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: 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/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: 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: 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: 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: 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: 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: Helicobacter pylori (H. pylori) is a significant global health issue causing chronic gastritis, peptic-ulcer, and gastric-malignancies. Unfortunately, many, particularly in the Middle East, continue to exhibit alarmingly rates of prevalence. This study aimed to elucidate local epidemiological patterns of H. pylori and examine its histopathological impact on the gastric mucosa. Methods: This retrospective-cross-sectional study included 805 symptomatic adults (329 males, 476 females) who underwent endoscopic evaluation at King Salman Hospital, Ha’il, Saudi Arabia. Biopsies from the antrum and body were processed using routine formalin-fixation and paraffin-embedding. Staining with hematoxylin-eosin (H&E) and Giemsa permitted assessment of chronic gastritis and detection of H. pylori. Data was evaluated by IBM SPSS (version 23, IBM Corp., Armonk, NY) for associations between infection, histopathology, and patient-characteristics. Results: A total of 727 (90.3%) were H. pylori positive with marginally higher rates in females (91.2%) than males (89.0%). Infection spanned all age-groups, reaching 100% in males aged 60–80 years. Chronic GI-complications were identified in 726 (99.9%), with chronic gastritis being the most profound histopathologically (19.3%). Lymphoid-aggregates in 93.0% biopsies, reflected a pronounced immune-response. Advanced lesions, including metaplasia (0.8%), atrophy (0.3%), and lymphoma (0.1%), were uncommon, though indicative of potential malignant-progression. Both sexes exhibited universal symptoms of gastritis, dyspepsia, and heartburn, whereas vomiting, nausea, and weight loss showed minor variability. No statistically significant gender-based differences emerged (p>0.05). Histopathology consistently revealed chronic active-gastritis with glandular-distortion, lymphoplasmacytic infiltration, and occasional mucosal erosions. Giemsa staining further confirmed abundant spiral-shapes underscoring a high bacterial-load. Conclusion: These findings highlight the age-specific persistently elevating rates of H. pylori significantly associated to chronic-gastric-inflammatory complications. Although advanced gastric lesions remain rare, the potential for malignant transformation underscores the importance of early detection, timely eradication therapy, and vigilant follow-up to avert severe disease outcomes.

Abstract: Background/Objectives: Unhealthy nutritional behaviors and excess body weight constitute a serious challenge for public health in children and adolescents. The aim of this study was to examine changes in body mass index (BMI), body fat mass (FM) and nutritional behaviors in the same group of children during a 4-year observation between 10th and 14th years of age. Methods: BMI and FM using bioelectrical impedance were assessed. To assess nutritional behavior, a questionnaire was used. The study was done in the group of 250 children, starting from the age of 10 and finishing at the age of 14. The measurements were done in the year 2017 and 2021. The results were compared and analysed. Results: The excessive BMI (overweight and obesity) was more often in girls (28.29%) than boys (23.63%), while normal body weight was more often in boys (65.76%) than girls (60.96%). Between the initial and final assessment, percentage of children with normal body mass decreased from 65.65% to 61.07%. Excessive BMI (overweight and obesity) increased from 27.09% to 29.50% in girls, and from 21.26% to 26.00% in boys. The mean percentage of FM was higher in girls than boys (23.17% vs. 16.20%, respectively). The mean FM decreased from 17.80% to 14.60% in boys and increased from 21.77% to 24.57% in girls. The poor nutritional behaviors were observed in 20.35% of children, more often in boys (22.25%) than girls (18.50%). Between the initial and final assessment, an increase in the mean consumption of fruit, whole grain bread, milk was noted. These were products that should be consumed more often in a healthy diet. However, the consumption of products that should be limited in a healthy diet as fried flour dishes, fried meat dishes, fatty cheeses, butter, fast food, sweets, and carbonated drinks, also increased. Boys more often than girls consumed red meat and poultry meat, eggs, butter, and fast food while girls more often than boys consumed fruit, vegetables, yoghurts, cottage cheese, wholemeal bread, fruit, and sweets. Conclusions: Children usually showed moderate nutritional behavior. With age, in the evaluated group unfavorable nutritional behaviors and excessive body weight share increased. A higher overweight and obesity share and a higher body fat content were more often in girls than boys. Although girls’ nutritional behaviors were more healthy, they were at a higher risk of excessive body weight. Increasing the promotion of healthy nutritional behaviors and elevated physical activity to decrease overweight and obesity in children and adolescents is highly recommended.

Abstract: Background: While immigrant children often exhibit better breastfeeding practices, they may face challenges in maintaining a healthy diet and engaging in organized sports. Despite the growing immigrant child population in Portugal, evidence on these behaviours, particularly among preschool aged children, remains limited. In this context, this study examines the associations between migrant status and breastfeeding patterns, fruit and vegetable consumption and participation in sports in children living in the Lisbon Metropolitan Area. Methods: Cross-sectional study nested within a cross-sequential cohort was carried out in the Lisbon region between May 2022 and April 2024. Approximately 720 children (49.4% immigrants) born in 2018 and 2020 were enrolled in the study, and data were collected through a face-to-face interview with parents using a structured questionnaire with information on socioeconomic variables, migration history, breastfeeding habits, and children's diet (fruit and vegetable consumption) and physical activity. We used parametric and non-parametric tests to compare migrant and non-migrant children. To quantify factors associated with the main outcomes, we estimated a logistic regression model and calculated crude and adjusted odds ratios and their respective CI95%. Results: Immigrant children were disproportionately represented in socioeconomically disadvantaged families. Breastfeeding initiation rates were higher among immigrant mothers (96.3%vs.87.6%, p < 0.001). Additionally, immigrant mothers had a longer median duration of any breastfeeding (14 vs. 8 months, p < 0.001) and of exclusive breastfeeding (6 vs. 4 months, p < 0.001). Being an immigrant child decreased significantly the odds of consuming three or more portions of fruit (aOR=0.700; CI95%:0.511-0.959; p=0.027) and two or more portions of vegetables per day (aOR=0.489; CI 95%: 0.350-0.684;p<0.001) compared with non-immigrant children. Immigrant children were twice as likely to not engage in sports (aOR=2.185; CI95%:1.512-3.158;p<0.001). Conclusions: The findings highlight the need to address social determinants of health and the challenges faced by immigrant families in promoting a balanced diet and sports participation for their children. Multisectoral, culturally appropriate interventions that support breastfeeding, improve access to healthy food, and encourage sports are crucial to reducing health inequalities.

Abstract: Coronavirus disease 2019 (COVID-19) was first described in Wuhan, China, in late 2019 and declared a pandemic by the World Health Organization (WHO) in March 2020. The present study aimed to characterize the clinical and chest computed tomography (CT) findings in a sample of patients with COVID-19 and to correlate them with the outcome of death. The specific objectives were to characterize the sample epidemiologically and to describe the tomographic patterns found. This retrospective, observational, and cross-sectional study analyzed associations between chest CT findings and outcomes in COVID-19 patients from a university hospital in southeastern Brazil, from April 2020 to June 2021. The most frequent symptoms included cough, dyspnea, fever, myalgia, chest pain, anosmia, and odynophagia. Common CT findings, in descending order, were ground-glass opacities, consolidations, mosaic paving, parenchymal bands, peribronchovascular consolidations, bronchial ectasia, subpleural lines, nodules with ground-glass halos, architectural distortion, and ground-glass bands. Patients with age ≥60 years and comorbidities were significant risk factors for mortality. Patients with >50% parenchymal involvement and indeterminate/atypical CT patterns also had a higher risk of death. While serological tests remain critical for diagnosis, this study highlights the importance of imaging in guiding treatment protocols, especially given the delays in test results.

Abstract: Healthcare in a hospital environment frequently involves patient companions who can serve as reservoirs and transmitters of infection. This study aimed to assess the knowledge and practices of patient companions regarding infection prevention and control (IPC) in healthcare settings of Bobo Dioulasso (Burkina Faso). A cross-sectional study including patient companions was conducted at Sourô Sanou University Hospital (CHUSS) and the Do and Dafra district hospitals. Multilevel linear regression model was employed to assess the associations between companion characteristics and their level of knowledge or practice. The statistical significance level was set at 5% for all analyses. A total of 789 patient companions were included. The average knowledge score on IPC was 32 out of 100. The average score for IPC practices in healthcare facilities was 81.0 out of 100. Male gender (P=0.029), urban residence (P=0.034), widower status (P=0.001), secondary education and above (P=0.000), and awareness (P=0.000) were found to be associated with a higher level of IPC knowledge. Secondary education and above (P=0.010), awareness (P=0.000), CHUSS and Do (P=0.012) were factors associated with good IPC practices. This results showed patient companions deficiency in IPC knowledge and practice. Main factors of this deficit were a paucity of education and insufficient awareness.

Abstract: Background: The burden of cervical cancer is highest in low- and middle-income countries. In the absence of organised screening programmes in Nigeria, opportunistic screening of women of reproductive age seeking maternal healthcare can help achieve increased uptake of cervical cancer screening. This study is aimed at understanding the practice of opportunistic cervical cancer screening and health education, and the barriers and facilitators experienced by health workers practicing in antenatal and postnatal clinics in Ogun State, Nigeria. Methods: This is a qualitative cross-sectional study. In-depth interviews were conducted among 43 health workers—doctors, nurses and community health extension workers, working in antenatal and postnatal clinics in public primary, secondary and tertiary health facilities. Data analysis was done using thematic analysis. Results: Health education on cervical cancer prevention was not done in most health facilities. Where cervical cancer health education was practiced, it was done mostly prior to family planning provision, and sometimes at antenatal, postnatal/infant immunization clinics. Facilities for cervical cancer screening was not available in most of the health facilities and patients had to travel long distances to tertiary facilities to have a Pap smear done. Barriers to cervical cancer screening and health education include, high cost of screening, manpower shortage, fear of positive result among patients, poor awareness among patients, and religious and cultural beliefs. The major facilitators to screening and health education mentioned were passion for their work and the desire that no woman should die from preventable cancers. Conclusion: Government should ensure adequate staffing of health facilities, health worker training, adequacy of reagents and equipment for screening, accessibility of screening centers and make screening free/more affordable. Awareness activities and community mobilization for cervical cancer screening is needed. It is recommended that health facilities include cervical cancer health education into routine antenatal and postnatal clinic activities, and screening at post-natal clinics.

Abstract: The national food consumption surveys are crucial for monitoring the nutritional status of population, defining nutrition policies, estimating dietary exposure to substances present in food, and assessing the environmental impact of the diet, among others. This study aims to compare energy and nutrient intakes of self-administered 24-hour recall to those obtained from interviewer-led 24-hour recall, using FOODCONS software in both cases. Methods: Thirty-nine adult volunteers the sample of was randomized in A and B groups: test method first vs reference method and vice versa. After 15 days the same process was repeated in the opposite way and then volunteers filled out a questionnaire to evaluate the software and the instruction materials. Results: not significantly differences between means of energy and nutrient intakes among the two methods except for α Linolenic acid and Linoleic acid; The Bland Altman analysis found a good agreement of the amount (g), drinking water, included protein and fiber intake except for two subjects (5.0%) out of the interval; good agreement was also observed for energy, carbohydrates, and fat intakes. Conclusion: The self-administered 24h recall could be a suitable alternative to face-to-face interviews for recording data on foods consumed and this would allow a higher participation rate in food consumption studies.

Abstract: This study examines the extensive incidence of microplastics (MPs) within freshwater and Marine ecosystems, characterizing their distribution, composition, and potential health implications for immunosuppressed populations. Utilizing an extensive dataset curated through collaboration with global stakeholders, we systematically analyzed microplastic concentrations and types in various aquatic environments, correlating findings with prevailing environmental parameters such as temperature and turbidity. Our results indicate a pronounced presence of MPs in both Fresh water and Marine Water, with distinct variations. Freshwater ecosystems predominantly exhibited microplastics originating from urban wastewater and recreational activities, demonstrating higher concentrations of fragments and fibers indicative of local anthropogenic influences. In contrast, Marine environments showcased a more diverse spectrum of microplastic morphologies, including debris from larger plastic aggregates and microbeads, facilitated by extensive oceanic dispersal mechanisms. The analysis revealed significant bioaccumulation potential of these contaminants within aquatic organisms, raising concerns regarding food chain transfer and subsequent exposure risks to humans, particularly immunocompromised individuals. Pathological assessments suggest that MPs may exacerbate pre-existing health vulnerabilities by serving as vectors for harmful substances, including endocrine-disrupting chemicals, thus posing increased risks of impaired immune responsiveness and chronic inflammatory conditions. Given these findings, our research underscores the urgency for more rigorous monitoring protocols and public health strategies aimed at mitigating microplastic pollution and protecting at-risk populations. Thus, this investigation not only contributes to the growing body of knowledge regarding microplastic dynamics in aquatic ecosystems but also emphasizes the critical necessity for a multidisciplinary approach to address the intricate relationship between environmental contaminants and human health outcomes.

Abstract: Background: Burnout is a significant problem for employees—particularly concerning COVID-19 and involving healthcare workers. One way for employees to avoid work-related burnout is to experience the psychological flow investigated by Csikszentmihalyi. Yet, COVID-19 may have contributed to the unattainability of psychological flow for burnout-prone employees. The objective is to determine the COVID-19 achievability of flow by employees and, if attained, whether flow resulted in burnout avoidance during the pandemic. Method: To examine the topic range of research, a scoping review includes searches of six primary databases (CINAHL, OVID, ProQuest, PubMed, Scopus, Web of Science), two searches of one supplementary database (Google Scholar), and one register (Cochrane COVID-19 register) of the keywords “burnout, COVID-19, employees, healthcare providers, psychological flow, Csikszentmihalyi”. Included are peer-reviewed, COVID-19-related, 2020-2025 journal publications. The exclusions are duplicates, non-COVID-19-related publications, reports lacking a research study, keywords, or relevant information. Results: In identifying 754 records, five records met the inclusion criteria. Conclusions: Psychological flow was possible during COVID-19 for various employee types, represents the opposite of burnout regarding a workplace stimulation scale, and attaining it permitted burnout avoidance, suggesting a focus on achieving flow in the workplace during pandemics would diminish the incidence of employee burnout.

Abstract: Physical fatigue is a significant concern in repetitive production line operations, often contributing to musculoskeletal disorders (MSDs) and high absenteeism rates. This study focuses on a pharmaceutical packaging line where workers frequently develop MSDs due to the repetitive nature of their tasks. To address this issue, biometric data from smartwatches, including pulse rate, internal temperature, electrodermal activity, and movement patterns, were collected alongside demographic factors such as age and experience and occupational factors related to task demands, including physical load, and operational conditions such as production line location, day of the week, work shift, and timing within the shift. Principal Component Analysis was first applied to reduce the dataset's dimensionality, extracting the most relevant features. Subsequently, fuzzy logic was employed to label the data into two and four levels of fatigue based on prior research. The resulting features and labels were then used as inputs for machine learning classification models to predict fatigue states. Our findings demonstrate that integrating wearable sensor data significantly enhances classification performance. In binary classification, the Random Forest model achieved an F1 score of 0.935 with biometric data and 0.681 without it. For the four-level classification, incorporating biometric data improved the F1 score from 0.573 to 0.903, highlighting its importance in fatigue prediction. This study contributes by developing a generalized predictive fatigue model and establishing a foundation for a real-time fatigue alert system to enhance worker safety and productivity.

Abstract: Objective: This study aims to examine the importance of patient education and awareness and discuss the role of nurses in the prevention and management of cardiovascular diseases, as well as the impact of these activities on improving quality of life and reducing mortality rates. Methodology: A literature review was conducted, analyzing recent studies on cardiovascular disease prevention, patient education, and the role of nurses in disease management. Data from peer-reviewed journals and public health reports were examined to assess the effectiveness of educational interventions and nursing strategies in reducing cardiovascular risk factors. Results: The findings indicate that patient education and awareness significantly contribute to the prevention and management of cardiovascular diseases. Educational programs led by nurses have been shown to improve adherence to treatment, promote healthier lifestyles, and reduce risk factors such as hypertension, high cholesterol, and obesity. Furthermore, active nursing involvement enhances patient self-care capabilities, leading to improved cardiovascular health outcomes and a decrease in hospitalization rates. Conclusions: Strengthening patient education and the role of nurses in cardiovascular disease prevention can lead to better health outcomes and reduced mortality rates. Integrating structured educational programs and nurse-led interventions into healthcare systems is essential for effectively managing cardiovascular diseases and enhancing patients’ quality of life.

Abstract: Long Covid is now regarded as a chronic disease that follows from an acute infection of SARS-CoV-2. Patients themselves were at the forefront of developing the scientific understanding of the disease, which was followed up by government related health institutions. This analysis describes how the patient led research initiated the development of the institutions’ “case definitions” of long Covid and which of these definitions is the more suited to providing a set of “diagnostic criteria” for long Covid.