Recognition of high-risk human papillomavirus (HPV) as the etiologic agent in nearly all cervical cancers has fundamentally reshaped screening strategies, driving the development and adoption of highly sensitive molecular HPV assays. Over the past several decades, cervical cancer screening guidelines have shifted from primarily cytology-based approaches toward HPV-based modalities, with primary HPV testing now recommended as the preferred method by the American Cancer Society and anticipated to be similarly endorsed by the United States Preventive Services Task Force. This article traces the evolution of cervical cancer screening, from the original Papanicolaou test to current guideline recommendations, and discusses the logistical requirements for transitioning to a primary HPV screening system, including triage strategies for HPV-positive cases. The authors additionally present an institutional experience of initiating primary HPV testing, highlighting its impact on cytopathology laboratory workflow and specimen volumes.

Stroke is a major complication of atrial fibrillation (AF), and risk prediction using the congestive heart failure, hypertension, age, diabetes, stroke, vascular disease, and sex category score (CHA₂DS₂-VASc) remains limited by residual heterogeneity. We aimed to identify plasma proteins associated with post-AF stroke and evaluate whether a protein score provides incremental predictive information beyond CHA₂DS₂-VASc.

We analyzed 709 AF participants from the UK Biobank Pharma Proteomics Project, with 76 incident strokes. Stroke-related proteins were identified using multivariable Cox regression, least absolute shrinkage and selection operator (LASSO) Cox regression, and machine-learning approaches. A five-protein score was constructed, and its incremental value beyond CHA₂DS₂-VASc was assessed by discrimination, calibration, reclassification, clinical net benefit, and 1000-bootstrap internal validation. Mendelian randomization served as supportive genetic evidence.

Five core proteins were identified: epidermal growth factor receptor (EGFR), V-type proton ATPase subunit D (ATP6V1D), neurotrophin 4 (NTF4), amnionless (AMN), and discoidin, CUB and LCCL domain-containing protein 2 (DCBLD2). Adding the five-protein score to CHA₂DS₂-VASc improved discrimination, increasing the concordance index from 0.681 to 0.768. The combined model had 3-, 5-, and 8-year receiver operating characteristic areas of 0.799, 0.775, and 0.806, respectively, and showed favorable five-year prediction error and calibration, with a Brier score of 0.0347, calibration intercept of -0.068, and calibration slope of 0.968. The score improved continuous net reclassification improvement (0.459; P = 0.028). Mendelian randomization provided supportive genetic evidence for AMN, EGFR, and DCBLD2.

The five-protein score provided incremental predictive information beyond CHA₂DS₂-VASc for post-AF stroke risk assessment.

The prevalence of overweight and obesity and the associated non-communicable diseases in young adulthood has increased significantly in the last decade. Urban Indian young adults fail to meet the recommended guidelines for healthy diet and physical activity. The aim of this qualitative study was to gain novel insights into the barriers and facilitators of a healthy lifestyle of Indian young adults residing in urban settings.

Underpinned by the social constructivism paradigm, in-depth interviews were conducted with young adults (aged 21-30 years) who were recruited using purposive and snowball sampling techniques from eight metropolitan cities (New Delhi, Mumbai, Kolkata, Chennai, Ahmedabad, Pune, Hyderabad, Bengaluru). Interviews were audio recorded and transcribed verbatim. Transcripts were transferred to NVivo software for inductive thematic analysis.

A total of 79 young adults (41 males, 38 females) participated in the interviews. Five themes and their associated sub-themes were identified: (i) Perceptions of a healthy lifestyle (consuming a balanced diet, leading an active life, having adequate sleep); (ii) Facilitators of a healthy lifestyle (family support and upbringing, health promotion by celebrities and famous personalities, built environment, body image, intrinsic motivation); (iii) Barriers to a healthy lifestyle (time constraints, food environment challenges, peer pressure); (iv) Strategies adopted to maintain a healthy lifestyle (dietary management, engaging in exercise and other forms of physical activity, reducing screen time); and (v) Recommendations for prospective interventions (education and awareness about nutrition and health, creating healthy and hygienic food environments).

The evidence emerging from this multisite inquiry offers first-hand information about the individual, social, and environmental level barriers and facilitators to the adoption of a healthy lifestyle among urban Indian young adults. Strategies and recommendations suggested during the interviews can be used to tailor prospective lifestyle interventions for encouraging the adoption of sustainable healthy lifestyle in young adults. Prospective interventions could focus on enhancing nutrition and health knowledge of young consumers and offering more healthy and hygienic food options in cafeterias of workplaces and educational institutions as well as other eateries.

Health literacy is a foundational determinant of health equity, yet remains understudied in Kuwait and the broader Gulf region. This venue-based survey assessed health literacy and its sociodemographic and health-related correlates among adults surveyed in Kuwait, to inform equity-oriented health communication and community health education.

A venue-linked, electronic cross-sectional survey was conducted across all six governorates of Kuwait (February-April 2026). Adults aged 18 years or older were recruited using quota-informed convenience sampling through an electronic self-administered questionnaire distributed at selected public venues and study channels. Validated Arabic and English versions of the HLS-EU-Q16 were administered, yielding 1,846 participants (81.1% Kuwaiti; 78.4% female). Associations were examined using ANOVA (including Welch), Kruskal-Wallis tests, general linear modelling, and logistic regression, with sensitivity analyses for the sparse poor-SRH category.

The mean HLS-EU-Q16 score was 12.89 (SD = 3.42; Cronbach's α = 0.849), and 37.2% of participants surveyed had limited health literacy (inadequate 10.6%; problematic 26.5%). Finding information on mental illness was the hardest task (C8: 57% rated it easy). Self-rated health (SRH) was the factor most strongly associated with limited health literacy, showing a graded gradient robust to tests not assuming equal variances or normality (Welch and Kruskal-Wallis both p < 0.001). The association persisted in the adjusted logistic model; because only 12 participants reported poor SRH, a model collapsing poor and fair SRH gave a stable adjusted odds ratio of 4.91 (95% CI 3.00-8.03). Increasing age was independently associated with lower odds (aOR = 0.989/year, p = 0.010), whereas a sociodemographic-only model was non-significant (Nagelkerke R ² = 0.011, p = 0.217).

Over one-third of the adults surveyed in Kuwait had limited health literacy. Self-rated health was the strongest correlate in the adjusted model, though the cross-sectional design precludes causal inference. Mental health information access represents a specific, actionable gap. These findings call for accessible, culturally and linguistically appropriate community health education, system-level responsiveness, and communication strategies prioritising individuals with poorer perceived health and chronic conditions. Because the sample was venue-recruited and predominantly Kuwaiti and female, estimates apply to the surveyed population rather than all residents of Kuwait.

Intimate partner violence is a major public health problem worldwide and a leading form of violence against women in Islamic Republic of Iran.

To estimate the prevalence of intimate partner violence among married women in Islamic Republic of Iran and identify associated socioeconomic factors.

Using an online questionnaire administered through the Porsline platform, we collected data from 602 married women living in Qazvin Province, Islamic Republic of Iran, who were literate and had access to a smartphone with active internet connection. The study was conducted between February and April 2024. It assessed the psychological, physical, sexual, and intimate partner violence status of the women. The data were analysed using SPSS version 27 and multivariable binary logistic regression was performed to identify factors associated with violence among the women.

Overall, the prevalence of intimate partner violence was 53.7%. Of the women, 51.0% reported psychological violence, 24.8% physical violence and 20.6% sexual violence. Spousal drug misuse and longer marriage duration were associated with higher odds of all violence types. Higher household economic status and greater emotional support from the paternal family were associated with lower odds of violence. Physical violence was more frequent among women whose marriages were not initiated through parental introduction.

Socioeconomic disadvantage, limited paternal family support and spousal drug misuse were associated with intimate partner violence among the study participants. Interventions to strengthen resilience among the women are needed, including improved economic opportunities, counselling and engagement, and substance abuse reduction services.

Hypertension is one of the most common non-communicable diseases, and reports indicate that its prevalence is escalating globally due to several factors. Studies in different countries have shown an upsurge in the use of Herbal Medicinal Products (HMPs), including herbal antihypertensive medicines taken by people with hypertension, and 20-80 % of hypertensive patients concurrently use these herbal medicines and conventional antihypertensive medicines or other drugs. The safety and efficacy of the concurrent use of herbal and orthodox medicines are of great concern because of the high possibility of herb-drug interactions.

An extensive literature search was undertaken, and the information obtained was subjected to critical analysis. This review aimed to update the available data on HMPs with reproducible evidence-based antihypertensive efficacies. Additionally, the major phytochemical and bioactive constituents of these HMPs were identified along with a discussion of their potential to modulate activities of drug-metabolizing enzymes and drug transport systems, especially Pglycoprotein.

More than 50 commonly used medicinal plants from different regions of the world have been documented for their anti-hypertensive activity. Most of these studies used animal models to authenticate the antihypertensive activities of the herbs. In contrast, a few studies on extracts of Hibiscus sabdariffa, Allium sativum, Apium graveolens, Nigella sativa, Linum usitatissimum, and Camellia sinensis involved clinical trials. Potentials for herb-drug interactions varied among the clinically effective HMPs due to the wide variability in their phytochemical constituents.

Safety issues in using these HMPs were highlighted by the identification of beneficial or adverse, clinically significant herb-drug interactions.

Nucleophosmin1 (NPM1) proteins, initially recognized as central guardians of nucleolar architecture and function, have recently been redefined as pivotal hubs that integrate diverse forms of chronic cellular stress signaling. Although the roles of NPM1 have been extensively elucidated in tumor biology, its broad involvement in non-communicable chronic inflammatory diseases (NCDs) remains insufficiently and unsystematically summarized. Here, we highlight NPM1 as a key sensor of stress-induced nucleolar disassembly, nucleocytoplasmic translocation, and p53 stabilization. In pathological conditions such as myocardial ischemia, endothelial dysfunction, atherosclerosis, and chemotherapy-associated cardiotoxicity, NPM1 exhibits pronounced context dependence functioning either to initiate cytoprotective responses or to promote inflammation and apoptosis. In parallel, NPM1 plays a central role in maintaining genomic stability by sequestering, mobilizing, and regulating essential enzymes across multiple DNA damage repair pathways, including base excision repair (BER) and translesion synthesis (TLS). Dysregulation of these functions is closely linked to chronic pathological processes driven by metabolic stress, oxidative stress, and proteotoxicity. Collectively, available evidence suggests that NPM1, as a core node of the nucleolus-nucleoplasm signaling axis, may constitute a common molecular pathological basis underlying multiple chronic inflammatory diseases, including cancer, cardiovascular diseases, diabetes, and neurodegenerative disorders. A deeper dissection of its post-translational modifications, stress-dependent subcellular re-localization, and interactions with partner proteins is expected to provide a novel conceptual framework and therapeutic avenues for the development of NPM1-based targeted interventions. Accordingly, this review synthesizes the core molecular mechanisms of the NPM1 in the maintenance of cellular homeostasis, including regulating nucleolar stress, DNA damage repair, and inflammation, We place a particular emphasis on how these baseline pathways translate into distinct functional phenotypes within the pathological processes of chronic diseases, including cardiovascular, metabolic, and neurodegenerative disorders.

Candida esophagitis (CE) is a recognized opportunistic infection in immunocompromised individuals, but data from HIV-negative patients remain limited. This study aimed to determine the prevalence, clinical manifestations, risk factors, and molecular characteristics of CE in HIV-negative adults undergoing upper gastrointestinal endoscopy.

In this cross-sectional study, 455 HIV-negative adults with upper gastrointestinal symptoms who underwent esophagogastroduodenoscopy were evaluated. An esophageal mucosal sample for fungal culture was collected from all patients, while biopsy for histopathology was performed only when endoscopic findings suggested Candida infection. Active CE was defined by compatible endoscopic lesions, histopathological evidence of tissue invasion, and a positive fungal culture. Candida species were identified using PCR-RFLP.

Candida was detected in 84 patients (18.5%), and histopathologically confirmed that CE was identified in 16 patients (3.5%). The most common symptoms among CE patients were epigastric pain (68.8%) and acid reflux (56.3%). Diabetes mellitus (OR = 6.19, p = 0.001), denture use (OR = 3.72, p = 0.020), corticosteroid use (OR = 4.54, p = 0.025), and antibiotic use (OR = 5.08, p = 0.018) were significantly associated with CE. Among patients with CE (n = 16), molecular analysis showed Candida albicans as the predominant species (81.3%), followed by C. glabrata (12.5%) and C. tropicalis (6.2%).

CE is an uncommon yet clinically relevant condition in HIV-negative patients. Metabolic factors, medication exposure, and denture use significantly increase the risk of CE. Early identification of high-risk individuals and accurate species detection may support timely diagnosis and appropriate management.

Pediatric cancer remains a leading cause of morbidity and mortality worldwide, particularly in low-and middle-income countries. Cancer treatment may impair nutritional status, alter body composition, and exacerbate cancer-related fatigue (CRF). Phase angle (PhA), a bioelectrical impedance-derived marker of cellular integrity, has emerged as a potential noninvasive indicator associated with functional status, yet its role in pediatric oncology remains underexplored.

To investigate longitudinal changes in nutritional status and CRF and to examine the association between PhA and CRF in children/adolescents with cancer during the first 3 months of treatment.

Prospective longitudinal study included children/adolescents (0-18 years) newly diagnosed with cancer or central nervous system (CNS) tumors. Participants were assessed at diagnosis-[T0], 1 month-[T1], and 3 months-[T2] after treatment initiation. Data collected included clinical/sociodemographic characteristics, nutritional status (anthropometry/STRONGkids), body composition, and CRF (PedsQLMFS). Repeated measures analyses and linear mixed models were performed, with α = 5%.

A total of 23 patients (mean age 5.7 years old; 65.2% female) were included. Over time, significant reductions were observed in body mass index (p = 0.044), PhA (p = 0.013), and lean mass (p = 0.037). Self-reported fatigue worsened, particularly in the general fatigue domain (p = 0.043). Correlation analyses demonstrated significant associations between fatigue and body composition indicators, particularly calf circumference (r = 0.809-0.861), body fat mass (r = 0.756-0.844), and PhA (r = 0.521-0.752) in self-reports. In linear mixed-effects models, PhA was independently associated with total fatigue over time (β = 19.97; p = 0.011).

Children and adolescents undergoing cancer treatment experience early deterioration in nutritional status and body composition, accompanied by worsening CRF. Fatigue was consistently associated with PhA and lean mass-related indicators, suggesting that body composition and cellular integrity may be associated with fatigue severity during treatment. PhA emerged as a particularly promising noninvasive marker, independently associated with fatigue over time. These findings support the incorporation of PhA and comprehensive nutritional assessment beyond conventional weight- and height-based measures to improve the early identification of patients at risk.