The International Union Against Tuberculosis and Lung Disease or The Union, is a global scientific organization headquartered in Paris with the stated goals to "improve health for people in low- and middle-income Countries". The Union focuses its work in three areas: Tuberculosis, Tobacco Control, and Lung and non-communicable diseases. The antecedents of The Union date to an 1867 meeting to discuss the tuberculosis plague, and include the former Central Bureau for the Prevention of Tuberculosis and the International Union Against Tuberculosis (IUAT). The Union no longer uses the acronym "IUATLD" as its short-form name.
Modern DevSecOps environments face a persistent tension between accelerating deployment velocity and maintaining verifiable compliance with regulatory, security, and internal governance standards. Traditional snapshot-in-time audits and fragmented compliance tooling struggle to capture the dynamic nature of containerized, continuous delivery, often resulting in compliance drift and delayed remediation. This paper introduces the Continuous Compliance Framework (CCF), a data-centric reference architecture that embeds compliance validation directly into CI/CD pipelines. The framework treats compliance as a first-class, computable system property by combining declarative policies-as-code, standardized evidence collection, and cryptographically verifiable attestations. Central to the approach is a Compliance Data Lakehouse that transforms heterogeneous pipeline artifacts into a queryable, time-indexed compliance data product, enabling audit-ready evidence generation and continuous assurance. The proposed architecture is validated through an end-to-end synthetic microservice implementation. Experimental results demonstrate full policy lifecycle enforcement with a minimal pipeline overhead and sub-second policy evaluation latency. These findings indicate that compliance can be shifted from a post hoc audit activity to an intrinsic, verifiable property of the software delivery process without materially degrading deployment velocity.
Psilocybin is a promising therapy for cancer-related distress, but existing individual treatment models are resource intensive. In this study, we designed and tested a group model of psilocybin therapy for people with metastatic cancer and cancer-related anxiety and depression. Eligibility criteria included metastatic cancer, moderate-to-severe symptoms of anxiety or depression without a pre-cancer mental health diagnosis, performance status adequate to attend a 3-day retreat that required self-care, and tapering of antidepressants. Exclusion criteria included enrollment in hospice. The design of the intervention included: two virtual preparatory sessions; a 3-day in-person retreat in a rustic setting that included the third prep session, the psilocybin session, and the first integration session; and two additional virtual integration sessions. Psilocybin was administered in oral capsules at 25 mg. A retreat team of four core facilitators and two backup facilitators conducted a series of eight retreats. The first retreat had five participants. For subsequent retreats, we used the primary safety outcome from each cohort, other safety outcomes, and qualitative feedback to make decisions to increase, decrease, or hold steady the participant number. The primary safety outcome was “unattended episodes of participant distress” during the psilocybin session requiring a backup facilitator. The primary exploratory efficacy outcome was reduction in anxiety and depression symptoms measured using the Hospital Anxiety and Depression Scale (HADS). We enrolled 55 participants, of whom 3 withdrew prior to the retreat, leaving a total of 52. Their mean age was 53, and mean duration of living with cancer was 36 months, mean (range 5, 176); anticancer therapy was ongoing for 46 (88%); antidepressants were tapered for 18 (35%). The first retreat cohort had five participants, and the final retreat cohort had eight. For the primary safety outcome, there was not a single episode of unattended participant distress requiring a backup facilitator. The mean baseline at Day −14 (D −14) HADS total score was 17.5 (range 6–28); at D +28, the mean HADS total score was 10.2 (1–30), so the mean decrease in HADS from D −14 to D +28 was 7.3. ( p < 0.0001). The Group Retreat Psilocybin Therapy was safe and well tolerated, and exploratory measures show efficacy that is promising. A group configuration of eight participants with four core facilitators can be safe for future studies with participants with serious medical illness.
Tuberculosis persists as the world's deadliest infectious disease, despite improved diagnostics and effective treatment. The tuberculogenic environment describes the sum of influences, vulnerabilities, policies, life conditions, and health factors that sustain the tuberculosis pandemic in vulnerable communities. The persistence of these environments is attributable to challenges upstream of the health system, involving sectors such as trade, taxation, finance, agriculture, employment, social services, and education. The availability, affordability, access, and acceptability of safe infrastructure (including housing), nutritious foods, protection against harmful consumption (tobacco, alcohol, sugar, etc), and adequately resourced health services are all linked to tuberculosis risk. Yet people affected by tuberculosis and national tuberculosis control programmes continue to bear almost the sole responsibility for a problem that is largely beyond their control. Reframing tuberculosis through the lens of complex systems science highlights the array of decision makers who, by action or inaction, have a shared responsibility to end tuberculosis as a global pandemic.
Background: Tuberculosis (TB) remains a major global health challenge, with transmission influenced by the incidence of contagious people with TB, the duration of infectivity, and the probability of contact with susceptible individuals. This review synthesizes recent evidence on established and emerging risk factors influencing TB transmission, particularly in light of global trends such as migration, urbanization, and demographic shifts, to guide future prevention and control strategies. This scoping review maps and synthesizes evidence from systematic reviews on risk factors for Mycobacterium tuberculosis exposure. Methods: A preliminary general literature search was conducted in PubMed on 25 August 2024, using the keywords “tuberculosis,” “risk factors,” and “systematic review.” A subsequent targeted search focused on systematic reviews published since 2000 that examined social and environmental determinants of exposure to M. tuberculosis identified in the general search. Original research and reviews spanning pre-2000 were excluded. Data extraction and synthesis followed PRISMA-ScR guidelines. Results: Of the 344 systematic reviews identified, 14 met the eligibility criteria, reporting on key risk factors contributing to the incidence of contagious people with TB, the duration of infectivity, and the probability of contact. These risk factors included homelessness, migration, occupational exposure, urbanization, climate change, and air pollution. The findings emphasize the complex interrelated role of social and environmental determinants in driving TB transmission. Conclusion: This review highlights the need for a multi-sectoral approach to TB, as climate change, air pollution, overcrowding, stigma, and limited healthcare access exacerbate established risks related to poverty. Effective prevention and control require targeted interventions that address these interconnected factors.
Background: Tuberculosis (TB) remains a major global health threat, particularly in low- and middle-income countries, with TB infection (TBI) serving as the primary source of TB disease. While HIV infection has long been recognised as a major risk factor for TB progression, the rise of Non-Communicable Diseases (NCDs), which may exert immunosuppressive effects, further compounded by their treatment, contributes to increased TB susceptibility. This scoping review synthesises evidence from systematic reviews on medical and behavioural risk factors for TBI progression to TB disease, for both asymptomatic and symptomatic disease. Methods: A preliminary literature search was conducted on 11 January 2025, in PUBMED using the keywords “tuberculosis,” “asymptomatic or subclinical tuberculosis” “risk factors,” and “systematic review” followed by targeted reviews on the identified medical and behavioural risk factors for TB infection progression to TB disease. Results: A total of 25 systematic reviews were included. Medical risk factors for progression from TB infection to TB disease included diabetes mellitus (DM), chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), undernutrition (including iron and vitamin D deficiency), cancer—particularly haematological malignancies—and immunosuppressive therapies (TNF-α inhibitors and glucocorticoids). Iron and vitamin D deficiency, particularly severe deficiency, is linked to increased TB risk, especially among people living with HIV. Behavioural risk factors, including tobacco, drug, and alcohol use, were also highlighted. Geographic variations in TB prevalence, diagnostic practices, and healthcare systems contributed to differences in risk estimates across reviews. No systematic reviews were identified that examined risk factors for asymptomatic TB. Conclusions: The convergence of TB with NCDs, compounded by immunosuppressive therapies, poses a public health challenge in high TB burden settings. Effective TB prevention requires targeted screening, along with enhanced management of these NCDs. Nutritional support, particularly screening and treatment of anaemia and vitamin D deficiency, may benefit individuals with TBI, comorbid NCDs, and HIV. A multidisciplinary approach, integrating behavioural interventions and tailored prevention strategies, is essential to achieving WHO’s End TB targets. Addressing the evidence gap on risk factors for asymptomatic TB is also critical to improve early detection and interrupt transmission.
