While prior studies have identified regional reduction in gray matter (GM) volume in schizophrenia, it remains unclear whether these alterations are concentrated in specific brain functional areas and how they relate to genetic factors. This study aimed to identify Brodmann's areas (BAs) with affected GM volume in individuals with schizophrenia, explore associated genetic variants through a genome-wide association study (GWAS), and investigate the potential roles of these genes during cortical development.

The study recruited 194 individuals with schizophrenia and 330 healthy controls from the Taiwan Aging Mental Illness cohort. T1-weighted MRI scans were processed to assess GM volume changes, and the cerebral cortex was parcellated into BAs for detailed analysis. GWAS was conducted to identify schizophrenia-associated genetic variants, followed by functional mapping, single-cell RNA sequencing analysis of developing human cortical cells, and in situ hybridization analysis in the developing mouse neocortex.

Significant reductions in GM volume were found in specific BAs, particularly in the ventral frontal cortex, anterior temporal lobe, and cingulate cortex, with BA13, BA23, BA24, BA25, BA27, BA28, BA31, BA34, BA35, and BA38 showing the most pronounced changes. GWAS identified multiple genetic variants associated with these affected BAs. Further, single-cell RNA sequencing and in situ hybridization analyses revealed dynamic expression patterns of the schizophrenia-associated genes during cortical development, suggesting their potential roles in the structural abnormalities observed in schizophrenia.

The findings support the hypothesis that specific BAs are more vulnerable to GM volume reduction in schizophrenia, potentially driven by distinct genetic factors.

Health equity has become a common objective in both global and public health. Although there has been recent scholarship to critically examine how this concept has been applied by the World Health Organization (WHO), there has not been any detailed investigation into the WHO's work on noncommunicable diseases (NCDs). This study aims to fill this gap by investigating the approaches taken by WHO technical officers working on NCDs to address health equity.

The perspectives of technical officers working on NCDs at the WHO were collated through semi-structured key informant interviews. Interviews were transcribed verbatim to facilitate data analysis by two independent reviewers in NVivo 14.

Key informants felt: a disconnect between NCDs programmatic efforts and health equity; that equity in health primarily involves ensuring equitable access to healthcare, with an emphasis on addressing financial hardship; and that equity in health entails targeting those who are most 'vulnerable'. In investigating how health equity is being applied in NCD efforts, it was apparent that a consideration of health equity is missing in program implementation and policy design, and that donors' goals supersede long-term prevention efforts. Lastly, in pinpointing concrete changes or results seen around how health equity is operationalized in NCDs efforts, several success stories from various regions emerge.

The findings of this study demonstrate that WHO technical officers working on NCDs often possessed a limited understanding of health equity that resulted in little meaningful action to embed health equity considerations into programmatic and policy work. Evidently, WHO technical officers need to better navigate or contest industry interference and learn more about health equity as a concept and the links to NCDs.

Non-communicable diseases (NCDs) are a public health challenge in Zambia. This is driven by economic transitions, urbanization, and lifestyle changes. This study examines how NCDs cluster and relate to socioeconomic factors such as education, income, and employment.

Using data from the 2017 Zambia WHO STEPS survey (N = 4,302 adults, mean age: 36.57 years), Latent Class Analysis identified NCD risk profiles, and multinomial logistic regression assessed their associations with socioeconomic determinants.

Three NCD risk groups emerged: Low-Risk (12.0%), Intermediate-Risk (64.3%), and High-Risk (23.7%). The Low-Risk group maintained healthy lifestyles. The Intermediate-Risk group, the most prevalent, showed borderline metabolic indicators and occasional unhealthy behaviours. The High-Risk group exhibited multiple risk factors, including obesity, hypertension, diabetes, and substance use. Males had 22.8 times higher odds of being in the High-Risk group than females. Surprisingly, higher education increased the odds of being in the Moderate- and High-Risk groups.

NCD prevention in Zambia requires risk-stratified strategies: primary prevention for Intermediate-Risk groups and intensive intervention for High-Risk populations. Critical policy actions include taxing tobacco, alcohol, and unhealthy foods; expanding universal screening; integrating NCD care into primary health systems; and addressing urbanization, cultural practices, and healthcare disparities.

Heart Failure adversely affects the patients' quality-of-life. Quality-of-life in patients with heart failure is related to their self-care and other factors. This study aimed to investigate the correlation of quality-of-life and self-care among patients with heart failure and to determine their associated factors.

This descriptive-correlational study was conducted on 217 patients with heart failure at the Farshchian Heart Hospital in Hamadan, Iran, from April 13, 2022, to March 29, 2023. Patients completed the self-care questionnaire for patients with heart failure and the Minnesota quality-of-life questionnaire. A quantile regression model was used to identify factors related to self-care and quality-of-life in patients with heart failure. Analysis was done using R.4.4.0 (P < 0.05).

The mean(± SD) of age, quality-of-life and self-care were 62.16(± 7.86), 60.05(± 8.85), and 35.16(± 5.36), respectively, indicating a low level of quality-of-life and moderate level of self-care. There was no significant correlation between self-care and quality-of-life(r = 0.007; P = 0.916). The correlates of self-care which were significant in almost all Deciles included duration of disease(P < 0.05 for 4th and 5th deciles and P < 0.001 for other deciles), gender(P < 0.01 for the 1st,7th,8th,9th deciles and P = 0.017 for 2nd ), education (P < 0.001), income(P < 0.05 for 3rd -7th deciles and P < 0.001 for 8th and 9th deciles), substance abuse (P = 0 < 0.001 to P = 0.047 for various deciles), and history of hypertension (P < 0.05). Moreover, for the quality-of-life the associated variables included duration of disease (P < 0.001 for the 1st to 5th deciles and P = 0.028 for the 8th decile), sufficient income (P:0.001, 0.004, 0.018, 0.026,<0.001, and < 0.001 for the 2nd, 3rd, 5-6th, and 8-9th deciles).

The non-significant correlation between self-care and quality-of-life shows that lower self-care is linked to a diminished quality-of-life. Patients motivated to engage in self-care are likely to experience fewer hospital readmissions and an improved quality-of-life. Healthcare providers/policymakers should be aware of the importance of self-care in patients with heart failure and help promote their quality-of-life by enhancing their self-care behavior through personalized interventions as own efforts to prevent further worsening of HF. Specifically, such interventions should consider the multifactorial nature of these outcomes and the diverse demographic, socio-economic, and health-related characteristics of this population.

The United Nations Sustainable Development Goal (UN-SDG) 3.4 aims to reduce premature mortality from non-communicable diseases, including breast cancer, by one-third by 2030 relative to 2015. However, many countries, particularly those with lower income, appear off track. Although mortality rates are commonly used to gauge progress, mortality-to-incidence ratios (MIRs) may provide additional insight by accounting for varying incidence and the effectiveness of cancer control measures.

We obtained age-standardised breast cancer incidence and mortality rates for women aged 30-69 years from 2000 to 2019, covering 199 countries stratified by World Bank income groups (low, lower middle, upper middle and high) from the Institute for Health Metrics and Evaluation Global Burden of Disease (GBD) 2019 study. Using vector autoregressive time-series analyses, we modelled and forecasted income-level and county-level mortality rates and MIRs for female breast cancer from 2020 to 2030.

From 2015 to 2030, breast cancer mortality is projected to increase by 22.8% and 7.8% in low-income and lower middle-income countries, while decreasing by 10% and 5.4% in upper middle-income and high-income countries. MIR is projected to decrease across all income groups, with the most significant reductions seen in lower income countries, highlighting incremental improvements in breast cancer control initiatives. Only nine countries, predominantly higher income, are expected to achieve the one-third mortality reduction target. Despite MIR improvements in lower income countries, substantial mortality reductions remain elusive.

Relying solely on mortality underestimates progress in breast cancer control. Although most countries are unlikely to meet the SDG 3.4 target, concurrent use of mortality and MIR provides a more nuanced understanding of screening, diagnosis and treatment advances. Integrating MIR trends into global health evaluations may better inform breast cancer prevention strategies.

Open science promotes the accessibility of scientific research and data, emphasising transparency, reproducibility, and collaboration. This study assesses the Openness and FAIR (Findable, Accessible, Interoperable, and Reusable) aspects of data-sharing practices within the biosciences at the University of Edinburgh from 2014 to 2023. We analysed 555 research papers across biotechnology, regenerative medicine, infectious diseases, and non-communicable diseases. Our scoring system evaluated data completeness, reusability, accessibility, and licensing, finding a progressive shift towards better data-sharing practices. The fraction of publications that share all relevant data increased significantly, from 7% in 2014 to 45% in 2023. Data involving genomic sequences were shared more frequently than image data or data on human subjects or samples. The presence of data availability statement (DAS) or preprint sharing correlated with more and better data sharing, particularly in terms of completeness. We discuss local and systemic factors underlying the current and future Open data sharing. Evaluating the automated ODDPub (Open Data Detection in Publications) tool on this manually-scored dataset demonstrated high specificity in identifying cases where no data was shared. ODDPub sensitivity improved with better documentation in the DAS. This positive trend highlights improvements in data-sharing, advocating for continued advances and addressing challenges with data types and documentation.

Noncommunicable diseases (NCDs) represent one of the greatest global burdens of disease and disability, and there is evidence that mental disorders associated with NCDs may reduce quality of life (QOL). We investigated the factors mediating the association between the severity of NCDs and subjective health-related QOL in 173 patients with NCDs.

We hypothesized that mental health indicators and inflammatory cytokines mediate the association between physical disease severity and subjective health-related QOL. We conducted a structural equation model analysis and selected variables representing mental health and inflammatory cytokines using a multivariable regression analysis and factor analysis.

The structural equation model showed that mental health indicators such as anxiety and positive emotions are potential mediators, and that proinflammatory cytokines such as interleukin-6 (IL6) and tumor necrosis factor-α (TNF-α) may reduce subjective health-related QOL by increasing anxiety and suppressing positive emotions, without being particularly related to physical disease severity. The findings also suggest that anti-inflammatory cytokines such as interleukin-10 (IL10) and adiponectin (ADPN) are activated as physical disease severity increases, and likely protect against physical disease by enhancing positive emotions, potentially increasing subjective health-related QOL and resilience.

Mental health mediates the association between physical disease and subjective health-related QOL, and between inflammatory cytokines and subjective health-related QOL. Anti-inflammatory cytokines are activated by physical disease severity and have a protective effect on mental health.

It's a well-established fact that non-communicable diseases (NCDs) originating in childhood contribute significantly to long-term morbidity. While breastfeeding is a known protective factor for various health outcomes, limited national-level data exist linking breastfeeding duration to chronic pediatric conditions. The study aims to assess the prevalence of key pediatric NCDs and examine the association between breastfeeding duration and the risk of heart disease, diabetes mellitus (DM), musculoskeletal disorders, cancer, and mental health problems in a weighted sample of children aged 0-14 years in Türkiye. This community-based cross-sectional study analyzed data from the 2022 Türkiye Health Survey microdata, including 4229 children and representing a weighted national pediatric population of 15,725,436. Breastfeeding duration was categorized as 0-5, 6-12, 13-23, and ≥ 24 months. Weighted prevalence estimates were calculated for each NCD, and multivariable logistic regression models-adjusted for age, sex, maternal education, household income, and kindergarten attendance-were used to estimate adjusted odds ratios (aORs) and corresponding 95% confidence intervals (CIs) for the breastfeeding categories and NCD outcomes. The weighted prevalence of musculoskeletal disorders, mental health conditions, heart disease, DM, and cancer was 1.39% (1.02-1.76), 1.21% (0.86-1.56), 1.19% (0.85-1.53), 0.26% (0.10-0.42), and 0.05% (0.01-0.12), respectively. Cancer prevalence was higher in boys than girls (93.9% vs. 6.1%, p = 0.004), and musculoskeletal and mental health conditions increased with age (p = 0.031 and p = 0.017). In adjusted analyses, breastfeeding for 6-12 months (aOR = 0.347, 95% CI 0.137-0.876, p = 0.025) and 13-23 months (aOR = 0.335, 95% CI 0.143-0.786, p = 0.012) was associated with lower odds of musculoskeletal disorders compared with 0-5 months. No significant associations were observed for heart disease, DM, and mental health disorders.

The findings of this large-scale population-based study indicate that moderate breastfeeding duration (6-23 months) was associated with lower odds of pediatric musculoskeletal disorders but showed no association with other NCDs. Policy interventions should prioritize breastfeeding support and education to mitigate the future burden of chronic diseases beginning in childhood.

• Breastfeeding supports early childhood development and protects against infections. • Its long-term effects on chronic diseases in children are less well understood.

• Breastfeeding for 6-23 months was significantly associated with lower odds of musculoskeletal disorders in children, while no associations were observed for heart disease, DM, or mental health disorders. • The findings highlight a selective protective association between moderate breastfeeding duration and specific pediatric health outcomes, warranting further longitudinal investigation.

Kidney diseases affect around 850 million people globally and are a growing public health burden, with high rates of associated cardiovascular mortality and no major decline in age-standardized mortality compared to other noncommunicable diseases. Climate change is an inequitable driver of kidney diseases, and climate-related disasters can disrupt access to life-sustaining kidney replacement therapies. Conversely, the care of patients with kidney diseases contributes to greenhouse gas emissions, pollution, and generates large amounts of waste.

Environmentally sustainable kidney care planning is pursuing kidney care practices and innovations that minimize environmental harm while remaining patient-centered and cost-effective. An adaptation and mitigation framework (a structured approach to developing adaptation strategies, policies, and measures) to guide this is lacking.

We propose the 'PASIGE' framework to guide climate science integration in kidney care planning -> Prevent: approaches to prevent kidney disease, its progression to kidney failure, and complications; Adopt: sustainable lifestyle, practices and therapies; Screen: targeted population screening for early detection and identification of kidney disease; Innovate: technology, manufacturing, procurement, energy sources and transportation; Generate: sustainably powered and produced low-impact net zero waste kidney replacement therapies resilient to climate threats; and Enhance: patient engagement, care quality, and system resiliency.

This study aimed to investigate factors influencing the acceptance of smartphone applications among high-risk pregnant women in the Lao People's Democratic Republic to support continuous care.

An explanatory sequential mixed-methods design.

The quantitative phase included 167 high-risk pregnant women recruited from four tertiary hospitals in Vientiane, Lao PDR. Validated questionnaires were used to measure demographics, digital technology usage, eHealth literacy and anxiety. Data were analysed using descriptive statistics and multiple regression analysis. In the qualitative phase, in-depth interviews with 20 women were conducted to further explore experiences, perceptions and barriers related to smartphone application usage. Interviews were analysed via direct content analysis.

Quantitative findings indicated that smartphone application acceptance was significantly predicted by eHealth literacy (B = 1.53, 95% CI 1.22-1.84, p < 0.001) and pre-existing non-communicable diseases (B = 4.39, 95% CI 1.05-7.73, p = 0.010). Anxiety negatively impacted acceptance (B = -0.28, 95% CI -0.51 to -0.05, p = 0.019). The model explained 53.9% of the variance in smartphone application acceptance (R² = 0.539). Qualitative findings highlighted four key themes: awareness of pregnancy risks, unclear health information, perceived benefits of smartphone applications including accessibility and emotional reassurance and practical barriers such as internet costs and limited digital literacy.

Positive perceptions of smartphone applications regarding accessibility and reassurance were observed, alongside significant barriers, such as limited digital literacy and internet costs. Addressing these factors may enhance the adoption and effective utilisation of digital health technologies among high-risk pregnant populations.

No patient or public contribution.