Young adults report heightened cannabis use yet show gaps in cannabis-related risk knowledge. Risk knowledge gaps in young adults with diverse cannabis use experience and across countries with varying cannabis policies, as well as associations with knowledge levels were explored.

The International Cannabis Policy Study (ICPS) is a cross-sectional, web-based survey that uses non-probability sampling and post-stratification weighting. Data from the 2023 ICPS national surveys conducted in Canada, Germany and the UK were used. A total of n = 2,945 18- to 25-year-olds were included in the analyses (Canada: n = 2,047; Germany: n = 446; UK: n = 452). Risk knowledge gaps were assessed through 7 health-related risk items. Inaccurate responses were turned into an index variable to measure participants’ level of risk knowledge. Negative binomial regression models were used to examine associations between sociodemographic and use-related variables and knowledge level.

Risk knowledge levels were highest among German participants, and lowest among UK participants. Some risks were better known than others across all countries. Risk knowledge was lowest among regular cannabis consumers, for whom being from the UK was associated with decreased knowledge levels (IRR = 1.227) and being at moderate risk of harm from use was associated with increased knowledge levels (IRR = 0.701). Among occasional consumers, age (IRR = 1.041), being male (IRR = 1.222) and being at moderate (IRR = 1.236) and high (IRR = 1.818) risk of harm from use were associated with decreased risk knowledge, whereas peer use (IRR = 0.718) was associated with increased risk knowledge.

This study showed that there are differences in the perception of cannabis risks among young adults, which are associated with individual consumption patterns as well as country-specific and sociodemographic factors. Findings extend the current understanding of differences and similarities in risk knowledge gaps among young adults across different countries, allowing for a more tailored risk education towards the needs of this target group.

Research has produced a substantial and expanding body of evidence-based practices (EBPs), encompassing interventions, programmes, clinical guidelines, protocols, care pathways and models of care supported by the best available evidence. Despite this, healthcare delivery is still frequently characterised as insufficiently evidence-based, reflecting a persistent gap between what is known to be effective and what is routinely implemented in practice. Traditional explanations only partially account for this gap, often overlooking culture as a critical yet under-theorized influence. Culture is a learned phenomenon rooted in social contexts, encompassing shared norms, values, beliefs and assumptions that define a group, whether a team, profession or organization. This paper argues that the uptake and sustainability of EBPs are profoundly shaped by cultural dynamics operating across three key layers: organizational, professional and disciplinary.

Organizational culture shapes openness to change, learning and psychological safety, influencing whether EBPs are seen as improvements or burdens. Professional cultures, rooted in education and identity, affect how physicians, nurses and other professionals apply guidelines and protocols. Disciplinary cultures, tied to clinical environments (e.g. emergency, intensive, mental health, palliative care), also shape how EBPs are received. Enhancing cultural responsiveness requires aligning EBPs with the shared norms, values, beliefs and assumptions of the intended users. Strategies include fostering clinician engagement in the development of EBPs, cultural competence, local adaptation and leveraging cultural champions.

Implementation of EBPs is shaped by culture, not solely by the strength of evidence or implementation strategies. Organizational, professional and disciplinary cultures interact to influence how EBPs are interpreted, accepted, adapted or resisted in practice, helping to explain persistent variation in uptake. Misalignment between EBPs and prevailing norms, values, beliefs and assumptions undermines implementation even when evidence is strong.

Resistant starch (RS) has been widely investigated as a dietary component with potential metabolic benefits, including improved insulin sensitivity, lipid profile, and inflammatory markers. However, clinical findings remain inconsistent, particularly regarding RS type and dosage. This integrative review aimed to synthesize evidence on the effects of RS consumption in dietary interventions on metabolic and cardiovascular parameters in adults and older adults.

RS intake, particularly RS2 and RS3, was associated with significant reductions in postprandial glucose, insulin, and HOMA-IR, as well as improvements in total cholesterol, LDL-C, and triglycerides. Additional findings indicated modest decreases in blood pressure and central adiposity, linked to increased short-chain fatty acid production and higher GLP-1 and PYY levels. Despite promising results, methodological heterogeneity and short intervention durations limit the strength of conclusions. RS shows potential as a functional nutrient for cardiometabolic modulation, particularly for glycemic and lipid control. However, longer, standardized clinical trials are required to confirm efficacy and clarify its physiological mechanisms.

Cardiovascular-kidney-metabolic (CKM) syndrome represents a new framework to address the non-communicable disease burden in ageing populations. However, evidence on the association between physical activity and the integrated CKM syndrome is scarce, particularly among older Asian adults. We aimed to investigate this association in a large sample of older Chinese adults.

This cross-sectional study utilised data from the China Ageing and Health Survey, including 41 829 community-dwelling adults aged ≥65 years. Physical activity was assessed using the validated Physical Activity Scale for the Elderly (PASE). Cardiovascular-kidney-metabolic syndrome was defined based on the 2023 American Heart Association criteria (Stages 1-4 vs. Stage 0). Multivariable logistic regression models were used to examine the association between PASE quartiles and CKM syndrome prevalence.

The prevalence of CKM syndrome was 80.3%. After full adjustment, a significant inverse dose-response relationship was observed between physical activity and CKM syndrome (P for trend <0.001). Participants in the highest physical activity quartile had 21% lower odds of CKM syndrome compared to the lowest quartile (adjusted odds ratio (aOR) = 0.79; 95% CI = 0.74-0.85). This inverse association was consistent across sexes but was strongly age-dependent: it was most pronounced among individuals aged ≥80 years (P for trend <0.001) and non-significant in the 65-69 age group (P for trend >0.05).

Higher physical activity is independently associated with a lower prevalence of CKM syndrome in older Chinese adults. This inverse association was strikingly age-dependent and most pronounced in the oldest-old (aged ≥80 years). For aging populations globally, promoting accessible, age-appropriate physical activity may represent a high-priority, low-cost public health strategy to reduce CKM burden, particularly in this most vulnerable demographic.

Lactobacillus species play a key role in maintaining vaginal microbial homeostasis and protecting against genital infections. Disruption of this microbial balance can increase susceptibility to vaginitis. Population-specific variations in the composition of vaginal Lactobacillus communities may influence disease risk and therapeutic responses. This study aimed to evaluate the distribution of major vaginal Lactobacillus species in healthy Iranian women and those with vaginitis using species-specific molecular assays.

In this case-control study, 100 women with clinically confirmed vaginitis and 100 healthy controls were enrolled. Vaginal swabs were examined by Gram staining, followed by DNA extraction and PCR amplification using universal and species-specific 16S rRNA primers targeting L. iners, L. crispatus, L. acidophilus, L. gasseri, and L. jensenii. Associations between bacterial species and clinical status were evaluated using Odds Ratio (OR), Relative Risk (RR), Phi coefficient (Φ), and Chi-square tests.

Lactobacillus spp. were detected in 97% of healthy women compared with 53% of symptomatic participants. L. jensenii and L. acidophilus were significantly more prevalent in healthy individuals, demonstrating strong protective associations with vaginal health. In contrast, L. iners was more frequently detected in women with vaginitis, consistent with its proposed role as a transitional species associated with microbiome instability. Although L. crispatus is often reported as protective in other populations, it did not show a statistically significant protective association in this study population.

Our findings highlight the protective association of dominant Lactobacillus species, particularly L. jensenii and L. acidophilus, in maintaining vaginal microbial balance. The higher prevalence of L. iners among symptomatic women further supports its association with disturbed vaginal microbiota. These results suggest the presence of population-specific microbial patterns and underscore the importance of considering regional microbiome characteristics when developing diagnostic approaches and probiotic-based interventions.

The objective of this study was to assess the wound healing traits of Valeriana officinalis and Chelidonium majus hydro-alcoholic (HA) extracts on surgical wounds in Wistar rats. The HA root extracts were separated using percolator and 96 degree alcohol in desiccator device. Additionally, 24 Wistar rats (six months old, 200 g) were divided into three groups: control, V. officinalis, and C. majus. Wound creation (2 cm in diameter) was developed by initial intraperitoneal injection of anesthetic drugs (5% ketamine and 5mg/kg of diazepam) and hair shaving. 24 hours after wound creation, treatment was initiated using ointment containing 5% of each V. officinalis and C. majus HA extract, applied for 21 days. Wound imaging on days 4, 7, 14 and 21 was performed using a digital camera. Histopathologic examination of the wounds was conducted at 4, 7, 14 and 21-day intervals. Microscopic and macroscopic observations revealed significantly higher wound healing rates in treated groups compared to the control. Histopathologic examinations indicated sufficient angiogenesis, existence of collagen and fibroblast cells and reduction in the inflammatory cells. Moreover, wound contraction was observed in the treated groups. Noticeably, the C. majus HA extract treated the wounds more efficiently. The wound healing in Wistar rats using HA extracts from V. officinalis and C. majus was promising though more investigations are required. Additionally, C. majus HA extract demonstrated healing effect compared to that of V. officinalis. It is proposed to evaluate the cytotoxic levels of extracts and formulate them in future studies to achieve more efficient and rapid healing of wounds. In addition, combination of extracts from various herbal medicines and with synthetic drugs can be studied for wound healing applications.

Antimicrobial resistance has posed considerable health and economic burdens globally (approximately five million deaths annually), particularly in developing countries. The estimated annual treatment costs in the United States include US$4.6 billion. Vast antibiotic resistance among Gram-negative and Gram-positive bacterial species has spread from healthcare to the environment, community, and animals. These conditions have limited and in some cases, failed infection eradication options and facilitated the distribution of drug-resistant organisms. The spread of drug-resistant bacterial infections is a major human health concern, hence, seeking novel antibacterial agents is crucial. This study used nanoemulsions of Citrus aurantium and Artemisia annua essential oils (EOs) as natural antibacterial agents. Gas chromatography mass spectrometry (GC-MS) analysis showed that limonene (31.4%) and artemisia ketone (26.2%) were major components, respectively. After that, their nanoemulsion dosage forms with mean droplet sizes of 181 ± 7 and 160 ± 5 and zeta potential values 3.1 ± 0.8 and -4.9 ± 0.5 mV were prepared. Meanwhile, successful loading of the EOs in nanoemulsion was confirmed by Attenuated Total Reflection-Fourier Transform Infrared (ATR-FTIR) analysis. A. annua nanoemulsion with 40% antioxidant effect was significantly more potent than C. aurantium nanoemulsion. Meanwhile, nanoemulsions' antibacterial and antibiofilm activity against clinical and standard strains, Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumonia, were investigated. The best efficiency was related to the effect of C. aurantium nanoemulsion against S. aureus; minimum inhibitory (MIC) and minimum bactericidal concentrations (MBC) were 500 and > 2000 µg/mL. In addition, no biofilm was formed after treatment with both nanoemulsions. Therefore, C. aurantium and A. annua EO nanoemulsions may act as natural antioxidant and antibacterial agents in complementary medicine.

The global incidence of early-onset (EO) cancers-defined as malignancies diagnosed in individuals under the age of 50-has increased significantly over recent decades, particularly in high-income countries. However, epidemiological data from Latin America remain fragmented and underexplored. This study protocol describes a scoping review designed to systematically map and synthesize the available evidence on EO cancer incidence trends in Latin American populations.

The review will be conducted in accordance with the JBI Manual for Evidence Synthesis and reported following PRISMA-ScR guidelines. A comprehensive search will be performed across multiple databases (PubMed, Embase, Scopus, LILACS, Cochrane, Web of Science), clinical trial registries, and gray literature sources without language or date restrictions. Studies reporting incidence data on solid tumors diagnosed before age 50 in Latin American countries will be included. Study selection and data extraction will be performed independently by four reviewers using a standardized form. Data will be analyzed through descriptive statistics and qualitative synthesis. The findings aim to highlight incidence patterns by cancer type, population characteristics, and methodological approaches.

The final scoping review will present the search results, the study inclusion process, and the data analysis.

This review will provide a consolidated epidemiological overview to inform public health policy, improve cancer surveillance, and identify research gaps in the region.

This protocol was registered on the Open Science Framework (OSF). The registry number is OSF.IO/TZ67D. This registration ensures the transparency and credibility of our research process, as it provides a public record of our study design and methods.