One of the greatest COVID-19 related challenges for children and their families was managing distance learning due to school closures. We also know from previous research that families with a child with a neurodevelopmental disorder such as ADHD or ASD were struggling more than others, but also experiences some positive effects. However, few qualitative studies have been conducted. The present study therefore aimed to investigate parental experiences of negative and positive effects of distance learning during the COVID-19 pandemic in a large sample of families with an adolescent with ADHD and/or ASD and a matched comparison group (n = 682). Data was collected through open-ended questions as part of a larger survey study. Five main themes, with different sub-themes were identified for both negative and positive effects: 1) Teaching, 2) Social, 3) Support, 4) Child factors, and 5) Home environment. In addiction, the main themes “Technical problems” were identified for negative effects. Families with a child with ADHD/ASD reported negative effects related to “Child factors” and “Support” more frequently than the controls, as well as negative effects related to some aspects of “Teaching” and “Technical problems”. Regarding positive effects, significant group differences were primarily found for the theme “Child factors”. These findings are discussed botn in terms of how to best prepare for possible future pandemics, but also how to best provide educational support for children with ADHD and/or ASD when schools are open.

Inflammation is a vital aspect of the body's immune response, appearing either as an acute reaction that swiftly develops (e.g., after injury or during an infection) or as a chronic condition that persists over a prolonged period, often linked with autoimmune disorders or cancer. This study introduces potential TNF-alpha inhibitors investigated by Molecular Docking investigation. They are Dactolisib with a binding energy of -10.1 kcal/mol, Nilotinib with -9.6 kcal/mol, Eltrombopag with -9.7 kcal/mol, Radotinib with -9.6 kcal/mol, and Nilotinib again with -9.7 kcal/mol. Additionally, Hypericin exhibited a notable binding energy of -9.9 kcal/mol, suggesting its potential as a natural TNF-alpha inhibitor. While these computational results are preliminary, they provide a foundation for further biological studies to confirm their efficacy. The significance of these findings extends to the scientific community, offering potential applications in the field of inflammatory diseases.

In 2021, the American Association of Colleges of Nursing (AACN) added “the impact of climate change on environmental and population health” into The Essentials: Core Competencies for Professional Nursing Education. Presently, little guidance exists for nursing faculty new to climate education. The year prior, the Nurses Climate Challenge (NCC) - a campaign to educate 50,000 health professionals about health impacts of climate change - launched the School of Nursing Commitment through a series of focus groups and collaborative content development. With an aim of increasing access to knowledge and tools to support education about the health impacts of climate change, the NCC Commitment partners with nursing schools and provides a community of practice. Partner schools use NCC resources in courses and report the number of students educated. Within three years, 61 nursing schools in 30 states joined the Commitment. Participants included academic health centers, research institutions, multi-state schools, and small private colleges, and programs ranged from AD to PhD. Faculty 1) integrated resources into didactic and clinical settings such as population or organ-system content, leadership, and policy and 2) used resources to support assignments. In four years, faculty reported educating over 37,700 students using NCC resources in 439 educational sessions. The Commitment may be valuable for faculty fulfilling AACN Essentials by bringing climate change to the classroom, community, and bedside. Furthermore, the Commitment may be a replicable model for health professional education and inspiring action on climate change.

Background: MicroRNAs are short non-coding RNAs that have an essential role in controlling gene expression at the post-transcriptional level. Additionally, they can serve as biomarkers in the management of obesity. Circulating levels of miRNAs have been shown to fluctuate with exercise, exhibiting a variety of physiological and biological consequences on the biological systems, including structural and functional changes. Aim: The purpose of this study is to evaluate the profile of Ci-miRNAs 423-5p and 128-1 in young obese adolescents before and after aerobic exercise, as well as to analyse the relationship between those microRNAs and obesity-related parameters in response to aerobic exercise training. Methods: A total of 64 adolescent individuals (32 obese & 32 healthy individuals) were enrolled in the study to participate in 6-month aerobic exercise program. Anthropometric measurements, biochemical parameters and blood samples were collected from all the participants prior to exercise training and after 6-month exercise program. Gene expression analysis of the study participants was performed using quantitative real-time PCR. Results: Expression levels of circulating microRNAs 423-5p(p<0.01) & 128-1(p<0.01) were significantly differed before and after exercise in study population. Circulating miRNA 423-5p increased and correlated significantly with BMI while Circulating miRNA 128-1 decreased and correlated significantly with BMI after 6-month aerobic exercise program. Logistic regression statistics proves that the elevation in the expression of miRNAs genes has a strong significant association with elevation of the cytokines IL-6 & TNF-α (p<0.05). Conclusion: Obesity leads to alterations in Ci-miRNA 423-5p & Ci-miRNA 128-1 expressions and significant alterations associated with the aerobic exercise program shows that these miRNAs can be used as diagnostic and target predictive biomarkers in obesity.

New digital interventions have shown potential in managing asthma and improving patients' quality of life compared with conventional interventions. Our objective was to conduct an exhaustive survey of the application of digital health technologies in evaluating, treating, and self-managing psychological and psychopathological elements linked to asthma. We analyzed a compendium of research papers and systematic reviews pertaining to asthma, encompassing themes such as outdoor air pollution, early life wheezing disorders, atopic dermatitis, digital strategies for asthma self-management, psychiatric conditions and asthma, familial impacts on pediatric asthma, and the utilization of mobile health apps for managing asthma. We scrutinized eight chosen studies to evaluate the capacity of digital health technologies to enhance the man-agement and treatment outcomes of psychological factors related to asthma. The studies under review indicate that eHealth interventions, mixed reality instruments, mHealth technolo-gy-augmented nurse-led interventions, and smartphone apps incorporating Bluetooth-enabled sensors for asthma inhalers can markedly enhance self-management of symptoms, quality of life, and mental health outcomes, particularly in children and adolescents with asthma. Nonetheless, additional research is required to ascertain their efficacy and practicability across diverse populations and environments. Customized interventions that cater to the unique needs and preferences of asthma patients and associated psychological elements are vital to ensure the persistent and equitable adoption of these technologies. We underscore the significance of addressing psychological elements in the management and treatment of asthma and advocate for ongoing research and development in this domain.

This study focused on the investigation of myeloperoxidase through a Molecular Docking approach with various natural compounds to identify potential substances for cardiovascular research. Recent research has linked elevated myeloperoxidase levels to the severity of coronary artery disease. The results of the docking analysis revealed Polydatin, Daidzin, Astringin, Ginkgetin, and Amentoflavone as promising compounds with excellent binding capacity. To complement this, toxicity prediction studies were conducted using pkCSM. Overall, all four investigated molecules (Amentoflavone, Daidzin, Ginkgetin, and Astringin) were found to be non-toxic, exhibiting high maximum tolerated doses (human) and favorable values for Oral Rat Acute Toxicity and Oral Rat Chronic Toxicity. Moreover, they showed non-AMES toxicity and non-hepatotoxicity. Astringin, in particular, stood out with the highest positive effects, including a high maximum tolerated dose (human) and favorable values for Oral Rat Chronic Toxicity, along with dual inhibition of hERG II and hERG I. These findings suggest the potential utility of these compounds in cardiovascular research with minimized unwanted effects.

The aim of the study was to identify factors associated with non-adherence to tuberculosis (TB) preventive treatment among contacts with latent TB infection of new cases of pulmonary TB cases reported in Catalonia in 2019-2021. All contacts aged 18 years or older with a latent TB infection who received a TB preventive treatment were included in the study. The Chi square test and the odds ratios (OR) were used to assess the association between non-adherence to TB preventive treatment and the study variables, considering a p < 0.05 as statistically significant. Multiple logistic regression analysis was used to detect the in-dependent factors associated with TB preventive treatment non-adherence, considering a p < 0.05 as statistically significant. The percentage of non-adherence to TB preventive treatment found in this study was 23.7%. A multivariable logistic regression analysis determined that the following factors were significantly associated with TB preventive treatment non-adherence among adult contacts: “exposure at school or workplace” (aOR = 3.34), “exposure to an index case without laboratory confirmation of TB” (aOR = 2.07), “immigrant contact” (aOR = 1.81), “male gender” (aOR = 1.75) and “exposure duration <6 hours per week or sporadic exposure” (aOR = 1.60). By contrast, the factor “short-term TB preventive treatment regimen” (aOR = 0.38) was significantly associated with a lower treatment non-adherence. Adherence to TB preventive treatment should be improved among adult contacts of TB pulmonary cases with latent TB infection by recommending short-term treatment regimens and by developing health education activities, with a greater focus on contacts with factors associated with treatment non-adherence.

Microplastics are small plastic pieces with sizes less than 5 mm. They are becoming a global concern due to the potential risk to human health. The potential risks of microplastics may be greater for infants because they do not have sufficiently developed metabolizing enzymes, have a lower ability to remove them, high sensitivity of target organs. Infants should be breastfed for the first six months of life. Breast milk is considered to be the most complete and suitable source of nutrition. However, if breastfeeding during this period is not possible, it is necessary to use formulas designed for infant initial feeding. Infants may be exposed to higher levels of MPs through infant foods or plastics products. The aim of this study is to describe the possible sources of exposure to microplastics such as human placenta, plastic feeding bottles, toys as well as the presence of released microplastics in infants feces, breast milk and infant formulas. There is still not enough data available from the studied area. Therefore, it is necessary to pay increased attention to minimizing the negative effects of microplastics on human health.

: Suicide is a serious public health problem, with a global mortality rate of 1.4% of all deaths worldwide, and the leading cause of unnatural death in Spain. The use of clinical simulation has proven to be a beneficial tool in the training of nursing students. Such experiences allow them to develop cognitive and affective skills that are fundamental for the detection of warning signs and use of interventions in cases of people who want to take their own lives. Working in a mental health environment can be difficult for nursing students; therefore, the purpose of this study was to explore the perceptions of nursing students on the approach, management and intervention of suicidal crisis through clinical mental health simulation. Methods: qualitative descriptive phenomenological study through focus groups and reflective narratives in a sample of 45 students. A thematic analysis was performed using ATLAS-ti. Results: After the analysis, three themes were obtained: (a) management and handling of emotions (b) identification of suicide motives (c) intervention in suicidal crisis. Discussion: Clinical simulation in mental health allows students to exercise clinical judgment reasoning, detect warning signs for a better treatment approach, and provide tools for effective intervention and management of patient care. The results of this study indicate that nursing students face challenges in approaching mental health clinical simulation due to lack of prior exposure.

Sensory processing is a crucial function of the nervous system that significantly affects a large portion of the population, particularly older individuals who may be dealing with different forms of dementia. The global population of people aged 65 or older has reached a substantial count of around 703 million, representing approximately 9% of the total global population. Within this demographic, an estimated 5-8% of those aged 60, highlighting the growing need to address sensory modulation challenges for healthy aging. Sensory diet, derived from sensory integration theory, provide a tailored approach to modulating sensory experiences and triggering neuroplastic changes in the brain. Recent neuroimaging studies have revealed intricate structural and functional alterations in the brain associated with the implementation of sensory diets. Furthermore, the integration of the Metaverse, augmented reality, and virtual reality has opened up personalized experiences, fostering cognitive stimulation and emotional well-being for individuals during aging. This article offers a comprehensive exploration of the effectiveness of sensory diets in enhancing attentional control, self-regulation, and alleviating sensory-related distress among the healthy aging and dementia population. By employing precise quantitative evaluations such as sensory processing scales and advanced neuroimaging methodologies, it presents solid evidence of the tangible impact of these interventions. Emphasizing the importance of interdisciplinary cooperation and leveraging technological advancements, the article underscores the crucial need for customized sensory diets to optimize sensory processing and improve the overall well-being of older individuals contending with sensory modulation challenges and dementia.

Aims: The study aims to take the COVID-19 pandemic as an example to provide a scientific reference for diabetic patients’ self-health management and nurses’ work for these patients when facing future pandemics. Review Methods: It conducted a comprehensive literature search and analysed relevant texts. This article reviews the daily health management of diabetic patients in the context of the COVID-19 pandemic and the role that nurses should play in this process. Results: Diabetic patients face challenges in self-health management during the pandemic, including disruptions in healthcare access, increased mental problems, and unhealthy lifestyles. Nurses serve as the front-line interface between these patients and the healthcare system. Adopting telehealth and remote consultation has effectively bridged the gap created by social distancing measures. Conclusion: Daily self-health management can significantly improve glycemic control and reduce the risk of diabetes-related complications, which is vital during the pandemic when patients may be experiencing disruptions to their routine care. Moreover, empowering patients through educational initiatives led by nurses can bring better self-monitoring, medication adherence, and lifestyle modifications, all of which are crucial in mitigating the effects of diabetes on the body’s immune response, thus reducing the severity of COVID-19 if contracted.

Prior work has suggested that discrimination and immigration-related stress may impede mental health care seeking and utilization among Latinx populations. These effects may be more nuanced as both discrimination and immigration-related stress may increase symptomology, particularly posttraumatic stress disorder (PTSD) and depression. Both symptoms may in turn prompt attempts to seek care. The current study examined the direct effects of discrimination and immigration-related stress on care access, as well as potentially indirect effects with PTSD and depression symptoms as mediators. Interviews and online surveys were completed with 234 Latinx residents of the Midwest assessing everyday discrimination, discrimination in healthcare, PTSD symptoms, depression symptoms, current mental health utilization, and previous unsuccessful attempts to seek care. Direct effects of discrimination and immigration-related stress were largely unrelated to care access variables. Discrimination in healthcare settings predicted both unsuccessful attempts to seek care and current use, but this effect was positive. The indirect effect was largely supported, but only for PTSD symptoms and not depression. Results indicate further investigation is necessary to understand the direct effects of discrimination on care access. Further, discrimination and immigration-related stress may indirectly prompt attempts to seek mental health care.

Type 2 diabetes mellitus (T2DM) poses a significant public health challenge. Prioritising its prevention is essential. With the growing interest in wearable health technologies continuous glucose monitoring systems (CGMs) have expanded their scope, transitioning from exclusive use in diabetes management to lifestyle enhancement for individuals without diabetes. While CGMs primarily target glycaemic stabilization, their potential role in mitigating noncommunicable conditions, including T2DM, warrants exploration. This review examines the regulation of CGMs and critically assesses the purported benefits of CGMs for individuals without diabetes, as presented in the 'health and wellness' sector: (1) early dysglycaemia detection through glucose variability observation; (2) refining glycaemic control by tailoring nutrition according to postprandial glucose response; and (3) promoting and fine-tuning physical activity based on instantaneous data feedback. We find a lack of compelling evidence for the utility of CGMs in PNLD, including accuracy, data analysis and interpretation metrics, and user acceptability markedly under-researched. A paucity of research exists on the unanticipated negative consequences of CGM usage, such as obsessive symptom tracking and potential onset of disordered eating, like orthorexia. Given the increasing adoption of CGMs by individuals without diabetes, this review underscores the need of addressing these research gaps to ensure safety and reliability of CGMs in novel contexts. We emphasise the importance of refining CGM regulation in the UK, particularly when considering its ‘off-label’ use. Marrying robust scientific evidence with effective regulation is pivotal in fortifying the coherence, equity, and effectiveness of diabetes prevention initiatives, while protecting the wellbeing of CGM users.

Purposes: Engaging in regular physical activity has been consistently linked to improved physical health and academic performance. Despite its known benefits, there is a concerning trend of decreased physical activity among children globally. The study primarily aims to investigate the level of physical activity among junior high school students in Taiyuan and analyze the main affecting factors from a socio-ecological perspective. Methods: A cross-sectional study was conducted, involving 650 junior high school students from 7 schools in Taiyuan, and 648 valid questionnaires were collected. Physical activity levels were assessed using the Children’s Leisure Activities Study Survey Questionnaire. Factors influencing physical activity were evaluated through the Student Perceived Factors Affecting Physical Activity Questionnaire. Results: In this study, students from the 7th, 8th, and 9th grades participated in physical activities, averaging 214.5 minutes per week in moderate-intensity and 25 minutes in high-intensity activities, cumulatively averaging 280 minutes weekly. Notably, a significant disparity (p<0.05) was observed in the combined duration of moderate and high-intensity activities, with male students engaging more time compared to their female counterparts (307.500 vs 255.000 minutes). This variance extended across different grades, particularly evident in 8th graders who recorded the highest weekly high-intensity activity duration (31.000 minutes) and overall physical activity time (320.500 minutes), surpassing the 7th graders. Furthermore, an exploratory factor analysis of a 32-item questionnaire, designed to identify determinants of physical activity, revealed six principal components. These components were found to positively correlate with both moderate and high-intensity physical activities. Conclusion: This study emphasizes the necessity for educational institutions and community programmes to provide engaging physical activities, especially during weekends. It highlights the importance of tailoring physical education curricula to address gender and grade differences and investing in quality sports equipment and facilities by schools and local governments.

As artificial intelligence takes an increasingly prominent role in healthcare, a growing body of research is being dedicated to its application in the investigation of communication sciences and disorders (CSD). This study conducts a bibliometric analysis of AI-based research in the field of CSD published up to December 2023. Utilizing the Web of Science and Scopus databases, we identified 15,035 publications, with 4,375 meeting our inclusion criteria. From 1985 onwards, there has been a consistent annual increase in publications, averaging at 16.51%, notably surging from 2012 to 2023. The primary communication disorders studied include autism, dysarthria, dementia, Parkinson’s, and aphasia. Noteworthy AI techniques employed in CSD research encompass machine learning, automatic speech recognition, support vector machine, and deep learning. Our analysis provides a comprehensive overview, serving as a valuable resource for researchers, developers, and professionals seeking to comprehend the evolving landscape of AI in CSD research. Moving forward, collaborative efforts need to prioritize addressing ethical concerns, ensuring data privacy, enhancing methodological enhancements, and considering ecological validity in the application of AI in studies related to communication disorders.

Introduction: It is widely recognized that young female sex workers (YFSWs) are at greater risk of HIV infection than their older counterparts. This study aims to unravel the complexities surrounding HIV transmission among this demographic group, by determining the prevalence of HIV infection and identifying high-risk sexual practices associated with HIV infection among YFSWs in Lubumbashi, in the Democratic Republic of the Congo. Methods: We conducted an analytical cross-sectional study and used a comprehensive sample of all YFSWs who presented to the HIV/Sexually Transmitted Infections Screening and Treatment Center in Lubumbashi between April 2016 and December 2017. We collected data on age, number of years in the practice of selling sex, number of sexual encounters per day, number of clients per week, systematic condom use, having suffered from sexually transmitted infections in the last 3 months before the survey, regular alcohol consumption, having anal sex in the last 12 months, having had forced sex in the last 12 months. Multiple logistic regression was used to identify potential factors associated with HIV infection. Results: A total of 572 YFSWs were included in the study, 19 of whom were HIV-positive (3.3%; 95% CI: 2.1% - 5.1%). Participants who were forced to have sex (adjusted OR=12.2; 95% CI: 3.2 - 46.4; p&lt;0.0001), those who did not use condoms systematically (adjusted OR=4.1; 95% CI: 1.3 - 13.0; p=0.018), and those who had anal sex (adjusted OR=23.8; 95% CI: 6.9 - 82.4; p&lt;0.0001) were more likely to be HIV-positive. Conclusion: The results of this study suggest that HIV prevalence among YFSW is higher than in the general Congolese population, and is significantly associated with high-risk sexual practices. Interventions aimed at increasing YFSW’s knowledge of high-risk behaviors should be vigorously pursued.

(1) Background: “Zero-dose” (ZD) refers to a child not receiving any doses of the pentavalent (diphtheria-tetanus-pertussis-Haemophilus influenzae type b (Hib)-Hepatitis B) vaccine in the routine national immunization schedule. These children are vulnerable to vaccine-preventable diseases (VPDs), and are often already disadvantaged due to poverty, conflict, and lack of access to basic health services. The Luambo health district (HD) is one of the 26 HDs in the Kasai Central Province and has the largest number of ZD children. This study was conducted to examine the factors associated with ZD status in the Luambo HD; (2) Methods: We conducted a mixed study of children aged 12-23 months in the Luambo HD in the Kasai Central Province; (3) Results: A total of 445 children aged 12-23 months were included in the study, including 89 cases and 356 controls. Correlates of zero dose (ZD) status in children aged 12-23 months were mothers who were not receiving Antenatal Care (ANC), of not knowing any VPD, the fact of the children being born in Angola and the fact of the children being born at home. In addition, the perceptions of children’s parents influenced child immunization; (4) Conclusions: Missing ANC services during pregnancy leads to home delivery with consequences being lack of knowledge on childhood’s VPD and subsequently children not being vaccinated.

The prevalence and incidence of obesity and the comorbidities linked to it are increasing in the world population. Current therapies for obesity and associated pathologies have proven to cause a broad number of adverse effects and often, they are overpriced or not affordable for all patients. Among the alternatives currently available, natural bioactive compounds stand out. These are frequently contained in pharmaceutical presentations, nutraceutical products, supplements, or functional foods. The clinical evidence for these molecules is increasingly solid, among which epigallocatechin-3-gallate, ellagic acid, resveratrol, berberine, anthocyanins, probiotics, carotenoids, curcumin, silymarin, hydroxy citric acid, and α-lipoic acid stand out. The molecular mechanisms and signaling pathways of these molecules have been shown to interact with the endocrine, nervous, and gastroenteric systems, as well as regulate the expression of multiple genes and, therefore, proteins involved in starvation-satiety processes, activation of brown adipose tissue, increased lipolysis, decreased lipogenesis, and inflammation, beneficial changes in metabolism and improved insulin sensitivity. This review provides a comprehensive view of nature-based therapeutic options to address the increasing prevalence of obesity. It offers a valuable perspective for future research and subsequent clinical practice, addressing everything from the molecular, genetic, and physiological bases to the clinical study of the bioactive compound.

Background: Breast cancer remains a significant health concern among women globally. Despite advancements in awareness and diagnostic techniques, it persists as a leading cause of death, with profound impacts on affected individuals' quality of life. Primary and secondary prevention, including regular screenings and practices like Breast Self-Examination (BSE), are pivotal in ensuring early diagnosis. The NHS in Italy offers screenings for women aged 50-69 every two years, managed by the Local Health Authority. However, the participation rates, especially among the Chinese female population residing in Italy, are not well-understood. Methods: Using a snowball method, we electronically disseminated a survey to investigate how Chinese women living in Italy engage with available NHS screening programs. The survey also explores their practice of BSE, the use and impact of technological tools on prevention, and aims to understand their depth of knowledge and misconceptions about breast cancer. Results: The data revealed a significant gap in breast cancer screening adherence and knowledge among Chinese women in Italy, with a notable discrepancy between the general population and those who have previously encountered cancer. Conclusions: The results highlight the urgent need for interventions that are culturally sensitive, stressing that these actions are not only desirable but essential.

The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) infection has required a complete change in the management of patients with gastrointestinal disease who needed to undergo endoscopic procedures. In the second year of the COVID-19 pandemic, due to restrictions for elective endoscopic procedures a large number of cancer patients were prevented from early diagnosis of several digestive cancers, which has led to a serious burden in the health system which nowadays needs to be dealt with. We designed a prospective study that included patients in whom access to elective endoscopic examinations during the COVID-19 pandemic has been delayed. Our aim was to investigate the impact of the COVID-19 pandemic on the diagnosis rate of digestive tract malignancies in the context of a health crisis management that generates an ethical dilemma regarding the balance of utilitarianism versus deontology. Our study shows that the decrease in the number of newly diagnosed gastrointestinal cancers by endoscopy and biopsy during the pandemic restrictions and the delay in diagnosis have hads a clear impact on stage migration due to disease progression.

The aim of this study was to describe the trend of traffic accident mortality and social inequalities in Ecuador for the period 2011-2020, distributed by year, gender, age group, geographic location, and type of accident, alongside social disparities. An ecological approach was used to evaluate traffic accident mortality data. The average traffic accident mortality rate in the country during this period was 19.1 per 100,000 inhabitants, with rates being significantly higher in males (31.3) than in females (7.2). The highest mortality rate was recorded in 2011, predominantly impacting the 60 and older age group, the Santo Domingo de los Tsáchilas province, and the Amazon region. The study also noted a declining trend in these rates over the years, with an Annual Percentage Variation of -1.2%. A notable finding was the decrease in traffic accident mortality inequality based on per capita income in 2019, compared to 2011, which rose by 247.7%, whereas the inequality based on illiteracy rates decreased by 18.9% from 2014 to 2019. These findings highlight the significant decrease in traffic accident mortality rates across Ecuador, though marked disparities remain evident across different genders, age groups, and provinces.

Non-pharmaceutical interventions (NPIs), including social distancing, wearing personal protective equipment, and lockdown measures, have been at the forefront of outbreak control in nursing homes. We used a mixed methodology to assess which NPIs nursing homes in the canton of Geneva, Switzerland, followed for their staff and residents during the first wave of the pandemic, between March 1, 2020 and June 1, 2020. For the qualitative component, we interviewed the attending physicians and/or director of each nursing home. Based on in-vivo codes, NPIs for nursing home workers and residents in each nursing home were thematically classified as: maximally restrictive, moderately restrictive, and minimally restrictive. In the quantitative component, we calculated incident rate ratios (IRR) for infection between the three levels of COVID-19-related measures taken in these nursing homes. We found an equal distribution of maximally (n=4), moderately (n=4), and minimally (n=4) restrictive NPIs. The extent of restriction did not show to be significantly associated with the cumulative incidence of COVID-19 cases among residents (maximally restrictive IRR = 3.90, 95%CI 0.82-45.54, p = 0.184; moderately restrictive IRR = 3.55, 95%CI 0.75-41.42, p = 0.212 ; minimally restrictive IRR = reference). Variabilities in NPIs adopted by nursing homes, and the number of COVID-19 cases appear to be randomly affected.

Marginalised families faced significant challenges during the COVID-19 pandemic. This study explores inequalities in Japanese mothers’ and children’s health and wellbeing and family economic stability before and during the pandemic. Data sources were: nationwide surveys in 2019 and 2021 of families with children using medical institutions across Japan; infant mortality and adolescent suicide rates between 2018 and 2021 from publicly available sources. Outcomes by poor and non-poor families were compared for 2019 and 2021 using simple descriptive statistics. Poor mothers' part-time working increased from 41% to 61% and regular employment was reduced by two-thirds. Well-being of poor mothers worsened from 39% to 55%. Employment opportunities and wellbeing did not change for non-poor mothers. School subsidies among poor families increased from 23% to 55%. The infant mortality rate (IMR) among unemployed families increased significantly from 12.9/1,000 to 18.2/1,000 between 2018 and 2021 compared with a decreasing overall IMR from 1.9/1000 to 1.7/1000. Suicide rates in 10-19 year olds increased over the same period although no socio-economic indicators were available. Inequalities in mothers’ and children’s health and well-being indicators and family economics increased between 2019 to 2021 in Japan. This study cannot attribute cause but suggests a possible role of the pandemic.

(1) Background: The rapid expansion of 4G and 5G networks has raised public concerns about potential health risks associated with electromagnetic radiation. This study addresses these fears by investigating electromagnetic measurements in crowded squares, where human exposure is heightened. Despite rigorous scientific methodologies showing generally low levels of radiation from these technologies, public apprehension persists; (2) Methods: We conducted 496 measurements in Larissa's major squares, using a portable field strength analyzer and GIS mapping. Squares were categorized by traffic and population density; (3) Results: Low-traffic squares exhibited exposure ratios consistently below ICNIRP limits, with median values of 0.0012 and 0.00173 in non-active and active mobile phone cases, respectively. In high-traffic squares, the median exposure ratio was 0.00335 in non-active mobile phone cases, remaining below recommended limits; (4) Conclusions: These findings indicate no significant risk of electromagnetic radiation in crowded squares in Larissa, emphasizing the importance of factual communication and dispelling public misconceptions.

Background: Mechanical ventilation in preterm neonates aims for synchrony, preventing complications such as lung injury. Neurally Adjusted Ventilatory Assist (NAVA) stands out as a unique mode relying on diaphragmatic electrical signals for synchronization. We attempted to review studies that have explored the long-term consequence of using invasive NAVA in neonates with a specific focus on respiratory outcomes, namely bronchopulmonary dysplasia (BPD). Methods: A systematic review following PRISMA explored invasive NAVA in preterm neonates. Primary objectives compared NAVA to conventional ventilation, assessing BPD incidence, ventilation duration, length of stay, and adverse events. Secondary objectives analyzed ventilator parameters. Results: After screening 282 records, nine studies were included. NAVA showed reduced oxygen requirement at 28 days but no significant differences in oxygen need at 36 weeks postmenstrual age, total length of stay, or ventilator days. Adverse events such as air leak, mortality, patent ductus arteriosus, and intraventricular hemorrhage revealed no substantial variations. Ventilator variables favored NAVA, indicating decreased peak inspiratory pressure, tidal volume, work of breathing, and respiratory severity score. Conclusion: Despite short-term benefits, our study found no significant reduction in BPD with NAVA. Future large-scale trials are essential to comprehensively assess NAVA's impact on preterm infants' long-term outcomes.

As breast cancer continues to take a devasting public health toll, most primary prevention approaches are targeted at individual actions. We have proposed, instead, developing systemic, population approaches to preventing the disease. We used a combined qualitative-quantitative methodology, Group Concept Mapping (GCM), to identify Importance and Feasibility ratings of systemic interventions across a wide spectrum of approaches and stakeholders. Participants (n=351) from across the state of California sorted 84 potential interventions into topical piles, and then rated each intervention on perceived Importance and Feasibility. Multidimensional scaling and cluster analysis identified eleven clusters or themes of interventions. Participants rated interventions on Importance and Feasibility differently depending on the region of the state in which they lived. The results of this study underscore the importance of sharing health information with and seeking public health solutions from community partners in general and from beyond the urban areas usually studied.

Our target point within this following steps, is prostate cancer. Phosphatases are implicated in differents cell alterations, including proliferation, differentiation and carcinogenesis. In specific life circumstances, proteins are regulators with implications in intracellular signaling pathways. Alterations in phosphatases functionality represent a key point in malignancy development. We try within our description, to focus on an important process refering to dysregulation of phosphatase activity. More than, we will discuss therapeutic key points refering to compounds that inhibits phosphatase proteins with implications in carcinogenesis. So finally after folowing describtion steps, purposed aim is to conclude on prostate cancer and different key points abordation.

Heat waves are a significant consequence of climate change threatening public health by increased morbidity and mortality. The aim of this study was to estimate individuals’ knowledge, attitudes and practice related to heat waves. We conducted an exploratory cross-sectional study in Greece during September 2023. We employed a convenience sample of 1055 participants. We used the heat wave knowledge, awareness, practice and behavior scale (HWKAPBS) to measure our outcome. We measured several socio-demographic variables, such as gender, age, educational level, etc. as potential determinants. Mean scores for the knowledge, awareness, practice and behavior factors were 12.5, 22.7, 22.2 and 12.1 respectively. Females had higher scores on the four factors compared with males. We found a positive relationship between self-perceived health status and awareness, practice and behavior about heat waves. Similarly, we identified a positive relationship between self-perceived financial status and awareness and behavior about heat waves. Increased age was associated with increased practice score, while increased educational level was associated with increased knowledge score. Additionally, behavior score was higher among participants in urban areas than those in rural areas. We found statistically significant positive correlations between the four factors. Levels of knowledge, awareness, practice and behavior about heat waves were high in our sample. Several socio-demographic variables affect participants’ knowledge, awareness, practice and behavior concerning heat waves.

Background: Delivery of quality family planning services depends on availability of skilled health care providers, which is often a challenge in Low- and middle-income countries. This study evaluates the effects of a targeted training program on family planning services delivered by the Lady Health Workers (LHWs) in six districts of Punjab, Pakistan. The primary goal was to enhance the quality and accessibility of family planning services, recognizing the pivotal role of LHWs in community health. Methods: Using a robust panel data difference-in-differences (DiD) approach, we analyzed the electronic medical records (EMR) of 1,410 LHWs over a nine-month period. This timeframe in-cluded both pre-training (July to December 2022) and post-training (April to June 2023) phases. Our assessment focused on the impact of training on five outcome variables: the number of follow-up clients, the number of Intrauterine Contraceptive Device (IUCD) clients, the number of condom clients, the number of modern method clients, and the number of injection clients. We also con-sidered control variables such as LHW age, LHW education, the number of eligible couples in each LHW's catchment area, and a categorical variable for the districts. Results: The positive and statistically significant (p<0.05) coefficients across various service cat-egories – Follow Up Clients [Coeff: 1.00, CI: (0.30 - 1.70)], IUCD Clients [Coeff: 0.23, CI: (-0.01 - 0.46)], Condom Clients [Coeff: 1.41, CI: (0.97 – 1.86)], Modern Method Clients [Coeff: 1.82, CI: (0.96 – 2.68)], and Injection Clients [Coeff: 0.32, CI: (0.14 – 0.50)]. These findings indicate enhanced productivity among LHWs who have received training, with results significant at the 95% con-fidence interval (CI). Conclusion: The study highlights the effectiveness of targeted training programs in boosting family planning services at the community level and offers insightful implications for policy-makers and health practitioners. While focused on six districts in Punjab, these promising results emphasize the need for ongoing training and support for frontline health workers to bolster family planning initiatives.

Electrochemotherapy (ECT) is one of the newest therapeutic strategies employed as medical procedure for skin neoplasms’ treatment, especially for Classic Kaposi’s Sarcoma (CKS). The aim of this study was to demonstrate ECT clinical response and local control of CKS disease. Primary endpoint was to value the worth and efficacy of this local therapy in CKS skin lesions’ treatment. Nineteen CKS patients were enrolled, 14 males and 5 females with median age at diagnosis of 72. Complete response (CR) has been gained in 12 patients after first ECT attempt, meanwhile 3 and 4 out of 19 patients obtained a Partial response (PR), so that they underwent to a second and a third ECT treatment, each other. Clinical response was evaluated during all the time of the follow-up, which ranged between 3 months and 4 years with a median of 18 months. CKS skin lesions control still represents a challenge for surgeons and oncologists. Nevertheless, according to this and other authors’ recent experiences, ECT could be considered the gold standard strategy for early-stage patients, but at the same time it could be considered as a valid option in controlling Kaposi’s Sarcoma locally advanced lesions.

A crucial aspect in developing machine learning algorithms (or any type of predictive models) is the comparison of different algorithmic candidates based on evaluation criteria that measure their accuracy and practical value in terms of successfully capturing the complexity of the underlying problem and generalizing in a wide range of real-world scenarios. In the domain of diabetes mellitus machine learning techniques are widely employed in the prediction of future values of glucose concentration in the blood in order to assist the patient in avoiding deviations from the normo-glycemic value range and the consequences of hyper- and hypoglycemia. In the relative literature there is an apparent lack of a uniformly adopted evaluation metric which could combine the clarity and direct comparative nature of statistical mathematical formulas dealing with prediction error residuals (e.g., the RMSE) with the clinical insights and the visual-qualitative approach of clinical evaluation tools (e.g., Clarke's EGA). Mean Adjusted Exponent (MADEX) error metric, proposed in this paper, attempts to address this need by providing a validation tool based on an easy to implement mathematical formula, that incorporates adjustable parameters of clinical significance.

: Background: Vaccination against COVID-19 has been the main strategy used by most countries to limit the spread of the virus. However, vaccine uptake has been low in Africa, leading to the implementation of several interventions in order to improve vaccine coverage. This study was conducted due to the lack of information about COVID-19 vaccine coverage and the factors associated with vaccine hesitancy. Methods: This cross-sectional study was carried out in Kinshasa city using multi-stage random sampling. A total of 2160 households were included in the study. The data were analyzed using Stata 15 software. The means and standard deviations were calculated for normally distributed continuous variables, while proportions with their 95% confidence intervals (CIs) were calculated for categorical variables. Pearson’s chi-square test or Fisher’s exact test was used to test the associations between dependent variables and each independent variable. Logistic regression was used to identify the factors associated with hesitancy receiving the COVID-19 vaccination. Results: The majority of respondents were aged between 25 and 34 and 35 and 49 (28.9%). During this study, 15% (95% CI [13.25–17.9]) of respondents had received at least one dose of the COVID-19 vaccine. Among the reasons given for refusing to be vaccinated, most respondents cited concerns about the vaccine being unsafe or causing adverse reactions (45%). Among the reasons given for accepting the vaccine, 26% thought that the vaccine prevented superinfection. The factors associated with hesitancy toward the COVID-19 vaccine were female gender, an age of less than 35 years, and living in non-slum households. Conclusions: Despite the interventions implemented across the country, the reluctance to be vaccinated remains a problem; this could lead to poor health outcomes, especially among the elderly and those with pre-existing conditions. It is important to step up awareness-raising campaigns in the community in order to increase the uptake of vaccination.

Keywords: Addis Ababa; dietary factors; nutritional status; school-age children

Background: There is a lack of knowledge about how nurses and general practitioners (GPs) collaborated during the COVID-19 pandemicin primary care settings. Our study examined the roles of primary care nurses during the pandemic’s first wave, between March and June 2020, in Switzerland. Methods: The study involved all eight general practices implementing of a nursing role to the practice’s team. Primary care practice staff members (nurses, GPs and medical assistants) have been involved on the development of a new organizational model. A mixed-methods design study collected quantitative data using daily activity monitoring and an electronic survey. Additionally, eight nurses and nine GPs participated in a focus group discussion and individual interviews. Results: GPs recognized the substantial contributions, versatility, and autonomy of the primary care nurses in their practices during the pandemic. Those nurses experienced their involvement positively, mainly thanks to their perceived autonomy. The distribution of activities between primary care practice professionals was heterogenous due to extrinsic and intrinsic factors. Conclusion: Both nurses and GPs agreed that there was added value in having primary care nurses ingeneral practices in time of crisis, and this agreement will bolster plans to integrate this workforce across the canton. The development of nurses’ roles in primary care during the pandemic was reliant on many factors, including practice organization and Switzerland’s healthcare reimbursement and payment system

At secondary healthcare, Carbapenem-Resistant Enterobacterales (CREs) such as observed in Klebsiella pneumoniae are a global public health priority with significant clinical outcomes. In this study, we describe clinical, phenotypic, and genotypic characteristics of three pan-drug resistant (PDR) isolates that demonstrated extended resistance to conventional and novel antimicrobials. All patients had risk factors for acquisition of multidrug resistant organisms while microbiological susceptibility testing showed resistance to all conventional antimicrobials. Advanced susceptibility testing demonstrated resistance to broad agents such as ceftazidime-avibactam, ceftolozane-tazobactam, and meropenem-vaborbactam. Nevertheless, all isolates were susceptible to cefiderocol, one of the novel antimicrobials that demonstrated potent in vitro activity against resistant Gram-negative bacteria including CREs pointing towards potential therapeutic role for PDR pathogens. Expanded genomic studies revealed multiple antimicrobial resistant genes (ARGs), including blaNMD-5 and blaOXA derivative types as well as a mutated outer membrane porin protein (OmpK37).

Violence against paramedics is widely recognized as a serious, but underreported, problem. While injurious physical attacks on paramedics are generally reported, non-physical violence is less likely to be documented. Verbal abuse can be very distressing, particularly if the harassment targets personal or cultural identities, such as race, ethnicity, gender, or sexual orientation. Leveraging a novel, point-of-event reporting process, our objective was to estimate the prevalence of harassment on identity grounds against paramedics in a single paramedic service in Ontario, Canada, and assess its potentially differential impact on emotional distress. In an analysis of 502 reports filed between February 1, 2021, through February 28, 2022, two paramedic-supervisors independently coded the free-text narrative descriptions of violent encounters for themes suggestive of sexism, racism, and homophobia. We achieved high interrater agreement across the dimensions (k=0.73-0.83), and after resolving discrepant cases, we found that 1 in 4 violent reports documented abuse on at least one of the identity grounds. In these cases, paramedics were 60% more likely to indicate being emotionally distressed than for other forms of violence. Our findings offer unique insight into the type of vitriol paramedics experience in the course of their work and its potential for psychological harm.

Background: Antimicrobial Stewardship Programs (ASP) were introduced in healthcare as a public health priority to promote appropriate prescribing of antimicrobials, reduce antimicrobials adverse events as well as control challenges of antimicrobial resistance. To deliver aimed outcome objectives, ASPs involve multiple implementation measures. A review of systematic review was conducted to evaluate ASPs process and outcome measures. Guided by PRISMA frames, published systematic reviews (SR) focusing on ASPs restricted to secondary healthcare were evaluated over the past 10 years by examining major and primary databases involving all age groups. Out of 265 identified SR studies, 63 met inclusion criteria, the majority were conducted in European and North American regions. All age groups were examined in the studies but mainly conducted in adults when compared to children and infants . Both ASPs process and outcomes measures were examined equally and simultaneously through 25 different concepts, dominated by efficacy , antimicrobial resistance , and economic impact while information technology as well as role of pharmacy and behavioural factors were equally examined . The main broad conclusions from the review , that across the globe, ASPs demonstrated effectiveness, proved efficacy, and confirmed efficiency while focused evaluation advocate that developed countries should target medium and small sized hospitals while developing countries should continue rolling ASPs in their healthcare facilities . Additionally , the future of ASPs should focus on embracing evolving information technology to bridge gaps in knowledge, alter attitude and enhance decision making .

The research identified norovirus genotypes that circulated among Gambian children less than five years of age with diarrhoea during 2007-2012. The study highlights the importance of continuous surveillance for detecting the emergence of new norovirus genotypes.

Meals on Wheels (MoWs) are critical in enabling adults with care and support needs to live independently. However, many individuals are unaware that the service exists. The aim of this study was to review the websites of local authorities in the UK, and those of 3^rd-party providers they signpost to, to establish the quality of online information available on MoWs services, and the websites’ overall quality. Two data capture forms were used to extract information from local authority and 3^rd-party providers, consisting of 35 items across five domains, and 36 items across five domains, respectively. Items were awarded a score based on whether certain criteria were met or not, resulting in a maximum total score of 50 and 43 points for each local authority, and 3^rd-party provider, website, respectively. A total of 271 websites (223 local authority and 48 3^rd-party provider) were reviewed. The mean total score was 14.9 (SD 10.6, range: 1-40 points) for local authority websites, and 21.4 (SD 5.3, range: 10-35 points) for 3^rd-party provider websites. For all websites combined, online provision of MoWs information was generally poor, with the vast majority of websites (69.4%, n=188) assessed as requiring improvement, whereas only 4.4% of websites (n=12) were assessed as very good. These findings suggest that local authorities and 3^rd-party providers in the UK should seek to improve their online information provision on MoWs to enhance awareness of the service, and ensure that potential service users, and individuals who refer them to the service, can access high-quality information on MoWs.

1) Background: Patients with neurological disorders are particularly at risk of falling and requiret functional rehabilitation. HUBER® is a motorised rotating platform that allows simultaneous work on balance, stability and strength with continuous adaptation and immediate feedback. This study aimed to measure the impact of rehabilitation with the HUBER® on the physical performance and quality of life of patients with neurological diseases requiring functional rehabilitation. 2) Methods: 32 subjects were enrolled in CHU Liège CNRF and randomly divided into 2 groups. The first group received classical rehabilitation combined with two training sessions per week on the HUBER® for 8 weeks. The second group received their usual treatment. This randomized control trial has been registered on clinicaltrials.gov under the number NCT04687293. Physical performance and quality of life were evaluated at different time. 3) Results: There was no significant difference between the 2 groups after enrolment. In terms of physical performance, an improvement in SPPB chair stand test (p=0.021) and total SPPB (p=0.003) was observed in the HUBER® group. In terms of quality of life, a higher improvement was observed overall in the HUBER® group (p&lt;0.05 between groups). 4) Conclusion: The HUBER® showed promising results in functional rehabilitation of patients with neurological pathologies, as a complement to classical rehabilitation management by physiotherapy.

Purpose：Herein, aimed to explore routines to improve students' physical health.Methods:We explored the integration of extracurricular fitness running "Lerun" into college physical education curriculum. Firstly, experimental and the referring groups were selected by experimental method, in which only the experimental group was intervened in combination with extracurricular fitness running "Lerun". After two experiments, the experimental and referring groups were compared in terms of physical fitness (speed, strength, endurance, flexibility, explosive force, etc.), sports skills, body shape, cardiopulmonary function, etc. Results:After T-test, significant differences (p<0.05) between these two groups prove that the students' physical health status of experimental group is better than that of the referring group. Conclusion：It manifests that integrating extracurricular fitness running "Lerun" into college physical education curriculum is an effective means to improve students' physical health.

Aim: Utilizing the subjective experience of nurse executives who have supervised nurses during a major disaster in a hospital setting, this study aims to describe the subjective experience of nurse executives (NE) who have supervised nurses’ response to major disaster. This paper will focus on strategies to support nursing response to disaster, specifically to strengthen resiliency and the ability to maintain function despite the shock of disaster, including those caused by climate changes. Methods: Semi-structured interviews were conducted with 11 hospital-based nurse executives who supervised nurses during some of the worst natural and human-made disasters in different regions of the United States. A phenomenological approach was used to analyze and describe emerging themes from qualitative data. Results: Three Nurse Executives demonstrated theme saturation for mitigation steps to augment traditional disaster readiness activities: 1.) Assessment of Human Infrastructure: Daily Skills Needed During Disaster Response, 2.) Identification and Study of Failure Points & Metrics, 3.) Strengthening Human Infrastructure: Rectifying Deficiencies), and 4.) Monitoring Metrics & Making Corrections During Conventional Periods. Conclusion: Mitigation steps may improve outcomes in hospital function during conventional times; therefore, may improve resiliency and the ability to maintain functions during major disasters, including climate change.

(1) Background: The aim of study was to investigate the salt consumption by children and adolescents from the Silesian Province (Poland), taking into account the region’s dietary traditions and number of years of school education. (2) Methods : 300 students aged 10–18 from different types of schools, were enrolled in the study and divided into groups in terms of: school, sex, the state of nutrition. The survey questionnaire about dietary habits, including the frequency and serving size with respect to 12 salty products was used. On the basis of the frequency and the amount of consumed products, as well as the data on salt content, the amount of total daily intake of salt was estimated.; (3) Results: The mean daily intake of salt by children and adolescents was 1.083 g ( 0.433 g of sodium); children aged 10–12 consumed the highest amount of salt (1.296 g/day) compared to pupils aged 13–15 (1.131 g of sodium) and adolescents aged 16–18 (0.863 g/day); (4) Conclusions: With age, as a result of various factors, the consumption of salt declines. The parents impact and the familial socio-environmental factors begin to wane, and other factors start to have influence, e.g. school education of healthy lifestyle, health behavior of peers.

AbstractCurrently, public health researchers are investigating several complex and multi-faced health problems that require mixed-method approaches (MMA) to clearly understand problems and design proper intervention approaches and policy formulation. Besides, a comprehensive comprehension of the complex operation of society is vital. The MMA helps in having a broader understanding of the functioning and structure of the community at large. MMA deliberately integrates qualitative and quantitative approaches carefully to build on the merits of each other and confirm that the findings of research are closer to the truth. Therefore, public health scholars must have an excellent comprehension of the MMA and its philosophical foundations for discovering the complex conditions that challenge public health nowadays. However, public health researchers do not clearly understand the theoretical underpinnings and practical application of MMA, despite its popularity in developing countries. Therefore, this article aimed to provide comprehensive evidence on the theoretical underpinnings and practical application of MMA.

Urinary tract infections (UTIs) caused by Uropathogenic Escherichia coli (UPEC) are a serious healthcare concern that must be treated with appropriate antibiotic therapy. However, antibiotic resistance among UPEC strains is increasing, particularly among individuals with recurrent illness. The proliferation of Extended-Spectrum Beta-Lactamase (ESBL) generating UPEC, as well as the increase of UPEC strains that display resistance to several antimicrobial drugs, adds to the difficulty of managing UTIs. UPEC strain genetic variants have a significant influence in their capacity to resist antimicrobial agents and adapt to changing environments. Understanding the genomic landscape of developing UPEC strains is critical for understanding the genetic basis of their resistance. Furthermore, tracking these genetic strains is critical for identifying patterns of resistance spread, directing infection control efforts, and educating.

Abstract Background: Metabolic syndrome (MetS) is a complex disorder characterized by insulin resistance (IR), central obesity, atherogenic dyslipidemia and higher glucose levels. It increases the risk of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM), imposing an economic burden on the healthcare system. However, the historical origins of MetS as well as the development and evolution of its definitions have not been conclusively documented in the literature. Aim: This study seeks to enhance the understanding of the developmental trends of MetS during the preceding two decades, placing particular emphasis on the definition, diagnosis and prevalence. Methods: An extensive search was performed from 1920 to 2023 across prominent scientific research engines, including Scopus, PubMed, MDPI, and others. Results: Despite advancements, many aspects of MetS remain inadequately understood. As the understanding of the nature and pathophysiology of MetS progresses, the development and refinement of its diagnostic criteria, and assessment and treatment guidelines will continue. Additionally, there exists significant variation in the global prevalence of metabolic syndrome, ranging from 14 to 39%. This prevalence is projected to increase due to the adoption of less healthy dietary patterns and sedentary lifestyles. The observed disparities in metabolic syndrome prevalence can be attributed to multiple factors, including demographic characteristics. Furthermore, the lack of a standardized definition across studies also contributes to the variation in reported prevalence rates. Conclusion: Further studies focusing on the standardization of the MetS definition across different research are crucial. The establishment of consistent criteria would enhance the reliability and validity of research findings, enabling more meaningful comparisons and interpretations.

Over the past few decades, digitalisation has pushed patient care towards a new era, inducing the evolution of health care delivery and enhancing the overall sustainability of health systems worldwide. Despite the ever-evolving technology leading to a change in health care provision, the uptake of these novel technologies by medical professionals is slow, largely because of concerns about the potential impact on patient care and patient safety, and medico-legal implications. Hence, this research aimed to understand doctors’ perceptions of the adoption of digital virtual consultations in the practice setting.In this survey, an online questionnaire, adapted from the construct by Venkatesh and Bala and based on the Technology Acceptance Model by Davis, was distributed to 886 hospital doctors. Altogether 133 responses were obtained.Results suggest that the respondents perceived digital virtual consultations as adjuncts to face-to-face consultations and as able to diminish time and place barriers. Doctors were willing in principle to utilise these alternatives to traditional methods if the appropriate infrastructure and technology were in place. Feasibility and cost-effectiveness studies are recommended to establish the technology-fit factor and the impact of the technology on the workforce, coupled with a stakeholder analysis to include all the actors involved in such a strategy.

Background: Infections of Coronavirus Disease-2019 (COVID-19) can cause long-term effects known as long COVID. This pilot study aimed to evaluate the feasibility of a clinical study as well as the efficacy and safety of traditional East Asian herbal medicines in alleviating fatigue and cognitive dysfunction “brain fog” in patients with long COVID. Methods: This prospective pilot study investigated the use of three types of herbal medicines, Bojungikki-tang (BIT), Kyungok-go (KOG), and Cheonwangbosim-dan (CBD), for a 12-week period as potential treatments for fatigue and cognitive dysfunction in patients with long COVID. Forty-five patients with long COVID were recruited, and one of three drugs was given based on the patient’s symptoms and pattern identification. The effect of herbal medications on fatigue and cognitive function outcomes was assessed over a 36-week period, with patient adherence closely monitored. Results: After 12 weeks of herbal drug administration, fatigue symptoms improved significantly across all groups, with treatment success rates of 80%, 53.33%, and 46.67% in the BIT, KOG, and CBD groups, respectively. However, “brain fog” symptoms showed less improvement, with treatment success rates of 40%, 46.67%, and 13.33% in the BIT, KOG, and CBD groups, respectively. All adverse events reported were mild and unrelated to the medication. The study design was found to be feasible with high medication adherence. Conclusions: This study demonstrated the feasibility of conducting a clinical trial with three herbal medicines to treat long COVID symptoms like fatigue and “brain fog.”

Background: India leads in road traffic accident (RTA) deaths, according to the 2018 World Road Statistics. Most unidentified patients exhibit poor Glasgow Coma Scale (GCS) scores ,often less than eight , heightened trauma severity, and suboptimal outcomes despite standard treatment. Our study concentrates on individuals involved in hit-and-run RTAs or found unconscious and brought to the emergency department and their final outcome.Case Presentation: We are presenting a case series featuring five patients admitted to our hospital for treatment. At the time of admission, all these patients' identities were unknown.We did not face any legal challenges in managing the unidentified patients as we followed preestablished protocols. We report a case series of five male patients who had been admitted after road traffic accidents. All of them regained consciousness after conservative management. These complex cases frequently led to extended hospital stays, underscoring the intricacies of providing care to individuals with uncertain medical histories. All of the patients were treated and successfully discharged. Conclusion: Addressing challenges with unidentified adult patients requires proactive measures like staff training and improved resources. In a developing nation, prioritizing public awareness on road safety, prehospital trauma care, and enhancing healthcare delivery, especially in hospitals, is essential for optimal outcomes.

Long-term care (LTC) settings are increasingly used for palliative care in Japan. This study aimed to assess the proportion of LTC settings that provide palliative care services for older clients with advanced dementia in Japan and the trends across the types of settings. A nationwide questionnaire survey was conducted between November 2022 and January 2023, targeting 1,000 geriatric hospitals (GHs), 1,000 geriatric health services facilities (GHSFs), and 1,000 home nursing care stations (HNCSs). The palliative care practices for older patients with advanced dementia and their families in the agencies were assessed. Less than half of the GHs supported family participation or the spiritual needs of their older clients with dementia, while many had access to pain and symptom assessments and analgesic prescriptions by physicians. Less than half the GHSFs used pain assessment tools, assessed and supported family caregivers' pain and distress, and supported family participation in palliative care. More than 80% of the HNCSs practiced most of the listed palliative care. Current palliative care practices for older adults with dementia vary among GHs, GHSFs, and HNCSs. This emphasizes the need for targeted approaches to improve the provision of palliative care for patients with dementia across LTC settings in Japan.

Emergency is a health condition that poses an imminent risk to life. In this context, operations and triage protocols play an important role in the correct functioning of the Emergency Department, a key component of national health systems. The aim of the study was to explore and describe the experiences of a group of patients regarding emergency departments that use the Manchester Triage System, a triage protocol widely adopted in Europe. The research approach used was phenomenography, which allows us to explore in depth the diversity of experiences lived by a group of patients. The data was collected through semi-structured interviews and analysed to identify the categories that allows a qualitative description of patient’s experiences. The results are structured in the following categories: “Healthcare professional roles“, “Waiting time to be cared“, “Triage protocol“ and “Emergency department utilization“. These results can be used to improve the way patients experience emergency situations and to contribute to increasing knowledge about the impact of emergency departments and triage protocols on patients.

In the European Union, Occupational Safety and Health legislation generally refers to European Regulation (CE) n. 1272/2008 to define and classify carcinogens of concern for occupational risk assessment and exposure assessment. In Europe, the current reference is Directive (UE) 2022/431, regarding carcinogen, mutagen and reprotoxic agents (CMRs) exposure. However, at worldwide level, different classification approaches are used to establish carcinogenicity of substances and it is often difficult to compare the classifications of carcinogenicity (CoCs) proposed by different international bodies. This study aims to investigate a list of carcinogens of concern in occupational settings based on the CLP (Classification Labelling Packaging) CoC, and to create a tool that allows a rapid translation-comparison of some international CoCs with the reference one. CoCs proposed by various sources were consulted and used to apply a translation method, to favor an alignment of different CoCs according to a reference. Results outlined that considering diverse sources, CoCs can result in different classifications of the same chemicals. Overall, this may have implications for the hazard assessment process, which is the base of risk assessment. The proposed tool is expected to help risk assessors in the occupational field when it is needed to have a comparison with different CoC systems.

High insertion torques increase the primary stability of dental implants, which might be beneficial for immediate loading protocols, but may lead to local ischemia and necrosis of the bone-implant interface. This study compared the outcomes of implants placed with low (&lt;45Ncm), conventional(45-70Ncm), and high (≥75Ncm) insertion torques in All-on-4 concept cases with up to 2-year follow-up. Patients included in this study presented edentulous or partially dentate arches with an indication for full-arch rehabilitation. Implants were installed following the All on four protocol and were divided into 3 groups: Low, Conventional, and High torque, and were followed periodically for 2 years with ISQ measurements. The results showed no significant differences in success rates between the three groups. This suggests that high insertion torques may maintain higher primary stability values for immediately loaded implants during the healing period. Further studies are necessary to confirm these findings.

Immediate load of full-arch rehabilitations over implants, specially over 4 implants are very well documented in the literature. More recently, the use of computed surgical guides to help the planning and the execution of these treatments, in many situations without the need of raising a flap, and diminishing the appearance of hematomas, bleeding and with less trauma to the patient has gained preference among implantologists. The objective of this case report is to show a clinical case of an immediate load full-arch fixed rehabilitation over 4 implants produced by 3D printing manufacturing technology, and placed with a computed surgical guide, in the same appointment, and the 24 months follow-up. The patient returned after 3 months to replace the immediate temporary fixed prosthesis for a new one, with metallic bar, better teeth and more delicate. Soft and hard tissue around the implants seemed to be stable, without signs of inflammation, either on the 3 or the 24 months follow-up. 3D printing of implants by direct metal laser sintering is a technology that seems to be promising for oral implantology, with solid studies showing reliable results, as seen in this single case. More clinical studies are necessary to testify its efficacy.

In the follow-up of treated high-grade cervical intraepithelial neoplasia (HSIL/CIN) lesions, cer-vical cytology has a high false-negative rate, while high-risk human papillomavirus (HR-HPV) DNA testing showed high sensitivity and lower specificity. The detection of messenger RNA of the HR-HPV E6 and E7 oncoproteins (E6/E7 mRNA) seems to be an indicator of viral integration and it allows the identification of severe lesions. Our objective was to assess the clinical utility of E6/E7 mRNA determination in the follow-up of patients treated for HSIL/CIN. A retrospective obser-vational study including 407 patients treated for HSIL/CIN was performed. The recurrence rate and the validity of E6/E7 mRNA testing were evaluated. The recurrence rate of high-grade lesions was 1.7%. The sensitivity of the test was 88% in the first clinical revision and 100% in the second and third revisions. Specificity was 91% in the first revision, 92% in the second revision, and 85% in the third revision. The positive predictive value was 18% in the first medical revision, 10% in the second and 14% in the third. The negative predictive value was 100% in all follow-up visits. In conclusion, the E6/E7 mRNA test seems to be effective in ruling out recurrence after treatment for HSIL/CIN lesions.

Obesity is associated with serious comorbidities and economic implications. Bariatric surgery, most commonly Roux-en-Y gastric bypass and sleeve gastrectomy, are effective options for weight loss and improvement of obesity-related comorbidities. With the growing obesity epidemic, there has been a concomitant rise in bariatric surgeries, particularly in sleeve gastrectomy, which has been the most widely performed bariatric surgery since 2013. Gastroesophageal reflux disease (GERD) is highly prevalent in obese individuals, can significantly impact quality of life and may lead to serious complications. Obesity and GERD both improve with weight loss. However, as the incidence of sleeve gastrectomy rises, recent data has revealed a risk of exacerbation of pre-existing GERD or the development of de novo GERD following sleeve gastrectomy. We performed a detailed review of GERD post-sleeve gastrectomy, including its overall incidence, pathophysiology and current treatment paradigms.

Increasing research has indicated a strong association between identity functioning and eating disorder (ED) symptomatology. However, a detailed investigation of identity throughout ED treatment is lacking. The present longitudinal study examined identity in inpatients with an ED and explored its co-development with ED symptomatology throughout treatment. At admission (Wave 1), 110 women with an ED (Mage=21, SD=6.08, range:14-45) participated, of whom 83.64% participated during treatment (Wave 2) and 55.45% at discharge (Wave 3). Questionnaires on identity synthesis, identity confusion, identity processes, and ED symptomatology were completed. Latent growth curve modeling was used to address the research questions. Throughout treatment, a decrease in identity confusion and an increase in identity synthesis and adaptive identity processes were found. Accordingly, increases in identity synthesis and identification with commitment were related to general decreases in drive for thinness and body dis-satisfaction. Similarly, such decreases in ED symptoms were related to general decreases in identity confusion and ruminative exploration. The present study points to an increase in identity functioning throughout treatment, and longitudinal associations between identity functioning and ED symptomatology were found. Helping the patient to decrease ruminative exploration and to increase identification with previously made life commitments seem important in ED treatment.

In response to the COVID-19 crisis, decisionmakers in countries around the world adopted policies such as lockdowns, mask requirements, and once vaccines became available, vaccine mandates and vaccine passports. However, political polarization and differences in risk perceptions in the populous generated strong support for and opposition to such measures. This research identifies the factors with support for and against vaccine mandates and vaccine passports. An online survey of COVID-19 health experiences in the United States population was conducted. The survey collected information regarding potential reasons for why respondents might favor or oppose COVID-19 vaccine mandates and vaccine passports, including experiences with COVID-19 illness and COVID-19 vaccinations by respondents and those in their social circles. Analysis using a Logit regression technique was conducted to identify factors influencing the likelihood of opposing vaccine mandates and vaccine passports. The survey was completed by 2,840 participants between December 18 and 23, 2021. Respondents who knew someone who experienced a health problem following vaccination were more likely to oppose vaccine mandates (OR: 2.040, 95% CI: 1.635-2.254, and vaccine passports (OR: 1.691, 95% CI: 1.361-12.101)) Twenty-two percent (612 of 2,840) of respondents reported that they knew at least one person who had experienced a health problem following COVID-19 inoculation. Perceptions of vaccine safety based on personal experiences appear to be an important determinant of opposition to vaccine mandates and vaccine passports.

Positive Health (PH) has been described as a promising transformative innovation to address the challenges of promoting well-being and reducing the burden of disease. The aim of this study is to review the current state of knowledge about PH as introduced by Huber et al. (2016) within the available scientific literature. A rapid review of the literature following the Cochrane Rapid Review recommendations. Three databases were searched (PubMed, Google Scholar, and CINAHL). Data were extracted and synthesized using a narrative approach. A total of 55 articles were included. Initial evaluation studies reveal promising results both at individual and collective levels. However, a need is expressed in several articles for further refinement of the conceptualization of PH and ways to make the effects of the PH approach more measurable. Professionals also expressed a desire for a more informed application and elaboration of the PH method across various settings and populations to enhance its effectiveness in practice. This rapid review highlights the transformative potential of PH in shifting from a disease-focused to a health-oriented paradigm of healthcare. It underscores the need for continued research regarding further development of the concept and its practical method, along with the necessity for methodological innovation.

The possible future emergence of new SARS-CoV-2 virus variants pushes the development of new chemoprophylaxis protocols complementary to the unspecific and specific immune-prophylaxis measures currently used. The SARS-CoV-2 virus is particularly sensitive to oxidation due to the relevant positive electrical charge of its spike protein used as a ligand for target cells. The present study evaluated the safety and efficacy of a new oxidant preparation, liquid hyperoxygen (IOL), to neutralize the SARS-CoV-2 virus. IOL was incubated with throat swabs containing a human wild-type virus. The samples were then incubated with cells expressing the ACE2 receptor and therefore very sensitive to SARS-CoV-2 infection. The ability to neutralize SARS-CoV-2 was determined by assessing the amount of viral nucleic acid inside cells by PCR. The results obtained indicate that IOL, even at considerable dilutions, is capable, after incubation times of less than 30 min and even equal to 5 min, to completely inhibit SARS-CoV-2 infection. This inhibitory effect has been shown to be due to the oxidizing capacity of the IOL. This oxidizing capacity is exerted towards the virus but does not damage eukaryotic cells either in the in vitro or in the in vivo skin model. Obtained results indicate that the use of IOL, a hydrophilic liquid mixture saturated with highly reactive oxygen and nitrogen species, is a new powerful, safe, and effective tool for preventing possible future outbreaks of COVID-19 disease.

Performance of the overhead squat may affect golf swing mechanics associated with golf-related low back pain. This study investigates the difference in lumbar kinematics and joint loads during the golf downswing between golfers with different overhead squat abilities. Based on the per-formance of the overhead squat test, 21 golfers aged 18 to 30 years were divided into the highest-scoring group (HS, N=10, 1.61 ± 0.05 cm, and 68.06 ± 13.67 kg) and lowest-scoring group (LS, N=11, 1.68 ± 0.10 cm, and 75.00 ± 14.37 kg). Data collection used a motion analysis system, two force plates, and TrackMan. OpenSim software was used to simulate the joint loads for each lum-bar joint. An independent t-test was used for statistical analysis. Compared to golfers demonstrat-ing limitations in the overhead squat test, golfers with better performance in the overhead squat test demonstrated significantly greater angular extension displacement on the sagittal plane, smaller lumbar extension angular velocity, and smaller L4-S1 joint shear force. Consequently, the overhead squat test is found to be a useful index to reflect lumbar kinematics and joint loading patterns during the downswing, and provides a good training guide reference for reducing the risk of a golf-related low back injury

Dementia education and training for workforce development is becoming increasingly important in bridging knowledge gaps among health and social care practitioners in the UK and internationally. Dementia Education for Workforce Excellence (DEWE) was developed during the COVID-19 pandemic blending both synchronous and asynchronous instruction and delivered across three different contexts: care homes, home care, and nurse education within the UK and India. This study aimed to evaluate DEWE using mixed methods with online survey data analyzed descriptively and interview data analyzed thematically. Integration of survey and interview data aimed toward a comprehensive evaluation of this novel approach for dementia workforce development. Thirty-four social care practitioners and nurse educators completed the online survey demonstrating high-level learner satisfaction; learning gains; behavioral change, and motivation to share new knowledge. Four key themes developed from the analysis of interviews (n=9) around participants’ pursuit of new knowledge; delivery modes in DEWE; learning gains and impact of DEWE; and adaptations for future program implementation. Findings suggest DEWE is an innovative resource that promotes person- and relationship-centered dementia care across all stages of one’s dementia journey. Cultural adaptations are recommended for international delivery to ensure contextual alignment and maximum impact.

Patients with bipolar disorder (BD) experience more frequent and intense emotions in response to environmental conditions relative to healthy subjects, which leads to mood instability. The aim of this study was to investigate the time-course of emotion regulation strategies, distraction, and reappraisal, in euthymic BD patients using electroencephalography (EEG). Fourteen BD patients and 13 matched healthy controls took part in an experiment constituted of three conditions, i.e., a passive viewing of positive, negative, and neutral pictures and two regulation conditions, one with reappraisal strategy and the other with distraction strategy. Critically, ERP results indicated that during passive viewing, the Late Positive Potential (LPP) was larger in BD patients compared with healthy controls, but only for neutral pictures. During emotion regulation, LPP amplitude was reduced in distraction condition compared with viewing one, especially for negative emotions in both patients and controls. Importantly, LPP was reduced in reappraisal condition compared with passive viewing in an early time window for negative emotions and in a later time window for positive emotions in controls but not in patients. Our findings showed that the neurochronometry of emotion regulation is faster for negative than for positive emotion in controls but not in BD patients.

(1) Background: This text emphasizes concerns regarding the safety of Spanish police officers at-tributed to inadequate training, employing biomechanics for the analysis and mitigation of risks during Use of Force training. The elevated global prevalence of musculoskeletal disorders under-scores the imperative for effective occupational health measures. The study concentrates on evalu-ating injury risks in novice police officers during Use of Force training. (2) Research method: The movements of police officers were captured using a Rokoko Smartsuit Pro equipped with 19 sen-sors. The Biomechanics of Bodies software processed the data, providing REBA and Marras risk scores. Statistical tests were conducted, and Operational Tactical Procedures (OTP) were inte-grated into police training. A diverse group of officers participated, categorized by training level and equipped with the Rokoko Smartsuit. (3) Results: The study evaluates police force training us-ing REBA and Marras methods. REBA scores indicate a moderate to high injury risk, suggesting effective technique design. ANOVA reveals no significant differences between training levels. Marras analysis, characterized by non-normal distribution, unveils varied risk perceptions among groups via the Kruskal-Wallis test. (4) Conclusions: The analysis of both the REBA and Marras methods implies the effectiveness of the OTP technique in reducing injury risks across dif-ferent training levels. The ANOVA test indicates no significant differences in REBA Maximum Scores between the groups. However, the Kruskal-Wallis test for Marras Probability of high-risk values suggests distinctions in medians between training levels. The combined analysis visually illustrates variations in membership regions between expert, intermediate, and novice groups.

Despite the crucial role the COVID-19 vaccine played in curbing the pandemic, a significant portion of Black and African American individuals expressed hesitancy in being vaccinated. This review aimed to identify the determinants of COVID-19 vaccine hesitancy among Black and African American individuals in the USA. The literature search was conducted in December 2022 according to the PRISMA criteria focusing on empirical studies. Data extraction methods, critical appraisal, and secondary thematic analysis were conducted on both quantitative and qualitative studies. Sixteen quantitative studies identified key factors associated with vaccine hesitancy such as confidence in vaccine effectiveness, safety, and trust in the healthcare system. 14 qualitative studies revealed major themes of mistrust, fear, and information needs, including historical mistrust, concerns about the vaccine development process, and contemporary institutional mistrust. The synthesis of quantitative and qualitative findings derived from this review provides a nuanced understanding of determinants of vaccine hesitancy in Black and African American communities in the USA, offering a foundation for the development of evidence-based interventions. Mistrust in the healthcare system, fear, and informational gaps on vaccine safety and effectiveness have been identified as significant barriers to vaccination, demanding targeted interventions.

Objective: This study investigated the effects of an easily implemented 8-week program centered around jump rope exercise (JRE) on executive function among children with ADHD. Methods: Using the Stroop Color Word Test to assess inhibitory control, the n-back task (1- and 2-back) to assess working memory, and task switching to assess cognitive flexibility. Results: After the intervention, there were within-group effects only for the experimental group, with higher accuracy on the 1-back working memory task (t= -2.79，p= 0.011< 0.05，Cohen’s d= 0.60) and on task switching after compared with before the JRE intervention (t= -4.00，p=0.01<0.05，Cohen’s d= 0.85), but with no change in reaction time. There was no significant within-group difference on the Stroop test (P> 0.05). Additionally, there were no between-group effects as assessed by one-way analyses of variance. Conclusion: 8-week program focused on JRE improved two aspects of executive function, working memory and cognitive flexibility, with no significant effect on a third aspect, inhibitory control, among children with ADHD aged 7 to 12 years.

Background: Fertility is a crucial component of population maintenance and growth. A declin-ing fertility trend has been observed over the past two decades, and it continues. Objective: The aim of this research was to examine the level of fertility knowledge, factors in-fluencing fertility knowledge, and the relationship between fertility knowledge and the decision to have a child. Methods: A cross-sectional study was conducted on a sample of mothers in five hospitals on the Adriatic coast of the Republic of Croatia, involving 1541 mothers from September 2021 to De-cember 2023. The Cardiff Fertility Knowledge Scale was used for the research. Results: The participants were divided into two groups based on fertility status in women, spe-cifically the period of declining fertility in women. Group 1 included participants aged 18-31 with sustained fertility, and Group 2 included participants aged 32 and older experiencing de-clining fertility. Fertility knowledge was 58.9%. Women with higher educational status showed better results (62.3%). The most common sources of fertility knowledge were the healthcare sys-tem and the internet. Factors associated with the level of fertility knowledge included higher education, marital status, and higher economic status. Conclusion: The research results reveal a lack of fertility knowledge among participants, as well as an intention to have a child in later stages of life. The lack of formal education on this topic leads to information gathering from unreliable sources.

To meet the calls of the International Labor Organization and National Institutes of Occupational Safety and Health, this paper discusses how to build Occupational, Health, Safety (OSH), and Well-Being competence by expanding education to non-traditional undergraduate disciplines. The authors provide (1) theoretical background on why this would benefit society as a whole, (2) learning theory strategies for teaching OHS and Well-being outside of traditional majors, (3) case studies of how this can occur in undergraduate classes and (4) opportunities and challenges for the future.

Background: Children's environmental health encompasses a wide range of factors that impact the well-being of children, including physical, chemical, biological, and social elements in their immediate environment. Safeguarding children from harmful substances is the crucial role of nursing students. Nursing students play a vital role as valuable resources for individuals, families, communities, and policymakers. This study aims to assess the knowledge and skills of nursing students concerning children's environmental health at academic institutions delivering nursing program in Nekemte town, Ethiopia. Methods: An institutional-based cross-sectional study design was carried out from August 1–30, 2023, among nursing students in Nekemte Town, and 634 study participants were selected through simple random sampling. Data was entered into Epinfo version 6.4 and exported to STATA version 14 for analysis, and multicollinearity was checked. Finally, from the bivariate analysis, variables of < 0.2 were included in the multivariate analysis; an adjusted odd ratio with a 95% CI was computed; and variables with a P-value <0.05 in the multivariable analysis were taken as significant associated factors. Results: The overall nursing students' level of knowledge about children's environmental health was insufficient (56%). More than one-third (34%) demonstrate their skill towards children's environmental health insufficiently, and one-fourth (25%) and 27% of the learners conduct their craft to prevent children from ecological hazards to a good and better level, respectively. While gender of the participant, age of the participant, year of the study, training history of the participants, and field of study of the students were significantly associated variables with their knowledge of children's environmental health. Conclusion: The study reveals that nursing students' knowledge of children's environmental health is limited, with factors such as gender, age, training history, and field of study significantly influencing their understanding. Therefore, female students should be considered for more tutorials to be effectively knowledgeable regarding children’s environmental health.

Emotional intelligence can contribute to quality of life and as a health predictor. The aim of this study is to analyze emotional intelligence, quality of life and the correlation factors associated in patients undergoing chronic hemodialysis. A quantitative, observational, cross-sectional design was performed, and one hundred and thirty-eight multi-centers hemodialysis patients were recruited. A battery of questionnaires, including Trait Meta-Mood Scale (TMMS-24), Kidney Disease Quality of Life-Short Form (KDQOL-SF), and an ad-hoc sociodemographic questionnaire, were answered. Sex differences existed when assessing the three dimensions of emotional intelligence: ranked by order, the highest scores in males were in clarity, repair, and attention. However, in females were in repair, clarity, and attention. Males had higher scores than females in emotional role (p=0.045). Younger participants had better scores in all physical functions (p=0.001) and vitality (p=0.038) than older. Moreover, those who had a higher level of education presented better physical function (p=0.027) and higher scores in emotional wellbeing (p=0.036). Finally, in females, emotional attention (p=0.046) and repair (p<0.001) were strongly associated with general health perception. The assessment of emotional intelligence considering sex differences in patients undergoing chronic hemodialysis can be an indicator of quality of life including the use in health interventions.

Recurrent respiratory papillomatosis (RRP) is a non- malignant disease, characterized by the production of wart-like growths in respiratory tract, affecting both young and adults (Juvenile-Onset Recurrent Respiratory Papillomatosis, JORRP and Adult-Onset Recurrent Respiratory Papillomatosis, AORRP, respectively). Infection caused by Human Papillomavirus (HPV) is known as the main factors involved in RRP development. Complications of RRP may rarely occur, including lung involvement and malignant transformation. The present systematic review was aimed to evaluate the prevalence of severe complications, as lung involvement and lung tumor in JORRP and AORRP patients, following the guideline for reporting systematic reviews and meta-analysis (PRISMA Statement). Among the 378 studies were found on PubMed and Scopus using the following MESH terms “recurrent respiratory papillomatosis and lung tumor” and “pulmonary tumor and recurrent respiratory papillomatosis”. Basing on inclusion and exclusion criteria, a total of 11 studies were included in the systematic review. We found a pooled prevalence of 8% (95% CI:4%-14%; I2: 87.5%) for lung involvement in RRP patients. In addition, we found a pooled risk difference of 5% in lung involvement between JORRP and AORRP (95% CI: -7%-18%; I2 :85.6%, p-value: 0.41). Among patients with lung involvement, we observed a pooled prevalence of lung tumor of 4% (95% CI:1%- 7%; I2: 67.1%), and a pooled prevalence mortality for this group of 4% (95% CI:2%-6%; I2: 0%). Overall, the positivity rate for HPV-6 and -11 in patients with RRP was 91%. Considering only cases with pulmonary involvement, the pooled prevalence for HPV 11 was 21% (95% CI: 5%-45%; I2: 77.2%). Our results evidenced a low/middle risk of pulmonary involvement and lung tumor in JORRP and AORRP patients, with an increased risk for HPV-11 positive patients. Further studies should be performed to improve knowledge and adopt preventive measures to contrast the progression to severe diseases in RRP patients.

The modern age offers many challenges in terms of health related physical condition, such as new technologies, fast and stressful lifestyle, unhealthy diets, alarming statistics on physical activity, etc. Additionally, the COVID-19 pandemic accentuated the existing problems, being necessary to answer the following questions: what is the fitness level of the population? and how important are physical exercises in human life? The purpose of this paper is to monitor the fitness level of a group of students, with the help of a new fitness test system, providing individualized feedback, guidance, or motivation to the subjects. Thus, we applied the new EFB system (European Fitness Badge), that evaluates certain components of physical condition in relation to health (endurance, strength, coordination, flexibility), on a group of 180 students, 78 male (43.3%) and 102 female (56.7%), with the average age m = 23.59 ± 7.38 years, from different specializations within the U.A.V. Arad. The subjects were divided into two groups: beginners - TP1 (N-93) and advanced - TP2 (N-87). The results showed significant differences in most components of overall fitness depending on the test profile (basic or advanced), demografic factors (sex and age), and student’s major (sport, economics, psychology, etc.), a stronger association between ABSI and overall fitness than BMI, and that test profile acts as mediator between demografic factors (sex and age) and fitness abilities. In conclusion this study evidenced tendencies toward differences between the groups of subjects based on the test profile. Also the advanced profile participant scores were higher than those of the basic profile participants. The results reflect as well a lower BMI and ABSI indexes for the advanced profile participants.

Antibiotic resistance currently considered as a global concern mostly impacting low- and middle-income nations and it can be accelerated by antibiotic abuse and other forms of excessive antibiotic use. There is little data on community practices and understanding in Somaliland on antibiotics and antibiotic resistance. To provide evidence-based communication intervention techniques for safer antibiotic use the qualitative study was done from November 1st to December 1st, 2023, and consisted of in-depth semi-structured interviews with adult heads of households in Hargeisa, Somaliland, using purposive and snowball sampling strategies. Participants were chosen from a variety of medical and educational backgrounds. Thematic analysis was used to investigate community knowledge and antibiotic use in the sampled population. To investigate the level of awareness on antibiotic use, 20 respondents (households) were questioned (Table 1). Of these, 17 (85%) became aware of the term antibiotic itself, with 7 (35%) being prescribed by a physician, 9 (45%) receiving laboratory diagnosis when using antibiotics, and 6 (30%) becoming aware of the potential risks associated with improper antibiotic use. This study highlighted the community's lack of understanding about antibiotic use. The majority of the study participants knew the phrase "antibiotic" but had no idea what it meant, the side effect of the antibiotics and other medical science related information regarding how to safely use antibiotics. According to the findings, initiatives for antibiotic stewardship should focus on community education to prevent antibiotic misuse or abuse.

Cadmium (Cd) is an environmental toxicant of worldwide public health significance. Diet is the main non-workplace Cd exposure source other than smoking. The intestinal absorption of Cd involves the transporters for iron, zinc, copper, and calcium. These metal transporters essentially determine the body burden of Cd because only 0.001-0.005% of Cd accumulated in the body can be excreted in urine each day. The International Agency for Research on Cancer listed Cd as a human lung carcinogen. Current evidence, however, suggests that environmental Cd may increase the prevalence of many types of cancer, notably lung, liver, breast, pancreas, and kidney. A two-year bioassay that mimics a lifelong exposure demonstrates Cd caused neoplasms in multiple tissues of mice. Also, several non-tumorigenic human cell lines underwent malignant cell transformation, when they were exposed to a sublethal dose of Cd for a prolonged time. Cd does not directly damage DNA, but it can profoundly affect gene expression through its interactions with various proteins, and Cd can thus be viewed as a transcription modulator. The present review highlights epidemiological studies that connected an enhanced risk of various neoplastic diseases to chronic exposure to environmental Cd. Special emphasis is on the impact of body iron stores on the absorption rate of Cd, and its implications for breast cancer prevention in highly susceptible subpopulation groups of women. Resistance to cell death and other cancer phenotypes acquired during Cd-induced cancer-cell transformation, under in vitro conditions, are briefly discussed. The potential role for ZnT1 efflux transporter in cellular acquisition of tolerance to Cd cytotoxicity are highlighted.

Background: Patients with bipolar disorder (BD) receive traditional Chinese Medicine (TCM) for unmet clinical needs with psychotropic medications. However, the clinical characteristics of practices and outcomes of TCM in BD are not fully understood. This cohort study investigated the clinical characteristics, principal diagnoses, TCM interventions, and TCM prescriptions in patients with BD. Methods: 12,113 patients with BD were withdrawn from Taiwan's longitudinal health insurance database 2000 (LHID 2000) between 1996 and 2013. Chi-squared test for categorical variables and independent t-test for continuous variables. A p-value less than 0.05 indicated significance. Results: One-thousand and three hundred nineteen patients who visited TCM clinics after the diagnosis of BD were in the TCM group, while those who never visited TCM were in the non-TCM group (N= 1,053). Compared to the non-TCM group, patients in the TCM group had younger average age, a higher percentage of female individuals, more comorbidities of anxiety and alcohol use disorders, and higher mood stabilizer usage rates. The TCM group exhibited pain-related indications, including joint pain, myalgia, myositis, headache, and sleep disturbances. Corydalis yanhusuo and Shu-Jing-Huo-Xue-Tang were the most useful single herb and herbal formulas. Conclusions: Physicians need to be aware of the use of TCM in Patients with BD.

Background and objectives: Effective management for chronic diseases, hereditary and rare diseases and Thalassaemia in particular constitutes an important indicator for the quality of healthcare systems. We aimed at assessing healthcare services in different countries by using publicly available health indicators and by surveying Thalassaemia patients and their caregivers. Materials and Methods: We reviewed official worldwide databases from the WHO, World Bank, and scientific resources and also used a structured patient tailored self-completed questionnaire to survey Thalassaemia patients and their caregivers in 2023. Results: A total of 2,082 participants were surveyed (mean age 27 years, males 42%). About 1 in 4 respondents had less than high school education, while 24% had a bachelor degree. About a third of respondents were married and had either full- or part-time employment. The vast majority (~80%) had initiated transfusion therapy between 1 – 4 years of age. Only 42% reported no delays in receiving blood transfusion, while 47% reported occasional delays and 8% serious delays. About half of patients reported being very satisfied (11%) or satisfied (38%) with the quality of provided services, while 1 in 3 patients reported being unsatisfied or very unsatisfied, and their access to treatment was difficult or very difficult due to traveling expenses and high cost of treatment. Conclusion: Important improvements in the care of Thalassaemia patients have been documented during the past decades. Nevertheless, our recent survey reveals many unmet needs where additional focus is required through national healthcare systems in order to address them effectively and achieve satisfactory patient outcomes.

The impact of COVID-19 pandemic on the cardiovascular healthcare services in Croatia has not been systematically examined. In this study, we compared utilization and provision of cardiovascular services in Croatia during the pre-pandemic period (2017 to end of 2019) and pandemic period (2020 to end of 2021) by using large nationwide data from the Croatian Health Insurance Fund, an institution covering 95% of all insurance claims in Croatia. We report that the use of advanced heart failure treatment modalities increased while the number of coronary angiographies decreased while the number of performed percutaneous coronary interventions remained similar, even increasing in the setting of acute myocardial infarction, comparing pandemic to pre-pandemic period. Similarly, the number of transcatheter aortic valve implantations increased significantly during the pandemic era. There was a significant increase in laboratory diagnostic testing with troponin and natriuretic peptide assays during the pandemic period while the use of most cardiovascular services remained stable or only slightly decreased, compared to pre-pandemic period. These data suggest that Croatian cardiovascular healthcare services during COVID-19 pandemic showed resilience and managed to maintain or even increase the number of various diagnostic and interventional procedures despite the widespread societal and logistical challenges encountered during pandemic.

The quality of veterinary medicinal products (VMP) is essential for efficient disease management. Therefore, VMPs that do not meet the required standards of quality can lead to increased sickness, death, and the development of antimicrobial resistance, posing a danger to both animals and humans. This study aimed to identify substandard and falsified VMPs on the Rwandan market using the Global Pharma Health Fund (GPHF)-Minilab™. VMP samples were purchased and collected in a cross-sectional study from veterinary retail pharmacies from five districts in four provinces of Rwanda, during May and June 2023. These samples were transported to the Veterinary Laboratory of the School of Animal Sciences and Veterinary Medicine, Nyagatare campus, University of Rwanda, and stored until analysis. The samples were subjected to physical and chemical analysis following the GPHF-Minilab™’s guidelines. A total of 130 samples from two categories of VMP were purchased from 10 veterinary retail pharmacies in urban and rural areas. The results of this study revealed that none of the assessed VMP samples failed physical tests (visual inspection, weight verification, and disintegration test). 10 samples (Sulfamethoxazole/Trimethoprim) out of 130 (7.7%) passed the visual inspections but later failed to comply with Thin-Layer Chromatography result specifications. This is an indication of the presence of substandard and falsified VMP circulating in Rwanda that warrants regular inspection and chemical quality control of VMPs along the supply chain.

Objectives: To analyse and detail surgical process improvement activities that achieve the highest economic impact. Methods: Over 4 years, a team of technicians and healthcare professionals implemented a set of Lean surgical process improvement projects at Vall d’Hebron University Hospital (VHUH), Barcelona, Spain. These projects now form part of the daily routine in the surgical process. The economic impact on the hospital's surgical activity budget was analysed. Results: Process improvements have led to annual operational savings of over € 8.5 million. These improvements include better patient flow, better management of information between healthcare professionals, and improved logistic circuits. Conclusions: The current cultural shift towards process management in large hospitals implies shifting towards results-based healthcare, patient-perceived value (VBHC) and value-added payment. A Lean project implementation process requires long-term stability. The reason a considerable number of projects fail to complete process improvement projects is the difficulty involved in establishing the project and improving management routines. Few studies in the literature have investigated the economic impact of implementing Lean management a posteriori, and even fewer have examined actual cases. In this real case study, changes to surgical block management were initiated from zero. After being carefully thought through and designed, changes were carried out and subsequently analysed.

To support the development of research evidence and behavioral health policy that aligns with the priorities of youth and families serviced in child and youth mental health systems, this project documents the service outcomes that caregivers value most. A diverse group of caregivers, representing six regions of the United States, participated in two rounds of virtual one-hour focus groups. In round 1, participants identified what they hoped to gain from using behavioral health services for themselves, their families, and their child and discussed what made services a positive experience for them. They then reported their top three most hoped for outcomes. In round 2, groups validated and refined summary findings from round 1. Caregivers prioritize service quality outcomes, primarily. They expressed a desire for an accessible, respectful, and supportive treatment environment underpinned by well-trained and culturally responsive professionals. Caregivers also desire seamless cross-sector provider collaboration and care transitions which integrate the insights and preferences of families and children themselves to craft a customized care plan. Priority outcomes not related to service quality included hoping to gain increased knowledge, resources, and tools and techniques to support the mental health needs of their children, help them improve their daily functioning, and develop more effective interpersonal communication skills. Caregivers also reported hoping to experience less stigma related to the mental health needs of their children and to achieve personal fulfillment for themselves and their children. Research and policies should prioritize and be designed to address the outcomes that matter to youth and families.

Climate change presents an urgent and impending threat to virtually all global biological systems. In recent years, there has been a surge in research endeavors aimed at investigating the potential relationship between changes in climate patterns and the spread of infectious diseases. This scoping review included studies on global warming and infectious diseases from 2019 to 2023, The studies included in this research were obtained from reputable academic databases such as Web of Science and google scholar. A systematic keyword search was conducted to identify relevant studies, and a predefined set of inclusion criteria was applied to review and select the appropriate studies for analysis. This review found that climate change has a remarkable impact on the dissemination and incidence of many infectious diseases, it increases microbial resistance and may increase the prevalence the arthropods-borne diseases with mild effect on fungal infections, also, the low to middle income countries may be affected more than other countries from these virulent pathogens, this study concluded that a future research in the field of climate change and infectious diseases should involve a thorough examination of the transmission of diseases, considering both direct and indirect modes of transmission

Abstract: (1) Background: Post-COVID syndrome is defined as symptoms that occur simultane-ously with or after COVID-19 infection, last for 12 weeks, and are not due to another diagnosis. Limited data are available on people’s long-term quality of life (QoL) following COVID-19 infection. The aim of this cross-sectional study was to investigate long-term QoL after COVID-19 among employees of the St. Josef Hospital in Paderborn, Germany, and to identify risk factors. (2) Methods: A monocentric, cross-sectional study was conducted using the validated and digitized WHOQOL-BREF questionnaire via Netigate® between 10/2022 and 02/2023. Data on QoL and global health status were collected in the following four domains: physical health, mental health, social relationships, and environment. (3) Results: The response rate was 73.84% (923/1250). Furthermore, 63.45% of hospital staff respondents reported at least one persistent symptom after COVID-19 infection, leading to significant differences in QoL. Pre-existing conditions, persistent symptoms, and disability after COVID-19 infection, as well as high BMI, no partnership, and low educational level were found to significantly contribute to long-term low QoL. (4) Conclusions: Obesity, lack of partnership, and a low level of education were independent risk factors for lower QoL post-COVID-19 infection in this cohort of hospital staff. Further multicenter studies are re-quired to validate the incidence and their suitability as independent risk factors for post-COVID syndrome.

In 2020, following the World Health Organization's declaration of COVID-19 as a pandemic, dental practices faced unprecedented disruptions globally. This retrospective cross-sectional study, conducted at a leading university dental hospital in the Lisbon Metropolitan Area, investigated the impact of these disruptions on dental caries. The study, spanning June 2019 to June 2021, included a full-mouth X-ray examination, along with sociodemographic, behavioral, and medical data. Our sample comprised 3,380 participants (2,007 females and 1,373 males), aged 18 to 99 years, divided into pre-lockdown and post-lockdown groups. We employed the Decayed, Missing, and Filled Teeth (DMFT) index to measure dental caries. Our findings revealed that nearly 90% of participants in both groups experienced dental caries, indicating a statistically significant difference between the pre-lockdown and post-lockdown periods. However, the impact of COVID-19 confinement varied among different demographic sectors, with age, educational background, and professional status emerging as the key determinants. This study highlights the need for a more nuanced understanding of the impact of the pandemic on oral health, emphasizing the role of sociodemographic factors in shaping dental health outcomes during such global health crises.

Background. The markerless motion capture system (MLS) is a new technology that uses deep learning to detect body segments from digital images. This study tested the agreement between the MLS and a force-plate based system (FPS, “gold standard”) to quantify stability control and motor performance (MP) during gait initiation (GI). Methods. Healthy adults (young and elderly) and patients with Parkinson’s disease (PD) performed GI series at spontaneous and maximal velocity on an FPS while being filmed by an MLS. Signals from both systems were used to compute the peak of forward center-of-mass velocity (indicator of MP) and the braking index (BI, indicator of stability control). Results. Descriptive statistics indicated that both systems detected between-groups differences and velocity effects similarly, while a Bland-Altman (BA) plot anal-ysis showed that BI and MP mean biases were virtually zero in all groups and conditions. Bayes factor 01 indicated strong (for BI) and moderate (for MP) evidence that both systems provided equivalent values. However, trial-by-trial analysis of BA plots revealed the possibility of differ-ences > 10% between the two systems. Conclusion. Although non-negligible differences do occur, MLS appears to be as efficient as FPS in detecting PD and velocity condition effects on BI and MP

: A comprehensive analysis was performed, considering blockchain technology (BT) proprieties in digital health, addressing medico-legal, privacy, and regulatory considerations. Adherence to personal data protection and healthcare regulatory guidelines were analyzed and compared for GDPR (Europe), HIPAA (United States), CCPA (California), PIPEDA (Canada), Privacy Act of 1988 (Australia), APPI (Japan), and LGPD (Brazil). Issues such as Health Systems, Strengthening and aligning policy orientations and initiatives, and emphasizing the role of data analysis in shaping health policies were explored. The study addressed conflicts between the legal frameworks and blockchain, comparing and suggesting solutions like revision of laws and integration of com-pliance mechanisms. Additionally, it sought to enhance IT-health literacy by integrating healthcare and legal domains. Ongoing collaboration between legal, health, and IT experts is essential for designing systems that effectively balance privacy rights and data protection while maximizing the benefits of disruptive technologies like blockchain.

At the beginning of 2023 the Italian former prime minister, the former health minister and 17 others including the current president of Lombardy region, were placed under investigation on suspicion of aggravated culpable epidemic in connection with the government’s response at the start of the COVID-19 pandemic. The charges revolve around the failure by authorities to take adequate measures to prevent the spread of the virus in the Bergamo area, which experienced a significant excess of deaths during the initial outbreak. The aim of this paper is to analyse pandemic data of Italy and Lombardy region in the first 10 days of the pandemic, spanning from the 24th of February 2020 to the 4th of March 2020. The objective is to determine whether the use early warning indicators could have facilitated the identification of a critical increase in infections. This identification, in turn, would have enabled the timely formulation of strategies for pandemic containment, thereby reducing the number of deaths. In conclusion, to translate our findings into practical guidelines, we propose a low-cost early warning method for infectious respiratory diseases with asymptomatic carriers.

Pressure ulcers carry a significant risk in clinical practice and require effective preventive measures. This paper proposes a practical and interpretable approach to estimate the risk levels of pressure ulcers using decision tree models. In order to address the common problem of imbalanced learning in nursing classification datasets, various oversampling configurations are analyzed to improve data quality prior to modeling. The decision trees built are based on three easily identifiable and clinically relevant pressure ulcer risk indicators: mobility, activity and skin moisture. Their analysis allows nursing professionals to predict the risk levels of pressure ulcer and make informed decisions about patient care. Additionally, this research introduces a novel tabular visualization method to enhance the usability of the decision trees in clinical practice. The approach proposed aims to support nursing professionals in making timely decisions regarding the appropriate preventive interventions according to the risk levels of pressure ulcers, thus improving patient outcomes and healthcare costs. The usefulness and effectiveness of the models presented make them a valuable resource for nursing care in the prevention of pressure ulcers.

The purpose of this scoping review was to comprehensively clarify the methodology of Mental practice (MP) to date by systematically mapping studies that have performed MP on post-stroke paralytic upper extremity function. Specifically, (1) When is the most common timing of MP in-tervention after stroke onset? (2) What is the MP load (intervention time, number of interven-tion days, and intervention period)? (3) What are the most common methods of Motor Imagery (MI) recall and MI tasks during MP? (4) Is MP often used in conjunction with individual rehabili-tative therapies? (5) What is the paralyzed side's upper limb and cognitive function level at the start of MP intervention? Our scoping review was performed ac-cording to PRISMA-ScR to iden-tify research questions. Then, the PubMed, Scopus, Medline, and Cochrane Library databases were used to screen articles published by July 19, 2022. Eligible articles were selected all study designs were included, including studies involving the use of MP for post-stroke paralytic upper extremity function. Selection of eligible papers was done by two or more independent persons. Data were extracted from the eligible papers for items necessary to identify the research ques-tions. English-language articles identified for this study were 694, of which 62 were accepted. The most common intervention time was 30 minutes or less and the duration of the intervention was 5 times a week in MP. The most common method of recalling MI during MP was using an audio guide. In the future, it will be important to conduct accumulation of research to unify the varied widely MP methodologies identified in this study.

Clinical work conducted over the last seventeen years at the EEG Institute in Los Angeles and by other neurofeedback providers around the world has demonstrated the utility of extending frequency-based neurofeedback deep into the infra-low frequency (ILF) region, using the method of endogenous neuromodulation described herein. The method is characterized by the absence of any overt reinforcements, which makes it possible to extend the clinical reach to extremely low frequencies. As the training frequency is lowered, the signal becomes more difficult to discriminate, and ultimately it can only be discerned by the brain itself, in the process of endogenous neuromodulation. The method emulates how the brain does skill learning in general: It must observe itself performing the skill, with feedback on its performance. While the immediate target of ILF neurofeedback is enhanced self-regulatory competence--with symptomatic relief and functional recovery the secondary consequences, progressive lowering of the target frequencies has led to improved outcomes in application to challenging dysfunctions such as episodic suicidality, migraine, seizures, and bipolar mood swings. The work has also yielded insights into how the frequency domain is organized. The training proceeds best at frequencies that are specific to each individual, and these are referred to as optimal response frequencies (ORFs). These frequencies differ for various placements but stand in two fixed relationships to one another, one that holds over the EEG spectral range, and another that holds over the entire ILF range. Training in the ILF region engages the dynamics of the glial-neuronal networks, which govern tonic, resting state regulation. The collective clinical experience with ILF neuromodulation within a large practitioner network supports the case for making protocol-based, individualized ‘homeodynamic’ regulation a therapeutic priority, particularly for our most impacted clinical populations: addiction, trauma formations, traumatic brain injury, and the dementias. The case is made for further outcome studies and foundational research.

Urbanization influences food culture, particularly in low- and middle-income countries, where there is an increasing consumption of processed and pre-packaged foods. This shift is contributing to a rise in non-communicable diseases. Food labeling standards are crucial for regulating manufacturing practices and aiding consumers in making healthy food choices. We aimed to assess the compliance of local and imported pre-packaged snacks with Tanzanian and international labeling standards in Dar es Salaam, Tanzania. A cross-sectional study was conducted on 180 snack products. A checklist based on Tanzanian and Codex labeling standards was used to evaluate adherence. We also examined factors influencing adherence, such as product origin, price, category, purchase location, and package size. The majority of the snacks demonstrated partial adherence to labeling standards. Imported products showed significantly better full adherence to both Tanzanian and International standards. Notably, over half of the products used English for labeling, and infrequently used the recommended World Health Organization Front-of-Pack nutrition Labeling. Product category, origin, and package size were significantly associated with higher levels of International standard adherence (p<0.05). The inadequate adherence to mandatory labeling standards, scarce use of Swahili and FoPL highlight the need to strengthen labeling practices and potential challenges faced by consumers in understanding nutritional information. Thus, strengthening and emphasizing good labeling practices is of urgency as we seek to address diet-related Non-communicable diseases.

Circadian rhythm disruption is increasingly considered an environmental risk factor for the development and exacerbation of inflammatory bowel disease. We have reported in a previous study that nychthemeral dysregulation is associated with an increase in intestinal barrier permeability and inflammation in mice with dextran sulfate sodium (DSS)-induced colitis. To investigate the effect of circadian rhythm disruption on the composition and diversity of the gut microbiota (GM). Sixty male C57BL/6J mice were divided initially to two groups, the shifted group (n=30) exposed to circadian shifts for three months and the non-shifted group (n=30) under a normal light-dark cycle. The mice of the shifted group were cyclically housed for five days under the normal 12:12 hour light-dark cycle followed by another five days under reversed light-dark cycle. At the end of the three months a colitis was induced by 2 % DSS given in the drinking water of 30 mice. Animals were then divided into four groups (n=15 per group), sham group non-shifted (Sham-NS), sham group shifted (Sham-S) and DSS non-shifted (DSS-NS) and DSS shifted (DSS-S). Fecal samples were collected from rectal content to investigate changes in GM composition by DNA extraction followed by high-throughput sequencing of the bacterial 16S rRNA gene. The mouse GM was dominated by three phyla: Firmicutes, Bacteroidetes and Actinobacteria. The Firmicutes/Bacteroidetes ratio decreased in mice with induced colitis. The richness and diversity of the GM were reduced in the colitis group, especially in the group with inverted circadian rhythm. Moreover, GM composition was also modified in the inverted circadian rhythm group, with an increase in Alloprevotella, Turicibacter, Bacteroides and Streptococcus genera. Circadian rhythm inversion exacerbates GM dysbiosis to a less rich and diversified extent in a DSS-induced colitis model. These findings shows a possible interplay between circadian rhythm disruption, GM dynamics, and colitis pathogenesis.

Background and objectives: Musculoskeletal (MSK) pain significantly impacts physical activity and quality of life in the elderly, potentially influencing mortality. This study explored the relationship between MSK pain, physical activity, muscle mass, and mortality among older adults. Material and Methods: We studied 1000 participants of the Korean Longitudinal Study on Health and Aging (KLoSHA), a prospective, population-based cohort study of people aged 65 years or older. Survival status was tracked over a 5-year period. Correlations between Low back pain (LBP), knee pain, regular exercise, appendicular skeletal muscle mass (ASM), and other variables were analyzed. Logistic regression analyzes were used to identify independent risk factors for mortality. Results: Of the total participants, 829 (82.9%) survived after a 5-year period. Survivors tended to be younger, had a higher BMI, and were more active in regular exercise. In contrast, non-survivors exhibited a higher prevalence of both LBP and knee pain, along with increased instances of multiple MSK pain. Lower ASM correlated moderately with LBP and knee pain, whereas higher ASM was associated with regular exercise Lower ASM was moderately associated with LBP and knee pain, while higher ASM correlated with engagement in regular exercise. There was a moderate correlation between LBP and knee pain, both of which were associated with a lack of regular exercise. Age, sex, ASM, and regular exercise were significant predictors, even though MSK pain itself did not directly predict all-cause mortality. Conclusions: This study demonstrated the independent association between ASM, regular exercise, and mortality. Although MSK pain did not directly correlate with all-cause mortality, the non-survivor group had higher levels of both single and multiple MSK pain. Recognizing the interplay of MSK pain, physical activity, and muscle mass for older adults, the research underscores the need for holistic strategies to enhance health outcomes in older individuals with MSK pain.

To win a taekwondo competition, more points must be scored, and the key to scoring points is to improve the motor performance of the kick. The wing kick is an offensive and defensive maneuver. Core stability appears to be important for improving athletic performance, but the specific relationship and effect of core stability on athletic performance in the aerial phase of taekwondo is unclear. The aim of this study was to investigate the relationship between core stability and athletic performance in taekwondo in order to provide appropriate theoretical support for training and to help coaches and athletes to improve athletic performance. A total of 16 subjects (height: 167.34±9.2 cm; weight: 61±8.96 kg; age: 24.7±3.25 years) were studied. Data were captured using 13 infrared cameras at 120Hz, kinematic and kinetic data were captured using a motivated motion capture system, and the data were exported to Visual3D in order to calculate the execution time of the aerial phase, the angular momentum of the left lower extremity, and MVC analysis of the EMG using EMG works. The core stability level of the subjects were measured using the Sahrmann Core Stability Test (SCST) to correlate with the other data, and then the subjects were grouped according to their core stability levels and the data from both groups were analyzed with t-tests. Results During the double fly lifting of aerial segments, SCST levels showed a very strong negative correlation with execution time (r= -0.739) and there was a statistically significant difference in execution time between high and low SCST levels (p &lt; 0.001), and the desired negative correlation was also seen in lower limb angular momentum X-axis (thigh r= -0.6294, shank r= -0.536, foot r= -0.6175), especially in the X-axis. The left rectus femoris (LRF) data had greater activation in the low SCST group(p=0.0019*). Through this experiment, we found that athletes with high core stability had faster execution times, lower angular momentum, and higher core muscle activation. Therefore, we conclude that incorporating core stability training into taekwondo training has the potential to improve kicking performance.

We assessed the association between cirrhosis and severe COVID-19-related outcomes among people with laboratory-diagnosed COVID-19 infection in British Columbia, Canada. We used data from the British Columbia (BC) COVID-19 Cohort, a population-based cohort that integrates data on all individuals tested for COVID-19 with data on hospitalizations, medical visits, emergency room visits, prescription drugs, chronic conditions, and deaths in the Canadian province of BC. We included all individuals, aged ≥ 18 who tested positive for SARS-CoV-2 by real-time reverse transcription-polymerase chain reaction, from January 01, 2021, to December 31, 2021. Multivariable logistic regression models were used to assess the associations between cirrhosis status and COVID-19-related hospitalization and ICU admission. Of the 162,509 individuals who tested positive for SARS-CoV-2 and were included in the analysis, 768 (0.5%) had cirrhosis. In the multivariable models, cirrhosis was associated with increased odds of hospitalization (aOR=1.97, 95% CI: 1.58 – 2.47) and ICU admission (aOR=3.33, 95% CI: 2.56 – 4.35). In the analyses stratified by age, we found that the increased odds of ICU admission among people with cirrhosis were present in all the assessed age-groups. Cirrhosis is associated with increased odds of hospitalization and ICU admission among COVID-19 patients.

Background: Post-traumatic stress disorder (PTSD) is a mental health concern among traumatized children and adolescents. The specific objective is to describe post-traumatic stress disorder in children (6 to 12 years old) and adolescents (12 to 18 years old). This comprehensive review compiles the clinical interventions targeting PTSD in this age group and systematizes the empirical evidence about their efficacy. Methods: The PRISMA method was used to present and evaluate the clinical interventions implemented for PTSD. Results: Significant symptoms of PTSD include avoidance, overstimulation, and flashbacks, typically accompanied by a depressed mood and anxiety. Cognitive Behavioral Therapy (CBT), trauma-focused CBT, Eye Movement Desensitization and Reprocessing (EMDR), Systemic Therapy, Play Therapy, Exposure Therapy, Relaxation Techniques, and Psychodynamic Psychotherapy are essential interventions for the treatment of patients between the ages of 6 and 18. CBT, particularly Trauma-focused CBT, is the most effective and extensively used therapy for dealing with cases of juvenile PTSD, according to the findings of the vast majority of previous research. Conclusions: The present systematic review summarizes the findings of several studies on psychotherapeutic interventions for PTSD in children and adolescents. PTSD in this population differs from PTSD in adults, necessitating various age-appropriate approaches and therapeutic models.

Abstract: The Kingdom of Saudi Arabia (KSA) aims to achieve measles elimination by 2015. Since the beginning of elimination efforts in early 2000, there has not been a study tracking the national incidence over time. Thus, we described the distribution and incidence rates (IR) of measles in all 13 provinces of KSA from 2002 – 2012. This should give policymakers a clear picture about how to improve measles surveillance and accelerate elimination efforts. Using the national measles notification data reported to the Ministry of Health from 2002 through 2012 from all 13 provinces of KSA. Trends in annual measles IR stratified by age, gender, nationality, province, month, and immunization status in KSA were determined. There were 9,643 confirmed cases of measles reported in KSA from 2002 – 2012. Most were reported from Makkah (21.9%) and were among the age group 0 – 14 years of age. Madinah province showed a continuous IR increase from 2009. Baha province has been measles free since 2008. KSA could eliminate measles by 2015 by maintaining high vaccination coverage in the population and improving public health surveillance.

This study investigated the chemical composition, and total phenolic content(TPC), total flavonoid content (TFC), and antioxidant activity Reziz date pomace extracted using different solvent system. The recovery, bioaccessibility, and stability of bioactive compounds were evaluated using In vitro gastrointestinal digestion. The results showed that pomace rich source of fiber but low in fat, and protein. Extraction data revealed that methanol, and ethanol were the most effective solvent for TPC and TFC extraction with higher antioxidant activity. In vitro gastrointestinal digestibility significantly affected recovery, bio-accessibility and stability of bioactive compounds. The TPC, TFC, and antioxidant activities were significantly increased after the mouth digestion but decreased during the gastric and intestinal digestion. The bioaccessibility of polyphenol and flavonoid were 35.22% and 23.57% respectively after the intestinal digestion. The chyme insoluble fraction (pellet) showed higher bioactive compounds and antioxidant activity compared to the chyme soluble fraction. The high fiber content of the date pomace seemed to affect the bioaccessibility of the bioactive compounds. TPC or TFC and the antioxidant activity determined by DPPH and ABTS were found to have a positive correlation with the oral, gastric, and intestinal digestion. The GC-MS analysis of digested date pomace in mouth, gastric, or intestinal digestion revealed an increase in the number of peaks (compounds) compared to the undigested sample. According to these findings, Ruzeiz date pomace could be utilized as a bioactive ingredient source in formulation of functional foods to promote healthy life.

Background: Learning arrangements in health care profession education are increasingly taking place in digital environments. VR in nursing education, as one of the digital elements, is the subject of controversial debate. On the one hand it supports the authenticity of case studies by adding realistic perspectives and information. On the other hand, the costs of developing and maintaining software and hardware hinder long-term implementation. Methods: In this paper, we describe our findings and insights from two different research projects focused on the incorporation of digital tools, particularly virtual reality (VR), into nursing education. Based on the German context, our aim is to promote the adoption of innovative digital methods in nursing education and to offer invaluable experiences from the field. Results: Starting with a brief recapitulation of the projects, we then elucidate the pedagogical strategies for embedding VR-driven scenarios in nursing education. Based on our experiences during the projects we identify various positive aspects, such as change of perspective and simulating acute situations. Key findings: Although potential drawbacks remain, we advocate long-term implementation and specific use of VR at the interface between theory and practice. Nevertheless it is crucial to establish regular evaluation observing the value of digitalisation, especially VR; for nursing education.

The feeling of emotional self-efficacy helps people understand how to handle positive and negative emotions. Emotion regulation indicates the process that helps modulate emotions, to adapt suitably to the demands of the environment. This study has a two-fold aim. Firstly, it analyses the relationships among emotion regulation; the personality traits of extraversion and emotional stability; and the feeling of efficacy of positive and negative emotions in an adolescent population. Secondly, it analyses the mediating role of personality traits (extraversion and emotional stability) in the relationship between emotion regulation and self-efficacy for positive and negative emotions. There were 703 adolescents who took part (49.9% male and 50.1% female) aged between 15 and 18 years (M=15.86, TD=0.30). The results observe the significant relationships among emotion regulation; the personality traits of extraversion and emotional stability; and self-efficacy for positive and negative emotions. The structural equation model confirms that the link between emotion regulation and self-efficacy is direct and is also mediated by the personality traits of extraversion and emotional stability. The study confirms that emotional self-efficacy beliefs are connected to the emotional regulation strategies used. Effective emotional regulation favours self-perception and emotional coping. There is a discussion about the results, which are connected to previous research.

In conclusion, this review highlights the challenges in the current screening pathway and the potential for AI, particularly LLM, to revolutionize DR screening in Japan. The future direction will depend on leadership from ophthalmologists and stakeholders to address long-standing challenges in DR screening so that all people have access to accessible and effective screening.