A man in his 60s with multiple vascular comorbidities presented with sudden, painless vision loss in one eye. Although he had a high risk for atherosclerotic events, initial evaluation for stroke was negative for acute ischemia, but found to have markedly elevated inflammatory markers. Accordingly, giant cell arteritis was investigated and Ophthalmologic findings and fulfillment of the 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology classification criteria supported the diagnosis of giant cell arteritis, despite a negative temporal artery biopsy. Management included high-dose glucocorticoids and delayed tocilizumab initiation due to the need for multiple vascular surgeries. Vision loss was irreversible, but systemic symptoms resolved and vascular interventions were successful. This case highlights the diagnostic and management complexities of biopsy-negative giant cell arteritis in patients with severe atherosclerotic vascular disease, emphasizing the importance of clinical judgment and established classification criteria when imaging and biopsy results are inconclusive.

A residual-set framework is introduced for analyzing additive prime conjectures, with particular emphasis on the Strong Goldbach Conjecture (SGC). For each even integer $E_n\ge 4$, the residual set $ℛ\left(E_n\right)=\{E_n-p\mid$ $p<E_n,p\in \mathbb{P}\}$ is defined, and the universal residual set ${ℛ}_{\mathbb{E}}={{{\displaystyle \cup }}^{\text{}}}_{E_n}ℛ\left(E_n\right)$ is constructed. It is shown that ${ℛ}_{\mathbb{E}}$ contains infinitely many primes. A nontrivial constructive lower bound is derived, establishing that the number of Goldbach partitions satisfies $G\left(E\right)\ge 2$ for all $E\ge 8$, and that the cumulative partition count satisfies ${\displaystyle \sum }_{E\le N}G\left(E\right)\gg \frac{N^2}{{\text{log}}^{4}N}$. An optimized deterministic algorithm is implemented to verify the SGC for even integers up to 16,000 digits. Each computed partition $E_n=p+q$ is validated using elliptic curve primality testing, and no exceptions are observed. Runtime variability observed in the empirical tests corresponds with known fluctuations in prime density and modular residue distribution. A recursive construction is formulated for generating Goldbach partitions, using residual descent and leveraging properties of the residual sets. The method extends naturally to Lemoine's Conjecture, asserting that every odd integer $n\ge 7$ can be expressed as $n=p+2q$, where $p,q\in \mathbb{P}$. A corresponding residual formulation is developed, and it is proven that at least two valid partitions exist for all $n\ge 9$. Comparative analysis with the Hardy-Littlewood and Chen estimates is provided to contextualize the cumulative growth rate. The residual-set methodology offers a deterministic, scalable, and structurally grounded approach to additive problems in prime number theory, supported by both theoretical results and large-scale computational evidence.

Background: Proper umbilical cord care prevents neonatal infections and reduces neonatal mortality. Despite global recommendations for evidence-based cord care practices, traditional beliefs, and inadequate maternal knowledge often lead to unsafe practices, particularly in low-resource settings like Bangladesh. This study aimed to assess the understanding of umbilical cord care among mothers of neonates in Sherpur District, Bangladesh, and identify factors associated with knowledge levels. Methods: A descriptive cross-sectional study was conducted from July to October 2020 at Sherpur Sadar Hospital. A total of 193 mothers of neonates were recruited using a non-randomized purposive sampling method. Data was collected through a pre-tested, semi-structured, interviewer-administered questionnaire. Knowledge levels were categorized as "Good" (>6) or "Poor" (≤6) based on responses to 10 structured questions. Statistical analyses, including chi-square tests and crude odds ratios (COR), were performed to identify socio-demographic factors associated with knowledge levels. Results: Of the 193 participants, 48.7% demonstrated "Good" knowledge, while 51.3% had "Poor" knowledge. Education level (p = 0.01), occupation (p = 0.02), family type (p < 0.001), and family size (p = 0.04) were significantly associated with knowledge levels. Mothers with higher education and those from joint families exhibited better knowledge. However, 28.5% of respondents were unaware of the typical umbilical cord-shedding timeframe, and 44% could not identify signs of infection. Unsafe practices, such as using medications (14.5%) or hot compression (7.2%) for drying the cord, were reported. Conclusion: The study reveals significant gaps in maternal knowledge regarding umbilical cord care in Sherpur District, driven by socio-demographic disparities and cultural practices. Targeted health education programs, emphasizing evidence-based cord care practices and leveraging local social structures, are urgently needed to improve neonatal health outcomes in similar resource-limited settings. Future research should evaluate the effectiveness of these interventions to inform policy and practice.

The integration of LiDAR and Artificial Intelligence (AI) has revolutionized feature detection in urban environments. LiDAR systems, which utilize pulsed laser emissions and reflection measurements, produce detailed 3D maps of urban landscapes. When combined with AI, this data enables accurate identification of urban features such as buildings, green spaces, and infrastructure. This synergy is crucial for enhancing urban development, environmental monitoring, and advancing smart city governance. LiDAR, known for its high-resolution 3D data capture capabilities, paired with AI, particularly deep learning algorithms, facilitates advanced analysis and interpretation of urban areas. This combination supports precise mapping, real-time monitoring, and predictive modeling of urban growth and infrastructure. For instance, AI can process LiDAR data to identify patterns and anomalies, aiding in traffic management, environmental oversight, and infrastructure maintenance. These advancements not only improve urban living conditions but also contribute to sustainable development by optimizing resource use and reducing environmental impacts. Furthermore, AI-enhanced LiDAR is pivotal in advancing autonomous navigation and sophisticated spatial analysis, marking a significant step forward in urban management and evaluation. The reviewed paper highlights the geometric properties of LiDAR data, derived from spatial point positioning, and underscores the effectiveness of machine learning algorithms in object extraction from point clouds. The study also covers concepts related to LiDAR imaging, feature selection methods, and the identification of outliers in LiDAR point clouds. Findings demonstrate that AI algorithms, especially deep learning models, excel in analyzing high-resolution 3D LiDAR data for accurate urban feature identification and classification. These models leverage extensive datasets to detect patterns and anomalies, improving the detection of buildings, roads, vegetation, and other elements. Automating feature extraction with AI minimizes the need for manual analysis, thereby enhancing urban planning and management efficiency. Additionally, AI methods continually improve with more data, leading to increasingly precise feature detection. The results indicate that the pulse emitted by continuous wave LiDAR sensors changes when encountering obstacles, causing discrepancies in measured physical parameters.

The price of grains like maize and sorghum is subject to significant fluctuations, which can have a significant impact on a country's economy and food security. The aim of the study is to model sorghum and maize price volatility in Nigeria. The data utilized in the study was extracted from World Bank Commodity Price Data (WBCPD), 2022. The data consists of monthly prices in nominal US dollars for maize and sorghum from January 1960 – August 2022. The Autoregressive Conditional Heteroskedasticity (ARCH) and Generalized Autoregressive Conditional Heteroskedasticity (GARCH) models were utilized for capturing the two-grain price volatility. Two types of conditional heteroscedastic models exist, the first group uses exact functions to control the evolution of , while the second group describes with stochastic equations. It is inferred from the result that inherent uncertainties and fluctuations existed in the prices of maize and sorghum in Nigeria which implies that the price volatility is positive and statistically significant suggesting that historical information and past shocks play a crucial role in determining the volatility observed in the grains. It is recommended that the ARCH, GARCH, EGARCH, TGARCH, PARCH, CGARCH, and IGARCH models should be employed for modeling and managing the volatility of maize and sorghum prices in Nigeria. These models have shown effectiveness in capturing different aspects of volatility, including the impact of past shocks, conditional volatility, asymmetry, and other relevant factors.

Background: Recently specific interactions and crosslinks between the gut microbiota and the lungs have been recognized, particularly with regard to respiratory immune and anti-microbial reactions. This is often known as the “gut-lung axis” or “a common mucosal immunological system”. Objective: The aim of the current systematic review was to evaluate evidence, from published clinical trials and cohort studies, if probiotics may have an effect in improving and managing COVID-19 symptoms. Materials and methods: The available studies were searched through a comprehensive search of electronic databases that included PubMed, Science Direct, Scirus, ISI Web of Knowledge, Google Scholar and CENTRAL (Cochrane Central Register of Controlled Trials), using a combination of the following keywords: “COVID-19" OR "SARS-CoV-2" AND "Microbiota" OR "Probiotics” OR “Gut Lung Axis”. The literature was reviewed until August 31, 2022. Results: Only 3 studies were included. One of them evaluated the efficacy of probiotics in COVID-19 patients to obtain complete remission of all signs and symptoms. The clinical trial proves that probiotics have a significant effect on complete remission of all signs and symptoms of COVID-19 patients with statistical significant difference. Only one clinical trial out of the 3 included studies had evaluated the need for O2 therapy during the study between the probiotics and control groups, but without statistical significant difference. No statistical significant difference between the probiotics group and placebo group was observed regarding fatal prognosis during the only clinical trial that measured death as an outcome. Conclusion: We couldn’t judge on these results as they are insufficient data for pooling and meta-analysis. However, what we can say is “Most probably Probiotics have no role in treatment of COVID-19 infection”.

The pulmonary characteristics of Staphylococcus aureus (S. aureus) co-infection with respiratory viruses, such as SARS-CoV-2 and influenza virus, are still unclear. Case series: Two patients with methicillin-susceptible S. aureus (MSSA) infection in the lungs co-infected with either SARS-CoV-2 or influenza virus are reported. Case 1 was a 66-year-old woman who was admitted with SARS-CoV-2 infection. Her chest X-ray and computed tomography (CT) showed multiple cavity formations with infiltration shadows, and MSSA was detected from her sputum and blood, suggesting COVID-19-related bacterial pneumonia and pulmonary embolism. No catheters had been used, but she had skin eruptions and a history of SARS-CoV-2 vaccination. Ampicillin/sulbactam (ABPC/SBT) was administered, and she finally improved. Case 2 was an 87-year-old man with a history of atopic dermatitis who was admitted with moderate pneumonia, and influenza virus co-infection was found. He showed multiple cavitary shadows, and MSSA was isolated from both his sputum and blood. He was diagnosed with influenza-related bacterial pulmonary embolism. No catheters had been used, but he had a history of influenza vaccination. He was also treated by ABPC/SBT and finally improved. Conclusions: These cases suggest that MSSA showed affinity to the lungs when co-infected with either SARS-CoV-2 or influenza virus, and it presented as septic emboli without catheter use. We should consider MSSA infection when patients have SARS-CoV-2 or influenza virus co-infection, and multiple cavity formation and skin disorders are seen, even though they were vaccinated and no catheters were used.

Background: There is paucity of data on health-related quality of life (HRQoL) among Health Information Managers/Health Record Officers (HROs) in the Nigeria health system. Hence, this study investigated the impact of the COVID-19 pandemic on health-related quality of life (QoL) among HROs in Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Nigeria. Methods: A cross-sectional study was conducted in the University Hospital, where a total of 52 health record officers were purposively sampled. Relevant data were collected using the Short Form survey (SF-36v2) questionnaire. One-way ANOVA was used to determine mean group differences across the nine and the two QoL (physical and mental) summary domains based on respondents’ socio-demographics, while level of significance was set at 0.05. Results: All the QoL sections of the instrument used yielded an α-Cronbach’s score of > 0.70. Analysis of some QoL physical component dimensions showed that; Bodily pain (BP) was found to be significantly (P=0.032) associated with marital status, Physical functioning (PF) with gender (P=0.023), and general health (GH) with age group (P=00.025) and highest level of education (P=0.023). On the other hand, mental health component analysis revealed that Social Functioning (SF) was associated with age group (P=014), Role limitation (RE) with marital status (P=0.048), highest level of education (P=0.048) and years of service (P=0.015) etc. Conclusion: The QoL among HROs studied was generally above average, and demographic characteristics such as age, gender and marital status significantly influence QoL. Health managers and stakeholders should consider some of the factors identified in managing HROs.

Background: The World Health Organization (WHO) has declared COVID-19 a public health emergency of international concern. In this context, effective and affordable diagnostic procedures are essential for identifying and managing cases. Complete blood counts (CBC) are among the most common and readily available diagnostic tests. The current study aimed to evaluate the efficacy of CBC in diagnosing COVID-19 and identifying cases. Patients and Methods: A case-control study was conducted on 173 patients at Ain Shams University Hospitals over a period of three months. Patients were allocated into two groups according to COVID-19 PCR results: Group 1 included patients with COVID-19 positive PCR, and Group 2 included patients with COVID-19 negative PCR. Results: The study found that differential CBC had significant value in diagnosing COVID-19 disease. Many COVID-19 patients had lymphopenia and leucopenia compared to non-COVID-19 suspected patients. The low values of leukocytes, neutrophils, lymphocytes, and eosinophils with a CBC test were found to be valuable in the initial diagnosis of COVID-19. Conclusion: The definitive diagnosis of COVID-19 requires RT-PCR analysis, which is time-consuming and less accessible. Thus, the initial diagnosis and treatment of patients may be delayed. This study suggests that CBC, which is easily available and affordable, can be valuable in the early identification of COVID-19 cases, allowing for prompt treatment and management.

Background: The phenomenon of "empty nest youth" is becoming increasingly ubiquitous, capturing the attention of society at large. However, few studies have been conducted in recent years on this group, especially focusing on their family and mental health. As such, this study investigates the correlation between family health and well-being among "empty nest youth," as well as the function of social support and loneliness in this relationship. Methods: A cross-sectional survey was conducted from June to August 2022 across 32 provinces, municipalities, and autonomous regions in China, utilizing a multi-stage sampling technique. And we screened individuals who were unmarried, living alone, and between 22-44 years old, resulting in a valid sample size of 908 cases; multiple regression analysis, mediation effect testing, and moderation effect testing are used to examine research hypotheses. Results: The regression analysis results show that family health not only has a direct impact on well-being (β = 0.36, p < 0.001) but also indirectly affects well-being through social support [β = 0.23, 95% CI: 0.19 0.28]. Additionally, the loneliness moderates the predictive impact of not only family health on social support (β = -0.13, p < 0.001) but also social support on well-being (β = -0.06, p < 0.001). Conclusions: These findings underscore the significance of directing policymakers and healthcare professionals towards the "empty nest youth's" familial and social support systems. It underscores the need for the development of policies aimed at addressing their emotional and material requirements by leveraging these familial and social networks. This approach ultimately contributes to the enhancement of their overall psychological well-being, promoting a more coherent and logical pathway for intervention and support.

Neurodegeneration and aging are pressing issues with significant personal, economic, ethical, and social consequences. However, the underlying biological mechanisms of these conditions remain largely unknown, making the development of effective treatments challenging. The difficulty in early detection and diagnosis of neurodegenerative diseases further compounds the issue. Recent advancements in genetics, genomics, and brain imaging technology hold great promise for improving our understanding of neurodegeneration and aging, as well as the development of personalized medicine and new drugs and therapies. Addressing these challenges will require a multi-disciplinary and collaborative approach from researchers in various fields. This Special Issue offers valuable insights and perspectives on this critical area of research, which can help advance our understanding and improve the health and well-being of our aging population.

Today, the presentation of a three-dimensional model of real-world features is very important and widely used and has attracted the attention of researchers in various fields, including surveying and spatial information systems, and those interested in the three-dimensional reconstruction of buildings. The building is the key part of the information in a three-dimensional city model, so extracting and modeling buildings from remote sensing data is an important step in building a digital model of a city. LiDAR technology due to its ability to map in all three modes of one-dimensional, two-dimensional, and three-dimensional is a suitable solution to provide hyperspectral and comprehensive images of the building in an urban environment. In this review article, a comprehensive review of the methods used in identifying buildings from the past to the present and appropriate solutions for the future is discussed.

Meigs’ syndrome is a rare triad of a benign ovarian fibroma (or fibroma‑like tumor), ascites, and pleural effusion that resolves after tumor resection. A 53‑year‑old multiparous woman presented with progressive exertional dyspnea and right‑sided pleuritic chest pain. Respiratory and cardiac evaluations were initially unrevealing. Bedside assessment identified mild right basal dullness, and point‑of‑care abdominal ultrasound demonstrated mild free fluid and a solid right adnexal mass. Chest radiography confirmed a small right pleural effusion. Without computed tomography and without diagnostic paracentesis or thoracentesis, Meigs’ syndrome was suspected. The patient underwent laparotomy with total abdominal hysterectomy and bilateral salpingo‑oophorectomy. Histopathology confirmed an ovarian fibroma. Postoperatively, symptoms resolved dramatically, and follow‑up imaging demonstrated complete resolution of the pleural effusion and ascites. This case highlights the importance of considering gynecologic etiologies in unexplained pleural effusion and dyspnea, especially when accompanied by abdominal distension or pelvic pressure.

Introduction: Ovarian torsion is a rare gynecological emergency that can result in permanent ovarian loss if not promptly recognized and managed. Cases involving multiple rotations of the ovary are highly unusual and pose a significant risk for ovarian viability. Clinical Description: A 33-year-old P2 woman presented with sudden severe lower abdominal pain. Imaging showed a complex midline adnexal mass, more towards left and mild free fluid with suspected torsion. Emergency laparotomy showed a sixfold torsion of the right ovary with a dermoid cyst. Detorsion and cystectomy were performed with preservation of the ovary. Postoperative recovery was uneventful and histopathology further confirmed a benign dermoid cyst. Discussion: Ovarian torsion with multiple rotations is extremely rare so early recognition and timely surgical intervention enable ovarian salvage even in severe cases. Moreover, Dermoid cysts are the most common predisposing factor. Conclusion: This case highlights the importance of prompt diagnosis and immediate management of ovarian torsion to prevent complications, preserve ovarian integrity and fertility.

Background: The sacroiliac joint (SIJ) plays a crucial role in transmitting axial loads and maintaining pelvic stability. Sacroiliac joint arthropathy (SIJA) accounts for 10%–30% of low back pain cases but remains underrecognized due to overlapping pain referral patterns and nonspecific imaging findings. Diagnosis relies primarily on characteristic pain distribution and provocative maneuvers, with image-guided intra-articular block serving as the diagnostic gold standard. This study aimed to characterize the clinical profile of block-confirmed SIJA, emphasizing referral pain distribution, triggering position, and provocative test responses. Methods: A cross-sectional study was conducted on 98 patients with diagnostic block–confirmed SIJA at Siloam Hospital Lippo Village, Indonesia. Demographic data, referral pain sites, sitting duration, and results of FABER, compression, and distraction tests were analyzed descriptively. Results: The mean age was 52.07 ± 14.17 years, with 72.4% females. Referral pain most frequently involved the lower back (28.6%) and thigh (28.6%), with occasional extension to the groin (8.2%) or calf (4.1%). Over half of patients (55.1%) reported sitting more than six hours daily. Pain was predominantly triggered during sit-to-stand transitions (85.7%) and while sitting (74.5%). SIJ tenderness (98.0%) and FABER positivity (75.5%) were most consistent. Conclusion: The dominant referral pain in SIJA involves the lower back and posterior thigh. Sit-to-stand transition is the most frequent triggering position, while FABER testing demonstrates the highest diagnostic yield among provocative maneuvers. These consistent patterns may serve as practical clinical indicators to improve diagnostic accuracy in suspected SIJ-related pain.

Introduction: Colorectal cancer during pregnancy is a complex and rare condition often presenting with benign gastrointestinal symptoms that overlap with normal pregnancy related changes, leading to delayed or misdiagnosis. Further, hepatic metastases may complicate recognition, especially when initially interpreted as benign lesions such as hemangiomas. So, early identification and management are crucial and remain challenging for optimizing maternal and fetal outcomes. Clinical Description: A case of 39-year-old gravida 5 para 4 at 24 weeks+1 day with chronic hypothyroidism, longstanding anemia and a one year history of epigastric + right upper quadrant pain with suspected hemorrhage from a known liver hemangioma. Further imaging suggested a malignant hepatic lesion where colonoscopy and biopsy confirmed stage IV metastatic colon adenocarcinoma with liver and adrenal metastases. Her condition deteriorated and delivered a stillborn infant at 26 weeks of 780 grams following placental abruption. She continued to decline despite supportive care and died. Conclusion: This case illustrates the diagnostic challenges of colorectal cancer in pregnancy where nonspecific symptoms and inaccurate imaging results contributed to delayed diagnosis. The aggressive nature of the disease emphasizes the importance of prompt diagnosis and integrated care approach to improve both maternal and fetal outcome.

Introduction: Stroke remains one of the leading causes of death and disability worldwide, with ischemic stroke accounting for most cases. Structural vascular factors such as carotid artery tortuosity have gained attention as potential markers of vascular aging and cerebrovascular risk. The carotid tortuosity index (CTI), defined as the ratio of actual vessel length to the straight-line distance between two fixed points, provides a quantitative measure of arterial curvature. A CTI value of ≥1.2 indicates pathological tortuosity. Although noninvasive modalities such as CTA and MRA are frequently used, digital subtraction angiography (DSA) remains the gold standard for evaluating vessel geometry due to its higher spatial precision. This study aimed to determine the association of age, sex, and hypertension with CTI measured by DSA. Methods: A cross-sectional study was conducted from November to December 2025 at the Neurointervention Clinic, RS Pelni Jakarta, Indonesia, involving 61 adult patients who underwent carotid DSA. CTI was measured bilaterally using digital imaging software and classified as <1.2 (non-tortuous) or ≥1.2 (tortuous). Clinical data, including age, sex, and hypertension status, were collected from medical records and analyzed using bivariate tests. Results: Older age (≥65 years), female sex, and hypertension were significantly associated with higher CTI values on both carotid sides. Tortuosity was more common among hypertensive patients and elderly females, indicating the influence of vascular remodeling and chronic hemodynamic stress. Conclusion: Carotid tortuosity increases with age, hypertension, and female sex. DSA-based CTI measurement provides a reliable and precise approach for evaluating vascular changes associated with cerebrovascular risk.

Background: Adolescence is a critical developmental stage for the emergence of major depressive disorder (MDD). Structural and diffusion neuroimaging studies have highlighted the anterior cingulate cortex (ACC) as a key region implicated in emotion regulation, stress reactivity, and mood processing. However, few studies have examined whether microstructural characteristics of the ACC, reflected by mean diffusivity (MD) within gray matter–white matter (GM–WM) contrast regions, are associated with depression in early adolescence. Objective: To examine whether mean diffusivity (MD) within the GM–WM contrast of the left caudal anterior cingulate cortex (ACC) is associated with a past diagnosis of MDD among adolescents in the Adolescent Brain Cognitive Development (ABCD) Study, after accounting for demographic, socioeconomic, and adversity-related factors. Methods: Data were drawn from adolescents with diffusion MRI–derived mean diffusivity measures and diagnostics. The independent variable was mean diffusivity (MD) of the GM–WM contrast in the left caudal ACC. The primary outcome was past MDD diagnosis based on structured psychiatric assessments. Covariates included age, sex, socioeconomic status (SES), and exposure to adverse childhood experiences (ACEs). Logistic regression models tested the association between ACC MD and past MDD. A secondary model evaluated the relationship between ACC MD and past suicide attempt. Results: Mean diffusivity of the left caudal ACC was associated with the odds of past MDD, independent of age, sex, SES, and adversity exposure. In contrast, ACC mean diffusivity was not associated with a history of suicide attempt. Conclusions: Increased mean diffusivity in the caudal ACC may indicate microstructural alterations associated with depressive vulnerability in adolescence. ACC tissue integrity may serve as a sensitive neural correlate of early-onset depression.

Background: Tobacco endgame, defined as elimination of commercial tobacco sales The U.S. tobacco control landscape is a complex, adaptive system shaped by diverse stakeholders, evolving products and regulations, shifting social norms, and the strategic countermeasures of a powerful industry. Managing such complexity requires more than isolated interventions—it demands a coordinated, enterprise-wide approach that accounts for dynamic interactions, feedback loops, and emergent risks. Objective: Drawing on complex systems thinking, Zachman enterprise architecture model, and public health best practices, we conceptualize tobacco control as an evolving enterprise progressing through six interconnected phases: (1) Conception & Initiation, (2) Policy & System Design, (3) Implementation & Operation, (4) Evaluation & Adaptation, (5) Consolidation & Endgame Transition, and (6) Sustainment or Sunset. Each phase incorporates governance structures, performance benchmarks, and transition criteria designed to manage interdependence and reduce systemic vulnerabilities. Results: The lifecycle framing emphasizes how tobacco control in the U.S. can evolve as a complex, adaptive enterprise—integrating public health objectives with legal, operational, and cultural change processes. This model supports strategic sequencing, cross-sector alignment, and risk mitigation against emergent industry tactics, enabling a resilient and measurable pathway to the endgame. Conclusions: Seeing tobacco control as a complex enterprise that operates under a lifecycle model may offer a roadmap for achieving and sustaining the tobacco endgame. Using this approach may enhance policy coherence, resource efficiency, and adaptability, ensuring tobacco endgame is achieved.