Rapid changes in urbanization in India have paralleled increased prevalence in non-communicable diseases [NCDs] including type 2 diabetes [T2D], hypertension [HTN], and obesity. To examine sex-specific temporal trends in the prevalence of T2D, HTN, general obesity [GO], and abdominal obesity [AO] among urban populations in India since 2000, a systematic review and meta-analysis was conducted in accordance with a registered PROSPERO protocol [CRD42024548962]. PubMed, Global Health [via EBSCOhost], Embase, Scopus, and Web of Science were searched for studies from 2000-2025 [initial search: 12 October 2024; update: 4 July 2025]. Eligible studies were cross-sectional and reported the prevalence of T2D or HTN or Obesity, in urban Indian populations. Screening, data extraction and risk-of-bias assessment using the Hoy tool were performed independently by two reviewers, with a third resolving conflicts. Pooled prevalence was estimated via random-effects meta-analysis in R (version 4.5.3), with forest and funnel plots generated using ggplot2. Out of 3143 records screened, 57 studies were included. The pooled prevalence demonstrated upward trajectory. T2D rose from 13% in 2000-2005 to 21% in 2021-2025, and HTN from 29% to 31%. For obesity, GO increased from 24% in 2000-2005 to 36% in 2016-2020, while AO rose from 47% to 72% over the same period. Sex-stratified analyses showed greater increases among males for T2D and HTN, whereas AO increased more among females. These findings underscore increasing T2D, HTN, and obesity in urban India, highlighting the need for strengthened primary care and supportive environmental and policy measures address the urban NCD burden.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne viral disease with a high fatality rate among older adults. It is posing a growing public health threat across Asia, with increasing potential for geographic spread beyond the region. Control efforts remain largely confined to individual-level tick-bite prevention, reflecting persistent gaps in understanding the ecological mechanisms that sustain SFTS transmission, particularly how environmental factors shape transmission dynamics across vectors, animal reservoirs, and human populations. We systematically reviewed 2910 studies to synthesize evidence on associations between environmental factors and SFTS occurrences across populations. Temperature, humidity, precipitation, elevation, and land cover are consistently linked to human SFTS occurrence through nonlinear, often reverse-U-shaped, relationships, underscoring the need for analytical frameworks capable of capturing the inherently nonlinear nature of environmental influences. However, we identified no quantitative assessments of how environmental factors shape SFTS occurrence in vectors or animal reservoirs, nor any stage-specific assessment of how these factors act across the transmission cycle, leaving multifaceted environmental effects acting across the tick-animal-human interface collapsed into oversimplified estimates based solely on human cases. To address these critical gaps, research must prioritize stage-specific elucidation of environmental drivers across the SFTS transmission cycle through mechanistic modeling approaches integrated with transboundary surveillance under a One Health framework. As climate and land-use changes continue to reshape vector habitats and expand regions at risk, such efforts will be essential for enhancing ecological understanding and guiding One Health-grounded surveillance and control strategies that can mitigate the growing transboundary burden of SFTS.

Despite growing recognition that changes in the unregulated drug supply are central drivers of drug-related morbidity and mortality, there is little consensus on how population-level drug supply data are, or should be, incorporated into health outcomes research. Here, we describe the role unregulated drug supply data play in health outcomes research in the substance use field. We searched the MEDLINE, Embase, Scopus, and Europe PubMed Central databases and relevant published conference abstracts on May 28, 2025. Studies must have incorporated population-level or ecological measures of the unregulated drug supply (i.e., nonpharmaceutical) as an independent variable and reported either individual-level or population-level health outcomes, including but not limited to drug poisonings (i.e., overdose), deaths (drug-related or all-cause), hospitalizations, and emergency department visits. Of the 31 included studies, 26 were conducted in the United States and 5 in Canada. Drug supply data were used in multiple analytic roles, including as primary variables and as covariates (or predictors) of health outcomes. These data were derived from 4 distinct sources: law enforcement seizures (n = 25), drug-checking services (n = 2), hospital or clinic urinalysis results (n = 3), or postmortem toxicology results (n = 3). Most studies assessed the impact of drug supply metrics on drug toxicity (overdose) counts or rates within a given region (n = 27). We found that population-level drug supply data demonstrate predictive capacity for health outcomes and may represent an underutilized confounding factor in policy evaluation. However, their incorporation into health research remains inconsistent and conceptually fragmented.

Gastrointestinal (GI) diseases represent a significant global health burden, and emerging evidence suggests air pollution may be a risk factor. We reviewed relevant literature and performed a meta-analysis. We searched original studies investigated the associations between long- and short-term exposure to particulate matter (diameter ≤ 2.5 µm [PM2.5], ≤ 10 µm [PM10]) and gaseous pollutants (nitrogen dioxide, sulfur dioxide, carbon monoxide, and ozone [O3]) and GI diseases. DerSimonian and Laird random-effects meta-analyses were conducted when at least 2 studies were available for a given pollutant (per 10 μg m-3 increment) and a specific GI disease. A total of 70 studies were included. Long-term exposure to PM2.5 was significantly associated with increased mortality rate from all GI cancers (OR = 1.128; 95% CI, 1.019-1.248), with the strongest association observed for colorectal cancer (OR = 1.214; 95% CI, 1.061-1.389). For non-cancer GI diseases, long-term exposure to PM2.5 was significantly associated with increased risks of duodenal ulcer (OR = 1.073; 95% CI, 1.057-1.089) and irritable bowel syndrome (OR = 1.353; 95% CI, 1.222-1.497); PM10 was also linked to the latter (OR = 1.108; 95% CI, 1.012-1.213). Short-term exposure, particularly to PM2.5, PM10, and O3, was significantly associated with appendicitis hospitalization (OR = 1.003 [95% CI, 1.001-1.004]; OR = 1.017 [95% CI, 1.015-1.019]; and OR = 1.001 [95% CI, 1.000-1.003], respectively). PM2.5 was also associated with peptic ulcer bleeding (OR = 1.006; 95% CI, 1.001-1.011). Long- and short-term exposures to air pollution, especially PM2.5, are associated with increased risks of GI diseases.

Digital solutions are essential for eliminating tuberculosis as a public health problem. They can be applied across all stages of patient care, health surveillance, program management, workforce development, and community engagement. In this study, we aimed to identify and map digital solutions for tuberculosis developed and/or validated within the context of primary health care. We retrieved studies from Medline, Scopus, Embase, Web of Science, and Google Scholar that focused on digital solutions for tuberculosis, targeting managers, health professionals, or patients. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines to review, synthesize, and report the findings of articles that met our inclusion criteria. Of 3133 identified publications, 96 were included after full-text screening. Most solutions focused on treatment monitoring and adherence (n = 46 studies). There was particular emphasis on electronic directly observed therapy, smart pillboxes, and mobile applications. Artificial intelligence-based solutions also emerged that were applied to diagnosis, prediction of treatment nonadherence, and prognosis. The findings show that digital solutions have evolved from simple tools to advanced artificial intelligence models. We conclude that the systematic incorporation of these technologies into national protocols is crucial to accelerate progress toward the targets established by the End TB Strategy.

People with disability experience health inequities and mostly live in low- and middle-income countries (LMICs), because that is where most of the world's population resides. Despite this, existing evidence on health equity for people with disability mostly comes from high-income settings. Monitoring and evaluation of health equity are crucial for countries to address and track progress toward goals, such as the highest attainable standard of health for people with disability. This scoping review summarizes the available literature on approaches and indicators used in LMICs to evaluate health-related outcomes between people with and without disability. Peer-reviewed articles were included that were published between 2008 and 2024 that compared health-related outcomes between these 2 populations. We identified 59 eligible studies from a broad range of LMICs. Disability indicators varied, with most studies using 1 of multiple Washington Group question sets to enable disaggregation of data by disability status. Survey data were the type most frequently used; only 2 studies used administrative data. A wide range of health-related outcomes were explored; themes of maternal and child health and HIV-related outcomes emerged as key areas of focus. Disparities were consistently found, with almost all included studies reporting poorer outcomes for people with compared with people without disability. There was a noticeable lack of action taken to improve future policy or monitoring and evaluation or to enact real and meaningful change in health equity for people with disability.

HPV-induced oropharyngeal cancer (HPV-OPC), caused by persistent infection with high-risk subtypes such as HPV16 and HPV18, poses a significant global health challenge. Epidemiological research on HPV-OPC focuses on prevention, detection, distribution, and disease incidence, revealing an increasing OPC burden related to HPV exposure. The objective of this study was to identify research hotspots and trends in HPV-OPC epidemiology, highlighting the role of epidemiology in guiding prevention and control strategies. A bibliometric analysis of 960 articles (published between 1987 and 2025) from the Web of Science Core Collection, SCOPUS, and PubMed Central was performed, using Python to assess collaborations across countries, institutions, and individuals, as well as literature citation, research timelines, and clustering. Results show a substantial increase in publications, especially from 2013 to 2025, with researchers in United States and China as leading contributors and identifies several prolific authors. Research has primarily focused on HPV vaccination, screening, attributable fraction, and incidence prediction, though challenges such as data quality, vaccination efficacy, limited resource, and modeling limitations also are foci. Future directions include improving data reliability, promoting early and direct vaccination, strengthening international funding, and integrating multiple models. This bibliometric study provides valuable insights into research hotspots and future directions in HPV-OPC, offering researchers and clinicians an overview of current situations and future developments in HPV-OPC epidemiology, potentially improving HPV vaccination and screening strategies and promoting preventive and diagnostic approaches to reduce OPC incidence.

Loneliness and social isolation are emerging public health concerns among young adults, yet the role of community and societal factors remains poorly understood. Existing research has predominantly focused on individual or interpersonal determinants. This systematic review synthesized observational evidence on community- and societal-level factors associated with loneliness and social isolation among young adults aged 18-30 years. Five databases were searched for observational studies examining place-based community or societal exposures and loneliness or social isolation outcomes. Thirteen eligible studies were identified, and a structured narrative synthesis was undertaken. The exposure variables explored were diverse. Neighborhood characteristics (including trust, safety, and atmosphere), community participation, cultural and societal norms, and structural conditions demonstrated consistent associations with loneliness. Greater neighborhood cohesion, safety, and belonging were protective, whereas neighborhood disorder, minority status, perceived discrimination, and individualistic cultural orientations were associated with greater loneliness. Evidence for social isolation was sparse and methodologically heterogeneous, though area-level disadvantage and remoteness showed emerging relevance. Most studies had a cross-sectional design, and the ways loneliness and social isolation were measured across studies were heterogenous. Community and societal determinants meaningfully shape young adults' experiences of loneliness, but evidence for social isolation remains limited. Findings highlight the need for longitudinal research, improved consistency in the use of measurement tools, and further examination of moderators between individual factors and community influences, which will all contribute to the development of multilevel public health strategies addressing structural and neighborhood conditions.

Persistent inequities in the social determinants of health contribute to poor health outcomes among people with disability. People with disability are more likely to live in unaffordable housing, which is associated with increased risk of chronic conditions and poor mental health. However, there is limited research on how housing affordability affects health in this priority population. We undertook a scoping review to evaluate existing evidence on the health impacts of living in unaffordable housing for people with disability. Peer-reviewed literature published in English between 2004 and 2024 was considered. The MEDLINE, SocIndex, and Web of Science databases were searched to identify studies examining possible links between housing affordability and any health outcome in a population of people with disability. Two independent reviewers performed study screening and data extraction. Of the 1386 studies identified initially, 3 met the eligibility criteria. The included studies focused on individuals with acquired, psychiatric, or military-related disability. Each study provided evidence suggesting unaffordable housing negatively affected mental health in people with disability. Substantial methodological and conceptual heterogeneity limited direct comparison or synthesis. This review highlights a critical knowledge gap in the relationship between housing affordability and health for people with disability, limiting the development of evidence-informed policy and intervention. People with disability have a fundamental right to access affordable, appropriate housing, as well as the right to the highest attainable standard of health. High-quality, targeted research using consistent definitions of disability and housing affordability, as well as validated health outcome measures, is needed to inform future policy.

Hepatitis E virus (HEV) infection can progress to chronic hepatitis in immunosuppressed individuals. The seroprevalence of hepatitis E among people living with HIV remains controversial. In this systematic review and meta-analysis, the pooled global seroprevalence of hepatitis E among people living with HIV is estimated. This study followed the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines and was registered in PROSPERO. Searches were conducted in the PubMed, Embase, and Web of Science databases. The seroprevalence of hepatitis E (anti-HEV IgG) among people living with HIV was estimated by meta-analysis using the random-effects model. Subgroup meta-analyses were performed for each continent. A total of 88 studies from 5 continents were included; most were conducted in European countries (48.9%). The pooled seroprevalence of HEV infection was 16.0% (95% CI, 13.0-18.0; I2 = 97.7%). Subgroup analyses revealed seroprevalence rates of 12.0% in Europe, 24.0% in Asia, 19.0% in Africa, and 11.0% in the Americas, and a notably high prevalence was observed in low-income countries (37.0%). Sensitivity analyses restricted to studies with sample sizes of more than 200 participants and risk of bias score ≥ 7 indicated seroprevalence estimates of 18.0% and 15.0%, respectively. In conclusion, this meta-analysis demonstrates a pooled global seroprevalence of HEV infection of 16.0% among people living with HIV, ranging from 11.0% to 24.0% across the continents.

Chronic pain is the leading cause of disability worldwide and chronic neuropathic pain (NP) disproportionately affects individuals with unmet health care needs, especially those facing health inequities. This scoping review addresses 3 research questions: (1) What are the characteristics and outcomes of cognitive behavioral therapy (CBT), mindfulness, and meditation-based intervention studies designed to manage NP? (2) Do these intervention studies include participants from populations experiencing health inequities? (3) Are the interventions customized to meet the needs of people experiencing health inequities? Ten databases were searched for studies focused on the search terms "cognitive behavioral therapy," "CBT," "mindfulness meditation," "and neuropathic pain." In total, 1732 abstracts were screened and a total of 24 articles from 22 original studies were included. The primary characteristics of the studies showed that 99% of participants had NP attributable to diabetes, cancer, or spinal cord injury. Outcomes were consistent with previous reviews, demonstrating promise for CBT, mindfulness, and meditation-based therapies in relieving NP. However, demographics were poorly reported, and there was little diversity among participants. Individuals from groups experiencing health inequities were largely unrepresented. Although 55% of studies tailored intervention materials and provided content to support long-term practice, few included long-term follow-up to evaluate sustained impact. In general, research on this topic has fallen short in including and addressing the needs of people experiencing health inequities. Future research should prioritize broader participant inclusion criteria, involve individuals with lived experience in intervention design and delivery, and conduct long-term follow-up to enhance the accessibility, relevance, and sustainability of NP interventions.

High-density lipoprotein (HDL) is a highly heterogeneous lipoprotein with multiple physiological functions. However, observational studies present conflicting evidence regarding its association with various diseases. This review systematically summarizes evidence from Mendelian randomization (MR) studies to investigate the causal relationships between HDL-related biomarkers and a wide spectrum of disease outcomes. We systematically searched multiple databases up to November 2024. The causal relationship between HDL and 158 diseases was studied. Findings reveal that the role of HDL is highly disease-specific. Genetically predicted higher HDL levels are protective against most circulatory and digestive system diseases. Conversely, however, they are associated with an increased risk of certain conditions, including breast cancer, intracerebral hemorrhage, and age-related macular degeneration. The MR analyses revealed inconsistent and sometimes conflicting findings for several disease outcomes, notably Alzheimer's disease. This review underscores the context-dependent nature of HDL's effects, which may be driven by factors like HDL particle heterogeneity and functional transformation into a pro-inflammatory state. Future research should move beyond concentration-based metrics to focus on HDL functionality and precise subtyping to fully understand its role in disease etiology.

Administrative data, including electronic health record (EHR) and claims data, are increasingly used to generate real-world evidence for epidemiologic research. Unlike clinical trials, which assess baseline conditions at the initial visit, observational studies using these data must define an appropriate look-back period to identify baseline characteristics. However, to our knowledge, no established guidelines exist on the optimal length of look-back periods by clinical outcome. We conducted a scoping review, with a lens on methodological studies, to assess the frequency and variability of look-back periods used in epidemiologic studies. We searched PubMed for studies that used look-back periods using EHRs, claims data, or international registries. Our search yielded 262 studies spanning a broad range of clinical outcomes. Look-back periods varied substantially, ranging from 12 hours to 39 years, depending on the clinical outcome. The most common clinical areas included pharmacology, cardiovascular disease, cancer, and health care utilization. Our review underscores the need for tailored look-back periods based on the clinical context; we suggest a one-size-fits-all approach may be inadequate. Research should focus on the impact of look-back periods on less-studied outcomes. This review provides a resource for researchers to make informed decisions on the appropriate look-back periods in epidemiologic studies using administrative data.

Hysterectomy is the most frequently performed nonobstetric surgery in women. Women with disabilities face barriers to reproductive health care, and little is known about their hysterectomy risk. The objective of this systematic review was to compare hysterectomy risk among women with and without disabilities. We searched the MEDLINE, Embase, PsycInfo, and CINAHL Plus databases from inception to May 2024 using validated search strategies. We included peer-reviewed observational studies that compared hysterectomy in women with physical, sensory, cognitive, and intellectual or developmental disabilities with those without disabilities. Study characteristics and data were extracted using a standardized form; the Newcastle-Ottawa Scale (NOS) was used for quality assessment. Study findings were summarized narratively following Synthesis Without Meta-analysis guidelines. The search yielded 3686 unique records, of which 5 met our criteria. These included 1 retrospective cohort and 4 cross-sectional studies, which were conducted in the United States (n = 3), Canada (n = 1), and South Korea (n = 1), and ranged in size from 881 to 42 842 participants. Evidence from 4 studies indicated hysterectomy frequency was higher among women with disabilities (range: 6.1% to 22.8%) compared with those without disabilities (range: 2.2% to 18.6%). Three studies suggested the disparity in hysterectomy was greatest among premenopausal women. Quality assessment scores on the NOS ranged from 0 to 8 (median, 3), with limitations mostly related to measurement of the exposure and outcome. The limited research on this topic points to the need for more studies on hysterectomy among women with disabilities, given historical reproductive injustices faced by this population.

The large number of people infected by SARS-CoV-2 necessitates estimation of the future health care burdens. We updated a systematic review examining associations between SARS-CoV-2 infection and incidence of new diagnoses and exacerbations of chronic conditions. Updated searches were run September 4, 2024, in the MEDLINE and Embase databases for observational studies with a control group, adjustment by sex and comorbid conditions, and reporting age-stratified data for 1 or more chronic condition category (n = 12) or condition type (n = 46) of interest. Two human reviewers screened 50% of titles and abstracts, then DistillerAI acted as second reviewer. Two human reviewers assessed full texts of relevant studies for eligibility based on a priori criteria. One reviewer extracted data and assessed risk of bias using the JBI cohort studies checklist; a second reviewer verified results data and risk-of-bias assessments. Pooled hazard ratios (HRs) were estimated with inverse-variance weighting. Using the Grading of Recommendations, Assessment, Development, and Evaluation approach, 2 reviewers assessed certainty in conclusions of little to no association (ie, HR = 0.75-1.25), small to moderate association (ie, HR = 0.51-0.74 or 1.26-1.99), or large association (ie, HR ≤ 0.50 or ≥ 2.00). We identified 46 new studies and brought forward 23 studies from the original review. After SARS-CoV-2 infection, there is probably increased risk of new diagnoses for several chronic conditions, especially in adults. Most findings are based on data from earlier pandemic periods; their relevance to contemporary populations is uncertain due to differences in vaccination rates and circulating variants of concern. PROSPERO registration identifier CRD42024585278.