group of viral pathogens transmitted by biting arthropod vectors, mainly mosquitoes, ticks, and midges, can cause a range of illnesses in humans, from mild, influenza-like symptoms to severe neurological complications including encephalitis and viral hemorrhagic fever. According to 2024 World Health Organization statistics, vector-borne diseases collectively account for over 700,000 human deaths annually, with mosquito-borne infections such as dengue, chikungunya, Zika, and yellow fever constituting a growing and significant proportion of this burden. What was once considered a problem localized to poorly resourced settings in tropical and subtropical regions is now becoming a pervasive global challenge. This is due largely to a combination of factors including climate change, transcontinental travel, and urbanization, with the geographical spread and intensity of arboviral outbreaks reaching unprecedented levels during the current century. In much the same way that the escalating global burden of bacterial infections resistant to antibiotics has been described as a silent pandemic, the insidious rise of arboviruses begs questions regarding outbreak preparedness, prevention and control. Here, we highlight the pressing need for comprehensive strategies that incorporate various health sectors to mitigate the emergence and resurgence of arboviral diseases. Future directives that should be prioritized are outlined. As demonstrated by epidemiological trends and historical outbreak data, an orchestrated global response is critical not only for managing current threats but also for preventing future epidemics. Full article

Methicillin-resistant S. aureus (MRSA) is listed by the World Health Organization as a priority pathogen posing a major worldwide threat to public health. Two lineages of MRSA predominate as causes of human infections in the U.S.: USA300 and USA100. Although they are most often grouped together as MRSA, these two lineages differ in pathogenetic mechanisms in important ways. The epidemic spread of these two dominant lineages has been problematic because of the multidrug-resistant profile of USA100 and the virulence of USA300, as well as their ability to adapt to both community and hospital environments. In this perspective, we examine what is currently known about their distinctive biology and the consequent differences in infections caused by these two main MRSA epidemic clones. The purpose of this perspective is to provide critical insights to the clinical microbiology community to stimulate further research to inform the design of new prevention and management strategies for MRSA. Full article

Background. Overcrowding in emergency departments (EDs), particularly pediatric emergency departments (PEDs), remains a significant challenge that affects patient outcomes and the efficiency of healthcare. Rapid diagnostic tests (RDTs) for respiratory viruses could be a promising tool for improving patient management by enabling prompt etiological diagnoses. This study investigated whether positive RDT results for influenza or adenovirus were associated with differences in length of stay (LOS) in a tertiary PED during epidemic seasons. Methods. A retrospective cohort study was conducted at IRCCS Istituto Giannina Gaslini, Genoa, Italy, over two epidemic seasons (December–February, 2023–2025). All consecutive pediatric patients presenting with fever and respiratory symptoms who underwent rapid diagnostic testing for influenza and/or adenovirus during two epidemic seasons were included. LOS was assessed as the time from triage to discharge (TTD) and from physician assignment to discharge (ATD). Patients were stratified by positive versus negative RDT results. Analyses between groups used the Mann–Whitney U-test for continuous variables and chi-square or Fisher’s exact test for categorical variables. A two-tailed p-value < 0.05 was considered significant. Results. Of the 1238 patients analyzed, the median age was 3.3 years (IQR 1.4–7.2), with male predominance (58.1%). A total of 330 patients (26.6%) tested positive. Compared with negative results, positive RDTs were associated with shorter median TTD (217.0 vs. 239.0 min, p < 0.001) and ATD (66.0 vs. 148.5 min, p < 0.001), which was consistent in both the influenza and adenovirus subgroups. No significant difference in 72 h readmission rates was observed between groups. Conclusions. Among children tested with RDTs for influenza and adenovirus, positive results were associated with reduced PED LOS without increasing early return visits. While these findings suggest a potential role in supporting patient flow, conclusions regarding the broader impact on PED overcrowding should be drawn with caution. Further prospective studies, including non-tested controls and additional viral targets, are required. Full article

White mold caused by Sclerotinia sclerotiorum (Lib.) de Bary continues to threaten yield and quality and remains a stubborn, sometimes unpredictable constraint in many cropping systems. The pathogen’s broad host range and its capacity to persist for years as sclerotia mean that fields can carry risk long after visible symptoms fade. Disease development is often driven by short windows of favorable temperature and moisture that promote germination and ascospore release and dispersal, while myceliogenic infection from soil-borne sclerotia can also initiate disease directly. Yet dependable control is still undermined by durable inoculum, limited stable host resistance, variable biocontrol performance, and shrinking chemical options together with fungicide resistance risk. Here we consolidate current understanding and ongoing uncertainties around sclerotial formation and germination cues, the environmental drivers that shape epidemic onset, and the processes governing host colonization, including the roles of cell wall-degrading enzymes, oxalic acid, and redox regulation, as well as the continuing debate over necrotrophic versus hemibiotrophic phases. Management is considered from a practical perspective, covering cultural risk reduction, forecasting-guided fungicide programmes supported by resistance-management principles, and biological control strategies targeting sclerotia. Across systems, the evidence points to the same lesson: single tactics rarely remain reliable under field variability, whereas integrated packages that reduce soil inoculum and align interventions with risk are more durable. Future priorities include resolving early infection events, improving prediction of carpogenic germination under changing climates, increasing the consistency of biocontrol, and accelerating resistance breeding supported by genomic resources. Full article

Pseudostellaria heterophylla, an important traditional medicinal plant in China, has suffered increasing yield and quality loss due to leaf spot disease in recent years. In this study, the causal agent was conclusively identified as Sclerotiophoma versabilis through detailed morphological characteristics and multi-locus phylogenetic analyses based on the internal transcribed spacer regions (ITS), the 28S large subunit of the nrDNA (LSU), RNA polymerase II (rpb2), and ß-tubulin (tub2) sequences. Pathogenicity tests fulfilled Koch’s postulates, thereby resolving previous taxonomic inconsistencies regarding this disease. The effects of environmental and nutritional factors on mycelial growth, conidial germination, and infection were systematically evaluated. Optimal mycelial growth occurred at 20–25 °C, pH 6–8, under continuous light. Optimal mycelial growth occurred at 20–25 °C, pH 6–8, under continuous light, while conidial germination was maximized at 20–25 °C and pH 6–7 under continuous light. Starch and glycine were identified as the most favorable carbon and nitrogen sources for the fungal mycelial growth, respectively. Infection assays indicated an incubation period of approximately 3 d and maximal disease development at moderate temperatures under low-light conditions, with 6 d-old cultures exhibiting the greatest infectivity. Microscopic observations revealed that S. versabilis penetrated host tissues directly or via stomata without forming specialized infection structures. These findings integrate taxonomic resolution with ecological and infection biology analyses, providing mechanistic insight into the environmental drivers of leaf spot epidemics and a scientific basis for disease-risk assessment and management in P. heterophylla production systems. Full article

Healthcare visualization has become a crucial approach for interpreting complex medical data, supporting informed clinical decision-making, and enhancing public health management. However, existing reviews tend to focus on specific technologies or application scenarios, offering limited insight into the field’s overall knowledge structure, developmental trajectory, and interdisciplinary integration. To address this gap, this study systematically reviews 1121 publications from 1994 to 2025 indexed in the Web of Science Core Collection. By combining bibliometric analysis with qualitative assessment, it maps the field’s evolution and underlying research paradigms. The findings reveal a clear shift from early innovation in technical tools toward the realization of clinical value, giving rise to an integrated research system that connects technology, data, clinical practice, and public health. Recent research has progressed beyond initial explorations of medical imaging, standalone devices, and isolated techniques, moving instead toward core domains such as immersive medical visualization, medical data visualization and analytics, health information systems and decision support, AI-assisted epidemic prediction and diagnosis, and integrated IoT-based healthcare frameworks. Looking ahead, an assessment of future trends suggests that, among other directions, the deep integration of explainable artificial intelligence (XAI) with visualization analysis, the development of IoT-driven real-time interactive systems, and the extension of visualization-enabled services from clinical applications toward inclusive population-level health coverage represent core driving forces for the future development of this field. These insights offer strategic guidance for future research, inform the design principles of next-generation visualization systems, and provide new models of interdisciplinary collaboration. The results also offer evidence-based support for health resource planning, technological innovation, and policy formulation. Full article

Here, we adopt an historical approach towards reviewing research since the 1970s on the seed-borne virus diseases of cool-season pulses caused by pea seed-borne mosaic virus (PSbMV) in Australia’s grain cropping regions. All relevant investigations concerning the principal cool-season pulse crops infected; field pea, lentil, faba bean, chickpea, and the minor ones, Lathyrus species, vetches and narbon bean, are covered. However, as the PSbMV field pea pathosystem is the most studied, this receives greatest emphasis. The review starts with brief background information, and by describing the disease symptoms caused and the advances in sample testing procedures. Next, findings from past PSbMV studies are covered in greater detail including transmission by aphids, contact and seeds; occurrence in crops and seed stocks; pathotypes and genetic diversity; host resistance; and phytosanitary, cultural and chemical control measures. What these studies found about PSbMV biology, epidemiology and control is emphasized by describing past glasshouse and field experimentation. Then, practical research outcomes identifying PSbMV’s epidemic drivers, forecasting its epidemics and devising an integrated disease management strategy are emphasized. Examples of images that illustrate past investigations and research outputs are provided. Finally, principal research achievements and priorities for future Australian PSbMV cool-season pulse research are highlighted. Full article

Pine wilt disease (PWD), caused by Bursaphelenchus xylophilus, is a destructive forest disease leading to rapid mortality. Although Chongqing is a major epidemic region in China, the population genetic structure of B. xylophilus and the ecological interactions among nematode occurrence, blue stain formation, and microbial community dynamics remain insufficiently clear. This study systematically surveyed nematode incidence and performed morphological and molecular identification, revealing strong correlations between nematode presence, blue stain, and insect infestation (p < 0.0001). Within Monochamus alternatus, nematodes were mainly distributed in the abdomen and thorax (p < 0.0001). High-throughput sequencing showed significantly higher fungal (e.g., Leptographium) and bacterial (e.g., Burkholderia-Caballeronia-Paraburkholderia) diversity in diseased than healthy pinewood, indicating pronounced microbial shifts during disease progression. mtCOI-based genetic analyses of 162 nematodes from 11 populations revealed five haplotypes, with Hap1 shared across all populations. AMOVA indicated that over 80% of genetic variation occurred within populations, and neutrality and mismatch analyses suggested recent expansion in some populations (Beibei, Jiangbei, Rongchang). These findings clarify nematode epidemiology, microbial shifts, and genetic characteristics in Chongqing, providing a scientific basis for precise sampling, rapid detection, and integrated management of PWD, and suggest that microbial community changes may contribute to rapid pine decline. Full article

Fusarium head blight (FHB) is one of the most significant diseases in wheat globally, affecting about 200 million tons of grain per year through mycotoxin contamination. Besides yield losses, mycotoxin contamination is a major concern. FHB resistance in wheat is partial and polygenic, and since the efficacy of plant protection measures is generally weak-to-moderate, an integrated approach is needed for successful control. We evaluated a more comprehensive methodology for improved protection; in this two-year study, five registered organic products and six conventional products were compared under artificial and natural infection conditions. The disease index (DI), Fusarium-damaged kernels (FDKs) and deoxynivalenol (DON) contamination were evaluated. The stability of the fungicides was also evaluated based on 10 epidemic conditions. The organic fungicides showed much lower efficacy than the conventional ones, although significant reductions in symptoms and DON contamination were observed. In each group, significant variability was detected. The best fungicides for DON contamination showed the lowest variance (highest stability) between 10 and 20 (Verben, Prosaro, Ascra Xpro). The organic fungicides were much less stable; the least stable showed a variance of 141 (Fusarium control: 264). The best organic fungicide was the Bordeaux mixture supported by sulfur addition (variance: 54). The DI and FDK values presented very similar trends. For the more resistant cultivar GK Pilis, the combined DON reduction exceeded 90% for all fungicides. For the most susceptible cultivar, GK Békés, the values were between 30 and 83%, respectively. High resistance to FHB and toxin contamination is the key to controlling FHB in both organic and conventional production. For efficient fungicide control, stable resistance to disease and toxin accumulation are equally required. Principal component analysis (PCA) verified the importance of considering all traits to identify the fungicidal “fingerprint” and demonstrated the differences between fungicides regardless of their organic or conventional nature. PC response differs for traits and fungicides, supporting the complex evaluation of plant and fungicide behavior. Knowledge of resistance levels, in addition to improving mycotoxin control, aids in disease forecasting and epidemic management. The results are applicable to both organic and conventional production systems. Due to the variability in resistance and fungicidal effects, there is an opportunity to improve food safety in both organic and conventional wheat production. Full article

Opioids represent one of the oldest classes of drugs in medicine and remain central to pain management to this day. However, their use is limited by a series of adverse effects, and they are notorious for their addiction potential and for contributing to the opioid epidemic in the US. Nanomedicine, the branch of nanotechnology that utilizes materials at the nanoscale for drug delivery, provides a unique platform that can potentially revolutionize conventional opioid treatment. The aim of this literature review is to summarize the latest research on opioid nanoformulations and their potential to increase analgesic efficacy while minimizing associated risks. Preclinical studies have already demonstrated that both liposomal and dendrimer-based opioid formulations allow for extended release and, consequently, more prolonged and stable analgesia. Moreover, nanoemulsions are currently being investigated for the delivery of opioid compounds, offering formulation versatility and improved bioavailability while maintaining an improved safety profile. At the same time, the use of nanomedicine for vaccines against opioids may enable novel therapeutic strategies to be developed for individuals with opioid addiction. However, several barriers need to be overcome for the promise of nanomedicine to be fulfilled, including the lack of clinical trials, difficulties in mass production of several nanoparticles, toxicity concerns, and regulatory issues. Full article

This study examines the historical relationship between water management and epidemic diseases in the Region of Murcia (Southeast Spain) between the 16th and 19th centuries. It focuses on two major pathologies—yellow fever and cholera—which, despite differing transmission mechanisms (vector-borne and waterborne, respectively), both depended critically on aquatic and semi-endorheic ecosystems. By analysing archival records, parish death registers, and historical reports of floods and droughts, the paper demonstrates how inadequate hydraulic infrastructure and poor sanitation practices intensified epidemic outbreaks. At least five large-scale epidemic episodes (1804, 1834, 1854, 1865, and 1885) coincided with extreme hydrological events, indicating a clear correlation between water governance failures and mortality peaks. Conversely, periods of effective state intervention through regulation and infrastructure maintenance reveal a marked reduction in disease incidence. The results highlight that water governance was not only a technical challenge but also a socio-political determinant of public health. These historical insights remain relevant today, particularly as climate change exacerbates water-related risks worldwide. Understanding the long-term interactions between ecology, infrastructure, and disease contributes to current debates on environmental resilience and sustainable management of water resources as key components of collective health and social stability. Full article

Background/Objectives: There is an invisibility of the diabetes epidemic among Vietnamese Americans. Not only is there limited availability of culturally and linguistically tailored national Diabetes Prevention Program (DPP) and Diabetes Self-Management Education and Support (DSMES) programs, but there are enrollment and retention challenges that hinder these programs’ sustainability and expansion. The purpose of this study was to explore the cultural beliefs, perceived barriers, and motivating factors that influence Vietnamese Americans’ willingness to engage in existing diabetes prevention and self-management programs. Methods: A qualitative descriptive study design was used. A total of 26 participants were recruited through snowball sampling. Bilingual Vietnamese American researchers conducted semi-structured interviews. Content analysis was used to analyze data. Results: Most participants were in the earlier stages of readiness for engagement in a national diabetes program. Major barriers to engagement were related to financial and time constraints, notable among middle-aged participants. Key motivators for engagement included increasing health awareness and family and other social support. Despite their hesitation regarding diabetes program engagement, most participants were further along in the stages of readiness for self-directed lifestyle management. Conclusions: These results will guide the development of a linguistically and culturally adapted diabetes prevention and management program that will support individuals at various stages of their behavior change journey. The program should align with cultural values, address structural barriers, and emphasize the integration of social and familial motivators. Full article

The foliar pathogens of wheat, particularly Zymoseptoria tritici and Pyrenophora tritici-repentis, represent a significant threat to yield. We used a SEIR (Susceptible–Exposed–Infected–Removed) model to quantify epidemic dynamics based on different fungicide application strategies, focusing on the daily dynamic growth rate r(t) (net infection increase) and the removal rate γ(t) (loss infectious tissue) after BBCH 37. In Scenario A (treatment of seed with Systiva^®), the r(t) of Z. tritici was positive only during the early phase of the epidemic, followed by progressive suppression over time, while the r(t) for P. tritici-repentis remained negative throughout. Scenario B (seed treatment combined with foliar propiconazole) resulted in uniformly negative r(t) values for both pathogens, indicating stronger and sustained suppression. These findings highlight the practical utility of epidemic growth rate modeling for evaluating fungicide strategies and support integrated seed + foliar applications as a robust approach to disease management in wheat. Full article