Search Results (8,642)

Background: Mpox is a re-emerging viral zoonotic disease that remains relevant for public health preparedness, risk communication, and vaccination literacy. University students are an important population for infectious disease communication because they are socially active, digitally connected, and may act as knowledge multipliers. This study assessed Mpox-related knowledge, risk perception, preventive practices, and willingness to receive Mpox vaccination among university students in Aktobe, Kazakhstan, and identified independent predictors of adequate knowledge and vaccination willingness. Methods: A cross-sectional questionnaire-based survey was conducted among students from three universities. The questionnaire collected socio-demographic characteristics, Mpox-related knowledge, information sources, attitudes, preventive practices, perceived risk, and vaccination willingness. Knowledge was summarized using a three-item score; adequate knowledge was defined as a score of at least 2 out of 3. Two multivariable logistic regression models were fitted: one for adequate Mpox-related knowledge and one for willingness to receive Mpox vaccination. Results: The final descriptive dataset included 482 respondents. Most participants were female (66.8%), from urban areas (80.5%), and aged 17–18 years (61.6%). Only 217 students (45.0%) had previously heard about Mpox, 193 (40.0%) correctly identified rash as the main symptom, and 179 (37.1%) knew that vaccination against Mpox exists. Adequate knowledge was observed in 201 students (41.7%), while only 150 students (31.1%) were willing to receive Mpox vaccination. In the multivariable model, adequate knowledge was independently associated with studying at Marat Ospanov West Kazakhstan Medical University (aOR = 5.66; 95% CI: 2.95–10.84), use of medical websites as an information source (aOR = 1.71; 95% CI: 1.09–2.69), and following infectious disease news (aOR = 2.81; 95% CI: 1.76–4.48). Vaccination willingness was independently associated with considering Mpox a dangerous infectious disease (aOR = 2.04; 95% CI: 1.11–3.77) and perceiving Mpox as a threat to Kazakhstan (aOR = 2.16; 95% CI: 1.30–3.59). Conclusions: Mpox-related knowledge among university students in Aktobe was limited, while vaccination willingness remained low despite moderate perceived risk. Reliable information exposure improved knowledge, whereas vaccination willingness was more strongly associated with perceived disease threat. These findings support university-based health literacy, vaccine literacy, and risk communication interventions aimed at improving preparedness for emerging infectious diseases. Full article

Background/Objectives: Middle-aged Korean women (aged 40–65 years) face compounded physiological and psychosocial health burdens, yet controlled evidence for non-pharmacological interventions in this population remains limited. This systematic review and meta-analysis aimed to quantify the effects of forest therapy on health-related outcomes in middle-aged Korean women and to identify program characteristics associated with differential therapeutic effects. Methods: Ten databases were searched for controlled studies published from January 2000 to February 2025 following PRISMA 2020 and PICOTS-SD criteria; only controlled studies conducted in Korea were included in the meta-analysis. Of 9563 records screened, 24 controlled Korean studies (RCT, n = 13; NRCT, n = 11; k = 128 effect sizes) met inclusion criteria. A three-level random-effects model with robust variance estimation (RVE) was used as the primary analysis. Results: The primary three-level RVE model, applied to 24 controlled Korean studies, yielded a pooled Hedges’ g = 0.596 (95% CI: 0.432–0.760); a supplementary standard random-effects model yielded g = 0.542 (95% CI: 0.420–0.664). Substantial heterogeneity and potential publication bias were observed; overall evidence certainty was rated Low (GRADE). Conclusions: These findings provide preliminary, low-certainty evidence (overall GRADE: Low) that forest therapy may benefit middle-aged Korean women. They do not justify broad clinical or policy adoption at present. High-quality, independently conducted international RCTs and standardized trials outside Korea are required to confirm and generalize these findings. Full article

Background/Objectives: Drug supply disruptions represent an increasingly serious problem for health systems worldwide, with systemic antibiotics among the most frequently affected therapeutic categories. Although regulatory authorities have repeatedly signaled this risk, comparative studies analyzing patterns of antibiotic shortages across multiple countries simultaneously remain scarce. Methods: We performed a cross-sectional comparative analysis based on data from public national shortage registries in seven jurisdictions: Belgium, France, Germany, Romania, Spain, the United States (FDA), and the Kingdom of Saudi Arabia. All records corresponding to systemic antibiotics in ATC group J01 were extracted, harmonized, and analyzed, with the active substance (INN) as the unit of analysis. The association between critical drug status according to the EMA list and the multinational recurrence of shortages was assessed using chi-square tests, the Mann–Whitney U test, and multivariate logistic regression. To verify the robustness of the results, a sensitivity analysis was also performed using alternative thresholds for jurisdictions. Results: A total of 350 shortage records were mapped, corresponding to 64 unique active pharmaceutical ingredients. On average, each active substance was reported as out of stock in 3.48 jurisdictions (SD = 1.46). Macrolides (J01F) and quinolones (J01M) exhibited the widest geographic spread of shortages. Antibiotics included on the EMA’s list of critical medicines were reported as missing in multiple countries simultaneously significantly more frequently than those not included on this list (82.86% vs. 37.14%; χ² = 71.99, p < 0.001; Cramer’s V = 0.454). In the multivariate logistic regression model, EMA critical medicine status remained an independent predictor of multinational recurrence of shortages (OR = 8.29; 95% CI: 4.93–13.94; p < 0.001), while the injectable route of administration did not reach the threshold for statistical significance (OR = 0.78; p = 0.341). Sensitivity analysis confirmed that this association remains statistically significant regardless of the threshold chosen. Conclusions: Shortages of systemic antibiotics tend to occur simultaneously in multiple countries, and drugs designated as critical by the EMA are disproportionately affected. The results suggest that the identified weaknesses are not specific to a single health system but reflect structural fragilities in international antibiotic supply chains. This underscores the need for internationally coordinated strategies, both for monitoring the availability of essential antibiotics and for preventing and managing shortages. Full article

Background: Sexually transmitted infections (STIs) remain a major public health concern among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA). Although routine STI screening is essential for early diagnosis and prevention, uptake among AGYW is often suboptimal and influenced by multiple individual and contextual factors. This study assessed factors associated with STI screening uptake among AGYW enrolled in HIV prevention programs in Namibia. Methods: A secondary analysis of anonymized programmatic data was conducted among AGYW aged 15–24 years who received services through the DREAMS project and REACH PHN activity between 2018 and 2024. Descriptive statistics, Chi-square tests, and multivariable logistic regression analyses were performed to identify factors associated with STI screening uptake. Results: A total of 26,689 AGYW were included in the analysis, of whom 97.2% were screened for STIs. STI screening uptake was significantly associated with district of residence, year of enrolment, inconsistent or no condom use, perceived risk of HIV infection, use of family planning, and having had sex under the influence of alcohol or drugs. AGYW who perceived themselves to be at risk of HIV and those using family planning methods had higher odds of STI screening, while those who reported sex under the influence of alcohol or drugs were less likely to be screened. Significant geographic disparities in screening uptake were also observed across districts. Conclusion: STI screening uptake among AGYW enrolled in HIV prevention programs in Namibia was high. While this may reflect the effectiveness of integrated, community-based service delivery models, the results should be interpreted with caution, as they are based on a convenience sample. However, behavioural and geographic disparities persist. Strengthening integrated sexual and reproductive health services, addressing substance-related barriers, and implementing targeted district-level interventions may further improve equitable access to STI screening among AGYW. Full article

Food allergy (FA) is an increasing public health concern, highlighting the urgent need for safe, bioactive-based preventive strategies. This study evaluated genistein, a plant-derived isoflavone, in an ovalbumin (OVA)-induced murine FA model. Genistein was administered before sensitization and throughout allergy induction. Clinical symptoms, rectal temperature, diarrhea, OVA-specific antibodies, mast cell responses, intestinal barrier markers, gut microbiota, short-chain fatty acids (SCFAs), and fecal metabolites were assessed using immunological, histological, microbiome, and metabolomic analyses. Genistein pretreatment prevented OVA-induced clinical symptom scores, rectal temperature decline, diarrhea occurrence, OVA-specific antibody responses, and mast cell responses. These changes were accompanied by preservation of jejunal tight junction-related markers and modulation of T-cell-associated immune responses. In vitro, genistein modulated antigen uptake, maturation-associated features of bone marrow-derived dendritic cells (BMDCs), and BMDC-driven CD4⁺T-cell polarization. In parallel, genistein-pretreated mice showed altered gut microbial structure, higher relative abundances of selected SCFA-associated taxa, increased fecal butyrate, and fecal metabolomic alterations involving purine metabolism, bile-acid-related metabolism, and tryptophan-related microbial metabolites. Consistently, correlation analyses indicated associations among microbial taxa, metabolites, immune indicators, and intestinal barrier markers. Together, these findings provide preliminary mechanistic insight into genistein in experimental FA and support further investigation of genistein as a dietary bioactive candidate for FA prevention. Full article

Background: Multimodal rehabilitation represents standard practice in musculoskeletal care, where exercise therapy is routinely combined with manual therapy, electrotherapy, education, and cognitive–behavioral strategies. However, research has largely evaluated these modalities in isolation, and no bibliometric synthesis has characterized multimodal rehabilitation despite its predominance in routine practice. Objective: To characterize global research activity, thematic clusters, and diagnostic patterns underpinning multimodal musculoskeletal rehabilitation and to examine their alignment with contemporary rehabilitation guidelines and practice models. Methods: A bibliometric and altmetric analysis was performed using Web of Science Core Collection (1989–2026). Studies indexed under exercise therapy, manual therapy, electrotherapy, education, and cognitive–behavioral approaches were included. Network analyses (co-occurrence, co-authorship, thematic evolution, and bibliographic coupling) were conducted using Bibliometrix and VOSviewer. Diagnostic subgroups included osteoarthritis, low back pain, chronic musculoskeletal pain, tendinopathy, and shoulder disorders. Results: A total of 409 publications were identified. Five multimodal combinations were recurrent: exercise + education, exercise + cognitive–behavioral therapy, exercise + manual therapy, exercise + electrotherapy, and mixed multimodal programs. Diagnostic subgrouping showed distinct patterns, with osteoarthritis and low back pain clustering around exercise + education, chronic musculoskeletal pain around exercise + CBT/self-management, and tendinopathy/shoulder disorders around exercise + manual therapy. Temporal analyses demonstrated a shift from unimodal electrophysical agents toward guideline-aligned biopsychosocial models. Altmetric signals suggested relevant dissemination and policy attention. Conclusions: Multimodal musculoskeletal rehabilitation is research-intensive, diagnosis-specific, and aligned with guideline recommendations prioritizing exercise, education, self-management, and behavioral strategies. These findings support multimodal rehabilitation as a maturing evidence-based practice model with implications for pragmatic trials, guideline implementation, and clinical service delivery. Beyond research implications, these patterns are relevant for musculoskeletal care pathways, training of rehabilitation professionals and health system planning. Full article

Vaccination stands as a preeminent public health measure in the fight against infectious diseases, with a proven track record of significantly reducing morbidity and mortality rates. However, the presence of vaccine hesitancy and misinformation, particularly evident during the course of the pandemic, has emerged as a significant challenge. The present study analyzes public perceptions of vaccination by examining YouTube comments on 215 vaccine-related videos, which total over 94,000 comments. Employing advanced topic modeling techniques, such as Hierarchical Dirichlet Process (hLDA), Latent Semantic Analysis (LSA), and Non-Negative Matrix Factorization (NMF), the study identifies key themes, including vaccine safety, side effects, pharmaceutical ethics, and public trust in healthcare authorities. The findings indicate that debates frequently center on political, social, and scientific concepts. Vaccine hesitancy has emerged as a pervasive global phenomenon that transcends cultural boundaries. The dissemination of misinformation regarding the efficacy of vaccines and the safety of treatments, such as ivermectin, is a prevalent phenomenon on social media platforms. This poses significant challenges to public health efforts. The subjects of child vaccination and parental standpoints are also recurring topics of concern. This study underscores the pivotal function of digital platforms such as YouTube in influencing public attitudes regarding vaccination. This underscores the necessity for targeted communication strategies, advanced digital literacy, and proactive policies by social media platforms to address misinformation and promote evidence-based information. Such precautions are imperative to sustaining elevated vaccination rates and safeguarding public health in the digital age. Full article

Hantaviruses are emerging zoonotic pathogens responsible for two severe clinical syndromes: (i) haemorrhagic fever with renal syndrome (HFRS) and (ii) hantavirus cardiopulmonary syndrome (HCPS), collectively causing more than 200,000 human cases annually worldwide. Despite their public-health importance, the molecular mechanisms governing the host response and the population-level dynamics of rodent-to-human spillover remain incompletely characterised. The timeliness of this framework is underscored by the April–May 2026 outbreak of Andes orthohantavirus aboard the MV Hondius cruise ship, the first such cluster in a maritime setting, with three deaths reported across multiple countries. This event revealed critical gaps in existing models that treat humans solely as dead-end spillover hosts. Our coupled Susceptible-Exposed-Infectious-Recovered-Dead (SEIRD) model assumes no human-to-human transmission and is therefore designed for hantavirus strains where spillover does not lead to secondary human cases, specifically Hantaan virus (HTNV), Puumala virus (PUUV), Sin Nombre virus (SNV), and Dobrava-Belgrade virus (DOBV). The Andes virus (ANDV) outbreak aboard the MV Hondius is used as a real-world case study to assess the boundaries of our model and to motivate future extensions, not as a direct validation target for its quantitative predictions. Here, we present an integrated computational study combining three complementary analyses. First, we performed a preliminary phylogenetic analysis of the viral sequence, identifying Orthohantavirus andesense as the likely etiological agent responsible for the vessel-associated outbreak. Second, we carried out a downstream transcriptomic analysis of Hantaan virus (HTNV)-infected human umbilical vein endothelial cells (HUVECs), using publicly available RNA-seq data (GEO accession GSE133751, $n=3$ per group). This analysis identified 184 upregulated and 19 downregulated genes, highlighting a transcriptional response dominated by interferon-stimulated genes (ISGs), including CXCL10, CXCL11, MX2, DDX58, IRF7, STAT1, OASL, and CMPK2. We then constructed a protein–protein interaction (PPI) network using STRING, comprising 176 nodes and 3210 edges, and applied a composite network centrality score to rank putative regulatory hubs. This analysis identified ISG15, IRF1, CXCL10, STAT1, and DDX58 as the most central nodes. Pathway enrichment analysis confirmed a strong activation of interferon signalling (Reactome, $p=1.3\times {10}^{-63}$), antiviral defence mechanisms (Gene Ontology, $p=3.8\times {10}^{-58}$), and NF-$\kappa$B-related pathways, together with a concurrent suppression of ribosomal translation. Finally, we developed a coupled SEIRD epidemiological model that explicitly represents rodent-to-rodent and rodent-to-human transmission with logistic rodent population growth. Preliminary simulation analysis demonstrates that reducing human exposure to rodent excreta is substantially more effective than rodent population control alone for reducing human disease burden, and that rodent control in isolation can paradoxically increase human cases through a dilution-like effect. The integrated framework provides molecular and epidemiological insights relevant to hantavirus surveillance, therapeutic target identification, and public-health intervention design. Full article

Obesity is a major public health concern because of its high prevalence and association with cardiometabolic comorbidities. This study compared nine ensemble and meta-ensemble learning models for multiclass obesity-status classification using the Obesity Dataset, comprising 1610 records, 14 predictors, and four body-weight status classes. To ensure a leakage-aware evaluation, all preprocessing and resampling steps were embedded within the validation workflow. Standardization, one-hot encoding, and RandomOverSampler were applied only within the training folds; SMOTE and no-resampling configurations were retained as configurable alternatives but were not used to generate the reported results. Model performance was assessed using complementary classification, discrimination, agreement, and calibration metrics, including accuracy, balanced accuracy, weighted F1-score, macro F1-score, weighted ROC-AUC, Matthews correlation coefficient, Brier score, and multiclass expected calibration error. Overall, the ensemble models achieved strong discriminative performance, with eight of nine classifiers exceeding 82% accuracy and obtaining weighted ROC-AUC values close to or above 94%. LightGBM showed the strongest mean metric-based profile, with an accuracy of 85.41 ± 2.85%, weighted F1-score of 85.25 ± 2.88%, weighted ROC-AUC of 95.58 ± 1.52%, and MCC of 0.779 ± 0.042. Random Forest and Stacking achieved comparable classification performance, although Stacking presented poorer calibration. The Friedman test detected significant global differences among classifiers, χ² = 38.7733, p = 0.000005. However, the Nemenyi post hoc test indicated that Stacking, Random Forest, LightGBM, Voting, Gradient Boosting, and Extra Trees belonged to the same high-performance statistical group. Therefore, LightGBM was selected as the final model based on its practical balance of predictive performance, calibration behavior, stability, and implementation feasibility, rather than on unequivocal statistical superiority. On the independent holdout set, LightGBM maintained strong generalization, achieving accuracy = 0.8447, weighted F1-score = 0.8435, MCC = 0.7653, and weighted ROC-AUC = 0.9464. Calibration was moderate, with Brier score = 0.2575 and multiclass ECE = 0.1070, indicating that predicted probabilities should be interpreted cautiously when used to support threshold-based decisions. Full article

Tree-based machine learning (ML) models offer a powerful classification framework for rapidly screening groundwater for heavy metal contamination and associated health risks. This study applies several tree-based algorithms to classify groundwater samples from the Jamshedpur Township area, Jharkhand, India, as safe or unsafe with respect to selected heavy metals, using physicochemical parameters as predictors and WHO/BIS limits as class thresholds. Groundwater samples collected from shallow and deeper wells were analyzed for pH, EC, TDS, and heavy metals such as As, Pb, Cd, Cr, Ni, Cu, Zn, Fe and Mn, and compared with drinking water standards to define binary class labels. Groundwater samples were classified into safe and unsafe categories based on WHO/BIS standards and health risk thresholds (HI > 1, CR >${10}^{-4}$). Health risk assessment indicated significant non-carcinogenic and carcinogenic risks, particularly among children. Decision Tree, Random Forest, Gradient Boosting, and an Optimized Forest-type ensemble were trained and evaluated using accuracy, precision, recall, F1-score, and ROC–AUC, supported by confusion matrices. The Optimized Forest and Random Forest models yielded the highest classification performance, achieving high recall for unsafe samples, which is critical for public health screening, while feature importance analysis highlighted EC, TDS, pH, and specific ions as key predictors. The results indicate that tree-based ML models using routinely measured water quality parameters can serve as efficient decision-support tools for rapid identification of heavy metal risk zones in Jamshedpur Township and similar industrial urban environments. Full article

Background: Influenza vaccination uptake among healthcare professionals remains suboptimal despite their key role in influencing public vaccination behavior. This study investigated motivational and behavioral determinants of influenza vaccination uptake and advocacy among primary healthcare professionals in Greece. Methods: A cross-sectional study was conducted among 304 physicians and pharmacists using an anonymous online questionnaire. Vaccination uptake (2023–2024 season and annual) and motivational and advocacy constructs were assessed using the validated MoVac-flu and MovAd scales. Factor structure was evaluated using confirmatory and exploratory factor analyses. Multivariable logistic regression models were applied to identify predictors of vaccination uptake. Results: The study sample consisted of 304 healthcare professionals of whom 61.2% were physicians and 38.8% were pharmacists. More than half of the participants were female (52.6%) and aged 41–60 years (57.6%). Influenza vaccination uptake was 77.6% for the 2023–2024 season and 75.3% for annual vaccination. A two-factor structure was identified for the MoVac-flu scale (F1: Vax Self-Care, F2: Vax Awareness), whereas a four-factor structure was identified for the MovAd scale (F1: Vax Communication, F2: Vax Influence, F3: Vax Confidence, F4: Vax Choice). The overall scales demonstrated high internal consistency, while most subscales showed satisfactory to high reliability. Motivation toward influenza vaccination and vaccination advocacy were high among the participants. Vaccinated participants demonstrated higher motivation and vaccination advocacy scores compared with non-vaccinated participants. In multivariable analyses, higher scores on Vax Self-Care (aOR = 3.22, 95% CI: 2.08–4.96, p < 0.001) and Vax Communication (aOR = 1.64, 95% CI: 1.14–2.34, p = 0.007) subscales, reflecting higher motivation and vaccination advocacy, respectively, as well as male sex (aOR = 2.35, 95% CI: 1.14–4.83, p = 0.020) were associated with higher odds of annual vaccination. Higher scores on the Vax Self-Care subscale (aOR = 3.66, 95% CI: 2.33–5.77, p < 0.001) were also found to be associated with higher odds of 2023–2024 vaccination uptake, as well as living with vulnerable individuals (aOR = 2.95, 95% CI: 1.18–7.38, p = 0.020). Conclusions: Influenza vaccination uptake among primary healthcare professionals in Greece was relatively high; however, it was strongly driven by intrinsic motivational factors, particularly the perceived personal and public health benefits of vaccination. Communication-related competencies also independently contributed to vaccination behavior, highlighting the link between professional practice and personal uptake. In contrast, household-related contextual characteristics, such as cohabitation with vulnerable individuals, appeared to exert a less consistent influence on vaccination behavior. These findings suggest that interventions focusing on strengthening intrinsic motivation and communication skills may contribute to sustained improvements in both vaccination uptake and advocacy among healthcare professionals. Full article

Background/Objectives: Psoriasis is a chronic immune-mediated inflammatory disease increasingly recognized as a systemic disorder associated with significant metabolic and cardiovascular comorbidities. Among these, obesity (defined as BMI > 30 kg/m²) plays a pivotal role, acting both as a risk factor for psoriasis development and as a modifier of disease severity, clinical phenotype, and therapeutic response. The relationship between psoriasis and obesity is bidirectional and sustained by shared inflammatory and metabolic pathways. This review aims to provide a comprehensive and updated synthesis of the epidemiological association between psoriasis and obesity, to elucidate the underlying pathophysiological mechanisms, and to discuss the clinical and therapeutic implications of excess body weight in psoriasis management. Methods: A narrative review of the literature was conducted, including epidemiological studies, mechanistic research, clinical trials, and real-world evidence addressing the interplay between psoriasis and obesity. Relevant data were identified from peer-reviewed publications focusing on inflammatory pathways, metabolic dysfunction, cardiovascular risk, and treatment outcomes in obese patients with psoriasis. The graphical figures included in this manuscript were created with the assistance of a large language model–based image-generation tool, ChatGPT-5 by OpenAI, using author-defined prompts. The prompts requested schematic medical illustrations summarizing the pathophysiological links between obesity and psoriasis, including adipose tissue dysfunction, adipokine imbalance, systemic inflammation, and activation of the IL-23/Th17 axis. For the therapeutic algorithm, the prompt requested a stepwise clinical flowchart for obese patients with psoriasis, including BMI assessment, comorbidity screening, universal weight-management measures, psoriasis severity stratification, obesity-adapted biologic selection, and management of suboptimal response. The generated images were subsequently reviewed, edited, and approved by the authors to ensure scientific accuracy, clarity, and consistency with the manuscript content. Results: Epidemiological evidence consistently demonstrates a higher prevalence of obesity among patients with psoriasis, with obesity independently associated with increased disease severity. Shared mechanisms include adipose tissue–driven cytokine production, dysregulated adipokine secretion, insulin resistance, endothelial dysfunction, and activation of the IL-23/Th17 axis, collectively contributing to systemic inflammation and accelerated atherogenesis. Obesity negatively impacts the efficacy, pharmacokinetics, and long-term drug survival of conventional systemic agents and biologic therapies, leading to suboptimal clinical outcomes. Conclusions: Obesity is a key determinant of psoriasis burden, influencing disease expression, comorbidities, and therapeutic response. Integrating weight reduction strategies into personalized psoriasis management may improve both dermatological outcomes and overall cardiometabolic health, supporting a holistic approach to patient care. Full article

Environmental pollution has emerged as one of the most significant threats to human and ecosystem health, with growing evidence suggesting that chronic exposure to toxic substances may accelerate aging. The concept of gerontogens, toxic compounds capable of accelerating this biological process, has gained increasing attention in toxicological research, particularly in the context of global demographic shifts toward older populations. Current research on gerontogens relies heavily on invertebrate models with short lifespans, such as Caenorhabditis elegans, Drosophila melanogaster, and Saccharomyces cerevisiae, which are valuable for studying conserved mechanisms in aging pathways, but present significant limitations for translational accuracy to many aspects of vertebrate biology. Vertebrate models traditionally employed in toxicology, including mice and zebrafish, require substantially longer experimental timelines and higher financial investments, making lifetime exposure and aging assays particularly challenging. In this context, the turquoise killifish Nothobranchius furzeri emerges as a highly promising vertebrate model for aging toxicology research. Recognized as the shortest-lived vertebrate species maintained under laboratory conditions, N. furzeri reaches sexual maturity within 14 days and displays complete senescence by 4 months of age, at which point individuals are considered elderly, offering a decisive advantage over conventional vertebrate models. Furthermore, its capacity for embryonic diapause enables practical embryo storage, long-distance transport, and synchronized hatching, greatly facilitating experimental designs. Although N. furzeri is well established in gerontological research, with studies addressing hallmarks of aging such as telomere shortening, neurodegeneration, and cellular senescence, its application in ecotoxicology remains remarkably limited, with fewer than 10 published studies to date. This article argues that N. furzeri may represent a critical bridge between toxicology and aging research, offering an efficient and translationally relevant platform for investigating the effects of environmental contaminants on vertebrate aging. Current limitations of the model, such as lack of husbandry standardization, are also discussed. Expanding its use in this field holds considerable potential for advancing evidence-based strategies in public health and environmental conservation related to chronic exposure to contaminants. Full article

Indoor monitoring of biological contamination is essential for protecting cultural heritage and public health. However, conventional culture-based methods limit timely intervention. This study presents an affordable modular multisensor system for indirectly detecting airborne fungal contamination using Penicillium chrysogenum as a representative model organism and its environmental signatures. The proposed prototype integrates PMSA003I, BME688 and AMG8833 sensors and was evaluated under controlled environmental conditions. Biological ground truth was established using a volumetric inertial-impaction sampling protocol (SAS sampler), validating four contamination levels (~6 to 165, CFU/m³). A total of 1989 observations were analyzed. Non-parametric statistical tests (Kruskal–Wallis and Mann–Whitney U) confirmed significant differences between all the exposure conditions ($p<0.001$). Supervised machine learning (ML) models showed strong performance across all the classification tasks, with accuracy and AUC values near 100%. In most cases, pressure alone was sufficient. The statistical and ML analyses consistently identified pressure, particulate-related variables, gas resistance and humidity as the most informative features. Overall, the results indicate that the proposed approach can reliably capture indirect environmental signatures associated with airborne fungal presence under controlled conditions. The study supports the feasibility of low-cost multisensor systems for continuous indoor bioaerosol monitoring while highlighting the need for further optimization and validation in real-world environments. Full article

Background: Surgical operations are an integral part of healthcare delivery and impose a substantial clinical and operational burden. Understanding how the operation- and process-management literature in healthcare reflects the intensity of surgical services and how this may affect the specialization preferences of healthcare professionals is important for strategic workforce planning. Methods: A bibliometric analysis was conducted on 272 academic publications obtained from the Web of Science Core Collection with the keywords “lean philosophy”, “health” and “process” to capture the operational and process-improvement perspective of healthcare services. In this work, the “lean philosophy” keyword was taken to denote the operation- and process-management view of healthcare services, not to reflect the whole literature on surgical intensity. This selection was performed due to the multiple reasons, with an example being that lean-related studies often discuss complexities of workflow, efficiency, organizational responsiveness, and quality optimization, which are aspects also directly linked to surgical operational intensity. The data were analyzed using the bibliometrix R package, R-4.6.0 to construct the keyword co-occurrence network. Based on this network, a cognitive map was designed to visualize the conceptual relationships among the themes. Thematic clusters based on the co-occurrence network were then evaluated and prioritized by using the Analytic Network Process (ANP). Pairwise comparison data were derived from seven experts (surgeons and healthcare managers), and the model was implemented in Super Decisions with consistency ratios below 0.10. Results: The findings of the co-occurrence analysis are five main thematic clusters with surgical intensity themes including Healthcare Services, Quality, Care, Health and Outcomes. The cognitive map shows that Healthcare Services and Quality have the most central positions and structural hubs in the literature, whereas Outcomes is a dimension of great importance in terms of performance. The ANP results show that Quality (limiting weight ≈ 0.21), General Topics (≈0.14) and Management and Leadership (≈0.13) are the most influential sub-themes with regard to surgical operational intensity and, indirectly, to specialization preferences. Conclusions: The findings reveal that quality management, organizational leadership and larger health policy concerns are closely associated with the intensity of operations of surgical services as depicted in the operation- and process-management literature. Healthcare workers might be inclined to relocate to job positions related to quality improvement and leadership in lieu of places with a high direct clinical burden. Such insights can guide the policies of strategic human resource planning and specialization balancing in healthcare systems. Full article