Studies suggest that chronic psychological stress can lead to oral health deterioration, alter the immune response, and possibly contribute to increased inflammation, which can impact the physiological healing of periodontal tissues. This cross-sectional study seeks to assess and improve clinical understanding regarding the relationship between perceived stress, mindfulness, and periodontal health. A total of 203 people were analysed from December 2022 to June 2023. The Periodontal Screening and Recording (PSR), score and Bleeding Index (GBI), and Plaque Control Record (PCR) of every patient were registered. Subsequently, participants completed the Sheldon Cohen Perceived Stress Scale (PSS) and the Mind-fulness Awareness Attention Scale (MAAS) questionnaires. The collected data was analysed statistically, and correlations and dependencies were evaluated. The p-value was 0.004265 in Welch's t-test to assess the relationship between MAAS and the variable's presence or absence of periodontitis, highlighting that patients with periodontitis have significantly different MAAS scores compared to patients unaffected by periodontitis. The Pearson correlations between GBI and perceived stress, PCR and perceived stress, and PCR and MAAS resulted in p-values of 2.2-16, 3.925-8, and 2.468-8, respectively, indicating a statistically significant correlation in this case. Despite the limitations, the findings of this study suggest a significant relationship between psychological stress, mindfulness and periodontal tissue health. Clinical trials are necessary to incorporate the assessment of a patient’s psychological status as a new valuable tool in the management of periodontal health.

Alzheimer’s disease manifests itself as a complex pathological condition with neuroinflammation, oxidative stress and cholinergic dysfunction being a few of the many pathological changes. Due to the complexity of the disease current therapeutic strategies aim at a multitargeted approach often relying on a combination of sub-stances with versatile and complementary effects. In the present study, unique combination of α-lipoic acid, citicoline, extracts of leaves from olive tree and green tea, Vitamin D3, selenium and an immune supporting complex was tested in a scopolamine-induced dementia in rats. Using behavioral and biochemical methods we assessed the effects of this combination on learning and memory, and elucidated the mechanisms under-lying its effects. Our results showed that as compared to the components, experimental combination was most efficient in improving short- and long-term memory assessed by the step-through method as well as spatial memory, assessed by T-maze and Barnes maze underlying decrease in AChE activity and LPO, in-creases in SOD activity in cortex; activities of catalase and GPx, levels of BDNF and pCREB in the hippocam-pus. No significant histopathological changes or blood parameter changes were detected, making the experi-mental combination an effective and safe candidate in a multitargeted treatment of AD.

Although child-centred care is increasingly referred to within the nursing literature, a clear definition of child-centred care and clarity around the concept is yet to be achieved. The objectives of this review were to examine: 1) What constitutes the concept of child-centred care in healthcare? 2) How has the concept of child-centred care developed? 3) What is the applicability of child-centred care and what are its limitations? and 4) How does the concept of child-centred care benefit and inform children’s healthcare? In total, 2984 papers were imported for screening, following removal of duplicates and screening, 21 papers were included in the scoping review.The findings suggest that child-centred care is an emerging, ambiguous, poorly defined concept; no clear consensus exists about what constitutes child-centred care. Although it seems antithetical to argue against child-centred care, little robust evidence was identified that demonstrates the impact of, and benefit from, child-centred care. If child-centred care is to be a sustainable, convincing model to guide practice and compete with other models of care it needs to establish robust evidence of its effectiveness, impact on children and their families as well as the wider impacts on the healthcare system.

To gain insight into the real-life care of patients in the healthcare system, data from hospital information systems and insurance systems are required. Consequently, linking clinical data with claims data is necessary. To ensure their syntactic and semantic interoperability, the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) was chosen. However, there is no detailed guide that would allow researchers to follow a consistent process for data harmonization. Thus, the aim of this paper is to conceptualize a generic data harmonization process for OMOP CDM. For this purpose, we conducted a literature review focusing on publications that address the harmonization of clinical or claims data in OMOP CDM. Subsequently, the process steps used and their chronological order were extracted for each included publication. The results were then compared to derive a generic sequence of the process steps. From 23 publications included, a generic data harmonization process for OMOP CDM was conceptualized, consisting of nine process steps: dataset specification, data profiling, vocabulary identification, coverage analysis of vocabularies, semantic mapping, structural mapping, extract-transform-load-process, qualitative and quantitative data quality analysis. This process can be used as a step-by-step guide to assist other researchers in harmonizing source data in OMOP CDM.

Abattoir workers are liable to zoonotic infections from animals and animal products, pri-marily to diseases with asymptomatic and chronic clinical manifestations in animals such as brucellosis. No published reports exist on the seroprevalence of brucellosis in abattoir workers in South Africa. Therefore, this cross-sectional study was conducted to estimate the occurrence and risk factors for Brucella exposure in abattoir workers in Gauteng Province. A total of 103 abattoir workers and managers from six abattoirs, where brucellosis-positive slaughtered cattle and sheep were previously detected, were interviewed, and tested with serological assays using the Rose Bengal test (RBT), BrucellaCapt, and IgG-ELISA. A pre-tested questionnaire was administered to consenting respondents to obtain infor-mation on risk factors for brucellosis. Of the 103 respondents tested, the distribution of fe-male and male workers was 16 (15.5%) and 87 (84.5%), respectively. The seroprevalence for exposure to brucellosis was 21/103 (20.4%, 95%CI: 13.1-29.5) using a combination of RBT, BrucellaCapt, or IgG-ELISA. For test-specific results, seroprevalences by RBT, BrucellaCapt, and IgG-ELISA were 13/103 (12.6%, 95%CI: 6.9-20.6), 9/103 (8.74%, 95%CI: 4.1-15.9) and 18/103 (17.5%, 95%CI: 10.7-26.2), respectively. Low-throughput abattoirs were identified as associated risk as 29.3% of workers were seropositive compared to 12.7% of workers in high-throughput abattoirs, which highlights that direct contact at abattoirs poses higher risk to workers than indirect and direct contact outside abattoirs. This study confirmed the occurrence of Brucella spp. antibodies among abattoir workers in South Africa, possibly due to occupational exposure to Brucella spp. and highlight the occupational hazard to workers. Furthermore, findings underscore that abattoir facilities can serve as points for active and passive surveillance for indicators of diseases of public health importance. We recommend periodic implementation of brucellosis testing of abattoir workers country-wide to establish baseline data for informing appropriate preventive practices and reduce the potential burden of infection rate among these high-risk workers.

Objectives: The aim of our current study was to analyze whether the use of important measures of methodological quality and reporting of randomized clinical trials published in the field of cardiovascular disease research have changed over time. Further aim was to investigate whether there was an improvement over time in the ability of these trials to provide a good estimate of the true intervention effect. Methods We conducted two searches in the Cochrane Central Register of Controlled Trials (CENTAL) database to identify cardiovascular clinical research trials published in either 2012 or 2017. Randomized clinical trials (RCTs) trials in cardiovascular disease research with adult participants were eligible to be included. We randomly selected 250 RCTs for both publication year 2012 and 2017. Trial characteristics, data on measures of methodological quality and reporting were extracted and risk of bias for each trial was assessed. Results As compared to 2012 in 2017 there were significant improvements in the reporting of the presence of a data monitoring committee (42.0% in 2017 compared to 34.4% in 2012), and a positive tendency of registering cardiovascular disease research RCTs in clinical trial registries (83.6% in 2017 compared to 72.0% in 2012). On the other hand, we also observed that significantly fewer RCTs reported sample size calculation (60.4% in 2017 compared to 98.4% in 2012) in 2017 as compared to 2012. RCTs in 2017 were more likely to have low overall risk of bias ( RoB ) than in 2012 (29.2% in 2017compared to 21.2% in 2012). Conclusion: As compared to 2012 in 2017 there were significant improvement in some, but not all the important measures of methodological quality. Although more trials in the field of cardiovascular disease research had a lower overall RoB in 2017, the improvement over time was not consistently perceived in all RoB domains.

Premenstrual syndrome (PMS) continues to impact the health outcomes and emotional well-being of reproductive-age women, globally. Several studies have provided conflicting evidence concerning the role of dietary approaches in improving PMS symptoms. Accordingly, this study aimed to evaluate the possible influence of a healthy diet and motivational strategies on PMS symptoms and health-related quality of life among Omani adolescents. This open-label, randomized, prospective controlled trial was conducted in two randomly selected secondary schools, in Al Seeb Willayah, in Muscat region. Adolescents with PMS symptoms, who were at grade 10 or 11, aged 16 years or above, had regular menstrual cycles and not known to have psychiatric disorder, were included in this study. Participants in the intervention group received an individual face-to-face dietary consultation and motivational phone consultation. The health outcomes, including the PMS symptoms in both groups, and quality of life, were recorded via a daily record of severity of problems questionnaire (DRSP) and the 14-item Self-Reporting-Based Perceived Stress Scale tools, respectively. The primary outcome was the differences in the mean premenstrual symptom scores between the two groups. Secondary outcomes included the quality of life and stress levels of participants. The study period was from 1 February and ended 30 June 2021. SPSS was used to analyze the data and intention-to-treat analysis was utilized.A total of 72 adolescents with PMS were randomized to the intervention and control groups (n=36 each). Both groups were similar at baseline (P-value>0.05). No significant association was found between healthy-diet and PMS symptoms (P-value>0.05). In addition, no significant association was found between healthy-diet and quality of life at follow-up (P-value=0.216). The outcomes of this study refuted any possible relationships between healthy diet and PMS symptoms. Accordingly, dietary consultations may not facilitate the clinical management of PMS symptoms in adolescent females.

Contagious pathogens have very high costs for dairy herds, and they may have zoonotic and reverse-zoonotic potentials, and may contribute in spreading antimicrobial resistance. One of the most important risk factors for spreading these infections is milking, when liner contamination may transfer the pathogens from infected to healthy cows. There is no effective protocol for avoiding the transmission of infection out of the segregation of infected cows. Recently, the availability of elastomers including patented antimicrobial components in their formulations has opened the way to explore alternative methods to decrease infection risk. Two different types of elastomers (rubber and silicon) and 9 different receipts were challenged by three major mastitis pathogens (S. aureus, S. agalactiae, and E. coli). The results showed interesting and unexpected results. Indeed, for the first time to our knowledge, we have shown that basic rubber materials have intrinsic antimicrobial activity. Silicon elastomers did not exhibit the same levels of killing activity, although they did exhibit some antibacterial capacity. Generally, a significant decrease in bacterial survival curves was observed with the tested formulations. The results observed for the various products are likely due to the specific activity of the chemical components, as well as the diverse chemical reactions that occur during their production. The availability of new tools able to reduce the risks for the spread of infections and generally decrease the bacterial load at milking, would be an important step forward to achieve a higher global sustainability of dairy production from a One Health perspective.

The aim of this report is to evaluate the segmental rib index (RI) from T1-T12 spinal level in mild and moderate idiopathic scoliosis (IS) curves of thoracic, thoracolumbar and lumbar type by gender. The relationship of segmental RI to the frontal plane radiological deformity presented as the Cobb angle and to the posterior truncal surface deformity presented as the scoliometric readings of Angle of Trunk Rotation (ATR) in these patients is also assessed. Any statistical significant rela-tionship of these parameters would be very important for biomechanical relations of the rib cage (RC) deformity presented as the rib hump deformity (RHD) and the deformity in the spine and it would thus provide valuable information about scoliogeny. The segmental rib index (RI) is presented in 83 boys and girls with mild and moderate IS. The measurements include the scoliometric readings for truncal asymmetry (TA), the Cobb angle assessment and the segmental RI from T1-T12. The statistical package SPSS 23 was used for statistical analysis. The TA is documented and the Cobb angle is presented by gender and curve type. The segmental RI of thoracic, thoracolumbar and lumbar curves are presented for the first time. The correlations of the segmental RI to surface deformity presented as the rib hump deformity (RHD) in all IS patients and particularly in thoracic curves, to Cobb angle by gender and age and the comparison of the segmental RI index of asymmetric but not scoliotic children to the scoliotic peers by curve (in thoracic, thoracolumbar, lumbar curves) in boys and girls are presented. The findings emphasize the significant protagonistic role of the thoracic asymmetry in relation to the spinal deformity mainly in girls for the thoracic and in boys for the thoracolumbar curves. The cut-off point of age of the examined scoliotics is 14 years, that is when the RI shows stronger correlation with the spinal deformity, namely when the thoracic deformity is decisively effective to the developing thoracic spinal deformity, in terms of Cobb angle. In summary, the results of this study provide aetiological implications for IS, as far as the role of thorax is con-cerned.

The objective was to conduct a scoping review and produce a publicly available database characterizing the design and reporting elements of the literature on dietary added sugars and select health outcomes. Relevant studies published from 1990 – 2021 were identified to create a database containing information on study and population characteristics, reported added sugars source and concentrations, diet energy balance, total energy intake, and outcome measures related to body composition, obesity, cardiovascular disease, and diabetes mellitus. There were 245 publications identified, 22% of which describe interventions and 78% describe observational studies. Publications pertaining to added sugars have risen dramatically since 2010, led by studies primarily assessing body composition (36%) or cardiovascular health (32%), including adults (65%), measuring liquid-only sources of added sugars (56%). Over 65% of studies reported total energy intake, 61% controlled for total energy intake in the design and analysis, and fewer than 5% of studies reported the energy balance of subjects. There has been a significant increase in research on added sugars since 2010, with substantial heterogeneity across all facets of methodology – study designs, exposures and outcomes of interest, terminology, and reporting of dietary intake data – thus limiting the ability to synthesize evidence in this scope of literature. This evidence map highlights gaps and important areas for improvement to strengthen the state of research to better inform future policies and dietary recommendations on added sugars.

This study aimed to investigate the potential correlations and differences between patients with Acute Coronary Syndrome (ACS) and controls. Emphasis was placed on examining the relationship between arterial blood gas PH value and arterial blood gas lactate value as well as assessing the utility of the Peripheral Perfusion Index (PI) in ACS management. Materials and Methods: A prospective observational study was conducted between January 1, 2023, and July 1, 2023, involving 60 ACS patients and 30 control subjects in an emergency department. The diagnosis of ACS was confirmed by experienced emergency physicians, and various parameters, such as peripheral perfusion index, blood gas values, and cardiac biomarker values, were collected. The statistical analyses included Pearson’s chi-square test, Mann-Whitney U test, Student’s t-test, and others, using SPSS version 18.0. There were significant differences in the mean age, perfusion index, and lactate levels between the patient and control groups. A robust negative correlation was found between age and PI, and a moderate negative correlation was observed between pH and lactate levels (r = -0.301, p=0.004). The perfusion index in the patient group was significantly lower, indicating its potential diagnostic utility. The findings demonstrate the importance of arterial blood gas pH and lactate values in understanding ACS patient profiles, emphasizing the potential of PI as a noninvasive diagnostic method. The negative correlation between pH and lactate levels may offer valuable insights into risk stratification and treatment strategies for patients with ACS.

The residue of chestnut processing generates a large amount of waste material, a resource not adequately exploited. The phenolic composition of water extracts from discarded pericarp of four (MURG, LOCG, ILDP and COEV) chestnut accessions and one marron variety belonging to the Sardinian biodiversity was studied. The antioxidant capacity of cold and hot water extracts was determined by DPPH, ABTS and cyclic voltammetry tests. The antiproliferative effect on normal cells (fibroblasts), and colon (RKO and SW48), breast (MCF7) and melanoma (B16F10) cancer cells, was evaluated by biological assays. MTT test demonstrated that temperature and different extraction times significantly influenced the growth of cells, both normal and tumor. The fibroblast viability was significantly reduced by moderate doses of cold extracts, but only by doses greater than 250 µg/ml of hot extracts, regardless of the accession or cultivar. An even more marked effect was observed when RKO and SW48 were treated with cold extracts, while treatments on B16F10 melanoma cells resulted less effective. Differently, the cold extracts of all accessions induced a significant increase in MCF7 cell viability starting from moderate doses (50 µg/ml), whereas hot extracts had a similar, but less evident, effect compared to reference fibroblasts.

(1) Background: Bronchial artery embolization has been shown to be effective in the management of neoplastic hemoptysis. However, knowledge of pulmonary artery embolization is lacking. To evaluate safety and efficacy of pulmonary artery embolization in patients presenting with hemoptysis related to lung tumors. (2) Methods: This retrospective study reviewed all consecutive patients with cancer and at least one episode of hemoptysis that required pulmonary artery embolization from December 2008 to December 2020. The endpoints of the study were technical success, clinical success, recurrence of hemoptysis and complications. (3) Results: A total of 92 patients were treated with pulmonary artery embolization (63.1 years ± 9.9; 70 men). Most patients had stage III or IV advanced disease. Pulmonary artery embolization was technically successful in 82 (89%) patients and clinically successful in 77 (84%) patients. Recurrence occurred in 49% of patients. Infectious complications occurred in 15 patients (16%). The 30-days mortality rate was 31%. At 3 years, survival rate was 3.6%. Tumor size, tumor cavitation and necrosis and pulmonary artery pseudo-aneurysm were significantly associated with recurrence and higher mortality. (4) Conclusions: Pulmonary artery embolization is an effective treatment to initially control hemoptysis in patient with lung carcinoma but recurrence rate remains high and overall survival remains poor.

The study of coordination practices in health policy and, especially in emergency situations is a central aspect. The COVID-19 pandemic has highlighted the need for further research on such practices, especially those that are deployed in complex and unforeseen situations to respond quickly while minimising errors. These dialogic coordination practices (DP) have been identified through case studies but have not been validated. The purpose of this study is to develop and validate a DP questionnaire for healthcare teams. The development of the items was based on a literature review and the content validation was carried out by means of a Delphi study. A total of 10 experts assessed the clarity and appropriateness of the items and their corresponding measurement scales. Consensus was reached after the second round, with a percentage of agreement greater than or equal to 90% for all items. The validation of these items constitutes a methodological innovation that responds to the call in the literature to open up new avenues for comparative studies, the possibility of generalising the findings obtained and the possibility of bringing together different approaches to the problem of coordination, key in health policy.

The purpose of this study was to analyze the influence of Chitosan 0.2% in various final cleaning methods on the bond strength of fiberglass post (FP) to intrarradicular dentin. Ninety bovine incisors were sectioned to obtain root remnants measuring 18 mm in length. The roots were divided: G1: EDTA 17%; G2: EDTA 17% + PUI; G3: EDTA 17% + EA; G4: EDTA 17% + XPF; G5: Chitosan 2%; G6: Chitosan 2% + PUI; G7: Chitosan 2% + EA; G8: Chitosan 2% +XPF. After carrying out the cleaning methods, the posts were installed, and the root cleaved to to generate two disks from each root third. Bond strength values (MPa) obtained from the micro push-out test data were assessed by Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner tests for multiple comparisons (α = 5%). Differences were observed in the cervical third between G1 and G8 (p=0.038), G4 and G8 (p=0.003), G6 and G8 (p=0.049), and Control and G8 (p=0.019). The final cleaning method influenced the adhesion strength of cemented FP to intrarradicular dentin. Chitosan 0.2% + XPF positively influenced adhesion strength, with the highest values in the cervical third.

Considering the importance of assessing the impacts resulting from a sport career, this study aimed at developing and validating a semi-structure interview guide suitable for quantifying the socio-demographic and epidemiological profile of former professional football players. Based on the theoretical frameworks and several methodological procedures, an interview guide was de-veloped, consisting of 3 areas of conceptual organization (A1. Biographical data; A2. Career data; and A3. Post-Career Transition data) and 8 data collection categories (C1. Personal data; C2. Pro-fessional data; C3. Socio-demographic pathway in the post-career; epidemiological pathway; C4. Epidemiological pathway; C5. Moment of leaving the career; C6. Socio-demographic pathway in post-career; C7. Epidemiological pathway in the post-career; and C8. Perceptions on post-career planning). The construction and validation of the interview guide following 4 steps: Ad hoc con-struction of the interview guide (step 1); Review of the interview guide by a panel of experts (step 2); Definition of procedures and protocol for the application of the interview (step 3); Application of the pilot study for face validation of the interview guide (step 4). Thus, in procedural terms, four stages were considered for the construction and validation of the interview guide, namely the Ad hoc construction of the interview guide (i), the review of the in-terview guide by a panel of experts (ii), definition of procedures and protocol for the application of the interview (iii), and the application of the pilot study for the face validation of the interview guide (iv). The results showed that the interview guide for the study of the impacts of the sports careers on the quality of life of Portuguese former football players shows reliability for the collec-tion of qualitative and quantitative information from the respective content analysis. The use of the interview guide characterizes the path of former player, providing information and knowledge on the socio-demographic and epidemiological impact factors resulting from their post-career (sports retirement).

1. Background: Cardiovascular diseases (CVDs) are India’s leading cause of mortality. This study aimed to recalibrate the original Framingham Risk Score (FRS) equations among adults in Kerala state. 2. Methods: Baseline survey data from the Kerala Diabetes Prevention Program were analyzed: 921 males and 567 females for lipid-based FRS scores and 1042 males and 646 females for BMI-based FRS scores. Recalibration of the original FRS scores was performed using local data on CVD risk factors and CVD mortality. 3. Results: Among males, the median 10-year CVD risk with the recalibrated lipid-based FRS score was 7.34 (IQR 4.33-12.42), compared with the original score of 8.88 (5.23-14.87) (p<0.001). For BMI-based FRS scores, the median 10-year CVD risk was 7.40 (4.27-11.83) with the recalibrated score, compared to 9.32 (5.40-14.80) for the original score (p<0.001). In females, the median 10-year CVD risk was 4.83 (2.90-8.36) with the recalibrated score, compared to 2.85 (IQR 1.71-4.98) with the original score (p<0.001). Similarly, the median 10-year CVD risk was 4.66 (2.74-8.81) with the recalibrated BMI-based FRS score, compared to 2.95 (1.72-5.61) with the original score (p<0.001). 4. Conclusions: Recalibrated FRS scores estimated a significantly lower 10-year CVD risk in males and a higher risk in females than the original FRS scores.

The resistance of Candida spp to fluconazole is a serious problem; Therefore, it must be investigated to expand the understanding of the phenomenon with a view to its clinical applicability. The aim was to evaluate the expression of ERG3, ERG11, CDR1, and SNQ2 genes involving computational analysis. Relative expression was quantified by RT-qPCR. Metrics were obtained by molecular docking and through Fisher's discriminant functions, a predictive classification against susceptibility to fluconazole was performed. The expression of ERG3, CDR1, and SNQ2 genes was higher in resistant strains than in dose-dependent sensitive strains. The gene with the highest expression in strains exposed to fluconazole was CDR1 and, in both resistant and dose-dependent sensitive strains exposed to fluconazole, the ERG11 gene had lower expression. The molecular docking model generated lower median fluconazole-ERG11 contacts than the median fluconazole-ERG3, -CDR1, and -SNQ2 contacts. The predicted classification through the multivariate model for fluconazole sensitivity obtained an accuracy of 73.5%. Resistant strains had a significant expression of CDR1, SNQ2 and ERG3 genes, compared to a comparatively low expression of ERG11. Molecular analysis identified a low affinity between fluconazole and its drug target, which may explain a lower intrinsic susceptibility of the fungus.

Many people with enduring mental health difficulties (EMHD) have reduced social connections and subsequent experiences of isolation and loneliness. This paper outlines the development and trial of a manualised social-identity-based group therapy intervention to increase social connection and develop social skills to build connections outside of healthcare settings. This intervention was developed in line with the quality intervention development (6SQuID) methodology. The paper describes initial data from a feasibility study (which was ceased prematurely due to COVID-19 restrictions). Semi-structured outcome interviews were conducted with the participants and analysed using thematic analysis. Uptake, retention and acceptability of participants was high. Four primary themes were identified across the dataset: Therapeutic Process, Social Identity, Generic Components of Group Therapy and Impact of COVID-19. Participants experienced positive changes in their social behaviour, mood and avoidance. Some were unsure of the concept of social identity while reporting positive changes. A theoretically coherent manualised treatment was developed and tested on a small scale. This study supports social identity-based CBT groups as a potentially effective way of increasing social connection in those with EMHD. Social identity theory supported participants to positively integrate an area of potential social threat into their self-concept and may offer a positive addition to current psychological interventions

This study aims to investigate the effects of self-paced high-intensity interval training (Sp-HIIT) vs self-paced moderate-intensity continuous training (Sp-MICT) on the aerobic fitness level, psy-chophysiological responses and antioxidant status, to assess the relationship between aerobic fit-ness level and antioxidant markers. Well-trained males were randomised into Sp-HIIT and Sp-MICT. The intervention consisted of 3 weekly sessions during an 8-wk period. Sp-HIIT per-formed two sets of 12–24 x 30-s high-intensity runs ≥85 %HRmax followed by 30-s rest periods, while Sp-MICT performed 24-48 min of continuous running at 60-75 %HRmax. Pre and post-intervention testing included maximal oxygen uptake (VO2max) assessment during a 30-15 intermittent fitness test (30-15 IFT), as well as resting blood samples analysed for oxidative stress markers (Malondialdehyde (MDA)) and intracellular antioxidant enzymes activity (Catalase (CAT), Superoxide Dismutase (SOD) and Reduced (GSH) and Oxidized Glutathione (GSSG)). The Sp-HIIT showed meaningfully greater improvement in velocity of 30-15 IFT, VO2max and MDA responses. Furthermore, the Sp-HIIT demonstrated higher psychophysiological responses than the Sp-MICT, except for anger responses. In conclusion, these results suggest that Sp-HIIT has higher level of exercise-induced beneficial effects in physiological responses with greater perceived exer-tion in young well-trained adults.

Background: This study aimed to investigate the association between the internal derangement of the temporomandibular joint (TMJ), in particular the severity of disc displacement (DD), and the presence of generalized joint hypermobility (GJH) in growing patients evaluated on magnetic resonance images (MRI). The study also investigated the relationship between the stages of DD severity and age. Methods: This cross-sectional study has been conducted on a pre-orthodontic population (8-16 years). The GJH was assessed with the Beighton test (cutoff ≥ 4) and the final sample of 56 patients was divided into two groups: a Study Group, 30 subjects with GJH, and a Control Group, 26 subjects without GJH. The disc position was evaluated on MRI and the severity of DD was classified in four stages. Pearson's χ2 Test was performed for the analysis of the statistical correlation. Results: A statistically significant relationship between GJH and disc position was found, in particular a disc displacement with reduction (DDwR) and DD severity. It also emerged a positive association between the severity of DD and age, that increased with increasing age. Conclusions: Growing patients with GJH have a higher risk of developing DD and with more severe stages. The risk of developing DD and the severity increases with increasing age.

Dentifrice performance in the removal of dental plaque is influenced by the interactions of dentifrice components with tooth surfaces. This randomized controlled clinical study assessed the effectiveness and safety of a novel fluoride dentifrice formulation that included a micro-fibrillated cellulose network with entangled microcrystalline cellulose and silica particles (ProtegeraTM), and compared this to a positive control fluoride dentifrice (Crest Cavity Protection™). Whole mouth dental plaque levels in 82 healthy adults were measured after the first supervised use, and following a week of twice daily use at home. Overall, the novel dentifrice was at least three times more effective in whole mouth plaque reductions than the reference dentifrice (p < 0.001), with a 38.6% reduction on first use, a 30.9% reduction at day 7, and a 41.6% reduction from day 1 to day 7, compared to reductions of 12.0%, 9.6%, and 11.6% respectively for the positive control. No safety issues arose from the use of the novel dentifrice. These results indicate that including micro-fibrillated cellulose enhances plaque removal effectiveness, without causing adverse changes to oral soft tissues.

Trauma in childhood and adolescence has long-term negative consequences in brain development and behavior and increases the risk for psychiatric disorders. Among them, post-traumatic stress disorder (PTSD) during adolescence illustrates the connection between trauma and substance misuse, as adolescents may utilize substances to cope with PTSD. Drug misuse may in turn lead to neuroadaptations in learning processes that facilitate the consolidation of traumatic memories that perpetuate PTSD. This reflects, apart from common genetic and epigenetic modifications, overlapping neurocircuitry engagement triggered by stress and drug misuse that includes structural and functional changes in limbic brain regions and the salience, default-mode, and frontoparietal networks. Effective strategies to prevent PTSD are needed to limit the negative consequences associated with the later development of a substance use disorder (SUD). In this review, we will examine the link between PTSD and SUDs, along with the resulting effects on memory, focusing on the connection between the development of a SUD in individuals who struggled with PTSD in adolescence. Neuroimaging has emerged as a powerful tool to provide insight into the brain mechanisms underlying the connection of PTSD in adolescence and the development of SUDs.

The association between obesity and clinical as well as radiological outcomes in patients suffering non-traumatic intracerebral haemorrhage (ICH) remains unclear. The obesity paradox suggests a protective effect regarding in-hospital mortality. This study evaluates the impact of body mass index (BMI) on functional long-term outcome and bleeding volume in patients with non-traumatic ICH. A retrospective cohort study including all consecutive patients with spontaneous ICH treated at a tertiary referral centre between December 2017 and June 2021, aged 80 years or younger (n = 218), were included. Patients were dichotomized into overweight (OW, BMI ≥ 25 kg/m2) and normal weight (NW, BMI < 25 kg/m2). Functional outcomes were assessed by the modified Rankin scale (mRS), extended Glasgow Outcome Scale (GOS-E) and the National Institutes of Health Stroke Scale score (NIHSS) at 1, 3, 6 and 12-months follow-up. Bleeding volumes were calculated as ABC/2. Univariate and multivariate analysis were performed to assess clinical predictors of favourable outcome in the long-term. Of 218 patients (66.04 ± 15.18 years) suffering non-traumatic ICH, 115 (52.75%) were OW (29.72 ± 3.82). Female sex (p = 0.1), NIHSS (p = 0.69), cardiovascular risk factors (p = 0.55), ICH volume (p = 0.19), and presence of anticoagulation (p = 0.67) did not significantly differ between the OW and NW cohort. At discharge, functional outcome did not significantly differ between both cohorts (NW, mRS 3.92 ± 2.54 vs. OW, mRS 3.21 ± 2.43, (p = 0.28)). Multivariate analysis revealed that haemorrhage volume (p = 0.01) was the only robust risk factor to predict functional outcome after 1 year. Our data suggests that in ICH patients, neither obesity nor patient’s age are negative predictors for functional outcome in the long-term. Instead, bleeding volume is a robust risk factor predicting poor functional status after ICH. Therefore, prospective randomized trials analysing this coherence are highly warranted.

Despite great interest in how dynamic fluctuations in psychological states such as mood, social safety, energy, present-focused attention, and burnout impact stress, well-being, and health, most studies examining these constructs use retrospective assessments. Here, we discuss how ecological momentary assessments (EMAs) address methodological issues associated with retrospective reports, able to reveal dynamic associations between psychological states at small timescales that are often missed in stress and health research. In addition to helping researchers characterize daily and within-day fluctuations and temporal dynamics between different health-relevant processes, EMAs can elucidate mechanisms through which interventions reduce stress and enhance well-being. EMAs can also be used to identify changes that precede critical health events, which can in turn be used to inform the delivery of ecological momentary interventions (EMIs of just-in-time interventions) that prevent such events from occurring. To enable this work, this narrative review provides examples of scales and single-item questions used in EMA studies, makes concrete recommendations for researchers seeking to employ EMAs in their research, and discusses limitations of EMA methods. In doing so, we aim to encourage the use of these methods in research given that, when used carefully, EMA methods are well-poised to greatly advance our understanding of how intrapersonal dynamics affect stress levels, well-being, and human health.

Keywords: Knowledge; Attitudes; Practices; Salt intake.

Studies in the field of experimental hypnosis highlighted the role of hypnotizability in the physiological variability of the general population. It is associated, in fact, with a few differences which are observable in the ordinary state of consciousness and in the absence of suggestions. The aim of the present scoping review is summarizing them, and indicate their relevance to the neural mechanisms of hypnosis and to the prognosis and treatment of a few medical conditions. Individuals with high, medium and low hypnotizability scores display different cerebral functional differences – i.e., functional equivalence between imagery and perception/action , excitability of the motor cortex, interoceptive accuracy - possibly related to brain structural and functional characteristics - , and different control of blood supply at peripheral and cerebral level, likely due to different availability of endothelial nitric oxide. These differences are reviewed to support the idea of their participation in hypnotic behaviour and to indicate their prognostic and therapeutic usefulness in a few medical conditions.

The COVID-19 pandemic globally had worrisome effects on health-promoting behaviors of children. Currently, the impact on primary school children's membership in sports clubs, especially considering gender differences, is poorly studied. The main objective of this study was to analyze the status of sports club memberships among children in Austria after the stringent COVID-19 restrictions in June 2021 and to identify gender differences. 755 Austrian school children (mean age 9.9 years, 49.9% girls) were interviewed about their sports club memberships. Our results show significantly lower self-reported sports club membership in June 2021 compared to pre-pandemic studies. 50% of boys reported being a member of a sports club, while the percentage for girls was only at 29.7% (p<0.001). Besides, a significant gender difference in the type of sports club membership was observed with most boys being members of ball sports clubs, while girls were more likely to be members of other sports clubs (p<0.001). Reduced rates of sports club membership after the COVID-19 pandemic underline the need of intervention programs. Health authorities, schools, sports clubs and families should form an alliance to promote an overall increase of physical activity and thus to support the long-term healthy development of children.

In order to meet the diversified rehabilitation needs of people, it is necessary to design a product for active rehabilitation of patients. Existing rehabilitation chairs use intelligent massage, which can cause problems such as large massage area, inability to local massage, large chair size, and inability to meet the continuous use of the damaged parts. In this paper, modular design method and multi-layer evaluation method are used to solve the problems related to rehabilitation chairs. The authors use the questionnaire survey method and the functional technology matrix method to determine the functional requirements of the rehabilitation chair, and then use the multilevel evaluation methods, including the AHP method, entropy weight method main and grey correlation analysis, to optimize the functional solutions of the rehabilitation chair, and finally obtain a chair for the rehabilitation of patients with upper and lower limb disorders. Problems such as generalisation of rehabilitation scope and non-durable use of components were solved, and the purpose of active exercise was achieved. This study verifies that the use of multilevel decision evaluation method can effectively improve the efficiency of programme decision-making, and provides theoretical and practical basis for the design of similar products.

Background: Regardless of the indisputable benefits of insulin therapy, initiating insulin for diagnosed children with diabetes might be intimidating for parents. This study assesses the experience, fears, barriers and adherence to insulin use among the parents of diagnosed children with diabetes. Methods: A cross-sectional online survey was utilized for data collection from 218 participants between February and March 2023 in Jordan. The survey consisted of six sections to evaluate and assess: sociodemographic for both children with diabetes and their parents, the experience of using the insulin, the diabetes fear of self-injecting questionnaire (D-FISQ), the barriers for insulin administration including both sociocultural and other insulin-related factors, and insulin adherence. Results: More than 80% of the participants perceived a number of sociocultural barriers to insulin administration such as the tendency for addiction, lower efficiency of insulin than oral medication, and preference for complementary medicine over insulin. More than two-thirds of the participants complained of insulin-related barriers such as infections and sudden death in addition to learning the correct injection method. The general fear level was low, 8.56±7.87 (out of 45); however, more fear of insulin injection and self-testing was significantly associated with both sociocultural and insulin-related barriers, especially at the younger age. Conclusion: The results of this study indicated that parents have several barriers to insulin administration, mainly related to insulin injection. Therefore, more awareness about insulin therapy can help adjust the cooperation of patients, acceptance of treatment, ending with improving the quality of life and well-being.

During the pandemic, nurses experienced anger that stemmed from a sense of threat, frustration or even a sense of injustice. The purpose of this study was to examine the relationship between vaccination hesitancy, anger, cynicism and medical mistrust among nurses, as there are no relevant studies in the literature. The study was conducted online by completing self-report questionnaires. The Dimensions of Anger Reactions-5, the 8-item "Cynical Distrust" scale and the Medical Mistrust Multiformat Scale were used. For vaccination hesitancy, two questions with a 5-point scale were used; one question examining hesitancy to get vaccinated with the COVID-19 vaccine, and another question examining hesitancy to get vaccinated with the influenza vaccine. 387 nurses (66 men and 321 women) participated in the study. Nurses showed statistically greater hesitancy for the COVID-19 vaccine compared to hesitancy for the influenza vaccine. The variation in Vaccine Hesitancy was explained by the scores in the Medical Mistrust Multiformat Scale, the Dimensions of Anger Reactions and the Cynical Distrust Scale. The Medical Mistrust Multiformat Scale mediated the relationship between Cynical Distrust Scale and Total Vaccine Hesitancy. The Dimensions of Anger Reactions Scale significantly moderated the indirect effect of Cynical Distrust Scale on Total Vaccine Hesitancy through the Medical Mistrust Multiformat Scale. In conclusion, it is highly likely that anger is involved in reported vaccine hesitancy both by activating schemas of distrust in others and by adopting antisystemic views of mistrust in the medical system.

The prevalence of digital devices in modern society has raised concerns about the potential neg-ative effects of blue light emissions on eye health and biological rhythms. Research into blue light emissions from digital devices and their potential impact on eye health emphasizes the importance of understanding and quantifying the extent and scope of blue light emissions produced by commonly used screens (smartphones, tablets and computers). This comparative study specifically evaluates three popular Apple devices: iPhone 12 mini®, iPad Pro 12.9® and MacBook Pro®. The devices' spectral power was measured using a spectroradiometer while displaying text and a game at different brightness levels. The study also examines the effectiveness of blue-blocking lenses from well-known brands. The research highlights the importance of quantifying blue light emissions and understanding their potential impact on eye health. By doing so, appropriate measures can be developed to mitigate adverse effects on ocular structures. Above all, this research provides valuable information about the risks associated with exposure to blue light, showing that all tested devices have blue wavelength peaks between 445 nm and 455 nm. By recognizing and addressing the potential negative impacts of blue light, the risks of eye health problems can be reduced and ensure more responsible and conscious use of digital devices.

Fibromyalgia syndrome (FMS) is a nonarticular rheumatic syndrome which presents as chronic musculoskeletal pain, stiffness and body aches. FMS affects approximately 2.5% of the population, mostly women. FMS causes physical and psychological problems and reduces quality of life. The objective of this study is to identify qualitative evidence about experiences of women diagnosed with FMS about their sexuality. Methods: Metasynthesis of qualitative studies. The search included articles published between 2000 and June 2023 on the PubMed, WOS, CINAHL, SCOPUS, and SCIELO databases. Results: 450 articles were found through the initial search, of which, only 9 fulfilled the criteria and were included in the thematic synthesis. From this analysis, three main themes emerged: (1) “I want to, but I can’t”: FMS causes a shift in feminine sexuality. (2) Resetting sex life and intimacy. (3) Taking charge of a “new sexuality.” Conclusions: Women with FMS suffer from limitations of their sexuality that affect their partner. Pain, stiffness and a loss of desire make sexual encounters difficult. Becoming aware of this and striving not to lose their sexuality is key to coping with this problem. Women and their sexual partners can change roles and encourage communication, games, foreplay or touching. The use of lubricants, physical exercise and complementary therapies, along with social, professional and partner support, are key to coping with FMS.

(1) Background: Little research is done on the link of diabetic kidney disease (DKD) progression and diabetic gastroenteropathy in type 1 diabetes (T1D). (2) Methods. We performed a cross-sectional study with 100 T1D patients, 27 of them had progressive DKD, defined as estimated glomerular filtration rate (eGFR) decline≥3 ml/min/year or increased albuminuria stage over the mean follow-up time of 5.89±1.73 years. Newly developed score with 17 questions on gastrointestinal (GI) symptoms was used. Faecal calprotectin was measured by ELISA. Lower GI endoscopies were performed in 21 patients. (3) Results: Gastrointestinal symptom score demonstrated high reliability (Cronbach's α=0.78). Patients with progressive DKD had higher GI symptom scores compared to those with stable DKD (p=0.019). The former group demonstrated more frequent bowel movement disorders (p=0.04). The scores correlated negatively with eGFR (r = -0.335; p = 0.001), positively with albuminuria (r=0.245; p=0.015), Hba1c (r=0.305, p=0.002), diabetes duration (r=0.251, p=0.012). Faecal calprotectin levels did not differ between DKD groups significantly. The most commonly reported histopathological findings of enteric mucosa were infiltration with eosinophils, lymphocytes, plasmacytes, presence of lymphoid follicles and lymphoid aggregates. Conclusion: progression of DKD positively correlated with gastrointestinal symptoms, but more research is needed to clarify the causal relationships of the gut-kidney axis in T1D.

A fascinating topic that has not been recently revisited by bioethics is the ethics of human experimentation within the military context, in keeping with the pace of modern technology development. Many research innovations stem from military research, where emerging technologies are first applied in the field then eventually repurposed for civilian contexts. This commentary presents an ethical framework for the usage of military personnel as research subjects, within the context of modern military research such as epigenetic technology development in soldiers. Tensions are raised between existing military versus civilian bioethical frameworks for human experimentation and compared to risk-benefit assessments within and beyond the military context. A harmonized ethical framework is proposed for the use of research subjects within the military. The pace of modern scientific research, particularly in genomics, poses new ethical considerations of genetic profiling, consent, risk, and data privacy that urges a timely revisit of military bioethics.

Background: ; Biotechnology is developing at an ever-increasing pace, and the progressive computerisation of health care and research is making it increasingly easy to share data. One of the fastest growing areas is biobanking. However, even with the best equipment and the best trained staff, a biobank will be useless without donors. For this reason, we have decided to gauge Polish citizens' awareness and attitudes towards biobanking and their willingness to donate biological samples. Methods: The survey was conducted among a nationwide group of 1,052 Poles aged 18 and over where the totals for gender, age and place of residence were selected according to representation in the population of adult Poles. The survey was conducted using the Computer Assisted Web Interview (CAWI) technique. Results:; N=701 (66.6%) respondents indicated that they had heard of scientific studies in which samples of biological material such as blood, saliva or urine are collected. More than half of respondents (N=613, 58.3%) have a positive opinion regarding scientific research in which samples of biological material are taken. Only N=220 (20.9%) of respondents had previously encountered the term biobanking. N=687 (65.3%) respondents would participate in a scientific study that biobanked biological material and health information. Conclusions: The level of knowledge and awareness of biobanks and their role in scientific research and the health care system among Polish citizens is low and requires education and information activities.

Pregnant women have been considered a high-risk group for SARS-CoV-2 infection; the impact of the disease on the health of a mother and her child is still being studied. The emotional impact of the pandemic on pregnant women has been extensively studied. Emotional distress is proposed as a perspective to explain the emotional manifestations of women during this stage as something common rather than pathological. The objective of this study was to know the emotional experience of women who tested positive for SARS-CoV-2 towards the end of their pregnancy, during the first and second waves of COVID in Mexico. A qualitative study was carried out: 18 pregnant women with COVID were interviewed. A thematic analysis of the data was performed, resulting in three main themes and 14 subthemes. The COVID-infected mothers-to-be experienced mild to moderate emotional distress. It was more intense for those with comorbidities. This distress was aggravated during obstetrical complications and comorbidities, as well as during COVID and postpartum. The emotional distress was appeased by both the perception of medical care and social support. The emotional distress of pregnant women with COVID requires emotional accompaniment to reduce its impact.

ESBL-producing E. coli is a growing public problem in healthcare settings and the community. Between 2009 and 2018, a total of 187 ESBL-producing pathogenic E. coli isolates were confirmed, and clonal complex (CC) 10 was the predominant clone. This study aimed to characterize ESBL-producing pathogenic E. coli CC10 strains obtained from diarrheal patients to improve the understanding of CC10 distribution in the Republic of Korea. A total of 57 CC10 strains were selected for molecular characterizations, such as the identification of serotype, antibiotic resistance genes, genetic environments, plasmid profiles, and the genetic correlation between CC10 strains. In the CC10 isolates, the most prevalent serotype was O25:H16, followed by O6:H16. ESBL genes were identified as blaCTX-M, and the most dominant ESBL gene was blaCTX-M-15 (56%) and blaCTX-M-14 (30%). Most blaCTX-M genes were located on plasmids, and these plasmid profiles were confirmed as IncB/O/K/Z, IncF, IncI1 and IncX1. The mobile elements located up-and down-stream mainly included ISEcp1 (complete or incomplete) and IS903 or orf477 were found, respectively. Phylogenetic analysis showed that the CC10 strains were genetically diverse and divided into several distinct lineages. In this study, we found that CC10 ESBL-producing pathogenic E. coli has been steadily isolated; particularly, CTX-M-15-producing E. coli O25:H16 isolates were the major type related with distribution in CC10 clones during the last decade. Identification of ESBL-producing pathogenic E. coli CC10 isolates highlights the possibility of the emergence of resistant isolates with epidemic potential within this CC. Therefore, continuous monitoring will be conducted to prevent further spread of resistant ESBL-producing E. coli CC10 strains.

Comprehensive sexuality education (CSE) is an important framework utilized worldwide to provide students and young people with accurate, affirming, and socially conscious sexuality education. However, there is still a lack of CSE curricula in school contexts that is relevant for students with various disabilities. This article takes the Ontario, Canada context as an example of where and how CSE can improve to be more inclusive for students with disabilities. This article reviews the current context of CSE in Ontario, Canada, including its controversies while providing recommendations for meeting the needs of students with various disabilities, including psychological, intellectual, and physical disabilities. This article aims to provide recommendations that are relevant for scholars, researchers, and policymakers in various international contexts for improving CSE for students with disabilities in schooling.

Diabetes mellitus, a metabolic disorder that is persistent in nature, is identified by an elevated concentration of glucose in the bloodstream. The disease has become a major public health problem, affecting millions of people globally, and is associated with significant morbidity and mortality. The increasing prevalence of diabetes and the lack of effective therapeutic interventions have led to the exploration of alternative and complementary forms of therapy, including ethnomedicine. Ethnomedicine is the study of traditional medical systems and the medicinal plants used by Indigenous communities. In other words, Ethnomedicine refers to the traditional medical practices and beliefs of a particular cultural or ethnic group. The most popular example of traditional medicine is the use of Aloe vera for the treatment of various diseases such as sunburn, cuts, burns, hypertension, diabetes, and jaundice for thousands of years [1]. In recent years, there has been increasing interest in the potential role of ethnomedicine in the management of diabetes, given its widespread use in many communities and its potential to offer cost-effective and culturally acceptable treatment options. It encompasses a range of traditional healing practices, including herbalism, acupuncture, and massage therapy. Despite the inconsistencies, there is growing evidence to suggest that certain ethnomedical practices may be effective in the management of diabetes [2,3]. For example, several studies have shown that certain herbal remedies, such as cinnamon, ginseng, and bitter melon, may have potential benefits in terms of improving glucose control and reducing the risk of complications associated with diabetes. Evidence-based ethnomedicine is an approach that applies scientific principles and methods to evaluate the efficacy and safety of traditional medical practices. This approach is crucial in the development of effective and safe ways to treat diabetes. To date, there have been numerous studies conducted to examine the efficacy and safety of various ethnomedical interventions for diabetes, including herbal remedies, dietary changes, and physical activity [4]. However, it is important to note that not all ethnomedical interventions for diabetes have been thoroughly evaluated, and many remain unproven. Furthermore, some interventions may be associated with significant risks, particularly in terms of drug interactions and adverse effects. As such, it is crucial that any ethnomedical interventions for diabetes be carefully evaluated using rigorous scientific methods and that patients be advised to consult with their healthcare provider before using any such interventions. It is important to note that the results of these studies have been mixed, with some showing promising results, while others have failed to demonstrate significant benefits. In this chapter, the evidence-based current state of ethnomedicine for diabetes was reviewed. We first provide an overview of diabetes and its pathophysiology, followed by a discussion of traditional medicinal practices used to treat the disease. We then present a systematic review of the scientific literature on the use of ethnomedicine for diabetes, focusing on herbal remedies and dietary interventions. Our review found that several medicinal plants offered promising results to treat all types of diabetes. For example, Gymnema sylvestre, a traditional Indian herb, has been shown to reduce blood glucose levels and improve insulin sensitivity [5]. Additionally, the use of bitter melon (Momordica charantia) has been shown to reduce fasting blood glucose levels and improve glucose tolerance in individuals with type 2 diabetes [6]. Another important aspect of ethnomedicine for diabetes is the use of dietary interventions [7]. Traditional diets, such as the Mediterranean diet, have been shown to have beneficial particularly in terms of improving glycaemic control, reducing the risk of cardiovascular disease, and insulin sensitivity [8]. Additionally, the use of low-carbohydrate diets, such as the ketogenic diet, has been shown to improve glycaemic control in individuals with type 2 diabetes [9]. Traditional medicine has a long history of treating the symptoms and managing the condition. However, the efficacy and safety of these traditional practices have not always been scientifically tested, and there is a lack of standardization and regulation in the production and use of traditional remedies for diabetes. This creates a challenge for healthcare providers and patients, who need to ensure that the treatments they use are safe and effective. Additionally, there is a need for further research to understand the mechanisms by which traditional remedies may be effective in managing diabetes and to determine the optimal dosage and administration methods [9]. Finally, it is also important to understand that the use of traditional remedies may interact with conventional medications, leading to adverse effects; for example, the use of Chinese traditional medicine, known as “herb ginseng,” for the treatment of various health conditions, including diabetes sometimes cause the side effect such as dizziness, confusion, and fainting while interacting with the anti-diabetic medications [10]. Therefore, it is important to approach the use of ethnomedicine for diabetes with caution and under the guidance of a qualified healthcare professional. In conclusion, evidence-based ethnomedicine offers a promising approach to the treatment of diabetes. While further research is needed to fully understand the mechanisms and safety of these interventions, the results to date suggest that traditional remedies and dietary interventions have the potential to be effective in the management of this disease. However, it is important to approach the use of ethnomedicine for diabetes with caution and under the guidance of a qualified healthcare professional and to continue to conduct rigorous scientific research to fully understand the benefits and risks associated with these interventions.

Purpose: To examine associations between subjective quality of life and other socio-demographic variables and to explore differences in experiences of people with different levels of quality of life (low, moderate, high). Materials and methods: Semi-structured interviews and standardized measures of mobility, function, health-related quality-of-life, and quality-of-life were used to collect the data for this mixed-method study. Results: Twenty-four participants were interviewed with an average age of 55 years and 54% were male. High quality of life, according to quantitative analysis, was strongly associated with being male, attending rehabilitation, and being married. The qualitative findings supported the quantitative findings and also revealed that people with a low quality of life felt the neighborhood-built environment was not supportive of people with incomplete spinal cord injury who can walk. Participants who reported a low/ moderate quality of life reported feeling devalued by able-bodied people and that their mobility was getting worse over time. Conclusion: Findings suggest that those with incomplete spinal cord injuries who can walk could benefit from improved quality of life by modifying their social and neighborhood's built environment. For instance, sensitivity training for the general population could help to reduce negative attitudes and misperceptions about invisible impairments and promote inclusion.

Rapid proliferation of traditional gold mining sites in Kédougou a Southeast region in Senegal, led to mass population migration from the neighboring West African countries and rapid expansion of small mining villages with poor hygiene and sanitation conditions. An outbreak of hepatitis E was reported in 2014 with several cases of febrile jaundice among traditional mine workers. In this study, we analyzed both HEV IgM and IgG seroprevalence and the associated risk factors of infection by testing any suspected case and contacts collected from February 2012 to November 2014. RNA-negative sera from suspected cases and contacts were tested for anti-HEV IgM and anti-HEV IgG. A total of 799 sera were collected from 290 suspected cases, 470 contacts and 39 individuals with missing information. The median age of the cohort study was 19 years (1-88 years) with a male/female sex-ratio of 1.9. We found an overall prevalence of 43.68% (332/760) of anti-HEV IgM and 38.15% (290/760) of anti-HEV IgG sera. Our data provide new insights into the HEV epidemiology and point to the crucial need to estimate the disease’s burden in Kédougou and assess the viral mechanisms driving the disease’s severity in pregnant women.

One of the most promising advancements in healthcare is the application of digital twin technology. Digital twins are virtual replicas of real-world human patients and can be used for monitoring, and diagnosis, and as a tool to design treatment strategies tailored to individual patients. Furthermore, digital twins could also be helpful in finding novel treatment targets and predicting the effects of drugs and other chemical substances in development. This review article delves into the various data sources and methodologies that contribute to the construction of digital twins. Each data source, including blood glucose levels, heart MRI and CT scans, cardiac electrophysiology, written reports, and multi-omics data, comes with different challenges regarding standardization, integration, and interpretation. We showcase how various datasets and methods are used to overcome these obstacles and generate a digital twin. While digital twin technology has seen significant progress, there are still hurdles in the way to achieving a fully comprehensive patient digital twin. Developments in non-invasive and high-throughput data collection, as well as advancements in modeling and computational power will be crucial to improve digital twin systems. We discuss a few critical developments in light of the current state of digital twin technology. Despite challenges, digital twin research holds great promise for personalized patient care and has the potential to shape the future of healthcare innovation.

The scope of this paper is to compare different dental sealants and flow materials indicated for sealing pit and fissures considering their chemical formula. The narrative review aims to address the questions: What is the essence of different dental sealants’ activity, how their chemical formula affects their mechanisms of caries prevention and what makes a dental sealant efficient mean of caries prevention. Another vital issue is whether the sealants which contain fluoride, or any other additions have potentially increased antimicrobial properties. Methods: An electronic search of the PubMed, Cochrane, Web of Science and Scopus databases was performed. The following keywords were used: (dental sealants) AND (chemical composition). Additionally, information about composition and indications for clinical use provided by manufacturers were utilized. The review aims are to find crucial elements of sealants’ composition which affect their cariostatic mechanisms.

This paper focuses on hyperglycemic hyperosmolar syndrome (HHS), a unique hyperglycemic state requiring divergent diagnosis and treatment approaches from diabetic ketoacidosis (DKA), despite some shared characteristics. We introduce the mnemonic DI-FF-ER-EN-CE-S to encapsulate unique HHS management and complications. 'DI' emphasizes the need to delay and reduce initial insulin therapy until serum glucose decline is managed by fluid resuscitation alone. 'FF' and 'ER' stress the importance of fluid and electrolyte replacement due to severe dehydration and imbalances. 'EN' denotes the potential for encephalopathy and the requirement for a controlled serum osmolality reduction. 'CE' indicates that cerebral edema is rare but necessitates aggressive fluid therapy. 'S' signifies systemic multiorgan failure. We categorize the associated risks into three mnemonic groups: the 3Rs (renal failure, respiratory distress, rhabdomyolysis), the 3Hs (heart failure, hypercoagulation, hyperthermia), and AP (arrhythmias, pancreatitis) to facilitate awareness and screening of HHS.

Many researches have identified that adverse childhood experiences (ACEs) are associated with non-suicidal self-injury (NSSI) and suicidality. However, most studies have been restricted to a few types of ACEs. This study aims to investigate associations of 13 common types of ACEs with NSSI, suicidal ideation (SI) and suicide attempt (SA), as well as the mediation of depressive and anxiety symptoms therein. A total of 1771 students aged 11-16 years who participated in the baseline survey of the Chinese Adolescent Health Growth Cohort study were included for the analysis. ACEs, SI, SA, depressive and anxiety symptoms were recorded by standard questionnaire. Of included participants, 92.0% reported one or more category of ACEs. Smoking, parent-child separation, emotional abuse, physical abuse and being bullied were positively associated with NSSI, with the adjusted odds ratio (aOR) of 2.41(95%CI, 1.01-5.75), 1.80(1.28-2.54), 1.69(1.21-2.37), 2.08(1.44-3.01) and 1.87(1.35-2.59), respectively; smoking (4.03, 1.66-9.81), parent-child separation (1.42, 1.07-1.90), emotional abuse (1.91, 1.41-2.59), physical abuse (1.80, 1.27-2.57), emotional neglect (1.78, 1.28-2.49) and being bullied (2.08, 1.54-2.81) were positively associated with SI; smoking(4.30, 1.67-11.10), emotional abuse (2.42, 1.58-3.72) and being bullied (1.75, 1.17-2.60) were positively associated with SA. The associations of ACEs with NSSI, SI and SA were each partially or completely mediated through depressive and anxiety symptoms. Children and adolescents who had experiences of smoking, physical abuse and being bullied during childhood are consistently and independently associated with NSSI and suicidality, and these associations may be largely mediated through depressive and anxiety symptoms.

Cardiac regeneration is a critical endeavor in the treatment of heart diseases, aimed at repairing and enhancing the structure and function of damaged myocardium. This review offers a comprehensive overview of current advancements and strategies in cardiac regeneration, with a specific focus on regenerative medicine and tissue engineering-based approaches. Stem cell-based therapies, which involve the utilization of adult stem cells and pluripotent stem cells hold immense potential for replenishing lost cardiomyocytes and facilitating cardiac tissue repair and regeneration. Tissue engineering also plays a prominent role employing synthetic or natural biomaterials, engineering cardiac patches and grafts with suitable properties, and fabricating upscale bioreactors to create functional constructs for cardiac recovery. These constructs can be transplanted into heart to provide mechanical support and facilitate tissue healing. Additionally, the production of organoids and chips that accurately replicate the structure and function of the whole organ is an area of extensive research. Despite significant progress, several challenges persist in the field of cardiac regeneration. These include enhancing cell survival and engraftment, achieving proper vascularization, and ensuring the long-term functionality of engineered constructs. Overcoming these obstacles offering effective therapies to restore cardiac function could improve the quality of life for individuals with heart diseases.

The current study is to examine the disparities in physical activity (PA), sedentary behavior (SB), and stress levels in Korean adolescents concerning changes in their perception of family socio-economic status (SES) during COVID-19. Among a total of 6144 Korean adolescents aged 12 to 18, the participants were categorized into two groups based on their responses regarding changes in their family SES during COVID-19: Lower SES (n = 3072) and Non-changed SES (n = 3072), with matching in terms of age, gender, and BMI. All variables were assessed using the 16th year (2020) of the Korean Youth Risk Behavior Survey. Statistical analyses were conducted using SPSS 26.0 version, employing independent t-tests to examine anthropometrics’ differences and multinominal logistic regression to predict the impact of perception of family SES on PA, SB, and stress while comparing the two groups. The significance level was set at α = 0.05. Adolescents in the Lower SES group were less likely to engage in vigorous-intensity PA (VPA) and muscular strength activities compared to those in the Non-changed SES group (p < 0.001) and were 2.3 times more likely to experience a very-severe stress level than the Non-changed SES group (p < 0.001). These results shed light on the importance of promoting VPA and muscular strength activities in adolescents for their physical and mental well-being, particularly during potential future pandemics. Understanding the impact of perceived SES changes on health behaviors can inform targeted interventions and support strategies to improve the health outcomes of adolescents during challenging times.

Covid-19 has had a significant impact on the lives of populations across the world. Since the first reported case of the coronavirus in Wuhan, China, the world faced a situation of dealing with a novel virus. While the physical health effects of the coronavirus was the center of focus for much of the pandemic, Covid-19 was accompanied with significant social and psychological consequences on the world populations. In this review, we aim to assess how the coronavirus pandemic has affected the African continent at large, highlighting the socio-psychological consequences. Through citing some examples of a few countries in Sub-Saharan Africa, the review will detail the experiences of the populations within this region which remain plagued with economic and health vulnerabilities that were further exposed by the pandemic.

Aging involves several changes depending on genetic and behavioural factors, such as lifestyle and number and quality of social relationships, which in turn can be influenced by empathy. Here, the change in the perceived social support across the life span as a function of empathy was investigated, considering the mediating role of the empathy, after controlling for gender and education. 441 people (18-91 years old) filled in the Italian short version of the Interpersonal Support Evaluation List (ISEL-12) and the Social Support Questionnaire (SSQ6) as well as the Empathy Questionnaire (EQ) and the Reading the Mind in the Eyes test (RMET). The mediation analyses with ISEL-12 showed that age and the EQ fully mediated the relationship between age and Appraisal, Belonging and Tangible scores. Further, the EQ fully mediated only the relationship between age and SSQ6-People. These results showed that empathic skills play a key role in the relationships between age and social support. This suggests: empathy can trigger social support and ultimately well-being if stimulated across the lifespan, especially since young age; this would help to form the socio-emotional competence across the years, as a sort of cushion that can be useful in the elderly to fulfil active aging.

Secure attachment, developed through consistent relationships with attachment figures in childhood, is a crucial factor in fostering healthy interpersonal relationships and a positive self-perception. This research aimed to assess how perceived security, as an indicator of secure attachment, predicts adult self-concept through the mediating effects of resilience and positive self-esteem. A quantitative, cross-sectional, and non-probabilistic study was conducted with 383 participants, of whom 76.2% were females, aged between 17 and 86 years (M = 28.52, SD = 12.23). Correlational analyses revealed significant positive associations between perceived security, self-concept, resilience, and positive self-esteem. Path analysis demonstrated that resilience and positive self-esteem sequentially mediate the relationship between perceived security during childhood and adult self-concept (Total Effect R2 = .34, F(1,381) = 193, p < .001; Indirect effect of sequential mediation b = .02, CI 95% [.01, .04]). Findings suggest that the ability to cope with ad-versity and personal acceptance underlie the impact of perceived security on self-concept. It is recommended to promote not only secure attachment in family interventions but also resilience and self-esteem in programs targeting adolescents, youth, and adults.

When “hijacked” by compulsive behaviors that affect the reward and stress centers of the brain, functional changes in dopamine circuitry occur as the consequence of pathological brain adaptation. As a brain explanans for mental health, with a central functional role in behavioral regulation from healthy reward seeking to pathological adaptation to stress in response to adversity, we may use dopamine regulation in interaction with other brain mechanisms, as discussed herein, to gather a deeper insight into environmentally triggered mental health changes to understand, for example, specific behavioral changes observed during and after the COVID-19 pandemic. Pandemic-related adversities, the stresses they engendered, and the long lockdown periods where people had to rely on digital tools to get feed-back rewards via the internet can be seen as the major triggers of changes in motivation and reward seeking behavior worldwide. The pathological adaptation of dopamine-mediated reward circuitry in the brain offers a highly plausible explanation why, when pushed by fate and circumstance into a physiological brain state of anti-reward, human behavior and mental health changes almost inevitably depending on individual vulnerability to stress. A unified conceptual account that places dopamine function at the centre of the current global mental health context is proposed.

Background: This study aims to investigate the patient safety culture at a sports medicine hospital and explore quality of healthcare and associated factors. Methods: In a cross-sectional study design, the tool Hospital Survey on Patient Safety Culture (HSOPC) was administered online among staff at a sports medicine hospital in Doha, Qatar. About 319 staff participated from 898 staff who received emails (35.5%). Results: The results showed that 49.2% of the staff rated the patient safety grade as excellent and 36.1% as very good, which sums up to 85.3%. Factors associated with better patient safety grade were work climate (OR 10.3 95% CI (3.2 to 33.6); teamwork OR 7.6 95% CI (2.8 to 20.9) and team communication (OR 2.9 95% CI (1.1 to 7.6). Conclusions: Addressing the work climate, enhancing communication, and cohesive work within teams facilitates a culture of trust that improves patient safety grade. Ensuring quick return to play is a team effort involving multiple disciplines, hence a high performance and safety culture can enhance teamwork. Reducing punitive response to error and encouraging staff and supervisors are key areas that can improve safety culture in sports medicine organizations, and efforts should be placed in this area.

During the COVID-19 pandemic, the education sector of Bangladesh suffered a lot. To adapt to this uncertain situation, the online teaching-learning method was introduced for the first time in the dental colleges to continue regular classes. This qualitative study explored the in-depth perception among students of this new, affordable, flexible online learning method and to find out the scope of improvement of the delivery method. Two focus group discussions (FGD) were conducted, each including 6-8 participants (N=16, the male: female ratio was 7:9) for gaining an in-depth understanding of the perception of online teaching among the dental students. With the help of the trigger questions, the facilitator and moderators conducted both the FGDs. By analysing the Focus group discussion, four distinct themes were identified. The main themes extracted from the data refer to the difficulties which students faced during participation in online classes (e.g., low attention span, unusual timing of classes, internet accessibility, power cut, boring content, etc.), advantages of online learning (e.g., saves time, able to continue studying during the lockdown, saves money, avoids commuting, being safe during a pandemic situation, one can participate in classes if sick, etc.), disadvantages of online classes (e.g., not feasible for clinical classes and lab works, lack of social interactions, lack of group study, long screen time, lack of after class peer discussion, lack of engagement, etc.), and also scopes of improvements (e.g., technological training for staff, recorded classes, technological orientation for students, more engaging contents, online support, more interactive lessons, short duration of the class, break after 30-45 minutes and also teachers training for online facilitation, etc.). In Bangladesh, the online teaching-learning method is not a regular practice. Most of the institutions were forced to adopt this method on very short notice because of the COVID-19 pandemic lockdown. Online education in a clinical subject like dentistry requires a special training program, online content preparation, and interactive lesson delivery setup which are big challenges for a re-source-constrained medical education setup. The focus group discussion unveiled some key issues which indicated that there are many scopes for improvement in online teaching methods. With the help of the medical education department and through faculty development the online learning sessions can be made attractive as well as beneficiary for the key stakeholders.

Attack on health has become a significant concern for non-belligerents of war, including healthcare personnel and facilities as witnessed in the ongoing Sudan conflict. About 1.5 billion people living in fragile and conflict-affected settings (FCAS) have a heightened need for essential health services. Conflicts often lead to the disruption of building blocks of health systems, lack of access to health facilities, failure of essential medical supply chains, the collapse of political, social and economic systems, migration of health care workers, and upsurges in illness. While health indicators often decline in conflict, health can also bring peace and harmony among communities. Investment in health systems and health diplomacy is a neutral starting point for bringing peace and mitigating conflicts. The international commitment towards Sustainable Development Goals (SDGs) provides the impetus to emphasize the relationship between health and peace with the amalgamation of SDG 3, SDG 16, and SDG 17. The inspection of how health should be used as a ‘tool for peace’ and not as leverage during the war must be reiterated by international institutions.

Background: Hypovitaminosis D is a public health problem due to its implications for various diseases. Vitamin D has numerous functions, such as modulating the metabolism of some cellular tissues, and is expressed through the VDR gene that may influence gene expression modulation, which plays an important role in vitamin D metabolism. Objective: To evaluate the effect of the genotypes of single nucleotide polymorphism (SNP) BsmI of the vitamin D receptor (VDR) gene on VDR, SOD2, and CYP24A1 gene expression in individuals with low serum vitamin D levels. Methods: This was a cross-sectional analytical study. Individuals were invited to participate and, after signing the informed consent form, answered a structured questionnaire with identification data. Blood was collected for biochemical analysis, and vitamin D was measured by chemiluminescence; BsmI polymorphism was determined using real-time polymerase chain reaction (PCR) assays with TaqMan allelic discrimination, and gene expression was conducted by qRT-PCR using QuantiFast SYBR® Green PCR Master Mix. Data were analyzed using the SPSS 20.0 software, and differences were considered significant at p&lt;0.05. Results: 98 individuals with vitamin D ≤20 ng/dL were evaluated, and the SNP BsmI of the VDR gene showed CYP24A1 overexpression and low SOD2 expression. Conclusion: SNP Bsm I of the VDR gene can modulate the expression of the genes evaluated without interfering with serum levels.

This article presents the main results of the Kids in Action (KIA) project, which aimed to promote physical activity and sport among children aged 3 to 11, by linking the education, sports and family sectors. It applies the concepts of proximity consumption and the 15-minute city to sustainable and healthy habits. This study aims to evaluate the application of the concept of proximity to the provision of physical sports activities from an early age, to reduce the drop-out rate of PA, through collaboration between schools, local government and the sports sector. A mixed methodology was used, applying a survey and interviews with the stakeholders to identify good practices in the promotion of physical activity at an early age. A total of 147 children and 10 adults (3 family members, 4 school managers or teachers and 3 sports managers) participated. The main results included the importance of introducing sport and providing adequate facilities, especially through guided workshops, as this not only influences the actual participation in sport but also the intention to continue practising it. It is observed that children with less affinity towards conventional sports benefit particularly from initiatives such as the KIA programme. On the other hand, the lack of available resources and the influence of the sports culture in families are identified as the main barriers, factors that harm the quality of participation.

Prostate cancer is the most common cancer among men in Poland. A significant proportion of prostate cancers can be cured, providing longer survival. Patients have the opportunity to undergo minimally invasive treatment methods like brachytherapy, while maintaining their previous quality of life. The disease itself, as well as treatment complications, primarily affect the functioning of the urinary and digestive systems and impact the sexual sphere. Aim: This study aims to assess the quality of life of patients after prostate brachytherapy. Methods: The research was conducted at the Lower Silesian Oncology Centre in Wroclaw. The study included fifty men aged between 51 and 85 years. The following questionnaires were used: EORTC QLQ-C30, QLQ-PR25. Scales: Katz, Mini-MAC, PSS-10. Moreover, the study used a self-designed survey covering socio-demographical factors. Results: Prostate brachytherapy has a significant impact on the degree of sexual dysfunction. Compared to sexually inactive individuals, sexually active individuals exhibit fewer negative psychological symptoms. Choosing a destructive coping strategy intensifies the occurrence of symptoms, lowers patients' level of independence, and negatively affects their quality of life. Conclusions: Brachytherapy contributes to worsening sexual function and temporarily affects urinary system function, which may lower the overall quality of life in patients.

The purpose of this study was to investigate the horizontal force and contribution of shoulder horizontal adductor and elbow extensor muscles activity during wide and narrow grip bench press (BP) in various conditions, such as resistance trained/non-trained, concentric/eccentric and muscle fatigue/non-fatigue.　We measured the horizontal force on the bar and the electromyographic (EMG) muscle activity of pectoralis major (PM) and triceps brachii (TB) during 10RM BP with wide grip (81cm) and narrow grip (40cm)　in 7　resistance trained men and 7 non-trained men. The all-reps average of the horizontal to vertical force ratio both in resistance trained and non-trained subjects was about 30% outward for the wide grip, and about 10% inward for the narrow grip. The EMG contribution ratio PM/TB shows no significant differences between narrow and wide grip in all evaluated conditions except in non-trained subjects muscle fatigue eccentric phase. Both resistance trained and non-trained subjects did not push the bar straight upward, and the EMG PM/TB was almost unchanged by hand width. The direction adjustment of the force on the bar that achieves almost the same muscle activity degree of the shoulder and elbow joints might be optimal BP kinetics.

The aim of the study was to identify the existence of positive relationships between certain psychomotor behaviors, which we consider specific to swimming, and learning the execution technique of some styles (front crawl and backstroke). The study was carried out during 10 months, including 76 children (40 boys and 36 girls) aged between 6-9 years who practice recreational swimming in a Romanian city. Several tests were used: Tapping test for manual dexterity and laterality, the Goudenough test for body schema, the Flamingo test for static balance, the horizontal buoyancy test for body balance on the water. Results indicated better ratings on all psychomotor behaviors analyzed by gender (in favor of girls compared to boys), except for laterality. The levels of all analyzed psychomotor behaviors are directly proportional to the age of the subjects. Also, moderate positive correlations of manual dexterity (rs = 0.63 in front crawl; rs = 0.57 in backstroke) and strong correlations were identified for body scheme, laterality, static balance and buoyancy, coordination with the learning of the two styles of swimming (r or rs between 0.77 and 0.85). In conclusion, psychomotor behaviors can be predictors for learning swimming styles.

The study's objective was to assess the impact of Mediterranean diet/lifestyle interventions for weight loss on Positive airway pressure (PAP) adherence, Body mass index (ΒΜΙ), sleepiness, and blood pressure measurements (BP) in patients with obstructive sleep apnea (OSA). We designed a randomized, controlled trial, including overweight and obese patients with moderate-to-severe OSA, randomized to standard care (SCG, n=37) and Mediterranean diet group (MDG, n=37). SCG received healthy lifestyle advice, while MDG underwent a 6-month behavioral intervention aiming to enhance weight loss and adherence to Mediterranean diet. PAP adherence, BMI, Epworth Sleepiness Scale (ESS) and BP measurements were evaluated pre- and post-intervention. Post-intervention PAP use was higher in MDG compared to SCG (6.1 vs 5.4, p=0.02). Diet/lifestyle intervention was one of the most significant predictive factors for PAP adherence (OR = 5.458, 95% CI = 1.144-26.036, p=0.03). The SCG demonstrated a rise in BMI, while the MDG displayed a decline (0.41 vs -0.75, p=0.02). The MDG also demonstrated a substantial reduction in adjusted SBP (-5.5 vs 2.8, p=0.014) and DBP (-4.0 vs 2.5, p=0.01). Ultimately, incorporating a dietary/lifestyle intervention with standard care yields superior PAP adherence, BMI, and BP measurements in contrast to standard care alone, underscoring the potential benefits of allocating increased time and support within the MDG group. Trial registry: ClinicalTrials.gov; No.: NCT05881824; URL: www.clinicaltrials.gov.

There is voluminous literature on Food Security in Africa. This study explicitly considers the spatio-temporal factors in addition to the usual FAO-based metrics in modeling and understanding the dynamics of food security and nutrition across the African continent. To better understand the complex trajectory and burden of food insecurity and nutrition in Africa, it is crucial to consider space-time factors when modeling and interpreting food security. The spatio-temporal anova model was found to be superior(employing statistical criteria) to the other there models from the spatio-temporal interaction domain models. The results of the study suggest that dietary supply adequacy, food stability, and consumption status are positively associated with severe food security, while average food supply and environmental factors have negative effects on Food Security and Nutrition. The findings also indicate that severe food insecurity and malnutrition are spatially and temporally correlated across the African continent. Spatio-temporal modeling and spatial mapping are essential components of a comprehensive practice to reduce the burden of severe food insecurity. likewise, any planning and intervention to improve the average food supply and environment to promote sustainable development should be regional instead of one size fit all.

Clinical pharmacists are employed at many hospital departments in Denmark, but not yet on the Faroe Islands. The purpose of this study was to test feasibility of a clinical pharmacist-led medication review service at the surgical ward of the National Hospital on the Faroe Islands. Hospitalised surgical patients were offered a medication review service by a clinical pharmacist. Identified drug related problems (DRPs) were classified according to the Pharmaceutical Care Network Europe (PCNE) model. The qualitative inputs from the ward’s staff were collected. In total, 42 patients with 171 identified DRPs were included. The majority of the DRPs concerned suboptimal effect and the safety of the drug treatment. The 49.6 % of the proposed medication changes were accepted by the ward physicians. According to the qualitative inputs, the interest for the service was greater among the younger physicians compared to the older ones, and among nurses compared to physicians. Identified barriers for the optimal service implementation were an absence of medication ordinations and poor visibility of pharmacist’s notes in electronic health records. For a successful implementation of the service, work on the physicians’ interest in an interdisciplinary cooperation and optimization of the electronic health records are warranted.

The home is becoming a key location for healthcare delivery, including the use of technology driven by autonomous systems (AS) to monitor and support healthcare plans. Using the example of a smart mirror, this paper describes the outcomes of focus groups with people with multiple sclerosis (MS; n=6) and people who have had a stroke (n=15) to understand their attitudes towards the use of AS for healthcare in the home. We thematic analysis to analyse the data. The results indicate that the use of such technology depends on the level of adaptability and responsiveness to the users’ specific circumstances, including their relationships with the healthcare system. A smart mirror would need to support manual entry, responsive goal setting, effective aggregation of data sources and integration with other technology, have a range of input methods, be supportive rather than prescriptive in messaging, and give the user full control of their data. Barriers to adoption include a perceived lack of portability and practicality, lack of accessibility and inclusivity, a sense of redundancy, being overwhelmed by multiple technological devices, and a lack of trust in data sharing. These results inform the development and deployment of future health technologies based on the lived experiences of people with health conditions who require ongoing care.

Keywords: Red meat; Processed meat; poultry; dairy; mortality

We evaluated the closure of idiopathic full-thickness macular holes (MHs) the day after surgery in minimizing the burden and maximizing patient outcomes. Herein, 25-gauge pars plana vitrectomy, internal limiting membrane peeling, and fluid-gas (20% sulfur hexafluoride) were performed for the treatment. Patients were instructed to remain in the facedown position until the confirmation of MH closure, and the position was discontinued in cases where the closure was confirmed. In total, 43 eyes of 43 patients, whose average age was 69.7±8.6 years, were enrolled in this study. We used swept-source (SS)-optical coherence tomography (OCT) for the confirmation of MH closure for gas-filled eyes and used spectral domain (SD)-OCT for the reconfirmation of MH closure after the gas volume was reduced to less than half of the vitreous cavity. MH closure was confirmed in 40 eyes (93%, the closure group) on the next day after surgery. The time from surgery to SS-OCT imaging was 24.7 hours. Although facedown positioning was terminated in cases where MH closure was confirmed, there were no cases in which the MH was re-opened afterward. The basal and minimum MH size was significantly larger in the non-closure group than that in the closure group (p = 0.027, p = 0.043, respectively). Therefore, checking with SS-OCT the day after surgery and terminating facedown positioning in cases where MH closure was confirmed would be a useful method, removing great burden for the elderly without sacrificing the MH closure rate.

Background: There is an exponential increase in caesarean sections with epidemic proportions worldwide, which is considered as a serious public health issue that influences negatively both maternal and childhood health. Aims: This study aimed to evaluate the associations between pre-dominant maternal risk factors and the prevalence of caesarean section in a representative sample of women from Greece. Methods: This is a cross-sectional study conducted on 5182 healthy, re-productive-aged women from 11 geographically diverse Greek areas after applying specific inclu-sion and exclusion criteria. Statistical analysis was applied to evaluate the impact of maternal so-ciodemographic, anthropometric, lifestyle and perinatal factors in the risk of caesarean section de-liveries. Results: A high prevalence of 56.4% of caesarean section deliveries was recorded in the study population. The incidence of caesarean sections reached to 51.5% in private hospitals in which an increasing rate of 47.5% for planned caesarean sections were noticed. Older maternal age, pre-pregnancy overweight and obesity, excess gestational weight gain, high rates of preterm birth, better economic status, smoking habits, and private type of birth hospital were significantly related with enhanced risk of caesarean section, independently of multiple confounding factors. Conclu-sions: Our study revealed that caesarean section rates are continuously increase, while several maternal risk factors, including especially pre-pregnancy overweight/obesity and excess gestational weight gain, cumulatively raise its prevalence which further increase the risk for postnatal adverse outcomes for both the mothers and their children. Emergent public health policies and strategies should be promoted to confront the predominant maternal risk factors-related with caesarean sec-tion and inform future mothers how to be prevented from them by applying healthier nutritional and lifestyle habits and to select caesarean section only due to emergency medical reasons. Alarmingly enough, targeted nutritional intervention strategies are strongly recommended to ef-fectively reduce the prevalence of maternal pre-pregnancy overweight/obesity and the excess gestational weight gain, which in turn may minimize the risk of childhood overweight/obesity.

Background Dietary guidelines typically recommend limiting the intake of fresh red meat, yet evidence linking red meat consumption with adverse health outcomes is inconsistent. Objective To assess the level of evidence from existing systematic reviews and meta-analyses and analyze the association between high consumption of red meat and cancer risk and adverse health outcomes. Methods Eight databases were searched to collect systematic reviews and meta-analyses from database inception to December 2022. Two independent reviewers screened and extracted data and used the AMSTAR 2 tool to evaluate methodological quality of the included studies. Meta-analysis was conducted using STATA 17.0. Results A total of 18 studies were included, of which 5 were rated as high quality, 4 as medium quality, 6 as low quality, and 3 as extremely low quality. Of the 9 SRs/MAs included, primary studies with overlap were identified, and 14 studies were eventually included. The meta-analysis results showed that compared with the lowest intake of red meat, the highest intake of red meat was associated with an increased risk of colorectal cancer (OR 1.21, 95% CI 1.07-1.37), gastric cancer (OR 1.37, 95% CI 1.18-1.59), non-Hodgkin's lymphoma (OR 1.10.95% CI 1.02-1.19), stroke (RR 1.11, 95% CI 1.03-1.20), type 2 diabetes (RR 1.19 95% CI 1.04-1.37), and ischemic heart disease (RR 1.09, 95% CI 1.06-1.12), as well as a negative effect on total cholesterol (WMD 0.264, 95% CI 0.144-0.383), triglycerides (WMD -0.181, 95% CI -0.349 to -0.013), low-density lipoprotein (WMD 0.198, 95% CI 0.065-0.330), and high-density lipoprotein (WMD -0.065, 95% CI -0.109 to -0.020). However, the associations with breast cancer (RR 1.05 95% CI 1.00-1.11), glycemic control (WMD 0.040, 95% CI 0.049-0.129), and changes in body weight status [overweight (β 0.89, 95% CI 0.48-1.64); obesity (β 1.06, 95% CI 0.30-3.71)] were not significant. Conclusions This comprehensive umbrella review suggests that high consumption of red meat may increase the risk of colorectal cancer, gastric cancer, non-Hodgkin lymphoma, stroke, type 2 diabetes, and cardiovascular disease, and that reducing red meat intake is a key modifiable dietary factor for reducing risk. However, there was no significant correlation with breast cancer, kidney stones, age-related eye disease or changes in body weight.

We explored the trends and the diversity of the mortality and risk factors of age-standardized cardiovascular diseases (CVD) and cerebrovascular disease (CBD) from 2000 to 2020 in five advanced Asian countries, including China, Japan, Singapore, South Korea, and Taiwan. Data were obtained from the Global Burden of Disease (GBD) report. Overall, the CVD mortality rates decreased gradually in all five Asian countries. Singapore had the highest rates before 2011, but Taiwan replaced Singapore as the nation of the highest mortality rates after 2012. Additionally, South Korea had the highest CBD mortality rates before 2016, while Taiwan experienced a peak in 2011 and remained high thereafter. The absolute difference (AD) and relative difference (RD) for CVD mortality rates showed clear declining trends in all five countries, with South Korea and China displaying the highest reductions, respectively. It is noteworthy that overweight and obesity exhibited an increasing trend in all these five Asian countries, with China demonstrating the highest AD and RD. Except for Taiwan, where a negative association of r=-0.732 was observed, CVD mortality was positively associated with CBD, hypertension, and DM mortality in all other four countries, therefore, further investigation into these relationships are needed.

Aim: This study aimed to carrying out a prospective survey on socio-demographics and lifestyle factors among a population of Caribbean immigrants living in the US. Materials and Methods: The data were processed and analysed using the SPSS software and Excel. Crosstabulations were done. The Chi-square test was use to evaluate different hypotheses in this study. Statistical significance was defined as p<0.05.Results: Gender was found statistically significant difference with the country of birth of the Caribbean immigrants (p=0.038), and in the cleanness of their neighbourhoods (p=0.045). There were differences in occupations between males and females (p=0.001). Males were less unemployed than females (p=0.011). Gender also showed statistically significant difference in how easy the immigrants balanced their work and personal life (p=0.044). Age groups depicted differences in the physical health of the immigrants (p=0.001). The use of alcohol and tobacco was not an important risk factor among participants (p=0.529).Conclusions: These facts suggest that socio-demographics among a population of Caribbean immigrants were significantly different among genders. However the use of tobacco and alcohol showed not significant differences among the immigrants.

This study examines the psychological repercussions of the COVID-19 pandemic on a medical team in an Israeli general hospital. The research explores the professional quality of life, burnout symptoms, secondary traumatic stress, and mindfulness among team members across three distinct phases of the pandemic. Analysis was conducted for different subgroups based on job roles and seniority, allowing for an evaluation of the phase-specific effects on the ProQOL (Professional Quality of Life) and mindfulness. Results align with established crisis trajectories, encompassing honeymoon/heroic phases, inventory, disillusionment, and recovery. The findings demonstrate a negative correlation between compassion satisfaction and burnout, as well as between mindfulness and burnout/secondary traumatic stress. Remarkably, male doctors exhibit a more pronounced negative impact on mindfulness compared to their female counterparts, primarily comprising healthcare workers. Temporal analysis reveals significant differences in compassion satisfaction and mindfulness, with baseline measurements being notably higher. Furthermore, the study sheds light on the vulnerability of male doctors, emphasizing the crucial role of hospital management in conveying the message and implementing effective measures to support professional quality of life. These findings underscore the necessity of prioritizing the well-being of medical professionals, particularly male doctors who face unique challenges in seeking assistance.

Living with a chronic disease involves a variety of daily life limitations that severely affect people in their daily life. Identifying and promoting self-management strategies may improve health outcomes and increase patients’ autonomy. The purpose of the present study was to explore the perceived limitations and self-management strategies of elder patients suffering from chronic diseases. An inductive content analysis was applied, with a purposive sampling of 21 patients living with chronic conditions. Data was collected through semi-structured interviews. Two main-categories were emerged from content analysis, namely “Limitations of daily life” and “Disease Management”. Physical restrictions and negative feelings were referred to as daily burdens, while scheduling and self-care, supporting environment and technology were related to disease management. Information, training and provision of digital literacy may increase patients' self-efficacy in managing their chronic condition.

The objective of the current investigation is to identify the first or first draining node or sentinel lymph node (SLN) from the primary tumor mass in a regional lymphocenter. Four different indirect lymphography (IL) methods were employed in 96 canine patients with different types of cancer between 2018 and 2021. The IL technique involved intradermal, submucosal, and peritumoral injections of 2ml contrast agent in the four-quadrant principle which were divided into equal aliquots. Lymphatic mapping with lipiodol (iodized oil) was 100% in squamous cell carcinoma of the head and neck, anal sac apocrine gland adenocarcinoma, mast cell tumor, squamous cell carcinoma of the skin, mammary carcinoma, and with methylene blue dye, 100% detection was achieved in testicular tumor and mammary carcinoma. Instead of a very short washout time of 2 minutes, Iohexol showed an excellent detection in indirect CT lymphography for histiocytic sarcoma and in indirect radiographic lymphography for lymphosarcoma. The significance of contrast and blue dyes in detecting the lymphatic spread of canine cancers is clearly emphasized in the current investigation. The nature of cancerous tissue was again analyzed through image and machine learning approach in this work. Supervised machine learning technique is applied in this work for automatic classification of cancerous and non-cancerous regions. Various statistical and texture-based features are extracted from X-Ray images and support vector machine with linear, polynomial, multilayer perceptron (MLP), and RBF kernel functions are applied for classification. Highest 95.53%, 94.64%, 93.05% sensitivity, specificity, accuracy, respectively, is achieved using RBF kernel function.

Background and Objectives: Elders’ needs are rarely examined beforehand, and thus, although technology-based tools can enhance self-management, acceptability rates are still low. This study aimed to examine and compare self-reported needs, priorities, and preferences of elders with heart failure (HF), diabetes mellitus (DM), and chronic obstructive pulmonary disease (COPD) toward technology use to enhance self-management. Materials and Methods: A convenience sample of 473 participants over 60s (60.5% females), diagnosed with HF (N=156), DM (N=164), or COPD (N=153) was recruited. They were administered a questionnaire about the usefulness of technology in general and in specific areas of disease management. Results: Most participants (84.7%) admitted that technology is needed for better disease management. This was equally recognized across the three groups both for the overall and specific areas of disease management (in order of priority: ‘Information’, ‘Communication with Physicians &amp; Caregivers’, and ‘Quality of Life &amp; Wellbeing’). Sociodemographic differences were found. Cell phones and PCs were the devices of preference. The four common features prioritized by all three groups were related to ‘information about disease management’ (i.e., monitoring symptoms, reminders for medication intake, management and prevention of complications), whereas the fifth one was related to ‘communication with physicians and caregivers (i.e., in case of abnormal or critical signs). The top disease-specific feature was also monitoring systems (of respiratory rate or blood sugar or blood pressure, oxygen), whereas other disease-specific features followed (i.e., maintaining normal weight for HF patients, adjusting insulin dose for DM patients, and training on breathing exercises for COPD patients). Conclusions: Elders in these three samples seem receptive to technology in disease management. mHealth tools, incorporating both common and disease-specific features and addressing different chronic patients, and being personalized at the same time, could be cost-saving and useful adjuncts in routine clinical care to improve self-management.

Diagnostics is believed to drive about 70% of medical interventions, but this may not be true for all demographics. With more than 30% of the African population living in extreme poverty ($1.9 per day - 2022); and healthcare costs competing unfavorably against unbridled access to antibiotics and herbal concoctions, especially in Sub-Saharan Africa, how do you convince such a people to choose diagnostics first? More importantly, how do you design a medical device targeted at meeting the diagnostic needs of this demographic? In developing diagnostic devices for such a market, what is worth sacrificing? How dire is the need for advanced technologies in devices developed for such a demographic? These are questions that remain unaddressed by the technological breakthroughs and current research in medical device development, especially for infectious disease diagnostics. The objective of this paper is to underscore critical concerns which must be considered in the bid to successfully design medical diagnostic devices for Africa and perhaps, other limited-resource settings. It is also written as a suggestive guidance document for researchers whose interest is in the development of infectious disease diagnostic platforms for rural Africa and similar limited-resource environments.

Objective: The objective of this review was to establish a modified meta-ethnography framework by integrating the traditional phases with methods from social constructivist grounded theory. The modified version was required to identify methods which can ensure analytic generalisability and honour critical inquiry. Method: A narrative synthesis review was undertaken using 4 electronic databases. Articles were located that described the methods and methodologies of meta-ethnography and social constructivist grounded theory. A synthesis was undertaken which integrated the methods of social constructivist grounded theory. Results: The meta-ethnography was undertaken in 5 phases: (1) The positionality of the researcher and the area of interest identified. (2) Identifying what is relevant. (3) Reading the study and determining how studies are related. (4) The iterative process of idea generation required for theory generation. And (5) Expression of the theory, model, or process. Conclusion: The current study provides a useful tool to support the development of a substantive theory (a theory in one area) which can be used then to consider its application in other areas. This approach will help create new lines of research and aid the explanation of problems in other areas.

Objective: To quantitatively analyze the production of Doctoral Theses on health issues related to gender in Spain. Method: Quantitative synthesis of the productivity indicators of the Doctoral Theses de-fended in Spanish Universities between 1976 and 2022, obtained from the Spanish TESEO data-base. Descriptive analysis, materialized in tables and graphs, and time series model, based on the Holt-Winters model methodology. Results: 18.75% of the defended Doctoral Theses represents the scientific production of the Universities. Madrid is where the greatest number defend themselves with 37.5%. One in three authors are graduates in medicine. The theme of the Theses is gender violence in 25.0%, the authors are women in 87.5%, 44.0% of women direct theses. The scientific production of directors according to the H Index is very uneven, since one person has an index of 76 and another of 1. The temporal sequence of production is erratic, since in some years no Doctoral Theses are defended, but in 2017 were three. Conclusions: Spanish research in clinical Doctoral Theses on gender is scarce. It would be desirable to develop doctoral programs that promote the generation of theses in health that have gender differences in health care as their central point.

(1)Background:The purpose of the study was conducted to investigate the recovery of heart rate according to the performance level and rest interval conditions during 65%1RM bench press exercise;(2)Methods:The subjects of this study were eight healthy male college studentsin their 20 (years) attending University C. 1RM was measured before theexperiment, and the exercise sequence of six rest intervals (30sec, 1, 2, 3, 4,5min) was randomly selected and cross-distribution experiment. The experimental measurement was conducted a total of six times according to the rest interval condition (six conditions) once every 3 days to minimize the learning effect. The data was verified with repeated measures Two-way ANOVA and Contrast's repeated method was applied for post-comparison;(3)Results: First, the amount of exercise and the number of repetitions statistically substantially dropped (p&lt;.001) as the number of sets rose, and a greater decline was shown when the rest periods got shorter. Second, the heart rate after exercise was increased significantly (p&lt;.01) as the set progressed in the long rest interval conditions (4, 5min), and the heart rate after rest was increased statistically significantly (p&lt;,05) as the set progressed in the short rest interval conditions (30sec, 1min). Third, the heart rate recovery rate (%) was able to perform more repetitions than in the short rest interval condition due to the relatively high physiological recovery of the neuromuscular and circulatory system under the long rest interval condition;(4)Conclusions: Therefore, according to the rest conditionduring the 65%1RM bench press exercise conducted in this study, the restinterval condition of 2~3min may be effective in improving muscular endurance,and the rest interval condition of 4~5min may be effective in improving muscular hypertrophy. As a result of this study, there was a significant difference in exercise performance (repetition) and physiological recovery depending on the rest interval condition according to the set progress during the same intensity resistance exercise. Through this, it is judged that it is possible to adjust the amount of exercise appropriate for the purpose of training by adjusting not only the intensity during resistance exercise but also the rest interval between sets.

Diets that restrict the amount of carbohydrates positively affect markers related to metabolic syndrome (MS). However, completely carbohydrate-free diets have been studied in lesser extent, being their effect on biochemical and morphometric parameters in a rat model of MS the main objective of this study. MS was induced by a high-glucose diet for 20 weeks in male Wistar rats with a subsequent exposition to an essentially carbohydrate-free diet (CFD) for 20 weeks. Daily measurements of food consumption and monthly measurements of body weight were made. At week 40, glucose, insulin, lipid profile, ketone bodies, C-reactive protein (CRP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), urea, creatinine, liver and muscle glycogen, and serum, hepatic, renal and pancreatic malondialdehyde (MDA) were assessed. Exposition to CFD showed decrease in caloric intake and body weight. Likewise, the group showed normalization in liver and serum MDA parameters, insulin, lipid profile, ALT, liver glycogen, and creatinine. The CFD decreased glucose concentration and the inflammatory state, also, increased the concentration of ketone bodies and urea. The change towards CFD reverses the metabolic alterations generated with MS except for glycemia and uremia, probably due to the high rate of gluconeogenesis generated by the high protein content in the diet.

Heart transplantation is a treatment of choice for patients with severe heart failure. Infection transmission from a donor to a recipient remains a prominent problem in organ transplantation. However, the risk of SARS-CoV-2 transmission through nonlung organ transplantation is still unclear. In the article we present a case of a 28-year-old pregnant woman who developed heart failure soon after recovery from SARS-CoV-2 infection in the third trimester of gestation. In the postpartum period the disease worsened and the patient required cardiac transplantation. We examined the recipient's heart and diagnosed left ventricular noncompaction cardiomyopathy. Immunohistochemical analysis showed the SARS-CoV-2 antigen expression in the donor’s heart before transplantation and after the surgery the endomyocardial biopsy was taken. Moreover, an ultrastructural assessment of the endomyocardial specimen revealed endothelial and pericyte injury and single particles on the surface of endothelium consistent with SARS-CoV-2. Recent findings were associated these damages with SARS-CoV-2 infection. The present study describes the rare case of SARS-CoV-2 transmission from donor to recipient through a heart transplant and resulting in endothelial cell and pericyte activation and humoral immune response activation.

Oral health involves physiological functions related to mouth, teeth and orofacial structures, but also includes psychological and social dimensions. In this sense, oral health is an integrated part of human general health and well-being. Our aim was to access and evaluate the general oral health status of a high- and elite-level sample of Portuguese athletes from different sports. One hundred and sixteen participants were examined regarding their dental relationships, teeth and periodontal health, the presence of parafunctional activities (bruxism), and current or past orthodontic treatment. Our sample were predominantly adolescents and young adults, including 54 high-level and 62 elite subjects (71 males and 45 males) from 11 different sports, but mainly from swimming and athletics. Most sport performers presented with normocclusion (77%), despite the presence of other sagittal, transverse and vertical malocclusions. Twenty-three participants were affected by dental caries and six had missing teeth. Gingivitis (~40%) and dental calculus (~30%) were presented in our sample. Bruxism signs (47%) and current or past orthodontic treatment (~22%) were also found. Oral health conditions are not under control among high- and elite-level athletes, supporting the importance of healthcare needs and oral health promotion strategies in sports.

Background: Studies addressing diet quality and mental health have shown a strong association. There is limited evidence of specific vitamins essential for treating depression. This study aims to understand the impact of diet quality through supplementation of vitamins D, B6, and magnesium on depressive symptoms. Methods: Multiple datasets from the National Health and Nutrition Examination Survey 2017-March 2020 investigated the associations between vitamin D, B6, and magnesium on depression symptoms. A cross-sectional sample of adults over 20 was extracted (n=9,232). Chi-square tests and logistic regression analyses were used to investigate the associations. Results: Individuals with low doses of vitamin D were more likely to report symptoms of depression relative to those with low doses of vitamin B6 (χ²=3.9063, p=0.0481 vs. χ²=5.2071, p=0.0225). These results remained significant among those with high magnesium proportionate to high vitamin B6 (χ²=6.1272, p=0.0133 vs. χ²=5.2071, p=0.0225). Logistic regression results provided associations for all models except unadjusted vitamin D and adjusted vitamin D. Conclusions: Preventive measures could be addressed by identifying the risks of vitamin deficiencies. Further epidemiological research is needed for the individual effects of vitamin supplementation and depression symptoms.

In neuroendocrine neoplasms (NENs), the use of new radiopharmaceuticals has improved the accuracy of diagnosis and staging, refined surveillance approaches, and introduced specific and personalized radiation therapies. Nuclear medicine has therefore acquired a crucial role in the management of NENs patients by improving their risk stratification and personalized therapies. Artificial intelligence (AI) and radiomics can enable physicians to further improve the overall efficiency and accuracy of the use of these tools in both di-agnostic and therapeutic settings by improving the prediction of tumor grade, differential diagnosis from other malignancies, assessment of tumor behavior and aggressiveness, and prediction of treatment response. This systematic review aims to describe the state-of-the-art on AI and radiomics applications in molecular imaging of NENs.

The study examines malnutrition's triple burden, including anaemia, overweight, and stunting, among children aged 6-59 months. Using data from the National Family Health Survey-5 (2019-21), the study identifies risk factors and assesses the contribution at different levels to existing malnutrition burden. A random intercept multilevel logistic regression model and spatial analysis are employed to identify child, maternal, and household level risk factors for stunting, overweight, and anaemia. The study finds that 34% of children were stunted, 4% overweight, and 66% anaemic. Stunting and anaemia prevalence were higher in central and eastern regions, while overweight was more prevalent in the north-eastern and northern regions. At macro-level, the coexistence of stunting, overweight, and anaemia circumstantiates the triple burden of childhood malnutrition with substantial spatial variation (Moran’s I: stunting-0.53, overweight-0.41 and anaemia-0.53). Multilevel analysis reveals that child, maternal, and household variables play a substantial role in determining malnutrition burden in India. The nutritional health is significantly influenced by a wide range of determinants, necessitating multilevel treatments targeting households to address this diverse group of coexisting factors. Given the intra-country spatial heterogeneity, the treatment also needs to be tailor-made for various disaggregated levels.

To understand the mechanisms involved in the anti-obesity effects Centella asi-atica (CA), we examined body weight, serum levels, white adipose tissue (WAT) weight, histological analysis, and the expression of cholesterol homeostasis- and lipid metabolism-related genes in mice with high-fat, high-sugar diet (HFHSD)-induced obesity that were orally treated with CA for 12 weeks. Eight-week-old, male C57BL/6J mice were assigned to the following four groups (eight mice/group): NOR, normal diet; Control, HFHSD; CA-L, HFHSD+CA 300 mg/kg; CA-H, HFHSD+CA 600 mg/kg. CA treatment signifi-cantly attenuated HFHSD-induced increase in body weight gain, serum glucose, serum triacylglycerol, and WAT weight (p < 0.05). Compared to that in Control group, adipocyte diameter and macrovesicular area of epididymal WAT signif-icantly decreased with CA treatment (p < 0.05). The mRNA expression levels of peroxisome proliferator-activated receptor gamma (PPARγ), fatty acid synthase (FAS), cluster of differentiation 36 (CD36), 3- hydroxyl-3-methylglutaryl CoA reductase (HMGCR), and stearoyl CoA desaturase 1 (SCD 1) were significantly downregulated in the CA-H group compared to the Control group (p < 0.05). CA exerts anti-obesity effects by lowering body fat accumulation via regulat-ing gene expression in the liver and thus, is a potential lipid-lowering agent.

Objective. The primary aim of this 6-month randomized, controlled, blinded clinical pilot study was to compare the percent root coverage obtained using an acellular dermal matrix allograft (ADM) and a coronally positioned tunnel (CPT) technique with two different suturing techniques. Materials and Methods. Sixteen patients with at least one Miller Class I or II recession defect ≥ 3 mm were randomly selected to receive a CPT with ADM using either two independent continuous sling sutures to secure the graft and the soft tissue separately (SEP) or a single continuous sling suture to secure both the graft and the soft tissue together (TOG) in the test group. Percent defect coverage, predictability of achieving 100% root coverage, keratinized tissue width, and attachment levels were assessed. Results. Both TOG and SEP suturing techniques achieved a significant amount of defect coverage, 83 vs. 85%, respectively, with no significant differences between groups. The predictability of achieving complete defect coverage was 63% for both groups. All maxillary sites had 100% coverage. There was a statistically significant gain of keratinized tissue for the TOG (1.1 ± 0.9 mm), while the SEP group gained only minimal amount (0.2 ± 0.8 mm). Conclusions. The single sling, for simultaneous suturing of the soft tissue and acellular dermal matrix, worked as well as two sling sutures used separately for the soft tissue and ADM. Suturing time was reduced by about 50% for the single sling group indicating a significant clinical advantage for the patient and surgeon.

Background: Human Papillomavirus causes various types of cancer in both men and women. Woman with HPV infection has a risk of developing invasive cervical cancer. Globally, HPV 16 and 18 were predominant. This study aims to find the distribution of various HPV types in South Andaman. Methods: A cross sectional study conducted among woman in South Andaman where cervical scrapes were collected after the collecting the written informed consent. Detection of HPV genotypes was carried out by using PCR assay. Further, sequencing analysis was performed using MEGA11 to identify various genotypes in this territory. Result: Of these 1000 samples, 32 were positive for HR-HPV16 and 4 were positive for HR-HPV18. Fifteen HPV genotypes were detected using molecular evolutionary analysis. Six cases were identified with multiple genotypes. Most prevalent genotype is HPV16 which belonged to Lineage-A and sub-lineage A2. HPV18 identified in South Andaman belonged to the lineage A1 to A5. Discussion: Various HPV types were identified among women in South Andaman. Global burden of cervical cancer associated with various HPV sub-lineages. HPV-16 A1 sub-lineage was globally widespread whereas sub-lineages A1, A2 and D1 was prevailing in South Andaman. Conclusion: High risk HPV identified in this study enlightening the importance of HPV vaccination among the woman in remote places. These findings will help to strengthen public health awareness programs and prevention strategies for the women in remote areas.

Dementia is a rising public health concern. Feeding and nutritional problems increase as the disease progresses, affecting clinical course and caregiver burden. While some guidelines advise against percutaneous endoscopic gastrostomy (PEG) and tube feeding in advanced dementia, conflicting evidence exists. This study aims evaluating nutritional status and the influence of PEG-feeding on outcome and evolution of nutritional/progonosis markers of patients with severe dementia (PWSD) who underwent gastrostomy for nutritional support. We conducted a 16-year rectrospective study on 100 PEG-fed PWSD with strong familiar support. We evaluated survival PEG-feeding period, safety, and objective nutritional/progonosis data at the gastrostomy day and after 3 months: Body Mass Index (BMI), Mid Upper Arm Circumference, Tricipital Skinfold, Mid-Arm Muscle Circumference, albumin, transferrin, total cholesterol and hemoglobin. Most patients presented low values in these nutritional/progonosis parameters. No major life-threatening PEG complications were reported. The mean survival time after gastrostomy was 27.9 months (median of 17 months). Female sex, BMI recovery at 3 months, and higher baseline hemoglobin levels were associated with a reduced risk of death and increased survival time. The study concluded that, in carefully selected PWSD with strong familiar support, PEG feeding can improve nutritional status and have a positive impact on survival.

Radiomics involves the extraction of information from medical images not visible to the human eye. There is evidence these features can be used for treatment stratification and outcome prediction. However, there is much discussion about the reproducibility of results between different studies. This paper studies the reproducibility of CT texture features used in radiomics, comparing two feature extraction implementations namely Matlab toolkit and Pyradiomics when applied on independent datasets of CT scans of patients i) the open access RIDER dataset containing a set of repeat CT scans taken 15 minutes apart for 31 patients (RIDER Scan 1 and Scan 2 respectively) treated for lung cancer and ii) the open access HN1 dataset containing 137 patients treated for head and neck cancer. Gross tumor volume (GTV) manually outlined by an experienced observer available on both datasets was used. 43 common radiomics features available on Matlab and Pyradiomics were calculated using 2 intensity-level quantization methods with and without an intensity threshold. Cases were ranked for each feature for all combinations of quantization parameters and the Spearman’s rank coefficient, rs, calculated. Reproducibility was defined when a highly correlated feature in the RIDER dataset also correlated highly in the HN1 dataset and vice versa. 29 out of 43 reported stable features were found to be highly reproducible between Matlab and Pyradiomics implementations, having consistently high correlation in rank ordering for RIDER Scan 1 and RIDER Scan 2 (rs &gt; 0.8). 18/43 reported features were common in RIDER and HN1 datasets, suggesting they may be agnostic to disease site. Useful radiomics features should be selected based on reproducibility. This study identified a set of features that meet this requirement and validated the methodology for evaluating reproducibility between datasets.

Background: Trigeminal neuralgia associated to vascular compression, by aberrant or ectopic arterial or venous vessels, is a frequent condition in clinical practice. Management with microvascular decompression through a Minimal invasive retrosigmoidal has shown high rates of pain control, with low complication rates and excellent therapeutic results. Objective: To describe the surgical technique and clinical outcomes in terms of pain relief after microvascular decompression for trigeminal nerve, through a minimal invasive retrosigmoidal parasterional burr-hole technique. Methods: A group of patients with trigeminal neuralgia refractory to medical management who underwent microvascular decompression considering outcomes based on Visual Analogue Scale (VAS), and Barrow Neurological Institute Pain Scale (BNIPS). Added to a technical note of the surgical technique for a minimal invasive retrosigmoidal parasterional burr-hole. Results: Twenty-two patients were evaluated, clinical assessment after surgical intervention showed a decrease pain according to VAS, resulting from an average preoperative state of 9.5 ± 0.37 to a postoperative condition of 1.32 ± 1.28, exhibiting statistically significant changes (p < 0.0001, d = 9.356). On the other hand, in relation to the BNIPS scale, a decrease from an average preoperative status of 4.55 ± 0.25, to a postoperative status at 12 months of 1.73 ± 0.54 was also demonstrated, showing significant changes (p < 0.0001, d = 3.960). Conclusion: Microvascular decompression of the trigeminal nerve through a minimal invasive retrosigmoidal parasterional burr-hole is feasible and can be a safe and effective technique for the management of pain.

Background: Portable oxygen concentrators (POCs) have shown efficacy in delivering adequate oxygen for various patient scenarios; however, there is a lack of research on POCs’ efficacy across different respiratory rates specifically among COPD patients. Methods: This bench study was conducted using the IngMar Medical Active Servo Lung 5000 attached to flexible tubing, which simulated an adult patient’s nares. An oxygen analyzer (Maxtec Handi+) was connected to the tubing 6 inches below the nares to estimate the inspired oxygen concentration at the adult trachea. A standard nasal cannula was placed in the simulated patient nares, which was also attached to each POC. The IngMar Lung was programmed to simulate a COPD patient at the following respiratory rates: 15, 20, 30, and 40 breaths/min. POC devices were then compared to an oxygen wall outlet and a standard oxygen concentrator (non-portable CAIRE device). The POCs included the CAIRE FreeStyle Comfort (with Autosat), CAIRE FreeStyle Comfort (without Autosat), Inogen G4, Inogen G5, Phillips SimplyGo Mini, GCE Zen-O lite, Drive Medical iGo2, and Kingon POCs. Descriptive statistics and ANOVAs were computed to determine statistically significant differences between POCS and control devices (wall oxygen and standalone oxygen concentrator). Results: Across most respiratory rate scenarios, the wall oxygen and standalone oxygen concentrator (control group) resulted higher oxygen measurements compared to the POCs. Among the POCs on setting 2, the highest oxygen measurement for 15, 30, and 40 breaths/min was the CAIRE FreeStyle Comfort with AutoSat on sensitivity 5 (24.43%, 24.81%, and 25.0%, respectively). On setting 2, the 20 breaths/min highest oxygen measurement was the Inogen G4 (24.43%). For setting 5, the highest oxygen measurement for 15 breaths/min and 40 breaths/min was the CAIRE FreeStyle Comfort without AutoSat (31.56% and 26.13%, respectively), while the highest oxygen measurement for 20 breaths/min was the Inogen G5 (30.26%), and the highest oxygen measurement for 30 breaths/min was the CAIRE FreeStyle Comfort with AutoSat on sensitivity level 5 (27.89%). Conclusions: The oxygen administered through the wall and the standalone CAIRE oxygen concentrator all delivered higher oxygen levels compared to the POCs (with the exception of the 40 breaths/min scenario on setting 2). However, among the POCs, the CAIRE Freestyle Comfort with AutoSat, CAIRE Freestyle Comfort without AutoSat, and the Inogen G4 all performed the best among the various breathing rate scenarios.

Background. Psoriasis (PS) is a common immune-mediated disease of the skin with pos-sible extension to joints, aorta and eye. Myocardial inflammation has been rarely sug-gested. Aims: Report of PS-related myocarditis Methods and Results: One hundred consecutive patients with PS were screened for car-diac involvement. Among them, five male patients (aged 56 ± 9.5 years) with moder-ate-severe form showed a dilated cardiomyopathy (LVEF <35%) with normal coronary ar-teries and valves. They underwent a left ventricular endomyocardial biopsy for evaluation of myocardial substrate. Endomyocardial samples were processed for histology and im-munohistochemistry, including myocardial expression of Toll-Like Receptor 4 (TLR4) and interleukin-17A (IL-17A), which plays a major role in psoriasis pathogenesis; real-time PCR for cardiotropic viruses and Western blot analysis for myocardial expression of IL-17A. Patients’ sera were tested for anti-heart autoantibodies.An active lymphocytic myocarditis was revealed in all 5 patients, characterized by absence of viral genomes at PCR, positive anti-heart autoantibodies, overexpression of TLR-4 and enhancement of IL-17-A at western blot analysis showing a 2,48-fold increase in psoriatic myocarditis compared with no psoriatic myocarditis and a 6-fold increase compared to myocardial controls. Treatment included combination of prednisone (1 mg/Kg daily for 4 weeks, ta-pered to 0.33 mg/Kg) + azathioprine (2 mg/Kg, daily) in 3 pts or secukinumab (SK, 100 mg/monthly) in 2 pts for 6 months. LVEDD and LVEF improved in the first 3 pts (-14% and + 118%, respectively) while completely recovered (LVEF> 50%) in the last 2 pts on SK. Conclusion. IL-17A-related myocarditis can occur in up-to 5% of patients with psoriasis. It manifests as a progressive dilated cardiomyopathy. It may completely recover following SK administration.

The years 2019 to 2022 are being marked by the pandemic resulting from a viral infection, COVID-19. The demand and use of PPE has never been so high and it is often discarded without considering the correct disposal route and the environmental impact that this type and volume of waste can generate. The aim of this study was to analyze the increased demand for PPE used during the pandemic and, consequently, the generation of these wastes. In addition to this analysis, it is extremely important to raise the discussion about the treatment of these residues and the possibilities of more ecological personal protection equipment, such as biodegradable or reusable ones. The extensive use of PPE, which is mostly plastics and is not easily degraded, mainly leads to its accumulation in landfills but, if disposed of incorrectly, it could reach marine environments, contributing to the formation of microplastics in the oceans. Therefore, this article also aims to relate these themes to the Sustainable Development Goals, as efficient management aligned with sustainable development goals is essential to mitigate these anticipated problems and ensure a more sustainable future.

The upper limb force-velocity relationship (FVR) is a crucial aspect of athletic performance, par-ticularly in para sports where upper limb movements play a leading role in activities such as wheelchair propulsion. Athletes’ mechanical capacities can be evaluated on the field or in lab conditions. However, no studies have indicated a relationship between ergometers and field FVR or performances. Understanding para-athletes’ upper limb FVR can provide important insights for developing effective training programs and improving athletic performance in wheelchair bas-ketball players. Twenty-three wheelchair basketball players (12 women and 11 men) from French national teams performed a battery of three tests consisting of a 20 m sprint (SP) with Inertial measurement units (IMU) on wheels, a horizontal upper limb push-offs on a frictionless sled with two Kistler force plates (HBP), and a crank ergometer sprints test (CES) derived from arm er-gometer sprints using Brachumera, Lode. For the SP test, the FVR was computed with an estimation of force from the acceleration, the rolling resistance, and an estimation of the air resistance. Correlations between each variable measured were computed via Pearson correlations in R, as-suming strong relationships for r=0.7-1.0, moderate when r=0.40-0.69, and weak relationship when r<0.1-0.39. Significant differences were assumed when p<0.05. Strong correlations were found between the results of three tests conducted. The correlation coefficient between maximal theo-retical force (F0) data ranged from 0.85 to 0.88 and that between maximal theoretical power (P0) data ranged from 0.87 to 0.94. However, for maximal theoretical velocity (V0) data, the correlations between the three tests were less important. The performance variables showed a strong corre-lation with power measured on the HBP test without load. There is a significant relationship between HBP, CES, and SP variables. There is a correlation between performances on the three tests in our population, especially for the power. However, the V0 value of HBP was not representative of any performances. This work can show multiple protocols to assess para-athletes’ performances and show that upper limb symmetry depends on the gesture of the task and personal sports’ wheelchairs.

Vaccine hesitancy remains a public health challenge. It has been argued that the sources of vaccine-related information may serve as important condiments to one’s decision to be vaccinated. However, little empirical attention is given to the subject. We contribute to this debate by assessing the level of COVID-19 vaccine hesitancy and the role of information explaining hesitancy, using the Nelson Mandela Bay Municipality of South Africa as a case study. Findings confirm high level of vaccine hesitancy, representing 78.8 percent of the respondents (which is above the national level of 41%). Furthermore, findings reveal that vaccination decisions are influenced by family, which is the most trusted among all institutions in the society, especially on sensitive matters and those shrouded by myths and misinformation. Additionally, the majority trusts health care workers and mass media as sources of health-related and general information; however, the use of popular personalities to convey health information is not supported. The findings reveal key socio-demographic and institutional drivers of COVD-9 vaccine hesitancy, such as age, inadequate information on the vaccine, trust issues, conspiracy beliefs, vaccine-related factors, and perceived side effects associated with the vaccine. Recommendations based on the findings are provided.

Background: Demographic aging is a reality in developed countries, which poses a social challenge of great responsibility. Thus, numerous studies have been developed in an attempt to understand which factors best predict healthy aging. The aim of this study was to investigate and systematize literature on intervention programs that simultaneously include cognitive stimulation and physical activity, understand the importance of the use of new technology in these programs, and understand their impact on cognitive function in older adults, giving indications about their contribution to healthy aging. Methods: A narrative approach was used for extraction and synthesis of the data. Relevant studies were identified from electronic databases such as PubMed, Scopus, Web of Science and Academic Search Complete. Results: Thirty-two articles, involving 2815 participants, were identified. All selected studies were randomized controlled studies. The studies were published between 2011 and 2020. All studies included a combination of cognitive and physical interventions. Many of the studies used technology to administer the cognitive stimulation program. Conclusions: Most of the analyzed studies use new technologies in physical and cognitive interventions, demonstrating that this new form of intervention exerts lasting and stable benefits in cognition.

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection, with septic cardiomyopathy being a common and severe complication. Despite its significant clinical impact, the molecular mechanisms underlying sepsis-induced cardiomyopathy (SICM) remain incompletely understood. In this study, we performed a comparative analysis of whole transcriptome profiles in two widely used mouse models of septic cardiomyopathy, the cecal ligation and puncture (CLP) model and the lipopolysaccharide (LPS) model. Our aim was to identify key genes and pathways involved in the development of septic cardiomyopathy and to evaluate the similarities and differences between the two models. Our findings suggested that 1) both methods can induce septic heart dysfunction within 24 hours; 2) distinct whole transcriptome expression profiles are revealed; 3) potentially different pathways are involved in causing heart failure in sepsis. The comprehensive comparison provides valuable insights into the molecular basis of septic cardiomyopathy and contributes to the ongoing search for effective treatment strategies, triggered by different factors for SICM.

Objective: To carry out a bibliometric analysis study of systematic reviews and meta-analyses in dentistry, divided into different thematic areas. Material and method: A search was conducted in the Science Citation Index-Expanded on the core collection of Web of Science, they were selected from the area of Dentistry and Oral Surgery and Medicine categories, the data was downloaded on April 20, 2022 and The 100 most cited articles from each of the thematic areas were selected. Results: An increase in this type of articles was observed in the last decade in the areas of pediatric and medical dentistry and oral pathology. The thematic area that received the most citations was periodontics. The two authors with the most citations are Zwahlen, Marcel and Pjetursson, Bjarni Eluar. The countries that receive the most citations are European, along with the USA and China. The topics that are most published in this type of article deal with Cancer with 50 publications, caries treatment with 25 and fluoridation with 1. The entities that finance this type of articles the most are private companies (26.76%). Conclusions: Together with an exponential increase in the number of publications in dentistry, there has been an increase in the number of publications in systematic reviews. The areas publishing the most articles and having the most citations are Periodontics and Implantology, despite the fact that the most studied topic is cancer.

Frontal incomes play an important role in human behavioral regulation and can be a determinant of eating behavior. The aim of this study was to analyse the frontal incomes in obese patients with and without Binge Eating Disorder (BED), compared to normoweight (NW) subjects and to analyse the effect of sex and binge disorder on quality of life, with age and BMI as covariates. A total of 114 participants comprised three different groups (obese with BED, obese without BED and NW) completed the Frontal Assessment Battery (FAB) and Impact of Weight on Quality of Life (IWQOL-lite). The results showed that obese patients, with and without BED, have poorer frontal functioning than NW persons. Obese patients with BED have lower performance in frontal income than obese patients without BED. Male participants have a higher perception of quality of life in all dimensions, with women showing lower values in self-esteem and sex life. Obese with BED show greater weaknesses in physical function. These results suggest that low frontal incomes and worse quality of life characterize obese patients, more evident in obese patients with BED.

A cross-sectional study was applied to investigate the influence of food systems and food environments on food choices and nutrition transition of households in Limpopo province, South Africa. A sample of 429 households were systematically selected using a paper selection draw from three districts. Food systems, food environments, food choices, and nutritional measurements of the households and informants were assessed, using a validated questionnaire. Most of the household informants responsible for food procurement were females (80.4%). There was a significant association (p < 0.001) between proximity to food stores and dietary diversity of the households. Staple foods were available in almost all surveyed households (95.6%). More than half of the households (59.8%) had home gardens in their yards. Almost half of the households (48.4%) had a low Dietary Diversity Score. The study revealed that 46.0% of households were food secure. Over a third (36.2%) of households’ informants were obese and 32.5% were diabetic. The mean total blood cholesterol was 3.69 ± 0.74 mmol/L. A high percentage of both females (89.6%) and males (91.5%) had normal haemoglobin levels. Most of the informants had normal systolic blood pressure levels (63%), with just over half who had high diastolic levels (57%). The 25 coping strategies were applied during food shortages periods. Even though the food environments provided both obesogenic and protective foods, the consumption of unhealthy foods was high.