The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgia.The agency's main goal is the protection of public health and safety through the control and prevention of disease, injury, and disability in the US and worldwide. The CDC focuses national attention on developing and applying disease control and prevention. It especially focuses its attention on infectious disease, food borne pathogens, environmental health, occupational safety and health, health promotion, injury prevention and educational activities designed to improve the health of United States citizens. The CDC also conducts research and provides information on non-infectious diseases, such as obesity and diabetes, and is a founding member of the International Association of National Public Health Institutes.The current Director of the CDC is Rochelle Walensky. The Director reports to the United States Secretary of Health and Human Services.
Zhongcheng Ke,1,* Tao Luo,2,* Xiaoling Cheng,3 Xuwen Chai,1 Zitong Zhu,1 Zhusheng Huang,4 Zhen Wang51College of Chemistry and Chemical Engineering, Huangshan University, Huangshan, People’s Republic of China; 2Medical Experimental Center Nanjing, Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China; 3Center for Disease Control, Tunxi Health Commission, Huangshan, People’s Republic of China; 4School of Chemistry and Life Sciences, Nanjing University of Posts and Telecommunications, Nanjing, People’s Republic of China; 5Hepatopancreatobiliary Surgery, XuZhou Central Hospital Affiliated to Southeast University, Xuzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhusheng Huang, School of Chemistry and Life Sciences, Nanjing University of Posts and Telecommunications, Nanjing, People’s Republic of China, Email iamzshuang@njupt.edu.cn Zhen Wang, Hepatopancreatobiliary Surgery, XuZhou Central Hospital Affiliated to Southeast University, Xuzhou, People’s Republic of China, Email seuwangzhen@163.comPurpose: Gambogic acid (GA) shows potent inhibitory activity against various malignancies. However, achieving precise targeted delivery and spatiotemporal control of drug release at tumor sites remains a significant challenge. This study aimed to develop a hyaluronic acid (HA)-modified, redox-responsive drug delivery system based on a methoxy polyethylene glycol-linked GA prodrug (mPEG-ss-GA).Methods: The amphiphilic prodrug, mPEG-ss-GA, was synthesized by conjugating GA to methoxy polyethylene glycol (mPEG) via a disulfide linkage. Subsequently, it spontaneously self-assembled with HA in an aqueous medium to form HA-modified mPEG-ss-GA micelles (HA/mPEG-ss-GA-M). The physicochemical properties of the micelles, including particle size, zeta potential, morphology, and in vitro release profiles, were systematically characterized. Cellular uptake in human non-small cell lung cancer cells (A549) was visualized using fluorescence microscopy. Furthermore, the in vitro pro-apoptotic effects were quantified using an Annexin V–propidium iodide (PI) binding assay. Finally, the in vivo anti-tumor efficacy was evaluated in a subcutaneous xenograft tumor model.Results: The HA/mPEG-ss-GA-M micelles exhibited an average particle size of 251 nm with a zeta potential of − 17.36 mV. The system demonstrated glutathione (GSH)-triggered drug release, with release kinetics that aligned well with the Higuchi model. In vitro studies revealed that HA/mPEG-ss-GA-M significantly enhanced cellular uptake, induced apoptosis, and suppressed cell migration. In vivo experiments showed that HA/mPEG-ss-GA-M achieved a tumor volume inhibition rate of 54.09%, compared to 29.56% for free GA.Conclusion: HA/mPEG-ss-GA-M is a promising drug delivery system for targeted non-small cell lung cancer therapy and offers precise and efficient treatment options.Keywords: gambogic acid, lung cancer, redox-responsive delivery, polymeric prodrug
Tick distribution in China has significantly expanded with urbanization and climate change. Chongqing, in southwestern China, faces a significant risk of severe fever with thrombocytopenia syndrome (SFTS), which is transmitted primarily by ticks, but targeted prevention efforts are challenging due to unclear exposure pathways. This study combined generalized linear model (GLM), Bayesian networks, and Bayesian multivariate GLM to assess environmental, agricultural, and socioeconomic drivers of tick exposure in southwestern China. Direct tick exposure risks primarily arose from proximity to shrublands and forests, and cattle farming. Pet ownership also increased risk, while proximity to croplands reduced exposure, likely due to pesticide/herbicide use and tillage. Bayesian networks revealed that socioeconomic factors indirectly mediated risk. Higher education levels reduced cattle farming likelihood and increased income tier, lowering exposure by altering land-use proximity and agricultural activities. Key factors showing no significant association included age or gender, grassland proximity, and crop cultivation. Bayesian methods resolved collinearity and mediation effects in GLM, clarifying township-level tick exposure mechanisms in Southwest China and mapping driver networks. Findings demonstrate that tick exposure stems from complex interactions among environmental, agricultural, and socioeconomic factors. Prevention in mountainous southwest China should prioritize the shrubland/forest-cattle farming ecological interface.
Background Dengue is a major vector-borne disease, with rising incidence driven by climate change, rapid urbanization, and increased international travel. Although early warning systems (EWSs) have shown promising predictive performance in endemic settings, limited evidence on implementation barriers from local end users hinders their integration into routine proactive vector control. Methods A qualitative study with in-depth interviews was conducted with local end users, including local authorities, health practitioners, and health volunteers. A deductive approach utilizing a predefined conceptual framework was employed to code the verbatim transcripts. Inductive coding was subsequently incorporated to capture emerging concepts that were not represented in the initial framework. Thematic analysis was performed to analyse the collected data. To enhance the methodological rigor, interviews and coding were performed by multiple and diverse researchers from various academic and practi ce institutions, and the transcripts were validated through member checking with selected participants. Results The lack of supportive policies, limited engagement from relevant stakeholders due to low familiarity with EWS concepts, and operational challenges were identified as critical barriers to implementing EWS-informed proactive source reduction. The perception that dengue risks were only during the rainy season, together with socio-economic constraints, water scarcity exacerbated by extreme weather events, and the application of inappropriate source reduction measures, further constrained household participation. The multi-level barriers collectively disrupted the translation of EWS alerts into proactive dengue prevention. Conclusions Early warning information alone is insufficient to translate into effective and sustained proactive vector control for dengue prevention. Strengthening enabling policies, local stakeholder and community engagement, and awareness of EWS-informed risk management across multiple levels are essential to translate EWS alerts into timely and sustained vector control actions in dengue-endemic settings similar to Vietnam. Further studies across diverse settings are needed to assess the broader applicability of EWS-informed approaches.
Gastric ulcers are one of the major public health burdens in the modern era, with increased complications that could be a result of alcohol abuse or H. pylori infection. In this study, we investigated the therapeutic potential and acute toxicity effects of Pterostilbene (PSB) in ethanol-mediated gastropathy, as well as its underlying molecular mechanism, in rats. Gastric ulcers are provoked by absolute ethanol (5 mL/kg, i.g.) in male Sprague–Dawley rats after receiving oral treatments: physiological saline (negative, 5 mL/kg), omeprazole (positive control, 20 mg/kg), and PSB (30 and 60 mg/kg). PSB pretreatment significantly alleviated clinical signs, reduced the macroscopic ulcer index, and improved gastric mucosal morphology, including gastric defense barriers (mucus and glycoprotein production). PSB Pretreatment improved ethanol-mediated microscopical alterations, as indicated by reduced submucosal oedema, decreased hemorrhagic/lesion areas, and restoration of mucosal integrity. PSB down-regulated apoptotic actions (reduced P53 and increased Bcl-2 protein expression), lowered inflammatory conditions (decreased TNF-α, IL-6, and increased IL-10), and limited oxidative stress tissue injuries (up-regulated SOD, CAT, and PGE2 while lowering MDA). The PSB gastroprotection may be linked to a strengthened gastric defense and anti-oxidative/anti-inflammatory pathways, ultimately curbing apoptotic actions by modulating death signals, P53, and Bcl-2 proteins. The outcomes present PSB as a viable nutraceutical and biopharmaceutical product for managing stomach disorders, including gastric ulcers.
Summary Background Production of affordable coronavirus disease 2019 (COVID-19) vaccines in low- and lower-middle-income countries is needed. NDV-HXP-S is an inactivated egg-based recombinant Newcastle disease virus vaccine expressing the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A public sector manufacturer in Vietnam assessed the immunogenicity of NDV-HXP-S (COVIVAC) relative to an authorized vaccine. Methods This phase 2 stage of a randomised, observer-blind, controlled, phase 1/2 trial was conducted at three community health centers in Thai Binh Province, Vietnam. Healthy males and non-pregnant females, 18 years of age and older, were eligible. Participants were randomised by age (18-59, ≥60 years) to receive one of three treatments by intramuscular injection twice, 28 days apart: COVIVAC at 3 µg or 6 µg, or AstraZeneca COVID-19 vaccine VAXZEVRIA. Participants and personnel assessing outcomes were masked to treatment. The main outcome was the induction of 50% neutralising antibody titers against vaccine-homologous pseudotyped virus 14 days (day 43) and 6 months (day 197) after the second vaccination by age group. The primary immunogenicity and safety analyses included all participants who received one dose of the vaccine. ClinicalTrials.gov NCT05940194 . Findings During August 10-23, 2021, 737 individuals were screened, and 374 were randomised (124-125 per group); all received dose one, and three missed dose two. On day 43, the geometric mean fold rise of 50% neutralising antibody titers for subjects age 18-59 years was 31·20 (COVIVAC 3 μg N=82, 95% CI 25·14-38·74), 35·80 (COVIVAC 6 μg; N=83, 95% CI 29·03-44·15), 18·85 (VAXZEVRIA; N=82, 95% CI 15·10-23·54), and for subjects age ≥60 years was 37·27 (COVIVAC 3 μg; N=42, 95% CI 27·43-50·63), 50·10 (COVIVAC 6 μg; N=40, 95% CI 35·46-70·76), 16·11 (VAXZEVRIA; N=40, 95% CI 11·73-22·13). Among subjects seronegative for anti-S IgG at baseline, the day 43 geometric mean titer ratio of neutralising antibody (COVIVC 6 μg/VAXZEVRIA) was 1·77 (95% CI 1·30-2·40) for subjects age 18-59 years and 3·24 (95% CI 1·98-5·32) for subjects age ≥60 years. On day 197, the age-specific ratios were 1·11 (95% CI 0·51-2·43) and 2·32 (0·69-7·85). Vaccines were well tolerated; reactogenicity was predominantly mild and transient. The percentage of subjects with unsolicited adverse events (AEs) during 28 days after vaccinations was similar among treatments (COVIVAC 3 μg 29·0%, COVIVAC 6 μg 23·2%, VAXZEVRIA 31·2%); no vaccine-related AE was reported. Interpretation Considering that induction of neutralising antibodies against SARS-CoV-2 has been correlated with the efficacy of COVID-19 vaccines, including VAXZEVRIA, our results suggest that vaccination with COVIVAC may afford clinical benefit matching or exceeding that of the VAXZEVRIA vaccine. Funding Vietnam’s Institute of Vaccines and Medical Biologicals (including support from Vietnam’s national COVID-19 vaccine fund and a charitable contribution from the Thien Tam fund of Vin group), Coalition for Epidemic Preparedness Innovations, a charitable contribution from Bayer AG, US National Institutes of Health.
