Public Health and Healthcare

Abstract: Background: After more than four years of the COVID-19 pandemic, the long COVID syndrome (LC) still affects a considerable population, and factors associated with the evolution of LC have been scarcely studied. Our objective was to estimate determinants related to long COVID persistence and recovery. Methods: We carried out a prospective population-based cohort study within the Borriana COVID-19 cohort (Spain), from May 2020 to August 2023. All participants had a confirmed laboratory SARS-CoV-2 infection, and we used the World Health Organization definition for LC, whereas recovery status was self-reported by the participants. Multivariable robust Poisson regression models were used in the statistical analysis. Results: In the cohort of 722 participants (response rate 63.8%), of whom 644 with SARS-CoV-2 infection, 184 suffered from LC (28.6%), and 135 patients remained affected (73.4%) with a mean age 42.0 ±14.5, being 94 women, of whom 49 have recovered, a mean age 41.3 ± 16.3, 35 women. Medical consultation for LC sequelae was 45.7%. Determinant related to LC persistence were old age, previous chronic disease, the AB blood group, and hospitalization. SARS-CoV-2 vaccination increased LC recovery. Conclusions: The persistent LC rate was high, and determinants of LC were estimated. Maintaining the follow-up of the cohort, increasing medical assistance for LC persistence, and improving health levels are recommended.

Abstract: Background: Dengue remains a major public health concern in tropical and subtropical regions, where serological assays are widely used for diagnosis and epidemiological surveillance. However, borderline enzyme-linked immunosorbent assay (ELISA) IgM results represent a frequent source of diagnostic uncertainty and may substantially influence estimates of disease prevalence. This study evaluated the impact of different analytical approaches to borderline ELISA results on dengue IgM seroprevalence among patients with suspected dengue infection in Trinidad and Tobago. Methods: A retrospective laboratory-based study was conducted using 161 consecutive serum samples submitted for routine dengue serology. Dengue virus-specific IgM antibodies were detected using the EUROIMMUN Anti-Dengue Virus ELISA (IgM). Samples were analysed in four independent laboratory batches (31, 29, 53, and 48 specimens). Sero-prevalence was calculated using three predefined analytical strategies: (i) conservative (borderline results classified as negative), (ii) exclusion (borderline results omitted from analysis), and (iii) liberal (borderline results classified as positive). Exact 95% confidence intervals (CIs) were calculated using the Clopper–Pearson method. Batch-to-batch reproducibility was evaluated using Cochran's Q heterogeneity test. Results: Of the 161 serum samples analysed, 20 (12.4%) were positive, 29 (18.0%) were borderline, and 112 (69.6%) were negative. Under the conservative analytical approach, the estimated dengue IgM seroprevalence was 12.4% (20/161; 95% CI: 7.7%–18.6%). Excluding borderline samples increased the estimated seroprevalence to 15.2% (20/132; 95% CI: 9.6%–22.6%), whereas classifying all borderline samples as positive yielded a prevalence of 30.4% (49/161; 95% CI: 23.4%–38.3%). Batch-specific seroprevalence estimates ranged from 10.3% to 15.1%, with no significant heterogeneity among analytical batches (Q = 0.41, p = 0.94; I² = 0%), demonstrating excellent reproducibility across laboratory runs. Conclusions: The estimated seroprevalence of dengue IgM was highly dependent on the analytical treatment of borderline ELISA results. Conservative classification provided the most cautious and reproducible estimate of recent dengue infection, while liberal interpretation substantially increased the apparent disease burden. These findings emphasize the importance of transparent reporting and standardized interpretation of equivocal serological results to improve the accuracy and comparability of dengue surveillance data, and support evidence-based public health decision-making.

Abstract: Background/Objectives: The relative contributions of treatment modality and traditional cardiovascular risk factors (CVRFs) to identified cardiovascular disease (CVD) burden remain poorly quantified in population-level outpatient administrative data. Methods: We conducted a cross-sectional study using CPAM Loire outpatient reimbursement claims (August 2023–August 2025). Treated psoriasis and prevalent CVD were identified via validated medication- and procedure-based proxy algorithms. Multivariable logistic regression identified factors associated with prevalent CVD. Inverse probability of treatment weighting (IPTW) assessed systemic treatment channelling bias, and E-values quantified robustness to unmeasured confounding. Results: The cohort comprised 10,331 adults (mean age 54.1 years; 50.9% male); overall CVD prevalence was 14.4%. After multivariable adjustment, treatment modality showed no independent association with prevalent CVD for non-biologic systemic therapy (adjusted OR [aOR] 1.07; 95% CI 0.78–1.45) or biologic therapy (aOR 1.08; 95% CI 0.93–1.27). Restricted IPTW sensitivity analysis confirmed no biologic-versus-non-biologic systemic difference (weighted OR 0.98; 95% CI 0.69–1.38). The dominant independent determinants were dyslipidaemia (aOR 3.75; 95% CI 3.27–4.30), hypertension (aOR 3.20; 95% CI 2.71–3.77), and diabetes mellitus (aOR 1.95; 95% CI 1.68–2.27). E-values exceeded 5.8 for dyslipidaemia and hypertension. Conclusions: Prevalent CVD burden in this regional French psoriasis cohort was primarily associated with traditional CVRFs rather than treatment category. These findings support systematic cardiovascular risk management in psoriasis care pathways. However, this outpatient claims analysis is structurally unable to establish temporal precedence or long-term causal modification of cardiovascular risk.

Abstract: Physical inactivity is a potential cost driver for health insurance as it may trigger undesirable health effects. In this study, the influence of health, marriage and cohabitation on physical inactivity is explored by means of fixed-effects logistic panel, random-effects logistic panel, and pooled logistic estimators. All three rely on data from the Survey of Health, Ageing and Retirement in Europe (SHARE) of 42,379 respondents aged 50 to 89 years old in 2015 from 12 European countries for the period 2015 to 2022. The analysis supports the positive influence of education and partnership on physical inactivity, as well as the negative one of ageing, illness, unemployment, limitations, and depression. In particular for partnership, the potentially positive influence on physical inactivity of being back single when higher depressed is surprising. Additionally, employed respondents relate to higher odds of reporting physical inactivity relative to retired respondents, suggesting that physical labour may be limited in their jobs. Lastly, Swedes, Danes, and Swiss relate to the lowest physical inactivity levels, and Italians to the highest. In conclusion, this study supports the importance of health and partnership for physical inactivity.

Abstract: The postpartum period involves profound bodily, psychological, and relational changes that may challenge women’s well-being and couple functioning, yet the role of flows of compassion and positive body image in postpartum relational outcomes remains largely unexplored. The present study examined whether body appreciation mediates the associations between different flows of compassion (self-compassion, compassion toward others, and compassion from others) and couple satisfaction in postpartum women. A total of 230 Italian postpartum women who had given birth in the previous six months (Mage = 33.65, SD = 4.43) completed online self-report measures assessing self-compassion, compassion toward others, compassion from others, body appreciation, and couple satisfaction. Direct and indirect associations among compassion flows, body appreciation, and couple satisfaction were examined using path analysis, controlling for breastfeeding status. Self-compassion and compassion from others were positively associated with body appreciation, which in turn was positively associated with couple satisfaction; compassion from others also showed a direct positive association with couple satisfaction, and significant indirect effects of self-compassion and compassion from others on couple satisfaction through body appreciation were observed. Body appreciation may represent a key psychological mechanism through which compassion-based processes support relational well-being in the postpartum period. This study is the first to examine the mediating role of body appreciation in the relationship between compassion flows and couple satisfaction in postpartum women. Integrating compassion flows with positive body image advances understanding of how intrapersonal and interpersonal emotional resources contribute to couple satisfaction following childbirth and informs interventions aimed at supporting postpartum adjustment.

Abstract: Atrial fibrillation (AF) affects more than 37 million people worldwide and substantially raises the risk of stroke, heart failure, and premature death. Wearable single-lead ECG devices offer a natural platform for continuous AF surveillance, yet automated detection from short, noisy recordings remains an unsolved clinical engineering problem. This paper presents a sys tematic benchmark of three deep learning architectures—a one dimensional ResNet-34 (1D-ResNet34), a Temporal Convolutional Network (TCN), and a novel State-Space Model (MambaECG)— evaluated under identical training protocols on two indepen dent public datasets: the PhysioNet Computing in Cardiology Challenge 2017 corpus (8,528 recordings) and the Chapman Shaoxing 12-lead ECG database (45,152 recordings, Lead I used). All models were trained exclusively on single-lead PhysioNet recordings and tested on Chapman–Shaoxing Lead I without fine-tuning, constituting the first cross-institutional generalisation study for this architectural family. The TCN achieves the highest AUROC of 0.957 with only 0.19M parameters, outperforming 1D-ResNet34 (AUROC 0.955, 35.34M parameters) and MambaECG (AUROC 0.928, 0.65M parameters). Notably, all three architectures demonstrate positive zero-shot transfer to Chapman–Shaoxing, with AUROCs of 0.961, 0.963, and 0.948 respectively—without any target-domain exposure during training. MambaECG achieves the fastest in ference at 0.04 ms per recording, enabling real-time deployment on resource-constrained wearable hardware. Gradient-weighted Class Activation Mapping (Grad-CAM) analysis confirms that MambaECG correctly localises clinically meaningful ECG fea tures: QRS complexes and P-waves for normal rhythm, irregular RR intervals and fibrillatory baseline for AF, and premature ventricular complex morphology for Other rhythm. These results provide evidence-based architectural guidance for wearable AF screening systems and demonstrate that lightweight temporal models match or exceed deep residual networks at a fraction of the computational cost.

Abstract: Background: Women's mental and physical health is often interpreted through a narrow biological lens or through a narrow cultural lens. Both approaches are insufficient. In many settings, girls and women are made accountable not only for their own bodies but also for family honor, fertility, fetal sex, domestic care, emotional stability, and the continuity of marital or kinship systems. Fetal-sex blame is an especially important example because it persists despite basic chromosomal biology and can transform a false attribution into a clinically significant exposure. Objective: To synthesize clinical, public-health, and social-science literature relevant to gendered reproductive accountability, with particular attention to fetal-sex blame, son preference, in-law and same-gender norm enforcement, menstrual and reproductive-stage distress, women's education, and integrated clinical care.Methods: This article is a narrative review and conceptual synthesis. Sources included clinical guidelines, peer-reviewed reviews and empirical studies, and major public-health documents on menstrual health, PMS/PMDD, perinatal and menopausal mental health, gender-biased sex selection, reproductive coercion, violence against women, unpaid care work, pain bias, child marriage, and girls' education. The purpose was integrative formulation rather than pooled estimation. Findings: Gendered reproductive accountability operates through four interacting pathways: biological vulnerability and symptom burden; family and in-law regulation; social norms that value sons, obedience, and self-sacrifice; and health-system responses that may either validate or dismiss symptoms. Son preference can generate repeated pregnancy pressure, reproductive coercion, violence, grief, anxiety, depression, trauma symptoms, sleep disturbance, pain, nutritional neglect, delayed care, and suicidal risk. Women may also reproduce harmful norms against other women when authority, security, and status are granted through compliance with patriarchal expectations. Education of girls and women is a protective determinant because it improves health literacy, autonomy, care-seeking, economic agency, and intergenerational outcomes; however, education of men and boys is necessary to prevent responsibility from being transferred back to women alone. Conclusion: A conclusive clinical approach should not ask whether women's symptoms are biological or social. It should ask how biological processes, psychological states, safety, family systems, and structural conditions interact in a specific life. This review proposes gendered reproductive accountability as a non-diagnostic framework for clinical formulation, research design, and public-health intervention. The framework supports evidence-based treatment while challenging the social conditions that turn women's bodies into sites of blame.

Abstract: Background: Malaria remains a leading cause of morbidity and mortality in sub-Saharan Africa, however the clinical profiles of older adults with malaria are poorly characterized. Here, we investigated age-related differences in inflammatory burden and acute kidney injury (AKI) among hospitalized patients with malaria in Luanda, Angola. Methods: We conducted a cross-sectional study of 518 malaria patients at two tertiary hospitals in Luanda, Angola, from January 2023 to December 2024. Logistic regression assessed associations between age group with inflammatory burden scores and AKI. Results: Older adults (>50 years) represented 9.8% of patients with malaria. Gender, ABO blood group, HbS genotype, parasitaemia, and AKI were not associated with age group after multivariable analysis (p>0.05). In contrast, moderate [AOR: 0.40 (95% CI: 0.18–0.90), p=0.028] and high inflammatory burden [AOR: 0.19 (95% CI: 0.04–0.91), p=0.038] were associated with lower odds of being in the older age group. AKI was more frequent in older adults (35.3% vs 34.7%) and showed a slightly increased odds (AOR: 1.09; p=0.842), although this was not statistically significant. Conclusions: Patients over 50 years of age constituted a clinically distinct group among hospitalised malaria cases, characterised by a markedly reduced inflammatory response and a slight increase in acute kidney injury compared to younger patients, despite similar parasitemia. These findings highlight important age-related differences in the pathophysiology of malaria and reinforce the importance of including the elderly in targeted clinical and public health strategies in malaria-endemic areas.

Abstract: Background/Objectives: Lebanon’s primary healthcare system operates under chronic constraint, fragmented governance, and recurrent shocks, limiting its ability to equitably allocate resources, maintain continuity of care, and adapt to population health needs. While Lebanon’s Vision 2030 prioritizes strengthening primary healthcare, implementation is hindered by weak sensing mechanisms, misaligned spatial distribution, and poorly integrated referral pathways. This study develops a context-specific, systems-level healthcare policy framework for primary healthcare reform by applying biomimicry principles derived from the drought-resistant root architecture of grapevine (Vitis vinifera). Methods: An Agent Based Approach within a biomimicry framework was used to translate biological strategies into healthcare policy design principles. Publicly available data from the Lebanese Ministry of Public Health, national assessments, and non-governmental organization registries were synthesized to examine mismatches between healthcare need and service capacity. Results: Structural deficiencies were identified in Lebanon’s primary healthcare system, including the absence of standardized need-based sensing, uneven geographic distribution of services, weak-referral integration, and limited adaptive feedback. Drawing on biomimicry, a policy framework is proposed centered on standardized Need Scores to translate frontline stress signals to rule-based responses, guide adaptive redistribution of capacity, and structurally anchor primary healthcare centers to referral hubs through defined catchments and electronic referral loops. Conclusions: Biomimicry provides a viable design logic for restructuring primary healthcare governance under conditions of chronic scarcity. By operationalizing biological resilience principles at the policy level, this approach can strengthen primary healthcare systems in low-resource settings while aligning with healthcare policy objectives such as those outlined in Lebanon’s Vision 2030.

Abstract: In this article, the relevance of the known economic benefits of marriage and cohabitation is reconfirmed. Based on data from the Survey of Health, Ageing and Retirement in Europe (SHARE) of the period 2015 to 2022 and 16 European countries, the severity of financial distress is explained by relational, health, financial, as well as general characteristics. The study reveals that singles are less likely to report greater easiness to make financial ends meet. Furthermore, income and employment appear to enable overcoming financial distress, while liabilities and reduced health facilitate financial distress. From all countries, primarily Danes report greater easiness to make ends meet. Econometrically, the study relies on ordered and non-ordered, panel and non-panel logistic estimators, which integrate, if possible, calibrated longitudinal weights. Overall, the study illustrates that partnership relieves financial distress and that the relationship stability does matter.

Abstract: Background/Objectives: Declining fertility rates pose a major demographic and public health challenge across Europe, including Croatia. Although health literacy and psychological well-being may influence reproductive decision-making, their relationships with fertility attitudes remain unclear. This study examined associations between health literacy, psychological distress, and fertility attitudes among postpartum women and tested whether anxiety and depression mediate the relationship between health literacy and fertility attitudes. Methods: A cross-sectional study included 1,656 postpartum women from seven coastal counties in Croatia. Participants completed validated measures of health literacy (NVS-HR), anxiety (STAI), depression (BDI-M), and breastfeeding attitudes (IIFAS). Results: Higher health literacy was associated with more positive fertility attitudes (r = 0.18, p < 0.001), while anxiety and depression were negatively associated with fertility attitudes (all p < 0.001). Health literacy was also negatively correlated with anxiety and depression. Logistic regression showed that health literacy (OR = 1.21, 95% CI 1.10–1.34), age (OR = 1.08, 95% CI 1.04–1.12), and positive breastfeeding attitudes (OR = 1.03, 95% CI 1.01–1.05) predicted more positive fertility attitudes, whereas depressive symptoms predicted less positive attitudes (OR = 0.74, 95% CI 0.63–0.88; all p < 0.05). Mediation analyses indicated a significant direct effect of health literacy on fertility attitudes (β = 0.020, p = 0.004), but no significant indirect effects through anxiety or depression. Conclusions: Health literacy was independently associated with positive fertility attitudes and may represent an important target for reproductive health promotion and fertility-related decision-making among postpartum women.

Abstract: Background/objective: This in vivo and in vitro studies aims to test the hypothesis that functional foods represented by fruit vinegars (FVs) can be an alternative dietary treatment for body weight loss in obesity, and metabolic syndrome/inflammation complications can lead to the diabetes development. Methods: In vivo experiment was carried on Wistar rat, Sprague Dawley strain, divided into 04 groups including n=30 rats/group: i) Group I or Control group fed the standard laboratory diet; ii) Group II or Control group, fed the HyperFat Diet (HFD); iii) Group III or therapeutic group, fed HFD and treated separately with pomegranate or prickly pear or apple FVs by 7ml /kg body weight/day administered orally for 18 weeks; iv) Group IV or Placebo group, fed HFD and received orally 7ml of saline solution (0.09%) for 18 weeks. In vitro experiment was conducted on 3T3-preadipocytes cell line to study the anti-adipogenic effects, and on Raw 264,7 cell line to study the anti-inflammatory effects. Results: The major results reveal that FVs exerts a powerful body-fat loss linked to fat oxidation, sustained by RQ=0.7 and increase BMR, associated with elevated serum free fatty acids, which confirms lipolytic activity. Among the 3 vinegars, pomegranate vinegar showed the greatest health benefit; however, hepatic steatosis and dyslipidemia were normalized by apple vinegar, which has proven to be the most effective. FVs exerts a spectacular anti- obesogenic effect by inhibiting the differentiation of 3T3-preadipocytes into mature adipocytes; and by inhibiting the inflammatory-necrotic process via the suppression of cytokines TNFα, IL-6, IL-1β production. The PPARγ, C/EBPα and NF-κB modulation signaling pathways is convincing. Conclusions: the data from this study are considered a preclinical phase with potential translational relevance, but not clinical recommendations. Ultimately, Fruit vinegars represent an emerging therapeutic prospective as functional foods, thus justifying further human clinical research.

Abstract: Background/Objectives: Cyberbullying is a growing public health concern among university students, yet robust psychometric evidence for its assessment in Latin American higher education remains scarce. This study evaluated the factorial structure, reliability, validity, and sex invariance of the European Cyberbullying Intervention Project Questionnaire (ECIPQ) in Chilean university students. Methods: A sample of 750 students (M = 21.6 years; SD = 5.59) completed the ECIPQ. Confirmatory factor analyses using WLSMV estimation tested alternative models. Reliability was assessed with omega coefficients, convergent and discriminant validity with AVE and HTMT, and measurement invariance by sex through multigroup CFA. Results: A correlated two-factor model of cybervictimization and cyberaggression showed the best fit (CFI = 0.995, RMSEA = 0.077, SRMR = 0.084). Both subscales demonstrated satisfactory reliability (ω = 0.836 and 0.908) and convergent validity (AVE &gt; 0.50), while HTMT supported discriminant validity. The high latent correlation (φ = 0.908) indicated substantial overlap between cybervictimization and cyberaggression. Configural, threshold, and metric invariance by sex were confirmed. Conclusions: The ECIPQ is a valid and reliable instrument for assessing cyberbullying in Chilean higher education. The strong interdependence between cybervictimization and cyberaggression suggests that these dimensions should be interpreted jointly rather than as independent roles. The findings support the use of the ECIPQ for early detection, monitoring, and integrated prevention strategies targeting cyberbullying and its impacts on student mental health and academic well-being.

Abstract: Real-world effectiveness of tirzepatide-supported obesity treatment depends on sustained adherence and engagement, yet the influence of peer-to-peer referral pathways within digital weight-loss services (DWLSs) is poorly understood. This retrospective cohort study analysed deidentified data from adults initiating tirzepatide through an Australian DWLS (Juniper) between 20 May and 2 December 2025. Patients were classified as peer-referred (via direct referral link) or non-referred (organically acquired). Baseline characteristics, financial markers and early engagement (month-1 weight logging) were compared between groups, and 6-month outcomes included medication adherence (≥5 orders within 183 days), per-protocol persistence (≥1 verified weight entry at days 173–193) and percentage weight loss. Propensity score matching (1:1, nearest neighbour) on age, sex at birth, ethnicity, baseline BMI, comorbidity count, prior GLP-1 RA use and first-order price was used to compare 6-month weight loss between referred and non-referred patients with adequate follow-up and weight data. The cohort comprised 2,576 referred and 31,873 non-referred patients; referred patients were more often male (23.0% vs 7.8%; p < 0.001) and less likely to have prior GLP-1 RA use (17.0% vs 23.0%; p < 0.001), with otherwise similar baseline profiles. Among 17,149 patients with ≥183 days of follow-up, referred patients showed higher 6-month medication adherence (48.0% vs 42.0%; p < 0.01) and per-protocol persistence (35.0% vs 27.0%; p < 0.01). In 1,076 matched pairs, referred patients achieved greater 6-month percentage weight loss (16.16% vs 14.06%; p < 0.001) and higher rates of ≥10% (84.0% vs 66.5%; p < 0.001) and ≥15% (62.0% vs 48.0%; p < 0.001) weight loss. These preliminary findings suggest that peer-to-peer referral pathways may be associated with improved retention and outcomes in unsubsidised, tirzepatide-supported digital obesity care.

Abstract: On 14 May 2026, the Member State Coordination Group on Health Technology Assessment (HTA Coordination Group) adopted Guiding Principles on Data Transparency under Article 3(7), points (c) and (h), of Regulation (EU) 2021/2282. The document opens with a disclaimer of legal force; its operational architecture, a self-authored definition of ‘commercially confidential information’, a categorical declaration that broad classes of clinical data are in general non-confidential, and a recourse procedure run by the same family of actors that produced the rule, has consequences that the disclaimer cannot dissolve. We argue that the Guiding Principles sit uneasily with EU lex specialis on commercial confidentiality and with case-by-case jurisprudence on disclosure; that, in producing them, the HTA Coordination Group has concentrated rulemaking, executive and quasi-judicial functions in a manner that engages the principle of conferred powers, the Meroni doctrine, and Articles 41 and 47 of the Charter; and that the corrective is institutional rather than substantive: the problem lies in how the rules were made and by whom, not only in their content.

Abstract: Young adulthood involves major lifestyle transitions that can negatively affect diet, physical activity, substance use, and mental well-being. University settings offer an opportunity to promote pre-pregnancy health, yet little is known about how women perceive and prepare for pregnancy. This study explored university women’s perspectives on pre-pregnancy health, including its importance, intended behaviors, challenges, and information needs. Using a qualitative phenomenological approach, women (≥19 years) enrolled at a Midwestern university completed semi-structured interviews (Zoom/phone) between April and June 2024. Interviews were audio-recorded, transcribed, and analyzed using directed content analysis and validated with peer debriefing and an audit trail. Participants (N=15; mean age 21.67±3.39) were primarily White (80%), 53.3% partnered, and mostly juniors (33.3%) or graduate students (26.7%). Four themes emerged: (1) pre-pregnancy health was viewed as important but sometimes overwhelming; (2) intended behavior changes included improving diet, increasing physical activity, avoiding substance use, and mental health; (3) barriers included financial constraints, life transitions, family/personal health history, and cultural taboos; and (4) women preferred practical, credible information, often using social media initially but seeking confirmation from healthcare professionals. Universities and healthcare systems may be well-positioned to deliver evidence-based pre-pregnancy education tailored to student life.

Abstract: Background: Men’s emotional suffering is frequently under-recognized because many social systems frame men as strong, self-reliant, productive, sexually competent, financially responsible, and emotionally controlled. Popular expressions such as “male PMS” are biologically imprecise, because premenstrual syndrome is defined in relation to the menstrual cycle. Yet the phrase may point toward a neglected clinical and social phenomenon: recurrent or episodic affective, somatic, cognitive, and behavioral distress in men.Objective: This narrative review synthesizes evidence and theory on male affective symptoms, testosterone and stress physiology, sleep and metabolic factors, externalizing presentations of depression, help-seeking barriers, and the social construction of masculine resilience.Methods: A narrative literature synthesis was conducted across premenstrual disorders, irritable male syndrome, testosterone physiology, sleep and stress biology, male depression, suicide epidemiology, masculinity norms, and mental-health help-seeking. This review does not propose “male PMS” as a formal diagnosis; rather, it evaluates the phrase as a cultural entry point into male episodic distress.Findings: Men do not experience PMS in the strict gynecological sense. Nevertheless, men may experience recurrent irritability, low mood, fatigue, anxiety, emotional withdrawal, sleep disturbance, reduced libido, anger, substance use, and loss of motivation through interactions among endocrine fluctuation, cortisol and sleep disruption, metabolic and physical health, psychiatric vulnerability, occupational stress, relationship strain, and masculine role expectations.Conclusions: The term “male PMS” should not be adopted as a medical diagnosis, but the distress it attempts to name deserves serious scholarly attention. We propose male episodic affective-somatic distress as a non-diagnostic framework for recurrent patterns of male suffering shaped by biological, psychological, and sociocultural mechanisms.

Abstract: Hantaviruses (family Hantaviridae, genus Orthohantavirus) are globally distributed zoonotic RNA viruses maintained in rodent, insectivore, and chiropteran reservoirs, with humans infected mainly through inhalation of aerosolized excreta. They cause two major syndromes: hemorrhagic fever with renal syndrome (HFRS), endemic in Europe and Asia, and hantavirus cardiopulmonary syndrome (HCPS), reported principally in the Americas and associated with higher case fatality. Surveillance and seroprevalence data indicate that the true burden is underestimated because subclinical infection and clinical overlap with dengue, leptospirosis, scrub typhus, and other acute febrile illnesses limit recognition. Recent trends include climate-associated shifts in rodent reservoir dynamics, land-use-driven expansion of human–rodent interfaces, and renewed concern regarding Andes virus, the only orthohantavirus with documented person-to-person transmission. No broadly licensed antiviral therapy is available, and vaccine access remains geographically limited. This review synthesizes current evidence on hantavirus taxonomy, epidemiology, transmission, pathogenesis, diagnosis, clinical management, vaccines, and prevention, while framing control within a One Health approach that integrates human, animal, and environmental surveillance.

Abstract: Background: Antibiotic resistance is becoming a serious problem in chicken production globally due to use of antibiotics. Despite the use of antibiotics in Mzimba is well known, the Multiple antibiotic resistance index (MARI) pattern in chicken meat is not known and not documented. Objective: To assess the prevalence of antibiotic-resistant E. coli, Salmonella, and Enterobacter species in broiler chicken meat sold in informal markets in Mzimba district, Malawi. Materials and method: A cross-sectional study was conducted between March and May 2025. A total of 100 meat samples were collected from the informal markets across the district. Stratified sampling technique was used to select chicken meat samples fromm various markets. Descriptive statistics and inferential statistics were performed using R version  4.5.3. Results: E. coli (69%) and Enterobacter (12%) species were the most frequently isolated pathogens. The highest prevalence of antibiotic resistance was observed in E. coli against ampicillin (91.3%), meropenem (82.6%), and tetracycline (71%). Similarly, the Enterobacter spp. showed substantial resistance to ampicillin ( 83.3%), meropenem (75%), and tetracycline (71%). MAR Index values were considerably high, which ranged from 0.1 to 0.75. Ninety-seven percent of the isolates had MAR index values of over 0.2. Twenty-eight isolates (29%) had extreme MAR Index values of 0.5 or higher. Location was the most significant predictor of the MAR index (p = 6.096e-05, η² = 0.372). Conclusions and recommendations: High levels of MAR Index revealed in this study. MAR index reflect high-risk contaminating sources with antibiotic treatment failure in both animal and human infections, and might be shared with the environment. As such, combating MDR requires coordinated multisectoral approaches through One Health programs that integrate surveillance, policy, and innovation in clinical and non-clinical settings.

Abstract: Background: Repeat blood donation is essential for ensuring a safe and sustainable blood supply, particularly in sub-Saharan Africa, where donation rates remain below WHO targets. Herein, we investigated the sociodemographic and clinical determinants associated with repeated blood donation among blood donors’ candidates in Luanda, the capital city of Angola. Materials and Methods: A cross-sectional study was conducted among 189 blood donors between June 2025 and February 2026. The outcome of interest was repeat blood donation, defined as more than two previous donations. Sociodemographic and clinical characteristics were collected, and multivariate logistic regression analysis was performed to identify factors independently associated with repeated donation. Results: Of the 189 participants, 14 (7.4%) had donated blood more than twice, with a median age of 34.5 years (IQR: 27.3–37.8). Male gender was independently associated with repeated blood donation [AOR: 5.81 (95% CI: 1.14–29.6), p=0.034]. Although not statistically significant, higher odds of repeat donation were also observed among donors aged ≥ 30 years (AOR: 2.83, p = 0.127), residents outside Luanda city (AOR: 1.22, p = 0.753), employed individuals (AOR: 2.05, p = 0.319), voluntary donors (AOR: 2.08, p = 0.326), and anaemic donors (AOR: 3.36, p = 0.106). Conclusions: Male gender was an independent determinant of repeated blood donation in this study. The higher frequency of repeated donation among anaemic donors highlights the need for further research on iron depletion and for improved donor monitoring strategies to ensure a safe and sustainable blood supply in Angola.