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Influenza illness burden is substantial, particularly among young children, older adults, and those with underlying conditions. Initiatives are underway to develop better global estimates for influenza-associated hospitalizations and deaths. Knowledge gaps remain regarding the role of influenza viruses in severe respiratory disease and hospitalizations among adults, particularly in lower-income settings. We aggregated published data from a systematic review and unpublished data from surveillance platforms to generate global meta-analytic estimates for the proportion of acute respiratory hospitalizations associated with influenza viruses among adults. We searched 9 online databases (Medline, Embase, CINAHL, Cochrane Library, Scopus, Global Health, LILACS, WHOLIS, and CNKI; 1 January 1996-31 December 2016) to identify observational studies of influenza-associated hospitalizations in adults, and assessed eligible papers for bias using a simplified Newcastle-Ottawa scale for observational data. We applied meta-analytic proportions to global estimates of lower respiratory infections (LRIs) and hospitalizations from the Global Burden of Disease study in adults ≥20 years and by age groups (20-64 years and ≥65 years) to obtain the number of influenza-associated LRI episodes and hospitalizations for 2016. Data from 63 sources showed that influenza was associated with 14.1% (95% CI 12.1%-16.5%) of acute respiratory hospitalizations among all adults, with no significant differences by age group. The 63 data sources represent published observational studies (n = 28) and unpublished surveillance data (n = 35), from all World Health Organization regions (Africa, n = 8; Americas, n = 11; Eastern Mediterranean, n = 7; Europe, n = 8; Southeast Asia, n = 11; Western Pacific, n = 18). Data quality for published data sources was predominantly moderate or high (75%, n = 56/75). We estimate 32,126,000 (95% CI 20,484,000-46,129,000) influenza-associated LRI episodes and 5,678,000 (95% CI 3,205,000-9,432,000) LRI hospitalizations occur each year among adults. While adults <65 years contribute most influenza-associated LRI hospitalizations and episodes (3,464,000 [95% CI 1,885,000-5,978,000] LRI hospitalizations and 31,087,000 [95% CI 19,987,000-44,444,000] LRI episodes), hospitalization rates were highest in those ≥65 years (437/100,000 person-years [95% CI 265-612/100,000 person-years]). For this analysis, published articles were limited in their inclusion of stratified testing data by year and age group. Lack of information regarding influenza vaccination of the study population was also a limitation across both types of data sources. In this meta-analysis, we estimated that influenza viruses are associated with over 5 million hospitalizations worldwide per year. Inclusion of both published and unpublished findings allowed for increased power to generate stratified estimates, and improved representation from lower-income countries. Together, the available data demonstrate the importance of influenza viruses as a cause of severe disease and hospitalizations in younger and older adults worldwide.

Signaling from estrogen receptor alpha (ERα) and its ligand estradiol (E2) is critical for growth of ≈70% of breast cancers. Therefore, several drugs that inhibit ERα functions have been in clinical use for decades and new classes of anti-estrogens are continuously being developed. Although a significant number of ERα+ breast cancers respond to anti-estrogen therapy, ≈30% of these breast cancers recur, sometimes even after 20 years of initial diagnosis. Mechanism of resistance to anti-estrogens is one of the intensely studied disciplines in breast cancer. Several mechanisms have been proposed including mutations in ESR1, crosstalk between growth factor and ERα signaling, and interplay between cell cycle machinery and ERα signaling. ESR1 mutations as well as crosstalk with other signaling networks lead to ligand independent activation of ERα thus rendering anti-estrogens ineffective, particularly when treatment involved anti-estrogens that do not degrade ERα. As a result of these studies, several therapies that combine anti-estrogens that degrade ERα with PI3K/AKT/mTOR inhibitors targeting growth factor signaling or CDK4/6 inhibitors targeting cell cycle machinery are used clinically to treat recurrent ERα+ breast cancers. In this review, we discuss the nexus between ERα-PI3K/AKT/mTOR pathways and how understanding of this nexus has helped to develop combination therapies.

The study discussed a micro-level dimension of the institutionalization of Gender Studies (GS) in Nigeria, emphasizing the growth of semi-autonomous centres over the last two decades. It focused on a case study of one particular centre; the Centre for Human Rights and Gender Education (CHURGE), based in Tai Solarin University of Education (TASUED) in the southwest of the country, offering an analysis of how funding, institutional politics, and a dearth of specialist researchers have shaped the evolution of GS in 21st century in Nigeria. The study employed a qualitative research approach with samples purposively selected among researchers at CHURGE. Although there are merits obtainable in having academics from diverse backgrounds work on gender issues, the study concluded that there is the need to employ the services of specialist researchers to enhance the activities of the centre.

Biogenic silver nanoparticles have been reported as good antimicrobial candidates. In this study, we synthesized and characterized silver nanoparticles using aqueous leaf extracts of Moringa oleifera (AgNPmo) and investigated their antimicrobial and antiviral activities. The AgNPmo demonstrated antibacterial activity against Pseudomonas aeruginosa and Staphylococcus aureus , with concentration-dependent zones of inhibition ranging from 6.5–15.5 mm and 0–7 mm, respectively. Cytotoxicity was assessed on Vero cells using a CCK-8 assay, which revealed an IC50 value of 38 µg/ml, indicating relatively low toxicity at effective concentrations. The antiviral activity against SARS-CoV-2 was confirmed using quantitative RT-PCR: AgNPmo exposure led to a time- and dose-dependent increase in Ct values for ORF1ab and N genes, with the strongest inhibition observed after 48 h. These results provide direct evidence of both antimicrobial and antiviral activity. The green synthesis using Moringa extracts offers added advantages by employing phenolic and flavonoid compounds as natural reducing and capping agents, making the process eco-friendly and biocompatible. While direct wastewater treatment was not tested, these findings highlight the advantages of Moringa leaf extract as a natural reducing and capping agent that enabled rapid, eco-friendly AgNP formation, while the resulting AgNPmo demonstrated antimicrobial and antiviral activity. Thus, AgNPmo represents a promising, sustainable option for point-of-use disinfection and potential environmental water treatment.”.

The study discussed a micro-level dimension of the institutionalization of Gender Studies (GS) in Nigeria, emphasizing the growth of semi-autonomous centres over the last two decades. It focused on a case study of one particular centre; the Centre for Human Rights and Gender Education (CHURGE), based in Tai Solarin University of Education (TASUED) in the southwest of the country, offering an analysis of how funding, institutional politics, and a dearth of specialist researchers have shaped the evolution of GS in 21st century in Nigeria. The study employed a qualitative research approach with samples purposively selected among researchers at CHURGE. Although there are merits obtainable in having academics from diverse backgrounds work on gender issues, the study concluded that there is the need to employ the services of specialist researchers to enhance the activities of the centre.

The proliferation of antibiotic-resistant bacteria and antimicrobial resistance is a pressing public health challenge because of their possible transfer to humans via contact with polluted water sources. In this study, three freshwater resources were assessed for important physicochemical characteristics as well as heterotrophic and coliform bacteria and as potential reservoirs for extended-spectrum beta-lactamase (ESBL) strains. The physicochemical characteristics ranged from 7.0 to 8.3; 25 to 30 °C, 0.4 to 93 mg/L, 0.53 to 8.80 mg/L and 53 to 240 mg/L for pH, temperature, dissolved oxygen (DO), biological oxygen demand (BOD 5 ) and total dissolved solids, respectively. The physicochemical characteristics mostly align with guidelines except for the DO and BOD 5 in some instances. Seventy-six (76) Aeromonas hydrophila and 65 Escherichia coli O157: H7 isolates were identified by preliminary biochemical analysis and PCR from the three sites. Among these, A. hydrophila displayed higher frequencies of antimicrobial resistance, with all 76 (100%) isolates completely resistant to cefuroxime and cefotaxime and with MARI ≥ 0.61. The test isolates showed more than 80% resistance against five of the ten test antimicrobials, with resistance against cefixime, a cephalosporin antibiotic being the highest at 95% (134/141). The frequency of the detection of the resistance genes in the A. hydrophila isolates generally ranged between 0% ( bla SHV ) and 26.3% ( bla CTX-M ), while the frequency of detection among the E. coli O157:H7 isolates ranged between 4.6% ( bla CTX-M ) and 58.4% ( bla TEM ). Our findings indicate that the distribution of antibiotic-resistant bacteria with diverse ESBL-producing capabilities and virulence genes in freshwater sources potentially threatens public health and the environment.

Single-nucleus analysis allows robust cell-type classification and helps to establish relationships between chromatin accessibility and cell-type-specific gene expression. Here, using samples from 92 women of several genetic ancestries, we developed a comprehensive chromatin accessibility and gene expression atlas of the breast tissue. Integrated analysis revealed ten distinct cell types, including three major epithelial subtypes (luminal hormone sensing, luminal adaptive secretory precursor (LASP) and basal-myoepithelial), two endothelial and adipocyte subtypes, fibroblasts, T cells, and macrophages. In addition to the known cell identity genes FOXA1 (luminal hormone sensing), EHF and ELF5 (LASP), TP63 and KRT14 (basal-myoepithelial), epithelial subtypes displayed several uncharacterized markers and inferred gene regulatory networks. By integrating breast epithelial cell gene expression signatures with spatial transcriptomics, we identified gene expression and signaling differences between lobular and ductal epithelial cells and age-associated changes in signaling networks. LASP cells and fibroblasts showed genetic ancestry-dependent variability. An estrogen receptor-positive subpopulation of LASP cells with alveolar progenitor cell state was enriched in women of Indigenous American ancestry. Fibroblasts from breast tissues of women of African and European ancestry clustered differently, with accompanying gene expression differences. Collectively, these data provide a vital resource for further exploring genetic ancestry-dependent variability in healthy breast biology. Through sequencing of 88,005 nuclei from the breast tissues of clinically healthy women of diverse genetic ancestry, a global breast single-nucleus atlas was developed that identifies distinct cell types and ancestry-level differences linked to epithelial and fibroblast cell states, which in turn could influence disease incidence, molecular subtypes and progression.

BackgroundThe mental health of people living with HIV (PLWH) is a growing concern globally, particularly in sub-Saharan Africa (SSA), where there is limited access to mental healthcare, with evidence showing high levels of depression, anxiety and neurocognitive disorders among this population. While Mental Health Disorders (MHDs) can impede HIV care and promote adverse health outcomes, there is limited literature on MHDs among PLWH. This scoping review will explore the existing literature on the burden and factors associated with MHDs among adults living with HIV in SSA.Methods and analysisArksey and O’Malley’s methodological framework will guide the search of this scoping review. Relevant original research articles published in English from 1 January 2000 to 31 May 2025 on MHDs among PLWH in SSA will be identified through searches in the African Index Medicus, African Journal Online, PubMed and Embase databases. Four independent reviewers, working in pairs (one reviewer and one verifier), will screen the titles, abstracts and later the full texts, adopting the population, concept and context framework. Other coauthors will serve as tiebreakers whenever there is disagreement on the eligibility. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews flowchart will be presented. We will perform a narrative synthesis to report our findings.Ethics and disseminationThis scoping review protocol does not require ethical approval, as it relies solely on publicly available existing data and does not involve human participants. We will disseminate the findings from this review through peer-reviewed publications and presentations at local and international conferences.Trial registrationThe protocol was registered in the Open Science Framework (https://osf.io/8ymqu).

Background Malaria remains a leading cause of morbidity and mortality in rural Nigeria, where socioeconomic, educational, and informational factors critically influence prevention and treatment behaviours. Methods This study is a cross-sectional analysis of the 2021 Malaria Indicator Survey (MIS) to investigate the relationships between household income, education, media exposure, and key malaria control outcomes among rural populations. Three complementary analyses were conducted: household-level associations between income and insecticide-treated net (ITN) ownership and use ( n  = 5,021 households); individual-level associations of education with malaria prevention awareness and ITN use among women aged 15–49 years ( n  = 9,546); and the influence of media exposure on malaria treatment-seeking behaviour ( n  = 893). Results Results indicated near-universal ITN ownership across income groups, demonstrating equitable distribution (97.7%), but usage was significantly lower (70.3%). However, ITN use varied inversely with income, with low-income households having 3.6 times higher odds of ITN use (95% CI: 3.07–4.29). Among women, education was a strong predictor of malaria prevention awareness, with higher education levels associated with increased knowledge (p < 0.001). Paradoxically, ITN use decreased as education increased, suggesting that behavioural or contextual factors modulate preventive practice despite greater awareness. Media exposure did not significantly influence the type of healthcare service accessed for malaria treatment, indicating that information access alone may not determine treatment-seeking patterns. Conclusions These findings highlight complex relationships between social determinants and malaria control behaviours. While ITN distribution efforts have achieved broad coverage, targeted behavioural interventions may be needed to improve ITN utilisation, particularly among higher-income groups who may underestimate their risk. Education is associated with increased awareness, but this does not necessarily lead to net use, highlighting the need for strategies that address barriers beyond knowledge. The limited impact of media exposure on treatment choices calls for comprehensive approaches that go beyond simply disseminating information, addressing structural and cultural factors in healthcare utilisation. Policymakers, including the Nigerian Ministry of Health (MOH) and the National Malaria Elimination Programme (NMEP), should design interventions that combine education, community engagement, and practical support to ensure sustained behaviour change. This study provides information to help optimise malaria control strategies and reduce the malaria burden in rural Nigeria by addressing both knowledge gaps and real-world barriers to prevention and treatment.

Developing countries have undertaken public sector reforms to enhance public institutions' operational efficiency. Accountability mechanisms, including implementing sanctions, have been incorporated into these reform programmes. The underlying assumption behind using sanctions is that public officials responsible for these services will adhere to the prescribed standards and rules. This paper examines the effectiveness of sanctions in driving work processes within the public sector, focusing on the assumption that superiors utilise sanctions to ensure subordinates fulfil their assigned tasks. Guided by the process management model, data was collected through close-ended questionnaires from a purposively selected group of public officials to determine the efficacy of sanctions in practice. This study's findings indicate that currently implemented sanctions are ineffective in driving work processes within the public sector. It concludes that while sanctions should not be discarded, there is a need to understand the context in which their application would be effective.