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: 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: 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 &lt; .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: 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: 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: 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: 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: 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.