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Physical Therapy, Sports Therapy and Rehabilitation
Demographic and Occupational Determinants of Work-Related 2 Musculoskeletal Disorders
Monika S. Popova,
Silviya Nikolova,
Silviya Filkova
Abstract: Work‐related musculoskeletal disorders (WMSDs) are a significant public health concern, particularly in professions requiring prolonged static postures. Objectives: This study examines the influence of demographic and occupational factors on WMSD prevalence and provides evidence‐ based recommendations for workplace health improvements. Methods: A cross‐sectional study (July–September 2024) surveyed 80 office employees in Varna, Bulgaria, using the Prevent 4 Work (P4Wq) questionnaire. ANOVA and t‐tests assessed WMSD prevalence across demographics, while Pearson’s correlations examined associations with age, BMI, and work experience. Data were analyzed in Jamovi v.2.6 (p < 0.05). Results: The sample (92.5% women, mean age 47.2 years)reported high WMSD prevalence, with cervical pain (88.8%), lower back pain (83.8%), and shoulder pain (75.0%) being most common. Work experience, age, and BMI were significantly correlated with WMSD severity, while gender showed no significant associations. Conclusions: WMSDs are highly prevalent among office employees, with lower back, neck, and shoulder pain being the most common complaints. Factors such as higher BMI, longer work experience, and increased workload are associated with greater symptom severity. These results emphasize the urgent need for targeted workplace interventions aimed at reducing ergonomic risks, improving posture, and enhancing employee well‐being, ultimately fostering a healthier and more productive work environment.
Abstract: Work‐related musculoskeletal disorders (WMSDs) are a significant public health concern, particularly in professions requiring prolonged static postures. Objectives: This study examines the influence of demographic and occupational factors on WMSD prevalence and provides evidence‐ based recommendations for workplace health improvements. Methods: A cross‐sectional study (July–September 2024) surveyed 80 office employees in Varna, Bulgaria, using the Prevent 4 Work (P4Wq) questionnaire. ANOVA and t‐tests assessed WMSD prevalence across demographics, while Pearson’s correlations examined associations with age, BMI, and work experience. Data were analyzed in Jamovi v.2.6 (p < 0.05). Results: The sample (92.5% women, mean age 47.2 years)reported high WMSD prevalence, with cervical pain (88.8%), lower back pain (83.8%), and shoulder pain (75.0%) being most common. Work experience, age, and BMI were significantly correlated with WMSD severity, while gender showed no significant associations. Conclusions: WMSDs are highly prevalent among office employees, with lower back, neck, and shoulder pain being the most common complaints. Factors such as higher BMI, longer work experience, and increased workload are associated with greater symptom severity. These results emphasize the urgent need for targeted workplace interventions aimed at reducing ergonomic risks, improving posture, and enhancing employee well‐being, ultimately fostering a healthier and more productive work environment.
Posted: 21 March 2025
Article
Public Health and Healthcare
Public Health and Health Services
Association of Low-Density Lipoprotein Levels with COVID-19 Severity: Insights from a Single-Center Cross-Sectional Study in Northern Greece
Athena Myrou,
Konstantinos Barmpagiannos,
Vasileios Kachtsidis,
Christina Kiouli,
Konstantinos Tziomalos
Abstract: Objective: To examine the relationship between low-density lipoprotein (LDL) levels and clinical outcomes in hospitalized COVID-19 patients in Northern Greece. Methods: A ret-rospective analysis was performed using data from 208 COVID-19 patients. Lipid profiles [including LDL (low-density lipoprotein cholesterol), HDL (high-density lipoprotein cho-lesterol), and triglycerides], prior antilipidemic treatment, and clinical outcomes were evaluated. Statistical analysis was conducted using SPSS version 19. Patients: 208 COVID-19 patients from Northern Greece. Results: The mean LDL level was 84.12 mg/dL, with no significant differences observed between survivors and non-survivors. Prior an-tilipidemic treatment did not significantly affect outcomes. Elevated triglyceride levels were noted in obese patients (BMI ≥ 30 kg/m²), and lower HDL levels were associated with higher CRP (C-reactive protein) levels. Although LDL levels declined over time in non-survivors, this decrease was not statistically significant. Longitudinal analysis showed normalization of LDL levels post-recovery, while HDL levels remained persis-tently low. Conclusion: Despite observable alterations in lipid profiles, their prognostic significance in this cohort was limited. These findings highlight the need for further in-vestigation into the role of lipid metabolism in the pathophysiology of COVID-19.
Abstract: Objective: To examine the relationship between low-density lipoprotein (LDL) levels and clinical outcomes in hospitalized COVID-19 patients in Northern Greece. Methods: A ret-rospective analysis was performed using data from 208 COVID-19 patients. Lipid profiles [including LDL (low-density lipoprotein cholesterol), HDL (high-density lipoprotein cho-lesterol), and triglycerides], prior antilipidemic treatment, and clinical outcomes were evaluated. Statistical analysis was conducted using SPSS version 19. Patients: 208 COVID-19 patients from Northern Greece. Results: The mean LDL level was 84.12 mg/dL, with no significant differences observed between survivors and non-survivors. Prior an-tilipidemic treatment did not significantly affect outcomes. Elevated triglyceride levels were noted in obese patients (BMI ≥ 30 kg/m²), and lower HDL levels were associated with higher CRP (C-reactive protein) levels. Although LDL levels declined over time in non-survivors, this decrease was not statistically significant. Longitudinal analysis showed normalization of LDL levels post-recovery, while HDL levels remained persis-tently low. Conclusion: Despite observable alterations in lipid profiles, their prognostic significance in this cohort was limited. These findings highlight the need for further in-vestigation into the role of lipid metabolism in the pathophysiology of COVID-19.
Posted: 21 March 2025
Article
Public Health and Healthcare
Health Policy and Services
A Pilot Observational Study of the Development and Utilization of a Psychotherapy Incorporating Horses Program at a Veterans Health Administration Medical Center
William R Marchand,
Elena Nazarenko,
Ryan Lackner,
Amir Ramezani,
Amber Martinson,
Amy Hartquist,
Lisa Finnell,
Dylan Taplin
Abstract: Psychotherapy incorporating horses (PIH) is often provided for veterans, though research is limited. Investigations are needed to explore how these services might be implemented and utilized. This study evaluated the safety, implementation and utilization of an PIH program. In addition to the overall program, data were collected for a specific PIH intervention, Whispers with Horses (WwH). This was a retrospective study of the first 46 months of implementation. Three hundred and forty veterans were referred to the program and 230 (68%) were enrolled. Seven hundred and nine sessions of PIH (637 individual and 74 group) were provided to veterans without any adverse effects to participants, staff or equines. Regarding WwH, 125 veterans were enrolled. The mean number of sessions attended was 3.64 (out of 6) and 66% were considered completers (attended > 50% of sessions). Additionally, 26% attended all sessions and the no show rate was 11%. These results indicate that it is feasible and safe to implement an EAS program within a VHA medical center. Treatment engagement was superior to VHA conventional mental health services with no-show and completion rates of 40% and 9.1% respectively. Thus, these results also suggest that a RCT of WwH is warranted.
Abstract: Psychotherapy incorporating horses (PIH) is often provided for veterans, though research is limited. Investigations are needed to explore how these services might be implemented and utilized. This study evaluated the safety, implementation and utilization of an PIH program. In addition to the overall program, data were collected for a specific PIH intervention, Whispers with Horses (WwH). This was a retrospective study of the first 46 months of implementation. Three hundred and forty veterans were referred to the program and 230 (68%) were enrolled. Seven hundred and nine sessions of PIH (637 individual and 74 group) were provided to veterans without any adverse effects to participants, staff or equines. Regarding WwH, 125 veterans were enrolled. The mean number of sessions attended was 3.64 (out of 6) and 66% were considered completers (attended > 50% of sessions). Additionally, 26% attended all sessions and the no show rate was 11%. These results indicate that it is feasible and safe to implement an EAS program within a VHA medical center. Treatment engagement was superior to VHA conventional mental health services with no-show and completion rates of 40% and 9.1% respectively. Thus, these results also suggest that a RCT of WwH is warranted.
Posted: 21 March 2025
Article
Public Health and Healthcare
Public, Environmental and Occupational Health
Assessment of Anger and Burnout Levels Among Serd Operators in Calabria and Sicily: A an Open Trial Study
Principato Francesco,
Romeo Vincenzo Maria
Abstract: Burnout and anger are prevalent among healthcare professionals in high-stress envi-ronments, particularly in addiction services. This study explores the relationship between burnout and anger among 124 operators working in public addiction services (SERD) in Calabria and Sicily. The objective is to assess how different anger dimensions contribute to burnout and identify protective factors that could inform targeted interventions. Methods: Burnout was measured using the Maslach Burnout Inventory (MBI), assessing emotional exhaustion, depersonalization, and personal accomplishment. Anger was evaluated through the State-Trait Anger Expression Inventory-2 (STAXI-2), examining trait anger, state anger, anger expression (anger-in, anger-out), and anger control. A cross-sectional design was used, with correlation and regression analyses controlling for gender and years of service. Results: High levels of burnout, particularly emotional exhaustion and depersonalization, were found. Emotional exhaustion correlated strongly with trait anger, indicating that individuals with a chronic predisposition to anger are more vulnerable to burnout. Suppression of anger (anger-in) significantly predicted depersonalization, exacerbating emotional disengagement from patients. Conversely, anger control acted as a protective factor, helping maintain a sense of personal accom-plishment. Conclusions: These findings underscore the importance of emotional regu-lation in mitigating burnout among addiction service workers. Interventions such as emotional regulation training and anger management programs could help reduce psychological distress and promote resilience. Workplace strategies that support emo-tional well-being may improve both staff retention and patient care quality. Further research should explore longitudinal trends and intervention effectiveness.
Abstract: Burnout and anger are prevalent among healthcare professionals in high-stress envi-ronments, particularly in addiction services. This study explores the relationship between burnout and anger among 124 operators working in public addiction services (SERD) in Calabria and Sicily. The objective is to assess how different anger dimensions contribute to burnout and identify protective factors that could inform targeted interventions. Methods: Burnout was measured using the Maslach Burnout Inventory (MBI), assessing emotional exhaustion, depersonalization, and personal accomplishment. Anger was evaluated through the State-Trait Anger Expression Inventory-2 (STAXI-2), examining trait anger, state anger, anger expression (anger-in, anger-out), and anger control. A cross-sectional design was used, with correlation and regression analyses controlling for gender and years of service. Results: High levels of burnout, particularly emotional exhaustion and depersonalization, were found. Emotional exhaustion correlated strongly with trait anger, indicating that individuals with a chronic predisposition to anger are more vulnerable to burnout. Suppression of anger (anger-in) significantly predicted depersonalization, exacerbating emotional disengagement from patients. Conversely, anger control acted as a protective factor, helping maintain a sense of personal accom-plishment. Conclusions: These findings underscore the importance of emotional regu-lation in mitigating burnout among addiction service workers. Interventions such as emotional regulation training and anger management programs could help reduce psychological distress and promote resilience. Workplace strategies that support emo-tional well-being may improve both staff retention and patient care quality. Further research should explore longitudinal trends and intervention effectiveness.
Posted: 21 March 2025
Article
Public Health and Healthcare
Physical Therapy, Sports Therapy and Rehabilitation
Investigating Countermovement and Horizontal Jump Asymmetry in Female Football Players: Differences Across Age Categories
Elena Mainer-Pardos,
Rafael Albalad-Aiguabella,
Víctor Emilio Villacicencio Álvarez,
Santiago Calero-Morales,
Demetrio Lozano,
Alberto Roso-Moliner
Abstract: Background/Objectives: Lower limb asymmetry is a critical factor influencing performance and injury risk in football players. Despite the increasing popularity of women’s football, limited research has examined how asymmetry varies across different age categories. This study aimed to investigate countermovement jump (CMJ) and horizontal jump (HJ) asymmetry in female football players across four age categories (U14, U16, U18, and +18). Methods: Seventy-six female football players from the same club participated in the study. Players performed unilateral CMJ and HJ tests to assess inter-limb asymmetry. A one-way ANOVA and Chi-square tests were conducted to examine age-related differences in asymmetry levels. Results: CMJ asymmetry significantly varied across age groups (p < 0.001), with the highest asymmetry observed in U14 and the lowest in +18. In contrast, HJ asymmetry remained consistently low across all age groups (p = 0.113). No significant correlation was found between CMJ and HJ asymmetry. Additionally, asymmetry levels in CMJ were significantly associated with age (p = 0.003), whereas no such association was observed for HJ. Conclusions: CMJ asymmetry is more prevalent in younger female football players and tends to decrease with age, suggesting that neuromuscular development plays a role in reducing asymmetry over time. These findings highlight the importance of monitoring asymmetry levels across different age groups to optimise training interventions and injury prevention strategies.
Abstract: Background/Objectives: Lower limb asymmetry is a critical factor influencing performance and injury risk in football players. Despite the increasing popularity of women’s football, limited research has examined how asymmetry varies across different age categories. This study aimed to investigate countermovement jump (CMJ) and horizontal jump (HJ) asymmetry in female football players across four age categories (U14, U16, U18, and +18). Methods: Seventy-six female football players from the same club participated in the study. Players performed unilateral CMJ and HJ tests to assess inter-limb asymmetry. A one-way ANOVA and Chi-square tests were conducted to examine age-related differences in asymmetry levels. Results: CMJ asymmetry significantly varied across age groups (p < 0.001), with the highest asymmetry observed in U14 and the lowest in +18. In contrast, HJ asymmetry remained consistently low across all age groups (p = 0.113). No significant correlation was found between CMJ and HJ asymmetry. Additionally, asymmetry levels in CMJ were significantly associated with age (p = 0.003), whereas no such association was observed for HJ. Conclusions: CMJ asymmetry is more prevalent in younger female football players and tends to decrease with age, suggesting that neuromuscular development plays a role in reducing asymmetry over time. These findings highlight the importance of monitoring asymmetry levels across different age groups to optimise training interventions and injury prevention strategies.
Posted: 21 March 2025
Article
Public Health and Healthcare
Public Health and Health Services
Determinants of COVID-19 Mortality AND Temporal Trends in the Health Regions of the State of São Paulo, Brazil
Tatiana Pestana Barbosa,
Thais Zamboni Berra,
Antônio Carlos Vieira Ramos,
Fernando Spanó Junqueira de Paiva,
Jonas Bodini Alonso,
Titilade Kehinde Ayandeyi Teibo,
Juliana Soares Tenório de Araújo,
Ariela Fehr Tártaro,
Ricardo Alexandre Arcêncio
Abstract: (1) Background: This study investigated the determinants of COVID-19 mortality and its temporal trends within São Paulo state’s Regional Health Departments (DRS) to inform the development of targeted public health interventions. (2) Methods: Utilizing an ecological study design, we analyzed confirmed COVID-19 cases and deaths (February 2020 – December 2021) obtained from the COVID Panel, incorporating relevant social and health indicators. The Generalized Additive Model for Location, Scale, and Shape (GAMLSS) was used to identify key determinants, and temporal trends in mortality and vaccination rates were analyzed across each DRS. (3) Results: The average mortality rate was 32.0 deaths per 100,000 inhabitants (median 67.9). Higher chronic disease mortality was associated with lower COVID-19 mortality. However, increased proportions of older adults in urban areas, and higher vaccination rates correlated with increased COVID-19 mortality. (4) Conclusions: COVID-19 mortality in São Paulo is shaped by a complex interplay of behavioral, economic, demographic, and environmental factors. Region-specific public health policies should consider these factors, along with geographic, socioeconomic, and budgetary contexts, to effectively address health disparities across the state’s DRS.
Abstract: (1) Background: This study investigated the determinants of COVID-19 mortality and its temporal trends within São Paulo state’s Regional Health Departments (DRS) to inform the development of targeted public health interventions. (2) Methods: Utilizing an ecological study design, we analyzed confirmed COVID-19 cases and deaths (February 2020 – December 2021) obtained from the COVID Panel, incorporating relevant social and health indicators. The Generalized Additive Model for Location, Scale, and Shape (GAMLSS) was used to identify key determinants, and temporal trends in mortality and vaccination rates were analyzed across each DRS. (3) Results: The average mortality rate was 32.0 deaths per 100,000 inhabitants (median 67.9). Higher chronic disease mortality was associated with lower COVID-19 mortality. However, increased proportions of older adults in urban areas, and higher vaccination rates correlated with increased COVID-19 mortality. (4) Conclusions: COVID-19 mortality in São Paulo is shaped by a complex interplay of behavioral, economic, demographic, and environmental factors. Region-specific public health policies should consider these factors, along with geographic, socioeconomic, and budgetary contexts, to effectively address health disparities across the state’s DRS.
Posted: 21 March 2025
Article
Public Health and Healthcare
Physical Therapy, Sports Therapy and Rehabilitation
Anterior Cruciate Ligament Reconstruction Using a Modified Transtibial Technique in Recreational and Professional Athletes: Clinical Outcomes and Return to Sport After a Minimum Follow-Up of 12 Months
Arcangelo Russo,
Giuseppe Gianluca Costa,
Maria Agata Musumeci,
Michele Giancani,
Calogero Di Naro,
Francesco Pegreffi,
Gianluca Testa,
Marco Sapienza,
Vito Pavone
Abstract: Anterior cruciate ligament (ACL) injuries are common among athletes and have a sig-nificant impact on knee stability and performance. Surgical reconstruction is the standard treatment, with the modified transtibial technique emerging as a promising approach for optimal graft positioning and reduced complications.Methods: A retrospective study was conducted on athletes who underwent primary ACL reconstruction using the modified transtibial technique between January 2020 and December 2023. Clinical outcomes were evaluated using the Lysholm score, IKDC subjective score, and objective knee stability assessments (Lachman test, Pivot-shift test, and KT-1000 arthrometer). Return to sport rates and associated factors were analyzed, distinguishing between professional and recreational athletes. Results: A total of 44 athletes were included (37 males, 7 females; mean age 21.2 ± 5.0 years). At a mean follow-up of 27.0 ± 12.2 months, significant improvements were observed in the Lysholm score (from 79.3 ± 8.6 at baseline to 95.4 ± 5.8 at last follow-up, p< 0.0001) and IKDC subjective score (from 78.5 ± 8.6 at baseline to 91.2 ± 7.9 at last follow-up, p< 0.0001). Overall, 88.2% of athletes returned to sports, with 65.9% achieving their preinjury level. Professional athletes had a significantly higher re-turn-to-preinjury-sport rate (79.3%) than recreational athletes (40.0%, p=0.0091). Concomitant meniscus injuries negatively impacted on return-to-sport rates (92.9% vs. 66.7%, p=0.0397). The overall failure rate was 4.6%, with two cases of graft insufficiency or re-rupture. Conclusion: ACL reconstruction using the modified transtibial technique provides favorable clinical outcomes, high return-to-sport rates, and low failure rates, particularly among professional athletes. The preservation of the meniscus plays a crucial role in optimizing postoperative recovery. Future research should focus on long-term outcomes and comparative studies with other ACL reconstruction techniques.
Abstract: Anterior cruciate ligament (ACL) injuries are common among athletes and have a sig-nificant impact on knee stability and performance. Surgical reconstruction is the standard treatment, with the modified transtibial technique emerging as a promising approach for optimal graft positioning and reduced complications.Methods: A retrospective study was conducted on athletes who underwent primary ACL reconstruction using the modified transtibial technique between January 2020 and December 2023. Clinical outcomes were evaluated using the Lysholm score, IKDC subjective score, and objective knee stability assessments (Lachman test, Pivot-shift test, and KT-1000 arthrometer). Return to sport rates and associated factors were analyzed, distinguishing between professional and recreational athletes. Results: A total of 44 athletes were included (37 males, 7 females; mean age 21.2 ± 5.0 years). At a mean follow-up of 27.0 ± 12.2 months, significant improvements were observed in the Lysholm score (from 79.3 ± 8.6 at baseline to 95.4 ± 5.8 at last follow-up, p< 0.0001) and IKDC subjective score (from 78.5 ± 8.6 at baseline to 91.2 ± 7.9 at last follow-up, p< 0.0001). Overall, 88.2% of athletes returned to sports, with 65.9% achieving their preinjury level. Professional athletes had a significantly higher re-turn-to-preinjury-sport rate (79.3%) than recreational athletes (40.0%, p=0.0091). Concomitant meniscus injuries negatively impacted on return-to-sport rates (92.9% vs. 66.7%, p=0.0397). The overall failure rate was 4.6%, with two cases of graft insufficiency or re-rupture. Conclusion: ACL reconstruction using the modified transtibial technique provides favorable clinical outcomes, high return-to-sport rates, and low failure rates, particularly among professional athletes. The preservation of the meniscus plays a crucial role in optimizing postoperative recovery. Future research should focus on long-term outcomes and comparative studies with other ACL reconstruction techniques.
Posted: 20 March 2025
Article
Public Health and Healthcare
Physical Therapy, Sports Therapy and Rehabilitation
Validation, Reliability, and Usefulness of the Functional Agility Square Test [FAST]
Romina Müller,
Daniel Büchel,
Jochen Baumeister
Abstract: Background/Objectives: Agility is crucial in game sports, requiring both motor and cognitive skills. Athletes must perceive and process information to adapt movements, yet traditional agility tests often lack cognitive and multidirectional demands. Additionally, modern test systems are mostly stationary. This study evaluated the novel and portable “Functional Agility Square Test” (FAST) for validity, reliability, and usefulness. Methods: To assess discriminant validity, 22 game sports (GS) and 22 non-game sports (NGS) athletes participated in one session. Test-retest reliability was examined with 36 GS athletes (20 female) across three sessions. Participants performed cognitive (FAST_COG), preplanned (FAST_MOT), and randomized (FAST_SAT) reactive change-of-direction tasks, each repeated three times per session. Results: Results showed significantly lower response times (RTs) in GS compared to NGS (p < .05). Mean RTs indicated moderate relative reliability (ICC .50–.74), while medians showed moderate to good reliability (ICC .59–.83). Usefulness was evident from the first session (FAST_MOT) or from the third session (FAST_SAT) based on median RTs. Conclusions: Thus, the FAST seems to be valid, reliable, and sensitive for GS-based agility assessment. Its portable setup enables ecologically valid field testing. Future research should further increase task complexity to better simulate game conditions.
Abstract: Background/Objectives: Agility is crucial in game sports, requiring both motor and cognitive skills. Athletes must perceive and process information to adapt movements, yet traditional agility tests often lack cognitive and multidirectional demands. Additionally, modern test systems are mostly stationary. This study evaluated the novel and portable “Functional Agility Square Test” (FAST) for validity, reliability, and usefulness. Methods: To assess discriminant validity, 22 game sports (GS) and 22 non-game sports (NGS) athletes participated in one session. Test-retest reliability was examined with 36 GS athletes (20 female) across three sessions. Participants performed cognitive (FAST_COG), preplanned (FAST_MOT), and randomized (FAST_SAT) reactive change-of-direction tasks, each repeated three times per session. Results: Results showed significantly lower response times (RTs) in GS compared to NGS (p < .05). Mean RTs indicated moderate relative reliability (ICC .50–.74), while medians showed moderate to good reliability (ICC .59–.83). Usefulness was evident from the first session (FAST_MOT) or from the third session (FAST_SAT) based on median RTs. Conclusions: Thus, the FAST seems to be valid, reliable, and sensitive for GS-based agility assessment. Its portable setup enables ecologically valid field testing. Future research should further increase task complexity to better simulate game conditions.
Posted: 20 March 2025
Article
Public Health and Healthcare
Public Health and Health Services
Association Between Screening Practices and Other Risks and Breast Cancer Among Indonesian Women: A Case‐Control Study
Primariadewi Rustamadji,
Ratu Ayu Dewi Sartika,
Pika Novriani Lubis,
Edy Purwanto,
Ismarulyusda Ishak,
Amalia Ane Istamayu,
Elvan Wiyarta
Abstract: Breast cancer is the predominant cause of cancer in developing nations, and screening with breast self-examinations and mammograms is crucial in mitigating morbidity and mortality. Nonetheless, geographic disparities in screening methods persist, attributable to socio-demographic variation and healthcare accessibility. This study aimed to analyze the influence of women’s screening practices for breast cancer and the other risks stratified to urban and rural areas in Indonesia. A case-control design was adopted, including all women who had breast cancer in 2014 as the study subjects. The Indonesian Family Life Survey data from 2007, with subjects aged at least 15 years, and from 2014 were used. Unconditional logistic regression was used to analyse the risk factors of breast cancer. After controlling for confounders, the odds of breast cancer diagnosis were higher in women who performed breast self examination (BSE) (aOR 10.22; 95% CI 1.04-50.81 and aOR 11.10; 95% CI 3.32-37.08) and those married before age of 19 (aOR 4.81;95% CI 1.93-6.05 and aOR 5.35;95% CI 1.49-19.7), respectively in urban-rural. In addition, women who had undergone mammography (aOR 48.04; 95% CI 10.33-83.45) had significantly higher odds of being diagnosed with breast cancer in urban. In rural areas, the paternal history of cancer-related death had higher odds of breast cancer (aOR 30.63; 95%CI 6.04-60.41) than those without a parental history of cancer. This study highlights the importance of intensifying national breast cancer screening, including BSE campaigns and expanding mammography infrastucture, particularly in rural areas, for improving breast cancer prevention and early diagnosis.
Abstract: Breast cancer is the predominant cause of cancer in developing nations, and screening with breast self-examinations and mammograms is crucial in mitigating morbidity and mortality. Nonetheless, geographic disparities in screening methods persist, attributable to socio-demographic variation and healthcare accessibility. This study aimed to analyze the influence of women’s screening practices for breast cancer and the other risks stratified to urban and rural areas in Indonesia. A case-control design was adopted, including all women who had breast cancer in 2014 as the study subjects. The Indonesian Family Life Survey data from 2007, with subjects aged at least 15 years, and from 2014 were used. Unconditional logistic regression was used to analyse the risk factors of breast cancer. After controlling for confounders, the odds of breast cancer diagnosis were higher in women who performed breast self examination (BSE) (aOR 10.22; 95% CI 1.04-50.81 and aOR 11.10; 95% CI 3.32-37.08) and those married before age of 19 (aOR 4.81;95% CI 1.93-6.05 and aOR 5.35;95% CI 1.49-19.7), respectively in urban-rural. In addition, women who had undergone mammography (aOR 48.04; 95% CI 10.33-83.45) had significantly higher odds of being diagnosed with breast cancer in urban. In rural areas, the paternal history of cancer-related death had higher odds of breast cancer (aOR 30.63; 95%CI 6.04-60.41) than those without a parental history of cancer. This study highlights the importance of intensifying national breast cancer screening, including BSE campaigns and expanding mammography infrastucture, particularly in rural areas, for improving breast cancer prevention and early diagnosis.
Posted: 20 March 2025
Article
Public Health and Healthcare
Physical Therapy, Sports Therapy and Rehabilitation
Intramyocardial Bridge in Sports Medicine: Strategies for Correct Follow-Up in Asymptomatic Athletes
Roberto Palazzo,
Melissa Orlandi,
Federico Fu,
Vittorio Bini,
Laura Stefani
Abstract: Background: Intramyocardial Bridge (MB) is a coronary anomaly where a segment of the artery is tunnelled within the myocardium, often asymptomatic but potentially leading to ischemic events. Though MB was previously considered a disqualifying factor in sports medicine, recent changes in 2023 allow MBs that do not meet certain morpho-logical criteria to be compatible with competitive sports. This study evaluates a com-bined provocative test integrating CPET and myocardial deformation (twist) to assess asymptomatic athletes diagnosed with a "significant" MB. Material and Methods: This retrospective observational study included 18 participants (9 cases, 9 controls), aged 18-78 years, who underwent competitive certification at our facility. The case group consisted of 9 athletes with a "significant" MB, diagnosed through CT coronary angi-ography, while controls were healthy, trained subjects. Both groups underwent resting echocardiography, speckle tracking analysis, and CPET to assess exercise capacity and myocardial function. Results: At rest, no significant differences in echocardiographic parameters were observed. However, during exercise, athletes with MB showed a sig-nificant reduction in GLS and ventricular twist compared to controls, indicating a loss of apical reserve. Conclusions: This study supports the use of combined CPET and myo-cardial deformation analysis as an effective tool for assessing the functional impact of MB in asymptomatic athletes. This approach offers a more comprehensive follow-up strategy for those at risk of ischemic events despite the absence of symptoms.
Abstract: Background: Intramyocardial Bridge (MB) is a coronary anomaly where a segment of the artery is tunnelled within the myocardium, often asymptomatic but potentially leading to ischemic events. Though MB was previously considered a disqualifying factor in sports medicine, recent changes in 2023 allow MBs that do not meet certain morpho-logical criteria to be compatible with competitive sports. This study evaluates a com-bined provocative test integrating CPET and myocardial deformation (twist) to assess asymptomatic athletes diagnosed with a "significant" MB. Material and Methods: This retrospective observational study included 18 participants (9 cases, 9 controls), aged 18-78 years, who underwent competitive certification at our facility. The case group consisted of 9 athletes with a "significant" MB, diagnosed through CT coronary angi-ography, while controls were healthy, trained subjects. Both groups underwent resting echocardiography, speckle tracking analysis, and CPET to assess exercise capacity and myocardial function. Results: At rest, no significant differences in echocardiographic parameters were observed. However, during exercise, athletes with MB showed a sig-nificant reduction in GLS and ventricular twist compared to controls, indicating a loss of apical reserve. Conclusions: This study supports the use of combined CPET and myo-cardial deformation analysis as an effective tool for assessing the functional impact of MB in asymptomatic athletes. This approach offers a more comprehensive follow-up strategy for those at risk of ischemic events despite the absence of symptoms.
Posted: 20 March 2025
Article
Public Health and Healthcare
Nursing
The Impact of Telepresence Robots on Family Caregivers and Residents in Long-Term Care
Lillian Hung,
Joey Wong,
Lily Haopu Ren,
Yong Zhao,
Jason Fu,
Jim Mann,
Lun Li
Abstract: Telepresence robots can enhance social connection and support person-centered care in long-term care (LTC) homes. This study evaluates their impact in facilitating virtual visits between family caregivers and older residents in Canadian care homes. Telepresence robots were placed in residents’ rooms, allowing virtual visits at mutual convenience. A total of 18 residents and 17 family caregivers participated. Quantitative assessments included the Zarit Burden Interview, the De Jong Gierveld Loneliness Scale and the Quality of Life in Alzheimer’s Disease scale, while qualitative data were collected through interviews, field notes, and observations. Repeated ANOVA showed that using telepresence robots significantly reduced caregiver burden (p=0.008), improved residents' quality of life (p=0.028), and decreased resident loneliness (p=0.038). Older caregivers experienced the greatest burden reduction, with scores dropping from a mean of 25.0 at baseline to 16.1 at two months. Qualitative findings provided further context, revealing that residents felt more connected, close and engaged, while families found the robots facilitated continuity of care, complemented in-person visits, reduced stress and guilt and provided reassurance. These findings suggest that telepresence robots can enhance the well-being of both residents and caregivers in LTC homes, though future research should explore their long-term impact and technological limitations.
Abstract: Telepresence robots can enhance social connection and support person-centered care in long-term care (LTC) homes. This study evaluates their impact in facilitating virtual visits between family caregivers and older residents in Canadian care homes. Telepresence robots were placed in residents’ rooms, allowing virtual visits at mutual convenience. A total of 18 residents and 17 family caregivers participated. Quantitative assessments included the Zarit Burden Interview, the De Jong Gierveld Loneliness Scale and the Quality of Life in Alzheimer’s Disease scale, while qualitative data were collected through interviews, field notes, and observations. Repeated ANOVA showed that using telepresence robots significantly reduced caregiver burden (p=0.008), improved residents' quality of life (p=0.028), and decreased resident loneliness (p=0.038). Older caregivers experienced the greatest burden reduction, with scores dropping from a mean of 25.0 at baseline to 16.1 at two months. Qualitative findings provided further context, revealing that residents felt more connected, close and engaged, while families found the robots facilitated continuity of care, complemented in-person visits, reduced stress and guilt and provided reassurance. These findings suggest that telepresence robots can enhance the well-being of both residents and caregivers in LTC homes, though future research should explore their long-term impact and technological limitations.
Posted: 20 March 2025
Article
Public Health and Healthcare
Other
Daily Sugar-Sweetened Beverages Intake and its’ Association with Undiagnosed Non-Communicable Diseases among Malaysian Adults: Findings from a Nationally Representative Cross-Sectional Study
Shi Hui Cheng,
Sumarni Mohd Ghazali,
Chee Cheong Kee,
Lay Kim Tan
Abstract: Background/objective: We examined the prevalence of daily SSB intake, identifying its sociodemographic determinants, and exploring its potential association with undiagnosed non-communicable diseases (NCDs) among Malaysian adults. Methods: This cross-sectional study analyzed data from 6,596 Malaysian adults participating in the 2019 National Health and Morbidity Survey (NHMS). Multiple logistic regression was used to examine the association between daily SSB intake and the risk of undiagnosed diabetes, hypertension, hypercholesterolemia, and obesity, while adjusting for potential confounders. Results: The prevalence of daily SSB intake was 53.6%, with higher intake observed among females, older adults, Indians, and unemployed individuals. After adjusting for confounders, daily SSB intake was not significantly associated with undiagnosed diabetes (adjusted OR:1.01, 95% CI:0.80-1.29), undiagnosed hypertension (adjusted OR:0.99, 95% CI:0.81-1.22), undiagnosed hypercholesterolemia (adjusted OR:0.99, 95% CI:0.83-1.18), or obesity (adjusted OR:1.08, 95% CI:0.91-1.27). Conclusions: This study highlights the high prevalence of daily SSB intake among Malaysian adults, driven by sociodemographic factors. While lack of direct associations with undiagnosed NCDs was observed, the high prevalence of SSB intake raises concerns about long-term health impacts. Targeted public health interventions are essential to address cultural and economic determinants of SSB intake, and future research adopting longitudinal designs to explore how sustained reductions in SSB intake influence the risk of developing NCDs.
Abstract: Background/objective: We examined the prevalence of daily SSB intake, identifying its sociodemographic determinants, and exploring its potential association with undiagnosed non-communicable diseases (NCDs) among Malaysian adults. Methods: This cross-sectional study analyzed data from 6,596 Malaysian adults participating in the 2019 National Health and Morbidity Survey (NHMS). Multiple logistic regression was used to examine the association between daily SSB intake and the risk of undiagnosed diabetes, hypertension, hypercholesterolemia, and obesity, while adjusting for potential confounders. Results: The prevalence of daily SSB intake was 53.6%, with higher intake observed among females, older adults, Indians, and unemployed individuals. After adjusting for confounders, daily SSB intake was not significantly associated with undiagnosed diabetes (adjusted OR:1.01, 95% CI:0.80-1.29), undiagnosed hypertension (adjusted OR:0.99, 95% CI:0.81-1.22), undiagnosed hypercholesterolemia (adjusted OR:0.99, 95% CI:0.83-1.18), or obesity (adjusted OR:1.08, 95% CI:0.91-1.27). Conclusions: This study highlights the high prevalence of daily SSB intake among Malaysian adults, driven by sociodemographic factors. While lack of direct associations with undiagnosed NCDs was observed, the high prevalence of SSB intake raises concerns about long-term health impacts. Targeted public health interventions are essential to address cultural and economic determinants of SSB intake, and future research adopting longitudinal designs to explore how sustained reductions in SSB intake influence the risk of developing NCDs.
Posted: 20 March 2025
Article
Public Health and Healthcare
Public Health and Health Services
Pertussis Dynamics in Tshwane, South Africa: The Role of Seasonality and Forecasting Techniques
Xolelwa Ntsham,
Tladi Daniel Ledibane
Abstract: Background: B. Pertussis remains a significant public health concern, with periodic outbreaks despite vaccination efforts. Understanding the temporal trends and seasonality of pertussis incidence is important for improving its surveillance and pre-vention strategies. Objectives: The aim of this study was to examine pertussis trends in Tshwane Health District, South Africa, from 2015 to 2019. Methods: A retrospective time series analysis was performed on reported pertussis cases in the Tshwane Health District from 2015 to 2019. Descriptive statistical techniques and time series decom-position were employed to investigate seasonal patterns. Autoregressive Moving Average (ARMA) models were employed to assess short-term trends, while cubic trend modelling was used to forecast future case trajectories. Residual diagnostics assessed model validity and analysed correlations between pertussis incidence and climate var-iables. Results: The incidence of Pertussis infection incidence exhibited seasonal pat-terns, with peak cases being reported in Spring and Winter. Time series decomposition confirmed annual fluctuations, suggesting potential environmental and social factors influencing disease transmission. The ARMA(4) model provided the best fit for short-term forecasting, while the cubic model effectively captured long-term trends. Residual diagnostics confirmed model reliability. Conclusion: This study highlights the utility of time series modelling in predicting pertussis trends and underscores the role of seasonality and climate factors in disease dynamics. The findings support enhanced surveillance, climate-adaptive interventions, and optimised vaccine timing to mitigate outbreaks. Integrating predictive modelling with public health strategies can improve outbreak preparedness and resource allocation.
Abstract: Background: B. Pertussis remains a significant public health concern, with periodic outbreaks despite vaccination efforts. Understanding the temporal trends and seasonality of pertussis incidence is important for improving its surveillance and pre-vention strategies. Objectives: The aim of this study was to examine pertussis trends in Tshwane Health District, South Africa, from 2015 to 2019. Methods: A retrospective time series analysis was performed on reported pertussis cases in the Tshwane Health District from 2015 to 2019. Descriptive statistical techniques and time series decom-position were employed to investigate seasonal patterns. Autoregressive Moving Average (ARMA) models were employed to assess short-term trends, while cubic trend modelling was used to forecast future case trajectories. Residual diagnostics assessed model validity and analysed correlations between pertussis incidence and climate var-iables. Results: The incidence of Pertussis infection incidence exhibited seasonal pat-terns, with peak cases being reported in Spring and Winter. Time series decomposition confirmed annual fluctuations, suggesting potential environmental and social factors influencing disease transmission. The ARMA(4) model provided the best fit for short-term forecasting, while the cubic model effectively captured long-term trends. Residual diagnostics confirmed model reliability. Conclusion: This study highlights the utility of time series modelling in predicting pertussis trends and underscores the role of seasonality and climate factors in disease dynamics. The findings support enhanced surveillance, climate-adaptive interventions, and optimised vaccine timing to mitigate outbreaks. Integrating predictive modelling with public health strategies can improve outbreak preparedness and resource allocation.
Posted: 19 March 2025
Article
Public Health and Healthcare
Public Health and Health Services
Optimizing Drug-Resistant Tuberculosis Treatment Outcomes in a High HIV- Burden Setting: A Study of Sputum Conversion and Regimen Efficacy in Rural South Africa
Mojisola Clara Hosu,
Lindiwe Modest Faye,
Teke Apalata
Abstract: Background: Sputum culture and smear conversion are key indicators of treatment response in drug-resistant tuberculosis (DR-TB). This study aimed to assess sputum conversion and regimen efficacy among DR-TB patients and identify factors influencing conversion rates. Methods: This retrospective cohort study analyzed medical records of DR-TB patients treated between 2018 and 2020 in the Eastern Cape Province, South Africa. Kaplan-Meier curves, Spearman correlation, and logistic regression models were used to assess time-to-sputum conversion and its predictors. Results: Among the 88% of patients who achieved sputum conversion, the median time ranged from 29 to 59 days. Patients on short treatment regimens converted significantly faster than those on long regimens (p = 7.55 × 10⁻¹⁵), with 90% of short-regimen patients achieving favorable outcomes compared to 52% in the long regimen group (p = 0.0000040). Spearman correlation revealed a weak but significant positive association between comorbidities and conversion time (r = 0.041, p = 0.041). HIV-positive patients had a slower conversion rate than HIV-negative patients, but this association was not statistically significant (χ² = 0.426, p = 0.514). Logistic regression identified older age as a predictor of favorable outcomes (coefficient = 0.039, p = 0.045), while regimen type and HIV status did not show significant predictive power. Conclusions: Shorter treatment regimens significantly improve sputum conversion rates and treatment outcomes. The findings support optimizing DR-TB treatment through personalized regimens based on patient health status and drug resistance patterns. This study provides evidence to enhance TB control efforts in high-burden regions, with implications for global treatment strategies.
Abstract: Background: Sputum culture and smear conversion are key indicators of treatment response in drug-resistant tuberculosis (DR-TB). This study aimed to assess sputum conversion and regimen efficacy among DR-TB patients and identify factors influencing conversion rates. Methods: This retrospective cohort study analyzed medical records of DR-TB patients treated between 2018 and 2020 in the Eastern Cape Province, South Africa. Kaplan-Meier curves, Spearman correlation, and logistic regression models were used to assess time-to-sputum conversion and its predictors. Results: Among the 88% of patients who achieved sputum conversion, the median time ranged from 29 to 59 days. Patients on short treatment regimens converted significantly faster than those on long regimens (p = 7.55 × 10⁻¹⁵), with 90% of short-regimen patients achieving favorable outcomes compared to 52% in the long regimen group (p = 0.0000040). Spearman correlation revealed a weak but significant positive association between comorbidities and conversion time (r = 0.041, p = 0.041). HIV-positive patients had a slower conversion rate than HIV-negative patients, but this association was not statistically significant (χ² = 0.426, p = 0.514). Logistic regression identified older age as a predictor of favorable outcomes (coefficient = 0.039, p = 0.045), while regimen type and HIV status did not show significant predictive power. Conclusions: Shorter treatment regimens significantly improve sputum conversion rates and treatment outcomes. The findings support optimizing DR-TB treatment through personalized regimens based on patient health status and drug resistance patterns. This study provides evidence to enhance TB control efforts in high-burden regions, with implications for global treatment strategies.
Posted: 19 March 2025
Article
Public Health and Healthcare
Public Health and Health Services
Evaluation of the Efficacy of a Dentifrice Tablet to Prevent Dental Caries: A Microbial Study
Bennett Tochukwu Amaechi,
Kannan Kanthaiah,
Rayane Farah,
Kelly Yang,
Amos Chiedu Obiefuna,
Parveez Ahamed Abdul Azees,
Mahalakshmi Vijayaraghavan
Abstract: Background/Objectives: Dentifrice tablets are a new over-the-counter dentifrice form that are gaining global interest. The aim of this microbial study was to investigate the effectiveness of dentifrice tablet (DT) containing nanohydroxyapatite (nHAP) to prevent tooth demineralization. Methods: 120 bovine tooth blocks were randomly assigned to four treatment groups (30/group): Nanohydroxyapatite DT (5% nHAP), placebo DT (Placebo), NaF toothpaste (1100ppm Fluoride), and no-treatment (Control). Blocks were subjected to 7-day demineralization by plaque growth in a mixed-organism Microbial Caries Model. Toothpaste was made into slurry (1 toothpaste:3 water), while DT was thoroughly crushed and homogenized with water (1 tablet:3 water) to slurry. Both slurries were applied twice daily for 2 minutes on each occasion. Demineralization was assessed using Surface Microhardness (SMH) testing before and after plaque exposure. Change (ΔSMH) and percentage change (%∆SMH) in SMH (percentage demineralization [%Dem]), and % demineralization inhibition (%Dem-Inhibition) in each group were calculated. Intra-group (SMH) comparison (paired t-test) and intergroup (%∆SMH) comparison (ANOVA/Tukey’s test) were conducted (α=0.05). Results: Paired t-test indicated significant difference (p<.001) between pre-treatment and post-treatment SMH in all groups. Intergroup comparison based on their %Dem using ANOVA/Tukey’s test showed that Control (29.93±5.58) had significantly (p<.05) higher %Dem than Placebo (22.81±7.47, p<.05), nHAP (13.93±11.31, p<.001), and Fluoride (14.44±10.65, p<.001). Placebo had significantly (p<.01) higher %Dem than nHAP and Fluoride. No significant difference between nHAP and Fluoride. Intergroup comparison based on their %Dem-Inhibition (calculated relative to the control) using ANOVA/Tukey’s test, nHAP (51.74±40.05, p<.01) and Fluoride (50.56±37.21, p<.05) had significantly higher %Dem-Inhibition than Placebo tablet (21.86±5.55). No significant difference in %Dem-Inhibition between nHAP and Fluoride. Conclusions: The present study demonstrated that dentifrice tablets containing 5% nanohydroxyapatite are as effective as NaF toothpastes containing 1100 ppm fluoride in preventing tooth demineralization.
Abstract: Background/Objectives: Dentifrice tablets are a new over-the-counter dentifrice form that are gaining global interest. The aim of this microbial study was to investigate the effectiveness of dentifrice tablet (DT) containing nanohydroxyapatite (nHAP) to prevent tooth demineralization. Methods: 120 bovine tooth blocks were randomly assigned to four treatment groups (30/group): Nanohydroxyapatite DT (5% nHAP), placebo DT (Placebo), NaF toothpaste (1100ppm Fluoride), and no-treatment (Control). Blocks were subjected to 7-day demineralization by plaque growth in a mixed-organism Microbial Caries Model. Toothpaste was made into slurry (1 toothpaste:3 water), while DT was thoroughly crushed and homogenized with water (1 tablet:3 water) to slurry. Both slurries were applied twice daily for 2 minutes on each occasion. Demineralization was assessed using Surface Microhardness (SMH) testing before and after plaque exposure. Change (ΔSMH) and percentage change (%∆SMH) in SMH (percentage demineralization [%Dem]), and % demineralization inhibition (%Dem-Inhibition) in each group were calculated. Intra-group (SMH) comparison (paired t-test) and intergroup (%∆SMH) comparison (ANOVA/Tukey’s test) were conducted (α=0.05). Results: Paired t-test indicated significant difference (p<.001) between pre-treatment and post-treatment SMH in all groups. Intergroup comparison based on their %Dem using ANOVA/Tukey’s test showed that Control (29.93±5.58) had significantly (p<.05) higher %Dem than Placebo (22.81±7.47, p<.05), nHAP (13.93±11.31, p<.001), and Fluoride (14.44±10.65, p<.001). Placebo had significantly (p<.01) higher %Dem than nHAP and Fluoride. No significant difference between nHAP and Fluoride. Intergroup comparison based on their %Dem-Inhibition (calculated relative to the control) using ANOVA/Tukey’s test, nHAP (51.74±40.05, p<.01) and Fluoride (50.56±37.21, p<.05) had significantly higher %Dem-Inhibition than Placebo tablet (21.86±5.55). No significant difference in %Dem-Inhibition between nHAP and Fluoride. Conclusions: The present study demonstrated that dentifrice tablets containing 5% nanohydroxyapatite are as effective as NaF toothpastes containing 1100 ppm fluoride in preventing tooth demineralization.
Posted: 19 March 2025
Review
Public Health and Healthcare
Public, Environmental and Occupational Health
Occurrence of Moulds and Yeasts in the Slaughterhouse: The Underestimated Role of Fungi in Meat Safety and Occupational Health
Melissa Alves Rodrigues,
Pedro Teiga-Teixeira,
Alexandra Esteves
Abstract: Despite their potential impact on meat safety and occupational health, fungi are often underestimated contaminants in slaughterhouses. Moulds and yeasts may be associated with meat contamination in multiple processing stages, and mycotoxigenic species, such as Aspergillus, Fusarium, and Penicillium, pose food safety concerns. Bioaerosols may carry infectious fungi at the slaughterhouse that are capable of causing respiratory conditions and allergies. Chronic exposure to mycotoxins can have hepatotoxic, nephrotoxic, and carcinogenic effects in humans. While bacterial meat contamination has been extensively studied, fungal contamination remains overlooked due to insufficient research, awareness, and standardised surveillance protocols. This review compiles published data on fungal occurrence in slaughterhouses from the past twenty-five years. It aims to highlight the primary mould and yeast isolated species, providing a context on their role in meat safety and occupational health. The findings emphasise the need for improved risk assessment and fungal monitoring in meat plants. Standardised fungal detection and control protocols are also suggested to be implemented to enhance meat safety and workplace conditions.
Abstract: Despite their potential impact on meat safety and occupational health, fungi are often underestimated contaminants in slaughterhouses. Moulds and yeasts may be associated with meat contamination in multiple processing stages, and mycotoxigenic species, such as Aspergillus, Fusarium, and Penicillium, pose food safety concerns. Bioaerosols may carry infectious fungi at the slaughterhouse that are capable of causing respiratory conditions and allergies. Chronic exposure to mycotoxins can have hepatotoxic, nephrotoxic, and carcinogenic effects in humans. While bacterial meat contamination has been extensively studied, fungal contamination remains overlooked due to insufficient research, awareness, and standardised surveillance protocols. This review compiles published data on fungal occurrence in slaughterhouses from the past twenty-five years. It aims to highlight the primary mould and yeast isolated species, providing a context on their role in meat safety and occupational health. The findings emphasise the need for improved risk assessment and fungal monitoring in meat plants. Standardised fungal detection and control protocols are also suggested to be implemented to enhance meat safety and workplace conditions.
Posted: 19 March 2025
Review
Public Health and Healthcare
Public Health and Health Services
Role of Pulmonary Mycoses in Tuberculosis Disease—An Indian Perspective
Jeevarahini Regupathy,
Priya Rajendran,
Vinod Kumar,
Sivakumar Shanmugam
Abstract: Tuberculosis poses serious challenges to healthcare personnel as it continues to be highly prevalent in a developing country like India. Several prominent strategies have been adopted to control this contagious infection, but the incidence rate remains high. Many studies have linked fungal infections and tuberculosis, apparently elevating concerns in the TB elimination program. Hence, it is essential to understand the mechanism underlying TB co-infection and pulmonary mycoses to combat the problems caused by these diseases successfully. In addition, differential diagnosis of TB and fungal infections is equally essential to initiate appropriate treatment. In this review, we have documented the findings of TB and fungal diseases individually and as coinfection, focusing on Indian perspectives. Misdiagnosis of fungal diseases as Tuberculosis in many studies elucidates the need for simultaneous diagnosis of both infections for appropriate diagnosis.
Abstract: Tuberculosis poses serious challenges to healthcare personnel as it continues to be highly prevalent in a developing country like India. Several prominent strategies have been adopted to control this contagious infection, but the incidence rate remains high. Many studies have linked fungal infections and tuberculosis, apparently elevating concerns in the TB elimination program. Hence, it is essential to understand the mechanism underlying TB co-infection and pulmonary mycoses to combat the problems caused by these diseases successfully. In addition, differential diagnosis of TB and fungal infections is equally essential to initiate appropriate treatment. In this review, we have documented the findings of TB and fungal diseases individually and as coinfection, focusing on Indian perspectives. Misdiagnosis of fungal diseases as Tuberculosis in many studies elucidates the need for simultaneous diagnosis of both infections for appropriate diagnosis.
Posted: 19 March 2025
Article
Public Health and Healthcare
Other
Purine Metabolism Pathway Influence on Running Capacity in Rats
Dengbo Chen,
Christian Noble Biney,
Qian Wang,
Mingzheng Cai,
Shi Cheng,
Wentao Chen,
Jinrui Zhang,
Junran Zhao,
Yuhan Zhang,
Wenzhong Zhang
Abstract: Abstract: Background: Natural differences in running capacities among rats remain poorly understood, and the mechanisms driving these differences need further investigation. Methods: Twenty male Sprague-Dawley (SD) rats were selected. High and low running capacity rats were identified using Treadmill Exhaustion Tests. Peripheral blood was collected for serum isolation, followed by metabolomics analysis using LC-MS/MS. Data were preprocessed, and principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA) were applied to identify metabolic profile differences. Significant metabolites were screened, and pathway enrichment analysis was conducted using the KEGG database to determine key metabolic pathways. Forty SD rats (equal male and female) were randomly divided into an ITP group (24.29 mg/kg.bw) and a control group. Running capacity was assessed after one week of continuous treatment. Results: Three independent measurements showed consistent differences in running capacity. A total of 519 differential metabolites were identified, with 255 up-regulated and 264 down-regulated. KEGG pathway analysis revealed significant enrichment of the Purine Metabolism pathway (ITP-ATP ) in the high running capacity group (P< 0.05). The ITP-treated group exhibited significantly higher running capacity than controls (P< 0.05), confirming the efficacy of dietary ITP supplementation. Conclusion: The running capacity of rats is influenced by the ITP-ATP pathway,and exogenous ITP administration through dietary intervention significantly improves running ability.
Abstract: Abstract: Background: Natural differences in running capacities among rats remain poorly understood, and the mechanisms driving these differences need further investigation. Methods: Twenty male Sprague-Dawley (SD) rats were selected. High and low running capacity rats were identified using Treadmill Exhaustion Tests. Peripheral blood was collected for serum isolation, followed by metabolomics analysis using LC-MS/MS. Data were preprocessed, and principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA) were applied to identify metabolic profile differences. Significant metabolites were screened, and pathway enrichment analysis was conducted using the KEGG database to determine key metabolic pathways. Forty SD rats (equal male and female) were randomly divided into an ITP group (24.29 mg/kg.bw) and a control group. Running capacity was assessed after one week of continuous treatment. Results: Three independent measurements showed consistent differences in running capacity. A total of 519 differential metabolites were identified, with 255 up-regulated and 264 down-regulated. KEGG pathway analysis revealed significant enrichment of the Purine Metabolism pathway (ITP-ATP ) in the high running capacity group (P< 0.05). The ITP-treated group exhibited significantly higher running capacity than controls (P< 0.05), confirming the efficacy of dietary ITP supplementation. Conclusion: The running capacity of rats is influenced by the ITP-ATP pathway,and exogenous ITP administration through dietary intervention significantly improves running ability.
Posted: 19 March 2025
Article
Public Health and Healthcare
Other
Understanding Cyclic Fatigue in Three Nickel-Titanium Pediatric Files: An In Vitro Study for Enhanced Patient Care
Alwaleed Abushanan,
Rajashekhara Bhari Sharanesha,
Fahd Aljarbou,
Hadi Mohammed Alamri,
Mohammed Hamad Almasud,
Abdulfatah AlAzmah,
Sara Alghamdi,
Mubashir Baig Mirza
Abstract: Nickel-titanium (Niti) instruments have enhanced root canal cleaning in primary teeth, but file fractures are still common. This study evaluated the cyclic fatigue resistance of 120 Niti files from four different systems, A: Kedo SG (n=30); B: Neoendo Pedoflex (n=30); C: Pedoflex Waldent files (n=30) and D: Vortex Blue files (n=30). All the files had similar tip diameters (0.25 mm) and tapers (0.4%) and underwent heat treatment during manufacturing. Cyclic fatigue tests showed notable variations in cycles to fracture (NCF) across groups. All fracture surfaces of the files were assessed through scanning electron microscopy. The mean values achieved in the experimental groups (A, B, C) were less than those in the control group D (976.90 ± 1085.19). Files in Group A demonstrated the highest NCF (697.01 ± 420.09), while Pedoflex files in Group C showed the lowest values (203.88 ± 155.46). Statistical analysis using the Mann-Whitney test revealed significant differences between groups A, B, and D compared to Group C. Still, no differences among groups A, B, and D. These findings suggest that Kedo SG and Neoendo Pedoflex files offer comparable cyclic fatigue resistance to Vortex Blue files. In contrast, Pedoflex Waldent files exhibit lower resistance to fracture.
Abstract: Nickel-titanium (Niti) instruments have enhanced root canal cleaning in primary teeth, but file fractures are still common. This study evaluated the cyclic fatigue resistance of 120 Niti files from four different systems, A: Kedo SG (n=30); B: Neoendo Pedoflex (n=30); C: Pedoflex Waldent files (n=30) and D: Vortex Blue files (n=30). All the files had similar tip diameters (0.25 mm) and tapers (0.4%) and underwent heat treatment during manufacturing. Cyclic fatigue tests showed notable variations in cycles to fracture (NCF) across groups. All fracture surfaces of the files were assessed through scanning electron microscopy. The mean values achieved in the experimental groups (A, B, C) were less than those in the control group D (976.90 ± 1085.19). Files in Group A demonstrated the highest NCF (697.01 ± 420.09), while Pedoflex files in Group C showed the lowest values (203.88 ± 155.46). Statistical analysis using the Mann-Whitney test revealed significant differences between groups A, B, and D compared to Group C. Still, no differences among groups A, B, and D. These findings suggest that Kedo SG and Neoendo Pedoflex files offer comparable cyclic fatigue resistance to Vortex Blue files. In contrast, Pedoflex Waldent files exhibit lower resistance to fracture.
Posted: 18 March 2025
Article
Public Health and Healthcare
Nursing
Nurses’ Perceptions of Barriers to Research Utilization in Clinical Practice in Sabah, Malaysia
Nadirah Sulaiman,
Peter Seah Keng Tok,
Juhanah Gimbo,
Ammar Rafidah Saptu,
Phylis Bridget Philip,
Yau Kim Yain,
Lilyiana Pengui,
Drina Dalie,
Norfairuziana Tinggal
Abstract: Background/Objectives: Evidence-based practice (EBP) has been widely adopted in clinical nursing practice, with nursing education efforts consistently emphasizing its importance in strengthening implementation efforts. Despite these efforts to promote translational research, the level of evidence-based practice (EBP) implementation in clinical nursing practice remains unsatisfactory. This study aimed to explore the barri-ers to research utilization in clinical settings, as perceived by nurses in Malaysia. Methods: A cross-sectional study was conducted in 2019 using the BARRIERS Scale, a validated tool that measures perceived barriers to research utilization across four do-mains: organizational barriers, nurses' research awareness and values, quality of re-search, and research communication. The study involved nurses from five tertiary hospitals in Sabah, Malaysia. Results: A total of 562 nurses participated in the study, with a mean age of 34.3 years (SD = 7.96) and mean duration of clinical practice of 10.0 years (SD = 7.58). Half of the nurses (53.9%) had a moderate understanding of EBP. Using the BARRIERS questionnaire, the top three prominent barriers perceived by nurses were ‘the nurse does not feel she/he has enough authority to change patient care procedures’(35.9%), ‘the nurse does not have time to read research’ (27.8%), and ‘re-search reports/articles are not published fast enough’ (25.8%). Among the four do-mains, organizational barriers scored highest (mean=2.7, SD=0.72), followed by re-search communication (mean=2.6, SD=0.73). Conclusions: The study findings em-phasize the challenges nurses encounter in integrating research into clinical practice and highlight the need for ongoing efforts to promote evidence-based practice and re-search utilization among nurses in Sabah while addressing the identified gaps.
Abstract: Background/Objectives: Evidence-based practice (EBP) has been widely adopted in clinical nursing practice, with nursing education efforts consistently emphasizing its importance in strengthening implementation efforts. Despite these efforts to promote translational research, the level of evidence-based practice (EBP) implementation in clinical nursing practice remains unsatisfactory. This study aimed to explore the barri-ers to research utilization in clinical settings, as perceived by nurses in Malaysia. Methods: A cross-sectional study was conducted in 2019 using the BARRIERS Scale, a validated tool that measures perceived barriers to research utilization across four do-mains: organizational barriers, nurses' research awareness and values, quality of re-search, and research communication. The study involved nurses from five tertiary hospitals in Sabah, Malaysia. Results: A total of 562 nurses participated in the study, with a mean age of 34.3 years (SD = 7.96) and mean duration of clinical practice of 10.0 years (SD = 7.58). Half of the nurses (53.9%) had a moderate understanding of EBP. Using the BARRIERS questionnaire, the top three prominent barriers perceived by nurses were ‘the nurse does not feel she/he has enough authority to change patient care procedures’(35.9%), ‘the nurse does not have time to read research’ (27.8%), and ‘re-search reports/articles are not published fast enough’ (25.8%). Among the four do-mains, organizational barriers scored highest (mean=2.7, SD=0.72), followed by re-search communication (mean=2.6, SD=0.73). Conclusions: The study findings em-phasize the challenges nurses encounter in integrating research into clinical practice and highlight the need for ongoing efforts to promote evidence-based practice and re-search utilization among nurses in Sabah while addressing the identified gaps.
Posted: 18 March 2025
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