As the population of persons living with HIV (PLWH) ages, the Peruvian National HIV, STI and Hepatitis Program (NHSTIHP) faces the question of how best to provide care for non-communicable diseases (NCDs) among PLWH. Using a qualitative approach, this study explores the barriers and facilitators of providing NCD care to PLWH in Peru through the perspective of NHSTIHP physicians and coordinators. HIV regional program coordinators and physicians affiliated with Peru's NHSTIHP were recruited for individual in-depth interviews from the Program's physician and coordinator registry and by peer referral. Interviews continued until thematic saturation was reached in both groups. The emerging themes were visualized using an adapted socioecological framework. All regional coordinators who volunteered (N = 25) were interviewed. Physicians were sampled to ensure variability in training background and region, and 14 physicians were interviewed to reach thematic saturation. Barriers and facilitators discussed by both groups were organized into major themes following a socioecological model: patient, provider, local clinic/hospital, regional, and national health system. Peru-specific themes identified included: concern about practicing outside of one's specialty ("intrusismo"), patient trust, the role of HIV coordinators and insurance, and the importance of national clinical practice guidelines. This study highlights the complex interplay between patient, provider, local, regional, and national factors that influence delivery of care to PLWH in Peru. Addressing the barriers will require co-creation of resource-adaptable national HIV guidelines, with the participation of providers, program coordinators, and patients. These guidelines should encompass not only NCD management and educational resources for HIV providers and patients, but also processes and implementation pathways. This will require coordination between existing NCD and HIV health programs, and generation of epidemiologic data on NCD in PLWH to optimize resource allocation.

Adverse Childhood Experiences (ACEs) are established life-course determinants of adult health, yet evidence linking ACEs to multimorbidity in sub-Saharan Africa remains limited. Nigeria is undergoing rapid demographic and epidemiological transitions characterized by population ageing and a rising burden of non-communicable diseases (NCDs). This study examined whether cumulative ACE exposure predicts multimorbidity among older adults in North-Central Nigeria.

A cross-sectional study was conducted among 734 adults aged ≥60 years in Niger State, Nigeria. ACE exposure before age 18 was assessed using the Adverse Childhood Experiences International Questionnaire (ACE-IQ) across 13 domains. Multimorbidity was defined as the presence of two or more chronic conditions (NICE criteria) from a list of 24 conditions and analyzed both as a count and dichotomized (≥3 vs. < 3 conditions). Descriptive statistics summarized participant characteristics. Chi-square tests examined bivariate associations. Hierarchical logistic regression models estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to determine independent predictors of multimorbidity.

High cumulative ACE exposure was observed, with 68.4% reporting ≥4 ACEs. Multimorbidity was common: 38.4% reported three or more chronic conditions. ACE exposure was strongly associated with multimorbidity (χ² = 116.07, p < 0.001). In unadjusted analysis, participants reporting ≥4 ACEs had significantly higher odds of multimorbidity (OR = 67.14; 95% CI: 9.25-487.04). After adjusting for socio-demographic covariates, cumulative ACE exposure remained an independent predictor (OR = 15.58; 95% CI: 1.33-182.21). Advanced age (≥80 years) and living in three-generation households were also independently associated with multimorbidity.

Cumulative childhood adversity significantly predicts multimorbidity among older Nigerian adults, demonstrating a clear dose-response relationship. These findings underscore the importance of life-course approaches and trauma-informed strategies in public health policy. Early identification and prevention of childhood adversity may contribute to reducing the long-term burden of multimorbidity in low- and middle-income settings.

Cancer remains a major cause of global mortality, while late-stage diagnosis and therapeutic resistance highlight the need for individualized strategies. Nanotheranostics has emerged as a promising paradigm by integrating cancer diagnosis and treatment within multifunctional nanosystems. However, most current approaches remain technology-driven rather than truly patient-specific. This review examines the emerging convergence of adaptive nanotechnology, artificial intelligence (AI), molecular profiling, and precision medicine to develop intelligent nanoplatforms capable of responding to individual biological characteristics. Based on a literature search of PubMed, Scopus, and Web of Science (January 2010-June 2026), we review nano-enabled diagnostic approaches, including SERS-based nanoprobes and circulating tumor DNA detection, therapeutic strategies such as stimuli-responsive drug delivery, CRISPR-Cas9 nanodelivery, and personalized nanovaccines, and integrated multimodal imaging-guided theranostic systems. We further evaluate clinical trials and translational studies, highlighting biological, manufacturing, regulatory, and ethical barriers to clinical implementation. Although generalized nanoparticle platforms have reached Phase II/III trials and some have received regulatory approval, truly patient-specific nanotheranostic systems remain largely at early clinical stages. AI may bridge patient molecular profiles and nanoplatform design by optimizing nanoparticle properties, predicting biological interactions, and enabling personalized treatment selection. This review provides a roadmap toward adaptive, intelligent, and patient-specific cancer nanotheranostics, supporting a paradigm shift from generalized treatment toward precision-guided personalized healthcare.

Systematic integration of circular RNA (circRNA)-disease associations is essential for elucidating the roles of circRNAs in disease pathogenesis and evaluating their potential as biomarkers and therapeutic targets. circRNADisease was established as a manually curated database of experimentally supported circRNA-disease associations. Here, we present circRNADisease v3.0, a substantially expanded and enhanced release containing 15 390 curated circRNA-disease entries involving 9168 circRNAs, 656 MONDO-standardized disease terms, and 66 species, representing more than a twofold increase in data volume compared with v2.0. Each record is assigned a confidence score according to the strength and diversity of supporting evidence, including clinical evidence, circular-transcript identity verification, expression detection, functional experiments, molecular-mechanism validation, and bioinformatic analysis. The updated database also incorporates genomic coordinates, subcellular localization, experimental validation methods, clinical significance, data and code availability, and cross-references to multiple disease terminologies. Two new modules have been introduced. Circ2CNV contains 2 962 504 circRNA-cancer cohort records with copy-number variations across 33 TCGA cancer cohorts, whereas Circ2Celltype comprises 2025 cell-type-resolved evidence records covering 29 cell types. Together with the existing Circ2Mut module, these additions connect literature-curated circRNA-disease associations with genomic alterations and cellular contexts. circRNADisease v3.0 provides a comprehensive and evidence-oriented platform for circRNA research and is freely available at http://cgga.org.cn/circRNADisease/.

Adolescents in low- and middle-income countries face increasing risks for all forms of malnutrition. In Kenya, undernutrition and micronutrient deficiencies persist alongside rising rates of overweight, obesity, and nutrition-related noncommunicable diseases, highlighting the need for contextually grounded, multilevel community-based strategies to improve adolescent diets.

This study aims to examine multilevel factors that influence dietary behaviors among adolescents living in Kibera, the largest informal settlement in Kenya, to inform the design of future community-based interventions.

We conducted qualitative formative research in Kibera using focus group discussions (FGDs) with adolescent girls (8 FGDs, n = 63) and boys (7 FGDs, n = 46) aged 10-18 y, parents and guardians (4 FGDs, n = 31), and teachers (3 FGDs, n = 21), as well as key informant interviews with school administrators (n = 5) and health care workers (n = 7). All discussions and interviews were audio recorded, transcribed, translated, and analyzed thematically using Atlas.ti.

Food insecurity and the high cost of nutritious foods were identified as the primary barriers to healthy eating. Adolescents described constrained physical food environments, including school meals that lacked diversity and nearby vendors selling inexpensive fried and sweet foods with few healthy options. Food safety concerns were raised for both school and vendor foods, although these concerns rarely influenced dietary behaviors. Although adolescents demonstrated strong nutrition knowledge and motivation to eat healthfully, economic constraints, limited affordable options, social norms, and taste preferences shaped actual food choices.

Adolescents in Kibera expressed strong motivation and knowledge related to eating balanced diets but faced substantial barriers at the individual, social, physical, and macroenvironmental levels that limited their ability to do so. These findings highlight the importance of addressing constrained food choices when designing community-based interventions tailored to the needs of adolescents in urban informal settlements.

Stroke is the second leading cause of death globally. We tested whether it was feasible to deliver a community-based intervention package for prevention of stroke and, whether such an intervention would reduce stroke mortality in a rural underserved community in central India.

In this two-arm, parallel group, open label, cluster randomised controlled trial, 64 villages were randomly assigned with 1:1 allocation to the control and the intervention arm in a demographic surveillance site. The intervention was delivered for 3.5 years. It included community-based screening for hypertension, diabetes and stroke among individuals ≥ 50 years of age by trained community health workers followed by village-based treatment by an outreach physician, awareness generation and active follow up. In the control arm, households were provided information on the ill effects of tobacco and steps to quit it. Cause of death was ascertained on all deaths using verbal autopsies by physician coders who were blinded to the treatment allocation.

There were 7671 individuals in the control arm and 8255 in the intervention arm who were ≥ 50 years of age. In the intervention arm, out of 8255 eligible individuals, 8026 were screened and 2793 were diagnosed with hypertension, 317 with diabetes and 182 with stroke and those with these three conditions received the intervention. The stroke mortality rate per 100,000 person-years in the last 2.5 years of the intervention, which was the primary outcome of the trial, was comparable in the intervention (416.7) and the control arm (484.9) (adjusted hazard ration [HR] 0.84, 95 % confidence interval [0.62,1.12]; p = 0.23). Important limitations include limited access to brain imaging and lipid profile measurements.

In this under resourced rural community in central India, a community-based intervention for stroke risk reduction did not reduce stroke mortality over the final 2.5 years of the trial. However, the trial intervention was acceptable and led to improved medication compliance, blood pressure control and awareness about stroke.

The trial was registered at the Clinical Trials Registry of India: CTRI/2015/12/006424.

We aimed to compare performance of three cardiovascular disease (CVD) risk estimation tools; the World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction tool, the American College of Cardiology/American Heart Association Atherosclerotic Cardiovascular Disease (ACC/AHA ASCVD) Risk Estimator, and Framingham risk score (FRS) in estimating the risk of fatal and nonfatal cardiovascular events.

We conducted a prospective, observational, hospital-based study involving 200 high-risk study participants, who visited a non-communicable disease clinic in a tertiary care hospital in eastern India. The 10-year CVD risk was estimated using the ACC/AHA ASCVD Risk Estimator, FRS, and the WHO/ISH risk prediction tool. We used kappa statistics to determine agreement among these CVD risk estimators.

The mean (SD) age of study participants was 54.07 (9.15) years, and the majority (63.5%) were males. About 96% of the participants were diabetic, 33.5% were hypertensive, and 16% were current smokers. About 18%, 20.5%, and 0.5% were classified as high-risk using the ACC/AHA ASCVD Risk Estimator, FRS, and WHO/ISH risk tools, respectively. The agreement was moderate between the ASCVD risk estimator and FRS (Kappa 0.541, P < 0.001) and fair between the ASCVD risk Estimator and WHO/ISH (Kappa 0.305, P < 0.001) and between FRS and WHO/ISH (Kappa 0.314, P < 0.001).

A higher level of agreement was found between FRS and ASCVD risk scores compared to the WHO-ISH risk score. The WHO-ISH risk score identified most study participants in the lower-risk category, contrary to the FRS and ASCVD risk scores.

Stunting, a chronic form of malnutrition characterised by impaired linear growth, remains a significant global public health concern. While supplementation programmes have shown potential to improve growth outcomes, long-term implementation may be constrained by poor adherence, high costs and limited sustainability. Increasing reliance on ready-to-eat (RTE) and ready-to-cook (RTC) foods in low- and middle-income countries highlights the potential of nutrient-dense food-based approaches that align with existing dietary practices. This scoping review aimed to map and synthesise existing evidence on the development and evaluation of functional food products intended to support the prevention or management of stunting among children, with a focus on formulation strategies and nutritional characteristics. Using the Population-Concept-Context (PCC) framework, 22 studies were identified, encompassing various product categories, including complementary foods, bakery products and ready-to-use supplementary foods. Formulations primarily used cereal-based staples combined with protein- and lipid-rich ingredients, with selected products incorporating micronutrient fortification or bioactive ingredients. Differences in ingredient combinations, nutrient targets and processing approaches resulted in wide variation in nutrient composition, particularly in energy density, fat and selected micronutrients. Achieving the intended nutrient profile required careful ingredient selection and proportioning, along with appropriate processing. Evidence on the effects of these products on stunting outcomes remains limited. Overall, the findings highlight the need to consider ingredient composition, nutrient targets and processing together when developing nutrient-dense RTE and RTC food products for young children.

Growing evidence highlights the central role of inflammation in the onset and progression of DKD. In this study, we investigate the association between the neutrophil percentage-to-albumin ratio (NPAR) and clinicopathological features, as well as long-term renal outcomes, in patients with diabetic kidney disease (DKD). Three hundred five biopsy-confirmed DKD patients with baseline eGFR ≥ 15 mL/min/1.73 m² were retrospectively enrolled in this study. Baseline clinical and pathological characteristics were compared across NPAR quartiles. The primary outcome was 2-year DKD progression, defined as a > 40% increase in serum creatinine, end-stage renal disease, or all-cause mortality. Multivariable logistic regression, restricted cubic spline (RCS) analysis, and subgroup analyses were conducted to examine the association between the NPAR and kidney outcomes. Subsequently, a prognostic nomogram was constructed for DKD patients incorporating NPAR to stratify individual risk. Higher baseline NPAR quartiles were significantly associated with renal dysfunction and advanced renal pathological lesions. In a subset of renal biopsy specimens, MPO immunostaining demonstrated increased renal neutrophil infiltration in patients with higher NPAR quartiles. Renal MPO expression was positively correlated with mesangial expansion, interstitial fibrosis, and tubular atrophy. Among patients with complete follow-up, 65.3% developed the composite kidney outcome. Compared with the lowest NPAR quartile, multivariable-adjusted odds ratios (95% CIs) for kidney outcomes were 1.68 (0.36-8.15), 6.21 (1.35-33.55), and 6.88 (1.27-46.86) for Q2, Q3, and Q4, respectively. RCS analysis indicated a nonlinear association between NPAR and kidney outcomes, with risk increasing sharply above an NPAR value of 1.38. Subgroup analyses identified significant interactions between NPAR and Kimmelstiel-Wilson nodules as well as SGLT2 inhibitor use on kidney outcomes. A prognostic model incorporating NPAR quartiles, age, total cholesterol, eGFR, and interstitial fibrosis demonstrated good discrimination (AUROC 0.863). In conclusion, elevated NPAR is associated with increased renal neutrophil infiltration, more severe histopathological injury, and adverse renal outcomes in patients with DKD, and independently predicts long-term renal progression.

The onset of type 1 diabetes mellitus (T1DM) in adolescence represents a challenge for patients, families, and health care professionals. Diabetes nurse educators identify a lack of adolescent-friendly educational resources, especially in nutrition education. Digital technology offers an opportunity to develop innovative tools to address these needs from a user-centered approach.

We aimed to design and evaluate the acceptability of the SMARTCLOTH-Odyssey platform, an interactive web tool designed to support diabetes nurse educators in delivering nutrition education based on carbohydrate counting to adolescents with recent T1DM, evaluated from the perspective of nurse educators.

A mixed study was carried out in three phases: (1) qualitative analysis through two focus groups with nurse educators in the Andalusian Community to identify barriers and needs; (2) development of the digital tool following a human-centered design methodology, incorporating narrative and gamified elements; and (3) quantitative evaluation of acceptability through an ad hoc questionnaire applied to 40 professionals who tested the platform.

Participants highlighted the lack of homogeneous and adapted debut materials, and the need for emotionally sensitive and visually appealing tools. SMARTCLOTH-Odyssey was rated positively in terms of usefulness, clarity, and clinical applicability. A total of 97.5% (39/40) felt it could facilitate nutrition education, and 90% (36/40) said they would use it in their practice. The platform was perceived as intuitive, innovative, and adapted to the characteristics of the adolescent patient.

SMARTCLOTH-Odyssey constitutes a viable and well-valued proposal by nurse educators. It has the potential to improve nutrition education from the diagnosis of T1DM. Its participatory development reinforces its applicability and sustainability in real clinical contexts.