ABSTRACT Background Climate change poses critical threats to human, animal, and environmental health, yet evidence on integrated One Health responses remains fragmented. Although numerous studies highlight climate‐driven health risks, many climate adaptation frameworks still underrepresent cross‐sectoral interactions and the needs of low‐resource settings. Objective This study aims to identify and operationalize key governance mechanisms, surveillance strategies, and collaborative approaches that can be implemented to support health‐adaptive policies. Methods A comprehensive search of peer‐reviewed literature and international reports (March 2020–June 2025) was conducted across Scopus, PubMed, Web of Science, the World Health Organization (WHO), WHO African region (AFRO), European Centre for Disease Prevention and Control (ECDC), the Food and Agriculture Organization (FAO), and the European Public Health Association (EUPHA) repositories. A narrative synthesis approach was adopted to integrate findings across heterogeneous study designs and contexts. Results Climate change intensifies vector‐borne diseases, heat‐related illness, food insecurity, biodiversity loss, and environmental degradation, disproportionately affecting low‐ and middle‐income countries. Evidence suggests that implementing a One Health approach through effective, evidence‐based actions such as fostering collaborative engagement, using a common operating picture for community‐based surveillance, and strengthening resilient food and livestock production systems that are adaptable to a changing climate could enhance surveillance capacity and accelerate preparedness and early warning processes. Conclusion Significant opportunities exist to improve One Health governance by, among other things, establishing coordinated surveillance systems, flexible policy approaches, an ecosystem‐based perspective, and inter‐sectoral engagement. Currently, policies fail to fully consider environmental and animal health aspects, which could pose significant risks.

Background: Rosuvastatin, a potent lipid-lowering statin, and curcumin, a bioactive naturally occurring polyphenolic phytochemical, both show pleiotropic antioxidant and anti-inflammatory properties. In addition, curcumin shows also antimicrobial, anticancer, hypolipidemic and antifibrotic effects. From the pharmacodynamic point, rosuvastatin and curcumin target overlapping molecular pathways—suggesting possible pharmacodynamic synergy that has emerged as a promising therapeutic approach in the management of various diseases, including cardiovascular, metabolic, kidney, and inflammatory diseases. Objectives: This review aimed to systematically summarize and critically evaluate all available preclinical data concerning the combined use of rosuvastatin and curcumin, emphasizing their possible synergistic effects. Methods: A total of seven preclinical studies that investigated the combination of curcumin and rosuvastatin, three in vitro and four in vivo, conducted between 2017 and 2025, were included in the analysis. Results: While in vitro studies suggested a promising synergy in lipid-lowering, antioxidant, and anti-inflammatory effects, in vivo findings confirmed enhanced lipid-lowering effects, potential hepatoprotection and nephroprotection when two agents are co-administered. In addition to pharmacodynamic interaction, pharmacokinetic studies also revealed that curcumin may increase systemic rosuvastatin exposure by inhibiting hepatic transporters, warranting further investigation into dosing and safety of the combination. Conclusions: While current evidence supports the therapeutic potential of the combined use of rosuvastatin and curcumin, additional pharmacokinetic, mechanistic, and clinical studies are needed to fully assess its translational value.

Summary Background Understanding the size, gender composition, and cadre mix of the health workforce and how it has evolved across time and locations can inform policies for planning, recruitment, training, and retention of human resources for health (HRH), and improvement of access to the health-care workforce among populations. Using comparable and standardised data sources, we aim to describe the composition and density of health workers by sex among 20 cadres for 204 countries and territories over 1990–2023 and quantify workforce shortfalls relative to universal health coverage (UHC) attainment. Methods We used 1816 country-years of data from population-based surveys, 82 from censuses, 3888 from administrative sources, and 96 from scientific literature. We harmonised reported occupation in all sources with the International Standard Classification of Occupations 2008. We produced estimates for 20 cadres and the total health workforce disaggregated by sex using spatiotemporal Gaussian process regression, a standardised method in the Global Burden of Diseases, Injuries, and Risk Factors study. Finally, stochastic frontier meta-regression was used to estimate the minimum density of doctors, nurses and midwives, dentists, and pharmacists required to reach a score of 80 out of 100 on the UHC effective coverage index. Findings In 2023, there were 122·1 million (95% uncertainty interval 115·4–130·5) health workers across 20 cadres, an increase of 81·2 million (72·0–90·5) or 198·5% (161·9–245·6) relative to 1990. Of that total, there were 15·1 million (13·1–18·2) doctors, 33·2 million (30·8–36·3) nurses, 2·4 million (2·0–2·9) midwives, and 7·6 million (6·7–8·6) community health workers (CHWs). 68·9% (66·9–70·6) of all health workers in 2023 were female, and female health workers accounted for 71·4% (64·5–77·4) of net HRH workforce growth. Less than half of doctors were female (43·9%, 34·5–53·2) and most nurses (80·7%, 76·2–83·1), midwives (96·0%, 83·9–98·5), and CHWs (89·5%, 83·6–93·7) were female. Substantial differences in HRH density remained into 2023: sub-Saharan Africa had the lowest HRH densities across cadres, with the exception of CHWs, while high-income countries had the highest HRH densities. To reach 80 out of 100 on the UHC index, an additional 7·1 million (6·6–7·5) doctors, 23·9 million (21·8–26·1) nurses and midwives, 1·8 million (1·6–1·9) dentists, and 1·6 million (1·4–1·9) pharmacists are required globally. Interpretation The global health workforce has expanded substantially since 1990, largely due to women entering the formal health workforce. However, this expansion has been uneven across regions and persistent shortfalls remain in doctors, nurses and midwives, dentists, and pharmacists relative to moderate UHC attainment. Addressing these gaps will require expansion of training capacity, retention and remuneration policies for early-career workers, and gender-responsive workforce arrangements. Funding Gates Foundation.

Summary Background WHO's Global Oral Health Action Plan (GOHAP) targets include a 10% relative reduction in the combined prevalence of main oral conditions by 2030. The first GOHAP evaluation was planned for 2023, with subsequent evaluations scheduled for 2026 and 2030. The aim of this systematic analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023 was to evaluate global and regional progress (2019–23) towards this target and related complementary indicators. Methods Using modelled estimates from epidemiological surveys and registries in 204 countries and territories, we estimated the age-standardised prevalence of untreated caries in deciduous and permanent teeth, severe periodontitis, edentulism, other oral disorders and orofacial clefts, and the age-standardised incidence of lip and oral cavity cancer. Progress towards GOHAP targets was measured by comparing the percentage change from 2019 to 2023 in the above indicators against the stated GOHAP target of a 10% relative reduction. Findings Globally, the age-standardised prevalence of main oral conditions declined (−1·55% [95% uncertainty interval −2·32 to −0·82]) between 2019 and 2023, but global cases increased by 3·07% (2·32 to 3·75), from 3·62 billion (3·35 to 3·95) to 3·73 billion (3·45 to 4·06). Among complementary indicators, reductions in age-standardised prevalence were observed for untreated caries in permanent teeth (−1·99% [−2·49 to −1·40]) whereas the age-standardised incidence of lip and oral cavity cancer increased (8·35% [0·13 to 16·32]), as did the age-standardised prevalence of orofacial clefts (2·25% [0·77 to 3·83]). Progress was heterogeneous across GBD super-regions, with south Asia having the largest reductions in the age-standardised prevalence of main oral conditions (−3·34% [−4·95 to −1·80]) and untreated caries in deciduous teeth (−9·09% [−17·62 to −0·08]). Sub-Saharan Africa showed the largest increase in prevalent cases of main oral conditions (9·51% [8·09–10·94]) and age-standardised incidence of lip and oral cavity cancer (14·86% [1·19–32·45]). The high-income super-region had an increase in the age-standardised prevalence of main oral conditions (1·24% [0·56–1·96]) and untreated caries in deciduous teeth (9·21% [6·60–11·89]). Interpretation Our modelled estimates of global trends in the prevalence of oral conditions from 2019 to 2023 suggest that early progress is modest and, at the current pace, insufficient to meet the 2030 GOHAP targets. Accelerated, equity-focused prevention and integration of essential oral health-care services within primary care and universal health coverage are needed, alongside strengthened oral cancer control and congenital anomaly care. Funding The Gates Foundation.

This article surveys emerging directions in the mathematics of democracy. It uses three case studies --- voting theory, participatory budgeting, and deliberative democracy --- to highlight how contemporary challenges motivate rigorous mathematical research that incorporates real-world data, institutional constraints, and implementation feasibility. Within each case, we highlight active and promising research frontiers, evidence of real-world impact, practical applications, and opportunities for getting involved.

Blood-based proteomics is approaching a translational inflection point. Driven by advances in measurement technologies, rapid expansion of analytical capabilities, and growing adoption across research and medical communities, there is increasing demand for clinically actionable biomarkers. As the field transitions away from purely large-scale discovery-oriented studies toward more informed, targeted, application-driven analyses, the generation of proteomic data is no longer the bottleneck. Instead, the central challenge is to translate these measurements into robust, reproducible, and clinically meaningful insights. In this Review, we assess recent technological and methodological developments, evaluate persistent preanalytical and interpretative limitations, and outline the key steps required for clinical translation. We focus on three deeply interconnected dimensions: the capabilities and constraints of current measurement platforms, the role of computational and machine learning approaches in extracting biological and clinical signals, and the emergence of large-scale population studies that create new opportunities for validation and generalization. Finally, we discuss a forward-looking vision in which proteomics plays a central role in dynamic, multilayered omics frameworks, where integration with genomics, temporal profiling, and imaging can deepen our understanding of health, disease, and therapeutic response.

This article surveys emerging directions in the mathematics of democracy. It uses three case studies --- voting theory, participatory budgeting, and deliberative democracy --- to highlight how contemporary challenges motivate rigorous mathematical research that incorporates real-world data, institutional constraints, and implementation feasibility. Within each case, we highlight active and promising research frontiers, evidence of real-world impact, practical applications, and opportunities for getting involved.

Uvod: Dijabetičko je stopalo posljedična komplikacija bolesti dijabetes melitus (DM), odnosno šećerne bolesti. Dijabetes melitus ozbiljna je kronična bolest koja nastaje kad gušterača ne proizvodi dovoljno inzulina za održavanje normalne razine šećera u krvi ili stanice neadekvatno reagiraju na inzulin. Uloga medicinske sestre u zbrinjavanju dijabetičkog stopala ključna je i obuhvaća širok spektar aktivnosti od rane prevencije i edukacije do specifične njege rana. Cilj: Cilj je rada ispitati stupanj znanja i stavova osoba oboljelih od dijabetesa o pravilnoj njezi stopala te procijeniti značaj edukativne i savjetodavne uloge medicinske sestre u prevenciji komplikacija dijabetičkog stopala. Provedeno istraživanje pokazat će koliki je utjecaj zdravstvene njege na ishod liječenja pacijenata s dijabetičkim stopalom i do koje su mjere oboljeli od dijabetesa educirani o pravilnoj njezi stopala. Medicinska je sestra primarni edukator koji pacijenta i njegovu obitelj educira o samopregledu i higijeni. Glavni je cilj spriječiti nastanak ulceracija, inficiranje postojećih rana i izbjeći amputaciju ekstremiteta. Metode: Provedena je prospektivno-deskriptivna studija, a podaci su dobiveni iz ankete koju su pacijenti samostalno popunili te su dali dobrovoljni pristanak za sudjelovanje u istraživanju. Vrsta anekte bila je anketni upitnik, a pitanja vezana za dijabetičko stopalo već su korištena za istraživanje javnozdravstvenog značaja zbrinjavanja dijabetičkog stopala u ordinaciji obiteljske medicine (Završni rad br. 102/SES/2015, Ivana Orban).Za obradu podataka korištene su metode deskriptivne statistike i Student t-test, uz nivo statističke značajnosti p < 0,05. Rezultati: Od ukupnog broja ispitanika u cjelokupnom uzorku, 33 ispitanika navela su da ih diplomirana medicinska sestra savjetuje o tome kako trebaju voditi pravilnu higijenu stopala. U tu skupinu spadaju ispitanici koji su odgovorili da su u posljednjih sedam dana 5 – 7 puta provodili higijenu stopala, što pokazuje da je edukacija pacijenata iznimno korisna. Od ukupnog broja ispitanika u uzorku, čak 32 ispitanika navela su da im najvažniji izvor informacija o njezi stopala predstavlja dipl. medicinska sestra. Zaključak: Na temelju dobivenih rezultata istraživanja i usporedbe s rezultatima drugih istraživanja o istoj temi, možemo zaključiti sljedeće: 1. zdravstvena njega pacijenata oboljelih od dijabetesa uvelike utječe na prevenciju nastanka dijabetičkog stopala; 2. edukacija pacijenata značajno utječe na njihovu svjesnost o mogućim neželjenim komplikacijama koje se mogu spriječiti.

Artificial intelligence (AI) increasingly mediates leadership-relevant judgment through models, dashboards, metrics, decision-support systems, and autonomous agents. This conceptual article develops a socio-technical systems theory of systemically mediated leadership, defined as a nested system-level condition and recurrent process configuration through which human actors, AI systems, organizational routines, governance institutions, and affected stakeholders jointly produce and revise direction, meaning, consequential judgment, legitimacy, and accountability through recursive feedback. A problem-driven conceptual synthesis was updated through 3 August 2026. A structured discovery pass yielded 97 candidate records; 85 sources were retained after relevance screening, citation chaining, concept mapping, and comparison of eight candidate mechanism families. Four proposed qualification conditions jointly define the construct within the present framework: AI mediation, leadership relevance, distributed judgment, and recurrent institutional embedding. Five mechanism families explain transformations in responsibility, legitimacy, control, attention, and feedback timing: moral delegation, interpretive laundering, ceremonial oversight, metric-driven sensemaking, and ethical latency. A causal-loop model specifies justificatory reinforcement, capability atrophy, power insulation, and accountable correction. Their relative dominance produces three ideal-type dynamic regimes: accountable adaptation, stabilized trade-offs, and destructive drift. The theory predicts that organizations using equally accurate models may produce divergent leadership and accountability outcomes because their feedback, power, and oversight architectures differ. Responsible AI leadership thus depends on system architecture and contestable institutional practice, not leader intention, formal human approval, or model accuracy alone.

Colorectal cancer (CRC) is the second leading cause of cancer-related death. The tumor immune microenvironment plays a critical role in tumor progression and immune evasion. B7-H3 (CD276), a member of the B7 family of immune checkpoint molecules, is frequently overexpressed in a variety of malignancies, including CRC. A systematic search of the literature was performed to identify studies evaluating B7-H3 in CRC. Data were extracted on study characteristics, B7-H3 expression and detection methods, molecular and signaling pathways, and clinical outcomes. Study quality and risk of bias were assessed using the MASTER scale, and findings were synthesized using a structured narrative approach. Sixty-three studies were included. B7-H3 expression was commonly reported but demonstrated substantial variability, largely driven by differences in detection and scoring methodologies. Preclinical evidence suggests that B7-H3 may contribute to tumor growth, invasion, immune evasion, and resistance to radio- and chemotherapy, potentially through pathways such as PI3K-AKT-mTOR, JAK-STAT, MAPK/ERK, NF-κB, VEGF/hypoxia, and Wnt/β-catenin. Preclinical studies have demonstrated that targeting B7-H3 may improve radiotherapy response and reduce metastatic burden in murine CRC models. However, these findings should be considered preliminary and are not yet supported by clinical evidence in humans. B7-H3 targeting remains an emerging therapeutic approach that requires further clinical validation. However, significant methodological heterogeneity in detection and scoring limits comparability across studies and precludes definitive conclusions regarding its clinical utility. B7-H3 should therefore be considered a candidate biomarker and further standardized. Prospective studies are needed to clarify its diagnostic, prognostic, and therapeutic relevance in CRC.

Objective. To show whether, in ecological terms, three lifestyle behaviors explain the different mortality rates from some cardiovascular diseases (CVD) across the 16 cohorts of the Seven Countries Study of Cardiovascular Diseases (SCS) in a 50-year follow-up. Material and Methods. Dietary habits, smoking habits, and habitual physical activity were converted into Dietary, Smoking and Physical Activity Scores using Principal Components Analysis (PCA). Then the three scores were compacted in a single Behavior Score using PCA again. End-points were mortality from coronary heart disease (CHD), Heart Diseases of Uncertain Etiology (HDUE) and Stroke. Moreover, total cardiovascular diseases (CVD) made by CHD+HDUE+Stroke were also considered. Results. Univariate and multivariate analyses showed that Dietary Score was directly and significantly related with CHD and to a lesser extent with CVD. HDUE and Stroke were not associated with any possible determinant and partly in a non-significant negative way. Physical Activity and Smoker Scores were not significantly associated with any end-point. The overall Behavior Score explained significantly the differences of CHD across cohorts. The overall Behavior Score was directly related with CHD and inversely related to Stroke in significant ways. Conclusions. Dietary habits are the only behavior that explains differences of CHD and partly of CVD across the 16 cohorts of the SCS since the variance of the other behaviors were not large enough to contribute.

Myelodysplastic syndromes (MDS) are a heterogeneous group of disorders caused by abnormalities at the hematopoietic stem cell level and are associated with ineffective hematopoiesis, peripheral cytopenias, and a propensity for leukemic transformation. Recent research elucidates the key mechanisms and roles of ribosomal proteins (RPs), microRNAs (miRNAs), extracellular vesicles (EVs), and long non-coding RNAs (lncRNAs) in the pathophysiology of MDS. Mutations or altered expression of RP genes lead to ribosomal stress and activation of p53, resulting in impaired erythropoiesis and apoptosis of hematopoietic progenitors. Dysregulation of miRNAs modulates gene expression programs that are essential for hematopoietic differentiation and apoptosis. Moreover, EV-associated miRNAs mediate multiple processes, including intercellular communication and regulation of the bone marrow (BM) microenvironment, thereby contributing to DNA damage and clonal evolution. EV-associated miR-10a and miR-15a have been reported to induce DNA damage in HSCs. LncRNAs have emerged as promising tools for cancer diagnosis and prognostic biomarkers. They play critical roles in regulating malignant cell proliferation, apoptosis, and epigenetic modifications. This overview highlights the molecular complexity of MDS pathogenesis, offering insights to support stratified diagnosis and the development of targeted therapies.

Across contemporary democracies, there is growing concern that some citizens increasingly view violence as a legitimate means to pursue political, ideological, or religious goals. Such attitudes threatens not only personal safety but also the very conditions that make democratic life possible: civil liberties, pluralism, and non-violent conflict resolution.There is a growing need for person-centered, pattern-based approaches that treat individuals’ lived experiences as configurations rather than as independent predictors. Hierarchical cluster analysis (HCA) heatmaps provide one promising tool for this purpose. These heatmaps allow researchers to visualize, for each individual, how experiences of violence and insecurity, feelings of belonging and trust, democratic orientations, religiosity, life satisfaction, and political activism co-occur – and how these multidimensional profiles relate to support for political violence. Such visual, exploratory methods are particularly well suited to complex phenomena like radicalization, where different constellations of similar ingredients may lead to different outcomes. In this paper, we draw on large-scale survey data from seven Western democracies to investigate how risk and protective factors related to belonging, democracy, and education cluster together at the individual level, and how these clusters are associated with the justification of terrorism as a political means. By employing Hierarchical cluster analysis (HCA) heatmaps as a complementary method to traditional statistical analyses, we aim to illuminate distinct pathways toward higher or lower propensity for political violence, and to highlight the role of social belonging and democratic norms as potential protective factors with direct implications for educational practice and policy.

Industrijski željeznički sustavi u čeličanama djeluju u izrazito opasnim uvjetima, gdje se mehanički, hemijski i ljudski faktori rizika međusobno preklapaju i djeluju visokim intenzitetom. Ovaj rad predstavlja sveobuhvatnu analizu sigurnosti željezničkog prometa i upravljanja logistikom u željezari ArcelorMittal Zenica, jednom od najznačajnijih metalurških postrojenja na zapadnom Balkanu. Na temelju interne operativne dokumentacije, relevantne znanstvene literature o procjeni rizika te strukturiranog pregleda sigurnosnih protokola, rad analizira internu mrežu pruga dužine 58 km, vozni park specijaliziranih željezničkih vozila, kao i višestanični dispečerski sustav. Ključni rizici identificirani su u četiri područja: sudari tijekom međupogonskog transporta, nepravilnosti pri utovaru vagona, mehanizmi iskliznuća iz tračnica te izloženost radnika profesionalnim štetnostima. Metode procjene rizika, uključujući Fuzzy Analitički hijerarhijski proces (FAHP), Analizu stabla grešaka (FTA) i dinamičke hibridne Bayesove modele, analizirane su s aspekta njihove primjenjivosti u industrijskom okruženju. Rad dodatno razmatra sustave osiguranja vagona, primjenu iskliznica, upravljanje pružnim prijelazima te tehnologije održavanja pruga, uključujući ultrazvučna ispitivanja i mjerenje geometrije kolosijeka. Identificirani su ključni nedostaci u automatizaciji sigurnosnih sustava, te su predložene mjere za digitalizaciju, modernizaciju infrastrukture i implementaciju integriranih sustava upravljanja sigurnošću (SMS). Rezultati rada doprinose širem području istraživanja sigurnosti rada u teškoj industriji i nude primjenjiv analitički okvir za slična metalurška postrojenja.

Marl, a transitional soft rock, exhibits complex geotechnical behavior due to its heterogeneous structure, parallel fissures, and variable cementation. The difficulty of obtaining undisturbed samples suitable for laboratory testing makes field-based calibration essential for realistic modeling of excavation performance. This paper presents field observations and numerical back-analysis of a strut-free excavation in marl rock supported by buttress pile walls. The study aims to calibrate the stiffness parameters of the Hardening Soil (HS) model to accurately reproduce the deformation behavior of the marl under actual excavation conditions. Field observations and a monitoring program, including systematic inclinometer measurements, were implemented to provide reliable reference data for model calibration and validation. The excavation was almost entirely in marl, ensuring consistent geotechnical conditions and eliminating the influence of other soil or rock layers that often complicate similar case studies. A three-dimensional finite-element back-analysis was conducted to evaluate the deformation behavior of the self-supporting buttress pile wall during staged excavation and to determine the stiffness parameters that best reproduce the observed field performance. Since both shear strength and stiffness govern wall displacements, shear strength values were fixed based on independent large-scale direct shear tests on intact marl and discontinuity samples from previous studies. Consequently, the analysis focused on identifying stiffness characteristics representative of marl rock under real excavation conditions. The calibrated parameters successfully captured the observed wall and ground deformations, providing a realistic representation of the excavation behavior. The findings offer valuable guidance for similar engineering problems, supporting more reliable prediction of system response in weak and transitional marl formations. Moreover, the results contribute to improved risk management and more informed geotechnical design decisions in future excavation projects under comparable geological and structural conditions.