Atherosclerosis is a chronic inflammatory disease characterized by progressive vascular dysfunction and remains a leading cause of cardiovascular morbidity and mortality worldwide. Endothelial dysfunction is an early and critical event in atherogenesis, contributing to inflammation, leukocyte recruitment, plaque progression, and thrombotic complications. Increasing evidence indicates that vascular endothelial cells use bioelectrical signaling mechanisms to integrate mechanical, metabolic, and inflammatory cues and maintain vascular homeostasis. At the core of these regulatory networks are ion channels and transporters, which coordinate membrane potential, ionic fluxes, calcium homeostasis, redox balance, and downstream biochemical signaling to regulate endothelial function in vascular health and disease. Dysregulation of these pathways may promote oxidative stress, inflammation, endothelial senescence, apoptosis, endothelial-to-mesenchymal transition, and impaired vasodilatory function, thereby contributing to atherosclerotic progression. Understanding how ion channels regulate endothelial function may provide important insights into atherosclerosis and facilitate the development of novel therapeutic strategies aimed at restoring endothelial homeostasis and reducing cardiovascular risk.

Neonatal encephalopathy (NE) is a condition that affects newborn and can lead to long-term neurological impairments and death. Hypoxic ischaemic encephalopathy is the subset of NE with evidence of a hypoxic ischaemic insult. In Aotearoa New Zealand, national data have been collected for infants ≥37 weeks since 2010 and ≥35 weeks from 2016. Although the mortality rate associated with NE has not been a focus of annual reports, it is an important outcome for counselling whānau (families) and for international comparison.

The Perinatal and Maternal Mortality Review Committee (PMMRC) dataset was used to calculate mortality rate for cases of moderate/severe NE for two gestational groups, 35 weeks to 36 weeks+6 days (2016-20) and ≥37 weeks (2010-2020). Annual mortality rates in infants ≥37 weeks with NE for the period 2010-20 were calculated overall and by prioritised ethnic group.

In the PMMRC dataset, there was frequently a history of fetal distress or antenatal sentinel event with the vast majority of included infants having low Apgar scores and requiring resuscitation at birth. The mortality rate was 0.23/1000 births (95% CL 0.17-0.29) for infants ≥37 weeks with no significant change over the study period. The mortality rate for infants with NE between 35 and 36+6 weeks was 0.68/1000 births (95% CL 0.31-1.28), giving a relative risk of 2.99 in preterm compared with term infants with NE. No statistical difference in mortality by prioritised ethnic group was demonstrated.

There has been no improvement in mortality rates for infants with NE despite ongoing efforts to improve early recognition and treatment. Preterm infants were at significantly higher risk of death. The analysis did not demonstrate any ethnic differences in mortality associated with NE.

Background: Cardiovascular diseases (CVD) are the leading cause of mortality globally, with a disproportionate burden in low- and middle-income countries (LMIC). The workplace presents a strategic setting for preventive interventions targeting modifiable risk factors like physical inactivity, sedentary behavior, and poor diet among adults. This systematic review aimed to synthesize evidence on the effectiveness and implementation of workplace interventions targeting physical activity, sedentary behavior, or diet among employees in LMICs. Methods: We conducted a systematic review following PRISMA guidelines. Five databases (PubMed, Scopus, Cochrane CENTRAL, OATD, Google Scholar) were searched for studies published between January 2000 and May 2025. Eligible studies included working adults in LMIC workplaces, assessed interventions targeting at least one CVD-related behavior (physical activity, sedentary behavior, diet), and reported behavioral or cardiometabolic outcomes. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Given the heterogeneity in study designs, interventions, and outcomes, findings were synthesized narratively. Results: Sixteen studies (11 randomized controlled trials (RCTs)) from six countries (South Africa, Malaysia, Iran, India, Thailand, Mexico) were included. Interventions were heterogeneous: seven (43%) focused on physical activity (PA), five (31%) on reducing sitting time, four (25%) included dietary interventions, embedded within larger multi-component programs. Technology‑supported interventions (e.g., Stepathlon pedometer programme) increased step counts by +3,519 steps/day. Environmental interventions (sit‑stand desks, text prompts) reduced sitting time by 6-66 minutes/day (largest effect: -66 min/day with frequent prompts). Multicomponent programmes that included dietary counselling or canteen modifications improved fruit and vegetable intake (27% to 64%) and reduced fat/calorie consumption (-553 ± 339 kcal). A standalone nutrition education programme also improved dietary knowledge and reduced sweet/snack intake. Multi‑component, theory‑informed programmes showed the most consistent improvements: systolic blood pressure reductions up to -10.2 mmHg, weight loss up to -1.8 kg, and total cholesterol reductions up to -0.45 mmol/L (≈17.4 mg/dL). Single‑component environmental or technology‑only interventions rarely improved biomarkers. Common implementation challenges included high attrition (15-30%) and declining digital engagement (app use fell from 77% to 31% by month 6). Overall risk of bias was moderate to high, driven by lack of blinding, reliance on self‑reported outcomes (60% of studies), and attrition bias. Conclusion: Workplace interventions in LMICs show promise for improving CVD risk profiles, particularly multi-component programs, although the number of studies remains limited. Simple modifications in physical activity, sedentary behavior and diet provide a feasible entry point but should be augmented with components designed to increase MVPA.

Malaria parasite genomes have been generated predominantly using Illumina short-read sequencing that requires expensive equipment, is time-consuming with complex protocols, and does not adequately interrogate complex genomic regions that harbour important malaria virulence determinants. The portable Oxford Nanopore Technologies MinION platform generates long reads in real time and may overcome these limitations. We present compelling evidence that Nanopore sequencing delivers valuable additional information for malaria parasites with similar data fidelity for single nucleotide variant (SNV) calls compared to standard Illumina whole-genome sequencing. We demonstrate this through sequencing of pure Plasmodium falciparum DNA, mock infections and natural isolates from low-density, asymptomatic infections. Nanopore has low error rates for haploid SNV genotyping and identifies structural variants not detected with short reads. Nanopore genomes can be directly compared to publicly available genomes and produce high-quality end-to-end chromosome assemblies including complex, previously difficult-to-access regions. Nanopore sequencing could expedite whole-genome surveillance of malaria and provide new insights into parasite genome biology.

Young people with HIV experience disproportionately poor outcomes across the HIV care continuum, high levels of stigma, and elevated alcohol and other substance use. Healthy Choices is a 4-session intervention that integrates motivational interviewing with brief cognitive-behavioral strategies and has demonstrated a positive impact on HIV stigma, alcohol use, depression, and viral load in prior trials among young people with HIV. Interventions such as Healthy Choices have the potential to improve the HIV care continuum in Caribbean settings. However, no interventions have been adapted in Spanish and pilot-tested to concurrently address stigma, mental health, alcohol use, and viral burden among young people with HIV in the Dominican Republic.

This study aims to adapt Healthy Choices for Spanish-speaking young people with HIV in the Dominican Republic and pilot-test the adapted intervention with implementation strategies to assess feasibility, acceptability, and a directional signal of its potential impact.

Guided by the exploration, preparation, implementation, and sustainment framework and the health stigma and discrimination framework, this 36-month study has 3 specific aims. In aim 1, we will conduct focus groups with community representatives and in-depth interviews with young people with HIV to identify barriers, adaptation needs, and implementation strategies. In aim 2, we will use assessment, decision, adaptation, production, topical experts, integration, training, and testing and co-design workshops with community partners and a youth advisory board to contextually translate and adapt Healthy Choices for the Dominican Republic in Spanish, and we will train peer navigators. In aim 3, we will conduct a pilot randomized controlled trial with 45 young people with HIV using a 2:1 allocation to the adapted Healthy Choices intervention (n=30, 67%) or a time-attention control condition (n=15, 33%). Primary outcomes are feasibility and acceptability. Secondary and exploratory outcomes include antiretroviral adherence, viral load, alcohol and other substance use, social support, positive affect, coping, depression, and HIV-related stigma, which will be assessed from baseline to follow-up.

The study period is from March 1, 2026, to February 28, 2029. At the time of manuscript preparation, formative partnership development and key-informant consultation had been completed. The study is positioned to proceed through qualitative exploration, intervention adaptation, peer navigator training, and pilot testing across the 36-month project period. Results from the pilot trial are expected after completion of follow-up assessments.

This protocol describes an implementation science-guided approach to adapting and testing a promising intervention for young people with HIV in a high-priority global setting with translational potential for Spanish-speaking populations in the United States. If the intervention is feasible and acceptable, the study will yield preliminary data for a future full-scale hybrid type 1 effectiveness-implementation trial.

ClinicalTrials.gov NCT07638618; https://tinyurl.com/5fsdn4fj.

PRR1-10.2196/103611.

Parent-mediated interventions are a core component of services for children with autism and other neurodevelopmental conditions. This study evaluated the feasibility and preliminary effectiveness of the World Health Organization's Caregiver Skills Training (WHO CST) program in South Korea, including its adaptation to an online, video-based delivery model.

A pre-pilot study was conducted between 2018 and 2020 with 50 caregiver-child dyads. During the COVID-19 pandemic, the program transitioned from in-person to synchronous online delivery. In the online format, caregivers practiced intervention strategies in naturalistic home settings and submitted video recordings of caregiver-child interactions. These recordings were reviewed by facilitators to provide individualized feedback during virtual home visits. The core content and structure of the CST program were maintained across delivery formats. Outcomes were assessed using measures of child functioning (WHODAS-C), caregiver knowledge and skills (CKST), and caregiver stress (PSS).

Significant improvements were observed following the intervention in child functioning, caregiver knowledge and skills, and caregiver stress (all p < .001). No significant differences were found between in-person and online delivery formats, although the online group demonstrated broader improvements across child functional domains. The online CST program implemented from 2020 to 2025 demonstrated strong feasibility, with high retention rates in both in-person (88%) and consistently high caregiver satisfaction (mean scores > 4.5 out of 5).

These findings suggest that WHO CST can be feasibly and effectively implemented in South Korea, and that online delivery incorporating video-based coaching represents a viable approach for expanding access to caregiver-mediated interventions.

Type 1 diabetes and disordered eating (T1DE) affects 8-37.1% of adults and is associated with high rates of morbidity and mortality. The absence of a standardised case definition of T1DE and its severity hinders effective screening, diagnosis and treatment. This systematic review aimed to (1) synthesise existing case definitions and diagnostic criteria for T1DE in adults and (2) identify key characteristics to inform consensus for future diagnostic criteria.

A systematic review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Eligible studies involved adults (≥18 years) with type 1 diabetes assessing disordered eating; paediatric studies, mixed samples without disaggregated data, non-empirical designs and non-English publications were excluded. PubMed, MEDLINE, EMBASE, CINAHL and PsycINFO were searched up to November 2025 for peer-reviewed studies involving adults with T1DE. Qualitative and quantitative data on definitions, diagnostic criteria and assessment tools were extracted. Study quality was appraised using a modified Graphical Appraisal Tool for Epidemiological studies (GATE) checklist. Due to heterogeneity of data, a narrative synthesis of findings was performed to describe current definitions of T1DE.

Sixty-one studies met the inclusion criteria, with a pooled sample of 111,208 participants (76% women) from over 22 countries. T1DE was defined using a heterogeneous array of terms, diagnostic frameworks and assessment tools (29 distinct methods). The Diabetes Eating Problem Survey-Revised (DEPS-R) was the most used questionnaire, but many studies relied on criteria adapted from general eating disorder classifications or generic questionnaires. Approximately three-quarters of the studies assessed insulin omission behaviours, but the operationalisation of the cognitions for insulin omission varied widely. Beyond physiological markers such as HbA_1c and BMI, studies explored various diabetes-related and psychological constructs, although often considering diabetes and disordered eating separately rather than as an integrated condition.

This systematic review highlights the lack of a unified, evidence-based definition of T1DE, resulting in inconsistent screening, diagnostic and reporting practices. Establishing clear, consistent, evidence-based diagnostic criteria and screening questionnaires for T1DE is critical to improving early detection and developing targeted interventions. These findings provide a foundation for refining T1DE definitions as a stepping stone to an international consensus definition.

PROSPERO registration no. CRD420250223622 FUNDING: King's College London and King's College Hospital through the KMRT KCH Joint Research Committee studentship. This work was also conducted as part of the National Institute for Health Research (NIHR; CS-2017-17-023)-funded STEADY project (Safe management of people with Type 1 diabetes and EAting Disorders studY). NZ's salary was part-funded by the NIHR via the NIHR Clinician Scientist award to MS; JT and KI are part-funded by the NIHR Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. MS was funded through her NIHR Clinician Scientist Fellowship (CS-2017-17-023).

The aim of this study was to investigate the effectiveness of adding non-immersive virtual reality-based exercise to a conventional rehabilitation program for pain, functionality, balance, and quality of life in patients with knee osteoarthritis.

This randomized controlled clinical trial involved 60 patients. Measurements were taken before and after treatment (at week 3). Visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index, and the Short Form-36 were measured. Postural Stability- Dynamic Overall Stability Index, Functional Reach Composite Score, and Clinical Test of Sensory Interaction on Balance-Composite Score were recorded using the Biodex Balance System.

In both groups, statistically significant improvements were observed in visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index, the Short Form-36 Physical Functioning, Postural Stability-Dynamic Overall Stability Index, Functional Reach Composite Score, and Clinical Test of Sensory Interaction on Balance-Composite Score scores in the post-intervention period (p<0.001). In both groups, statistically significant improvements were observed in all Short Form-36 subscales [Physical Functioning, Role Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role Emotional, and Mental Health were observed during the post-intervention period (p<0.001)]. In the two-way mixed-methods repeated-measures analysis of variance analysis, the time effect was found to be significant in all Short Form-36 subdimensions (p<0.001). The group-time interaction was not significant in the "Role Physical" and "Mental Health" subdimensions (p=0.151 and p=0.604, respectively).

The addition of virtual reality-based exercise to results in greater reductions in pain levels and improvements in disease-specific functional status and overall physical function, postural stability, dynamic balance, and sensory integration. Further improvements in quality of life across all subscales except for physical role limitations and mental health.

In the Unified Health System (SUS), one of the central challenges for workforce planning is adapting to the growing demands of public health. State Health Plans (PES) are management and social control instruments that define the guidelines and priority actions of the states, including those perspectives on work management, the focus of this present study. 22 PES were analyzed for the four-year period 2024-2027, considering three axes: Health Work Regulation; Valuing health work; and, Workforce Planning. The results highlight the diversity of proposed actions, such as the creation of job, career and salary plans; the promotion of healthy and safe work environments; the implementation of social protection and mental health policies for professionals; and those relating to the regulation of labor relations, with an emphasis on fair remuneration. The systematization of these initiatives makes it possible to identify and recognize the strategies prioritized by the states, providing support for strengthening and structuring the management of health work in Brazil.

To analyze the association between the co-occurrence of health risk behaviors and the presence of depression in Brazilians.

This was a cross-sectional study using data from the 2023 population-based telephone survey Vigitel. Depression was assessed by self-reported medical diagnosis. The co-occurrence of health risk behaviors was measured based on the sum of five behaviors: consumption of ultra-processed foods (UPF), physical inactivity, sedentary behavior, smoking, and binge drinking. This variable was subsequently categorized as "none," "one," "two," or "three or more" behaviors. Descriptive analyses, Pearson's χ2 test, and univariate and multiple logistic regression adjusted for sex, age, marital status, and level of education were carried out.

A total of 21,690 individuals participated in the survey, of whom 12.3% had depression, and approximately 79.8% reported at least one health risk behavior. Consumption of UPF (OR 1.35; 95%CI 1.08-1.68), physical inactivity (OR 1.29; 95%CI 1.04-1.60), and smoking (OR 1.76; 95%CI 1.36-2.27) were associated with depression. Individuals with two health risk behaviors had 1.36 times higher odds of depression (OR 1.36; 95%CI 1.08-1.73), while those with three or more had twice the odds (OR 2.01; 95%CI 1.49-2.71), compared to those with none.

Individuals with the co-occurrence of two or more health risk behaviors are more likely to have depression. These findings highlight the importance of integrated strategies for mental health promotion and the prevention of unhealthy behaviors in the Brazilian population.