Oral health and general health are closely linked, but the association between the two is still under discussion. This study aimed to update and expand a previously published systematic review and meta-analysis to include new data on the correlation between overall Oral Health-Related Quality of Life (OHRQoL) and Health-Related Quality of Life (HRQoL), and to examine how OHRQoL relates to the physical and mental components of HRQoL.

A comprehensive search of online databases (Ovid MEDLINE(R), Embase, CINAHL, PsycInfo, Scopus, and Web of Science) was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies reported correlations between validated OHRQoL and HRQoL instrument summary scores, and/or physical and mental component scores in adult populations. Correlation coefficients were pooled using the random-effects model. Subgroup analyses were performed by population setting (dental, medical, and nonpatient). A sensitivity analysis was conducted to compare pooled correlations for OHRQoL with the physical and mental components of HRQoL. Heterogeneity and publication bias were evaluated using Q, I², τ², funnel plots, and the trim-and-fill method.

Nine studies covering 12 populations from 6 countries were included in this update. The pooled correlation between OHRQoL and HRQoL summary scores was r = 0.42 (95% confidence interval [CI]: 0.33-0.49), indicating a medium relationship with improved precision (narrower CI) compared to prior results. Subgroup analyses showed similar associations across dental, medical, and nonpatient populations with no significant subgroup differences (Q_M = 1.80, P = .41). The pooled correlation between OHRQoL and Physical Component Score (PCS) was r = 0.35 (95% CI: 0.26-0.43), and for Mental Component Score (MCS) it was r = 0.38 (95% CI: 0.30-0.46). Both correlations were moderate in magnitude, meaning that oral health contributes similarly to physical and mental dimensions of overall well-being.

This updated analysis confirms a medium-strength relationship between oral and general health. In addition, oral health connects similarly with both the physical and mental components of HRQoL. These results support the idea that oral and general health influence each other and reinforce the importance of interprofessional collaborative approaches to improve patient health and well-being.

Acute myeloid leukemia (AML) represents 15% to 20% of all pediatric acute leukemias and is responsible for nearly 30% of deaths in this population. While high-income countries report overall survival (OS) rates near 75%, survival in Brazil remains significantly lower, ranging between 30% and 40%.

The objective of this study is to analyze the probability of OS and event-free survival (EFS) in pediatric patients with AML treated at a Brazilian university hospital, evaluate prognostic factors, and compare outcomes with international data.

This retrospective study included 51 patients (under 14 years old) diagnosed between 2004 and 2023 and treated with BFM-based protocols. The median age was 4.6 years. Patients with acute promyelocytic leukemia (APL) achieved an OS of 100% and EFS of 90%. For other AML subtypes, the 5-year OS and EFS were 53.7% and 43.7%, respectively. Implementation of improved supportive care (ISC) after 2008-including the opening of a pediatric ICU and better infection management-was a pivotal prognostic factor (p < 0.001). Following ISC implementation, OS increased dramatically from 8.3% to 74.5%, and the early death rate dropped to 5.7%, reaching levels comparable to high-income countries.

Pediatric AML outcomes in developing regions can achieve international standards when intensive chemotherapy is combined with optimized supportive care. The establishment of specialized pediatric intensive care and advanced management of infectious complications are essential pillars for bridging the survival gap in these populations.

Cervical cancer (CC) is a major public health concern, ranked as the fourth leading cause of cancer. Evidence shows that CC is preventable if detected and treated at the early stages. In the Democratic Republic of the Congo (DRC), national-level evidence on women's awareness of CC and its associated factors remains limited.

This study aimed to assess the level of cervical cancer awareness and identify factors associated with awareness among women of reproductive age in the DRC.

Cervical cancer (CC) is a major public health concern, ranked as the fourth leading cause of death. Evidence shows that CC is preventable if diagnosed at the early stages. In the Democratic Republic of the Congo (DRC), there is limited evidence at the national level and on factors associated with CC awareness among women of reproductive age. This study aimed to address this gap.

The study analysed secondary data from a total weighted sample of 27 583 women aged 15-49, drawn from the 2023-2024 DRC Demographic and Health Survey (DRCDHS). The dependent variable was CC awareness, and the independent variables were the sociodemographic characteristics of a woman. Descriptive, bivariable and multivariable analyses were conducted. A significant factor was determined at p-value < 0.05 at 95% confidence intervals (CIs).

The overall CC awareness among women of reproductive age in DRC was 21.3% (95% CI = 19.5-23.2). Logistic regression results revealed that women aged 25-34 (AOR = 1.36; 95% CI = 1.12-1.66) and 35-49 (AOR = 1.60; 95% CI = 1.27-2.02), women who were residing in urban areas (AOR = 1.53; 95% CI = 1.06-2.20), women with primary education (AOR = 1.45; 95% CI = 1.03-2.04), secondary education and above (AOR = 1.73; 95% CI = 1.22-2.45), employed women (AOR = 1.48; 95% CI = 1.20-1.84), women who had been examined for breast cancer (AOR = 4.72; 95% CI = 2.91-7.67), women who had been listening to radio (AOR = 1.60; 95% CI = 1.28-1.99), women who had visited health facility last 12 months (AOR = 1.63; 95% CI = 1.35-1.97), Christian (AOR = 2.35; 95% CI = 1.06-5.21), use internet (AOR = 1.67; 95% CI = 1.23, 2.28), reading newspaper/magazine (AOR = 1.33; 95% CI = 1.01-1.76) and delivered at health facility (AOR = 1.53; 95% CI = 1.18-1.98) were statistically significant associated with having CC awareness compared to their counterparts.

The study revealed overall suboptimal CC awareness among women of reproductive age in DRC. Although health education interventions should target all women of reproductive age, special attention should be given to younger women aged 15-24 years, those with no formal education and those living in rural areas, as these subgroups demonstrated particularly lower awareness levels. Strengthening tailored interventions for these vulnerable groups may therefore improve awareness within the broader reproductive-age population and the community at large.

Gastric cancer (GC) is a leading contributor to cancer-related illness and death globally, presenting a significant public health concern in Iran. There is a lack of extensive data regarding long-term trends at both national and regional levels for GC incidence and its anticipated future impact. This research aimed to investigate the changes in gastric cancer rates in Iran from 1990 to 2021 and to forecast incidence rates through 2030 by gender, age groups, and provinces.

This research used secondary ecological data from the GBD 2021 research to investigate the incidence of GC in Iran from 1990 to 2021. Temporal trends were assessed with Joinpoint Regression to determine the Average Annual Percent Change (AAPC). Also, a Bayesian age-period-cohort model was then applied to project new cases and incidence rates up to 2030. We used from R and Joinpoint software for all analyses.

From 1990 to 2021, Iran saw nearly a twofold increase in new GC instances; however, the age-standardized incidence rate (ASIR) significantly fell from 23.12 to 14.37 per 100,000 individuals. The most significant decreases were observed in the northwestern provinces and among females. Forecasts for 2030 show that the absolute number of cases will likely increase to around 12,070, yet the ASIR is predicted to see a slight drop to 13.44, with a stagnation in decrease for individuals over 80 years old, suggesting a gradual slowdown in the overall trend.

Although there has been a persistent reduction in the age-standardized incidence rate of GC in Iran over the last thirty years, the sheer number of cases is still increasing owing to demographic growth and an aging population. To combat this rising challenge, future initiatives should focus on implementing targeted screening in high-risk areas and for elderly populations, improving geriatric healthcare, and addressing inequalities in healthcare access through better collaboration across sectors.

 With the increasing burden of non-communicable chronic diseases, it is important to empower people to self-manage their conditions. This study aimed to explore the support that persons living with chronic disease require to self-manage their conditions at a Primary Health Care (PHC) facility in the Victor-Khanye subdistrict, Delmas, Mpumalanga.

 Individual in-depth interviews were conducted with 14 adult participants who collected their monthly medication for diabetes, human immunodeficiency virus or hypertension. Data were analysed manually using thematic analysis.

 Three themes were identified: (1) individual self-management; (2) support enhancing for self-management; and (3) barriers to self-management. The study highlights that self-management requires a combination of individual beliefs, capabilities, education, access to healthcare resources, financial assistance, emotional support from family and friends, and community support. While knowledge is crucial for empowering individuals to manage their diseases effectively, challenges such as financial constraints and a lack of specific self-management support provided by healthcare workers hinder many from fully implementing self-management strategies.

 Persons living with chronic disease require comprehensive care that extends beyond healthcare and includes emotional, social and financial support. Effective self-management requires access to tailored education and community support networks that allow people to take an active role in their health.Contribution: Understanding the support persons living with chronic diseases require for effective self-management is critical for improving health outcomes, enhancing quality of life and promoting sustainable healthcare systems.

This study investigates the molecular mechanisms of renal clear cell carcinoma (RCC) induced by Aristolochic acid A (AAA) using machine learning, deep learning, and molecular docking approaches.

To identify AAA target genes associated with RCC, differential expression analysis was performed on multiple datasets. Network toxicology, machine learning, deep learning, and molecular docking were used to explore the binding interactions between AAA and target proteins. The top candidate gene was validated using molecular dynamics simulation and in vitro Western blot assays.

A total of 74 genes were identified as potential targets in AAA-induced RCC. Subsequent machine learning analysis identified seven core genes as key regulators of RCC. Deep learning classification further highlighted five of these seven genes, including PYGL, ADH1B, PTGS1, EDNRA, and AURKA. Additionally, molecular docking simulations revealed strong binding affinities between AAA and these target proteins. Molecular dynamics simulation demonstrated the binding stability of the AAA-PYGL complex, and in vitro studies highlighted PYGL as a potential target of AAA. Elevated expression of PYGL was observed in both 786-O and AAA-induced HK-2 cells. Moreover, treatment with CP-91149 (a PYGL inhibitor) or PYGL knockdown restored the expression of E-cadherin, an epithelial-mesenchymal transition (EMT) marker, in HK-2 cells.

By combining advanced computational methods with in vitro studies, this work elucidates a key toxicity mechanism of AAA in RCC. Our approach provides a feasible and efficient framework for toxicological studies, offering significant value for toxicologists with limited access to clinical specimens.

Acute myeloid leukemia (AML) is an aggressive and molecularly heterogeneous hematologic malignancy associated with poor clinical outcomes, particularly in elderly and high-risk patients. Increasing evidence suggests that metabolic reprogramming plays a critical role in leukemia progression, immune dysregulation, and therapeutic resistance. However, the prognostic value of metabolism-associated molecular networks in AML remains insufficiently understood.

This study aimed to identify metabolism-related hub genes involved in AML progression and to establish a robust prognostic signature for survival prediction.

Integrated transcriptomic analyses were performed using multiple Gene Expression Omnibus datasets and the TCGA-LAML cohort. Weighted gene co-expression network analysis identified AML-associated gene modules, followed by protein-protein interaction and functional enrichment analyses. Metabolic-related hub genes were selected through integration with curated metabolic gene sets. A prognostic model was subsequently developed using univariable and least absolute shrinkage and selection operator (LASSO) Cox regression analyses and validated in independent cohorts. A four-gene metabolic signature consisting of CYP4F3, PFKL, G6PD, and DNMT3A was identified as an independent predictor of overall survival. Patients in the high-risk group showed significantly poorer survival outcomes compared with low-risk patients (p < 0.0001). The prognostic model demonstrated stable and reliable predictive performance across training, testing, and validation cohorts. Functional enrichment analyses revealed that the identified genes are closely associated with metabolic pathways, immune-related signaling, and leukemic microenvironment remodeling. Notably, increased expression of G6PD and PFKL was associated with adverse prognosis, supporting the contribution of altered glycolysis and redox homeostasis to AML pathogenesis.

Our findings establish a metabolic-based prognostic signature with strong predictive utility in AML. The identified metabolic hub genes provide insight into the interaction between metabolic dysregulation and immune remodeling in leukemia and may serve as promising biomarkers for risk stratification and potential therapeutic targets.

Increasing multimorbidity among people with human immunodeficiency virus (PWH; HIV) in sub-Saharan Africa can result in hospitalization. We investigated longitudinal associations between multimorbidity trajectories and hospitalization risk within the African Cohort Study (AFRICOS).

AFRICOS enrolls people with and without HIV from HIV clinics in Uganda, Kenya, Tanzania, and Nigeria. These analyses restricted PWH aged ≥18 years enrolled between 2013 and 2024. Multimorbidity (≥chronic conditions in addition to HIV) was ascertained from International Classification of Diseases codes and clinical measurements. Multimorbidity was categorized into 3 trajectories: resilient, developed, and continued. Hospitalization reasons were ascertained by medical record review. Andersen-Gill extensions of Cox proportional hazards models estimated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the association of multimorbidity trajectory and hospitalization.

Among 3028 PWH, 36.6% (n = 1109) had multimorbidity at enrollment. Over 17 740 person-years, 721 hospitalizations occurred (incidence density: 4.06 per 100 person-years). Systemic infections (n = 209, 29.0%), predominantly malaria (n = 182, 87.1%), led admissions. In adjusted models, PWH with continued multimorbidity had a significantly higher risk of hospitalization (aHR = 1.27, 95% CI: 1.06-1.53) compared with resilient PWH.

PWH with continued multimorbidity have a significantly increased risk of hospitalization. Intervening early with optimal ART and comprehensive chronic disease management is critical for improving long-term outcomes in sub-Saharan Africa.

 Non-communicable diseases (NCDs) disproportionately affect low- and middle-income countries, including Ethiopia. However, community health workers' (CHWs') capacity in NCD health promotion is sometimes limited.

 This study aimed to co-design a contextually appropriate intervention with and for CHWs to support their NCD health promotion services.

 This co-design study was conducted in Gondar City, northwest Ethiopia. The workshops were held in the meeting hall at the University of Gondar.

 A qualitative participatory action research design, guided by the PRODUCES (Problem, Objective, Design, User, Co-creators, Evaluation, and Scalability) framework, was employed. Sixteen participants, including CHWs (n = 6), community-dwelling adults with (n = 3) and without NCD diagnoses (n = 3), and health system managers (n = 4) were recruited using convenience and purposive sampling. Participants attended three workshops. In workshop 1, participants discussed the roles of CHWs in health promotion and areas for improvement. Workshop 2 focused on intervention components and delivery approaches. A draft of the intervention was reviewed during workshop 3. Discussion notes and artefacts were thematically analysed in NVivo.

 A 6-week, multicomponent intervention, 'Empower Community Health', was co-designed. Key themes included: (1) knowledge capacity building, (2) personal behaviour change, and (3) community-outreach initiatives. Proposed intervention topics included: (1) learning about NCDs; (2) skill motivational interviewing; and (3) behaviour change for diet and physical activity.

 The involvement of intervention users and stakeholders allowed for the sharing of experiences and fostered ownership in the 'Empower Community Health' programme.Contribution: The meaningful engagement of stakeholders ensures that the intervention is tailored to their needs, fosters ownership and enhances intervention buy-in. This study provides practical guidance for future co-designed health promotion programmes.

Acinetobacter baumannii is a major contributor to antimicrobial resistance (AMR), particularly in hospitals. Its rising resistance presents significant clinical and economic concerns. This study evaluated the national burden and economic impact of A. baumannii infections in Iran from 2000 to 2021 using GBD 2021 AMR data.

We estimated mortality and disability-adjusted life years (DALYs) per 100,000 people with 95% UIs under two scenarios: resistant infections replaced by susceptible ones (attributable burden) and replaced by no infection (associated burden). Economic burden was calculated using GDP per capita and purchasing power parity (PPP)-adjusted estimates.

From 2000 to 2021, total associated DALYs declined from 90,391.9 (95% UI: 80,178.0-100,605.9) to 69,740.5 (65,132.4-74,348.6) and attributable DALYs from 35,284.5 (30,843.1-39,725.9) to 28,085.9 (25,415.9-30,755.9). However, associated deaths increased from 2019.5 (1870.3-2168.8) to 2523.7 (2322.5-2724.9), with neonates and individuals aged 50 years and older most affected. Bloodstream and lower respiratory infections contributed most to DALYs. Resistance remained highest for cephalosporins and carbapenems. The economic burden peaked in 2010 at 584.6 million PPP and decreased to 435.2 million in 2021.

Although disease burden declined, rising mortality and resistance trends highlight the need for stronger infection control and stewardship to reduce A. baumannii-related AMR in Iran.