<b>Objectives</b><br/>The objective of this review was to analyze quantitative data on autism spectrum disorder (ASD) and to increase the accuracy of estimates of the prevalence of ASD.
<br/><b>Methods</b><br/>This review, which was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, included studies conducted from January 2008 to June 2024 on children aged 3 to 18 years that used standardized measurement tools and reported cut-off scores for ASD. The prevalence of ASD was the primary outcome analyzed in this review. The PubMed, Clinical Key, Scopus, Embase, CINAHL, and Web of Science databases were reviewed for relevant studies. The review protocol was registered with PROSPERO and followed the Cochrane collaboration guidelines.
<br/><b>Results</b><br/>A total of 66 studies reported on the prevalence of ASD, screening 21,313,061 children worldwide. Among these, 25 studies were conducted in Europe, 22 in Asia, and 13 in America. Additionally, 3 studies each were reported from Africa and Australia. According to a meta-analysis, 0.77% of children globally are diagnosed with ASD, with boys comprising 1.14% of this group. Notably, Australia showed the highest prevalence rate, with an effect size of 2.18, highlighting it as a critical area for public health focus.
<br/><b>Conclusion</b><br/>ASD represents a significant global health burden. Early detection, increased awareness among parents, and prompt intervention are crucial for mitigating developmental problems in children later in life. It is essential for health policymakers to acknowledge the prevalence and growing trends of ASD in order to implement effective interventions.
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Systematic review of optimizing brain-targeted vitamin D delivery: Novel approaches to enhance mental illness therapeutics Jinghu He, Zhiyuan Gao, Xilian Li, Long Zhao, Xue Tian, Biao Gao Brain Research.2025; 1858: 149656. CrossRef
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<b>Objectives</b><br/>Mild cognitive impairment (MCI) is prevalent among older adults and may progress to dementia. This study evaluated the effectiveness of a game-based brain exercise program in reducing MCI among older adults.
<br/><b>Methods</b><br/>A quasi-experimental study was conducted with 2 groups of older participants in Pathum Thani Province, Thailand. A total of 96 individuals with Thai mental state examination (TMSE) scores between 12 to 23, indicating MCI but no dementia diagnosis, were recruited. Using multi-stage sampling, participants were divided into an intervention group (n=48) and a control group (n=48). The intervention group participated in a 6-week game-based brain exercise program, while the control group received a self-administered brain exercise manual. Face-to-face interviews assessed outcomes at baseline, post-intervention, and 3-month follow-up. Data were analyzed using descriptive statistics and repeated-measures analysis of variance.
<br/><b>Results</b><br/>Significant differences were observed in mean TMSE scores and MCI knowledge between the intervention and control groups at the 3-month follow-up (p<0.001). The intervention group showed significant increases in TMSE scores and MCI knowledge post-intervention and at 3-month follow-up (p<0.001).
<br/><b>Conclusion</b><br/>The findings suggest that a game-based brain exercise program can improve cognitive function in older adults. Healthcare professionals can implement such programs to reduce MCI by addressing planning, management, and related issues in the future.
<b>Objectives</b><br/>This review and meta-analysis examined the effectiveness of non-pharmacological therapies delivered through school-based interventions for smoking cessation among adolescents in South and Southeast Asian countries.
<br/><b>Methods</b><br/>A systematic search was conducted across PubMed, Scopus, Science Direct, BioMed Central, the Cochrane Library, and ProQuest Dissertations & Theses Global from inception to October 2024. Eligible studies comprised randomized controlled trials and quasi-experimental studies that compared non-pharmacological smoking cessation interventions delivered in schools or other educational institutions. Data on smoking abstinence outcomes were extracted from published studies, and odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model via the Mantel-Haenszel estimator.
<br/><b>Results</b><br/>Seven studies involving 1,260 participants were included. The meta-analysis demonstrated that non-pharmacological school-based therapies significantly increased smoking abstinence compared to controls (OR, 2.83; 95% CI, 1.83–4.40; p<0.001. Subgroup analyzes revealed benefits across both randomized controlled trials and quasi-experimental studies with varying abstinence rates. Studies utilizing biochemical verification showed significant positive effects despite substantial heterogeneity, and short-term (<3 months) abstinence was significantly higher in intervention groups compared to controls. Overall, no differences were found between subgroups regarding intervention effectiveness.
<br/><b>Conclusion</b><br/>This meta-analysis indicates that non-pharmacological school-based interventions positively impact smoking abstinence rates, although effectiveness may vary based on study design, follow-up duration, and use of biochemical verification. The findings underscore the need for further research with larger sample sizes, extended follow-up periods, and improved methodological rigor in these regions.
<b>Objectives</b><br/>Vitamin D regulates immune function, cell proliferation, and differentiation. Its deficiency is linked to sepsis, although the causal relationship remains unclear. Studies suggest a strong correlation between FokI polymorphism and sepsis in the context of vitamin D deficiency. This study examined the association between vitamin D levels, the VDR FokI polymorphism, and sepsis risk through a systematic review and meta-analysis.
<br/><b>Methods</b><br/>Relevant articles from 2014–2024 were identified from various databases, including PubMed, Scopus, and Cochrane. A meta-analysis was conducted to assess the difference in vitamin D levels between the sepsis and control groups, as well as the relationship between VDR FokI genotypes (TT, CT, CC) and sepsis risk.
<br/><b>Results</b><br/>Vitamin D levels in sepsis patients were consistently lower than in the control group, with a mean difference of –4.17 ng/mL (95% confidence interval, –7.87 to –0.47; p=0.03). However, the relationship between VDR FokI genotype and sepsis risk was not statistically significant (p>0.05), although several individual studies showed a positive correlation. High heterogeneity was found in the analysis of vitamin D levels (I2=100%) and FokI genotypes (I2=91%), which affected the interpretation of the results.
<br/><b>Conclusion</b><br/>Vitamin D deficiency is a potential risk factor for sepsis, while the relationship between the VDR FokI polymorphism and sepsis risk requires further investigation. These findings highlight the importance of early detection of vitamin D deficiency as a preventive strategy in at-risk populations, although additional studies with more standardized designs are needed to definitively confirm this relationship.
<b>Objectives</b><br/>This study systematically reviewed and analyzed epidemiological evidence regarding the association between dietary total antioxidant capacity (DTAC) and both the risk of developing diabetes and glycemic biomarker levels.
<br/><b>Methods</b><br/>We searched the PubMed, Scopus, ScienceDirect, and Google Scholar databases through July 2024 without imposing any date restrictions. Original studies that examined the relationship between DTAC and either the risk of developing diabetes or glycemic biomarker levels—specifically fasting blood glucose (FBG), hemoglobin A1C (HbA1C), insulin, and the homeostatic model assessment for insulin resistance (HOMA-IR)—were eligible for inclusion. After eliminating duplicates and irrelevant records, relevant studies were selected, and data were extracted through rigorous critical analysis.
<br/><b>Results</b><br/>A total of 32 articles were included in the review. Of the 19 studies that evaluated diabetes risk, 15 reported a lower risk among subjects with higher DTAC values. All 4 studies examining prediabetes risk found lower risk in participants with high DTAC scores. Additionally, significant inverse relationships were observed between DTAC values and FBG (9/15 studies), HbA1C (1/6 studies), insulin (5/6 studies), and HOMA-IR (8/9 studies).
<br/><b>Conclusion</b><br/>The majority of evidence indicates that high adherence to an antioxidant-rich diet may reduce diabetes risk and improve glycemic biomarkers, including FBG, insulin, and HOMA-IR.
<b>Objectives</b><br/>Several previous studies have stated that consuming certain foods and beverages might increase the risk of chronic kidney disease (CKD). This study aimed to examine the relationships of food and beverage consumption with other risk factors for CKD. Methods: Data sources included the 2018 Basic Health Research (Riskesdas) and the National Socio-Economic Survey (Susenas), which were analyzed using a cross-sectional design. The study samples were households from 34 provinces in Indonesia, and the analysis was performed with provincial aggregates. Data were analyzed using risk factor analysis followed by linear regression to identify relationships with CKD. Results: The prevalence of CKD in Indonesia was 0.38%. The province with the highest prevalence was North Kalimantan (0.64%), while the lowest was found in West Sulawesi (0.18%). Five major groups were formed from 15 identified risk factors using factor analysis. A linear regression model presented 1 significant selected factor (p=0.006, R2 =31%). The final model of risk factors included water quality, consumption of fatty foods, and a history of diabetes. Conclusion: Drinking water quality, fatty food consumption, and diabetes are associated with CKD. There is a need to monitor drinking water, as well as to promote health education and provide comprehensive services for people with diabetes, to prevent CKD.
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<b>Objectives</b><br/>This study aimed to describe and compare health-related quality of life (QoL) as measured by the World Health Organization Quality of Life–BREF (WHOQoL-BREF) and the EuroQol-5 Dimensions (EQ-5D) among the Malaysian population, examining differences by sociodemographic characteristics including age, income, sex, ethnicity, educational level, and occupation. Methods: This cross-sectional study used data from 19,402 individuals collected as part of a health and demographic surveillance system survey conducted in the Segamat district of Malaysia in 2018–2019. Descriptive statistics and measures of central tendency were produced. Differences in QoL among demographic sub-groups were examined using the t-test and analysis of variance, while the correlations between the WHOQoL-BREF and EQ-5D were evaluated using Pearson correlation coefficients. Results: Based on complete case analysis (n=19,129), the average scores for the 4 WHOQoLBREF domains were 28.2 (physical), 24.1 (psychological), 12.0 (social relationships), and 30.4 (environment). The percentages of participants not in full health for each EQ-5D dimension were 12.8% (mobility), 3.1% (self-care), 6.9% (usual activities), 20.9% (pain/discomfort), and 6.8% (anxiety/depression). Correlations between the 4 WHOQoL-BREF domains and the 5 EQ-5D dimensions were relatively weak, ranging from –0.06 (social relationships with self-care and pain/discomfort; p<0.001) to –0.42 (physical with mobility; p<0.001). Conclusion: Although health-related QoL as measured by the WHOQoL-BREF and the EQ-5D are correlated, these 2 measures should not be considered interchangeable. The choice between them should be guided by the specific research questions and the intended use of the data.
Global health security threats in the post-coronavirus disease 2019 era include dense urban populations, increased human–animal proximity, migration driven by political or economic instability, climate change, humanitarian crises, antimicrobial resistance (AMR), and the misuse of biological research—including the accidental or intentional release of high-risk pathogens. The foundational preparation for these threats is to establish a robust, resilient public health system based on universal health coverage. The World Health Organization’s International Health Regulations must continue to promote global solidarity by maintaining core capacities such as surveillance, national laboratories, and epidemiological investigations of emerging infectious diseases, with timely reporting and information sharing within the global health security community. A One Health approach is essential for addressing AMR. Infection prevention and control must be enhanced to reduce healthcare-associated infections in medical facilities. Additionally, regulations concerning biosafety and biosecurity should address dual-use research of concern as well as the accidental or intentional release of highrisk pathogens from laboratories. Global health security is a collective responsibility because these threats know no borders and require coordinated action.
<b>Objectives</b><br/>This study aimed to identify safe, conserved, and highly immunogenic epitopes from all proteins of human-infecting norovirus (NoV) and to design a multi-epitope subunit vaccine construct from these epitopes using an immunoinformatics approach. Additionally, the vaccine construct was evaluated using both sequence- and structure-based assessments.
<br/><b>Methods</b><br/>Conserved fragments were identified from all proteins of human-infecting NoV, and B and T lymphocyte epitopes were subsequently predicted using multiple epitope prediction tools. The selected epitopes were linked to form a multi-epitope construct, incorporating various adjuvants in the design. Vaccine constructs with different adjuvants were analyzed for their physicochemical properties and immune simulation profiles, and the optimal combination was selected as the final vaccine candidate for further study. Finally, molecular docking and dynamics simulations were performed to visualize the interaction between the construct and a host immune receptor.
<br/><b>Results</b><br/>Twenty-two safe, conserved, and highly immunogenic epitopes were identified from all human-infecting NoV proteins. The construct adjuvanted with 50S ribosomal protein L7/L12 (50SrpL7/L12) was chosen as the final vaccine candidate due to its optimal physicochemical properties and favorable immune simulation profile. Furthermore, the construct exhibited high binding affinity and a stable interaction with toll-like receptor 4).
<br/><b>Conclusion</b><br/>The multi-epitope subunit vaccine designed in this study shows promise as a potential NoV vaccine candidate for human immunization. Further in vitro and in vivo experiments are warranted to validate these findings.
<b>Objectives</b><br/>Klebsiella pneumoniae is known as one of the most common causes of hospitalacquired infections. Its prevalence poses substantial challenges to both hospital and public health systems, particularly due to the rise of multidrug‐resistant strains. Understanding the epidemiology and resistance properties of K. pneumoniae can inform antimicrobial stewardship and infection control programs. A cross-sectional study was employed from November 2021 to November 2023. Methods: A total of 24 isolates underwent antimicrobial susceptibility testing using the disk diffusion method, an extended-spectrum beta-lactamase (ESBL) production test, and molecular gene detection. Results: The study found that 95.8% of clinical isolates were classified as multidrug-resistant. All isolates were resistant to ampicillin (100%). A high percentage of isolates were resistant to cefazolin (91.7%), ceftriaxone (87.5%), cefotaxime (87.5%), cefepime (87.5%), ciprofloxacin (83.3%), and sulfamethoxazole-trimethoprim (83.3%). Of the 24 isolates, 87.5% harbored ESBL genes, while the frequencies for GES, NDM, SIM, and OXA-48 were 16.7%, 20.8%, 8.3%, and 41.7%, respectively. Notably, the OXA-23 and OXA-51 genes, which are typically associated with Acinetobacter baumannii, were detected in 16.7% and 20.8% of isolates, respectively. Moreover, the prevalence of virulence genes rmpA, acrAB, and tolC was 0%, 95.8%, and 87.5%, respectively. Conclusion: This study demonstrated a high level of antibiotic resistance and a significant presence of virulence genes among K. pneumoniae isolates. Consequently, these findings represent a critical public health issue that requires heightened awareness among all stakeholders, including health workers.
The emergence of antimicrobial resistance raises the fear of untreatable diseases. Antimicrobial resistance is a multifaceted and dynamic phenomenon that is the cumulative result of different factors. While Gram-positive pathogens, such as methicillin-resistant Staphylococcus aureus and Clostridium difficile, were previously the most concerning issues in the field of public health, Gram-negative pathogens are now of prime importance. The World Health Organization’s priority list of pathogens mostly includes multidrug-resistant Gram-negative organisms particularly carbapenem-resistant Enterobacterales, carbapenem-resistant Pseudomonas aeruginosa, and extensively drug-resistant Acinetobacter baumannii. The spread of Gram-negative bacterial resistance is a global issue, involving a variety of mechanisms. Several strategies have been proposed to control resistant Gram-negative bacteria, such as the development of antimicrobial auxiliary agents and research into chemical compounds with new modes of action. Another emerging trend is the development of naturally derived antibacterial compounds that aim for targets novel areas, including engineered bacteriophages, probiotics, metal-based antibacterial agents, odilorhabdins, quorum sensing inhibitors, and microbiome-modifying agents. This review focuses on the current status of alternative treatment regimens against multidrug-resistant Gram-negative bacteria, aiming to provide a snapshot of the situation and some information on the broader context.
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<b>Objectives</b><br/>In the Republic of Korea, the previous surveillance system for zoonotic tuberculosis (TB) involved the X-ray testing of humans in contact with Mycobacterium bovis-infected livestock. In contrast, the updated surveillance system incorporates the genotyping of cultured Mycobacterium isolates for high-risk occupational groups. This study aimed to systematically document the detection, diagnosis, assessment, and response in the epidemic investigation of zoonotic TB in a laboratory worker in the Republic of Korea.
<br/><b>Methods</b><br/>M. bovis was confirmed using spoligotyping and whole genome sequencing. Clinical characteristics were reviewed through epidemiological investigation and interviews with the affected individual. Transmission routes and secondary spread were assessed via field epidemiological investigations and contact evaluations using chest X-ray and interferon gamma release assay for latent TB infection.
<br/><b>Results</b><br/>A 56-year-old laboratory worker presented with chest X-ray findings compatible with TB and subsequently tested positive for M. bovis. She had no clinical or family history of TB and remained asymptomatic. She completed a 6 month treatment regimen of isoniazid, rifampin, ethambutol, and pyrazinamide without hospitalization. Although no direct transmission pathways for zoonotic TB were identified, her work in a laboratory, processing specimens for zoonotic TB, indicated potential laboratory related exposure.
<br/><b>Conclusion</b><br/>This case underscores the importance of stringent use of personal protective equipment among high-risk occupational groups and the implementation of an enhanced surveillance system to report zoonotic TB. These findings highlight the need for a One Health approach and proactive surveillance, emphasizing the necessity of refining and strengthening surveillance systems for precise monitoring and an effective response.
<b>Objectives</b><br/>Malaria remains a serious public health challenge in tropical and subtropical regions, including Indonesia. Children under 5 years old face particular risk of contracting malaria due to low immunity. We examined potential factors associated with malaria infection among under-5 children in Papua Province, Indonesia.
<br/><b>Methods</b><br/>The study utilized secondary data from Indonesia Basic Health Research 2018. Multistage random sampling was employed, from the province level to census blocks (CBs). In Papua Province, interviews were conducted in 928 CBs. All 2,745 under-5 children were selected. The dependent variable was laboratory-confirmed malaria positivity; independent factors included residential area, socioeconomic characteristics, and behaviors such as sleeping under an insecticide net impregnated ≤3 years ago and the use of ventilation barriers. We also examined the conditions of the bedroom, kitchen, and living room according to the frequency of window-opening, proportion of ventilation area to the floor, and radiance.
<br/><b>Results</b><br/>Not sleeping under an insecticide net impregnated within the last 3 years (adjusted odds ratio [aOR], 0.518; 95% confidence interval [CI], 0.391–0.685; p<0.001); having a kitchen without windows (aOR, 0.491; 95% CI, 0.285–0.844; p=0.01); rarely opening the living room window (aOR, 2.804; 95% CI, 1.232–6.383; p=0.01), and having a windowless living room (aOR, 3.027; 95% CI, 1.369–6.696; p=0.01) displayed significant relationships with malaria infection among under-5 children.
<br/><b>Conclusion</b><br/>Not using an insecticide-treated net impregnated ≤3 years ago, along with opening the living room window daily and having a kitchen without windows, appear preventive of malaria infection among under-5 children.
<b>Objectives</b><br/>This study aimed to investigate the relationship between blood microbiota, specifically bacterial DNA, and cognitive decline in individuals with subjective cognitive decline (SCD) and amnestic mild cognitive impairment (aMCI). The objective was to identify potential microbial signatures that could serve as biomarkers for cognitive deterioration. Methods: Forty-seven participants were recruited, including 13 with aMCI, 20 with SCD, and 14 normal cognition (NC). Blood samples were collected, and microbial DNA was analyzed using 16S rRNA sequencing on the Illumina MiSeq platform. Bioinformatics analyses—including α- and β-diversity measures and differential abundance testing (using edgeR)—were employed to assess microbial diversity and differences in bacterial composition among groups. Logistic regression models were used to evaluate the predictive impact of the microbiota on cognitive decline. Results: Microbial diversity differed significantly between groups, with NC exhibiting the highest α-diversity. Both the aMCI and SCD groups showed reduced diversity. Taxa such as Bacteroidia, Alphaproteobacteria, and Clostridia were significantly decreased in the aMCI group compared to NC (p< 0.05). In contrast, Gammaproteobacteria increased significantly in the aMCI group compared to both NC and SCD, indicating progressive microbial changes from SCD to aMCI. No significant differences were found between the NC and SCD groups. Conclusion: Distinct bacterial taxa—particularly the increase in Gammaproteobacteria along with decreases in Bacteroidia, Alphaproteobacteria, and Clostridia—are associated with the progression of cognitive decline. These findings suggest that blood microbiota could serve as potential biomarkers for the early detection of aMCI. However, the small sample size and the lack of control for confounding factors such as diet and medication limit the findings. Larger studies are needed to validate these results and further explore the role of microbiota in neurodegeneration.
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