Next generation brain health: transforming global research and public health to promote prevention of dementia and reduce its risk in young adult populations.

Efforts to prevent dementia can benefit from precision interventions delivered to the right population at the right time; that is, when the potential to reduce risk is the highest. Young adults (aged 18-39 years) are a neglected population in dementia research and policy making despite being highly exposed to several known modifiable risk factors. The risk and protective factors that have the biggest effect on dementia outcomes in young adulthood, and how these associations differ across regions and groups, still remain unclear.

Associations between self-reported sleep duration and incident cardiovascular diseases in a nationwide prospective cohort study of Chinese middle-aged and older adults.

Purpose: This study explores the correlation between sleep duration and cardiovascular disease (CVD) among middle-aged and older adults in China. Furthermore, we aim to investigate the association between sleep duration and incident CVD in this population, while assessing potential variations across different age and gender subgroups.

Methods: Utilizing data from the nationwide prospective survey of the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011, 2013, 2015, and 2018, involving 17,596 participants aged 45 years and above, we employed Cox proportional hazards regression models.

Influence of renal function on blood pressure control and outcome in thrombolyzed patients after acute ischemic stroke: analysis of the ENCHANTED trial.

Background: The effect of renal impairment in patients who receive intravenous thrombolysis for acute ischemic stroke (AIS) is unclear. We aimed to determine the associations of renal impairment and clinical outcomes and any modification of the effect of intensive versus guideline-recommended blood pressure (BP) control in the BP arm of the International Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED).

Methods: We conducted a analysis of the ENCHANTED BP arm, which involved 2,196 thrombolyzed AIS patients.

State-wise variation and inequalities in caesarean delivery rates in India: analysis of the National Family Health Survey-5 (2019-2021) data.

Background: India's caesarean delivery (CD) rate of 21.5% suggests adequate national access to CD but may mask significant disparities. We examined variation in CD rates across states (geography), wealth, and health care sector (public versus private).

Artificial intelligence and sexual reproductive health and rights: a technological leap towards achieving sustainable development goal target 3.7.

Target 3.7 of the Sustainable Development Goals (SDGs) aims for universal access to sexual and reproductive health (SRH) services by 2030, including family planning services, information, education, and integration into national strategies. In contemporary times, reproductive medicine is progressively incorporating artificial intelligence (AI) to enhance sperm cell prediction and selection, in vitro fertilisation models, infertility and pregnancy screening.

Effectiveness and feasibility of a theory-informed intervention to improve Mediterranean diet adherence, physical activity and cognition in older adults at risk of dementia: the MedEx-UK randomised controlled trial.

Background: Despite an urgent need for multi-domain lifestyle interventions to reduce dementia risk, there is a lack of interventions which are informed by theory- and evidence-based behaviour change strategies, and no interventions in this domain have investigated the feasibility or effectiveness of behaviour change maintenance. We tested the feasibility, acceptability and cognitive effects of a personalised theory-based 24-week intervention to improve Mediterranean diet (MD) adherence alone, or in combination with physical activity (PA), in older-adults at risk of dementia, defined using a cardiovascular risk score.

Methods: Participants (n = 104, 74% female, 57-76 years) were randomised to three parallel intervention arms: (1) control, (2) MD, or (3) MD + PA for 24 weeks and invited to an optional 24-week follow-up period with no active intervention.

Interaction effects of exposure to air pollution and social activities on cognitive function in middle-aged and older Chinese adults based on a nationwide cohort study.

Background: Although there have been many studies on the relationship between ambient air pollution and cognitive functioning in developed countries, there are no studies focusing on the interaction between ambient air pollution and social activities. This study aims to examine interactive effects of ambient air pollution and social activities on cognitive function in Chinese middle-aged and older.

Methods: This study used nationally representative longitudinal survey data of China Health and Retirement Longitudinal Study (CHARLS) 2013, 2015 and 2018.

A Phase 1 randomized trial of homologous and heterologous filovirus vaccines with a late booster dose.

Filoviruses, including Ebola, Marburg, Sudan, and Taï Forest viruses, are zoonotic pathogens that can cause severe viral hemorrhagic fever and death. Developing vaccines that provide durable, broad immunity against multiple filoviruses is a high global health priority. In this Phase 1 trial, we enrolled 60 healthy U.

Are there any sociodemographic factors associated with non-uptake of HPV vaccination of girls in high-income countries with school-based vaccination programmes? A systematic review.

Background: Uptake of human papillomavirus (HPV) vaccination is generally high in high-income countries with school-based vaccination programmes; however, lower uptake in certain population subgroups could continue pre-immunisation inequalities in cervical cancer.

Methods: Six electronic databases were searched for quantitative articles published between 1 September 2006 and 20 February 2023, which were representative of the general population, with individual-level data on routine school-based vaccination (with >50% coverage) and sociodemographic measures. Titles, abstracts and full-text articles were screened for eligibility criteria and assessed for bias.

Management of adult sepsis in resource-limited settings: global expert consensus statements using a Delphi method.

Purpose: To generate consensus and provide expert clinical practice statements for the management of adult sepsis in resource-limited settings.

Methods: An international multidisciplinary Steering Committee with expertise in sepsis management and including a Delphi methodologist was convened by the Asia Pacific Sepsis Alliance (APSA). The committee selected an international panel of clinicians and researchers with expertise in sepsis management.

potentiation of tetracyclines in by RW01, a new cyclic peptide.

The pipeline for new drugs against multidrug-resistant remains limited, highlighting the urgent need for innovative treatments. New strategies, such as membrane-targeting molecules acting as adjuvants, aim to enhance antibiotic effectiveness and combat resistance. RW01, a cyclic peptide with low antimicrobial activity, was selected as an adjuvant to enhance drug efficacy through membrane permeabilization.

Evaluation of IMPALA 2.0: Addressing Patient Monitoring in Low-Resource Hospitals in Malawi.

BACKGROUND Patient monitoring systems (PMSs) are essential for monitoring and managing the condition of critically ill patients. In low-resource settings, limited access to technology, low-level digital literacy, and power outage challenges are usability concerns. The main aim of this study was to evaluate the usability of the IMPALA (Innovative Monitoring in Paediatrics in Low-resource settings: an Aid to save lives) PMS optimized for use in low-resource settings by assessing the opinions and experiences of 24 healthcare professionals.

Whole grain modified Nova ultra-processed food (UPF) definitions: a cross-sectional analysis of the impact on cardiometabolic risk measures when excluding high whole-grain foods from the UPF category in Australia.

Ultra-processed foods (UPF), defined using the Nova classification system, are associated with increased chronic disease risk. More recently, evidence suggests the UPF subgroup of whole-grain breads and cereals is in fact linked with reduced chronic disease risk. This study aimed to explore associations of cardiometabolic risk measures with Nova UPF intake versus when foods with ≥25% or ≥50% whole grain are excluded from the definition.

Profiles of the maternal occupational exposome during pregnancy and associations with intrauterine growth: analysis of the French Longitudinal Study of Children - ELFE study.

Background: Numerous agents in the workplace are suspected of impairing fetal growth. To date, no epidemiological studies have specifically described the occupational exposome during pregnancy.

Objective: The objectives were to determine maternal occupational exposome profiles and study their associations with intrauterine growth characteristics measured by small for gestational age (SGA), birthweight (BW), and head circumference (HC).

Effect of a spatial repellent on malaria incidence in an area of western Kenya characterised by high malaria transmission, insecticide resistance, and universal coverage of insecticide treated nets (part of the AEGIS Consortium): a cluster-randomised, controlled trial.

Background: Spatial repellent products are used for prevention of insect bites, and a body of evidence exists on spatial repellent entomological efficacy. A new option for vector control, spatial repellent products are designed to release active ingredient into the air for disruption of human-vector contact thereby reducing human exposure to mosquito-borne pathogens. Clinical trials have shown spatial repellent epidemiological efficacy against Aedes-borne viruses but inconclusive outcomes against malaria.

Effectiveness of the primary Bacillus Calmette-Guérin vaccine against the risk of Mycobacterium tuberculosis infection and tuberculosis disease: a meta-analysis of individual participant data.

Background: Tuberculosis vaccine trials using disease as the primary endpoint are large, time consuming, and expensive. An earlier immunological measure of the protection against disease would accelerate tuberculosis vaccine development. We aimed to assess whether the effectiveness of the Bacillus Calmette-Guérin (BCG) vaccine for prevention of Mycobacterium tuberculosis infection was consistent with that for prevention of tuberculosis disease.

International prevalence patterns of low eGFR in adults aged 18-60 without traditional risk factors from a population-based cross-sectional disadvantaged populations eGFR epidemiology (DEGREE) study.

The disadvantaged populations eGFR (estimated glomerular filtration rate) epidemiology (DEGREE) study was designed to gain insight into the burden of chronic kidney disease (CKD) of undetermined cause (CKDu) using standard protocols to estimate the general-population prevalence of low eGFR internationally. Therefore, we estimated the age-standardized prevalence of eGFR under 60 ml/min per 1.73m in adults aged 18-60, excluding participants with commonly known causes of CKD; an ACR (albumin/creatinine ratio) over 300 mg/g or equivalent, or self-reported or measured (HT) hypertension or (DM) diabetes mellitus, stratified by sex and location.

The long-run and intergenerational impact of early exposure to the Great Chinese Famine of 1959-61 on mental health.

We study the effects of early exposure to the Great Chinese Famine on the mental health and subjective well-being of survivors as well as their offspring using data from the 2010 and 2014 waves of the China Family Panel Studies. Our analysis focuses on K6 scores, severe mental illness, and life dissatisfaction. We find that early exposure to the famine has impaired the mental health outcomes of women, but not men (i.

An innovative Community Mobilisation and Community Incentivisation for child health in rural Pakistan (CoMIC): a cluster-randomised, controlled trial.

Background: Infectious diseases remain the leading cause of death among children younger than 5 years due to disparities in access and acceptance of essential interventions. The Community Mobilisation and Community Incentivisation (CoMIC) trial was designed to evaluate a customised community mobilisation and incentivisation strategy for improving coverage of evidence-based interventions for child health in Pakistan.

Methods: CoMIC was a three-arm cluster-randomised, controlled trial in rural areas of Pakistan.

Adaptive Platform Trials in Stroke.

Clinical trials of treatments for stroke have generally utilized 2-arm, randomized designs to evaluate a single intervention against a control. Running separate clinical trials, with each addressing a single therapeutic question, is resource intensive and slows evidence generation, especially in a field with rapidly expanding treatment options and evolving practices. Platform trials-randomized clinical trials designed to evaluate multiple interventions that may enter and exit the ongoing platform based on a master protocol-accelerate the investigation of multiple therapeutic options within a single infrastructure.

Disparities in kidney care in vulnerable populations: A multinational study from the ISN-GKHA.

Vulnerable populations, such as the elderly, children, displaced people, and refugees, often encounter challenges in accessing healthcare. In this study, we used data from the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) to describe kidney care access and delivery to vulnerable populations across countries and regions. Using data from an international survey of clinicians, policymakers, and patient advocates, we assessed the funding and coverage of vulnerable populations on all aspects of kidney replacement therapies (KRT).

Cell-free DNA methylation-based inflammation score as a marker for hepatocellular carcinoma among people living with HIV.

Background: People living with the human immunodeficiency virus (HIV) are at a greater risk of developing hepatocellular carcinoma (HCC), potentially due to the stimulation of inflammation by HIV infection. Inflammation-related DNA methylation signatures obtained in liquid biopsy, such as circulating cell-free DNA (cfDNA), may serve as promising minimally invasive biomarkers that can inform diagnosis of HCC.

Methods: Using data from 249 individuals with HIV (114 individuals with normal liver conditions, 69 with fibrosis, 30 with cirrhosis, and 36 with HCC), we constructed a cfDNA methylation-based inflammation score (inflammation-DNAm score) based on 54 CpGs previously associated with circulating C-reactive protein concentrations.