Abstract: Background and objectives: Musculoskeletal disorders (MSDs) are the most common work-related diseases in Korea, yet nation-wide estimations of their occupational burden remain scarce. This study aimed to (1) assess the prevalence and distribution of MSD symptoms by body part; (2) construct a body-part–specific job exposure matrix (JEM) for ergonomic risk factors using representative national data; (3) validate the JEM through expert consensus; and (4) examine dose–response relationships be-tween exposure intensity and MSD symptoms. Materials and Methods: We analyzed data from 215,000 Korean workers across five waves (2006–2020) of the Korean Working Conditions Survey (KWCS). A JEM was created based on self-reported ergo-nomic exposures by occupational category. Expert review and agreement statistics were used to validate exposure estimates. Logistic regression was applied to evaluate associations between exposure levels and MSD symptoms. Results: Symptoms were re-ported in the upper extremities and neck (35.3%), back (20.3%), and lower extremities (24.6%), with over 40% of respondents experiencing symptoms in multiple body parts. The JEM showed strong agreement with expert ratings (κ ≥ 0.80 for upper body and back), and exposure intensity was positively associated with symptom prevalence, particularly in the upper body and back. Occupations such as crop growers and construction workers had high levels of both exposure and symptom burden. Conclusions: This study developed and validated the first body-part–specific ergonomic JEM for Korean workers using nationally representative data. Findings support data-driven prioritization of high-risk occupations and provide a foundation for future surveillance and prevention of work-related MSDs in Korea.

Abstract: The present study aimed to quantify changes in spinal kinematics during Nordic walking compared to regular walking for 60 seconds on a training path among physically fit young males (n = 20, aged 19–22 years). Two walking speeds were analyzed: 3 km/h and 5 km/h. The experimental setup was designed to assess spinal angular rotations using five kinematic parameters: upper spine, lower spine, thoracic region, lumbar region, and pelvis. The data is acquired from 9 compact inertial sensors and the following motion analysis is carried out using 3D MioMotion IMU sensor’s analysis system. The differences in the obtained cyclic biomechanical parameters are detetcted using functional ANOVA (fANOVA) statistical tests. The key finding of the study is that Nordic walking significantly alters the angular kinematic pattern of spinal movement by revealed significant differences in all five measured parameters when compared to normal walking. Notably, the most pronounced changes were observed in the upper spine and pelvis motion. Additionally, the influence of Nordic walking on the two phases of the gait cycle, the stance and swing phases, was evaluated: i) significantly increased the duration of the stance phase in all three planes of motion; ii) significantly increased the velocity during the stance phase across all three planes. These reported findings highlight the biomechanical, preventive, therapeutic, and rehabilitative potential of Nordic walking.

Abstract: Background: People with Autism Spectrum Disorder (ASD) require a customised, multidisciplinary plan throughout their lifetime to support optimal health. The purpose of this scoping review was to synthesise research on the main scales used to detect signs of ageing in people with ASD. Methods: Eligible papers published between January 2003 and September 2024 were identified through searches of PubMed, PsycInfo, Scopus, Web of Science, NICE and Cochrane databases. The assessment was performed using the Joanna Briggs Institute critical appraisal and extraction checklist. Of the 707 papers reviewed, 22 were found to meet the established criteria. Results: Based on the evidence collected, 55 tools focusing on specific domains within the Comprehensive Geriatric Assessment were identified: 19 addressed the functional domain, 17 the mental, 6 the biomedical, 1 the social, 2 related to frailty, 1 to fall risk, and 9 to quality of life. Conclusions: This review highlights the need to obtain a ‘multi-domain’ tool for the detection of ageing in autistic people, which would facilitate the development of a Comprehensive Geriatric Assessment that makes planning customised care possible.

Abstract: Kampala, Uganda’s capital, is experiencing a growing solid waste crisis exacerbated by rapid urbanization, poor regulatory enforcement, inadequate infrastructure, and low collection coverage. The 2024 collapse of the Kiteezi landfill tragically highlighted the consequences of systemic neglect, claiming dozens of lives and displacing hundreds. This paper critically examines the city’s waste management failures and public health implications particularly in informal settlements and proposes the Kampala Integrated Waste Resilience (KIWR) Framework, a multidimensional, health-centered, and climate-resilient model for sustainable urban waste governance.Drawing on comparative insights from Kigali’s relatively successful public-private partnership (PPP)-based waste system, the study analyzes what Kampala can adopt, adapt, or avoid. While Kigali’s high collection coverage, enforcement discipline, and civic engagement through initiatives like Umuganda provide transferable lessons, its overreliance on collection and lack of circular economy integration reveal limitations that Kampala must overcome.The KIWR Framework is structured around six pillars: Circular Economy, Public Health Protection, Infrastructure Development, Regulatory Enforcement, Community Engagement, and Climate & Technology Integration. It proposes strategic interventions such as engineered landfills, decentralized composting, waste-to-energy systems, IoT-enabled waste monitoring, and expanded roles for informal waste workers. Through a three-phase implementation roadmap and actionable policy recommendations, this paper provides a scalable, evidence-based solution to Kampala’s waste crisis.Ultimately, the study repositions waste management as a critical urban health issue and advocates for a paradigm shift toward inclusive, data-driven, and environmentally sustainable governance anchored in both national policy frameworks and the Sustainable Development Goals (SDGs).

Abstract: Background and Objective: Pediatric obesity negatively impact metabolic and musculoskeletal health, particularly muscle quality and function. Ultrasound-derived measures like muscle thickness and echo intensity, combined with body composition data, provide a more comprehensive assessment of muscle status in this population. The purpose of our study was to examine the relationship between anthropometric measurements, muscle strength, bioelectrical impedance estimations, with ultrasound-derived indicators such as subcutaneous fat and quadriceps femoris thickness, and muscle quality through EI. Methods: This cross-sectional study included Hispanic children aged 6 to under 18 years with overweight or obesity (BMI ≥ 85th percentile per CDC standards). Participants were recruited consecutively from outpatient visits. All eligible children were invited for a standardized nutritional assessment, and those who consented were included. Results: The study included 294 children and adolescents (153 boys, 141 girls) with overweight or obesity, showing significant sex differences in anthropometric and body composition variables. Girls had higher intramuscular adipose tissue (IMAT), while boys had more lean and musculoskeletal mass. Body fat percentage strongly correlated with muscle echo intensity (EI) and IMAT across sexes, with girls showing stronger associations; linear models identified body fat and BMI percentile as key predictors of muscle quality indicators. Conclusions: This study found that higher body fat in children and adolescents with overweight or obesity is linked to poorer muscle quality, especially increased echo intensity and intramuscular fat. Ultrasound proves useful for early, non-invasive detection of musculoskeletal changes, emphasizing the need to assess both muscle size and quality.

Abstract: The integration of technology in healthcare has revolutionized patient data management and service delivery, with Electronic Health Records (EHRs) playing a central role. EHRs are digital repositories that allow healthcare providers to efficiently access, manage, and share patient information, replacing traditional paper records. This study examines the significant impact of EHRs on healthcare delivery and their financial benefits. EHRs enable real-time access to patient data, promoting coordinated, patient-centred care among providers. Embedded decision support tools enhance clinical decision-making, while EHRs also support population health by monitoring trends and identifying groups needing early intervention. Financially, EHR adoption streamlines administrative tasks, reduces paperwork, and improves billing accuracy, leading to operational efficiencies and cost savings vital for healthcare organizations. To deepen understanding, a questionnaire survey gathers insights from patients and providers on EHR familiarity, concerns, and expectations. The study highlights EHR benefits such as improved data accessibility, enhanced care quality, and operational efficiency, contributing to better healthcare outcomes and financial health. It also addresses regulatory compliance challenges and presents case studies of successful EHR integration. Finally, emerging technologies and trends shaping the future of EHRs are discussed, underscoring their ongoing importance in advancing healthcare.

Abstract: Work environments change, and this increasingly features in new aspects as variability and unpredictability, which can be characterised as unusual working conditions (UWC), including irregular schedules, spatial disruptions, and procedural or psychosocial insta-bility. These conditions negatively affect the work efficiency, consistency, quality, and safety, often exceeding the capabilities of conventional risk assessment approaches. This study introduces a structured, practice-oriented methodology for the identification, classi-fication, and risk assessment of work processes under UWC. The approach is grounded in a hybrid methodology combining expert interviews, structured observation, and mul-ti-criteria SWOT analysis, supported by the DMAIC process model. The method enables classification of work into physical, cognitive, and high-risk domains, each with tailored evaluation criteria for key stress parameters. Process flowcharts with embedded decision nodes allow differentiation between normal and critical working conditions based on ob-jective and subjective indicators This contributes directly to Sustainable Development Goal 8 by supporting structured assessment and continuous improvement of safety and performance under variable workplace conditions.

Abstract: Bread wheat (Triticum aestivum L.) is a staple food for over 2.5 billion people worldwide, providing a significant portion of dietary energy and protein. Despite its central role in global food security, wheat’s natural micronutrient density, especially iron and zinc, remains limited, contributing to widespread “hidden hunger” in wheat-dependent populations. The shift towards refined wheat products further reduces nutrient intake by removing fiber-rich bran and germ layers. This paper reviews global and regional wheat consumption patterns, the nutritional contribution of bread wheat, challenges associated with micronutrient deficiencies, and ongoing interventions such as biofortification and flour fortification. Emphasis is placed on the Ethiopian context, highlighting policy implications and the need for integrated strategies involving agriculture, health, and education sectors to improve nutritional outcomes. Investing in nutrition-sensitive agriculture, public awareness, and inter-sectoral collaboration is essential to leverage wheat’s full potential in combating malnutrition, especially in resource-constrained settings.

Abstract: Background/Objectives: This study examines the social epidemiology of digital health adoption and the determinants of the digital divide among Community Health Workers (CHWs), including Accredited Social Health Activists (ASHAs), Anganwadi Workers (AWWs), Auxiliary Nurse Midwives (ANMs), and their supervisors in Muzaffarpur, Bihar, India’s most populous aspirational district, with a focus on inequities across cadres, departments, and rural and urban contexts. Methods: An exploratory sequential mixed methods design was used. The quantitative phase included a cross-sectional survey of 95 CHWs across four blocks spanning urban, semi-urban, rural, and flood-prone areas. The qualitative phase comprised 32 in-depth interviews with CHWs, and block-level officers and six focus group discussions stratified by cadre and setting. Research tools were grounded in the behavior model. Quantitative data were analyzed using Jamovi software, and qualitative data with ATLAS.ti. Results: Urban, higher-income, and better-educated cadres reported greater use of digital applications, while limited device functionality, lower education, and rural flood-affected location constrained digital engagement. ANMs experienced app fatigue from multiple platforms, while AWWs and ASHA faced persistent device failures and financial burdens from personal smartphone use. Block-level officers and CHWs highlighted ongoing barriers, including technical failures, fragmented systems, workload, and reliance on informal support. Conclusions: The digital divide is shaped by intersecting social and structural factors across cadres, departments, and geography. Bridging this gap requires equitable infrastructure, continuous training, integrated user-centered systems, and supportive policy to ensure digital health reforms advance health equity in low-resource settings.

Abstract: Background: The One Health evolution in occupational health and safety (OSH) is influenced by technological innovation, climate adaptation, and workforce expectations. In advanced manufacturing and digitalized work environments, the demand for agile safety systems goes beyond regulatory compliance. As organizational ecosystems become autonomous, managing complex risks is crucial for worker well-being and operational resilience. Methods: The Foresight Systematic Analysis of emerging trends in OSH technologies, such as wearable safety technologies, AI-assisted inspections, digital twin modeling, and climate-informed risk assessment, was conducted using scenario mapping and systematic scoping literature methods. Stakeholder perspectives from public health authorities, industry leaders, and regulatory bodies were integrated to contextualize strategic priorities and barriers to adoption. Results: Findings indicate a shift toward integrated safety ecosystems characterized by real-time monitoring, predictive analytics, and adaptive learning environments. Climate-sensitive modeling and sensor-based feedback systems are projected to become core components of future workplace safety infrastructure, particularly in environmentally vulnerable regions. The role of safety professionals expands to include interdisciplinary competencies such as data interpretation, systems integration, and digital ethics. Standardized digital safety protocols, data privacy governance, and equitable access to intelligent safety tools across industries and regions correlated with One Health. Conclusion: The future of occupational safety depends on proactive, intelligence-driven frameworks that can adapt to dynamic risk landscapes. This requires sustained innovation, cross-sector collaboration, and a safety culture based on resilience and continuous learning. Preparing the workforce for these transformations is crucial for safety, health and productivity. One health regulatory body was integrated to help contextualize strategic priorities and adoption barriers.

Abstract: Globally, approximately 39.9 million individuals are currently living with HIV, with over one million new cases reported each year. In Indonesia, the incidence of new HIV infections has risen significantly by more than 400% in just over a decade. Various interventions have been implemented to prevent and reduce HIV transmission and address the associated impacts of HIV. However, there exists a significant gap in the literature, as no comprehensive studies have synthesised the available evidence to elucidate the current status and future trajectory of HIV interventions within the country. This study aims to fill this gap by exploring publication trends on HIV interventions, the types of interventions, targeted population groups, and the settings in which these interventions were implemented. A bibliometric analysis and a scoping review were conducted. The bibliometric analysis facilitated the identification of publication trends, key authors and collaborators, citation metrics, influential journals, trending topics in HIV interventions, and the co-occurrence of relevant keywords. The scoping review enabled the categorisation of various types of HIV interventions, the identification of targeted groups, and intervention settings. Databases including Scopus, Embase, PubMed, Web of Science, Google Scholar, Cochrane Library, CINAHL, Psychology and Behavioural Sciences Collection, Garuda, and Google were used. The bibliometric analysis encompassed 84 articles from a total of 847 retrieved from the Scopus and Web of Science databases, showing a steady increase in annual publication post-2008. These articles were published across 65 distinct journals and authored by 400 authors. The average citation rate per document was 8.48%. Key trending topics and co-occurring keywords identified included human immunodeficiency virus, HIV infections, acquired immune deficiency syndrome or anti-retrovirus, people who inject drugs, and adherence. The scoping review, which included 90 articles selected from a total of 2,224 retrieved, identified four types of HIV interventions, with HIV treatment, and prevention and education being the most common types. The interventions targeted 14 different population groups and were implemented across seven distinct settings in 19 districts/municipalities across 14 provinces. The findings underscore the pressing need for an expansion of HIV interventions that not only focus on prevention and treatment but also consider the social, cultural, and religious factors influencing both HIV transmission and its impact. Furthermore, the results highlight the necessity of targeting specific high-risk and underserved populations, such as men who have sex with men, transgender women, female sex workers and their male clients, pregnant women, individuals who use or inject drugs, prisoners, children, adolescents, and young people. Moreover, there is a critical need to extend the geographical coverage of these interventions into rural districts, often referred to as underdeveloped or disadvantaged areas within Indonesia.

Abstract: Background:Ubiquitous health (uHealth) and digital therapeutics require interoperable digital ecosystems to achieve an effective and scalable implementation. Alignment between technical standards and regulations is crucial to ensure the secure and patient-centric exchange of data as these technologies continue to evolve. Objective: This narrative review examines the existing interoperability frameworks that support uHealth and digital therapeutics. Technical standards and governance models were evaluated to identify barriers and recommend future directions for the universally scalable integration of these frameworks. Method: The authors conducted a systematic narrative synthesis to review existing interoperability standards, such as HL7 FHIR and TEFCA, as well as prominent regulations, including HIPAA and the GDPR. Real-world deployments, including those by the U.S. Department of Veterans Affairs, were examined to derive practical lessons. Emerging technologies, including AI, blockchain, and federated learning, were also considered, along with their potential contributions to interoperability. Results: This review highlights ongoing difficulties, including uneven standard implementation, disjointed regulatory regimes, sparse digital infrastructure, and semantic discrepancies among systems. These problems are particularly prevalent in low-income and middle-income nations. New technologies represent promising, yet untapped, remedies. Conclusion: Achieving sustainable interoperability requires reforming governance, adopting modular and standards-based architectures, and fostering widespread stakeholder engagement. Bridging the divide between policy and technology is crucial for building resilient digital health ecosystems that can support equitable, personalized, and globally integrated care delivery.

Abstract: Heart rate variability (HRV), a non-invasive measure of autonomic nervous system (ANS) function reflecting vagus nerve activity, is a promising biomarker in breast cancer (BC) management. This PRISMA-guided systematic review evaluates HRV electrophysiologic data from 5-minute vs. 24-hour ECG recordings in BC diagnosis and therapy follow-up, emphasizing the vagus nerve’s role in inflammation and tumor progression. Completing a search of PubMed, Scopus, Web of Science, and Embase (2009–2025), 16 studies (n=3,412 participants) were included. Lower HRV metrics (e.g., SDNN <50 ms, RMSSD <20 ms predicted relapse) correlated with advanced BC stages, elevated carcinoembryonic antigen (CEA), and poorer prognosis (HR=0.62, 95% CI: 0.48–0.79). Chemotherapy-induced HRV reductions (e.g., SDNN decrease by 20%) predicted cardiotoxicity, while vagus nerve stimulation (VNS) improved HRV and reduced inflammation. HRV showed diagnostic sensitivity up to 80% with biomarkers. A narrative synthesis was conducted due to methodological heterogeneity; meta-analysis was not feasible due to significant methodological heterogeneity across studies. HRV and vagal interventions hold transformative potential, necessitating standardized protocols and larger studies.

Abstract: Sarcopenia remains underdiagnosed in Vietnam due to the absence of simple, reliable screening instruments tailored to primary‐care settings, so we developed ViSarco to facilitate early identification of sarcopenia among community‐dwelling older adults; using a six‐phase exploratory mixed‐methods design, we generated candidate items through a comprehensive literature review and in‑depth interviews with 37 frontline healthcare providers, then conducted a cross‑sectional study of 416 adults aged ≥60 years applying AWGS 2019 criteria and logistic regression to assign scores of 2 for body‐mass index, 1 for arm circumference and 1 for calf circumference; we validated ViSarco in an independent cohort of 806 older adults and benchmarked its performance against six established international tools, finding that at a cut‑off score ≥2 it achieved 77.2% sensitivity, 76.6% specificity and an AUC of 0.77 in the derivation sample and maintained 78% overall accuracy with an AUC of 0.83 on external validation, outperforming all comparators; these results demonstrate that ViSarco is a brief, feasible and high‐performing screening tool well suited to resource‐limited primary‐care environments, offering robust diagnostic capability to support timely case finding and intervention for sarcopenia in older Vietnamese populations.

Abstract: BACKGROUND: Sleep disturbances and shift work are associated with increased cardiovascular risk, possibly through disruptions in endothelial and hemostatic function. While prior studies link acute sleep deprivation to vascular dysfunction, the impact of chronic sleep quality and circadian misalignment on endothelial health in healthy individuals, particularly shift workers, remains underexplored. AIM: To examine the association between objectively measured sleep quality and endothelial/hemostatic function in healthy female hospital nurses, comparing shift and day workers, and considering time-of-dayvariation. METHODS: In this repeated-measures study, 100 female nurses (51 shift, 49 day workers) aged 25–50 wore actigraphy devices for 7–14 days to assess total sleep time (TST), sleep efficiency (SEF), and wake after sleep onset (WASO). Endothelial function was measured using EndoPAT (Reactive Hyperemia Index – RHI). Hemostatic markers included plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor (VWF), heparanase and heparanase procoagulant activity assessed by ELISA and chromogenic assays in morning and evening. RESULTS: TST was not associated with any vascular outcomes. Poor sleep quality (low SEF, high WASO) was significantly associated with reduced RHI and elevated PAI-1 level, heparanase level, and heparanase procoagulant activity levels. Shift workers exhibited lower evening RHI and higher evening PAI-1 compared to day workers. Regression models revealed significant main effects of SEF and WASO on endothelial and coagulation markers, with some interactions depending on shift type and time of measurement. No significant associations were found for VWF. CONCLUSIONS: Impaired sleep quality, but not sleep duration, is associated with endothelial dysfunction and procoagulant activation, particularly among shift-working nurses. These findings suggest that sleep quality may play a critical role in vascular health and support the use of sleep-based interventions to reduce cardiovascular risk in shift work populations.

Abstract: Background/Objectives: Adolescence is a sensitive developmental window shaped by both vulnerabilities and adaptive potential. From an evolutionary standpoint, mental health difficulties in this period may represent functional responses to environmental stressors rather than mere dysfunctions. Despite increasing interest, integrative models capturing the dynamic interplay of risk and protective factors in adolescent mental health remain limited. This study presents a holistic, multi-level framework grounded in ecological and evolutionary theory to improve understanding and intervention strategies. Methods: A two-round Delphi method was used to develop and validate the framework. Twelve experts in adolescent mental health evaluated a preliminary draft derived from the literature. In Round 1, 12 items were rated across five criteria (YES/NO format), with feedback provided when consensus thresholds were not met. Revisions were made using consensus index scores. In Round 2, the revised draft was assessed across eight broader dimensions. A consensus threshold of 0.75 was used in both rounds. Results: Twelve out of thirteen experts (92%) agreed to join the panel. Round 1 item scores ranged from 0.72 to 0.85, with an average consensus index of 0.78. In Round 2, ratings improved significantly, ranging from 0.82 to 1.0, with an average of 0.95. The Steering Committee incorporated expert feedback by refining the structure, deepening content, updating sources, and clarifying key components. Conclusions: The final framework allows for the clustering of indicators across macro-, meso-, and micro-level domains. It offers a robust foundation for future research and the development of targeted, evolutionarily informed mental health interventions for adolescents.

Abstract: (1) Background: Physical activity (PA) is a key modifiable risk factor for chronic diseases, yet many adults do not meet PA guidelines. Just-in-time adaptive interventions (JITAIs), a type of mobile health (mHealth) intervention, offer tailored support based on an individual’s context to promote PA. Integrating behavior change techniques (BCTs) and theories is critical to the design of effective mHealth interventions. Understanding which BCTs and theories work best can inform future JITAI development. (2) Objective: To examine how behavior change theories and BCTs are implemented in mHealth PA JITAIs and assess their relationship to PA-related outcomes. (3) Methods: This scoping review followed the PRISMA-ScR guidelines. A total of 29 studies were included. (4) Results: The most commonly used BCTs include prompts/cues, goal setting (behavior), feedback on behavior, and self-determination theory and social cognitive theory are the most commonly used theory. However, there is insufficient evidence as to which theories and BCTs are most effective in eliciting effective PA behavior change. (5) Conclusion: Clearer re-porting and integration of BCTs and behavior change theories, along with optimized user interfaces, are needed to improve intervention quality, replicability, and long-term effectiveness of PA JITAIs.

Abstract: This study compared cognitive, language, and motor development outcomes among children attending public and private Early Childcare Centers (ECCs), considering birth factors and family and daycare environments. Additionally, it examined the proximal and distal factors influencing children’s development. Cognitive, language, and motor skills were assessed in the children, along with evaluations of ECC quality, teacher practices, and knowledge of child development. Results indicated that children enrolled in public ECCs achieved higher cognitive and language development scores despite coming from families with lower socioeconomic status and having lower birth weights. They also benefited from longer periods of breastfeeding. Teachers in public ECCs demonstrated greater daily practices, providing enhanced movement opportunities for children. Private ECCs offer more suitable outdoor spaces, whereas public ECCs have better indoor spaces. Regression analysis revealed that daily practice, teachers' experience, and the availability of gross motor toys explained 41% of the variance in motor development. The duration of breastfeeding explained 24% of the variance in cognitive development. Teachers' knowledge about children's development and attendance at public ECCs explains 31% of the variance in language development. These findings underscore the importance of prioritizing teacher education in public and private ECCs to optimize children's overall development.

Abstract: Background/Objectives: Previous studies assessing dietary intake have used self-report methods, prone to misreporting. Using researcher-conducted weighed food records, we assessed rural and urban mothers' energy and nutrient intakes and compared them to recommended nutrient intakes (RNIs). Methods: This cross-sectional study was conducted in rural (Asaase Kokoo) and urban (University of Ghana Staff Village) communities. Dietary data were collected from fifty-four mothers (26 rural, 28 urban) on 2 weekdays and 1 weekend day and were analyzed with software, programmed with West African, FNDDS, Kenyan, Ugandan, USDA food composition databases. Results: Mean (SD) ages (years) were 35.8 (11.6) and 44.4 (7.6), and mean energy intakes (kcal) were 2026 (461) and 1669 (385) for rural and urban mothers, respectively. Mean percentage contributions of macronutrients to daily energy intake were within recommended ranges for rural and urban mothers. All participants met or exceeded vitamin A RNI, irrespective of location. While all rural mothers met or exceeded iron RNI, some urban mothers (14.3%) did not. Few rural (7.7%) and urban mothers (10.7%) did not meet zinc RNI. About half of rural (46.2%) and urban mothers (53.6%) did not meet folate RNI. Most rural (96.1%) and urban mothers (92.8%) met or exceeded fiber RNI. Conclusions: Overall, rural mothers had higher energy and nutrient intakes than urban mothers. While most met RNIs, there were some micronutrient inadequacies, particularly folate, where almost half of rural and urban mothers consumed below RNI. Our findings indicate the need for tailored interventions to prevent nutrient deficiencies or excesses in Ghanaian mothers.

Abstract: Cystic fibrosis (CF) is a rare autosomal recessive genetic disease that has a progressive and multisystemic course. The spectrum and frequency of mutations in the gene enco-ding the cystic fibrosis transmembrane conductance regulator (CFTR) varies both in European countries and in other geographical regions. The aim of the our retrospective study was to present the genetic variants identified in a group of 48 patients with CF patients from the Moldova region (Romania), as well as to establish genotype-phenotype correlations. Genetic testing was initially performed for 38 CFTR mutations, and in heterozygous patients or in whom no mutation was detected, CFTR gene sequencing (NGS) was performed.The compound heterozygous genotype was identified in 26 (54.16%) of the patients (one of the alleles being F508del), while 22 (45.83%) patients had the homozygous F508del genotype. The F508del variant was the most frequent (69.79%), followed by: G542X (6.25%, 6/96), c.621 +1G>T (3.12%, 3/96), 1677delTA (3.12%, 3/96), 185+1G->T (3.12%, 3/96), 2184insA (2.08%, 2/96), c.917dupA (2.08%, 2/96) and 3849G>A (2.08%, 2/96). Several new variants were also identified, which had not been reported in other studies from Romania (R1158X, K598*, R347H, c.2589_2599del, R496H, and CFTRdele2). We compared the results obtained with data from the literature and correlated the detected CFTR variant (genotype) with the phenotypic manifestations, highlighting certain particularities present in some patients. Genetic testing allows for early diagnosis and adapted management, including personalized treatment for each patient. Identification of novel unclassified CFTR variants still remains a challenge for clinicians. NGS-based screening of heterozygous healthy carriers is important for both genetic counseling and prenatal diagnosis.