Introduction: The COVID-19 pandemic highlighted the critical need for robust crisis standards of care (CSC) protocols to handle extreme strain when scarce resources require rationing. Evaluating how such policies might perform in the real world remains paramount; however, to date, study of their performance has been limited to retrospective cohort designs using virtual simulations.1,2 The Sequential Organ Failure Assessment score (SOFA)—a composite 0-24 score of organ dysfunction incorporating neurologic, pulmonary, cardiovascular, hematologic, hepatobiliary, and renal subscores—remains ubiquitous in nearly all crisis standards of care protocols3,4,5 despite concerns regarding the utilization and potentially exacerbating existing racial inequities.5 Existing simulation studies have handled missing SOFA values by either imputing zero or assuming data are missing at random, followed by complex computational statistical modeling.6,7 This approach may introduce significant bias, with larger outcome implications than missing data in other forms of medical research, as these values directly affect decisions on who receives life-sustaining therapies. Our study aims to better understand the frequency, structure, and consequence of missing data in CSC simulation studies.

This article examines the evolution of breastfeeding practices in twentieth-century China, focusing on the complex interplay between medical knowledge, state policies and social transformation. This study demonstrates how medical recommendations concerning lactation timing, intervals and weaning were shaped by factors beyond purely scientific developments. Mid-twentieth-century biochemical studies validated traditional practices while revolutionising attitudes towards colostrum, marking a critical juncture in Chinese infant nutrition science. Following the establishment of the People’s Republic in 1949, maternal and child health initiatives underwent fundamental changes. Drawing on new understanding of breast milk’s nutritional value, health benefits, and economic advantages, healthcare professionals and state authorities actively promoted scientific breastfeeding methods. Their multifaceted approach reflected both the dissemination of medical knowledge and the state’s strategic consideration of female labour force participation. This study analyses how women’s liberation from feudal constraints, changing employment patterns, Soviet medical influence, and advances in artificial feeding technologies shaped breastfeeding practices. Through examining the intersection of medical advice, health policies, and women’s labour liberation, it provides fresh insights into the evolution of breastfeeding discourse within Chinese medical circles. Situating these developments within broader medical, social and cultural contexts, this research not only illuminates the multiple factors that shaped modern Chinese infant feeding practices but also contributes to our understanding of the complex relationships between medical practice, state policy, and social change in twentieth-century China.

This study investigates the prevalence of coliform contamination in fresh milk and the occurrence of multidrug-resistant (MDR) bacteria within poultry environments on an integrated farm in Minna, Niger State. Bacterial isolates obtained from raw milk, poultry cloacal swabs, and intestinal swabs from commensal rats included Salmonella, Escherichia coli, and Klebsiella species. These isolates were screened for extended-spectrum beta-lactamase (ESBL) production and antimicrobial resistance profiles. The results revealed a high level of bacterial contamination in milk samples, with significant associations between contamination levels and poor hygiene practices during milking and handling. Moreover, ESBL-producing bacteria displaying resistance to critically important antibiotics such as third-generation cephalosporins and fluoroquinolones were identified across both dairy and poultry sources. These findings highlight a pressing public health concern and emphasize the need for improved biosecurity, hygiene interventions and integrated antimicrobial resistance surveillance to safeguard food safety and reduce the spread of MDR pathogens in animal-source foods.

Numerous symposia and conferences have been held to discuss the promise of Artificial Intelligence (AI). Many center on its potential to transform fields like health and medicine, law, education, business, and more. Further, while many AI-focused events include those data scientists involved in developing foundational models, to our knowledge, there has been little attention on AI’s role for data science and the data scientist. In a new symposium series with its inaugural debut in December 2024 titled AI for Data Science, thought leaders convened to discuss both the promises and challenges of integrating AI into the workflows of data scientists. A keynote address by Michael Pencina from Duke University together with contributions from three panels covered a wide range of topics including rigor, reproducibility, the training of current and future data scientists, and the potential of AI’s integration in public health.

Artificial Intelligence (AI) is transforming public health, presenting both opportunities and ethical and legal challenges. This study adopts an interdisciplinary approach, integrating legal doctrinal analysis, public health ethics, AI governance scholarship and a scoping review of international legal instruments to evaluate and operationalize three core pillars: ethical accountability, regulatory adaptability and transparency. Through a scoping review of treaties, regional regulations and policy frameworks, the study maps jurisdictional gaps and proposes an adaptive public law framework that addresses critical shortcomings in existing AI governance models, such as the WHO’s limited enforceability and the GDPR’s rigid data-sharing rules. The framework introduces scalable, region-specific regulations to enhance interoperability while respecting local governance needs. Its human-centric design, modular regulation and accountability mechanisms ensure adaptability across diverse legal, cultural and health system contexts. Informed by case studies and a thematic synthesis of global best practices, this framework offers policymakers and practitioners a structured yet flexible approach to balancing AI-driven innovation with ethical imperatives, promoting equitable public health outcomes.

The family Brachycladiidae (Digenea) is a species-rich taxon restricted to marine mammals, well-known for its associated pathogenic load, but otherwise poorly understood. A major gap in our knowledge is their circulation pathways, as the life cycle has been elucidated only for a single brachycladiid species, Orthosplanchnus arcticus, a parasite of pinnipeds. Our goal was to determine whether small ocellate metacercariae previously reported from the Barents Sea edible cockles (Cerastoderma edule) belong to the brachycladiids. We searched for brachycladiid metacercariae in nine bivalve species across three sub-Arctic Seas. They were found in three cardiid species (Ciliatocardium ciliatum, C. edule, and Serripes groenlandicus) and a scallop, Chlamys islandica. Surprisingly, we discovered numerous brachycladiid metacercariae in a single infected whelk, Buccinum undatum. Obtained molecular genetic data (mitochondrial and nuclear ribosomal) indicated that all these metacercariae belong to O. arcticus. We used statistical analysis to explore potential preferences for the second intermediate hosts in this brachycladiid species. The results suggest that bivalve size, rather than species, more accurately predicts infection patterns with O. arcticus metacercariae. We also found no significant differences in morphology between metacercariae from different bivalve species. As such, O. arcticus exhibits broad specificity for the second intermediate hosts, with larger bivalve individuals showing higher infection rates. We discuss the factors underlying this broad specificity, the benefits of larger bivalve preference, and the unequal contribution of different hosts in the transmission of a parasite. Finally, we highlight the potential zoonotic risk associated with O. arcticus due to human consumption of its intermediate hosts.

This cross-sectional study evaluated the nutritional composition and labelling of commercial foods in Canada targeted to infants up to 18 months of age. Front-of-package labelling requirements were assessed based on daily values identified by Health Canada for saturated fatty acids, sugars, and sodium for children aged one year and older. Infant commercial food products were identified from online and in-person records of retailers across Canada. A total of 1,010 products were identified. Products aimed at older infants (12–18 months) contained significantly more calories, macronutrients, sugars, saturated fat, and trans fat compared to those targeted at younger infants (<12 months). In addition, 40% of products for children aged 12–18 months required a ‘high in sugar’ front-of-package label, while less required a ‘high in saturated fats’ (13%) and ‘high in sodium’ (5%) label. Organic products had higher added sugar and fibre, while they were lower in calories, total fat, saturated fat, and protein. Plant-based products, including vegetarian/vegan products, contained fewer calories, fat, saturated fat, trans fat, and protein, but more fibre. Gluten-containing products had more calories, macronutrients, sugar, fibre, and saturated fat. Non-GMO labelled products had more calories, carbohydrates, and sugar, but less saturated fat. Significant differences were observed for vitamins and minerals across food categories (p < 0.05). Our findings offer valuable guidance for parents, caregivers, and healthcare professionals on infant nutrition, highlighting the importance of selecting foods that align with infants’ specific dietary needs.

Since the escalation of hostilities in Gaza in October 2023, the health care system has been overwhelmed by mass casualties, infrastructure damage, and supply shortages. Amid these conditions, septic amputations have emerged as a desperate, life-saving measure for patients with severe limb wound infections. This article examines the rise of such procedures, drawing from contextual analysis and firsthand cases at Al-Aqsa Martyrs’ Hospital. It also highlights doctors’ observation of how delayed access to care, lack of sterile tools, antibiotic shortages, and multidrug-resistant infections have often made limb salvage impossible. These amputations, while medically necessary, reflect the collapse of trauma care and underscore the urgent need for adaptable humanitarian intervention, standards, and call for the protection of health care facilities and services continuity.