Health Alliance International

Youth represent un-tapped potential within the fight against antimicrobial resistance (AMR). This commentary describes the co-creation process of the Youth Manifesto on AMR which seeks to generate consensus on how equitable engagement of youth can be realised, despite policy, power and funding challenges. The Youth Manifesto on antimicrobial resistance (AMR) provides a blueprint for how the change-making potential of youth can be harnessed to promote equitable and sustainable action on AMR from a global, One Health perspective.

The World Health Organization (WHO) commissioned 12 systematic reviews (SR) and meta-analyses (MA) on health effects of exposure to radiofrequency electromagnetic fields (RF-EMF). The health outcomes selected for those reviews (cancer, electromagnetic hypersensitivity, cognitive impairment, birth outcomes, male fertility, oxidative stress, and heat-related effects) were based on a WHO-conducted international survey. The SR of the studies of cancer in laboratory animal studies was the only one that did not include a MA, because those authors considered it inappropriate due to methodological differences among the available studies, including differences in exposure characteristics (carrier frequency, modulation, polarization), experimental parameters (hours/day of exposure, duration of exposure, exposure systems), and different biological models. MAs in all the other SRs suffered from relatively few primary studies available for each MA (sometimes due to excessive subgrouping), exclusion of relevant studies, weaknesses in many of the included primary studies, lack of a framework for analyzing complex processes such as those involved in cognitive functions, and/or high between-study heterogeneity. Due to serious methodological flaws and weaknesses in the conduct of the reviews and MAs on health effects of RF-EMF exposure, the WHO-commissioned SRs cannot be used as proof of safety of cell phones and other wireless communication devices. However, the animal cancer SR, which was rated as “high certainty of evidence” for heart schwannomas and “moderate certainty of evidence” for brain gliomas, provided quantitative information that could be used to set exposure limits based on reducing cancer risk. The multiple and significant dose-related adverse effects found in the SRs on male fertility and pregnancy and birth outcome should also serve as the basis for policy decisions to lower exposure limits and reduce human reproductive risks. The report of harmful effects (e.g., cancer, reproductive toxicity, etc.) at doses below the adverse health effect threshold claimed by ICNIRP demonstrates that current exposure limits to RF-EMF, which were established by applying arbitrary uncertainty factors to their putative adverse threshold dose, lack scientific credibility.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12940-025-01220-4.

Abstract Despite the scarcity of data, individuals with type 1 diabetes mellitus (T1D) and diabetic kidney disease (DKD) are considered at moderate to high risk for Ramadan fasting and are individually advised against fasting.This subgroup analysis of the Diabetes and Ramadan (DaR) global survey was conducted to evaluate the outcomes and characteristics of patients with T1D complicated by DKD who observe fasting and to compare their outcomes with those of fasting people living with T1D uncomplicated by DKD.Using a specifically designed SurveyMonkey questionnaire, Muslim individuals with T1D and DKD were surveyed in several countries from different geographical regions and compared statistically to people with T1D without DKD or associated comorbidities.Note that 53.8% (N = 86) of individuals with T1D and DKD fasted during Ramadan in comparison with 74% (N = 1,523) of the control group. Those with DKD experienced higher rates of hypoglycemia (65.1%) and hyperglycemia (69.6%) than the control group (56.5 and 42.5%, respectively). They also had more frequent emergency visits and hospitalizations. Additionally, among individuals with T1D and DKD, nonfasters exhibited significant differences in biochemical markers and demographics compared with those who fasted.Individuals with T1D and DKD are generally older, have multiple diabetes-related complications, and are less likely to fast during Ramadan. For those who do fast, the risks are significant, including higher rates of hypoglycemia and hospital admissions compared with the control group. Ensuring safe fasting in this population requires interdisciplinary collaboration, patient education, and expert medical guidance.

CDKL5 deficiency disorder (CDD) is a rare developmental and epileptic encephalopathy. Greater understanding of the smallest meaningful improvements for individuals with CDD in clinical trials and practice is needed for a person-centred approach to treatment efficacy. This study explored how parent/caregivers of people with CDD understood meaningful improvements and described change for priority functional domains including communication, gross motor, fine motor, feeding. This study included an in-person workshop and a convergent mixed-methods online survey. Parent/caregivers (n = 19) attending the 6th Family Educational and Awareness Conference for CDD participated in discussion groups for the workshop component. The survey (n = 80) collected descriptive data and open-ended responses. Qualitative data were stratified by ability levels and analysed using a conventional content analysis. Definitions of meaningful improvement varied in terms of desired speed and magnitude of change and included health and skill stability. Parent/caregivers described meaningful increases in developmental skills that were specific to each domain and level of ability. Some concepts were common across ability levels within domains (e.g., increased independence across all gross motor levels) and others were consistent across domains (e.g., improved utensil use in fine motor and feeding domains). Meaningful improvement means different things to different people with some factors consistent regardless of ability level suggesting important underlying concepts for measurement requiring future investigation. These findings can contribute to the development of clinical treatments and trials that focus on factors that are important to people with CDD and their families.

Natural Climate Solutions (NCSs) represent a critical tool for addressing climate change, yet their long-term success is threatened by inadequate consideration of community impacts in current verification standards. While Article 6 of the Paris Agreement establishes rigorous requirements for carbon sequestration and emission avoidance verification, existing standards lack comprehensive frameworks for assessing and ensuring community well-being, undermining project permanence and market confidence. We developed an integrated framework combining community well-being assessment with verification requirements through analysis of Article 6 implementation requirements, existing voluntary carbon offset credit standards, emerging national standards, and community engagement mechanisms. Our analysis yielded a framework establishing five core tenets for community engagement (inclusion, engagement, contribution, ownership, and well-being) and nine essential well-being assessment domains, each with specific measurable indicators. The framework provides clear verification alignment protocols that integrate with existing standards while maintaining rigorous requirements and offering practical implementation guidance. Integration of community well-being assessment into NCS verification standards strengthens project permanence while meeting verification requirements, providing practical tools for standards bodies, project developers, and market participants to ensure both environmental and social benefits. As Article 6 mechanisms mature, this integration becomes increasingly crucial for project success.

Automotivedriving assistant systems (ADAS) and Automated driving (AD) technologies are commonly employed in the control of unmanned vehicles along a path. However, like many other technologies, they come with risks, including potential misdirection and collisions with obstacles along the vehicle's route. To mitigate these risks, various tracking systems, including radar tracking systems, are employed to detect and monitor targets along the trajectories of ADAS/AD vehicles. Nevertheless, the effectiveness of these tracking operations is crucial in assessing the reliability of both tracking systems and ADAS/AD technologies, especially at the edge-computing level. In this study, we introduce a tracking technique using a collaborative predictive model in a time series, named CoPreMo, aimed at enhancing the reliability of radar system tracking operations. We conducted three experiments with this model on a simulated radar system to track a target's range at varying speeds across three ADAS/AD scenarios. The experiments yielded range tracking errors of 0.21 m, 0.26 m, and 0.32 m, outperforming the baseline models.

Abstract Study question Can observation through Time Lapse Microscopy (TLM) be leveraged to standardize trophectoderm biopsy outcomes across different operators? Summary answer TLM-based blastocysts’ observation to pinpoint the ideal time-of-biopsy (t-biopsy) indicated comparable inconclusive PGT-A results rates among seven embryologists operating across eight years. What is known already Optimal timing for trophectoderm biopsy in blastocysts lacks clear guidelines, with current literature presenting mixed outcomes regarding its effect on molecular analysis reliability. Inappropriate biopsy timing can potentially yield inconclusive PGT diagnoses due to insufficient blastocyst expansion. Minimizing the need for a second biopsy is essential, as multiple manipulations can affect embryo reproductive competence. Thus, TLM and artificial intelligence (AI) offer valuable tools to objectively define biopsy timing based on blastocyst expansion. Study design, size, duration Observational analysis of 1,943 blastocysts cultured in TLM between 2013-2020 and biopsied with a sequential zona-pellucida opening and trophectoderm biopsy approach. Seven operators were trained to establish the stage of biopsy based on blastocysts’ full-expansion achieved between 110-169 hours-post-insemination (hpi; mean:134±15). AI (CHLOE, Fairtility) was retrospectively applied to annotate all timings and expansion as area of the embryo-proper at the median focal plane in µm2 at the time-of-expanding-blastocyst (tEB) and at the t-biopsy. Participants/materials, setting, methods We assessed all features possibly associated with the inconclusive result rate after trophectoderm biopsy: biopsy-operator, t-biopsy and embryo-proper area, blastocyst quality (based on Gardner and CHLOE embryo-quality score), day of the week (Monday-Sunday), hour of the working day (retrieved through RI electronic-witnessing-system; 8am-8pm), year (2013-2020), comprehensive-chromosome-testing technology (qPCR/NGS). Associations with euploidy and live-birth (LB) per euploid transfer were also tested. Logistic regression and Generalized Estimating Equations analyses were adopted to this end. Main results and the role of chance The overall inconclusive results rate was 3.3% (N = 64/1,943) varying 1%-5% across operators and years. The largest fluctuation occurred when transitioning from qPCR (2013-Oct2017; N = 35/1,222, 2.9%) to NGS (Oct2017-2020; 4%), but decreased to 2.3% (N = 2/88) in 2020. These differences were not-significant, suggesting that fluctuations can be minimized by monitoring operators’ performance systematically. Among all parameters investigated, none associated with inconclusive results. The embryo-proper area at t-biopsy was larger for day6-7 blastocysts (unstandardized coefficient-B day5 to day7:+730µm2, 95%CI:+301 to + 1,158,p<0.001), and smaller for poorer-quality blastocysts (unstandardized coefficient-B AA-grade to CC/BC/CB-grade:-1,115µm2, 95%CI:-1,332 to -897,p<0.001). The year was associated with embryo-proper area at t-biopsy (unstandardized coefficient-B 2013 to 2020:+309µm2, 95%CI:+168 to + 450,p<0.001) becoming significantly larger since 2017 (22,000-23,500µm2 to 24,000-25,000µm2), when NGS was implemented. No difference was reported among biopsy-operators, days of the week, nor hours of the working-day, except for sporadic cases of blastocysts biopsied between 8-9am showing lower expansion. Dispersion plots indicated more pronounced expansion from tEB to t-biopsy among day5 blastocysts, while this appeared less evident among day6-7 blastocysts. When adjusted for maternal-age and blastocyst-quality, embryo-proper area was associated with higher euploidy-rates (each 500µm2-increase OR:1.17,95%CI:1.07-1.28). Only blastocyst-quality and t-biopsy, instead, associated with LB per euploid-transfer. Limitations, reasons for caution Retrospective study to be confirmed prospectively with a larger sample size. Only the protocol entailing simultaneous laser-assisted zona pellucida opening and trophectoderm biopsy plus pulling was adopted. Wider implications of the findings The adoption of standard operating procedures and the continuous monitoring of operators’ performance minimized fluctuations in inconclusive PGT-A results, even when changing CCT technology or introducing new biopsy practitioners. TLM and AI can help monitoring and defining the optimal t-biopsy based on embryo-proper area, enhancing standardization, efficiency and safety. Trial registration number No

The field of autonomous vehicles (AVs) predominantly leverages multi-modal integration of LiDAR and camera data to achieve better performance compared to using a single modality. However, the fusion process encounters challenges in detecting distant objects due to the disparity between the high resolution of cameras and the sparse data from LiDAR. Insufficient integration of global perspectives with local-level details results in sub-optimal fusion performance.To address this issue, we have developed an innovative two-stage fusion process called Quantum Inverse Contextual Vision Transformers (Q-ICVT). This approach leverages adiabatic computing in quantum concepts to create a novel reversible vision transformer known as the Global Adiabatic Transformer (GAT). GAT aggregates sparse LiDAR features with semantic features in dense images for cross-modal integration in a global form. Additionally, the Sparse Expert of Local Fusion (SELF) module maps the sparse LiDAR 3D proposals and encodes position information of the raw point cloud onto the dense camera feature space using a gating point fusion approach. Our experiments show that Q-ICVT achieves an mAPH of 82.54 for L2 difficulties on the Waymo dataset, improving by 1.88% over current state-of-the-art fusion methods. We also analyze GAT and SELF in ablation studies to highlight the impact of Q-ICVT. Our code is available at https://github.com/sanjay-810/Qicvt