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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

A balanced diet model, rich in fruits and vegetables and ensuring the intake of natural products, has been shown to reduce or prevent the occurrence of many chronic diseases. However, the choice to consume large quantities of fruits and vegetables leads to an increase in the amount of waste, which can cause the alteration in environmental sustainability. To date, the concept of "by-product" has evolved, understood as a waste product, from which it is still possible obtain useful compounds. Therefore, the by-products in the agricultural sector, are a rich source of bioactive compounds, capable to possess a second life, decreasing the amount of waste products, the disposal costs and the environmental pollution. A promising and well-known citrus of the Mediterranean diet is the bergamot (Citrus bergamia, Risso et Poiteau). The composition of bergamot is known and the rich presence of phenolic compounds and essential oils has justified countless beneficial properties found, including anti-inflammatory, antioxidant, anti-cholesterolemic and protective activity for the immune system, heart failure and coronary heart diseases. The industrial processing of bergamot fruits leads to the formation of bergamot juice and bergamot oil. The solid residues, referred as "pastazzo", are normally used as feed for livestock or pectin production. The fiber of bergamot (BF) can be obtained from pastazzo and could exert an interesting effect thanks to its content of polyphenols. The purpose of this work was to test the effects of BF on an in vitro model of neurotoxicity induced by treatment with amyloid beta protein. In particular, this experimental model included both neurons and oligodendrocytes in order to measure the involvement of the glia and compare it with the neurons one. The results obtained showed a protective activity of BF, although the oligodendrocytes were more sensitive and fragile than neurons. Further experiments are necessary and if the trend was confirmed, solid residues of bergamot could be used in AD, and, at the same time, could help to avoid the accumulation of waste products.

Purpose: This study aimed to evaluate the nanomechanical properties and chemical composition of restorative materials and dental surfaces using different toothpastes. Methods: Enamel (n=60) and dentin (n=60) bovine blocks were obtained and restored using resin-modified glass ionomer cement (RMGIC, n=30) or composite resin (CR, n=30) to form the dentin adjacent to RMGIC (DRMGIC), enamel adjacent to RMGIC (ERMGIC), dentin adjacent to CR (DCR), and enamel adjacent to CR (ECR). After restoration, one hemiface of each specimen was coated with an acid-resistant varnish to create the control (C) and eroded (E) sides (erosion: 5 days, 4 × 2 min/day; 1% citric acid / abrasion: 2 × 15 s followed by immersion on slurries 2 min). Three toothpastes were used: without fluoride (WF; n=10), sodium fluoride (NaF; n=10), and stannous fluoride (SnF2; n=10). The specimens were analyzed for nanohardness (H), elastic modulus (Er), and chemical composition using energy-dispersive X-ray spectroscopy (EDS) and Raman microscopy. Data were analyzed using ANOVA two-way repeated measures and Tukey’s test (α = 0.05). Results: The NaF presented lower values of H for DRMGIC-C, with a statistical difference for WF (p < 0.05). SnF2 resulted in lower Er values for ERMGIC-E and RMGIC-E than WF and NaF (p < 0.05). WF showed lower calcium and phosphorus concentrations for DCR-E than other types of toothpastes (p < 0.05). Only stannous-based toothpaste damaged the elasticity of eroded glass ionomer restorations performed in enamel. Toothpastes with fluoride was capable for maintaining main chemical elements of dentin adjacent to restorative materials under challenge conditions.

Pufferfish (Tetraodontidae) inhabiting the Mediterranean Sea can represent an emerging public health risk due to the possible accumulation of marine neurotoxins (TTXs and STXs) in their tissues. In this study, the presence of pufferfish species in the Strait of the Sicily (Lampedusa Island, Italy) was investigated using a Citizen Science (CS) approach involving local fishermen. A sub-group of specimens collected were sent to the National reference Laboratory on Marine Biotoxins for de-termining the presence of TTXs using a validated HILIC-MS/MS method on fish tissue. The STXs presence was also screened in some specimens. Overall, 56 specimens, identified as Sphoeroides pachygaster (Müller &Troschel, 1848) were collected. Data on specimen total length, body weight, fishing method, catch area (with relative depth temperature and salinity) were analyzed and compared with the S. pachygaster records reported in Guardone et al. (2018), which were appro-priately updated until 2022. All the analysed tissues were found to be negative for both TTXs and STXs. The key role of the CS in monitoring potentially toxic marine species was proved. Outcomes from this study, the first investigating the toxicity of S. pachygaster in Italian waters, may provide useful data for the proper assessment of this emerging risk

There is a need for a modified Global Physical Activity Questionnaire (GPAQ) to estimate physical activity levels more accurately in populations. We aimed to develop a modified GPAQ and examine its construct validity among adults in Kerala state, India. We incorporated locality-specific, metabolic equivalent task (MET)-based activities into the original GPAQ and administered this modified GPAQ among randomly selected 451 individuals (age ≥20 years) residing in the Trivandrum district of Kerala. Construct validity was assessed using Generalized Linear Models by examining the association of total moderate-to-vigorous physical activity (MVPA) MET-minutes per week estimated by the modified GPAQ with clinical measures. The mean age of participants was 45.4 (SD: 14.1) years and 52.6% were female. Increasing total MVPA MET-minutes per week was associated with decreasing weight (β=-0.011 kg, 95% CI: -0.020, -0.002), waist circumference (β=-0.013 cm, 95% CI: -0.023, -0.004), and systolic blood pressure (β=-0.009 mmHg, 95% CI: -0.015, -0.002), independent of age, sex, education, occupation, current smoking, current alcohol use, and fruit and vegetable intake. The validity coefficients and associations between total MVPA MET-minutes per week and theoretical constructs of physical activity were in agreement with those predicted, providing evidence of construct validity for the modified GPAQ.

1) Background: This study focused on the validity of audible replies to voice queries in gyneco-logic oncology by Siri, Alexa, Google, and Cortana virtual assistants (VAs).; (2) Methods: 21 evaluators analyzed VA audible answers to voice queries related to gynecologic oncology. A 3-tier template was utilized for each voice query: “X?” (A), “What is X?” (B), and “Define X?” (C) in a 24-question panel, allowing questions to be posed in different formats to assess the VAs at a greater depth. Responses were scored using a rubric designed to assess the validity and quality of each answer; (3) Results: For general queries, Google provided the most correct audible replies (ncorrect = 20; 83.3% correct), followed by Alexa (ncorrect = 16; 66.7% correct), Siri (ncorrect = 11; 45.8% correct), and Cortana (ncorrect = 5; 20.8% correct.; For Gynecologic Oncology related queries, Google also provided the most correct audible replies (ncorrect=222; 18.14%), followed by Alexa (ncorrect=75; 6.51%), Siri (ncorrect=55; 5.46%), and Cortana (ncorrect=23; 2.28%). (4) Conclusions: The audible replies to oral queries on gynecologic oncology topics varied between Siri, Alexa, Google, and Cortana. Google’s audible reply accuracy was superior to audible replies by Siri, Alexa, and Cortana. Since there is room for considerable improvement in VA performance, the authors advise caution when using VAs for medical queries in gynecologic oncology.

Outliers can influence regression model parameters and change the direction of the estimated effect, over-estimating or under-estimating the strength of the association between a response variable and an exposure of interest. Identifying visit-level outliers from longitudinal data with continuous time-dependent covariates is important especially when the distribution of such variable is highly skewed at follow-up visits. The primary objective was to identify potential outliers at follow-up visits using interquartile range (IQR) statistic, motivated by a large TEDDY dietary longitudinal and time-to-event data with a continuous time varying vitamin B12 intake as the exposure of interest and time to developing Islet Autoimmunity (IA) as the response variable. The IQR method was also applied to simulated data. To assess the impact of IQR-method detected outliers, data was analyzed using Cox-proportional hazard model with robust sandwich estimator. Partial residual diagnostic plots were used to detect highly influential outliers. Results showed how some of the detected outliers had large influence on the Cox regression model and changed both the direction of hazard ratios and the strength of association with the risk of developing IA. In conclusion, the IQR method is useful in identifying potential outliers at visit-level which can be further investigated.

Introduction: The COVID-19 severely marred the Indian poultry industry, worth approximately one trillion INR. Hence, this study was conducted to understand the COVID-19 related factors that harmed the poultry production and distribution network and explore their varied impact on its actors in Gujarat, India. Methods: An exploratory qualitative study, using semi-structured interviews, was conducted with 34 poultry stakeholders in Gujarat. The data were thematically analysed using an interpretative phenomenological approach. Results: The study revealed that COVID-19 and the associated lockdown had hugely impacted the production, distribution and consumption of poultry products. The first COVID-19 lockdown disrupted the supply of production inputs and the distribution of poultry and poultry products because of movement restrictions. Rumours also played a crucial role in decreasing the consumption of poultry products between March and June 2020. The market situation, including the prices and availability of poultry products, was found to be improved post-lockdown as there was an increase in consumption; however, the profits were not sufficient to immediately compensate for the losses incurred during the lockdown. Conclusion: The first COVID-19 lockdown restricted the production and distribution of essential goods and influenced the perception of consumers regarding poultry products. COVID-19 resulted in many short- and medium-term challenges in the poultry sectors in India, which need to be addressed to make this sector more resilient to face any such crisis in future.

Background The purpose of this study was to clarify the relationship structure of quality of life (QOL) in survivors of breast cancer, including difficulty in daily life and negative experience as health-related indicators. Methods Participants were survivors of breast cancer for more than 2 years after primary breast cancer surgery and belonged to self-help groups. The assessment used FACT-B (QOL), HADS (anxiety and depression), SOC (sense of coherence), WHODAS 2.0 (difficulties in daily life), and CAOD (negative experiences). Bayesian structural equation modeling (BSEM) was performed to analyze the hypothesized model. If the causal model was significant, multiplication of the path coefficient from anxiety and depression to QOL, and from SOC to anxiety and depression, was considered a direct effect on QOL, and from SOC to difficulty in daily life, from difficulty in daily life to negative experiences, and from negative experiences to anxiety and depression were considered indirect effects on QOL. Results Goodness of fit of the model in the BSEM was satisfactory. The direct effect was 0.274, and indirect effect was 0.163. Conclusions These direct and indirect approaches to difficulties in daily life are very significant because they can provide a basis for development of support strategies to increase QOL.

Several theories have been proposed on the subject of fundamental psychological human needs. A brief overview was given for some of these major theories. A more recent theory on core emotional needs, derived from the vantage point of schema therapy, was also proposed and comparisons were drawn with the other models, each with different psychological boundaries. Implications and what these psychological needs mean to parents were also discussed covering cultural norms that may inadvertently inflict harm on young children and adolescents.

Controlling water and food contamination by pathogenic organisms requires quick, simple, and low-cost methods. using affinity between mannose and type I fimbriae in the cell wall of Escherichia coli bacteria as evaluation elements compared to the conventional plate counting technique enables a reliable sensing platform for the detection of bacteria. In this study, a simple new sensor based on electrochemical impedance spectroscopy (EIS) for rapid and sensitive detection of Escherichia coli was developed. Biorecognition layer of the sensor was formed by covalent attachment of p-carboxyphenylamino mannose (PCAM) to gold nanoparticles (AuNPs) electrodeposited on the surface of glassy carbon electrode (GCE). The resultant structure of PCAM was characterized and confirmed using FTIR. The developed biosensor demonstrated a linear response with a logarithm of bacterial concentration (R2 = 0.998) in the range of 1.3 × 10 1~ 1.3 × 106 CFU.mL−1with the limit of detection of 2 CFU.mL−1 within 60 min. The sensor did not generate any significant signals with two non-target strains, demonstrating high selectivity of the developed biorecognition chemistry. Selectivity of the sensor and its applicability to analysis of the real samples was investigated in samples of tap water. Overall, the developed sensor has shown to be promising for the detection of E. coli pathogen in water due to its high sensitivity, short detection time, low cost, high specificity, and user-friendliness.

Seafood products are the main dietary source of n-3 polyunsaturated fatty acids (n-3 PUFA), which are essential for human health. However, due to the widespread use of processed fish products, the presence of these n-3 PUFAs may be subject to changes related to different processing methods. The aim of this study was to determine the fatty acid composition, with a focus on n-3 polyunsaturated fatty acids (n-3 PUFAs), in different processed fish and shellfish food of EU and non-EU origin purchased in supermarkets and ethnic food shops in Messina (Italy), using gas chromatography with flame-ionization detector (GC-FID). From the fatty acid profile, the atherogenic index (AI), thrombogenicity index (TI) and flesh-lipid quality index (FLQ) were determined: 0.13-1.04 (AI), 0.31-9.84 (TI) and 0.41-29.90 (FLQ). The percentages of saturated (SFA), monounsaturated (MUFA) and polyunsaturated (PUFA) fatty acids had the following ranges: 13.55-50.48%, 18.91-65.58%, 13.84-52.73%, respectively. All samples showed a good presence of PUFAs and, in particular, eicosapentaenoic (EPA, 20:5n-3) and docosahexaenoic acid (DHA, 22:6n-3) were the main n-3 polyunsaturated fatty acids (n-3 PUFA).

The inappropriate use of pesticides in the world and particularly in Africa, explains their presence in various environmental compartments. This presence in the environment has harmful consequences on living beings, especially humans. This review, based on scientific publications, aims to analyze the problem of pesticides in Africa. From a corpus of 81 articles published in Africa on this topic between 1996 and 2019, we have outlined the issues relating to phytosanitary practices, environmental pollution, food contamination, intoxication of farmers and consumers, qualitative and quantitative analysis methods used, as well as the regulations on the subject and their application in Africa. Based on an analysis of the factors that are at the root of the problems of environmental pollution, contamination and health that they cause in Africa, possible solutions were proposed to produce healthy products and preserve our common environmental heritage.

Parvovirus infections have been well known for around 100 years in domestic carnivores. However, the use of molecular assays and metagenomic approaches for virus discovery and characterization has led to the detection of novel parvovirus species and/or variants in dog. Although some evidence suggests that these emerging canine parvoviruses may act as primary causative agents or as synergistic pathogens in the diseases of domestic carnivores, several aspects regarding epidemiology and virus-host interaction remain to be elucidated.

Wellness is a multidimensional concept that touches upon the various physical, mental, emotional, spiritual, social and environmental facets of health. Interest towards and importance of wellness have been growing constantly for the past two decades and thus makes it crucial to understand which factors affect public engagement with wellness information for multiple stakeholders. The Instagram account of New York Times (NYT) specifically for sharing wellness content with the handle nyt_well was selected as the object of study. 773 posts from this account between March of 2019 and December of 2022 were collected and analyzed to answer the research question of which factors are most influential to public engagement with wellness content. Two negative binomial regressions were run on features including the type of post, length, word count, sentiment score and topic with number of likes and comments as the dependent variables for each of those regression models. Results indicated that the type of post and its sentiment score were the two most influential determinants of public engagement with p-values smaller than 0.05. While the effects of some of these factors aligned with findings from previous studies conducted on social media content not related to wellness (e.g., marketing), some others affected the two separate public engagement metrics in opposite directions, warranting future studies to investigate further on the cause of this phenomenon.

The adoption of harmful postures due to a sedentary lifestyle, which involves long periods at work in offices, is a factor that exacerbates musculoskeletal risks. To examine these risks, there are numerous postures analysis methods, such as Rapid Upper Limb Assessment (RULA) and Rapid Office Strain Assessment (ROSA). RULA is a consolidated method to evaluate the exposure of individual workers to ergonomic risk factors associated with upper extremity musculoskeletal disorders. In turn, ROSA is a more recent method that quantifies exposure to risk factors in an office work environment. This research aims to identify whether there is harmony between these two methods, ROSA and RULA. Through applied research, from a qualitative perspective, the scientific procedures adopted were direct observation and ROSA and RULA postural assessment instruments. The study was conducted in the radiology service and focused on the outpatient reception workstation. Results indicated that further investigation must occur to make working conditions changes as soon as possible and that both methods are harmonic. As contributions of the analysis, we have discussed the working conditions and suggested improvements to reduce the risks of musculoskeletal morbidity symptoms. We recommend future studies aimed at measuring the levels of complementarity between these methods by quantitative approaches.

Socks with the same three-dimensional plantar design, but with different compositions in the separation of their weaves could have different thermoregulatory effects. The objective of this study was therefore to evaluate the temperatures on the sole of the foot after a 10-km run, using two models of socks with different weave separations. In a sample of 20 individuals (14 men and 6 women), plantar temperatures were analysed using a Flir E60bx® (Flir Systems) thermographic camera before and after a run of 10 km wearing two models of socks that had different separations between the fabric weaves (5 mm versus 3 mm). After the post-exercise thermographic analysis, the participants responded to a Likert type survey to evaluate the physiological characteristics of the two models of socks. There was a significant increase in temperature in the areas of interest (p&lt;0.001) after the 10-km run with both models of sock. The temperature under the 1st metatarsal head was higher with the AWC 2.1 model than with the AWC 1 (33.6±2.0°C vs 33.2±2.1°C) (p = 0.014). No significant differences were found in the scores on the physiological characteristics comfort survey (p&gt;0.05 in all cases. The two models presented similar thermoregulatory effects on the soles of the feet, although the model with the narrowest weave separation generated greater temperatures (+0.4°C) under the first metatarsal head.

Research has provided substantial evidence on the role of parents’ well-being in the quality of parent-child relationship and children’s adjustment. Parents’ stress and parental couple conflict have been linked to children’s adverse developmental outcomes. However, little is known about the factors that affect parent’s wellbeing when coping with multiple with stressors such as those brought by the recent COVID-19 global pandemic. Our study intended to examine the predictors of parental well-being looking at the contextual factors of COVID-19 home confinement, i.e. the use of digital media and parents’ domestic workload, and family resilience. Also, age and number of children were controlled as potential variables impacting parents’ well-being. A three-step hierarchical regression analysis was applied. The results showed that family resilience was a very strong predictor of parents’ well-being after controlling for any other variable. Parental couple’s conflict over the use of technology predicted lower levels of family well-being, while notably parent child-conflict and domestic workload were not associated with parents’ well-being. Additionally, age of children did play a role: the higher the mean age of children in the family the better the parents’ well-being. The findings are discussed in the light of their implications for research and practice.

Motor impairments are among the most relevant, evident, and disabling symptoms of Parkinson’s disease that adversely affect quality of life, resulting in limited autonomy, independence, and safety. Recent studies have demonstrated the benefits of physiotherapy and rehabilitation programs specifically targeted to the needs of Parkinsonian patients in supporting drug treatments and improving motor control and coordination. However, due to the expected increase of patients in the coming years, traditional rehabilitation pathways in healthcare facilities could become unsustainable. Consequently, new strategies are needed, in which technologies play a key role in enabling more frequent, comprehensive, and out-of-hospital follow-up. The paper proposes a vision-based solution using the new Azure Kinect DK sensor to implement an integrated approach for remote assessment, monitoring, and rehabilitation of Parkinsonian patients, exploiting non-invasive 3D tracking of body movements to objectively and automatically characterize both standard evaluative motor tasks and virtual exergames. Preliminary results show the system’s ability to quantify specific features of motor performance, easily monitor changes and disease progression over time, and the possibility of using exergames to support motor condition assessment and training. The main innovation relies precisely on the integration of evaluative and rehabilitative aspects, which could be used as a closed loop to design new protocols for remote management of patients tailored to their actual conditions.

Coronavirus disease 2019 restrictions impacted Canadians' daily living, especially those at higher risk of compromised health conditions. This study aimed to describe the physical, psychological, and social well-being of adults with disabilities, and older adults from May to June 2020. An online survey was used to administer standardized measures of mobility, anxiety and depression, boredom, resilience, technology readiness, social support, social networks, and participation. Seventy-two participants were recruited, with a mean age (SD) of 61.2 (13.8). 69.4% of participants had a disability, and 51.4% were older adults. 27.8% and 16.7% of participants exceeded the anxiety and depression cut-off scores, respectively. Boredom and restriction in participation were experienced by 76.4% and 80.1% of participants, respectively. Participants' mean (SD) resilience and life space scores were 72.4 (14.0) and 51.9 (24.0), respectively. Individuals with disabilities have comparatively higher mean anxiety (5.5 to 3.3), depression (4.8 to 2.9), and boredom (92.2 to 72.3) scores than those without. Individuals with a disability had lower resilience (69.9 to 78.0) and felt more life space restrictions (45.4 to 67.6). Our findings revealed issues with anxiety, boredom, participation, and life space activity. This information may provide supporting evidence when creating policies to mitigate existent health and social inequities.

Introduction: Pre-Exposure Prophylaxis (PrEP) for HIV prevention has been implemented in several countries. Previous literature has shown that its cost-effectiveness (and, under some specifications, cost-saving character) is dependent on the reduction in price due to generics, the time-horizon and its effectiveness. The intervention has never been studied in Catalonia, a territory with extensive implementation. Methods: Economic evaluation of the implementation of HIV pre-exposition prophylaxis using administrative data from Men who have Sex with Men (MSM) who receive the treatment (at the generic price). A deterministic compartmental model and a social perspective with a micro-costing approach over the time horizon 2022-2062 are used. A baseline 86% effectiveness of PrEP is assumed. Results: Daily oral PrEP is found to be cost-saving: discounted savings in costs are attained after 16 years, and after 40 years they reach 81 million euros. In terms of health indicators, 10,322 additional discounted QALYs are generated by the intervention. Results are sensitive to sexual behavioral patterns among MSM, the price of PrEP (reduced if offered on-demand), its effectiveness and the discount rate. Conclusions: The use and promotion of PrEP in Catalonia is predicted to result in substantial health and monetary benefits because of reductions in HIV infections. Short-term investments in the promotion of PrEP will result in important cost-savings in the long term.

Health-related data originating from diverse sources are commonly stored in manifold databases and formats, making it difficult to find, access and gather data for research purposes. In addition, so-called secondary use scenarios for health data are usually hindered by local data codes, missing dictionaries and the lack of metadata and context descriptions. Following the FAIR principles (Findable, Accessible, Interoperable and Reusable), we developed a decentralized infrastructure to overcome these hurdles and enable collaborative research by making the meaning of health-related data understandable to both, humans and machines. This infrastructure is currently being implemented in the realm of the Swiss Personalized Health Network (SPHN), a research infrastructure initiative for enabling the use and exchange of health-related data for research in Switzerland. The SPHN ecosystem for FAIR data consists of the SPHN Dataset (semantic definitions), the SPHN RDF Schema (linkage and transport of the semantics in a machine-readable format), a project RDF template, extensive guidelines and conventions on how to generate SPHN RDF schema, a Terminology Service (converter of clinical terminologies in RDF), and a Quality Assurance Framework (automated data validation with SHACLs and SPARQLs). The SPHN ecosystem has been built in a way that it can easily be adapted and extended by any SPHN project to fit individual needs. By providing such a national ecosystem, SPHN supports researchers in generating, processing and sharing FAIR data.

Machine learning has become an increasingly ubiquitous technology, as big data continues to inform and influence everyday life and decision-making. Currently in healthcare, as well as in most other industries, the two most prevalent machine learning paradigms are supervised learning and transfer learning. Both practices rely on large-scale, manually annotated datasets to train increasingly complex models. However, the requirement of data to be manually labeled leaves an excess of unused, unlabeled data available in both public and private data repositories. Self-supervised learning (SSL) is a growing area of machine learning that has the ability to take advantage of unlabeled data. Contrary to other machine learning paradigms, SSL algorithms create artificial supervisory signals from unlabeled data and pretrain algorithms on these signals. The aim of this review is two-fold: firstly, we provide a formal definition of SSL, divide SSL algorithms into their four unique subsets, and review the state-of-the-art published in each of those subsets between the years of 2014-2020. Second, this work surveys recent SSL algorithms published in healthcare, in order to provide medical experts with a clearer picture of how they can integrate SSL into their research, with the objective of leveraging unlabeled data.

Abstract: The objective of this meta-analysis was to evaluate the factors associated with mortality of elderly Italians diagnosed with the new coronavirus who resided in institutions or who were hospitalized as a result of the disease. Methods: A systematic review following the recommenda-tions of The Joanna Briggs Institute (JBI), where the PEO strategy was utilized - Population, Exposure and Outcome. P, being the elderly over 65 years old. E, the SARS-CoV_2 pandemic. O, mortality. The NCBI / PubMed, LILACS, EMBASE and CINAHL databases were used until July 31, 2020.; Results: Five Italian studies were included in the meta-analysis, with the number of elderly people varying between 18 and 1591 patients. The main morbidities presented by the elderly in the studies were: dementia, diabetes, chronic kidney disease and hypertension. Conclusions: The factors as-sociated with the mortality of elderly Italian people diagnosed with SARS-CoV-2 who lived in in-stitutions or who were hospitalized because of the disease were evaluated. It was found that de-mentia, diabetes, chronic kidney disease and hypertension are the main the main diagnosed dis-eases for mortality in elderly people with Covid-19.

Is it possible to measure the dispersion of ex-ante chances (i.e. chances “before the event”) among people, be it gambling, health, or social opportunities? We explore this question and provide some tools, including a statistical test, to evidence the actual dispersion of ex-ante chances in various areas with a focus on chronic diseases. Using the principle of maximum entropy, we derive the distribution of the risk to become ill in the global population as well as in the population of affected people. We find that affected people are either at very low risk like the overwhelming majority of the population but still were unlucky to become ill, or are at extremely high risk and were bound to become ill.

Evolutionary psychology theories propose that contact with green, natural environments may benefit physical health, but little comparable evidence exists for brown, natural environments, such as the desert. In this study, we examined the association between “brownness” and “greenness” with fasting glucose among young residents of El Paso, Texas. We defined brownness as the surface not covered by vegetation or impervious land within Euclidian buffers around participants’ homes. Fasting glucose along with demographic and behavioral data was obtained from the Nurse Engagement and Wellness Study (N = 517). We found that residential proximity to brownness was not associated with fasting glucose when modeled independently. In contrast, we found that residential greenness was associated with decreased levels of fasting glucose, despite the relatively low levels of greenness within the predominantly desert environment of El Paso. A difference between the top and bottom greenness exposure quartiles within a 250 m buffer was associated with a 3.5 mg/dL decrease in fasting glucose levels (95% confidence interval: -6.2, -0.8). Our results suggest that within the understudied context of the desert, green vegetation may be health-promoting to a degree that is similar to other, non-desert locations in the world that have higher baselines levels of green.

Frailty is defined as a state of increased vulnerability to stressors, and it predicts the disability and mortality in the older population. This study aimed to investigate standardized prevalence and multidimensional risk factors associated with frailty among the Korean community-dwelling older adults. We analyzed the baseline data of 2,907 adults aged 70–84 years (mean age 75.8±3.9 years, 57.8% women) in the Korean Frailty and Aging Cohort Study. The Fried frailty phenotype was used to define frailty. Analyzed data included sociodemographic, physical, physical function, biological, lifestyle, health condition, medical condition, psychological, and social domains. Data were standardized using the national standard population composition ratio based on the Korean Population and Housing Census. The standardized prevalence of frailty and pre-frailty was 7.9% (95% confidence interval [CI] 6.8–8.9%) and 57.2% (95% CI 45.1–48.8%), respectively. The following 14 risk factors had a significant association with frailty: at risk of malnutrition, sarcopenia, severe mobility limitation, poor social capital, rural dwellers, depressive, poor self-perceived health, polypharmacy, elevated high-sensitivity C-reactive protein, elevated glycosylated hemoglobin, low 25-hydroxy vitamin D level, longer timed up and go, and low short physical performance battery score (p<0.05). Physico-nutritional, psychological, sociodemographic, and medical factors are strongly associated with frailty.

Each sport has its specific rules, which determine what is allowed (or not) impacting directly on the sport demands. Studies involving physiological and time-motion measurements have shown that soccer is a highly demanding sport. The new coronavirus disease 2019 (COVID-19) has been a world health crisis. Soccer seasons were interrupted worldwide to avoid spreading the virus. Leagues resumed the season (no fans at the arenas) after several weeks of interruption, causing overlay of schedule. This overlay (e.g., games every Sunday and Wednesday) will cause accumulated fatigue on players, raising the risk of injuries. Considering this condensed calendar, the Fédération Internationale de Football Association (FIFA) has changed (temporarily) up to five substitutions during elite games (instead of three as the regular rule allows). Considering the already published scientific evidence, clearly, the change in the soccer substitution rule due to COVID-19 is insufficient. Implementing unlimited substitutions may benefit soccer players' health, coaches’ jobs, more entertainment for fans and sponsors (e.g., keeping intensity during all game, including on the second half) and eventually prolonging the useful life of the players. A real game-changer!

Community pharmacists are involved in antimicrobial stewardship through self-care advice and delivering medications for uncomplicated infections. Objectives This mixed methods study aimed to identify opportunities to enhance the role of community pharmacists in the management of patients with suspected or confirmed urinary tract infection (UTI). Methods Data collection was through a service user survey (n=51) and pharmacist surveys and semi-structured interviews before (16 interviews, 22 questionnaires) and after (15 interviews, 16 questionnaires) trialling UTI leaflets designed to be shared with patients. Data were analysed inductively using thematic analysis and descriptive tabulation of quantitative data. Results Twenty-five percent (n=13/51) of service users with urinary symptoms sought help from a pharmacist first and 65% (n=33/51) were comfortable discussing their urinary symptoms with a pharmacist in a private space. Community pharmacists were confident as the first professional contact for service users with uncomplicated UTI (n=13/16, 81%), but indicated the lack of a specific patient referral pathway (n=16/16, 100%), the need for additional funding and staff (n=10/16, 62%), and the importance of developing prescription options for pharmacists (5/16, 31%). All community pharmacists reported playing a daily role in controlling antimicrobial resistance by educating service users about viral and bacterial infections and promoting a healthy lifestyle. Enhancing their role will need greater integrated working with general practices and more prescribers based in community pharmacy. Conclusion This study suggests that community pharmacists could play a greater role in the management of uncomplicated UTI. The current reconfiguration of primary care in England with primary care networks and integrated care systems could provide a real opportunity for this collaborative working with potential learning for international initiatives.

The market of natural and organic cosmetics has been growing in last decades. The increase in interest in this type of product is a consequence of the concern that consumers have been presenting in relation to the environment and health. In addition to the appreciation the use of sustainable ingredients in cosmetic formulations, the consumers are also concerned about pollution caused by the use of plastics, which leads industries to reinvent themselves and rethink about the composition of packaging. The factor that most drives the purchase of natural and organic cosmetics is the fact that the consumer, in addition to contributing to the preservation of the environment, is also using a sustainable product. The growing demand for natural and organic cosmetics results in a concern of the brands with the organic issue, with the decreased use of animal derived ingredients and with the updating the parameters required for certification of a cosmetic as natural or organic. Due to the few studies available in this area, the importance of clarifying the definitions and concepts of natural and organic cosmetics is evident, in order to contribute with accurate information for the cosmetic sector.

As there is lack of understanding about the effect of transitioning between different flooring materials on the gait of older adults, this study investigated the effect of transitioning between a carpeted floor and a vinyl floor on the gait characteristics of older adults. Fourteen older (65 years old and over) and 14 younger (18 to 35 years old) adults walked on different transitional floors by measuring various gait parameters. While the older participants had greater toe clearance than their younger counterparts, the older participants had smaller toe clearance on a carpeted floor than on a vinyl floor, which would increase the probability of a trip-induced fall. Further, the study found the slower transitional acceleration of the whole body COM and the increased friction demand, especially during the toe-off phase, rather than heel contact phase, which will lead to a slip-induced fall on a vinyl floor shortly after transitioning from a carpeted floor to a vinyl floor. Although the increased likelihood of a slip or trip accident was found throughout the changes in gait parameters, the older participants did not perceive of slipping and tripping much. Therefore, older adults are recommended to be made aware of the danger of slipping and tripping while transitioning between different flooring materials.

This study measures the noise levels in a baseball stadium and analyzes baseball fans’ attitude of effect of recreational noise exposure on their hearing. In the baseball stadium, noise levels were measured in four seating sections using a sound level meter during the games. The LAeq average of the 16 measures produced 91.7 dBA, showing a significantly high noise level in the red and navy sections. As a function of frequency by LZeq analysis, the noise levels were significantly higher in low frequencies than other frequencies. For the survey sample, 688 randomly selected participants completed a 16-question survey on their noise exposure during the game and on the potential risk of hearing loss. Despite the very high noise levels, 70% of the respondents preferred sitting in either the red or the navy section to be closer to the cheerleaders and to obtain a good view. Most respondents reported that they did not consider wearing earplugs, and one-third experienced hearing muffled speech after the game. We conclude that the noise levels in baseball stadiums are high enough to cause hearing damage and/or tinnitus later, but expect these results to improve public education regarding safe noise exposure during popular sports activities.

Spatial Data Infrastructures (SDI) support the harvesting, curating, storage, and sharing of data along with providing access to development, analytic, and visualization tools that enable the building of innovative applications to address broad or specific challenges. SDIs can be especially powerful in bringing together data and tools supporting a particular theme – and this paper discusses and demonstrates the value of an SDI focused on Health. Many potential benefits of a Health SDI are proposed, and the case of supporting emergency response efforts is developed in detail. Leveraging a Health SDI, a Health Risk Index was created that provides emergency response personnel (both Emergency Operations Managers and Emergency Medical Responders) key insights into the unique health risks the impacted population faces due to the disaster. In order to establish the Health Risk Index, datasets from multiple national and global sources representing health data and social data that influences health outcomes – typically called social determinants of health – are harvested, merged, and republished to support further efforts at advancing the Health Risk Index. Visualizations of the Health Risk Index at the global, national, and sub-national levels down to the address level are presented along with demonstrations of its use.

Objective: Health/wellness applications on mobile devices (Apps) may positively affect the health of seniors (persons age 65+). But for an App to promote health in its target audience, it must achieve meaningful use. Method: For one and a half years, residents at a Life Plan Community (mean age 86) used a wellness App running on iPad. In a digital survey, residents rated their overall satisfaction with the App on a scale from 1 (strongly dislike) to 10 (strongly enjoy). Results: User satisfaction (96 respondents of 252; 38% response rate) was distributed with maximum 8, median 7, mean 6.6, and standard deviation 2.3. Discussion: The results suggest that it is feasible to inspire seniors to pursue whole-person wellness using an App: technology may promote “active aging.”

Optoelectronic devices are gold standard for 3D evaluation in clinics but due to the complexity of such kind of hardware and the lack of access for patients affordable, transportable and easy to use systems must be developed to be largely used in daily clinics. The Kinect^TM sensor presents various advantages compared to optoelectronic devices: price, transportability but also some limitations: (in)accuracy of the skeleton detection and tracking as well as the limited amount of available points that make 3D evaluation impossible. To overcome these limitations a novel method has been developed to perform 3D evaluation of the upper limbs. This system is coupled to rehabilitation exercises allowing functional evaluation while performing physical rehabilitation. To validate this new approach a double step method was used. The first step is a laboratory validation where the results obtained with the Kinect^TM have been compared with results obtained with an optoelectronic device, 40 healthy young adults participated in this first part. The second step was to determine the clinical relevance of such kind of measurement. Results of the healthy subjects were compared with a group of 22 elderly adults and a group of 10 chronic stroke patients to determine if different patterns can be observed. The new methodology and the different steps of the validations are presented in this paper.

The supply chain has incorporated products by putting them into hair scarfs. This study introduces the use of mini chips in health and beauty products and can reduce fatigue through enhanced sleep patterns. The mini chip could be placed in the scarf and used as a prototype. RFID technology provides the supply chain with specific information that is used to identify products and make communication easier. (Muhammad, et. al. 2013) This paper presents a new tool herein referred to as a scarf prototype which is developed to analyse EMG (electromyogram), ECG (electrocardiography), EEG (electroencephalogram), and EOG (electro-oculogram) signals that focuses in the area of sleep disorders. The mini chips used can be used to determine a solution for sleep disruption by using automated analytics. This could lead to improvement in our understanding of sleep disruption and overall sleep physiology. Automated technology allows repeated measurements, evaluation of sleep patterns, and provide suggestions to improve a person’s quality of sleep. This analysis compares the use of polysomnography and the scarf prototype. The analytics provide models and shows correlation between variables, such as EMG, ECG, EEG, and EOG. This study shows that the results from the scarf prototype is just as reliable as the original method, polysomnography.