Frontiers in Public Health最新文献

Background: The scarcity of COVID-19 vaccines raised tough questions about who should get them first. While global guidelines stress fairness, they may overlook local realities and community voices. Without understanding these perspectives, efforts to ensure equity and build trust risk falling short. Therefore, this study aimed to assess the multifaceted perceptions, knowledge, and attitudes of community influencers in Uganda regarding COVID-19 vaccination.

Methods: This study adopted a mixed-methods cross-sectional descriptive design. The study participants were identified through community-based organizations (CBOs) to get a broad representation of the various community members and practical community entry points. Quantitative data were analyzed using the Statistical Package for Social Sciences (SPSS). Qualitative data were analyzed using thematic content analysis with NVivo 12.0 software.

Results: A total of 100 Ugandan participants took part in the study, less than half of the participants 46.0% knew Uganda/MoH guidelines only. Forty two percent (42%) were neutral on vaccines curbing COVID-19 spread, with uniform effectiveness beliefs (p > 0.05). Ninety percent (90%) supported guiding principles. Only few of the participants 31% agreed that they were very likely to contract COVID-19 after vaccination, 81% favored equal treatment but low trust in equity across classes or tribes. From the qualitative data, five themes which included, gender/power imbalances, economic divides, social norms, herbal alternatives, and tribalism. Global equity skepticism was high (57% no trust in LMIC/HIC quality parity); 86% endorsed national equity, but doubts persisted on at-risk prioritization and fair distribution.

Conclusion: While awareness of guidelines is relatively high, it is overshadowed by pervasive skepticism regarding vaccine efficacy, profound distrust in the fairness and integrity of distribution processes, and a feeling of exclusion from decision-making at global and national levels. Therefore, addressing these challenges requires a multi-pronged approach that goes beyond simply disseminating information about COVID-19 vaccination. With the strong support for ethical principles in COVID-19 vaccination, addressing equity gaps through culturally attuned strategies is essential for equitable distribution and sustained public trust in Uganda.

Antimicrobial resistance (AMR) is a persistent global health challenge that is associated with morbidity, mortality, and healthcare costs. In most outpatient (OP) settings, such as emergency rooms, primary and specialty care clinics, and dental clinics, antibiotics are often inaccurately prescribed due to patient expectations, empirical decision-making, and limited access to diagnostic data. Despite existing national frameworks, surveillance systems, and stewardship initiatives, resistance among key pathogens in the United Arab Emirates (UAE), a part of the World Health Organization's (WHO's) Eastern Mediterranean Region (EMR), is increasing. Many OP settings are underdeveloped, as most efforts focus on hospital inpatients, leading to inappropriate antibiotic use, the promotion of resistant pathogens, and an increased risk of community-acquired infections. Intensifying antimicrobial stewardship (AMS) practices in OP settings brings an opportunity to enhance patient care, limit unnecessary prescriptions, prevent adverse reactions, and reduce healthcare costs. This perspective provides insights into regional AMR trends in the EMR, reviews existing governance, regulatory frameworks, and surveillance systems of the UAE, and identifies gaps with OP stewardship practices in the Emirate of Abu Dhabi. It recommends a multi-level framework to support optimisation of OP antibiotic use, guided by regional trends, current practice, and lessons learnt from the COVID-19 pandemic. By adopting this framework, current stewardship efforts can be strengthened, responsible antibiotic use promoted, and surveillance improved, progressing towards a coordinated, multi-sector strategy to preserve antimicrobial efficacy and sustain long-term progress against resistance.

Background: Accurate and interpretable influenza forecasting is critical for public health preparedness, yet many models struggle to capture multi-scale temporal dynamics and to provide reliable uncertainty estimates. These challenges are particularly pronounced in China, where influenza seasonality differs between northern temperate and southern subtropical regions.

Methods: We propose FaXNet, a frequency-adaptive, explainable, and uncertainty-aware deep learning framework that integrates data-driven spectral representation with interpretable component selection and probabilistic forecasting. We compiled weekly influenza positivity rates from the Chinese National Influenza Center and aligned them with ERA5-Land meteorological variables (temperature, dew point, and precipitation) for northern and southern China from 2011 to 2023. FaXNet was evaluated against representative statistical, machine learning, deep learning, and decomposition-based baselines for 1-4-week-ahead forecasting using standard accuracy and calibration metrics.

Results: FaXNet achieved consistently superior performance in both regions, with 1-week-ahead R² of 0.9319 (north) and 0.8665 (south), and 4-week-ahead R² of 0.4493 (north) and 0.4960 (south). The proposed method maintained a statistically significant performance advantage against all benchmarks across varying horizons, validating the effectiveness of frequency-adaptive modeling in mitigating error accumulation. Model explanations highlighted precipitation as the dominant meteorological driver in the north and temperature as the primary factor in the south.

Conclusion: FaXNet provides accurate, interpretable forecasts with calibrated prediction intervals across 1-4-week horizons, offering actionable lead time for region-specific risk assessment and resource planning. Performance may depend on surveillance data completeness and the limited set of exogenous covariates considered, motivating future extensions with additional drivers (e.g., mobility or vaccination) and broader external validation.

Importance: Low-dose computed tomography (LDCT) lung cancer screening (LCS) has been shown to significantly reduce mortality rates. As its effectiveness relies on LDCT uptake, understanding uptake rates and their determinants can enhance the implementation and effectiveness of screening programs.

Objective: This study aimed to analyze LDCT uptake and its influencing factors in lung cancer screening within an Asian population.

Methods: Studies published between 1 January 2011 and 31 October 2025 were retrieved from four databases, and those reporting LDCT uptake and/or the factors influencing it were included. A random-effects model was applied to combine the effect estimates and 95% confidence intervals. Subgroup analyses were conducted to explore heterogeneity.

Results: A total of 35 studies involving 1,716,756 participants were analyzed, yielding a pooled LDCT uptake rate for lung cancer screening of 46% (95% confidence interval [CI], 41-51%). Program-level factors included sample scale, year of LDCT uptake, and program setting (p < 0.05). Patient-level factors that facilitated participation included a family history of lung cancer (odds ratio [OR], 1.95; 95%CI, 1.45-2.63), harmful occupational exposure (OR, 1.48; 95%CI, 1.33-1.64), chronic respiratory diseases (OR, 1.97; 95%CI, 1.62-2.38), alcohol consumption (OR, 1.20; 95%CI, 1.06-1.36), passive smoking exposure (OR, 1.43; 95%CI, 1.24-1.64), a higher body mass index (BMI; OR, 1.12; 95%CI, 1.05-1.20), and higher education levels (OR, 1.35; 95%CI, 1.17-1.56). Patient-level barriers included being a man (OR, 0.61; 95%CI, 0.55-0.68), engaging in frequent exercise (OR, 0.89; 95%CI, 0.84-0.94), smoking (OR, 0.76; 95%CI, 0.66-0.88), and being middle-aged (OR, 0.92; 95%CI, 0.85-0.99).

Conclusion: LDCT uptake for lung cancer screening is lower in Asia than in academic programs, and it varies widely due to program design and population characteristics. Adopting smaller-scale screening designs and targeting key populations may help improve implementation efforts.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42025641277, identifier CRD42025641277.

Background: Mercury poisoning remains a serious public health issue due to its multiple exposure routes and diverse clinical presentations. However, existing clinical evidence is fragmented, especially regarding real-world case data. This study addresses the gap by systematically reviewing global case reports to analyze clinical features, diagnosis, and treatments, thereby offering more robust evidence for clinical practice.

Methods: Case reports of diseases caused by accidental mercury exposure, published from January 1950 to April 2025, were identified through a comprehensive search of three electronic databases: PubMed, Embase, and Web of Science. Following quality assessment using the Joanna Briggs Institute tool, data extraction was conducted on demographic characteristics, clinical manifestations, diagnostic methods, exposure sources, treatment modalities, and patient outcomes to facilitate further analysis.

Results: This study analyzed 80 articles encompassing 126 cases of mercury poisoning, involving 61 males, 60 females, and 5 cases of unspecified sex. Patient ages ranged from 45-day-old neonates to 88-year-old adults. Clinical manifestations were diverse, primarily featuring systemic, respiratory, neurological, and gastrointestinal symptoms. Domestic/environmental exposure was the most common poisoning route (59.5%), followed by medical/iatrogenic exposure (16.7%) and occupational exposure (13.5%). Elemental and inorganic mercury were the predominant forms involved. Treatment primarily included chelation therapy, supportive care, and pharmacological interventions. Chelating agents were administered to 84.1% of patients, with DMSA, Dimercaprol (BAL), DMPS, and D-penicillamine being the most frequently used. Outcomes included complete recovery in 48.4% of cases, death in 13.5%, and long-term sequelae in some patients.

Conclusion: Mercury poisoning induces severe and multisystemic symptoms, notably neurological damage. Public awareness remains insufficient, and universally accepted diagnostic criteria are still lacking. This study highlights the urgent need to enhance public education, refine clinical guidance, and advance research toward standardized management protocols.

Systematic review registration: CRD420251133420.

The environmental color, as a core visual environment element of living streets, has significant impacts on the users' psychology and spatial perception. The seasonal variations in living streets' environmental color are poorly understood, with existing literature mainly focusing on the warmer seasons. Meanwhile lacking natural experiences, outdoor activities and lights caused by cold climate, residents develop more urgent need to derive psychological support from their daily environment. This study firstly quantified eight streetscape color metrics using the K-means algorithm, then measured positive emotions by collecting human-factor signals and subjective evaluations. Subsequently, the mutual influences between the two were analyzed to address the effects of street interface color on positive emotions in winter. The results showed that: (1) Females exhibit significantly stronger positive emotional responses than males to winter street interface color; (2) Snow-free conditions generate markedly greater positive affect than snow-covered scenes; (3) The primary color saturation, primary color value, secondary color hue, secondary color value, and color harmony of winter street interface colors were significantly negatively correlated with positive emotions, while color complexity was significantly positively correlated positive emotions. These findings can provide urban planners and managers with theoretical basis and practical guidance for winter streetscape design, ultimately enhancing residents' well-being and quality of life in winter.

[This corrects the article DOI: 10.3389/fpubh.2025.1672645.].

[This corrects the article DOI: 10.3389/fpubh.2025.1698477.].