Search Results (2,032)

Although trap-neuter-return (TNR) is a popular method for managing free-roaming domestic cat populations, a common criticism is that sterilization fails to mitigate the public health risks posed by free-roaming cats. One of these risks is the environmental contamination of Toxoplasma gondii, a parasite that can be spread in the feces of actively infected felids (both domestic and wild). In healthy humans, toxoplasmosis tends to be mild or asymptomatic; however, the disease can have severe consequences (e.g., for pregnant women) and even be fatal in immunocompromised individuals. Previous research has examined the extent to which free-roaming domestic cats might contaminate sites frequented by young children (e.g., schools and parks). However, the model used included several assumptions that are not reflective of sterilized cats in an urban setting (e.g., smaller home range). By properly accounting for several key factors (e.g., reproductive status, home range), our modeling revealed considerably lower rates of potential incursions by sterilized free-roaming cats than those reported previously. More importantly, our results show that sterilization contributes to a considerable reduction in the risk of environmental contamination; TNR therefore appears to be a valuable harm reduction strategy in mitigating the risks of T. gondii infection. Full article

Background/Objectives: Excessive intake of salt, oil, and sugar constitutes a major dietary risk factor for chronic diseases in China. Although salt, oil, and sugar reduction (“Three Reductions”) has been promoted at the national level, the population’s knowledge remains inadequately evaluated. This study aimed to assess the “Three Reductions” knowledge level among Chinese adults and its association with nutrition-related chronic diseases. Methods: Data were obtained from the Chinese Nutrition and Health Knowledge Survey 2022, a nationally representative cross-sectional study. A total of 68,673 participants aged 18–64 years were recruited from 200 survey sites of 31 provinces by multi-stage stratified random cluster sampling methods. A standard questionnaire was used for data collection, and multivariable logistic regression models were employed to examine factors associated with “Three Reductions” knowledge and its relationship with chronic diseases. All analyses were weighted by complex sampling. Results: In 2022, the mean “Three Reductions” knowledge score was 16.43 ± 4.17 (the full score is 24 points), and the awareness rate was 49.3% (95% CI: 47.0–51.6%). Females, those with higher education and income levels, those employed in medical institutions, and residents in urban and eastern areas had higher “Three Reductions” levels (p < 0.05). The “Three Reductions” knowledge level was significantly associated with chronic disease risk (p < 0.05). Specifically, the risk of chronic disease was reduced by 5% in the medium-score group (OR = 0.95, 95% CI: 0.90–1.00) and by 11% in the high-score group (OR = 0.89, 95% CI: 0.84–0.95). Conclusions: “Three Reductions” knowledge among Chinese is at a moderate level, with a significant association between “Three Reductions” knowledge level and chronic disease status. Dissemination of “Three Reductions” knowledge, especially practical knowledge, should be enhanced at the national level through various routes to reduce chronic disease risk. Full article

Emerging infectious diseases, particularly those of zoonotic origin, often originating from wildlife reservoirs represent a growing threat to global health. Human-driven environmental changes such as habitat fragmentation, climate change, and urban expansion have intensified interactions at the wildlife–domestic animal–human interface, facilitating cross-species viral transmission. Despite their epidemiological importance, systematic virological surveillance of wildlife remains challenging. In this study, we employed shotgun metagenomic sequencing to characterize the virome of wild animals rescued in the Pisa area and hospitalized at the “Mario Modenato” Veterinary Teaching Hospital (VTH) at the University of Pisa. Fecal samples collected from injured wildlife admitted between September 2020 and September 2021 were analyzed to detect both known and novel viruses. This approach builds upon previous PCR-based investigations of the same biological material, enabling a more comprehensive assessment of viral diversity. We adopted a shotgun approach for analyzing six sample pools—four were positive for at least one viral target—identifying diverse viral families, including Astroviridae, Circoviridae, Picornaviridae, Adenoviridae, and Retroviridae, in asymptomatic wildlife admitted to a veterinary hospital, highlighting their potential role as reservoirs. Our findings provide insights into the influence of environmental and anthropogenic factors on wildlife virome composition and highlight the value of hospital-based sampling strategies for urban viral surveillance. The results contribute to the development of integrated monitoring and prevention strategies within a One Health framework. Full article

Background: Cervical cancer is considered to be a global health challenge, particularly in low- and middle-income countries. Romania reports one of the highest burdens in Europe due to limited access to screening and HPV vaccination. Chemoradiotherapy is standard for locally advanced disease, but the impact on quality of life (QoL) for a low- and middle-income population has not yet been explored. This study aims to evaluate the effect of chemoradiotherapy on the QoL of cervical cancer survivors in the Romanian population. Methods: This prospective observational study included 111 patients with stage I–IV cervical cancer undergoing chemoradiotherapy. QoL was assessed using the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire before, during, and after treatment. Demographic and clinical data were collected. The statistical analyses included t-tests, ANOVA, and linear mixed-effects models to evaluate changes over time and the influence of sociodemographic and treatment-related factors. Results: FACT-G scores significantly increased after treatment, with improvements in physical and functional well-being. Better before-treatment QoL was associated with urban residence, early-stage disease, marital status, and higher education. Among treatment toxicities, only nausea had a statistically significant negative effect on QoL during treatment, while other toxicities showed no significant impact. Conclusions: Chemoradiotherapy in cervical cancer patients was not associated with a substantial deterioration in quality of life during treatment and was followed by significant improvement after therapy completion. These findings highlight a favorable short-term QoL trajectory and emphasize the need for longitudinal studies to assess whether such benefits are maintained over the long term. Full article

Urban greenspace exposure associates with improved health outcomes, particularly chronic disease mitigation. Based on the need to characterize spatial heterogeneity in the health benefits of urban greenspaces, this study quantified the association between greenspace accessibility and chronic disease mortality in London, while examining the modulating effects of urbanization and age. Utilizing nighttime light (NTL) data to define urbanization gradients and road-network analysis to measure greenspace accessibility, we applied geographically weighted regression (GWR) across 983 neighborhoods. Key findings reveal that over 60% of central London residents live within 300 m of greenspace, yet 20% fall short of WHO standards. Greenspace accessibility showed significant negative associations with standardized mortality ratios for both cancer (β = −0.0759) and respiratory diseases (β = −0.0358), and this relationship was more pronounced in highly urbanized areas and neighborhoods with higher working-age populations. Crucially, central urban zones show amplified effects: a 100 m accessibility improvement was associated with a potential reduction in cancer deaths of 1.9% and in respiratory disease deaths of 2.4% in high-sensitivity areas. Urbanization levels and working-age population proportions exert significantly stronger moderating effects on greenspace–respiratory disease relationships than on cancer outcomes. While observational, our findings provide spatially explicit evidence that the greenspace–mortality relationship is context-dependent. This underscores the need for precision in urban health planning, suggesting interventions should prioritize equitable greenspace coverage in highly urbanized cores and tailor functions to local demographics to optimize potential co-benefits. This study reframes understanding of greenspace health benefits, enhances spatial management precision, and offers models for healthy planning in global high-density cities. Full article

Background: Endometrioid ovarian carcinoma is a subtype of epithelial ovarian carcinoma and is the second most common type of malignant ovarian neoplasm. Studies investigating delayed treatment of ovarian cancer have identified significant impacts on overall survival rates. This study utilizes the Surveillance, Epidemiology, and End Results (SEER) database to identify cases of endometrioid ovarian carcinomas and factors associated with delays in time to treatment (TTT) greater than one month. Methods: The SEER database was queried to identify females with biopsy-confirmed cases of ovarian endometrioid carcinoma from 2010 to 2015. Chi-square tests, two-sided Fisher’s exact tests, and multivariable binary logistic regressions were completed using SPSS version 29.0.2. Statistical significance was confirmed when p < 0.05. Results: A total of 11,235 relevant patients were identified within the SEER database. A majority were Non-Hispanic White (69.2%), aged 50–59 (30.1%), had an annual income of $75,000+ (58.9%), resided in urban communities (90.0%), and were diagnosed with AJCC stage 1 disease (62.0%). When investigating treatment, 94.9% of patients received treatment within 1 month of diagnosis, while 5.1% experienced a delay of over 1 month before starting treatment. Multivariable binary logistic regression analysis demonstrated that American Indian and Alaksa Native (AIAN) patients independently experienced a +376% increased likelihood of treatment delays exceeding 1 month (aOR 4.76; 95% CI 1.32–17.08; p = 0.017). Patients diagnosed at AJCC stage III (aOR 1.88; 95% CI: 1.22–2.91; p = 0.004) or stage IV (aOR: 4.50; 95% CI: 2.75–7.38; p < 0.001) additionally had +88% and +350% higher odds of treatment delays greater than 1 month, respectively. Conclusions: AIAN patients and those presenting with later stage disease for endometrioid ovarian carcinoma face significantly longer TTT, indicating disparities in timely care. Our findings demonstrate an urgent need for targeted interventions to address systemic barriers contributing to delayed treatment in these populations. Full article

Background: Although the expansion of medical resources has largely alleviated challenges of “more diseases but fewer medicines”, the growing urbanization and rapid aging in China have led to increasing demands of healthcare services in metropolitan cities. The uneven distribution of medical facilities makes services unequal for residents in the city. To achieve fair and rapid access to medical services, healthcare accessibility and equity have become key concerns. The introduction of tele-health, i.e., online visits or digital health, can help balance the distribution of medical resources to improve accessibility and equity, particularly for elderly patients with chronic diseases. Methods: To quantitatively assess the spatial accessibility of healthcare facilities, an improved two-step floating catchment area method with tele-health (i2SFCA-TH) is proposed to study the demand–supply ratio by considering traveling time, chronic diseases, and online visits based on services provided by community and tertiary hospitals. An optimization model using mixed-integer programming to maximize average accessibility under resource constraints could help improve overall accessibility and reduce differences in access among all residential divisions to achieve better equity in the region. Results: By applying the method in a metropolitan city in China, it is observed that the overall spatial accessibility of residential divisions in the city is 0.72, but the gap between the highest and the lowest reaches 2.36; i.e., significant differences exhibit due to uneven allocation of medical resources. By introducing tele-health, the gaps of access among different divisions can be decreased, with the largest gap reduced to 1.49, and the accessibility in divisions with poor medical resource allocation can be increased. Finally, the mean healthcare accessibility and equity in the study region can be improved to 0.75. In addition, it is shown that proper management of medical resources and patients’ willingness to accept online visits could help improve accessibility and equity, which can provide insights for hospital management and urban planning. Conclusions: An integrated framework to quantitatively assess and optimally improve healthcare accessibility and equity of medical resource allocation through tele-health is presented in this paper. An i2SFCA-TH method and an optimization model are used in the framework, which provides hospital management and urban planners a quantitative tool to improve accessibility and equity in metropolitan cities in China and other countries. Full article

Type 2 Diabetes (T2D) is a prevalent metabolic disease with a strong association with cardiovascular complications. This study evaluated glycemic control and lipid profiles (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides) in patients with T2D, based on glycated hemoglobin and fasting glucose levels, through a cross-sectional analysis of 4814 individuals (mean age: 66.2 ± 16.07 years with normal distribution; 51.5% male) from the Hospital Universitario Lucus Augusti in Northwest Spain. The aim was to assess the metabolic differences and potential influences of age, sex, and geographic setting. We observed that patients with T2D had lower low-density lipoprotein cholesterol, but higher triglycerides and high-density lipoprotein cholesterol levels compared to patients without T2D. A positive correlation was found between age and fasting glucose levels (r = 0.182; p < 0.05), with the highest glucose concentrations occurring in postmenopausal women. No significant differences were observed between rural and urban participants. These findings support the integration of targeted nutritional strategies and education programs in the clinical management of T2D, particularly in older adults. Full article

This study aims to develop, implement, and evaluate an Early Warning System (EWS) to alert communities and government agencies in KwaZulu-Natal, South Africa, about extreme weather events (EWEs) and related disease outbreaks. The project focuses on eThekwini and Ugu municipalities, using a participatory, co-creation approach with communities and health providers. A systematic review will be undertaken to understand the impact of climate change on disease outbreaks and design an EWS that integrates data from rural and urban healthcare and environmental contexts. It will assess disease burden at primary healthcare clinics, examine health needs and community experiences during EWEs, and evaluate health system resilience. The project will also evaluate the design, development, and performance of the EWS intervention, including its implementation costs. Ethical approval will be sought, and informed consent obtained from participants. Based on the findings, recommendations will be made to the Department of Health to enhance early warning systems and health system resilience in response to EWEs and disease outbreaks. Full article

Background: Non-communicable diseases (NCDs) have become a major threat to global public health, with the disease burden particularly severe in developing countries, China being one of them. The preventive and control effects of traditional treatment methods on NCDs are limited, and innovative strategies are urgently needed. In recent years, vaccine technology has expanded from the field of infectious diseases to non-communicable diseases (NCDs). Therapeutic vaccines have shown the potential to intervene in chronic diseases through immunomodulation, but their research and development (R & D), as well as promotion, still face multiple challenges. Methods: This article systematically reviews the current development status of NCD vaccines worldwide and points out the imbalance in their matching with disease burden: current research focuses on the field of cancer, while there is a lack of targeted vaccines for high-burden diseases such as hypertension and chronic kidney disease; the progress of independent R & D in China lags behind, and there are implementation obstacles such as uneven distribution of medical resources between urban and rural areas and low public willingness to be vaccinated. Results: By analyzing the biological mechanisms of NCD vaccines and non-biological challenges, phased solutions are proposed: In the short term, focus on target discovery and improvement of vaccine accessibility. In the medium term, strengthen multi-center clinical trials and international technology sharing. In the long term, build a digital health monitoring system and a public–private partnership financing model. Conclusions: The breakthrough of NCD vaccines requires interdisciplinary collaboration and systematic policy support. Their successful application will reshape the paradigm of chronic disease prevention and control, providing a new path for global health equity. Full article

Infectious disease modeling and forecasting tools are crucial for outbreak management. However, variability exists in the capacity of state and local health departments to effectively utilize these tools, influenced by factors such as infrastructure, funding, staff capacity, and data access. This study aims to identify the current priorities, needs, and capacities of state and local public health departments regarding infectious disease modeling and forecasting tools. Key informant interviews were conducted with epidemiologists, informaticists, and leadership across state and local health departments from Montana, Utah, and Washington. Thematic coding and axial coding were used for thematic analysis. Three themes emerged: (1) models and tools must be adaptable based on the jurisdiction type (rural, urban, state); (2) building trust in models and tools is an important precursor to adoption; and (3) there are concerns about the availability and quality of data. This study highlights the need for adaptable modeling tools that are tailored to specific public health jurisdictions. Building trust in modeling and forecasting tools and addressing data quality issues are essential for successful tool implementation and adoption across diverse public health settings. Full article

The objective of this study was to estimate the seroprevalence of Ehrlichia canis in clinically suspect dogs in the Laguna Region of Coahuila, Mexico, and to analyse its association with several clinical, haematological, and social variables. The present study focuses on the veterinary care provided to a total of 249 dogs during the period from August 2023 to November 2024. The implementation of an immunochromatographic test was undertaken for the purpose of antibody detection. The observed seroprevalence was 63.9% (n = 156). Firstly, statistically significant associations were identified with clinical haemorrhagic signs (77.33%; OR = 5.03; p < 0.001), anaemia (81.25%; OR = 4.17; p < 0.001), and thrombocytopenia (96.26%; OR = 43.24; p < 0.001). Secondly, rural dogs exhibited a higher prevalence (70.54%) compared to urban dogs (54.17%), which was found to be statistically significant (p < 0.01). Multivariate analysis and logistic regression identified thrombocytopenia as the most robust predictor. The findings emphasise the substantial circulation of Ehrlichia canis in the region, thereby reinforcing the clinical significance of haemorrhagic manifestations and haematological parameters as diagnostic tools in low-resource settings. The implementation of epidemiological surveillance, vector control, and community education programmes is recommended in order to reduce the impact of this disease on animal and public health. Full article

Urban landscapes have given rise to novel ecosystems (e.g., green areas), which differ in design and ecological quality depending on local planning strategies. Europe has the goal to increase conservation through increasing greenspace; however, urban wildlife health impacts, particularly on birds, are poorly studied. This study investigates associations between haemosporidians and intestinal coccidia in the Eurasian Tree Sparrow (Passer montanus), as well as their body condition and immunological status, from five urban green areas in Madrid, Spain, from 2019 to 2022. These green areas differ in green infrastructure, and because these birds are adapted to urban environments, they are a good model to evaluate how green area infrastructure may affect the birds’ health. We detected a 29% prevalence of haemosporidians (Haemoproteus being the most common, followed by Leucocytozoon and Plasmodium) and a 4% prevalence of intestinal coccidia. We found that haemosporidian prevalence was significantly higher in green areas with untreated stagnant water surrounded by muddy areas, ideal conditions for vector reproduction. Therefore, effective management strategies, especially related to water treatment, are essential for protecting urban wildlife and human health. This study provides valuable information for researchers and urban wildlife managers to incorporate appropriate management strategies into urban green area planning to preserve urban biodiversity and protect public health. Full article

Climate change and air pollution are associated with a range of health outcomes, including cardiovascular and respiratory disease. Evaluation of the synergic effects of air pollution and increasing natural temperature on mortality is important for understanding their potential joint health effects. In this study, the modification effects of air temperature on the short-term association of ambient fine particulate matter (PM_2.5) and ozone (O₃) with non-accidental death (NAD) and cardiovascular disease (CVD) mortality were evaluated by using the generalized additive model (GAM) combined with the distributed lag nonlinear model (DLNM) in urban areas of Taiyuan, a representative of energy and heavy industrial cities in Northern China. The data on the daily cause-specific death numbers, air pollutants concentrations, and meteorological factors were collected from January 2013 to December 2019, and the temperature was divided into low (<25th percentile), medium (25–75th percentile), and high (>75th percentile) categories. Significant associations of PM_2.5 and O₃ with NAD and CVD mortality were observed in single-effect analysis. A statistically significant increase in the effect estimates of PM_2.5 and O₃ on NAD and CVD mortality was also observed on high-temperature days. But the associations of those were not statistically significant on medium- and low-temperature days. At the same temperature level, the effects of PM_2.5 and O₃ on the CVD mortality were larger than those on NAD (1.74% vs. 1.21%; 1.67% vs. 0.57%), and the elderly and males appeared to be more vulnerable to both higher temperatures and air pollution. The results suggest that the acute effect of PM_2.5 and O₃ on NAD and CVD mortality in urban Taiyuan was enhanced by increasing temperatures, particularly for the elderly and males. It highlights the importance of reducing PM_2.5 and O₃ exposure in urban areas to reduce the public health burden under the situation of global warming. Full article

Background: The COVID-19 pandemic magnified long-standing health disparities in the United States, particularly among rural, disadvantaged populations. These communities experience greater barriers to healthcare access, a higher prevalence of chronic illness, and increased vaccine hesitancy factors that collectively contribute to poorer health outcomes. Methods: This narrative review examines rural–urban disparities in COVID-19 vaccine uptake and their impact on mortality, with a focus on cardiovascular disease (CVD) outcomes. We synthesized the peer-reviewed literature, CDC data, and U.S. Census reports to assess factors contributing to vaccine hesitancy, vaccination coverage, COVID-19-related mortality, and CVD mortality trends. Results: Rural residents were less likely to initiate COVID-19 vaccination, showed greater vaccine hesitancy, and experienced higher rates of both COVID-19 and CVD mortality. These disparities were further driven by safety concerns surrounding mRNA technology, misinformation, infrastructural barriers, and sociodemographic factors including political affiliation, education, poverty, and religion. Notably, pre-existing CVD increased vulnerability to severe COVID-19 outcomes in rural communities. Conclusions: Expanding vaccination efforts and improving healthcare infrastructure are essential for addressing these widening health inequities. Future public health strategies should prioritize culturally tailored interventions and rural-specific outreach to reduce vaccine hesitancy and improve mortality outcomes in underserved populations. Full article