Background: Non–sputum-based, point-of-care triage tests for pulmonary tuberculosis could enhance tuberculosis diagnostic programs. We assessed the diagnostic accuracy of 2 finger-stick blood tests: the Cepheid 3 gene host-response cartridge (Xpert-HR), which measures 3 host messenger RNA transcripts, and the 3-host protein multibiomarker test (MBT). Methods: We performed a prospective diagnostic accuracy study of consecutive participants with symptoms compatible with pulmonary tuberculosis in The Gambia, South Africa, Uganda, and Vietnam. A composite reference standard for active pulmonary tuberculosis incorporated chest radiography, symptom resolution, and sputum microbiological test results. A training-test set approach was used to evaluate test cutoff specificities at 90% sensitivity. Results: Between 1 November 2020 and 1 May 2023, we screened 1262 participants aged 12–70 years with cough lasting >2 weeks and another symptom suggestive of tuberculosis. Of those who were classifiable by reference tests, 1154 participants had evaluable Xpert-HR results and 961 had evaluable MBT results. Xpert-HR had an area under the receiver operating characteristic (AUROC) curve of 0.92 at a cutoff of −1.275 or below, with a sensitivity of 92.8%, specificity of 62.5%, positive predictive value of 47.9%, and negative predictive value of 95.9%. The MBT had an AUROC of 0.91 at a cutoff of ≥0.42, with a sensitivity of 91.4%, specificity of 73.2%, positive predictive value of 52.0%, and negative predictive value of 96.4%. Conclusions: Our results show that both Xpert-HR and the MBT are promising non–sputum-based point-of-care tests. The MBT met the World Health Organization target product profile for a triage test, which suggests it should be further developed.

Video gaming is highly prevalent among university students, yet its health associations remain poorly understood. This study examined relationships between video gaming frequency and health in Australian university students. A cross-sectional survey of 317 Western Australian university students assessed gaming habits, diet quality (Diet Quality Tool), physical activity (International Physical Activity Questionnaire), sleep quality (Pittsburgh Sleep Quality Index), eating behaviors (Three-Factor Eating Questionnaire), and perceived stress (Perceived Stress Scale). Participants were categorized into tertiles based on gaming frequency (low [0-5 h/wk], moderate [6-10 h/wk], and high [>10 h/wk]). High-frequency gamers had significantly poorer diet quality scores (median 45.0 versus 50.0, P < 0.001), higher BMI (median 26.3 versus 22.2 kg/m², P < 0.001), and worse sleep quality (PSQI score 7.0 versus 6.0, P < 0.001) compared to low-frequency gamers. Correlation analyses confirmed these associations in which gaming frequency negatively correlated with diet quality (r = -0.26, P < 0.001) and physical activity (r = -0.13, P = 0.03) and positively correlated with BMI (r = 0.38, P < 0.001). Multiple regression analysis revealed total gaming hours independently predicted poorer diet quality (β = -0.16, P = 0.02) after controlling for demographic and lifestyle factors. Higher video gaming frequency was associated with poorer diet quality and increased BMI among university students. These findings suggest excessive gaming may contribute to adverse health outcomes. Public health interventions targeting excessive or high gaming levels and promoting healthy lifestyle habits in university populations are warranted.

Background: Video gaming is a highly prevalent leisure activity globally, with complex associations across multiple health domains. Methods: This narrative review critically appraised the existing literature identified through targeted searches of PubMed and Google Scholar to synthesise evidence on associations between video gaming and psychosocial stress, physical activity, sleep quality, eating behaviour, and diet quality. Theoretical, biological, and psychosocial mechanisms underlying these relationships were examined, and methodological limitations and research gaps were identified. Results: The relationships between video gaming and health outcomes appear bidirectional and context dependent. While video gaming may provide short-term stress relief and social connection, frequent or prolonged gaming may be associated with sedentary behaviour, physical inactivity, impaired sleep quality, disrupted eating patterns, and poorer diet quality. These associations may vary by age, sex, gaming duration, timing, content, and motivational drivers. Gaming-related cognitive absorption and physiological arousal may influence appetite regulation, sleep onset, and stress responses, while temporal displacement and environmental factors, such as food availability and marketing exposure, also contribute. Conclusions: An integrated biopsychosocial framework is proposed to describe the interconnected pathways through which video gaming may influence health, incorporating biological arousal, psychological immersion, and social and environmental contexts. Significant gaps remain, including the scarcity of longitudinal studies, limited consideration of moderating factors, and inconsistent measurement of gaming behaviours. Addressing these gaps is essential for refining public health surveillance and supporting the development of evidence-based strategies that promote healthy gaming behaviours while preserving potential psychosocial benefits.

Inorganic nitrate, reduced in vivo to nitric oxide via the nitrate-nitrite pathway, has been proposed to influence brain health through vasoactive and neurovascular mechanisms. A 2019 meta-analysis found no effect of nitrate supplementation on cognition or cerebral blood flow, but evidence was then limited to small, short trials in healthy adults. We updated this systematic review, searching MEDLINE, Embase and PsycINFO to June 2026, and extended it to observational studies of habitual dietary nitrate intake. Two reviewers independently screened studies, extracted data and assessed risk of bias (RoB 2; ROBINS-E). Standardised mean differences from 22 randomised trials were pooled in random-effects models; supplementation did not improve cognition (14 trials, 383 participants; SMD 0.100, 95% CI -0.023 to 0.224), resting cerebral blood flow (9 trials; SMD 0.102, 95% CI -0.161 to 0.364) or stimulated cerebral blood flow (6 trials; SMD 0.226, 95% CI -0.064 to 0.516). Seven observational studies could not be pooled, but all five prospective cohorts reported associations favouring higher habitual nitrate intake for brain health outcomes. These findings confirm the earlier null trial result; small, short, underpowered trials and heterogeneous but promising cohort evidence leave open whether dietary nitrate benefits brain health.

Background: Epidemiological evidence suggests that green leafy vegetables (GLV) may reduce the risk of cardiovascular disease (CVD). However, the relationship remains incompletely understood due to inconsistencies between findings from observational studies and randomized controlled trials (RCTs). Therefore, a comprehensive synthesis of evidence across study designs is warranted. This systematic review and meta-analysis aimed to evaluate the association between GLV consumption and CVD risk, as well as related cardiovascular risk factors, including blood pressure (BP) and endothelial function, based on evidence from observational studies and RCTs. Methods: Systematic searches of PubMed, EMBASE, APA PsycInfo, and Ovid databases were conducted through 30 October 2024. Risk of bias was assessed using the ROBINS-E tool for observational studies and the RoB 2 tool for RCTs. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated for observational studies, whereas mean differences (MDs) were used for RCT outcomes. Random-effects meta-analyses were performed, and heterogeneity was evaluated using Cochran’s Q and I² statistics. Results: Higher GLV consumption was significantly associated with a reduced risk of CVD in observational studies (RR: 0.89; 95% CI: 0.82–0.97; p < 0.01; I² = 80%; Q = 55.88) and lower CVD mortality (RR: 0.79; 95% CI: 0.62–0.97; p < 0.01; I² = 80%; Q = 4.93). However, pooled analysis of seven RCTs showed no significant improvement in vascular function following GLV intake (MD: −0.37; 95% CI: −1.90 to 1.16; p = 0.64; I² = 88%; Q = 18.59). No significant associations were observed between GLV consumption and hypertension risk in observational studies, nor were significant effects found on systolic or diastolic BP in RCTs. Conclusions: Higher GLV consumption may be associated with a lower risk of CVD in observational studies. However, evidence from RCTs remains limited and inconclusive. Further well-designed clinical trials are needed to confirm these associations, establish dose–response relationships, and elucidate the mechanisms underlying the cardioprotective effects of GLVs to support evidence-based dietary recommendations.