Dengue, an Aedes mosquito-borne viral infection, is on the rise with climate and demographic change. In 2023, WHO declared dengue its highest grade of emergency, following the largest number of cases and deaths in recorded history. This emergency highlighted the absence of safe and effective dengue-specific treatments as a gap in the product landscape for care for people with dengue. To accelerate development of dengue-specific treatments for wide implementation and access in all dengue-endemic countries, WHO conducted a landscape analysis of the dengue therapeutics pipeline and convened a global expert and public consultation to develop target product profiles for treatments for non-severe and severe dengue. These target product profiles provide strategic guidance for product developers, regulators, procurement agencies, and funders on the intended use, target populations, and key product characteristics of dengue-specific treatments required to meet public health needs, setting clear targets to drive development of dengue drugs accessible to those who need them the most.
Osteoporosis is a major and growing health concern in the Asia-Pacific region, y et it remains widely underdiagnosed and undertreated due to limited access to dual-energy X-ray absorptiometry (DXA) in many areas. Artificial intelligence (AI) offers new opportunities to improve osteoporosis screening and management, but unvalidated tools pose risks of inconsistent care. This consensus was developed to provide regionally harmonized guidance on the safe, effective, and equitable use of AI in osteoporosis care. Purpose The aim of this work was to establish expert consensus recommendations on the role of AI in osteoporosis screening and management in the Asia-Pacific region. Key objectives were to define appropriate applications of AI (e.g., imaging-based bone assessment and fracture risk prediction) and specify minimum standards for validation and reporting, addressing region-specific implementation challenges and ensuring that AI use aligns with clinical guidelines and ethical principles. Methods This consensus was developed through multidisciplinary collaboration among experts across the Asia-Pacific region. Each participant reviewed draft statements, contributed feedback during virtual meetings, and provided insights based on clinical experience and current evidence. Consensus was reached iteratively until full agreement was achieved for all statements. The process integrated global best practices and regional adaptations, drawing from peer-reviewed studies, international AI guidelines, and local fracture registry data. The final recommendations emphasize the validation, transparency, and ethical implementation of AI within regional healthcare systems, ensuring compatibility with local regulations. Ultimately, twelve consensus statements were established to guide the responsible use of AI for osteoporosis screening and management in the Asia-Pacific region. Results The panel produced 12 consensus statements covering the role of AI as an adjunct for opportunistic osteoporosis screening rather than a diagnostic tool, requirements for imaging quality and AI model transparency, standards for validation and performance reporting, integration of AI with clinical risk stratification, demonstration of clinical utility in real-world settings, adherence to data protection laws and ethical AI principles, training of clinicians in AI use, strategies for implementation and monitoring (including post-market surveillance and feedback loops), and recognition of technical, clinical, and equity limitations of AI. All 12 statements give extensive recommendations for using AI to improve osteoporosis management while ensuring patient safety, accuracy, and equity. Conclusion This first Asia-Pacific consensus on AI in osteoporosis concludes that AI, when appropriately validated and implemented, can help bridge the osteoporosis care gap by identifying high-risk patients who would otherwise remain undiagnosed, thus facilitating earlier intervention. It emphasizes that AI should complement-not replace-standard diagnostic methods and clinical judgment. The guidance emphasizes validation, transparency, and ethical oversight to facilitate early intervention while minimizing risks associated with unvalidated or premature AI adoption.
Existing self-administered, pre-participation screening questionnaires for physical exercise have not demonstrated high take-up rates in many populations. There is evidence that part of the reason for this may be the language of these questionnaires and difficulty in understanding these questions by lay persons, especially those with existing medical conditions that may be of concern if engaging in physical exercise. The medical referral rates for existing questionnaires appears excessive. There has also not been a demonstrable decrease in sports emergencies following current use of these questionnaires. Based on the lessons learnt from previous surveys and the evidence behind existing questionnaires, an eight-question International Physical Exercise Screening Questionnaire (IPESQ) is proposed. This paper discusses the roles played by pre-participation screening questionnaires in preventing or minimizing the occurrence of sports emergencies, desired characteristics of pre-participation exercise screening questionnaires and describes the justification for each of the IPESQ questions and how the Questionnaire may be implemented. It proposes a tool that is based on studies that have actively sought public feedback, and used the level of evidence currently available in the scientific literature as proof of relevance and usefulness. The proposed IPESQ will need to be actively implemented and its impact determined with monitoring of sports-related emergency rates. It is relevant to an international audience, since sports emergencies such as cardiovascular collapse, injuries and heat illnesses are universal phenomena. The IPESQ can be regarded as a promising but not yet proven instrument to minimize the occurrence of sports emergencies.
What is known? Hip fractures are debilitating osteoporotic fractures that are increasingly pervasive in our aging population. SES has an overarching influence on health outcomes and well-being, having already been proven in other morbid diseases. What is new? Overall, this study demonstrates that hip fracture patients experience poorer perioperative quality of life at different time points based on SES, though both groups recuperate to attain comparable outcomes by 1 year. What is the impact? Our findings suggest that hip fracture prevention should be emphasised across all socioeconomic strata. Health policies and coverage should be re-examined in the aging population, especially the need for mental health support during immediate recovery. Hip fractures are increasingly prevalent in our fast-aging population, but effects of socioeconomic status (SES) on these patients’ perioperative wellbeing are not well understood. This study aims to investigate the effect of SES, represented by hospital ward class, on perioperative function and health-related quality of life (HRQoL) in hip fracture patients. Four hundred forty-five hip fracture patients were prospectively followed up and categorised into private (PTE) and government-subsidised (SUB) ward classes as a surrogate for SES. Patients were evaluated using Parker Mobility Score (PMS), EuroQol-5 Dimensions (EQ-5D) and Short Form-36 (SF-36; including Physical Function [PF] and Mental Health [MH]) scores premorbidly, and postoperatively at 3 months, 6 months and 1 year. Group PTE scored significantly higher in PMS across all time points and in PF at 6 months (42.5 ± 27.3 vs 35.0 ± 29.1, p = 0.033) postoperatively. Group PTE also had superior EQ-5D scores at 3 (0.620 ± 0.282 vs 0.497 ± 0.325, p = 0.002) and 6 months (0.715 ± 0.268 vs 0.576 ± 0.334, p = 0.001) postoperatively. Group PTE had higher MH scores at 3 months (85.9 ± 15.0 vs 80.9 ± 18.1, p = 0.014) postoperatively, though its scores continued to decline by 6 months. Changes over time in EQ-5D scores favoured Group PTE (p = 0.016). Both groups had an overall decline at 3 months before gradually returning towards baseline at 1 year. This study highlights SES-based disparities in hip fracture patients perioperatively, though both groups converge to comparable outcomes by 1 year. Health policies should consider MH support during recovery for all, regardless of SES.
Hip fracture represents a singular traumatic experience with substantial health and socioeconomic repercussions in the elderly. While clinical and functional outcomes are well established, patient experience has emerged as another measure of quality-of-care. However, factors influencing patient experience after osteoporotic hip fracture surgery remain poorly defined. This study aims to determine factors influencing postoperative satisfaction and patient expectation. Retrospective analysis of a prospectively followed up cohort (n = 257) of hip fracture patients (1st of January–31st of December 2023) was performed. Demographics, co-morbidities and patient-reported outcome measures (EQ5D, NPRS, HHS and SF36) were correlated with 6-month postoperative satisfaction (6-point Likert scale) and expectation (7-point Likert scale). Statistical analyses included normality testing, univariate analysis and ordinal logistic regression (SPSS v29.0.2.0, α = 0.05), with Spearman’s correlation and odds ratios reported for significant variables in logistic regression. Among 257 patients (74 males, 183 females; mean age 79.0 ± 8.0 years), 59
